Santa Clara Local Systems Orientation Exam

SANTA CLARA LOCAL SYSTEMS
ORIENTATION EXAM

In6addition6to6any6specific6criteria6for6withholding6or6discontinuing6resuscitation6containe
d6within6individual6treatment6protocols,6resusitative6efforts6may6be6withheld,6discontinue
d,6and/or6death6determined6under6the6following6circumstances6(BLS)6-6ans--
1.6Five6signs6of6immediate6DOA
2.6A6pulseless6and/or6apneic6patient6with6a6valid6DNR
3.6A6pulseless6and/or6apneic6patiend6who6has6exercised6his/
her6right6to6die6under6the6end6of6life6option.

if6criteria6met6EMS6will6discontinue6resuscitate6effort,6cancel6prehospital6personnel6in6rou
te,6provide6appropriate6care6to6bystanders,6and6complete6PCR6documentation6about6acti
ons6taken6and6reason6for6pronounced6death.

valid6forms6of6identification6for6a6physician6on6scene6-6ans--
valid6CA6physicians6medical6license

other6ID6that6indicates6physician6CA6medical6license6#6and6business6address

physical6involvement6of6a6physician6at6the6scene.6-6ans--
patient6must6give6consent.6then6care6may6be6relinqueshed6to6the6physician6who6will6rem
ain6responsible6for6care6until6another6MD6takes6over.6physician6may6manage6care,6but6ul
timately6accepts6responsibility6for6patient.6must6accompany6crew6and6patient6in6ambulan
ce.

documentation6when6physician6at6scene6(56things)6-6ans--1.6physician6name
2.6CA6medical6license6#
3.6business6phone6#
4.6level6of6patient6care6involvement
5.6all6procedures6and6treatments6performed6at6the6scene.

patient6destinations:6patient6choice6-6ans--
patient6may6betransported6to6requested6facility6as6long6as6facility6meets6medical6require
ments,6barring6any6EMS6surge6and6hospital6diversion.

patient6destination:6routine6patient6destination6-6ans--
patients6may6be6transported6to6routine6emergency6department6UNLESS6patient6meets6c
riteria6that6requires6specialty6care.

SCCO6Specialties6Trauma6facilities6-6ans--
Trauma:6Regional6MC,6Stanford,6Santa6Clara6Valley6MC

, SCCO6Specialties6Psyciatric:6-6ans--
psyciatric:6El6Camino6MV,6Santa6Clara6Valley6MC6EPS,6PA6VA6hospital,6Stanford.

SCCO6Specialties6Burn6-6ans--Santa6Clara6Valley6Medical6Center

SCCO6Specialties6Stroke6-6ans--
Comprehensive:6El6Camino6MV,6Good6Samaritan,6Regional6Medical6center6SJ

Primary:6All6hospitals6except6PA6VA6hospital

SCCO6Specialties6STEMI6-6ans--
All6hospitals6except6st.6louise6regionaal,6PA6VA,6El6Camino6LG

Special6circumstances:6EMS6surges/6MCI6incidents6-6ans---
All6destinations6will6be6assigned6by6county6communications

-6may6be6transported6to6out6of6county6hospital,6or6mobile6field6hospitals6with6approval.

Diversion6-6ans---
Only6one6hospital6may6be6on6ambulance6diversion6(red)6at6any6given6time6in6a6diversion6
zone

-
May6divert6for6906minutes6per6occurence,6but6must6allow6for6another6906minutes6before6
next6diversion.

Diversion6zones6North6-6ans--
North:6Stanford6hospital,6El6Camino6Hospital6MV,6Kaiser6SC

Diversion6centers6Central6-6ans--
Central:6Regional6MC6SJ,6Santa6Clara6Valley6MC,6O'Connor

Diversion6centers6Southern6-6ans--
Southern:6Good6Samaritan6Hospital,6Kaiser6SJ,6St.6Louise.

Acceptable6DNR6documents6-6ans--
1.6POLST6(physician6order6for6life6sustaining6treatment6stating6no6CPR)
2.6EMSA6and6CMA6approved6EMS,6prehospital6DNR6form
3.6CA6approved6DNR6medallion
4.6Durable6Power6of6Attorney6for6Health6Care6(DPAHC)

What6to6do6if6proper6DNR6document(s)6present6-6ans--
If6EMS6personnel6arrive6and6patient6is6pulseless6and6apneic:6
-Establish6DNR/advanced6directives/code6status
-may6withhold6resuscitative6effort6if6valid6DNR6form6stating6DNR.