Book 35 - EMS Field Manual - LAFD Training

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CHILD / ELDER / DEPENDENT ADULT ABUSE Section 1: Field Procedures 1 Protocols EMT-Is and EMT-Ps are required to report all cases of suspected abuse and/or neglect as soon as possible. ABUSE NEGLECT CHILD ELDER , , punishment, willful cruelty, unjustifiable punishment, or sexual assault. Failure of any person having the care and/ or custody of a child, elder, or dependent adult to exercise that degree of care which a reasonable person in a like position would exercise. Any person between the ages of 18 and 64 years that cannot fully care for DEPENDENT - himherself due to physical and/or ADULT mental limitations. 1. Request OCD to notify and have the appropriate law enforcement agency report to the incident location or hospital if the patient is to be transported. 2- The law enforcement agency will assign an investigator. If the patient does not require immediate transport wait for the responding law enforcement agency unless a responsible Any person under 18 years old. I1 adult (other than the abuser) remains on scene. 3. The member in charge of patient care shall Any person 65 years old or older. forward the completed Department of Social Services Report to the appropriate EMS Battalion Captain within 36 hours. 4. Make a Journal (F-2) entry, that shows the , report was completed and forwarded. NB: While on scene obtain names, addresses, and telephone numbers of witnesses, victims, siblings, parents, and law enforcement / investigating officer (s) involved with the incident, Field members may obtain copies of the Social Services (8572) form "Suspected ChildAbuse Report" from the concerned EMS Battalion Captain or find the form listed in the Prehospital Care Policy Manual, Book 33, Reference No. 822.2. The Social Services form "Suspected Dependent Adult/Elder Abuse " may also be found in Book 33, Reference No. 829.2. Revised: 712003 \
DETERMINATION OF DEATH A patient may be determined dead if in addition to the absence of respiration, cardiac activity, and \ neurological reflexes, one or more of the following conditions exists (DHS, Reference # 814): ) + Decapitation. + Massive crush injury. + Penetrating or blunt injury with evisceration of the heart, lung, or brain. + Decomposition. 4 Incineration. + Extrication time greater than 15 minutes, with no resuscitative measures performed prior to extrication. + Pulseless, non-breathing victims of a multiple victim incident where insufficient medical resources precluded initiating resuscitative measures. + Drowning victims, when it is reasonably determined that submersion has been greater than one hour. - + Rigor mortis requires assessment (as described in Section 1.7a ). Patients Determined to be Dead If the initial assessment reveals rigor mortis andor post-mortem lividity &, EMS personnel shall perform the following assessments: (NN: Assessment steps may be performed concurrently.) RESPIRATORY * Assuring that the patient has an open airway * Look, listen, and feel for respiration (This includes auscultation of the lungs for a minimum of 30 seconds) CARDIAC * Auscultation of the apical pulse for a minimum of 60 seconds * Adults and children: Palpation of the carotid pulse for a minimum of 60 seconds Infants: Palpation of the brachial pulse for a minimum of 60 seconds NEUROLOGICAL * Assess pupil response with a penlight or flashlight * Check for a response to painful stimuli Resuscitative measures shall not be initiated on patients who have been determined dead (according A to this policy) or on patients who meet DHS, ~ ef. No. 815, "Honoring Prehospital DNR Orders" Medical Patients in Cardiopulmonary Arrest Initiate immediate resuscitation and ALS intervention for patients who do not meet conditions described in Section 1.7. In general, these patients shall be: * Treated in the field long enough for possible resuscitation to occur. , * Rapidly transported if an adequate airway or venous access cannot be established. * Treated and transported if the patient is: A suspected drug overdose, hypothermic, in refractory ventricular fibrillation or ventricular tachycardia. Revised: 1212001 PAGE 1 OF 2
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BIBLIOGRAPHY Section 4: Records 1 D
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I Los Angeles Fire Department EMS F
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Book 35 - EMS Field Manual - LAFD Training

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