TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER g: EMERGENCY SERVICES AND HIGHWAY SAFETY
PART 515 EMERGENCY MEDICAL SERVICES, TRAUMA CENTERS, PEDIATRIC EMERGENCY AND CRITICAL CARE CENTERS, STROKE CENTERS HOSPITAL CODE
SECTION 515.APPENDIX D ADMINISTRATIVE, LEGAL AND EMS PROTOCOLS AND GUIDELINES



 

Section 515.APPENDIX D   Administrative, Legal and EMS Protocols and Guidelines  

 

Administrative, Legal and EMS Protocols and Guidelines shall include, but not be limited to the following:

 

1)         Administrative and Legal:

 

•     Patient disposition/selection of receiving facility

•     Patient choice and refusal regarding treatment, transport or destination

•     Patient abandonment

•     Do Not Resuscitate (DNR)/Practitioner Orders for Life Sustaining Treatment (POLST)/Advance Directives/Health Care Power of Attorney (POA) status

•     When and how to notify a coroner or medical examiner

•     Appropriate interaction with law enforcement on the scene

•     The duty to perform all services without unlawful discrimination

•     Patient confidentiality and release of information/Health Insurance Portability and Accountability Act (HIPAA)

•     Appropriate interaction with an independent physician/nurse on the scene

•     Offering immediate and adequate information regarding services available to victims of abuse, for any person suspected to be a victim of domestic abuse

•     Mandated reporting policy

•     Relinquished newborn

•     Consent for treatment of minors

•     A policy that addresses the EMS System Participant safety, disinfection of EMS vehicles and equipment, and assessment, treatment, transport and follow-up of patients with suspected or diagnosed infectious diseases

•     Significant or high risk occupational exposure of EMS System Participants to an infectious disease, including notification to the designated infection control officer of the EMS provider agency following exposure

•     A policy concerning the use of latex-free supplies

•     Medical records documentation, retention, and reporting policy

•     Incident reporting/equipment malfunction/sentinel event reporting

•     Crisis response and medical surge policy/multiple patient incidents

•     Professional ethical standards and behavioral expectations

•     Any procedures regarding disciplinary or suspension decisions and the review of those decisions that the System has elected to follow in addition to those required by the Act

•     A policy for notifying another EMS System of an EMT, EMT-I, AEMT, Paramedic, PHRN, PHAPRN, PHPA system suspension when that EMT, AEMT, EMT-I, Paramedic, PHRN, PHAPRN, PHPA is known to have dual participation with another EMS System.

•     Resource Hospital overrides (situations in which Associate Hospital orders are overruled by the Resource Hospital)

•     Protocols for ILS/AEMT and ALS personnel to assess the condition of a patient being initially treated in the field by BLS personnel, for the purpose of determining whether a higher level of care is warranted and transfer of care of the patient to the ILS or ALS personnel is appropriate;  the protocols shall include a requirement that neither the assessment nor the transfer of care can be initiated if it appears to jeopardize the patient's condition, and shall require that the activities of the System personnel be under the immediate direction of the EMS MD or designee

•     A policy on treatment and transport of law enforcement animals

•     A policy on transport of a service/support animal

•     Any System policies regarding abuse of controlled substances or conviction of a felony crime by EMS Personnel, whether on or off duty

     A Medication and Equipment Exchange Policy for System Participants

•     A policy for use of PPE during patient encounters

•     A policy on securing a weapon prior to transport of a patient

•     A policy on waste of controlled substance

•     Procedure/policy for provider notification when leaving the state for an EMAC or NAC response

•     A policy on additional healthcare personnel assisting in the transport of a patient in an ambulance, including but not limited to an RN, Physician or C.T. tech.

•     Requirements for EMS personnel who have identified an EMS system as secondary

•     Crisis response and medical surge policy

•     Complaint investigation including suspension

•     Storage and security of medication

•     A policy on identification of type of EMS patient care reports and crew member responsible for filling out patient care report for transport and non-transport EMS calls and submission of data

•     Policy for in system and out of system types of continuing education programs allowed

•     Replacement of medications and equipment for inter and intra facility transports

•     Notification of IDPH Division of EMS when an EMS crew member is killed in the line of duty

•     Policy on patient transport to a licensed mental health care facility

•     Policy on patient transport to a licensed urgent or immediate care facility

•     Policy requiring all licensed EMS personnel to participate in a process to physically demonstrate the correct use of defined pediatric-specific equipment minimally every recertification period

 

2)         EMS Standing Medical Orders/Standard Operating Guidelines/Procedures

 

•   Cardiovascular:

    Adult and Pediatric Syncope and Pre-syncope

    Chest Pain/Acute Coronary Syndrome (ACS)/ST-segment Elevation Myocardial Infarction (STEMI)

    Tachycardia with a Pulse

    Bradycardia with a Pulse

    Heart Failure/Pulmonary Edema/Cardiogenic Shock

 

•   Resuscitation:

    Cardiac Arrest (VF/VT/Asystole/PEA)

    Adult Post-ROSC (Return of Spontaneous Circulation) Care

    Determination of Death/Withholding or Termination of Resuscitative Efforts

 

•   Respiratory:

    Airway/Ventilatory Management

    Acute Respiratory Conditions

    Chronic Respiratory Conditions

 

•   Medical:

    Agitated or Violent Patient/Behavioral Emergency; Use of Restraints

    Anaphylaxis and Allergic Reaction

    Altered Mental Status

    Hypoglycemia/Hyperglycemia

    Pain Management

    Seizures

    Shock

    Suspected Stroke/Transient Ischemic Attack

    Nausea/Vomiting

    Functional Needs/Special Needs Populations

 

•   Pediatric Prehospital Protocols (BLS, ILS, AEMT and ALS):

    Initial Medical Care/Assessment

    Initial Trauma Care/Assessment

    Neonatal Resuscitation

    Pediatric AED

    Pediatric Allergic Reaction/Anaphylaxis

    Pediatric Altered Mental Status

    Pediatric Brief Resolved Unexplained Event (BRUE)

    Pediatric Bradycardia

    Pediatric Burns

    Pediatric Drowning

    Pediatric Environmental Hyperthermia

    Pediatric Hypothermia

    Pediatric Nerve Agent/Organophosphate Antidote Guidelines

    Pediatric Pulseless Arrest

    BLS Pediatric Pulseless Arrest

    ALS/ILS Asystole/PEA Pathway

    ALS/ILS VF/VT Pathway

    Pediatric Respiratory Distress

    Pediatric Respiratory Distress with a Tracheostomy Tube

    Pediatric Respiratory Distress with a Ventilator

    Pediatric Respiratory Failure

    Pediatric Seizures

    Pediatric Shock

    Pediatric Tachycardia

    BLS Pediatric Tachycardia

    ALS/ILS Narrow QRS Pathway

    ALS/ILS Wide QRS Pathway

    Pediatric Toxic Exposures/Ingestions

    Pediatric Trauma (with Head Trauma Addendum)

    Suspected Child Abuse and Neglect

 

•   GI/GU/Gyne:

    Childbirth/Complicated and Uncomplicated Delivery

    Newborn Care

    OB Complications/All Trimesters

    Obstetrical/Gynecological Conditions

 

•   Trauma:

    General Trauma Assessment/Management

    Blast Injuries

    Head/Facial/Neck Injury

    Thoracic

    Abdominal/Pelvic

    Musculoskeletal Trauma/External Hemorrhage Management

    Acute Spine Trauma and Selective Spine Precautions

    Conducted Electrical Weapon (e.g., TASER)

    Blunt, Penetrating and Perforating Injuries

 

•   Environmental:

    Hyperthermia/Heat Exposure

    Hypothermia/Cold Exposure

    Submersion Incidents

    SCUBA Injury/Accidents

 

•   Burns:

    Electrical

    Lightening/Lightening Strike Injury

    Radiation Exposure

    Thermal

    Chemical

    Inhalation

 

•   Toxins:

    Bites and Envenomation

    Poisoning/Overdose Universal Care

    Acetylcholinesterase Inhibitors (Carbamates, Nerve Agents,

Organophosphates) Exposure

    Stimulant Poisoning/Overdose

    Central Nervous System Depressant Poisoning/Overdose

    Cyanide Exposure

    Hallucinogenic

    Beta Blocker Poisoning

    Calcium Channel Blocker Poisoning/Overdose

    Carbon Monoxide/Smoke Inhalation

    Biological Agents

 

(Source:  Amended at 48 Ill. Reg. 16159, effective November 1, 2024)