PROTOCOL TABLE OF CONTENTS
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1 Section I Adult Treatment Protocols 1-1 Abdominal Pain Non Traumatic 1-2 Adult Trauma 1-3 Altered Mental Status 1-4 Anaphylaxis/Allergic Reaction 1-5 Burns 1-6 Cerebrovascular Accident (CVA, Stroke) 1-7 Drowning/Near Drowning/Submersion 1-8 General Pre-hospital Care 1-9 Heat Emergencies 1-10 Hypothermia/Frostbite 1-11 Nausea/Vomiting 1-12 Obstetrical Emergencies (Update 10-14) 1-13 Poisoning and Overdose (Update 10-15) 1-14 Psychiatric Emergencies 1-15 Respiratory Distress 1-16 Seizures 1-17 Sepsis 1-18 Shock 1-19 Soft Tissue & Orthopedic Injuries 1-20 Spinal Injury Assessment (Update 10-14) 1-21 Syncope 1-22 Excited Delirium (Update 10-14) Section II Adult Cardiac Protocols 2-1 Asystole/Pulseless Electrical Activity 2-2 Bradycardia 2-3 Cardiac Arrest General 2-4 Cardiac Arrest Return of Spontaneous Circulation (ROSC) 2-5 Chest Pain Acute Coronary Syndrome 2-6 Hypothermia Cardiac Arrest 2-7 Pulmonary Edema/CHF 2-8 Tachycardia 2-9 V-Fib Pulseless Ventricular Tachycardia Section III Pediatric Treatment Protocols 3-1 Pediatric Altered Mental Status 3-2 Pediatric Anaphylaxis/Allergic Reaction 3-3 Pediatric Assessment Treatment Definitions and MI MEDIC (New 10-14) 3-4 Pediatric Bronchospasm 3-5 Pediatric Burns 3-6 Pediatric Drowning / Near Drowning / Submersion 3-7 Pediatric Fever 3-8 Pediatric Nausea & Vomiting 3-9 Pediatric Newborn Assessment, Treatment and Resuscitation (Update 10-14) 3-10 Pediatric Poisoning/Overdose 3-11 Pediatric Respiratory Distress, Failure, or Arrest 3-12 Pediatric Seizures 3-13 Pediatric Shock 3-15 Pediatric Medication Emergency Dosing and Intervention Cards (New 10-14) Section IV Pediatric Cardiac Protocols 4-1 Pediatric Asystole / Pulseless Electrical Activity 4-2 Pediatric Bradycardia 4-3 Pediatric Cardiac Arrest General 4-4 Pediatric Narrow Complex Tachycardia 2015Table of Contents and Index v.1015 Page 1 of 7
2 Section IV Pediatric Cardiac Protocols (continued) 4-5 Pediatric V-Fib Pulseless Ventricular Tachycardia 4-6 Pediatric Wide Complex Tachycardia Section V Procedures Protocols Lead ECG 5-2 Abuse and Neglect (Suspected) 5-3 Adrenal Crisis 5-4 Assault and Sexual Assault 5-5 Automatic External Defibrillator (AED) 5-6 Contaminated Patient 5-7 CPAP/BiPAP Administration (Optional) 5-8 Dead on Scene 5-8(S) Dead on Scene - Supplement 5-9 Do-Not-Resuscitate 5-10 Electrical Therapy 5-11 Emergency Airway Procedure 5-12 EMS Immunization & TB Testing 5-13 Epi-Pen Procedure 5-14 Helmet Removal 5-15 Impedence threshold Device (ITD) (Optional) 5-16 Intranasal Medication Administration (Update 10-15) 5-17 Medication Shortage (Optional) 5-18 Nebulized Bronchodilators 5-19 Oxygenation Administration 5-20 Pain Management 5-21 Patient Assessment 5-22 Patient Care Record & Electronic Documentation & EMS Information 5-23 Patient Restraint 5-24 Patient Sedation 5-25 Pleural Decompression 5-26 Refusal of Care; Adult & Minor (Update 10-14) 5-27 Spinal Precautions (New 10-14) 5-28 Suspected Pandemic Influenza 5-29 Termination of Resuscitation 5-30 Tourniquet Application 5-31 Vagal Maneuvers 5-32 Vascular Access & IV Fluid Therapy 5-33 Waveform Capnography (Capnometry and Capnography) 5-34 IV Ancillary Supply Exchange 5-35 Southeast Michigan Medication Exchange and Replacement Protocol 5-36 Crush Syndrome (Update 10-14) 5-37 Epi-Pen Exchange 5-38 D50 Shortage Protocol 5-39 Narcan Administration (New 10-15) 5-40 MFR-BLS Naloxone Medication Kit-Stocking and Exchange (New 10-15) Section VI System Protocols 6-1 Cancellation/Downgrade of Call Policy 6-2 Communicable Disease 6-4 Complaint Investigation & Resolution 6-6 Disciplinary Action Appeal 6-7 Documentation Procedure 6-8 Due Process & Disciplinary Procedures 6-10 Health Insurance Portability Accountability Act (HIPAA) 6-12 Infection Control Policy 6-13 Intercept Policy 6-14 Inter-facility Patient Transfers, Critical Care Patient Transports (Optional) 6-15 Latex Sensitivity Procedure 6-16 Licensure Level Requirement of Attendant during Transport (Optional) 2015Table of Contents and Index v.1015 Page 2 of 7
3 Section VI System Protocols (continued) 6-18 Medical Control Privileges 6-24 Quality Improvement Program 6-25 Responsibilities of the Participants in the MCA System 6-26 Violent/Hazardous/Chemical Scene 6-28 Access to the HEMS Communication System 6-29 Additional Equipment and Training 6-30 Adult Trauma/Trauma Burn Transportation 6-31 Coordination of Services and Ambulance Transportation Agreement, Monroe County and Wayne County Medical Control Authorities 6-32 Emergency Facilities Limitation Policy 6-33 EMS Communications Interoperability 6-34 EMS Operations at a Crime Scene 6-35 EPCR/PCR and Transfer of Care 6-36 General Considerations 6-37 HEMS Addendum Operationalized Mass Casualty Incidents 6-38 Hospice Patient Coordination of Services 6-39 Integrated Agency/System Quality Improvement (QI) Plan 6-40 Medical Response to a Crime Scene 6-41 Nitroglycerin and Heparin Drip Interfacility Protocols 6-42 Operation of Mike/Echo Unit 6-43 Pediatric Trauma/Trauma Burn Transportation 6-44 Pre-Hospital/Emergency Department (ED) Management of Psychiatric Patients 6-45 Pre-Hospital Equipment Responsibility 6-46 Scene and Patient Management Policy 6-47 System Participation Criteria for Adult and Pediatric Trauma and Trauma Burn Facilities 6-48 System Participation Criteria for Cardiac (Interventional) Hospitals 6-49 Transport of Patients with Suspected Acute Myocardial Infarction 6-50 Transportation of Patients General Medical 6-51 Use of Helicopter Ambulance in the Field 6-52 Use of Lights and Siren Section VII CBRNE Protocols 7-1 Chemical Exposure 7-2 CHEMPACK 7-3 Cyanide Exposure 7-3(S) Cyanide Exposure Supplemental Protocol for Use of Cyanokit 7-4 General CBRNE Identification of Agents 7-5 MEDDRUN 7-6 Nerve Agent/Organophosphate Pesticide Exposure Treatment 7-8 Incidents Involving Suspicious Powders 7-9 Hazardous Material Procedure 7-10 Hazardous Materials Medical Treatment 7-11 Radiation Emergency Procedure Section VIII HazMat Team Protocols 8-1 General HAZMAT Materials Treatment 8-2 Ammonia (Liquid & Gas) 8-3 Asphyxiants - Simple 8-4 Chlorine and Related Compounds 8-5 Corrosive Agents 8-6 Cyanide Exposure 8-7 HAZMAT Eye Irrigation 8-8 Hydrocarbons and Halogenated Hydrocarbons 8-9 Hydrogen Fluoride 8-10 Hydrogen Sulfide, Sulfides and Mercaptans 8-11 Methemoglobinemia 8-12 Organophosphate Poisoning 2015Table of Contents and Index v.1015 Page 3 of 7
4 Section VIII HazMat Team Protocols (continued) 8-13 Hazardous Materials Medication Box and Exchange Procedure 8-14 Cyanokit Medication Pack Exchange Procedure and Use Replacement Form Section IX Facility and Service Participation Guidelines 9-1 EMS Agency Criteria for MCR Endorsement 9-2 EMS Agency Annual Letter of Compliance 9-3 Application for Optional 12 Lead Program Lead Supplemental Letter of Compliance 9-5 Optional Inter-Facility Critical Care Transport Application 9-6 Critical Care Supplemental Letter of Compliance 9-7 Helicopter Agency Criteria for MCR Endorsement 9-8 Helicopter Agency Annual Letter of Compliance 9-9 Emergency Medical Dispatch Provider Criteria for Endorsement 9-10 Emergency Medical Dispatch Provider Annual Letter of Compliance 9-11 Online Medical Control Hospital Criteria for MCR Endorsement 9-12 Online Medical Control Hospital Annual Letter of Compliance 9-13 Non Medical Control Care Facility Criteria for MCR Endorsement 9-14 Protocol for Designation of Non Medical Control Care Facilities 9-15 Non-Medical Control Care Facility Annual Letter of Compliance 9-16 Wayne County Hospitals & Health Care Organizations Mutual Aid Assistance Agreement and SOP 9-18 Life Support Unit Personnel Staffing Requirement Section X HEMS MCA Reference Documents Only 10-1 Hospital Emergency Department Capability Definitions 10-2 HEMS Abbreviations Guide 10-3 Electronic PCR Fax/E Mail Transmission Routes 10-4 Phone Numbers For DHS And Protective Services 10-5 DEMCA Matrix 2015Table of Contents and Index v.1015 Page 4 of 7
5 PROTOCOL INDEX Protocol Name Lead ECG Lead Supplemental Letter of Compliance 1-1 Abdominal Pain Non Traumatic 5-2 Abuse and Neglect (Suspected) 6-28 Access to the HEMS Communication System 6-29 Additional Equipment and Training 5-3 Adrenal Crisis 1-2 Adult Trauma 6-30 Adult Trauma/Trauma Burn Transportation 1-3 Altered Mental Status 8-2 Ammonia (Liquid & Gas) 1-4 Anaphylaxis/Allergic Reaction 9-3 Application for Optional 12 Lead Program 8-3 Asphyxiants - Simple 5-4 Assault and Sexual Assault 2-1 Asystole/Pulseless Electrical Activity 5-5 Automatic External Defibrillator (AED) 2-2 Bradycardia 1-5 Burns 6-1 Cancellation/Downgrade of Call Policy 2-3 Cardiac Arrest General 2-4 Cardiac Arrest Return of Spontaneous Circulation (ROSC) 1-6 Cerebrovascular Accident (CVA, Stroke) 7-1 Chemical Exposure 7-2 CHEMPACK 2-5 Chest Pain Acute Coronary Syndrome 8-4 Chlorine and Related Compounds 6-2 Communicable Disease 6-4 Complaint Investigation & Resolution 5-6 Contaminated Patient 6-31 Coordination of Services and Ambulance Transportation Agreement, Monroe County and Wayne County Medical Control Authorities 8-5 Corrosive Agents 5-7 CPAP/BiPAP Administration (Optional) 9-6 Critical Care Supplemental Letter of Compliance 5-36 Crush Syndrome (Update 10-14) 7-3 Cyanide Exposure 8-6 Cyanide Exposure 7-3(S) Cyanide Exposure Supplemental Protocol for Use of Cyanokit 8-14 Cyanokit Medication Pack Exchange Procedure and Use Replacement Form 5-38 D50 Shortage Protocol 5-8 Dead on Scene 5-8(S) Dead on Scene Supplement 10-5 DEMCA Matrix 6-6 Disciplinary Action Appeal 6-7 Documentation Procedure 5-9 Do-Not-Resuscitate 1-7 Drowning/Near Drowning/Submersion 6-8 Due Process & Disciplinary Procedures 5-10 Electrical Therapy 10-3 Electronic PCR Fax/E Mail Transmission Routes 5-11 Emergency Airway Procedure 6-32 Emergency Facilities Limitation Policy 9-10 Emergency Medical Dispatch Provider Annual Letter of Compliance 9-9 Emergency Medical Dispatch Provider Criteria for Endorsement 9-2 EMS Agency Annual Letter of Compliance 9-1 EMS Agency Criteria for MCR Endorsement 6-33 EMS Communications Interoperability 5-12 EMS Immunization & TB Testing 6-34 EMS Operations at a Crime Scene 6-35 EPCR/PCR and Transfer of Care 5-37 Epi-Pen Exchange 5-13 Epi-Pen Procedure 1-22 Excited Delirium (Update 10-14) 7-4 General CBRNE Identification of Agents 6-36 General Considerations 8-1 General HAZMAT Materials Treatment 1-8 General Pre-hospital Care 2015Table of Contents and Index v.1015 Page 5 of 7
6 PROTOCOL INDEX Protocol Name 7-9 Hazardous Material Procedure 7-10 Hazardous Materials Medical Treatment 8-13 Hazardous Materials Medication Box and Exchange Procedure 8-7 HAZMAT Eye Irrigation 6-10 Health Insurance Portability Accountability Act (HIPAA) 1-9 Heat Emergencies 9-8 Helicopter Agency Annual Letter of Compliance 9-7 Helicopter Agency Criteria for MCR Endorsement 5-14 Helmet Removal 10-2 HEMS Abbreviations Guide 6-37 HEMS Addendum Operationalized Mass Casualty Incidents 6-38 Hospice Patient Coordination of Services 10-1 Hospital Emergency Department Capability Definitions 8-8 Hydrocarbons and Halogenated Hydrocarbons 8-9 Hydrogen Fluoride 8-10 Hydrogen Sulfide, Sulfides and Mercaptans 2-6 Hypothermia Cardiac Arrest 1-10 Hypothermia/Frostbite 5-15 Impedence threshold Device (ITD) (Optional) 7-8 Incidents Involving Suspicious Powders 6-12 Infection Control Policy 6-39 Integrated Agency/System Quality Improvement (QI) Plan 6-13 Intercept Policy 6-14 Inter-facility Patient Transfers, Critical Care Patient Transports (Optional) 5-16 Intranasal Medication Administration (Update 10-15) 5-34 IV Ancillary Supply Exchange 6-15 Latex Sensitivity Procedure 6-16 Licensure Level Requirement of Attendant during Transport (Optional) 9-18 Life Support Unit Personnel Staffing Requirement 7-5 MEDDRUN 6-18 Medical Control Privileges 6-40 Medical Response to a Crime Scene 5-17 Medication Shortage (Optional) 8-11 Methemoglobinemia 5-40 MFR-BLS Naloxone Medication Kit-Stocking and Exchange (New 10-15) 5-39 Narcan Administration (New 10-15) 1-11 Nausea/Vomiting 5-18 Nebulized Bronchodilators 7-6 Nerve Agent/Organophosphate Pesticide Exposure Treatment 6-41 Nitroglycerin and Heparin Drip Interfacility Protocols 9-13 Non Medical Control Care Facility Criteria for MCR Endorsement 9-15 Non-Medical Control Care Facility Annual Letter of Compliance 1-12 Obstetrical Emergencies (Update 10-14) 9-12 Online Medical Control Hospital Annual Letter of Compliance 9-11 Online Medical Control Hospital Criteria for MCR Endorsement 6-42 Operation of Mike/Echo Unit 9-5 Optional Inter-Facility Critical Care Transport Application 8-12 Organophosphate Poisoning 5-19 Oxygenation Administration 5-20 Pain Management 5-21 Patient Assessment 5-22 Patient Care Record & Electronic Documentation & EMS Information 5-23 Patient Restraint 5-24 Patient Sedation 3-4 Pediatric Bronchospasm 3-10 Pediatric Poisoning/Overdose 3-1 Pediatric Altered Mental Status 3-2 Pediatric Anaphylaxis/Allergic Reaction 3-3 Pediatric Assessment Treatment Definitions and MI MEDIC (New 10-14) 4-1 Pediatric Asystole / Pulseless Electrical Activity 4-2 Pediatric Bradycardia 3-5 Pediatric Burns 4-3 Pediatric Cardiac Arrest General 3-6 Pediatric Drowning / Near Drowning / Submersion 3-7 Pediatric Fever 3-15 Pediatric Medication Emergency Dosing and Intervention Cards (New 10-14) 4-4 Pediatric Narrow Complex Tachycardia 3-8 Pediatric Nausea & Vomiting 2015Table of Contents and Index v.1015 Page 6 of 7
7 PROTOCOL INDEX 3-9 Pediatric Newborn Assessment, Treatment and Resuscitation (Update 10-14) 3-11 Pediatric Respiratory Distress, Failure, or Arrest Protocol Name 3-12 Pediatric Seizures 3-13 Pediatric Shock 6-43 Pediatric Trauma/Trauma Burn Transportation 4-5 Pediatric V-Fib Pulseless Ventricular Tachycardia 4-6 Pediatric Wide Complex Tachycardia 10-4 Phone Numbers For DHS And Protective Services 5-25 Pleural Decompression 1-13 Poisoning and Overdose (Update 10-15) 6-45 Pre-Hospital Equipment Responsibility 6-44 Pre-Hospital/Emergency Department (ED) Management of Psychiatric Patients 9-14 Protocol for Designation of Non Medical Control Care Facilities 1-14 Psychiatric Emergencies 2-7 Pulmonary Edema/CHF 6-24 Quality Improvement Program 7-11 Radiation Emergency Procedure 5-26 Refusal of Care; Adult & Minor (Update 10-14) 1-15 Respiratory Distress 6-25 Responsibilities of the Participants in the MCA System 6-46 Scene and Patient Management Policy 1-16 Seizures 1-17 Sepsis 1-18 Shock 1-19 Soft Tissue & Orthopedic Injuries 5-35 Southeast Michigan Medication Exchange and Replacement Protocol 1-20 Spinal Injury Assessment (Update 10-14) 5-27 Spinal Precautions (New 10-14) 5-28 Suspected Pandemic Influenza 1-21 Syncope 6-47 System Participation Criteria for Adult and Pediatric Trauma and Trauma Burn Facilities 6-48 System Participation Criteria for Cardiac (Interventional) Hospitals 2-8 Tachycardia 5-29 Termination of Resuscitation 5-30 Tourniquet Application 6-49 Transport of Patients with Suspected Acute Myocardial Infarction 6-50 Transportation of Patients General Medical 6-51 Use of Helicopter Ambulance in the Field 6-52 Use of Lights and Siren 5-31 Vagal Maneuvers 5-32 Vascular Access & IV Fluid Therapy 2-9 V-Fib Pulseless Ventricular Tachycardia 6-26 Violent/Hazardous/Chemical Scene 5-33 Waveform Capnography (Capnometry and Capnography) 9-16 Wayne County Hospitals & Health Care Organizations Mutual Aid Assistance Agreement and SOP 2015Table of Contents and Index v.1015 Page 7 of 7
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