EMD Rules
Abdominal Pain/Problems - ANS-Abdominal pain in a female of child-bearing age (12-50) who
as fainted (or nearly fainted) is considered an ectopic pregnancy until proven otherwise.
Abdominal Pain/Problems - ANS-Abdominal pain/cramping anytime during pregnancy should be
considered contractions until proven otherwise.
Abdominal Pain/Problems - ANS-Alert Patients with abdominal pain and a confirmed diagnosis
of aortic aneurysm should be coded as 1-C-2.
Abdominal Pain/Problems - ANS-Epicanthic pain (above the navel) in cardiac age-range
patients (females greater than and equal to 45, males greater than and equal to 35) is
considered a "heart attack" until proven otherwise.
Abdominal Pain/Problems - ANS-Pain described as at the level of the navel should be
considered below the naval.
Abdominal Pain/Problems - ANS-Testicle or groin pain in a male patient is considered a
testicular torsion condition (twisting off of a testicle's blood supply) until proven otherwise.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-A history of severe allergic reaction
to the same type of insect or substance should warrant staying on the line to determine if the
patient's condition is worsening.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-Determining the presence of
difficulty breathing or swallowing (airway compromise) is a key to a proper dispatch.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-If an extremity snakebite is known
to be caused by an elapid (coral) snake, use instructions in AI-1.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-If the caller asks whether the
patient should be given their medication now, the EMD should only give instructions included in
the protocol.
Animal Bites / Attacks - ANS-Spider, insect, or snake bites should be handled on Protocol 2.
ASA - Aspirin Dx - ANS-1st party callers should not be asked to locate any aspirin outside of
their own home.
ASA - Aspirin Dx - ANS-2nd party callers can be asked to have someone else check for aspirin
with neighbors or others close by.
ASA - Aspirin Dx - ANS-Aspirin-containing medications should not be administered to patients
who are not alert, under age 16, or have reported STROKE symptoms.
ASA - Aspirin Dx - ANS-If the caller asks if the patient can drink something to wash down the
chewed aspirin, tell them that they may use just a mouthful of water to wash it down.
ASA - Aspirin Dx - ANS-If the patient is reported to have just taken aspirin, or routinely takes
aspirin, it is okay to advise them to take the dispatch-recommended dose now. Since aspirin
resistance is quite common, an additional does should not commonly be a problem.
ASA - Aspirin Dx - ANS-If they have a medicine not listed in the Aspirin-Containing Medications,
they should be advised not to take it, unless they are sure it contains aspirin.
ASA - Aspirin Dx - ANS-The Aspirin Diagnostic should be used for all qualified patients
presenting with heart attach symptoms.
, Assault / Sexual Assault / Stun Gun - ANS-Direct pressure on the would should be avoided in
the presence of visible fractured bone or foreign objects.
Assault / Sexual Assault / Stun Gun - ANS-If a spinal injury is suspected in a breathing patient
and PAI's are not necessary, PDI's may be enhanced by encouraging the patient not to move
and by advising the rescuer to use her/his hands to stabilize the patient's head and neck in the
position found.
Assault / Sexual Assault / Stun Gun - ANS-Sexual assault patients often require a very high
level of compassionate care.
Assault / Sexual Assault / Stun Gun - ANS-The head-tilt is the only recognized method of airway
control in the PAI dispatch environment. When presented with a TRAUMA patient described as
not alert with INEFFECTIVE BREATHING, the EMD should protect life over limb and open the
airway.
Assault / Sexual Assault / Stun Gun - ANS-The preservation of evidence in sexual assault
situations may be of much greater eventual importance to the patient than initial response and
treatment of physical injuries.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-Alert patients with back or flank pain
and a confirmed diagnosis of aortic aneurysm should be coded as 5-C-2.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-Back pain should only be selected as
the Chief Complaint when it is initially clear on Case Entry that the cause is NON-RECENT
traumatic or NON-TRAUMATIC back pain. If unclear, select Protocol 30.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-NON-TRAUMATIC back pain
associated with fainting (or near fainting) in patients >50 is considered to be a dissecting aortic
aneurysm until proven otherwise.
Breathing Problems - ANS-A patient having breathing problems may worsen at any time.
Always advise to call back if condition worsens.
Breathing Problems - ANS-Asthma patients are usually very experienced in managing their
disease. When the status of these patients is reported as "Can't Breathe," "Unable to breathe,"
or a similar description, this should be considered INEFFECTIVE BREATHING.
Breathing Problems - ANS-Breathing problems are potentially life-threatening until proven
otherwise.
Breathing Problems - ANS-If the caller asks whether the patient should be given their
medication now, the EMD should only give instructions included in the protocol.
Breathing Problems - ANS-When the complainant description involves both NON-TRAUMATIC
chest pain/heart attack symptoms and breathing problems, choose the Chief Complaint Protocol
that best fits the patient's foremost symptom, with ECHO-level conditions taking precedence.
(>16, alert, no reported STROKE symptoms) Use the Aspirin Diagnostic & Instruction Tool on
either protocol as appropriate.
Burns (Scalds) / Explosion (Blast) - ANS-All electrical burns are considered to be worse than
they look externally.
Burns (Scalds) / Explosion (Blast) - ANS-Consider the type of location, along with the building
type, when processing explosion incidents. The type of location (residences/offices of
high-profile persons, government buildings, industrial/research facilities, mass transit) may
indicate a deliberate terrorist act has occurred.
Abdominal Pain/Problems - ANS-Abdominal pain in a female of child-bearing age (12-50) who
as fainted (or nearly fainted) is considered an ectopic pregnancy until proven otherwise.
Abdominal Pain/Problems - ANS-Abdominal pain/cramping anytime during pregnancy should be
considered contractions until proven otherwise.
Abdominal Pain/Problems - ANS-Alert Patients with abdominal pain and a confirmed diagnosis
of aortic aneurysm should be coded as 1-C-2.
Abdominal Pain/Problems - ANS-Epicanthic pain (above the navel) in cardiac age-range
patients (females greater than and equal to 45, males greater than and equal to 35) is
considered a "heart attack" until proven otherwise.
Abdominal Pain/Problems - ANS-Pain described as at the level of the navel should be
considered below the naval.
Abdominal Pain/Problems - ANS-Testicle or groin pain in a male patient is considered a
testicular torsion condition (twisting off of a testicle's blood supply) until proven otherwise.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-A history of severe allergic reaction
to the same type of insect or substance should warrant staying on the line to determine if the
patient's condition is worsening.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-Determining the presence of
difficulty breathing or swallowing (airway compromise) is a key to a proper dispatch.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-If an extremity snakebite is known
to be caused by an elapid (coral) snake, use instructions in AI-1.
Allergies (Reactions) / Envenomations (Stings, Bites) - ANS-If the caller asks whether the
patient should be given their medication now, the EMD should only give instructions included in
the protocol.
Animal Bites / Attacks - ANS-Spider, insect, or snake bites should be handled on Protocol 2.
ASA - Aspirin Dx - ANS-1st party callers should not be asked to locate any aspirin outside of
their own home.
ASA - Aspirin Dx - ANS-2nd party callers can be asked to have someone else check for aspirin
with neighbors or others close by.
ASA - Aspirin Dx - ANS-Aspirin-containing medications should not be administered to patients
who are not alert, under age 16, or have reported STROKE symptoms.
ASA - Aspirin Dx - ANS-If the caller asks if the patient can drink something to wash down the
chewed aspirin, tell them that they may use just a mouthful of water to wash it down.
ASA - Aspirin Dx - ANS-If the patient is reported to have just taken aspirin, or routinely takes
aspirin, it is okay to advise them to take the dispatch-recommended dose now. Since aspirin
resistance is quite common, an additional does should not commonly be a problem.
ASA - Aspirin Dx - ANS-If they have a medicine not listed in the Aspirin-Containing Medications,
they should be advised not to take it, unless they are sure it contains aspirin.
ASA - Aspirin Dx - ANS-The Aspirin Diagnostic should be used for all qualified patients
presenting with heart attach symptoms.
, Assault / Sexual Assault / Stun Gun - ANS-Direct pressure on the would should be avoided in
the presence of visible fractured bone or foreign objects.
Assault / Sexual Assault / Stun Gun - ANS-If a spinal injury is suspected in a breathing patient
and PAI's are not necessary, PDI's may be enhanced by encouraging the patient not to move
and by advising the rescuer to use her/his hands to stabilize the patient's head and neck in the
position found.
Assault / Sexual Assault / Stun Gun - ANS-Sexual assault patients often require a very high
level of compassionate care.
Assault / Sexual Assault / Stun Gun - ANS-The head-tilt is the only recognized method of airway
control in the PAI dispatch environment. When presented with a TRAUMA patient described as
not alert with INEFFECTIVE BREATHING, the EMD should protect life over limb and open the
airway.
Assault / Sexual Assault / Stun Gun - ANS-The preservation of evidence in sexual assault
situations may be of much greater eventual importance to the patient than initial response and
treatment of physical injuries.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-Alert patients with back or flank pain
and a confirmed diagnosis of aortic aneurysm should be coded as 5-C-2.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-Back pain should only be selected as
the Chief Complaint when it is initially clear on Case Entry that the cause is NON-RECENT
traumatic or NON-TRAUMATIC back pain. If unclear, select Protocol 30.
Back Pain (Non-Traumatic or Non-Recent Trauma) - ANS-NON-TRAUMATIC back pain
associated with fainting (or near fainting) in patients >50 is considered to be a dissecting aortic
aneurysm until proven otherwise.
Breathing Problems - ANS-A patient having breathing problems may worsen at any time.
Always advise to call back if condition worsens.
Breathing Problems - ANS-Asthma patients are usually very experienced in managing their
disease. When the status of these patients is reported as "Can't Breathe," "Unable to breathe,"
or a similar description, this should be considered INEFFECTIVE BREATHING.
Breathing Problems - ANS-Breathing problems are potentially life-threatening until proven
otherwise.
Breathing Problems - ANS-If the caller asks whether the patient should be given their
medication now, the EMD should only give instructions included in the protocol.
Breathing Problems - ANS-When the complainant description involves both NON-TRAUMATIC
chest pain/heart attack symptoms and breathing problems, choose the Chief Complaint Protocol
that best fits the patient's foremost symptom, with ECHO-level conditions taking precedence.
(>16, alert, no reported STROKE symptoms) Use the Aspirin Diagnostic & Instruction Tool on
either protocol as appropriate.
Burns (Scalds) / Explosion (Blast) - ANS-All electrical burns are considered to be worse than
they look externally.
Burns (Scalds) / Explosion (Blast) - ANS-Consider the type of location, along with the building
type, when processing explosion incidents. The type of location (residences/offices of
high-profile persons, government buildings, industrial/research facilities, mass transit) may
indicate a deliberate terrorist act has occurred.
