Policies and SOGs combined Flashcards
Who is the clearinghouse for citizens complaints?
Operations and administrative services
Who is allowed to take or contact the complaint?
Lieutenant or higher officer
How is the 1st notification made in the chain of command for complaints?
Verbally to the DC or supervisor.
If not available then BC.for the complaints battalion.
What is a customer inquiry?
Inquiry - Request for information -
Lost item
Securing property
Gratitude
Obtain inform
GIS
Gratitude
Information
Securing property
What is a customer complaint?
Misconduct
Taking of property of value
Dissatisfaction with policy or procedures
When are statements with regards to citizens complaints necessary?
Statements are needed :
- Damage or loss of property
- Poor treatment
- Patient wishes- ie. Not securing residence or wrong transport location
- When the officer needs statements
Who gets contacted with finding of an investigation with regards to citizens complaints?
DC get contacted for findings of Citizens complaints
Who holds the records for citizens complaints and inquiries?
Fire rescue administrative secretary
Customer complaints regarding fire safety includes what types?
Codes
Overcrowding
Parking in fire lanes
Customer complaints with regards to matters of fire safety are ha fled by?
Community risk reduction and notification to DC or BC
Customer complaints concerning communication center go to who?
Communications center supervisor
Reportable events are defined as:
An occurrence during emergency calls, training, pub ed, emergency or non emergency situations
An IRE is defined as:
With regards to any Citizen, patient, fire rescue personnel:
- Harm caused by action or inaction
- Caused by equipment failure
- Immoral, unethical , or illegal action
- Cause for litigation
- Poltically sensitive
- Media scrutinization
An IRE is reported immediately to whom?
Supervisor
For expediency of an IRE notification is made how?
By telephone or face to face to the BC.
Who can place an unit OOS for an IRE?
BC or equivalent supervisor
A “DRE” is defined as:
Events that occur during emergency calls, training, pub ed, emergency or non emergency situations:
Potential to cause harm
Equipment failure that had potential but did not.
Who is responsible completing and submitting the DRE form and where does it go?
First person to report event and uploaded to sharepoint.
Who can participate in ride alongs ?
Students and observers
Definition of Student in regards to ride times?
Enrolled in an education program at an accredited facility that has an agreement with fire rescue.
To include: EMT and paramedic programs
Emergency medical responder
Training programs at secondary school of palm beach county.
Limitations of Student riders?
Only perform or assist in activities where proficiency has been verified by training facility.
No riding alone with pt’s in pt compartment
Logged in station log book
Wear uniform that training facility has issued
Not subject to duties outside of agreement
prior to riding, First time students on ride alongs must provide the following items:
Written verification of name, year/ class and status in program.
Background check and criminal hx
Written verification of. Proficiency in BSI
Have stethoscope, eye protection, mask and fit tested.
Written confirmation of vaccinations
Written verification of skill proficiency
Students may ride at what times?
School Students: 0700-1600
EMR students only 0900-1600
What forms are required by students to ride - legal documents?
Copy of Student/ observer ride time
Release of Liability and covenant not to sue.
Indemnification agreement
HIPPA confidentiality agreement
Insurance coverage
Who may ride as an observer?
Local Dr’s, nurses, PA’s, Nurse practitioners, and other medical students or professionals.
EMT’s or paramedics with other local agencies from their chief on letterhead
Individuals seeking employee or are in training
Others approved by the fire rescue administrator and FR HIPPA compliance officer
Observers paperwork differs from students in one way?
Application signed by FR HIPPA compliance officer
The preferred location for observers to ride is:
Battalion HQ’s unless otherwise specified in the approval process.
Students unable to keep ride times :
MUST notify the clinical coordinator of their facility in advance
And coordinator MUST notify the recruitment and human resource development officer
Observers unable to keep ride times:
MUST notify the recruitment and human resource development officer in advance.
Upon arrival the student or observer MUST report to who?
Operational captain and then paired with the LT.
Who may terminate a student or observers ride time?
Operational Captain
EMS captain
BC or DC
If a student or observers ride time is terminated who is then notified?
Deputy chief of operations is notified.
What is the dress code for Student riders?
Designated uniform by training facility
Badge or other identifying means
Observer dress code is:
White shirt- SS or LS
Black, dark blue pants
Black closed shoes w/ dark socks
Guidelines for Operational Capt and Lt with Students/ observers?
Let to obtain proper paperwork for student
Safe place to observe with seat belt
Introduce person to others in the station
Familiarity with apparatus
Log person in station logbook
Log person on ePCR’s for calls and treatments performed
Students will arrive at ride time with what equipment?
Stethoscope
Eye protection
Respiratory protection
Clinical and skills documentation able to perform.
Copy of state EMT and BLS cards.
Who has the responsibility to call for a fire investigator?
IC
Who is responsible for securing and maintaining scene integrity for a fire investigation?
Operations personnel. Not LE
How is a fire investigator requested?
The IC requests through the communications center.
When must a fire investigator be called?
- Fire is suspicious or crime related-
- Loss of injury or life
- accidental fire w/ substantial monetary loss or structural damage.
- Juvenile related incidents
- Explosive devices/ explosion
- Undetermined
Evidence that a fire is suspicious in nature or crime related means:
Incendiary fires/ explosive devices
Firebombs
Stolen vehicles
Burglaries
Loss of life/ injury definition for fire investigator call out?
Fire or explosion related deaths
Fire or explosion related injuries which require transport by FR.
Definition of Accidential fire with substantial monetary loss or structural damage?
Monetary fire loss of $70,000 or structural damage exceeding 20%
Any suspicious or crime related incident regardless of dollar value.
Definition of Juvenile related incidents for fire investigation?
Suspected to be the result of juvenile involvement in the ignition process
For which of the following fire investigatory incidents shall a Fire investigator be contacted via radio or cell phone?
Juvenile related incidents.
What type of work related injuries must be reported?
All injuries no matter how minor
What must the employee have in order to go to the OHC?
A completed employee injury /illness report. Form FRH-302
Who and where does PPE go if an injury occurs on an emergency incident?
BC secures PPE and training AMS safety division
Who fills,out report for minor injuries and where does it go?
Immediate supervisor and forwarded to BC
An example of injury while wearing PPE would be?
Burns to the hands while wearing gloves.
What are the options for a minor injury requiring treatment?
- shall report to the OHC for further evaluation
- if OHC is closed then may go to the nearest hospital or wait till OHC opens.
When does notification of an injury need to,be reported to the state?
- one or more FF are hospitalized for,more than 24hrs
- LODD
- serious injury related to an equipment failure.
Notification of a serious injury meeting criteria for the state gets reported to who and when?
Bureau of,fire standards and training- FF Safety and health section within 4 hours.
Employees with work related injuries must be cleared by the OHC before what?
Traveling out of the area.
Injury tracking is entered by who ? And then forwarded to who?
Training and safety division
Wellness coordinator
How often is injury tracking analyzed
On a quarterly basis
Clearance from the OHC prior to returning to work must of,had what types of conditions?
- work related injury that resulted in being off duty from WC or LD
- Out patient surgery or hospitalization
Responsibility for,returning to work is who’s?
The employee to notify the BC/ supervisor
What is the order for clearance by the OHC prior to returning to work?
Obtain the day before returning to work and if unable notify the BC/supervisor they are reporting to,the OHC for clearance .
If an employee cannot,obtain clearance to return to work because the OHC is closed what happens?
The BC MAY allow the employees to return to work if not I’ll and without limitations but must still receive clearance from the OHC before Their next day
If allows to return to work with the BCs permission when must the employee go,to the OHC for clearance?
Before the next work day
When must an employee be required to complete a medical exam and fitness assessment?
Prior to returning to full duty from any injury or illness or any leave greater than 6 months
For employees returning to full duty who must clearance be obtained from other than the OHC/?
Compliance officer and training division.
What is the time frame employees can be held to complete target solutions and other identified training?
1 week
If the reporting system is down how shall the incident report be documented?
Should be documented on the a “field report”
Report writing will be in accordance with which type of code?
“Dispatched code”
Who can enter information on a medical report?
Any crew member as ;long as it’s consistent with the authors level of training and certification.
What information is needed to finalize a medical report?
“Report author”
HIPPA or PPA signed
Signature of patient or witness
“Transfer of care “ by hospital staff
MRN
Any students or observers must be listed.
How does a reservist get entered in the causality page?
RESERVE1 is the ID number
PBCFR is the first name
RESERVIST was the last name
What information is to be entered on a level 1 or 2 MCI?
Name
DOB
Phone number
Brief narrative
Security of all medical supplies applies to what type?
All non controlled substances , medications, fluids , and medical equipment.
Fire rescue has an agreement with who for purchasing all pharmaceutical supplies and medications?
Health care district of Palm beach county.
Battalion level procurement of equipment will go through who?
Medical supplies warehouse.
Storing of medications in the station supply room are to be kept at what temperature?
70-75 degrees
Storing of medication on the rescue truck need to be kept at what temperature?
65-80 degrees Fahrenheit
Rotations of medications are to happen on what day ? AND who is responsible the inspection ?
On the first day of each month and the operational captain or designee
Where are adulterated or expired medications kept?
In a designated “quarantine “ are within the supply closets.
What are the 6 rights to medications?
Right Patient
Right medication
Right Dose
Right Route
Right time and Frequency
Right indication
All medication errors and immediate and delayed outcomes for errors gets reported to who?
EMS captain
The exposure control manual provides information on 5 areas. What are they?
Risk
Prevention
Determination
Care and cleaning
Biomedical waste
Significant exposures are defined as and are what type?
Exposure through a needle stick , sharps to the following body fluids:
Blood or and body fluid containing visible blood
Semen
Vaginal secretions
CSF
Synovial fluid
Peritoneal fluid
Plueral fluid
Pericardial fluid
Amniotic fluid.
Body fluids to mucus membranes
Chapped or a braided skin
Exposure to Airborne contagions
Measures to be taken immediately after a significant exposure?
Clean the wound
Notify the EMS captain
Accompany the source patient to the hospital
Fill out the hospitals exposure log book using the Case number
Report to the OHC immediately or the next business day
Discontinue and treatment after being notified by the OHC of a negative result.
EMS captains responsibility post significant exposure are?
Make sure exposed employee requests patient source testing at the hospital
Consult with the ER physician
Notify the exposure control officer during normal hours unless employee receives post exposure treatment-
Then have the communications center page the control officer at any time
The definition of a newborn to be left at a fire station is defined as?
7 days old or less left by the parent
What is the difference between “Safe Haven” and “Safe Place”
Safe haven is referencing new borns
Safe Place is for teenagers
Under the “Safe Haven “ parents may not be pursued unless?
The parents are seeking to reclaim the new born infant
Parents under the “Safe Haven “ law can regain custody as longs as what?
The infant shows no signs of abuse
Under the safe haven law, Law enforcement should not be contacted unless?
Signs of physical abuse are present at the time of surrender.
Who get notified when a newborn infant is surrendered at a fire station?
PIO
How does the newborn infant get entered in the PCR if it is unclear the safe haven law?
“Safe Haven Baby”
Who gets notified for a Safe place incident?
The communications center and that the a unit is OOS until a Safe harbor representative arrives.
Under the safe place law, when should law enforcement be contacted?
- Child is followed by and angry parent to the fire station
- Abuse is ssuspected
- Suicidal/ homicidal
- Teen is hallucinating and out of control
Medical supply warehouse record keeping inventory items are stored where?
On the “G:” drive in the support services folder
Expired medications shall not be held in quarantine for more than?
30 days
If an employee is having training issues how should it be documented?
On a professional development form
Who can complete a Professional development form ?
Any employee
Where is professional development form submitted ?
To the affected employees battalion chief
Professional development needs assessments include:
Additional research in the questionable subject
Reading combined with per and post assessments
Attendance on training sessions
Performance training and evaluations
Attendance at courses provided by vendors
Other
What is considered successful professional development?
Acceptable job performance as described within the plan
Where do completed professional development forms get submitted to ?
The compliance officer electronically
What is the maximum amount of time allotted for professional development remediation?
Maximum 18 shifts
Property and damage reports are defined as?
Damage to fore rescue property and or property belonging to the members of the public. NOT RESULTING FROM A VEHICLE ACCIDENT.
When damage does occur from a fire rescue vehicle and DOES NOT sustain damage who is notified?
Battalion chief
Where can phone numbers for contacting parties be found?
Fire Rescue intranet (share point) under phone list
Documentation for Property loss, damage, or theft includes?
Property and liability report
Employee statements
Law enforcement report if necessary
Photographs with digital color
Property damage tracking number
Who is notified via email once a property damage tracking number is pulled ?
Training and safety division
ALL Deputy Chiefs
ALL Division chiefs
ALL District chiefs
ALL Battalion chiefs
Risk management
Incidents involving bodily injury sustained by the pubic at a fire rescue facility what happens?
Render appropriate treatment
Notify the communications center
Officers to notify the battalion chief
Stretcher malfunctions are handled how?
Render appropriate treatment
Call for an additional rescue
Call for an EMS captain
Take the rescue out of service
Sequester stretcher at battalion HQ
Label the stretcher “Out of Service- do not use”
Place in assetworks as a “HIGH probity”
Report incident to Central shop and CQI
What has to be “Clearly” written on the tag for a stretcher malfunction?
OUT OF SERVICE- DO NOT USE
After securing the malfunctioning stretcher- Where does the item get reported to ?
Assetworks as a HIGH priority
What is the purpose of paramedic development?
Provide a uniform process for new employees attempting to work as a paramedic
Address development for paramedics requiring remediation
The Paramedic Development course is for?
New employees and
Those needing remediation
How are new employees selected for the paramedic development course?
Based on Senority
What are the requirements to get into the Paramedic development course?
Current ACLS card
Current state of Florida or National paramedic certification
Complete sign off skill sheets
Complete IV skill sheet
Evaluation material for the paramedic development course include what?
Medical protocols
EMS related SOGs
Exposure control manual
PDC skill sheets
Pharmacology
ECG interpretation
Scenario based assessments on Praxctical application of protocols and or patient assessment
The Paramedic development entrance exam includes?
ON the first day completing a written test at 80% or above
IF an employee fails the PDC entrance exam what happens?
Returned to shift as soon as possible
Cannot re try until next scheduled PDC
IF the employee fails the 2nd time- must wait 24 month before applying again.
Paramedic probation consists of:
18 shifts probation period which can me ended at any time with an EMS captains approval.
Memorandum with task book to be sent from the EMS captain to the compliance officer
Extensions for paramedic probation are ?
Done by the EMS captain and documented on a professional development form for an additional 18 shifts.
If the extension period is still less than satisfactory then the EMS captain. Recommends the person be referred to the medical services division and medical director for further evaluation.
All documentation to be sent to the compliance officer
Per CQI and Adverse event is defines as ?
Incident causing injury or other medical condition to a patient as a result of treatment rendered by EMS personnel.
Per CQI, A near miss is defined as?
Incident that had the potential to harm a patient as a result of care rendered by EMS personnel BUT DID NOT actually harm the patient.
Per CQI, an ERROR is defined as?
Failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim
Reportable adverse, near miss, or errors are sent to who?
EMS CQI officer
What are the common means of reporting CQI events?
Field personnel vis chain of command
Reportable events
Hospitals via complaint as a performance improvement process
Patients vis a complaint to the agency
EMS CQI Reportable events are?
Airway or ventilation issues or errors
Electrical therapy issues or error
Deviation from EMS protocols with out justification
Advanced procedure issues or errors:
Paralytic use, pleural decompression, Cricothyrotomy
Repetitive minor issues that cannot be resolved on a supervisor level
Any other issue or error that causes harm or has significant potential to do so.
MInor CQI errors include?
Spelling or topographical errors
TIme delays without patient harm
Lack of detail
Intracranial- report inconsistencies
Protocol deviation without patient harm or potential.
Incidents identified by the EMS CQI officer level containing an EMS CQI reportable event are handled how?
Emailed to the appropriate EMS captain to be handled.
Who are responsible for the accurate inventory, distribution, transfer, documentation, and record keeping of all controlled substances on a unit?
All department protocoled Paramedics assigned to a unit.
Special events , dignitary details with regard to controlled substances are handled how?
Receive written authorization from the division chief of medical services or designee.
What kind of lock can be used for the EMS captains Storage container of controlled substances?
Key, coded, or biometric lock
When must controlled substances be inventoried?
Begin and end of shift
Custody change
When locked tag seal is changed
If the paramedic who signed the controlled substance log can longer keep possession and no relief is available who do they go to?
Lieutenant or operational captain or designee
IF trauma hawk is taken out of service where are the controlled substances kept?
In a department issued lockable safe
What shall be recorded on the controlled substance inventory log?
Total amount in Mg, MCG, etc
NDC or Lot number
Expiration date
How long before the expiration date are crews to notify the EMS captain that the controlled substance is about to expire?
7 days
How are explained discrepancies handled with controlled substances?
Report to Lt or operational captain
Single line strike though with initials next to change
How are UNexplained discrepancies handled for a unit?
Notification to the EMS captain and EMS captain contact the Division chief of medical services
How are UNexplained discrepancies handled for the EMS captains stock?
Notification to the division chief of medical services
One a controlled substance is removed from the container how long till it needs to be re-sealed?
Immediately following or as soon as reasonably possible
Distribution of controlled substances from the EMS captain to a unit are signing in what spaces in the book?
EMS captain signs Given/ Issued by and Unit sign received by section .
Damage of a controlled substance from a a unit is handled how?
Notification t o the EMS captain
Property loss form and tracking number
“Broken/ damaged” written in the case# spot
The EMS captain notifies the division chief of medical services
Damage from the EMS captains stock are handled how?
Notification to Chief of medical services
Property loss and tracking number
H ow are lost or stolen controlled substances handled from a unit?
Notification to the EMS captain
Property loss form and tracking number
Law Enforcement report attached
EMS captain then to notify the Division chief of medical services
EMS captain to Ensure all paperwork is completed
If theft or loss of a controlled substance from the EMS captains stock- how is it handled?
The same as a unit loss except the EMS captain contacts the division chief of medical services 1st.
Disposal, Destruction of controlled substances are handled how by a unit?
Draw upon Unused medication and dispose of it “as directed by the medical services division,.
Record disposal in log book using 2 different employees.
How are expired controlled substances handled by the unit?
Unit gives the expired medication to the EMS captain and records “Expired” in the logbook for the case #
How are the collected expired controlled substances handled?
Hand delivered to an authorized member of the medical services division for proper disposal.
Definition of a “PAR” level?
The “ideal quantity of each controlled substance carried by a unit in order to maintain sufficient operations.
Who sets the running par level at the battalion for controlled substances?
The EMS captain.
Where can the “Running “ par level for a controlled substance for each unit be found?
Front cover of the units controlled substance logbook
And
EMS captains logbook
Minimum par levels with controlled Substances can be found where?
PBC portal/ PBCFR/medical services under the quick link- Controlled substances minimum quantities.
A serious injury not requiring state notification get reported to who and within how many hours
OHC and 4 hours
Who delivers all investigative material for an IRE?
DC to the Division chief of operations
the investigative material fro an IRE has to be sent when?
ASAP during normal business hours
what is the time frame for completing a customer complant file and by who?
30 days
DC / Supervisor
how far in advance should paperwork for students/ observers be completed?
3 weeks
who contacts to State Bureau of standanrds and training for reportable events?
FOO with authorization by DC
inspection of controlled substances includes?
medication condition
NDC
lot number
expiration date
cointainer breakage
alteration
tampering
What is the minimum time for logs and records with regards to controlled substances kept?
2 years
With regards to reporting, what are code numbers identified as “FIres”?
100-173
Who is responsible for completing all fire related pages?
Individual with the most knowledge of the incidentr
Who is responsible for checking completeness of fire reports and notifies who how and by when?
BCVia email to captainChanges completed by end of next shift
what are the EMS CQI areas (7)?
EMS CQI reportable events
EMS excellence awards
EMS CQI committee
EMS CQI studies and goals
EMS CQI Surveys
EMS CQI best practices
EMS CQI Hospital outcomes
What are the FIRE CQI Areas (4)
Fire CQI
Fire CQI committee
Fire CQI Studies
FIRE CQI Best practicea
What are the 4 possible outcomes from EMS CQI?
System Faults
lessons learned
remedial training
CQI officer level
who does the administrative secretary or FOO contact after a complaint tracking number is issued?
Deputy chief and or Division chief supervisor
once discipline is warrented or may a the result during a customer complaint who should be consulted?
DC or supervisor
the documents generated in a customer complaint are refered to as?
Inquiry logs
who initiates the primary investigation for an IRE
BC or supervisor
Who are the comp forms IRE fowarded to by the end of the day ?
Divison chief of operations
DC’s
internal affairs
Litigation officer
EMS CQI
FIRE CQI
safety committee
DREs are handled by the _______ and notifies the _______
via ___________ before the end of the day.
BC
DC
who initiates a meeting with the involved supervisory staff to ascertain the need for an investigation?
Division Chief of operations
What is the age for observers?
18
examples of undetermed cause for a fire and fire investigator response are:
Fire sprinkler activation
overcrowding
when the IC determines a significant life safety issue
Who determines is the PBSO bomb squad is required?
Fire investigator
work related injures and incidents is inclusive of ?
employeees
Reservists performing offical duites.
DOES NOT APPLY TO CADETS
who is responsible for their employees safe working performance and environment?
Each supervisor
who adjusts leave types for an injury?
Payroll section
who approves workers compensation?
OHC
when an employee is transported to the hosptial who is responsible completed paperwork
BC
When does the employee report to the OHC after an injury?
ASAP or within 48hrs.
who assists the employee in completing the appropriate dept of labor forms for processing medical claims?
OHC
If hospitalization of an employee is required who is required to complete the required forms?
Risk management
who enters injury tracking data information into the computer database?
Training and safety division
For and exposure, when must the employee report to OHC?
immediately or next business day if occured after business hours
Who contacts the hospital ICC to verify source patient testing?
Exposure control officer
Who is responsible for determing workers compensation coverage?
OHC
the logbook in reagrds to the controlled substances policy is also known as ?
record keeping binder
who is responsible for designating who will complete the data entry for a fire report?
Highest ranking IC
Vehicle accident reports with occupants who are denying injures will have their demographic information completed in which program?
ePCR
The safe haven prgram is based on what statue?
Florida
In what situations can parents attempt to regain custody of a newborn?
no signs of physical abuse
parents state of mind
can contact the selected hospital
who shall provide the teen with a safe enviornment ?
Lt or operational captain
who notifies the communcications center that thir station is OOS for a safe place incident?
Lt or operational captain
who creates the professional development plan?
Batallion command staff
The employee with meet with who to discuss progress of a proffesional development plan?
supervisor and DC
completed professional developmetn forms are fowarded to who and how?
complaince offcer
electronically
Future updates to the property damage and injury policy is the responibily of who?
Division Chief of safety and training
who amd when are notified when a unit is involved with property damage but the vehicle does not sustain damage?
BC prior to leaving scene
immediately
who is notified if the BC is unreacable for property loss or damage?
FOO
Who can be assigned portions of the property damage/ injury report?
Lt
operational captain
What are the DCs responsibilty for property damage/ injury reports?
ensure all documentaion is accurate and complete
Inital report indicating the report id complete
Ensure discipline
foward all documentation to the training and safety divsion
EMS CQI reportable events should not be confused with what other reports?
an IRE or DRE
Best practices from the FIRE CQI side are submited to who?
Deputy chief of operations
Paramedic development class is how many hours?
80 hrs
Who’s responsibility is it to assign a safety officer?
IC
All safety officers will have the authority to ?
Identify and correct safety and heath hazards
To alter,suspend, or terminate un -safe acts that involve an imminent hazard to personnel
Inform the IC of the 2 items above
A safety office should have a working knowledge of what?
Safety concerns for fire rescue in typical incidents
Fire behavior
Building construction
EMS
Only those person who have completed and approved Incident safety officer course ________ be used as a safety officer.
SHOULD
A safety office shall be appointed on the following incidents?
HWH-hazardous, Wildland, high hazard
Incident becomes so large, complex, or dangerous that reasoned safety is potentially threatened.
Hazardous or potentially hazardous environments:
Structure fires
Special operations incidents
Large multi casualty incidents
Wild land fires with 4 or more units or during extreme weather.
Any high Hazard Training:
Live burn evolutions
Smoke drills
Dive rescue
Extrication
Elevated victim rescue
above or Below grade operations
confined space rescue
Once assigned to Safety officer what are the duties?
Don appropriate vest and PPE
Ensure no entry into the hot zone as a single person
Ensure all control zones are established or adjust as necessary
Ensure exclusion zones are recognized
Rehab
Atmospheric monitoring
Remain on scene until relieved by the IC or designee
Document actions as to the incident reporting guide
any accidents injuries or unsafe acts or safety concerns should follow the CQI
Communicate with EMERGENCY TRAFFIC the exclusion zone
Who do assistant safety officers report to?
Directly to the Incident safety officer
How are safety officers general y assigned?
To a geographical or functional area.
The following incidents REQUIRE an assistant safety officer?
Hazardous material
Dive team operations
Open water incidents
Rehab when assigned
“Mayday” definition is?
Lost
Trapped
Disoriented
Seriously injured
Experiencing an Air emergency
In need of immediate help
The term “MAYDAY” should be used when ?
Lost
Trapped
Disoriented
Seriously injured
Air emergency
‘In need of immediate help
When a “MAYDAY” is called what happens to the Tac channels?
The MAYDAY remains on the original channel and other operations will switch .
During a “MAYDAY” the ISO should request what?
An additional safety officer
The TAC stick shall only be used to?
Identify an energized source so an exclusionary zone can be created
The ONLY useful purpose for a TAC stick is:
To identify energy sources that were not previously aware of
The TAC stick has 4 indicators?
Detects AC current only
Provides warning in audible beeps and flashes
Warning signals increase in strength as amplitude increases
Warning signal s make it possible to locate the signal quickly
The TAC stick does not?
Read DC current
Or pick up shielded AC voltage
The 3 sensitivities for the TAC are?
HIGH
LOW
FRONT
When using the TAC stick the user should start on which sensitivity?
HIGH and move to lower ones later.
During which incidents is the TAC stick particularly useful?
Night operations and post storm area searches.
Fires
Powerlines down
Atmospheric monitors are carried on which vehicles
Engines
Aerials
Rescues
BC
EMS captain
Special ops
Who is equipped with the drager X-am 5000 5 gas monitor
EMS captains
The difference between the drager X am 2500 and 5000 is ?
The 500o does OV monitoring for Ethylene oxide
The Drager X am 5000 monitors which substances?
O2
Flammability
CO
H2S
OV
When an atmospheric monitor alarms who SHALL be informed?
IC
Active atmospheric monitoring is used when ?
Firefighter is actively monitoring an atmosphere to detect the presence of a leak
Investigating residential or commercial alarm activations to determine hazards
What are the common gasses between the drager atmospheric monitors
O2
Flammability
CO
What gas and how much is required for both drager monitors to operate correctly?
02 and 10% above
What are normal atmospheric conditions
O2- 21%
LEL -0%
CO- 0 PPM
H2S- 0 PPM
H2s has an almond like Oder detectable at what levels?
1-5ppm and 60-70% of the population
The ISO with regards to atomospheric monitoring SHALL ensure:
Levels are safe before allowing personnel to remove SCBA during overhaul
Benefits outweigh risks with OV
Respiratory protection is used accordingly
Half mask cartridge respirators with organic vapor filters can be used when 2 conditions apply?
OV only and 02 is normal
What are Half mask cartridge respirators w/ organic vapors particularly used for?
Wildland fires
D/O operating at the pump panel
ISO
Post fire activities
The IC or ISO shall determine if it is safe for what to happen when atmospheric monitoring?
- FF remove their respiratory protection
- Occupants to enter the structure
- Fire investigators to enter any structure
TIC operations: our eyes work by seeing contrast by objects that are illuminated by either. _______ or. __________.
Sun or another from of light
TIC operations in normal temperatures - a victim or FF will appear what color?
White
TIC operations with victim or FF in structure fire will appear ?
Dark
TIC operations for the most prominent feature of a FF is ?
SCBA bottle
TIC’s are assigned to which apparatus?
Every Engine, rescue, EMS captain , and BC.
Who are responsible for checking the TIC?
All company officers and chief officers in custody of the TIC.
TICs are used for:
Search and rescue
Fire Attack
Overhaul
HAZMAT
Vehicle accidents
TIC limitations:
Cannot see into a windowless building- need temperature differences
Cannot see under water
Cannot see through windows or glass
Cannot see through highly reflective materials - stainless, steel, mirrors, windows
PBCFR used which Rehab standard for Heat stress index?
WBGT- Wet bulb globe temperature
The heat stress index Is made up from ?
- Air Temperature
- Air Speed
- Humidity
- Radiation - direct sun light
How many of hours of work may be sustained if ________, _________, _________ and hours__________.
Rest
Hydration
Energy nutrition
At least 4 hours
What are the 5 components of REHAB?
- Rest
- Energy nutrition
- Hydration
- Accommodation for weather
- BLS and ALS monitoring
What is the priority order for REHAB?
RHBEA
- Rest
- Hydration
- BLS/ALS
- Energy nutritionand ALS
- Accommodation for weather.
What is the most important V/S to stabilize?
CORE temperature
What percent is active cooling better than passive cooling?
50-60% more
What are the medical NO-GO criteria?
SBP< 100
Pulse >100 with ANY of the following:
Temp > 101
SBP> 180
DBP>100
SPCO>0
ALS S/S.
What are the time frames for rehab?
20 min X 2 for a total of 40 minutes. After 40 minutes BLS/ALS tx, and transport or referral to OHC
Rehab 6 hours post fire incident is in reference to ?
Cardiac arrest and WILL be treated for cyanide exposure
Rehab 24 hours post fire incident refer to as?
Carbon monoxide and cyanide exposures
The rehab unit works under which command branch?
Logistics
If there is no logistics branch who does the rehab unit report to?
IC
Companies should be placed in rehab when ?
Worked for 45min
Used 2 air bottles consecutively
Rehab chart
An assistant safety officer may be assigned by the IC for rehab under what incidents?
Physical labor of > 2 hours
Excessive rotation of companies
Incidents that require defined hourly work periods
Hire rise fires not controlled by a single company
Wildland fires
Hazmat incidents
Confined space incidents
The incident safety officer will have the 1st EMS captain on all __________ __________ and _____________ __________provide what to whom?
Working fires and Hazmat incidents their rainbow sensor to the Rehab unit.
Where should the SCBA refill are be located?
Near the “Drop Zone” in the WARM zone
The rehab tracking worksheet has what recorded on them ?
Pulse
BP
Temp
Respirations
SP02
SPCO
SPMET
Where do companies leaving rehab report to?
Staging
The unit rehab tracking worksheet becomes part of what?
Permanent medical record.
A patient exists when ?
medical complaint,
obvious injury,
appears in distress
Suggestive of acute illness or injury
Such as: HX, MOI, appearance
Lack of capacity
Motor vehicle accident criteria for a patient?
Greater than minor damage
No restraint used
Air bag deployed
Steering wheel damage
Other occupants have injuries
Appearance and behavior not normal
People on the ground are patients when?
Unable to get up without assistance
Gets up but does not have capacity
The definition of “Capacity “ is?
The ability to understand the benefits, risks, and alternatives to a proposed tx or intervention.
Public assists are patients when?
Inability to ambulate is acute
Summary of a patient is when the following are met?
Any medical complaint, injury or distress
Suggestive acute injury or illness
Lack of capacity
MVC with more than :
Minor Damage
no restraints
air bags
Steering wheeL
occupant injuries
appearance and behavior not normal
Fall that cannot get up on their own
Public assists with acute ambulatory issues
Definition of an MCI?
One that exceeds the capabilities of the first arriving units?
MCI levels are what numbers?
1- 1-10
2-11-20
3.21-100
4.101-1000
5.greater than 1000.
MCI types are classified as:
CBRNE
Shootings
MVC’s
Plane crashes
Collapse
Name, DOB, phone number and brief narrative are required for which levels of an MCI?
Levels 1 and 2
METTAG number, basic information and tx information are required for what level MCI?
3 or above
Command structure assignments for an MCI may include what?
Treatment
Transport
Triage
Staging
Rehab
Hazard mitigation
Who maintains the list of resources that may be beneficial in an MCI?
FOO
The first arriving unit responsibilities to an MCI are what ?
Establish Command
360
Establish exclusion zone
Declare LEVEL and TYPE MCI
Initial triage
Assign incoming units based on LIPE
Additional resources
Staging officer
When declaring an MCI what 2 things must be included?
LEVEL and TYPE
Safety officer responsibility for an MCI are to do 3 things:
- Request LE
- Provide physical security
- Exclusion zone
Additional backboards can be requested from who?
Support 81
Rescues in staging
Inventory specialist
During an MCI command needs to be updated with what information?
Number of patients
Patient categories
Additional resources needed.
The MCI transport log has what information on it?
Patient METTAG ID
Destination hospital
Transport unit number
An “After Action Review” is required for what level MCI?
Level 3 or higher
With refusals, who may help convince a patient?
Family members
Friends
Physician
EMS captain
Medical director
In order to sign a refusal for transport Fire rescue personnel SHALL?
Exhaust all reasonable efforts have been exhausted
Inform the patient that if at any time they change mind or condition deteriorates/ changes they should call 911
What patients my be examined, treated, or transported without their consent?
Suspected medical conditions that are likely to be incapacitated from intoxication or other medical conditionsl
Adult who can refuse treatment or transport criteria?
>18 yrs old
AAOx4
Clinically sober
Hypoxia< 94 on room air
COPD < 90
Syncope
Head injury w/ LOC
>100.5
Sever pain
Hypotension
Stroke
Minors refusal criteria?
Parent or legal guardian
<18 yrs old if Married
emancipation
military
Parent or guardian by phone w/ person on scene willing to sign
If a parent is consenting by phone to not have minor treated or transported and no one can sign the refusal form what happens?
Minor to be transported to the appropriate emergency department
Pregnant minors can refuse transport only for?
Only if the condition if the condition is related to the pregnancy. If not, then no refusal. Ie. Broken leg.
Diabetics can refuse transport if ALL the following are met?
Baseline, Levels, Food, Adult, oral
Regained baseline mental status
Blood sugar has returned to normal levels
Immediate access to food
A competent adult is present and willing to assume care
Meets criteria to for a general refusal.
Not taking oral hypoglycemic medications
What are the oral hypoglycemic medications?
Glipizide
Glyburide
Glimperide
If a parent or guardian refuses a physical exam what must be documented?
Visual exam
Mental status
General appearance
Work of breathing
Circulation to skin
What shall be documented in the pcr for refusals of treatment?
Refusal can result in death or disability
They were AAOx4- clinically sober w/ no life or potential life threatening conditions
Have the capacity to refuse
What shall be documented for refusals of Transport?
Death Disablity, AAOx4, Clinically sober, impaired judgement, capacity, assessment, exam, 2 set v/s.
Not being transported may result in death or disability
AAOx4- clinically sober, with no life or potential life threatening conditions to impair judgment
Capacity
Patient assessment
Physical exam
2 sets of V/S
Refusal breakdown chart?
Refusals:
Adults
Minors
Pregnancy
Diabetics
Treatment refusal:
Death or disability
AAOx4 w/ no life or potential life threatening condition to impair judgment
Have Capacity
Transport refusal:
Death or disability
AAOx4 w/ no life or potential life threatening condition to impair judgment
Have capacity
Patent assessment
Physical exam
2 sets of V/S
Meet all previous criteria for refusal
A DNRO applies to who?
Cardiac or respiratory arrest
Succumbing to a disease process of a terminal illness
The following SHALL NEVER be performed on patients with a DNRO?
Artificial respiration
BVM
ET tube
Supraglottic A/W
Chest compressions
Defibrillation
A valid DNRO shall be:
Signed by the competent patient or patients representative
Signed by the licensed Florida physician
Be on original canary yellow or copied on similar colored paper.
The DNRO identification device must be signed by who if the patient cannot provide consent?
Surrogate
Proxy
court order
Power of attorney
What are acceptable forms of ID for DNRO
Drivers license
Other photo identification
Witness in the presence of the patient
Who can revoke a DNRO?
Patient
Surrogate
Proxy
Court order
Power of attorney
How can a DNRO be revoked?
By writing
Physical destruction
Failure to produce
Orally expressing a contrary intent
For termination of resuscitation efforts who does the scene get turned over to?
Law enforcement
Or CARES team.
When can a body be covered with a sheet?
When no suspicion of a crime scene
What other documentation is needed post resuscitation termination of efforts?
EKG strip to PCR
ETCO2 to PCR for advanced airway placement
What is the primary goal with an active shooter event?
Ensure joint command and communications from FR and LE to minimize the risk and maximize safety for all response personnel.
What does ASHER/ MCI stand for?
Active Shooter Hostile Event Response- Mass casualty incident
Who has the ultimate responsibility for an ASHER/MCI (Active shooter hostile event response)?
Law Enforcement
What is the main role in an ASHER/MCI for Fire Rescue?
Fire and medical decisions
The THREAT acronym for an ASHER/ MCI stands for what ?
Threat Supression
Hemorrhage Control
Rapid extrication
Assessment
Transport
What does RTF-PEM stand for?
Rescue task Force- Protective element medical
Who makes up the RTF-PEM Team?
3 Fire rescue
4 LE
Where does the RTF-PEM team operate?
Warm zone only.
What are the 4 zones for ASHER/MCI?
Exclusion
Hot
Warm
Cold
Definition of the “exclusion zone”?
Risks outweigh the benefits
No FF operations allowed
Definition of HOT zone with ASHER/MCI?
HIgh risk area
No FF operations allowed
Definition of “Warm Zone” for ASHER/ MCI?
Area with “LITTLE” risk
RTF-PEM teams operate
CCP operates here
Definition of “Cold Zone” for an ASHER/ MCI?
Area of no risk
Cold “O” no “O”
All support operations
Unified command
Final approach position
Staging
The IC shall be advised immediately during an ASHER/ MCI when ?
Fire rescue personnel are requested to or are found in the “HOT or Exclusion “ zones
RTF-PEM teams are committed by the IC only when ?
Threat to life
Benefits outweigh risks
Unified command will use which management system?
NIMS- National incident Management system
Response code levels to an ASHER/MCI by Fire Rescue are?
Code 3 with lights and sirens until unit crosses the LE perimeter./
Who gets notified of an ASHER/MCI incident?
FOO
PIO
1st arriving unit responsibilities on a ASHER/MCI?
Establish command
Set LEVEL 2 staging
Set up command at Staging
Establish a unified command with LE.
What level MCI and why should be set for ASHER/MCI ?
Level 2 due to unknown amount of victims
The IC should request how many TAC channelsfor an ASHER/ MCI
3 TAC channels:
- RTF-PEM
- Medical
- Staging
1st Arriving EMS captain on a ASHER/MCI “SHOULD”?
BE the incident safety officer
Ensure the following items are brought to the FUP - Forming up Position
- Available RTF- PEM kits
- Available SKEDS
-Available TQ’s
-Available Mega movers
-Available Trauma rapid response kits
The Fire rescue RTF-PEM supervisor is established by who and works on which TAC channels
IC and 7a or 8/a and 14a or 15a.
Where is the fire rescue RTF-PEM group supervisor located?
Next to the Tactical LE officer in the “Cold Zone”
The fire rescue RTF- PEM TEAM leader reports what to the Fire rescue RTF-PEM group supervisor
PAR levels
- going in and out of the warm zone
- going in and out of structures in the warm zone
- Changing floors or levels with in the warm zone
The Fire rescue RTF-PEM TEAM leader reports what to the LE RTF-PEM ?
Total number of victims
Non ambulatory patients
When ready to move
The FUP in a ASHER/MCI is defined as?
Forming Up Position where FR and LE meet to form a team
What is the FAP definition for ASHER/ MCI?
Final Approach position- is the outside area where the RTF-PEM team enters the warm zone
What is the Definition of a “Strong Hold” with and ASHER/MCI ?
Defensible area within the warm zone that has no windows and all doorways are covered by LE
Also serves a CCP
What categories do ASHER/ MCI patients get categorized to using TECC? (MCI level)
Immediate and Delayed
the Definition of the CCP in an ASHER/MCI?
Casualty Collection Point- in the warm zone where patients are triaged and treated.
ASHER/MCI incidents with fire are what mode of operation?
Defensive
Blood Draws are performed when ?
Request of LE
Who’s responsible for restraining an patient for a blood draw?
LE
If a patient is too combative for a blood draw and at the discretion of the PM?
Blood draw will not be performed and EMS captain notified.
Documentation of blood draw will include what?
Name and badge number of Officer
Kit sealed Y/ N
PM name
Site
Number of tubes drawn
Date and time
Who sample was turned over to
What pages in the ERG are used for LPG and Natural gas leaks?
20-25 and orange guide sections 115-116.
Natural gas has an LEL of?
5.3-14%
Propane has an LEL of?
2.1-9.5%
What gas type and pipe size does not contain mercaptan?
Natural gas in sizes 18” or greater
Common Natural gas lines that are 24” are found where in PBC?
Along the turnpike
Port of palm beach to West county energy center owned by FPL
Natural gas lines are what sizes?
Commercial 1-4”
Residential 1/2-3/4”
On a confirmed LPG/NG leak where does the “Hot zone” start
Where the 4 gas monitor has LEL readings above 0
What is the minimum size hose line and nozzle for confirmed LPG/NG leak?
1 3/4” with a fog nozzle
For exterior LPG/NG leaks on above ground containers - they should be cooled with what?
2 1/2” line at 200gpm
For exterior LPG/NG leaks on above ground containers of 1000lb or greater they should be cooled with what?
Ground monitor flowing minimum 500gpm
Documentation for LPG/NG response on the technician is?
Name
Phone number
ID or employee number
The 5 gas monitor will be used when ?
Incidents where combustion processes have taken place
In areas with close proximity to any fire- wildland, structure, vehicle, training, or dumpster
All atomspheric monitioring readings are entered where?
in the appropriate fire reporting system
what greatly influences the atomosphere surrounding the hot zone?
wind direction
Where shall H2S be monitored ?
areas of decomposition:
Sewers
Septic tanks
Horse barns
daily fluid intake should no exceed how much?
12 quarts
Sweating is also known as?
evaporative cooling
How many degrees are added to WBGT index is wearing
Full PPE and SCBA?
Full PPE without SCBA?
5 degrees
3 degrees
if a FF is treated and transported from REHAB what froms are used and sent where?
REHAB tracking worksheet becomes part of the medical record and fowarded to the reconds custodian.
Hazard mitigation during an MCI includes what examples?
fire supression
structural stabilization
vehicle stabilization
fuel leak containment
who is eqipped with the draeger xam 2500 gas monitor/
Engine
aerial
BC
SPLOPS
What are the typical storage tank capacities for NG and LPG?
BBQ- 20lb
Forklift- 33lb
Commerical -100-420lbs
Residential 500lb
HQ 30K
What ventialtion type and what percent must it be for clearing out a structure with gas?
Natural ventilation
2%
What offensice measrues can SPLOPS take with gas emergencies?
Grounding
Plugging
Cutting
Clampling
Squeezing
Flairing off
The HSO will respond to what investigate what incidents?
Injuries to Employee or reservist that rquires trasnport or are fatally injured.
Vehicle accidents that involve fatalities or injuries that require ALS and are non ambulatory.
The HSO will help in processing what information for an incident?
“3” IONS
Information
documentation
Notification
analysis
processing and mtigation
What has to be in place before a RTF-PEM team is deployed?
Unified command has to be in place
The HSO supports who for investigations regarding accidents or injires to personnel?
DC
BC
risk mgt
who is the preferred person to manage a Mayday?
ISO
there is only one thing the ISO should consider requesting for a mayday?
Request an assistant ISO
when the mayday FF is attempting to self extract and cannot find a door, window, or other egress point what can they use?
Exterior wall
one the mayday FF is at a wall the should search for what to lead them outside?
doors
windows
hallways
extreme caution should be used with ther tac stick for the possibilites of ?
open neutrals
automatic or back fed generators
who ensures atmospheric monitioing is established when incident command has not been established?
Company officer.
the TIC works by how?
seeing heat energy from objects
TICs should be used with caution in combustible gas enviornments why?
not intrinsically safe
who gets notified of any health concern or illness befroe or during scheduled training
Training instructor
What is considered moderate work for the rehab chart?
physical training
Vehicle extrication
Vehicle fire
Ladder raise and climb
Search and rescue non fire
Hose line advancement non fire
exposure control
salvage
What is considered Hard work for the Rehab chart?
Search and rescue live fire
Hose line advancement live fire
extinguishment
vertical ventilation
overhaul
Level A entries
What are the rehab flag colors?
no color
white
green
yellow
red
black
Who is assigned to the fact finding portion of the citizens complaint?
EMS captain or higher
all supporting documentation with regards to a citizens complaint, after the outcome is determined what does the status go from and to?
open to Submitted
