ECP Referral Guide
After completing a primary and secondary survey, contact the ECP. This chart is a guide only.
Extended care paramedics (ECPs) can provide treatment to patients at home or in a residential-care setting and thus help avoid unnecessary
trips to hospital. However, it’s important that they are called to the right cases. Certain patient conditions and situations mean an ECP may not
be appropriate (see ECP precautions/exclusions). If unsure in regards to ECP precautions/exclusions, please discuss with the ECP.
Wound Care
ECPs can attend:
 lacerations
 skin tears
 abrasions
 bites
 minor wounds
 existing wounds.
ECP
precautions/exclusions:
 injuries to face, genital
area, hands or feet or
over joints
 deep tissue wounds
 injuries requiring
extensive closure
 loss of function
 penetrating injuries
 distal skin flaps
 foreign bodies
 paediatrics
 pt on anticoagulants
and has head injury.
Support
ECPs can provide:
 crew consultation
(career and volunteer)
 CPG extension
paramedics (if no ICP
available)


client call-back and
alternate pathways
referral to respite
services for carers.
Palliative care
ECPs can attend:
 generalised
deterioration
 breakthrough pain
 respiratory distress
 vomiting
 agitation and delirium
 medication delivery –
systems issues, e.g.
pumps
ECP precautions:
 pt without advance –
directive document.
Allergies
ECPs can attend:
 mild to moderate
allergic reactions
 pts with no Hx of
deterioration
 cases not requiring
adrenaline
ECPs exclusions:
 anaphylaxis


significant comorbidity
(e.g. immunecompromised pt)
airway or mucosal
angioedema.
Continence and feeding
devices
ECPs can attend for
insertion of or issues with
 indwelling catheter
(IDC)
 supra-pubic catheter
(SPC)
 feeding tube (PEG).
Note: ECPs only attend if
regular continence
provider is not available.
ECP
precautions/exclusions:
 first-time catheters
 acute urinary retention
 bleeding around
catheter, recent TURP
or haematuria
 traction pull PEGs
(discuss on consult).
Gastrointestinal/Genital
ECPs can attend:




diarrhoea and/or
vomiting
dehydration/heatwave
rectal prolapse
paraphimosis.
ECP
precautions/exclusions:
 decreased urine
output over extended
time
 malaena or
haematemesis
 Hx of bowel obstruction
(abdo. distention or
tenderness)
 haemodynamic
compromise or altered
GCS
 significant comorbidity
that may benefit from
hospital assessment.
Infections
ECPs can attend:
 UTI (pt not pregnant
and no anuria)
 cellulitis
 respiratory (if no
previous ICU/HDU
admissions and not
needing increased O2).
ECP
precautions/exclusions:
 first presentation of
male UTI
 suspected
pyelonephritis
 immunocompromised
pt or risk of infection
 febrile neutropenia
(chemo)
 suspected sepsis
 pt currently taking
steroids
 comorbidity, i.e. CCF
or COAD.
Musculoskeletal pain
ECPs can attend:
 back pain
 chronic pain
 ring removal.
ECP exclusions:
 acute loss of
neurovascular integrity
 acute pain (if
secondary to trauma)
 undiagnosed abdo, or
chest pain.
Headaches
ECPs can attend:
 simple headaches

migraine with previous
Hx and identical
presentation.
ECPs exclusions:
 new presentation of
severe headache
 suspicion of
CVA/positive ROSIER
 pregnant pt
 Hx of recent head
trauma
 suspected infection,
e.g. Meningococcal,
septicaemia
 loss of consciousness
 lack of responsible
person for supervision
 decreased GCS.
Dizziness
ECPs can attend:
 vertigo/Hx of Meniere’s
 dizziness not central in
origin with known Hx of
benign causes.
ECP
precautions/exclusions:
 cardiac Hx
 CVA/other
neurological pathology
ECP Referral Guide

consider metabolic,
sepsis or other nonbenign causes.
After completing a primary and secondary survey, contact the ECP. This chart is a guide only.