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It covers guidelines for use, standard operating guidelines for EMS including medical communications and transfer of care, and policies for consent/refusal and patient dead on arrival. 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Donnelly, Sr. Fire & EMS Chief  \nSean G. Morgan, MD Medical Director  \nRevision: March 17 , 2026  \nIntroduction – Section 1  \nTable of Contents ........................................................................................... 1. 1  \nForeword ........................................................................................................ 1.2  \nGuidelines for Use ......................................................................................... 1.3  \nStandard Operating Guidelines (EMS)– Section 2  \nMedical Communications ..............................................................................2.1  \nTransfer of Care Policy ..................................................................................2.2  \nConsent / Refusal of Care Policy ...................................................................2.3  \nPatient Dead on Arrival (PDOA) ...................................................................2.4  \nDo Not Resuscitate (DNR) / MOST ..............................................................2.5  \nAir Transport Utilization................................................................................2.6  \nTransport to OCME…………………………………………………………2.7  \nGeneral Patient Management – Section 3  \nGeneral Assessment and Universal Care .......................................................3.1  \nAirway Management and Oxygen Therapy…………………………….......3.2  \nClinical Priorities ...........................................................................................3.3  \nHospital Capabilities Chart ............................................................................3.4  \nMedical Control .............................................................................................3.5  \nCrashing Patient-Medical…………………………………………………...3.6  \nTreatment Protocols-Resuscitation – Section 4  \nCardiac Arrest ................................................................................................4. 1  \nAsystole / Pulseless Electrical Activity (PEA) ..............................................4.2  \nVentricular Fibrillation / Pulseless V-Tachycardia........................................4.3  \nRefractory Ventricular Fibrillation / Pulseless V-Tachycardiac ....................4.4  \nSpecial Circumstances in Cardiac Arrest.......................................................4.5  \nReturn of Spontaneous Circulation (ROSC) ..................................................4.6  \nTermination of Resuscitation-Medical Cardiac Arrest ................................4.7  \nTraumatic Cardiac Arrest-Resuscitation and Termination ..........................4.8  \nNewborn Resuscitation ..................................................................................4.9  \nTreatment Protocols – Cardiac Emergencies – Section 5  \nWide Complex Tachycardia / V-Tach with a Pulse.......................................5.1  \nNarrow Complex Tachycardia .......................................................................5.2  \nBradycardia ....................................................................................................5.3  \nAcute Coronary Syndrome (ACS) / Chest Pain.............................................5.4  \nAcute Pulmonary Edema (CHF) ....................................................................5.5  \nVentricular Assist Device (VAD) .................................................................5.6  \nTreatment Protocols-Respiratory Emergencies – Section 6  \nAirway Obstruction ........................................................................................6. 1  \nBronchospasm Asthma / COPD.....................................................................6.2  \nCroup / Upper Airway Compromise ..............................................................6.3  \nRespiratory Failure / Arrest ...........................................................................6.4  \nPost Advanced Airway Management....................","cbCaitQeEvsIDfHP","https://ap.wps.com/l/cbCaitQeEvsIDfHP","pdf",9650303,531,"English","# Introduction – Section 1\n## Foreword\n## Guidelines for Use\n# Standard Operating Guidelines (EMS)– Section 2\n## Medical Communications\n## Transfer of Care Policy\n## Consent / Refusal of Care Policy\n## Patient Dead on Arrival (PDOA)\n## Do Not Resuscitate (DNR) / MOST\n## Air Transport Utilization\n## Transport to OCME\n# General Patient Management – Section 3\n## General Assessment and Universal Care\n## Airway Management and Oxygen Therapy\n## Clinical Priorities\n## Hospital Capabilities Chart\n## Medical Control\n## Crashing Patient-Medical\n# Treatment Protocols-Resuscitation – Section 4\n## Cardiac Arrest\n## Asystole / Pulseless Electrical Activity (PEA)\n## Ventricular Fibrillation / Pulseless V-Tachycardia\n## Special Circumstances in Cardiac Arrest\n## Return of Spontaneous Circulation (ROSC)\n## Termination of Resuscitation-Medical Cardiac Arrest\n# Treatment Protocols – Cardiac Emergencies – Section 5\n## Acute Coronary Syndrome (ACS) / Chest Pain\n## Acute Pulmonary Edema (CHF)\n## Bradycardia\n# Treatment Protocols-Respiratory Emergencies – Section 6\n## Airway Obstruction\n## Bronchospasm Asthma / COPD\n## Croup / Upper Airway Compromise\n## Respiratory Failure / Arrest\n# Treatment Protocols – General Medical Emergencies – Section 7\n## Abdominal Pain (Non-traumatic)\n## Altered Mental Status\n## Anaphylaxis / Allergic Reaction\n## CVA / Brain Attack\n## Pain Management\n# Treatment Protocols – Environmental Emergencies – Section 8\n## Hyperthermia\n## Hypothermia","[{\"question\":\"What sections are included in the DC Fire and EMS pre-hospital protocols document?\",\"answer\":\"The document includes an introduction section, EMS standard operating guidelines, general patient management, and treatment protocols organized by resuscitation, cardiac, respiratory, general medical, and environmental emergencies.\"},{\"question\":\"How does the document address consent and refusal of care in pre-hospital settings?\",\"answer\":\"It includes a specific policy section covering consent/refusal of care, along with related guidance within the EMS standard operating guidelines.\"},{\"question\":\"Which emergency categories are covered by treatment protocols beyond cardiac arrest?\",\"answer\":\"Beyond cardiac arrest, the document provides protocols for cardiac emergencies (e.g., tachycardia and ACS/chest pain), respiratory emergencies (e.g., airway obstruction and respiratory failure), general medical emergencies (e.g., seizures and anaphylaxis), and environmental emergencies such as hyperthermia and hypothermia.\"}]","DC Fire and EMS Pre-Hospital Treatment Protocols - Revision March 17 2026 | PDF",1790153268,1338]