EMS Providers

Introduction

The use or possession of the protocol book does not exempt field personnel from the responsibility to know the information in the San Mateo Policy and Procedures Manual. This Protocol book does not replace the Policy and Procedures Manual and is provided as a tool for their reference.

Routine Medical Care

A group of standard assessments and treatments, including but not limited to airway, breathing and circulation, and the use of routine monitoring devices. See Routine Medical Care (G01) under General Care.

Care Outside of Protocol Guidelines

No set of protocols can cover all patient problems. We encourage the use of Base Physician contact in such events.

Universal Precautions

Disease agents may be present in any body substance or fluid, and the presence of disease agents may or may not be known. Clinically healthy individuals may carry and be capable of transmitting these agents. Precautions with all patients shall include routine use of appropriate barrier precautions to prevent skin and mucous-membrane exposure when contact with blood or other body fluids is anticipated. Refer to Routine Medical Care (G01) for more information. 

Prehospital personnel who are exposed to potentially infectious materials should immediately follow the reporting procedures set up by their agency. 

Hospital emergency departments have specific requirements for managing exposure to body substances experienced by prehospital care personnel. Emergency departments are expected to actively assist prehospital personnel in evaluating risk and recommending and/or providing appropriate prophylactic care when needed. Emergency responders are expected to identify the source patient to the hospital, and to comply with emergency department procedures (e.g. Royce log) when reporting potential exposure to infectious materials.

Prophylactic care recommendations for health care workers are found in the CDC May 23, 2018 updated U.S. Public Health Service guidelines for the Management of Occupational Exposures to HIV and Recommendation for Post Exposure Prophylaxis. Emergency departments are expected to follow these guidelines when managing prehospital exposure to potentially infectious substances.

• Bibliography of Standard Texts   Rev 1/2009
• Pediatric Definitions  Rev 1/2009
• Abbreviation List  Rev 1/2009

General Care

• G00 - Guide to Protocol Utilization
• G01 - Routine Medical Care
• G02 - End of Life Care
• G03 - Ventricular Assist Devices
• G04 - MCI Triage

Adult Care

• CA01 - Cardiac Arrest
• CA02 - Asystole and PEA
• CA03 - V-Fib and Pulseless V-Tach
• CA03T - Refractory V-Tach/Pulseless V- Fib Mills-Peninsula Pilot
• CA04 - Post Resuscitation
• CA05 - Obvious Death

• CD01 - Symptomatic Bradycardia
• CD02 - Narrow Complex Tachycardia
• CD03 - Wide Complex Tachycardia

• Abdominal Pain
• Allergic Reactions
• Altered Mental Status/Seizure
• Bites and Stings
• Burns
• Chest Pain: Suspected Acute Coronary Syndrome
• Decompression Illness
• Hyperthermia
• Hypothermia
• Nausea and Vomiting
• Near Drowning
• Obstetrical Emergencies/Childbirth
• Interim Pain Assessment & Management
• Poisoning and Overdose
• Respiratory Distress
• Snake Bites
• Stroke
• Trauma Evaluation and Management

Pediatric Care

• Allergic Reaction
• Altered Mental Status
• Apparent Life Threatening Events (ALTE)
• Burns
• Cardiac Arrest: Asystole
• Cardiac Arrest: Ventricular Fibrillation/Pulseless Ventricular Tachycardia
• Cardiac Arrest: Overview
• Dysrhythmias: Bradycardia
• Dysrhythmias: Tachycardia
• Interim Pain Assessment & Management
• Nausea and Vomiting
• Neonatal Resuscitation
• Patient Assessment/Routine Medical Care
• Poisoning and Overdose
• Respiratory Distress
• Seizures
• Shock
• Trauma Evaluation and Management

Drug Lists

• Adult Drug List Rev 3/1/2019
• Pediatric Drug List Rev 3/2018
• Pediatric Drug List (old)*

*For temporary reference: morphine sulfate dosage for pediatric pediatric patients. See 6/12 memo to Prehospital Care Providers re: Interim Pain Policies.