Emergency Medical Services Protocols and Guidelines

Pediatric Resuscitation and Triage

The manual covers a spectrum of pediatric crises, including:

• Pediatric Cardiac Arrest: Specific algorithms for managing cessation of breathing or heartbeat in children.
• Pediatric Tachycardia with Pulse: Clinical pathways for managing rapid heart rates in pediatric patients.
• JumpSTART Triage: A specialized system used to categorize pediatric patients during mass casualty incidents.
• Pediatric Intraosseous (IO) Therapy: Guidelines for accessing the bone marrow when intravenous (IV) access is unobtainable.

Neonatal and Newborn Care

For the youngest patients, the MOM provides protocols for Neonatal Resuscitation and Newborn Delivery and Care. Clinicians are expected to utilize tools like the APGAR Score to assess the newborn's transition to extrauterine life:

Behavioral Health and Harm Reduction

Recognizing the complexity of mental health crises, the AFD has integrated specialized teams and protocols into its medical operations.

Mobile Crisis Team (MCT) and De-escalation

The AFD Mobile Crisis Team (MCT) is a specialized resource designed to respond to behavioral health emergencies. When interacting with patients in crisis, the manual emphasizes the use of Crisis Verbal De-escalation techniques to maintain safety and reduce the need for physical intervention.

Opioid Overdose and Harm Reduction

The department operates the Project HOPE harm reduction program, which focuses on opioid overdose rescue. This includes the use of the Buprenorphine Field Start Guideline for managing opioid withdrawal, utilizing the Clinical Opioid Withdrawal Scale (COWS) to assess patient needs, and managing the replacement of opioid overdose rescue kits.

Operational Standards and Equipment Management

Effective EMS delivery relies on the proper maintenance of equipment and the secure handling of controlled substances.

Equipment and Documentation

The manual provides troubleshooting protocols for critical life-support equipment, such as the LUCAS CPR device. For all patient encounters, the use of ePCR (electronic Patient Care Report) is mandatory to ensure accurate documentation and continuity of care.

Controlled Substance Management

The management of narcotics is highly regulated through the OpIQ system. This includes:

• Chain of Custody: Strict procedures for the "Transfer" and "Pick Up" of controlled substances during shift changes or "Hot Swaps".
• Incident Reporting: Mandatory "Incident Reports" must be filed if a controlled substance event occurs that requires DEA reporting.
• Security Verification: Both the Controller and a Witness must complete security verification fields to finalize the transfer of medications.

Inter-agency Coordination and Public Safety

The MOM defines how AFD personnel interact with other agencies, such as the Anchorage Safety Patrol (ASP), including specific ASP-ASC Client Triage Criteria. It also provides a clear Public Inebriate Definition to guide reporting and incident disposition.

Clinical Note: When transporting patients, always consult the Anchorage Area Hospital Specialty Destination Chart to ensure patients are taken to the appropriate facility (e.g., ANMC for pediatric or certain psychiatric cases).