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TABLE OF CONTENTS

Medical Director Authorization

Section 1 - Administrative Policies

Printable Version

Section	Description	Revision Date
1.01	General Measures	February-18
1.02	Radio Report Format	March-16
1.03	Refusal of Service	October-17
1.04	Physician or Nurse on Scene	March-09
1.05	Initiation of CPR and Determination of Death	July-16
1.06	Determination of Death in Trauma	March-09
1.07	Crime or Unattended Death Scene	March-09
1.08	Medical Evaluation of Person in Police Custody	March-09
1.09	Trauma Transport Protocol	February-19
1.10	Emergency Transport	March-09
1.11	Criteria for Helicopter Transport	March-09
1.12	Medical Patient Transport Decision	April-14
1.13	Obstetrical Patient Transport Decision	Feb-15
1.14	Emergency Inter Facility Transport	March-09
1.15	EMS Saturation Disaster Response Levels	April-16
1.16	EMS Offload Policy	March-09
1.17	EMT and Paramedic County Certification Procedure	August-14
1.18	EMS Quality Improvement Program	March-09
1.19	HIV Post Exposure Prophylaxis (PEP)	March-09
1.20	Scope of Practice	March-09
1.21	Freestanding ED Transport Criteria	August-19
1.22	Hospital Capability Chart - DRAFT	September-19
1.23	Documentation Guidance	June-17
1.24	School Medication Authorization Forms	June-18

Section 2 - Primary Care

Printable Version

Section	Description	Revision Date
2.01	Initial Medical Assessment and Care	March-09
2.02	Initial Trauma Assessment and Care	September-17
2.03	Rapid Trauma Assessment, Focused History and Physical Exam	Sept-15
2.04	Analgesia and Sedation	February-18
2.05	Drug Assisted Intubation	December-16

Section 3 - Respiratory

Printable Version

Section	Description	Revision Date
3.01	Acute Asthma or COPD with Wheezing	February-19
3.02	Carbon Monoxide Inhalation	June-19
3.03	Foreign Body Airway Obstruction	March-09
3.04	Infectious Upper Airway Obstruction - Croup or Epiglottitis	April-16
3.05	Severe Respiratory Pathogens	November-10
3.06	Anxiety or Hyperventilation	February-11

Section 4 - Cardiac

Printable Version

Section	Description	Revision Date
4.01	Chest Pain Acute Coronary Syndrome	Sept-17
4.02	Asystole	April-16
4.03	Atrial Fibrillation Atrial Flutter	June-17
4.04	Pulseless Electrical Activity (PEA)	January-16
4.05	Premature Ventricular Contractions (PVC)	May-12
4.06	Supraventricular Bradycardia and AV Blocks	March-09
4.07	Supraventricular Tachycardia	January-20
4.08	Ventricular Fibrillation Pulseless Ventricular Tachycardia	December-16
4.09	Ventricular Tachycardia with a Palpable Pulse	July-12
4.10	Wide Complex Tachycardia Uncertain Origin	May-12
4.11	Acute Cardiogenic Pulmonary Edema Pneumonia	March-09
4.12	Code Cool Post ROSC Induced Hypothermia	March-09
4.13	Adult Immediate Post-Cardiac Arrest Care	April-12
4.14	Ventricular Assist Devices	August-18

Section 5 - Medical

Printable Version

Section	Description	Revision Date
5.01	Acute Abdominal Pain	April-16
5.02	Allergic Reaction Anaphylactic Shock	March-19
5.03	Altered Mental Status (AMS)	April-17
5.04	Suspected Stroke or Transcient Ischemic Attack	June-19
5.05	Drug Overdose Poisoning	March-09
5.06	Cold Emergencies	April-12
5.07	Heat Emergencies	August-15
5.08	Hazardous Materials	March-09
5.09	Severe Hypertension	March-09
5.10	Hypo or Hyperglycemia	April-16
5.11	Psychological Behavioral Emergencies	March-09
5.12	Seizure	April-16
5.13	Non-Hemorrhagic Shock	October-18
5.14	Sickle Cell Anemia Crisis	March-09
5.15	Syncope	March-09
5.16	Vertigo	March-09
5.17	Sepsis Septic Shock	May-19
5.18	Suspected Kidney Stone	April-16
5.19	Cyanide Poisoning	April-16
5.20	Excited Delirium or Drug Induced Agitation	November-17
5.21	Ebola Virus Disease Patient Management	October-14
5.22	Acute Adrenal Insufficiency	June-18

Section 6 - Trauma

Printable Version

Section	Description	Revision Date
6.01	Animal Bites Stings	August-18
6.02	Burns - Thermal, Electrical, Chemical	March-09
6.03	Selective Spinal Immobilization	August-14
6.04	Chest Injuries	March-09
6.05	Decompression Sickness or Dysbarism	March-09
6.06	Extremity Injuries	February-15
6.07	Head Injuries	November-17
6.08	Near Drowning	March-09
6.09	Ophthalmic Injuries	March-09
6.10	Suspected Abuse Neglect	March-09
6.11	Suspected Sexual Assault	March-09
6.12	Trunk Penetrating Injuries	April-12
6.13	Hemorrhagic Shock	October-18

Section 7 - Pediatric and Obstetrical

Printable Version

Section	Description	Revision Date
7.01	Pediatric Asystole	April-16
7.02	Pediatric Pulseless Electrical Activity PEA	April-16
7.03	Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia	April-16
7.04	Pregnancy Induced Hypertension (PIH)	April-20
7.05	Preterm Labor	November-17
7.06	Emergency Childbirth	November-17
7.07	Childbirth Complications	November-17
7.08	Newborn Care	April-16
7.09	Post Partum Care	November-17
7.10	Pediatric Febrile Emergency	April-16
7.11	Vaginal Bleeding	March-09
7.12	Trauma In Pregnancy	March-09

Section 8 - Medication Guidelines

Printable Version

Section	Description	Revision Date
8.00	Authorized Medications	April-16
Cyanokit	April-16
Dopamine	April-16
Epinephrine	April-16
Flumazenil	April-16
Ketamine	November-17
Morphine Sulfate	November-16
Naloxone	April-16
Nitrous Oxide	November-16
Pontocaine	November-17
8.04	Antagonists	April-16
8.05	Antianginals	April-17
8.06	Antiarrhythmics	July-17
8.07	Antidiabetics	April-16
8.08	Antipyretic / Anti Inflammatory	March-09
8.09	Antiemetics	April-16
8.10	Antihistamines	April-16
8.11	Bronchodilators	April-16
8.12	Corticosteroids	January-17
8.13	Diuretics	April-16
8.14	Electrolytes	April-16
8.15	Sedative Hypnotics	April-16
8.16	Medical Gases	March-09
8.17	Hormones Vitamins	October-13
8.18	Salicylates	March-09
8.19	Anti-Fibrinolytic	July-19
	Medication Infusion Tables	March-09

Section 9 - Procedure Guidelines

Printable Version

Section	Description	Revision Date
9.00	Autopulse Resuscitation System	July-16
9.01	Autovent	March-09
9.02	Blood Alcohol Draw on Scene	March-18
9.03	Blood Draw using Vacutainer Tubes	March-09
9.04	Blood Glucose Test	March-09
9.05	Buretrol Usage	March-09
9.06	Cardiac Monitor	April-12
9.07	Cardioversion	March-09
9.08	Continuous Positive Airway Pressure Device	March-09
9.09	Cricothyrotomy Needle	March-09
9.10	Cricothyrotomy Surgical	March-09
9.11	Defibrillation	March-09
9.12	Defibrillation Pediatric	March-09
9.13	End Tidal CO2 Monitoring and Capnography	March-09
9.14.1	Intraosseous Infusion - Femoral	February-15
9.14.2	Intraosseous Infusion - Humeral Head	December-16
9.15	Intubation Endotracheal	March-09
9.16	Intubation Nasotracheal	March-09
9.17	IVAC Medsystem III MultiChannel Infusion Pump	March-09
9.18	King Tube	March-09
9.19	Medication Administration Intramuscular	March-09
9.20	Medication Administration Nasal Atomizer	March-09
9.21	Medication Administration Nebulizer	March-09
9.22	Medication Administration Subcutaneous	March-09
9.23	Nasogastric/Orogastric Tube	March-09
9.24	Oxygen Administration	March-09
9.25	Peripheral IV Administration	March-09
9.26	Pleural Decompression	March-09
9.27	Removal of Taser Probes	March-09
9.28	Reconstitution of Medications	March-09
9.29	ResQPOD Impedance Threshold Device	March-09
9.30	Transcutaneous Pacing Procedure	March-09
9.31	ResQGuard Impedance Threshold Device	April-11
9.32	Emergency Chest Wall Escharotomy	April-11
9.33	Venous Lactate Monitoring Procedure	May-12
9.34	Central Venous Access Devices	June-12
9.35	Medication Administration Cross Check	Jun-12
9.36	Combat Application Tourniquet	Jan-14
9.37	Zoll LifeVest Wearable Defibrillator	Dec-14
9.38	iTClamp Hemorrhage Control System	Feb-15
9.39	I-gel Supraglottic Airway	May-16

Section 10 - References

Section	Description	Revision Date
10.01	Abbreviations	March-09
10.02	Apgar Score	March-09
10.03	Glasgow Coma Score	March-09
10.04	Pediatric Vital Signs	March-09
10.05	Adult Trauma Alert Criteria	March-09
10.06	Pediatric Trauma Alert Criteria	March-09
10.07	Pediatric Trauma Score	March-09
10.08	Nitroglycerin Drip	March-09
10.09	Checking Range of Motion	March-09
10.10	Rules of Nine	March-09
10.11	Florida Statutes	March-09
10.12	Evaluation and Treatment Flow Chart	March-09
10.13	Spinal Injury Assessment Critical Criteria	March-09
10.14	Celox Gauze Powerpoint	April-12
10.15	Sepsis and Venous Lactate Powerpoint	April-12
10.16	LVAD EMS Guide	Sept-18
10.16.1	HeartMate III LVAD - Green	Sept-18
10.16.2	HeartMate II LVAD - Red	Sept-18
10.16.3	HeartWare LVAD - Dark Blue	Sept-18
10.16.4	Jarvik 2000 LVAD - Lavendar	Sept-18
10.16.5	Thoratec LVAD - Light Blue	Sept-18
10.16.6	DuraHeart LVAD - Purple	Sept-18
10.16.7	Total Artificial Heart LVAD - Pink	Sept-18

Section 11 - Medical Director Memos

Subject	Effective Date
Clarification on Destination Choices	2019-11-14
Transport to the OD Hospital – Advent Health Altamonte Clarification	2019-11-07
Transport to the OD Hospital – Advent Health Altamonte	2019-11-04
Further clarification on Advent Health OD Facility	2019-08-26
Transporting of Overdose Patients to AdventHealth Altamonte	2019-08-12
EMS Reports on Lift Assists	2019-03-01
Blood Draws - Nurses refusing tubes	2018-08-23
Clarification of Baker Act patients transported by EMS	2018-04-11
Opening of Oviedo Medical Center	2017-01-29
Blood Draws - Florida Hospital	2017-01-25
Medical Alerts	2016-04-27
Florida Hospital East Pediatric ED	2015-11-23
Discontinuation of Central Venous Access	2013-08-03
Shortage of Atropine	2013-04-11
EMS Blood Draws for SSCH	2013-03-07
Respiratory/Breathing Treatments	2012-12-19
OB Transports	2011-01-14
Aspirin Administration Documentation	2010-12-01
Transport of Psychiatric Patients	2010-05-17
Alert Terminology	2010-05-06
Transport of STEMI Patients	2010-03-19
Aircare Update	2010-03-19
Delayed Offloads with Critical or Unstable Patients	2010-02-25
Transport of STEMI Patients	2010-02-19
Response to Physicians Offices	2009-10-14
Patient Reports Being Given to Hospitals	2009-09-23
Patient Medications	2009-07-20
H1N1 Update	2009-06-24
Multiple Patient Refusal - Wording	2009-06-04
Request for Call Reviews	2009-05-14
H1N1 Update	2009-05-05
Clarification on Selection for Spinal Immobilization	2009-04-30
EKG Strips	2009-04-23
Patient Medications	2009-04-23
Leaving run reports at the E.R.	2009-02-03
Hyperbaric Chamber at CFRH	2008-10-16
Stemi Transport Destinations	2008-07-22
STEMI Alerts to Winter Park Hospital	2008-02-04
Documentation of Medications	2005-01-27

Section 12 - Paramedic Clinical Assessment Program

Section	Description	Revision Date
12.01	PCAP Guidelines	Jan-19
12.02	ALS Contact Form	June-10
12.03	Evaluation Form - Equip	Jan-13
12.04	Evaluation Form - Protocols	Jan-13
12.05	ALS Contact Definition	June-10
12.06	Daily Performance Eval	Sept-17
12.07	MD Meetings Roster	May-13
12.08	Mentor Evaluation	May-13
12.09	Verification of EMT Skills	May-13
12.10	PCAP Completion Checklist	Sept-17
12.11	Verification of Paramedic Skills	May-13
12.12	ALS Contact Form Example 1	Dec-14
12.13	ALS Contact Form Example 2	Dec-14
12.14	Incapacitated Patient Management	Dec-14

Section 13 - COVID-19

Section	Description	Revision Date
13.01	List of COVID-19 Testing Locations	2020-03-17
13.02	MD Memo - Please use Common Sense	2020-03-13
13.03	Hospital Screening and Procedures	2020-03-26
13.04	Dispatch Screening and Procedures	2020-04-01
13.05	Strict Respiratory Precautions Question Card	2020-04-01
13.06	American Red Cross Changed Response Procedures	2020-03-31