Delaware Advanced Life Support Protocols

A medical control facility for paramedics in Delaware.

The use of technology to provide medical advice or direction to paramedics remotely.

A request made by a paramedic to a medical control physician for an order or consultation.

A patient with a critical medical condition requiring immediate attention and advanced care.

A patient who does not require immediate medical attention.

A written record of the patient's care provided by the paramedic.

An electronic record of the patient's heart rhythm.

A detailed report given by the paramedic to a physician upon arrival at the hospital.

A scoring system used to assess the severity of opioid withdrawal symptoms.

A medication used to treat opioid withdrawal symptoms, administered sublingually.

A medication used to treat nausea, administered orally or intravenously.

A medical condition characterized by a dangerously high blood pressure, typically with a diastolic pressure greater than 120 mmHg or a mean arterial pressure (MAP) greater than 150 mmHg.

A medication used to lower blood pressure, administered intravenously. It's often used to treat hypertensive crisis.

A condition characterized by high blood pressure in pregnant women, often accompanied by symptoms such as headache, vision changes, and epigastric pain.

A medication used to lower blood pressure and prevent seizures, administered intravenously.

A type of medication-assisted treatment (MAT) that provides patients with evidence-based medication and counseling for substance use disorder.

Interruptions during chest compressions should be brief, lasting no more than 10 seconds.

Deliver breaths during chest compressions with a bag-valve-mask (BVM) device. One breath should be given for every 10 compressions, aiming for 8-10 breaths per minute.

Monitor the waveform produced by capnography throughout CPR to assess the effectiveness of compressions. Aim for an ETCO2 level above 20 mmHg. If ETCO2 drops, consider rotating compressor personnel.

Establish IV or intraosseous (IO) access for medication administration, with IV preferred if feasible.

Consider using an advanced airway device like an endotracheal tube (ETT) to secure the airway, but only after 3 cycles of CPR, vascular access, and medication administration.

If CPR is effective and the patient shows signs of responsiveness or consciousness, consider giving 0.5 mg/kg of Ketamine IV/IO for sedation.

CPR should be performed on scene for at least 20 minutes before transport, unless there are extenuating circumstances.

A mechanical CPR device is strongly recommended for transport of patients needing ongoing CPR.

Refusal of Services occurs when a patient declines medical treatment and/or transportation by EMS. This is a legal process with specific documentation requirements.

The ALS provider must accompany patients even if they refuse ALS treatment. In such cases, the patient might agree to treatment later during transport.

A signed Refusal of Service form is mandatory for documenting the informed consent process. This form should include details about the patient's concerns and the physician's number if applicable.

EMS providers need to identify patients who require medical attention, even if the patient denies needing it, if there's evidence of injury or illness.

EMS calls classified as 'service call or public assist' can be entered into the Delaware Electronic Medical Reporting system as such.

An individual who is sick, injured, incapacitated, or helpless and seeks immediate medical attention is considered a patient.

ALS providers must perform a complete assessment and history of the patient. This may include information from BLS providers.

ALS providers can transfer care to BLS providers for transport without contacting medical control unless specific conditions exist, including acute changes in mental status, respiratory distress, or chest pain.

A person defined as anyone involved in health care, including physicians, nurses, social workers, law enforcement, and more.

The Department of Health and Social Services's Division of Services for Aging and Adults with Physical Disabilities is responsible for providing services to adults who need protection.

All paramedics must be proficient in these skills, which are the foundation of providing advanced medical care.

Techniques for stabilizing the spine, which help prevent further injury.

The process of securing an airway, which is essential for breathing.

Inserting a tube into the trachea to help maintain an open airway.

A central line is a type of intravenous catheter that is placed in a large vein in the chest or neck.

The administration of medications by various routes, such as intramuscular, intravenous, or nebulized.

Paramedics in Delaware are not independent providers of advanced life support services, they function as physician extenders, meaning they are allowed to perform ALS procedures only under the supervision of a physician and as part of an authorized paramedic service.

A specific set of pre-approved medical treatments that paramedics can administer to patients in an emergency situation, without having to contact medical control first. These are designed to stabilize the patient before transport to the hospital.

A medical control physician authorizes paramedics to deviate from standard protocols or procedures to deliver more specific patient care in an emergency. This is used when patients present unique needs requiring individualised treatment plans.

The off-duty paramedic is not considered a first responder and should only act as a good Samaritan, offering basic aid, unless called upon by their agency to provide specific help.

A pre-hospital advanced life support team consisting of a paramedic and other qualified medical personnel, authorized by the State Emergency Medical Service, who respond to medical emergencies and provide advanced medical care.

A period determined by the State EMS Director when all Delaware paramedic agencies must be fully operational and capable of performing all required standing orders.