POLICIES
REMS Protocols
The Rappahannock EMS Council Regional Medical Direction Committee has approved the following protocols (revised 2017) for use throughout the REMS region. Please note that some of these protocols are optional and at the discretion of the Agency Operational Medical Director.
Please consult your local Agency OMD for further guidance.
Medication Narcotic Accountability SOG
In order to provide a region wide medication and narcotics accountability and control system, the Rappahannock EMS (REMS) Council and their OMD Committee has adopted the following standard operating guideline (SOG). This SOG shall establish regional guidelines for medication and narcotics exchange, security and storage.
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Regional Hospital Diversion Plan
The Regional Hospital Diversion Plan lays out the steps to maintain an orderly, systematic and appropriate distribution of emergency patients transported by ambulances during a single or multiple hospital diversion situation within the Rappahannock EMS Council region.
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Regional MCI Plan
The goal of the Rappahannock Emergency Medical Services Council (REMS) Mass Casualty Incident Plan is to prepare on a regional basis for a unified, coordinated and immediate emergency medical services (EMS) mutual aid response by pre-hospital and hospital agencies to, and the effective emergency medical management of, the victims of any type of mass casualty incident (MCI).
It includes patients who are involved in any emergency evacuation of any health care facility in the REMS region and/or any such facility outside the region. This document, hereinafter referred to as the MCI Plan, should be the primary reference and standard operating guidance for in-hospital and out-of-hospital training and response to regional MCI’s in the 3,071 square mile REMS Council region, Planning Districts 9 and 16, and Colonial Beach. This document also addresses the field criteria that must be employed when the number of patients exceeds immediately available resources.
REMS Regional Surge Plan published
The Rappahannock EMS Council's Disaster Committee has recently released the REMS regional EMS Surge Capacity Planning document. This document will be included as an appendix to the Regional Mass Casualty Incident Plan. This planning tool provides commonly needed information for resource planners should a MCI occur requiring initial surge resources.
Forms:
REMS Quality Improvement Plan
The ultimate purpose of the EMS Quality Improvement (EQI) Committee is to improve the performance of the EMS agencies within the Rappahannock Emergency Medical Systems (REMS) Council region as it relates to pre-hospital Medical Issues. This is achieved in partnership with other agencies and hospitals, by providing the highest quality of emergency medical services and by being an innovative leader in the emergency medical field.
The Council's EQI Committee will monitor general EMS responses in our region to include run data, personnel or agency issues, and educational needs as brought to their attention through the quarterly QI agency reports, OMD committee, area hospitals, and each agency's Quality Management Committee. The committee reports to and makes recommendations to the Regional OMD Committee.
The Rappahannock EMS Council's Quality Improvement Committee maintains the Regional Medical Performance Improvement Plan.
Trauma Quality Improvement Plan
The ultimate purpose of the Trauma Quality Improvement (TQI) Committee is to improve the performance of the EMS Agencies and Trauma Systems within the
Rappahannock Emergency Medical Systems (REMS) Council region as it relates to pre-hospital trauma issues. This is achieved in partnership with other agencies and hospitals, by providing the highest quality of emergency medical services and by being an innovative leader in the emergency medical field.
The Council's TQI Committee will monitor Trauma Performance Improvement issues in our region to include run data, personnel or agency issues, and educational needs as brought to their attention through the quarterly QI agency reports, OMD committee, area hospitals, and each agency's Quality Management Committee. The committee reports to and makes recommendations to the Regional OMD Committee.
The Rappahannock EMS Council's Quality Improvement Committee maintains the Regional Trauma Performance Improvement Plan.
REMS Strategic Plan
This plan was developed as part of the effort to standardize long-range planning across the eleven EMS regions in Virginia, along with the long-range statewide EMS plan developed by the Virginia Office of Emergency Medical Services.
The Strategic EMS Plan is very broad in scope. It is not intended to address ongoing and day-to-day work initiatives. These strategies and initiatives help guide the council into areas which need improvement or require new council involvement over a multi-year period. The next major revision will occur in 2022.
This plan must be reviewed annually and revised triennially, or as needed. Council staff and members of the Strategic Planning Committee share the responsibility for development and annual review of the plan. The current plan represents a review of the mandates set forth in the Code of Virginia and the Rappahannock EMS Council contract with the Virginia Office of EMS.
The vision of the Rappahannock EMS Council through the work of our Strategic Planning Committee and Board on the EMS Plan is to be a catalyst for effective regional Emergency Medical Services system development and delivery for our service area.
REMS Stroke Plan
Under the Code of Virginia §32.1-111.3, the Office of Emergency Medical Services, acting on behalf of the Virginia Department of Health has been charged with the responsibility of maintaining a Statewide Stroke Triage Plan. The Rappahannock EMS Council, Inc. (REMS) is responsible for establishing a strategy through a formal region-wide Stroke Triage System incorporating the regions’ geographic variations, variances within out-of-hospital providers capabilities and acute stroke care capabilities and resources including hospital capabilities and the capacity to transfer patients between community hospitals and tertiary care centers, such as Joint Commission “certified” Stroke Centers, or comparable process of care consistent with the recommendations of the brain attack coalition.
The purpose of the Rappahannock EMS Council Regional Stroke Plan is to establish a consistent baseline of criteria for pre-hospital and inter-facility triage and transport of acute stroke patients with a goal to direct acute stroke patients to designated/primary stroke centers in a timely manner. The plan will identify formalized regional stroke plans to augment the state stroke triage plan to recognize and address variations with the regional EMS and hospital resources. This Regional Stroke Plan addresses patients experiencing an “acute Stroke,” defined as, “a patient suspected of having an acute cerebral ischemic event or ‘stroke’ with the onset of any one symptom within a three-hour period.” The primary focus of this plan is to provide guidelines to facilitate the early recognition of the acute stroke patient and to expedite transport to a primary stroke center that is able to provide definitive care within the three-hour window; although acknowledgement of an extension of time beyond this may be appropriate in situations where advanced medical consult is available.
Trauma Triage Plan
The Rappahannock EMS Council Inc. recognizing the complexity of the region’s variability in demographics and geography has adopted the Virginia Trauma Triage Plan as template for the REMS Regional Trauma Triage Plan. REMS has developed, monitored, and revised a regionalized trauma triage plan. Through regionalized Performance Improvement Committees, all issues of trauma triage, trauma care on scene, in transit and within hospitals can be addressed. Under the Code of Virginia § 32.1-111.3, The Office of Emergency Medical Services acting on behalf of the Virginia Department of Health has been charged with the responsibility of maintaining a Statewide Trauma Triage Plan. Emergency Medical Services (EMS) Agencies are required by EMS Regulation 12 VAC 5-31-390 to follow triage plans. This plan is to include pre-hospital and inter-hospital patient transfers