Introduction and Use

The following document has been approved by the Old Dominion Medical Control Committee and will serve as Pre-Hospital Patient Care Protocols in the Old Dominion EMS Alliance region. These protocols are the result of nearly two years of work and review by numerous physicians, nurses and pre hospital providers from each of ODEMSA's four EMS councils: Crater, Metro Richmond, South Central and Southside. The were formulated to meet the specific and sometimes unique needs of each area -- rural to suburban to urban -- and to serve as a master plan for a standardized minimal level of patient care that can be delivered on a regional basis. Included is a section of Pediatric Patient Care Protocols, the first ever drafted in the Central Virginia region.

The authors did not intend this document to be a comprehensive patient care manual. Instead, it should be studied and reviewed periodically by hospital and pre-hospital providers who then will be better prepared to act in concert in delivering effective patient care in an actual emergency situation.

The Pre Hospital Patient Care Protocols are designed for use by providers trained to the Basic Life Support and Advanced Life Support levels. With the exception of the Pediatric section, the issue of Medical Control has been left to the discretion of local Operational Medical Directors and Emergency Department Physician Directors. In the case of Pediatrics, it was decided to initiate hospital contact at uniformly specific points within each protocol.

Each section of these protocols is labeled and is color-coded for ease of access and to reduce the possibility of error in the field. Cross-references are provided and an index is located in the back of the document. A complete set of Pre-Hospital Patient Care Protocols consists of all sections including Administrative, Clinical Procedure, Medical, Trauma, Behavioral, Environmental and Pediatric Patient Care, Communications and Medications Reference. A copy of that document should be kept in every Emergency Department, EMS agency and ambulance unit in the ODEMSA region. The document for BLS and ALS pre-hospital providers consists of all protocols printed on a reduced format for easier handling. A copy will be given to each BLS and ALS provider; additional copies will he available from ODEMSA at cost.

The Pre-Hospital Patient Care Protocols are dated by month and year. They will be reviewed annually by the Old Dominion Medical Control Committee with the assistance of hospital and pre hospital providers from throughout the ODEMSA region. When approved, changes will be made and revised pages will issued to Operational Medical Directors and Emergency Department Physician Directors who will be responsible for any necessary in-service training. Suggestions for additions and/or revisions should be submitted in writing to the Old Dominion EMS Alliance, 5902 Hampstead Ave., Richmond, VA 23226.