LA County Protocols 100%
VERIFIED ANSWERS
2024/2025 CORRECT
Ref. 304 Purpose of base hospital
Base hospital is ?
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?
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:
1. Be lic. 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
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
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
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 ?
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
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
ALS patient is any patient who requires paramedic assessment or intervention,
including not limited to patient meeting the criteria outlined in ref. 808
Ref. 503 Guidelines for hospital requesting diversion
who is responsible maintaining ReddiNet
Receiving hospital are responsible for maintaining and updating ReddiNet
Ref. 503 Guidelines for hospital requesting diversion
ED Saturation defined as
ED resources( beds, equipment and staff) are fully committed or are not sufficient to
care for addtl incoming ALS patients. hospitals may request ED diversion via the
ReddiNet for up to one hour at a time. at the end of the hour Reddinet will automatically
re-open the hospital
only one hour increments
Ref. 503 guidelines for hospital requesting diversion
CT Scanner

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
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)
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
diversion may be requested only when all cardiac cath 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
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.
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
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?
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 doesnt exceed 30 mins
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
less than 20/min in infants requiring ventilation support
3.cardiopulmonary arrest with penetrating torso, unless found to meet 814
4. all penetrating injuries to head, neck, torso, and extremities proximal to the elbow or

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knee
5. blunt head injury associated with suspected skull fracture, ALOC, GCS<14, seizures,
unequal pupils, or neuro deficit
Ref 506 trauma triage
patients who fall into one or more of the following are to be transported to a
trauma center
6. injury to spine, with acute sensory or motor deficit
7. fail chest
8. diffuse abd. tenderness
9. suspected pelvic fracture
10. extremity injury: crushed, degloved, mangeld, amputation proximal to wrist or ankle,
fractures of two or more long bones
Ref. 506 trauma triage
patients who fall one or more of the following are to be transported to trauma
center
11. falls: adult >15 ft. Peds >10ft or 3 times the height of kid
12. passenger space intrusion >12 inches occupied space
13. ejected from vehicle partial or complete
14. auto vs. ped/bike thrown, run over, or over 20 mph
15. unenclosed transport crash with significant over 20 mph
Ref 506 Guidelines
trauma triage
1. Passenger space intrusion 18 inches into any unoccupied space
2. auto vs. ped/bike impact equal or less than 20 mph
3. injured victims of vehicular crashes in which a fatality occurred same vehicle
4. pt. requiring extrication
5. vehicle of high risk injury
6. injured pts. on anticoagulation or bleeding disorders

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Ref 506 Trauma triage
special considerations
1. adults over 55
2. Systolic BP less than 110 mmHg may represent shock after 65
3. Prego over 20 weeks
4. Prehospital judgment
Ref 506 trauma triage
Extremis Patients
require immediate transport to MAR
1. Patients with an obstructed airway
2. Patients, as determined by the base hospital personnel, whose lives would be
jeopardized by transportation to any destination but the MAR
Ref. 508 sexual assault
SART Center
a lic. general acute care hospital, lic. ER or a hospital sponsored program clinic that has
met the specific requirements, approved by LA County to receive patients who are
victims of sexual assault
Ref.508 sexual assault
Policy
1. Sexual assault pt. who deny physical injuries and who do not meet base hospital
contact and transport criteria may be released at the scene to PD for follow up
2. Every effort should be made to transport sexual assault patients. who meet base
hospital contact and transport criteria to the MAR that has been designated SART
Center
Ref 510 PEDS Pt. Destination
PEDS Age?

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children 14 years or younger
Ref 510 PEDS Pt. Destination
EDAP?
ER that has been approved to receive 9-1-1 patients
Ref 510 PEDS Pt. Destination
PMC
Pediatric Medical Center
acute care hospital that can receive critically ill 9-1-1 peds.
Ref 510 PEDS Pt. Destination
PTC
Pediatric Trauma Center
acute care hospital that can receive critically injured 9-1-1 peds.
Ref 510 PEDS Pt. Destination
Guidelines for transporting to EDAP, PMC, PTC, or trauma canter
1. Patients who require transport and don't meet guidelines for transport to a PMC and
PTC shall be transported to EDAP
2. BLS units shall call for an ALS unit or transport PEDS to the most accessible EDAP
Ref 510 PEDS Pt. Destination
Patients meeting medical guidelines for transport to a PMC?
1. Shall be transported to the most accessible PMC if ground transport is 30 mins. or
less
2. If transport to a PMC is greater than 30 mins, transport to most accessible EDAP
Ref 510 PEDS Pt. Destination
Patients meeting trauma criteria / guidelines for transport to PTC

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2024-2025 LA County Protocols Practice Exam with Answers (113 Solved Questions)

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