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SANTA CLARA LOCAL SYSTEMS ORIENTATION EXAM
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SANTA CLARA LOCAL SYSTEMS ORIENTATION EXAM
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SANTA CLARA LOCAL SYSTEMS ORIENTATION EXAMIn addition to any specific criteria for withholding or discontinuing resuscitation
contained within individual treatment protocols, resusitative efforts may be withheld,
discontinued, and/or death determined under the following circumstances (BLS) -
Answers- 1. Five signs of immediate DOA
2. A pulseless and/or apneic patient with a valid DNR
3. A pulseless and/or apneic patiend who has exercised his/her right to die under the
end of life option.
if criteria met EMS will discontinue resuscitate effort, cancel prehospital personnel in
route, provide appropriate care to bystanders, and complete PCR documentation about
actions taken and reason for pronounced death.
physical involvement of a physician at the scene. - Answers- patient must give consent.
then care may be relinqueshed to the physician who will remain responsible for care
until another MD takes over. physician may manage care, but ultimately accepts
responsibility for patient. must accompany crew and patient in ambulance.
documentation when physician at scene (5 things) - Answers- 1. physician name
2. CA medical license #
3. business phone #
4. level of patient care involvement
5. all procedures and treatments performed at the scene.
valid forms of identification for a physician on scene - Answers- valid CA physicians
medical license
other ID that indicates physician CA medical license # and business address
patient destinations: patient choice - Answers- patient may betransported to requested
facility as long as facility meets medical requirements, barring any EMS surge and
hospital diversion.
patient destination: routine patient destination - Answers- patients may be transported
to routine emergency department UNLESS patient meets criteria that requires specialty
care.
SCCO Specialties Trauma facilities - Answers- Trauma: Regional MC, Stanford, Santa
Clara Valley MC
SCCO Specialties Psyciatric: - Answers- psyciatric: El Camino MV, Santa Clara Valley
MC EPS, PA VA hospital, Stanford.
SCCO Specialties Burn - Answers- Santa Clara Valley Medical Center
, SCCO Specialties Stroke - Answers- Comprehensive: El Camino MV, Good Samaritan,
Regional Medical center SJ
Primary: All hospitals except PA VA hospital
SCCO Specialties STEMI - Answers- All hospitals except st. louise regionaal, PA VA, El
Camino LG
Special circumstances: EMS surges/ MCI incidents - Answers- -All destinations will be
assigned by county communications
- may be transported to out of county hospital, or mobile field hospitals with approval.
Diversion - Answers- -Only one hospital may be on ambulance diversion (red) at any
given time in a diversion zone
-May divert for 90 minutes per occurence, but must allow for another 90 minutes before
next diversion.
Diversion zones North - Answers- North: Stanford hospital, El Camino Hospital MV,
Kaiser SC
Diversion centers Central - Answers- Central: Regional MC SJ, Santa Clara Valley MC,
O'Connor
Diversion centers Southern - Answers- Southern: Good Samaritan Hospital, Kaiser SJ,
St. Louise.
Acceptable DNR documents - Answers- 1. POLST (physician order for life sustaining
treatment stating no CPR)
2. EMSA and CMA approved EMS, prehospital DNR form
3. CA approved DNR medallion
4. Durable Power of Attorney for Health Care (DPAHC)
What to do if proper DNR document(s) present - Answers- If EMS personnel arrive and
patient is pulseless and apneic:
-Establish DNR/advanced directives/code status
-may withhold resuscitative effort if valid DNR form stating DNR.
- if no forms continue resusitative efforts until they are provided
if patient (with a valid DNR form) is conscious and states he/she wants resusitative
efforts... - Answers- ...DNR form is ignored (document request)
if unfamiliar DNR form is presented... - Answers- ....continue resuscitative efforts until
proper form provided.
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