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 and Paramedic
- Ensure scene safety and take appropriate Body Substance Isolation (BSI) precautions
- Initial assessment
- Spinal Motion Restriction as patient condition dictates
- Open and maintain airway. Administer oxygen / provide ventilatory support as appropriate
- Control obvious bleeding as needed
- If suspected abuse or neglect, notify law enforcement, Child Protective Services (CPS), or Adult Protective Services (APS), as appropriate.
- Initiate CPR as indicated
- Treat fractures and soft tissue injuries
- Perform cardiac monitoring /12 lead, as appropriate. Provide a copy when transferring care.
- Obtain history related to the event
- Vital signs (to include pulse, respirations, BP, pulse oximetry, ETCO2 (if available), and skin temperature
- Repeated as needed, based upon patient severity.
Paramedic Only
- Establish and/or maintain a patent airway
- If nasotracheal intubation is necessary, administer 2-3 sprays of NeoSynephrine as needed.
- Establish vascular access. For life threatening situations, IO is preferred. Any IV medication may be administered IO.
- Consider placing a gastric tube when the patient has been ventilated > 2 minutes