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Penn State Emergency Medical Services Penn State EMS Standard Operating Procedures and Constitution University Ambulance Service Centre County Company 20 Procedures Manual
TRAINEE MANUAL THE PENNSYLVANIA STATE UNIVERSITY UNIVERSITY AMBULANCE SERVICE University Ambulance Service (UAS) is currently a BLS service which provides primary services to the University Park campus. It has a full crew of paid EMT's and Paramedics. When requested UAS also provides coverage for the surrounding communities. Coverage is provided 24 hours a day, seven days a week. Weekdays between 8:00am and 4:00pm a full-time staff is on call, and between 4:00pm and 8:00am a part-time staff is on call. All part-time staff are University students. In addition to ambulance emergencies, the Universities Office of Emergency Medical Services (OEMS) provides coverage for special events at University Park. In conjunction with the department of University Safety on-site coverage is provided for events such as football games special olympics, arts festival, agricultural progress day, and a host of other Penn State events. INTRODUCTION The University Ambulance Service orientation program was designed to provide new volunteers with a comprehensive guidebook for providing emergency services at Penn State. This handbook is not intended to be a rulebook for every situation you may encounter, but is a general statement of operations and objectives to serve as a basis for involvement with UAS. It is hoped that this manual will serve as an effective tool to introduce EMS providers to this particular EMS system. This orientation manual will cover a wide variety of duties, roles, and responsibilities of the UAS crew member. It is important that trainees fully understand what is expected of them. If any part of this manual is unclear or objectionable, feel free to discuss your concerns with the OEMS staff. Most importantly, do not let any questions remain unanswered. In keeping with the standards of a professional EMS organization, trainees should be thoroughly familiar with the contents of this manual before riding on the ambulance. UNIFORMS All Personnel must wear the proper uniform when representing University Ambulance Service and the office of EMS. The standard uniform is a dark blue pair of work or uniform-type pants and a white uniform shirt (long or short sleeved). Uniform shirts must display the following: 1. Patch for the highest level of certification (AFA,EMT,EMT-P) on the left shoulder. All appropriate rockers may also be displayed. 2. University Ambulance Service patch on the right sleeve. ** Patches should be sewn on 2" below the shoulder seam. 3. One pair of collar pin insignia (optional). The office of OEMS reserves the right to deny the display of anything they feel is inappropriate. 4. Name tag over right pocket (optional). Footwear must fit into one of the following types (black or brown only): 1. Work boots with ankle support 2. Hiking boots with ankle support 3. Military-type boots 4. Black uniform shoes/boots **Although it is not required, footwear with steel-toed support is desirable. The following communications equipment must be worn with your uniform: 1. Motorola HT2000 Flashport 800MHz portable (designated for trainee). 2. Motorola Pagecom pager or Minitor II if available. ** See attached instructions for 800MHz Portables. The use of hip holsters designed to carry personal medical equipment, such as, trauma shears, scissors, gloves, exam light, etc. may be used at your discretion. With the uniform guidelines in mind, all trainees must present themselves appropriately for their shifts at UAS. The crew has the discretion to ask a trainee to fix their appearance if they are not properly prepared to run their shift. THE TRAINEE PROGRAM The UAS trainee serves in a volunteer capacity. Trainees are not employed by the OEMS, but they are part of the crew they ride with. The trainee has varying responsibilities while on calls. As employees of the University, crew members are responsible for all ambulance calls including, but not limited to, trainees and equipment. The degree of involvement and use of equipment on the trainees part is under the discretion of the crew at all times.
Trainees run on a rotational schedule. This schedule is designed around the availability of the trainees on a semester basis. However, being scheduled to run as a trainee should not be treated as a non-mandatory, voluntary performance. Enthusiasm and dedication of the trainee is noticed by the staff and will be reflected in recommendations for regular employment. Furthermore, missing a shift as a trainee is wasting valuable experience that could be gained by someone else. Therefore, trainees should treat their involvement as a job, and obtain suitable coverage in the event they cannot work a shift. If a trainee displays continued neglect of his/her responsibilities, the OEMS may reevaluate the trainees status on the schedule. Again, scheduling difficulties should be brought to the attention of one of the supervisors, and every effort will be made to accommodate acceptable scheduling for all trainees. Since trainees are volunteers at UAS they are not obligated to take part in the shift responsibilities of the crew. It is however encouraged that all trainees interact with the crews responsibilities, such as sec check, crutches, rig check, etc. The more interaction a trainee has with the crew the more familiar that trainee will become with crew responsibilities. ** If you choose to leave the UAS trainee program, it is requested that you notify the Trainee Supervisor verbally. DAYTIME TRAINEES Daytime trainees are those who run on a sign up basis Monday thru Friday between 8am and 4pm. These trainees have the same responsibilities as night time trainees except they are not put on a predetermined schedule. The daytime trainees have a schedule in the duty room which they may sign up to run on one week prior to the shift(s) they want. During the shift the trainee must have a crew member sign them off on the shift list so they can receive credit for their time. ** All trainees must give a copy of current certifications, CPR cards, and Drivers license to the assistant training officer before running on the ambulance. DUTY ROOM The duty room is available for use by all crew members. Trainees are always welcome, but should remember that they are guests in the duty room. The duty crew is responsible for the duty room during their shift. Two futons are automatically reserved for the duty crew, and the third is for the trainee. Since the duty room is limited in space all members need to be considerate of the duty crew during off hours. RADIO COMMUNICATIONS There are a few key aspects in the area of communications with which UAS personnel must be familiar with. UAS is subject to two different sources of radio and dispatch traffic. The most common origin of our calls is the Centre County Emergency Operations Center (CCEOC), which dispatches UAS (Company 20) via UHF Med pagers. UAS is dispatched according to three classifications: - Ambulance Emergency: Denotes a situation which is serious or possibly life threatening. The ambulance must respond with flashing lights/strobes and audible warning signals to the scene. - Ambulance Immediate: Denotes an urgent, but not an emergency situation. In this case the ambulance must respond without delay. Lights and sirens should not be used. - Routine Transfer This type of situation does not require any immediate action, unless the ambulance is already available. Generally used in cases of a Ritenour-toCentre Community transfer. ln all response situations the CCEOC must be informed of the status of the ambulance. When communicating with Centre County plain english should be used. - When Acknowledging a Call/Initiating a Response: Example: 20-51: Centre CountY 20-51 CCEOC: 20-51 20-51: 20-51 is responding Med Patches When transporting to Centre Community Hospital, patient information must be transmitted to the Emergency Department. This is accomplished by the use of a Med Patch through the CCEOC. To obtain a patch it must be requesting by using the following format: 20-51: Centre County, 20-51 CCEOC: 20-51 20-51: 20-51 is requesting a patch to Centre Community for abdominal pain. (Always state the chief complaint). CCEOC: Okay, Go to Med 7 and standby. (The Med channel assigned can change at times). CCEOC: 20-51, your patch is up, go ahead. Note: At this point you are now addressing Centre Community Hospital, not Centre County. 20-51: At this point you will go ahead with your patch. Note: The new Med system is voice activated. This means that before you begin your patch you should say the word "Ok" to open the patch, then begin. When the patch is complete you need to contact Centre County and advise them that the patch is complete. They will then tell you to return to Med 9. If at any point the patients condition changes you can request the patch to be re-enabled to advise the hospital. Communications With the Paramedic unit If there is a need on a call to talk directly with the Medic unit the crew must first attempt to use the MED 9 talk around frequency. If they are unable to reach the Medic unit, then they must call Centre County and ask them to put up the Repeater. When the repeater in no longer needed Centre County must be told to take down the Repeater. Responding To a File Call Fire calls are dispatched on a different frequency than medical calls. When responding and communicating on a fire call, the fire channel must be used. Channel 4 on the University radio in the rig is the only place this channel can be utilized. If at any time during the call the rig has to transport a patient they no longer use the fire channel. They now go back and use Med 9. UNIVERSITY COMMUNICATIONS When responding and communicating on calls, in addition to talking to Centre County, we also need to talk to the University. This can be achieved by using the 800MHz portables carried by the crew. When talking to the University Ten Codes are to be used (They can be found in the back of this manual). The University must be notified of all actions of the ambulance while on a call. If the rig is dispatched by Centre County, then the University must be notified. Likewise, if the University dispatches the ambulance on a call, then Centre County must be notified. Note: It is expected that there might be some confusion on the radio system. There will be a meeting which will explain the system in detail. TRAINEE EVALUATIONS After every shift an evaluation must be filled out on the trainee. These forms can be found in the duty room. The skill sheets in the back of this manual must also be filled out appropriately. It is the trainee's responsibility to make sure the proper paper work is completed. If these evaluations and skill sheets are not kept up to date, it may effect the hiring process. ** The evaluations MUST be filled out by the Crew first and then the trainee. If there are no calls on a shift an evaluation must be filled out regardless. There is also a section on the skill sheets that is for training done in station. All training done in station must be marked off on the skill sheets. This training must also be noted on the evaluation. ** All completed evaluations must go in the Trainee supervisors box, and will then be filed accordingly. BEING HIRED WHAT WE LOOK FOR The purpose of this section is to give trainees an idea of what the Crew is looking for when considering moving people from trainee status to Crew. Qualification/Certification: University Ambulance only employees EMT's and Paramedics with current Pennsylvania State Certification. In addition, this service requires (to be on Crew): EVOC, Hazardous Materials, and AED regional training. You must have all of these or have made arrangements to get all of these before you can be moved to Crew status. Competency: The most important factor in being moved from trainee to Crew will be an individuals abilities in EMS. As a paid service, University Ambulance has a responsibility to the University to provide not only competent care on the ambulance, but at special events as well. Therefore, each trainee is considered by ALL Crew members before he/she is hired to insure that the Crew feel the trainee can perform as expected by the University. Time: How long you have been with University Ambulance is important in cases of people with equal abilities. We work under the assumption that the longer you have been here, the more you will learn in regards to our system. Shift: How often you run is the best way for us to gauge your EMS experience. This not only means showing up for your scheduled shifts, but making an effort to run extra shifts, attend UAS training and signing up for special events. Documented Outside Experience: Both in local services and through services that you may have worked for before coming here. This experience will be looked at on an individual basis and is only important in specific cases. Requirements This section describes the qualifications required for being moved from trainee status to Crew. I) Run for at least 1 semester. 2) Have a 'significant' number of evaluations filled out by the Crew. 3) Have demonstrated to the Crew an understanding of both patient care AND the operations of UAS including, but not limited to Crew responsibilities, UHS duties, radio operations, maintenance. and driving. 4) Must run at least one shift with (or be checked out by) EITHER the Trainee Supervisor or the Training Supervisor. This is to insure that there is at least one constant in all evaluations when comparing one trainee to another. 5) Be recommended by the consensus of the Crew. 6) Be approved by Wes Cartwright EMS Supervisor. IMPORTANT: This is a policy we are instituting to try to make advancement through UAS more uniform. Please remember that this is only a guideline and the EMS Supervisor can alter or remove any or all requirements as he sees fit. EMPLOYEE DISCIPLINE Employees are expected to act in a professional manner at all times. Your uniform represents the entire University, as well as the Office of EMS. If any UAS member acts in an unprofessional manner, or one inconsistent with the goals or operations of this service, the matter will be investigated by the supervisory staff. The EMS supervisor has the option of verbal reprimand, written reprimand, suspension, or dismissal of any UAS member. In more serious matters, no second chances will be given. All actions will be noted in the employee's personnel file. I have read and I understand all that is contained in the attached document; This being the UAS Orientation Guide. I will abide by all the rules set forth in said document and understand that any failure to do so may result in any of the following punitive actions; Verbal warning, written waning, suspension, demotion and termination of employment. The actions of suspension, demotion and termination require a review board which will consist of the Director of EMS, EMS Supervisor, and the UAS Crew Supervisor. The personnel file will be reviewed as will all evidence and testimony pertinent to the situation before a final decision will be made. Witnessed Trainee Supervisor Signed Trainee --------------------------------------------------------------------------UNIVERSITY HEALTH SERVICES STATEMENT OF CONFIDENTIALITY In the performance of your duties and responsibilities at University Health Services, you are expected to maintain and protect the confidentiality of patient information. Confidential patient information may be released only with the patient's written authorization, by court order or as otherwise mandated by law. Confidential Patient Information includes but is not limited to: 1. Patient Name and other information obtained upon admission or registration at medical records, outpatient department, observation unit and urgent care clinic; 2. All case discussions, diagnoses, consultations, examinations, and treatments;
3. All forms of patient records and copies of orders;
and
4. All information about the disposition or personal characteristics of patients.
Any breach of your duty to maintain and protect the confidentiality of patient information, including the unauthorized release of confidential information to third parties, may subject you to disciplinary action including dismissal. I acknowledge receipt of the University Health Services' "Statement of Confidentiality." Signature Date Name (please print) Witness
Date
--------------------------------------------------------------------------Motorola MTS 2000 Flashport Operation/Functions (SEE NEXT PAGE) 1. On/Off Volume Control 2. Channel Selector 3. Channel Bank Selector 4. Not in Use 5. Emergency Button Note: If you push this button you will hear an audible tone. It will also alert the University that you are in trouble. If it is a false alarm call the University with the radio and tell them "false emergency button activation, resetting. Then push and hold down the orange button until you hear a tone approx. 2-3 seconds. The radio should now be reset. 6. Light 7. Scan On/Off 8. Private call receive 9. Talk How To Private Call Press one of the buttons to bring up the menu. Press (.) to select the CALL feature. Use the buttons to select the person you want to call. Push the talk button to initiate the call. Press HOME to clear and return to regular function. How to Receive a private call When you hear the call tone press button 8 (Diagram Next Page) and key the talk button to open the call. When you are done press HOME to clear the call. Muting the Audio Press For Menu Press (.) to select mute Press the button under selection for on/off --------------------------------------------------------------------------Trainee Skill Sheets Vital Signs In Station In Station On Call On Call Patient Assessment In Station In Station On Call On Call Radio Reports In Station In Station On Call On Call Lifting and Moving Litter Reeves Scoop Stair Chair Long Board Short Board KED Other: Splinting C-Collar Long Board C I D Upper Extremity Clavicle Humerus Lower Arm Hand Elbow Hip Femur (Hare/Traction) Knee Lower Leg Ankle and Foot Bandaging Head Eye Face Neck Shoulder Arm Chest Abdomen Genitalia Legs Burns 02 Administration and Airway Management Changing Rig 02 Changing Port. 02 Nasal Cannula Simple Face Mask Non Rebreather BVM with 02 Positive Pressure/Demand Oral Airway Nasal Airway Suction in Units Yankauer French Catheter Automatic Defibrillator Equipment and Vehicle Operations Rig Check Placement of All Equip. Use of Maps Restocking Rig Universal Precautions Proper Radio Use Fueling Rig Who To Call For Maintenance Operating Policies Driver Training Other: --------------------------------------------------------------------------UAS TEN CODES 10-1 Signal Weak 10-2 Signal Good 10-3 Stop Transmitting 10-4 Affirmative 10-6 Busy 10-7 Out of Service 10-8 In Service 10-9 Repeat 10-10 Negative 10-12 Stand-by 10-17 In Route 10-20 Location 10-21 Call by Phone 10-22 Disregard 10-23 Arrived on Scene 10-24 Assignment Complete 10-25 Report to/Meet with 10-26 Estimated Time of Arrival 10-42 On Station 10-45 Motor Vehicle Accident 10-97 Radio Check 10-99 Engage Take-over Switch
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