Palm Beach County Fire Rescue SOG 500-01 PDF

Palm Beach County Fire Rescue Standard Operating Guideline SOG 500-01 Determining if a Patient Exists Issue Date: 1...

Palm Beach County Fire Rescue Standard Operating Guideline SOG 500-01 Determining if a Patient Exists Issue Date: 12/21/2020 Effective Date: 1/18/2021 PURPOSE: The purpose of this standard operating guideline is to provide guidelines to determine if a patient exists. AUTHORITY:  Fire Rescue Administrator  Medical Director, Palm Beach County Fire Rescue SCOPE: This standard operating guideline shall apply to all Fire Rescue Personnel. These guidelines provide a basic framework to assist Fire Rescue personnel with determining if a patient exists when making contact with citizens. PROCEDURE: 1. General a. Document all incidents according to policy PPM FR-M-201 Incident Reporting. b. If there is any doubt as to whether a citizen is a patient, it shall be assumed the citizen is a patient. c. If a citizen is determined to be a patient, they shall receive a full assessment. For any patient who refuses an assessment, refer to SOG 520-03 Patient Refusal. 2. Contact with a Citizen a. Fire Rescue personnel encounter citizens in a variety of settings that may or may not be related to an incident. Citizens who are station walk-ins, blood pressure checks, etc…, may become patients at any time. b. Fire Rescue personnel, shall use the following criteria to assist in determining if a patient exists: i. Any citizen with whom Fire Rescue personnel make contact that has a medical complaint, obvious injury, or appears to be in possible distress at any time, is a patient. ii. Anything indicative or suggestive of acute illness or injury about a citizen’s assessment makes them a patient (e.g., recent history, mechanism-of-injury, or general appearance). SOG 500-01 Determining if a Patient Exists Page 1 of 3  iii. Specific citizens who we are called upon to assess, and are determined to lack capacity are patients. 1. Capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). 2. This is where professional judgment is necessary. Walking through a crowded bar while on duty, with multiple intoxicated citizens who could all be deemed to lack capacity, is not a Mass Casualty Incident. 3. Refusals a. Refer to SOG 520-03 Patient Refusal for all patient refusals. 4. Specific Incidents a. Minors i. Refer to SOG 520-03 Patient Refusal for all minors. b. Motor Vehicle Collisions i. Fire Rescue personnel often arrive on motor vehicle collisions (MVC’s) to find occupants who have no complaints and show no outward signs of injury. Anything that elevates Fire Rescue personnel’s index-of-suspicion for an injury based on the mechanism-of-injury deems that citizen a patient. All of the following situations listed below require a full patient assessment as outlined in the PBCFR Patient Care Protocols. Refer to SOG 520-03 Patient Refusal to determine if a PBCFR Patient Refusal Form is required. 1. Greater than minor damage noted to the vehicle 2. No restraint use 3. Airbag deployment 4. Steering wheel damage noted 5. Other occupants have complaints, injuries, or deaths 6. The appearance, behavior, or emotional state of the occupant is not normal c. Citizens Found On The Ground i. Any citizen found on the ground: 1. Unable to get up without assistance, is a patient. 2. That is able to get up on their own, is denying complaint, has no obvious injury, shall be assessed for capacity. If this citizen does not have capacity, they are a patient. 3. That is able to get up on their own, is denying complaint, has no obvious injury, shall be assessed for capacity. If this citizen does have capacity, they are not a patient. d. Request for Help from One Location to Another i. Crews shall determine if the individual’s reason for their inability to ambulate is new (acute) or old (chronic). 1. If acute, the citizen shall be classified as a patient. SOG 500-01 Determining if a Patient Exists Page 2 of 3  2. If chronic, the crew may document this patient as Public Assist. The crew should inquire about the need for ongoing assistance. Based upon the need for ongoing assistance, the crew can create an MIH referral. a. Refer to SOG 510-01 Public Assist Supersession History 1. SOG #2370, issued 08/01/2015 2. SOG 500-01, clerical 05/01/2018 3. SOG 500-01, issued 05/21/2018 4. SOG 500-01, issued 12/21/2020 SOG 500-01 Determining if a Patient Exists Page 3 of 3