To provide guidance for all prehospital care providers
What is the purpose of the
and emergency department physicians within the Clark
manual?
County EMS system
What is the goal of the To standardize prehospital patient care in Clark County.
manual?
Guidelines, nothing contained in these protocols shall
be constructed to expand the scope of practice of any
The protocols are licensed attendant beyond that which is identified in the
CC Emergency Medical Services Regulations and these
protocols
Nothing within these Delay rapid patient transport to a receiving facility.
protocols is meant to Patient care should be rendered while en-route
General assessment protocol must be followed in the
specific sequence noted. For all other treatment
Order of protocols
protocols, the algorithm defines the care every patient
should receive, usually in the order described.
A person who has a complaint or mechanism suggestive
of potential illness or injury
A patient is any individual
A person who has obvious evidence of illness or injury
that meets at least one of
A person identified by an informed 2nd or 3rd party
the following criteria
caller as requiring evaluation for potential illness or
injury
For patients < 18 yo, use the Pediatric Patient Destination
protocol.
Pediatric patient Pediatric treatment protocols are to be used on children
considerations who have not yet experienced puberty. Signs of puberty
include chest or underarm hair on males, and any breast
development on females.
,The protocols demonstrate Commitment to a consistent approach to quality patient
a care
Scene safety / scene size up
Nature of call / mechanism of injury
General adult assessment 1
PPE / BSI
Bring all equipment to patient's side
Level of consciousness -> unresponsive -> check pulse ->
none -> *Cardiac arrest
Airway -> signs of compromise or not protecting ->
*ventilation management
General adult assessment 2 Breathing -> inadequate or respiratory distress ->
*Respiratory distress
Circulation -> bleeding -> *General trauma
Disability -> altered or confused -> *altered mental
status/syncope
History - HPI & AMPLE
Vital signs and physical exam
Blood glucose testing as indicated
*Specific treatment protocol as indicated
*Cervical stabilization as indicated
General adult assessment 3
Comfort measures (splint, position of comfort)
Cardiac monitor as indicated
Vascular access as indicated
Oxygen therapy to keep SOP2 >94
Pain management as indicated
Radio contact for all trauma center patients, Code 3
returns, need for telemetry physician and as per
protocol
General adult assessment 4
Transport per Disposition criteria, if applicable
*Transport to closest facility for: airway emergencies
(inability to adequately ventilate)
Should only be established by radio. Telephone contact
Contact with online medical
may only be used if the call is routed via a recorded
control
phone patch through FAO at 702-382-9007
, Pediatric patients shall be In accordance with the pediatric destination protocol
transported
Patients with evidence of a In accordance with the Stroke (CVA) Protocol
stroke shall be transported
Sexual assault victims <13 yo Shall be transported to Sunrise Hospital
Sexual assault victims 13 yo Shall be transported to Sunrise or UMC
to 18 yo
Sexual assault victims >18 yo Shall be transported to UMC
For sexual assault victims Transport to the nearest appropriate facility
outside a 50 mile radius
from the above facilities
Excluding patients on a legal psychiatric hold, meeting
all of the following criteria
1. Normal vital signs
2. Did not receive any parenteral medications during
EMS transport except a single dose of analgesia and/or
an antiemetic
Waiting room criteria 3. In the judgment of the paramedic, does not require
continuous cardiac monitoring. Note: any ECG
monitoring initiated by a transferring facility may not be
discontinued by EMS personnel
4. Can maintain a sitting position without adverse impact
on their medical condition
5. Is left with a verbal report to hospital personnel
Heart rate: 60-100
Respiratory rate: 10-20
Systolic BP: 100-180
Waiting room vital signs
Diastolic BP: 60-110
Room air pulse oximetry >94%
Alert and oriented x 4
Facility is to be bypassed for all patients except patients
Internal disaster in cardiac arrest or in whom the ability to adequately
ventilate has not been established
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