Initial Medical Care
Initial medical care is that care routinely provided to every patient, and that is individually listed in nearly every treatment algorithm. While only certain key elements are included in each algorithm, it is understood that every appropriate element of initial medical care is to be included in the care of the patient. Initial medical care shall include:
EMT
- Ensure scene safety
- Take appropriate Body Substance Isolation (BSI) precautions
- Initial assessment
- Stabilize cervical, thoracic, and lumbosacral spine as patient condition dictates
- Open and maintain airway
- Administer oxygen using cannula or mask, or provide ventilatory support as appropriate
- Control obvious bleeding as needed
- Position patient appropriately
- Loosen or remove clothing, as appropriate
- Initiate CPR as indicated
- Stabilize fractures and dress soft tissue injuries
- Keep patient warm in cases of shock and/or hypothermia
- Obtain history related to the event
- SAMPLE History - Signs and symptoms, Allergies, Medications, Pertinent medical history, Last oral intake, Events leading to the call
- OPQRST History – Onset, Provokes/ Palliates, Quality, Radiation, Severity, Time
- Document exceptions to survey, pertinent negatives – Vital signs (to include pulse, respirations, BP, pulse oximetry, and skin temperature)
- Repeated at least every 10 minutes for non-critical patients and every 5 minutes for critical patients critical patients
EMT
- Establish and/or maintain a patent airway (Combitube, OPA/NPA with BVM)
- Attach AED as indicated with patient condition.
- Establish vascular access with normal saline and appropriate infusion set and infuse at 30 mL/hr, unless overridden by other specific protocol.
- Administer medications as outlined in the Treatment Algorithms or as directed by on-line medical control
- Transmit required information to receiving facility; notify receiving facility of significant changes