PreHospital

Prehospital Medical Screening & 5150 Holds: Field guide

1.0 Del Norte and Lake County 5150 Holds should be transported according to North Coast EMS Destination Policy #2309. All patients with a potential life-threatening illness or injury should be transported according to North Coast EMS Destination Policy #2309.

1.1 For all Humboldt County 5150 Holds, to determine if medical clearance is required, answer the following questions:

  • Is there a medical or traumatic reason why this individual should not be transported to the psychiatric facility?
  • Is the individual unconscious or unresponsive?
  • Is the individual pale, sweaty, dizzy, or showing signs of shock?
  • Does the individual have chest pain? abdominal pain? significant bleeding from trauma?
  • Does the individual have any open wound, laceration, skin ulcer, or decubitus that requires anything more than once daily dry gauze & tape dressing?
  • Is the individual significantly intoxicated or overdosed on drugs, unable to ambulate, &/or may have taken an overdose of medication?
  • Is the individual a drowning or hanging, or attempted drowning or hanging victim?
  • Is the individual > 65 years old showing an abrupt change in behavior or cognition?
  • Field placement of saline lock or intravenous line?

    • Destination

    Medical Clearance: If the answer to ANY question in # 1.1 is “YES”, the individual requires medical clearance and should be transported as follows:

  • Adults – pursuant to North Coast EMS Policy #2309
  • Adolescents (age 12 through 17) – pursuant to North Coast EMS Policy #2303 & Policy #2309
  • Children (age 11 and under) – pursuant to North Coast EMS Policy #2303 & Policy #2309

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    Psychiatric Evaluation: If the answer to ALL questions in # 1.1 is “NO”, the individual does not require medical clearance and should be transported to the following LPS-designated 5150 evaluation facility:

  • Adults – Humboldt County Mental Health LPS-designated Psychiatric Health Facility. Notify County Mental Health en route at 707- 445-7710
  • Adolescents (age 12 through 17) – Humboldt County Mental Health designated LPS-Psychiatric Health Facility. Notify County Mental Health en route at 707- 445-7710
  • Children (age 11 and under) – Humboldt County Mental Health LPS-designated Psychiatric Health Facility. Notify County Mental Health en route at 707- 445-7710

    • Ambulance Diversion – North Coast EMS does not have a diversion policy and ambulance destination decisions should be followed pursuant to North Coast EMS Policy #2309.

    Exclusionary Diagnosis for Humboldt County Mental Health LPS-designated Psychiatric Health Facility:

  • Alcohol withdrawal or other drug/substances. An individual with withdrawal symptoms will not be accepted for transfer (Title 22, Division 5, Chapter 9, Article 4 Section 77113).
  • Not licensed to treat individuals with a primary eating disorder (CA Health & Safety Code Section 21254.5(b)).
  • Individuals with dementia or other cognitive disorders should be referred to Adult Protective Services (WIC 15700-15705).