Policy Text
Roll Call Training Bulletin
Produced by: Lt. Stephen Quinn Rick Braziel, Chief of Police
Volume III
November 19, 2009
Fire EMS Protocol When Responding to Offi cer Initiated Requests for Medical Assistance
ISSUE: What role does Fire Emergency Medical Services (EMS) play at a scene when either an officer
requests Fire EMS or a suspect requ ests/refuses medical treatment?
ANSWER: Since Fire paramedics must be licensed to prac tice and are named in lawsuits, their practices are
scrutinized by County and State EMS aut horities. Previously, medics were co mfortable “clearing” injured or ill
suspects for transport and booking in the jail with little examination. Due to the County of Sacramento Office
of Emergency Medical Servi ces’ recent polic ies, medics will only be able to “clear” a susp ect under certain
criteria (not at the request of police officers on scene).
The County of Sacramento Office of Emergency Medical Services’ policy regarding patients who are released
at the scene by a paramedic must me et ALL of the following criteria:
- The patient must have a clearly articulate d plan for medical evaluation and/or follow-up.
- The patient plan must have a reasonable and prudent transportation plan to reach follow-up
medical care in a timely manner.
- After complete assessment, the paramedic superv isor must concur with the appropriateness of
scene release and the medical approp riateness of the follow-up plan.
- Patients with minor traumatic injuries shall NOT meet the critical trauma criteria.
- Medical complaints must NOT be of new onset (first time symptoms).
- The patient must sign a release form stating th at the emergency evaluation has been rendered,
transportation offered and that the patient chooses an alternative evaluation plan.
- The provider (Fire EMS) will audit 100% of scen e releases under this policy based on available
data for medical appropriateness, compliance with Department/company policy and compliance
with County policies.
Paramedics under this policy will NOT release the following classes of patients at the scene:
- Patients requesting ambulance transpor t shall not be denied transport.
- Patients with any new onset medical complain ts such as seizures, headache, hypoglycemia,
respiratory distress, chest pain, etc. rega rdless of the duration of the complaint.
- Paramedics may not knowingly release a patien t under this policy more than once in a 24-hour
period.
Roll Call Training Bulletin
Produced by: Lt. Stephen Quinn Rick Braziel, Chief of Police
Volume III
November 19, 2009
- Children under 1 year of age.
- Elderly patients who are difficult to assess or whose mental status is chronically altered.
- Minors under eighteen (18) year s of age shall not be released under this policy except at the
request of a parent or guardian.
Patients/suspects, while suffering from an illness or injury, may decline all or part of the assessment, emergency
treatment and/or transportation only if the following factors are NOT present:
- The subject’s impaired capacity to understand th e emergent nature of their medical condition due
to alcohol, drugs or medication, mental illn ess, traumatic injury or grave disability.
- The subject is under eighteen (18) years of age.
Patients/subjects who are refusing part or all treatmen t/transportation and who in the judgment of paramedics
require treatment shall consider the invol vement of law enforcement if there is a threat to self /other or if the
subject is gravely disabled. DISCUSSION:
Fire Paramedics are the authorities who are charged with determining whether a
subject/suspect is transported for medical treatment per Sacramento EMS’ protocols . Law enforcement agencies
should not attempt to influence paramedics to re lease or “clear” subjects for transport to jail.
If you have questions, please contact th e Training Divisi on at (916) 808-2418