Utah EMS Pandemic Influenza Guidelines Approved 10/7/2009

Introduction: This Plan is based on the following guidelines:

a. Utah Department of Health. Governor’s Taskforce on Pandemic Influenza Preparedness: Final Report to Governor. Salt Lake City, Utah, April 2007.

b. Utah Pandemic Influenza Hospital and ICU Triage Guidelines. UDOH, 2009.

i. Pandemic Triage Levels 1-3 based on surge volume, bed capacity and staff absenteeism.

c. EMS Pandemic Influenza Guidelines for Statewide Adoption. US DOT/ NHTSA, 2007.

d. Preparing for Pandemic Influenza: Recommendations for Protocol Development for 9-1-1 Personnel and Public Safety Answering Points (PSAPs). US DOT/ NHTSA, 2007.

e. Interim Guidance for Influenza. CDC, 2009 as updated. f. Pandemic Flu and Protocol 36: Special Procedures Briefing. MPDS, 2009

(Appendix D).

Incident Management: a. NIMS Command: DHHS/CDC b. Statewide Area Command: UDOH c. Countywide Area Command: Local Health Departments (LHD)

i. Local JIC/JIS d. Local EMS Command: Agency(s) having jurisdiction/licensure:

ii. 911 Response 1. Influenza-like-illness (ILI) 2. All other call types

iii. Interfacility Transport

1. Pre-pandemic Surveillance Period (each subsequent period to include preceding measures unless otherwise specified): a. Dispatch:

i. Screen for Severe Respiratory Illness. 1. Drop-down in MPDS, determined by other Dispatch systems

as needed. (Appendix A) 2. Alerts EMS Crews to don PPE.

3. Can be sent as an alert to LHD via FirstWatch or manually from dispatchers.

4. Initially used for: chest pain, respiratory distress, headache, and selected “sick person” calls.

ii. Participate in daily/weekly briefings from LHD, UDOH, CDC (Appendix C)

b. EMS Responders: i. Medical Directors should monitor national, state and local websites

and participate in conference calls and meeting with public health authorities throughout the pandemic/epidemic period. Pertinent information should be relayed to EMS providers, administration and dispatchers periodically. (Appendix C)

ii. Track ILI encounters using CDC case definition. Reported to UDOH and/or Local Health Department (LHD).

1. SLCFD ILI Sample Reporting Format (Appendix B). iii. Vaccine for Health Care Workers (HCWs) if available.

1. Follow CDC Interim Guidance. 2. Coordinate with LHD First Responder Plan.

iv. Use appropriate PPE in all patient encounters. 1. N-95 mask, gloves, eye protection.

a. Fit-test respirators as practical. b. Surgical mask for EMS if N-95 not obtainable.

2. Place surgical mask on coughing or sneezing patient as tolerated.

3. Disposable gown if patient actively coughing or sneezing. c. Public Health:

i. RODS. Used by some LHDs. Includes selected doctor’s office, clinic and ED visits and OTC cold/flu remedy sales.

1. LHD decides response. ii. Mandatory reporting.

1. Influenza reporting not currently required except hospitalizations and deaths.

a. May change during pandemic/epidemic period. 2. May elect to receive reports from Dispatch and EMS

surveillance if available. iii. Activate First Responder Vaccination/ Prophylaxis Plans as

indicated. 1. Vaccine 2. Local antiviral caches if available. 3. SNS if needed.

2. Pandemic Period, Early. (Staffing and Hospital Capacity Adequate, call volume for ILI increasing, Hospital Triage Level 1)

a. Dispatch: i. Continued surveillance of selected call types as above.

ii. Consider Use of specific Influenza Triage (MPDS Card 36, Appendix F).

1. Screen callers with complaints suggestive of ILI. a. Protocols 6, 10, 18, or 26 (as in Appendix D).

2. May not be necessary at this point if staffing adequate and EDs at or below capacity.

a. Decision by Medical Director and EMS Administration.

3. Agencies not using MPDS are offered free use of this card by MPDS (http://www.medicalpriority.com/), or may adopt Initial Triage for Pandemic Influenza, Appendix A of Utah Pandemic Influenza Hospital and ICU Triage Guidelines.

b. EMS: i. Mandate use of PPE as above for patients meeting CDC case

definition. ii. Begin prophylaxis of unprotected exposures if indicated.

1. Depends on availability and effectiveness of vaccine. 2. Follow CDC Interim Guidance. 3. Coordinate with LHD First Responder Plan.

iii. Track and report ILI encounters as above. c. Public Health

i. Continued surveillance as above. ii. Assure that automatic waivers/variances for force multiplication and

altered standards of care are in place. 1. BEMS Director declares staffing waiver in effect for Public

Health Event. 2. Agencies notify BEMS when and what variances are in

effect for those agencies. a. Call BEMS Hotline at 1-866-364-8824.

3. Force multiplication variances may include but are not limited to:

a. ALS = 1 PM or EMT-I + 1 EMT-B b. ALS = 1 PM or EMT-I + 1 non-certified personnel. c. ALS and/or BLS assessment units:

i. these respond to scene, begin measures while awaiting response vehicle or ambulance, or triage the patient to POV transport or no transport.

ii. Staff with at least one EMT-B or higher. BLS equipment and AED recommended as minimum. May transport ambulatory patients to alternate destinations.

d. BLS transport of selected ALS patients. iii. Activate First Responder Vaccination/ Prophylaxis Plans as

indicated. 1. Vaccine

2. Local antiviral caches if available. 3. SNS if needed.

3. Pandemic Period, Moderate. (EMS and Hospital Staffing reduced by 20-30%, Hospital Triage Level II)

a. Dispatch: i. Screen all callers for ILI

ii. Activate Influenza Triage (MPDS Card 36) for patients with ILI. 1. Determined prior to implementation by Medical Direction

and EMS Administration. 2. Selected low-risk patients may receive no or delayed non-

emergent response. (Appendices D and E) iii. Activate Altered Response Modes for other patients (Appendix E).

1. No EMS response to selected calls. 211 or see your MD. 2. Modified response to BLS calls. Van or other vehicle with

delayed response. b. EMS;

i. Influenza Patients: 1. Low risk flu patients not requiring treatment to 211 or

equivalent, no EMS response. 2. High Risk flu patients likely to respond to treatment (See

Utah Hospital Influenza Triage Scheme): to designated facility.

3. High Risk flu patients unlikely to respond to treatment: follow influenza-specific standing orders or contact medical control.

a. Transport may be to Influenza Alternate Care Facility (if available) or none.

b. Comfort care and non-transport an alternative. ii. Other Patients: Altered Standards of Care:

1. Low risk patients who do not require emergent or urgent care (as defined by Medical Director):

a. Release at scene. i. Advise to “Call 211 or see your MD”.

ii. Contact Medical Control if in doubt. 2. Patients with mild illness or injury requiring non-emergent

care: a. POV, non-ambulance or ambulance transport to

Urgent Care Center, Clinic, Doctors office or other Alternate Care site as approved by Medical Director.

b. Transport may be delayed as appropriate to the situation.

3. Patient with moderate to severe illness or injury requiring emergent care:

a. Ambulance transport as per existing EMS Protocol.

b. Exceptions (Always in consultation with Medical Control):

i. EMS/DNR order, POLST order or other Do Not Resuscitate order

ii. Other terminal illness including incurable metastatic cancer

iii. Severe, irreversible, chronic persistent coma or vegetative state

iv. Known severe dementia medically treated and requiring assistance with activities of daily living.

v. Advanced untreatable neuromuscular disease (such as ALS, end-stage MS, or SMA, MD) requiring assistance with activities of daily living or requiring chronic ventilatory support.

vi. Known chromosomal or other untreatable congenital disorders that are uniformly fatal in the first 2 years of life.

c. Excepted patients may be offered comfort care as appropriate.

c. Public Health: i. Assure that automatic variances for force multiplication and altered

standards of care are in place. (As above.) ii. Consider long-term prophylaxis of EMS personnel during the

Pandemic/Epidemic period (as per DHHS/CDC guidance).

4. Pandemic Period, Severe. (EMS and Hospital Staffing reduced by 30-40%, Hospital Triage Level III)

a. Dispatch: i. Screen all callers for ILI as able dependent on staffing.

ii. Continue use of Influenza Triage (MPDS Card 36) for patients with ILI.

1. Selected low-risk patients may receive no or delayed non-emergent response. (Appendix B)

iii. Continue use of Altered Response Modes for other patients. 1. No EMS response to selected calls. 211 or see your MD.

iv. Modified response to BLS calls. Van or other vehicle with delayed response.

b. EMS: i. Continue measures as in 5.b. above.

ii. Force Protection. 1. Consider long-term prophylaxis.

a. Follow CDC Interim Guidance. b. Coordinate with LHD First Responder Plan

2. Consider higher level of PPE with HEPA filter and full face protection (PAPR, APR), mandatory use of gowns.

3. Consider special teams for ILI calls. a. Vaccinated against seasonal and pandemic influenza

as available. b. PPE as above. c. Use limited number of ambulances for ILI teams.

iii. Force Multiplication. a. Variances as determined by UDOH BEMS on a

statewide basis or as agency-by-agency requests. (As above.)

2. Use ambulance only for selected calls. 3. Consider use of “Work Quarantine”.

a. Exposed but not ill, no vaccine or prophylaxis available.

b. Social distancing measures at work. c. Hygiene and PPE at work and during patient

encounters. d. Consider alternate living quarters while off work

during quarantine period. 4. Consider callback of retired personnel. 5. Mobilize day workers to field.

c. Public Health: i. Assure that automatic variances for force multiplication and altered

standards of care are in place. (As above.) ii. Consider long-term prophylaxis of EMS personnel during the

Pandemic/Epidemic period (as per DHHS/CDC guidance). Acknowledgments: EMS Pandemic Influenza Guidelines Planning Committee Peter Taillac, MD (Chair) Steven Joyce, MD (Principal author) Mark Bair, MD Ben Buchanon, MD Chuck Cruz Guy Dansie Marc McElreath Andy Ostler Eric Sandstrom Michael Stever Hannah Stream Megan Timothy Beth Todd Mike Veenendaal

Appendix A: Severe Respiratory Infection Surveillance Questions. MPDS

Appendix B: Sample Influenza Encounter Reporting Form

 

Salt Lake City Fire Department 

H1N1 Data Please fill out this form for any possible exposure to H1N1 

(Swine Flu) 

Incident number   What caused the crew to believe possible H1N1 exposure, (check all that apply) 

Information from Dispatch 

Fever  degrees 

Cough 

Sore throat 

Head congestion 

Patient contact with someone with H1N1 

Informed by hospital 

BSI Used, (check all that apply) 

Gloves  Mask  Glasses 

Gown 

Comments / Additional information 

 

Appendix C: Sources of Periodic Briefings, Websites, Alerts. CDC: www.cdc.gov http://www.cdc.gov/H1N1flu/guidance_homecare.htm includes sign-up for e-mail updates coca@cdc.gov sign up for CDC Conference Calls and Alerts and Updates for Clinicians http://www.cdc.gov/emailupdates/index.html sign up for general updates from CDC including Weekly Flu Report UDOH: www.pandemicflu.utah.gov for general pandemic planning www.health.utah.gov/h1n1flu for H1N1 specific planning and weekly updates To sign up for automatic updates, lyris@list.utah.gov ; put “subscribe to h1-pandemic” in subject line.

Appendix D: Sample Alternate Responses for ILI Calls Using MPDS Card 36.

Determinant  MPDS Description Level 1 Response Level 2 Response Level 3 Response Addiitonal Comments 

DELTA

36‐D‐1 Ineffective Breathing W flu symptoms ALS Without BLS Response W TX ALS Where available W TX Assessment Unit ‐ No TX L‐3 could be ALS or BLS based on availability

36‐D‐2 Not alert with flu symptoms ALS Without BLS Response W TX ALS Where available W TX BLS Assessment without TX

36‐D‐3 Diff Speaking Between Breaths w Flu Symptoms ALS Without BLS Response W TX ALS Where available W TX Assessment Unit ‐ No TX

36‐D‐4 Changing Color W Flu Symptoms ALS Without BLS Response W TX ALS Where available W TX Assessment Unit ‐ No TX

CHARLIE

36‐C‐1 Chest Pain > 35 W single flu symptom ALS Without BLS Response W TX ALS Assess without TX Assessment Unit ‐ No TX These could be one or two person units at L‐3

36‐C‐2 Abnormal Breathing W single flu symptom/asthma ALS Without BLS Response W TX ALS Assess without TX Assessment Unit ‐ No TX

ALPHA

36‐A‐1 Chest Pain > 35 W multiple flu symptoms BLS assessment W TX BLS Assessment without TX 2‐1‐1 Referal

36‐A‐2 Chest Pain < 35 W single flu symptom BLS assessment W TX BLS Assessment without TX 2‐1‐1 Referal

36‐A‐3 Abnormal Breathing W Multiple flu symptoms BLS assessment W TX BLS Assessment without TX 2‐1‐1 Referal

Omega

36‐O‐1 Flu Symptoms only (cough, fever, chills or sweats… 2‐1‐1 Referal 2‐1‐1 Referal 2‐1‐1 Referal These calls may be answered at an alternative point at L‐3

36‐O‐2 Chest Pain < 35 W multiple flu symptoms 2‐1‐1 Referal 2‐1‐1 Referal 2‐1‐1 ReferalED Over ride allowed ‐ TX Unit Only No Over Ride Allowed No Over Ride Allowed

Salt Lake City Fire DepartmentAlternative Responses To Pandemic Flu Outbreak

Appendix E: Sample Alternate Responses for Non-ILI Calls Using MPDS.

 Abbreviation   Incident Type Description Current Alterred01A01 Abdominal Pain 1A 2‐1‐1: No EMS, see your MD/ED01C01 Ab Pain/Suspected Aortic Aneurysm>50 1BLS / 1ALS / 1A01C02 Ab Pain/Known Aortic Aneurysm 1BLS / 1ALS / 1A01C03 Ab Pain/Faint or Near Faint >50 1BLS / 1ALS / 1A01C04 Female w/Faint or Near Faint 12‐50 1BLS / 1ALS / 1A01C05 Males w/Pain Above the Navel >35 1BLS / 1ALS / 1A01C06 Females w/Pain Above the Navel >45 1BLS / 1ALS / 1A01D01 Ab Pain/Not Alert 1BLS / 1ALS / 1A02A01 Allergic Reaction/Rash, Hives 1A No EMS, 211 or see your MD/ED02A01I Allergic Reaction / Injection Admin 1A No EMS, 211 or see your MD/ED02A01M Allergic Reaction / Meds Admin 1A No EMS, 211 or see your MD/ED02A02 Spider or Insect Bite 1A No EMS, 211 or see your MD/ED02A02I Spider Bite / Injection Admin 1A No EMS, 211 or see your MD/ED02A02M Spider Bite / Meds Admin 1A No EMS, 211 or see your MD/ED02B01 Allergic Reaction/Unk Status 1BLS / 1A No EMS, 211 or see your MD/ED02B01I Unk Status / Injection Admin 1BLS / 1A No EMS, 211 or see your MD/ED02B02M Unk Status / Med Admin 1BLS / 1A No EMS, 211 or see your MD/ED02C01 Allergic Reaction/Special Meds 1BLS / 1ALS / 1A02C01I Diff Breath / Swallow / Injection Admin 1BLS / 1ALS / 1A02C01M Diff Breathing / Swallow / Med Admin 1BLS / 1ALS / 1A02C02 Hx of Allergic Reaction 1BLS / 1ALS / 1A02C02I Hx of Severe Allergic React / Inj Admin 1BLS / 1ALS / 1A02C02M Hx of Severe React / Med Admin 1BLS / 1ALS / 1A02D01 Not Alert 1BLS / 1ALS / 1A02D01I Not Alert / Injection Admin 1BLS / 1ALS / 1A02D01M Not Alert / Med Admin 1BLS / 1ALS / 1A02D02 Diff Speaking 1BLS / 1ALS / 1A02D02I Diff Speaking / Injection Admin 1BLS / 1ALS / 1A02D02M Diff Speaking / Med Admin 1BLS / 1ALS / 1A02D03 Swarming Attack 1BLS / 1ALS / 1A02D03I Swarm Attack / Injection Admin 1BLS / 1ALS / 1A02D03M Swarm Attack / Med Admin 1BLS / 1ALS / 1A02D04 Snakebite 1BLS / 1ALS / 1A02D04I Snakebite / Injection Admin 1BLS / 1ALS / 1A02D04M Snakebite / Med Admin 1BLS / 1ALS / 1A02D05 Snakebite/Envenomations 1BLS / 1ALS / 1A20 Allergic Reaction/Ineffective Breathing 1BLS / 1ALS / 1A02E01I Ineffective Breath / Injection Admin 1BLS / 1ALS / 1A02E01M Ineffective Breath / Med Admin 1BLS / 1ALS / 1A03A01 Animal Bites/Not Dangerous 1A No EMS, see your MD/ED03A02 Animal Bites/Non‐Recent 1A No EMS, see your MD/ED03A03 Animal Bite/Superficial 1A No EMS, see your MD/ED03B01 Animal Bites/Ps Dangerous 1BLS / 1A03B02 Animal Bites/Serious Bleeding 1BLS / 1A03B03 Animal Bite/Unk Status 1BLS / 1A03D01 Animal Bites/Uncon‐Arrest 1BLS / 1ALS / 1A03D02 Animal Bites/Not Alert 1BLS / 1ALS / 1A03D03 Animal Bite / Chest or Neck Injury 1BLS / 1ALS / 1A03D04 Animal Bites/Dangerous Body Area 1BLS / 1ALS / 1A03D05 Animal Bites/Large Animal 1BLS / 1ALS / 1A03D06 Animal Attacks/Exotic Animal 1BLS / 1ALS / 1A03D07 Attack or Multiple Animals 1BLS / 1ALS / 1A04A01A Assault/Not Dangerous Injs 1A No EMS, see your MD/ED, Dispatch to notify PD04A01S Assault/Not Dangerous /Sexual 1A No EMS, see your MD/ED, Dispatch to notify PD04A02A Assault/Non‐Recent Injs 1A No EMS, see your MD/ED, Dispatch to notify PD04A02S Assault/Non‐Recent Injs/Sexual 1A No EMS, see your MD/ED, Dispatch to notify PD04B01A Assault w/Ps Dangerous Injs 1BLS / 1A No EMS, see your MD/ED, Dispatch to notify PD04B01S Assault w/Ps Danger Injs/Sexual 1BLS / 1A No EMS, see your MD/ED, Dispatch to notify PD

04B02A Assault w/Serious Bleeding 1BLS / 1A04B02S Assault w/Serious Bleeding/Sexual 1BLS / 1A04B03A Assault/Unk Status 1BLS / 1A No EMS, see your MD/ED, Dispatch to notify PD04B03S Assault/Unk Status/Sexual 1BLS / 1A No EMS, see your MD/ED, Dispatch to notify PD04D01A Assault/Uncon‐Arrest 1BLS / 1ALS / 1A04D01S Assault/Uncon‐Arrest/Sexual 1BLS / 1ALS / 1A04D02A Assault/Not Alert 1BLS / 1ALS / 1A04D02S Assault/Not Alert/Sexual 1BLS / 1ALS / 1A04D03A Assault 1BLS / 1ALS / 1A04D03S Assault/Chest or Neck Injury / Sexual 1BLS / 1ALS / 1A04D04A Assault w/Multiple Vics 1BLS / 1ALS / 1A04D04S Assault w/Multiple Vics/Sexual 1BLS / 1ALS / 1A04D05A Assault w/Multiple Victims 1BLS / 1ALS / 1A04D05S Assault w/Multiple Victims/Sexual 1BLS / 1ALS / 1A05A01 Back Pain/Non‐Traumatic 1A No EMS, see your MD/ED05A02 Back Pain/Non‐Recent 1A No EMS, see your MD/ED05C01 Suspected Aortic Aneurysm 1BLS / 1ALS / 1A05C02 Known Aortic Aneurysm 1BLS / 1ALS / 1A05C03 Fainting / Near Fainting >50 1BLS / 1ALS / 1A05D01 Back Pain/Not Alert 1BLS / 1ALS / 1A06C01 Breathing Problems/Abnorm Resps 1BLS / 1ALS / 1A Card 36 if activated.06C01A Breathing Problems/Abnorm Resps/As 1BLS / 1ALS / 1A Card 36 if activated.06C02 Breathing Problems/Cardiac Hx 1BLS / 1ALS / 1A Card 36 if activated.06C02A Breathing Problems/Cardiac Hx/Asthma 1BLS / 1ALS / 1A Card 36 if activated.06D01 Not Alert 1BLS / 1ALS / 1A Card 36 if activated.06D01A Not Alert / Asthma 1BLS / 1ALS / 1A Card 36 if activated.06D02 Diff Speaking Between Breaths 1BLS / 1ALS / 1A Card 36 if activated.06D02A Diff Speak Between Breath/Asthma 1BLS / 1ALS / 1A Card 36 if activated.06D03 Changing Color 1BLS / 1ALS / 1A Card 36 if activated.06D03A Changing Color / Asthma 1BLS / 1ALS / 1A Card 36 if activated.06D04 Clammy 1BLS / 1ALS / 1A Card 36 if activated.06D04A Clammy / Asthma 1BLS / 1ALS / 1A Card 36 if activated.60 Breathing Problems/Ineffective 1BLS / 1ALS / 1A Card 36 if activated.06E01A Breath Problems/Ineffective/Asthma 1BLS / 1ALS / 1A Card 36 if activated.07A01 Burns/Less than 18% Body area 1A No EMS, see your MD/ED07A01E Burns/explosion less than 18% 1A07A01F Burns/less than 18% fire 1A07A02 Fire Alarm, Unk Situation 1A07A02E Fire Alarm w/ Explosion 1A07A02F Fire Alarm w/Fire Present 1A07A03 Sunburn/minor burns, hand size 1A No EMS, see your MD/ED07A03E Sunburn/minor burns, explosion 1A07A03F Sunburn/minor burns, fire pres 1A07B01 Blast Injuries 1BLS / 1A07B01E Blast Injuries / Explosion 1BLS / 1A07B01F Blast Injury‐Fire present 1BLS / 1A07B02 Unk Status 1BLS / 1A07B02E Unk Status / Explosion 1BLS / 1A07B02F Unk Status / Fire Present 1BLS / 1A07C01 Structure Fire/persons inside 1BLS / 1ALS / 1A07C01E Structure Fire, persons inside 1BLS / 1ALS / 1A07C01F Structure Fire, person inside 1BLS / 1ALS / 1A07C02 Burns w/Resp Distress 1BLS / 1ALS / 1A07C02E Burns w/Resp, explosion 1BLS / 1ALS / 1A07C02F Burns w/Resp, fire present 1BLS / 1ALS / 1A07C03 Burns/More than 18% Body Area 1BLS / 1ALS / 1A07C03E Burns/More than 18%, explosion 1BLS / 1ALS / 1A07C03F Burns/More than 18% Body Area, 1BLS / 1ALS / 1A07C04 Significant Facial Burns 1BLS / 1ALS / 1A

07C04E Significant Facial Burns/Explosion 1BLS / 1ALS / 1A07C04F Significant Facial Burns / Fire Present 1BLS / 1ALS / 1A07D01 Burns/Multiple Victims 1BLS / 1ALS / 1A07D01E Burns/Multiple Victims, Explosion 1BLS / 1ALS / 1A07D01F Burns/Multiple Victims, fire pr 1BLS / 1ALS / 1A07D02 Burns/Uncon or Arrest 1BLS / 1ALS / 1A07D02E Burns/Uncon or Arrest, explos 1BLS / 1ALS / 1A07D02F Burns/Uncon or Arrest/fire pre 1BLS / 1ALS / 1A07D03 Burns/Not Alert 1BLS / 1ALS / 1A07D03E Burns/Not Alert/Explosion 1BLS / 1ALS / 1A07D03F Burns/Not Alert/ Fire pre 1BLS / 1ALS / 1A07D04 Burns/Diff Speaking Between B 1BLS / 1ALS / 1A07D04E Burns/Diff Speak Betw Breath / Exp 1BLS / 1ALS / 1A07D04F Burns/Diff Speak Betw Breath/Fire presen 1BLS / 1ALS / 1A08A01 Carbon Monoxide Detector Alarm 1E Engine with CO Detector08B01 Alert w/o Resp Distress 1BLS / 1A No EMS, see your MD/ED08B01B Alert w/o Diff Breathing  (Biological) 1BLS / 1A No EMS, see your MD/ED08B01C Alert w/o Diff Breath (Chemical) 1BLS / 1A No EMS, see your MD/ED08B01G Alert w/o Diff Breath (Smell of gas/fum) 1BLS / 1A No EMS, see your MD/ED08B01M Alert w/o Diff Breath (CO) 1BLS / 1A No EMS, see your MD/ED08B01N Alert w/o Diff Breathing (Nuclear) 1BLS / 1A No EMS, see your MD/ED08B01R Alert w/o Diff Breathing (Radiological) 1BLS / 1A No EMS, see your MD/ED08B01S Alert w/o Diff Breath (Suicide Att/CO) 1BLS / 1A No EMS, see your MD/ED08B01U Alert w/o Diff Breath (Unk) 1BLS / 1A No EMS, see your MD/ED08C01 Alert w/Resp Distress 1BLS / 1ALS / 1A08C01B Alert w/Diff Breath (Biological) 1BLS / 1ALS / 1A08C01C Alert w/Diff Breath (Chemical) 1BLS / 1ALS / 1A08C01G Alert w/Diff Breath (Smell of gas/fumes) 1BLS / 1ALS / 1A08C01M Alert w/Diff Breath (CO) 1BLS / 1ALS / 1A08C01N Alert w/Diff Breath (Nuclear) 1BLS / 1ALS / 1A08C01R Alert w/Diff Breath (Radiological) 1BLS / 1ALS / 1A08C01S Alert w/Diff Breath (Suicide Attempt CO) 1BLS / 1ALS / 1A08C01U Alert w/Diff Breath (Unk) 1BLS / 1ALS / 1A08D01 Unconscious or Arrest 1BLS / 1ALS / 1A08D01B Unc or Arrest (Biological) 1BLS / 1ALS / 1A08D01C Unc or Arrest (Chemical) 1BLS / 1ALS / 1A08D01G Unc or Arrest (Smell of Gas/Fumes) 1BLS / 1ALS / 1A08D01M Unc or Arrest (CO) 1BLS / 1ALS / 1A08D01N Unc or Arrest (Nuclear) 1BLS / 1ALS / 1A08D01R Unc or Arrest (Radiological) 1BLS / 1ALS / 1A08D01S Unc or Arrest (Suicide Attempt) 1BLS / 1ALS / 1A08D01U Unc or Arrest (Unk) 1BLS / 1ALS / 1A08D02 Severe Respiratory Distress 1BLS / 1ALS / 1A08D02B Not Alert (Biological) 1BLS / 1ALS / 1A08D02C Not Alert (Chemical) 1BLS / 1ALS / 1A08D02G Not Alert (Smell of Gas/Fumes) 1BLS / 1ALS / 1A08D02M Not Alert (CO) 1BLS / 1ALS / 1A08D02N Not Alert (Nuclear) 1BLS / 1ALS / 1A08D02R Not Alert (Radiological) 1BLS / 1ALS / 1A08D02S Not Alert (Suicide Attempt) 1BLS / 1ALS / 1A08D02U Not Alert (Unk) 1BLS / 1ALS / 1A08D03 Diff Speak Betwe Breaths 1BLS / 1ALS / 1A08D03B Diff Speaking (Biological) 1BLS / 1ALS / 1A08D03C Diff Speaking (Chemical) 1BLS / 1ALS / 1A08D03G Diff Speaking (Smell of Gas/Fumes) 1BLS / 1ALS / 1A08D03M Diff Speaking (CO) 1BLS / 1ALS / 1A08D03N Diff Speaking (Nuclear) 1BLS / 1ALS / 1A08D03R Diff Speaking (Radiological) 1BLS / 1ALS / 1A08D03S Diff Speaking (Suicide Attempt) 1BLS / 1ALS / 1A

08D03U Diff Speaking (Unk) 1BLS / 1ALS / 1A08D04 Multiple Vics 1BLS / 1ALS / 1A08D04B Multiple Victims (Biological) 1BLS / 1ALS / 1A08D04C Multiple Victims (Chemical) 1BLS / 1ALS / 1A08D04G Multiple Victims (Smell of Gas/Fumes) 1BLS / 1ALS / 1A08D04M Multiple Victims (CO) 1BLS / 1ALS / 1A08D04N Multiple Victims (Nuclear) 1BLS / 1ALS / 1A08D04R Multiple Victims (Radiological) 1BLS / 1ALS / 1A08D04S Multiple Victims (Suicide Attempt) 1BLS / 1ALS / 1A08D04U Multiple Victims (Unk) 1BLS / 1ALS / 1A08D05 Unk Status 1BLS / 1ALS / 1A08D05B Unk Status (Biological) 1BLS / 1ALS / 1A08D05C Unk Status (Chemcial) 1BLS / 1ALS / 1A08D05G Unk Status (Smell of Gas/Fumes) 1BLS / 1ALS / 1A08D05M Unk Status (CO) 1BLS / 1ALS / 1A08D05N Unk Status (Nuclear) 1BLS / 1ALS / 1A08D05R Unk Status (Radiological) 1BLS / 1ALS / 1A08D05S Unk Status (Suicide Attempt) 1BLS / 1ALS / 1A08D05U Unk Status 1BLS / 1ALS / 1A08D06 CO/Inhal/HazMat‐Unk Status 1BLS / 1ALS / 1A09B01a Obvious Death/Cold & stiff 1BLS / 1A Ask SRI Questions, Engine only09B01b Obvious Death/Decapitation 1BLS / 1A Ask SRI Questions, Engine only09B01c Obvious Death/Decomposition 1BLS / 1A Ask SRI Questions, Engine only09B01D Obvious Death/Incineration 1BLS / 1A Ask SRI Questions, Engine only09B01e Obvious Death/Non‐recent 1BLS / 1A Ask SRI Questions, Engine only09B01f Obvious Death/Severe injs 1BLS / 1A Ask SRI Questions, Engine only09B01g Obvious Death/Submersion over 6 hrs 1BLS / 1A Ask SRI Questions, Engine only09B01z Obvious Death/Severe Injs 1BLS / 1A Ask SRI Questions, Engine only09D01 Respiratory Arrest/Ineffective Breathing 1BLS / 1ALS / 1A09D02 Obvious or Expected Questionable 1BLS / 1ALS / 1A90 Person Not Breathing at All 1BLS / 1ALS / 1A900 Breathing Uncertain (agonal) 1BLS / 1ALS / 1A9000 Hanging 1BLS / 1ALS / 1A90000 Strangulation 1BLS / 1ALS / 1A900000 Suffocation 1BLS / 1ALS / 1A9000000 Underwater 1BLS / 1ALS / 1A09O01 INACTIVE09O01x Expected Death/Terminal 1BLS / 1A Ask SRI Questions, Engine only09O01y Expected Death/DNR 1BLS / 1A Ask SRI Questions, Engine only10A01 Chest Pain/Normal Breathing/Under 35 1A Card 36 if activated: No EMS, see your MD/ED10C01 Chest Pain/Abnormal Breathing 1BLS / 1ALS / 1A Card 36 If Activated10C02 Chest Pain/Heart Attack or Angina Hx 1BLS / 1ALS / 1A Card 36 If Activated10C03 Chest Pain/Cocaine 1BLS / 1ALS / 1A Card 36 If Activated10C04 Chest Pain/Normal Breathing/Over 35 1BLS / 1ALS / 1A Card 36 If Activated10D01 Chest Pain/Not Alert 1BLS / 1ALS / 1A Card 36 If Activated10D02 Chest Pain/Diff Speak Betw Breath 1BLS / 1ALS / 1A Card 36 If Activated10D03 Chest Pain/Changing Color 1BLS / 1ALS / 1A Card 36 If Activated10D04 Chest Pains / Clammy 1BLS / 1ALS / 1A Card 36 If Activated11A01 Choking/Not Choking Now 1A No EMS, see your MD/ED11D01 Choking/Abnormal Breath 1BLS / 1ALS / 1A11D02 Choking/Not Alert 1BLS / 1ALS / 1A110 Complete Obstruction/Ineffective Breathi 1BLS / 1ALS / 1A12A01 Not Seizing Now/Breathing Regu 1A New Onset: Ambulance Only

12A01E Not Seizing Now/Breathing Hx 1AKnown Seizure Disorder: No EMS, see your MD/ED

12A02 Focal Seizure 1A New Onset: Ambulance Only

12A02E Focal Seizure Hx of Epilepsy 1AKnown Seizure Disorder: No EMS, see your MD/ED

12A03 Impending Seizure 1A New Onset: Ambulance Only

12A03E Impending Seizure / Hx of Epilepsy 1AKnown Seizure Disorder: No EMS, see your MD/ED

12B01 Effective Breath Not Verif<35 1BLS / 1A New Onset: Ambulance Only

12B01E Effective Breath Not Verif<35 / Hx 1BLS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12C01 Focal Seizure 1BLS / 1ALS / 1A New Onset: Ambulance Only

12C01E Focal Seizure Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12C02 Seizure / Pregnancy 1BLS / 1ALS / 1A New Onset: Ambulance Only

12C02E Seizure / Pregnancy Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12C03 Seizure / Diabetic 1BLS / 1ALS / 1A New Onset: Ambulance Only

12C03E Seizure / Diabetic / Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12D01 Seizure‐Not Breathing 1BLS / 1ALS / 1A New Onset: Ambulance Only

12D01E Seizure/Not breathing w/Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12D02 Continuous or Multiple Seizures 1BLS / 1ALS / 1A New Onset: Ambulance Only

12D02E Continuous/Multiple Seizures w/Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12D03 Seizure/Irregular Respirations 1BLS / 1ALS / 1A New Onset: Ambulance Only

12D03E Seizure/Irregular Respirations w/Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

12D04 Seizure/Unverified Respirations/Over 35 1BLS / 1ALS / 1A New Onset: Ambulance Only

12D04E Seizure/Unverified Respirations w/Hx 1BLS / 1ALS / 1AKnown Seizure Disorder: No EMS, see your MD/ED

13A01 Diabetic/Alert 1A No EMS, see your MD/ED13A01C Diabetic/Alert, Combative 1A13C01 Diabetic/Not Alert 1BLS / 1ALS / 1A13C01C Diabetic/Not Alert, Combative 1BLS / 1ALS / 1A13C02 Diabetic/Abnormal Behavior 1BLS / 1ALS / 1A13C02C Diabetic/Abnormal Behavior, Combative 1BLS / 1ALS / 1A13C03 Diabetic/Abnormal Breathing 1BLS / 1ALS / 1A13C03C Diabetic/Abnormal Breathing, Combative 1BLS / 1ALS / 1A13D01 Diabetic/Unconscious 1BLS / 1ALS / 1A13D01C Diabetic/Unconscious, Combative 1BLS / 1ALS / 1A14A01 Drowning/Diving‐Alert/Breathe 1A No EMS, see your MD/ED14B01 Drowning/Diving‐Alert w/Injs 1BLS / 1A14B02 Drowning/Unk Status (3rd Party) 1BLS / 1A14C01 Drowning/Abnormal Breathing 1BLS / 1ALS / 1A14D01 Drowning/Unconscious 1BLS / 1ALS / 1A14D02 Drowning/Not Alert 1BLS / 1ALS / 1A14D03 Diving or Neck Injury 1BLS / 1ALS / 1A14D04 Scuba Accident 1BLS / 1ALS / 1A15C01E Electro / Alert / Breath Normally 1BLS / 1ALS / 1A Ambulance Only15C01L Electro /Alert/Breath Normally/L 1BLS / 1ALS / 1A Ambulance Only15D01E Electrocution/Unconscious 1BLS / 1ALS / 1A15D01L Electrocution/Uncon/Lightning 1BLS / 1ALS / 1A15D02E Electrocution/not disconnected 1BLS / 1ALS / 1A15D02L Lightning/not disconnected 1BLS / 1ALS / 1A15D03E Electrocution/Power not off 1BLS / 1ALS / 1A15D03L Electrocution/Power not off / L 1BLS / 1ALS / 1A15D04E Electro /Extreme Fall>30ft 1BLS / 1ALS / 1A15D04L Electro /Extreme Fall/Lightning>30ft 1BLS / 1ALS / 1A15D05E Electrocution/Long Fall 1BLS / 1ALS / 1A15D05L Electrocution/Long Fall/Lightning 1BLS / 1ALS / 1A15D06E Electrocution/Not Alert 1BLS / 1ALS / 1A15D06L Electrocution/Not Alert/Lightning 1BLS / 1ALS / 1A15D07E Electro /Abnormal Breath 1BLS / 1ALS / 1A15D07L Electro Abnormal Breath/Lightning 1BLS / 1ALS / 1A15D08E Electrocution / Light Unk (Electric) 1BLS / 1ALS / 1A

15D08L Electrocution / Light Unk (Lightning) 1BLS / 1ALS / 1A15E01E Electrocution/Not Breathing 1BLS / 1ALS / 1A15E01L Electrocution/Not Breathing/Lightning 1BLS / 1ALS / 1A

16A01 Eye Injury/Moderate 1ANo EMS, see your MD/ED unless unable to flush chemical injuries or unable to see to transport self

16A02 Eye Injury/Minor 1ANo EMS, see your MD/ED unless unable to flush chemical injuries or unable to see to transport self

16A03 Medical Eye Problems 1ANo EMS, see your MD/ED unless unable to flush chemical injuries or unable to see to transport self

16B01 Eye Injury/Severe 1BLS / 1A16D01 Eye Injury/Not Alert 1BLS / 1ALS / 1A17A01 Fall Victim/Not Dangerous Injs 1A No EMS, see your MD/ED17A01G Not Dangerous (On the Ground) 1A No EMS, see your MD/ED17A01J Fall/Not Dangerous Inj/Jumper 1A No EMS, see your MD/ED17A02 Fall Victim/Non‐Recent Injs 1A No EMS, see your MD/ED17A02G Non‐Recent (On the Ground) 1A No EMS, see your MD/ED17A02J Fall/Non‐Recent/Jumper 1A17A03 Public Assist 1BLS Call friends/family/neighbors if available17A03G Public Assist (On the Ground) 1BLS Call friends/family/neighbors if available17B01 Fall / Ps Dangerous Injs 1BLS / 1A17B01G Poss Dangerous / On the Ground 1BLS / 1A17B01J Fall/Ps Dangerous Inj/Jumper 1BLS / 1A17B02 Fall /Serious Hemorrhage 1BLS / 1A17B02G Serious Hemorrhage / On the Ground 1BLS / 1A17B02J Fall/Serious Hemorrhage/Jumper 1BLS / 1A17B03 Fall Victim/Unk Status 1BLS / 1A17B03G Unk Status / On the Ground 1BLS / 1A17B03J Fall/Unk Status/Jumper 1BLS / 1A17D01 Extreme Fall >30ft 1BLS / 1ALS / 1A17D01G Extreme Fall >30ft On the Gorund 1BLS / 1ALS / 1A17D01J Extreme Fall >30ft/Jumper 1BLS / 1ALS / 1A17D02 Fall Unc/Arrest 1BLS / 1ALS / 1A17D02G Unc or Arrest / On the Ground 1BLS / 1ALS / 1A17D02J Unc/Arrest Jumper 1BLS / 1ALS / 1A17D03 Fall Victim/Not Alert 1BLS / 1ALS / 1A17D03G Not Alert / On the Ground 1BLS / 1ALS / 1A17D03J Fall/Not Alert/Jumper 1BLS / 1ALS / 1A17D04 Fall Chest or Neck Inj/Abnormal Resps 1BLS / 1ALS / 1A17D04G Chest or Neck Injury / On the Ground 1BLS / 1ALS / 1A17D04J Fall Chest or Neck/Abnormal Resps/Jumper 1BLS / 1ALS / 1A17D05 Long Fall 1BLS / 1ALS / 1A17D05G Long Fall / On the Ground 1BLS / 1ALS / 1A17D05J Long Fall / Jumper 1BLS / 1ALS / 1A17O01 Fall Assessment‐Omega response 1BLS Call friends/family/neighbors if available18A01 Headache/Breathing Normally 1A Card #36 if activated: No EMS, see your MD/ED18B01 Headache/Unk Status (3rd Party) 1BLS / 1A Card #36 if activated: Ambulance Only if Not18C01 Headache/Not Alert 1BLS / 1ALS / 1A Card #36 if activated18C02 Headache/Abnormal Breathing 1BLS / 1ALS / 1A Card #36 if activated18C03 Headache/Speech Problems 1BLS / 1ALS / 1A Card #36 if activated18C04 Headache/Sudden Onset 1BLS / 1ALS / 1A Card #36 if activated18C05 Headache/Numbness 1BLS / 1ALS / 1A Card #36 if activated18C06 Headache/Paralysis 1BLS / 1ALS / 1A Card #36 if activated18C07 Headache/Change in Behavior 1BLS / 1ALS / 1A Card #36 if activated19A01 Heart Rate over 50/under 130 1A19A02 Heart/Chest Pain Under 35 yrs 1A19B01 Heart Problem/Unk Status 1BLS / 1A19C01 Heart Problem/Firing AICD 1BLS / 1ALS / 1A19C02 Heart Problem/Abnormal Resps 1BLS / 1ALS / 1A19C03 Heart Problem/Chest Pain/Over 35 1BLS / 1ALS / 1A19C04 Heart Problem/Cardiac Hx 1BLS / 1ALS / 1A

19C05 Heart Problem/Cocaine 1BLS / 1ALS / 1A19C06 Heart Problem, Rate<50 1BLS / 1ALS / 1A19C07 Heart Prob (Unk Status) 1BLS / 1ALS / 1A19D01 Heart Problem/Not Alert 1BLS / 1ALS / 1A19D02 Heart Prob/Diff Speak Betwe Breath 1BLS / 1ALS / 1A19D03 Heart Problem/Changing Color 1BLS / 1ALS / 1A19D04 Heart Prob/ Clammy 1BLS / 1ALS / 1A19D05 Just Resuscitated / Defibrillated (Exte) 1BLS / 1ALS / 1A20A01C Cold Exposure/Alert 1A No EMS, see your MD/ED20A01H Heat Exposure/Alert 1A No EMS, see your MD/ED20B01C Cold Exposure/Skin Color 1BLS / 1A20B01H Heat Exposure/Skin Color 1BLS / 1A20B02C Cold Exposure/Unk Status 1BLS / 1A20B02H Heat Exposure/Unk Status 1BLS / 1A20C01C Cold Exposure/Heart Attack or Angina Hx 1BLS / 1ALS / 1A20C01H Heat Exposure/Heart Attack or Angina Hx 1BLS / 1ALS / 1A20D01C Cold Exposure/Not alert 1BLS / 1ALS / 1A20D01H Heat Exposure/Not Alert 1BLS / 1ALS / 1A20D02C Cold Exposure/Multiple Victims 1BLS / 1ALS / 1A20D02H Heat Exposure/Multiple Victims 1BLS / 1ALS / 1A20D05M Not Alert 1BLS / 1ALS / 1A21A01 Hemorrhage/Not Dangerous 1A No EMS, see your MD/ED21A02 Hemorrhage/Minor 1A No EMS, see your MD/ED21B01 Hemorrhage/Ps Dangerous 1BLS / 1A21B02 Hemorrhage/Serious 1BLS / 1A21B03 Hemorrhage/Bleeding disorder 1BLS / 1A21B04 Hemorrhage / Blood Thinners 1BLS / 1A21C01 Hemorrhaging Thru Tubes 1BLS / 1ALS / 1A21C02 Hemorrhage / Hemor of Dialysis Fi 1BLS / 1ALS / 1A21D01 Unc or Arrest 1BLS / 1ALS / 1A21D02 Hemorrhage/Not Alert 1BLS / 1ALS / 1A21D03 Hemorrhage/Dangerous Hemorrhage 1BLS / 1ALS / 1A21D04 Hemorrhage / Abnormal Breath 1BLS / 1ALS / 1A22A01 Inaccessible Incident/No Injs 1BLS / 1A No EMS, see your MD/ED22A01A Inaccessible Incident/Above ground 1A No EMS, see your MD/ED22A01B Inaccessible Incid/Above ground, multi 1A No EMS, see your MD/ED22A01M Inaccessible Incid/Multiple victim 1A No EMS, see your MD/ED22B01 Inaccessible Incident/Unk injs 1BLS / 1A22B01A Inaccessible Incident/Unk, above ground 1BLS / 1A22B01B Inaccessible Incident/Unk both 1BLS / 1A22B01M Inaccessible Incident/Unk Multi 1BLS / 1A22B02 Inaccessible Incident/Periph Entrap 1BLS / 1A22B02B Inaccessible Incident/Periph Below 1BLS / 1A22B02M Inaccessible Incident/Periph Multi Vic 1BLS / 1A22B02X Peripheral Entrapment / Both Above 1BLS / 1A22B02Y Peripheral Entrapment / Both Below 1BLS / 1A22B03 Inaccessible Incident/Unk status 1BLS / 1A22B03A Inaccessible Incident/Unk above ground 1BLS / 1A22B03B Inaccessible Incident/Unk Below 1BLS / 1A22B03M Inaccessible Incident/Unk w/Mult Vic 1BLS / 1A22B03X Inacc Inc/Unk /Both Above 1BLS / 1A22B03Y Inacc Inc/Unk Both Below 1BLS / 1A22D01 Machinery Entrapment 1ALS / 1BLS / 1HR / 1A / 1BC22D01A Machinery/Above Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D01B Machinery/Multiple Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D01M Machinery/Multiple Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D01X Mech/Machinery Entrap / Both Above Groun1BLS / 1ALS / 1A22D01Y Mech/Machinery Entrap/Below Ground 1BLS / 1ALS / 1A22D02 Trench Collapse 1ALS / 1BLS / 1HR / 1A / 1BC

22D02A Trench Collapse/Above ground 1ALS / 1BLS / 1HR / 1A / 1BC22D02B Trench Collapse/Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D02M Trench Collapse/Multiple Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D02X Trench Collapse / Above Ground 1BLS / 1ALS / 1A22D02Y Trench Collapse / Below Ground 1BLS / 1ALS / 1A22D03A Structure Collapse/Above ground 1ALS / 1BLS / 1HR / 1A / 1BC22D03B Structure Collapse/Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D03M Structure Collapse/Multiple Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D03X Structure Collapse / Above Ground 1BLS / 1ALS / 1A22D03Y Structure Collapse / Below Ground 1BLS / 1ALS / 1A22D04 Confined Entrapment 1ALS / 1BLS / 1HR / 1A / 1BC22D04A Entrapment/Confined/Above Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D04B Entrapment/Confined/Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D04M Entrapment/Confined/Mult Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D04X Confined Space / Above Ground 1BLS / 1ALS / 1A22D04Y Confined Space / Below Ground 1BLS / 1ALS / 1A22D05 Inaccessible Terrain 1ALS / 1BLS / 1HR / 1A / 1BC22D05A Inaccessible Terrain/Above Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D05B Inaccessible Terrain/Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D05M Inaccessible Terrain/Multiple Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D05X Inaccessible Terrain / Above Ground 1BLS / 1ALS / 1A22D05Y Inaccessible Terrain / Below Ground 1BLS / 1ALS / 1A22D06 Mudslide/Avalanche 1ALS / 1BLS / 1HR / 1A / 1BC22D06A Mudslide/Avalanche/Above ground 1ALS / 1BLS / 1HR / 1A / 1BC22D06B Mudslide/Avalanche/Below Ground 1ALS / 1BLS / 1HR / 1A / 1BC22D06M Mudslide/Avalanche/Multiple/Victims 1ALS / 1BLS / 1HR / 1A / 1BC22D06X Mudslide / Avalanche / Above Ground 1BLS / 1ALS / 1A22D06Y Mudslide / Avalanche / Below Ground 1BLS / 1ALS / 1A23B01A Overdose/Accident 1BLS / 1A Ambulance Only23B01I Overdose/Intentional 1BLS / 1A Ambulance Only23B01P Overdose/Poison control requested 1BLS / 1A Ambulance Only23B01V Overdose / Violent 1BLS / 1A Ambulance Only23C01A Poisoning/Not Alert/Accident 1BLS / 1ALS / 1A23C01I Overdose/Not Alert/Intentional 1BLS / 1ALS / 1A23C01P Poisoning/Not Alert 1BLS / 1ALS / 1A23C01V Overdose / Not Alert / Violent 1BLS / 1ALS / 1A23C02A Overdose/Abnormal Breath/Accidental 1BLS / 1ALS / 1A23C02I Overdose/Abnormal Breath /Intentional 1BLS / 1ALS / 1A23C02P Overdose, Not Alert, Poisoning 1BLS / 1ALS / 1A23C02V Overdose/Abnorm Breath/Violent 1BLS / 1ALS / 1A23C03A Poisoning /Antidepressants/Accident 1BLS / 1ALS / 1A23C03I Overdose /Antidepressants/Intentional 1BLS / 1ALS / 1A23C03P Poisoning w/Abnormal Resps 1BLS / 1ALS / 1A23C03V Overdose/Antidepressants/Violent 1BLS / 1ALS / 1A23C04A Poisoning/Cocaine/Accident 1BLS / 1ALS / 1A23C04I Overdose/Cocaine/Intentional 1BLS / 1ALS / 1A23C04P Poisoning/Tricyclics 1BLS / 1ALS / 1A23C04V Overdose/Cocaine or Meth/Violent 1BLS / 1ALS / 1A23C05A Poisoning/Narcotics/Accident 1BLS / 1ALS / 1A23C05I Overdose/Narcotics/Intentional 1BLS / 1ALS / 1A23C05P Overdose, Cocaine, Poisoning 1BLS / 1ALS / 1A23C05V Overdose/Narcotics/Violent 1BLS / 1ALS / 1A23C06A Poisoning/Acid or Alkai/Accident 1BLS / 1ALS / 1A23C06I Overdose/Acid or Alkai/Intentional 1BLS / 1ALS / 1A23C06P Overdose, Narcotics, Poisoning 1BLS / 1ALS / 1A23C06V Overdose/Acid or Alkali/Violent 1BLS / 1ALS / 1A23C07A Poisoning/Unk Status/Accident 1BLS / 1ALS / 1A23C07I Overdose/Unk Status/Intentional 1BLS / 1ALS / 1A23C07P Overdose, Acid or Lye, Poisoning 1BLS / 1ALS / 1A

23C07V Overdose/Unk Status/Violent 1BLS / 1ALS / 1A23C08A Poisoning/Poison Control Request/Acciden 1BLS / 1ALS / 1A23C08I Overdose/Posion Control Request / Intent 1BLS / 1ALS / 1A23C08P Overdose, Unk Status, Poisoning 1BLS / 1ALS / 1A23C08V Overdose/Poison Control/Violent 1BLS / 1ALS / 1A23C09A Poisoning/Poison Control/Reqst/Accident 1BLS / 1ALS / 1A23C09I Overdose/Poison Control request for 1BLS / 1ALS / 1A23C09P Overdose,  Poisoning, Poisoning 1BLS / 1ALS / 1A23CP INACTIVE23D01A Poisoning/Unconscious/Accident 1BLS / 1ALS / 1A23D01I Overdose/Unconscious/Intentional 1BLS / 1ALS / 1A23D01P Poisoning/Unconscious 1BLS / 1ALS / 1A23D02A Poisoning/Changing Color/Accident 1BLS / 1ALS / 1A23D02I Overdose/Changing Color/Intentional 1BLS / 1ALS / 1A23D02P Poisoning/Severe Resp Distress 1BLS / 1ALS / 1A23D02V Changing Color/Violent 1BLS / 1ALS / 1A23O01 Poison Control NO RS Poison Control

24A01 1st Trimester Bleeding/Miscarriage 1ANo EMS, see your MD/ED/ L&D: unless unable to get POV

24B01 Labor/Not Imminent 1BLS / 1ANo EMS, see your MD/ED/ L&D: unless unable to get POV

24B02 Pregnancy/Unk Status (3rd Part 1BLS / 1ANo EMS, see your MD/ED/ L&D: unless unable to get POV

24C01 Pregnancy/2nd trimester 1BLS / 1ALS / 1A24C02 Pregnancy/Serious bleed 1st trimester 1BLS / 1ALS / 1A24C03 Baby Born/No Complications 1BLS / 1ALS / 1A24D01 Breech Birth or Cord Presentation 1BLS / 1ALS / 1A24D02 Birth/Head Visible/Out 1BLS / 1ALS / 1A24D03 Imminent Delivery 1BLS / 1ALS / 1A24D04 3rd Trimester Bleeding 1BLS / 1ALS / 1A24D05 High Risk Complications 1BLS / 1ALS / 1A24D06 Baby Born / Comp w/Baby 1BLS / 1ALS / 1A24D07 Baby Born / Complications w/Mother 1BLS / 1ALS / 1A

24O01 Pregnancy/Water Broken/Omega 1ANo EMS, see your MD/ED/ L&D: unless unable to get POV

25A01 Psychiatric/Non‐Violent/Non‐Suicidal 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A01B Non‐Suicidal/Violent & weapon 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A01V Psychiatric/Non‐Suicidal/Violent 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A01W Psychiatric/Non‐Suicidal w/weapon 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A02 Psychiatric/Suicidal/Alert 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A02B Suicidal/Alert, Both violent & 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A02V Suicidal/Alert, Violent 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25A02W Suicidal/Alert, Weapon 1A No EMS, see your MD/ED/ VMH Clinic: PD ?25B01 Psychiatric/Serious Hemorrhage 1BLS / 1A25B01B Psychiatric/Serious Bleed, both viol 1BLS / 1A25B01V Psychiatric/Serious Bleed, Violent 1BLS / 1A25B01W Psychiatric/Serious Hemorrhage/Weapon 1BLS / 1A25B02 Psychiatric/Not serious hemorrhage 1BLS / 1A25B02B Psychiatric/Minor bleed, both 1BLS / 1A25B02V Psychiatric/Minor bleed, violent 1BLS / 1A25B02W Psychiatric/Minor bleed w/weapon 1BLS / 1A25B03 Threatening Suicide 1BLS / 1A25B03B Threats, Violent w/weapon 1BLS / 1A25B03V Threats, Violent 1BLS / 1A25B03W Threats w/Weapon 1BLS / 1A25B04 Psychiatric Prob/Jumper Threat 1BLS / 1A25B04B Jumper, violent & weapon 1BLS / 1A25B04V Jumper, violent 1BLS / 1A25B04W Jumper, w/weapon 1BLS / 1A25B05 Near Hanging, Alert 1BLS / 1A

25B05B Near Hanging, Violent & weapon 1BLS / 1A25B05V Near Hanging, Violent 1BLS / 1A25B05W Near Hanging, w/Weapon 1BLS / 1A25B06 Psychiatric/Unk Status 1BLS / 1A25B06B Psychiatric/Unk, violent & weapon 1BLS / 1A25B06V Psychiatric/Unk, violent 1BLS / 1A25B06W Psychiatric/Unk w/weapon 1BLS / 1A25D01 Psychiatric/Not Alert 1BLS / 1ALS / 1A25D01B Psychiatric/Not alert, violent & weapon 1BLS / 1ALS / 1A25D01V Psychiatric/Not alert, violent 1BLS / 1ALS / 1A25D01W Psychiatric/Not alert w/weapon 1BLS / 1ALS / 1A25D02 Psychiatric/Dangerous Hemorrhage 1BLS / 1ALS / 1A25D02B Psych/Dangerous Bleed, violent & weapon 1BLS / 1ALS / 1A25D02V Psychiatric/Dangerous Bleed, violent 1BLS / 1ALS / 1A25D02W Psychiatric/Dangerous Bleed w/weapon 1BLS / 1ALS / 1A26A01 Sick Person/No Priority Symptom 1A No EMS, see your MD/ED26A01X Non‐Recent >6hrs Peripheral Wounds 1A No EMS, see your MD/ED26A02 Sick / Blood Pressure Abnormality 1A No EMS, see your MD/ED26A03 Sick /Dizziness / Vertigo 1A No EMS, see your MD/ED26A04 Sick / Fever / Chills 1A No EMS, see your MD/ED26A05 Sick / General Weakness 1A No EMS, see your MD/ED26A06 Sick / Nausea 1A No EMS, see your MD/ED26A07 Sick / New Onset of Immobility 1A No EMS, see your MD/ED26A08 Sick / Other Pain 1A No EMS, see your MD/ED26A09 Sick / Transportation Only 1A No EMS, see your MD/ED26A10 Sick / Unwell / Ill 1A No EMS, see your MD/ED26A11 Sick / Vomiting 1A No EMS, see your MD/ED26A12 Sick Person/Earache 1A No EMS, see your MD/ED26A13 Sick Person/Enema 1A No EMS, see your MD/ED26A14 Sick Person/Gout 1A No EMS, see your MD/ED26A15 Sick Person/Hemorrhoids 1A No EMS, see your MD/ED26A16 Sick Person/Hepatitis 1A No EMS, see your MD/ED26A17 Sick Person/Hiccups 1A No EMS, see your MD/ED26A18 Sick Person/Hungry 1A No EMS, see your MD/ED26A19 Sick Person/Nervous 1A No EMS, see your MD/ED26A20 Sick Person/Object stuck 1A No EMS, see your MD/ED26A21 Sick Person/Object swallowed 1A No EMS, see your MD/ED26A22 Sick Person/Penis probs, pain 1A No EMS, see your MD/ED26A23 Sick Person/Rash or skin disorder 1A No EMS, see your MD/ED26A24 Sick Person/STD 1A No EMS, see your MD/ED26A25 Sick Person/Sore Throat 1A No EMS, see your MD/ED26A26 Sick Person/Toothache 1A No EMS, see your MD/ED26A27 Sick Person/Transport Only 1A No EMS, see your MD/ED26A28 Sick Person/Wound infected 1A No EMS, see your MD/ED26B01 Sick Person/Unk Status 1BLS / 1A Ambulance Only26C01 Sick / Altered LOC 1BLS / 1ALS / 1A Protocol 36 if activated: Ambulance Only26C02 Sick / Abnormal Breathing 1BLS / 1ALS / 1A Protocol 36 if activated: Ambulance Only26C03 Sick / Sickle Cell / Thalassemia 1BLS / 1ALS / 1A Protocol 36 if activated: Ambulance Only26D01 Sick Person/Not Alert 1BLS / 1ALS / 1A26O02 Sick / Boils 1A No EMS, see your MD/ED26O03 Sick / Bumps (Non‐Traumatic) 1A No EMS, see your MD/ED26O04 Sick / Can't Sleep 1A No EMS, see your MD/ED26O05 Sick / Can't Urinate (w/o Abdominal Pain 1A No EMS, see your MD/ED26O06 Sick / Catheter (In/Out w/o Hemorrhage) 1A No EMS, see your MD/ED26O07 Sick / Constipation 1A No EMS, see your MD/ED26O08 Sick / Cramps/Spasms/Joint Pain 1A No EMS, see your MD/ED26O09 Sick / Cut‐off Ring Request 1A No EMS, see your MD/ED26O10 Sick / Deafness 1A No EMS, see your MD/ED26O11 Sick / Defecation / Diarrhea 1A No EMS, see your MD/ED

26O12 Sick / Earache 1A No EMS, see your MD/ED26O13 Sick / Enema 1A No EMS, see your MD/ED26O14 Sick / Gout 1A No EMS, see your MD/ED26O15 Sick / Hemorrhoids / Piles 1A No EMS, see your MD/ED26O16 Sick / Hepatitis 1A No EMS, see your MD/ED26O17 Sick / Hiccups 1A No EMS, see your MD/ED26O18 Sick / Itching 1A No EMS, see your MD/ED26O19 Sick / Nervous 1A No EMS, see your MD/ED26O20 Sick / Object Stuck 1A No EMS, see your MD/ED26O21 Sick / Object Swallowed w/o Diff Breath 1A No EMS, see your MD/ED26O22 Sick / Painful Urination 1A No EMS, see your MD/ED26O23 Sick / Penis Prob/Pain 1A No EMS, see your MD/ED26O24 Sick / Rash Skin Disorder w/o Diff Breat 1A No EMS, see your MD/ED26O25 Sick / Sexually Transmitted Disease (STD 1A No EMS, see your MD/ED26O26 Sick / Sore Throat 1A No EMS, see your MD/ED26O27 Sick / Toothache 1A No EMS, see your MD/ED26O28 Sick / Wound Infected 1A No EMS, see your MD/ED27A01G GSW/Non‐recent Peripheral 1BLS / 1A No EMS, see your MD/ED, Dispatch to Notify PD27A01P Penetrating Trauma/Non‐rcnt/Pr 1BLS / 1A No EMS, see your MD/ED, Dispatch to Notify PD27A01S Stabbing/Non‐recent Peripheral 1BLS / 1A No EMS, see your MD/ED, Dispatch to Notify PD27A01X Non‐Recent >6hrs Peripheral / Self Infli 1A No EMS, see your MD/ED, Dispatch to Notify PD27B01G GSW/Non‐recent Single Central 1BLS / 1A27B01P Penetrating Trauma/Non‐Rcnt Single Centr 1BLS / 1A27B01S Stabbing/Non‐Recent/Single Central 1BLS / 1A27B01X Non‐Recent >6hrs Single Central Wound 1BLS / 1A27B02G GSW/Single‐Peripheral 1BLS / 1A27B02P Penetrating Trauma/Single/Per 1BLS / 1A27B02S Stabbing/Single/Peripheral 1BLS / 1A27B02X Known Single Peripheral Wound 1BLS / 1A27B03G GSW/Serious Bleeding 1BLS / 1A27B03P Penetrating Trauma/Serious Bleed 1BLS / 1A27B03S Stabbing/Serious Bleeding 1BLS / 1A27B03X Serious Hemorrhage / Self Inflicted GSW 1BLS / 1A27B04G GSW/Unk Status/3rd Party 1BLS / 1A27B04P Penetrating Trauma/Unk Status 1BLS / 1A27B04S Stabbing/Unk Status/3rd Party 1BLS / 1A27B04X Unk Status/Self Inflicted GSW 1BLS / 1A27B05G GSW/Obvious Death 1BLS / 1A27B05P Penetrating Trauma/Obvious Death 1BLS / 1A27B05S Stabbing/Obvious death 1BLS / 1A27B05X Obvious Death/Self Inflicted GSW 1BLS / 1A27D01G GSW/Uncon or Arrest 1BLS / 1ALS / 1A27D01P Penetrating Trauma/Uncon or Arrest 1BLS / 1ALS / 1A27D01S Stabbing/Uncon or Arrest 1BLS / 1ALS / 1A27D01X Unc or Arrest/Self Inflicted GSW 1BLS / 1ALS / 1A27D02G GSW/Not Alert 1BLS / 1ALS / 1A27D02P Penetrating Trauma/Not Alert 1BLS / 1ALS / 1A27D02S Stabbing/Not Alert 1BLS / 1ALS / 1A27D02X Not Alert/Self Inflicted GSW 1BLS / 1ALS / 1A27D03G GSW/Central Wounds 1BLS / 1ALS / 1A27D03P Penetrating Trauma/Central 1BLS / 1ALS / 1A27D03S Stabbing/Central Wounds 1BLS / 1ALS / 1A27D03X Central Wounds/Self Inflicted GSW 1BLS / 1ALS / 1A27D04G GSW/Multiple Wounds 1BLS / 1ALS / 1A27D04P Penetrating Trauma/Multiple Wounds 1BLS / 1ALS / 1A27D04S Stabbing/Multiple Wounds 1BLS / 1ALS / 1A27D04X Multiple Wounds/Self Inflicted GSW 1BLS / 1ALS / 1A27D05G GSW/Multiple Victims 1BLS / 1ALS / 1A27D05P Penetrating Trauma/Multiple Victims 1BLS / 1ALS / 1A

27D05S Stabbing/Multiple Victims 1BLS / 1ALS / 1A27D05X Multiple Victims 1BLS / 1ALS / 1A28A01G Stroke/Normal Breathing/>8hrs 1A No EMS, see your MD/ED28A01L Stroke/Normal Breathing/<8hrs 1A No EMS, see your MD/ED28A01U Stroke/Normal Breathing/Unk time 1A No EMS, see your MD/ED28B01G Stroke/Unk/>8hrs 1BLS / 1A No EMS, see your MD/ED28B01L Stroke/Unk/<8hrs 1BLS / 1A No EMS, see your MD/ED28B01U Stroke/CVA‐Unk Status 1BLS / 1A No EMS, see your MD/ED28B01W Psychiatric/Serious Bleed w/weapon 1BLS / 1A No EMS, see your MD/ED28B02X Serious Hemorrhage 1BLS / 1A No EMS, see your MD/ED28C01G Stroke/Not Alert/>8hrs 1BLS / 1ALS / 1A28C01L Stroke/Not Alert/<8hrs 1BLS / 1ALS / 1A28C01U Stroke/Not Alert/Unk 1BLS / 1ALS / 1A28C02G Stroke/Abnormal resps/>8hrs 1BLS / 1ALS / 1A28C02L Stroke/Abnormal resps/<8hrs 1BLS / 1ALS / 1A28C02U Stroke/Abnormal Resps/Unk Time laps 1BLS / 1ALS / 1A28C03G Stroke/Speech/Movement/>8hrs 1BLS / 1ALS / 1A28C03L Stroke/Speech/Movement/<8hrs 1BLS / 1ALS / 1A28C03U Stroke/CVA‐Speech/Movement 1BLS / 1ALS / 1A28C04G Stroke w/Numbness/>8hrs 1BLS / 1ALS / 1A28C04L Stroke w/Numbness/<8hrs 1BLS / 1ALS / 1A28C04U Stroke w/Numbness, unk 1BLS / 1ALS / 1A28C05G Stroke w/Vision Probs/>8hrs 1BLS / 1ALS / 1A28C05L Stroke w/Vision Probs/<8hrs 1BLS / 1ALS / 1A28C05U Stroke w/Vision Probs, unk 1BLS / 1ALS / 1A28C06G CVA w/Headache Onset/>8hrs 1BLS / 1ALS / 1A28C06L CVA w/Headache Onset/<8hrs 1BLS / 1ALS / 1A28C06U CVA w/Sudden Headache Onset 1BLS / 1ALS / 1A28C07G Stroke/CVA w/Hx/>8hrs 1BLS / 1ALS / 1A28C07L Stroke/CVA w/Hx/<8hrs 1BLS / 1ALS / 1A28C07U Stroke/CVA w/Hx, Unk 1BLS / 1ALS / 1A28C08G Stroke w/Normal breathing/>8hrs 1BLS / 1ALS / 1A28C08L Stroke w/Normal breathing/<8hrs 1BLS / 1ALS / 1A28C08U Stroke/CVA w/Normal breathing 1BLS / 1ALS / 1A29A01 Not Dangerous/1st Party 1A No EMS, see your MD/ED29B01 Traffic Accident w/Injuries 1BLS / 1A29B01A Injuries (Mult Pts/Addt'l Resources) 1BLS / 1ALS / 1A29B01M Injuries (Multiple Patients) 1BLS / 1A29B01U Injuries (Unk No of Pts) 1BLS / 1A29B01X Injuires / Unk Pts/Addt'l Response Rq 1BLS / 1ALS / 1A29B02 Serious Hemorrhage 1BLS / 1A29B02A Serious Hemor / Multi Pt Add'l Response 1BLS / 1ALS / 1A29B02M Serious Hemorrhage/Multiple Pts 1BLS / 1A29B02U Serious Hemorrhage/Unk No Pts 1BLS / 1A29B02X Serious Hemorr/Unk No Pts/Addt'l Respons 1BLS / 1ALS / 1A29B03 Other Hazards 1BLS / 1A29B03A Other Haz/Mutl Pt/Addt"l Response 1BLS / 1A29B03M Other Hazards/Multi Pts 1BLS / 1A29B03U Other Hazards/Unk No of Pts 1BLS / 1A29B03X Other Hazards/Unk Pts/Addt'l Response 1BLS / 1A29B04 Unk Status 1BLS / 1A29B04A Unk Status/Mult Pts/Addt'l Response 1BLS / 1A29B04M Unk Status/Multi Pts 1BLS / 1A29B04U Unk Status/Unk No of Pts 1BLS / 1A29B04X Unk Status/ Unk Pts/Addt'l Response 1BLS / 1A29B05 Traffic Accident/Other Hazards 1BLS / 1A29B06 Traffic Accident/Unk Status 1BLS / 1A29D01a Aircraft Incident 1ALS / 1BLS / 1HR / 1A / 1BC29D01b Bus Accident 1ALS / 1BLS / 1HR / 1A / 1BC

29D01c TRAX Accident 1ALS / 1BLS / 1HR / 1A / 1BC29D01d Train Accident 1ALS / 1BLS / 1HR / 1A / 1BC29D01e Watercraft Accident 1ALS / 1BLS / 1HR / 1A / 1BC29D01f Multi‐Veh Pile‐Up >10 1ALS / 1BLS / 1HM / 1A / 1BC29D02a ATV Accident 1BLS / 1ALS / 1A29D02b Auto‐Bicycle or Motorcycle 1BLS / 1ALS / 1A29D02c Auto‐Ped 1BLS / 1ALS / 1A29D02d Ejected Person 1BLS / 1ALS / 1A29D02e Personal Watercraft Accident 1BLS / 1ALS / 1A29D02f Rollover 1BLS / 1ALS / 1A29D02g Vehicle Off Bridge/Height 1ALS / 1BLS / 1HR / 1A / 1BC29D02k High Mechanism / ATV accident 1BLS / 1ALS / 1A29D02l High Mechanism / Auto‐Bike/Motorcycle 1BLS / 1ALS / 1A29D02m Auto‐Ped 1BLS / 1ALS / 1A29D02n Ejection 1BLS / 1ALS / 1A29D02o Personal Watercraft 1BLS / 1ALS / 1A29D02p Rollover 1BLS / 1ALS / 1A29D02q Vehicle off Bridge/Heig 1BLS / 1ALS / 1A29D02r Possible Death at Scene 1BLS / 1ALS / 1A29D02s Sinking Vehicle 1BLS / 1ALS / 1A29D03 Traffic Accident Involving HazMat 1ALS / 1BLS / 1HM / 1A / 1BC29D03A Hazmat/Mtlti Pts/Addt'l Response 1ALS / 1BLS / 1HM / 1A / 1BC29D03M Hazmat/Multi Pts 1ALS / 1BLS / 1HM / 1A / 1BC29D03U Hazmat/Unk No of Pts 1ALS / 1BLS / 1HM / 1A / 1BC29D03X Hazmat/Unk No of Pts/Addt'l Response 1ALS / 1BLS / 1HM / 1A / 1BC29D04 Pinned or Trapped Person 1BLS / 1ALS / 1A29D04A Pinned Victim/Multi Pts/Addt'l Response 1BLS / 1ALS / 1A29D04M Pinned Victim/Multi Pts 1BLS / 1ALS / 1A29D04U Pinned Victim/Unk No of Pts 1BLS / 1ALS / 1A29D04X Pinned Victim/Unk No Pts/Addt'l Response 1BLS / 1ALS / 1A29D05 TA /Not Alert 1BLS / 1ALS / 1A29D05A Not Alert/ Multi Pts/Addt'l Response 1BLS / 1ALS / 1A29D05M Not Alert / Multi Pts/Addt'l Response 1ALS / 1BLS / 1A / 1BC29D05M Not Alert / Multiple Patients 1BLS / 1ALS / 1A29D05U Not Alert/Unk No of Pts 1BLS / 1ALS / 1A29D05X Not Alert/Unk No Pts/Addt'l Response 1BLS / 1ALS / 1A29O01 No Injuries Confirmed 1A No EMS, see your MD/ED29O01 No Injury Traffic Accident NO RS No EMS, see your MD/ED30A01 Traumatic Injs/Not Dangerous 1A No EMS, see your MD/ED30A02 Traumatic Injs/Non‐Recent 1A No EMS, see your MD/ED30B01 Traumatic Injs/Ps Dangerous 1BLS / 1A30B02 Traumatic Injs/Serious Bleeding 1BLS / 1A30D01 Traumatic Injs/Unc or Arrest 1BLS / 1ALS / 1A30D02 Traumatic Injs/Not Alert 1BLS / 1ALS / 1A30D03 Traumatic Injs/Chest or Neck Injury 1BLS / 1ALS / 1A31A01 Fainting Episode/Alert >35 1A31A02 Fainting Episode <35 w/Cardiac Hx 1A31A03 Fainting Episode <35 w/o Cardiac Hx 1A No EMS, see your MD/ED31C01 Fainting /Alert/Abnormal Breath 1BLS / 1ALS / 1A31C02 Fainting and Alert >35 w/Cardiac Hx 1BLS / 1ALS / 1A31C03 Females 12‐50 w/Abdominal Pain 1BLS / 1ALS / 1A31C04 Unconscious/Fainting‐Alert over 35 1BLS / 1ALS / 1A31C05 Unconscious/Fainting‐Abdominal pain 12‐5 1BLS / 1ALS / 1A31D01 Unconscious /Agonal or Ineffective Breat 1BLS / 1ALS / 1A31D02 Unconscious / Effective Breath 1BLS / 1ALS / 1A31D03 Unconcious Person‐Not Alert 1BLS / 1ALS / 1A31D04 Changing Color 1BLS / 1ALS / 1A310 Unconscious/Ineffective Breathing 1BLS / 1ALS / 1A32B01 Unk Prob/Stand/Sit/Move/Talking 1BLS / 1A Ambulance Only (or assessment unit)

32B02 Medical Alarm 1BLS / 1A Ambulance Only (or assessment unit)32B03 Unk Prob/Man Down‐Unk status 1BLS / 1A Ambulance Only (or assessment unit)32B04 Language Not Understood 1BLS / 1A Ambulance Only (or assessment unit)32D01 Unk Prob/Life Status Questionable 1BLS / 1ALS / 1A33A01 ACUITY I (no priority symptoms) 1BLS / 1A33A02 ACUITY II (no priority symptoms) 1BLS / 1A33A03 ACUITY III (no priority symptoms) 1BLS / 1A33C01 Not Alert 1BLS / 1ALS / 1A33C02 Abnormal Breathing 1BLS / 1ALS / 1A33C03 Hemorrhage or Shock 1BLS / 1ALS / 1A33C04 Acute Severe Pain 1BLS / 1ALS / 1A33C05 Heart Problems or MI 1BLS / 1ALS / 1A33C06 Emergency Response request 1BLS / 1ALS / 1A33D01 Cardiac or Respiratory Arrest 1BLS / 1ALS / 1APOLICEM Police Assist (Medical) 1BLS / 1A Ambulance Only Unless Rescue is neededSTAGED Delaying Disp for Scene Securi NO RS

Appendix F: http://www.prioritydispatch.net/downloads/flu/Pandemic%20Flu%20Special%20Procedures.pdf