CFR-D Flashcards
Company Commanders shall assign CFR-D certified members to groups that ensure the greatest likelihood that
AT LEAST two (2) CFR-D qualified Firefighters will report for duty
on any given tour.
Company Officers of CFR-D Units shall ensure that
two (2) CFR-D Firefighters will be working each tour. Officers shall notify their respective Battalion for needed details prior to the start of the tour.
In order to be in service as a CFR-D Unit, there shall be a minimum of
two (2) trained members (Firefighters or Officer) with current CFR-D Certification.
While CFR-D Units must begin each tour with two (2) certified Firefighters, in the
event that during a tour the minimum CFR-D staffing reduces to 1 Firefighter and 1
Officer, the Company shall
remain available for CFR-D response.
A. Without two CFR-D certified members, the Company shall
not respond to
any CFR-D calls. The Company may still be dispatched for calls received
directly from the public to assist civilians.
During roll call the Officer in Charge shall determine the number of CFR-D
certified personnel on duty. If that number has fallen below the minimum, the
Officer in Charge should notify who
Notify the dispatcher and Battalion and enter the event in the Company
Journal.
At each change of tours, 0900 and 1800 hours, Unit status defaults to their normal
CFR-D status.
Companies are
instructed to use the signal 10-99 when they expect they will be operating for
more than 30 minutes.
When approaching the scene the Officer in Charge shall perform the following: BARNS
A. Observe the scene for safety of the crew, patient and bystanders.
B. Identify the number of patients involved.
C. Ensure BSI (Body Substance Isolation) procedures are used and personal
protective gear is on.
D. Determine the need for additional resources.
If it is determined that the patients condition is either CRITICAL or UNSTABLE, the Officer in Charge shall:
A. Ask the dispatcher for an ETA
B. Advise the dispatcher to relay the seriousness of the patient’s condition to
the responding EMS Unit(s).
When requesting an ambulance, Companies must provide the following information to
the dispatcher for relay to EMD: CCC PAR
- 11.1 CUPS Status
- 11.2 Age
- 11.4 Chief complaint
- 11.5 If CPR initiated
- 11.6 Pulse and respiratory rate
If the patient is CRITICAL or UNSTABLE, packaging efforts must
begin immediately
while treating life threats. Immobilize to a spineboard if indicated.
If the patient is POTENTIALLY UNSTABLE or STABLE, perform
the appropriate
focused physical exam for the patient.
Critical means
Patients either receiving CPR,
in respiratory arrest or
requiring and receiving life-sustaining ventilatory/circulatory support
Unstable means
DRUG
Difficulty breathing
Responsive but unable to follow commands
Unresponsive with no gag or cough reflexes
Poor general impression
Potentially Unstable
CPUSS
Pale skin or other signs of poor perfusion (shock) Complicated childbirth Uncontrolled bleeding Severe pain in any area of the body Severe chest pain, especially with a systolic BP of less than 100mmHg Inability to move any part of the body Systolic upper number
If equipment has been left with the patient or supplies have been expended and
the Company does not have the minimum amount
the Company is to go back in service for fire duty but advise the borough fire
dispatcher and the BATTALION that it is not available for CFR-D responses.
Notify dispatch when ready for CFRD service
All responses require an incident report to be completed. The signals listed below will be
Auto-closed, if the signal is transmitted on the MDT, and require no action by the unit.
10-33 Code 1 10-37 Code 1 10-33 Code 2 10-37 Code 2 10-34 Code 2 10-37 Code 3 10-35 No Code 10-37 Code 4 10-35 Code 1 10-38 Code 1 10-35 Code 2 10-91 10-35 Code 3 10-92
If during a CFR-D response, a verbal alarm for an additional sick or injured person is received, the Company shall make every attempt to make patient contact and notify the
dispatcher. If contact is made with the 2nd patient, the company shall do what ?
the Company shall not leave the scene
until relieved by EMS or the patient leaves the scene
Comm 6.5.2 Cross Ref
In the event the unit is responding to another alarm and it is evident human
life is not in jeopardy at the scene of the verbal alarm, the unit shall
proceed to the original alarm after transmitting radio notification of a verbal alarm to dispatcher and RECEIVING acknowledgement.
Once on the scene, a CFR-D Unit must transmit a signal 10-99 (Company will be
operating for at least 30 minutes) in the following instances:
CAR30
Confirmed cardiac/respiratory arrest
Any situation where the Company officer determines that the Company will likely
remain on the scene for 30 minutes or more
in response to a request for an ETA for EMS from the Company at the scene, EMS reports no Unit available.
Fire Department personnel will
begin resuscitation efforts unless the following conditions exist:
LORD Vador
- 4.1 Obvious death
- 4.2 Dependent lividity
- 4.3 Rigor mortis
- 4.4 Decomposition
- 4.5 Valid Do Not Resuscitate Order
When does LIVIDITY START AND END
Lividity usually starts one to two hours after death and is completed after three to four hours
1234
If a patient’s whereabouts are not known, the responding Company will make every
effort to ascertain the location of said individual. If, after a complete search of the area in question, no patient is found, the following procedure shall be used
- shall review the response printout
- verify the information with the dispatcher.
- Company shall attempt to contact neighbors, building superintendent and/or security personnel
- If no patient is found enter a 10-92 via MDT
- Notation Company journal upon return to Quarters.
If forcible entry is required to gain access, the officer in command must have the
premises safeguarded by members until custodianship is turned over to the
POOR
PD
OWNER
Occupant
Responsible person
If forced entry is the only option, the officer in command should
Request PD (10-47) for security/safety AND have the fire dispatcher advise the responding EMS Units of the situation.
If others within the premises deny access to the patient, the Officer in Charge
shall immediately request
PD
PD will then determine the appropriate action to be taken.
If EMS has not arrived by
the completion of the __________ the Officer in Charge shall contact the fire
dispatcher to relay to EMS a report on the patient’s
initial assessment, CUPS status, age, chief complaint, pulse, respiratory rate and if CPR has been initiated. CCC PAR no mention of ETA
The telemetry phone number shall be kept posted on the chart holding the
Unit’s PCR forms. Before calling telemetry the Unit shall have completed the
Primary survey and C.U.P.S. status determination, and should identify themselves as a CFR-D
Unit
Telemetry may be utilized for medical consultation and as access to the
International Language Bank.
If the illness or injury is non-urgent in nature, If the parent or guardian will not allow treatment to be rendered the
following steps should be taken:
- Carefully explain the reason(s) for the treatment
- Notify the dispatcher to notify EMS.
3.Contact FDNY/EMS Telemetry directly if a phone is available. - Do not leave the scene before EMS
arrives.
Out of Hospital Do Not Resuscitate (DNR) Order VALID ?
YES
A medical order applicable to a
patient who is not in or originating from a hospital or nursing home, that authorizes a health care provider to NOT perform CPR
DOES NOT EXPIRE
should be updated every ninety (90) days
but remains valid even if it has not been updated.
Medical Orders for Life-Sustaining Treatment (MOLST) VALID ?
ONLY IF it contains a DNR order
a MOLST form without a DNR Order is not sufficient for the withholding of CPR.
Hospital and Nursing Home DNR Forms
VALID ?
In order for a Hospital or Nursing Home DNR Order to be honored
Form must be current - it may NOT be expired.
Hospital and Nursing Home DNR Forms may be honored ONLY if the patient originates from the
nursing home or hospital that issued the Order.
when informed of or presented with any of the following stop CPR
Out-of-Hospital DNR Form
DNR Bracelet
Non-expired Hospital or Nursing Home DNR Form
MOLST Form with a DNR Order
A DNR Order shall be disregarded and full resuscitative efforts shall be initiated in any
of the following circumstances
Any case where there is reasonable evidence to suggest that the DNR Order has been revoked or cancelled.
If the patient is conscious and states that they wish resuscitative measures.
If the patient is unable to state his/her desire and a family member is present and requests resuscitative measures for the patient and a confrontational situation is likely to result if the request is denied.
A physician directs that the Order be disregarded
If the patient is NOT in cardiac or respiratory arrest, full treatment for all injuries, pain, difficult
or insufficient breathing, hemorrhage and/or other medical conditions must be provided.
T/F
TRUE
If there are any questions about the validity of the DNR Order, unusual circumstances, or
a potential confrontation between pre-hospital providers and persons at the scene appears
likely as a result of the DNR Order, request
the response of an EMS Officer and contact
the OLMC Physician.
If unable to complete transmission of the MD-X3 via fax,
call the Bureau of Health Services
File the original MD-X3 in the UFS/Station File of the unit where the member
was working when exposed and give one copy to the member.
Make an entry in the Company Journal/Logbook, documenting the exposure and the faxing of the MD-X3 and the PCR to BHS.
For “non-casual” at-risk exposures and for meningitis exposures for which
prophylactic medication may be indicated, notify
BHS immediately at
during business hours or
Car 32/33 through FDOC during off-hours.
The following body fluids are NOT considered at-risk of transmitting bloodborne diseases
unless visibly contaminated with blood;
- Saliva
- Nasal secretions
- Urine
- Sweat
- Feces
- Tears
- Vomit
Tuberculosis While exposure under proper conditions can cause infection, it does not usually cause active disease. Less then what percentage of people become infected ?
10% of the people infected with the tuberculosis bacteria
actually become ill with the active disease.
Only persons with active disease are
infectious to others.
CFR-D Depot Officers shall contact Solid Waste Technologies, Inc.
to have the Depot’s Red Bags picked up for proper disposal.
In the event of a missed pick-up of Red Bags, the CFR-D Depot Officer shall
contact
the Resource Center
Members believing that they are experiencing an allergy to disposable latex
gloves shall notify their Company Commanding Officer, as soon as
possible. The Company Commanding Officer shall
notify BHS as soon as possible in order to have BHS evaluate the allergy claim
Suitable goggles and masks for members who wear corrective lenses, and
members requiring small or extra large disposable gloves, shall be specially
ordered from
Technical Services
Protective goggles are not
disposable and will be issued to the individual member
Disposable body bags.
They may be obtained from the
Deputy Chief on the scene. If a
Deputy Chief is not on the scene, the IC shall call a
Deputy Chief to the scene.
Waste may not be stored for more
than
30 days.
Technical Services will distribute packets of bleach and one gallon bleach
solution spray bottles. These packets will produce a mixture of one part bleach to
ninety-nine parts water. When is it dumped ?
Mixtures remaining after 24 hours shall be disposed in the slop sink.
Officers shall ensure that the solution is prepared DAILY and the old solution
discarded.
If a Motorola HT becomes contaminated with blood or other body fluids, it shall be decontaminated in quarters. Can they be completely immersed ?
YES
These HT’s may be completely immersed in fluid.
If a member’s coat, pants and/or gloves are sent to the SOC laundry for
decontamination, the member’s officer will contact
Division and
request replacement gear in an appropriate size.
In the event that the cab or seating area of an apparatus becomes contaminated,
the member assigned to clean the area shall:
A. Don protective clothing
B. Clean the contaminated area using soap and warm water, then rinse
thoroughly.
C. Disinfect the contaminated area using the disinfectant solution and allow the apparatus to completely air-dry
most times its bleach first then rinse
Members overexposed to bleach shall be moved to fresh air. In case of contact,
immediately flush skin or eyes with running water for
at least 15 minutes. The
Officer on duty shall notify BHS during normal clinic hours or the Medical
Officer on emergency duty at all other times.
Hydraulic fluid AT LEAST 20 mins
All patient care providers, upon completion of training and fit testing,
should use a Department issued respirator when treating and transporting a patient
with a cough which has lasted more than
48 hours or who is otherwise believed to
have tuberculosis.
Firefighters, responding to alarms at prisons and shelters should be prepared to use either
a self contained breathing apparatus or the proper face protection (N95 respirator).
Casual exposure does not normally result in transmission of tuberculosis. The
tuberculosis organism does not readily cause active disease in the majority of people who come into contact with it.
T/F
True
The rabies virus can live how long outside the body
1.3 The rabies virus can survive for__________ inside the body of a dead animal.
few hours outside the body in saliva and body fluids.
several days
Freezing temperatures will extend this survival period.
Any individual with an exposure (bite, scratch, or direct contact with blood or body fluids
to a cut or mucous membrane) shall contact the Bureau of Health Services when ?
before the end
of the tour of duty.
MRSA
This bacterium is usually spread from
direct skin contact from person to
person or
contact with shared items or surfaces that have come in contact with someone else’s infection. (e.g. towels, used bandages)
MRSA For most persons, these bacteria will cause a localized skin infection that may look like
a boil
a reddened or inflamed pimple
a spider bite.
Adult bed bugs look like what ?
flat rusty-red-colored oval bodies.
Adult
bed bugs are about the size of an apple seed, they are big enough to be easily seen. When
bed bugs feed, their bodies swell and become brighter red.
1.6 If notified that bed bugs may be present at the call location, members shall don Blood-Borne Pathogen personal protective equipment including
gowns
shoe covers
hair covers.
Members shall inspect all equipment and the ambulance/apparatus following an
assignment where bed bugs may have been present. If found, bed bugs can be caught by
using tape or crushed with paper towels
When Apparatus are grossly contaminated with numerous bed bugs, the officer shall
place the unit out of service
notify the Battalion, Division, and dispatcher.
The officer
shall call help team (24 hours a day, 7 days a week) to generate a Work Order for the Department exterminator.
Furniture that is believed to be infested shall immediately disposed of
T/F
FALSE
not be disposed of until properly identified
as bed bugs by the OSHA Unit.
Bedding that is infested shall be washed in the
washing machine using hot water only.
Part One, the original, is to be forwarded to the Office of Medical Affairs at
FDNY Headquarters, 4th floor, when ?
through the bag, by the end of each tour.
Part Two is the Research Copy and is to be
retained at Quarters and must be
secured by the Company Officer in the Company files at all times.
Part Three is the Hospital Patient Record Copy and if completed is to be given to
the EMS Unit operating at the scene. If Part Three is not given to the EMS Unit,
it shall be forwarded with the original to OMA.
A PCR is required when making patient contact which is defines as
any instance in which a Certified First Responder has
visualized
approached
communicated with
initiated history taking
and/or a physical exam on any individual for whom help was requested).
At any scene NOT requiring a PCR or a NYFIRS report, the Company Officer has
the option of completing
an Unusual Occurrence Report.
When a CFR-D Company applies and turns on their AED during a cardiac arrest
resuscitation attempt the original PCR (Part One) shall be
- immediately faxed and forwarded to OMA
- A copy of the original PCR shall be turned in to the CFR-D Depot
along with the AED module upon completion of the assignment - The serial number of the module shall be documented on the PCR.
If the CFR-D Company’s AED is not applied to a patient during a response to a
cardiac arrest, the details of the incident and what prevented the application of the
Company’s AED shall be indicated in the
Comments section.
All times recorded on the PCR are written in military time
T/F
True
To make corrections on the PCR, members shall place a ________ through the word(s) to be omitted or corrected and write the accurate information ________
to be corrected.
a single line
above the word(s)
When correcting a darkened circle, place a ______________
through the error and fill in the correct section. The initials of the member making the correction shall be placed ______?
single line
above the single line.
If unable to obtain patients name a description of the patient’s gender preceded by ?
‘Unknown’ shall be written in these boxes (e.g., Unknown Male).
This area shall never be left blank and
Enter the patient’s age. The patient’s age must be entered even if the date
of birth is documented. If unknown, enter the patient’s approximate age. If the
patient’s age is less that 1 year, enter the
number followed by the appropriate
letter (H - hours, D – days, W – weeks, M = months).
A six day old infant shall
be entered 06D
A minimum of one set of vital signs is required for all adult patients except for
Cardiac Arrests and DOAs. For cardiac arrests and DOAs, Respiration and Pulse
are documented as
Resp and Pulse ‘0’,
Blood Pressure is not taken and the space is left blank.
Blood Pressure – Enter the Blood Pressure as systolic or diastolic pressure. If the
blood pressure is taken by palpation, record the
systolic pressure over P (e.g.,
90/P).
upper number
CPR Started – Enter the time that CPR was first started by the
CFR-D Company
responding to the scene or if the Company assisted in CPR.
Time From Arrest Until CPR – Document the best approximation of the
patient’s down time prior to CPR being administered by
anyone
Members shall document the names and certification numbers of the CFR-D
certified members who responded to the call and provided patient care. The name of the member in charge of the call shall be entered where ?
in the first box
the second CFR-D
certified member’s name shall be entered in the ??
second box (driver's name). If the chauffeur does not provide patient care, do not enter his or her name on the PCR.
If there are more than____ CFR-D certified members on the call, list the additional names in the
four
comment section.
Circle the name of the member completing the
PCR.
Company Officer is responsible for the accuracy, completeness and legibility
of the PCR, and shall assign a CFR-D certified member to complete the PCR.
