Policy Text
Policy
408Fremont Police Department
Emergency Medical Response Guidelines
408.1 PURPOSE AND SCOPE
The Police Department has the responsibility for overall scene management of a medical
emergency, until relieved by the Fire Department, unless it is a potential crime scene, in which
case the Police Department shall retain control of the scene. Authority for patient health care in
a medical emergency shall be vested in that licensed health care professional/paramedic at the
scene of the emergency most medically qualified. The Police Department shall assist the Fire
Department or qualified medical personnel in coordinating activities as necessary, to assure that
all responders render the best possible service to the public. An ambulance will be requested
whenever person(s) are in need, or believed to be in need, of such emergency service and every
effort shall be made to ensure that emergency ambulances are not inadvertently or erroneously
canceled.
The purpose of this policy is to provide basic guidelines for planning and coordinating medical
emergency incident activities and conducting professional emergency scene management
operations. Also, to set guidelines for the requesting, dispatching, and canceling of ambulances
at all scenes under the control of department personnel.
408.2 PROCEDURES FOR MEDICAL SCENE MANAGEMENT
Personnel must be cognizant that legal and practical medical emergency scene management is
usually coordinated between the Police Department and the licensed health care professional.
This on-site coordination should not imply police personnel will be involved in internal direction or
manipulation of specialized medical functions, but only advise what needs to be accomplished, or
to address police related matters should they arise.
(a)The officer first arriving on the scene shall be designated as scene manager. He/she
shall remain scene manager until relieved or reassigned by a superior or qualified
medical personnel.
(b)The scene manager must prepare for the arrival, convergence, and coordination of
ambulance, fire, additional police equipment/ personnel, and the media.
(c)The scene of a medical emergency shall be managed in a manner designed to
minimize risk of death or health impairment to the patient and to other persons who
may be exposed to the risks as a result of the emergency condition.
(d)The scene manager has the authority to close or limit scene access to unauthorized
persons. If the scene manager determines to close or limit scene access, the scene
status shall be transmitted to responding fire and medical units via radio or through
other available means. The following terms will be used when referring to a particular
type of scene:
1.Closed Access Crime Scene (stay out)
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Emergency Medical Response Guidelines
(a)The potential hazard still exists, such as a hostage situation or the suspect
is still on scene and not under control.
2.Limited Access Crime Scene (scene manager will direct entrance)
(a)Critical evidence could be destroyed or compromised.
(b)Hazards may still be present.
1.Hazardous chemicals present
2.Unsafe structure
3.Open Access Scene
(a)No evidentiary concerns
(b)No hazards present
408.2.1 PATIENT CONSENT AND REFUSAL
Health and Safety Code Section 1482.5 authorizes patient health care management in a medical
emergency shall be vested in the most medically qualified licensed health care professional/
paramedic at the scene of the emergency. In most cases, this will be fire or ambulance personnel.
The senior medical person on the scene is responsible for determination if medical evaluation
is necessary. Police personnel shall be cognizant of the following Alameda County procedures
regarding consent and refusal of medical treatment:
(a)Consent by parties needing treatment.
1.There are implied consents by incompetent patients who are unconscious,
delirious, and/or obviously out of control emotionally.
2.There are competent consents by patients who appear rational and cooperative
to medical attention and direction.
3.There are competent consents by legally emancipated minors and all competent
adults.
(b)Refusal of treatment by parties involved in the incident.
1.When the senior medical person on the scene determines that medical
evaluation is necessary, only competent adults and emancipated juveniles are
capable of refusing medical treatment. If a competent adult or emancipated
juvenile refuses treatment:
(a)Medical personnel will have an A.M.A. form that should be signed by the
patient and witnessed.
2.Incompetent Adults - Any patient who falls into one of the following categories
may not refuse treatment/transport:
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Emergency Medical Response Guidelines
(a)Any patient with an altered level of consciousness. This includes alcohol
and drug influenced patients.
(b)Any patient who has attempted suicide or verbalizes suicidal intent.
(c)Any patient under a hold pursuant to Welfare and Institutions Code § 5150.
3.Patients meeting the above criteria as incompetent adults shall be transported
to an appropriate facility.
(a)If the person is in police custody, the officer legally assumes responsibility
for the decision of immediate medical treatment.
(b)The arresting officer shall always base his/her decision on the immediacy
of the need for medical treatment and the mode of transportation on advice
of the senior medical person at the scene.
4.Juvenile Injury Cases - Injured juveniles generally cannot refuse medical
treatment or transportation to an appropriate facility for evaluation and
clearance. Those capable of refusing treatment are the following:
(a)Emancipated competent juveniles.
(b)Juveniles in the presence of their competent parent, legal guardian, or