Chapter 2 Unit Procedures-Operational guidlines Flashcards
Reports of vehicular accidents with persons trapped will require the dispatch of what companies?
1.3.1
The nearest available Engine, Ladder or Rescue Company.
Ay a vehicular accident with persons trapped additional Companies, including additional CFR-D Companies, may be requested by whom?
1.3.2
An Incident Commander at the scene following a size-up.
Who may temporarily suspend CFR-D responses when unusual fire or emergency conditions exist?
1.4
In accordance with established guidelines, the Chief of Operations or designee may
temporarily suspend CFR-D responses when unusual fire or emergency conditions exist.
Company Commanders shall assign CFR-D certified members to groups that ensure the
greatest likelihood that at least ______ CFR-D qualified Firefighters will report for duty
on any given tour.
Fill in the blank
1.6
Two (2)
1.7
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 how many trained members?
1.8
Two (2) trained members (Firefighters or Officer) with current CFR-D Certification.
NOTE: 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.
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 take what actions in regards to CFR-D responses?
1.8.1 A, B
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.
Notify the dispatcher and Battalion and enter the event in the Company Journal. Upon notification that a Company will not be able to respond to
any CFR-D incidents, the fire dispatcher shall change or remove that Company’s status in the STARFIRE system.
NOTE: At each change of tours, 0900 and 1800 hours, Unit status defaults to their normal CFR-D status.
Assignments for scene survey and patient assessment begin at the start of each tour when
the Officer in Charge assigns CFR-D responsibilities. Companies shall use the following
guide for the distribution of work for CFR-D, based upon the availability of CFR-D personnel.
ABCDE
2.1
-“A” Airway – Firefighter responsible for manually stabilizing the patient’s spine (if trauma is suspected) while opening the airway, maintaining the airway, and administering oxygen if needed. In a response to a cardiac arrest, begins ventilation. This firefighter should carry the oxygen bag.
- “B” Boss – The Officer in Charge. The officer should carry a portable radio and a handlight.
-“C” Checker – Firefighter responsible for conducting the patient assessment and performing any hands-on care. In response to a cardiac arrest, this Firefighter checks pulse and begins compressions and shall carry the Trauma Bag.
-“D” Defib/Documenter – Firefighter responsible for completing the Pre-Hospital Care Report (PCR). In a response to a cardiac arrest, hooks up and operates the defibrillator.
-“E” Equipment – If a CFR-D Unit is riding with five firefighters, the fifth firefighter should initially remain with the apparatus and help carry any additional
equipment needed.
-The chauffeur or a non-CFR-D trained member remains with the apparatus.
If, at any time, CFR-D availability falls below the established threshold levels, CFR-D responses for Companies within a particular area will be discontinued until availability is returned above the threshold level except for what type of responses?
3.3.1
Segment ONE responses.
To ensure that remaining available companies are deployed to provide appropriate coverage during periods of high fire and/or CFR-D activity, Companies are instructed to use the signal 10-99 when they expect they will be operating for
more than ___ minutes.
Fill in the Blank
3.3.3
30
When approaching the scene the Officer in Charge shall perform the following:
BANS
- 6.1
- Ensure BSI (Body Substance Isolation) procedures are used and personal protective gear is on.
- Determine the need for additional resources.
- Identify the number of patients involved.
- Observe the scene for safety of the crew, patient and bystanders.
Individuals may identify themselves as patients or may be identified to the Company as such by family, friends or bystanders. Once an individual has been identified as a patient, the Company has the duty to evaluate, render appropriate treatment and generate
3.9.1
A PCR.
A PCR is not required when a CFR-D Company is on-scene (10-84) at any CFR-D assignment unless
3.10.1
Patient care is provided.
When requesting an ambulance, Companies must provide the following information to the dispatcher for relay to EMD:
PAR 3 C’s
- 11
- Pulse
- Age
- Respiratory rate
- Chief complaint
- CPR initiated
- CUPS Status
If the incident involves attempted resuscitation of a non-breathing/cardiac arrest patient, all efforts shall be exhausted until released by EMS. Fire Department personnel will begin resuscitation efforts unless the following conditions exist:
LORD
4.4 Obvious death Dependent lividity Rigor mortis Decomposition Valid Do Not Resuscitate Order NOTE: The CFR-D Unit must complete a Pre-Hospital Care Report even if the patient is DOA, to document that the Company properly examined the patient to confirm that the patient exhibited the criteria for obvious death.
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:
-The Officer in Charge shall review the response printout for additional information as to incident location, cross street, dwelling or unit number, and any other pertinent information provided by the EMD or 911 comment section of the printout.
-If after rechecking the information provided no patient is found the Officer in Charge shall verify the information with the dispatcher.
-After re-verification of the dispatch information, the responding Company shall attempt to contact neighbors, building superintendent and/or security personnel.
-If no patient is found after the above efforts have been exhausted, the Officer in Charge shall enter a 10-92 via MDT (therefore canceling the EMS response) and return to service.
What shall the Officer do when returning to quarters?
4.7
The Officer in Charge shall make a notation in the Company journal upon return to Quarters.
When a patient refuses medical aid, what must be completed?
4.9.1
When a patient refuses medical aid, a Pre-Hospital Care Report (PCR) must be completed. If the patient insists on leaving the scene, the Officer in Charge should notify the dispatcher and the Unit shall go back in service after the patient has left.
If a physician is on the scene of a CFR-D response when EMS is not yet on the scene and offers his/her assistance, he/she should be asked to produce proper identification. The Unit may accept such assistance and notify the fire dispatcher that a physician is on the scene and request that EMS is notified. The Unit shall ask for what?
4.12
The physician’s six-digit New York State license number and include the number on the PCR. Members must continue to perform within their scope of practice and not do anything they are not
trained to do.
If ESU arrives on the scene of a medical emergency after the CFR-D Unit has initiated patient care; the CFR-Ds should retain responsibility for patient care until a transporting agency assumes responsibility of the patient. If the ESU EMTs assumes the role of higher level pre-hospital care provider and assumes responsibility for patient care, the Company shall release the patient to ESU. When will the CFR-D Unit retain patient care?
4.13.1
However, if ESU is not equipped with what with a SAED, the CFR-D Unit shall retain patient care responsibilities as per the Regional Coordination of Pre-hospital Resources Protocol.
What vehicles can be used to transport patients?
4.17
As advised by the New York State Department of Health, under no circumstances shall fire apparatus or vehicles other than NYS-certified ambulances be used to transport patients.
In the event that a CFR-D Unit needs medical advice during a CFR-D response, the Unit may telephone the FDNY/EMS telemetry physician at 800-281-8356, if a telephone is available. The telemetry phone number shall be kept posted where?
5.3
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 and be prepared to give a concise report to the physician. CFR-D Units shall follow the advice given by the telemetry physician, noting all instructions on the PCR. Telemetry may be utilized for medical consultation and as access to the International Language Bank.
Some FDNY members may have previously been trained as EMTs, paramedics or nurses, how shall they operate in regards to patient care?
5.2 & 5.4
Regardless of this level of personal certification, members shall operate as CFR-D providers based solely upon their Department Certification level, and shall immediately relinquish care of the patient to EMS on their arrival.
-All CFR-D trained members shall render emergency care only within the scope of their
training and Regional protocols.
Where a minor is found to be suffering from a life-threatening illness or injury, immediate medical intervention must be provided. Regardless of what?
6.1.1 A
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.
In the event a parent or legal guardian refuses permission for medical treatment for their minors, treatment should nonetheless be provided
whenever the minor is:
- 1.1 B
- suffering from a life-threatening illness or injury and
- it is apparent that a delay in treatment, even if minimal, would jeopardize the minor’s life
If the illness or injury is non-urgent in nature, treatment should still be provided unless the parent or guardian refuses to allow this treatment. If
the parent or guardian will not allow treatment to be rendered the following steps should be taken:
- 1.1 C
- Carefully explain the reason(s) for the treatment, what intervention is necessary to correct the problem and the consequences if the injury/illness is not treated.
- Notify the dispatcher of the events unfolding and have them notify EMS. Contact FDNY/EMS Telemetry, if phone is available. Implement their recommendations (if any) while awaiting EMS arrival. Do not leave the scene before EMS arrives.
- Return the Unit to service after EMS arrives.
