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TABLE OF CONTENTS

Medical Director Authorization

Section 1 - Administrative Policies

Printable Version

Section Description Revision Date
1.01 General Measures February-18
1.02 Radio Report Format March-16
1.03 Refusal of Service October-17
1.04 Physician or Nurse on Scene March-09
1.05 Initiation of CPR and Determination of Death July-16
1.06 Determination of Death in Trauma March-09
1.07 Crime or Unattended Death Scene March-09
1.08 Medical Evaluation of Person in Police Custody March-09
1.09 Trauma Transport Protocol February-19
1.10 Emergency Transport March-09
1.11 Criteria for Helicopter Transport March-09
1.12 Medical Patient Transport Decision April-14
1.13 Obstetrical Patient Transport Decision Feb-15
1.14 Emergency Inter Facility Transport March-09
1.15 EMS Saturation Disaster Response Levels April-16
1.16 EMS Offload Policy March-09
1.17 EMT and Paramedic County Certification Procedure August-14
1.18 EMS Quality Improvement Program March-09
1.19 HIV Post Exposure Prophylaxis (PEP) March-09
1.20 Scope of Practice March-09
1.21 Freestanding ED Transport Criteria August-19
1.22 Hospital Capability Chart - DRAFT September-19
1.23 Documentation Guidance June-17
1.24 School Medication Authorization Forms June-18

Section 2 - Primary Care

Printable Version

Section Description Revision Date
2.01 Initial Medical Assessment and Care March-09
2.02 Initial Trauma Assessment and Care September-17
2.03 Rapid Trauma Assessment, Focused History and Physical Exam Sept-15
2.04 Analgesia and Sedation February-18
2.05 Drug Assisted Intubation December-16

Section 3 - Respiratory

Printable Version

Section Description Revision Date
3.01 Acute Asthma or COPD with Wheezing February-19
3.02 Carbon Monoxide Inhalation June-19
3.03 Foreign Body Airway Obstruction March-09
3.04 Infectious Upper Airway Obstruction - Croup or Epiglottitis April-16
3.05 Severe Respiratory Pathogens November-10
3.06 Anxiety or Hyperventilation February-11

Section 4 - Cardiac

Printable Version

Section Description Revision Date
4.01 Chest Pain Acute Coronary Syndrome Sept-17
4.02 Asystole April-16
4.03 Atrial Fibrillation Atrial Flutter June-17
4.04 Pulseless Electrical Activity (PEA) January-16
4.05 Premature Ventricular Contractions (PVC) May-12
4.06 Supraventricular Bradycardia and AV Blocks March-09
4.07 Supraventricular Tachycardia January-20
4.08 Ventricular Fibrillation Pulseless Ventricular Tachycardia December-16
4.09 Ventricular Tachycardia with a Palpable Pulse July-12
4.10 Wide Complex Tachycardia Uncertain Origin May-12
4.11 Acute Cardiogenic Pulmonary Edema Pneumonia March-09
4.12 Code Cool Post ROSC Induced Hypothermia March-09
4.13 Adult Immediate Post-Cardiac Arrest Care April-12
4.14 Ventricular Assist Devices August-18

Section 5 - Medical

Printable Version

Section Description Revision Date
5.01 Acute Abdominal Pain April-16
5.02 Allergic Reaction Anaphylactic Shock March-19
5.03 Altered Mental Status (AMS) April-17
5.04 Suspected Stroke or Transcient Ischemic Attack June-19
5.05 Drug Overdose Poisoning March-09
5.06 Cold Emergencies April-12
5.07 Heat Emergencies August-15
5.08 Hazardous Materials March-09
5.09 Severe Hypertension March-09
5.10 Hypo or Hyperglycemia April-16
5.11 Psychological Behavioral Emergencies March-09
5.12 Seizure April-16
5.13 Non-Hemorrhagic Shock October-18
5.14 Sickle Cell Anemia Crisis March-09
5.15 Syncope March-09
5.16 Vertigo March-09
5.17 Sepsis Septic Shock May-19
5.18 Suspected Kidney Stone April-16
5.19 Cyanide Poisoning April-16
5.20 Excited Delirium or Drug Induced Agitation November-17
5.21 Ebola Virus Disease Patient Management October-14
5.22 Acute Adrenal Insufficiency June-18

Section 6 - Trauma

Printable Version

Section Description Revision Date
6.01 Animal Bites Stings August-18
6.02 Burns - Thermal, Electrical, Chemical March-09
6.03 Selective Spinal Immobilization August-14
6.04 Chest Injuries March-09
6.05 Decompression Sickness or Dysbarism March-09
6.06 Extremity Injuries February-15
6.07 Head Injuries November-17
6.08 Near Drowning March-09
6.09 Ophthalmic Injuries March-09
6.10 Suspected Abuse Neglect March-09
6.11 Suspected Sexual Assault March-09
6.12 Trunk Penetrating Injuries April-12
6.13 Hemorrhagic Shock October-18

Section 7 - Pediatric and Obstetrical

Printable Version

Section Description Revision Date
7.01 Pediatric Asystole April-16
7.02 Pediatric Pulseless Electrical Activity PEA April-16
7.03 Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia April-16
7.04 Pregnancy Induced Hypertension (PIH) April-20
7.05 Preterm Labor November-17
7.06 Emergency Childbirth November-17
7.07 Childbirth Complications November-17
7.08 Newborn Care April-16
7.09 Post Partum Care November-17
7.10 Pediatric Febrile Emergency April-16
7.11 Vaginal Bleeding March-09
7.12 Trauma In Pregnancy March-09

Section 8 - Medication Guidelines

Printable Version

Section Description Revision Date
8.00 Authorized Medications April-16
Cyanokit April-16
Dopamine April-16
Epinephrine April-16
Flumazenil April-16
Ketamine November-17
Morphine Sulfate November-16
Naloxone April-16
Nitrous Oxide November-16
Pontocaine November-17
8.05 Antianginals April-17
8.06 Antiarrhythmics July-17
8.07 Antidiabetics April-16
8.08 Antipyretic / Anti Inflammatory March-09
8.09 Antiemetics April-16
8.10 Antihistamines April-16
8.11 Bronchodilators April-16
8.12 Corticosteroids January-17
8.13 Diuretics April-16
8.14 Electrolytes April-16
8.15 Sedative Hypnotics April-16
8.16 Medical Gases March-09
8.17 Hormones Vitamins October-13
8.18 Salicylates March-09
8.19 Anti-Fibrinolytic July-19
Medication Infusion Tables March-09

Section 9 - Procedure Guidelines

Printable Version

Section Description Revision Date
9.00 Autopulse Resuscitation System July-16
9.01 Autovent March-09
9.02 Blood Alcohol Draw on Scene March-18
9.03 Blood Draw using Vacutainer Tubes March-09
9.04 Blood Glucose Test March-09
9.05 Buretrol Usage March-09
9.06 Cardiac Monitor April-12
9.07 Cardioversion March-09
9.08 Continuous Positive Airway Pressure Device March-09
9.09 Cricothyrotomy Needle March-09
9.10 Cricothyrotomy Surgical March-09
9.11 Defibrillation March-09
9.12 Defibrillation Pediatric March-09
9.13 End Tidal CO2 Monitoring and Capnography March-09
9.14.1 Intraosseous Infusion - Femoral February-15
9.14.2 Intraosseous Infusion - Humeral Head December-16
9.15 Intubation Endotracheal March-09
9.16 Intubation Nasotracheal March-09
9.17 IVAC Medsystem III MultiChannel Infusion Pump March-09
9.18 King Tube March-09
9.19 Medication Administration Intramuscular March-09
9.20 Medication Administration Nasal Atomizer March-09
9.21 Medication Administration Nebulizer March-09
9.22 Medication Administration Subcutaneous March-09
9.23 Nasogastric/Orogastric Tube March-09
9.24 Oxygen Administration March-09
9.25 Peripheral IV Administration March-09
9.26 Pleural Decompression March-09
9.27 Removal of Taser Probes March-09
9.28 Reconstitution of Medications March-09
9.29 ResQPOD Impedance Threshold Device March-09
9.30 Transcutaneous Pacing Procedure March-09
9.31 ResQGuard Impedance Threshold Device April-11
9.32 Emergency Chest Wall Escharotomy April-11
9.33 Venous Lactate Monitoring Procedure May-12
9.34 Central Venous Access Devices June-12
9.35 Medication Administration Cross Check Jun-12
9.36 Combat Application Tourniquet Jan-14
9.37 Zoll LifeVest Wearable Defibrillator Dec-14
9.38 iTClamp Hemorrhage Control System Feb-15
9.39 I-gel Supraglottic Airway May-16

Section 10 - References

Section Description Revision Date
10.01 Abbreviations March-09
10.02 Apgar Score March-09
10.03 Glasgow Coma Score March-09
10.04 Pediatric Vital Signs March-09
10.05 Adult Trauma Alert Criteria March-09
10.06 Pediatric Trauma Alert Criteria March-09
10.07 Pediatric Trauma Score March-09
10.08 Nitroglycerin Drip March-09
10.09 Checking Range of Motion March-09
10.10 Rules of Nine March-09
10.11 Florida Statutes March-09
10.12 Evaluation and Treatment Flow Chart March-09
10.13 Spinal Injury Assessment Critical Criteria March-09
10.14 Celox Gauze Powerpoint April-12
10.15 Sepsis and Venous Lactate Powerpoint April-12
10.16 LVAD EMS Guide Sept-18
10.16.1 HeartMate III LVAD - Green Sept-18
10.16.2 HeartMate II LVAD - Red Sept-18
10.16.3 HeartWare LVAD - Dark Blue Sept-18
10.16.4 Jarvik 2000 LVAD - Lavendar Sept-18
10.16.5 Thoratec LVAD - Light Blue Sept-18
10.16.6 DuraHeart LVAD - Purple Sept-18
10.16.7 Total Artificial Heart LVAD - Pink Sept-18

Section 11 - Medical Director Memos

Subject Effective Date
Clarification on Destination Choices 2019-11-14
Transport to the OD Hospital – Advent Health Altamonte Clarification 2019-11-07
Transport to the OD Hospital – Advent Health Altamonte 2019-11-04
Further clarification on Advent Health OD Facility 2019-08-26
Transporting of Overdose Patients to AdventHealth Altamonte 2019-08-12
EMS Reports on Lift Assists 2019-03-01
Blood Draws - Nurses refusing tubes 2018-08-23
Clarification of Baker Act patients transported by EMS 2018-04-11
Opening of Oviedo Medical Center 2017-01-29
Blood Draws - Florida Hospital 2017-01-25
Medical Alerts 2016-04-27
Florida Hospital East Pediatric ED 2015-11-23
Discontinuation of Central Venous Access 2013-08-03
Shortage of Atropine 2013-04-11
EMS Blood Draws for SSCH 2013-03-07
Respiratory/Breathing Treatments 2012-12-19
OB Transports 2011-01-14
Aspirin Administration Documentation 2010-12-01
Transport of Psychiatric Patients 2010-05-17
Alert Terminology 2010-05-06
Transport of STEMI Patients 2010-03-19
Aircare Update 2010-03-19
Delayed Offloads with Critical or Unstable Patients 2010-02-25
Transport of STEMI Patients 2010-02-19
Response to Physicians Offices 2009-10-14
Patient Reports Being Given to Hospitals 2009-09-23
Patient Medications 2009-07-20
H1N1 Update 2009-06-24
Multiple Patient Refusal - Wording 2009-06-04
Request for Call Reviews 2009-05-14
H1N1 Update 2009-05-05
Clarification on Selection for Spinal Immobilization 2009-04-30
EKG Strips 2009-04-23
Patient Medications 2009-04-23
Leaving run reports at the E.R. 2009-02-03
Hyperbaric Chamber at CFRH 2008-10-16
Stemi Transport Destinations 2008-07-22
STEMI Alerts to Winter Park Hospital 2008-02-04
Documentation of Medications 2005-01-27

Section 12 - Paramedic Clinical Assessment Program

Section Description Revision Date
12.01 PCAP Guidelines Jan-19
12.02 ALS Contact Form June-10
12.03 Evaluation Form - Equip Jan-13
12.04 Evaluation Form - Protocols Jan-13
12.05 ALS Contact Definition June-10
12.06 Daily Performance Eval Sept-17
12.07 MD Meetings Roster May-13
12.08 Mentor Evaluation May-13
12.09 Verification of EMT Skills May-13
12.10 PCAP Completion Checklist Sept-17
12.11 Verification of Paramedic Skills May-13
12.12 ALS Contact Form Example 1 Dec-14
12.13 ALS Contact Form Example 2 Dec-14
12.14 Incapacitated Patient Management Dec-14

Section 13 - COVID-19

Section Description Revision Date
13.01 List of COVID-19 Testing Locations 2020-03-17
13.02 MD Memo - Please use Common Sense 2020-03-13
13.03 Hospital Screening and Procedures 2020-03-26
13.04 Dispatch Screening and Procedures 2020-04-01
13.05 Strict Respiratory Precautions Question Card 2020-04-01
13.06 American Red Cross Changed Response Procedures 2020-03-31