hƉĚĂƚĞĚ11/07/2019 LJƉƌĞƐƐƌĞĞŬD^ System Policies and Treatment Guidelines 1 INTRODUCTION Revised 8/2016 Approved: Levon Vartanian, MD Table of Contents Introduction .................................................................................................................................................. 8 General Protocols/Treatment Guidelines .................................................................................................................. 9 Approval of Protocols ............................................................................................................................................... 12 Definition of Terms ................................................................................................................................................... 13 Reference Values ...................................................................................................................................................... 17 Delegation of Medical Practice ...................................................................................................................................... 18 Clinical Policies ............................................................................................................................................ 24 Air Medical Utilization .............................................................................................................................................. 25 Child/Elder Abuse Recognition and Reporting ......................................................................................................... 27 Criteria for Death/Withholding Resuscitation .......................................................................................................... 29 Do Not Resuscitate (DNR) Orders............................................................................................................................. 30 Documentation Guidelines ....................................................................................................................................... 31 Field Termination ..................................................................................................................................................... 35 Fire Standby Response/Fire Rehab .......................................................................................................................... 36 Inter-facility Transfers .............................................................................................................................................. 37 Paramedic Initiated Referral .................................................................................................................................... 38 Patient Determination/Non-Transportation ............................................................................................................ 42 Physician on Scene ................................................................................................................................................... 46 Quality Management Process .................................................................................................................................. 47 Safe Transport of Pediatric Patients ......................................................................................................................... 48 Self-Reporting of Clinical Incidents........................................................................................................................... 49 Operational Policies......................................................................................................................................... 50 CCEMS First Responder ............................................................................................................................................ 51 Child Lockedin aVehicle ................................................................................................................................................ 54 Communications ....................................................................................................................................................... 55 Controlled Medication Management ....................................................................................................................... 57 Crime Scene Management ....................................................................................................................................... 61 Firearms Policy ......................................................................................................................................................... 62 Forcible Entry ........................................................................................................................................................... 63 Mandatory Supervisor Notification .......................................................................................................................... 64 Partner Agencies First Responders ........................................................................................................................... 65 Posting Plan .............................................................................................................................................................. 66 Readiness for Response ............................................................................................................................................ 69 Scene Safety ............................................................................................................................................................. 70 Span of Control ......................................................................................................................................................... 73 Ambulance Staging ................................................................................................................................................... 74 Use of Lights and Sirens ................................................................................................................................................ 80 Transport Destination Determination ........................................................................................................... 81 General Transport Guidelines .................................................................................................................................. 82 Pediatric Patients ..................................................................................................................................................... 83 Cypress Creek EMS System Policies and Treatment Guidelines 2 INTRODUCTION Revised 8/2016 Approved: Levon Vartanian, MD Post-Cardiac Arrest ................................................................................................................................................... 84 Trauma and Burns .................................................................................................................................................... 85 STEMI ........................................................................................................................................................................ 87 Stroke ....................................................................................................................................................................... 88 Adult Medical .............................................................................................................................................. 89 Cardiac Arrest ........................................................................................................................................................... 90 Ventricular Fibrillation/Pulseless Ventricular Tachycardia .................................................................................................... 92 Asystole/Pulseless Electrical Activity ........................................................................................................................ 94 Post-Resuscitation Care ............................................................................................................................................ 95 Narrow Complex Tachycardia .................................................................................................................................. 97 Wide Complex Tachycardia/Ventricular Ectopy ....................................................................................................... 98 Bradycardia ............................................................................................................................................................... 99 Chest Pain: Cardiac/STEMI ..................................................................................................................................... 100 Respiratory Distress: CHF/Pulmonary Edema ........................................................................................................ 102 Respiratory Distress: COPD/Asthma ...................................................................................................................... 103 Deceased Person (DOS) .......................................................................................................................................... 104 Abdominal Pain .....................................................................................................................................................