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Base contact required

The Base Contact sections is an overview of the Drugs, Procedures, and Circumstances in which a Paramedic would need to make Base Hospital Contact.

Base Hospital Contact (BHC) refers to situations where contact needs to be made during the call, for instance; all Trauma calls are Base Hospital Contact calls, but you can start treating the patient prior to contacting.

Base Hospital Order (BHO) refers to situations that need permission from the Base Hospital before performing.  An example of this would be Push Dose Epi.

 
Base Contact Required in all of the following situations:

Vital Signs - Adult patients with unstable vital signs for whom there is no applicable Standing Order.

Unstable Vital Signs:

  • Pulse (bpm)           <50 or > 130

  • Respirations          <12 or > 26

  • Blood Pressure     <90

1. Specialty Receiving:

  • SNRC

  • PTRC

  • CVRC

  • Burn

  • Vascular (AAA)

  • Replant Center patients

2. Inter-Facility Transports (IFTs)

3. Full Arrest:

  • ROSC

  • requesting pronouncement

  • family questioning DNR/POLST

4. MCI

5. Snake Envenomations

6. PEDS Drowning

7. PEDS Seizures (Treated, Transported, or Neither)

7. Severe Hyperthermia

8. End of Life Situations

9. Field Delivery  / OB Hypertension

10. AICD firing twice or more times in less than 15 min

11. Triage Decisions

12. AMA Issues: 

  • Patients on whom an ALS procedure is performed including en EKG.

  • Patients for whom a 12-lead was performed and then requests to sign out AMA.

  • ALTE / BRUE patients.  

  • ALS refusal with question of capacity.

  • Complicated AMA’s - refusal to go to specialty, complicated DNR, etc…

  • Patient signing AMA that meets Base Hospital Contact criteria.

  • Patients signing AMA with abnormal vital signs (see Unstable Vitals above).

13. Transport Issues: 

  • Any transport or destination issues.

14. Diversion:

  • No pt. may be transported to a Hospital on Diversion without a BHO.

  • After contact has been made to 3 Hospitals on Diversion, make Base Hospital Contact for destination.

  • Base Hospital has final decision on destination of all patients.

15. Procedures: 

  • Needle Thor - For patients with pulses (SO in MCI, remote rescue, tactically unstable scene)

  • Pacing - Contact the Base for possible transport to CVRC

  • PEDS - SVT treatment

  • PEDS V-Tach with pulses 

  • PEDS cardioversion

16. Medications requiring Base Hospital Order:

  • Adenosine (Peds)            

  • Push Dose Epi (Adult/Peds)    

  • Amiodarone (Peds)

  • Nitroglycerin (Peds)

  • ASA (Peds)

  • Versed for pre-cardioversion sedation (Adult/Peds)

  • Versed for PEDS under 12 months

  • Fentanyl for PEDS under 2 years

  • Epinephrine for Asthma (Adult)

Special Circumstances:
  • Victims of sexual assault should be transported to the nearest PRC or PTRC.

  • OC Paramedics are NOT allowed to “Medically Clear” a patient.

  • Base Hospital Contact shall be made for complicated calls.

  • Patient restraint needed and PD will not engage in patient restraint.

**Complete 330.15 tab on the ePCR when BHC required and not completed**

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