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2011 Protocol Update

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2011 Protocol Update

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    1. 2011 Protocol Update Medical Control Authority Protocols

    2. Why the change? Standardized care Drug boxes Liability protection The universalization of EMS protocols will create an interoperability among EMS Systems. It will also help LSA’s servicing MCA border areas to operate under alike protocols, eliminating the need for the EMS providers to learn multiple sets of protocols. The universalization of EMS protocols will create an interoperability among EMS Systems. It will also help LSA’s servicing MCA border areas to operate under alike protocols, eliminating the need for the EMS providers to learn multiple sets of protocols.

    3. Timeline Development » 2008 Revisions » Spring 2010 Focus Group » August 2010 Training » March 2011 Implementation » Starting-April 4, 2011 QA/QI The implementation date is April 4, 2011. We would like to have training completed and all Life Support Agencies working under the new protocols no later than June 4, 2011. This interrim period will allow our LSA’s proper time to get familiar with the new medications and protocols. The implementation date is April 4, 2011. We would like to have training completed and all Life Support Agencies working under the new protocols no later than June 4, 2011. This interrim period will allow our LSA’s proper time to get familiar with the new medications and protocols.

    4. How does this apply to your system locally State Protocols A group of protocols that are uniformed throughout the state. These protocols are typically all of the adult/pediatric medical treatment protocols. Regional Protocols Some protocols are still Regional Protocols and can be located in the Procedure Section of the new protocol manual. For example: IV Ancillary Supply and Exchange Medication Exchange and Replacement Procedure System Protocols This group of protocols are MCA specific and were previously know as the operational section. This section will include protocols such as: Use of Lights and Sirens Equipment Policy Mutual Aid Policy Rerouting

    5. The New Protocol Manual Table of Contents (6 Sections) Section 1: Adult Treatment Section 2: Adult Cardiac Section 3: Pediatric Treatment Section 4: Pediatric Cardiac Section 5: Procedure Protocols Section 6: System Protocols

    6. Our Focus This education will concentrate on the first five sections of the protocol manual. The additional System section will be presented later this year as it becomes available. The MCA operational protocols, currently in place will remain in effect until further notice or as advised by your individual MCA.

    7. Anatomy of the New Protocols Example: Abdominal Pain The format of the new protocol is very similar to the old protocols used by the Southeast Michigan Regional Protocols group. The format of the new protocol is very similar to the old protocols used by the Southeast Michigan Regional Protocols group.

    8. Is Your Treatment Pre or Post Medical Control Contact? Many of the new protocols contain check boxes that will identify whether that specific treatment is pre-medical control order or post-medical control order. Previously this was described as pre-radio or post-radio contact. The check box in this protocol indicates that the selected pain medication(s) are pre-medical control order. Hence the medication can be given as indicated without contacting medical control. Many of the new protocols contain check boxes that will identify whether that specific treatment is pre-medical control order or post-medical control order. Previously this was described as pre-radio or post-radio contact. The check box in this protocol indicates that the selected pain medication(s) are pre-medical control order. Hence the medication can be given as indicated without contacting medical control.

    9. How can you determine which medications are selected for a specific protocol? If the medications are checked that indicates that those are the selected medication choices for your MCA. If the medications are checked that indicates that those are the selected medication choices for your MCA.

    10. If the protocol medication choice box is checked “not included” that this means that medication is not included in your treatment options for that protocol. If the protocol medication choice box is checked “not included” that this means that medication is not included in your treatment options for that protocol.

    11. Review Section 1: Adult Treatment This section covers adult treatment protocols. Some of the protocols seen here can be considered new protocols to our EMS System and should be reviewed: Non-Cardiac Chest Pain Abdominal Pain-*Can give pain meds! Hypothermia-Cardiac Arrest Psychiatric Emergencies Soft Tissue Syncope The “New” treatment protocols are newly developed protocols. However, some of these protocols may seem familiar as they may have existed in some form in the Southeast Michigan Regional Protocols. The “New” treatment protocols are newly developed protocols. However, some of these protocols may seem familiar as they may have existed in some form in the Southeast Michigan Regional Protocols.

    12. Review Section 1: Adult Treatment These protocols has significant updates and will need to be reviewed in their entirety: Anaphylaxis-*Solu-Medrol added. Obstetrical Emergencies-*Magnesium Sulfate. Poisoning/Overdose Respiratory Distress Seizures

    13. Review Section 2: Adult Cardiac These protocols has significant updates and will need to be reviewed in their entirety: Asystole Bradycardia Cardiac Arrest Chest Pain Narrow Complex Tachycardia Pulmonary Edema V-Fib Pulseless Tachycardia Wide Complex Tachycardia These are the cardiac protocols that were updated. These will require review by each EMS Provider in the EMS System. These are the cardiac protocols that were updated. These will require review by each EMS Provider in the EMS System.

    14. Review Section 3: Pediatric Treatment This section covers pediatric treatment protocols. Some of the protocols seen here can be considered new protocols to our EMS System and should be reviewed: Pediatric Assessment and Treatment Pediatric Bronchospasm Pediatric Drowning/Near Drowning/Submersion Pediatric Newborn Assessment, Treatment, and Resuscitation Pediatric Shock

    15. Review Section 3: Pediatric Treatment These protocols has significant updates and will need to be reviewed in their entirety: Pediatric Altered mental Status Pediatric Anaphylaxis Pediatric Poisoning/Overdose-*Solu-Medrol added. These are the treatment protocols that were updated and will require review by each EMS Provider in the EMS System. These are the treatment protocols that were updated and will require review by each EMS Provider in the EMS System.

    16. Review Section 4: Pediatric Cardiac These protocols has significant updates and will need to be reviewed in their entirety: Asystole Bradycardia Cardiac Arrest Narrow Complex Tachycardia V-Fib Pulseless Tachycardia Wide Complex Tachycardia These are the cardiac protocols that were updated and and have an in-depth pediatric focus. These will require review by each EMS Provider in the EMS System. These are the cardiac protocols that were updated and and have an in-depth pediatric focus. These will require review by each EMS Provider in the EMS System.

    17. Review Section 5: Procedure Protocols Updated ProcedureProtocols: CPAP/BiPap-Updated Do-Not-Resuscitate-Updated Refusal of Care-Adult and Pediatric-Updated New Procedure Protocols Electrical Therapy Emergency Airway Procedure EMS Immunization Nebulized Bronchodilators Obstructed Airway Patient Assessment Patient Sedation Physical Patient Restraint Termination of Resuscitation Tourniquet Application Vagal Maneuvers Waveform Capnography

    18. Out with the old. . .in with the new Chemical Burns Electrical Burns Thermal Burns Rules of Nines The old burn protocols have now been consolidated into one burn protocol located in both section 1 adult treatment and section 3 pediatric treatment.The old burn protocols have now been consolidated into one burn protocol located in both section 1 adult treatment and section 3 pediatric treatment.

    19. Heat Exhaustion Heat Cramps Heat Stroke Out with the old. . .in with the new The old heat related protocols have now been consolidated into one burn protocol located in section1 adult treatment.. The old heat related protocols have now been consolidated into one burn protocol located in section1 adult treatment..

    20. Out with the old. . .in with the new Frostbite/Hypothermia The old frostbite/hypothermia protocol have now been diversified into two protocols that can be located in section 1 adult treatment. The old frostbite/hypothermia protocol have now been diversified into two protocols that can be located in section 1 adult treatment.

    21. Used to Cardiogenic Shock and now is Shocked which is located in both Section 1 Adult Treatment and Section 3 Pediatric Treatment. Chest Pain/Suspected AMI is not referred to as Chest pain acute coronary syndrome and can be locate in Section 2 Adult Cardiac.Used to Cardiogenic Shock and now is Shocked which is located in both Section 1 Adult Treatment and Section 3 Pediatric Treatment. Chest Pain/Suspected AMI is not referred to as Chest pain acute coronary syndrome and can be locate in Section 2 Adult Cardiac.

    22. Is now Pediatric Respiratory Distress, Failure, or Arrest and can be found in Section 3 Pediatric Treatment.Is now Pediatric Respiratory Distress, Failure, or Arrest and can be found in Section 3 Pediatric Treatment.

    23. These are both now Abuse and Neglect and Assault/Sexual Assault and are locate in Section 5 Procedure Protocols and covers both adult and pediatric patients. These are both now Abuse and Neglect and Assault/Sexual Assault and are locate in Section 5 Procedure Protocols and covers both adult and pediatric patients.

    24. Is now Termination of Resuscitation and Dead on Scene and is located in Section 5 Procedures Protocols. Is now Termination of Resuscitation and Dead on Scene and is located in Section 5 Procedures Protocols.

    25. These two protocols are changed to CPAP/BiPAP Administration and Vascular Access and are located in Section 5 Procedure Protocols. These two protocols are changed to CPAP/BiPAP Administration and Vascular Access and are located in Section 5 Procedure Protocols.

    26. Medications (New and Review) Versed Solu-Medrol Lidocaine Magnesium Sulfate-*Review

    27. Protocol Adherence EMS protocols are NOT suggestive. Deviations from protocols are often necessary, however Medical Control Physician approval and proper documentation is required.

    28. Training is Ongoing EMS Coordinators are the foundation of continuing education for the EMS System and they will provide great resources for Protocol information and questions. It is the responsibility of each EMS Provider to be proficient and knowledgeable regarding the Protocols in the EMS System in which they provide care.

    29. Southeast Michigan EMS System The Medical Control Authority is proud to be part of a comprehensive and supreme EMS System. Thank you for your hard work and dedication to the Southeast Michigan EMS System.

    30. Oakland County Medical Control Authority Contacts Steve McGraw, DO EMS Medical Director 313-930-5481 smcgraw@comcast.net Trina Basaj, MBA System Administrator 248-975-9704 trina@ocmca.org Bonnie Kincaid, PhD Executive Director 248-975-9704 bonnie@ocmca.org www.ocmca.org

    31. Genesee County Medical Control Authority Bruce Trevithick Executive Director 810-766-8898 btrevithick@gcmedcontrol.org www.gcmca.org

    32. HEMS, Inc Thomas McKeown, M.D. EMS Medical Director 734-727-7280 tmckeow1@hfhs.org Robert Miljan Executive Director 734-727-7280 rmiljan@hems.org

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