Protocol 2-924 - Universal Patient Care

Polk, Hickory, Cedar, & St Clair EMS Protocols







Patient weight (lbs): (kg):

NEMSIS Protocol: 9914075 - General-Universal Patient Care/ Initial Patient Contact


Change Log:

DateLink to
Description of change
10/04/13pdfAdded orthostatic. Added 4-lead and 12-lead BLS vs ALS clarification.
11/11/13Added quote from MO Statutes on transporting TCD.
11/11/13pdfAdded quote from MO Statutes on transporting TCD trauma.
01/28/14Changed ALS indicated pulseox to reflect Oxygen titration changes.
01/29/14Coordinated protocol with CMH policies.
01/29/14pdfDefined mass casualty from policy. Added first arriving crew’s responsibilities from policies. Added when Triage tags used from policies.
12/12/14pdfAdded if patient contact time less than 15 min, only one set of vitals needed. Added definition of DELIBERATE ACTIONS.
12/12/14pdfAdded comment to maintain patient temp. Added comment if patient contact time less than 15 min, only one set of vitals needed. Added definition of DELIBERATE ACTION. Removed list of trauma centers.
12/12/14Created Decontamination protocol.
12/12/14pdfNew, clearer image for SALT Triage algorithm.
12/26/14pdfAdded Celox and Tourniquet to BLS if bleeding cannot be controlled by simple means.
03/02/15Removed DELIBERATE ACTION. Moved location from 5-010 to 1-020 to keep general assessment protocols together.
03/30/15Added trauma destination determination flowchart.
04/03/15Added consider SMR.
05/31/15Added comment to maintain patient warmth.
08/06/15pdfChanged instruction to keep football equipment in place to remove football equipment prior to transport based on new recoommendations by the National Athletic Trainers Association.
01/28/16Created Protocol 5-085 - Superficial Penetration.
02/03/16pdfAdded EMD section.
07/20/16pdfAdded comment that scene comms should be done on VTAC12.
07/22/16pdfAdded comment than BLS truck with ALS patient shall transport to closest ER or CMH.
07/25/16pdfAt the request of Dr. Merk, added comment to recommend followup with physician for infection monitoring.
08/02/16At the request of Dr. Kramer, added nipple line and above, grossly contaminated wound, and only one end of fish hook through the skin as contraindications for field removal.
06/15/17Per Dr. Carter: Give pain meds to all possible fractures. Clarified to consider giving pain meds to all possible fractures.
07/01/17pdfAdded comment to allow ALS patient refusal for BLS ambulance to transport to closest facility.
07/01/17pdfShortened title.
08/24/17Added instructions to replace Propofol drips with Ketamine on transfers of intubated patients.
09/20/17Added comment to wear high-visibility apparel. Added comment that routine use of lights and siren is not warranted. Added AEMT to give LR bolus to maintain SBP at 90. Added target scene time of 10 minutes.
09/22/17Added cardiac monitoring and 12-lead for taser.
10/16/17Added comment to consider active re-warming.
11/11/17pdfClarified requirements for ALS vs BLS patients based on complaint to allow more flexibility.
11/11/17pdfClarified requirements for ALS vs BLS patients based on complaint to allow more flexibility.
11/11/17pdfAdded comment to not put anyone in an ambulance without decontaminating them first.
11/11/17pdfAdded this SALT triage section from the image that was too small to read in Protocol 6-130 - Triage.
08/24/18pdfPer Dr. Kramer, added comment to wrap other hooks before manipulation.
07/23/19pdfAdded reference to new hemhorrage protocol. Moved requirement for 10 minute scene time from ALS to EMT. Added link to performance graph.
07/23/19Created this hemorrhage protocol as one place for all things hemorrhage, even non-traumatic causes of hemorrhage.
07/23/19pdfRemoved specifics of which crew member on the first arriving ambulance is triage officerwhich is transportation officer. Added link to acquisition of medical control protocol for contact info.
11/27/19pdfMoved tourniquet to EMT to comply with new national scope of practice.
11/27/19pdfAdded comment that cardiac monitoring12-lead is only needed if unresponsivecardiac symptoms.
12/03/19pdfAdded comment to divert AMS if CMH on CT divert.
12/03/19pdfAdded comment to divert AMS if CMH on CT divert.
03/30/20Added content from old Protocol 1-010 - General AssessmentTreatment - Medical. Added comment to divert from CMH if altered mental statusCMH on CT divert, per Dr. Cauchi.
03/30/20pdfAdded content from old Protocol 5-085 - Superficial Penetration.
03/30/20pdfAdded content (without substantive modification) from old Protocol 6-055 - Decontamination.
03/30/20pdfAdded content from old Protocol 6-130 - Triage. Removed comment to use triage tags on patients taken by airTriage Tuesdays due to the region no longer does Triage Tuesdays. Removed entire section for HEAR radio report triaging due to the region moving away from HEAR radio reports. Removed SALT triage. Added comment for crews to stay in their ambulancelimiteliminate triagetreatment on the scene.
03/30/20pdfAdded merged content from 1-020 - General AssessmentTreatment - Trauma.
03/30/20pdfAdded content from 5-075 - Hemorrhage.
04/03/20Added content from old Section 6-125 - Transfer Out of Hospital. Removed section requiring paramedic attendant if physician requests ALS transfer. This is per conversation with Dr. Cauchi on 1/31/20.
07/22/20Per conversation with Dr. Nicholes on 7/22/20: Transport all patients to the closest ER unless the patient refuses (obtain signature)they need to go to a TCD center.
02/18/21pdfChanged 2-880-02 to 2-880-72.
02/19/21pdfAdded section to investigate causes of altered mental status per the Protocol Committee meeting on 1/27/21. Added clarification that all overdoses are ALS patients. Added option for NeoSynephrine for nosebleed control after direct pressure does not work. Added link to transfer priority calculator.
06/06/21pdfMoved to
10/14/21pdfChanged link for 2-220-01 to 2-220-50.
11/05/21pdfRemoved trauma content and added it to new protocol 2-451.
02/28/22Updated link to tPA.
02/28/22Updated link for Propofol.
02/28/22Fixed typo in link for Propofol.

Return to Protocols Table of Contents.

Search protocols:

CMH PHS Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."
Creative Commons License Polk, Hickory, Cedar, & St Clair County EMS Protocols by Theron Becker is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.