Protocol 1 - Initial Medical Care PDF

GENERAL Protocol 1 INITIAL MEDICAL CARE / ROUTINE CARDIAC CARE GENERAL PATIENT ASSESSMENT Prehospital providers shall always assess the scene to assure the safety of all personnel. Patient care and tr...

GENERAL Protocol 1 INITIAL MEDICAL CARE / ROUTINE CARDIAC CARE GENERAL PATIENT ASSESSMENT Prehospital providers shall always assess the scene to assure the safety of all personnel. Patient care and treatment begins at the “bedside.” Prehospital personnel shall take all reasonable precautions to prevent exposure to blood and/or body fluids of any patient. Use fluid repellent gowns, masks and goggles as situation dictates. For pediatric dosing, utilize a length based Pediatric Tape or Chart B EMT B I EMT-I I GENERAL PATIENT ASSESSMENT P Paramedic P Initial Assessment: 1. Circulation (pulse) and hemorrhage control (if indicated) Eye opening: 2. Airway - Establish and/or maintain an airway (4 points) SPONTANEOUS (cervical spine control, if indicated) (3 points) VOICE 3. Breathing - Assist ventilation as required (2 points) PRESSURE 4. Disability (Level of Consciousness) (1 point) NONE “Alert” Best Verbal Response: “Verbal” - (responds to verbal stimuli) (5 points) ORIENTED “Pain” - (responds to painful stimuli) (4 points) CONFUSED “Unresponsive” (3 points) INAPPROPRIATE WORDS 5. Expose and examine (if indicated) (2 points) INCOMPREHENSIBLE SOUNDS Focused Assessment: (1 point) NO VERBAL RESPONSE 1. Vital signs, and where applicable, GCS parameters Best Motor Response: 2 Systematic head-to-toe detailed assessment (6 points) OBEYS SIMPLE COMMANDS 3. History of present illness/injury (5 points) LOCALIZES PRESSURE 4. Advanced Directives, if available (4 points) FLEXION WITHDRAWAL 5. Medication List, if available (3 points) ABNORMAL FLEXION (2 points) ABNORMAL EXTENSION INITIAL MEDICAL CARE/ROUTINE CARDIAC CARE (1 point) NO MOTOR RESPONSE 1. Reassure patient, provide comfort and loosen tight clothing. 2. Sit patient in semi-Fowler’s or position of comfort (if applicable). 3. Obtain Pulse Oximeter value prior to oxygen delivery. Deliver OXYGEN 2-6L by nasal cannula or 12-15L by mask, if appropriate, unless otherwise specified. 4. Evaluate cardiac rhythm, if indicated. Consider use of 12-lead (if available). All ALS patients do not necessarily require continuous ECG monitoring or transmission of a strip to the hospital. 5. I If patient’s condition warrants, obtain IV access (Saline lock or NS). Attempt x2 unless requested to P continue. 6. For adult and pediatrics ≥ 4 years old experiencing nausea, consider Zofran 4mg ODT/IV x1 dose. BLS: For adult and pediatrics ≥ 4 years old experiencing nausea, consider Zofran 4mg ODT x1 dose. 7. Contact hospital as soon as patient’s condition permits. Transmit assessment information and await orders. If no radio contact can be established or patient’s condition requires immediate treatment, refer to appropriate protocol and begin intervention immediately. 8. Recheck vitals and other pertinent signs at least every 15 minutes and record, note the times. 9. Transport to closest hospital. NOTE: By law, a physician must certify that the benefits outweigh the risk of transport to a facility other than the nearest hospital. If the patient refuses care or transport to the closest hospital, refer to policy and document signatures and situation. NOTE: In a combative or uncooperative patient, the requirement to initiate initial routine medical care, as written, may be altered or waived in favor of rapidly transporting the patient for definitive care. Document the patient's actions or behaviors which interfered with the performance of any assessments and/or interventions. Revised: 12/01/24 Effective: 05/01/98