CFR-D Chapter 2 - Unit Procedures - Operational Guidelines

Question 1

The COMPANY COMMANDER shall ensure the greatest likelihood that AT LEAST ___ CFR-D qualified F/F’s will report for duty at any given tour?

Answer 1

Two (2)

Question 2

Company Officers of CFR-D Units shall ENSURE that ___ CFR-D F/F’s will be working each tour?

Answer 2

Two (2)

Question 3

In order to be in service as a CFR_D Unit there shall be a MINIMUM of ___ trained members (F/F’s OR OFFICER) with current CFR-D Certification?

Answer 3

A minimum of two (2).

Question 4

If the minimum number of CFR-D certified members falls below the minimum, who shall the officer notify?

Answer 4

The dispatcher and battalion.

Make a company journal entry.

Question 5

Without ___ CFR-D members, the company shall not respond to any CFR-D calls.

Answer 5

Two (2)

*the company may still be dispatched for calls received directly from the public.

Question 6

What are the assignments of the CFR-D company members?

Answer 6

A - Airway - Maintain airway, administer O2;
In response to cardiac arrest, begins ventilation
Carries the Oxygen bag.
B - Boss - Officer; Carries portable radio and handlight.
C - Checker - Conducts patient assessment:
In response to cardiac arrest, checks pulse/begins compressions
Carries Trauma bag.
D - Defib/Documenter - Completes the PCR;
In response to cardiac arrest, hooks up/operates the defib.
E - Equipment - Remains w/ apparatus/carry any additional equipment needed.

Question 7

If a company expects to be operating for MORE THAN ____ minutes, they are instructed to use signal ____?

Answer 7

MORE THAN 30 minutes and

Signal 10-99

Question 8

An individual is considered a patient if?

Answer 8

a) The individual is SICK or Injured, or
b) The individual was exposed to a situation or condition that could have the potential to cause injury, e.g., smoke condition, C.O. poisoning, MVA.

Question 9

A PCR is ________ when a CFR-D Company is on-scene (10-84) at any CFR-D assignment UNLESS patient care is provided.

Answer 9

NOT REQUIRED.

Question 10

What information must be provided to EMD when requesting an ambulance?

Answer 10

CCCRAP

• CUPS Status
• Age
• Chief complaint
• If CPR is initiated
• Pulse
• Respiratory rate

Question 11

Which criteria is required in order for a Company to become unavailable for both FIRE DUTY and CFR-D responses?

Answer 11

If decontamination of
 1) a member
2) PPE or
3) the equipment used is required,
the Company will not be available until the situation has been rectified.

Question 12

A company is UNAVAILABLE for CFR-D responses but AVAILABLE for fire duty when?

Answer 12

When the company does not have the minimum amount of CFR-D supplies. The company is to go back into service for fire duty but advise the borough fire dispatcher and the Battalion that it is not available for CFR-D responses.

Question 13

A company will begin resuscitation efforts UNLESS the following conditions exists?

Answer 13

DR DOV

• Decomposition
• Rigor Mortis
• Dependent Lividity
• Obvious death
• Valid Do Not Resuscitate Order

Question 14

Is a PCR required if a company encounters an obvious DOA?

Answer 14

YES. The CFR-D Unit MUST complete a PCR even if the patient is DOA.

Question 15

What is the procedure to be followed in the event a CFR-D company is having difficulty ascertaining the location of a patient?

Answer 15

1) The Officer in Charge shall review the response printout for additional information.
2) Verify the info with the dispatcher.
3) After re-verification of the dispatch info, attempt to contact neighbors.
No patient found - transmit a 10-92
Officer will make a notation in the Co.Journal upon r/t to qtrs.

Question 16

Are EMS personnel tasked with safeguarding a premise?

Answer 16

NO. This shall not be delegated to EMS personnel.This includes awaiting the arrival of PD.

Question 17

Is a PCR required when a patient refuses medical aid?

Answer 17

YES. It must be completed. Notify dispatch if pt. insists on leaving the scene.

Question 18

When a patient is exhibiting altered mental status or appears to be an EDP, declines treatment, what should a unit do?

Answer 18

The Officer in charge should

a) Request police assistance AND
b) Remain on scene until the arrival of EMS.

Question 19

When operating at a CFR-D response and an individual states that they are a physician and would like to offer their assistance, what should we do?

Answer 19

a) Ask for their identification
b) Accept their assistance and notify our dispatcher
c) Obtain their six (6) digit NYS license number and include on the PCR.
* Members are not to do anything that they are not trained to do.*

Question 20

If NYPD ESU has already initiated patient care PRIOR TO our arrival, what are we responsible for?

Answer 20

They retain responsibility for patient care.
The Officer will ascertain if our assistance is required.
IF NOT - Transmit a 10-91 and go 10-8
IF YES - They have medical authority until the arrival of an ambulance.

Question 21

IF NYPD ESU arrives after we have already initiated patient care, what is the procedure?

Answer 21

The CFR-D unit retains responsibility for patient care until a transporting agency assumes responsibility of the patient.
If NYPD ESU assumes the role of HIGHER LEVEL pre-hospital care provider and assumes responsibility for patient care, RELEASE to ESU.
IF ESU is not equipped with a SAED - The CFR-D Unit shall retain patient care responsibilities. DO NOT RELEASE!

Question 22

Are fire apparatus or vehicles other than NYS certified ambulances be used to transport patients?

Answer 22

NO. Under no circumstances.

Question 23

Where is the telemetry phone number posted?

Answer 23

It shall be kept posted on the chart holding the Unit’s PCR forms.

Question 24

What should a CFR-D Unit do BEFORE calling the telemetry?

Answer 24

The Unit shall have

a) completed the primary survey
b) CUPS status determination
c) Identify themselves as a CFR-D Unit
d) Be prepared to give a concise report to the physician.

Question 25

What should a CFR-D Unit do with the advice given by the telemetry physician?

Answer 25

They should follow advice given AND note all instructions given on the PCR.

Question 26

In addition to medical consultation, what else mat the telemetry be utilized for?

Answer 26

Access to the International Language Bank.

Question 27

Is a CFR-D permitted to give immediate medical intervention to a minor suffering from a LIFE THREATENING ILLNESS OR INJURY?

Answer 27

YES. Regardless of whether the parent/guardian is available OR refuses to give consent, treatment for a LIFE THREATENING ILLNESS or INJURY requires IMMEDIATE medical intervention.

Question 28

Who does a CFR-D Unit report the circumstances of suspected child abuse to?

Answer 28

Circumstances of suspected child abuse shall be reported to EMS personnel at the scene.
Officer shall make a Co. journal entry (Names/Unit designation)

Question 29

What is the MINIMUM requirement that a valid DNR issued by a nursing home MUST contain?

Answer 29

A physician’s signature.

A nursing home DOES NOT have to utilize the NYS Out of Hospital DNR form.

Question 30

Does a current date need to be on a DNR order?

Answer 30

No. A DNR order need not have a current date.

Question 31

Is a Living Will valid in the pre-hospital setting for pre-hospital emergency care?

Answer 31

No. It is not valid.

Question 32

Is a Health Care Proxy valid in the pre-hospital setting for pre-hospital emergency care?

Answer 32

No. It is not valid.

Question 33

Who is designated the I/C whenever fire units and EMS are operating at an incident?

Answer 33

The RANKING fire officer on the scene is the I/C.
With the exception of patient care matters.
The I/C is responsible for evaluating the scene and providing safety of all patients and operating personnel.

Question 34

Who shall the ranking Fire Suppression officer consult with and be guided by regarding patient care decisions?

Answer 34

The HIGHEST LEVEL pre-hospital emergency medical provider at the scene. (e.g., Volunteer PARAMEDIC)

Question 35

With regard to a pre-hospital care provider receiving an order believed to be DETRIMENTAL to the patient’s condition, who will the pre-hospital care provider contact?

Answer 35

A written statement, through channels, to the Office of Medical Affairs (OMA).