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EMS SYSTEM GUIDELINES PART II:
IMPLEMENTATION RESOURCE
March 1994
EMSA #102
Prepared by:
Richard A. Narad, DPA
California State University, Chico
Northern California EMS, Inc.
Laura J. Venegas
EMS Systems Planner
California EMS Authority
Maureen McNeil
Chief, EMS Division
California EMS Authority
Support Staff
California EMS Authority
~
Joseph E. Morales, M.D., MPA
Director
California EMS Authority
Sandra R. Smoley, R.N.
Secretary
Health and Welfare Agency
Pete Wilson
Governor
EMERGENCY MEDICAL SERVICES SYSTEM GUIDELINES
EMS Planning Guidelines
Table of Contents
INTRODUCTION
1. DIVISION 2.5 UPDATE
2. EMSA INTERPRETATIONS OF DIVISION 2.5 & REGULATIONS
3. RESOURCES LIST BY SUBJECT
System Organization & Management
Staffing/Training
Communications
4. EMS AUTHORITY PUBLICATIONS
5. SUMMARIES OF NON-EMSA MATERIALS
EMS Implementation Resource Information Submittal Form
INTRODUCTION
Purpose
Part II of the Emergency Medical Services System Guidelines--Implementation Resource, is
intended to assist local Emergency Medical Services (EMS) agencies in planning and
implementing their systems. It expands on Part I by providing additional information and
examples of the items listed in the basic System Guidelines.
Contents
The Implementation Resource includes information on the following:
- The annual update of Division 2.5 of the Health and Safety Code.
- Summaries of EMS Authority interpretations of Division 2.5 and the EMS regulations. These are organized by subject area.
- Areas for additional information, including but not limited to EMS Authority publications and materials submitted by local EMS agencies. These are organized by subject area.
- Summaries of EMS Authority publications.
- Summaries of non-EMS Authority materials, including information on their availability.
Process for Updating
The EMS Implementation Resource is viewed as a living document which must be constantly
updated. To this end, the EMS Authority plans an annual update which will include new and
replacement materials. Local EMS agencies are encouraged to submit new materials which they
believe will be useful for other agencies. Use the EMS Implementation Resource Information
Submittal Form for submitting updates and new material, located at the end of this document.
Special project grantees will be required to include materials for the Implementation Resource
describing any products developed under the grants.
How to Obtain Copies
To obtain copies of listed resource materials in Part 4 (EMS Authority Publications) and those
documents in Part 3 (Cross-References of Resources with a reference number beginning with
"EMSA", contact the EMS Authority.
For copies of all other resource materials in Part 3 and all documents in Part 5 (Summaries of
Non-EMSA Materials) contact the local EMS agency identified on the "Source" line.
1. DIVISION 2.5 UPDATE
A compilation of the statutes of Division 2.5 of the Health and Safety Code (the EMS Statutes) is
updated annually and mailed to local EMS agencies. Others may obtain a copy by writing the
EMS Authority at:
Emergency Medical Services Authority
1930 9th Street, Suite 100
Sacramento, CA 95814
Regulations are found in Division 9 of Title 22 of the California Code of Regulations. Division
9. Prehospital Emergency Medical Services, includes the following chapters:
| Chapter 1. | Emergency Medical Services Authority and Commission on Emergency Medical Services - Conflict of Interest Code |
| Chapter 1.2 | First Aid Testing for School-Bus Drivers |
| Chapter 1.5 | First Aid Standards for Public Safety Personnel |
| Chapter 1.8 | Training Standards for Use of the Automated External Defibrillator by Non-Licensed or Non-Certified Personnel |
| Chapter 2. | Emergency Medical Technician-I |
| Chapter 3. | Emergency Medical Technician-II |
| Chapter 4. | Emergency Medical Technician-P |
| Chapter 6. | Emergency Medical Services Personnel Certification Review Process Guidelines |
| Chapter 7. | Trauma Care Systems |
| Chapter 8. | Prehospital EMS Aircraft Regulations |
| Chapter 9. | Poison Control Center Regulations |
Copies of the Regulations may be obtained through Barclays by writing to:
Barclays Law Publishers
P.O. Box 3066
South San Francisco, CA 94083-3066
To order by telephone call (415) 244-6611. Barclays charges for copies of regulations. Inquire
for the current price.
2. EMSA INTERPRETATIONS OF DIVISION 2.5 AND REGULATIONS
Policy decisions regarding interpretations of Health and Safety Code Division 2.5 and Division 9,
Title 22 Regulations are mailed to local EMS agencies as they become available. Others
interested in viewing these interpretations should contact their local EMS agency.
3. RESOURCES LIST BY SUBJECT
This section identifies specific documents which may be helpful to local EMS agencies in
planning, implementing, and managing their systems. The items are sorted according to
applicable sections of the California EMS System Standards and Guidelines.
A reference number is shown for each item. Documents with an "EMSA #" were issued by the
EMS Authority (EMSA) and are described in Section 4. Copies of these documents may be
obtained by contacting the EMS Authority. Other documents are referenced by the year in which
they were submitted to the Implementation Resource and are described sequentially in Section 5.
These other documents may be obtained by contacting the local EMS agency identified on the
"Source" line.
SYSTEM ORGANIZATION AND MANAGEMENT
Agency Administration
| Title: | Agreement designating Northern California Emergency Medical Services, Inc. as the "Local EMS Agency" and authorizing powers pursuant thereto |
| Source: | Northern California EMS |
| Date: | June 1991 |
| Ref. No. | 93-1 |
Planning Activities
| Title: | Los Angeles County Trauma Systems: Blue Ribbon Advisory Committee Final Report |
| Source: | Los Angeles County EMS |
| Date: | August 1990 |
| Ref. No. | 93-26 |
Regulatory Activities
| Title: | Provider agreements for EMT-ID, FR-D, EMT-II, and EMT-P |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-2 |
| |
| Title: | Base hospital/Alternative base hospital contracts |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-3 |
| |
| Title: | Trauma system RFP |
| Source: | Northern California EMS |
| Date: | February 1990 |
| Ref. No. | 93-5 |
| |
| Title: | Trauma Plan |
| Source: | Northern California EMS |
| Date: | November 1989 |
| Ref. No. | 93-7 |
| |
| Title: | Certificate review process |
| Source: | Northern California EMS |
| Date: | August 1991 |
| Ref. No. | 93-10 |
| |
| Title: | RAP--Emergency Ambulance Service |
| Source: | San Mateo County EMS |
| Date: | March 1990 |
| Ref. No. | 93-13 |
| |
| Title: | Emergency Ambulance Contract |
| Source: | San Mateo County EMS |
| Date: | January 1992 |
| Ref. No. | 93-14 |
| |
| Title: | Trauma center contract |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-18 |
| |
| Title: | Trauma center standards for Level I |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-19 |
| |
| Title: | Trauma center standards for Level II |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-20 |
| |
| Title: | Trauma center standards for pediatric |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-21 |
| |
| Title: | Trauma services hospital agreement |
| Source: | Los Angeles County EMS |
| Date: | October 1992 |
| Ref. No. | 93-25 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
System Finance
| Title: | Funding of Emergency Medical Services Agencies with State General Funds and Federal Block Grants
|
| Date: | December 1993
|
| Ref. No. | EMSA #104 |
Medical
| Title: | Guidelines for EMS Personnel Regarding Do Not Resuscitate (DNR) Directives |
| Date: | March 1993 |
| Ref. No. | EMSA #111 |
| |
| Title: | Hazardous Materials Medical Management Protocols (Second Edition) |
| Date: | February 1991 |
| Ref. No. | EMSA #231 |
| |
| Title: | Hazardous Materials Medical Management Protocols (Update for decontamination section of "Patient Management in the Hot Zone/Decon Area") |
| Date: | May 1991 |
| Ref. No. | EMSA #91A |
| |
| Title: | Base hospital/Alternative base hospital contracts |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-3 |
| |
| Title: | Determination of death policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-9 |
| |
| Title: | Do not resuscitate policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-11 |
| |
| Title: | Defibrillation--Training program for EMTs and First Responders |
| Source: | Northern California EMS |
| Date: | October 1988 |
| Ref. No. | 93-12 |
| |
| Title: | Base hospital agreement |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-16 |
| |
| Title: | Base hospital standards |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-17 |
| |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-23 |
| |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| |
| Title: | Base hospital treatment guidelines |
| Source: | Los Angeles County EMS |
| Date: | 1992 |
| Ref. No. | 93-27 |
| |
| Title: | EMT-I defibrillation program |
| Source: | Los Angeles County EMS |
| Date: | October 1991 |
| Ref. No. | 93-28 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
| |
| Title: | Guidelines for EMT-Paramedic Scope of Practice:
Request for Additions to the EMT-P Scope of Practice |
| Date: | August 1991 |
| Ref. No. | EMSA #112 |
| |
| Title: | Model Transfer Guidelines, Protocols and Model |
| Date: | September 1991 |
| Ref. No. | EMSA #113 |
STAFFING/TRAINING
General
| Title: | Certificate review process |
| Source: | Northern California EMS |
| Date: | August 1991 |
| Ref. No. | 93-10 |
| |
| Title: | EMT-Paramedic Certification Test/Candidate Preparation Guide
|
| Date: | May 1991 (undergoing revisions)
|
| Ref. No. | EMSA #126 |
Local EMS Agency
(No references)
Dispatchers
| Title: | Emergency Medical Services Dispatcher Training Guidelines |
| Date: | March 1986 |
| Ref. No. | EMSA #132 |
First Responders
| Title: | Defibrillation--Training program for EMTs and First Responders |
| Source: | Northern California EMS |
| Date: | October 1988 |
| Ref. No. | 93-12 |
| |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-23 |
| |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| |
| Title: | EMT-I defibrillation program |
| Source: | Los Angeles County EMS |
| Date: | October 1991 |
| Ref. No. | 93-28 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
| |
| Title: | SIDS for EMS personnel (video) |
| Source: | Los Angeles County EMS |
| Date: | July 1991 |
| Ref. No. | 93-30 |
| |
| Title: | Advanced prehospital care curriculum |
| Source: | Los Angeles County EMS |
| Date: | February 1990 |
| Ref. No. | 93-31 |
| |
| Title: | Prehospital care pharmacology handbook |
| Source: | Los Angeles County EMS |
| Date: | June 1990 (2nd edition) |
| Ref. No. | 93-32 |
| |
| Title: | Paramedic training manual |
| Source: | Los Angeles County EMS |
| Date: | 1981 |
| Ref. No. | 93-33 |
| |
| Title: | EKGs: A quick reference |
| Source: | Los Angeles County EMS |
| Date: | 1987 |
| Ref. No. | 93-34 |
| |
| Title: | EMT-I curriculum |
| Source: | Los Angeles County EMS |
| Date: | 1989 |
| Ref. No. | 93-35 |
| |
| Title: | EMT-I Instructor Syllabus |
| Date: | September 1985 |
| Ref. No. | EMSA #122 |
| |
| Title: | EMT-II Instructor Syllabus |
| Date: | June 1986 |
| Ref. No. | EMSA #123 |
| |
| Title: | EMT-P Instructor Syllabus |
| Date: | June 1986 |
| Ref. No. | EMSA #124 |
Transport Personnel
| Title: | MICN general provisions |
| Source: | Northern California EMS |
| Date: | September 1989 |
| Ref. No. | 93-8 |
| |
| Title: | Defibrillation--Training program for EMTs and First Responders |
| Source: | Northern California EMS |
| Date: | October 1988 |
| Ref. No. | 93-12 |
| |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-23 |
| |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| |
| Title: | EMT-I defibrillation program |
| Source: | Los Angeles County EMS |
| Date: | October 1991 |
| Ref. No. | 93-28 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
| |
| Title: | SIDS for EMS personnel (video) |
| Source: | Los Angeles County EMS |
| Date: | July 1991 |
| Ref. No. | 93-30 |
| |
| Title: | Advanced prehospital care curriculum |
| Source: | Los Angeles County EMS |
| Date: | February 1990 |
| Ref. No. | 93-31 |
| |
| Title: | Prehospital care pharmacology handbook |
| Source: | Los Angeles County EMS |
| Date: | June 1990 (2nd edition) |
| Ref. No. | 93-32 |
| |
| Title: | Paramedic training manual |
| Source: | Los Angeles County EMS |
| Date: | 1981 |
| Ref. No. | 93-33 |
| |
| Title: | EKGs: A quick reference |
| Source: | Los Angeles County EMS |
| Date: | 1987 |
| Ref. No. | 93-34 |
| |
| Title: | EMT-I Instructor Syllabus |
| Date: | September 1985 |
| Ref. No. | EMSA #122 |
| |
| Title: | EMT-II Instructor Syllabus |
| Date: | June 1986 |
| Ref. No. | EMSA #123 |
| |
| Title: | EMT-P Instructor Syllabus |
| Date: | June 1986 |
| Ref. No. | EMSA #124 |
Hospital
| Title: | MICN general provisions |
| Source: | Northern California EMS |
| Date: | September 1989 |
| Ref. No. | 93-8 |
| |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
| |
| Title: | Prehospital care pharmacology handbook |
| Source: | Los Angeles County EMS |
| Date: | June 1990 (2nd edition) |
| Ref. No. | 93-32 |
| |
| Title: | EKGs: A quick reference |
| Source: | Los Angeles County EMS |
| Date: | 1987 |
| Ref. No. | 93-34 |
| |
| Title: | EMT-I curriculum |
| Source: | Los Angeles County EMS |
| Date: | 1989 |
| Ref. No. | 93-35 |
COMMUNICATIONS
Communications Equipment
(No references)
Public Access
(No references)
Resource Management
(No references)
RESPONSE/TRANSPORTATION
| Title: | Competitive Process for Creating Exclusive Operating Areas |
| Date: | July 1985 |
| Ref. No. | EMSA #141 |
| Title: | Guidelines for Out-Of-Jurisdiction EMS Aircraft |
| Date: | May 1986 |
| Ref. No. | EMSA #142 |
| |
| Title: | California Air Ambulance Providers |
| Date: | May 1991 |
| Ref. No. | EMSA #91B |
| | |
| Title: | Provider agreements for EMT-ID, FR-D, EMT-II, and EMT-P |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-2 |
| | |
| Title: | Air ambulance policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-4 |
| | |
| Title: | Defibrillation--Training program for EMTs and First Responders |
| Source: | Northern California EMS |
| Date: | October 1988 |
| Ref. No. | 93-12 |
| | |
| Title: | RFP--Emergency Ambulance Service |
| Source: | San Mateo County EMS |
| Date: | March 1990 |
| Ref. No. | 93-13 |
| | |
| Title: | Emergency Ambulance Contract |
| Source: | San Mateo County EMS |
| Date: | January 1992 |
| Ref. No. | 93-14 |
| | |
| Title: | RFP-Non emergency transport of county patients
| | Source: | San Mateo County EMS
| | Date: | April 1991
| | Ref. No. | 93-15
| | | |
| Title: | EMT-I policies and procedures
| | Source: | San Diego County EMS
| | Date: | 1992
| | Ref. No. | 93-23
| | | |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| | |
| Title: | EMT-I defibrillation program |
| Source: | Los Angeles County EMS |
| Date: | October 1991 |
| Ref. No. | 93-28 |
| | |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
FACILITIES/CRITICAL CARE
| Title: | Trauma Plan Development Guidelines |
| Date: | April 1987 |
| Ref. No. | EMSA #151 |
| |
| Title: | Designated Trauma Centers in California |
| Date: | April 1993 |
| Ref. No. | EMSA #90B |
| |
| Title: | Base hospital/Alternative base station contracts |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Ref. No. | 93-3 |
| |
| Title: | Trauma system RFP |
| Source: | Northern California EMS |
| Date: | February 1990 |
| Ref. No. | 93-5 |
| |
| Title: | Emergency Department Approved for Trauma (EDAT) application packet |
| Source: | Northern California EMS |
| Date: | October 1990 |
| Ref. No. | 93-6 |
| |
| Title: | Trauma Plan |
| Source: | Northern California EMS |
| Date: | November 1989 |
| Ref. No. | 93-7 |
| |
| Title: | Base hospital agreement |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-16 |
| |
| Title: | Base hospital standards |
| Source: | San Diego County EMS |
| Date: | 1988
| | Ref. No. | 93-17
| | |
| Title: | Trauma center contract |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-18 |
| |
| Title: | Trauma center standards for Level I |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-19 |
| |
| Title: | Trauma center standards for Level II |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-20 |
| |
| Title: | Trauma center standards for pediatric |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Ref. No. | 93-21 |
| |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-23 |
| |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| |
| Title: | Trauma services hospital agreement |
| Source: | Los Angeles County EMS |
| Date: | October 1992 |
| Ref. No. | 93-25 |
| |
| Title: | Los Angeles County Trauma Systems: Blue Ribbon Advisory Committee Final Report |
| Source: | Los Angeles County EMS |
| Date: | August 1990 |
| Ref. No. | 93-26 |
| |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Ref. No. | 93-29 |
DATA COLLECTION/SYSTEM EVALUATION
| Title: | EMS Data System Survey
|
| Date: | June 1990
|
| Ref. No. | EMSA #90A
| | | |
| Title: | Prehospital quality assurance system |
| Source: | San Diego County EMS |
| Date: | 1990 |
| Ref. No. | 93-22 |
| | |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-23 |
| | |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Ref. No. | 93-24 |
| | |
| Title: | Emergency Medical Services Data System Standards |
| Date: | November 1993 |
| Ref. No. | EMSA #161 |
PUBLIC INFORMATION AND EDUCATION
(No references)
DISASTER MEDICAL SERVICES
| Title: | Emergency Medical Services Authority Disaster Medical Response Plan |
| Date: | July 1992 |
| Ref. No. | EMSA #201 |
| | |
| Title: | Annex D Emergency Medical Services Authority Contents |
| Date: | December 1989 |
| Ref. No. | EMSA #202 |
| | |
| Title: | Casualty Collection Point Guidelines Preliminary Draft |
| Date: | February 1989 |
| Ref. No. | EMSA #203 |
| | |
| Title: | Regional Disaster Medical Health Coordinator Procedures for Support of State Medical Response to a Catasrophic Disaster |
| Date: | December 1985 |
| Ref. No. | EMSA #204 |
| | |
| Title: | Procedures for Acquisition for Volunteer Medical Personnel in Response to a Catastrophic Disaster |
| Date: | August 1988 |
| Ref. No. | EMSA #205 |
| | |
| Title: | Medical Volunteer Orientation Disaster Response |
| Date: | April 1985 |
| Ref. No. | EMSA #206 |
| | |
| Title: | Disaster Medical Supplies List |
| Date: | February 1991 |
| Ref. No. | EMSA #211 |
4. EMS AUTHORITY PUBLICATIONS
This section identifies documents issued by and available from the EMS Authority.
| Ref. No. | EMSA #104 |
| Title: | Funding of Emergency Medical Services Agencies with State General Funds and Federal Block Grants |
| Date: | December 1993 |
| Synopsis: | The EMS Authority has developed this policy document to convey funding criteria, eligibility requirements, and the allocation methodology to potential applicants.
The documents include EMS Authority policy on funding EMS agencies, program management and reporting requirements, budget and reporting formats. |
| Ref. No. | EMSA #111 |
| | |
| Title: | Guidelines for EMS Personnel Regarding Do Not Resuscitate (DNR) Directives |
| Date: | March 1993 (Revised) |
| Synopsis: | The purpose of these guidelines is to provide assistance to local EMS agencies in
developing Do No Resuscitate (DNR) policies for their jurisdictions. The recent
revisions to the guidelines respond to the need for a statewide policy to allow
emergency responders to honor a patient's wish to forego resuscitative attempts.
Although many local EMS agencies have established policies to allow responders
to honor DNR orders in the prehospital setting, there previously was not a
standardized mechanism or statewide policy to honor patients' DNR directives.
The guidelines recommend the use of a standardized advanced directive form,
Emergency Medical Services Prehospital Do Not Resuscitate (DNR) Form, a
sample of which is included, and the optional use by the patient of a specially
inscribed Medic Alert medallion or bracelet. |
| Ref. No. | EMSA #112 |
| | |
| Title: | Guidelines for EMT-Paramedic Scope of Practice: Request for Additions to the EMT-P Scope of Practice |
| Date: | August 1991 |
| Synopsis: | This document contains guidelines for when a request for approval of undefined scope of practice is necessary. |
| Ref. No. | EMSA #113 |
| | |
| Title: | Model Transfer Guidelines, Protocols and Model Transfer Agreements |
| Date: | September 1991 |
| Synopsis: | Developed under a special project grant, this document presents guidelines and standards for the interfacility transfer of patients for use by local EMS agencies wishing to implement such guidelines. Model transfer agreements are included as
well as an initial analysis of a statewide survey on the number, kinds, and extent of
existing transfer guidelines and agreements. |
| Ref. No. | EMSA #121
| | | |
| Title: | Approved Prehospital Care Training Programs |
| Date: | January 1993 |
| Synopsis: | This document is a compilation of the approved prehospital care training programs for EMT-I, EMT-II, EMT-Paramedic, and MICN in the State of California. |
| Ref. No. | EMSA #126 |
| | |
| Title: | EMT-Paramedic Certification Test Candidate Preparation Guide |
| Date: | May 1991 (under revision) |
| Synopsis: | This document provides an overview of the California EMT-P examination process. A study guide and sample questions are provided to help prepare the candidate for the certification exam. |
| Ref. No. | EMSA #132 |
| | |
| Title: | Emergency Medical Services Dispatcher Training Guidelines |
| Date: | March 1986 |
| Synopsis: | These guidelines were developed to assist local EMS agencies and dispatching services with the development of a training program for an Emergency Medical Dispatcher (EMD) program. This document addresses the role of the EMD, the
various levels (there are three) of emergency medical dispatching, and training unit
guidelines. There are ten training units: medical dispatcher orientation, basic
telecommunications, obtaining information from caller, use of medical dispatch
priority reference system, providing pre-arrivalinstructions, medical/legal
considerations, allocation of local EMS resources, practical lab, multi-casualty
incidents and disaster procedures, and written and practical testing. Each unit has
a recommended allocated time for teaching, a goal, and performance objectives. |
| Ref. No. | EMSA #141 |
| | |
| Title: | Competitive Process For Creating Exclusive Operating Areas |
| Date: | July 1985 |
| Synopsis: | This document outlines the process for creating exclusive EMS operating service areas, using Division 2.5 of the California Health and Safety Code and the Emergency Medical Services Plan as references. A description of when a competitive process is/is not required is provided.
In the event an Invitation for Proposal (IFP) is required, this document outlines recommended procedures, including protocol for formal advertising, the responders conference, IFP content, submission of proposals, receipt and
evaluation of the proposals, and rejection of proposals. Contract issues such as award and length are also reviewed, in addition to protocol for award protests and cancellation of the procurement process. |
| Ref. No. | EMSA #142 |
| | |
| Title: | Guidelines for Out-Of-Jurisdiction EMS Aircraft |
| Date: | May 1986 |
| Synopsis: | These guidelines address the development of agreements for airborne prehospital response. These agreements should be developed between the requesting EMS agency and the air ambulance or air rescue provider or the local EMS agency in
the area of origin. Individuals should use the Prehospital EMS Aircraft Regulations (Air Regs.) when developing such agreements. The necessary issues to be addressed are noted in the guidelines.
For EMS aircraft that are used on a sporadic basis, the guidelines recommend a mutual aid or continuation of call agreement be developed between the requesting EMS agency and the provider of the EMS air service. Again, applicable sections of the Air Regs. are specified for the development of such agreements. |
| Ref. No. | EMSA #151 |
| | |
| Title: | Trauma Plan Development Guidelines |
| Date: | April 1987 |
| Synopsis: | These guidelines provide EMS agencies with the minimum requirements (as put
forth in the Trauma Regulations) for preparation of trauma planning documents to
be submitted to the State EMS Authority. The document is broken into eight
sections: Plan Summary (which includes Trauma System Criteria and Plan
Details), Organizational Structure, Trauma System Design and Policy
Development, Objectives, Proposed Actions and Implementation Schedule, Fiscal
Impact of the System, Local Approval, Data Collection, and Trauma System
Evaluation. These guidelines provide a comprehensive tool for the development of
trauma planning documents. It may be of assistance to have the Trauma
Regulations available for reference when reviewing this document. |
| Ref. No. | EMSA #161 |
| | |
| Title: | Emergency Medical Services Data System Standards |
| Date: | November 1993 |
| Synopsis: | The Emergency Medical Services Data System Standards is a compilation of five products: the Standard Prehospital Data Element List, the Standard Prehospital Data Element Dictionary, the local EMS Agency Data System
Recommendations, the local EMS Agency Reporting, Recommentations, and the
EMS Authority Aggregate Data Report. |
| Ref. No. | EMSA #201 |
| | |
| Title: | Emergency Medical Services Authority Disaster Medical Response Plan |
| Date: | July 1992 |
| Synopsis: | The Emergency Medical Services Authority (EMSA) is the state agency charged with coordinating the state emergency medical response to a disaster. The purpose of this plan is to describe the policies and general procedures governing the
Authority's response to major disasters creating mass casualties. To provide
context, the plan details the roles and responsibilities of local, state, and private
agencies and organizations. It also describes the structure, concepts, and policies
under which the response will operate.
Although this plan defines a disaster medical response system, the EMS Authority
recognized that circumstances may require deviation from this plan. This
document should serve as a template for development of both state and local plans
and procedures.
This plan does not apply to day-to-day emergencies. It addresses the large scale
event which overwhelms, or potentially overwhelms, the response capacity of a
local jurisdiction. Except where noted, this plan is concerned with the response of
the EMS Authority to a catastrophic, or potentially catastrophic disaster. Although
an earthquake is the most likely hazard to create a disaster of catastrophic impact,
other events, such as hazardous materials releases, explosions, and dam failures
also might create massive numbers of casualties. |
| Ref. No. | EMSA #202 |
| | |
| Title: | Annex D Emergency Medical Services Authority Contents |
| Date: | December 1989 |
| Synopsis: | This annex presents general concepts and policies to be followed in provideing disaster medical services to people during each operational phase of a natural of technological emergency. It describes California's disaster medical care system
and assigns state agency responsibilities. |
| Ref. No. | EMSA #203 |
| | |
| Title: | Casualty Collection Point Guidelines Preliminary Draft |
| Date: | February 1989 |
| Synopsis: | These guidelines are meant to promote minimal standardization of Casualty Collection Points (CCPs) in the event of a disaster requiring a State medical response. Although the designation, establishment, and operation of CCPs are
county responsibilities, standardization is necessary to ensure coordination of State
and local responses. These guidelines also discuss CCP operations, including use,
site designation, and setup issues.
These guidelines describe a fully functional, full purpose CCP. Depending on the
magnitude of a disaster and the availability of resources, a jurisdiction may decide
that CCPs are not an appropriate disaster response strategy. Instead, the
jurisdiction may choose to implement short-term staging areas or other
alternatives. In those instances, these guidelines may still prove useful for those
more limited operations.
[Note that the central theme of this document is that CCPs are a response strategy
of last resort. We encourage planning for other types of operations as well,
recognizing that CCPs may neither be feasible nor appropriate for all types of
disasters or response environments.] |
| Ref. No. | EMSA #204 |
| Title: | Regional Disaster Medical/Health Coordinator Procedures for Support of State Medical Response to a Castastrophic Disaster |
| Date: | December 1985 |
| Synopsis: | These procedures have been developed to assist Regional Disaster Medical/Health
Coordinators (RDMHCs) and county health officers in unaffected areas of
California to provide medical mutual aid as part of the state's overall medical
response to a catastrophe. These procedures, based on the concept paper, "The
Role and Responsibilities of Regional Disaster Medical/Health Coordinators"
specify how the Medical Annex to the State's Earthquake Response Plan, Plan
Caldera (the state volcano response plan), and the California Emergency Plan will
be implemented at the regional level. They are intended to be specific enough to
assist RDMHCs with designing and implementing systems to support an effective
disaster medical response yet flexible enough to allow for the wide variety of
EMS systems now in place in California. (RDMHCs in affected areas would not
be called upon to participate since they would be coordinating the disaster
response for their own counties.)
A catastrophic event, such as a Great Earthquake in Southern California, could
result in tens of thousands of casualties and billions of dollars in property
damage. The coordinated assistance of the unaffected areas of the state and the
nation would be required to meet the needs of the disaster victims. These
procedures assume that California public officials and private businesses will,
without hesitation, give the highest priority to providing this assistance. |
| Ref. No. | EMSA #205 |
| | |
| Title: | Procedures for Acquisition for Volunteer Medical Personnel In Response to a Catastrophic Disaster |
| Date: | August 1988 |
| Synopsis: | These procedures were developed for Regional Disaster Medical/Health
Coordinators and County Health Officers to help them locate volunteer medical
personnel following a disaster. Following a list of assumptions about the
prospective scenario, the Procedures discuss how the volunteer medical
personnel should be utilized, planning protocols, and procedures. Additionally,
the Procedures address the role of the hospitals and ambulance companies,
noting the importance of use of those outside of the disaster areas and their
responsibilities as participants in the disaster recovery process. |
| Ref. No. | EMSA #206 |
| | |
| Title: | Medical Volunteer Orientation Disaster Response |
| Date: | April 1985 |
| Synopsis: | This document addresses organization of medical disaster volunteers. It
contains information such as responsibilities of potentially involved state
agencies. Specific to volunteers, it discusses potential assignments for
volunteers, shifts and how to recognize signs of stress in overworked volunteers
and what to do about them as well as functions of volunteers on-site, at casualty
collection points, and at Disaster Support Area (DSA) (Los Alamitos) and
Satellite DSA's (MEDSATS). This orientation packet concludes, with
guidelines, as to how to deal with miscellaneous considerations (i.e. type and
severity of injuries of waiting casualties, time considerations), safety
considerations (i.e. aftershocks or downed power lines, and limited water
supply). Sample forms are attached. |
| Ref. No. | EMSA #211 |
| | |
| Title: | Disaster Medical Supplies List |
| Date: | February 1991 |
| Synopsis: | This is a standard listing of medical supplies and equipment that the State will deliver into an area impacted by a catastrophic disaster. |
| Ref. No. | EMSA #231 |
| | |
| Title: | Hazardous Materials Medical Management Protocols (Second Edition) |
| Date: | February 1991 |
| Synopsis: | These protocols are provided as guidelines to inform health care providers as to
how to manage medical problems instigated by exposure to hazardous materials.
The EMT's role and training requirements are addressed. Federal Occupational
Safety and Health Administration (OSHA) has requirements for training, and
California OSHA is following suit in Title 8 of the California Code of
Regulations. These standards are enforced by California OSHA. It is
recommended that agencies remain aware of these requirements in addition to
those set forth in this document. This document does not address radioactive
materials.
Secondary contamination is a concern that is analyzed in this document.
Substances of high risk and low risk for secondary contamination are outlined,
and suggestions for reducing risk are given. These are a supplement to the basic
decontamination protocols which deal with proper attire, and evaluation and
treatment of victims. A section devoted to prehospital care is provided, dealing
with field response (including organization of incident area), hazard information
about specific chemicals, prehospital provider protection (including EMS vehicle
equipment for hazardous material incidents), prehospital decontamination and
triage, and decontamination of prehospital personnel.
Protocols are also provided for emergency department care, addressing
preplanning and risk assessment, how to handle the contaminated victim,
protective clothing for personnel, decontamination and medical management of
the victim, and decontamination of personnel and clean up. Suggested equipment
lists are also provided.
These protocols conclude with a listing of sources for acute hazards information
and protocols for hazardous materials medical management of unknown chemicals
and the most common chemicals. |
| Ref. No. | EMSA #90A |
| | |
| Title: | Emergency Medical Services Data System Survey
| | Date: | June 1990 |
| Synopsis: | This document is produced as a result of a study of EMS data handling capability in
local EMS agencies in California. It addresses issues and concerns for data handling
capabilities revealed by the study. The areas involved are: EMS data source documents
(patient care records and dispatch records, base hospital/on-line medical control, and
trauma), EMS agency budget and hardware allocation for data processing, utilization of
the data, patient care report forms (data elements), fatal accident report system, and
EMS sensitivity index.
Recommendations are made based upon the findings of the study. They address EMS-Management Information Systems (MIS) data elements (including critical time
elements, patient information, care given, etc.), and reports for local EMS agencies.
An extensive section of sample summary output reports is attached, including an
appendix with data survey forms used in the study, and local EMS agency activities indexed by type of local EMS agency. |
| Ref. No. | EMSA #90B |
| | |
| Title: | Designated Trauma Centers in California |
| Date: | April 1993 |
| Synopsis: | This document is devoted to location of designated trauma centers, including county and address, type of care provided (pediatric or level), and bed capacity. |
| Ref. No. | EMSA #91A |
| | |
| Title: | Hazardous Materials Medical Management Protocols (Update for Decontamination Section of Patient Management in the Hot Zone/Decon Area) |
| Date: | May 1991 |
| Synopsis: | This is an update, providing clarification for some of the chemicals referred to in
this section. |
| Ref. No. | EMSA #91B |
| | |
| Title: | California Air Ambulance Providers |
| Date: | May 1991 |
| Synopsis: | This is a directory of all Air Ambulance Providers in California. Information
provided includes: County, name, location, address, telephone, equipment type,
identification (ID) number, and capabilities. |
5. SUMMARIES OF NON-EMSA MATERIALS
This section identifies documents available from local EMS agencies. Contact the local EMS
identified on the "Source" line for a copy.
| Ref. No. | 93-1 |
| Title: | Agreement designating Northern California Emergency Medical Services, Inc. as
the "Local EMS Agency" and authorizing powers pursuant thereto |
| Source: | Northern California (Nor Cal) EMS |
| Date: | June 1991 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | These documents define the local EMS agency responsibilities delegated to Nor Cal EMS. Each county delegating responsibilities has a separate agreement with the agency. |
| Ref. No. | 93-2 |
| | |
| Title: | Provider agreements for EMT-ID, FR-D, EMT-II, and EMT-P |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | These documents authorize prehospital providers to utilize personnel accredited in
the use of automatic defibrillators or to utilize EMT-II or EMT-P personnel.
The document is signed by the local EMS agency, the provider agency, and the
assigned base hospital. |
| Ref. No. | 93-3 |
| | |
| Title: | Base hospital/Alternative base hospital contracts |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | These documents define the responsibilities of a base hospital in directing the medical control of prehospital advanced life support (ALS) providers. |
| Ref. No. | 93-4 |
| | |
| Title: | Air ambulance policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | This policy provides a description of the aircraft classifications, fee structure,
dispatch center requirements, cancellation procedure, medical control
requirements, record keeping, advertising, required equipment, and the
application procedure for air ambulance service provider authorization. |
| Ref. No. | 93-5 |
| | |
| Title: | Trauma system RFP |
| Source: | Northern California EMS |
| Date: | February 1990 |
| Availability: | Document is available for $25.00 from Nor Cal EMS. |
| Synopsis: | This document provides an overview of the Trauma Care System Plan, general information and instructions for application, the request for proposals process,
trauma center standards, legal requirements, and contract provisions. |
| Ref. No. | 93-6 |
| | |
| Title: | Emergency Department Approved for Trauma (EDAT) application packet |
| Source: | Northern California EMS |
| Date: | October 1990 |
| Availability: | Document is available for $ 25.00 from Nor Cal EMS. May be available on disk. |
| Synopsis: | This document provides an overview of the EDAT concept and how it applies to
the overall trauma system. It gives a description of the EDAT approval process,
the application requirements, and the standards to be met by Basic and Standby
EDATs. |
| Ref. No. | 93-7 |
| | |
| Title: | Trauma Plan |
| Source: | Northern California EMS |
| Date: | November 1989 |
| Availability: | Document is available for $ 25.00 from Nor Cal EMS. |
| Synopsis: | This document contains a plan summary, identifies the organizational structure,
provides an overview of the trauma care system design and policy development.
It defines the objectives, the designation process, and the implementation
schedule. It describes the local approval process, delineates the required data
collection process, and contains the evaluation methodologies to provide quality
improvement. |
| Ref. No. | 93-8 |
| | |
| Title: | MICN general provisions |
| Source: | Northern California EMS |
| Date: | September 1989 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | Document includes:
Mobile Intensive Care Nurse (MICN) scope of practice field and base
authorization requirements,
Training standards,
Protocols/standardized procedure, and
Reauthorization requirements. |
| Ref. No. | 93-9 |
| | |
| Title: | Determination of death policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | Describes criteria for determining patients who are not viable candidates for resuscitation. |
| Ref. No. | 93-10 |
| | |
| Title: | Certificate review process |
| Source: | Northern California EMS |
| Date: | August 1991 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | Describes process for any/all negative certificate actions. |
| Ref. No. | 93-11 |
| | |
| Title: | Do Not Resuscitate policy |
| Source: | Northern California EMS |
| Date: | January 1992 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | Describes acceptable criteria to withhold resuscitation in prehospital situations (patient terminal illness). |
| Ref. No. | 93-12 |
| | |
| Title: | Defibrillation--Training program for EMTs and First Responders |
| Source: | Northern California EMS |
| Date: | October 1988 |
| Availability: | Document is available for $10.00 from Nor Cal EMS. |
| Synopsis: | Includes learning objectives and presentation outline for topics
- Cardiac anatomy and physiology
- Cardiac electrophysiology
- EKG monitoring
- EKG analysis
- Defibrillator operation
- Dysrhythmia recognition
- Defibrillation
- Medical control
Also includes policies for operation, continuing education, and remediation. |
| Ref. No. | 93-13 |
| | |
| Title: | RFP--Emergency Ambulance Service |
| Source: | San Mateo County EMS |
| Date: | March 1990 |
| Availability: | Document is available for $0.05 per page (appx. 75 pages) from San Mateo County EMS. |
| Synopsis: | Request for proposals for performance-based ambulance contract. |
| Ref. No. | 93-14 |
| | |
| Title: | Emergency Ambulance Contract |
| Source: | San Mateo County EMS |
| Date: | January 1992 |
| Availability: | Document is available for $0.05 per page (appx. 93 pages) from San Mateo County EMS. Also available on disk. |
| Synopsis: | Performance-based contract. Includes use of County's dispatch center with a fee paid by contractor. |
| Ref. No. | 93-15 |
| | |
| Title: | RFP-Non emergency transport of county patients |
| Source: | San Mateo County EMS |
| Date: | April 1991 |
| Availability: | Document is available for $0.05 per page (appx. 40 pages) from San Mateo County EMS. Also available on disk. |
| Synopsis: | Request for proposals for transport of 5150 patients and other county patients. |
| Ref. No. | 93-16 |
| | |
| Title: | Base hospital agreement |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (appx. 11 pages) from San Diego County EMS. |
| Synopsis: | Contract for base hospital status. Useful for those wanting to contract with base hospitals. |
| Ref. No. | 93-17 |
| | |
| Title: | Base hospital standards |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (4 pages) from San Diego County EMS. |
| Synopsis: | Standards for base hospital status. Useful for those wanting to contract with base hospitals. |
| Ref. No. | 93-18 |
| | |
| Title: | Trauma center contract |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (10 pages) from San Diego County EMS. |
| Synopsis: | Contract sample for trauma center. Useful for those wanting to contract with hospitals for trauma status. |
| Ref. No. | 93-19 |
| | |
| Title: | Trauma center standards for Level I |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (16 pages) from San Diego County EMS. |
| Synopsis: | Standards for trauma center. Useful for those wanting to contract for trauma status. |
| Ref. No. | 93-20 |
| | |
| Title: | Trauma center standards for Level II |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (10 pages) from San Diego County EMS. |
| Synopsis: | Standards for trauma center. Useful for those wanting to contract for trauma status. |
| Ref. No. | 93-21 |
| | |
| Title: | Trauma center standards for pediatric |
| Source: | San Diego County EMS |
| Date: | 1988 |
| Availability: | Document is available for $0.10 per page (17 pages) from San Diego County EMS. |
| Synopsis: | Standards for pediatric trauma center. Useful for those wanting to contract with
pediatric hospitals for trauma status. |
| Ref. No. | 93-22 |
| | |
| Title: | Prehospital quality assurance system |
| Source: | San Diego County EMS |
| Date: | 1990 |
| Availability: | Document is available for $0.10 per page (7 pages) from San Diego County EMS. |
| Synopsis: | An overview of the Quality Assurance (QA) system design and process. Monitoring activities of QA oversight and brief discussion of committee meetings. Useful for those wanting to establish a QA program. |
| Ref. No. | 93-23 |
| | |
| Title: | EMT-I policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Availability: | Document is available for $0.10 per page (appx. 69 pages) from San Diego County EMS. |
| Synopsis: | Polices and procedures establishing EMT-I system. |
| Ref. No. | 93-24 |
| | |
| Title: | EMT-P policies and procedures |
| Source: | San Diego County EMS |
| Date: | 1992 |
| Availability: | Document is available for $0.10 per page (150 pages) from San Diego County EMS. |
| Synopsis: | Polices and procedures establishing EMT-P system. |
| Ref. No. | 93-25 |
| | |
| Title: | Trauma services hospital agreement |
| Source: | Los Angeles County EMS |
| Date: | October 1992 |
| Availability: | Document is available on disk from Los Angeles County EMS. |
| Synopsis: | This document is the contractual agreement between the County and designated
trauma care centers. It specifies the standards and requirements for Level I and II
trauma hospitals and reflects state requirements. |
| Ref. No. | 93-26 |
| | |
| Title: | Los Angeles County Trauma Systems: Blue Ribbon Advisory Committee Final Report |
| Source: | Los Angeles County EMS |
| Date: | August 1990 |
| Availability: | Document is available at no cost from Los Angeles County EMS. |
| Synopsis: | Document summarizes recommendations and comments of the interdisciplinary
planning retreat. It includes discussion of medical, economic, and societal issues,
as well as strategies and tactics for addressing problem areas. |
| Ref. No. | 93-27 |
| | |
| Title: | Base hospital treatment guidelines |
| Source: | Los Angeles County EMS |
| Date: | 1992 |
| Availability: | Document is available for $15.00 from Los Angeles County EMS. |
| Synopsis: | This document consists of sign/symptom-based field testament protocols in an
easy-to-use "at the radio" format. |
| Ref. No. | 93-28 |
| | |
| Title: | EMT-I defibrillation program |
| Source: | Los Angeles County EMS |
| Date: | October 1991 |
| Availability: | Document is available at no cost from Los Angeles County EMS. |
| Synopsis: | This is a complete document outlining the L.A. County EMS Agency's EMT-I
Defibrillation Program including the training program, policies, protocols, and
requirements. |
| Ref. No. | 93-29 |
| | |
| Title: | Prehospital care policy manual |
| Source: | Los Angeles County EMS |
| Date: | Original January 1986 with ongoing revisions |
| Availability: | Document is available for $22.00 from Los Angeles County EMS. |
| Synopsis: | This document is L.A. County EMS Agency's policy and procedure manual for
all prehospital care | |