SOP 108 - EMS Procedures Flashcards
(129 cards)
1
Q
What is the role of the lead provider on an ambulance?
A
The lead provider is the one in charge of patient care.
2
Q
Who is the Senior Paramedic in Rockford Fire?
A
The Senior Paramedic is the one with the most time as a Paramedic on Rockford Fire.
3
Q
What are some responsibilities of the Senior Paramedic?
A
- In charge of out of station non-medical decisions and duties
- Obtaining necessary equipment
- Notifying the Company Officer or D/C of actions taken
4
Q
What happens if there is a gross violation of patient care?
A
- An explanation of circumstances must be given to the Company Officer
- A report outlining the situation must be completed and submitted prior to the end of the shift
5
Q
What is the minimum oxygen level before oxygen cylinders should be changed out?
A
Oxygen cylinders should not drop below 200 psi.
6
Q
When should the CO or Lead Provider consider asking for a District Chief?
A
- Conscious, oriented persons refuse transport but have a head injury or overdose
- Minors whose parents refuse intervention
- Missing valuables potentially implicating personnel
- Criminal acts against Fire Department personnel
- Involvement of off-duty RFD personnel
7
Q
What are two ways a District Chief can be helpful?
A
- Elevates responsibility for a decision
- Their perceived power might expedite the resolution of the problem
8
Q
What must be done if an unusual event occurs?
A
The Company Officer will contact the EMS Training Coordinator in writing and forward documentation to the D/C and OPS Chief.
9
Q
What are the two criteria for patient refusal?
A
- Alert to time, place, person, and situation
- Capable of making the decision to refuse
10
Q
What qualifies as an emancipated minor?
A
- Having a child
- Having own residence
- Court documentation
11
Q
What are the colors of the Region 1 prehospital Refusal forms?
A
- Top-White: to Fire Department
- Yellow: To EMS System
- Pink: To the patient
12
Q
What should be placed in the signature space if the patient refuses to sign the refusal form?
A
Place ‘Refuse to sign’.
13
Q
What form must every patient be provided with?
A
The Department Notice of Privacy Practices.
14
Q
What is the ambulance billing authorization form number?
A
RFD 503A.
15
Q
Who gets notified if the patient is employed by the City of Rockford?
A
Notify the on duty District Chief.
16
Q
How many ambulance reports are required per run?
A
A minimum of 2 ambulance reports.
17
Q
What are the training requirements for EMT B’s?
A
- Recertify every 4 years
- 60 hours of continuing education
- CPR certification
18
Q
What is form number for off-duty continuing education for Paramedics?
A
Form #506.
19
Q
What must a citizen demonstrate to assist in an incident?
A
- They are indeed who they claim to be
- They have the certification or licensure level they claim
20
Q
What happens if a citizen’s care exceeds the training of the Fire Department personnel?
A
Overall care remains with the Rockford Fire Department.
21
Q
What is the procedure if a patient has a life-threatening condition and a hospital is on diversion?
A
Transport to the closest facility, regardless of diversion.
22
Q
What is the exception for patient delivery to the ER?
A
Mass Casualty incidents may allow walking the patient to the ambulance.
23
Q
What are some forms included in the ambulance clipboard?
A
- Ambulance billing and privacy form
- EMS supply requisition form
- Intubation proficiency forms
- Regional I refusal forms
- RFD form #136, exposure reports
- RFD form #160 false and medical alarm reports
- Region I-patient care report short form
24
Q
What day of the week is the Ambulance Inventory Information Sheet completed?
A
Every Monday.
25
What happens if an ambulance inventory is short item(s)?
Complete an EMS Requisition Form and leave it at the EMS Supply Station.
26
What happens if vital equipment needs to be replaced immediately?
* Obtain at the Resource Hospital using the Equipment Replacement Form
* Replace missing medications through the Resource Hospital
27
What are some responsibilities of the home company regarding reserve ambulances?
* Complete the apparatus inventory
* Ensure medications are current
* Maintain fluid levels, lights, and radios
* Fuel no less than ¾
28
What medications are to be changed over from the frontline to the reserve ambulance?
Only the controlled substances.
29
What happens if the home company officer of the reserve ambulance is not available?
Complete the changeover and get the Officer’s signature later.
30
What substances must be changed over when moving from frontline to reserve ambulance?
Controlled substances
## Footnote
Only controlled substances are required to be transferred.
31
What should be done if the home company officer of the reserve ambulance is not available during changeover?
Complete the changeover and obtain the Officer’s signature before the end of the shift.
32
Who notifies the ambulance company when returning the reserve ambulance?
The Equipment/Safety Manager or their designee.
33
What must be completed when an ambulance returns to its home company?
RFD Form 501 and Form #579 must be completed, along with RFD 504 for the entire vehicle inventory.
34
What happens if tags on the drawers of the reserve ambulance are intact?
No need to re-inventory the drawers.
35
What is the minimum passing score required for the IDPH Basic Medical Technician State Test?
70%
36
How many hours of continuing education are required to maintain EMT-B certification?
60 hours
37
What form number is used for Paramedics Students to challenge the State Test?
Department form #653
38
How many hours of continuing education must Paramedics document to maintain certification?
100 hours
39
What is the inventory number for ALS fire companies?
#511
40
What is the responsibility of the Medical Branch Director?
Overall charge of the Medical Branch
## Footnote
Reports to IC or Operations Sections Chief.
41
Who does the Triage Division Supervisor report to?
Medical Branch Director
42
What are the responsibilities of the Transportation Division Supervisor?
* Request personnel for stretcher-bearers
* Prompt loading and transport of patients
* Record patient transport details
* Maintain radio silence unless patient condition deteriorates
43
What is the role of the EMS Staging Manager?
* Communicate with Triage Division Supervisor
* Ensure medical personnel report to Triage Division Supervisor
* Stage ambulances for prompt loading
44
What should Triage Personnel assess?
Each patient’s condition using trauma scores.
45
What is the primary responsibility of Stretcher-Bearers?
Prompt removal of patients starting with red-tagged patients.
46
What constitutes a Medical Team?
* At least one ED doctor
* One RN with TNS and MICU training
47
What is the purpose of the Ryan White Comprehensive AIDS Resource Emergency Act of 1990?
Ensures notification of emergency response personnel within 48 hours of a communicable disease diagnosis.
48
What is the procedure if an employee declines the Hep B vaccination?
They must sign the Hep B Vaccine Declination.
49
How often must the NIOSH approved N-95 be fit tested?
Annually
50
What form number is used for exposures?
RFD 136
51
What happens to clothing contaminated with potential protective material?
Placed in a biohazard bag for laundry.
52
What distance should personnel maintain from the landing zone of an aircraft?
100 feet
53
What should be used to mark the landing zone?
Weighted construction cones or chem-light sticks
## Footnote
Barrier tape and tarps should not be used.
54
What is the landing zone area size for the aircraft?
100 feet wide and 100 feet long
55
What should personnel do when approaching an aircraft?
Remain in the pilot's normal vision and approach from the aircraft side.
56
What are the colors of the EMS Disaster Vests?
* Medical Branch Director: Green/white
* Triage Division Supervisor: Green/red
* Transportation Division Supervisor: Green/yellow
* Paramedics: Green armbands
* EMTs: Red armbands
57
What is the maximum landing slope for a landing zone?
10 degrees
58
What are the two ways to report an exposure incident?
From the staff at the receiving hospital, and through the patient or patient’s family.
59
What reports must be filled out after an exposure incident?
* Report of Injuries and Exposure-Form #98A
* Employees First Report of Injury/Illness form #98B
* Authorization for Medical Records and Communication Form #574
* Firehouse Casualty Report-Firehouse NIFR 33
* PMA Workmen’s Comp Procedures.
60
What information is included in the exposure report?
Details being performed, means of transmission, portal of entry, type of personal protection used.
61
Who is responsible for infection control retraining or management counseling?
The Infection Control Officer.
62
What precautions should employees take before exposure?
* Cover any cuts or lesions
* Avoid contact with patients if having unprotected weeping lesions or dermatitis
* Use bandages to maintain skin integrity.
63
What type of gloves are used for patient care?
Nitrile gloves.
64
What are mid-weight rubber gloves used for?
Non-patient care activities, such as handling contaminated equipment and cleaning the vehicle.
65
What type of respirator is used for TB protection?
N-95 TB respirator.
66
What are the signs and symptoms of TB?
* Productive cough (over 3 weeks)
* Fever
* Chills
* Night sweats
* Fatigue
* Loss of appetite
* Weight loss
* Hemoptysis.
67
Who is at high risk for TB?
* Persons with HIV
* Close contacts of infectious TB cases
* Persons with medical conditions increasing TB risk
* Foreign born individuals from high prevalence countries
* Low income populations
* Alcoholics or IV drug users
* Individuals undergoing invasive procedures.
68
When did the increase of TB in the US occur?
Late 1980s and early 1990s.
69
What were the causes for the increase of TB in the US?
* Poverty
* Crowded housing
* Lack of access to healthcare
* Immigration from high-risk countries
* Co-infection with HIV.
70
What steps should be taken with body fluids found at the scene?
Wipe up or flush into a sewage drain and reduce accidental exposure to the public.
71
How should contaminated materials be handled?
Collect and bring to the receiving hospital for disposal.
72
How should a needle be recapped safely?
Using either a one-hand method or a mechanical device.
73
What cleaning solution is used for spilled blood and body fluids?
An EPA approved germicide while wearing rubber gloves.
74
What should an employee do if intentionally exposed to dangerous conditions?
They may restrain the patient if necessary.
75
What constitutes a significant exposure to body fluids?
Exposure of body fluids entering the body through mouth, nose, mucous membranes, or breaks in the skin.
76
What information is confidential regarding patient testing results?
Results of source individual’s testing will be confidential and only released as required by law.
77
What are the three levels of patient care equipment?
* Non-Critical: e.g., stethoscopes (requires cleaning)
* Semi-Critical: e.g., stretchers (requires disinfection)
* Critical: e.g., resuscitation equipment (requires sterilization or high-level disinfection).
78
What is the definition of cleaning?
Physical removal of dirt and debris using soap and water.
79
What is the definition of disinfection?
Reducing disease-producing organisms by physical or chemical means.
80
What does the EAP assist with?
Substance abuse, stress, or personal problems affecting job performance.
81
Do EAP records become part of the personnel file?
No, confidentiality must be maintained.
82
Are employees with communicable diseases allowed to provide patient care?
No, consultation with a private physician is required.
83
When is training provided to employees with occupational exposure risks?
Within 90 days of initial assignment and at least annually thereafter.
84
How long will training records be maintained?
3 years.
85
How long will exposure records be maintained?
Length of employment plus 30 years.
86
What is the definition of a Bariatric Patient?
Any person that challenges the ability of EMS providers to safely move them due to their weight or size.
87
What is the maximum weight capacity of the cots used by the RFD?
700 lbs in the raised position and 1000 lbs in the lowered position.
88
What is the maximum weight capacity of the cots used by the RFD in the raised position?
700 lbs.
89
What is the maximum weight capacity of the cots used by the RFD in the lowered position?
1000 lbs.
90
What should the CO do if a crew encounters a bariatric patient?
Contact the Alarm Office and request a ladder company to respond for a bariatric procedure.
91
What equipment does the ladder assemble for a bariatric procedure?
* Winch with power cord
* Remote cord
* Two 4-foot loop straps
* Two 6-foot loop straps
* Four ¼ inch cotter-less hitch pins
* Hitch pen keeper
* Direction sheet
* Two ramps
92
Where do the two short straps go when loading a bariatric patient?
On the bar between two swivel wheels touching the ground at the head position of the cot.
93
What is the procedure for placing the ramps during a bariatric procedure?
The ramps are placed at the rear of the ambulance and pinned in all four holes at the base of the doors.
94
What should be done if there is a failure of the winch during a bariatric procedure?
A replacement shall be dispatched, or manual means shall be used.
95
What should be documented when a bariatric patient has been transported?
Document the use of extra manpower for transport and the use of bariatric equipment in the NFIRS report.
96
What forms reflect the proper inventory of medication for controlled substances?
#504 (Ambulance Inventory) and #511 (ALS Non-Transport Vehicle Inventory).
97
Is it acceptable to maintain a surplus of controlled substances?
No surplus of controlled substances will be allowed to remain on the fire apparatus, ambulance, or in the fire station.
98
How are controlled substances stored?
All controlled substances will be kept secure in a tagged container that cannot be opened without showing signs of tampering.
99
Describe the Narcotics control tag.
A plastic breakaway tag that has an inscribed identification number and is red in color.
100
Who is responsible for supplying the Narcotics control tags to the companies?
Station 3, the EMS Equipment and Supply Station.
101
When is a visual inspection performed for the Narcotics on a fire apparatus?
At the start of the shift with verification of the tag number, drug name, and integrity of the container and narcotic tag.
102
What is the procedure if there is a discrepancy in the recorded numbers of controlled substances?
Identify immediately and bring to the attention of the CO.
103
What should be done if a fire apparatus has leftover controlled substances?
The medication should be given to the Senior Paramedic on the ambulance.
104
What is the procedure for exchanging medications on a fire apparatus?
All fire apparatus companies will exchange medications 3 months prior to their expiration date with any ambulance company.
105
What should be done if the Non-Ambulance company has expired medications?
The CO must contact the EMS TC to exchange such medication.
106
What is the procedure for exchanging medications on the ambulance?
All ambulances will exchange medications one month prior to expiration.
107
How can we assist the Private Ambulance with medical care?
We can assist with care as needed, but NO MEMBER OF THE RFD SHALL DRIVE ANY AMBULANCE NOT OWNED BY RFD OR the City of Rockford.
108
What are some examples of unusual circumstances with a private ambulance?
* Patient care issues
* Extended response times
* Equipment issues
* Personnel issues
* Other significant events
109
What should emergency responders anticipate all patients may have?
Concealed weapons.
110
What should emergency responders do if they encounter a weapon?
Law Enforcement SHOULD ALWAYS BE CALLED to secure the scene and disarm ALL ARMED INDIVIDUALS.
111
What is the procedure for a conscious patient willing to relinquish a weapon?
Ask the patient to secure the weapon in a secure location at home or in their vehicle.
112
What should be done if a patient is unwilling to relinquish a weapon?
Request law enforcement to assist with the situation.
113
What should responders do if a weapon is found on a patient with altered levels of consciousness?
Request law enforcement immediately to assist disarming these patients.
114
What should emergency responders do when a weapon is discovered during a hands-on assessment?
Follow the established procedures for securing the weapon.
115
What should be done if a patient is conscious and has a weapon?
Request law enforcement immediately to assist in disarming the patient.
## Footnote
If a weapon is removed by a law enforcement officer, they will maintain possession of the weapon.
116
What steps should be taken if a patient is unconscious and requires emergent care?
Carefully separate the weapon from the patient prior to transport.
## Footnote
A firearm should be removed from the patient while still in the holster, when possible.
117
What is permissible when removing a weapon from a patient?
Cut the holster straps to remove the weapon if necessary.
## Footnote
If it jeopardizes safety to remove the weapon and holster together, the weapon may be removed without the holster.
118
What are the steps for removing a weapon if it has to be removed from the holster? (List 5 steps)
* Handle all weapons carefully.
* Place the weapon in the holster into the Weapon Box.
* Secure the Weapon Box with a security seal.
* Conduct a thorough secondary exam for a secondary weapon.
* If additional weapons are found, repeat the process.
119
How should the hospital be notified about a weapon being transported?
Information must be conveyed via a MERCI transmission or cellular phone contact.
## Footnote
It is up to each hospital's internal policies on how the weapon(s) will be handled after transfer.
120
Under what circumstances can emergency personnel turn over a weapon to a family member?
Under NO CIRCUMSTANCES shall a weapon be turned over to any bystander, family member, or acquaintance.
## Footnote
Law enforcement should be requested if a patient attempts to turn over their weapon.
121
What documentation must be completed regarding the chain-of-possession of a weapon?
The Officer in charge and the ambulance crew will document the chain-of-possession in their NFIRS and EMS patient care report.
## Footnote
Additional documentation must record who took possession of the weapon.
122
What must be done to the Weapons Container after inspection?
Seal the Weapons Container with a numbered red tag after visual inspection by hospital security.
## Footnote
Appropriate paperwork must be completed, including the red tag number.
123
What is the procedure if used medical waste is left at a scene?
* Notify the District Chief immediately.
* If the complaint is valid, request an incident number for a NFIRS report.
* Photograph the findings at the scene.
* Make the scene safe and request additional resources if needed.
124
What happens if both District Chiefs are unavailable for immediate response?
The EMS TC will be dispatched, and if unavailable, the Division Chief of Operations.
125
What is the procedure if a private ambulance is responsible for used equipment left at the scene?
The District Chief will respond to make the scene safe, and the Division Chief of Operations will be notified.
## Footnote
This ensures the appropriate private ambulance company is informed.
126
When must all ambulance doors be locked?
When the vehicle is unattended, including both emergency and non-emergency situations.
127
What must be done with the keys if the ambulance is left running?
Activate the ignition safety switch and remove the keys.
128
How are controlled substances secured on the ambulance?
Controlled substances are maintained in the Knox Med Vault.
## Footnote
If the Knox Med Vault cannot be used, they must be secured in a locked drawer.
129
How are non-controlled substance medications secured on the ambulance?
They are secured in a locked medication drawer, excluding IV bags and sterile water.
