Special Care Protocols

Question 1

What is CPEP?

Answer 1

Comprehensive Psychiatric Emergency Program

Question 2

What are the requirements for using CPEP?

Answer 2

1. Age 18 or greater and less than 65
2. Vital signs and blood glucose within normal range
3. There is an isolated behavioral problem
4. Transport should be completed by law enforcement
5. No medical problems/injuries that need to be evaluated at a hospital

Question 3

Resuscitation should be initiated unless?

Answer 3

1. Patient meets PDOA criteria

2. or a Valid out of hospital DNR order is present

Question 4

What are the 4 exclusions for termination of resuscitation where CPR must be initiated and the patient transported to a hospital?

Answer 4

1. Scene is unsafe for providers to remain at.
2. Patient is less than 18 years of age.
3. Patient is known of suspected to be greater than 20 weeks pregnant - when in doubt transport.
4. Hypothermia is thought to be the cause of the patient’s arrest.

Question 5

How many minutes must all providers attempt to stay on scene providing high quality CPR prior to requesting termination of resuscitation?

Answer 5

at least 20 minutes

Question 6

Who must grant permission before resuscitation is terminated?

Answer 6

A medical control physican

Question 7

What must be written in the ePCR when a medical control physician gives permission to terminate resuscitation efforts?

Answer 7

“The patient was pronounced dead on DATE at TIME by PHYSICIAN FIRST AND LAST NAME from HOSPITAL NAME.

Question 8

What are the primary criteria for PDOA for which all must be met?

Answer 8

1. pulseless
2. apneic
3. no signs of life
   All of the primary criteria must be met for PDOA

Question 9

What are the secondary criteria for PDOA for which at least 1 will be met?

Answer 9

1. Rigor Mortis
2. Dependent Lividity
3. Decomposition
4. Incineration
5. Submersion greater than 24 hours
6. Valid out of hospital DNR order is present
7. a valid licensed physician, on scene orders that resuscitation not be attempted
8. Traumatic injuries incompatible with life

Question 10

Who will be listed as the pronouncing physician for all PDOAs?

Answer 10

The current DC FEMS EMS medical director must be listed in the EPCR as the pronouncing physician NOT on-line medical control.

Question 11

Who are all Fire/EMS providers required to report suspected child/elder abuse or neglect to?

Answer 11

Police agency responsible for the area in which the call occurred or the DC Child and Family Services Agency (24 hour hotline at 202-671-7233)