EMS protocols all paramedics should follow


In discussing EMS protocols that paramedics should follow, we first need to distinguish what this term means. They are the recognized operating procedures that all emergency medical service workers such as paramedics and EMTs (Emergency Medical Technicians) must follow for patient treatment, transportation and delivery.

EMS protocols are designed by national, state and local medical authorities and institutions. They are reviewed on an annual basis and revised according to necessity. When protocols are revised, updated and amended, they are published and distributed to all emergency medical services within their jurisdiction. It is the responsibility of the EMS departments to train all of their workers on the revised protocols. EMS workers also must attend trainings yearly to familiarize themselves with the latest protocols.

The purpose of EMS protocols is to standardize medical procedures for all emergency medical services and thus provide the highest level of care for patients. They also help provide a framework to help EMTs make decisions when operating in crisis situations. All EMTs operating in the jurisdiction must follow the protocols or face disciplinary action. The exception to this is if an EMT calls in online medical direction, which is assistance from a higher medical authority, such as a physician or the EMS worker’s medical director. Often this happens is in the case of medication consultation or extreme rescue situations that are outside the normal scope of EMT operations. In this case, standard protocol can be overridden by the online medical direction.

Here are the EMS protocols that every paramedic should follow:

  1. Obtaining a patient’s history is secondary to their treatment. Any life-threatening problems must be assessed and treated prior to obtaining medical history and other patient information.
  2. Trauma induced cardiac arrest is not to be treated with standard medical cardiac arrest protocols. Trauma patients should be transported promptly with the proper CPR procedures, as well as external hemorrhage control, cervical spine immobilization, and other indicated procedures attempted en route to the hospital.
  3. Paramedics should only attempt two IV insertions in patients with non-life-threatening conditions who require such treatment. Any additional IV attempts must be approved by medical control or other higher authority.
  4. Patient transport and other needed treatments receive priority and shouldn’t be delayed for multiple attempts at endotracheal intubation.
  5. When receiving online medical direction, paramedics must verbally repeat all orders received before they initiate them.
  6. Any patient who is experiencing chest pain, unstable blood pressure, irregular pulse, dyspnea or a history of cardiac dysfunction, should be placed on a cardiac monitor.
  7. If the patient's condition doesn’t conform to standard protocol, the paramedic should always contact medical control for instruction.

By following EMS protocols, a paramedic is ensured that they’re performing their duties to the best of their ability within the parameters of recognized standards.

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