Today’s “Did You Know?” moment:
There is one contraindication for Medevac Request:
EMS/DNR-B or MOLST B patients are NOT candidates for field medevac transport.
(page 280 of MD protocol, July 1, 2021 version)
With that said, although these patients do not qualify for helicopter utilization, this doesn’t prevent the patient from ground transportation to a specialty referral center should they meet the criteria.
While we are on the subject of MOLST patients, remember that providers do not need to ask permission via consult to control pain with analgesia for MOLST B patients. Pain management is a standing order for the MOLST B population.
Lastly, it is inappropriate for a provider to consult a physician to invalidate or revoke a MOLST form for any reason. There are three ways an EMS/DNR order may be revoked at any time:
* Physical cancellation or destruction of all EMS/DNR order devices; or * A verbal statement by the patient made directly to EMS clinicians requesting resuscitation or palliative care only. In this case, EMS/DNR devices do not need to be destroyed. EMS clinicians must thoroughly document the revocation. A verbal revocation by the patient is only good for the current response for which it was issued. * Decision-makers with the authority to revoke an EMS/DNR order must either void or withhold all EMS/DNR order devices if they wish resuscitation for the patient. An authorized decision-maker, other than the patient, cannot revoke an EMS/DNR order verbally. (page 59 of MD protocol, July 1, 2021 version)
There is one contraindication for Medevac Request:
EMS/DNR-B or MOLST B patients are NOT candidates for field medevac transport.
(page 280 of MD protocol, July 1, 2021 version)
With that said, although these patients do not qualify for helicopter utilization, this doesn’t prevent the patient from ground transportation to a specialty referral center should they meet the criteria.
While we are on the subject of MOLST patients, remember that providers do not need to ask permission via consult to control pain with analgesia for MOLST B patients. Pain management is a standing order for the MOLST B population.
Lastly, it is inappropriate for a provider to consult a physician to invalidate or revoke a MOLST form for any reason. There are three ways an EMS/DNR order may be revoked at any time:
* Physical cancellation or destruction of all EMS/DNR order devices; or * A verbal statement by the patient made directly to EMS clinicians requesting resuscitation or palliative care only. In this case, EMS/DNR devices do not need to be destroyed. EMS clinicians must thoroughly document the revocation. A verbal revocation by the patient is only good for the current response for which it was issued. * Decision-makers with the authority to revoke an EMS/DNR order must either void or withhold all EMS/DNR order devices if they wish resuscitation for the patient. An authorized decision-maker, other than the patient, cannot revoke an EMS/DNR order verbally. (page 59 of MD protocol, July 1, 2021 version)
If you have any questions, suggestions, comments, please let me know!
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375