Emergency Medical Services (Notes)



Oklahoma City Fire-Rescue

Emergency Medical Services

(Updated through 1/15/03)

TRG/002   FIRST RESPONDER AGENCY

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

TRG/003   EMS EDUCATION SCHEDULE

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

TRG/004   EMS 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 |

|EMT-D (Defibrillator) |AED certification from 8 hour AED course |

| |Licensed as EMT-Basic |

| |Minimum of 2 hours continuing education per calendar quarter |

TRG/005   LAPSED 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.

TRG/006   EMS 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 |Certified for period of 1 year |State EMT license |

|Instructor |Must maintain CPR Instructor/EMT, attend OCFD |CPR Instructor |

| |Instructor update seminar annually, and accept |OSU-FST Instructor I or II, or equivalent |

| |teaching assignments |Active EMT for 1 year |

| | |Complete OCFD EMS Instructor course |

|EMT-Paramedic |Certified to teach Advanced EMS Refreshers, |State EMT-Paramedic license |

|Instructor |Advanced Continuing Education, ACLS, and any |CPR Instructor |

| |EMT-B courses |OSU-FST Instructor I or II, or equivalent |

| |Certified for period of 1 year |Active EMT-Paramedic for 1 year |

| |Must maintain CPR Instructor/EMT-P/ACLS, attend |Complete OCFD EMS Instructor course |

| |OCFD Instructor update seminar annually, and |Current ACLS status |

| |accept teaching assignments | |

▪ Each course taught will have a Primary instructor responsible for completion of course roster, documentation.

▪ Practical skills assistants can assist with lectures but are mostly used for practical skills evaluation.

▪ The EMS Coordinator 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 (agreement says 75 basic and 30 Paramedic instructors max).

OPS/001   FIRST 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/002   FIRST 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/003   MEDICAL 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/005   EMSA - 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/006   RESPONSE 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/007   SCENE 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/008   TRANSFER 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/009   PREHOSPITAL 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/010   CPR 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/012   EQUIPMENT 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/013   EQUIPMENT EXCHANGE PROCEDURES

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

|Equipment that may |Backboards (with straps & head stabilization devices) |

|be exchanged at | |

|the scene with EMSA | |

| |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) |

OPS/014   OXYGEN EQUIPMENT PROCEDURES

▪ Oxygen does not burn, but does support combustion.

▪ Metal in oxygen regulators or cylinders may burn under high pressure oxygen.

▪ The post valve and regulator inlet should be inspected prior to installation.

▪ The regulator pressure gauge should not be looked at until the valve is fully open.

▪ The post valve gasket is replaced every time an oxygen bottle is refilled.

▪ A bag of 20 Post Valve Gaskets will be carried in all medical kits on every apparatus.

▪ After refilling, the post valve should be cracked to remove any debris.

▪ Spare bottles should have a 3 inch green plastic sleeve cap covering post valves.

▪ Hydrostatic testing (every 5 years) of oxygen cylinders began in the year 2000.

|Hydrostatic Testing of Oxygen Cylinders |

|Cylinder color code |Years to test |

|RED |2000/2005 |

|BLUE |2001/2006 |

|YELLOW |2002/2007 |

|WHITE |2003/2008 |

|BROWN |2004/2009 |

▪ Open cylinder valves slowly to minimize heat produced.

▪ Do not allow post valves to come in contact with combustible substances (oil, greases, lubricants, etc.)

▪ Any repairs of oxygen equipment must be performed by the maintenance shop.

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