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Santa Clara County EMS Test
What is the protocol for EMS Surges/ Multiple patient events? - โ โ 1. All destinations will be assigned by county communications
- may be transported to out of county hospital, or Mobile Field Hospitals with approval Tell me about diversion. - โ โ 1. Only one hospital may be on ambulance diversion (red) at any given time in a Diversion zone
- May divert for 90 minutes per occurrence, but must allow for another 90 minutes before next diversion What are the diversion zones for North, Central, and South? - โ โ Diversion Zones
- North: SUH, ECH, KSC
- Central: RSJ, VMC, OCH
- Southern: GSH, STH, SLH What are the proper DNR documents? - โ โ i. Physicians Orders for Life Sustaining Treatment (POLST) form stating NoCPR
ii. EMSA and CMA approved Emergency Medical Services, Prehospital DNR form
iii. CA approved DNR medallions
iv. Durable Power of Attorney for Health Care (DPAHC) What are the DNR procedures? - โ โ i. If EMS personnel arrive, patient is pulseless and apneic:
- Establish DNR/ Advanced Directives/ Code Status
- May withhold resuscitative efforts if:
- a. Provides a valid DNR form, no code chart order, DNR medallion, POST, or DPAHC that clearly states Do Not Resuscitate.
- If no forms provided, continue resuscitative efforts until such form is provided If patient dies en route to destination, withhold BLS/ALS interventions and choose one of the 3 options: - โ โ Transport to pre-arranged destination Return to point of departure
How can individuals refuse care? - โ โ a. Individuals legally authorized to refuse care is:
- An adult who has capacity
- A minor legally authorized to consent to medical treatment and who has capacity
- A legal representative of the patient who has capacity
- Not currently suicidal
- Is not on a psychiatric hold (5150) What is 600 series about? - โ โ 600: Field Pronouncement of Deatha. - - Criteria-In addition to any specific criteria for withholding or discontinuing resuscitation contained within individual treatment protocols, resuscitative efforts may be withheld, discontinued, and/or death determined What are the five signs of immediate DOA - โ โ Five signs of Immediate DOA
- Decapitation
- Total incineration of the body
- Decomposition of the body
- Rigor mortis accompanied by post mortem lividity
- A pulseless patient with total separation and/or obvious destruction of the heart, brain, and/or lungs What are the two different criteria for stopping resuscitation? - โ โ ii. A pulseless and/or apneic patient with a valid Do Not Resuscitate (DNR) directive (refer to Santa Clara County Prehospital Care Policy 604: Do Not Resuscitate (DNR) / Advanced Directives) iii. A pulseless and/or apneic patient who has exercised his/her right to die under the End of Life Option Act (refer to Santa Clara County Prehospital Care Policy 619: End of Life Option) What do EMS personnel do when 600 series criteria are met? - โ โ i. Discontinue/withhold any resuscitative efforts ii. Cancel and prehospital personnel still en-route iii. Provide appropriate comfort and care to bystanders iv. Complete PCR documenting care, actions taken, including reason for pronounced death. All communications noted and necessary times provided What is 601 series? - โ โ 601: Physician at Scene
What do Physicians need to provide if they are on scene? - โ โ i. Identification(Valid Forms)
- All procedures and treatments performed at scene What is series 602 about? - โ โ 602: 911 EMS Patient Destination Name all Santa Clara County Hospitals - โ โ 1. El Camino Hospital of Los Gatos
- El Camino Hospital of Mountain
- Good Samaritan Hospital
- Kaiser Foundation San Jose
- Kaiser Foundation Santa Clara
- O'Connor Hospital
- Palo Alto Veterans Administration
- Regional Medical Center of San Jose
- Saint Louise Regional Medical
- Santa Clara Valley Medical
- Stanford University Medical Center What is the 100 series composed of? - โ โ 107 - Stakeholder involvement 108 - System Variance Reporting
Name all committees involved in 107 - โ โ - Emergency Medical Services Committee (EMSCo.)
- Prehospital Providers Advisory Committee
- Medical Directors Advisory Committee (MDAC)
- Multi-Casualty Incident (MCI) Committee
- Clinical Practice Advisory Committee (CPAC) Define Emergency Medical Services Committee (EMSCo.) and which series does it belong to - โ โ Series 107 A diverse group of representatives of all provider levels (field paramedics, EMTs, city managers, etc.) that provide recommendations to the Agency and Health Advisory Commission Define Prehospital Providers Advisory Committee and which series does it belong to - โ โ Series 107 Made of representatives from each provider agency, hospitals, law enforcement, etc. that focuses on the logistics and operations of EMS Define Medical Directors Advisory Committee (MDAC) and which series does it belong to - โ โ Series 107 Comprised of various physician groups (South Bay Medical Directors Association, provider agency Medical Directors, etc.) that focus on clinical care issues and integration of patient care resources
- Submit copy of PCR and statements of those involved in the incident What is Level B Variance? Which series does it belong to? When do you report this? - โ โ - 108 series
- Any incident that does not result in patient harm, but is a deviation from EMS Agency protocols, policies, and procedures
- Report to EMS Agency within 5 business days What is Level C Variance? Which series? When do you report this? - โ โ - Incidents where responders provided outstanding care and went above and beyond expectations of responders
- Report within 7 business days What is the 400 series? - โ โ 403: Trauma Center Service Areas
Which hospitals are Adult Trauma centers? - โ โ - Stanford University Hospital SUH
- Santa Clara Valley Med Center VMC
- Regional Medical San Jose RSJ What is SUH catchment zone - โ โ Northern border of SCC to De Anza Blvd in Cupertino and through the center of Sunnyvale
What are VMC catchment zones? - โ โ i. South of De Anza Blvd in Cupertino and south of Sunnyvale-Saratoga Road to East Remington/Fair Oaks Ave in Sunnyvale ii. Eastern border is North First Street/Monterey Highway from San Jose (Alviso) to the southern boundary at the intersection of highway 101 and 85 in SJ iii. Patients requiring transport from areas south of 101/85 and West of 101 extending to the southernmost border of the county will be transported to VMC What are RSJ catchment zones - โ โ - Extends from all areas east of North First Street/Monterey Highway (includes Milpitas) to the southern boundary at the 101/85 intersection in SJ. The northern border is SF Bay
- Patients requiring transport from areas south of 101/ interchange and east of 101 extending into the southernmost borders of the county shall be transported to RSJ
What is the 500 series? - โ โ 501: Hospital Radio Reports What should you do for standard hospital notifications? - โ โ Standard hospital notifications shall occur via cell phone or service dispatch centers What happens if Major Trauma Victim, STEMI, stroke, critical Code 3 transports to the hospital & phone contact is not
- Explain and report abnormal findings
- Otherwise, state "within normal limits" (WNL)
- Treatment provided Does the patient have a choice to choose a facility? - โ โ Patient may be transported to requested facility as long as facility meets medical requirements, barring any EMS system surge and hospital diversion Can patients go to the ED? - โ โ Patients may be transported to routine emergency department Unless patient meets criteria that requires specialty care. What are the pediatric trauma center? - โ โ Stanford University Hospital Santa Clara Valley Medical Center
What are the psychiatric centers? - โ โ El Camino Hospital Mountain View (ECH) Santa Clara Valley Medical Center (VMC) EPS Palo Alto Veterans Hospital (PAV) Stanford University Hospital (SUH)
What is the burn center? - โ โ VMC
What are the stroke centers for comprehensive? - โ โ Comprehensive:
- ECH (mountain view)
- GSH (good samaritan)
- RSJ (regional san jose)
- SUH (stanford university hospital) What are the stroke centers for primary? - โ โ Primary: ALL except PAV and EPS
- El Camino Hospital of Los Gatos
- El Camino Hospital of Mountain
- Good Samaritan Hospital
- Kaiser Foundation San Jose
- Kaiser Foundation Santa Clara
- O'Connor Hospital
- Regional Medical Center of San Jose
- Saint Louise Regional Medical
- Santa Clara Valley Medical
