Clinical Operating Guidelines Ver. 02012016 Effective February 1st 2016 thru January 31st 2018 or revised Table of Contents Medical Directors Signature Page Clinical Standards ........................................................................................................................... Page Atypical Protocol Utilization and Online Medical Direction .................................................................. CS-1 Cancellation or Alteration of Response ................................................................................................. CS-2 Child Abuse Recognition and Reporting ................................................................................................ CS-3 Clinical Event Review ............................................................................................................................. CS-4 Crime Scene ........................................................................................................................................... CS-5 Criteria for Death or Withholding Resuscitation ................................................................................... CS-6 Definition of a Patient ............................................................................................................................ CS-7 Discontinuation of Prehospital Resuscitation ........................................................................................ CS-8 DNR Advanced Directives ...................................................................................................................... CS-9 Documentation of Patient Care Report ............................................................................................... CS-10 Documentation of Vital Signs .............................................................................................................. CS-11 Domestic Violence Recognition and Reporting ................................................................................... CS-12 Emergency Medical Dispatch ............................................................................................................... CS-13 Equipment Failure ................................................................................................................................ CS-14 Hospital Diversion ................................................................................................................................ CS-15 Identification Badges ........................................................................................................................... CS-16 Infant Abandonment ........................................................................................................................... CS-17 Interfacility Transfers ........................................................................................................................... CS-18 Minimal Equipment to Patient Side ..................................................................................................... CS-19 On-scene Authority .............................................................................................................................. CS-20 Patients with Special Healthcare Needs .............................................................................................. CS-21 Physician on Scene ............................................................................................................................... CS-22 Provider Clinical Performance Review ................................................................................................. CS-23 Provider Credentialing ......................................................................................................................... CS-24 Provider Qualifications ........................................................................................................................ CS-25 Refusal of Treatment and/or Transport .............................................................................................. CS-26 Safe Transport of Pediatric Patients .................................................................................................... CS-27 Suspension or Revocation of Credential to Practice ........................................................................... CS-28 System Design ...................................................................................................................................... CS-29 Transport Destination Decision ........................................................................................................... CS-30 Transfer of Care to Provider of Lesser Credentials .............................................................................. CS-31 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 Pulmonary Edema ............................................................................................................................ R-03 Respiratory Distress ......................................................................................................................... R-04 RSI/Medication Assisted Intubation (>37kg) ..................................................................................... R-05 Cardiac Arrest ................................................................................................................................ CA-01 Asystole/PEA .................................................................................................................................. CA-02 Ventricular Fibrillation & Pulseless Ventricular Tachycardia ............................................................ CA-03 Induced Hypothermia ≥ 18 yrs ........................................................................................................ CA-04 Post Resuscitation .......................................................................................................................... CA-05 Chest Pain, 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 Abdominal Pain ...............................................................................................................................M-01 Allergic Reaction .............................................................................................................................M-02 Altered Mental Status .....................................................................................................................M-03 Back Pain.........................................................................................................................................M-04 Behavioral .......................................................................................................................................M-05 Bites and Envenomations ................................................................................................................M-06 Excited Delirium ..............................................................................................................................M-07 Eye Injury/Complaint .......................................................................................................................M-08 Fever/Infection Control ...................................................................................................................M-09 Hyperthermia ..................................................................................................................................M-10 Hypotension (Non-trauma)..............................................................................................................M-11 Hypothermia ...................................................................................................................................M-12