SYSTEM ENTRY REGION XL EMS
Explain86the86difference86between86an86online86medical86control86(OLMC)86and86a86pre-
notification86call?86-86answer--
Online86Medical86Control86(OLMC):86Base86Station86contact86is86required86for:861)86Med
ical
direction86in86Regionalized86Systems86of86Care86patients86or86complex86patient86care86s
ituations86or
2)86Situations86not86clearly86defined86by86the86Region86XI86Policies86&86Procedures86as8
6needed86by
the86EMS86provider.
A.86Goal:86To86provide86immediate86medical86direction86to86the86EMS86provider86for86sit
uations
where86patient86care86or86destination86may86be86impacted.86
Communication86method:86OLMC86calls86will86be86made86through86the86MED86Channel
s86or
cellular86lines86and86all86contact86will86be86recorded.
Pre-
Notification:86EMS86should86contact86the86receiving86hospital86directly86for86ALS86transp
orts86in
situations86where86the86Region86XI86Standing86Medical86Orders/
Protocols86have86been86followed.
A.86Goal:86To86provide86direct86communication86between86EMS86providers86and86the86r
eceiving
hospital86for86straightforward86BLS86or86ALS86patient86transports.
No86medical86direction86will86be86given86by86non-
Region86XI86Base86Station86hospitals86receiving
pre-notification86reports.
Communication86method:86Pre-notification86reports86should86be86given86through86a
hospital's86dedicated86telemetry86line86if86the86hospital86is86a86Resource/
Associate86Hospital
within86Region86XI86(or86another86Region).86Contact86may86also86be86through86a86dedic
ated
EMS86telephone86line86or86MERCI86radio86if86the86participating86hospital86does86not86ha
ve86a
telemetry86line.
Write86out86an86example86of86a86pre-notification86call?86-86answer--Pre-
Notification86Report
,A.86Identify86agency86and86number
B.86State86"This86is86a86pre-notification86report."
C.86Age86and86sex
D.86Chief86complaint
E.86Vital86signs
F.86"Routine86protocols86followed"
G.86Additional86details86that86may86be86needed86for86the86receiving86hospital86to86prepar
e86for86the86patient
H.86Destination86and86ETA
An86example86includes86patients86with86spinal86immobilizatipn86or86who86are86unable86t
o86sit86in86a86wheelchair86or86chair.86Those86who86may86need86an86immediate86bed86up
on86emergency86department86arrival.
List86386examples86that86should86be86called86in86as86OLMC86rather86than86a86pre-
notification86call?86-86answer--
1.86Regionalized86Systems86of86Care86transports86including86patients86with:
a.86Acute86coronary86syndrome86and86STEMI86criteria
b.86Suspected86acute86stroke
c.86Trauma86Field86Triage86Criteria86(Steps861-4)
d.86Ventricular86Assist86Device86(VAD)
e.86Obstetric86related86complaint
2.86Cardiac86Arrest
a.86For86patients86in86whom86resuscitation86is86initiated,86OLMC86should86be86consulted
before86moving86the86patient.86OLMC86is86required86in86making86the86decision86to
continue86on-scene86resuscitation,86transport,86or86terminate86resuscitation.
b.86Patients86that86meet86criteria86for86withholding86resuscitation86(see86Initiation86or
Withholding86of86Resuscitative86Measures86Policy86B.5)86do86not86require86OLMC
consultation86(i.e.86DOA).
3.86Complex86patient86care86situations86and/or86questions86regarding86the86appropriate
destination.86For86example:
a.86Any86patient86potentially86requiring86a86Level86186Trauma86Center,86but86not86clearly
meeting86Trauma86Field86Triage86Criteria
b.86Patients86with86possible86acute86coronary86syndrome86or86stroke86symptoms86that86
may
not86meet86defined86criteria86for86specialty86center86transport
c.86Patients86potentially86requiring86diversion86for86critical86airway86stabilization
What86should86you86do86in86the86event86you86cannot86reach86your86assigned86base86sta
tion86for86an86OLMC86call?86-86answer--If
the86contact86is86unsuccessful:
1.86Attempt86to86contact86the86next86closest86Resource/Associate86Hospital.
2.86All86attempts86at86contact86must86be86documented86in86the86patient86care86report.
3.86Notification86of86a86communication86problem86must86be86made86to86the
Resource/
Associate86Hospital86and86the86ambulance86service86provider's86supervisor86on
, duty86after86arriving86at86the86receiving86hospital.
Name86the86686call86disposition86types86-86answer--
Patient86Transported86to86Appropriate86Emergency86Department:
Patient86Initiated86Refusal
No86Patient86Found
Patient86Deceased86on86Arrival86(DOA
Cancelled86Prior86to86Arrival86on86Scene
Handled86by86Police
When86is86it86appropiate86to86use86"Handled86by86Police"86as86a86call86disposition?86-
86answer--In86the86event86where86EMS86and86the86Chicago86Police86Department
(CPD)86both86respond86to86a86scene,86CPD86may86elect86to86handle86the86situation86in86
certain
circumstances86such86as86behavioral86emergencies,86DUIs,86or86criminal86investigation
s86and
take86custody86of86the86patient.86In86these86situations,86it86is86expected86that86EMS86will
86still
attempt86to86perform86a86full86patient86assessment86unless86CPD86refuses86access86to86
the
patient86due86to86scene86safety.86EMS86should86advise86CPD86of86any86potential86risks
associated86with86the86patient86not86receiving86EMS86care86and/
or86transport.86OLMC86is
required86for86these86situations.
List86the86equipment86that86is86required86to86be86brought86in86with86EMS86personnel86for
86all86calls:86-86answer--Equipment
When86responding86to86all86requests86for86out-of-
hospital86care,86the86EMS86personnel86(First
Responder,86EMT-
B,86Paramedic)86must86take86the86following86to86the86initial86contact86with86the
patient:
1.86Quick86response86bag
2.86Conveyance86device
3.86AED,AED86100086(386Lead),86or86monitor/defibrillator
4.86O2
List86the86additional86eqiupment86that86is86required86to86be86brought86in86for86a86patient8
6witgh86a86possible86cardiac86or86respiratory86complaint:86-86answer--
EMS86personnel86must86bring86in86the86monitor/
defibrillator86for86any86known86cardiac86or86respiratory
calls.
According86to86Region86XI86Helicopter86EMS86policy86who86can86initiate86a86call86for86a8
6helicopter86response:86-86answer--Initiating86HEMS86response
Explain86the86difference86between86an86online86medical86control86(OLMC)86and86a86pre-
notification86call?86-86answer--
Online86Medical86Control86(OLMC):86Base86Station86contact86is86required86for:861)86Med
ical
direction86in86Regionalized86Systems86of86Care86patients86or86complex86patient86care86s
ituations86or
2)86Situations86not86clearly86defined86by86the86Region86XI86Policies86&86Procedures86as8
6needed86by
the86EMS86provider.
A.86Goal:86To86provide86immediate86medical86direction86to86the86EMS86provider86for86sit
uations
where86patient86care86or86destination86may86be86impacted.86
Communication86method:86OLMC86calls86will86be86made86through86the86MED86Channel
s86or
cellular86lines86and86all86contact86will86be86recorded.
Pre-
Notification:86EMS86should86contact86the86receiving86hospital86directly86for86ALS86transp
orts86in
situations86where86the86Region86XI86Standing86Medical86Orders/
Protocols86have86been86followed.
A.86Goal:86To86provide86direct86communication86between86EMS86providers86and86the86r
eceiving
hospital86for86straightforward86BLS86or86ALS86patient86transports.
No86medical86direction86will86be86given86by86non-
Region86XI86Base86Station86hospitals86receiving
pre-notification86reports.
Communication86method:86Pre-notification86reports86should86be86given86through86a
hospital's86dedicated86telemetry86line86if86the86hospital86is86a86Resource/
Associate86Hospital
within86Region86XI86(or86another86Region).86Contact86may86also86be86through86a86dedic
ated
EMS86telephone86line86or86MERCI86radio86if86the86participating86hospital86does86not86ha
ve86a
telemetry86line.
Write86out86an86example86of86a86pre-notification86call?86-86answer--Pre-
Notification86Report
,A.86Identify86agency86and86number
B.86State86"This86is86a86pre-notification86report."
C.86Age86and86sex
D.86Chief86complaint
E.86Vital86signs
F.86"Routine86protocols86followed"
G.86Additional86details86that86may86be86needed86for86the86receiving86hospital86to86prepar
e86for86the86patient
H.86Destination86and86ETA
An86example86includes86patients86with86spinal86immobilizatipn86or86who86are86unable86t
o86sit86in86a86wheelchair86or86chair.86Those86who86may86need86an86immediate86bed86up
on86emergency86department86arrival.
List86386examples86that86should86be86called86in86as86OLMC86rather86than86a86pre-
notification86call?86-86answer--
1.86Regionalized86Systems86of86Care86transports86including86patients86with:
a.86Acute86coronary86syndrome86and86STEMI86criteria
b.86Suspected86acute86stroke
c.86Trauma86Field86Triage86Criteria86(Steps861-4)
d.86Ventricular86Assist86Device86(VAD)
e.86Obstetric86related86complaint
2.86Cardiac86Arrest
a.86For86patients86in86whom86resuscitation86is86initiated,86OLMC86should86be86consulted
before86moving86the86patient.86OLMC86is86required86in86making86the86decision86to
continue86on-scene86resuscitation,86transport,86or86terminate86resuscitation.
b.86Patients86that86meet86criteria86for86withholding86resuscitation86(see86Initiation86or
Withholding86of86Resuscitative86Measures86Policy86B.5)86do86not86require86OLMC
consultation86(i.e.86DOA).
3.86Complex86patient86care86situations86and/or86questions86regarding86the86appropriate
destination.86For86example:
a.86Any86patient86potentially86requiring86a86Level86186Trauma86Center,86but86not86clearly
meeting86Trauma86Field86Triage86Criteria
b.86Patients86with86possible86acute86coronary86syndrome86or86stroke86symptoms86that86
may
not86meet86defined86criteria86for86specialty86center86transport
c.86Patients86potentially86requiring86diversion86for86critical86airway86stabilization
What86should86you86do86in86the86event86you86cannot86reach86your86assigned86base86sta
tion86for86an86OLMC86call?86-86answer--If
the86contact86is86unsuccessful:
1.86Attempt86to86contact86the86next86closest86Resource/Associate86Hospital.
2.86All86attempts86at86contact86must86be86documented86in86the86patient86care86report.
3.86Notification86of86a86communication86problem86must86be86made86to86the
Resource/
Associate86Hospital86and86the86ambulance86service86provider's86supervisor86on
, duty86after86arriving86at86the86receiving86hospital.
Name86the86686call86disposition86types86-86answer--
Patient86Transported86to86Appropriate86Emergency86Department:
Patient86Initiated86Refusal
No86Patient86Found
Patient86Deceased86on86Arrival86(DOA
Cancelled86Prior86to86Arrival86on86Scene
Handled86by86Police
When86is86it86appropiate86to86use86"Handled86by86Police"86as86a86call86disposition?86-
86answer--In86the86event86where86EMS86and86the86Chicago86Police86Department
(CPD)86both86respond86to86a86scene,86CPD86may86elect86to86handle86the86situation86in86
certain
circumstances86such86as86behavioral86emergencies,86DUIs,86or86criminal86investigation
s86and
take86custody86of86the86patient.86In86these86situations,86it86is86expected86that86EMS86will
86still
attempt86to86perform86a86full86patient86assessment86unless86CPD86refuses86access86to86
the
patient86due86to86scene86safety.86EMS86should86advise86CPD86of86any86potential86risks
associated86with86the86patient86not86receiving86EMS86care86and/
or86transport.86OLMC86is
required86for86these86situations.
List86the86equipment86that86is86required86to86be86brought86in86with86EMS86personnel86for
86all86calls:86-86answer--Equipment
When86responding86to86all86requests86for86out-of-
hospital86care,86the86EMS86personnel86(First
Responder,86EMT-
B,86Paramedic)86must86take86the86following86to86the86initial86contact86with86the
patient:
1.86Quick86response86bag
2.86Conveyance86device
3.86AED,AED86100086(386Lead),86or86monitor/defibrillator
4.86O2
List86the86additional86eqiupment86that86is86required86to86be86brought86in86for86a86patient8
6witgh86a86possible86cardiac86or86respiratory86complaint:86-86answer--
EMS86personnel86must86bring86in86the86monitor/
defibrillator86for86any86known86cardiac86or86respiratory
calls.
According86to86Region86XI86Helicopter86EMS86policy86who86can86initiate86a86call86for86a8
6helicopter86response:86-86answer--Initiating86HEMS86response