Clark County

Emergency Medical Services

Operating Guidelines and Procedures Manual

Introduction

Clark County’s Emergency Medical Services providers are charged each day with providing emergent, high acuity care to the citizens of Springfield and Clark County. The Clark County Emergency Medical Services Council, in cooperation with Community Hospital and Mercy Medical Center, has adopted and amended the Regional Physician Advisory Board guidelines for an EMS protocol. The adoption of this protocol, coupled with keen medical direction and critical thinking on the part of the EMS provider, will insure each patient will receive state of the art emergency field care. As well, this protocol will allow for simpler updates in the future and a phased introduction of new skills and treatments.

Clark County Emergency Medical Services Council

Protocol Committee

1999

Erik C. Scheiderer, RN, CEN, EMT-P

Committee Chair

Mercy Medical Center

Tom Duffee, EMT-P

Department of Education

Community Hospital

Samuel Barnes, NREMT-P

EMS Council President

Roberta Fife, RN, NREMT-P

EMS Liason

Community Hospital

Tim Wendling, NREMT-P

Chief, Enon EMS

Don Swabey, NREMT-P

Paramedic Instructor/Coordinator

Clark State Community College

Pam Brubaker, NREMT-P

Med-Trans/New Carlisle Fire & EMS

Teresa Brennan, NREMT-P

Moorefield Fire & EMS

Kent Spitler, RN, NREMT-P

Past Instructor/Coordinator

Clark State Community College

I. ADULT PROTOCOL

Abdominal Pain 1

Altered Level of Consciousness 4

Arrhythmias 7

Bradycardia 11

Stable Tachycardia 12

Unstable Tachycardia 13

Unstable Atrial Tachycardia 14

Burns 15

Cardiac Arrest 19

V-Fib/Pulseless V-Tach 24

Asytole/PEA 25

Near Drowning 27

Cardiac Chest Pain 28

Childbirth/Obstetrical Emergencies 31

Delivery Complications 34

Obstetrical Emergencies 36

Diabetic Emergencies 37

Eye Injuries 39

Hypothermia/Frostbite 41

Extreme Heat 45

Poisoning 48

Psychiatric Emergencies 51

Respiratory Distress 52

Seizures 60

Shock 62

Stroke 66

Trauma Emergencies 69

Trauma Arrest 76

Glasgow Coma Scale 78

Revised Trauma Score 78

ADMINISTRATIVE PROTOCOLS

Aeromedical Transport 1

Communications 2

Dead On Arrival 3

Patient Refusal 7

Non-Transport 12

Heavy Patients 14

On-Scene EMT Intervener 15

Physician At The Scene 16

Restraint Policy 17

Interfacility Transport 18

Termination Of Resuscitation Efforts 19

III. SPECIAL PROCEDURES

Chest Decompression 1

Cricothyrotomy -- Needle/Surgical 3

Endotracheal Intubation 6

Nasotracheal Intubation 7

External Pacemaker 12

IV Procedures 13

Interosseous Infusion 16

Pneumatic Anti-Shock Garment 18

Nitronox 20

Pulse Oximetry 22

Patient Assessment 26

IV. MEDICATION APPENDIX: REFERENCE DOCUMENT

Pharmacology Review 2

Adenosine (Adenocard) 6

Aspirin 7

Atropine Sulfate 8

Bretylium Tosylate (Bretylol) 10

25% Dextrose (D25) 11

50% Dextrose (D50) 12

Diazepam (Valium) 13

Diphenhydramine HCI (Benedryl) 14

Dopamine (Intropin) 15

Epinephrine (Adrenaline) 16

Furosemide (Lasix) 18

Glucagon 19

Lidocaine (Xylocaine) 2% 20

Midazolam (Versed) 21

Morphine Sulfate 22

Naloxone (Narcan) 23

Nitroglycerin 25

Nitrous Oxide 26

Oxygen……………………………………………………………………………………………………….27

Phenergan 28

Proventil/Ventolin (Albuterol) 29

Sodium Bicarbonate 30

Tetracaine (Pontocaine, Ophthalmic) 32

CLARK COUNTY

EMERGENCY MEDICAL SERVICES COUNCIL

PREHOSPITAL PATIENT CARE GUIDELINES AND PROCEDURES

All algorithms are color coded to denote procedures which may be performed by each level of certification. To perform procedure color coded red, Medical Control must be contacted for permission.

Higher levels of certification will perform lower level evaluations and procedures when interpreting the algorithms.

KEY TO ALGORITHMS

EMT-BASIC (B) EMT-INTERMEDIATE (I)

EMT PARAMEDIC (P)