EMS Policy Manual - Contra Costa Health Services

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Contra Costa Emergency Medical Services POLICY #: 27 PAGE: 3 of 3 3. Specific risks and consequences discussed – patient acknowledged understanding. 4. Specific comments made by patient (with quote marks) in declining care/transport. 5. Base contact/physician name, if done. 6. Advisory for patient to contact 911 or seek further care if s/he should change mind. 7. Disposition – released to self, custody of parent/guardian, law enforcement or other person. 8. Signature of patient/responsible party or documentation of refusal to sign. 9. Name/signature of witness, if available, plus permanent identifier. 10. Name of interpreter if used. 11. Any other information appropriate to document situation or event. B. If a first responder agency has patient contact, the call results in no transport, and the transport agency has no patient contact, first responder agency personnel are responsible for completion of appropriate documentation. C. If patient care has been transferred from first responders and a patient subsequently declines further treatment or transport, the transport crew is responsible for appropriate documentation. VIII. HOSPITAL RESPONSIBILITIES Hospitals should implement mechanisms to assure that prehospital documentation arriving with the patient is readily available to ED staffs and is incorporated into the hospital medical record system. IX. ELECTRONIC SYSTEM FAILURE A. Back-up systems to provide for paper PCR documentation must be in place for use should an electronic documentation system fail. Electronic documentation system failure is NOT an exception for providing the required PCR documentation. B. The EMS Agency shall be notified of downtime or transmission difficulties lasting more than 24 hours. X. MULTI-CASUALTY INCIDENTS A. Electronic or paper PCRs shall be completed for all patients in multi-casualty incidents unless requirements have been shifted to documentation on triage tags per MCI plan directives. B. In incidents with large numbers of persons refusing treatment or transport, efforts should be made to document as much information as possible.
Contra Costa Emergency Medical Services BASE HOSPITAL DESIGNATION I. PURPOSE POLICY #: 29 PAGE: 1 of 3 EFFECTIVE: 01/01/09 REVIEWED: 08/10/09 To define the criteria, which shall be met by acute care hospitals in Contra Costa County for Base Hospital designation. II. AUTHORITY Health and Safety Code, Division 2.5, Sections 1798, 1798.101, 1798.105, 1798.2 and California Code of Regulations, Title 22, Section 100175. III. DEFINITION AND FUNCTION A Base Hospital is a hospital designated by the Local EMS Agency as responsible for directing the advanced life support system and prehospital care system assigned to it by the local EMS agency. The Base Hospital functions within the Local EMS system to facilitate and expedite safe, high-quality, patient-centered care providing destination and prehospital on-line decision making support without interruption, 24 hours per day, 7 days a week. The base hospital works in partnership with local EMS stakeholders in accordance with California EMSA and Local EMS Agency requirements. IV. DESIGNATION PROCESS A. Contra Costa Emergency Medical Services designates Base Hospitals. B. Application and agreement process is defined by the Contra Costa Emergency Medical Services Agency in compliance with California Emergency Medical Services Authority (EMSA) requirements. C. The designation period will coincide with the period covered in a written agreement between the Base Hospital and the Contra Costa Emergency Medical Services (EMS) Agency. V. DESIGNATION CRITERIA A. Current California Licensure as an acute care facility providing Basic Emergency Medical Services and Joint Commission Accreditation. B. Ability to enter into a written agreement as Base Hospital with the Contra Costa EMS Agency. C. Continuous availability of Base Hospital service without interruption (24-hours/7-days a week). D. Ability to provide immediate response to each and every request by prehospital personnel for medical consultation or trauma destination. E. Commitment to collaborate with Contra Costa EMS Agency to provide and maintain function of communication equipment for the purposes of communicating with prehospital personnel without interruption. F. Ability to promptly notify receiving hospital of every patient for whom there is Base Hospital direction. G. Ability to provide audio and written documentation of radio and telephone consultations with Prehospital personnel including trauma destination determinations. H. Commitment to assist the county in implementing new policies and procedures issued by the county. I. Designate appropriate personnel to support and oversee Base Hospital functions including: 1. Base Hospital Liaison Physician Physician responsible for providing oversight and leadership to the Base Hospital EMS QI program.
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EMS Policy Manual - Contra Costa Health Services

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