Walworth Fire Department Ambulance

Standard Operating Guidelines

WALWORTH FIRE DEPARTMENT AMBULANCE

STANDARD

OPERATING

GUIDELINES

TABLE OF CONTENTSPAGE

Section 1:Introduction 3

Section 2: Personnel

2.1 General Requirements of All Members 4

2.2 Emergency Vehicle Operators 4

2.3 Patient Care Personnel 5

2.4 General Responsibilities of Officers 8

2.5Orientation and Continuing Education 9

2.6 Performance of Duty 11

Section 3: Maintenance

3.1 Vehicles 13

3.2 Facility 13

3.3 Equipment 13

Section 4:Operations

4.1 Call Procedures 14

4.2 Mutual Aid 26

4.3 Rescue Situations 27

4.4 Requests for On-Scene Stand-bys 28

4.5 Hospital Destination 29

4.6 Incident Management 31

Section 5:Safety Management

5.1 Vehicle Operation 32

5.2 Scene Safety 34

5.3 Work Environment Health & Safety 35

5.4 Accident/Illness Reporting & Investigation 36

5.5 Hazardous Materials 36

5.6 Pathogen Exposure Control 37

5.7 Required Reports 41

Section 6:Quality Management

6.1 Quality Improvement Program 42

6.2 Quality Improvement Coordinator 43

Addendum

Incident ReportTB Screening

Member ProfileMedic Qualification Card

New Member OrientationDriver Qualification Card

SECTION 1: INTRODUCTION

The Standard Operating Guidelines of the WFD Ambulance is to provide direction for its personnel on daily operations, requirements of membership, job descriptions, and safety issues.

The SOG’s are divided into the following sections:

  • Personnel
  • Maintenance
  • Operations
  • Safety Management
  • Quality Management

Each section is marked with the date approved/implemented. The ambulance committee reviews all SOG’s at least annually.

The effectiveness of SOG’s begins and ends with the personal commitment of every WFD Ambulance member. Each member is expected to be thoroughly familiar with the policies and procedures, and must agree, in writing, at the time of his/her application for membership to abide by these policies and procedures.

EMS by its very nature is very unpredictable and personnel are expected to make sound, split-second decisions. So, while no policy/procedure manual can hope to address all possible situations, it gives a general guideline which makes the decision process easier and operations safer and more efficient. The focus of SOG’s therefore, is on health, safety, and operational issues critical to effective EMS operations and designed for the legal and personal protection of each WFD Ambulance member and their patients.

SECTION 2: PERSONNEL

SECTION 2.1: GENERAL REQUIREMENTS OF ALL MEMBERS

All members, regardless of job assignment must:

  • Agree to abide with the bylaws and standard operating guidelines of the WFD Ambulance, Fire Department and commissioners
  • Be a member in good standings with the Walworth, Lincoln, or West Walworth Fire Departments.
  • Have satisfactory physical and mental health to carry out all usual WFD Ambulance-related responsibilities and obligations
  • Have the ability to communicate verbally, in writing, via telephone and radio equipment
  • Have the ability to interpret written and oral instructions
  • Have the ability to use good judgment and remain calm in high-stress situations
  • Have the ability to be unaffected by loud noises and flashing lights
  • Have the ability to read English language manuals, write, and converse in English
  • Have knowledge of radios and proper communication skills
  • Have the ability to accurately discern street signs
  • Have good manual dexterity, with ability to perform all tasks related to motor vehicle operation and/or patient care
  • Have the ability to bend, stoop, and crawl on uneven terrain
  • Have the ability to withstand varied environmental conditions such as extreme heat, cold, and moisture
  • Have the ability to work in low light and difficult conditions

SECTION 2.2: EMERGENCY VEHICLE OPERATORS

All designated motor vehicle operators as well as any patient care providers who wish to operate the ambulance or Medic 25 (under any circumstances) must meet the following requirements:

  • Have a valid NYS Driver’s License with a MV record acceptable to the WFD Ambulance’s Insurance Carrier
  • Be over the age of 21
  • Complete an EVOC or CEVO course and maintain current certification. In house training may be acceptable if a class is not currently available (with D/O approval).
  • Have knowledge of local hospital locations and main and alternate routes of travel.
  • All operators cleared after February 1, 2007, must maintain current CPR certification
  • Be able to read, understand, and operate instrumentation, switches, and gauges
  • Be familiar with equipment and placement
  • Ability to properly drive a vehicle in reverse and ability to position vehicle in proper bay
  • Drivers will be cleared on each separate type of vehicle (fly car, type I, & type III rig)
  • At any time driving privileges can be suspended by the D/O. This can be for lack of call taking, any driving related complaints received, or not following the SOG’s. After retraining, driving privileges may be reinstated by the D/O.

EMERGENCY MOTOR VEHICLE OPERATOR

Job Description

The emergency motor vehicle operator is expected to operate the vehicle in a safe manner according to all applicable WFD Ambulance’s SOG’s and NYSDOH Policy Statement 00-13 dated 11/01/00. In addition, the emergency motor vehicle operator is responsible for the following:

  • Assisting the medic in completing all duties listed on the “Post-Call Checklist”
  • Providing assistance moving patient on scene or at the hospital
  • Gathering and operating needed equipment
  • Operation of the stretcher and stair chair
  • Rescue operations (procedures not involving medical aspects of patient care)
  • Performing CPR on patients.
  • Running radios as needed. If the other member is in the passenger seat, they are encouraged to assist with the lights, siren, radios and map reading so driver can have their attention on driving.

SECTION 2.3: PATIENT CARE PERSONNEL

All patient care personnel must be currently certified by the NYS Department of Health and maintain the level of Certified First Responder (CFR), CFR-Defibrillation (CFR-D), Emergency Medical Technician (EMT), EMT-Defibrillation (EMT-D), Advanced EMT-Intermediate, Advanced EMT-Critical Care, or EMT-Paramedic. Patient care personnel must present their original copy of their certificate to the D/O upon applying for membership, and each time the certification is renewed. A photocopy will be made of the certificate for the member’s file, and the original returned to the member. The only exception to this will be persons enrolled in certification training courses who may perform patient care tasks within their present level of training, but only under the direct supervision of a currently certified member at or above the level of the trainee. CPR trained personnel may help with CPR. All patient care must be in accordance with applicable NYS approved protocols, FLREMS approved protocols or by a medical control physician. The chief, D/O, medical director, or state DOH may suspend a medics right to practice at anytime.

PATIENT CARE PERSONNEL

Job Description

  • All personnel shall conduct themselves according to the expectations outlined in Section 800.15 of Chapter 6 Title 10 of the NYS Emergency Medical Services Code Part 800 Regulations.
  • Determines the nature and extent of the illness or injury, makes determination of patient status, and renders appropriate emergency care based on competency level.
  • Assists in lifting, carrying, and transporting patients.
  • Applies light rescue and extricates patient from entrapment as able while wearing approve PPE.
  • Complies with all protocols and regulations per NYS DOH and REMAC in handling patients.
  • Assists the driver in completing all duties listed on the “Post-Call Checklist”.

Certified First Responder (CFR) and CFR-Defibrillation (CFR-D)

On scene, Certified First Responders will perform patient care tasks within their level of training according to current NYS-DOH and REMAC standards of care. In the ambulance, the CFR will perform patient care tasks under the supervision of an EMT or Advanced EMT.

Emergency Medical Technician and EMT-D

The EMT and EMT-D will perform patient care tasks within their level of training according to current NYS-DOH and REMAC standards of care.

ADVANCED EMT

The Advanced EMT (I/CC/P) practices under the supervision and control of the agency medical director and medical control physician. In addition to maintaining current NYS certification, the Advanced EMT must also meet all of the skills practice and CME requirements of the Regional Medical Advisory Committee.

Advanced EMT – Intermediate

The EMT-Intermediate will perform patient care tasks within their level of training according to current NYS-DOH and REMAC standards of care.

Advanced EMT-Critical Care

The EMT-Critical Care will perform patient care tasks within their level of training according to current NYS-DOH and REMAC standards of care.

EMT-Paramedic

The EMT-Paramedic is the highest level of pre-hospital emergency medical care provider. The Paramedic will perform patient care tasks within their level of training according to current NYS-DOH and REMAC standards of care.

It is recommended that the EMT-Critical Care and EMT-Paramedic maintain a currently valid ACLS, BTLS, PALS card

SECTION 2.4: GENERAL RESPONSIBILITIES OF OFFICERS

AMBULANCE CHAIRMAN/DIRECTOR OF OPERATIONS:

The Ambulance Chairman/Director of Operations (D/O) shall be elected as per the WFD By Laws. The D/O will oversee all the actions and functions of the Walworth Ambulance and its members and tend to the needs of said members. The D/O is responsible for all members and officers that fall under this position. The responsibilities of the D/O include:

  1. Delegation of tasks and authority as needed.
  2. Attendance at most operational, administrative, monthly, line officer, or special meetings, or delegate the proper personnel to represent the ambulance at said meeting.
  3. Offering monthly reports and/or any report requested of the D/O.
  4. Maintenance of all mutual aid agreements and cohesiveness of the Walworth, West Walworth, and Lincoln EMS personnel.
  5. Final review of all medic and driver certifications and clearance.
  6. Insuring that the yearly fund drive is sent out by June 1.
  7. Ordering of medical supplies, office supplies, and equipment as needed.
  8. Review of all medic and driver training and training expenses in coordination with the training officer.
  9. Review of all bills submitted to ambulance.
  10. Upholding the Walworth Fire District and Walworth Ambulance SOG’s and By-Laws and take proper disciplinary action as needed.
  11. Obtaining bi-yearly NYS-DOH certifications.
  12. Maintenance of all member files and certifications.
  13. Responsibility to the WFD Fire Chief in all operational matters.
  14. Responsibility to the WFD President in all administrative matters.
AMBULANCE TREASURER
  1. Responsible for all moneys and accounts held by the Walworth Ambulance.
  2. Supply the membership with a monthly, written report of income and expenses.
  3. Provide a report at the monthly FD meeting
  4. Send out “Thank You” letters as related to donations
  5. Assure that local funeral homes have proper envelopes for use in donating to the ambulance.
AMBULANCE LIEUTENANTS

The D/O shall appoint up to six Ambulance Lieutenants (three of which will be members of the ambulance committee) and an unlimited number of supporting staff positions in order to efficiently delegate the responsibilities of operating the WFD Ambulance. The responsibilities of these officers shall be determined by the D/O annually. A written job description for each officer shall be provided to the WFD Fire Chief.

SECTION 2.5: ORIENTATION AND CONTINUING EDUCATION

One inevitable fact facing EMS providers today is that we all have to spend a significant amount of time during our EMS careers in training and education. This is true for motor vehicle operators as well as patient care providers. Our agency is responsible for training all of our personnel in hazardous materials recognition, infection control, hazard communications, V&T law, protocols, etc. It is important for all prospective members to understand the time commitment necessary and that it is simply not enough anymore to be available to respond to calls.

ORIENTATION OF PERSONNEL

All new members will be required to complete an orientation program after being accepted into membership by the agency. The orientation will be under the direction of the D/O or a designated lieutenant.

This orientation will include but may not be limited to the following subjects:

  1. Review of Standard Operating Guidelines
  2. Infection Disease Orientation plus Exposure Control Plan and Procedures
  3. Emergency Vehicle Operation, V&T Law, Driving Orientation, and Practice

(Unless member will never be responsible for vehicle operation)

  1. MSDS
  2. Hazmat Awareness
  3. Vehicle Maintenance
  4. Tour of Building and Ambulance Vehicle, Supplies and Equipment
  5. Review of Rescue and MCI Equipment and Supplies
  6. ALS Orientation (AEMT’s only)

CLEARING OF MEDICS

A cleared medic may perform the duties of such independently and without trainer supervision. The clearing process will include familiarization with ambulance equipment, location of supplies, and at least six written evaluations from medic trainers (a medic trainer can be any medic that has been cleared for at least two years.) As the medic completes training requirements, it will be recorded on a “Medic Qualification Card” (see appendix). Any EMT with prior experience may have a modified clearing process if the D/O determines the need for such. The D/O will provide final approval. A cleared medic will have received a letter from the D/O relating such.

Based on the direction of the Medical Director, an EMT must remain active, taking at least one transporting call every three months in order to remain a cleared medic. If an EMT fails to meet this requirement, they will be placed back into training and will have to take three calls under the supervision of a medic trainer. Failure to take a transporting call for more than one year will result in the EMT having to repeat the entire clearing process.

CLEARING OF DRIVERS

A cleared driver may perform the duties of such independently and without trainer supervision. The clearing process will include familiarization with ambulance equipment, location of supplies, and at least four written evaluations from driver trainers (a driver trainer can be any driver that has been cleared for at least one year and has attended an EVOC course). As the driver completes training requirements, it will be recorded on a “Driver Qualification Card” (see appendix). Any driver with prior experience may have a modified clearing process if the D/O determines the need for such. The D/O will provide final approval. A cleared driver will have received a letter from the D/O relating such.

In order to remain a cleared driver, one must remain active, taking at least one transporting call every six months. If a driver fails to meet this requirement, they will be placed back into training and will have to take three calls under the supervision of a driver trainer. Failure to take a transporting call for more than one year will result in the driver having to repeat the entire clearing process.

TRAINING/CONTINUING EDUCATION

A lieutenant designated by the D/O will be responsible for conducting monthly training sessions and any additional special sessions as may be required or requested. The forth Monday of each month will be Ambulance meeting at 1900 followed by EMS training for that month. Certain EMS training drills will be mandatory (such as EpiPen updates, Albuterol updates, and FLREMS protocol updates).

The WFD Ambulance suggests that each member attend as many continuing education sessions as possible. The cost for these classes will be paid for by the ambulance if the member is in “good standing” as defined by these SOG’s. Books and supplies will be paid for any classes associated with EMS training. Tuition to a college course will not be included. Conferences and other events held outside the area can be attended and will be evaluated on cost and numbers attending. Number of attendees and multiple trips by a member will be reviewed by the D/O. Any member who has not taken a call in over six months will not be sponsored to refresh their EMT card or to advance in certification level.

SECTION 2.6: PERFORMANCE OF DUTY

It is extremely important that all members and prospective members realize that any person, whether paid or volunteer, who has agreed to take upon him or herself the responsibility of providing emergency medical care, is assuming a very serious obligation. The WFD Ambulance takes very seriously the protection of the patients who have placed themselves in our care, the health and safety of all of its members, and the health and safety of all persons with whom the WFD Ambulance, in fulfilling its duties, comes into contact. Members are expected to act in a professional manner at all times and at no time to act in a way that may bring discredit to the WFD Ambulance.

MAINTENANCE OF PATIENT CONFIDENTIALITY: HIPPA

All WFD Ambulance personnel shall abide by all current HIPPA laws. All members must keep all patient care records and calls confidential. Details of calls may be discussed with hospital staff as may be necessary, and within the agency for training and QI purposes. Breach of confidentiality will result in disciplinary action to be determined by the D/O and fire chief.