LA COUNTY PROTOCOLS
QUESTIONS & ANSWERS
Ref. 304 Purpose of base hospital
Base hospital is ? - ANSWERresponsible for providing medical direction and destination
to pre-hospital care personnel within LA County EMS system according to standard
procedures consistent with statewide guidelines
Ref. 304 Purpose of base hospital
MICN is what? - ANSWERregistered nurse who has been authorized by the medical
director, qualified to provide prehospital advanced life support or to issue instructions to
EMS personnel within LA County
Ref. 304 Purpose of base hospital
base hospital shall: - ANSWER1. Be lic. by CA state dept. of public health
2.special permit for basic or comprehensive emergency service
3. Be accredited , deemed acceptable for Medicare and Medicaid
4.Meet or exceed standards for PEDS unless exempted
5. Have a written contractual agreement with EMS agency
6. Implement and monitor LA County policies
***7. Designate a base hospital medical director who shall be responsible of the base
hospital. base hospital medical director shall be a physician on the hospital******
and a lot of more shit to remember
Ref. 408 ALS Unit Staffing
ALL ALS units shall - ANSWERboth public and private
shall be staffed at least two state licensed paramedics accredited in Los Angeles
County
Ref. 409
Procedure for reporting ALS unit staffing exceptions - ANSWER1. Complete a report for
each calendar month where an ALS unit operates with less than the minimum staff.
2. the report must be submitted no later than 10 days after the close of the calendar
month to DHS
Ref. 502 Patient Destination
MAR defined as - ANSWERthe most accessible receiving (MAR) may or may not be the
closest facility geographically.
consider traffic, weather conditions, that may influence transport time
,Ref. 502 Patient Destination
pts. shall not be transported ? - ANSWERpt. shall not be transported to a medical
facility that is on diversion due to internal disaster
Ref. 502 Patient Destination
Pt. should be transported to the MAR unless - ANSWER1. The base hospital
determines that another facility is more appropriate to meet the needs of the pt. or
2. the patient meets criteria or guidelines to a specialty care center
Ref. 503 Guidelines for hospital requesting Diversion of ALS Pt.
ALS pt. defined as - ANSWERALS patient is any patient who requires paramedic
assessment or intervention, including not limited to patient meeting the criteria outlined
in ref. 808
Ref. 503 Guidelines for hospital requesting diversion
who is responsible maintaining ReddiNet - ANSWERReceiving hospital are responsible
for maintaining and updating ReddiNet
Ref. 503 Guidelines for hospital requesting diversion
ED Saturation defined as - ANSWERED resources( beds, equipment and staff) are fully
committed or are not sufficient to care for addtl incoming ALS patients. hospitals may
request ED diversion via the ReddiNet for up to one hour at a time. at the end of the
hour Reddinet will automatically re-open the hospital
only one hour increments
Ref. 503 guidelines for hospital requesting diversion
CT Scanner - ANSWERhospital is unable to provide essential diagnostic procedures
due to lack of a functioning CT scanner
Ref. 503 guidelines for hospital requesting diversion
trauma centers requesting diversion - ANSWERhospital is unable to care for additional
trauma patients because trauma team is fully committed caring for trauma patients
a. critical equipment unavailable
b. operating room unavailable
c. trauma team encumbered
Ref. 503 guidelines for hospital requesting diversion
, Pediatric Medical Center (PMC) - ANSWERdiversion may be requested only when
critical equipment essential to definitive diagnosis or treatment of critical medical
pediatric patients is unavailable
lack of available PICU beds alone is not sufficient cause to request PMC Diversion
Ref. 503 guidelines hospital requesting diversion
STEMI - ANSWERdiversion may be requested only when all cardiac cath labs are fully
encumbered caring for STEMI pt.
ED sat. not sufficient cause to request SRC diversion
Ref. 503 guidelines hospital requesting diversion
Internal Disaster defined as - ANSWERHospital must request diversion to MAC by
phone
1. power outage
2. critical infrastructure or systems
3. fire
4. bomb threat/explosion
5. flooding
6. water disruption/contamination
7. hazmat
Ref 506 trauma triage
transport of hypotensive pt. - ANSWERdo not delay transport of hypotensive patients
with penetrating torso trauma in order to apply spinal immobilization
Ref 506 trauma triage
transport of hypotensive pt. by an 800 - ANSWEREMT personnel may immediately
transport hypotensive patients with life threatening, penetrating injuries to the torso to
the closest trauma center, not the MAR, when transport time is less than the estimated
time of paramedic arrival. the transporting unit should make every effort to contact the
receiving trauma center
Ref 506 trauma triage
Pt. in blunt arrest shall be transported when? - ANSWERPatients in blunt traumatic full
arrest, not meeting 814, should be transported to the most accessible medical facility
appropriate to their needs
Ref 506 trauma triage
patients who fall into one or more of the following are to be transport to trauma center, if
transport time doesnt exceed 30 mins - ANSWER1. Systolic BP below 90 mmHg, or
less than 70 1 year old or younger
2. RR greater than 29/min, less than 10/min
less than 20/min in infants requiring ventilation support
3.cardiopulmonary arrest with penetrating torso, unless found to meet 814
QUESTIONS & ANSWERS
Ref. 304 Purpose of base hospital
Base hospital is ? - ANSWERresponsible for providing medical direction and destination
to pre-hospital care personnel within LA County EMS system according to standard
procedures consistent with statewide guidelines
Ref. 304 Purpose of base hospital
MICN is what? - ANSWERregistered nurse who has been authorized by the medical
director, qualified to provide prehospital advanced life support or to issue instructions to
EMS personnel within LA County
Ref. 304 Purpose of base hospital
base hospital shall: - ANSWER1. Be lic. by CA state dept. of public health
2.special permit for basic or comprehensive emergency service
3. Be accredited , deemed acceptable for Medicare and Medicaid
4.Meet or exceed standards for PEDS unless exempted
5. Have a written contractual agreement with EMS agency
6. Implement and monitor LA County policies
***7. Designate a base hospital medical director who shall be responsible of the base
hospital. base hospital medical director shall be a physician on the hospital******
and a lot of more shit to remember
Ref. 408 ALS Unit Staffing
ALL ALS units shall - ANSWERboth public and private
shall be staffed at least two state licensed paramedics accredited in Los Angeles
County
Ref. 409
Procedure for reporting ALS unit staffing exceptions - ANSWER1. Complete a report for
each calendar month where an ALS unit operates with less than the minimum staff.
2. the report must be submitted no later than 10 days after the close of the calendar
month to DHS
Ref. 502 Patient Destination
MAR defined as - ANSWERthe most accessible receiving (MAR) may or may not be the
closest facility geographically.
consider traffic, weather conditions, that may influence transport time
,Ref. 502 Patient Destination
pts. shall not be transported ? - ANSWERpt. shall not be transported to a medical
facility that is on diversion due to internal disaster
Ref. 502 Patient Destination
Pt. should be transported to the MAR unless - ANSWER1. The base hospital
determines that another facility is more appropriate to meet the needs of the pt. or
2. the patient meets criteria or guidelines to a specialty care center
Ref. 503 Guidelines for hospital requesting Diversion of ALS Pt.
ALS pt. defined as - ANSWERALS patient is any patient who requires paramedic
assessment or intervention, including not limited to patient meeting the criteria outlined
in ref. 808
Ref. 503 Guidelines for hospital requesting diversion
who is responsible maintaining ReddiNet - ANSWERReceiving hospital are responsible
for maintaining and updating ReddiNet
Ref. 503 Guidelines for hospital requesting diversion
ED Saturation defined as - ANSWERED resources( beds, equipment and staff) are fully
committed or are not sufficient to care for addtl incoming ALS patients. hospitals may
request ED diversion via the ReddiNet for up to one hour at a time. at the end of the
hour Reddinet will automatically re-open the hospital
only one hour increments
Ref. 503 guidelines for hospital requesting diversion
CT Scanner - ANSWERhospital is unable to provide essential diagnostic procedures
due to lack of a functioning CT scanner
Ref. 503 guidelines for hospital requesting diversion
trauma centers requesting diversion - ANSWERhospital is unable to care for additional
trauma patients because trauma team is fully committed caring for trauma patients
a. critical equipment unavailable
b. operating room unavailable
c. trauma team encumbered
Ref. 503 guidelines for hospital requesting diversion
, Pediatric Medical Center (PMC) - ANSWERdiversion may be requested only when
critical equipment essential to definitive diagnosis or treatment of critical medical
pediatric patients is unavailable
lack of available PICU beds alone is not sufficient cause to request PMC Diversion
Ref. 503 guidelines hospital requesting diversion
STEMI - ANSWERdiversion may be requested only when all cardiac cath labs are fully
encumbered caring for STEMI pt.
ED sat. not sufficient cause to request SRC diversion
Ref. 503 guidelines hospital requesting diversion
Internal Disaster defined as - ANSWERHospital must request diversion to MAC by
phone
1. power outage
2. critical infrastructure or systems
3. fire
4. bomb threat/explosion
5. flooding
6. water disruption/contamination
7. hazmat
Ref 506 trauma triage
transport of hypotensive pt. - ANSWERdo not delay transport of hypotensive patients
with penetrating torso trauma in order to apply spinal immobilization
Ref 506 trauma triage
transport of hypotensive pt. by an 800 - ANSWEREMT personnel may immediately
transport hypotensive patients with life threatening, penetrating injuries to the torso to
the closest trauma center, not the MAR, when transport time is less than the estimated
time of paramedic arrival. the transporting unit should make every effort to contact the
receiving trauma center
Ref 506 trauma triage
Pt. in blunt arrest shall be transported when? - ANSWERPatients in blunt traumatic full
arrest, not meeting 814, should be transported to the most accessible medical facility
appropriate to their needs
Ref 506 trauma triage
patients who fall into one or more of the following are to be transport to trauma center, if
transport time doesnt exceed 30 mins - ANSWER1. Systolic BP below 90 mmHg, or
less than 70 1 year old or younger
2. RR greater than 29/min, less than 10/min
less than 20/min in infants requiring ventilation support
3.cardiopulmonary arrest with penetrating torso, unless found to meet 814
