Questions and Answers
What are the four things a provider must do if there is a protocol variation?
What must the EMS Quality Assurance Officer do within 5 days of a protocol variation?
EMS providers that need guidance from the poison control center should ensure that what is in place?
What must you do if there is any act or failure to act that is inconsistent with established protocol?
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Which protocol requires immediate notification to the State EMS medical director upon an incident?
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What are the four ways to assess a patient's mental status?
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When is hyperventilation indicated for head-injured patients?
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What are the rates of hyperventilation for adults, children, and infants?
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At what rate should all priority 2 patients experiencing cardiovascular, respiratory, or neurological compromise receive oxygen?
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What should patients less than 1 year of age with poor perfusion and pulse < 60 bpm or absent pulse do?
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Study Notes
Protocol Variation Response
- If a protocol variation occurs, notify the consulting physician immediately upon discovery of the error.
- Monitor the patient closely for any changes in their condition after a protocol deviation.
- Notify the receiving physician upon patient arrival to ensure continuity of care.
- Inform the local EMS jurisdiction or licensed commercial service and medical director within 24 hours of the incident.
EMS Quality Assurance Protocol
- An EMS Quality Assurance officer must submit written notification to relevant authorities within 5 days of a protocol variation.
- Within 14 days, a medical review committee QA investigation must be initiated for oversight.
- Results of the review should be forwarded to MIEMSS compliance office and state EMS medical director within 30 days.
Poison Control Center Guidance
- EMS providers seeking assistance from the poison control center must ensure that an approved base station is available for medical consultation.
Reporting Inconsistencies in Care
- Any act or omission in patient care that deviates from established protocol requires immediate notification of the supervisor and local medical director within 24 hours.
Extraordinary Care Reporting
- Protocols for Physician Orders for extraordinary care not covered by Maryland Protocol mandates immediate notification to the State EMS medical director via syscom regarding any incidents.
Mental Status Assessment
- Assess a patient's mental status using four levels: Alert, Verbal response, Painful stimuli response, and Unresponsive.
Hyperventilation in Head Injuries
- Hyperventilation is indicated in head-injured patients when signs of herniation are present, including unequal pupils, posturing, or paralysis, and especially when there is a rapidly decreasing GCS or upon online medical consultation.
Hyperventilation Rates
- The recommended rates of hyperventilation are 20 breaths per minute for adults, 30 breaths per minute for children, and 35 breaths per minute for infants.
Oxygen Administration for Priority 2 Patients
- All priority 2 patients showing cardiovascular, respiratory, or neurological compromise should receive oxygen at a rate of 12-15 liters per minute via a nonrebreather mask, which also includes COPD patients.
Ventilation for Infants
- Infants under 1 year of age with poor perfusion and pulse rates below 60 bpm or absent pulse should be ventilated for 30 seconds, pending pulse evaluation.
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Description
Test your knowledge on the essential Maryland Medical Protocols with these informative flashcards. Each card covers critical steps providers must follow regarding protocol variations and the responsibilities of EMS quality assurance officers. Perfect for medical professionals looking to reinforce their understanding of protocols.