TL;DR
POLST/MOLST Forms: Portable physician orders for life-sustaining treatment recognized across care settings.
POLST/MOLST Forms
Definition
Portable physician orders for life-sustaining treatment recognized across care settings.
Related Procedures
Procedures related to polst/molst forms in the EMS setting:
- STEMI protocol: 12-lead ECG within 10 min then aspirin 324mg then NTG if SBP >90 then notify cath lab then transport code 3
- Pediatric weight-based dosing: Broselow tape for length-based weight estimation in emergencies
Practical Example
Field Scenario: A construction worker stung by wasps, developing urticaria, stridor, and hypotension. Anaphylaxis: epinephrine 0.3mg IM, IV fluids, diphenhydramine, albuterol for bronchospasm.
This scenario tests your ability to apply knowledge of polst/molst forms under time pressure with incomplete information, exactly the type of decision-making the certification exam assesses.
Regulatory Context
Regulatory context for polst/molst forms includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.
Differential Diagnosis
When assessing polst/molst forms, use structured assessment tools to differentiate between possible causes:
Trauma Score: Components: GCS, Systolic BP, Respiratory rate. Scoring: Revised Trauma Score: coded values 0-4, sum correlates with survival probability.
APGAR: Components: Appearance, Pulse, Grimace, Activity, Respiration. Scoring: 0-10 at 1 and 5 minutes, under 7 needs intervention.
Equipment & Tools
Equipment used in polst/molst forms assessment and treatment:
- Waveform capnograph
- Measures end-tidal CO2 continuously with waveform display. Available sizes: Mainstream (inline), Sidestream (sampling)
- IO drill
- Intraosseous access device for emergent vascular access. Available sizes: EZ-IO: 15mm (peds), 25mm (adult), 45mm (obese)
- King airway
- Supraglottic blind-insertion airway device. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
- BVM
- Bag-valve-mask for manual ventilation. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)
Calculation Methods
Dosage calculations related to polst/molst forms in EMS:
- adenosine: 6mg rapid IV push, then 12mg if needed (IV rapid push with flush)
- atropine: 0.5mg IV q3-5min, max 3mg (IV/IO)
- amiodarone: 300mg IV/IO first dose, 150mg second dose (IV/IO)
Pediatric dosing: always calculate by weight (mg/kg). Use Broselow tape if weight is unknown.
Why It Matters
POLST legal authority in prehospital setting tested on EMT and Paramedic exams.
Related Terms
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