Protocols

[fortsmithman]

Who writes your protocols? My service it's the senior members who are writing them instead of our medical director. I'd like to know what you all think of that. Shoulf it be the medical director or the services members. The NWT has no legislation on EMS so it's basically the individual service who determines who can do what.

 

[Epi-do]

We have county protocols that all of the medical directors in the county sign off on. They review literature, as well as look at how well (in general) the current protocols are being utilized. From that, they determine what training is needed, and make any changes to protocols. Generally speaking, our protocol changes are rolled out once per year, typically in March.

That being said, we do have a procedure to follow if we want to request any changes, additions, or removals of the protocols. We are expected to do the research required to support our request. We are also expected to come up with the initial writing of the proposed new protocol. The medical directors meet throughout the year for various things, including reviewing any proposals written by the EMTs/medics working the street. They then decide what happens with the proposal, and make any changes that may be needed to the proposed protocol, if it is going to be accepted.

 

[Foxbat]

We use PA statewide protocols.

 

[nemedic]

double post

 

[nemedic]

:deadhorse:

We use PA statewide protocols.

Living in the People's republic of MA, there is no way the government wouldn't put out the protocols

 

[mycrofft]

My protocols do not match the County's

and we are a County entity. County EMS has no comment.

 

[MrBrown]

Before 1999 we had national procedures but these ceased to exist with the disbandment of the Ambulance Education Council and protocols got downloaded to individual services' medical directors.

The system I have the most experience in had a Clinical Management Group which is made up of five physicians (four emergency medicine consultants and an intensevist), the clinical education manager, operations director and clinical support manager. This group is responsible for writing the Clincal Guidelines.

Within the new system I am entering at the moment, they have a Clinical Governance Group which consists of the medical director, ambulance manager and some ambos. Like the other service, this group is responsible for writing the Clincal Guidelines.

I think its important to recognize that here we have "Guidelines" and not "protocols". They are a guideline and can be interpreted flexibly to suit the patients condition and do not have to the followed to the letter, its not cookbook medicine. Without significant clinical judgement and experience it is expected that the Guideline will be followed as it provides the safest degree of treatment and highest degree of legal protection.

Now, as for the future with Paramedics and Intensive Care Paramedics becoming regulated health professions and the formation of a national scope of practice I expect a reversion back to national Guidelines will be a natural one.