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TABLE OF CONTENTS

Medical Director Authorization

Section 1 - Administrative Policies

Section Description Revision Date
1.01 General Measures March-09
1.02 Radio Report Format March-09
1.03 Refusal of Service August-14
1.04 Physician or Nurse on Scene March-09
1.05 Initiation of CPR and Determination of Death Feb-15
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 May-15
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 March-09
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 October-13

Section 2 - Primary Care

Section Description Revision Date
2.01 Initial Medical Assessment and Care March-09
2.02 Initial Trauma Assessment and Care March-09
2.03 Rapid Trauma Assessment, Focused History and Physical Exam March-09
2.04 Analgesia and Sedation March-09

Section 3 - Respiratory

Section Description Revision Date
3.01 Acute Asthma or COPD with Wheezing March-13
3.02 Carbon Monoxide Inhalation March-09
3.03 Foreign Body Airway Obstruction March-09
3.04 Infectious Upper Airway Obstruction - Croup or Epiglottitis March-09
3.05 Severe Respiratory Pathogens November-10
3.06 Anxiety / Hyperventilation February-11

Section 4 - Cardiac

Section Description Revision Date
4.01 Chest Pain Acute Coronary Syndrome March-09
4.02 Asystole April-12
4.03 Atrial Fibrillation Atrial Flutter March-09
4.04 Pulseless Electrical Activity (PEA) April-12
4.05 Premature Ventricular Contractions (PVC) May-12
4.06 Supraventricular Bradycardia and AV Blocks March-09
4.07 Supraventricular Tachycardia April-12
4.08 Ventricular Fibrillation Pulseless Ventricular Tachycardia July-12
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 March-13

Section 5- Medical

Section Description Revision Date
5.01 Acute Abdominal Pain Jan-14
5.02 Allergic Reaction Anaphylactic Shock March-09
5.03 Altered Mental Status (AMS) March-09
5.04 Suspected Stroke or Transcient Ischemic Attack April-14
5.05 Drug Overdose Poisoning March-09
5.06 Cold Emergencies April-12
5.07 Heat Emergencies April-12
5.08 Hazardous Materials March-09
5.09 Severe Hypertension March-09
5.10 Hypo or Hyperglycemia August-14
5.11 Psychological Behavioral Emergencies March-09
5.12 Seizure March-09
5.13 Shock March-09
5.14 Sickle Cell Anemia Crisis March-09
5.15 Syncope March-09
5.16 Vertigo March-09
5.17 Sepsis Septic Shock May-12
5.18 Suspected Kidney Stone March-09
5.19 Cyanide Poisoning April-09
5.20 Excited Delirium or Drug Induced Agitation November-10
5.21 Ebola Virus Disease Patient Management October-14

Section 6 - Trauma

Section Description Revision Date
6.01 Animal Bites Stings March-09
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 Feb-15
6.07 Head Injuries May-15
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

Section 7 - Pediatric and Obstetrical

Section Description Revision Date
7.01 Pediatric Asystole March-09
7.02 Pediatric Pulseless Electrical Activity PEA March-09
7.03 Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia July-12
7.04 Pregnancy Induced Hypertension (PIH) March-09
7.05 Preterm Labor March-09
7.06 Emergency Childbirth March-09
7.07 Childbirth Complications March-09
7.08 Newborn Care March-09
7.09 Post Partum Care March-09
7.10 Pediatric Febrile Emergency March-09
7.11 Vaginal Bleeding March-09
7.12 Trauma In Pregnancy March-09

Section 8 - Medication Guidelines

Section Description Revision Date
8.01 Adrenergics March-09
8.02 Analgesics March-09
8.03 Anesthetics March-09
8.04 Antagonists March-09
8.05 Antianginals March-09
8.06 Antiarrhythmics July-12
8.07 Antidiabetics March-13
8.08 Antipyretic / Anti Inflammatory March-09
8.09 Antiemetics Jan-14
8.10 Antihistamines March-09
8.11 Bronchodilators March-09
8.12 Corticosteroids March-09
8.13 Diuretics March-09
8.14 Electrolytes March-09
8.15 Sedative Hypnotics November-10
8.16 Medical Gases March-09
8.17 Hormones Vitamins October-13
8.18 Salicylates March-09
Medication Infusion Tables March-09

Section 9 - Procedure Guidelines

Section Description Revision Date
9.00 Autopulse Resuscitation System March-09
9.01 Autovent March-09
9.02 Blood Alcohol Draw on Scene March-09
9.03 Blood Draw using Vacutainer 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 / Capnography March-09
9.14 Intraosseous Infusion Feb-15
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

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

Section 11 - Medical Director Memos

Subject Effective Date
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 May-13
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 May-13
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 May-13