Current through Register Vol. 50, No. 9, September 20, 2024
A. In
those parishes where the parish or component medical society has established a
written pre-hospital EMS protocol for use in the parish, the ambulance service
must follow that protocol, and/or the protocols of the Louisiana Emergency
Response Network as applicable.
B.
In those parishes where the parish or component medical society have not
established a written pre hospital EMS protocol for use in the parish, the EMS
service must develop a protocol to be used by its personnel. The appropriate
portions of this protocol must be approved by the parish or component medical
society.
C. These protocols shall
include protocols for the care of:
1. cardiac
arrest;
2. ventricular
tachycardia;
3. supraventricular
tachycardia;
4. suspected
cardiogenic chest pain or suspected myocardial infarction;
5. stroke or suspected stroke;
6. bradydysrhythmias;
7. hypoglycemia;
8. anaphylactic reactions;
9. hypovolemic shock;
10. unconsciousness or altered mental
status;
11. suspected drug
overdose;
12. treatment induced
unconsciousness, altered mental status, hypotension, or respiratory depression
from physician ordered or protocol appropriate paramedic administered
narcotics;
13. respiratory failure
or respiratory arrest;
14. active
seizure;
15. hospital patient
destination;
16. pre-hospital
diversion;
17. patient with
advanced directives;
18. mass
casualty incidents;
19. injuries
from weapons of mass destruction;
20. pediatric specific care; and
21. traumatic injuries.
D. The EMS service shall adopt the protocols
established by the Louisiana Emergency Response Network (LERN) or develop an
agency specific protocol with specific language related to the transportation
of the following patients:
1. Acute stroke
patients shall be transported to the closest appropriate primary stroke center,
acute stroke ready hospital, or closest appropriate hospital if the patient
exhibits a compromise of airway, breathing or circulatory function, or other
potential life threatening emergency as defined by the protocols implemented by
the ambulance services medical director. Acute stroke patients may also be
diverted to the closest appropriate hospital by order of LERN or online medical
control from the local facility, potential receiving facility or medical
director.
2. Patients suffering an
acute ST elevation myocardial infarction (STEMI) shall be transported to the
closest appropriate STEMI receiving center or, when appropriate, a STEMI
referring center.
3. In any case
where the treating emergency medical technician's evaluation, according to
protocol, indicates a potentially unstable condition or potential medical
emergency that, if traveling the extra distance to the recommended appropriate
facility could put the patient at higher risk, the emergency medical technician
in his/her discretion may divert to the nearest appropriate facility.
E. All protocols shall:
1. meet or exceed the requirements of these
licensing standards and all applicable federal, state, and local
laws;
2. be consistent with the
January 2009 National EMS Education Standards scope of practice and the rulings
of the Louisiana EMS Certification Commission;
3. be reviewed annually by the licensed
agencys medical director, or the parish medical society; and
4. be submitted to the department no more
than 30 days after the implementation of the protocol.
F. Ambulance services are accountable for
assuring compliance with applicable protocols by their personnel. Exceptions to
these protocols must be reviewed on a case-by-case basis by the physician
medical director.
1. Treatment decisions shall
be considered given the current health status of the patient in conjunction
with all of the associated risks factors including, but not limited to,
distance to the nearest stroke facility.
G. Ambulance services must produce, and
provide to all personnel, a policy and procedures manual governing the services
operation.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:1133.14 and
40:1135.3.
