Chapter 1 Administrative Policy Flashcards
1010
Intro
1020
Scope of practice
1030
consent and competency
Emergency care to minors
Fs 743.064
Emergency exam and treatment of incapacitated persons
Fs 401.445
1030 refusal to treat documentation
Mentally competent
Axo x4
No signicant mental impairment
Not mentally incompetent
If concerned for minor contact rescue dis/ bat chief for assistance with transport
1030 a patient is
A person with subjective and or objective signs and or symptoms or complaints which results evaluation and or treatment
1030 patient encounter
Patient encounter is dependent on neither treatment nor transport nor cooperation from the patient. If I technician perceives a medical problem that requires a valuation, patient encounter has been made in a full report must be completed.
1030 baker act
A Baker act is involuntary mental health commitment by law-enforcement if the patient needs any of the following criteria
Mentally incompetent, danger to self or others
Suicidal
Homocidal
Jfrd members are not legally authorized to execute a baker act
1040
Controlled substance
1040 what days of the month are the Chiefs inspection for controlled substance
Monthly 23 24 25
1040 who will restock all controlled substances
The rescue district/battalion chief
1040 restocking should occur when
Minimum aLS inventory is reached
Minimum rescue inventory is reach
Month prior to expiration date
Prior to holiday or weekend when stock is close to minimum rescue inventory
1060
Cooperation with law enforcement
1070
Blood draw
1080
Patient restraints
1080 jfrd allowed restraints
Soft limb
Stretcher straps/harness
Wide cloth
Supine only
No hogtie
Restraints shall not prohibit eval of mental status or injure the patient in anyway
Frequently assess the patient- airway, distal limb is adequate and restraints can be release quickly if patients condition deteriorates
Check extremeties every five mintes
Never leave patient unattended
1080 documentation of restraints
Behavior
Type
Status of circulation distal to res
1090
PCR
1090 rescue officers will provide what color ems copy to hospital
Rescue officers will provide the white copy to hospital
1090 app ems field copies must be
Shredded after completion of EPCR
Pcr 1090 cancelled by dispatch
Cancelled by frcc
1090 cancel by ems agency
Cancelled by private ambulance
Cancelled by law enforment
Jso, jbpd ect
1090 citizen assist
Assist a citizen without a medical complaint
1090 stand by meaning
Non transporting rescue/non-primary supression unit on a cardiac arrest, hostage situation, secondary units for education, MCI’s or any additional manpower request
1090 false call
No patient found any false call
Doa
Any obvious death
Pronouncement of death
Any patient that is pronounced dead on scene MVA,GSW
Evaluation only
Patient evaluation only
Lawn Enforcment
Patient evaluated by Jfrd but transported by law enforcement
Refused evaluation
Anytime a patient refuses an assessment
Refused treatment/transport
Patient refused treatment and/or transport after evaluation
Treated and refuse transport
Patient treated on scene and refused transport
Transfer to another EMS agency
Transferred to ATU
Unit assist
Unit assist will be used every time a suppression unit arrives on scene at the same time or has the same patient contact time as a rescue unit
Treated and transferred care within agency
Treated and transferred care within agency must be used when the suppression apparatus arrives on scene first and provide patient care prior to the arrival of the rescue unit. This documentation must also include all information from patient contact time to the transfer of care to the rescue unit
Assessment times
Five for unstable patient
15 minutes if patient is stable
Min two required, one at patient contact time, one at hospital
Anytime als procedure is performed, must be listed on flow sheet
Parent information must be
Added to the billing section underneath n0K (next of kin)for all pediatric patients
Acquire the patients health insurance info from
Hospitals face sheet when Possible and document into billing section
If the laptop is not functioning following a transport,
A paper responsibility signature must be completed.
The form is located on our target solutions under Jfrd EMS resources
The paper signature form must be delivered to rescue district/battalion chief he will then hand-deliver it to quality improvement officer
Only approve Jfrd format for PCR narrative
Cc
Hpi
Pe
Tx
Cc
Patients main complaint
Hpi
Exactly how the patient presented to Jfrd personnel
Complete description of why patient called
Include a detailed description of the patients compaints
Physical exam
Evaluate objective and atomic Vinings through the use of observation, palpitation, percussion, and ausciltation
Include location, quality, pain scale, duration and any associated signs or symptoms that may relate to the present illness
Include pertinent positive and negative findings
Tx
And sure that you document;
How the patient was moved to stretcher and details of the ER transfer to include staff members name that receive the patient
Any changes in patient condition that occurred during the transport and transfer of care at hospital
The continuous monitoring of the patient
Note section
The additional section will be used for any unusual circumstances that occurred during the entire duration of the incident
Refusal
One set of vitals per patient Any improvement Phys exam: A + O x 4 TRauma medical psych toxins "TMPT" Competency of patient: Greater than or equal to 18 or court emancipated minor Is a +O x 4 No drugs or alcohol
Patient is competent
Explain need for treatment risk associated with refusal willingness of ema to transport patient and that they should call 911 if anything changes
Document of pcr for refusal
All cases of refusal
All cases with an assessment of competency
All refusal language
Name of patent
Signature of patient or guardian
No one else can sign for a legally competent adult
If patient refuses to sign document it
Printed name, signature and phone number of competent witnes
Appropriate witnesses in order of preference
Spouse, relatives, lawn force meant, friends, and other fire rescue personnel
1110
Qi
1120
Reporting abuse/neglect
Vulnerable adult
Defined as one Hugh, due to their age or disability, maybe unable to adequately provide for their own care or protection
Reporting abuse
Report suspicions to ED doc
State of florida req:
Oic verbal report to staye toll free # 1800-962-2873
Notify rescue district chief
Notify div chiefbof rescue in 24 hours including only first name and id number of the contact person. NO patient info in email.
Resuscitation protocol
1130
Unquestionable death
Unresp Apneic Pulseless And Lividity Body decay Rigor mortis Open cranium Decapitated or severed trunk
Trauma death criteria
Apneic
Pulseless
If rythmis asystile or wide complex vent ruthm of 30 or lesswithout a pulse, document time and call code
Trauma patients of unstable nature should be transported
Within 10 minutes when possible
If patient not assessed within 15 minutes talk to charge nurse
If transfer of car delayed more than 30 minutes contact frcc
1140
Atu should be considered for critically ill or injured patients at any time ground transport to the closedt appropriate hospital
exceeds 20 minutes
Service animals are defined as
Dogs that are individually trained to do work or perform task for people with disabilities
Service dog questions
Only two questions allowed
Is the dog a service dog because of a disability
What work or task has the dog been trained to perform
Ada mini horses
Range inheigth from 24 inches to 34 inches measures to the shoulders and weigh between 60 and 100 lbs
Trauma alert criteria 1160
Airway- assisted beyond o2
Circulation- no radial and heart rate greater than 120 or systolic of less than 90
Best motor response BMR gcs four or less or prescense of paralysis or suspicion of spinal cord injury with loss of sensation
Cutaneous- 2nd or 3rd dregres burns to 15% or more of total body surface areas. Or proximal amp to wrist or ankle or any penetrating i jury to head. Neck or torso
Long bone two or more
Anytime two trauma alert
Airway 30 or greater
Circulation sustained hr of 120 bpm or greater
Bmr of 5 on the motor component of the glasgow coma scale
Cutaneous soft tissue loss from degloving or major flap avulsion greater than 5 inches or has a gsw to extremeties of body
Long body fracture- single long bone fracture resulting from motor vehicle collisoon or fall from an elevation of ten feet or greater
Age-55 or greater
Moi- ejected from a motor vehicle, of any type or impacted steering wheel causing deformity
Pediatric criteria for trauma alert one of these
Airway airway is maintain by adjust suction intubation or jaw thrust
Circulation non palpable carotid or femoral or systolic less than 50
Consciousness - ams, lethargy inibiloty to follow commands unresponsiceness to voice coma spinal iniurt
Fracture long bone fracture open or multiple fracture sites
Cutaneous- major flap or degloving; 2 or 3 degree burns to 10% of the body surface are.
Amp promomal to wrist or ankle, penetrating injury to head. Neck or torso
Pediatric two or more
Consciousness symptoms of amnesia or loss of consciouness
Curculation cortid or femoral palpable but radial or pedal not; or the systolic pressure is less than 90mmhg
Fracture signs or synptoms of a single closed long bone fracture
Size pediatric trauma of 11 kilograms or less body length 33 inches
Issuing a trauma alert
Jfrd call trauma alert
Frcc shall notify satc or saptc
Medical director or issuing ed physcian are only ones allow to change trauma alert status
