Pediatric emergency medicine trisk 4604 4604
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TABLE 134.1
NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, U.S. DEPARTMENT OF
TRANSPORTATION, NATIONAL EMERGENCY MEDICAL SERVICES EDUCATION
STANDARDS: MINIMUM PSYCHOMOTOR SKILLS
Medical direction of field clinical practice occurs in two forms: indirect, or offline , and direct, or online.
Offline medical direction typically occurs through established protocols, or a set of standing orders for a specific
condition or presenting symptom ( Fig. 134.2 ). Offline protocols guide rescuers’ actions in the field, standardize
patient care, and can facilitate rapid and effective treatment. They can also serve as a gauge to measure adherence
to guidelines, furthering the quality of prehospital care. Medical directors are responsible for every action
outlined in offline protocols, and for every patient outcome resulting from proper adherence to these protocols.
An example of a protocol for allergic reaction/anaphylaxis is provided in Figure 134.2 . Note that there are a
