Protocol 4-957 - General Social Assessment

CMH EMS & MIH Protocols

EMT w/CHW:

• Assess and include the patient's primary caretaker.
• Ask the patient what their greatest social concern is.
• Discuss housing security. Is the patient concerned about getting housing or losing their housing?
• Assess number of persons living in the same household.
• Standardized Social Determinants of Health Screening. Ask the patient the following questions:
• Food:
1. Within the past 12 months, did you worry that your food would run out before you got money to buy more?
2. Within the past 12 months, did the food you bough just not last and you did not have money to get more?
• Housing/Utilities:
3. Do you have housing?
4. Are you worried about losing your housing?
5. Within the past 12 months, have you or your family members you live with been unable to get utilities (heat, electricity) wen it was really needed?
• Transportation:
6. Within the past 12 months, has lack of transportation kept you from medical appointments, getting your medicines, non-medical meetings or appointments, work, or from getting things that you need?
• Interpersonal Safety:
7. Do you feel physically and emotionally safe where you currently live?
8. Within the past 12 months, have you been hit, slapped, kicked, or otherwise physically hurt by someone?
9. Within the past 12 months, have you been humiliated or emotionally abused in other ways by your partner or ex-partner?
• Urgency:
10. Are any of your needs urgent?
• Assess other material security such as clothing, childcare, and internet service.
• Assess isolation to determine how often they talk to people they care about.
• Assess the patient's support structure to include family, church, work, etc.
• Assess stress level by asking about frequency of anxiousness, nervousness, lack of sleep, etc.
• Assess activity level to include work, leisure, hobbies, family, church, etc.
• Assess employment status.
• Assess level of education completed.
• Assess current situation by determining recent job termination, family changes, jail/correctional facility placement, etc.
• Assess substance use and abuse.
• Discuss and refer appropriately for advanced directives and healthcare power of attourney.

AEMT w/CHW:

• Ensure completion of applicable items above.

RN w/CHW:

• Ensure completion of all applicable items above.

Medic w/CHW:

• Ensure completion of all applicable items above.

CP:

• Ensure completion of all applicable items above.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.