TITLE: MEDICAL PRIORITY DISPATCH SYSTEM RESPONSE AND MODE ASSIGNMENTS FOR CARDS 1-34 EMS Policy No. 3202

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Beverly Carpenter
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1 PURPOSE: The purpose of this policy is to establish approved Medical Priority Dispatch System response and mode assignments for use by authorized Emergency Medical Dispatch Centers. AUTHORITY: Health and Safety Code, Division 2.5, Section DEFINITIONS: A. means an emergency advanced life support (ALS) ambulance. B. Provider means an entity properly permitted to operate an emergency advanced life support ambulance service in San Joaquin County. C. means an emergency response without delay not requiring emergency lights and siren except as may be required for scene access. D. means an emergency response without delay using emergency lights and siren as appropriate for driving conditions. E. EMS Agency means the San Joaquin County Emergency Medical Services (EMS) Agency. F. Emergency Medical Dispatch (EMD) means a series of components that allow the dispatcher to triage calls, send appropriate resources with the appropriate response, and provide pre-arrival/post-dispatch instructions as needed. G. Emergency Medical Responder () means a basic life support (BLS) or ALS non-transport vehicle operated by an provider. H. Provider means an organization authorized by the EMS Agency to participate in the EMS system for the purpose of providing non-transport prehospital patient care. I. Fire means public safety fire service resources separate from their role as an. J. Valley Regional Emergency Communications Center or VRECC means the EMD center operated by American Medical Response and designated as the EMS dispatch center for all of San Joaquin County. K. MPDS means the Medical Priority Dispatch System. L. NAED means the National Academies of Emergency Dispatch. POLICY: I. This policy is used in conjunction with NAED EMD Protocol Version 12.x MPDS. Effective: July 1, 2014 Page 1 of 13

Provider means an entity properly permitted to operate an emergency advanced life support ambulance service in San Joaquin Co

2 II. III. IV. VRECC shall dispatch ambulance and resources and notify other dispatch centers to dispatch resources to respond to medical emergencies in accordance with the response levels and modes established by this policy. All public safety answering points and dispatch centers shall adhere to the requirements of this policy when managing the response of ambulance and resources. After an EMD determinant is reached VRECC shall dispatch ambulance and resources in accordance with the MPDS response and mode assignments. If resources are already en route when a determinant is reached or additional information is obtained changing the determinant, VRECC shall direct resources to upgrade, reduce, or cancel their response in accordance with the MPDS response and mode assignments. V. and resources shall comply with instructions from VRECC to upgrade, reduce, or cancel their response. VI. EMS Agency approved MPDS response and mode assignments for use by authorized EMD Centers are as follows: Card 1 Level Response Mode Abdominal Pain/Problems N/A N/A Card 2 Level Response Mode Allergies (Reactions)/ Envenomations (Stings, Bites) Effective: July 1, 2014 Page 2 of 13

this policy. All public safety answering points and dispatch centers shall adhere to the requirements of this policy when managing the response of ambulance and resources.

3 Card 3 Level Response Mode N/A N/A Animal Bites/Attacks B-1, B-2 B-3 Card 4 Level Response Mode Assault/Sexual Assault N/A N/A Card 5 Level Response Mode Back Pain (Non-Traumatic or Non-Recent Trauma) N/A N/A Card 6 Level Response Mode Breathing Problems N/A N/A N/A N/A Effective: July 1, 2014 Page 3 of 13

Mode Back Pain (Non-Traumatic or Non-Recent Trauma) N/A N/A Card 6 Level

4 Card 7 Level Response Mode Burns (Scalds)/ Explosion (Blast) A-1 A-2 Fire A-3 A-3 F & E A-3 W Card 8 Level Response Mode Carbon Monoxide/ Inhalation/ Hazmat/ CBNR N/A N/A Omega Fire Card 9 Level Response Mode N/A N/A Cardiac or Respiratory Arrest/ B-1 Death N/A N/A Omega Effective: July 1, 2014 Page 4 of 13

Hazmat/ CBNR N/A N/A Omega Fire Card 9 Level Response Mode N/A N/A Cardiac

5 Card 10 Level Response Mode Chest Pain (Non-Traumatic) N/A N/A Card 11 Level Response Mode Choking N/A N/A N/A N/A Card 12 Level Response Mode Convulsions/Seizures Card 13 Level Response Mode Diabetic Problems A-1 A-1C Effective: July 1, 2014 Page 5 of 13

Level Response Mode Convulsions/Seizures Card 13 Level Response

6 Card 14 Level Response Mode Drowning (Near)/ Diving/ Scuba Accident Card 15 Level Response Mode Electrocution/Lightning N/A N/A N/A N/A Card 16 Level Response Mode N/A N/A Eye Problems/Injuries A-1 A-2; A-3 Effective: July 1, 2014 Page 6 of 13

N/A N/A N/A N/A Card 16 Level Response Mode N/A N/A Eye

7 Card 17 Level Response Mode N/A N/A B-1; B-2 Falls B-3 A-2 G A-1; A-2; A-3 Card 18 Level Response Mode N/A N/A Headache Card 19 Level Response Mode Heart Problems/ Automatic Implanted Cardiac Defibrillator (A.I.C.D.) N/A N/A Card 20 Level Response Mode Heat/Cold Exposure Effective: July 1, 2014 Page 7 of 13

Heart Problems/ Automatic Implanted Cardiac De

8 Card 21 Level Response Mode Hemorrhage/Lacerations Card 22 Level Response Mode N/A N/A Inaccessible Incident/ Other Entrapments (Non- B-1 Vehicle) B-2; B-3 Fire Fire Card 23 Level Response Mode Overdose/ Poisoning (Ingestion) N/A N/A Omega As Directed by Poison Control Center Effective: July 1, 2014 Page 8 of 13

Fire Fire Card 23 Level Response Mode Overdose/ Poisoning (Ingestion) N/A N/A

9 Card 24 Level Response Mode Pregnancy/ Childbirth/ Miscarriage Omega Card 25 Level Response Mode N/A N/A Psychiatric/ B-1 Abnormal Behavior/ Suicide Attempt B-2 to B-6 Law N/A Enforcement Card 26 Level Response Mode Sick Person Omega Effective: July 1, 2014 Page 9 of 13

Behavior/ Suicide Attempt B-2 to B-6 Law N/A Enforcement Card 26

10 Card 27 Level Response Mode Stab/Gunshot/ N/A N/A Penetrating Trauma Card 28 Level Response Mode N/A N/A Stroke (CVA) ; Note: Set L and G suffix codes to two hours Card 29 Level Response Mode N/A N/A Traffic/ Transportation Incidents B-1; B-2 B-3; B-4 Omega Fire Effective: July 1, 2014 Page 10 of 13

codes to two hours Card 29 Level Response Mode N/A N/A Traffic/

11 Card 30 Level Response Mode Traumatic Injuries (Specific) N/A N/A Card 31 Level Response Mode Unconscious/Fainting (Near) N/A N/A A-1; A-3 A-2 Card 32 Level Response Mode N/A N/A B-1 Unknown Problem (Man Down) B-2 B-3 B-4 N/A N/A Effective: July 1, 2014 Page 11 of 13

A-1; A-3 A-2 Card 32 Level Response Mode N/A N/A B-1 Unknown

12 Card 33 Level Response Mode C-1 C-2 Transfer/ C-3 Interfacility/ C-4 Palliative Care C-5 C-6 N/A N/A (Acuity I,II,III) (BLS or ALS) Card 34 Level Response Mode Automatic Crash Notification (ACN) N/A N/A Omega None None VII. Exceptions to Determinants Listed Above: A.,,, and responses to the following medical clinics with a physician on site do not require the dispatch of resources unless these resources are requested by medical clinic staff or responding ambulance personnel: 1. All Kaiser Permanente medical facilities. 2. St. Joseph s Immediate Care 1801 E. March Ln, Stockton, CA. 3. Sutter Gould Medical Group 2505 W. Hammer Ln, Stockton, CA. 4. Sutter Gould Medical Group 2545 W. Hammer Ln, Stockton, CA. 5. Channel Medical Center 701 Channel St., Stockton, CA. 6. Veterans Medical Clinic 7777 E. Freedom Rd, French Camp, CA. Effective: July 1, 2014 Page 12 of 13

,,, and responses to the following medical clinics with a physician on site do not require the dispatch of resources unless these resources are requested by medical clinic staff or responding

13 B.,,, and responses to the San Joaquin County Jail do not require the dispatch of resources unless these resources are requested by the SJC Sheriff s Department staff or responding ambulance personnel. C. and responses within the City of Stockton or areas served by the Stockton Fire Department (SFD) do not require the dispatch of resources unless the response determinant specifies the dispatch of resources without an accompanying ambulance such as Card 32 B1 and B2 (Unknown Problem Medical Alarm). 1. Note: All other resources dispatched by the SFD Emergency Communication Center (e.g. Manteca City Fire Department) shall be notified of and responses per the assigned determinants for each card. VIII. IX. Card 33 Specific Definitions: A. Medical Professional means a Physician, Registered Nurse, Family Nurse Practitioner, or Physician s Assistant. B. Medical Care Facility means a licensed skilled nursing facility or a private residence served by hospice. C. Acuity II means a request specifically for BLS procedures that require service in less than four hours for any of the following patient conditions: 1. G tube Replacement. 2. Foley Catheter Replacement. VRECC shall monitor and regularly report compliance with this policy to the EMS Agency. Effective: July 1, 2014 Page 13 of 13

and responses within the City of Stockton or areas served by the Stockton Fire Department (SFD) do not require the dispatch of resources unless the response determinant specifies the dispatch of

STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 152 STATE HOUSE STATION AUGUSTA, MAINE 04333

STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 152 STATE HOUSE STATION AUGUSTA, MAINE 04333 PAUL R. LEPAGE GOVERNOR JOHN E. MORRIS COMMISSIONER SHAUN A. ST. GERMAIN DIRECTOR