EMS

Question 1

EMS mission and policy statement:(read only)

Answer 1

Mission:
“Dedicated to doing our very best in the development and management of programs which enable our members to provide the highest level of emergency medical care to our community through innovative, reliable training and support.”

Policy:
The EMS Section is responsible for the development, implementation, and evaluation of programs necessary to enable fire personnel to provide emergency medical care to the citizens and visitors of Mesa. The staff members of the EMS Section are committed to delivering the highest quality service possible.
400.02
2/6

Question 2

The EMS Deputy Chief and members of the EMS Staff shall:(read only)

Answer 2

-Serve as liaisons to other medical entities, such as hospitals, ambulance services, Department of Health Services, and other public safety agencies.
-Plan, develop, implement, and evaluate training programs for all Department medical providers.
-Prepare and manage the EMS budget.
-Develop; implement, and monitor appropriate Quality Management (QM) programs of medical care provided.
-Coordinate the selection process by which personnel are chosen to be sponsored by the Mesa Fire Department for initial Paramedic training and certification.
-Investigate concerns/complaints from the public, or employees of Mesa Fire Department or other agencies, regarding the delivery of pre-hospital care, and recommend appropriate action.
-Maintain records of all Arizona State certifications and coordinate the certification process.
-Provide support to the Fire and Life Safety Section for community education programs on topics such as EMS, CPR, and first aid.
-Develop and maintain EMS Standard Operating Procedures and Guidelines in conjunction with Fire Administration and in accordance with regional and state authorities.
-Conduct research to evaluate and improve the patient care delivery system.
-Manage contracts with educational facilities, transportation providers, and medical institutions.
-Serve as a medical information resource for field providers.
-Serve as a resource for medical-legal and risk management issues.
400.02
3/6

Question 3

The Administrative Medical Director shall report to the EMS Deputy Chief, and his/her duties shall include:(read only)

Answer 3

-Provide medical direction for the fire department continuing education program.
-Serve as a consultant to the fire department for ongoing evaluation of the department’s medical services (emergency and non-emergency) programs.
-Assist the fire department’s training division or assigned program manager with research, development and continuous quality improvement for all respective programs and/or pilot projects within the EMS Division.
-Participate in the cooperative delivery of Medical Direction with the Mesa Fire Department base station Medical Director and other receiving facilities for resolution of pre-hospital care issues.
-Represent the Mesa Fire Department at local, regional and State meetings. -Provide input in the administrative and legislative processes affecting the local, regional and State pre-hospital and healthcare systems.
-Annually develop, review, and revise:
*The fire department’s emergency medical services
policies and procedures.
*Non-emergency medical services.
*Emergency medical dispatch protocols.
*Mesa Fire Department off-line protocol.
-Provide medical expertise, development and assistance in designing and obtaining research grants associated with the delivery of emergent and non- emergent medical services.
-When necessary, provide medical legal expertise for claims brought against the fire department or one of its pre-hospital providers.
-Oversee all aspects of the public access defibrillation program, including training, emergency medical services coordination, protocol approval, standing orders, communications, protocols and automated external defibrillator deployment strategies.
400.02
5/6

Question 4

The MFMD Fire Chief shall be responsible for delegating the duties of department Privacy Officer. These duties shall include, but not be limited to:(read only)

Answer 4

• Overseeing activities related to the development, implementation, and maintenance of an organization’s policies and procedures covering the confidentiality of Protected Health Information (PHI).
• Serving as the key compliance officer for federal and state laws that apply to the privacy of PHI, the Privacy Officer shall act as a Liaison with the U.S. Department of Health and Human Services Office of Civil Rights and the AZ Dept of Health Services on matters involving patient privacy.
• Ensure that the organization’s policies and procedures relating to the privacy of, and access to, Protected Health Information are followed.
• Developing, implementing, and documenting the initial and ongoing training of department members on healthcare information privacy requirements.
• Receiving, investigating, and resolving questions/complaints concerning Protected Health Information.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 and Arizona Administrative Code (AAC) have set the standards for this policy.

MFMD DESIGNATED PRIVACY OFFICIALS
The MFMD Technical Services Assistant Chief and Administrative Medical Director provide oversight of the Department’s privacy compliance issues and delegate the duties of MFMD Privacy Officer.
401.04
3/4

Question 5

Within the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Individual rights afforded include, but are not limited to the following:

Answer 5

-The right to be informed about protections on and use of their health information
-The right to inspect, copy, and review their health records
-The right to request amendments to their health records
-The right to request restrictions on use and disclosure of health information
-The right to request reasonable personal communications
-The right to an accounting of disclosures of their health information
-To right to file a complaint against covered entity
401.06
2/8

Question 6

HIPAA mandates that healthcare entities establish business practices that are “privacy aware.” Practices are to include:(read only)

Answer 6

-Ensuring use and disclosure of a patient’s PHI is restricted to the “minimum necessary”
-Establishing “Role Based” policies on the use of health-related information
-Establishing accountability and sanctions for compliance failures to ensure that workforce practices follow policies
401.06
2/8

Question 7

Any department member who becomes aware of a violation or potential violation to the security of PHI must report the incident by?

Answer 7

Means of a Pre-Hospital Quality Management form forwarded to the Mesa Fire and Medical Department Privacy Officer. The Privacy Officer shall gather all pertinent data. The EMS Deputy Chief and Administrative Medical Director shall determine if an improper disclosure has occurred and determine appropriate corrective/disciplinary action.
401.06
8/8

Question 8

Disclosures of PHI, whether intentional or unintentional, can incur serious federal and state penalties:(read only)

Answer 8

-Violators that unintentionally disclose PHI will be subject to penalties of $100 per violation, up to $25,000 per person, per year for each requirement or prohibition violated.
-Up to $50,000 and one year in prison for obtaining or disclosing protected health information.
-Up to $100,000 and up to five years in prison for obtaining protected health information under “false pretenses”.
-Up to $250,000 and up to 10 years in prison for obtaining or disclosing protected health information with the intent to sell, transfer or use it for commercial advantage, personal gain, or malicious harm.
401.06
8/8

Question 9

When referencing service animals, what are some Examples of associated tasks as provided by ADA & ARS?(read only)

Answer 9

-Assisting blind or low vision individuals with navigation or other tasks
-Alerting the hearing impaired to the presence of people or sounds
-Providing nonviolent protection or rescue work
-Pulling a wheelchair
-Assisting an individual during a seizure
-Alerting individuals to the presence of allergens
-Retrieving items such as medicine or telephones
-Providing physical support, stability or assistance with balance
-Helping individuals with psychiatric and neurological disabilities by preventing or interrupting impulsive or destructive behaviors
-Reminding a person with mental illness to take prescribed meds
-Calming a person with PTSD during an anxiety attack
-Performance of other duties
401.07
2/6

Question 10

In an attempt to determine the validity of a proclaimed Service Animal, both the ADA and ARS make it clear that requesting documentation of such constitutes discrimination and shall be avoided. To assist in determining validity, the ADA allows only the two following questions to be asked:

Answer 10

• Is the service animal required because of a disability?
• What work or task has the dog been trained to perform?

Specifically, you are not allowed to ask about:
• Proof of documentation
• Demonstration of the declared task(s) performed
• Nature of the person’s disability

A service animal is not required to wear an identifying vest, ID tag or any specific harness.
At any point in which it becomes unclear as to the validity of the claim, assume the claim to be valid and concentrate on high quality patient care and when able start the process of making arrangements for the transport of the animal.
401.07
3/6

Question 11

Service Animal (ADA)

Answer 11

• Dog or miniature horse that is individually trained to do work or perform tasks for people with disabilities. The task(s) performed by the animal must be directly related to the person’s disability.
  401.07
  2/6

Question 12

Miniature horse (ADA)

Answer 12

Horses that generally range in height from 24 inches to 34 inches measured to the shoulders and generally weigh 70 – 100 pounds.
401.07
2/6

Question 13

Service Animal (ARS)

Answer 13

– Any dog or miniature horse that is individually trained to do work or perform tasks for the benefit of an individual with a disability, or a qualifying animal being trained for such purposes.
401.07
2/6

Question 14

Individual with Disability (ARS)

Answer 14

An individual who has a physical or mental impairment that substantially limits one or more of the major life activities.
401.07
3/6

Question 15

Transportation of the animal is not required if the following conditions are present:

Answer 15

-The animal fundamentally alters the nature of the services or activities provided
-The animal poses an undue burden
-The animal poses a direct threat to the health or safety of others
401.07
4/6

Question 16

Direct Threat to the Health or Safety of Others (ARS)

Answer 16

A significant risk to the health or safety of others exists and cannot be eliminated by the modification of policies, practices or procedures or by the provision of auxiliary aids or services.
401.07
4/6

Question 17

The following includes criteria that can result in a service animal being excluded from the ADA provision and ARS requirements:(read only)

Answer 17

• An animal that is not housebroken
• Failure of an owner to maintain control of the animal, or failure to regain control in a reasonable time
• Repeated allowance of the animal to wander; even if readily recalled when prompted
• Continued disruptive barking; barking upon provocation or occasionally is not considered disruptive.

Animals whose sole function is to provide comfort or emotional support do not qualify as service animals under the ADA or ARS.

Species of animals other than dog and miniature horse will not be considered as service animals regardless of whether wild, domestic, trained, untrained or being trained.

In the unfortunate circumstance that the owner/animal relationship is broken it is the responsibility of the party breaking the ties to inform the owner of the animal’s location. Reunification is the responsibility of the owner.
401.07
5/6

Question 18

Restraint:

Answer 18

Restraint is any mechanism that physically restricts a person’s freedom of movement, physical activity, or normal access to his/her body.

Restraints may be necessary:
1. For those patients exhibiting behaviors that are harmful to self or others.
2. For those patients attempting an act that poses an immediate threat of harm to self or others (e.g., attempting to move a live electrical wire, attempting to walk into the path of a moving vehicle, attempting to inflict bodily harm on MFMD members or bystanders).
3. In clinically justified situations (e.g., incapacitated persons that require emergency medical intervention such as a head-injured patient or a patient in shock).
402.01
2/3

Question 19

Combative patient:

Answer 19

A combative patient is an individual that resists patient care attempts and may bring harm to himself or others. The threat of harm may be intentional or unintentional.

Restraints may be necessary:
1. For those patients exhibiting behaviors that are harmful to self or others.
2. For those patients attempting an act that poses an immediate threat of harm to self or others (e.g., attempting to move a live electrical wire, attempting to walk into the path of a moving vehicle, attempting to inflict bodily harm on MFMD members or bystanders).
3. In clinically justified situations (e.g., incapacitated persons that require emergency medical intervention such as a head-injured patient or a patient in shock).
402.01
2/3

Question 20

Violent patient:

Answer 20

A violent patient is an individual that demonstrates intent to harm himself, bystanders, or rescuers. Police assistance should be requested immediately.

Restraints may be necessary:
1. For those patients exhibiting behaviors that are harmful to self or others.
2. For those patients attempting an act that poses an immediate threat of harm to self or others (e.g., attempting to move a live electrical wire, attempting to walk into the path of a moving vehicle, attempting to inflict bodily harm on MFMD members or bystanders).
3. In clinically justified situations (e.g., incapacitated persons that require emergency medical intervention such as a head-injured patient or a patient in shock).
402.01
2/3

Question 21

If a medication is given in error by MFMD or our transportation partners. What are the steps for reporting it and the follow up supervisiorial actions.

Answer 21

Procedure

• All medication errors will be documented on Patient Care records and immediately brought to the attention of the receiving facility. In addition, any errors made by MFMD Paramedics or witnessed on-scene will also warrant a patient care ride-in to ensure continuity of care and documentation/notification of error.
• Medication errors by one of our own members or a contract ambulance member will be reported to the EMS office as soon as the error is discovered through a written Pre-hospital report forwarded to the EMS office. The Pre- hospital report will be reviewed by the EMS Deputy Chief and Department Medical Director, and the designated contract ambulance supervisor.
• A member or members of the EMS staff will interview the crew and investigate the facts leading to the medication error. Included in this investigation will be the proximate cause of the error, potential adverse effect of the error, patient outcome, and any other pertinent information.
• Upon completion of the investigation by the EMS staff members, the findings will be reviewed and evaluated by the EMS Deputy Chief and the Medical Director.

If deemed to be a critical mistake requiring discipline rather than remedial training, the EMS Deputy Chief will advise the Human Resources Deputy Chief of the incident, along with a union representative if requested by the accused. They will then recommend a disciplinary action plan to the Operations Chief. Recommendations may include, temporary cessation of paramedic status within the Mesa Fire and Medical Department, written reprimand, or other disciplinary action.

• If deemed by the EMS Deputy Chief to be caused due to a need for remedial training, the EMS Division will first advise the paramedic’s immediate supervisor of the situation so that the incident can be noted in their station file. Next, share the plans for remedial training with the paramedic and present an action plan designed to coach the paramedic back to a confident functional status.

• If deemed by the EMS Deputy Chief to be a medication error requiring no discipline and no further remedial training, the paramedic’s supervisor will be advised and the recommendations will be given.
403.03
2/3

Question 22

If a RxFOB is lost/misplaced what are the steps for getting a new one?

Answer 22

Immediately upon realization that an RxFOB in unaccounted for the member must notify the EMS Division by email to MFMDEMS@mesaaz.gov and contact the EMS Phone @ 480-682-7103.

Upon notification of a lost RxFOB the EMS Division will ensure the unique RxFOB has its access revoked and a notation is made on the log sheet.

During EMS business hours EMS will issue a new RxFOB to the member following the guidelines outlined above. If the EMS Division is not available, Car 209 will be contacted to issue the member a temporary RxFOB. Once a member is available in the EMS Division, the temporary RxFOB will be replaced with a permanent device.

Car 209 will be issued three (3) temporary RxFOB’s and shall email MFMDEMS@mesaaz.gov immediately upon issuing a temporary RxFOB to a member including the unique RxFOB identifier (stamped number), the member name, employee number and reason for issuance. Car 209 will be responsible for accountability of the temporary RxFOB’s assigned to them.

Each member who has been granted access to MFMD drug boxes will be issued a Proximity Card (RxFOB) which will open the electronic MFMD drug box storage devices.
• RxFOB’s will be issued through the EMS Division under the supervision/delegation of the EMS Deputy Chief.

The use of the emergency access code should be extremely rare and will require the contents of the drug box to be reported as soon as possible utilizing the electronic drug box inventory process. The EMS Division shall follow-up on each electronically reported use of the emergency access code; abuse of the emergency access code will be reported to the EMS Deputy Chief for follow-up. Any instance of misuse or abuse of the emergency access code could lead to disciplinary action.
403.04A
3/3

Question 23

Who reviews the electronic Drug Accountability Checklists are being completed daily? Who follows through on all incomplete checklists?

Answer 23

The BCs and BSOs review all DACs on a daily basis. ED and BC follow up with the crews on incomplete checklists.
403.04
4/7

Question 24

What is the Drug Box Inventory Compromise procedure?

Answer 24

• Contact the paramedics assigned to the off-going shift to determine if they used the medication or supply and failed to restock it.
*Check Patient Care Reports (PCR) for incidents that your unit responded to during the previous shift to determine if a medication or supply was used and not replaced; If so, print the PCR and restock the medication or supply.
• If the medication or supply cannot be accounted for the paramedic must notify the Company Officer.
• Complete an electronic Drug Accountability Check and document the discrepancy (i.e. missing, extra, expired, altered, etc.).
• The Company Officer must notify their Battalion Chief by telephone and e- mail as soon as they determine a medication is missing.
• The Battalion Chief will work with the crew and the EMS Division to formally document that the drug box contents were compromised, and a plan will be developed to restock the medication or supply that is unaccounted for.
• If it is determined that the drug box contains medication that exceeds the levels identified on the electronic Drug Accountability Checklist, it must be documented in the exceptions. Notify EMS of overstock and EMS will make arrangements to pick up the extra medications.
• When medications are found to be missing, expired, or tampered with, EMS and the respective BC will work through a discovery process to determine what happened. The findings of the investigation will be submitted to the BC in writing by the EMS division. If there is failure to comply to this policy an appropriate course of action will be taken by BC and EMS up to and including formal discipline. If a controlled substance is not accounted for, MFMD is required to self-report to the AZ Department of Health Services, and an investigation will be initiated by the State.
403.04
5/7

Question 25

Mobile phones are assigned to response units for enhancement of service delivery and improvement of communications in the delivery of EMS and daily operations. It will be the responsibility of the Company Officer to assure mobile phone usage adheres to this policy. Compliance will ensure that costs are controlled while allowing the benefits of mobile phones to be provided. Mobile phones are not to be used for personal use unless in an emergency and at the discretion of the Company Officer.

Answer 25

Mobile phones may be used by field crews to:
• Establish On-line Medical Control
• Contact another crew, Battalion Chief, Connectors, etc. directly
• Establish On-line Medical Control for patient destination determination for possible Trauma Center transport (i.e., mechanism, stable presentation, etc.).
• Notify receiving facilities for patient transports.
• Conduct trauma center or hospital inventory through alarm.
• Contact parents or a responsible party for permission to treat, transport, or release a minor.
• Make contacts for immediate operational needs and to connect customers to appropriate support agencies.
• Crews are dispatched through the Phoenix G2 app as a potential backup option in the event of a CAD outage.
• Google Maps may be utilized as a backup routing option in the event of a CAD outage.
• Google Translate may be utilized during situations requiring language translation.
• If a patient requests to call from a scene (i.e., family, work) and the call is urgent, assist the person requesting the call and limit air time to essential business.
404.01
2/4

Question 26

Security (Mobile Phones)

Answer 26

In order to prevent stolen or lost phones, it shall remain either with the Company Officer or mounted in the Captain’s position in the truck at all times in the trauma box when not in use. If lost, contact MPD to make a report, complete a prehospital incident report, and contact Tech Services to arrange deactivation and replacement of the phone.

Batteries should charge to 50% within 45 minutes and completely recharge within 4 hours.
404.01
3/4

Question 27

Examples of Medical Facilities that can receive patients from MFMD:

Answer 27

-Medical Center Emergency Department
-Specialty Medical Center Department:
o Labor/Delivery
o Burn Center
-Free Standing Emergency Centers
-Other facilities that meet the standard set forth by MFMD, AEMS Red Book or approved by Medical Control
404.02A
2/4

Question 28

Status “Caution” (Yellow) for hospitals:(read only)

Answer 28

Ideally the caution status gives agencies a one-hour notification window that a significant overload may occur. Hospitals will consider “Caution” status reporting when all emergency department beds are full and two or more ambulances are waiting to transfer patients. Also included is the temporary failure of specialty equipment such as x-ray, CT scan, etc.
404.03
2/5

Question 29

Status “Bypass” (Red) for hospitals:(read only)

Answer 29

Indicates that the reporting facility is saturated or overcrowded to the point that emergency department resources are unavailable. *Critical patients will always be triaged to the closest appropriate hospital.
404.03
2/5

Question 30

Status “Closed” (Black) for hospitals:(read only)

Answer 30

Indicates that the medical facility cannot receive emergency patients due to an internal disaster. Internal disasters include; physical plant shutdown, fire, bomb threat, hostage situation, utility outage, flood, etc.
404.03
2/5

Question 31

Pre-hospital incidents include but are not limited to:(read only)

Answer 31

-Medication or treatment errors
-Extenuating circumstances which could potentially impact patient outcomes, such as extended response times, delayed on scene times, etc.
-Equipment that is not available or is inoperable
-Inappropriate language, behavior or appearance of any member of the health care team
-HIPAA violations
-Facility policies considered inconsistent with MFMD standard of care
-Abuse or suspected abuse (i.e. patient abuse, child abuse, elder abuse, domestic abuse, etc.) of any kind by fire/ambulance personnel or a care provider. Witnessing abuse or having reason to believe that abuse has occurred triggers an immediate duty to report the incident. Child and elder abuse must be reported pursuant to the Duty to Report SOP. Incidents must also be reported immediately to a direct supervisor and Battalion Chief, who will then notify the Department Human Resources Deputy Chief.
-Concerns regarding interactions with transportation partners and/or receiving facilities
405.03
2/3

Question 32

Steps involved in completing (pre hospital incident) the form.

Answer 32

• Complete form as soon after the incident as possible to allow better recollection of the event
• Complete details on the top of the form
• Describe in detail what occurred, stating the facts and quotes where
appropriate
• If individuals were involved include their names if known and/or available
Depending on the incident, either an EMS representative or a department Human Resource representative will follow up with the individual who submitted the report. Based on the nature of the incident, further investigation may be required. All reports will be maintained in the EMS Quality Management files.
405.03
3/3

Question 33

To be valid, a PMCD must:

Answer 33

• Be printed on an orange background (letter or wallet size)
• Be filled out completely
• Be signed and dated by the following individuals:
  1. A Licensed health care provider.
  2. Patient or surrogate
  3. Witness (not a relative, surrogate, or beneficiary)
• Readily available or located within a reasonable amount of time (1-2 minutes)

Emergency personnel will perform an assessment of the patient to determine the patient’s condition. When a PMCD is present, the document appears valid, and the patient is without vital signs, emergency medical personnel shall not begin resuscitation. EMS personnel will complete the necessary documentation, notify the proper law enforcement agency, and initiate Grief Support. Base station contact is not required.

It is important for all emergency personnel to document the encounter. Documentation shall include information about the Pre-hospital Medical Care Directive (that it was complete and present), that the patient was found without vital signs, and that the patient was left with law enforcement personnel (include name and badge number). A reasonable effort must be made to obtain the Pre-hospital Medical Care Directive and include it with the EMS Encounter Form for entry into records. If the document is unavailable, note that with an explanation on the encounter form.
406.01
4/4

Question 34

Providers requesting follow-up information on patients can obtain by:

Answer 34

-Calling EMS.
-Emailing EMS
-Through the use of the patient care follow up form on ZOI
406.03
2/2

Question 35

Mesa Fire and Medical Department EMS providers shall not conclude the EMS- Patient relationship(Patient transfer to ground transport)once established until three essential criteria are met:

Answer 35

• Transfer should be made to medical personnel whose qualifications are equal to or greater than the transferring personnel unless criteria are met under MFMD ALS Treatment Algorithms ALS Release for BLS Transport or to qualified health care practitioners i.e. mental health specialists, NP’s, or PA’s as deemed appropriate by the MFMD Administrative Medical Director.
• The MFMD EMS provider must remain with the patient until transfer occurs.

• The MFMD EMS provider must convey all relevant patient information and documentation to those accepting responsibility for the patient.
1. At a minimum patient information, initial assessment, treatments rendered and response to treatment shall be transferred to receiving members unless impractical due to extenuating circumstances. i.e. mass casualty incident, load and go with limited resources, etc.
407.01
2/3

Question 36

It is appropriate to utilize an air ambulance when the information available at the time of the transport indicates:(read only)

Answer 36

• The patient has an anticipated medical or surgical need requiring transport or transfer and without helicopter transport, the patient would be placed at significant risk for loss of life or impaired health; and
• Available alternative methods may impose additional risk to the life or health of the patient; or
• Available alternative methods would make ambulance services unavailable or severely limited in the community service area.

Medical necessity for scene flights may be established under the following circumstances:
1. Speed and critical care capabilities of the helicopter are essential; or
2. The patient is inaccessible to ground ambulances or distance to a hospital from the scene would require unnecessary prolonged ground travel time; or
3. Patient transfer is delayed in entrapment, traffic congestion, or other barriers; or,
4. Advanced life support is unavailable or subject to excess response time.
5. Specialty missions with specialized medical care personnel, medical products and equipment, emergency supplies, and special assistance for major casualty incidents or disasters, or mutual aid to other air medical services are medically necessary.
407.02
3/3

Question 37

Medical necessity for scene flights(helicopters) may be established under the following circumstances:

Answer 37

1. Where speed and critical care capabilities of the helicopter are essential; or
2. Where the patient is inaccessible to ground ambulances or distance to a hospital from the scene would require unnecessary prolonged ground travel time; or
3. Where patient transfer is delayed in entrapment, traffic congestion, or other barriers; or,
4. Where advanced life support is unavailable or subject to excess response time.
5. Specialty missions with specialized medical care personnel, medical products and equipment, emergency supplies, and special assistance for major casualty incidents or disasters, or mutual aid to other air medical services are medically necessary.
   407.02
   3/3

Question 38

A patient may be treated, released, and referred to a receiving facility by MFMD, and transported by a Police Department under the following circumstances:

Answer 38

• The patient has met the criteria for and signed within the ‘Signature’ section under ‘Patient Refusal’ and, if appropriate has signed under the ‘Signature Form’ (i.e. Section I, Section II, etc.) within the same ‘Signature’ section; or,
• The patient is being transported to an alcohol detoxification center or similar and is considered “medically cleared” based on consultation with Centralized Medical Control; or,
• If the patient refuses treatment, refuses to sign a ‘Patient Refusal’, has no obvious injuries or illness, and is not in need of medical treatment then utilization of the ‘video signature’ may be appropriate.

Once entered into an EMS-Patient relationship, a MFMD member should not conclude that relationship unless the patient no longer requires emergency medical services and can be safely transferred by police personnel.
The patient must have a disposition of any of the following.
• Evaluated / Treated, Refused Transport (Refusal Form)
• Refused Evaluation/Treatment/Transport (Refusal Form)
• Treated, Transferred Care to Transport Unit (with approval from Centralized
Medical Control to be released to the police department)
Once the patient has been released, the facts surrounding the case (including the
police officer’s badge number) should be documented on the patient’s ePCR. If the officer is accepting or signing for the patient, obtain both the officer’s signature and badge number in the appropriate fields within the ‘Signature’ section.
407.03
2/3

Question 39

Recognizing that it is impossible to produce a comprehensive list of all possible patient situations, the following are provided as examples of situations that involve an unstable patient:(read only)

Answer 39

• Adult – active seizure or status epilepticus
• Imminent delivery
• Electrical therapy used or may be used during transport to the receiving facility(e.g., synchronized cardioversion, defibrillation, or transcutaneous pacing)
• Trauma - all immediate (by injury) patients
• Pediatric - first-time seizure, active seizure, or status epilepticus
• Chest pain and/or cardiac symptoms suggestive of Acute Coronary Syndrome
• Respiratory distress

The following are provided as examples of situations that may involve an unstable
patient:
• Altered mental status (altered for patient)
• Eclampsia / preeclampsia
• Medication given without significant improvement or relief of symptoms
• Continuous IV medication infusion established (e.g., lidocaine, dopamine, or oxytocin)
• Restraints used. (If restrained by PD, request PD to accompany MFMD member in ambulance).
• Seizures
• Vaginal bleeding in pregnant patient with fetus of viable age (24 weeks)
• Request of ambulance paramedic

An ALS member is required to follow-up (ride-in) with the patient to the receiving facility in the following situations:
• Controlled substance administrated, or may be administered to a patient either on scene or in transit/transport to receiving facility (e.g., etomidate, diazepam, midazolam, lorazepam, fentanyl, or morphine).
• Rapid sequence intubations (RSI) performed and the patient is transported by ground ambulance.
• Patient is in respiratory or cardiac arrest.
• A “Stroke Alert” is declared for a patient exhibiting a positive FAST score of 2 or more.
• A “Cardiac Alert” is declared for a patient whose ECG indicates an S-T segment elevation myocardial infarction (STEMI).
407.04
2/4

Question 40

Recognizing that it is impossible to produce a comprehensive list of all possible patient situations, the following are provided as examples of situations that MAY involve an unstable patient:

Answer 40

• Altered mental status (altered for patient)
• Eclampsia / preeclampsia
• Medication given without significant improvement or relief of symptoms
• Continuous IV medication infusion established (e.g., lidocaine, dopamine, or oxytocin)
• Restraints used. (If restrained by PD, request PD to accompany MFMD member in ambulance).
• Seizures
• Vaginal bleeding in pregnant patient with fetus of viable age (24 weeks)
• Request of ambulance paramedic

An ALS member is required to follow-up (ride-in) with the patient to the receiving facility in the following situations:
• Controlled substance administrated, or may be administered to a patient either on scene or in transit/transport to receiving facility (e.g., etomidate, diazepam, midazolam, lorazepam, fentanyl, or morphine).
• Rapid sequence intubations (RSI) performed and the patient is transported by ground ambulance.
• Patient is in respiratory or cardiac arrest.
• A “Stroke Alert” is declared for a patient exhibiting a positive FAST score of 2 or more.
• A “Cardiac Alert” is declared for a patient whose ECG indicates an S-T segment elevation myocardial infarction (STEMI).
407.04
3/4

Question 41

Spare EMS equipment will be stored in locked cabinets at Battalions 201, 202 and 203. Each Emergency Issue Equipment Cache will include the following:(read only)

Answer 41

• Drug box
• ECG monitor
• ALS airway kit (including pulse oximeter)
• ALS trauma kit
• Suction unit
• Kendrick Extrication Device(K.E.D.)
• C-Spine Bag
• PEDS Mattress
• Sager Splint
• Limited pharmaceuticals
• Other EMS equipment when practical
• Glucometer

Sets of EMS equipment are assembled and designated for special uses. This equipment is reserved for:
• Equipping temporary in-service units
• Replacement of malfunctioning or damaged equipment
• City/Department sponsored special events
408.02
2/4

Question 42

It is important that crews have access to the emergency issue equipment at all times. When a complete or partial supply of emergency issue equipment is needed, the following sequence should be followed:(read only)

Answer 42

-The Battalion Safety Officer (BSO) shall be contacted by the company officer and advised of the equipment request.
-The Battalion Safety Officer will access the Emergency Issue Equipment Cache to determine the availability and functionality of the requested items.
-The company officer will be informed when the equipment is ready for retrieval and the BSO and company officer will determine the most appropriate means for delivery.
-When it is anticipated that Emergency Issue Equipment will be logged out for a significant period of time (more than 3 shifts) the BSO shall contact EMS to arrange for replacement equipment. Whenever practical, a complete set of ALS equipment should be available in each Emergency Issue Cache to outfit temporary in-service units or special event crews.
-When possible, the EMS division will maintain an extra set of ALS equipment which will be made available for issue when attempts to replace equipment through the Emergency Cache system have failed. EMS shall be contacted to determine availability of this equipment.
408.02
3/4

Question 43

Paramedics assigned and selected to the TEMS Medic program will adhere to the following criteria:(read only)

Answer 43

1. TEMS Medics will participate in SWAT Training school for initial certification prior to being deployed on any TEMS incident. Training shall include weapons familiarization training, as part of their initial orientation, as determined by MPD SWAT Team leaders.
2. TEMS Medic follows up and maintains advocacy for injured officer,and maintains good working relationships within the EMS system and receiving medical facilities.
3. Evaluation/consultation by the TEMS Medic to monitor the medical effects of environmental conditions on individual and team performance; including considerations such as heat or cold stress. The TEMS Medic will advise the Incident Commander or SWAT Team Leader of any detected problems.
4. Conduct medical threat assessments to determine the potential impact of medical or health factors on a mission outcome.
5. May maintain important medical history, immunization, and current health records of each SWAT Team Member. The confidentiality of this information is to be ensured by the TEMS Medic and is intended to provide critical medical information and history to the appropriate medical personnel to save valuable time during the treatment of any injury or illness.
6. May participate in a continuous Quality Improvement Program, to include post incident and/or post training analysis and debriefings.
7. Conduct in-service training of SWAT officers to keep them advised of medical concerns / self-help scenarios, to include participation in “officer down” scenarios with the SWAT team.
8. Will only deploy to an incident when requested and through the proper procedures as determined by the MFMD Operations Chief.
9. Will wear the MFMD approved TEMS uniform shirt at MPD incidents and MPD training.
10. Will NOT attend TEMS training NOT approved by the Mesa Fire and Medical Department.
11. Represent the MFMD in a professional manner during training exercises and MPD incidents.
12. MFMD TEMS Medics are prohibited from carrying a firearm while participating in a MPD incident.
13. Failure to comply with the procedures outlined in this SOP may result in the removal of the member’s participation in the TEMS program.
14. 06

Question 44

The course content, drug profiles, and off-line protocols serve as treatment guidelines. In the event of a HAZMAT incident with patients involved or where there is a significant exposure risk to rescue personnel, a responding paramedic with toxicology capabilities shall establish contact with the Poison Control Center en-route if the chemical hazard is known. This shall facilitate appropriate:

Answer 44

• Personal Protective Equipment for MFD personnel
• Decontamination
• Treatment
• Hospital destination

If no initial information is known while en-route, the responding paramedic with toxicology capabilities shall contact Poison Control as soon as chemical information is available. To help facilitate information gathering the MFMD Toxicology Report Form can be utilized. Contact with Medical Control would then be secured for treatment orders.
409.05
4/5

Question 45

The intent of this program (Tox Program)is to prepare members to provide Advanced Life Support (ALS) with an increased awareness and further knowledge of the medical aspects of hazardous materials and chemical exposure incidents. After receiving training in toxicology, providers will have the ability to better recognize and manage:

Answer 45

• The potential for a toxicological exposure or illness
• Recommend preventative measures to protect MFMD personnel, civilians, and other public servants
• Initiate appropriate decontamination and medical therapy specific to an exposure

The MFMD Administrative Medical Director shall be responsible for approving and overseeing the Paramedic Toxicology Program (8 Hrs)training.
409.05
2/5

Question 46

Quality Management (QM) is:(read only)

Answer 46

The sum of all activities undertaken to assess and improve the products and services provided throughout the entire Emergency Medical Services (EMS) system. The goal is to deliver a service that is timely, consistent, appropriate, compassionate, cost-effective and, most importantly, beneficial to the patient’s outcome and/or comfort.
410.01
2/7

Question 47

Reasons for QM review include:(read only)

Answer 47

a. Action plan follow-up
b. Base Hospital request
c. MFMD administration request
d. Legal review
e. MFMD Medical Director request
f. MFMD member request
g. New skill/medication used
h. Other EMS agency request
i. Patient complaint
j. Random review
k. Restraints used
l. Sentinel/adverse event
m. Staff request
n. Student

It is the responsibility of the EMS Deputy Chief and members of the EMS Staff to develop, implement, and monitor appropriate quality management programs as well as corrective action plans when review of cases indicate the need to do so.
410.01
3/7

Question 48

The MFMD EMSQM team:

Answer 48

MFMD Administrative Medical Director, the EMS QA Specialist, EMS Deputy Chief and EMS Educator(s).
410.01
5/7

Question 49

Possible QM actions (after review)include (but are not limited to):(read only)

Answer 49

• No action necessary
• Discussion with member/crew involved
• Revoking of the document to allow addition of an addendum (see S.O.P. 405-01)
• Letter to member/crew involved for explanation, with QM comments included, for review and/or commendation
• Review of MFD policies/procedures/protocols required
• Forward to member Captain for action
• Forward to EMS Captain/Chief for action
• Forward to member Battalion Chief for action
• Forward to MFD Medical Director for review/action
• Meeting with MFD Medical Director and EMS Deputy Chief
• Additional clinical experience
• Attend lecture/didactic presentation
• Attend skills lab
• Attend structured course
• Attend tape and chart session
• Field observation recommended/required
• Change in treatment algorithm
• Change in department policy
410.01
7/7

Question 50

In a QM evaluation, what is being considered?

Answer 50

-Was the use of medical control/MFMD treatment algorithms appropriate?
-Were MFMS EMS policies followed?
-Was patient care documentation consistent with patient assessment, treatment and response to treatment?
-Were medications/skills performed in accordance with protocol or medical control?
- Was the treatment rendered in compliance with established treatment guidelines?
410.01
6/7

Question 51

What are the individual rights covered by HIPAA of 1996?

Answer 51

1. The right to be informed about protections on and use of their health information.
2. The right to inspect, copy, and review the health records.
3. The right to request amendments to their health records.
4. The right to request restrictions on use and disclosure of health information.
5. The right to request reasonable personal communications.
6. The right to an accounting of disclosures of their health information.
7. The right to file a complaint against covered entity.

HIPAA allows for disclosure of PHI to “persons involved in the patient’s care and other contact persons” which might include; blood relatives, spouses, roommates, boyfriends and girlfriends, domestic partners, neighbors, and colleagues. The disclosure is to include only the minimum information necessary that is directly relevant to the person’s involvement with the patient’s healthcare.
401.06
2/8

Question 52

What does PHI stand for?

Answer 52

Protected Health Information.

401.06

Question 53

How to restock expired/expiring meds?

Answer 53

1. First day of the month check all medications for expiration dates.
2. Utilize the electronic Restock procedure in the Drug Accountability Section of the EPCR.
3. Crews that can’t feasible obtain medications from Controlled Access Pharmaceutical Dispenser or BDMC will email EMS to coordinate delivery.
   403.04
   6/7

Question 54

Where should the Med phone be kept.

Answer 54

In the possession of the Captain or plugged in at the Captains position overnight.
404.01
3/4

Question 55

What is an Emancipated Minor?

Answer 55

AZ resident of at least 16 years of age who can provide a AZ issued ID containing the words”emancipated minor “, or a resident of another state that can provide convincing evidence of emancipation.
404.02C
2/3

Question 56

Dispo code for any citizen who requires assistance in lifting or moving a patient who has no medical complaint and no mechanism for injury.

Answer 56

Disposition code 554.

This Disposition Code is applicable in a limited number of situations. Any citizen who requires assistance in lifting or moving a patient who has no medical complaint and no mechanism for injury or similar request is assigned a Disposition Code of 554 Documentation for this event-type requires an ePCR. If any of the following is present, the call cannot be designated as Disposition Code 554: injury, illness, chief complaint, or history of a mechanism of injury (falls, etc.).
404.04
2/3

Question 57

Dispo code for a MVA that doesn’t result in injury.

Answer 57

Disposition code 324.

Disposition Code 323, Motor Vehicle/Pedestrian Accident
Disposition Code 331 Vehicle Lock-In
This category is exclusively for persons who are locked inside a vehicle and have no medical complaint or potential for illness or injury due to their lock in status. The crew will gain access to the vehicle and classify the situation as a Disposition Code 331. If the person complains of any illness or injury or has the potential for illness based on scene conditions or health status an ePCR must be completed and a Disposition Code of 321 should be selected.
404.04
3/3

Question 58

Dispo code for when a unit arrives on scene and is unable to locate a patient, there was an inadvertent 911 activation or false medical alarm, or the unit arrives on scene is assigned duties not requiring pt care.

Answer 58

Disposition code 381.

Disposition Code 611, Call for Service, Cancelled En-route
404.04
3/3

Question 59

During Altered Protocols, which are the 5 nature codes that will have a ambulance dispatched still?

Answer 59

1. Code/CodeP/CodeC
2. Child birth
3. Drowning
4. CVA
5. MMVA(Will be limited to one ground ambulance)

When operating under altered transportation protocol, MRDC will only provide automatic EMS transportation unit dispatch on calls that meet the automatic code three-transport unit requirement. These calls include non-breathers, drowning incidents, and childbirth; stroke and 2N1 Medical calls. Specific call types are CODE / CODEP / CODEC, DR, CB, CVA, MMVA (all varieties). Automatic EMS transportation response on 2and1 medicals will be limited to one ground ambulance.

If no contract ambulance units are available for pending EMS cases, Alarm will access all available alternative transport sources. This includes but is not limited to Mesa Fire and Medical Department Rescues, Life Line, Superstition Fire and Medical Medic Units and Phoenix Fire.
404.03
3/5

Question 60

When a Emergency Facility has been assigned to a mass casualty incident, status notification through the EMSystem will be required every — minutes.

Answer 60

15.

Emergency departments will have the responsibility for maintaining current facility status on the EMSystem. Status updates will be entered as often as necessary and will be required to be updated every 24 hours. When an emergency facility has been assigned to a mass casualty incident, status notification will be required every 15 minutes during the incident.
404.03
4/5

Question 61

HIPAA mandates that healthcare organizations establish business practices that are “privacy aware”. The following practices are required: (Read only)

Answer 61

1. Appointing a “privacy officer” to monitor the organizations HIPAA compliance.
2. Educating every member of the organizations workforce regarding privacy rules”as necessary and appropriate to do his/her job”.
3. Ensuring that appropriate safeguards exist to protect health information. Providing a Notice of Privacy Practices to all patients when billable medical services are provided.
   401.04
   2/4

Question 61

Who is the MFMD designated privacy officials?

Answer 61

The MFMD Technical Services Assistant Chief and the Administrative Medical Director.
401.04
4/4

Question 62

Restock of Expired Meds

Answer 62

• On the First day of each Month all medications will be reviewed for expiration dates, and any medication expiring within the current month will be noted.
• Crews will utilize an electronic Restock procedure in the Drug Accountability section of our ePCR.
• Crews that cannot feasibly obtain the ordered medication from Controlled Access Pharmaceutical Dispenser or Banner Desert will email EMS to coordinate delivery of the order.
• Any medications that are not replaced through this process will be managed by the individual companies.
403.04
6/7

Question 63

Responsibility for the disposition of personal property on an emergency scene is the responsibility of the?

Answer 63

Company officer,
but the task may be delegated to the appropriate fire personnel or police officer.

PROCEDURE
As personal belongings are removed from the patient, regardless of their perceived value or condition, these items should be placed in a bag. All the items placed in the bag should be documented on the Patient Care Report (PCR). Wallets should not be opened to inventory contents, except for identification and driver’s license removal, if appropriate. Jewelry, dentures, and clothing should be noted generically, i.e. (1) ring, (1) necklace, (1) tie tack, etc. When appropriate, a police officer with adequate PPE should be involved in this process.
When turning over a patient’s belongings to either ambulance, helicopter, hospital, or police personnel, the name, the agency, and unit number of the crew or person should be documented on the PCR.
404.02B
2/2

Question 64

Altered Protocol is?

Answer 64

A plan that has been developed to provide maximum use of ambulances during peak demand hours. This protocol was developed as a recommendation by the Regional Emergency Transportation Subcommittee and approved by the Central Arizona Life Safety Response Council. Under this protocol, the valley is divided into two ambulance regions: Eastern and Western. Mesa is part of the Eastern Region, which also includes the communities of Apache Junction, Chandler, Gilbert, and Tempe.
404.03
3/5

Question 65

If a citizen is involved in an incident and meets all of the following criteria, they may fall into the INI category:

Answer 65

• No significant mechanism
• No complaints of injury
• No complaints of pain
• No complaints of illness
• No obvious injuries
• No obvious impairment
• Does not want an assessment and/or vital signs assessed
• Does not appear altered in any fashion
• Is A&Ox4
405.01A
2/3

Question 66

The purpose of EMS documentation is to:

Answer 66

• Provide a complete Electronic Patient Care Record (ePCR) of the incident for the receiving hospital and subsequent placement in the patient’s permanent medical record.
• Provide the Department with an ePCR of the incident for risk management and legal purposes.
• Provide the Receiving facility or Base Hospital pharmacy with pertinent information for replacement of drug box medications.
• Provide data for the fire department database.
405.01
2/4

Question 67

The following steps are followed by the records department when a report is missing or remains open in the system. There is a successive progression of steps if the ePCR remains unfinished and not exported into the data base.

Answer 67

• For open and incomplete calls after one working shift an e-mail will be sent to the primary unit Captain and CC to the Battalion Chief describing the steps needed to complete the call.
• After 2 working shifts, a second e-mail is sent to the Battalion Chief regarding the open call.
• E-mail sent to Battalion Chief & Assistant Chief requesting a personal follow up to the documenter and crew.
• E-mail if needed will be sent to Assistant Chief requesting action.
• E-mail will be sent to the Assistant Chief requesting final disposition.

Recommendations
• Proof read narratives prior to submitting
• Verify times and values of vitals, assessments, treatments, and other
events prior to submitting
• Preview completed ePCR prior to submitting it
• Have a crew member that was on the call review the ePCR
• Practice closed loop communication including times with your crew
• Carry a pen
405.01
3/4

Question 68

Mesa Public Schools Agreement:

Answer 68

Based upon these procedures, the Mesa Fire and Medical Department will not require that a Public or Private School representative sign any document related to children involved in bus accidents in which the bus was under the responsibility of the school district at the time of the incident. The intent of this agreement is to limit any unnecessary delays in patient transportation.

PROCEDURE
Upon arrival at a multi-patient incident involving a school bus, it is the responsibility of the first arriving Company Officer to assess the scene and follow the procedures outlined in the Medical Operations SOP. Once triage and immediate life-threatening injuries have been addressed, each patient involved in the incident will receive the appropriate care and EMS patient documentation.

Determination of patient disposition and mode of transportation to definitive care shall be made using currently accepted protocols and guidelines. The release of all students under the responsibility of a school at the time of the incident, who do not require transportation to a medical facility, must be physically transferred to a school Official. This transfer does not require the signature of the School Official on the patient encounter form.
406.02
2/2

Question 69

Acceptable Uses(Digital Recording usage for PT care)

Answer 69

Acceptable uses:

• Obtain a photograph of any vehicle involved in a motor vehicle accident in which the patient is transported to a Trauma Center and knowing the amount of damage to the vehicle would be useful to a facility Provider.
• Obtain a photograph of an EMS scene in which an enhanced image of the scene would be useful to the receiving Physician, NP or PA.
• Obtain a recording of a high-risk refusal, for documentation purposes. High-risk refusals must adhere to all SOP’s and Red Book guidelines as well.

• Other uses that will improve patient care outcomes or documentation, such as medication lists, DNR’s or cardiac strips (4 lead or 12 lead).
408.01
2/3

Question 70

Tactical Emergency Medical Support(Read only)

Answer 70

The primary mission of the TEMS Medic is to provide emergency medical care in the field to officers or citizens injured or ill during high-risk MPD tactical incidents. Further, the TEMS Medic will provide humanitarian medical assistance to non-law enforcement personnel who become injured or ill during an operation until appropriate transfer of care can be completed.

The TEMS Medic program will be administered through the Operations Division of the Mesa Fire and Medical Department. The Personnel Section may oversee the eligibility and qualifications of interested suppression Paramedics, and the establishment of a list of qualified individuals.

All TEMS Medics will operate in a safe controlled area under the direction of the SWAT Team Leader, or his/her designee, during training, tactical operations and follow ALL of MFMD SOP’s.

Concept of Operations
TEMS Medics will serve as the “Medical Officers” of the team.
TEMS Medics will provide medical coverage during both training and actual tactical operations. The role of TEMS Medics during training missions will include:
• Provide immediate emergency care in the event of an injury to a team member.
• Provide safety advice and observation to avoid injuries.
• Monitor team health to ensure proper and safe performance; Continuous
monitoring includes maintaining adequate hydration, hyperthermia and hypothermia prevention, and observation for performance decrements due to health conditions.
• Provide medical problem scenarios to challenge the team. These scenarios should include “officer down” situations.
• Assist with set-up and equipment use during training exercises.
• Deliver first-responder or “buddy-aid” presentations to the SWAT team members.
409.06
3/5

Question 71

ALS Integration Process(Read only)

Unassigned Personnel

Answer 71

• Unassigned ALS personnel:

1. Will be responsible for maintaining current ALS Certifications by coordinating with the EMS Section.
2. May be permitted to perform ALS skills (to maintain state certification) upon approval by the EMS Deputy Chief and the MFMD Administrative Medical Director. ALS skills shall only be performed under the direct supervision of a MFMD ALS member. Unassigned ALS members cannot perform independently as an ALS Provider.
3. Will attend on-duty ALS Continuing Education sessions and tape- and chart meetings as assigned by the EMS Section. Off-duty attendance is the responsibility of the employee.
   • Unassigned ALS personnel will be eligible for ALS assignment after successful completion of the current probationary firefighter period with the Mesa Fire and Medical Department and successful completion of the ALS Integration Program. The start of the integration program may begin before the probationary year has ended determined by department needs and approved by MFMD Administration. Supervisor approval will be necessary if ALS integration is requested prior to completion of the one year probationary period.
   • Unassigned ALS providers who do not intend to accept an ALS assignment with MFMD, or who have been unsuccessful in completion of the ALS Integration Program with MFMD will be required to maintain their ALS certification on their own and provide proof of continued ALS certification to the EMS Section.
   • With the approval of the EMS Deputy Chief and the MFMD Administrative Medical Director, an unassigned ALS provider may choose to certify at the EMT level following the procedures outlined by the Arizona Department of Health Services.
   • Unassigned ALS personnel will be considered for ALS assignment only as vacancies occur and upon the approval of the Emergency Services Chief.
   • Unassigned ALS personnel who have received Paramedic certification on their own, or who have been hired with an ALS certification will be placed on a list and will be selected by seniority, based on department need.
   409.04
   3/4

Question 72

To be eligible for probationary ALS internship unassigned ALS providers must complete the following procedures:

Answer 72

1. Meet with the EMS Deputy Chief and Administrative Medical Director to discuss the candidate’s desire to work as an ALS provider for the organization.
2. Upon approval from the EMS Deputy Chief and Administrative Medical Director, the candidate will be assigned to a probationary ALS internship by the Shift Commanders. The location and duration of the assignment will be determined by the EMS Deputy Chief and Operations, and will be for a period not less than 9 shifts, and not more than 30 shifts. During this internship period, the following guidelines must be met:
   a. The probationary ALS intern will be precepted by an MFMD Preceptor(s). The Preceptor will orient the intern to the EMS policies, procedures, and responsibilities related to being an ALS provider, as defined in the MFMD Preceptor Guidelines. The Preceptor will observe the intern and must document performance on the MFMD preceptor forms at the conclusion of each set of shifts. The intern’s Preceptor and Field Supervisor will review this documentation with the intern prior to forwarding to the EMS Section. Problem areas or concerns will be addressed with all parties working to correct them, and resolutions forwarded to the EMS Deputy Chief. The EMS Division will provide the Preceptor with a “Guidance Document” to assist with the expectations of the precept process and to ensure consistency and accountability.
   b. A performance review session will be scheduled within one week after the midpoint of the internship and will include the designated EMS staff member, Preceptor, Field Supervisor, and the probationary ALS intern.
   409.04
   3/4

Question 73

Civilian AED Quality Management:(Read only)

Answer 73

When in the course of rendering emergency pre-hospital care, a MFMD member encounters an AED in use by a civilian, the MFMD member(s) will assume care of the patient after appropriate care is rendered. MFMD will notify the owner/operator of the AED of their reporting and maintenance obligations in reference to the Arizona Revised Statutes (ARS) listed below and includes the following.

It is important to note one exception; a person who obtains an automated external defibrillator for home use pursuant to a physician’s prescription is exempt from the requirements of reporting per ARS (36-2264) guidelines.
410.02
2/2

• AED use must be reported in writing to the physician overseeing purchase and use of the device within five working days after its use.
• Ensure that the AED is maintained in good working order and tested according to the manufacturers guidelines.

A member of the MFMD EMS Division will assist the MFMD member(s) in the reporting process. It will be the responsibility of the responding crew to make the EMS Division aware of the civilian use of an AED.

Question 74

What does OPIM stand for?

Answer 74

Other Potentially Infectious Material.
411.01
2/3

Question 75

Personnel will report any concern about conduct they believe to be improper including, but not limited to, conduct in violation of our Code of Conduct or any conduct that could be seen as violating the principles or standards of our Compliance Program. Concerns are to be brought to:

Answer 75

The Compliance Officer’s attention as soon as possible after the incident or behavior occurs that causes concern or constitutes the perceived improper conduct.
As a general rule, personnel should bring concerns to their immediate supervisor. If the concern is compliance related or if for any reason, personnel do not feel comfortable in reporting the concern to an immediate supervisor, report the concern to the Compliance Officer instead. Personnel have the discretion to report any concern about our operations or personnel conduct to the Compliance Officer, whether or not they also report the concern to an immediate supervisor.
411.03
2/4