Grey (Operations) Initial Summary Of Changes-Page 1
Location of Change / Change / Purpose of Change / Expected Impact- Operational
- Educational
- Financial
Grey 1 –
II.C.1. / "EMS DNR orders from other states' EMS/DNR programs; If the order or device appears to be in effect, and is understandable to the crew...... " / Clarity / Educational / Yes / Grammar
Grey 1 – II.D. Line 2 / “is presented to EMS personnel; once executed by the patient……” / Clarity / Educational / Yes / Grammar
Grey 2 – III.G.1.e. / Provide pain and other medications of comfort only to a conscious patient (ALS per OLMC/Hospice provider). / Clarity / Educational / Yes / Grammar
Grey 2 -III.G.1.g / Contact patient’s physician/PA/NP/Hospice provider or OLMC if questions arise. / Clarity / Educational / Yes / Inclusion of palliative care providers
Grey 3 – J.1.b. / Refer to TOR protocol here / Clarity / Educational / Yes / Consistency; old language does not fit with TOR protocol
Grey 4 – J.2.b. / Refer to TOR protocol here / Clarity / Educational / Yes / Consistency; old language does not fit with TOR protocol
Grey 5 – II.B.1. / “….(OCME) or whether the death certificate may be signed by the patient’s private attending physician / Clarity / Educational / Yes / Clarity
Grey 5 – III.J. / “….deaths in a Mental, or DHS Residential Care Facility.” / Clarity / Educational / Yes – get rid of caps / Clarity
Grey 6 – V.B. / “….EMS run sheets should be given to police investigators and/or the OCME as soon as possible if asked. Therefore, it is important that they are very thorough, proof-read, and completed promptly.” / Clarity / Educational / No, Refer to Brown 2 statement.
Grey 7 – 1. / “BODIES SHOULD BE LEFT IN PLACE AT THE SCENE….” / Clarity / Educational / Yes
Grey 7 – 2. / “….as determined by distances and/or the needs of other patients in the ambulance.” / Clarity / Educational / Yes
Grey 7 – 4. / “ a tag with at least the name, date of birth and time of death of the patient/decedent along with….” / Clarity / Educational / Yes
Grey 8 - BLACK / “….or requiring CPR when no personnel are available / Clarity / Educational / Yes
Grey 8 / Add: “In the event of a public health emergency or declared disaster, EMS providers may be asked to divert selected patients with certain conditions to hospital-established or state-established alternate care sites by OLMC.” / Clarity / Educational / Yes
Grey 10 – 11. / “…..of possible injuries, the chance to obtain pregnancy and sexually transmitted disease prophylactic treatment, and appropriate counseling.” / Clarity / Educational / Yes
Grey 11 – Possible indicators of abuse – 3.
- 5. / “Atypical, diffuse, and/or severe injuries – especially when not over bony prominences.”
“Delay in seeking treatment or not wanting the provider to speak alone with the child.” / Clarity
Clarity / Educational
Educational / Do this; maybe look at the training that DHHS does re: this education.
Grey 12 – bottom of page.
Grey 12 – c. / “if a child is under 6 months of age or is otherwise non-ambulatory and exhibits evidence of one or more of the following:
Change “subdural hematoma” to “significant head injury” / Clarity / Educational / Should not change the wording as it is taken directly from the law.
Should we reinforce that they have to do the training? Yes / Reviewed the law and made changes so that it matches.
Added the verbiage re: the training requirement
Grey 13 – Paragraph 2 / Change Adult Protective Phone number from black to red / Clarity / Educational / Bolded and copy to Grey 12
Grey 14 / “….would be one who has one or more of the following: / Clarity / Educational / Yes
Grey 14 – 6. / “….for all of these interactions, and must include the following….. / Clarity / Educational / Yes
Grey 14 – 6.a. / “ absence of any acute…that impairs the patients’ own capacity to consent.” / Clarity / Educational / Make it “decision-making capacity”
Grey 15 – 7. / “…..discuss the refusal of care or transfer directly with….” / Clarity / Educational / Yes – change “transfer” to “transport”
Grey 16 – paragraph 3 / “…..Maine law as physician extenders to physically or chemically restrain any…..” / Clarity / Educational / Want to remove physically and chemically; look at law’s wording
Grey 17 / Should we add……If attempts to remove the headgear cause new or worsening neuro symptoms…..Leave the Headgear in Place (I can’t draw arrows) / Clarity / Educational / Do not add this; leave as is