EMERGENCY MEDICAL SERVICES - POLICY INDEX
O/EMS-201 EMERGENCY MEDICAL RESPONSE AGENCY 1
O/EMS-202 MEDICAL RESPONSE 1
O/EMS-203 INCIDENT REHABILITATION 7
O/EMS-204 ALL-TERRAIN MEDICAL RESPONSE (ATMR) 12
O/EMS-205 MEDICAL SUPPLIES & EQUIPMENT 13
O/EMS-206 MEDICAL OXYGEN 14
O/EMS-208 EMS CONTINUING EDUCATION 16
O/EMS-209 CPR PROGRAM 16
O/EMS-211 EMS LICENSURE 24
O/EMS-213 CAREFUSION CLIPPERS 25
O/EMS-214 OMD CREDENTIALING 25
O/EMS-201 EMERGENCY MEDICAL RESPONSE AGENCY
UPDATED1/1/2012
The OCFD is certified by the Oklahoma State Department of Health (OSDH) EMS Division as an Emergency Medical Response Agency (EMRA). This certification authorizes OCFD to provide emergency medical care in the pre-hospital environment. To maintain EMRA status, we must comply with the rules and regulations (State Statutes) of the OSDH. This certification requires that all OCFD personnel involved in the delivery of pre-hospital emergency medical care must be certified at the Emergency Medical Responder level or above.
MEDICAL CONTROL
As an EMRA, the OCFD provides medical care under supervision of the Medical Control Board and the Physician Medical Director. Patient care delivered by OCFD personnel will be dictated by detailed medical care protocols that are provided by the Physician Medical Director, deviation from these established written protocols will not be acceptable.
O/EMS-202 MEDICAL RESPONSE
UPDATED7/10/2017
MEDICAL PRIORITY DISPATCH SYSTEM (MPDS)
The priority dispatch system is utilized by EMSA to determine the nature and prioritization of all medical calls. This system is designed to dispatch fire apparatus on only those incidents where there is a legitimate need. The objective of this system is to obtain the most efficient and effective use of personnel and equipment while providing a high quality emergency medical response. There are four major medical priority dispatch system (MPDS) priority classifications, Alpha, Bravo, Charlie, and Delta level calls. Within this system life threatening calls are known as Delta level calls and possible life threatening calls are known as Charlie level calls. The Fire Department will respond to all life threatening and possible life threatening medical emergencies known as Delta and Charlie level calls and automobile accidents with injuries.
RESPONSE TO VIOLENT OR POSSIBLE VIOLENT INCIDENTS
If dispatch obtains information from the police, EMSA or by other means that the scene of an incident is possibility violent, dispatch will advise companies responding to avoid ingress to the scene until police have secured the area or the company officer determines the scene is secure. The responding company will go to level one staging or enter the scene if determined secure. When responding to a potentially violent scene and not advised by dispatch, the company officer will make the decision whether to stage or enter the scene. Incidents involving a violent nature are potential crime scenes. Police have the primary responsibility and authority for crime scenes and Fire Department personnel should use caution entering these scenes. Review Protocols for more information. Potentially violent scene incidents include:
1. Any incident where Police request staging.
2. Aggravated assault involving a weapon and the assailant is on the scene.
3. Attempted suicide where the patient is conscious and threatening.
4. Violent psychiatric patients.
5. Any other incident that presents an unreasonable danger to the responding companies.
SCENE CONTROL
When any safety hazard exists at the scene of a medical emergency, the company officer will assume command of the scene and accept responsibility for the safety of the patient and rescue personnel. It may be necessary to delay patient care access by ambulance and Fire Department personnel if the officer feels that life hazards exist or that there is a threat of injury to rescue personnel. Any delay in patient care should be discussed with the lead paramedic of the transport agency.
When hazards exist at a crime scene or traffic safety hazards exist, the ranking Law Enforcement Officer on scene will be accountable for the safety of patients and rescue personnel.
GUIDELINES FOR PATIENTS WITH WEAPONS
If a firefighter becomes aware of a firearm at the scene of an incident, either by admission of the patient or by actual observance of the firearm, the Oklahoma City Police Department should be requested immediately. The police officer will make the decisions regarding how to proceed with the firearm. The mere presence of a handgun should not indicate a threat to personnel safety. However, under no circumstances should personnel take any action that would compromise his/her safety or the safety of the public.
If the patient is unconscious, requires urgent care and the Police Department is not on-scene, Fire Department personnel may carefully separate the weapon from the patient if it is necessary to treat the patient and secure the weapon until the Police Department arrives. Every effort should be made to minimize physical contact with the firearm. The Officer in Charge shall assign personnel to remain with the firearm until the Police Department arrives and takes possession of the firearm.
If Fire Department personnel are at the residence of a compliant patient and the patient has a firearm on their person, personnel should instruct the patient to secure the firearm and leave it at the residence.
If the patient is not compliant and refuses to secure the firearm in the residence, personnel should assess the situation and determine if the patient poses a threat to themselves or others. If the patient does not pose a threat to themselves or others, personnel may treat the patient and advise EMSA of the situation. If it is determined that the patient poses a threat, then personnel should evacuate the scene to a secure area and wait for the Police.
TRANSFER OF PATIENT CARE
Fire Department companies arriving on the scene of a medical emergency before the transport agency will assess the patient and initiate treatment per Protocols.
When the transport agency arrives on the scene, the lead Paramedic with the transport agency will assume responsibility of the patient and direct all patient care. Fire Department personnel will provide the transport paramedic with a patient report that includes: assessment findings, pertinent medical history and care given.
If requested, Fire Department personnel will assist the transport agency with patient care while enroute to the receiving medical facility. When this occurs, documentation of the occurrence and any care given should be added to the OKCFD patient care report.
AMBULANCE CALLS PROCEDURES
The following will apply in order to provide a cooperative effort between the fire department, EMSA, or any other transporting agency to ensure the highest level of patient care.
Fire or police officers who have been resuscitating a patient at a scene may continue to assist ambulance personnel to maintain continuity of care but will be at the direction of the lead ambulance paramedic. If an OKCFD paramedic perceives an intervention being attempted ambulance transport paramedic could harm to the patient, then it is the responsibility of the OKCFD paramedic to discreetly discuss the intervention with the transport medic. In any event, transport personnel have the primary responsibility for care of the patient.
If upon arrival you find that an ambulance is already at the scene, inquire to see if additional help is needed and if not, return immediately to service. The decision to transport a patient by ambulance will be made by the patient, a family member, or under special circumstances by the police department, but not by the fire department.
Complaints regarding EMSA or other transporting agency personnel are to be forwarded to the EMS office via email () as soon as practical. After investigating, the EMS Office will determine the appropriate action to be taken. The EMS Office will email the complaintant with the findings of the investigation.
UNIFIED ACTIVE THREAT RESPONSE
Plan Description
Multi-agency response plan for the rescue and management of casualties’ during an active threat situation where a person(s) is actively in the process of killing, inflicting serious bodily injury, or otherwise causing serious imminent danger to others. This coordinated rapid deployment plan integrates Police, Fire, and EMS to; stop the active threat, rescue victims, provide emergency medical care, and secure and preserve the crime scene.
Definitions
Active Threat - An active threat is any situation where a person(s) is actively in the process of killing, inflicting serious bodily injury, or otherwise causing serious imminent danger to others. An active threat may occur in any environment and is not limited to any particular weapon or means of causing danger. Active threats may occur inside a structure such as a school, mall, or business, but they can also occur outside, in public, and in other open areas.
Contact Team (Call sign Contact One) - A police officer or group of officers whose primary mission is to stop the active threat.
Rescue Team (Call sign Recue One) - A group of Fire and Police personnel assigned to enter areas cleared by the Contact Team to locate, recover, and facilitate the evacuation process of victims to safe areas for medical evaluation, treatment, and transport.
Inner Perimeter Team Manager (Call sign Inner Perimeter) – Role is to establish and manage the inner perimeter that encompassesthe danger zone.
Outer Perimeter Team Manager (Call sign Outer Perimeter) – Role is to establish and manage a large outer perimeter that encompasses the danger zone and staging areas for first responders and protects the public.
Intel Team Manager (call sign Intel) – Role is to obtain and analyze intelligence on the event.
Family Assistance Center (FAC) - A safe reception center used to provide information and assistance about missing or unaccounted for persons and the deceased, reunification of survivors with friends and family, accounting for survivors of the incident, and handling missing person reports related to the incident.
Inter-Agency Communication
The police contact team/s will remain on their division’s primary channel. Communications on the Divisions primary channel will be limited for use by the contact team and police personnel involved with the movement and activity of the contact team/s. A secondary channel will be assigned (OCPD Dispatch 6) for all other on-scene police operations. A third channel will be used by the affected division for other non-related radio traffic.
Internal communications for responding Fire Department resources will take place on the assigned fire tactical channel. The responding Fire District/Battalion Chief (DO) will go to OCPD Dispatch 6 for initial communication with the on-scene OCPD Incident Commander and or the Police dispatch supervisor. All other fire department resources will assign one hand-held radio to monitor OCPD Dispatch channel 6. With the exception of the responding DO, fire personnel will not transmit on OCPD Dispatch 6 unless it is to provide emergency information.
Response Plan
When an active threat is reasonably believed to exist based on the determination of a law enforcement officer at the scene or a supervisor at the Public Safety Communications Center, the “active assailant” protocol will be activated. This protocol will be initiated through the Public Safety Communications Center resulting in the notification of Police, Fire, and Emergency Medical Services responders including necessary command staff and support personnel.
Fire Department response to an “Active Assailant” incident will include; 2- Engine Company’s, 1- Rescue Ladder, Hazmat 5, and the District/Battalion Chief (DO). Dispatch will also activate the Fire Departments “Command Page”.
Fire Response: Tthe Fire Department DO assigned to the event will go to OCPD Dispatch 6 on their handheld radio. The DO will attempt to establish communications with the on-scene OCPD Incident Commander. and contact Police Dispatch to establish communications with PD on-scene command/supervisor. PD dispatch will relay any needed information to the responding Fire DO until on-scene PD command is able to communicate directly. The immediate goal of establishing radio communication is to set up face-to-face contact as early in the incident as possible.
If communication is not immediately established with on-scene command, the DO will contact the OCPD dispatch supervisor using PD-6 for up to date information. The DO and other Fire resources will go to level one staging until Fire-PD communications has been established. As soon as safely possible, Fire companies will be directed to a specific area/(s) on-scene to form Fire /Police rescue teams to enter the scene for evacuation of civilians and civilian casualties and to provide treatment of life-threatening injuries.
Surviving injuries that are often associated with an active assailant can be dependent on the immediate availability of medical care. Being that all on-scene operations are coordinated through the Law Enforcement agency having jurisdiction, the urgency of establishing face-to-face communication with the Law EnforcementE on-scene commander/supervisor cannot be overstressed.
The first Fire Company officer at staging will assume the role as staging manager. The staging area will be located as close to the scene as possible in a protected area that does not interfere with ingress and egress of police and EMS vehicles. All remaining apparatus and fire department personnel will report to this location unless otherwise assigned. Police and ambulance staging will be adjacent to fire department staging when possible. First arriving units should assist with perimeter control, secure ingress and egress routes and deny scene access to civilian and non-essential personnel.
The staging manager will organize and maintain a running list of incoming Fire, Police, and Ambulance resources. Track resources by agency, unit ID, type, and time of arrival.
To prevent gridlock of Emergency Vehicles, later arriving fire companies may leave apparatus at staging area and transport crew to the scene by ambulance. If practical, to maximize safety, Rescue Teams can walk from staging to the scene using a fire department apparatus for concealment.
Initial Police Operations: The first arriving law enforcement personnel will establish contact teams consisting of 2-6 person teams. The sole purpose of the contact teams is to locate and stop the violent behavior. These Law Enforcement contact teams will not provide first aid or rescue until their initial assignment has been completed and the immediate threat has been eradicated.
The initial Contact Team will designate a radio officer on the Contact Team who will be responsible for communicating the entry point, direction of travel, suspect information, location of injured victims, and location of barricades or explosive devices, etcetc. and other safety or intelligence information to Communications using call sign Contact One. If there are additional Contact Teams deployed, call signs will be Contact Two or Contact Three.