Penn State Emergency Medical Services
Penn State EMS Standard Operating Procedures and Constitution
University Ambulance Service
Centre County Company 20
Procedures Manual
Penn State EMS Standard Operating Procedures and Constitution
Centre County Government Office of 9 - 1 - l/Emergency communications
STANDARD OPERATING PROCEDURE
Elwood G. Williams, Jr., Coordinator
Daniel A. Tancibok, Admin. Assistant
TABLE OF CONTENTS
SECTION VIII
EMERGENCY MEDICAL SERVICES DISPATCH PROCEDURES - 8.0
Emergency Medical Services - 8.1
Dispatching Appropriate EMS Service - 8.2
Med Channels - 8.2.1
Referred Calls - 8.2.4
County Wide Numbering System - 8.3
Routine Transport Ambulance Service - 8.4
Immediate Transport Ambulance Service - 8.5
Emergency Ambulance Service - 8.6
Med System - 8.7
Med Patch - 8.7.1
Med Repeater - 8.7.2
Air Ambulance Services - 8.8
Private Ambulance Services - 8.9
Quick Response Services (QRS) - 8.10
Paid Crews - 8.11
Scheduled Crew Tone - 8.11.3
Unscheduled Crew Tone - 8.11.3
Paramedic Ambulance Services - 8.12
Paramedic Coverage Area - 8.12.9
Paramedic Fire/Rescue Response - 8.12.11
Right to Refuse ALS - 8.12.14
EMS Command Post - 8.13
EMS Responding to Fire Calls - 8.14
Personal Phone Calls - 8.15
Personal Paging - 8.16
Informational Messages - 8.17
EMS Response Index - 8.18
Med Radio Maintenance - 8.19
CENTRE COUNTY 9-1-1/EMERGENCY COMMUNICATIONS CENTER
STANDARD OPERATING PROCEDURES
8.0 EMERGENCY MEDICAL SERVICES DISPATCH PROCEDURES
8.1 Emergency Medical Services
The Emergency Communications Center is the designated Center for dispatching of
EMS within Centre County as approved by the Centre County Commissioners.
8.1.1 PSTs will give EMS pre-arrival instructions as appropriate utilizing the
APCO Guidecards PRE-ARRIVAL INSTRUCTIONS section.
8.1.2 When a call is turned over to another agency for disposition, the complaint
card for the first EMS will be completed and notation made that the call was
turned over and the agency turned over to will be noted on the card. A new
card for the second service will be completed.
8.1.3 Any time when an ambulance call is turned over to another service, the ECC
will simulcast the first due company with the second due company and broadcast
the message. This will alert the first company that the call has been referred to
another service.
8.1.4 Use of the "Ten Signals" is not authorized for EMS communications. This is
to avoid potential confusion. The phrase word brevity code listed in section 5.1
of this Manual will be employed. The use of nicknames, slang, CB language, and
any type of profanity is strictly forbidden.
8.1.5 Incident numbers and times may be given by phone or faxed. Numbers and
times will not be given over the radio except when a time may be necessary for
medical treatment.
8.2 Dispatching Appropriate EMS Service
The Communications Center will dispatch the EMS company having jurisdiction
over the location of the call as determined by the Seven Mountains EMS Council
based on criteria established by Act 45.
All EMS companies dispatched through the Centre County ECC will be alerted by
tone activated pagers on the designated Med Channels.
8.2.1 Med Channels
Companies 13 and 23 will be dispatched on Med 10. All other Centre County
companies will be dispatched on Med 9.
8.2.2 All calls requiring EMS response will be evaluated by the PST using the APCO
CRITERIA BASED DISPATCH GUIDELINE CARDS FOR MEDICAL EMERGENCIES
AND TRAUMA (Guidecards). The Guidecards will form the basis for all EMS
dispatching in Centre County. The PST will dispatch. or route the call to a dispatcher
as indicated m the Guidecards. All medical terminology used will be in line with
APCO call guidelines.
8.2.3 If the EMS call meets the Advanced Life Support (ALS) criteria in the
Guidecards, the appropriate ALS unit will be dispatched.
8.2.4 Referred Calls
8.2.4.1 In the event the ECC receives an EMS call handled by another dispatch center,
the call will immediately switched over the tie line and the PST will remain on
the line until the other county accepts the call.
8.2.4.2 Should the tie line fail or not exist, the PST will secure the necessary
information from the caller and refer the call by the most expedient means
available. In this case, the PST will pull and complete a numbered EMS card (ECC-
3) to document the call.
8.4.2.3 When the PST receives a request from an out of county ambulance for a patch
to the hospital, the P.S.T. Should pull a numbered EMS dispatch card, fill in the
information with the requesting EMS unit as the complainant, mark the block for
routine and time stamp the card.
8.3 County Wide Numbering System
8.3.1 For purpose of brevity in EMS unit communication, a numbering system has
been established and will be utilized. The EMS company numbers and appropriate
unit numbers are listed below and will be utilized for all radio traffic.
Company Number Company Name
1 Logan
4 Centre Hall-Potter
6 Snow Shoe
7 Gregg Township QRS
8 Pleasant Gap
9 Milesburg
13 Sandy Ridge
14 Howard QRS
15 Port Matilda
16 Walker Township QRS
20 University Ambulance
21 East Centre
23 Philipsburg EMS & ALS Program
24 Centre Community Hospital ALS Program
25 Alpha Community Ambulance Service
Company Number plus -
23 QRS Unit
50-59 Ambulances
60-69 Officers
70-99 Portables
8.3.2 The proper radio procedure for calling and/or responding to the ECC or a
field unit is as follows:
To call the ECC:
"Centre County, (unit number)"
The ECC will respond:
"Go ahead, (unit number)"
The calling field unit may then transmit their message.
8.3.3 A field unit will not call the ECC and immediately blurt out their message.
Wait for the ECC to acknowledge your call, then begin. Failure to follow this
procedure may result in missed messages with dangerous results.
8.3.4 To call a field unit:
"(unit number), Centre County"
The field unit will respond
"Go ahead, Centre County" "(unit number), go ahead" is
also acceptable)
8.3.5 The dispatch messages will include the following information:
A. The number(s) of the services due on the call.
B. Type of the injury/illness
C. The Borough or Township for which the incident is in.
D. The location of the incident including street number, if available.
E. Cross streets and/or other landmarks, when available.
8.3.6 When an ambulance call is paged, authorized ambulance personnel are to
contact the ECC indicating the service that they represent, their name, level of
training and their destination.
8.3.7 As per Act 45, the ECC recognizes the following as levels of training:
Attendant, Driver, Advanced First Aid, EMT, Certified Health Care Professional,
and Paramedic. The ECC does not recognize "third person", "trainee", or other
internal company designations.
8.3.8 When paging multiple simultaneous calls for a single company, the page
should include the information "second call", "third call" etc.
8.3.9 Qualified personnel (AFA's, EMT's, etc.) that cannot drive an ambulance are
acceptable as crew for manpower requirements. They will identify themselves as
non-drivers. The ECC needs to make sure that at least one responding member of
the crew is a driver. It is the responsibility of the ambulance personnel to provide
us with their level of training and if they are non-drivers.
8.4 Routine Transport Ambulance Service
8.4.I All requests for routine transport should be made well in advance of the time
of the run. At least a day before, when at all possible.
8.4.2 Ambulance services that have a designated pager code that alerts the contact
person for that service that there is a routine call pending would have their
page code activated. Services without a designated pager code will be paged using a
voice message.
8.4.3 When a pager is activated, indicating a routine ambulance call is pending, the
contact person for that ambulance service will contact the communications
center by phone or by radio acknowledging the routine transport.
8.4.4 At that time, it is the responsibility of the ambulance contact person to obtain
a crew to handle the routine. If the contact person does not acknowledge the
page within ten (10) minutes, a second page will be made. If there is still no contact,
the telecommunicator will make a phone call to the contact person. If at that
time, the contact person still cannot be reached, the communications center will
contact the person or agency making the request and advise them of the situation
and determine what their wishes might be as far as canceling the call,
rescheduling, or use another ambulance service.
8.4.5 If that ambulance service is unable to handle the call, the contact
person can make contact with one of their mutual aid companies and turn the call
over to that company. At that time, the contact person should advise the
communications center that the call has been given to another ambulance service
to be handled.
8.4.6 If it is necessary to cancel the call, the communications center will
immediately page the appropriate service with the cancellation.
8.5 Immediate Transport Ambulance Service
8.5.1 Immediate transports are those calls requiring a timely ambulance response
yet which are not, in the opinion and judgement of the telecommunicator, an
emergency situation.
8.5.2 Immediate calls will be paged, then repaged after three (3) minutes; at six (6)
minutes total, the call will be repaged; at nine (9) minutes total, the call will
be turned over to the next nearest available ambulance service.
8.5.3 When manpower requirements are met for the call, the communications
center will put out a page stating that manpower has been fulfilled on the call.
8.6 Emergency Ambulance Service
8.6.1 The Emergency Communications Center is the designated Center for
dispatching of EMS within Centre County as approved by the Centre County
Commissioners.
8.6.2 The Communications Center will dispatch the EMS company having
jurisdiction over the location of the call, as determined by the Seven Mountains
EMS Council, based on criteria established by Act 45.
8.6.3 All calls requiring EMS response will be received either via telephone or
radio from various field users. The PST will determine if the incident requires the
ALS service to respond based on the criteria in the APCO Guidecards.
8.6.4 After the emergency call is paged, alerting the appropriate service; that being
the nearest available ambulance service, the call will be repaged at two (2)
minutes. At four (4) minutes total, if manpower requirements have not been
met, the ECC will simulcast and page the first due company with the second
due (next closest) ambulance service. This will alert the first due company that the
call has been referred to another service.
8.6.5 The procedure in section 8.6.4 will be followed until manpower requirements
are met for the call.
8.6.6 Responding ambulance personnel will contact the ECC, give their name, and
state their level of training and if they will be responding to the scene or to the
station.
8.6.7 For manpower purposes, a crew for any emergency ambulance call will
consist of an EMT and one other ambulance attendant that meets the
requirements in Act 45. Should a responding or on-scene ambulance require
additional help, they may request a mutual aid page.
8.6.8 Any service may request that a three person crew be dispatched on emergency
calls by notifying the ECC in writing. However, if a crew of three isn't obtained
within four (4) minutes, the ECC will page manpower fulfilled with a crew meeting
the minimum Act 45 requirements, rather than paging next due service.
8.7 Med System
8.7.1 Med Patch
Ambulance and medics units may request a med patch in order to relay medical
information and request medical command from the hospital emergency room.
When requesting a patch to the hospital, the EMS personnel must provide the PST
with the patients chief compliant. This allows the PST to prioritize and set up the
patch to the unit with the highest priority. It also allows the PST to advise the
hospital of the type of emergency it is about to receive. The med patch is reserved for
emergency use. As soon as the EMS personnel has completed using the patch, the
PST should be notified so that the patch is available for any other unit that may be
needing it.
The Med Patch System is a voice activated (VOX) system. It is therefore simplex:
that is you talk, then the other party talks. Both parties cannot talk at the same
time. It is necessary to start each transmission by saying "ok." This activates the
patch and the only thing lost in the transmission is the "ok." During the course of
the transmission, the operator must be careful not to pause for an extended period
of time, or let your voice "trail off." If this occurs, the system assumes you have
completed your transmission and deactivates the patch. In order to re-enable the
patch, you will need to start by saying "ok" and then proceed with your
transmission.
When one party has completed their transmission and another party wishes to talk
back, a brief delay (approximately 1.5 seconds) is required to allow the system to
deactivate from the first transmission and re-initiate from the return transmission.
Again, it is necessary to start the transmission by saying "ok" and then proceed.
A few cautions:
-- Start each transmission by saying "ok."
-- Do not let your voice trail off.
-- Do not turn your head away from the microphone--talk directly into the
microphone.
-- Do not attempt Med Patches when using a portable in a vehicle.
-- Do not pause longer than a second, otherwise, you must reactivate the
patch by saying `ok.'
-- Do not try to rush a reply. The equipment needs a second or two to switch
before you begin to talk--by saying "ok" and proceeding.
-- Don't try to talk when the other party is talking. It will not work. It is a
simplex system. "You talk, then I talk."
8.7.2 Med Repeater
The Med 9 and Med 10 repeaters will be enabled on request of EMS personnel for
emergency transmissions, only at the discretion of the PST. The repeater will be
disabled as soon as the transmission is completed. -
8.8 Air Ambulance Services
8.8.1 Scene response for helicopter transport patients will only be initiated after
EMS personnel have consulted with a Medical Command Physician. All
communications requesting scene response and air transportation of patients will be
referred through a Medical Command facility.
8.8.2 The helicopter should be summoned directly to an accident scene only by the
paramedic after consultation with the medical command physician whenever
possible.
8.8.3 The most likely situations requiring scene transport with a helicopter would
be major trauma in an area inaccessible to land vehicles, or multiple severe trauma
victims.
8.8.4 If ALS is unable to arrive at the scene, then the BLS unit should call for
instructions from the medical command facility.
8.8.5 If ALS and BLS are not available, the police or fire personnel must assess the
situation and determine the need, based on the above criteria, for a helicopter scene
response.
8.8.6 Requests for air ambulance activation will be referred by the ECC to medical
command via patch. If approved by medical command, the ECC will initiate
the request and coordinate the response.
8.8.7 When a transport is requested, be prepared to give detailed information on
the following:
1. Who is requesting the response
2. Nature of the incident
3. Number of patients
4; Sex, age, and vital signs of patient(s)
5. Specific injuries and level of consciousness
6. Location of the incident (using landmarks)
7. Call back telephone number or radio frequency
8. Any information that may be helpful to the flight team
8.9 Private Ambulance Services
8.9.1 Transmissions from private ambulance services not a participating member
of the Centre County Emergency Communications Systems will be limited to
emergencies in route and emergency relays to hospitals.
8.10 Quick Response Services (QRS)
8.10.1 QRS systems provide rapid emergency care and patient stabilization until an
ambulance can arrive on the scene and transport the patient(s).
8.10.2 Centre County ECC will support County QRS services. The ECC's priority is to
assure arrival of a certified patient transport service. Appropriate QRS services
will be paged along with the ambulance service until the manpower fulfilled
message. The ECC will maintain normal communications with the responding QRS
unit, and provide all necessary support as outlined in these operating procedures.
8.10.3 Centre County QRS services will be paged on appropriate fire frequencies.
QRS units with Med Radios will conduct their communication on the Med
channels, as outlined in this Section.
8.11 Paid Crews
8.11.1 Services with paid crews on duty will not receive a "manpower fulfilled"
message when the on-duty crew responds.
8.11.2 Services with on-duty paid crews having 1,500 or more runs per year may
implement a second "unscheduled crew" pager tone.
8.11.3 Services electing to use the two tone system will be paged according to the
following protocol:
Scheduled Crew Tones
1. All emergency and immediate calls when a scheduled crew is available.
Unscheduled Crew Tones:
1. When a reported scheduled crew does not respond after the first page.
2. When all scheduled crews are known to be unavailable.
3. All routine transports.
4. All out of County transports, routine or emergency.
5. All other pages such as tests, informational messages, etc.
6. Normal manpower fulfilled procedures will followed using this tone.
8.11.4 Crews will not be considered "scheduled" or "on duty" for periods of less than
six (6) hours.
8.11.5 It is the sole responsibility of the service utilizing this policy (Section 8.11) to
keep the ECC advised of the status of the scheduled crew.
8.12 Paramedic Ambulance Services
8.12.1 Advanced Life Support services represent a higher level of ambulance care
available to the sick or injured. Presently, there are two ALS services in Centre
County, which are the Philipsburg Emergency Medical Services (Medic 23) and the
Centre Community Hospital ALS Program (Medic 24). These services function as an
extension of the Hospital's Emergency Department in order to provide Advanced
Life Support care in the pre-hospital environment.
ALS services are to be dispatched to all emergency calls that fall under the ALS
dispatch criteria listed in the APCO Guidecards.
8.12.2 A blank complaint card will be pulled for all ALS calls simultaneously paged
with a Centre County BLS service. The card will be numbered with the BLS incident
number. ALS units responding on their own or with non-County BLS will receive a
numbered incident card.
8.12.3 Each paramedic will utilize a preassigned "paramedic number" for
communications with the hospital.
8.12.4 The ALS unit will be simultaneously paged with the BLS unit. After
dispatching the ALS unit, and no response is obtained within two (2) minutes, the
page will be repeated, if there is still no response after six (6) minutes total, the
Paramedic Coordinator should be paged and advised.
8.12.5 If the appropriate ALS unit(s) is/are unavailable and there is no designated
backup service, an EMS card will be completed and punched "TIME RECEIVED."
Should the ALS unit become available after the BLS unit makes patient contact, the
BLS unit will be asked by the ECC if ALS is needed, and dispatched accordingly. If
BLS is not yet on scene, the ALS unit will be dispatched upon their availability.
8.12.6 Responding ALS personnel will contact the ECC via radio. No "manpower
fulfilled'' page is necessary for the Medic Units.
8.12.7 Once dispatched, the ALS unit can only be recalled or canceled by the on-scene
EMT. Once the paramedic has started patient care, only the physician in command
can release the paramedic and allow him/her to go available.
8.12.8 An ALS Unit may arrive on the scene before or after the responding
ambulance(s), or may rendezvous with an ambulance enroute to the hospital. In
any instance, the paramedic will utilize his/her designation number for
communications with the hospital.
8.12.9 Paramedic Coverage Area
8.12.10 The normal response area for the Centre Community Hospital's
paramedics will include the coverage areas of all Centre County ambulance services
except for Sandy Ridge's (Company 13) and Philipsburg's EMS (Company 23). The
Philipsburg EMS (Company 23) will respond to the Burnside Township area of
Snow Shoe, in addition to its own coverage area and that of Company 23. A special
request is acceptable for a specific ALS unit to rendezvous with an ambulance
enroute to the ALS unit's "base hospital".
8.12.11 Paramedic Fire/Rescue Response
8.12.12 The paramedics will be dispatched to any fire with reported or
suspected entrapment, rescue situation (vehicle accident, cave rescue, terrain rescue,
etc.) with reported or suspected ALS response potential (in accordance with the
APCO Guidecards criteria).
8.12.13 A request from a chief officer for Medic 24 to standby, only at the scene
of a fire or rescue incident, will be complied with. However, the Medic 24 Paramedic
Coordinator is to be notified as soon as possible through the ECC.
8.12.14 Right to Refuse ALS
When placing a call for EMS service, the complainant (either a citizen or health care
professional) has the right to refuse the dispatch of ALS. The Telecommunicator
will comply with the request and indicate it on the complaint card.
8.13 EMS Command Post
8.13.1 A Command Post or position should be established for all EMS incidents.
This will enhance the flow of information between field users and the ECC. All
requests from the EMS scene will come through the Command Post. The Command
Post can be either a piece of apparatus or person, just as long as the ECC has a radio
unit to address all questions or information.
8.13.2 The first arriving EMS personnel or EMS unit on the scene will advise the
ECC that he/she is on scene and in command with a location and condition report.
The ECC will respond to requests from the command officers only.
8.14 EMS Responding to Fire Calls
8.14.1 Ambulances responding to fire calls are acting as fire equipment and will
maintain communications on the appropriate fire channel. However, for the
purposes of paging, simulcast will be used I.e. Paging will be done on both the fire
frequency for the fire company and on the Med Channels, 9 or 10 for the ambulance
service. Manpower fulfilled messages will be broadcast as soon as feasible
considering communications activity and the priority of the Fire dispatch. Should
an ambulance not respond and a chief fire officer on scene requests ambulance
response, additional paging on Med Channels 9 or 10 will be initiated. Should no
ambulance respond, the chief fire officer on scene will be advised of same, and
his/her wishes asked for further paging.
8.14.2 Should an ambulance transport a patient from a fire scene, communications
will immediately shift to the appropriate Med Channels and the normal EMS
procedures will be followed.
8.14.3 Ambulances responding to fire calls will have an unnumbered EMS card
pulled and numbered with the original fire incident number. Should an ambulance
transport a patient from the fire scene, a pre-numbered EMS card will be pulled and
the transport will be treated as a separate EMS incident.
8.15 Personal Phone Calls
The ECC will not make personal telephone calls for EMS units in the field. EX: calls
to places of employment, home, etc.
8.16 Personal Paging
The ECC will not page individual ambulance personnel except in extreme
emergencies at the discretion of the Shift Supervisor.
8.17 Informational Messages
At 0900 and 1800 hours each day, the ECC will broadcast the unit numbers of all
apparatus that are listed out of service with the ECC. This is for two reasons. One, to
advise field units what pieces are not available for service; and two, to remind those
companies that have units listed as out of service that they may have to use a
different piece of apparatus for calls. This will be broadcast on all FIRE/EMS
frequencies. It is imperative that each company be prompt in notifying the ECC
when taking units out of service for repairs and remembering to place the units back
in service with the ECC. In emergency situations, the unit status check may be
eliminated at the discretion of the Shift Supervisor.
EMS personnel should use caution when signing in quarters that they use the
proper terms and not list the unit out of service as it will be taken out of service and
a pager message will be broadcast to this effect.
8.17.1 The ECC will not transmit routine informational messages that relate to
social events, regularly scheduled meetings, funerals, viewing, fund raising sales,
etc. Messages about special meetings, special work details and training are permitted.
The on-duty Shift Supervisor will make the final determination of the suitability of
the request.
8.17.2 Permitted messages can be called into the ECC by phone, or faxed, by a chief
officer of the company. Such messages will be transmitted at 18:00 hours only.
Messages will be limited to being transmitted a maximum of two days, and they
must be received by the ECC prior to 17:00 hours. In emergency situations, the 18:00
hour messages may be eliminated at the discretion of the Shift Supervisor.
8.18 EMS Response Index
Use of the County Response Index for Mass Casualty Response follows the same
protocols as outlined in Section 7.16 of this manual, except that action is based on
the number of injuries involved.
8.19 Med Radio Maintenance
For any system to function well, from an equipment standpoint, it is essential to
have the equipment maintained on a regular basis and operating "peak"
performance.
It is, therefore, necessary to have vehicular and portable Med radio equipment
checked and adjusted as necessary, at least once a year. Proof of the maintenance
shall be provided to the Communications Center Coordinator within ten (10)
calendar days of the maintenance being performed.
The maintenance sheet shall conform to FCC regulations and shall be completed in
full for each individual unit listed.
[Penn State Home Page] [Student Affairs Home Page] [Penn State EMS Home Page]
02.22.02