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2026-09-04T11:54:32Z

Jonesk: /* Section 1 - Administrative Policies */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://scemsprotocols.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| September-26 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Trauma Transport Protocol Update]]
|2026-09-03
|-
|[[Metoprolol Use In A-Fib with RVR|Memo - Metoprolol Use]]
|2026-07-22
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-09-03T19:08:15Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://scemsprotocols.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Trauma Transport Protocol Update]]
|2026-09-03
|-
|[[Metoprolol Use In A-Fib with RVR|Memo - Metoprolol Use]]
|2026-07-22
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Memo - Trauma Transport Protocol Update

2026-09-03T19:07:47Z

Jonesk: Created page with "'''TO''': EMS Personnel<br> '''FROM''': Dr Todd Husty<br> '''DATE''': September 03, 2026<br> '''RE''': Trauma Transport Protocol Update In an effort to better address traumatic injuries involving patients involved in e-bike, motorcycle, and other unenclosed vehicle crashes, a recent protocol update has been made to Trauma Transport Parameter 1.09. The Office of the Medical Director has added the terminology "unenclosed vehicular accident" to the protocol to be..."

'''TO''': EMS Personnel<br>
'''FROM''': Dr Todd Husty<br>
'''DATE''': September 03, 2026<br>
'''RE''': Trauma Transport Protocol Update

In an effort to better address traumatic injuries involving patients involved in e-bike, motorcycle, and other unenclosed vehicle crashes, a recent protocol update has been made to Trauma Transport Parameter 1.09.

The Office of the Medical Director has added the terminology "unenclosed vehicular accident" to the protocol to better identify these types of incidents. This adjustment is intended to address the recent increase in e-bike and other unenclosed vehicle accidents, as well as the increased severity of traumatic injuries associated with these incidents. This update is intended to provide clearer guidance for the assessment and management of patients involved in these types of crashes.

Trauma Transport Protocol

2026-09-03T18:51:59Z

Jonesk: /* Adult Criteria */

==South Section 1 - ADMINISTRATIVE POLICIES==
===1.09 TRAUMA TRANSPORT PROTOCOLS===

In the Seminole County Emergency Medical Services System, the Trauma Transport Protocols (TTPs) are subject to paramedic discretion. That is to say, if in a paramedic’s judgment he or she believes the patient requires transport to a Trauma Center even though they don’t meet the criteria, the paramedic is empowered to transport that patient to the Trauma Center.

=== Dispatch Procedures ===

====Communications Center====
*Seminole County Public Safety E-911 Communications Center is located at 150 Eslinger Way in the city of Sanford, FL. All EMS calls for Seminole County are received by and dispatched by this center. The entire county has enhanced 911 and a computer aided dispatch system.

==== List of information to be obtained from caller ====
*Location of patient
*Type of trauma (Circumstances)
*Number of trauma victims
*Extent and severity of trauma injury
*Scene security / safety
*Name of caller
*Callback number

====Method used to identify and dispatch the most readily available unit====
*The Seminole County EMS System operates under a sophisticated “First Response” agreement between 8 cities and two counties. In this agreement the parties agree to provide reciprocal assistance on a joint response/automatic aid based on geographical location. Agencies participating in the First Response Agreement are:
{| class="wikitable"
|-
! Seminole County !! Orange County
|-
| Lake Mary FD || Maitland FD
|-
| Longwood FD || Orange County Fire Rescue
|-
| Oviedo FD || Winter Park FD
|-
| Sanford FD ||
|-
| Seminole County FD ||
|}

*The closest available unit(s) will be dispatched by the Emergency Medical Services dispatcher based on CAD recommendations and/or Automatic Vehicle Locator (AVL) data.

Prior to the first unit’s arrival, multiple response units may be dispatched by request of the Communications Supervisor or EMS Commander based on information received from caller(s). Paramedics upon arrival can request multiple response units.

====Process used to request assistance from emergency response agencies====
* Fire department is requested to respond to all vehicle accidents, trauma alerts and unconfirmed trauma alerts.
* Law enforcement is requested to respond to all vehicle accidents, violent or potential violent crimes.
* Public utility agencies are requested when need is identified.
* Aero-Medical support may be requested by an on-scene Paramedic. In addition, the Communications Supervisor or EMS Commander can request air support prior to a unit’s arrival on scene based on information received from caller(s). Aero-medical resources are requested through the communications center. The following air resources are assigned by region based on availability and weather conditions:
{| class="wikitable"
|-
! COUNTY !! PRIMARY !! SECONDARY !! TERTIARY
|-
| SEMINOLE || AIR CARE 3 (SSCH) || AIR CARE 1 || AIR CARE 2
|}

'''All Seminole County EMS System units and EMS Command personnel will be dispatched on recorded channels. All other requests for an emergency response agency will be made on recorded phone lines.'''

====Pre-Hospital Procedures====
Adult Trauma Triage Criteria & Methodology
The EMT or paramedic shall assess the condition of those injured persons with anatomical and physiological characteristics of a person sixteen (16) years of age or older for the presence of at least one of the following four criteria to determine whether to transport as a trauma alert. These four criteria are to be applied in the order listed, and once any one criterion is met that identifies the patient as trauma alert, no further assessment is required to determine the transport destination in accordance to the Adult Trauma Scorecard methodology as set forth in 64J-2.004 FAC.

====Adult Criteria====
* Meets color-coded triage system (see below)
* GCS ≤ 12 Patient must be evaluated via GCS if not identified as a trauma alert after application of criterion 1.
* Meets local criteria (specify): ''Likely to require surgery within one to four (1-4) hours.''
* Paramedic Judgment: Patient does not meet any of the trauma criteria listed above however, in the judgment of the Paramedic, should be transported as a trauma alert (document as required per 64J-1.014, FAC)

{| class="wikitable"
|-
! ADULT COMPONENT !! <font color="blue">BLUE</font> !!<font color="red"> RED</font>
|-
| AIRWAY<sup>1</sup>|| <font color="blue">RR ≥ 30</font> ||<font color="red"> REQUIRES ACTIVE AIRWAY ASSISTANCE<sup>2</sup></font>
|-
| CIRCULATION || <font color="blue">SUSTAINED HR ≥ 120 BPM</font> ||<font color="red"> LACK OF RADIAL PULSE WITH SUSTAINED RAPID HEART RATE > 120 BPM OR <br /> BP < 90 mm hg</font>
|-
| BEST MOTOR RESPONSE || <font color="blue">BMR = 5</font> || <font color="red"> BMR OF ≤ 4 <br /> PRESENCE OF PARALYSIS OR <br /> SUSPECTED SPINAL INJURY <br /> LOSS OF SENSATION</font>
|-
| CUTANEOUS ||<font color="blue"> TISSUE LOSS<sup>3</sup> OR <br /> GSW TO EXTREMITIES</font> || <font color="red"> AMPUTATION<sup>4</sup> OR <br /> 2°/3° BURNS TO ≥ 15% TBSA OR <br /> ANY PENETRATING INJURY TO HEAD, NECK OR TORSO<sup>5</sup></font>
|-
| LONGBONE FRACTURE || <font color="blue">SINGLE LONGBONE FX DUE TO MVA OR <br /> FALL > 10’</font> || <font color="red"> SIGNS OR SYMPTOMS OF MULTIPLE LONGBONE FX SITES<sup>6</sup></font>
|-
| AGE ||<font color="blue">≥ 55</font> ||
|-
| MECHANISM OF INJURY ||<font color="blue"> EJECTION FROM VEHICLE<sup>7</sup> OR <br /> DEFORMED STEERING WHEEL<sup>8</sup></font> ||
|}

<font color="red"> RED</font> = any one (1) transport as a trauma alert <font color="blue">BLUE</font>= any two (2) transport as a trauma alert

<sup>1</sup> Airway evaluation is designed to reflect the intervention required for effective care

<sup>2</sup> Not just Oxygen

<sup>3</sup> Degloving injuries, major flap avulsions (> 5 in.)

<sup>4</sup> Amputations proximal to the wrist or ankle

<sup>5</sup> Excluding superficial wounds in which the depth of the wound can be easily determined

<sup>6</sup> Humerus, (radius,ulna), femur, (tibia or fibula)

<sup>7</sup> Including Rider Separation: Rider separated from a transport vehicle with significant impact (e.g., motorcycle, moped, motor scooter, e-bike, ATV/UTV, personal mobility device, horse, or the open body of a pickup truck

<sup>8</sup> Only applies to driver of the vehicle

====Pediatric Trauma Triage Criteria & Methodology====
* The EMT or paramedic shall assess the condition of those injured persons with anatomical and physiological characteristics of a person (15) years or younger using the scorecard methodology outlined in 64J-2.005 FAC. Seminole County Emergency Medical Services System recognizes that a child is not simply a small adult and that the adult trauma scores cannot be used as a reliable indicator of the degree of injury in the pediatric patient. Therefore, all pediatric patients will be scored using the pediatric trauma score outlined below; the presence of at least one of the following two criteria to determine whether to transport as a trauma alert. These two criteria are to be applied in the order listed, and once any one criterion is met that identifies the patient as trauma alert, no further assessment is required to determine the transport destination.

====Pediatric Criteria====

* Meets color-coded triage system (see below)
* Patient does not meet any of the trauma criteria listed above but, in the judgment of the EMT or paramedic, should be transported as a trauma alert (document a required per 64J-1.014, FAC)

{| class="wikitable"
|-
! COMPONENT !! <font color="blue">BLUE </font>!!<font color="red"> RED</font>
|-
| AIRWAY<sup>1</sup> || || <font color="red">REQUIRES ACTIVE AIRWAY ASSISTANCE<sup>2</sup></font>
|-
| CONSCIOUSNESS || <font color="blue">SYMPTOMS OF AMNESIA <br /> LOSS OF CONSCIOUSNESS</font>||<font color="red"> ALTERED MENTAL STATUS<sup>3</sup> <br /> PRESENCE OF PARALYSIS OR <br /> LOSS OF SENSATION <br /> SUSPECTED SPINAL INJURY</font>
|-
| CIRCULATION || <font color="blue">LOSS OF RADIAL OR PEDAL PULSES<sup>4</sup> OR <br /> SYSTOLIC B/P < 90 mm hg</font> ||<font color="red"> FAINT / NONPALPABLE CAROTID PULSE OR <br /> FAINT / NONPALPABLE FEMORAL PULSE OR <br /> BP < 50 mm hg</font>
|-
| FRACTURE || <font color="blue">SIGNS OR SYMPTOMS OF A CLOSED LONG BONE FRACTURE (DOES NOT INCLUDE ISOLATED WRIST OR ANKLE FXs)</font> || <font color="red">OPEN LONG BONE FX.<sup>5</sup> OR <br /> MULTIPLE FX SITES OR <br /> MULTIPLE DISLOCATIONS (EXCEPT FOR ISOLATED WRIST OR ANKLE FX OR DISLOCATIONS)</font>

|-
| CUTANEOUS || ||<font color="red"> MAJOR SOFT TISSUE DISRUPTION<sup>6</sup> OR <br /> 2°/3° BURNS TO ≥ 10% TBSA OR <br /> AMPUTATION<sup>7</sup>, OR <br /> PENETRATING INJURIES TO HEAD, NECK OR TORSO<sup>8</sup></font>
|-
| SIZE ||<font color="blue"> ≤ 11 KILOGRAMS<sup>9</sup> (Kg)</font>||
|}

<font color="red">RED</font> = any one (1) transport as a trauma alert <font color="blue">BLUE</font> = any two (2) transport as a trauma alert

<sup>1</sup> Airway evaluation is designed to reflect the intervention required for effective care

<sup>2</sup> Patient requiring intubation, manual jaw thrust, continuous suctioning or use of airway adjuncts to assist ventilatory efforts

<sup>3</sup> Including drowsiness, lethargy, inability to follow commands, unresponsive to voice, totally unresponsive or coma

<sup>4</sup> Carotid and femoral pulses are palpable but, radial or pedal pulses are not palpable

<sup>5</sup> Humerus, (radius,ulna), femur, (tibia or fibula)

<sup>6</sup> Major degloving injuries or major flap avulsions

<sup>7</sup> Amputations proximal to the wrist or ankle

<sup>8</sup> Excluding superficial wounds in which the depth of the wound can be easily determined

<sup>9</sup> Or body length is equivalent to this weight on the Handtevy System

====Issuing a Trauma Alert:====
* A “Trauma Alert” is to be called by the first arriving unit, if and when in the judgment of the Paramedic, EMT in charge, the adult or pediatric trauma patient meets the criteria.
* To initiate a “Trauma Alert”:
**Establish direct communication with the Trauma Center, Pediatric Trauma Center or other receiving facility on the appropriate facility’s radio talkgroup utilizing either an 800 MHz or VHF radio frequency.
**Give agency name, unit number and state “Trauma Alert”. Give brief description of the situation, location, criteria for call the “Trauma Alert” and approximate E.T.A.
**Once transporting unit is enroute to the trauma center or receiving facility, a complete radio report will be given as outlined in Administrative Policy – [[Radio Report Format|RADIO REPORT FORMAT]] (1.02).
* The transporting agency will provide documentation as prescribed in 64J-2.004 FAC for each adult or 64J-2.005 FAC for each pediatric patient or provide documentation on the Seminole County Abbreviated Report to the hospital staff upon delivery of the patient to the Trauma Center or receiving facility.

====Transport Procedures:====
All trauma alert patients will be transported to the State Approved Trauma Center (SATC) or State Approved Pediatric Trauma Center (SAPTC) nearest to the location of the incident; that meets all criteria as required in the Department of Health Pamphlet DHP 150-9 (January 2010 revision) and 64J-2.002.
* Initial efforts are to direct transportation of the trauma alert patient to the closest SATC.
* The EMT, Paramedic that finds any trauma patient that meets the criteria using the appropriate Trauma Scorecard Methodology, as required in sections 64J-2.004 or 64J-2.005 FAC shall immediately notify their Communications Center and issue a “Trauma Alert”.
* The Paramedic will advise the Communications Center of the following information about the trauma alert scene:
**Total number of patients
**Total number of trauma alert patients
**Criteria by which the alert was called
**Mechanism of injury
**Additional resources needed

====Guidelines for transportation are as follows:====
* AIR SUPPORT to a State Approved Trauma Center (SATC):
**Air support response time is less than 30 minutes.
* GROUND TRANSPORT to a State Approved Trauma Center (SATC):
**The ground transport time is less than 30 minutes.
* AIR TRANSPORT TO INITIAL RECEIVING HOSPITAL (IRH)
**The TTP of the Air Transport Agency indicate diversion (e.g. Cardiac Arrest etc.).
**MCI situations*
**GROUND TRANSPORT to an IRH nearest the scene of the incident:
**When air transport is not available or response time is greater than 30 minutes and ground transport to SATC is greater than 30 minutes. **Cardiac arrest secondary to trauma.
**Lack of patent airway.
**MCI situation*.

<nowiki>*</nowiki>For situations with multiple trauma patients, not meeting trauma alert criteria, the critical patients should be transported to the initial receiving hospital nearest the scene of incident. The non-critical patients should be transported to a different initial receiving hospital, if possible. There may be instances in mass casualty situations when the ground units will be overburdened and may need air transport to facilitate movement of multiple patients to initial receiving hospitals. This decision will be made by the Field Supervisor on the scene.
* If a trauma center or an initial receiving hospital nearest the scene of the incident notifies EMS that it is temporarily unable to provide adequate care for the trauma alert patient, EMS personnel under the direction of Medical Control, will determine which hospital is in the patient’s best interest.

====Emergency inter-facility transfers of Trauma Victims:====
* In accordance with 64J-2.002 FAC, inter-facility transfers to the Trauma Center shall be conducted by services licensed by the department in appropriately permitted ambulances when the patient needs, or is likely to need, medical attention during transport. A critical care patient shall be transported in a permitted air ambulance or ground vehicle that is staffed and equipped requisite to the patient’s requirements. Under extreme circumstances, such as: a patient requiring immediate life, limb, or bodily function saving surgery; an inability to provide that surgery in a timely manner at the originating hospital; and a lack of timely response by a permitted inter-facility transport vehicle, EMS may need to provide that transfer. The attending physician and the originating hospital will ensure that the level of patient care established in the originating hospital is appropriately provided during the transport. The originating hospital will provide personnel and equipment as necessary for the safest transfer possible. '''If that level of care is, in the determination of EMS, not being provided for contact the Medical Director on call.'''
*Assess the patient upon arrival.
*Transport to the facility where the patient has been accepted by physician.

====List of Hospitals====

====TRAUMA CENTERS====
* The following is a list of trauma centers to where Seminole County Emergency Medical Services System will routinely transport trauma alert patients. It is preferable that pediatric patients (15 years old and younger) and burn patients be transported to a Level I trauma center.
{| class="wikitable"
|-
| Orlando Regional Medical Center (TL I)

29 W Sturtevant St

Orlando, Florida 32806

Arnold Palmer Hospital for Children (TL I)

92 West Miller Street

Orlando, FL 32806
| HCA Florida Lake Monroe (TL II)

1403 Medical Plaza Dr

Sanford, FL 32771

Halifax Hospital Medical Center (TL II)

303 North Clyde Morris Blvd.

Daytona Beach, Florida 32015
|}

====INITIAL RECEIVING HOSPITALS====
* The following is a list of initial receiving hospitals to where Seminole County Emergency Medical Services System will routinely transport trauma patients that are not trauma alerts. Initial receiving hospitals are indicated by written documentation.
{| class="wikitable"
|-
| '''Seminole County'''
AdventHealth Altamonte Springs

601 E. Altamonte Dr.

Altamonte Springs, Florida 32701

Oviedo Medical Center

8300 Red Bug Lake Road

Oviedo, FL 32765

Orlando Health Lake Mary

380 Rinehart Rd

Lake Mary, FL 32746

'''Volusia County'''

AdventHealth Fish Memorial

1055 Saxon Blvd

Orange City, Florida 32763

| '''Orange County'''

AdventHealth Apopka

2100 Ocoee Apopka Road

Apopka, FL 32703

AdventHealth East Orlando

7727 Lake Underhill Road

Orlando, Florida 32822

AdventHealth Orlando

601 East Rollins Street

Orlando, Florida 32803

AdventHealth Winter Park Memorial Hospital

200 Lakemont Ave

Winter Park, Florida 32792

Nemours Children Hospital

13535 Nemours Parkway

Orlando, FL 32827 (407) 567-4000
|}

====FREE STANDING EMERGENCY DEPARTMENTS====
The following is a list of Free Standing Emergency Departments to where Seminole County Emergency Medical Services system will elect to transport when the injured patient appears to have a minor injury and is unlikely to require hospital admission or emergent or urgent surgical intervention beyond the capabilities of a free standing emergency department.
{| class="wikitable"
|-
|
AdventHealth Oviedo ER

8100 Red Bug Lake Road

Oviedo, FL 32765

AdventHealth Lake Mary

950 Rinehart Road

Lake Mary, FL 32746

AdventHealth Waterford Lakes ED

13691 E Colonial Drive

Orlando FL 32826

HCA Florida Baldwin Park ER

2361 N Semoran Blvd

Orlando, FL 32807

HCA Florida Heathrow ER

4525 International Parkway

Sanford, FL 32771

Orlando Health Emergency Room – Longwood

555 W SR 434

Longwood, FL 32750

HCA Florida Casselberry

2560 S US Hwy 17-92

Casselberry, FL 32707

HCA Florida Maitland

9401 Summit Centre Way

Orlando, FL 32810

HCA Florida Alafaya

1434 N Alafaya Trail

Orlando, FL 32828

|}

====Deviations:====
'''''Any deviation from these protocols will be documented and justified on the Patient Care Report.'''''

[[Category:Administrative Policies|0109]]

Removal of Taser Probes

2026-08-27T14:10:21Z

Jonesk: /* Assessment of a Patient that has been Tasered: */

==Procedure Guidelines==
===9.27 REMOVAL OF TASER PROBES===

====Scene Safety Consideration:====
* Before touching any patient who has been subdued using a Taser, determine if the patient is cooperative and restrained by Law Enforcement.
* BSI precautions: Wear gloves and eye protection.

====Taser and Probes:====
[[File:Taser.jpg|200px|thumb|left|]]
[[File:Taser_Probes.jpg|200px|thumb|left|]]

<br style="clear: both" />
====Assessment of a Patient that has been Tasered:====
* Identify the location of the probes on the patient’s body. If any of the probes are embedded in the following areas do not remove them and transport the patient to an Emergency Department:
** Face (except cheek)
** Neck
** Groin
** Spinal Column

====Removal of Probe:====
If the probes are located in an area that is not specified above it can be removed by an EMT or paramedic. To remove the probe:
* Place gloved hand on the patient in the area where the probe is embedded and stabilize the skin surrounding the puncture site. Place your other gloved hand firmly around the probe.
* In one fluid motion pull the probe straight out from the puncture site.
* Repeat procedure with second probe.
* Removed probes should be handled and disposed of like contaminated sharps in a designated sharps container.
* Check with your local law enforcement agency, they may require that the probes be kept as evidence.

[[Category:Procedure Guidelines|0927]]

Main Page

2026-07-22T19:36:10Z

Jonesk: /* TABLE OF CONTENTS */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://scemsprotocols.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Metoprolol Use In A-Fib with RVR|Memo - Metoprolol Use]]
|2026-07-22
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-07-22T19:30:51Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Metoprolol Use In A-Fib with RVR|Memo - Metoprolol Use]]
|2026-07-22
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Metoprolol Use In A-Fib with RVR

2026-07-22T19:30:35Z

Jonesk: Created page with "'''TO''': EMS Personnel<br>'''FROM''': Dr Todd Husty<br>'''DATE''': July 22, 2026<br>'''RE''': Metoprolol use in A-Fib with RVR The Office of the Medical Director is implementing a new Metoprolol treatment parameter for patients with Atrial Fibrillation accompanied by Rapid Ventricular Response (RVR). This update is straightforward and is not intended to complicate patient care. Please take the time to read the new parameter carefully and ensure you understan..."

'''TO''': EMS Personnel<br>'''FROM''': Dr Todd Husty<br>'''DATE''': July 22, 2026<br>'''RE''': Metoprolol use in A-Fib with RVR

The Office of the Medical Director is implementing a new Metoprolol treatment parameter for patients with Atrial Fibrillation accompanied by Rapid Ventricular Response (RVR).

This update is straightforward and is not intended to complicate patient care. Please take the time to read the new parameter carefully and ensure you understand its indications and application.

This treatment approach has been recommended by our hospital emergency department partners as the preferred management strategy for appropriate unstable patients. It is important to emphasize that this protocol is not intended for patients who simply have an elevated heart rate. Clinical Judgement and adherence to the specified inclusion criteria remain essential.

Thank you for your attention to the update and for your continued commitment to providing safe, evidence-based patient care.

Respectfully,

Todd M. Husty, DO<br>Medical Director
[[File:Metoprolol Memo.png|center|thumb]]

Main Page

2026-07-22T19:18:51Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Metoprolol Use]]
|2026-07-22
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

File:Metoprolol Memo.png

2026-07-22T19:15:25Z

Jonesk:

Atrial Fibrillation Atrial Flutter

2026-07-22T19:11:00Z

Jonesk: /* POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: */

==Section 4 - CARDIAC==
===4.03 ATRIAL FIBRILLATION / ATRIAL FLUTTER===

'''CONSIDER MEDICAL ETIOLOGY AND REFER TO APPROPRIATE PRACTICE PARAMETER:'''
* [[Chest Pain Acute Coronary Syndrome|CHEST PAIN / ACUTE CORONARY SYNDROME]] (4.01).
* Hypoxia, [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* Toxic effects of medications or alcohol.
* Thyroid Disease.

==== POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
* If rate is greater than 150 beats/minute and narrow complex. Consider administration of [[Metoprolol|METOPROLOL]] 5mg slow IV push. If inadequate response after 2-5 minutes and HR >150 with stable BP, may repeat [[Metoprolol|METOPROLOL]] 5mg slow IV push. If after 2-5 more minutes with inadequate response and HR >150 with stable BP, may repeat one additional time to a max of 3 total doses (15mg MAX).
* '''<u>CONTRAINDICATED IF RAPID A-FIB IS SUSPECTED SECONDARY TO COCAINE USE.</u>'''
* If rate greater than 150 beats/minute and wide complex refer to [[Wide Complex Tachycardia Uncertain Origin|WIDE COMPLEX TACHYCARDIA PARAMETER]] (4.10)
* [[Aspirin|ASPIRIN]] 81mg, chewed, if not previously administered or with known hypersensitivity to the drug or active ulcer disease.

==== UNSTABLE: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)- [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
*O2 saturation, monitor in place.
* [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 50 Joules.
*Consider pre-medication with [[Versed|MIDAZOLAM (VERSED)]]. Start at 2-5 mg then 2 mg every 30 seconds to 1 min IVP or IN if patient is conscious.
*May repeat as necessary to allow for sedation. See [[Analgesia and Sedation|ANALGESIA/SEDATION PARAMETER]] (2.04)
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 100 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 200 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 300 Joules.

'''''Physician's Orders: If NO response, contact Medical Control for consult.'''''

This Standing Order is divided between the care and treatment of the stable patient verses the unstable patient. As a matter of definition agreed upon by the Medical Directors, the UNSTABLE patient is one who presents with any of the following: '''''SIGNIFICANT CARDIAC SYMPTOMS, SIGNIFICANT DYSPNEA, ALTERED MENTAL STATUS, OR HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION, OR SIGNIFICANT COMPROMISE OF AIRWAY, BREATHING AND/OR CIRCULATION.'''''

'''''If there is a prolonged delay or difficulty obtaining synchronization, and the patient is extremely UNSTABLE, then [[Defibrillation|DEFIBRILLATION]] should be administered.'''''

[[Category:Cardiac|0403]]

Atrial Fibrillation Atrial Flutter

2026-07-22T19:10:25Z

Jonesk: /* POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: */

==Section 4 - CARDIAC==
===4.03 ATRIAL FIBRILLATION / ATRIAL FLUTTER===

'''CONSIDER MEDICAL ETIOLOGY AND REFER TO APPROPRIATE PRACTICE PARAMETER:'''
* [[Chest Pain Acute Coronary Syndrome|CHEST PAIN / ACUTE CORONARY SYNDROME]] (4.01).
* Hypoxia, [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* Toxic effects of medications or alcohol.
* Thyroid Disease.

==== POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
* If rate is greater than 150 beats/minute and narrow complex. Consider administration of [[Metoprolol|METOPROLOL]] 5mg slow IV push. If inadequate response after 2-5 minutes and HR >150 with stable BP, may repeat [[METOPROLOL]] 5mg slow IV push. If after 2-5 more minutes with inadequate response and HR >150 with stable BP, may repeat one additional time to a max of 3 total doses (15mg MAX).
* '''<u>CONTRAINDICATED IF RAPID A-FIB IS SUSPECTED SECONDARY TO COCAINE USE.</u>'''
* If rate greater than 150 beats/minute and wide complex refer to [[Wide Complex Tachycardia Uncertain Origin|WIDE COMPLEX TACHYCARDIA PARAMETER]] (4.10)
* [[Aspirin|ASPIRIN]] 81mg, chewed, if not previously administered or with known hypersensitivity to the drug or active ulcer disease.

==== UNSTABLE: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)- [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
*O2 saturation, monitor in place.
* [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 50 Joules.
*Consider pre-medication with [[Versed|MIDAZOLAM (VERSED)]]. Start at 2-5 mg then 2 mg every 30 seconds to 1 min IVP or IN if patient is conscious.
*May repeat as necessary to allow for sedation. See [[Analgesia and Sedation|ANALGESIA/SEDATION PARAMETER]] (2.04)
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 100 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 200 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 300 Joules.

'''''Physician's Orders: If NO response, contact Medical Control for consult.'''''

This Standing Order is divided between the care and treatment of the stable patient verses the unstable patient. As a matter of definition agreed upon by the Medical Directors, the UNSTABLE patient is one who presents with any of the following: '''''SIGNIFICANT CARDIAC SYMPTOMS, SIGNIFICANT DYSPNEA, ALTERED MENTAL STATUS, OR HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION, OR SIGNIFICANT COMPROMISE OF AIRWAY, BREATHING AND/OR CIRCULATION.'''''

'''''If there is a prolonged delay or difficulty obtaining synchronization, and the patient is extremely UNSTABLE, then [[Defibrillation|DEFIBRILLATION]] should be administered.'''''

[[Category:Cardiac|0403]]

Atrial Fibrillation Atrial Flutter

2026-07-22T19:08:52Z

Jonesk: /* POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: */

==Section 4 - CARDIAC==
===4.03 ATRIAL FIBRILLATION / ATRIAL FLUTTER===

'''CONSIDER MEDICAL ETIOLOGY AND REFER TO APPROPRIATE PRACTICE PARAMETER:'''
* [[Chest Pain Acute Coronary Syndrome|CHEST PAIN / ACUTE CORONARY SYNDROME]] (4.01).
* Hypoxia, [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01).
* Toxic effects of medications or alcohol.
* Thyroid Disease.

==== POTENTIALLY UNSTABLE AND TIME TO ED > 15 MINUTES: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
* If rate is greater than 150 beats/minute and narrow complex. Consider administration of [[METOPROLOL]] 5mg slow IV push. If inadequate response after 2-5 minutes and HR >150 with stable BP, may repeat [[METOPROLOL]] 5mg slow IV push. If after 2-5 more minutes with inadequate response and HR >150 with stable BP, may repeat one additional time to a max of 3 total doses (15mg MAX).
* '''<u>CONTRAINDICATED IF RAPID A-FIB IS SUSPECTED SECONDARY TO COCAINE USE.</u>'''
* If rate greater than 150 beats/minute and wide complex refer to [[Wide Complex Tachycardia Uncertain Origin|WIDE COMPLEX TACHYCARDIA PARAMETER]] (4.10)
* [[Aspirin|ASPIRIN]] 81mg, chewed, if not previously administered or with known hypersensitivity to the drug or active ulcer disease.

==== UNSTABLE: ====
* [[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01)- [[Oxygen|OXYGEN]] @ 100% via NRB mask or assist with BVM.
*O2 saturation, monitor in place.
* [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 50 Joules.
*Consider pre-medication with [[Versed|MIDAZOLAM (VERSED)]]. Start at 2-5 mg then 2 mg every 30 seconds to 1 min IVP or IN if patient is conscious.
*May repeat as necessary to allow for sedation. See [[Analgesia and Sedation|ANALGESIA/SEDATION PARAMETER]] (2.04)
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 100 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 200 Joules.
* If NO response, [[Cardioversion|SYNCHRONIZED CARDIOVERSION]] @ 300 Joules.

'''''Physician's Orders: If NO response, contact Medical Control for consult.'''''

This Standing Order is divided between the care and treatment of the stable patient verses the unstable patient. As a matter of definition agreed upon by the Medical Directors, the UNSTABLE patient is one who presents with any of the following: '''''SIGNIFICANT CARDIAC SYMPTOMS, SIGNIFICANT DYSPNEA, ALTERED MENTAL STATUS, OR HYPOTENSION WITH SIGNS OF DECREASED TISSUE PERFUSION, OR SIGNIFICANT COMPROMISE OF AIRWAY, BREATHING AND/OR CIRCULATION.'''''

'''''If there is a prolonged delay or difficulty obtaining synchronization, and the patient is extremely UNSTABLE, then [[Defibrillation|DEFIBRILLATION]] should be administered.'''''

[[Category:Cardiac|0403]]

Main Page

2026-07-22T19:02:47Z

Jonesk: /* Section 8 - Medication Guidelines */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Metoprolol]]
|July-26
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Metoprolol

2026-07-22T19:02:21Z

Jonesk: Created page with "== Section 8 - MEDICATION GUIDELINES == === ANTAGONISTS === ==== Metoprolol / Antagonist ==== '''DESCRIPTION''' * It is a β-adrenergic antagonist '''INDICATIONS''' * For patients with Atrial Fibrillation accompanied by Rapid Ventricular Response (RVR). '''CONTRAINDICATIONS''' * Cocaine Use '''DOSAGE''' * 5mg slow IV push * If inadequate response after 2 - 5 minutes AND Heart Rate > 150 with stable BP, may repeat 5mg slow IV push * If inadequate response after a..."

== Section 8 - MEDICATION GUIDELINES ==

=== ANTAGONISTS ===

==== Metoprolol / Antagonist ====
'''DESCRIPTION'''

* It is a β-adrenergic antagonist

'''INDICATIONS'''

* For patients with Atrial Fibrillation accompanied by Rapid Ventricular Response (RVR).

'''CONTRAINDICATIONS'''

* Cocaine Use

'''DOSAGE'''

* 5mg slow IV push
* If inadequate response after 2 - 5 minutes AND Heart Rate > 150 with stable BP, may repeat 5mg slow IV push
* If inadequate response after additional 2 - 5 minutes AND Heart Rate > 150 with stable BP, may repeat an additional 5mg slow IV push
* Max of 3 doses (15mg MAX)

Main Page

2026-05-27T13:52:27Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Transporting of Patients from the Seminole County Jail|Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-05-27T13:50:57Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Transports from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-04-28T15:15:57Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-04-27T19:16:16Z

Jonesk: /* Section 11 - Medical Director Memos */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Transporting of Patients from the Seminole County Jail]]
|2026-04-15
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Transporting of Patients from the Seminole County Jail

2026-04-27T19:16:01Z

Jonesk:

'''TO''': EMS Personnel<br>'''FROM''': Dr Todd Husty<br>'''DATE''': April 15, 2026<br>'''RE''': Transporting of Patients from the Seminole County Jail

For continuity of medical care and known security reasons, please follow the direction of SCJail nursing staff and/or the SCJail medical provider when determining transport destination. The majority of the patients transported from Seminole County Jail should be transported to HCA Lake Monroe. Exceptions to this rule would include pregnancy related patients, recent surgery or procedure at another facility, or specific direction this is a directive from SCJail nursing staff or providers.

Please direct your crews to follow the destination plan directed by SCJail nurses or providers.

Transporting of Patients from the Seminole County Jail

2026-04-27T19:13:40Z

Jonesk: Created page with "'''TO''': EMS Personnel '''FROM''': Dr Todd Husty '''DATE''': April 15, 2026 '''RE''': Transporting of Patients from the Seminole County Jail For continuity of medical care and known security reasons, please follow the direction of SCJail nursing staff and/or the SCJail medical provider when determining transport destination. The majority of the patients transported from Seminole County Jail should be transported to HCA Lake Monroe. Exceptions to this rul..."

'''TO''': EMS Personnel

'''FROM''': Dr Todd Husty

'''DATE''': April 15, 2026

'''RE''': Transporting of Patients from the Seminole County Jail

For continuity of medical care and known security reasons, please follow the direction of SCJail nursing staff and/or the SCJail medical provider when determining transport destination. The majority of the patients transported from Seminole County Jail should be transported to HCA Lake Monroe. Exceptions to this rule would include pregnancy related patients, recent surgery or procedure at another facility, or specific direction this is a directive from SCJail nursing staff or providers.

Please direct your crews to follow the destination plan directed by SCJail nurses or providers.

Main Page

2026-04-27T18:53:34Z

Jonesk: /* Section 4 - Cardiac */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-04-27T18:50:39Z

Jonesk: /* Section 8 - Medication Guidelines */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.12||<s>Code Cool Post ROSC Induced Hypothermia</s> REMOVED||March-26
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Main Page

2026-04-27T18:34:51Z

Jonesk: /* Section 8 - Medication Guidelines */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.12||<s>Code Cool Post ROSC Induced Hypothermia</s> REMOVED||March-26
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Fentanyl]]
|April-26
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

MediaWiki:Deletereason-dropdown

2026-04-27T18:26:15Z

Jonesk: Created page with "* Common delete reasons ** No Longer in Protocol ** Spam ** Vandalism ** Copyright violation ** Author request ** Broken redirect"

* Common delete reasons
** No Longer in Protocol
** Spam
** Vandalism
** Copyright violation
** Author request
** Broken redirect

Head Injuries

2026-04-23T14:01:25Z

Jonesk: /* 6.07 HEAD INJURIES */

==Section 6 - TRAUMA==
===6.07 HEAD INJURIES===

[[Initial Trauma Assessment and Care|INITIAL TRAUMA CARE]], (2.02) [[Oxygen|OXYGEN]] @ 100% via NRB mask or hyperventilate with BVM.
* Elevate head and shoulders 15 - 30 degrees if systolic BP > 90 mm Hg.
* Refer to [[Altered Mental Status (AMS)|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).
* If '''Combative''' refer to [[Dissociative Anesthetic|DISSOCIATIVE ANESTHETIC]] (2.05)
* [[Morphine_Sulfate|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)
::'''AND / OR'''
* [[Ketamine|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%

'''TRAUMATIC BRAIN INJURY MANAGEMENT'''
* If the following criteria have been met:
** GCS < 8 (Consider airway management with an i-gel if no gag reflex)
** AND Any one of the following:
*** Unilateral fixed or dilated pupil
*** Unilateral paralysis
*** Posturing
*** Seizure after injury
*** Skull deformity
''ADULT''
* [[Hypertonic Saline|3% Saline]] bolus, 250 ml IV or IO
* [[Keppra|KEPPRA (LEVETIRACETAM)]] 1 gram IV or IO in 10cc NORMAL SALINE, administered over 2 minutes
''PEDIATRIC''
* [[Hypertonic Saline|3% Saline]] bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set
* [[Keppra|KEPPRA (LEVETIRACETAM)]] 20mg/kg (not to exceed 1g) IV/IO in 10cc NORMAL SALINE, administered over 2 minutes (may be repeated once at 40mg/kg if seizure continues)
* Transport patient to nearest Pediatric Trauma Center via appropriate method

<BR>
'''OTHER OPTIONS'''
* [[Versed|MIDAZOLAM (Versed)]] - Initial dose 2-5mg IV or IN then 2 mg every 30 seconds to 1 minute.
** (Max dose 15 mg) in the intubated patient. IM .07-.08 mg/kg with onset in approximately 15 minutes. IM injection requires immediate IV access upon sedation.
* [[Valium|DIAZEPAM (VALIUM)]] 2 - 20 mg SLOW IVP or IM to desired effect.
* These drugs may be given in combination for maximum effectiveness.
* Ensure that Pulse Oximeter is in place.
* Ensure that BVM and [[Flumazenil|ROMAZICON]] and/or [[Naloxone|NARCAN]] are readily available.

[[Category:Trauma|0607]]

Main Page

2026-04-23T13:53:10Z

Jonesk: /* Section 6 - Trauma */

==TABLE OF CONTENTS==

[[Medical Director Authorization]]

[[IMS]]

[https://roaddoc.com/scems/index.php/Special:RecentChanges?hidebots=1&limit=50&days=60&enhanced=1&urlversion=2 Changes in past 60 days]

===Section 1 - Administrative Policies===
{| class="wikitable"
|-
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || April-25 ||
|-
| 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]]|| February-19 ||
|-
| 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]]|| June-25 ||
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| April-25 ||
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
| 1.22|| [[Hospital Capability Chart]]|| May-24 ||May-24
|-
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||

|}

===Section 2 - Primary Care===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
||2.04||[[Analgesia and Sedation]]||March-26
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|-
|2.06
|[[Patient Assist]]
|January-25
|}

===Section 3 - Respiratory===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}

===Section 4 - Cardiac===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|4.02 || [[Asystole]]||December-22
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||June-25
|-
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|4.12||<s>Code Cool Post ROSC Induced Hypothermia</s> REMOVED||March-26
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}

===Section 5 - Medical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||February-26
|-
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|5.04||[[Suspected Stroke Transient Ischemic Attack TIA|Suspected Stroke or Transient Ischemic Attack]]||May-15
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|5.06||[[Cold Emergencies]]||April-12
|-
|5.07||[[Heat Emergencies]]||August-15
|-
|5.08||[[Hazardous Materials]]||July-22
|-
|5.09||[[Severe Hypertension]]||March-09
|-
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|5.12||[[Seizure]]||April-16
|-
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|-
|5.15||[[Syncope]]||March-09
|-
|5.16||[[Vertigo]]||March-09
|-
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}

===Section 6 - Trauma===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|6.01||[[Animal Bites Stings]]||August-18
|-
|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]]||November-25
|-
|6.07||[[Head Injuries]]||April-26
|-
|6.08||[[Near Drowning]]||March-09
|-
|6.09||[[Ophthalmic Injuries]]||March-09
|-
|6.10||[[Suspected Abuse Neglect]]||February-26
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||November-25
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}

===Section 7 - Pediatric and Obstetrical===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|7.01||[[Pediatric Asystole]]||April-16
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|7.05||[[Preterm Labor]]||November-17
|-
|7.06||[[Emergency Childbirth]]||November-17
|-
|7.07||[[Childbirth Complications]]||November-17
|-
|7.08||[[Newborn Care]]||April-16
|-
|7.09||[[Post Partum Care]]||November-17
|-
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|7.11||[[Vaginal Bleeding]]||March-09
|-
|7.12||[[Trauma In Pregnancy]]||March-09
|}

===Section 8 - Medication Guidelines===

INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Buprenorphine]]
|December-24
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Ceftriaxone|Ceftriaxone/Rocephin™]]
|November-25
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||February-26
|-
|[[Pontocaine]]/Tetracaine||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||July-25
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}

===Section 9 - Procedure Guidelines===

{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||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 and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|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 Escharotomy|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||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|-
|9.43||[[Elegard - Adult]]||Mar-25
|-
|9.44||[[Elegard - Pediatric]]||Mar-25
|}

===Section 10 - References===
{| class="wikitable"
|-
! 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||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||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
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}

===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
|[[Memo - Stroke Alerts]]
|2025-05-12
|-
|[[Memo - Medical Clearance]]
|2025-03-31
|-
|[[Memo - Patient Assists]]
|2025-03-31
|-
|[[Memo - Face to face Medical Director meetings]]
|2025-03-31
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|<s>EMS Reports on Lift Assists</s>]] - RESCINDED|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}

===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}

===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}

[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In]

[[IMS]]

Head Injuries

2026-04-23T13:51:03Z

Jonesk: /* 6.07 HEAD INJURIES */

==Section 6 - TRAUMA==
===6.07 HEAD INJURIES===

[[Initial Trauma Assessment and Care|INITIAL TRAUMA CARE]], (2.02) [[Oxygen|OXYGEN]] @ 100% via NRB mask or hyperventilate with BVM.
* Elevate head and shoulders 15 - 30 degrees if systolic BP > 90 mm Hg.
* Refer to [[Altered Mental Status (AMS)|ALTERED MENTAL STATUS PRACTICE PARAMETER]] (5.03).
* If '''Combative''' refer to [[Dissociative Anesthetic|DISSOCIATIVE ANESTHETIC]] (2.05)
* [[Morphine_Sulfate|MORPHINE]] - Initial dose 2-5 mg IVP, IM or IN followed by 2 mg doses. (Max 15 mg)
::'''AND / OR'''
* [[Ketamine|KETAMINE (KETALAR)]] Titrate to effect, starting dose of 0.5 mg/kg slow IVP or 1 mg/kg IM.
* Maintain ETCO2 between 30-35 mmHg and Oxygen saturation >95%

'''TRAUMATIC BRAIN INJURY MANAGEMENT'''
* If the following criteria have been met:
** GCS < 8 (Consider airway management with an i-gel if no gag reflex)
** AND Any one of the following:
*** Unilateral fixed or dilated pupil
*** Unilateral paralysis
*** Posturing
*** Seizure after injury
*** Skull deformity
''ADULT''
* [[Hypertonic Saline|3% Saline]] bolus, 250 ml IV or IO
* [[Keppra]] 1 gram IV or IO in 10cc NORMAL SALINE, administered over 2 minutes
''PEDIATRIC''
* [[Hypertonic Saline|3% Saline]] bolus at 5 ml/kg (max of 250 ml) IV/IO drip utilizing 10ggts drip set
* [[Keppra]] 20mg/kg (not to exceed 1g) IV/IO in 10cc NORMAL SALINE, administered over 2 minutes (may be repeated once at 40mg/kg if seizure continues)
* Transport patient to nearest Pediatric Trauma Center via appropriate method

<BR>
'''OTHER OPTIONS'''
* [[Versed|MIDAZOLAM (Versed)]] - Initial dose 2-5mg IV or IN then 2 mg every 30 seconds to 1 minute.
** (Max dose 15 mg) in the intubated patient. IM .07-.08 mg/kg with onset in approximately 15 minutes. IM injection requires immediate IV access upon sedation.
* [[Valium|DIAZEPAM (VALIUM)]] 2 - 20 mg SLOW IVP or IM to desired effect.
* These drugs may be given in combination for maximum effectiveness.
* Ensure that Pulse Oximeter is in place.
* Ensure that BVM and [[Flumazenil|ROMAZICON]] and/or [[Naloxone|NARCAN]] are readily available.

[[Category:Trauma|0607]]

IMS

2026-04-03T15:39:28Z

Jonesk:

[[Main Page|Protocols]]

== Section 1 - Command Operations ==
{| class="wikitable"
|+
!Section
!Description
!Issue Date
!Revision Date
!Effective Date
|-
|1.1
|[[Incident Management System Organization]]
|January 1, 2017
|January 1, 2026
|January 1, 2026
|-
|1.2
|[[1.2 Organization / Command Structure|Organization / Command Structure]]
|January 1, 2017
|
|January 1, 2026
|-
|1.3
|[[1.3 Area Command|Area Command]]
|January 1, 2017
|
|January 1, 2026
|-
|1.4
|[[1.4 Unified Command|Unified Command]]
|January 1, 2017
|
|January 1, 2026
|-
|1.5
|[[1.5 Incident Commander|Incident Commander]]
|January 1, 2017
|
|January 1, 2026
|}

== Section 2 - Operations ==

== Section 3 - Special Hazards Operations ==

== Section 4 - Safety ==

== Section 5 - Fire Cause Investigation ==

== Forms / Checklists ==

IMS

2026-04-03T15:38:00Z

Jonesk:

1.3 Area Command

2026-04-03T12:13:26Z

Jonesk:

==== Purpose ====
Oversee the management of incident(s), focusing on strategic assistance, direction, and resolving competition for resources. This position does not supersede any Incident Commanders or Unified Commands but supports and provides strategic direction.

==== Responsibilities ====
The overall direction and setting of priorities for Incident Management Teams (IMTs) assigned to incidents in close proximity or large complex incidents. This includes ensuring that conflicts are resolved, that incident objectives are established, and that strategies are selected for the use of critical resources. The Area Commander has the responsibility to coordinate with local, state, federal, and volunteer assisting and/or cooperating organizations.

==== Activation ====
Multiple simultaneous alarms with implementation of the Incident Management System in the same geographical area. The complexity and span or control of an incident warrants. Critical lifesaving or property values are at risk, and incidents are utilizing limited resources. The incidents will continue into the next operational period.

<div style="margin-left: 2em;">'''Location:''' Area Command Post
</div>

<div style="margin-left: 2em;">'''Recommended Staffing:''' Most qualified in management of large complex incidents with respect to their functional areas
</div>

<div style="margin-left: 2em;">'''Reports To:''' Agency Administrations
</div>

==== Procedure ====

* Arrive in area and establish Area Command.

* Establish appropriate location for the Area Command facilities, consider Mobile Command Center Vehicle.
* Notify the Incident Commanders covered by the Area Command.
* Activate the elements of the area command needed to manage the incident(s) via Branch Commanders. (Planning, Logistics, Aviation, Tech Specialists, etc.)
* Review objectives and strategies for each incident, including expectations of Agency Administrators, concerns, or restraints.
* Assess the incident situation; establish priorities and objectives for the overall command.
* If operating as a Unified Area Command, develop working agreement for how Area Commanders will function together.
* Determine and assign an appropriate Area Command team. A small team is more manageable.
* Identify and allocate critical resources to best meet the needs of Area Command.
* Consider establishing an Area Command Staging Area / Mobilization Center to pool resources prior to allocation to area incidents or individual staging areas.
* Obtain incident briefing and IAP’s from Incident Commanders (as appropriate).
* Assess incident situations prior to strategy meeting.
* Brief the Area Command Staff and IMT, if established.
* Determine need for an assigned Technical Specialists to support Area Command.
* Participate in the preparation and authorize the implementation of the Incident Action Plan (IAP).
* Develop an operating guide for the Area Command staff.
* Prepare for additional operational cycles.
* Establish PIO or, if needed, Joint Information Center (JIC).
* Review the progress of the incident and channel organizational efforts towards highest priority tasks.
* Approve overall plan for demobilization and return to normal operating status.
* Maintain log of major actions/decisions.
* Prepare a final incident summary.
[[IMS|back to IMS]]

1.3 Area Command

2026-04-03T12:08:43Z

Jonesk:

==== Purpose ====
Oversee the management of incident(s), focusing on strategic assistance, direction, and resolving competition for resources. This position does not supersede any Incident Commanders or Unified Commands but supports and provides strategic direction.

==== Responsibilities ====
The overall direction and setting of priorities for Incident Management Teams (IMTs) assigned to incidents in close proximity or large complex incidents. This includes ensuring that conflicts are resolved, that incident objectives are established, and that strategies are selected for the use of critical resources. The Area Commander has the responsibility to coordinate with local, state, federal, and volunteer assisting and/or cooperating organizations.

==== Activation ====
Multiple simultaneous alarms with implementation of the Incident Management System in the same geographical area. The complexity and span or control of an incident warrants. Critical lifesaving or property values are at risk, and incidents are utilizing limited resources. The incidents will continue into the next operational period.

<div style="margin-left: 2em;">'''Location:''' Area Command Post
</div>
<br>
<div style="margin-left: 2em;">'''Recommended Staffing:''' Most qualified in management of large complex incidents with respect to their functional areas
</div>
<br>
<div style="margin-left: 2em;">'''Reports To:''' Agency Administrations
</div>
<br>
==== Procedure ====

* Arrive in area and establish Area Command.

* Establish appropriate location for the Area Command facilities, consider Mobile Command Center Vehicle.
* Notify the Incident Commanders covered by the Area Command.
* Activate the elements of the area command needed to manage the incident(s) via Branch Commanders. (Planning, Logistics, Aviation, Tech Specialists, etc.)
* Review objectives and strategies for each incident, including expectations of Agency Administrators, concerns, or restraints.
* Assess the incident situation; establish priorities and objectives for the overall command.
* If operating as a Unified Area Command, develop working agreement for how Area Commanders will function together.
* Determine and assign an appropriate Area Command team. A small team is more manageable.
* Identify and allocate critical resources to best meet the needs of Area Command.
* Consider establishing an Area Command Staging Area / Mobilization Center to pool resources prior to allocation to area incidents or individual staging areas.
* Obtain incident briefing and IAP’s from Incident Commanders (as appropriate).
* Assess incident situations prior to strategy meeting.
* Brief the Area Command Staff and IMT, if established.
* Determine need for an assigned Technical Specialists to support Area Command.
* Participate in the preparation and authorize the implementation of the Incident Action Plan (IAP).
* Develop an operating guide for the Area Command staff.
* Prepare for additional operational cycles.
* Establish PIO or, if needed, Joint Information Center (JIC).
* Review the progress of the incident and channel organizational efforts towards highest priority tasks.
* Approve overall plan for demobilization and return to normal operating status.
* Maintain log of major actions/decisions.
* Prepare a final incident summary.
[[IMS|back to IMS]]

1.3 Area Command

2026-04-03T12:07:44Z

Jonesk: /* Activation */

IMS

2026-04-03T12:07:11Z

Jonesk:

1.5 Incident Commander

2026-04-03T12:06:53Z

Jonesk: Created page with "==== Purpose ==== The Incident Commander (IC) provides comprehensive leadership and management to the response effort. The position is the focal point of all facets of the operation consistent with the Incident Management System. ==== Responsibilities ==== The IC is ultimately responsible for all incident response activities including development and implementation of an Incident Action Plan (IAP) plan to stabilize the incident, make decisions and issue orders for effi..."

==== Purpose ====
The Incident Commander (IC) provides comprehensive leadership and management to the response effort. The position is the focal point of all facets of the operation consistent with the Incident Management System.

==== Responsibilities ====
The IC is ultimately responsible for all incident response activities including development and implementation of an Incident Action Plan (IAP) plan to stabilize the incident, make decisions and issue orders for efficient and effective utilization of resources. The IC must process information and cues obtained through radio transmissions, face to face reports, and observations from a variety of sources and relay and receive same from Section Chiefs and Command Staff operating within their span of control. '''It is recognized that the IC may not have knowledge of unique or specialized operations (i.e. confined space, hazmat, etc.) and thus may utilize group or division leaders who are technical specialists to aid in command and control of the incident.''' '''It is therefore imperative that their role be confined to managing the alarm and resources required.'''

==== Activation ====
Any situation requiring four or more units where, in the judgment of the on-scene ranking officer, the Incident Management System (IMS) should be implemented for concerns of safety for personnel, management of resources, and scene control.

<div style="margin-left: 2em;">'''Location:''' On Scene at Command Post</div>

<div style="margin-left: 2em;">'''Recommended Staffing:''' First arriving Fire Department officer until relieved by higher authority</div>

<div style="margin-left: 2em;">'''Reports To:''' Final Authority</div>

==== Procedure ====

* Arrive on the scene and establish or assume command; obtain incident briefing previous IC.
* If not previously established, identify command name (“4th Avenue Command”), report command post location and establish A (Alpha) side.
* Assess the incident situation and conduct an initial strategy briefing with the current operation command personnel.
* Activate the elements of the IMS appropriate for management of the incident.
* Brief Command Staff and primary Section Chiefs.
* Participate in the preparation and authorize the implementation of an (the) Incident Action Plan (IAP).
* Determine conditions and needs to make informed command decisions and transmit incident objectives to command staff.
* Coordinate primary IC Staff activities.
* Manage overall incident operations and resource utilization.
* Approve requests for and utilization of additional resources.
* Authorize release of information to the media.
* Ensure the incident status form (worksheet) or command board is utilized and completed. Ensure that proper forms are available and utilized by section and group leaders.
* Obtain briefings from Section Chiefs, Command Staff, and agency representatives on incident management issues and/or concerns.
* Obtain information on environmental issues and/or concerns.
* Review the progress of the incident and direct organizational efforts towards higher priority tasks.
* Ensure that safety procedures are utilized and followed by all personnel.
* Approve plan for demobilization of resources and return to normal operating status.
* Prepare a final incident summary for media briefing, reports, etc.
[[IMS|back to IMS]]

Incident Management System Organization

2026-04-03T11:52:58Z

Jonesk:

== 1.1 Incident Management System Organization ==

=== Purpose ===
The organizational structure outline in this plan has been derived from the '''National Interagency Incident Management System (NIMS)'''. '''NIMS''' is utilized by the Federal Government and is recognized and recommended by the Florida Fire Chiefs’ Association as the standard Incident Command System. In addition, certain portions of this manual have been adapted from Firescope, Phoenix Fireground Command System, Florida Incident Field Operations Guide, and the National Fire Service Incident Management System Consortium.

=== General ===
Under the Incident Management System, (IMS), the ultimate control and direction of all emergency response falls under a single individual, the Incident Commander, except where a Unified Command or Area Command is established. Incident Command is responsible for the overall incident response effort and the implementation of the appropriate portions of this plan. This command system is quite flexible in that the incident commander can activate, consolidate, or delete various positions depending on the needs of the incident. Although this structure is designed for full or partial implementation, it is important that all position roles are reviewed to ensure vital functions are not overlooked.

=== NIMS ===

* It is recommended that the person ultimately taking command at an incident be a chief officer or other qualified individual, highly trained and skilled in the Incident Management System. The Incident Management System is not rank structured but can be filled from whatever positions are best suited for the needs of the individual department.
* The degree of plan implementation will again depend upon the nature and magnitude of the incident. The following pages outline the roles and responsibilities of the various areas of the command structure.
* The IMS organizational structure develops in a modular fashion based on the kind and size of an incident. The organization’s staff builds from the top down with the responsibility and performance placed initially with the Incident Commander. As the need exists, four separate sections can be deployed, each with several units that may be established. The General Staff positions are:
** Operations
** Planning
** Logistics
** Administration (Finance)
* In addition to these four sections, Command Staff may include the following:
** Safety Officer
** Public Information Officer (PIO)
** Liaison Officer
** Incident Command Aide
[[IMS|back to IMS]]

Incident Management System Organization

2026-04-03T11:52:29Z

Jonesk:

IMS

2026-04-03T11:50:27Z

Jonesk:

1.4 Unified Command

2026-04-03T11:50:11Z

Jonesk: Created page with "==== Purpose ==== A Unified Command links the responding organizations to the incident and provides a forum for these agencies to make consensus decisions. The Unified Command establishes a common set of incident objectives and strategies while Incident Commanders continue to carry out their respective agency’s jurisdictional responsibilities. ==== Responsibilities ==== The overall management of an incident. The Unified Command will develop overall objectives and stra..."

==== Purpose ====
A Unified Command links the responding organizations to the incident and provides a forum for these agencies to make consensus decisions. The Unified Command establishes a common set of incident objectives and strategies while Incident Commanders continue to carry out their respective agency’s jurisdictional responsibilities.

==== Responsibilities ====
The overall management of an incident. The Unified Command will develop overall objectives and strategies. The Unified Command will have ultimate approval of all resources. Unified Command is intended to be a ‘decision by committee’. If a decision cannot be agreed on by the Unified Command, the Unified Command member with the most jurisdictional responsibility will be deferred to for the final decision.

Unified commands with routine agencies such as law enforcement, other fire departments, and management teams from private entities shall be established using a streamline process to prevent delays in operations activities with the goal of hazard mitigation.

==== Activation ====
When an incident affects the jurisdictional or statutory responsibility of more than one agency. The incident is multijurisdictional and without a common system or organizational framework.

<div style="margin-left: 2em;">'''Location:''' Incident Command Post</div>

<div style="margin-left: 2em;">'''Recommended Staffing:''' Top management personnel from Agencies having Jurisdiction (AHJ). Non-government responders and private industries when an incident affects their facilities.</div>

<div style="margin-left: 2em;">'''Reports To:''' Authority having Jurisdiction (AHJ)</div>

==== Procedure ====

* Agreement by Authority having Jurisdiction for a Unified Command to be established.
* Selection of members to the command determined by specifics of the incident.
* Establish a Unified Command and obtain an incident briefing from the previous Incident Commander.
* Establish a Unified Command Post that is Co-Located with all Unified Command Personnel; consider use of Mobile Command Vehicles.
* If needed, fill the Command staff positions. There should be only one Operations Section Chief to oversee Branch directors from each discipline.
* Assess the incident situation and conduct a strategy meeting with members of the Unified Command.
* Prepare one set of Incident Objectives based off of all unified discipline strategies.
* Brief the Command Staff and primary Section Chiefs.
* Prepare and approve an Incident Action Plan.
* Determine needs to make informed command decisions and relate these needs to the command staff.
* Manage overall incident operations.
* Consider a joint staging area for incident resources.
* Coordinate primary staff activities.
* Approve requests for and utilization of extended resources.
* Authorize release of information to the media. Establish a Joint Information Center (JIC) for PIOs and Media if size of incident warrants.
* Ensure the incident status form (worksheet) or command board is utilized and completed. Ensure that proper forms are available and utilized by section group leaders.
* Obtain briefing from Section Chiefs, Command Staff and agency representatives on management concerns.
* Obtain information on environmental concerns.
* Review the progress of the incident and channel organizational efforts towards highest priority tasks.
* Ensure that safety procedures and disciplines are practiced and maintained by all personnel.
* Approve plan for demobilization and return to normal operating status.
* Prepare final incident summary for media briefing, reports, etc.
[[IMS|back to IMS]]

1.3 Area Command

2026-04-03T11:36:35Z

Jonesk:

==== Purpose ====
Oversee the management of incident(s), focusing on strategic assistance, direction, and resolving competition for resources. This position does not supersede any Incident Commanders or Unified Commands but supports and provides strategic direction.

==== Responsibilities ====
The overall direction and setting of priorities for Incident Management Teams (IMTs) assigned to incidents in close proximity or large complex incidents. This includes ensuring that conflicts are resolved, that incident objectives are established, and that strategies are selected for the use of critical resources. The Area Commander has the responsibility to coordinate with local, state, federal, and volunteer assisting and/or cooperating organizations.

==== Activation ====
Multiple simultaneous alarms with implementation of the Incident Management System in the same geographical area. The complexity and span or control of an incident warrants. Critical lifesaving or property values are at risk, and incidents are utilizing limited resources. The incidents will continue into the next operational period.

<div style="margin-left: 2em;">'''Location:''' Area Command Post</div>

<div style="margin-left: 2em;">'''Recommended Staffing:''' Most qualified in management of large complex incidents with respect to their functional areas</div>

<div style="margin-left: 2em;">'''Reports To:''' Agency Administrations</div>

==== Procedure ====

* Arrive in area and establish Area Command.

* Establish appropriate location for the Area Command facilities, consider Mobile Command Center Vehicle.
* Notify the Incident Commanders covered by the Area Command.
* Activate the elements of the area command needed to manage the incident(s) via Branch Commanders. (Planning, Logistics, Aviation, Tech Specialists, etc.)
* Review objectives and strategies for each incident, including expectations of Agency Administrators, concerns, or restraints.
* Assess the incident situation; establish priorities and objectives for the overall command.
* If operating as a Unified Area Command, develop working agreement for how Area Commanders will function together.
* Determine and assign an appropriate Area Command team. A small team is more manageable.
* Identify and allocate critical resources to best meet the needs of Area Command.
* Consider establishing an Area Command Staging Area / Mobilization Center to pool resources prior to allocation to area incidents or individual staging areas.
* Obtain incident briefing and IAP’s from Incident Commanders (as appropriate).
* Assess incident situations prior to strategy meeting.
* Brief the Area Command Staff and IMT, if established.
* Determine need for an assigned Technical Specialists to support Area Command.
* Participate in the preparation and authorize the implementation of the Incident Action Plan (IAP).
* Develop an operating guide for the Area Command staff.
* Prepare for additional operational cycles.
* Establish PIO or, if needed, Joint Information Center (JIC).
* Review the progress of the incident and channel organizational efforts towards highest priority tasks.
* Approve overall plan for demobilization and return to normal operating status.
* Maintain log of major actions/decisions.
* Prepare a final incident summary.
[[IMS|back to IMS]]

IMS

2026-04-03T11:35:24Z

Jonesk: /* Section 1 - Command Operations */

1.3 Area Command

2026-04-03T11:35:13Z

Jonesk: Created page with "==== Purpose ==== Oversee the management of incident(s), focusing on strategic assistance, direction, and resolving competition for resources. This position does not supersede any Incident Commanders or Unified Commands but supports and provides strategic direction. ==== Responsibilities ==== The overall direction and setting of priorities for Incident Management Teams (IMTs) assigned to incidents in close proximity or large complex incidents. This includes ensuring tha..."

==== Purpose ====
Oversee the management of incident(s), focusing on strategic assistance, direction, and resolving competition for resources. This position does not supersede any Incident Commanders or Unified Commands but supports and provides strategic direction.

==== Responsibilities ====
The overall direction and setting of priorities for Incident Management Teams (IMTs) assigned to incidents in close proximity or large complex incidents. This includes ensuring that conflicts are resolved, that incident objectives are established, and that strategies are selected for the use of critical resources. The Area Commander has the responsibility to coordinate with local, state, federal, and volunteer assisting and/or cooperating organizations.

==== Activation ====
Multiple simultaneous alarms with implementation of the Incident Management System in the same geographical area. The complexity and span or control of an incident warrants. Critical lifesaving or property values are at risk, and incidents are utilizing limited resources. The incidents will continue into the next operational period.

<div style="margin-left: 2em;">'''Location:''' Area Command Post</div>

<div style="margin-left: 2em;">'''Recommended Staffing:''' Most qualified in management of large complex incidents with respect to their functional areas</div>

<div style="margin-left: 2em;">'''Reports To:''' Agency Administrations</div>

==== Procedure ====

* Arrive in area and establish Area Command.

* Establish appropriate location for the Area Command facilities, consider Mobile Command Center Vehicle.
* Notify the Incident Commanders covered by the Area Command.
* Activate the elements of the area command needed to manage the incident(s) via Branch Commanders. (Planning, Logistics, Aviation, Tech Specialists, etc.)
* Review objectives and strategies for each incident, including expectations of Agency Administrators, concerns, or restraints.
* Assess the incident situation; establish priorities and objectives for the overall command.
* If operating as a Unified Area Command, develop working agreement for how Area Commanders will function together.
* Determine and assign an appropriate Area Command team. A small team is more manageable.
* Identify and allocate critical resources to best meet the needs of Area Command.
* Consider establishing an Area Command Staging Area / Mobilization Center to pool resources prior to allocation to area incidents or individual staging areas.
* Obtain incident briefing and IAP’s from Incident Commanders (as appropriate).
* Assess incident situations prior to strategy meeting.
* Brief the Area Command Staff and IMT, if established.
* Determine need for an assigned Technical Specialists to support Area Command.
* Participate in the preparation and authorize the implementation of the Incident Action Plan (IAP).
* Develop an operating guide for the Area Command staff.
* Prepare for additional operational cycles.
* Establish PIO or, if needed, Joint Information Center (JIC).
* Review the progress of the incident and channel organizational efforts towards highest priority tasks.
* Approve overall plan for demobilization and return to normal operating status.
* Maintain log of major actions/decisions.
* Prepare a final incident summary.

1.2 Organization / Command Structure

2026-04-03T11:13:39Z

Jonesk:

[[File:1.2 Regular Response.png|center|640x640px]]

=== <div style="text-align: center;">Expanding or Moderate Structure Fire, HazMat Incident, or EMS Response</div> <div style="text-align: center;">(to include multiple alarm responses)</div> ===
[[File:1 2 Exanding Struture Fire.png|center]]

=== <div style="text-align: center;">Major Inciddent</div> ===
[[File:Major Incident.png|center]][[IMS|back to IMS]]

1.2 Organization / Command Structure

2026-04-03T11:11:44Z

Jonesk:

File:Major Incident.png

2026-04-03T11:01:03Z

Jonesk:

Major Incident

IMS

2026-04-01T20:46:03Z

Jonesk:

1.2 Organization / Command Structure

2026-04-01T20:34:42Z

Jonesk: Created page with "640x640px center"

[[File:1.2 Regular Response.png|center|640x640px]]

[[File:1 2 Exanding Struture Fire.png|center]]

File:1 2 Exanding Struture Fire.png

2026-04-01T20:33:40Z

Jonesk:

Expanded

File:1.2 Regular Response.png

2026-04-01T20:31:08Z

Jonesk:

Small Structure Fire, HazMat Incident, or EMS Response. First Alarm Units

Incident Management System Organization

2026-04-01T20:28:10Z

Jonesk: