DB 21-05 - Updated Patient Disposition Policy

Question 1

Patient Disposition Policy (PDP) Chart sections A through D:

Answer 1

Question 2

Patient Disposition Policy (PDP) sections E and F:

Answer 2

Question 3

The revised Patient Disposition Policy (PDP) reflects the increased capabilities of Basic Life Support (BLS) resources to now capture:

Answer 3

-blood oxygen saturation (SPO2)

-blood glucose levels

-inclusion of TELEMEDICINE.

Question 4

The LAFD PDP represents the single most important EMS policy since it determines the ______ level of service needed to provide an appropriate level of patient care.

Answer 4

minimum level

Question 5

Any patient with a condition listed in the PDP (Sections A or B) who refuses transport requires an ALS assessment.

Any patient who refuses transport with a condition listed in Section C requires?

Answer 5

a telemedicine evaluation or an ALS assessment.

Question 6

Paramedics performing an AMA shall make Base Station contact while with the patient and request that the Mobile Intensive Care Nurse (MICN) speak with the patient to record their refusal and confirm their mental capacity for the following circumstances:

Answer 6

1. For conditions indicated with an asterisk (*) in Sections A, B or C.
2. When indicated by the Department of Health Services (DHS) Treatment Protocols.
3. Whenever an audio recording of the patient’s AMA refusal is desired, or when MD/MICN input is requested

Question 7

Patient Disposition Policy

1. Section A: ALS _______ Required
2. Section B: ALS _______ Required
3. Section C: BLS _______ Required

Answer 7

1. ALS Transport
2. ALS Assessment (ALS/BLS Transport per Paramedic Judgment)
3. BLS Transport (Telemedicine or ALS Assessment Required for Non-Transport)

Question 8

Section A:

A BLS ambulance may transport a patient with a life‐threatening condition if?

Answer 8

the ETA for the ALS resource exceeds the estimated transport time to the hospital.

(Notification to the receiving facility SHALL BE made through MFC.)

Question 9

Section C: BLS Transport Required if….

Answer 9

-Age < 12 months (any complaint)*

-Age 12‐36 months (excludes minor trauma)*

-Age > 70 years with any medical complaint*

-Chest wall pain due to trauma

-Diabetic > 40 years with vague complaint*

-Dialysis patient with vague complaint*

-Suspected femur or humerus fracture

-MFC Telemedicine‐generated incidents (try to re‐contact TMP or request ALS if unable)

-Temporary loss of consciousness (traumatic)

Question 10

Documentation:

Obtain and document at least TWO sets of vital signs (BP, HR, RR) on all patients, at least ____ minutes apart

Answer 10

5

(All patients require at least ONE (1) recording of GCS, skin signs, lung sounds, SpO2, and pupils)

Question 11

What Section letter is the LA County DHS Trauma Center Decision Scheme?

Answer 11

Section F

Question 12

For patients under ____ years old, document capillary refill instead of blood pressure

Answer 12

3 years old

Question 13

Symptomatic hypertension is defined as severe hypertension with a BP of _____ with neurological symptoms (headache, dizziness, blurry vision, etc.)

Answer 13

> 200/120

Question 14

Abnormal Adult Vital Signs:

Answer 14

-Systolic Blood Pressure: <90 mmHg

-Hypertension in pregnancy (BP >140/90) >20 weeks or postpartum < 6 weeks

-Heart Rate: <50 bpm or >120 bpm

-Respiratory Rate: <12 or >24 bpm

-SpO2 < 94%

Question 15

Some Trauma Center Criteria:

Answer 15

-Critical Burns:
1. Adult (15 years and older) with 2nd or 3rd degree >20%
2. Child (14 years and younger) with 2nd or 3rd degree >10%

-Falls:
1. Adults >15 ft
2. Peds >10 ft or > 3 times height of child

-Passenger Space Intrusion >12 inches into occupied passenger space

-Auto vs ped/bike/motorcycle thrown, ran over, or impact >20mph

-Unenclosed transport crash with significant impact >20mph

-Ejected from vehicle (partial or complete)