Escambia County Emergency Medical Services
The purpose of these protocols, procedures, and policies here in are to provide uniform standards of care for the treatment of pre-hospital patients. While they cannot replace sound clinical judgment, or on-line medical control, they facilitate rapid and effective treatment. They also serve to standardize management actions so that, pre-hospital provider will know how to proceed in a given patient presentation. They also provide an unambiguous gage by which adherence to EMS practice standards may be measured.
Medical control encompasses both on-line and off-line aspects. Direct medical control is the on-line guidance provided by designated Emergency Department Physicians to pre-hospital providers during emergency calls. Off-line medical control consists the agency's Medical Director providing administrative assistance with the development of patient care protocols, training programs, and quality assurance measures within the agency. The off-line medical control is also available for on-line consultations should the need arise. In deciding which interventions should be dictated by on-line verses off-line medical direction, the EMS provider should consider how taking time to contact on-line medical control may have a detrimental effect on patient outcome. These considerations should include but not be limited to:
- Establishment of patient airway and the treatment of respiratory distress of failure.
- Defibrillation or cardioversion during cardiopulmonary failure of arrest
- Treatment of shock.
- Treatment of seizures.
- Treatment of anaphylaxis.
The EMS provider is encouraged to contact the on-line medical control as soon as possible for any patients requiring ALS procedures, urgent or emergent transport, or any unusual patient presentations.
Charles Lee Neal D.O. F.A.C.E.P.
Medical Director
Escambia County EMS/Fire
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