Emergency Medical Services (Notes)

BOOK: Operations II SECTION: Emergency Medical Services (CHIEF NOTES) Page 1 of 4

Oklahoma City Fire-Rescue
Emergency Medical Services
(Updated through 1/15/03)

ADN/005SPECIAL EVENTS

EMS office coordinates FD coverage of special events when EMS equipment/personnel are involved.

ADN/006EMS COMPUTER SYSTEMS

The EMS Officer assists with EMS computer systems involving education, equipment inventory, QA programs, and computer programs involving EMS or employee health.

ADN/007RESPONDING TO INCIDENTS

EMS office staff must report to IC if responding to call (requires EMS Officer be notified before leaving office or if out already ASAP).

ADN/009SUPPORT TO OTHER SECTIONS

The EMS office acts as a liaison for emergency medical and employee health issues.
The EMS office responds to all multiple alarms to ensure treatment/transportation, to set up medical branch, set up treatment/rehab areas, act as liaison for medical transport, and keeps PIO updated of medical situation.
The EMS office responds to all hazmat incidents where decon is required.
Random EMS office responses to incidents will fulfill requirements of NFPA 1581 and for quality assurance.
The EMS officer is responsible for coordinating EMS education/course catalog (with training section), maintaining educational equipment, assisting maintenance division with equipment ordering, assisting administration in incentive pay programs, and coordination with Special Teams.

ADN/011EMS EDUCATION MANAGEMENT

Updating, development, and implementation of all course curricula will be executed by EMS office.
EMS office provides educations equipment, supplies, annual instructor education/QA to all OCFD EMS instructors.

ADN/012EXPOSURE CONTROL

EMS Officer attends/chairs meetings with Exposure Control Committee.
A QA program is maintained for the Exposure Control Plan.
EMS Officer manages exposure reporting system.
EMS Officer is available at ALL hours for exposure counseling.

ADN/013DEFIBRILLATION PROGRAM

Repair of defibrillators and related equipment is coordinated through the EMS office or Quality Assurance Officers.

ADN/014CPR TRAINING

EMS office manages all CPR education.
Shift/District Coordinators assure all personnel have current CPR training.

ADN/015INCENTIVE PAY

Requirements for EMS Incentive Pay
Level / Requirements
EMT-B /

CURRENT State EMT License/CPR status
Meet all Medical Director requirements

EMT-P /

CURRENT State EMT Paramedic License/CPR status/ACLS status
Meet all Medical Director requirements

OCFD EMS Instructor /

CURRENT State EMT License/CPR Instructor status
OSU Fire Service Training Instructor I or II certification or equivalent
Active EMT for at least 1 year
Completion of OCFD EMS Instructor Course
At least 1 year with OCFD

Current copies of State EMT cards must be on file with EMS office (forward new copies to EMS office for placement in EMS file).

TRG/001EDUCATION MANAGEMENT

EMS office updates, develops, and implements curricula for Basic/Advanced EMS Refreshers, and other EMS courses with classroom space coordinated through Training Section.

TRG/002FIRST RESPONDER AGENCY

To retain First Responder agency status, OCFD must maintain all personnel at First Responder level (minimum).

TRG/003EMS EDUCATION SCHEDULE

EMS education at station level must be approved by EMS office and coordinated with District/Station officers.

TRG/004EMS EDUCATIONAL REQUIREMENTS AND COURSES AVAILABLE

EMS Courses/Requirements
Course / Requirements
First Responder /

Complete DOT First Responder course (written and practical)
24 hour refresher every 2 years
Failed/expired EMTs must retake full First Responder course

EMT-Basic /

Complete DOT EMT course (written and practical)
Current CPR card
Refresher consists of 24 hour course with 48 hours continuing education

EMT-Intermediate /

Complete DOT EMT-Intermediate course (written and practical)
Current CPR card
Refresher consists of 36 hour course with 36 hours continuing education
Verification of skills with Medical Control

EMT-Paramedic /

Complete DOT EMT-Paramedic course (written and practical)
Current CPR and ACLS certification
Refresher consists of 48 hour course with 24 hours continuing education
Verification of skills by Medical Control

Semi Automatic External Defibrillator /

AED certification from 4 hour AED course
Minimum of 2 hours continuing education per calendar quarter

TRG/005LAPSED LICENSES

Expired EMT licenses with expiration date within 2 years require completion of EMT refresher course and written/practical exam for recertification.
Licenses expired for more than 2 years require completion of initial training.
Personnel who have completed an EMT course and did not pass the National Registry Examination for EMT-Basic, must successfully pass the National Registry Examination for First Responders.

TRG/006EMS INSTRUCTORS

EMS instructors conduct all EMS courses for the department and are either Basic or Paramedic level instructors.

EMS Instructor Requirements/Information
Level / General Information / Requirements (Entry)
EMT-Basic Instructor /

Certified for period of 1 year
Must maintain CPR Instructor/EMT, attend OCFD Instructor update seminar annually, and accept teaching assignments

State EMT license
CPR Instructor
OSU-FST Instructor I or II, or equivalent
Active EMT for 1 year
Complete OCFD EMS Instructor course

EMT-Paramedic Instructor /

Certified to teach Advanced EMS Refreshers, Advanced Continuing Education, ACLS, and any EMT-B courses
Certified for period of 1 year
Must maintain CPR Instructor/EMT-P/ACLS, attend OCFD Instructor update seminar annually, and accept teaching assignments

State EMT-Paramedic license
CPR Instructor
OSU-FST Instructor I or II, or equivalent
Active EMT-Paramedic for 1 year
Complete OCFD EMS Instructor course
Current ACLS status

Each course taught will have a Primary instructor responsible for completion of course roster and documentation.
Practical skills assistants can assist with lectures but are mostly used for practical skills evaluation.
Instructor/student ratios can be found in the course catalog.
The EMS Officer is the course administrator for all EMS courses (responsible for course development, planning operation, and evaluation).
Instructors should be notified a minimum of 3 weeks before first day to teach (pre-course conference 2-3 weeks before class).
Evaluations of instructors is for quality assurance purposes.
The number of active instructors is determined by the Collective Bargaining Agreement (CBA says 75 total with 30 max Paramedic instructors).

TRG/008EMT CONTINUING EDUCATION PROGRAM

Continuing education hours fulfill the requirements of both the National Registry of Emergency Medical Technicians and the Oklahoma State Health Department, EMS Division.
Each month, 2 inservices are required to be completed at the station or district level (on EMS webpage).
The 1st month of each quarter will include a Defibrillator inservice and another inservice.
The Station Officer will be responsible for assuring inservices are completed by their personnel.
A maximum of 16 hours continuing education per renewal period is allowed for any one topic, with no more than 10 hours of video tapes.
CPR training and retraining is not acceptable for Continuing Education, but CPR refresher training is acceptable.
A record of all Continuing Education (inservices), for approximately the last 2 years, will be on the EMS web page.

OPS SECTION IS NOT UPDATED WITH 7/04 UPDATES

OPS/001FIRST RESPONDER AGENCY

OCFD is certified through the Oklahoma State Department of Health-EMS Division as a First Responder Agency.
OCFD must follow requirements of State Rules and Regulations of the Department of Health, Chapter 640, EMS, part 31, section 310:640-3-150.
Requirements for a first responder agency includes: sufficient coverage of the municipality, personnel responding certified to First Responder level or above, transport agency that directs and supervises patient care, and follow standards required by Medical Control Board.

OPS/002FIRST RESPONDER SYSTEM

Responsibilities of First Responders at emergency scenes include: scene control, gaining access to patients (extrication/forcible entry), patient assessment, emergency care (protocols), move or reposition patients, if necessary, per protocol, and orderly transfer of patient care.
No OCFD employee shall function above BLS level unless approved and authorized by Medical Control and OSDH-EMS Division.

OPS/003MEDICAL CONTROL

OCFD employees provide care under the supervision of the Medical Control Board and Physician Medical Director.
All patient care should follow First Responder protocols (no deviation).

OPS/004MEDICAL RESPONSE GUIDELINES

EMSA uses a priority dispatch system which is designed to only dispatch OCFD when needed.
The four major medical priority dispatch system (MPDS) priority classifications are Alpha, Bravo, Charlie (possibly life-threatening), and Delta (life-threatening).
Automobile accidents with injuries are known as MPDS card #29 and require OCFD response.
OCFD responds to all Charlie and Delta priority calls.

Examples of incidents requiring OCFD response
Priority type / Chief complaint / Patient condition
Charlie / Electrocutions / Alert & Breathing Normally
Electrocutions / Unconscious
Pregnancy/Childbirth / Labor-Delivery NOT Imminent
Pregnancy/Childbirth / Baby Born
Seizures / With Trauma
Seizures / Continuous/Multiple Seizures
Delta / Animal Bites / Any Snake
Assault/Rape / Dangerous Injuries
Stab/Gunshot / Wound Multiple Victims
Traffic Accidents / Severe Respiratory Distress
Traffic Accidents / Trapped

OPS/005EMSA - OCFD DISPATCH COMPUTER LINK PROCEDURES

OCFD is requested by EMSA using a dispatch computer link when calls are received by EMSA (not 9-1-1).
Calls received through 9-1-1 are re-routed to EMSA and call information is also sent to the OCFD dispatch computer.
When EMSA obtains the chief complaint from a call, information may be relayed through computer link to dispatch who relays it to company responding.
Dispatch link printer paper should be removed at 0000 hours each shift and printout turned in to EMS coordinator.
If dispatch link printer is down for more than 30 minutes, turn off printer and notify EMSA.

OPS/006RESPONSE TO VIOLENT OR POSSIBLE VIOLENT INCIDENTS

Companies will be advised by Dispatch to wait for PD if needed.
Company Officers may determine if a scene is safe to enter.
Police have primary responsibility and authority on crime scenes.
Potentially violent scenes include: incidents where PD requests staging, aggravated assault (with weapon) and assailant on scene, attempted suicides (patient conscious/threatening), violent psychiatric patients, and other incidents that present unreasonable danger.

OPS/007SCENE CONTROL

When a safety hazard exists, the Company Officer will assume command of a scene.
Patient care or access to patient may be delayed if life hazards exist.
Any delay in patient care should be discussed with the lead paramedic for the transport agency.
When hazards exist at a crime scene/traffic accident scene, the ranking law enforcement officer is responsible for safety of patients and rescue personnel.

OPS/008TRANSFER OF PATIENT CARE

Fire department personnel on scene first will initiate treatment per protocols and gather history including current medications.
When the transport agency arrives, the lead paramedic will assume responsibility of patient and direct patient care.
The patient report to the lead paramedic should include: assessment findings, pertinent medical history, and care given (written documentation if possible).
Personnel involved in riding along with EMSA to provide care enroute to hospital should be added to the OCFD run report.

OPS/009PREHOSPITAL DEFIBRILLATION PROGRAM

In the 1st few minutes of sudden death, 80%-90% of patient will be in V-fib.
V-fib, if not acted on will turn into asystole which carries a survival rate of less than 1%.
EMT-D training is offered to all OCFD personnel with EMT-B or above training.
EMT-D operational protocols are provided by Medical Control Board.
First Responders will participate in quarterly Defib in-services.
Modifications to Defib protocols will be introduced during Defib Quarterly In-services.

OPS/010CPR TRAINING PROGRAMS

American Heart Association (AHA) Healthcare Provider level CPR training is the minimum required CPR training for all suppression personnel.
AHA standards for CPR will be strictly adhered to.
OCFD offers ONLY Heartsaver and Pediatric CPR training to the public.
OCFD CPR cards are issued to the public, not AHA cards.

OPS/011EMERGENCY MEDICAL SUPPLY AND EQUIPMENT STANDARD INVENTORY

An OCFD approved trauma kit should be on all suppression apparatus.
Apparatus will have a complete inventory of EMS equipment/supplies the 1st day of each month.
No supplies or equipment NOT on the EMS supply/equipment list will be put on apparatus.
Permission to put items on rigs that does not appear on EMS equipment/supply inventory will be obtained through the EMS coordinator.
Items not listed in the complete EMS inventory, that are carried on some rigs (i.e.-KEDs), are the responsibility of the station to recover or replenish.
Mini Response kits are carried on support vehicles.

OPS/012EQUIPMENT RETRIEVAL PROCEDURES

OCFD EMS equipment used on patients will be retrieved (4 to 6 hours later) from the hospital, if within the response district.
If hospital is not in response district, the company in that district will be contacted to retrieve the item and route back to the proper company.
EMSA goes to hospitals every 2 to 3 days to retrieve equipment.
OCFD equipment found will be delivered to the EMSA service center at 2323 S. Walker.
EMSA service center will contact OCFD if equipment is found.

OPS/013EQUIPMENT EXCHANGE PROCEDURES

The exchange program is a one-for-one exchange of identical equipment at the scene ONLY.

Equipment that may be exchanged at the scene with EMSA / Backboards (with straps & head stabilization devices)
BVMs (disposable) adult and child
C-collars (Stiffneck brand) all sizes
Defibrillator electrodes (Fast Patch Physio Control brand)
KEDs
Oxygen masks (non-rebreather) adult and child
Nasal Cannulas (ADULT ONLY)