Lemhi County Medical Supervision Plan Emergency Medical Service Patient Care Protocols



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REFUSAL OF CARE /CONSENT TO TREAT Under Age Patient 6.8P


IN THE EVENT OF AN EMERGENCY WHEN LIFE AND/OR HEALTH ARE ENDANGERED,

TREAT AND TRANSPORT

INDICATIONS:

Refusal of care by an unaccompanied minor

Treatment and release of an unaccompanied minor

CONTRAINDICATIONS:

Endangerment of life and/or health by withholding or delaying treatment and/or transport.


1. A minor is a person under the age of 18 who has never been married or emancipated by

legal proceeding and is currently not under the care of a parent or guardian.

2. Except in an emergency, a parent or guardian must give consent for treatment/transport

of minors. If unavailable, a competent relative representing him/herself as the appropriate

responsible person for the minor may act for a minor.

3. In the case of a self reported infectious, contagious or communicable disease a person

over the age of 14 may seek treatment without parent/guardian consent.

4. Refusal of care is valid if the parent/guardian refusing for the minor is sufficiently aware of

pertinent facts regarding the need for treatment and/or transport, the nature of the

treatment and transport and the significant risks of refusing the treatment and/or transport.

5. Consent to treat and release does not have to be in writing.

6. Refusal of treatment/transport should be documented in the area provided on the back of

the Idaho EMS Patient Care Report or run report.

7. If a parent/guardian refuses treatment or transport of a minor child whom you feel needs medical attention, contact law enforcement immediately


















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Treatment During Decontamination (continued)



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Chemical Burns – Adult

Chlorine, Phosgene

Basic Standing Orders

Routine Patient Care.

If eye contamination occurs, irrigate with saline for 10-30 minutes until symptoms resolve.

Monitor for delayed effects as symptoms (mucus membrane irritation, cough, wheezing, choking) may not appear for 6-80 hours after exposure.

Consider ALS intercept.

Intermediate Standing Orders

Obtain IV access if situation permits.



Chemical Burns – Pediatric

Chlorine, Phosgene

Basic Standing Orders

Routine Patient Care.

If eye contamination occurs, irrigate with saline for 10-30 minutes until symptoms resolve.

Monitor for delayed effects as symptoms (mucus membrane irritation, cough, wheezing, choking) may not appear for 6-80 hours after exposure.

Intermediate Standing Orders

If possible contact medical control for obtaining IV access if not under specific orders.



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In the event of Chemical incident to include: Nerve Agents, Organophosphates, Cyanide, and Arsenic

Refer to the State of Idaho’s Scope of Practice modular JUST IN TIME TRAININIG

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(State of Idaho Module Just in time training)







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(State of Idaho Module Just in time training)

Cyanide and Arsenic- Adult/Pediatric

Basic Standing Orders

Decontaminate concurrent with initial resuscitation,(if you are trained and have appropriate PPE to do so without further harm to patient or yourself).

if patient exposed to gas only and does not have skin or ocular irritation, does not need decontamination

If patient exposed to liquid, decontamination required

Routine Patient Care, after appropriate decontamination.

Pulsoximetry may be inaccurate and should be avoided.

If available and you have been trained to do so, administer amyl nitrite inhalant from cyanide antidote kit

Crush 1-2 ampules onto gauze.

Have patient inhale amyl nitrite through gauze or place gauze within facemask, over intake valve of bag-valve-mask device during assisted ventilation.

Alternate amyl nitrite every 30 seconds, with 100 percent oxygen.

Obtain IV access for administration of sodium nitrite.

Immediate transport of patient.













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MUTUAL AID

EMT of any level may call for Mutual Aid under the following circumstances:

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