LAC 48:I.6047. Medical Protocol [Formerly §6037]

A. In accordance with R.S. 40:1133.14, ambulance service/provider shall follow out-of-hospital EMS protocols that have been approved by: 1. The parish or component medical society for use within its jurisdiction; 2. The ambulance service’s EMS medical director; or 3. The Louisiana Emergency Response Network. B. At a minimum, protocols, policies, or guidelines shall address the following conditions and/or situation for adult (if applicable), geriatric (if applicable) and pediatric (if applicable) patients: 1. universal care; 2. cardiovascular; 3. general medical; 4. resuscitation; 5. OB/GYN; 6. respiratory; 7. trauma; or 8. toxins and environmental C. The EMS service shall adopt the protocols established by the Louisiana Emergency Response Network (LERN) or develop an agency specific protocol with specific language related to the transportation of the following patients: 1. Acute stroke patients shall be transported to the closest appropriate comprehensive stroke center, thrombectomy capable stroke center, primary stroke center, or acute stroke ready hospital; however, acute stroke patients exhibiting signs or symptoms of airway, breathing or circulatory compromise, or any other potentially life-threatening emergency, as defined by protocols implemented by the ambulance service’s medical director, shall be transported to the closest appropriate hospital capable of caring for the patient’s emergency condition. a. Acute stroke patients may also be diverted to the closest appropriate hospital by order of LERN or online medical control from the local facility, potential receiving facility, or medical director. 2. Patients suffering an acute ST elevation myocardial infarction (STEMI), occlusion myocardial infarction (OMI), or non-occlusion myocardial infarction (NOMI) shall be transported to the closest appropriate STEMI receiving center or, when appropriate, a STEMI referring center. 3. In any case where the treating EMS Practitioner’s evaluation, according to protocol, indicates a potentially unstable condition or potential medical emergency that, if traveling the extra distance to the recommended appropriate facility could put the patient at higher risk, the EMS Practitioner in his/her discretion may divert to the nearest appropriate facility. D. All protocols shall: 1. meet or exceed the requirements of these licensing standards and all applicable federal, state, and local laws; 2. be consistent with the current National EMS Education Standards, the Louisiana Scope of Practice and the rulings of the Louisiana EMS Certification Commission; 3. be reviewed annually by the licensed agency’s medical director, or the parish medical society; 4. be immediately available to the department when requested for investigations and during surveys; and 5. contain medical directives for substitute medications during a national drug shortages. E. Ambulance services are accountable for assuring compliance with applicable protocols by their personnel. Exceptions to these protocols must be reviewed on a case-by-case basis by the medical director. 1. Treatment decisions shall be considered given the current health status of the patient in conjunction with all of the associated risks factors including, but not limited to, distance to the nearest stroke facility.