EMS Policy Manual - Contra Costa Health Services
EMS Policy Manual - Contra Costa Health Services EMS Policy Manual - Contra Costa Health Services
Contra Costa Emergency Medical Services PHYSICIAN ON SCENE I. PURPOSE POLICY #: 21 PAGE: 1 of 1 EFFECTIVE: 12/01/06 REVIEWED: 08/10/09 To provide direction for field personnel and physicians on prehospital emergency medical responses. II. POLICY Paramedics function by law under physician contact, however, most physicians are unfamiliar with the paramedic scope of practice, skills, drugs, equipment, and EMS protocols. Most physicians do not have the time to accompany paramedics and their patients to a Receiving Hospital. For this reason, Base Hospital physicians assume medical control through input into EMS protocols and through voice contact. If a physician at the scene wishes to direct paramedic care, s/he should be shown the card issued by the State of California entitled Note to Physician on Involvement with EMT-IIs & EMT-Ps (paramedic). The Endorsed Alternatives for Physician Involvement printed on the back of the card are: "After identifying yourself by name as a physician licensed in the State of California, and, if requested, showing proof of identity, you may choose to do one of the following: A. Offer your assistance with another pair of eyes, hands, or suggestions, but let the life support team remain under base hospital control; or, B. Request to talk to the base station physician and directly offer your medical advice and assistance; or, C. Take responsibility for the care given by the life support team and physically accompany the patient until the patient arrives at a hospital and responsibility is assumed by the receiving physician. In addition, you must sign for all instructions given in accordance with local policy and procedure. (Whenever possible, remain in contact with the base station physician.)” Even if a physician chooses option #3 listed on the card, in Contra Costa County, the paramedic must still maintain Base Hospital control through the voice contact.
Contra Costa Emergency Medical Services INFECTIOUS DISEASE PRECAUTIONS AND EXPOSURE MANAGEMENT FOR EMS PERSONNEL POLICY #: 22 PAGE: 1 of 4 EFFECTIVE: 1/13 REVIEWED: 12/12 I. AUTHORITY Division 2.5, California Health and Safety Code, Sections 1797.186, 1797.188. 1797.189. www.leginfo.ca.gov Bloodborne pathogens - 1910.1030, U.S. Department of Labor. www.osha.gov/SLTC/bloodbornepathogens/ II. PURPOSE To provide guidelines and procedures for EMS prehospital personnel, to reduce risk of infectious disease exposure to themselves and patients, and to evaluate and report suspected exposures to communicable diseases. A. Although the presence of disease-causing agents may or may not be known, these agents may be present in body fluids and substances. Even apparently healthy persons may carry and be capable of transmitting disease. B. Precautions identified in this policy are intended to provide prehospital personnel with information to safely care for all patients, regardless of disease status. III. EXPOSURE RISK REDUCTION A. Prehospital Personnel. Prehospital personnel shall: 1. Follow employer’s policies/procedures for infection control to protect both patients and themselves. 2. Use universal precautions in all patient contacts. Additional barrier precautions are to be used based on the potential for exposure to body fluids and substances. 3. Wash hands, prior to and following patient contact at a minimum, regardless of the use of gloves or other barrier precautions. Thorough hand washing with soap and water is the most effective infection control activity for prehospital personnel. Waterless hand sanitizers are an option if soap and water are not available. B. Provider Agency. Each provider agency shall: 1. Comply with all federal, state, and local regulations regarding infectious disease precautions. 2. Establish and maintain a written exposure control plan designed to eliminate or minimize employee exposure. This plan shall include a procedure to be used if an employee is possibly exposed to a communicable disease and this plan shall be made easily accessible. 3. Designate an infection control officer to evaluate and respond to possible infectious disease exposure of provider agency’s prehospital personnel. 4. Make available equipment, supplies and training necessary for prehospital personnel to reasonably protect themselves and their patients against infectious disease exposure. C. Receiving Facility. Receiving hospitals should have staff procedures for: 1. Assisting possibly exposed prehospital personnel in assessing the significance of the exposure, and the need for and provision of prophylaxis. 2. Obtaining the appropriate testing to determine whether or not the source patient is infected with a communicable disease. IV. EXPOSURE DEFINITION A significant communicable disease exposure is defined by criteria set by the Centers for Disease Control (CDC) and the Local Public Health Department and may include:
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<strong>Contra</strong> <strong>Costa</strong><br />
Emergency Medical <strong>Services</strong><br />
INFECTIOUS DISEASE PRECAUTIONS AND EXPOSURE<br />
MANAGEMENT FOR <strong>EMS</strong> PERSONNEL<br />
POLICY #: 22<br />
PAGE: 1 of 4<br />
EFFECTIVE: 1/13<br />
REVIEWED: 12/12<br />
I. AUTHORITY<br />
Division 2.5, California <strong>Health</strong> and Safety Code, Sections 1797.186, 1797.188. 1797.189.<br />
www.leginfo.ca.gov Bloodborne pathogens - 1910.1030, U.S. Department of Labor.<br />
www.osha.gov/SLTC/bloodbornepathogens/<br />
II. PURPOSE<br />
To provide guidelines and procedures for <strong>EMS</strong> prehospital personnel, to reduce risk of infectious<br />
disease exposure to themselves and patients, and to evaluate and report suspected exposures to<br />
communicable diseases.<br />
A. Although the presence of disease-causing agents may or may not be known, these agents may<br />
be present in body fluids and substances. Even apparently healthy persons may carry and be<br />
capable of transmitting disease.<br />
B. Precautions identified in this policy are intended to provide prehospital personnel with<br />
information to safely care for all patients, regardless of disease status.<br />
III. EXPOSURE RISK REDUCTION<br />
A. Prehospital Personnel. Prehospital personnel shall:<br />
1. Follow employer’s policies/procedures for infection control to protect both patients and<br />
themselves.<br />
2. Use universal precautions in all patient contacts. Additional barrier precautions are to<br />
be used based on the potential for exposure to body fluids and substances.<br />
3. Wash hands, prior to and following patient contact at a minimum, regardless of the use of<br />
gloves or other barrier precautions. Thorough hand washing with soap and water is the<br />
most effective infection control activity for prehospital personnel. Waterless hand<br />
sanitizers are an option if soap and water are not available.<br />
B. Provider Agency. Each provider agency shall:<br />
1. Comply with all federal, state, and local regulations regarding infectious disease<br />
precautions.<br />
2. Establish and maintain a written exposure control plan designed to eliminate or minimize<br />
employee exposure. This plan shall include a procedure to be used if an employee is<br />
possibly exposed to a communicable disease and this plan shall be made easily<br />
accessible.<br />
3. Designate an infection control officer to evaluate and respond to possible infectious<br />
disease exposure of provider agency’s prehospital personnel.<br />
4. Make available equipment, supplies and training necessary for prehospital personnel to<br />
reasonably protect themselves and their patients against infectious disease exposure.<br />
C. Receiving Facility. Receiving hospitals should have staff procedures for:<br />
1. Assisting possibly exposed prehospital personnel in assessing the significance of the<br />
exposure, and the need for and provision of prophylaxis.<br />
2. Obtaining the appropriate testing to determine whether or not the source patient is infected<br />
with a communicable disease.<br />
IV. EXPOSURE DEFINITION<br />
A significant communicable disease exposure is defined by criteria set by the Centers for Disease<br />
Control (CDC) and the Local Public <strong>Health</strong> Department and may include: