Medical Policies Flashcards
Criteria allowed for determining death before resuscitation attempts…
Decapitation, decomposition, rigor mortise, dependent lividity, cardiac arrest (as a result of exposure to hazardous chemical/ materials or blunt MOI), mortal wounds with obvious signs of organ destruction (incompatible with life), valid out-of- hospital DNR or device on pt., valid licensed physician on scene with providers orders not to resuscitate.
Pts that can be attended by EMT-B…
Stable Adult pt. with SBP > 100 mm Hg/ Pediatric pt. with normal vitals, pt. with SpO² > 90%, pt. who have not received medication related to their C/C in the hour preceeding EMS arrival, pt. not needing additional TX. other than O², DNR pt. with low vitals, pt. with any ostomy/saline lock/PICC line/wound vac/Groshong/other central line as long as there is no fluid running to it.
Pts EMT-B not allowed to attend…
Pt. with NG tunes, chest tube, pt. with advanced Airway management, pt. needing cardiac monitoring (if they are being transported from one facility to that of a higher level if care)
Medications administered at first aid (Special Events)
Acetaminophen: 325 mg Tab, one dose
Benadryl: 25 mg Tab/caplet, one dose
Ibuprofen: 200 mg Tab, one dose
Antiseptic spray: as needed
Hospital radio report requires…
Destination hospital, age, gender, C/C, event history, pertinent medical history, Tx/procedures, vitals, ETA to facility
START Triage…
(RR>30/min, Cap. refill>2 sec., Follows commands?)
Green: walking wounded
Yellow: cannot walk, RR<30/min, normal capillary refill, follows commands
Red: unstable Airway, R>30/min, delayed capillary refill, cannot obey commands
Black: dead or unable to save
Events in which Medical Direction and 805 need to be notified…
Unexpected pt. death during transport, any violations of the standard of conduct, any attempt at surgical airways (succ/unsucc), any cardiac/resp. arrest or pt. injury while performing chem./physical. restraint, providers who have operated outside of their scope of practice, serious injury to EMS provider, significant blood/body fluid exposure/infectious disease exposure/MCIs, serious pt. care concerns, medico-legal issues during pt. contact
TOR not allowed…
<18 years old, have ROSC, profoundly hypothermia, victims of penetrating trauma, family will not accept pre-hospital TOR, arrest occurred in public setting and you can’t secure the body, all pregnant women
High energy event definition…
Ejection from a vehicle, significant fall (>20 ft.), rollover, bent steering wheel, autoped, motor/bicycle involvement, significant assault
Major trauma in Pediatrics…
Multi. system blunt/penetrating trauma with unstable vitals (SBP< 90, RR< 10 or >60, GCS< 14)
Penetrative injury to neck, head, torso, groin
2nd/3rd degree burns > 20% TBSA or involving Face, hands, feet, genitalia
Amputations (with implantation potential)
Paralysis or other signs of spinal cord injury
Open/suspected depressed skull fracture
Flail chest
2 or more long bone fractures, unstable/suspected pelvic fracture
Major trauma in Adults…
Multi. system blunt/penetrating trauma with unstable vitals (BP< 90, HR> 120, GCS< 14)
Penetrative injury to neck, head, torso, groin
2nd/3rd degree burns > 20% TBSA or involving Face, hands, feet, genitalia
Amputations (with implantation potential)
Paralysis or other signs of spinal cord injury
Open/suspected depressed skull fracture
Flail chest
2 or more long bone fractures
