CoSD EMS 2022-2023 Treatment Protocol Packet PDF

TREATMENT PROTOCOL S-100 TREATMENT PROTOCOL INTRODUCTION Date: 7/1/2021 Page 1 of 1 The following protocols define basic life support (BLS) an...

TREATMENT PROTOCOL S-100 TREATMENT PROTOCOL INTRODUCTION Date: 7/1/2021 Page 1 of 1 The following protocols define basic life support (BLS) and advanced life support (ALS) treatment and disposition standards for San Diego County. 1. Treatments are listed in sequential order for each condition. See Skills List (S-104) for skills criteria. 2. All treatments may be performed by the EMT (Emergency Medical Technician), AEMT (Advanced Emergency Medical Technician), and/or Paramedic via standing orders (SO) except for those stating, “Base Hospital Order (BHO)” or “Base Hospital Physician Order (BHPO)” or a variation from standard County of San Diego ALS protocols as ordered by the Base Hospital Physician (P-408). All treatments requiring an order are at the discretion of the Base Hospital providing medical direction. EMTs, AEMTs, and Paramedics are authorized to implement standing orders without Base Hospital contact. Standing orders may be continued even after Base Hospital contact unless the Base Hospital directs otherwise. 3. EMT skills which took effect July 1, 2017 (including finger-stick blood glucose testing, intranasal naloxone administration, and epinephrine auto-injector assistance) may only be performed when a provider is on- duty operating as part of the organized EMS system, and in the prehospital setting including during interfacility transports. 4. Per Title 22, Chapter 1.5, § 100019, public safety personnel may administer intranasal naloxone when authorized by the County of San Diego EMS Medical Director. 5. BHPO: Mobile Intensive Care Nurses (MICNs) may relay BHPOs. See Physician on Scene (P-403) for situations with a physician on scene. 6. Abbreviations and definition of terms can be found in the Glossary of Terms (S-101) and List of Abbreviations (S-102). 7. All medications ordered are to be administered per protocols unless there is a contraindication, such as an allergy. 8. If there is a change in patient condition, a different protocol may be applied. 9. Personal protective equipment (PPE) must be used on all patient contacts per Guidelines for the Prevention of Transmission of Contagions and Contaminants (S-009). DISCLAIMER: PRINTED COPIES ARE FOR REFERENCE ONLY. PLEASE REFER TO THE ELECTRONIC COPY FOR THE LATEST VERSION.  TREATMENT PROTOCOL S-101 GLOSSARY OF TERMS Date: 10/18/2021 Page 1 of 2 BE FAST - Prehospital Stroke Scale in assessment of possible TIA or stroke patients B = Balance: Unsteadiness, ataxia E = Eyes: Blurred/double or loss of vision, asymmetric pupils F = Face: Unilateral face droop A = Arms and/or legs: Unilateral weakness exhibited by a drift or drop, numbness/tingling S = Speech: Slurred, inability to find words, absent T = Time: Accurate Last Known Well time Brief, Resolved, Unexplained Event (BRUE): An episode involving an infant younger than 12 months where an observer reports a sudden, brief, yet resolved episode of one or more of the following: 1) Absent, decreased, or irregular breathing 2) Color change (cyanosis or pallor) 3) Marked change in muscle tone (hypertonia or hypotonia) 4) Altered level of responsiveness Definitive Therapy: Immediate or anticipated immediate need for administration of a fluid bolus or medications. End-Tidal CO2 (EtCO2) (quantitative capnography): Quantitative capnometer to continuously monitor end-tidal CO2 is mandatory for use in the intubated patient. See Skills List (S-104) for exceptions. LEADSD: Acronym for the steps to be performed in the assessment and documentation of endotracheal intubation attempts: 1. Lung Sounds 2. End-Tidal CO2 Detection Device 3. Absence of Abdominal Sounds 4. Depth 5. Size 6. Documentation Nebulizer: O2-powered delivery system for administration of normal saline or medications. Opioid: Any derivative, natural or synthetic, of opium, morphine or any substance that has effects on opioid receptors (e.g., analgesia, somnolence, respiratory depression). Opioid-Dependent Pain Management Patient: An individual who is taking prescribed opioids for chronic pain management, particularly those with opioid infusion devices. Opioid Overdose (Symptomatic): Decreased level of consciousness and/or respiratory depression (e.g., respiratory rate of