Clinical Operating Guidelines Version 02012020 Katherine Remick MD Effective February 1st 2020 thru January 31st 2022 or revised Table of Contents Clinical Standards ..................................................................................................................... .Page Attended Patients at Clinic or Alternative Medical Site…………………………………………………………………….CS-1 Atypical Protocol Utilization and Online Medical Direction .................................................................. CS-2 Cancellation or Alteration of Response ................................................................................................. CS-3 Child Abuse Recognition and Reporting ................................................................................................ CS-4 Clinical Event Review ............................................................................................................................. CS-5 Crime Scene ........................................................................................................................................... CS-6 Criteria for Death or Withholding Resuscitation ................................................................................... CS-7 Definition of a Patient ............................................................................................................................ CS-8 Discontinuation of Prehospital Resuscitation ........................................................................................ CS-9 DNR Advanced Directives .................................................................................................................... CS-10 Documentation of Patient Care Report ............................................................................................... CS-11 Documentation of Vital Signs .............................................................................................................. CS-12 Domestic Violence Recognition and Reporting ................................................................................... CS-13 Emergency Medical Dispatch .............................................................................................................. CS-14 Equipment Failure ............................................................................................................................... CS-15 Hospital Diversion ................................................................................................................................ CS-16 Human Trafficking…………………………………………………………………………………………………………………………..CS-17 Identification Badges ........................................................................................................................... CS-18 Infant Abandonment ........................................................................................................................... CS-19 Interfacility Transfers ........................................................................................................................... CS-20 Minimal Equipment to Patient Side ..................................................................................................... 1CS-2 On-scene Authority .............................................................................................................................. CS-22 Patients with Special Healthcare Needs .............................................................................................. CS-23 Physician on Scene ............................................................................................................................... CS-24 Provider Clinical Performance Review ................................................................................................. CS-25 Provider Credentialing ......................................................................................................................... CS-26 Provider Qualifications ........................................................................................................................ CS-27 Refusal of Treatment and/or Transport .............................................................................................. CS-28 Safe Transport of Pediatric Patients .................................................................................................... CS-29 Suspension or Revocation of Credential to Practice ........................................................................... CS-30 System Design ...................................................................................................................................... CS-31 Transport Destination Decision ........................................................................................................... CS-32 Transfer of Care to Provider of Lesser Credentials .............................................................................. CS-33 Transport COGs Universal Protocols: All Patients...................................................................................................... Page Universal Patient Care............................................................................................................................ U-01 IV Access................................................................................................................................................. U-02 Patient Safety......................................................................................................................................... U-03 Deceased Person.................................................................................................................................... U-04 Spinal Motion Restriction....................................................................................................................... U-05 Adult Protocols: Patients ≥ 37 Kg..................................................................................................... Page Airway, Adult........................................................................................................................................... R-01 Airway, Adult - Obstruction..................................................................................................................... R-02 CHF & Pulmonary Edema........................................................................................................................ R-03 Respiratory Distress................................................................................................................................ R-04 RSI/Medication Assisted Intubation (>37kg)........................................................................................... R-05 Asystole/PEA.......................................................................................................................................... CA-01 Ventricular Fibrillation & Pulseless Ventricular Tachycardia................................................................. CA-02 Induced Hypothermia ≥ 18yrs................................................................................................................ CA-03 Suspected Acute Coronary Syndrome...................................................................................................... C-01 Bradycardia ............................................................................................................................................ C-02 Atrial Fibrillation with RVR....................................................................................................................... C-03 Supraventricular Tachycardia................................................................................................................... C-04 Wide Complex Tachycardia (VT) With a Pulse.......................................................................................... C-05 Allergic Reaction ................................................................................................................................... M-01 Altered Mental Status............................................................................................................................. M-02 Bites and Envenomations........................................................................................................................ M-03 Fever/Infection Control........................................................................................................................... M-04 Hyperkalemia………………………………………………………………………………………………………..…………………………...M-05 Hypertensive Crisis……………………………………………………………………………………………….…………………………….M-06 Hyperthermia.......................................................................................................................................... M-07 Hypothermia ........................................................................................................................................ M-08 Nausea/Vomiting ................................................................................................................................. M-09 Non Traumatic Bleeding.....................................................................................................................…...M-10 Overdose/Toxic Ingestion....................................................................................................................... M-11 Pain Management..................................................................................................................................