BPG

Burn Center Criteria (6)

-2nd and 3rd degree burns greater than 10% of TBSA under 10 years old or over 50 -2nd and 3rd degree greater than 20% TBSA in all other age groups -2nd and 3rd involving face, hands,feet, genitalia, perineum, and major joints -third degree burns greater than 5% TBSA any age group -chemical burns, electrical burns, inhalation injury -burn injury in patients with pre-existing medical conditions that could complicate recovery

CSID

-In the event that a critical call occurs, the crew is to be taken out of service immediately after the call. A second crew is to be called, or paged, into quarters to cover for the remainder of the shift. -The on-duty Field Supervisor is to contact the EMS Manager (or designee) and advise her/him on the nature of the call. -After CISD services have been provided, the crew members will be offered the opportunity to follow up with the Counseling Center on an individual, or group, basis.

Hazardous Material Response Key points

-crew members obtain vitals from the entry, backup, safety, and decon teams -standby ambulance does all vital sign monitoring in the cold zone -if the standby ambulance transports a patient, another rig has to come immediately to standby on scene -resource hospital should be notified as soon as possible to prepare -responsibility of OCHMRG to provide proper protection, if the can not they must provide transport

Reportable incidents

1. A patient dies, is injured, or otherwise harmed due to actions of commission or omission by a member of the ambulance service (SUA 500.17). 2. An EMS response vehicle operated by the service is involved in a motor vehicle crash in which a patient, member of the crew or other person is killed or injured to the extent requiring hospitalization or care by a physician (SUA 500.20). 3. Any member of the ambulance service is killed or injured to the extent requiring hospitalization or care by a physician while on duty (SUA 300.34). 4. Patient care equipment fails while in use, causing patient harm (SUA 500.17) 5. It is alleged that any member of the ambulance service has responded to an incident or treated a patient while under the influence of alcohol or drugs (SUA 300.31).

Service for Base/Mobile/Portable Radios

1. A service contract is maintained for the repair of non-operating and damaged equipment. 2. All damaged and non-operating radio units should be tagged "out of service" with date, time, type of problem experienced, an Equipment Failure Report completed, and the radio equipment returned to dispatch. 3. The Field Supervisor should be notified for radio problems, and will coordinate service requests with the EMS Manager.

HOSPITAL CLEARANCES-In the case of computer failure

1. AMR should be contacted for hospital statuses and to send clearances.

Adult weight for medication

1. Adults are defined as weighing greater than 30kg/66lbs and pediatrics are defined as individuals weighing less than 30kg/66lbs.

Dispatch of Second Ambulance

1. An ambulance call comes in and the first due unit is on a call, training with an un-cleared crew with no FTO available, or is otherwise unavailable. Under this circumstance an ambulance can respond to a call as long as there is both a cleared driver and cleared crew chief on board. 2. If the dispatcher establishes that the second unit is significantly closer, under this circumstance, an ambulance may respond to the call as long as there is both a cleared driver and cleared crew chief on board. 3. A cleared Driver Trainer can take a person out driver training so long as they receive permission from the on-duty Field Supervisor. Once this vehicle is on the road, the dispatcher must send the closest unit to any priority requests for service. In addition, the primary unit must remain in the immediate University area. 4. The EMS Manager or on-duty Field Supervisor may take the second ambulance for use in operational or administrative duties.

Death/injury of patient while in care of ambulance crew

1. Any injuries should be treated according to NYS BLS protocols and documented on a PCR. Note that any staff member that is treated becomes a patient and requires a run number and PCR. 2. The injured person should be transported to the appropriate health care facility (BARNES CENTER AT THE ARCH-HEALTH SERVICES or an area hospital) for evaluation. 3. Notify the on-duty Field Supervisor and EMS Manager. 4. Following completion of the call, the crew should be taken out of service in order to deal with documentation and reporting. Consideration will be made for CISD response. 5. All crewmembers will be responsible for submitting a detailed incident report for the incident to the on-duty Field Supervisor within 12 hours of the incident. 6. Within 24 hours of the incident the Field Supervisor and EMS Manager will review the reports and forward to the appropriate University and outside departments. 7. A call review will be completed within 3 days of the incident with all crewmembers involved in attendance. The on-duty Field Supervisor shall review the incident and work with the crew to identify why the injury/death occurred and how it can be avoided in the future. The meeting may/may not be open to all members of SUA. 8. The EMS Manager may elect to perform additional review as deemed necessary.

VIOLATIONS OF OPERATIONAL PROCEDURE:

1. Any member may report the apparent violation of the Code of Student Conduct using an occurrence report form. Only written, signed reports will be considered for action. Unsubstantiated rumors, or third party information which cannot be considered valid, will not be used. 2. A Field Supervisor and the EMS Manager will review circumstances. In all cases, the focus will be on clarification of policies and procedures, clarification of the details of the case at hand, education for staff involved as to operational procedure and the associated issues, and the prevention of further occurrences. 3. If the issue at hand is a result of an education or communication issue, and a reasonable agreement can be reached by all parties that resolve the matter, the issue will be considered closed and documentation and the outcome will be filed in the personnel file of all involved parties. 4. Some cases are clearly violations of policy. In cases where there has been a clear and intended violation of operational procedures, and following a review of the circumstances that indicate as such, the following actions apply:

TERMINATION OF MEMBERSHIP probies:

1. Failure to work their initial/start up shift. 2. Failure to work shifts as outlined by the Personnel Supervisor(s). 3. Failure to complete required paperwork with Personnel and the EMS Manager 4. Failure to successfully pass (receive a score of 80% of higher) the probationary exam

Seatbelt use

1. For drivers and passengers seated upright in seats, including rear bench seats, use seatbelts as provided. 2. For passengers in wheelchairs, the patient chair should be secured using the six- point restraint system in wheelchair-equipped vehicles, or the patient should be removed from the chair and secured on a stretcher. (Please note that if the wheelchair is carried separately, it too must be secured using long straps to a fixed object somewhere in the vehicle). 3. For patients on stretchers, and those lying on bench seats, minimum two straps securing patient to stretcher/bench, not counting straps used if patient is secured to a long spine board. 4. The ONLY exception to this policy is if the wearing of a seatbelt directly compromises the care being provided to a patient (i.e.: CPR).

EMERGENCY ASSISTANCE REQUESTED - CREW SAFETY

1. If the crew transmits a "Signal 50" (Emergency Assistance Requested) this is to be construed as an emergency where the ambulance crew is in danger. 2. Dispatcher must ascertain the exact location of the crew, and the nature of the emergency;all other radio traffic should be carried out over the SUA Trans frequency. 3. Dispatcher should call Public Safety and AMR, to request response from both agencies, communicating the nature of the emergency and the urgency of the situation. DPS will contact the SPD to respond. 4. The Field Supervisor and EMS Manager must be notified as soon as possible. All Syracuse Emergency services recognize the use of 10-50, or "Signal 50" as a distress signal.

CALLS CANCELED PRIOR TO DISPATCH

1. If the original request is made by Public Safety: they may cancel our response prior to dispatch. In order to do so, Public Safety Dispatch must notify SUA Dispatch on the direct line that an ambulance was not needed. This call would be cleared as Canceled Prior to Dispatch. 2. If the original request came from AMR: SUA can be canceled. AMR Dispatch must call SUA Dispatch on the direct line and state that SUA's services were no longer needed. This call would be cleared as Call Cancelled Prior to Dispatch. 3. If the original call is made by a third party caller, a patient or bystander: SUA cannot cancel an ambulance response prior to dispatch. The dispatcher should proceed with the dispatch as normal. They should include in the dispatch information that a callback was received requesting a cancellation. Priority responses should not be downgraded as a result of a third party, patient, or bystander callback.

Persons using wheelchairs that require non-emergency medical transport:

1. Medical transport in a wheelchair is reserved for temporary injuries only 2. All requests for wheelchair transportation, for someone with a permanent disability, must be directed to the Office of Disability Services. Please take the request, including name and callback number, and contact ODS immediately. 3. Persons with permanent disabilities may be transported by MTS if their normal mode of transport is temporarily unavailable. Permission to transport must be approved by the EMS Manager 4. All MTS drivers and supervisors must be familiar with the operation of the wheelchair lift. In the event that we are unable to handle a wheelchair transport, due to scheduling or vehicle availability, please take the information as above and contact the EMS Manager, and will attempt to make other arrangements.

EXPOSURE PROCEDURES:

1. Notify Crew Chief. 2. Crew chief will treat medical emergencies or conditions as appropriate. Any personnel in need of immediate medical treatment shall be transported to a health care facility. 3. Crew Chief shall notify dispatch by telephone as soon as practical. Dispatch will notify the Field Supervisor. 4. Follow instructions from the Field Supervisor. In most cases, personnel will be referred to a contracted health care facility for medical follow-up. Therefore, it is advisable that personnel wait for instructions from a Field Supervisor before proceeding to the ED. Of course, personnel can be transported to the hospital if it is their wish. 5. Fill out an Incident/Exposure Report, detailing the exposure and including the appropriate run number. 6. Follow all instructions from the Field Supervisor. The Field Supervisor will notify the EMS Manager in cases of occupational exposure.

CALLS CANCELLED PRIOR TO ARRIVAL

1. On scene public safety agencies: Any on scene SU DPS officer, SUA Field Supervisor, Paramedic Personnel or Fire Department Personnel, can cancel an ambulance that is enroute. This must occur either over the telephone, the radio or on a direct line. This type of situation would be cleared as Cancelled Prior to Arrival. 2. Patients, bystanders and third party callers: A patient who requests that we cancel an enroute ambulance should be informed that it is our policy to continue a response. Patients should be informed that we continue to respond in order to confirm that an ambulance is not needed. It shall be the dispatcher's responsibility to notify the ambulance over the air of the call back and any subsequent shutdown prior to arrival. Priority responses should never be downgraded as a result of a patient, bystander or third party callback. Upon arrival the ambulance crew should attempt to make contact with the patient to confirm that an ambulance is not needed. This is done to ease agitated patients and/or callers. The crew should offer any appropriate advice or assistance. This type of a call should not be cleared as a refusal, but as a call Canceled After Arrival (See section below). A third party caller or bystander cannot cancel an ambulance response and priority responses should not be downgraded after a third party callback.

Staff callback

1. On-duty Field Supervisor reports to the scene of an emergency 2. Second supervisor responds to quarters to assist dispatch 3. Next arriving crew staffs second ambulance as needed 4. Additional responding staff remain in quarters until further directed 5. Under no circumstances is anyone, other than designated supervisory staff, to report to any emergency scene unless as identified above 6. Call back staff should report to quarters, and take direction from the supervisor in quarters

FIRST RESPONDERS:

1. The only persons authorized to first respond to a call are Field Supervisors (or their designees) using University equipment and communications. First responders must have two-way communication with dispatch. 2. The Field Supervisor can respond to a scene while a backup ambulance is paged out. When on scene, the Field Supervisor should advise the dispatcher of patient status and request the ambulance to proceed as necessary (P2, P3, refusal, etc.). The Field Supervisor may take the second ambulance to the scene to stabilize the patient until the primary ambulance can clear and come back in service. 3. Dispatch should transmit over the air that there is a first responder going to the scene, and whether a crew chief/ driver is needed at quarters (to get the ambulance) or at the scene (to meet the first responder). 1. When the first responder arrives on scene, that is the documented arrival time of the service for the PCR.

REPEATER SYSTEM AND FAILURE PROCEDURE

1. Users can switch to the SUA Disp channel (Channel 2 selector), but this has significantly less range than SUA county frequency. 2. Issues that can cause repeater failure include lightning strike, power failure that is of such duration that the backup battery wears down*, and mechanical repeater failure. 3. TheFieldSupervisor and EMS Manager should be notified in the event of a repeater failure[EK1] . [EK1]You would call physical plant

CALLS CANCELLED AFTER ARRIVAL

1. When other public safety agencies are on scene: This may be the case in automobile accidents where no personal injury has occurred. This is not a refusal and it is not unfounded. There is an accident so it cannot be unfounded. There is no patient care to be rendered so a patient cannot refuse care and hence need to sign a refusal. Note that even if SFD is doing a refusal we do not have to, unless the accident occurred on Syracuse University property. If the call is off campus, the patient and any subsequent refusal is the responsibility of SFD. Public Safety on scene, at a call on campus, can tell the SUA crew that services are not needed and this would be Canceled After Arrival. Note that only SU DPS/Safety officers can do this, not roommates or RA's or people in the hallway. The ambulance crew should attempt to get a history of the incident, i.e.: who called and why our services were not needed. This information along with the SU DPS/Safety officer's name should go on the PCR for the call. For example: "Crew was met at front door of Flint Hall by SU DPS Officer Johnson. Per Officer Johnson, patient's roommate called believing patient to be unconscious. Upon his arrival Officer Johnson discovered patients merely to be asleep in bed." 2. Patients, Callers, and Bystanders: RA's, housing staff, complex directors, roommates and bystanders have no authority to cancel a crew. If the SUA crew is on scene and there are no other public safety agencies on scene, the patient is the only individual capable of canceling the ambulance after its arrival. Calls are Cancelled after Arrival only if there is no injury or illness to be treated. If there is any illness or injury the call must be cleared as a signed patient refusal. As always the crew must thoroughly document the reason for a cancellation. IE: "Crew was met in hallway by pt's roommate who said he panicked and called the ambulance after dinner because he thought his roommate had cut himself. Crew found patient sitting on bed with ketchup spilled on his arm. Crew confirmed there was no injury. Call Canceled After Arrival."

Injury on duty to a crew member

1. mmediately notify the on-duty supervisor. 2. Any injuries will be treated as per NYS BLS Protocol. Notify AMR for ALS as per protocol. Remember that if a staff person is treated for an injury, they then become a patient and require a PCR. 3. Dispatch should be notified as soon as is practical. 4. The on-duty supervisor, EMS Manager and other appropriate Health Service or University personnel will be notified of any incident involving personal injury or death. 5. The injured person should be transported to the Health Service or hospital, as appropriate, for evaluation and initiation of documentation. 6. In the event of the death of a crewmember, CISD will be utilized as needed. 7. Within 12 hours following the incident, the staff involved (as able) should fill out an Occurrence Report detailing the circumstances surrounding the incident. 8. Within 24 hours of the incident, the appropriate supervisor and EMS Manager will review the reports and forward to the appropriate University/outside departments. 9. The staff person injured will refrain from handling calls immediately following an on-the-job injury until supervisory personnel and the Health Service Director review the situation. 10. On-the-job injuries and or death are covered under the University Worker's Compensation program. As a result, it is important that all steps above be completed as outlined to ensure timely medical care, and the filing of appropriate documentation.

Motor vehicle accident (MVA) response

AMR and the Syracuse Fire Department (SFD) will be notified to respond to all personal injury auto accidents, using the following procedure: 1. Dispatcher will notify "911". 911 will dispatch all appropriate agencies (R/M, SFD, SPD). 2. SUA will initiate Basic Life Support care. On arrival of the SFD, all aspects of patient extrication should be turned over to SFD (without lapse in patient care, of course). 3. If SFD is on the scene prior to the arrival of SUA, the Crew Chief should check with SFD to determine if any equipment is needed, and then stand by until further instructed. 4. If the patient is BLS and an S.U. Student, SUA will transport. 5. In cases where the patient is ALS and an S.U. Student, the patient should be transported in the SUA rig with the AMR paramedic aboard EXCEPT in caseswhere patient care may be compromised; in these cases, the patient will be transported in the AMR rig with the Crew Chief offering his/her assistance as needed. 6. In all cases it should be understood that an auto accident on city streets is the jurisdiction of SFD and AMR. Extrication of patients is the primary function of SFD. Our role is one of support, and if appropriate as outlined above, transport. SUA crews will utilize turnout coats, helmets, and extraction gloves in situations where there is a hazard(s) that may cause injury to rescuers, such as in the case of auto extrication.

Hepatitis-B virus (HBV) inoculation

Ambulance volunteers are offered the Hepatitis-B vaccination at no charge through the SU Barnes Center at the Arch-Health Services. Hepatitis B Virus (HBV) is one of the most common and serious infectious diseases in the world. Like HIV, HBV lives in body fluids such as blood, semen, and vaginal secretions. HBV is 100 times easier to transmit. For example, the chances of being infected with the HIV virus from a single contaminated needle are 0.5%. For HBV, the chance is 20-33%. 1,000 healthcare workers contract HBV each year, where less than 1 contracts HIV. As healthcare and emergency workers, we are at a high risk for contracting HBV. OSHA regulations require healthcare institutions to offer free vaccinations for healthcare workers.

Minors and refusal of transport

An individual who is legally a minor cannot give effective legal/informed consent to treatment and therefore, conversely, cannot legally refuse treatment. There are alternatives to EMS and hospitals for custody and supervision of minors. An uninjured child may be supervised by law enforcement personnel or a school or activity (soccer, etc.) supervisor until a parent is contacted. In some situations, a responsible adult (grandparent, aunt, brother, etc.) with the child can assist in the decisions making. Therefore SUA crews should do the following when presented with a patient who is under 18: 1. If the patient is under 18 and their parent or legal guardian is present, the parent or guardian may refuse treatment on behalf of the patient. This is only the case if the parent or legal guardian will also consent to the refusal. As with any refusal, both the patient and the parent or guardian should be advised of the patient's condition and any possible negative effects of refusing treatment and or transport. The parent or guardian must sign the PCR refusal. 2. If the parent or legal guardian is not on scene, the crew should attempt to make contact with the parent or guardian. If at all possible the parent or legal guardian should meet the crew on scene. If this is not possible, or if waiting will compromise the patient's health, the crew can get a decision on treatment/transport of the patient over the phone. The parent/guardian should be advised of all risks of refusing transport. This conversation must be well documented in the Patient Care Report and the refusal signature should be signed by DPS as the responsible party. If the decision is made to transport the patient, the parent or guardian should be advised of which care facility the patient will be taken to and if possible, told to meet the ambulance at the destination. 3. If it is not possible to get permission from the parent or legal guardian, the crew may transport after the child has been placed in the protective custody of a police officer on scene. This action should be initiated and coordinated by DPS as they have a working relationship with SPD. 4. As with any patient, if the minor is suffering from an altered state of consciousness they may be treated and transported according to implied consent.

CLEARING A PATIENT FOR TRANSPORT TO BARNES CENTER AT THE ARCH-HEALTH SERVICES

CLEARANCE PROCEDURE 1. The Crew Chief in the ambulance will call via cellphone the "Go To" team for that week using the following phone numbers: Team One- 315-443-9015 or Team Two- 315-443-8576 2. Wait for the nurse to acknowledge the call. Be aware that it may take a few minutes for the nurse to answer the phone. If there is no response, attempt to contact the other team and give them the patient report. 3. When the nurse responds, the ambulance should give the clearance. The nurse may ask additional questions about the patient. Remember that it is the receiving facility's discretion whether or not to accept a patient.. 4. Remember that it is the Health Service's discretion whether or not to accept a patient. They do not treat employees or non-students at any time.

BACK UP CALL PAGING

Call Priority Hold time Comments P-1 0 min Dispatch ALS at time of call P-2 4 min If crew has not called up responding within four minutes, dispatch mutual aid P-3 8 min If crew has not called up enroute within eight minutes, dispatch mutual aid

Cardiac

Crouse and St.Joes and Upstate

Labor and Delivery Hospital

Crouse, St. Joseph's, Community

Geriatrics

Crouse,Community

Infection disease exposure policy

Disposable gloves, disposable facemarks, eyewear,

Carrier Dome standby operations Basketball

Dome Medical Staffing: · 1-2 physicians; 2 nurses; 19 staff members AMR Medical Services · Normally there is no standby crew and they are called for transports when needed. · However, if they are standing by, they are there for the spectators. · Park outside Gate A Syracuse University Ambulance · Crew is there for the players only · Dedicated crew; no patient transports (unless otherwise stated by Dome medical). · Park and stage where directed by Dome staff. BLS transports: handled by SUA back up crew, or AMR if SUA not available. ALS transports: handled by AMR

dome med

Dome Medical is a patient care provider for all Dome events. The staff is comprised of Physicians, Nurses, Paramedics, Critical Care Technicians and EMTs. Their medical director is Dr. John McCabe and the physicians come from University hospital. The volume of patients they see can vary depending on the event, the time it starts, and even the weather. Typically for a big event they see an average of around 10 people. Dome Med staff members are stationed at various locations throughout the Dome. For football and basketball, they have 2 ALS crews: one in the first aid room and one upstairs on the second level. During football there are BLS crews at Gate C, 124 and all 4 corners upstairs. There are also 3 supervisors, a dispatcher, a person for wheelchairs, and 1 support person. Basketball is similar, but there are a couple less BLS crews and 1 less Supervisor. Athletic trainers provide initial care for the athletes whether it a SU or a high school event. For the most part they are certified athletic trainers however, during the high school events they may be a Paramedic, Critical Care Technician or an EMT. They are the first ones on the scene of an injured athlete and determine if Dome Medical and the standby crew needs to evaluate the athlete. Other than SU events once the trainer requests evaluation from Dome Medical and the standby crew, all patient care becomes the direct responsibility of Dome Medical. Dome medical needs to be notified of all injuries or illness that occur during a Dome event. If a patient walks up to an ambulance crew for an injury or illness, Dome medical needs to be notified via the radio. Dome medical staff decides who does and does not get transported to a hospital. They determine if the patient will be transported ALS or BLS. Any question of the decision for ALS or BLS needs to be discussed with Dome Medical before the patient is transported. Ambulance standby crews' roles vary according to the event. See below for the breakdown of procedures. On arrival, at any Dome standby, the crew is to get a radio (as needed) from Dome Medical and then introduce themselves to the trainer. The radio must be returned at the end of the event.

OTHER EVENTS (LESS THAN 30,000 SPECTATORS):

Dome Medical staffing: · Physicians, Nurses Paramedics, Critical Care Technicians and EMTs. · The type of event determines level of staffing. AMR Medical services: · Not needed for standby Syracuse University Ambulance · Crew is there for the spectators and participants · Contact Dome Medical for staging locations, as it will vary depending on the event. · Normally, you will park at one of the following locations: inside the airlock, outside the airlock or by Gate A BLS transports: Patients transported by standby crew ALS transports: handled by AMR

Carrier Dome standby operations Football

Dome medical staffing: · 1-2 physicians; 3 nurses; 22 staff members AMR Medical Services · Crew is there for the players only. · They are dedicated and do not transport patients. · Park and stage in the tunnel Syracuse University Ambulance · Crew is there for the spectators. · Park outside Gate A BLS transports: will be handled by the SUA (standby) crew ALS transports: will be handled by a AMR (non-standby) crew.

OTHER EVENTS (GREATER THAN 30,000 SPECTATORS):

Dome medical staffing: · Physicians, Nurses, Paramedics, Critical Care Techs and EMTs Ambulance service: · If AMR and SUA are both involved with this event, BLS will be handled by SUA and AMR will handle ALS. Ambulance placement · Both vehicles will stage outside of the Dome In the event a situation arises that is not covered under the above procedures, the crew is to contact Dome Medical Command for instructions. All decisions and responsibilities fall back on Dome Medical Command.

reprimands

First offense) Will result in a verbal warning by the Supervisor who observed the behavior, or the company Supervisor. It will also be followed up by a first written reprimand to the student, explaining the reason why such actions are unacceptable. A meeting between the member and the supervisor involved will be held to discuss the problem and subsequent corrective action. The disciplinary procedures will also be reviewed with the member so they are aware of the process. The member should be asked to acknowledge in writing the verbal warning and should state that the employee has been made aware of and counseled on the issue. This warning will then be placed in the personnel file of the member involved. Second offense) Will follow the same procedure as the first offense, and; the member involved we be asked to meet with all of the Field Supervisors to discuss corrective action. The member will also be made aware that after another reprimand their membership will be up for review which may include up to the members dismissal from the organization. Third offense) Will follow the same procedures as the first and second offense. Depending on the nature and severity of the offense, a decision may be warranted by the supervisor involved to temporarily suspend the staff member's activities pending a review, at which time an action plan will be created and enforced to stop the offending behavior. The Field Supervisors, the member, and the EMS Manager will attend third offense reviews. After a third offense, a formal suspension (2 weeks) from the organization will occur and termination of membership may occur if the supervisory staff deems it necessary. If the member then receives a forth written warning after he/she returns to active membership after a suspension, that member will be terminated from the organization. If a member at any point in their membership with the organization is separated from the University due to findings from the Office of Student Rights and Responsibilities, membership of that person will be terminated according to established University policy. The person will then have the right to re-apply for membership if/when they return to the University as an enrolled student.

FORCED ROTATION

If all area hospitals are on ALS/BLS diversion the system will be placed on "forced rotation". 1. Ambulances transporting ALS or BLS must follow a hospital rotation. 2. For ALS patients, Onondaga County Fire Control should be contacted for the next hospital in the rotation, but can also be determined by a Paramedic if there is one riding along. 3. For BLS patients, SUA dispatch is to contact AMR dispatch for the next hospital in the BLS rotation. 4. Patients are still entitled to demand transport to a specific hospital, but they must be made aware of extended wait times, availability of appropriate care, etc.

TURNING CALLS OVER TO AMR

If unable to get a crew for a call, and the call needs to be turned over to AMR, 1. The call should be assigned to an SUA rig. 2. Cancel the call. 3. The cancellation reason should state, "SUA unable to complete" 4. The "Initial Priority" field on the call taking screen should state the initial priority of the call. 5. The "Transport Priority" field on the call taking screen should state, "Turned over to AMR"

CAD FAILURE

In any event the dispatch CAD fails, first attempt to reboot the computer. After rebooting, if the CAD is still not functioning, but the internet is still functioning, notify the on-duty Field Supervisor and the dispatcher should contact RightCAD at 1-800-663-3911, to advise them of the failure and for technical assistance. If, after rebooting, the CAD is not functioning, and neither is the internet, SU's IT department should be notified of a network failure. Contact x2677 and press option 3. Someone will call you back. The dispatcher is to immediately utilize the CAD failure binder located above the dispatcher. All calls, runs, times, crewmembers, etc., must be logged into the binder. Once the CAD problem has been resolved, the runs should be input into the CAD in chronological order, so the appropriate run number can be assigned to the run.

Observers

In order for an observer to be eligible to ride on any SUA vehicle during a scheduled shift or event, they must meet the following requirements. · Must be at least eighteen years of age or older. · An observer release form must be submitted. · Release and Waiver for Participation. · The on-duty Field Supervisor and EMS Manager must be notified. At the time of the observational period, the signature of the crew chief must be obtained and added to the observer release form.

MSU Activation (medical support unit)

In the event of a mass casualty incident off campus or an event requiring the use of the MSU, the following procedure should be used in order to minimize confusion. If not already at quarters or at the scene of the emergency, the on-duty field supervisor should be notified via phone that the MSU is being requested. As soon as practical, the MSU should be activated. All doors should be unlocked, all chocks removed and the generator prepped and fueled. The dispatcher should ascertain the exact location of the emergency, the approximate number of injuries and what resources are being requested. Should the request include just the trailer, an emergency call should be generated and S4 should begin responding as soon as practical. If possible, an additional crew member should accompany the field supervisor to help. If an ambulance is also requested, the dispatcher should page out for a full crew. Upon receiving word that both a cleared driver and crew chief are coming to headquarters, the primary rig can begin responding consistent with the mutual aid procedure. If the removal of the supervisor will unclear the crew, the first available personnel combination that clears a crew will respond to the call in the secondary rig. A second emergency call should be created for the rig and they should be dispatched accordingly. Upon arrival of S4 on the scene, the field supervisor will coordinate with incident command to discuss the allocation of resources. As soon as practical, the field supervisor should advise dispatch of any additional resources that are needed including additional personnel, vehicles, etc. If the need for more manpower becomes evident, the dispatcher should page out to all pagers requesting that all available personnel report to headquarters. The page should also indicate NOT to call dispatch but to report as quickly as possible. Based on the situation, the field supervisor and dispatcher will coordinate the release of personnel to the scene via any available vehicles. As a rule, FTOs, trainers, and trainer progressions should be sent first. After that, cleared crew chiefs and drivers can be sent. Ensure that at least one ambulance and one MTS van remain on campus to handle normal responsibilities.

Leaves of Absence (LOA)

LEAVES OF ABSENCE DEFINITION A leave of absence is defined as a member who meets one or more of the following criteria and as a result is not held to any department or organization requirements (i.e. shift count and mandatory trainings): 1. A member who is abroad for a given semester 2. A member who requests a leave of absence in writing to the Field Supervisors and EMS Manager and gains approval for the leave of absence LEAVES OF ABSENCE RESTRICTIONS: · A leave of absence is not valid unless the member's leave is approved by the Field Supervisors and EMS Manager after receiving a written request o Members going abroad do not need to request a leave of absence · Members who are on a leave of absence are held to the same standards as any visitor or observer to SUA o Member's on a leave of absence may not work shifts, ride on the ambulance without approval of the on-duty supervisor, operate any SUA vehicles, attend any officially sanctioned events (i.e. trainings, conferences, banquets, or meetings) unless attending as a visitor and approved by the Field Supervisors or EMS Manager. The member while on a leave of absence, may not act in any capacity as a representative of Syracuse University Ambulance. RETURN TO ACTIVE MEMBERSHIP A request to return to active membership must be submitted in writing to the EMS Manager and will then be reviewed by the supervisory staff after which the member will be returned to active membership.

"Member in Good Standing"

MEMBER IS GOOD STANDING DEFINITION: A member in good standing is defined by a member who is a full active member of SUA and meets the following criteria: 1. Does not have more than 2 formal letters of reprimand outstanding on file (2 offences) 2. Works shifts regularly and at any given time is on-trackto meet shift count for the semester a. On-trackis defined as having worked a number of shift equal to the amount of weeks into the semester at the time in question minus 3 shifts (i.e. during the 5th week of the semester, a member in good standing must have worked a minimum of 2 shifts) MEMBER IN GOOD STANDING RESTRICTIONS: · Members who are notin good standing and are on a leave of absence are not eligible to attend the annual banquet unless attending as a paid guest to a current member in good standing. · Members who are notin good standing who choose to take a leave of absence will have their disciplinary file suspended, which means any disciplinary action on file will not expire until one full semester without any disciplinary action after the member returns from the leave of absence.

Incidents requiring immediate notification to EMS Manager:

MVA (with or without injury) - SUA or MTS vehicles involved Fatalities/Full Arrests Crew Member/MTS Driver Injury requiring immediate medical treatment Crew Member Exposure (needle stick, body fluid exposure, etc) Mass Casualty Incident Crime committed against a crew member

EMERGENCY TRANSPORT

ON AND OFF CAMPUS--When the student needs emergency transportation to any area hospital Emergency Department: 1. Call SU Ambulance at 443-4299 or x711 on campus to take the student to a hospital emergency room immediately. 2. The advocate does not need to be with the student before calling for emergency transport.

NON-EMERGENCY TRANSPORT- ON CAMPUS

ON CAMPUS--When the student is on campus and needs transportation to the emergency room or to SU Barnes Center at the Arch-Health Services: 1. Medical Transport is available 24 hours/day during the academic year except during breaks. Break hours are usually from 8a.m. to 4:30p.m, Monday through Friday. 2. When Medical Transport is not in service, call Public Safety at 443-2224 or x711 (on campus).

Reporting suspected child abuse

On arrival at the Emergency Room, you are to report all findings to the Emergency Room nurse, and all appropriate police agencies. Carefully and factually document all statements and observations made to or by the crew in the PCR. A report shall be made immediately by telephone to Onondaga County Child Protective Services at 422-9840 or the Statewide Register of Child Abuse and Maltreatment at 1-800-635-1522. The information required for reporting are the names, ages, dates of birth and addresses for ALL involved parties. Oral Reports shall be followed with a written report within 48 hours utilizing NYSDOH form DSS-2221-A, which is available both in the ambulances and in quarters. Written reports will be mailed or faxed to Onondaga County Child Protective Services by the EMS Manager. A copy of the completed and submitted form DSS-2221-A should given to the on-duty supervisor. Any SUA EMT participating in good faith in the making of a report, or the removal or keeping of a child shall have immunity from any liability, civil or criminal. Any person who is required to report a case of suspected child abuse or maltreatment who willfully fails to do so shall be guilty of a Class A misdemeanor. Any person who is required to report a case of suspected child abuse or maltreatment who knowingly and willfully fails to do so shall be civilly liable for the damage proximately caused by such failure.

Dispatch Trainer position description

Only internal candidates are qualified. Must have a minimum of one semester of service as a cleared dispatcher with appropriate experience, and have successfully completed or be enrolled in the next available National Academy of Emergency Dispatch (EMD) class, and as appointed by the EMS Manager and/or Field Supervisors.

Driver position QUALIFICATIONS FOR APPOINTMENT:

Only internal candidates are qualified. Must have satisfied the requirements of the attendant program. Must successfully complete the University Vehicle Operator's Course, Coaching the Emergency Vehicle Operator's course and be approved by the Risk Management Department. Successful completion of departmental driver training and as appointed by the supervisory staff. It is also highly recommended that new drivers have at least one year of driving experience before entering this process.

OCHMRG?

Onondaga County Hazardous Materials Response Group (OCHMRG)

Dispatch procedure for out of city calls

Please note the dispatch procedure for ambulance calls to University properties outside the Syracuse City Fire District (SFD). When a call is received for an ambulance to University property outside the SFD district, such as: Hawkins Warehouse SOUTHWOOD FD Skytop Office Building SOUTHWOOD FD (Including the access road behind Skytop by I-481) SOUTHWOOD FD Drumlins Country Club JAMESVILLE FD The dispatcher should contact Onondaga County Fire Control (OCFC) to advise them, initiating the response of the local Fire Departments serving those districts. OCFC only need be notified for emergencies requiring extra assistance. 1. Dispatch SUA units. 2. Contact OCFC by calling "9-911". 3. Identify yourself to the call taker. 4. Give the street address for the facility, nature of the call, and what you are sending.

Active Alumni Members

QUALIFICATIONS: In order to be an Active Alumni member, the member must have previously been a member of SUA in good standing, and must currently be a part time student, full time student, or paid employee of the University. LIMITATIONS: More than 10% of members may not be Active Alumni or part time students at any given time. Active Alumni members are limited to volunteer shifts only. EXEMPTIONS/EXCEPTIONS: Active Alumni will not be placed in companies with the general membership, however, they will be displayed on the personnel board under their own "Active Alumni" category and are subject to the same operational, personnel, and disciplinary procedures as the general membership. Some exceptions and exemptions are made for Active Alumni. These exceptions/exemptions may include but are not limited to: - Shift requirements - Company meetings - Attendance at trainings - As determined by the EMS Manager At the beginning of each semester, when Field Supervisors create companies, members who qualify as Active Alumni will be placed in this category in consultation with the EMS Manager.

Sexual harassment

REMEDIAL OPTIONS: Informal means of dealing with problems of sexual harassment: 1. Most reports of sexual harassment can be handled informally. Here are some methods that persons who believe they have been harassed can use: 2. The person may consult their respective field supervisor and/or the personnel supervisor and EMS Manager, who are responsible for the resolution of workplace problems of this nature. 3. The persons concerned may arrange a meeting to discuss the problem or the person may write a personal letter to the alleged harasser that outlines the problematic behavior, describes the effect of that behavior on the letter writer, and expresses a wish for the behavior to stop. 4. The EMS Manager reserves the right to formalize the complaint and notify the proper entities, as outlined below. FORMAL COMPLAINTS: 1. Complaints against faculty, administrators, and staff with instructional responsibilities will be referred to the chair of the Senate Committee on Academic Freedom, Tenure, and Professional Ethics, who will appoint a two-person investigative team from a pool of faculty and administrators trained for this duty. 2. Complaints against non-teaching staff will be referred to the Associate Vice-President for Human Resources, who will appoint an investigative team from a similarly trained staff pool. 3. Complaints against undergraduate students will be handled according to procedures adopted in cases of nonconsensual sexual activity, as modified by this policy statement.

FIELD SUPERVISOR (FS) NOTIFICATION

The Field Supervisor is notified for the following situations: 1. When requested by the on-duty crew 2. When requested by the EMS Manager 3. As requested by the on-duty Field Supervisor 4. As policy in this manual dictates. 5. Whenever the dispatcher feels they have unusual situation. 6. When the crew has a patient refusal and the Field Supervisor is not on scene. 7. When any emergency call comes in, even if SUA is unavailable. The on-duty Field Supervisor and Policy and Procedure manual should always be the first resource when there is a question about policy and procedure.

VA Hospital support for incoming patients to the University area

The Veterans Administration Hospital (VAH) on Irving Avenue is a designated reception site for multiple patients in the event of a disaster involving military personnel. Under certain conditions and in certain circumstances the Dome West parking area may be used as a landing zone for incoming medevac patients as an alternate to Hancock Airport. In the event that this site is used as a reception area, S.U. ambulance and transport vehicles will be requested as part of the overall response team to the VA for support. Other members of this team include S.U. Safety, Public Safety, Parking, Onondaga County EMS, City Fire Department, and AMR. Dispatch will be notified by the VAH (through Safety/Public Safety) that there are incoming medevacs. There is GENERALLY a 30-40 minute lead time between the time we are notified and the arrival of inbound flights, though that may be reduced due to communications problems. When notified that there are incoming Medevac's to the Stadium area: 1. Confirm expected arrival time; 2. Notify the Field Supervisorand page all off-duty Field Supervisors about the incident. The FS will respond to the medevac reception area and report to the command post to facilitate communications with EMS units. Notify the EMS Manager. 3. Page for available crewmembers to respond to quarters. DO NOT have crewmembers respond directly to the reception area 4. Sendfirst due ambulance to transport patients from the landing zone 5. Staff second due ambulance with a cleared crew on standby for campus calls 6. Crews are to be certain they are wearing clothing that clearly identifies this department (SUA uniform, turnout coats and helmets) Twenty minutes prior to expected arrival time: 1. Dispatch one ambulance and one transport to the staging area on Henry Street between Van Buren Street and East Raynor Avenue heading south. All vehicles should proceed in a non-emergency fashion to the staging area. (GOAL - Keep one ambulance and one transport available for campus service until it has been determined that they are needed to assist in the transfer.) 2. Upon report from scene that they are needed, dispatch second ambulance and second transport to the staging area. All vehicles should proceed in a non-emergency fashion to the staging area. On arrival of medevacs: 1. Crew should stay with the vehicle and await instructions from on scene VAH staff. 2. As with all multiple patient incidents, the driver stays with the vehicle ALWAYS. 3. VAH staff will supervise the unloading of patients from helicopters. 4. NEVER approach a helicopter without an indication from the flight crew that it is safe to do so. 5. NEVER approach a helicopter from the rear (rotor) area; always approach from the front (you can see the pilot and s/he can see you). 6. If the rotors are still moving, STAY LOW and REMOVE any nametags, hats, or loose articles of clothing that could be swept into rotors. 7. Allow flight crew staff to open doors and remove patients. ALWAYS follow their directions regarding actions around the helicopter. 8. Patients will be transferred to the VAH, where casualty reception staff will meet them. All patients should be transferred to the VAH staff with basic information regarding problems. Initiate a PCR for each patient (does not need to be completed right away under these circumstances, but can be filled out following the transfer of all patients). 9. When clear, contact dispatch for further instructions.

In any instance where a patient requests that they be transported to a hospital outside of the Syracuse area, AMR is to be contacted to transport the patient

The following factors must be considered before such requests can be honored: · Emergent versus non-emergent transport. · Availability of AMR for transfer of care. · Patient stability and condition. · Weather factors.

MTS transportee no-show

The following is done on medical transport runs when the student is not found: 1. The MTS van will wait for approximately 7 minutes after the scheduled time of the transport. 2. The dispatcher will call the student when a call back number is available and time permits. Be sure to leave a message that you called, the time, and that the van arrived and waited for the rider. Ask them to call back when they get the message. 3. The dispatcher will cancel the run out of the CAD as "MTS Transportee No-Show". Be sure to document these calls well. Often a student will call to complain that we did not pick them up, and when presented with facts (arrival time, clear time, attempt by phone call documented in the notes) we can avoid conflicts with riders.)

Burn Hospital

Upstate

Poisoning/Hazmat Hospital

Upstate

Trauma Hospital

Upstate

Stroke Hospital

Upstate, Crouse, St. Joseph's

Pyschiatric

Upstate,St Josephs's

Flu vaccine

WHEN TO RECEIVE THE VACCINE AND WHY: 1. Since influenza changes continually, the vaccine must be taken every year. 2. Antibodies produced in response to the vaccine decline over time, and lower your antibody levels after approximately one year. 3. The vaccine contains the three most prevalent strands of the influenza virus for that particular year. The vaccine is changed every year to target the top three strands for that year

EMS MCI response plan

When an emergency occurs in a University facility requiring the response and triage/treatment of a high number of patients, the following procedures apply: UNCONFIRMED INJURIES: Many types of disasters indicate a high potential for injured/ill personnel. When emergencies of this type occur (gas leak in occupied building, bomb threat, hazardous material spill in occupied building, structural collapse, etc.), a minimum EMS response should be initiated, until it has been confirmed that there are no patients, or the incident has been mitigated. The dispatcher will send 1 BLS ambulance to the scene. Dispatch should monitor AMR for their dispatch to an incident through the City Fire Department. The ambulance will stage at a location that is accessible to the scene, out of the way of other emergency vehicles. The ambulance crew will report to the Incident Commander to report location and availability, and to receive a status report. The ambulance crew will monitor the Public Safety channel for messages regarding the incident, and be designated "SUA". Upon confirmation that there are no injuries, or that the danger in the incident has passed, the crew should check with Incident Command to ensure that it is clear to leave. CONFIRMED INJURIES: In the event of confirmed injuries at an incident, key information that can assist in resource allocation for EMS will be the number of patients (if more than one), and extent of injuries. Based on the initial report of the emergency, dispatch will respond a minimum of one SUA ambulance, and additional BLS/ALS units as indicated. For incidents involving more than 6 patients, the Medical Support Unit (MSU) should be utilized. < 6 patients BLS/ALS units as indicated 6 - 10 patients BLS/ALS units as indicated Activate SUA MSU Response Initiate MCI support from AMR Medical Services > 10 patients BLS/ALS units as indicated Activate SUA MSU Response Initiate MCI support from AMR Medical Services The first due SUA unit will initiate the incident command structure, and establish a unified command post, or locate the unified command post created by SFD or Public Safety supervisory personnel. Additional personnel to begin triage utilizing the S.M.A.R.T. triage method within the established incident command structure. EXTENDED OPERATIONS The Health Service External Emergency Response Plan (Section VI-Article 120) should be implemented in a large scale incident that may produce "walking wounded" that will seek the Health Service for care, or produce non-emergent patients that can be transported to the Health Service for care to reduce the burden on area hospitals. The medical sector can be discontinued at the discretion of the incident commander, or at the termination of the incident.

NON-EMERGENCY TRANSPORT- Off CAMPUS

When the student is off campus and needs transportation to SU Barnes Center at the Arch-Health Services or Public Safety: 1. A reliable friend/support can drive the student to SU Barnes Center at the Arch-Health Services or Public Safety to meet with the Advocate or Counseling Center therapist. 2. The Department of Public Safety may be able to transport the student to their office or to Barnes Center at the Arch-Health Services.

SpCO indications:

a. 0-5% - Normal in non-smokers. Re-evaluate enroute to hospital. b. 5-10% - Normal in smokers. Consider high flow oxygen for non-smokers. c. 10-15% - Abnormal indication. Consider high flow oxygen and transport. d. >15% - Significantly abnormal. Use high flow oxygen and consider ALS. e. >20% - Contact Medical Control for treatment and transport instructions. f. >30% - Significantly abnormal. Patient will likely be altered mental status. Consider ALS. Contact Medical Control for treatment and transport instructions. 1. All patients with a confirmed SpCO reading greater than 15% shall be transported to a hospital without delay. 2. If an abnormal SpCO indication is found, re-assess on another finger with limited movement. 3. Do NOT delay transport or removal from current environment to re-test.

DPS Shuttle U Home hours

transport available from 8:15 pm to 3:00 am

Foot responder crew radios

use the portables assigned to A-3 and use the A-3 portable that corresponds with the stand-by position.

Alcohol and drug use by crew member

· Temporarily suspended from all participation with the program · Subject to testing for alcohol or other drugs through the S.U. Risk Management Department/Safety Division's safe driver awareness testing program, if the allegation involves operation of a University vehicle · Referred to the University Office of Judicial Affairs for investigation · Referred to New York State Department of Health as required by law for emergency medical technicians