4Squad Assignments and Responsibilities for Full-time 8
5Call Response 9
6Final Call Responsibility 10
7Mutual Aid Transports 10
8Patient Follow-up 11
9Report Forms 11
10Responsibilities of the Officers and Committees 11
11Responsibilities of Chair People and Their Committees 12
12Medical Standbys 15
13Appendix 15
Bunn Rescue & EMS, Inc.
Standard OPERATING Guidelines
Purpose:
The purpose of these Standard Operating Guidelines, herein after referred to as SOG, is to give a guideline for all rescue members to conduct themselves while carrying out the duties of being a member of Bunn Rescue & EMS, Inc., hereinafter referred to as Bunn Rescue. It is the intent of these guidelines to follow procedures outlined by Franklin County Emergency Medical Services (FCEMS).
Scope:
The scope of this SOG applies to both full time and auxiliary members that want to be a member of Bunn Rescue. This also replaces any other Bunn Rescue in house SOG, formally referred to as SOP.
Responsibility:
It is the responsibility of the Officers, Board of Directors, Squad Captains, and the General Membership to make sure all SOGs are carried out and fulfilled. It is also the responsibility of the Chief of Bunn Rescue and the Chairman of the Board of Directors of Bunn Rescue to see that these SOGs are reviewed at least every two (2) years. They shall also have the responsibility of appointing a committee of at least four (4), but no more than six (6), members of Bunn Rescue to complete said review.
1. Dress Code and Standards of Behavior
1.1. Dress Code
1.1.1. Members of Bunn Rescue should wear their uniform shirts, or appropriate clothing identifying them with Bunn Rescue when on a call, at special meetings, or fund raising/public events.
1.1.2. Uniform shirts should be white with the following patches located on it:
Bunn Rescue
Certification
Franklin County Association
1.2. Personal Appearance
1.2.1. Each member should be clean and neat in their appearance, particularly when representing the Bunn Rescue squad. No revealing clothing that may draw attention to any rescue member, should be worn while at or on a rescue call or event.
1.3. Conduct
1.3.1. All members while on duty, at a rescue meeting or function shall act in a respectable manner. Absolutely no unbecoming conduct will be tolerated. All members will respect and preserve all squad property.
1.4. Profanity
1.4.1. Profanity should not be used while on duty or while representing the rescue squad at any function. Each member is encouraged to conduct himself/herself with clarity and with the use of appropriate language, as is expected of ladies and gentlemen.
1.5. Alcohol
1.5.1. Any member that has been consuming alcohol shall not run, or respond to, a call on a squad vehicle or a personally owned vehicle. No member or guest shall be allowed onto Bunn Rescue property after, or while, consuming alcohol. Failure to comply with these rules will result in suspension.
1.6. Disciplinary Action
1.6.1. Any failure to follow these SOGs will be discussed in a meeting with the Chairman of the Board, the Chief, the Assistant Chief, and the Secretary. Disciplinary actions shall be proposed and carried out on an individual basis. These actions may include a verbal warning with a note in the member’s file, written warning, suspension of rescue duties and privileges, and/or others as deemed appropriate.
2. Radio Traffic and Communications
2.1. Telephones
2.1.1. The Bunn Rescue phone number is 919-496-5606. Any member that uses the phones for long distance calls should write the number they call down on the paper beside the phone. Phones with the above mentioned sheet for documentation include the phone in the kitchen and the office.
2.2. Radio Traffic and Related Procedures
2.2.1. Any and all members using the radios should follow the following rules:
All members should learn the basic 10 codes used in Franklin County-See item 2.3
Members should not be paged unless it is rescue related or it is an emergency
All members shall talk in a professional manner at all times on the radio. Any and all unnecessary radio traffic should be avoided
2.3. Basic Radio Procedures
2.3.1. The following is an example of the radio traffic used to answer a call:
When checking the truck in for a call state “Franklin County Unit Number is 10-8" Or “ in service”
When enough members are available and the truck is ready to respond state “Franklin County Unit Number is 10-17" Or “Enroute”
Upon arrival at the scene state “Franklin County Unit Number is 10-23" Or “On Scene”
When the patient is loaded and you are ready to go to the medical facility state “Franklin County Unit Number is 10-17 Or “Enroute” to Medical Facility Name running Code 1 (non-emergency) or Code 3 (emergency) whichever is appropriate
When the truck is ready to return to station state “Franklin County Unit Number is 10-17 or Enroute back to the station
When back at the station state “Franklin County Unit Number is 10-24 or Out at Station"
After arrival on scene, if the patient does not wish to be transported, state “Franklin County Unit Number is 10-17 or Enroute back to station, no transport”
3 Vehicle Operation and Maintenance
3.1 Riders in the Ambulance
3.1.1 One family member of the patient, at the discretion of the Bunn Rescue Officer In Charge, herein after referred to as OIC, or member in charge of the call, may ride in the front of the ambulance with the driver.
3.1.2 If the patient is a pediatric (or non English speaking) patient one family member may ride in the back with the patient, at the discretion of the OIC or member in charge of the call.
3.1.3 If the call is considered an emergency transport, it is discouraged to allow any family member to ride during transport. Again, this will be to the discretion of the OIC or rescue member in charge of the call.
3.2 Emergency Vehicle Response Operation
3.2.1 Prior to moving the vehicle, the emergency vehicle driver shall make a circle of safety around the vehicle to see that all equipment is secured, that all compartment doors are securely closed and any physical obstructions moved out of the way. During the circle of safety the emergency vehicle driver shall encircle the vehicles and visually inspect all 4 sides and the top of the vehicle before entering the cab. This shall be conducted prior to moving the vehicle regardless of whether or not the vehicle is about to leave on an emergency or non-emergency.
3.2.2 Speeds shall be reasonable and safe when driving the squad vehicle to any call. Traffic and weather conditions should be taken into consideration at all times. Squad vehicles should not be operated at more than 10 mph above the posted speed limit. All drivers shall attempt to maintain control of the vehicle that they are operating in such a manner as to provide the maximum level of safety for both their passengers and the general public. Emergency vehicle drivers should be aware that the civilian vehicle operators may not react in the manner in which is expected or felt to be appropriate. An attempt should be made to have options available when passing or overtaking vehicles. If another vehicle operator fails to yield the right of way to an emergency vehicle, the emergency vehicle driver can not force the right of way, nor can you assume the right of way, therefore you do not have the right of way until the other vehicle yields to you. The emergency vehicle driver shall be aware of his/her rate of closure on other vehicles and pedestrians at all times to make sure that a safe following distance is established and maintained. All drivers shall follow the rule for safe following distance and allow 2 seconds of following distance for speeds less than 40 mph and an additional second for each 10 mph for speeds over 40 mph.
3.2.3 No request for service will be answered Code 1 unless directed by Franklin County Dispatch or a full time active member of Bunn Rescue[SC1] .
3.2.4 Drivers shall take the most direct and safest route of travel to all calls and to the place of destination after picking up the patient.
3.2.5 Whenever a vehicle is parked at a scene it should be parked so that it is visible to all traffic, unless completely off the road, with the warning lights still on.
3.2.6 All visible warning lights will be used in conjunction with audible warning devices in all emergency (code 3) responses and transports.
3.3 Personally Owned Vehicles (POVs)
3.3.1 Members should adhere to the following items concerning their POVs:
Display a Bunn Rescue front bumper plate
Red light on dash, in grill, roof mounted, or a combination thereof
Flashing or alternating headlights will be restricted to the Chief and/or Assistant Chief
Sirens will be restricted to the Chief and/or Assistant Chief
If the call is canceled while enroute, red lights/flashing lights should be turned off
3.3.2 Any member responding to a call on their POV shall be aware of all traffic laws. In particular, realize that a POV is not an emergency vehicle and it is not permitted the same exemptions to vehicle traffic laws as such. The flashing red dash light is asking for right of way not demanding it. If any non-rescue individuals are in your POV you should respond in a non-emergency manner without warning lights. On call members should consider spending part of their shift at the building to minimize POV responses.
3.4 Squad Vehicles involved in Accidents
3.4.1 Any squad vehicle that has been involved in an accident should stay there until told to move by an Investigating Law Officer, if at all possible.
3.4.2 If the call can not be continued notify Franklin County Dispatch of the problem and request another unit to help complete the call. If needed, request a unit to the 10-50 that the ambulance was involved in if any rescue personnel need.
3.4.3 If the ambulance is 10-17 or Enroute to a medical facility notify Franklin County Dispatch of the problem. Inform the other vehicle’s owner involved in the 10-50 that you have a patient inside and that you need to continue the transport if the unit is able to travel. Inform the individual that you have contacted Franklin County Dispatch requesting a law official and that you will return.
3.4.4 If the ambulance cannot continue the transport contact Franklin County Dispatch and request another unit to complete the call.
3.4.5 Notify the Chief (or highest ranking officer available) as soon as possible.
3.5 Towing of Squad Vehicles
3.5.1 If there is a need to have a squad vehicle towed call one of the following wrecker services:
Howard Lee’s Body Shop - 269-9188
Bunn Exxon - 496-3984
3.5.2 Notify the Chief and/or Captain as soon as possible.
3.5.3 Upon returning to the building put the next truck that is in line on line.
3.6 Vehicle’s Equipment
3.6.1 All of the vehicles shall be checked out each Sunday by the on-call squad. They shall use the Weekly Checklist to check-off each vehicle..
3.6.2 Each Sunday a vehicle is to be decontaminated by the on-call squad. The vehicle to be done and the procedure to complete decontamination are located in the Decon Log Book.
3.6.3 After each call the vehicle should be restocked to the same standards as a Sunday. This includes the ambulances and the crash unit.
3.6.4 Make all efforts possible to pick-up any equipment that maybe at the hospital.
3.6.5 Any problems with any equipment or vehicles should be reported to the Captain as soon as possible.
3.7 Emergency Vehicle Drivers
3.7.1 All drivers of emergency vehicles shall be over 21 years of age. All new drivers shall drive in non-emergency situations without a patient on board, for a minimum of five hours while supervised by a squad officer. New drivers should be approved, before driving in emergency situations (lights & siren), by an officer. When possible, new drivers should complete and EVD course prior to driving in emergency situations. Non-emergency situations could include driving back from the hospital or training.
3.7.2 All new drivers are expected to take an EV driver class within one year of joining the squad. All new members will have a driver’s license (MVR) check. All members will annually sign a certification stating they have reported all moving violations, and any license restrictions to the Chief. (See Appendix)
4 Squad Assignments and Responsibilities for Full-time
4.1 Squad Assignments
4.1.1 The full-time members of Bunn Rescue are divided into four (4) squads with at least one (1) Paramedic per squad. The four (4) squads will be determined at the beginning of each fiscal year by the newly elected officers and will be changed as necessary during the year.
4.1.2 Each squad will have a Squad Captain to be in charge of the squad. The Squad Captain should be one of the elected officers.
4.2 Squad Rotation and Responsibility
4.2.1 Each squad will be on call every fourth (4) day/night. Monday through Friday call hours shall by 18:00 to 06:00 (6:00 pm - 6:00 am). Saturday and Sunday will be from 06:00 to 06:00 this will be 24hours (6:00 am - 6:00 am). Each member will be provided a copy of the squads’ rotation each month.
4.2.2 Sunday is considered the day for clean-up and vehicle check-off. The squad on call each Sunday is responsible for checking out each vehicle per the Weekly Checklist. The squad will also be responsible for checking all supplies. Additionally, the squad is responsible for cleaning the building and to decontaminate a specific vehicle. See item 3.6.1 and 3.6.2.
4.2.3 Any member that cannot be on call for any part of their squad call time should do the following:
Find a member of equal or higher training certification to fill in during your squad call time; or if unable to do so,
Find any current member (full-time or auxiliary) to fill in during your squad call time
Any member needing off should notify their Squad Captain of the change. The member filling in is then responsible for answering any calls, completing clean-up or other duties the squad will be responsible for while on-call. Squad Captains shall notify the Chief if their Squad will not be able to fulfill its requirements, for any time they are on call.
5 Call Response
5.1 Normal Rescue Call
5.1.1 Any time a vehicle from Bunn Rescue responds to a call, all personnel involved with the call shall make every effort to have a Paramedic on the vehicle. If a Paramedic cannot be on the vehicle then arrangements should be made to meet one on the scene or en-route after the patient has been picked up. These could include Bunn Rescue or FCEMS paramedics.
5.1.2 If the steps above were followed and the Paramedic was met enroute (or at the scene ) and the Paramedic does not feel Paramedic level care is needed, the vehicle may continue to the medical facility. This decision should be documented on the Patient Care Report, herein after referred to as Report, narrative along with the name of the Paramedic making this decision.
5.1.3 When the tones are set off for the first page, the on-call squad will report to the building or scene whichever is closer for the member, after ensuring at least one member is responding to the building.
5.1.4 When the tones are set off for the same call but second page or second call, everyone available should respond either to the scene or building whichever is appropriate.
5.1.5 Any two (2) members with radios should check 10-17 or Enroute to the building or scene with Franklin County Dispatch. Anyone who is a Paramedic should respond to Franklin County Dispatch as such (i.e. Paramedic rescue number is 10-17 or Enroute to the building/scene).
5.1.6 On 10-18 or 10-33 calls any available members should respond. The first three (3) qualified members should respond in the rescue vehicle and all other responding members should respond to the scene unless a second rescue vehicle is needed. This may be modified based on updated information such as members enroute, or equipment required on scene.
5.1.7 If the rescue vehicle has been exposed to body fluids or any equipment has been exposed it is the responsibility of the members having run the call to decontaminate the vehicle. This decontamination process should be the same as that for a Sunday decontamination.
5.1.8 Any and all patient care is to be carried out per the Franklin County Medical Protocols.
5.2.1 When the tones are set off for the first page everyone available should respond.
5.2.2 The crash unit should respond when the first two (2) qualified members arrive (unless advised that the crash unit will not be needed).
5.2.3 The rescue vehicle should respond when three (3) qualified members arrive (this should include at least one (1) Paramedic).
5.2.4 Members that respond for any type of call in any Bunn Rescue Emergency Response Vehicle are required to stay with that vehicle unless instructed by an OIC or rescue member in charge of patient care.
5.2.5 If command has not been established then the first officer/member with a radio should assume command and advise Franklin County Dispatch of such. Once established, command will be maintained until transferred to another person.
6 Final Call Responsibility
6.1 The OIC, will assume the final responsibility for the call, subject to Section 6.2.
6.2 The responder with the highest certification level has the final responsibility for patient care. This may be a Bunn Rescue member or a FCEMS employee.
6.3 Any questions or comments regarding procedure or treatment will be reserved for discussion after the call is complete. NO discussions in reference to a call or a patient will be allowed in PUBLIC at any time.
6.4 All responses to the Media shall be from the Chief or in his/her absence the Assistant Chief.
7 Mutual Aid Transports
7.1 Any request for mutual aid transports may be answered by anyone except the on-call duty crew when possible.
8 Patient Follow-up
8.1 Members are not to get personally involved with the patient’s condition or treatment once the patient is released from the Medical Facility or the Doctors care.
8.2 No member shall discuss a patient’s condition or treatment with patient’s family or friends.
8.3 Any response to an emergency call may result in some type of legal action on the part of the patient and Bunn Rescue must therefore, remain in a neutral position.
8.4 Time will be allocated during regular business meetings & in house training sessions to discuss any calls that a member desires to discuss. The intent of these discussions is to analyze patient care & response, discuss unusual events and implement a lessons learned analysis.
9 Report Forms
9.1 Bunn Rescue will follow the Procedures set by Franklin County with respect to Patient Care Reports. These reports are legal documents and part of the patient’s hospital records. They will not be given to any individual without written request to Franklin County EMS. This request must come directly from the patient’s legal services.
9.2 Every Report should be filled out completely and wholly. The use of the narrative section is strongly encouraged. The report shall be as complete and accurate as possible.
9.3 All reports should be completed on laptops when possible. The report should be uploaded to the server as soon as possible after first making a copy for the hospital. All orders by a physician must be documented in the narrative.
9.4 A copy of the report should be left with the hospital or faxed back to the receiving facility when completed.
9.5 If the patient refuses transport, a report should be completed and the appropriate signatures should be obtained. Whenever there is patient contact, a report should be completed. All refusals should follow a standard procedure or checklist, ensuring the patient is aware of his rights and responsibilities. See Appendix for sample checklist.
10 Responsibilities of the Officers and Committees
10.1 The following responsibilities are in addition to the ones listed in the By-Laws. The Officer with the responsibility can delegate to any willing members the job to be done. But the Officer doing the delegating still has the final responsibility to see the job is done correctly and on time.
10.2 Chief
All responsibilities are outlined in the By-Laws.
10.3 Assistant Chief
He/She shall be responsible for maintaining all insurance policies. This individual will work with the Captain, Secretary, and Treasurer to complete this task.
He/She shall be responsible for keeping a list of all pagers and radios that are the possession of Bunn Rescue, such list is to be updated annually. He/She shall be responsible for all repairs of pagers and radios that are the possession of Bunn Rescue.
He/She shall be responsible for the issuing of all pagers as needed.
All other responsibilities are outline in the By-Laws.
10.4 Captain
All responsibilities are outlined in the By-Laws.
10.5 Lieutenant - Rescue
Currently combined with Lieutenant – EMS.
10.6 Lieutenant - EMS
He/She shall be responsible for the ordering and issuing of all rescue clothing (i.e. dress uniforms, jump suits, coats, etc.) that any members, new or existing, may be in need of.
He/She shall be responsible for the ordering and issuing of all rescue patches required.
He/She shall be responsible for filling the drink machine.
All other responsibilities are outlined in the By-Laws.
He/She shall be responsible for ordering and maintaining supplies.
10.7 Secretary
He/She shall be responsible for the maintenance of all Reports and Narratives. This individual will be responsible for all reports required by the State and any other official office regarding said Report and Narratives. This individual shall not be responsible for the accuracy of these reports, but only, that records are maintained.
All other responsibilities are outlined in the By-Laws.
10.8 Treasurer
All responsibilities are outlined in the By-Laws.
11 Responsibilities of Chair People and Their Committees
11.1 Committees may be activated or deactivated on an as required basis.
11.2 Membership Committee
11.2.1 Responsible for interviewing and reviewing By-laws, Call Policy, SOG, etc. with prospective members. Responsible for reporting to Squad the recommendation/non-recommendation for membership to Bunn Rescue & EMS the prospective member.
11.3 Training Committee
11.3.1 Responsible for preparation & organization of training programs, drill elements of Rescue Service, the use of equipment, first aid & all training records.
11.4 Call Report Committee
11.4.1 Responsible for maintenance of REPORT Forms.
11.5 Building and Grounds Committee
11.5.1 Responsible for maintenance of Bunn Rescue & EMS building and surrounding grounds.
11.6 Equipment Committee
11.6.1 Responsible for maintenance of all equipment owned by Bunn Rescue & EMS.
11.7 Mail Campaign Committee
11.7.1 Responsible for preparation & organization of yearly mail campaign.
11.8 Social Committee
11.8.1 Responsible for preparation & organization of Association meetings held at Bunn Rescue & EMS, Squad Christmas party and any other social functions.
11.9 Budget Committee
11.9.1 Responsible for preparation & organization of yearly budget.
11.10 Nominating Committee
11.10.1 Responsible for voting new members, officers, etc.
11.11 Disaster Committee
11.11.1 Responsible for preparation & organization of all members in cases of disaster.
11.12 First Responder Committee
11.12.1 Responsible for overseeing First Responders, all training records, etc.
11.13 County Audit & Review
11.14 County Disaster Planning
11.14.1 Responsible for meeting with EMS Planner & reporting to Squad. All plans to be carried out, in the event of a disaster, by the Disaster Committee.
11.15 Truck Committee
11.15.1 Responsible for the purchase of any additional ambulances. Requesting and receiving bids and making recommendations to the Squad.
12 Medical Standbys
12.1 Bunn Rescue will occasionally provide prearranged medical standbys at community events such as football games. To prevent misunderstandings about what and when it is to be provided, it will be the responsibility of the requesting organization to directly contact the Chief. The requesting agency must contact the Chief at least ten days prior to the event in order to facilitate scheduling a second crew. The primary responsibility of the squad on call is to respond to 911 dispatches, any standbys must be secondary to that. The second crew will consist of two members, at least one of which will be an EMT B. If additional assistance is required the standby crew will request the on call squad be dispatched. Note that any transport will require following FCEMS protocols including having a Franklin County paramedic on scene and documenting the call on the laptop. Standbys are in addition to the normal volunteer schedule, county wide it has become necessary to compensate, up to two, members of this standby crew. Currently this amount is $25 per person and is to be paid directly to the crew members by the requesting organization. See appendix for a sample agreement form.
13 Appendix
13.1 Patient Refusal Guidelines (Attached)
13.2 Annual Certification of Motor Vehicle Accidents & Moving Violations. (Attached)
13.3 Medical Standby Agreement
Patient Refusal Information Sheet
Please Read and Keep This Form!
This form has been given to you because you have refused treatment and/or transport by Bunn Rescue & EMS. Your health and safety are our primary concern. Even though you have decided not to accept our advice, please remember the following:
Initials _____ 1. The evaluation and/or treatment provided to you by Bunn Rescue & EMS is not a substitute for medical evaluation and treatment by a doctor. We advise you to get medical evaluation and treatment.
Initials _____ 2. Your condition may not seem as bad to you as it actually is. Without treatment, your condition or problem could become worse. If you are planning to get medical treatment, a decision to refuse treatment or transport may result in a delay which could make your condition or problem worse.
Initials _____ 3. Medical evaluation and/or treatment may be obtained by calling your doctor, if you have one, or by going to any hospital Emergency Department in this area, all of which are staffed 24-hours a day by Emergency Physicians. You may be seen at these Emergency Departments without an appointment.
Initials _____ 4. If you change your mind or your condition becomes worse and you decide to accept treatment and transport by EMS, please do not hesitate to call us back, by dialing 911. We will do our best to help you.
Initials _____ 5. Don’t wait! When medical treatment is needed, it’s usually better to get it right away
6. If the box at the left has been checked, it means that your problem or condition has been discussed with a doctor at the hospital by radio or telephone and the advice given to you by the Emergency Medical Service has been issued or approved by the doctor.
7. If the box at the left has been checked that indicates that you are the patient’s legal guardian in this situation and are acting on behalf of the patient. By signing below you indicate that you have read and understand the above information regarding refusal of treatment/transport.
Guardian’s Name (printed):_______________________ Relationship to Patient:__________
Witness Signature:______________________________ Relationship to patient___________
Annual Certification
Of
Motor Vehicle Accidents & Moving Violations
By my signature I hereby certify that I have reported all motor vehicle accidents and moving violations of which I have been convicted or charged during the past year to the Chief of Bunn Rescue. I realize that failure to properly report this information is grounds for dismissal or other disciplinary action.
SignaturePrint NameDate
Medical Standbys
As a service to the community, Bunn Rescue & EMS agrees to provide, on an as available basis, one of its ambulances for a medical standby
at _________________________________ (location) on _________________. (date)
The Ambulance will be required from __________ Hours to approximately __________ Hours.
On Call Squad Standby
If the standby ambulance is manned by the on call squad, it will remain only until called into service by Franklin County Dispatch or in response to a medical emergency at the scene. If it is called into service, it is the responsibility of the event sponsor to secure and maintain a replacement standby medical unit for medical care or transport as necessary and delay or postpone the event until the necessary medical standby is on scene. All transports will be handled as per Franklin County Protocols & Procedures.
____________(Initials)
Second Crew Standby
If the event sponsor has made arrangements to have the standby ambulance manned by a second (non on call) squad the event standby will be its primary function. If there is an event related medical emergency, the crew standing by will initiate patient care & request the dispatch of the “on call squad”. The on call squad will either transport or fill in for the standby ambulance until it returns. All transports will be handled as per Franklin County Protocols & Procedures.
_____________(Initials)
Standby crews will consist of two members, at least one of which will be certified as an EMT B. or higher. Second crews may be compensated directly, by the event sponsor, at a rate of $25 per person for up to two persons.
I have selected one of the above options, as indicated by my initials, & agree to the above:
Event Sponsor __________________________________ date _______________
