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