General Measures

Section 1 - ADMINISTRATIVE POLICIES

1.01 GENERAL MEASURES

The following guidelines shall be applied to help promote speed and efficiency when rendering emergency medical care to the sick, ill, injured or infirm. They were developed for the use of the Paramedic in the field and the Emergency Department Medical Control physician.

• The safety of EMS personnel is paramount to quality patient care. Each scene should be properly evaluated for hazardous materials, fire, violent patients, etc. Also, assess the need for additional EMS support.

• Proper Personal Protective Equipment (PPE) MUST be utilized according to each Agency's Exposure Control Plan / Infection Control Policy.

• Always try to obtain verbal consent prior to treatment. Respect the patient's right to privacy and dignity. Courtesy, concern and common sense will assure the patient of the best possible care.

• The Paramedic should generally be able to decide within 3 minutes after patient contact if advanced life support (ALS) measures will be needed and should be instituted almost simultaneously with the initial assessment. A comprehensive exam is appropriate after the patient has been stabilized.

• Generally, the initial assessment and initial therapy should be completed within the first 10 minutes after patient contact. Except for extensive extrication, or other significantly atypical situations, the trauma patient should be enroute to a receiving facility within 10 minutes and the medical patient should be enroute to the receiving facility within 20 minutes. Additional therapy, if indicated; should be continued during transport. The Paramedic is responsible for all patient care and is required to attend the patient(s) in the patient compartment during transport. The Paramedic may designate an EMT to attend BLS patients. Patients who have an intravenous line are NOT considered BLS patients and must be attended by the Paramedic. An EMT may tend to patients with a Heparin-lock or saline-lock provided the patient's chief complaint or diagnosis is not ALS in nature. All patients who receive treatment are to be transported by ambulance to a receiving facility for further evaluation or be released by the Medical Control physician.

• Please note that all medication dosages listed are for adults, unless otherwise specified. For medication administration, according to the Handtevy System, an adult patient is one who is 14 years of age or over. A pediatric patient is under 13 years of age.

• For trauma situations, a pediatric patient is with the anatomical and physical characteristics of a person fifteen (15) years or younger.

• In cases of out of county, mutual aid response, Seminole County EMS agencies are directed to utilize these Practice Parameters in conducting patient care.

• A State Approved EMS Patient Care Report will be generated by each agency at the conclusion of each patient contact. Patient contact is defined as any time a person is evaluated for a potential injury or illness. This includes the patient assessment, vital signs if taken, and any procedure performed.

• A complete copy of the full report or the approved Patient Care Field Report must be left with the receiving facility at the time of patient transfer.

• Attach the patient’s name (either by handwriting or placing a patient sticker from the ED) to the strip(s).

• Make sure your times are on your Hospital report prior to leaving it with the ED Staff.

• Patient Care Reports or copies, may not discussed or given to anyone other than the receiving facility or the transporting unit. Any request for Personal Health Information (PHI) must go through the Agency’s Privacy Officer.

• In the event that medical direction is required, personnel should contact the on-line physician at the receiving facility. If further medical direction is needed, contact the oncall Medical Director by contacting the Communication Center. For the purpose of these parameters, “Online Medical Control” is the Physician at the receiving facility. If that Physician is unavailable or the on-scene Paramedic or EMT is uncomfortable with the receiving facility’s direction, the on-call Medical Director may be contacted.