A quick check for medical-control contact before transport or escalation.
OCEMS source summary · Updated 2026-09-16
Common triggers, not the full policy
Contact is also appropriate whenever the patient would benefit. After contact, follow base orders. Use 310.00 and the applicable standing order for complete requirements.
Contact base when…
The applicable standing order requires contact; do so before transport. Contact base when care beyond standing orders is needed.
An adult is unstable without an applicable standing order: pulse below 50 or above 130, respirations below 12 or above 26, or systolic BP below 90.
Specialty destination criteria apply, including stroke, trauma/replantation, burns, or cardiovascular receiving-center criteria.
A patient requests refusal/AMA after an ALS procedure, or decision-making capacity/refusal criteria are uncertain.
Field helicopter transport or MCI destination coordination requires contact; follow the policy’s MCI contact-point exception.
Children younger than 15
A pediatric-capable base (CCERC) is preferred. Triggers include respiratory distress, circulatory compromise, BRUE (even resolved), arrest/ROSC, drowning, suspected assault, trauma, or burns.
Without an applicable standing order, unstable pediatric thresholds include pulse below 60 or above 200, respirations below 12 or above 50, or systolic BP below 80.
Make the contact useful
State the patient’s age, presenting problem, vital-sign trend, mental status, and why base contact is required. Include treatment and response when requesting further medical direction.
For pediatric respiratory or circulatory compromise, a reported BRUE, arrest/ROSC, drowning, suspected abuse, or specialty destination needs, follow the pediatric contact provisions even if a symptom has resolved.
Standing orders & subsequent care
Standing orders apply to on-duty OCEMS-accredited paramedics working for approved providers. Need for treatment beyond the standing order calls for further online medical direction.
After base contact, follow base orders. If contact is discontinued, 310.00 allows resuming the appropriate standing order.
PR-230 effective April 2026 removes the adult push-dose epinephrine order/contact requirement for that procedure. PR-205 still requires a pediatric order; the two pathways must not be conflated.