Penn State Emergency Medical Services

Penn State EMS Standard Operating Procedures and Constitution

University Ambulance Service
Centre County Company 20
Procedures Manual

TRAINEE MANUAL
THE PENNSYLVANIA STATE UNIVERSITY
UNIVERSITY AMBULANCE SERVICE

University Ambulance Service (UAS) is currently a BLS service which provides
primary services to the University Park campus. It has a full crew of paid EMT's and
Paramedics. When requested UAS also provides coverage for the surrounding
communities. Coverage is provided 24 hours a day, seven days a week. Weekdays
between 8:00am and 4:00pm a full-time staff is on call, and
between 4:00pm and 8:00am a part-time staff is on call. All part-time staff are
University students.

In addition to ambulance emergencies, the Universities Office of Emergency Medical
Services (OEMS) provides coverage for special events at University Park. In
conjunction with the department of University Safety on-site coverage is provided
for events such as football games special olympics, arts festival, agricultural progress
day, and a host of other Penn State events.

INTRODUCTION

The University Ambulance Service orientation program was designed to provide
new volunteers with a comprehensive guidebook for providing emergency services
at Penn State. This handbook is not intended to be a rulebook for every situation
you may encounter, but is a general statement of operations and objectives to serve
as a basis for involvement with UAS. It is hoped that this manual will serve as an
effective tool to introduce EMS providers to this particular EMS system.

This orientation manual will cover a wide variety of duties, roles, and
responsibilities of the UAS crew member. It is important that trainees fully
understand what is expected of them. If any part of this manual is unclear or
objectionable, feel free to discuss your concerns with the OEMS staff. Most
importantly, do not let any questions remain unanswered. In keeping with the
standards of a professional EMS organization, trainees should be thoroughly
familiar with the contents of this manual before riding on the ambulance.

UNIFORMS

All Personnel must wear the proper uniform when representing University
Ambulance Service and the office of EMS. The standard uniform is a dark blue pair
of work or uniform-type pants and a white uniform shirt (long or short sleeved).

Uniform shirts must display the following:

1. Patch for the highest level of certification (AFA,EMT,EMT-P) on the left shoulder.
All appropriate rockers may also be displayed.

2. University Ambulance Service patch on the right sleeve.

** Patches should be sewn on 2" below the shoulder seam.

3. One pair of collar pin insignia (optional). The office of OEMS reserves the right to
deny the display of anything they feel is inappropriate.

4. Name tag over right pocket (optional).

Footwear must fit into one of the following types (black or brown only):

1. Work boots with ankle support

2. Hiking boots with ankle support

3. Military-type boots

4. Black uniform shoes/boots

**Although it is not required, footwear with steel-toed support is desirable.

The following communications equipment must be worn with your uniform:

1. Motorola HT2000 Flashport 800MHz portable (designated for trainee).

2. Motorola Pagecom pager or Minitor II if available.

** See attached instructions for 800MHz Portables.

The use of hip holsters designed to carry personal medical equipment, such as,
trauma shears, scissors, gloves, exam light, etc. may be used at your discretion.

With the uniform guidelines in mind, all trainees must present themselves
appropriately for their shifts at UAS. The crew has the discretion to ask a trainee to
fix their appearance if they are not properly prepared to run their shift.

THE TRAINEE PROGRAM

The UAS trainee serves in a volunteer capacity. Trainees are not employed by the
OEMS, but they are part of the crew they ride with. The trainee has varying
responsibilities while on calls. As employees of the University, crew members are
responsible for all ambulance calls including, but not limited to, trainees and
equipment. The degree of involvement and use of equipment on the trainees part is
under the discretion of the crew at all times.


Trainees run on a rotational schedule. This schedule is designed around the
availability of the trainees on a semester basis. However, being scheduled to run as a
trainee should not be treated as a non-mandatory, voluntary performance.
Enthusiasm and dedication of the trainee is noticed by the staff and will be reflected
in recommendations for regular employment. Furthermore, missing a shift as a
trainee is wasting valuable experience that could be gained by someone else.
Therefore, trainees should treat their involvement as a job, and obtain suitable
coverage in the event they cannot work a shift. If a trainee displays continued
neglect of his/her responsibilities, the OEMS may reevaluate the trainees status on
the schedule. Again, scheduling difficulties should be brought to the attention of
one of the supervisors, and every effort will be made to accommodate acceptable
scheduling for all trainees.

Since trainees are volunteers at UAS they are not obligated to take part in the shift
responsibilities of the crew. It is however encouraged that all trainees interact with
the crews responsibilities, such as sec check, crutches, rig check, etc. The more
interaction a trainee has with the crew the more familiar that trainee will become
with crew responsibilities.

** If you choose to leave the UAS trainee program, it is requested that you notify the
Trainee Supervisor verbally.

DAYTIME TRAINEES

Daytime trainees are those who run on a sign up basis Monday thru Friday between
8am and 4pm. These trainees have the same responsibilities as night time trainees
except they are not put on a predetermined schedule. The daytime trainees have a
schedule in the duty room which they may sign up to run on one week prior to the
shift(s) they want. During the shift the trainee must have a crew member sign them
off on the shift list so they can receive credit for their time.

** All trainees must give a copy of current certifications, CPR cards, and Drivers
license to the assistant training officer before running on the ambulance.

DUTY ROOM

The duty room is available for use by all crew members. Trainees are always
welcome, but should remember that they are guests in the duty room. The duty
crew is responsible for the duty room during their shift. Two futons are
automatically reserved for the duty crew, and the third is for the trainee. Since the
duty room is limited in space all members need to be considerate of the duty crew
during off hours.

RADIO COMMUNICATIONS

There are a few key aspects in the area of communications with which UAS
personnel must be familiar with. UAS is subject to two different sources of radio
and dispatch traffic. The most common origin of our calls is the Centre County
Emergency Operations Center (CCEOC), which dispatches UAS (Company 20) via
UHF Med pagers. UAS is dispatched according to three classifications:

- Ambulance Emergency: Denotes a situation which is serious or possibly life
threatening. The ambulance must respond with flashing lights/strobes and audible
warning signals to the scene.

- Ambulance Immediate: Denotes an urgent, but not an emergency situation. In this
case the ambulance must respond without delay. Lights and sirens should not be
used.

- Routine Transfer This type of situation does not require any immediate action,
unless the ambulance is already available. Generally used in cases of a Ritenour-to-
Centre Community transfer.

ln all response situations the CCEOC must be informed of the status of the
ambulance. When communicating with Centre County plain english should be
used.

- When Acknowledging a Call/Initiating a Response: Example: 20-51: Centre CountY
20-51

CCEOC: 20-51

20-51: 20-51 is responding

Med Patches
When transporting to Centre Community Hospital, patient information must be
transmitted to the Emergency Department. This is accomplished by the use of a Med
Patch through the CCEOC. To obtain a patch it must be requesting by using the
following format:

20-51: Centre County, 20-51

CCEOC: 20-51

20-51: 20-51 is requesting a patch to Centre Community for abdominal pain. (Always
state the chief complaint).

CCEOC: Okay, Go to Med 7 and standby. (The Med channel assigned can change at
times).

CCEOC: 20-51, your patch is up, go ahead.

Note: At this point you are now addressing Centre Community Hospital, not Centre
County.

20-51: At this point you will go ahead with your patch.

Note: The new Med system is voice activated. This means that before you begin
your patch you should say the word "Ok" to open the patch, then begin.

When the patch is complete you need to contact Centre County and advise them
that the patch is complete. They will then tell you to return to Med 9. If at any point
the patients condition changes you can request the patch to be re-enabled to advise
the hospital.

Communications With the Paramedic unit

If there is a need on a call to talk directly with the Medic unit the crew must first
attempt to use the MED 9 talk around frequency. If they are unable to reach the
Medic unit, then they must call Centre County and ask them to put up the Repeater.
When the repeater in no longer needed Centre County must be told to take down
the Repeater.

Responding To a File Call

Fire calls are dispatched on a different frequency than medical calls. When
responding and communicating on a fire call, the fire channel must be used.
Channel 4 on the University radio in the rig is the only place this channel can be
utilized. If at any time during the call the rig has to transport a patient they no
longer use the fire channel. They now go back and use Med 9.

UNIVERSITY COMMUNICATIONS

When responding and communicating on calls, in addition to talking to Centre
County, we also need to talk to the University. This can be achieved by using the
800MHz portables carried by the crew. When talking to the University Ten Codes are
to be used (They can be found in the back of this manual). The University must be
notified of all actions of the ambulance while on a call. If the rig is dispatched by
Centre County, then the University must be notified. Likewise, if the University
dispatches the ambulance on a call, then Centre County must be notified.

Note: It is expected that there might be some confusion on the radio system. There
will be a meeting which will explain the system in detail.

TRAINEE EVALUATIONS

After every shift an evaluation must be filled out on the trainee. These forms can be
found in the duty room. The skill sheets in the back of this manual must also be
filled out appropriately. It is the trainee's responsibility to make sure the proper
paper work is completed. If these evaluations and skill sheets are not kept up to
date, it may effect the hiring process.

** The evaluations MUST be filled out by the Crew first and then the trainee.

If there are no calls on a shift an evaluation must be filled out regardless. There is
also a section on the skill sheets that is for training done in station. All training
done in station must be marked off on the skill sheets. This training must also be
noted on the evaluation.

** All completed evaluations must go in the Trainee supervisors box, and will then
be filed accordingly.

BEING HIRED
WHAT WE LOOK FOR

The purpose of this section is to give trainees an idea of what the Crew is looking for
when considering moving people from trainee status to Crew.

Qualification/Certification: University Ambulance only employees EMT's and
Paramedics with current Pennsylvania State Certification. In addition, this service
requires (to be on Crew): EVOC, Hazardous Materials, and AED regional training.
You must have all of these or have made arrangements to get all of these before you
can be moved to Crew status.

Competency: The most important factor in being moved from trainee to Crew will
be an individuals abilities in EMS. As a paid service, University Ambulance has a
responsibility to the University to provide not only competent care on the
ambulance, but at special events as well. Therefore, each trainee is considered by
ALL Crew members before he/she is hired to insure that the Crew feel the trainee
can perform as expected by the University.

Time: How long you have been with University Ambulance is important in cases of
people with equal abilities. We work under the assumption that the longer you
have been here, the more you will learn in regards to our system.

Shift: How often you run is the best way for us to gauge your EMS experience. This
not only means showing up for your scheduled shifts, but making an effort to run
extra shifts, attend UAS training and signing up for special events.

Documented Outside Experience: Both in local services and through services that
you may have worked for before coming here. This experience will be looked at on
an individual basis and is only important in specific cases.

Requirements

This section describes the qualifications required for being moved from trainee
status to Crew.

I) Run for at least 1 semester.

2) Have a 'significant' number of evaluations filled out by the Crew.

3) Have demonstrated to the Crew an understanding of both patient care AND the
operations of UAS including, but not limited to Crew responsibilities, UHS duties,
radio operations, maintenance. and driving.

4) Must run at least one shift with (or be checked out by) EITHER the Trainee
Supervisor or the Training Supervisor. This is to insure that there is at least one
constant in all evaluations when comparing one trainee to another.

5) Be recommended by the consensus of the Crew.

6) Be approved by Wes Cartwright EMS Supervisor.

IMPORTANT: This is a policy we are instituting to try to make advancement
through UAS more uniform. Please remember that this is only a guideline and the
EMS Supervisor can alter or remove any or all requirements as he sees fit.

EMPLOYEE DISCIPLINE

Employees are expected to act in a professional manner at all times. Your uniform
represents the entire University, as well as the Office of EMS. If any UAS member
acts in an unprofessional manner, or one inconsistent with the goals or operations
of this service, the matter will be investigated by the supervisory staff. The EMS
supervisor has the option of verbal reprimand, written reprimand, suspension, or
dismissal of any UAS member. In more serious matters, no second chances will be
given. All actions will be noted in the employee's personnel file.

I have read and I understand all that is contained in the attached document; This
being the UAS Orientation Guide. I will abide by all the rules set forth in said
document and understand that any failure to do so may result in any of the
following punitive actions; Verbal warning, written waning, suspension, demotion
and termination of employment.

The actions of suspension, demotion and termination require a review board which
will consist of the Director of EMS, EMS Supervisor, and the UAS Crew Supervisor.
The personnel file will be reviewed as will all evidence and testimony pertinent to
the situation before a final decision will be made.

Witnessed Trainee Supervisor	

Signed Trainee

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UNIVERSITY HEALTH SERVICES

STATEMENT OF CONFIDENTIALITY

   In the performance of your duties and responsibilities at University Health
Services, you are expected to maintain and protect the confidentiality of patient
information. Confidential patient information may be released only with the
patient's written authorization, by court order or as otherwise mandated by law.

Confidential Patient Information includes but is not limited to:

	1. Patient Name and other information obtained upon admission or
registration at medical records, outpatient department, observation unit and urgent
care clinic;

	2. All case discussions, diagnoses, consultations, examinations, and
treatments;

	3. All forms of patient records and copies of orders;

       and

	4. All information about the disposition or personal characteristics of patients.

   Any breach of your duty to maintain and protect the confidentiality of patient
information, including the unauthorized release of confidential information to
third parties, may subject you to disciplinary action including dismissal.

I acknowledge receipt of the University Health Services' "Statement of
Confidentiality."

Signature            Date

Name (please print)

Witness			              Date

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Motorola MTS 2000 Flashport

Operation/Functions (SEE NEXT PAGE)

1. On/Off Volume Control

2. Channel Selector

3. Channel Bank Selector

4. Not in Use

5. Emergency Button

Note: If you push this button you will hear an audible tone. It will also alert the
University that you are in trouble. If it is a false alarm call the University with the
radio and tell them "false emergency button activation, resetting. Then push and
hold down the orange button until you hear a tone approx. 2-3 seconds. The radio
should now be reset.

6. Light

7. Scan On/Off

8. Private call receive

9. Talk

How To Private Call

Press one of the <> buttons to bring up the menu. Press (.) to select the CALL feature.
Use the <> buttons to select the person you want to call. Push the talk button to
initiate the call. Press HOME to clear and return to regular function.

How to Receive a private call

When you hear the call tone press button 8 (Diagram Next Page) and key the talk
button to open the call. When you are done press HOME to clear the call.

Muting the Audio

Press <> For Menu
Press (.) to select mute
Press the button under selection for on/off

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Trainee Skill Sheets

Vital Signs
In Station
In Station
On Call
On Call
Patient Assessment
In Station
In Station
On Call
On Call
Radio Reports
In Station
In Station
On Call
On Call
Lifting and Moving
Litter
Reeves
Scoop
Stair Chair
Long Board
Short Board
KED
Other:
Splinting
C-Collar
Long Board
C I D
Upper Extremity
Clavicle
Humerus
Lower Arm
Hand
Elbow
Hip
Femur (Hare/Traction)
Knee
Lower Leg
Ankle and Foot
Bandaging
Head
Eye
Face
Neck
Shoulder
Arm
Chest
Abdomen
Genitalia
Legs
Burns
02 Administration and
Airway Management
Changing Rig 02
Changing Port. 02
Nasal Cannula
Simple Face Mask
Non Rebreather
BVM with 02
Positive Pressure/Demand
Oral Airway
Nasal Airway
Suction in Units
Yankauer French
Catheter
Automatic Defibrillator
Equipment and Vehicle Operations
Rig Check
Placement of All Equip.
Use of Maps
Restocking Rig
Universal Precautions
Proper Radio Use
Fueling Rig
Who To Call For Maintenance
Operating Policies
Driver Training
Other:

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UAS  TEN CODES

10-1 Signal Weak
10-2 Signal Good
10-3 Stop Transmitting
10-4 Affirmative
10-6 Busy
10-7 Out of Service
10-8 In Service
10-9 Repeat
10-10 Negative
10-12 Stand-by
10-17 In Route
10-20 Location
10-21 Call by Phone
10-22 Disregard
10-23 Arrived on Scene
10-24 Assignment Complete
10-25 Report to/Meet with
10-26 Estimated Time of Arrival
10-42 On Station
10-45 Motor Vehicle Accident
10-97 Radio Check
10-99 Engage Take-over Switch