LA County Protocols Exam 114 Questions and
Answers.
Ref. 304 Purpose of base hospital
Base hospital is? - ANS responsible 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? - ANS registered 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: - ANS 1. Be lick. 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 - ANS both 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 - ANS 1. 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 - ANS the 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? - ANS pt. 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 - ANS 1. 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 - ANS ALS patient is any patient who requires paramedic assessment or
intervention, including not limited to patient meeting the criteria outlined in ref. 808
, ED Saturation defined as - ANS ED resources (beds, equipment and staff) are fully committed
or are not sufficient to care for addle incoming ALS patients. Hospitals may request ED
diversion via the Redline for up to one hour at a time. At the end of the hour Reddened will
automatically re-open the hospital
Only one hour increments
Ref. 503 guidelines for hospital requesting diversion
CT scanner - ANS hospital 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 - ANS hospital 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) - ANS diversion 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 - ANS diversion may be requested only when all cardiac catch 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 - ANS Hospital 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. - ANS do 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 - ANS EMT 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? - ANS Patients 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 doesn’t exceed 30 mines - ANS 1. Systolic BP below 90 mmHg, or less than 70 1
year old or younger
2. RR greater than 29/min, less than 10/min
Answers.
Ref. 304 Purpose of base hospital
Base hospital is? - ANS responsible 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? - ANS registered 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: - ANS 1. Be lick. 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 - ANS both 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 - ANS 1. 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 - ANS the 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? - ANS pt. 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 - ANS 1. 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 - ANS ALS patient is any patient who requires paramedic assessment or
intervention, including not limited to patient meeting the criteria outlined in ref. 808
, ED Saturation defined as - ANS ED resources (beds, equipment and staff) are fully committed
or are not sufficient to care for addle incoming ALS patients. Hospitals may request ED
diversion via the Redline for up to one hour at a time. At the end of the hour Reddened will
automatically re-open the hospital
Only one hour increments
Ref. 503 guidelines for hospital requesting diversion
CT scanner - ANS hospital 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 - ANS hospital 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) - ANS diversion 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 - ANS diversion may be requested only when all cardiac catch 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 - ANS Hospital 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. - ANS do 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 - ANS EMT 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? - ANS Patients 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 doesn’t exceed 30 mines - ANS 1. Systolic BP below 90 mmHg, or less than 70 1
year old or younger
2. RR greater than 29/min, less than 10/min
