STARS Aviation Canada Inc.
(collectively "STARS")
Conditions of use
Access and use of these Medical
Control Guidelines and/or the information contained therein (collectively the
"MCG") is provided on the condition that you accept the following
terms, and by accessing or using the MCG, you agree to such terms. If you
do not agree to accept and abide by these terms you may not access or use the
MCG.
THE MCG IS INTENDED FOR THE
ASSISTANCE OF STARS PERSONNEL. ANY USE BY PERSONS OTHER THAN STARS
PERSONNEL ("OTHER USERS") IS SUBJECT TO THE FOLLOWING LIMITATIONS OF
LIABILITY. THE MCG IS INTENDED
Solely As A Reference Tool for Practicing, Experienced Healthcare Personnel
AND IS PROVIDED ON AN “AS IS” BASIS.
WHILE THE PROVIDERS OF THE MCG (THE "PROVIDERS") HAVE ENDEAVORED TO
ENSURE THE ACCURACY, ADEQUACY AND COMPLETENESS OF THE MCG, THE MCG IS SUBJECT
TO ONGOING UPDATES AND REVISION. AS SUCH, THE PROVIDERS EXPRESSLY
DISCLAIM ANY AND ALL REPRESENTATIONS, WARRANTIES AND CONDITIONS CONCERNING THE
MCG, INCLUDING ANY IMPLIED WARRANTIES, REPRESENTATIONS OR CONDITIONS OF
MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR WARRANTIES,
REPRESENTATIONS OR CONDITIONS AS TO ANY RESULTS TO BE OBTAINED FROM THE USE OF,
OR DERIVED FROM, THE MCG.
NO RESPONSIBILITY IS ASSUMED FOR
ERRORS OR OMISSIONS CONTAINED IN THE MCG, or ANY LIABILITY FOR LOSS, DAMAGE OR
INJURY WHICH MAY RESULT FROM THE USE OR RELIANCE THEREON. FOR GREATER
CERTAINTY, THE PROVIDERS SHALL NOT, REGARDLESS OF THE THEORY OF LIABILITY, BE
LIABLE FOR any loss, DAMAGE OR INJURY
(in contract, tort, warranty or otherwise) incurred in connection with (i) THE
ACCESS, use or reliance on the MCG; OR (ii) any decision made OR action or
inaction taken by any OTHER USER in reliance upon the MCG.
IN
ADDITION, Under no circumstances will THE PROVIDERS be liable for any ordinary,
direct, indirect, consequential, incidental, special, punitive or exemplary
damages arising out of any of the foregoing, WHETHER OR NOT THE PROVIDERS WERE
TOLD OF, KNEW OR OUGHT REASONABLY TO HAVE KNOW OF THE POSSIBILITY OF SUCH LOSS,
DAMAGE OR INJURY.
Copyright Alberta Shock Trauma Air
Rescue Society 2005
STARS’ MEDICAL CONTROL GUIDELINES – DEFINITION AND
PURPOSE
The Air Medical Physician Association believes that all air
medical transports require physician medical control and that the
responsibility for assuring appropriate medical control rests with the Medical
Director(s) of the air medical service. The Medical Director has the
final authority over all patient care aspects of the air medical service, which
includes medical control for all transports. The Medical Director may
however delegate the responsibility and authority for medical control to other
qualified individuals (AMPA
Manual 2001) (i.e. Referral Emergency
Physician (REP) or,
at times,
the sending physician).
‘EMS necessarily involves the practice of medicine in the prehospital setting, and because only physicians are
licensed to practice medicine, active physician participation in
In the absence of an REP (Referral Emergency Physician) in
direct attendance, the purpose of these Medical Control Guidelines is to
specify, in terms of written performance guidelines, standardized systems of
emergency medical care delivery for specific pre-hospital situations and
patient presentations, and to manage and standardize steps for patient-related
care and transportation. These Medical Control Guidelines will cover any
pre-hospital emergency medical care delivery within the scope of STARS Air
Medical Crews.
These Medical Control Guidelines are deliberately drafted in
flexible form. No attempt will be made to dictate or confine emergency
treatment or to remove the element of field judgment necessary in each specific
emergency circumstance.
These Medical Control Guidelines carry the authority of STARS’
Medical Director or designate(s), in their capacity as licensed physicians in
the
This Medical Control Guidelines Manual will be continually
reviewed, edited and updated as deemed necessary by the Medical Director.
These Medical Control Guidelines provide the following:
STARS’ MEDICAL CONTROL GUIDELINES –
HOW TO USE THEM
STARS Air Medical Crew (AMC) consists
of a Paramedic, a Registered Nurse, and at times, a Referral Emergency
Physician (REP). On missions where a REP is present, the physician will
be the Medical Authority. REP orders supercede
Medical Control Guidelines, whether or not the REP is in direct attendance or
providing on-line medical control.
On scene call missions when an REP is not present, these
Medical Control Guidelines will serve as treatment guidelines for the Paramedic
and Nurse. As there are no absolutes in medicine, these Medical Control
Guidelines will be considered tools to assist the Air Medical Crew's ability to
think and act appropriately in an emergency medical circumstance.
On interfacility missions without
a physician, AMC will contact the REP to review clinical issues and any aspects
of patient care which are not addressed by the MCGs.
The intent of Medical Control Guidelines is to provide prehospital care providers with written, systematic
guidelines referencing standards of care. At STARS, our interfacility missions involve a continuance of emergency
treatment already initiated by the sending physician. This presents the
STARS crew with unique circumstances not always addressed by traditional models
of ‘Off-line Medical Control’. It is the responsibility of the AMC to use
a significant degree of judgment in the management of all patients. AMC
must remember that the guidelines in this manual are not sequential in all
cases and that several algorithms may be involved in treating a patient.
In the absence of direct medical control, AMC should attempt to sequentially
follow the guidelines; however, in situations where the clinical situation does
not fit the guidelines, judgment is allowed and expected.
MEDICAL DIRECTORS
Medical Directors are individuals or designates who have
entered into an agreement with STARS to provide the service of medical control
and direction, in their capacity as licensed Physicians for the pre-hospital
medical activities of STARS. These individuals function as the local
medical authority, as defined in the Emergency Medical Technicians Regulation
of the Alberta Health Disciplines Act.
VARIATION OF MEDICAL CONTROL GUIDELINES
Although it is expected that the MCGs
will be followed whenever possible, they are intended to be used as
guidelines. It is impossible to anticipate every situation.
Therefore, it may be reasonable to expect that from time to time there
will be intentional variation from the MCGs in order
to manage specific cases. Should a situation arise necessitating a
potential variation from the MCGs, AMC will make
reasonable efforts to consult with the REP.
Any guideline variation should be documented on the patient
care report and be justified by supporting documentation. All such cases
are reviewed as part of our quality assurance and management program.
In the event of an unintentional variation from guideline(s)
or in the event of a treatment error;
SCENE CALLS
In the interests of rapid response, when STARS is dispatched
directly to the scene, the Air Medical Crew shall consist of the Flight Nurse
and the Flight Paramedic.
INTERFACILITY TRANSPORTS - TRANSFER OF MEDICAL
RESPONSIBILITY
During interfacility transfers when
the crew is ordered to initiate or continue treatment under the direction of
the sending physician that is normally outside of the MCGs,
the following should occur:
Until a formal transfer of care has occurred such that the
patient is solely under the care of our AMC, the orders of the sending
physician, as the highest local medical authority, supersede our MCGs. That being said, if reasonable practice,
experience, and common sense raise concerns with AMC with respect to these
orders, then the REP should be contacted as soon as possible. It is
preferable that the REP and sending physician discuss any perceived differences
in treatment plans in order to come to a consensus. AMC should then be
made fully aware of the agreed upon treatment plan prior to carrying on with
therapy.