In the early days of EMS, treatments and protocols were often based on assumptions and anecdotes, but not rigorous science. While studying emergency medicine—especially in the field—remains one of the most challenging areas in clinical research, prehospital research is now a vibrant and growing area of study. Meanwhile, the EMS community is more receptive of clinical evidence—and implement new pre-hospital care procedures, medications and technology based on comprehensive clinical trials.
The recent effort to develop evidence-based guideline and protocols, which are written using the body of evidence and the strength of the studies—not just the results—seeks to change that. The Denver Metro EMS Protocols provide the clinical pathways for our patients across most illnesses and injuries seen in the pre-hospital environment. The Colorado Department of Public Health and Environment establishes the rules outlining the care which can be provided in the field.
The EMTs, Advanced EMTs, EMT-Intermediates and Paramedics of ICFPD follow protocols have been developed and approved by the Denver Metro EMS Medical Directors (DMEMSMD) group. These protocols define the standard of care for EMS providers in the Denver Metropolitan area, and identify the expected practice, actions, and procedures to be followed.
No protocol can account for every clinical scenario encountered, and the DMEMSMD recognize that in rare circumstances deviation from these protocols may be necessary and in a patient’s best interest. Variance from protocol should always be done with the patient’s best interest in mind and backed by documented clinical reasoning and judgment. Whenever possible, prior approval by direct verbal order from base station physician is preferred. Additionally, variance from protocols must be documented and submitted for review by the agency’s Medical Director in a timely fashion.
The EMS protocols are 146 pages in length. Copies of the protocols are available in each ambulance and our volunteer staff have a copy on their phones. Contact with an Emergency Physician is always available through our medical base hospital, St. Anthony’s Hospital in Lakewood. While St. Anthony’s is the ICFPD medical control center, we can transport patients to their preferred hospital based on patient condition, type of illness or injury, and the patient’s age.
