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ALL
EMS
PROTOCOLS MUST BE REVIEWED & MAY BE MODIFIED
Printed
version
Background
The North Dakota Department of Health, along with
an expert EMS protocol writing committee has developed a set of
protocols that all North Dakota
ambulance services may choose to use.
These “State Protocols” include every procedure that may be done
by EMS Professionals. The
protocols are divided into four broad categories; Advanced Life Support
(ALS - Paramedic), Intermediate Life Support (ILS, EMT-I ‘85), Basic
Life Support (BLS, EMT), and General Operational Protocols.
Based on your service’s staffing you may only need to utilize one
provider level (ALS, ILS, or BLS), or any combination of the three, and
the General Operational Protocols.
Process
The EMS Professionals on your particular ambulance
service might not be trained or competent to do all of the skills,
procedures, or treatments listed; therefore, each individual service and
medical director must evaluate each protocol and tailor them for their
own use based on the certification or licensure of their staff and their
medical director’s requirements.
The medical director for each service has also received a copy of
these protocols for reference. It
is up to the ambulance service manager to discuss this process with the
medical director and make any modifications required.
We have included basic visual instructions on how
to modify the protocols with a word processor.
In your protocol binder there is
a printed “sample” set of protocols and a CD ROM that includes all
protocols in an electronic format.
These electronic files are in ‘.rtf’ (rich text format) which
makes them easily modified using many types of word processing
applications. Each protocol is
included on the CD ROM in two different locations; one as an individual
electronic file, and another as part of a logical grouping of protocols.
This was done to make printing your edited protocols simpler.
There are many ways to modify and make these
protocols operational for your service.
We suggest that you:
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Take the printed “sample” copy to your medical director to review.
Your medical director can edit the protocols in a manner that
he/she sees fit; by lining out skills, procedures or treatments that
are not appropriate for your service, denying entire protocols, or
by editing the protocols electronically to better suite the
capabilities of the service’s personnel.
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The manager should then take the printed “sample” protocols that
have been edited by the medical director and make the changes
electronically if not already done by the medical director.
Change the header to identify your ambulance service’s name
on each protocol (see page 3).
You’ll have to save any changes to a local drive on your
computer (see page 4). Make
sure to update the table of contents so finding an appropriate
protocol is a simple process.
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Reprint the edited version and take them back to the medical
director for final review and signing (repeat step #2 if needed).
Each protocol must be signed by the medical director to be
valid.
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Once signed the protocols are operational.
It is the manager’s responsibility to make sure each EMS
Professional is familiar with the new standards and follows them
appropriately. A training
session may be required with staff to explain the new standards and
procedures.
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Keep the original version of the signed protocols on file and make
copies available for everyday use. Place
the everyday version in the binder that was provided using the tabs
to group them appropriately.
You may want to consider inserting the pages into page protectors
for longevity.
Word
Processing Tips
To edit a protocol, open the document that you wish
to modify by double clicking the file name.
Once this is done you may select
text by holding down the left mouse button and dragging the cursor
across the words you wish to change.
This will “highlight” them for editing (as seen below).

Once you have highlighted the text, you may either
delete or begin typing.
The next process is identifying your service’s name
in the header of each protocol. Double
click in the header area to open up the header and footer edit box.
Highlight “North Dakota
Ambulance Service” (by clicking ad dragging as described above) and
type in your own service’s name. You
will have to edit each protocol individually.

Once each protocol has been edited, make sure you save the document on a
local drive. This can be
accomplished in many different ways and the illustration below shows one
way. Save the file in
your word processor’s format like (i.e. ‘.doc’ in MS Word) and title
each document as you wish.

Finally when you are done editing, print out the documents and have your
medical director approve and sign each
protocol.
Remember to save often so your work is not lost in the process.
Funding for this
project was provided by the
North Dakota Department of Health-
Division of Emergency Medical Services
and
Emergency Medical Services for Children Program
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