STANDARD OPERATING
PROCEDURES
EMS DIVISION
ROUTINE OPERATIONS
MOUNT DORA FIRE DEPARTMENT
STANDARD OPERATION PROCEDURES
EMS DIVISION
ROUTINE OPERATIONS
TABLE OF CONTENTS
INTRODUCTION
1.01
1.02
1.03
1.04
PURPOSE
POLICY
RESPONSIBILITIES
AREAS COVERED
1-1
1-1
1-1
1-1
PARAMEDIC AND EMT APPRENTICESHIP PROGRAM
2.01
2.02
2.03
2.04
2.05
2.06
PURPOSE
POLICY
PROCEDURE
PROGRAM CONTENT
COMPETENCIES
PROGRAM EXIT TESTING COMPONENTS
2-1
2-1
2-1
2-1
2-2
2-3
PATIENT CARE QUALITY ASSURANCE
3.01
3.02
3.03
3.04
3.05
3.06
PURPOSE
POLICY
PROCEDURE
INFRACTION LEVELS
PARAMEDIC/EMT-B REMEDIATION
LENGTH/TPYE OF REMEDIATION
3-1
3-1
3-1
3-1
3-1
3-2
RECOVERY OF EMS EQUIPMENT & MANPOWER
4.01 PURPOSE
4.02 EQUIPMENT
4.03 PERSONNEL
4-1
4-1
4-1
CONTINUING EDUCATION UNITS
5.01
5.02
5.03
5.04
PURPOSE
POLICY
PROCEDURE
CEU TYPES AND TOTALS
5-1
5-1
5-1
5-1
EMS SUPPLY ROOM
6.01
6.02
6.03
6.04
6.05
6.06
PURPOSE
POLICY
MAINTENANCE
STOCK ORDER
INVENTORY
ACCOUNTABILITY
6-1
6-1
6-1
6-1
6-1
6-1
QUALIFICATIONS OF A FIELD TRAINING OFFICER
7.01 PURPOSE
7.02 POLICY
7-1
7-1
EMS STUDENT INTERNSHIP
8.01
8.02
8.03
8.04
PURPOSE
LEGISLATION
FIRE DEPARTMENT PERSONNEL
NON-FIRE DEPARTMENT PERSONNEL
8-1
8-1
8-1
8-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
Introduction
4-1
EFFECTIVE: 01/07
REVISED:
PAGE: 1 of 1
Authorized:
1.01 PURPOSE
To set forth and establish a standard, written source of departmental policies and
procedures which will promote the effective and efficient operation of the EMS division
within Fire Department.
1.02 POLICY
The Mount Dora Fire Department shall establish a manual containing written,
standardized operational policies, procedures and regulations dealing with the routine
daily activities and programs of the EMS division.
The Mount Dora Fire Department shall follow the Advanced Life Support Protocols as
established by the Lake County Medical Director when rendering aid to those that fall ill.
1.03 RESPONSIBILITIES
A.
B.
C.
D.
It shall be the responsibility of all employees to familiarize themselves with and
conform to the policies, regulations and procedures contained within the S.O.P.
It shall be the responsibility of all Fire Department Officers to supervise and
command their subordinates within the guidelines and philosophies contained within
the S.O.P.
It shall be the responsibility of the Fire Captain to supervise the overall operations of
the EMS division.
It shall be the responsibility of the Lieutenant assigned to EMS to oversee the day to
day operations of the EMS division.
1.04 AREAS COVERED
The EMS standard operating procedures are to cover but are not limited to the
following daily activities and EMS Programs:
A. Paramedic and EMT Apprenticeship Program
B. Patient Care Quality Assurance and Improvement
C. Recovery of EMS Equipment & Manpower
D. Continuing Education Units
E. EMS Supply Room
F. Qualifications of Field Training Officers
G. EMS Bike Team Operations
H. Community Resource information Packet
I. In-House Paramedic Training Program
1-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-2
Paramedic and EMT Apprenticeship Program
EFFECTIVE: 01/07
REVISED:
PAGE: 1 of 3
Authorized:
2.01 PURPOSE
To establish a guideline by which full-time employees are entered into and tested out of
the Mount Dora Fire Department Paramedic and EMT Apprenticeship Program.
2.02 POLICY
Any new employee holding either paramedic or EMT-B certification shall be subject to the
procedures within this S.O.P.
2.03 PROCEDURE
All new hire paramedics and EMT-B’s will be entered into the apprenticeship program
under the following conditions:
A. Personnel who have previously been employed in either Lake or Sumter Counties
that are in good standing with the current Medical Director and have successfully
passed a prior apprenticeship program, will be monitored by an approved Mount
Dora Field Training Officer for no less than three (3) shifts for acclimation into the
department. This condition does not warrant program exit testing or evaluation by
the Medical Director, but will be completed using adopted shift evaluation forms to
track proficiency. Following a review of evaluation forms and with approval of the
Fire Captain, EMS Lieutenant and EMS Coordinator, successful candidates will be
placed in a staff position on an assigned shift.
B. Personnel that have not been previously employed in Lake or Sumter Counties and
have not completed an approved apprenticeship program, will be required to
complete the following;
1. Paramedics will be assigned to their permanent shift and will consummately be
assigned to their respective FTO. The apprenticeship will begin on the first
assigned shift and will continue for no less than ten (10) 24 hour shifts with all
applicable evaluation forms completed prior to the end of each shift. Upon
completion of specific competencies, the apprentice will be recommended for exit
testing by the assigned FTO. Upon review of all applicable documentation by the
EMS Lieutenant and EMS Coordinator, the apprentice will be scheduled for exit
testing. Upon successful completion of the exit testing, the apprentice will be
moved to a staff paramedic position.
2. EMT-B’s will be assigned to their permanent shift and will consummately be
assigned to their respective FTO. The apprenticeship will begin on the first
assigned shift and will continue for no less than five (5) 24 hour shifts with all
applicable evaluation forms completed prior to the end of each shift. Upon
completion of specific competencies, the apprentice will be recommended for exit
testing by the assigned FTO. Upon review of all applicable documentation by the
EMS Coordinator, the apprentice will be scheduled of exit testing with the Fire
Captain and EMS Lieutenant. Upon successful completion of the exit testing, the
apprentice will be moved to a staff EMT-B position.
2.04 PROGRAM CONTENT
A. Paramedics will be evaluated under the following critical skills observations;
1. Patient assessment
2. Intravenous cannulation success rate
3. Orotracheal intubation success rate
4. Medication indication and administration
2-1
Routine Operations
S.O.P. #
5.
6.
7.
8.
9.
10.
11.
4-2
Paramedic and EMT Apprenticeship Program
PAGE: 2 of 3
Practice parameter quizzes and practical scenarios
Administrative policies quizzes
Documentation efficiency
ALS unit readiness
Effective use of assigned equipment
Teamwork
End of call critique
B. EMT-B’s will be evaluated under the following critical skills observations;
1. Patient Assessment
2. Approved BLS Airway insertion(s)
3. First Aid and CPR techniques
4. ALS assist skills
5. Practice parameter quizzes and practical scenarios
6. Administrative policies quizzes
7. Documentation efficiency
8. ALS unit readiness
9. Effective use of assigned equipment
10. Teamwork
11. End of call critique
2.05 COMPETENCIES
A. Paramedics will be required to achieve the following;
1. Successful I/V cannulation rate of greater than 70% for three (3) consecutive
shifts.
2. Successful orotracheal intubation rate of greater than 70% for the duration of the
program.
3. No evaluation scores of less than 2 for any category for three (3) consecutive
shifts.
4. Completion of assigned practice parameter quizzes.
5. Completion of no less than ten (10) documented treatment scenarios.
6. Completion of all assigned evaluation forms.
7. Recommendation from the assigned FTO.
8. Recommendation from the EMS Coordinator.
B. EMT-B’s will be required to achieve the following;
1. Successful application of CPR for three (3) instances if applicable.
2. Successful BLS airway insertion for three (3) instances if applicable.
3. No evaluation scores of less than 2 for any category for three (3) consecutive
shifts.
4. Completion of assigned practice parameter quizzes.
5. Completion of no less than ten (10) documented treatment scenarios.
6. Completion of all assigned evaluation forms.
7. Recommendation from the assigned FTO.
8. Recommendation from the EMS Coordinator.
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Routine Operations
S.O.P. #
4-2
Paramedic and EMT Apprenticeship Program
PAGE: 3 of 3
2.06 PROGRAM EXIT TESTING COMPONENTS
Upon completion of the program and with the applicable recommendation, the
apprentice will be scheduled for exit testing under the following applications;
A. Paramedics will test with the current Medical Director at the place of his/her choosing
on an agreed time and date. The apprentice will be subject to the following process;
1. Written protocol test to achieve a passing grade of greater than or equal to 80%.
2. Completion of skills testing to include;
a. Defibrillation
b. Stable v. Unstable Cardioversion
c. Pleural Decompression
d. Surgical Cricothyrotomy
e. Needle Cricothyrotomy
f.
Orotracheal Intubation
g. Application of CPR techniques
3. Completion of a medical and trauma treatment scenarios.
4. PCR review with the Medical Director.
B. EMT-B’s will test with the Fire Captain and EMS Lieutenant at the main fire station on
an agreed time and date. The apprentice will be subject to the following processes;
1. Written protocol test to achieve a passing grade of greater than or equal to 80%.
2. Completion of skills testing to include:
a. Application of CPR techniques
b. Application of first aid techniques
c. Completion of a medical and trauma treatment scenarios
d. PCR review
2-3
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-3
EFFECTIVE: 01/07
Patient Care Quality Assurance
REVISED:
PAGE: 1 of 2
Authorized:
3.01 PURPOSE
To establish a guideline by which full-time employees are evaluated for completeness
and accuracy in the area of patient care report writing.
3.02 POLICY
It is the policy of the Mount Dora Fire Department to strive for excellence in patient care
as reflected in the documentation of patient care reports.
3.03 PROCEDURE
All patient care reports will be evaluated by Quality Assurance personnel under the
following parameters:
A. Completeness (no blanks)
B. Accuracy
C. Comprehensive subjective and objective report writing
D. Efficiency in the delivery of BLS and ALS measures
E. Critical skills success rates
3.04 INFRACTION LEVELS
If a patient care report is found to be deficient in any of the above named areas, it will be
assigned an infraction level and returned to the author for review. Examples are:
A. Level 1
1. Spelling errors
2. Grammatical incorrectness
3. Data box(es) blank or incorrect (date/time/unit responding)
4. Incorrect treatment protocol entered
B. Level 2
1. Failure to enter corresponding dosages for documented medications
administered to include oxygen.
2. Mislabeled cardiac monitor strips.
3. Absence of cardiac monitor strips without justification for ALS patients.
4. Incorrect diagnosis (assessment) entry based on assessment and physical
findings (narrative based).
C. Level 3
1. Failure to deliver indicated treatment in a reasonable time frame of patient
contact without justification (greater than or equal to 5 minutes).
2. Incorrect performance of a critical procedure (Cricothyrotomy or I/O).
3. Failure to initiate the appropriate care level for a patient based on the chief
complaint, physical findings or abnormal vital signs presentation.
D. Level 4
1. Administration of a medication or procedure that produces and untoward effect
resulting in potential or actual harm to the patient.
2. Any avoidable patient abandonment incident.
3.05 PARAMEDIC/EMT-B REMEDIATION
A. A paramedic can be referred to a remediation program if any of the following
conditions exist.
1. Consistent I/V success rate of less than 70% for three (3) consecutive months.
3-1
Routine Operations
S.O.P. #
2.
3.
4.
5.
4-3
Patient Care Quality Assurance
PAGE: 2 of 2
Consistent OTI success rate of less than 70% for three (3) consecutive months.
Accumulation of three (3) infractions in a one (1) month period.
Any instance of issuance of one (1) Level 4 infraction.
Lieutenant/OIC discretion based on witnessed performance.
B. An EMT-B can be referred to a remediation program if any of the following conditions
exist.
1. Acceptance of care of an ALS patient in the presence of a paramedic on more
than one (1) occasion in any time frame.
2. Accumulation of three (3) Level 3 infraction in a one (1) month period.
3. Any instance of issuance of one (1) Level 4 infraction.
4. Lieutenant/OIC discretion based on witnessed performance.
3.06 LENGTH/TPYE OF REMEDIATION
A. A remediation program will be initiated based on the severity of the infraction(s).
There are three (3) current remediation processes;
1. Verbal – Occurring at the completion of the incident or by way of PCR review.
2. Written – Either a letter of counseling or form of written definition of a procedure
or medication administration.
3. Work Action Plan – If sufficient deficiencies exist, personnel may be reassigned
to apprenticeship status and placed with an FTO, not necessarily on the same
shift for re-entry into the program to correct said deficiencies.
B. The current Medical Director will be notified in any instance of issuance of a Level 3
or Level 4 infraction and in any instance of reassignment to apprenticeship status. If a
paramedic or EMT-B is reassigned as an apprentice, he/she will be subject to any or
all of the components of the initial apprenticeship program as well as exit testing.
3-2
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-4
EFFECTIVE: 01/07
Recovery of EMS Equipment & Manpower
REVISED:
PAGE: 1 of 1
Authorized:
4.01 PURPOSE
To provide policies, procedures and guidelines hat ensure swift and efficient recovery of
equipment and personnel utilized by LSEMS and/or Mount Dora Fire Department
paramedics during transport of patients to emergency room.
4.02 EQUIPMENT
A.
B.
C.
During care of an unstable patient, certain situations may arise when care being
provided by tools such as CPAP and LP12 cannot be discontinued until transfer of
care in the emergency room. Should these situations arise, these tools can and
should be left in place and subsequently be utilized during transport at the discretion
of the paramedic in conjunction with permission from the Lieutenant or OIC.
In such cases the Lieutenant or OIC should make every effort to recover these items
in a timely and efficient manner in which suits the needs of the department. Should a
back up or secondary device be unavailable, resulting in a “downed” ALS unit, that
unit should follow to the ER in order recover said item and minimize ALS down time.
Other reusable immobilization devices should be replaced on scene from the LSEMS
transport unit on a “one for one” basis. Should a replacement be unavailable, the
Lieutenant or OIC or their designee should coordinate a timely recovery.
4.03 PERSONNEL
A.
B.
C.
D.
In cases in which patients condition warrants assistance by Mount Dora Fire
Department personnel during transport, ALS presence in MDFD coverage area should
take precedence and every effort be made to maintain or restore that coverage as
soon as possible.
If a paramedic rider is needed and another paramedic is “on duty”, the ALS unit should
remain in service and a chase vehicle be sent to ER to retrieve the rider.
If a paramedic rider is needed and another paramedic is not “on duty”, the ALS unit
should be sent to ER to retrieve rider, minimizing ALS down time.
If an EMT rider is needed, the ALS unit should remain in service and a chase vehicle
is sent to ER to retrieve the rider.
4-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
Continuing Education Units
4-5
EFFECTIVE: 01/07
REVISED:
PAGE: 1 of 1
Authorized:
5.01 PURPOSE
To establish a guideline by which continuing education units are devised and distributed
for bi-annual re-certification for paramedics and EMT-B’s.
5.02 POLICY
It is the policy of the Mount Dora Fire Department to strive for excellence in maintaining
the knowledge base of assigned personnel, as well as to introduce them to more efficient
ways of delivery of BLS and ALS care.
5.03 PROCEDURE
All CEU’s will be complied by the EMS Coordinator as acceptable by the current Medical
Director and will be delivered in the following formats;
A. Internet based instructional packets with accompanying treatment scenarios.
B. In-house lecture program
C. Guest lecture program
D. Attendance of an outside agency approved course.
5.04 CEU TYPES AND TOTALS
The following categories will be addressed periodically through the bi-annual process for a
total of 32 hours. The categories are minimum requirements for re-certification. Additional
may be issued.
A. Cardiology – 4 hours
B. Airways – 4 hours
C. Trauma – 6 hours
D. Medical – 4 hours
E. Peds/OB – 4 hours
F. Operations – 6 hours
G. Electives – 2 hours
H. HIV/AIDS – 2 hours
5-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-6
EFFECTIVE: 01/07
EMS Supply Room
REVISED:
PAGE: 1 of 1
Authorized:
6.01 PURPOSE
To provide policies, procedures and guidelines to aid in proper use, maintenance, control
and security of the EMS supply room.
6.02 POLICY
A. All personnel shall insure that the EMS supply room is kept in a neat and orderly
fashion at all times.
B. Any and all personnel entering the EMS supply room must sign in and sign out.
C. When not in use, the EMS supply room will remain locked.
D. The EMS Coordinator has the ultimate responsibility in overall care of the EMS supply
room.
6.03 MAINTENANCE
A. EMS supply room will be kept neat and organized at all times. This includes
sweeping, mopping and taking out the trash.
B. In the event and item is expired, this item will be removed and then placed in the
“training bin” and the Supply Room Coordinator will be notified via email.
C. The air condition unit must be on at all times and set at exactly 75 degrees.
6.04 STOCK ORDER
A. The Supply Room Coordinator should have an order faxed to LSEMS on the first
Monday of the month, between the hours of 0800 and 1700 or as needed when
supplies are low to par or have run out.
B. If a particular piece of stock is needed or non-existent, an email may be sent to the
Supply Room Coordinator.
C. When the stock order arrives, the Supply Room Coordinator will be responsible for
putting the items away. This is to make sure the orders requested were received and
that all are accounted for.
D. The Supply Room Coordinator will utilize an up to date form provided by LSEMS
Logistics department for all ordering needs. Such form will be faxed to the Logistics
Coordinator. Contact information is subject to change, see related form.
6.05 INVENTORY
A. See EMS supply room par sheet for information on minimum supplies needed in
room.
B. Stock room par levels may change according to seasonal needs.
6.06 ACCOUNTABILITY
A. All personnel must fill out the Sign In/Sign Out sheet upon entering and leaving the
EMS Supply Room.
B. All personnel need to fill out the daily EMS par sheet for all vehicles and place that
sheet when completed in the EMS supply room, on the door.
6-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-7
EFFECTIVE: 01/07
Qualifications of a Field Training Officer
REVISED:
PAGE: 1 of 1
Authorized:
7.01 PURPOSE
To establish a guideline by which a qualified individual may be selected as an EMS Division Field
Training Officer (FTO).
7.02 POLICY
Any employee assigned to the operations division assigned to a 24/48 shift may apply for the
position of EMS Division FPO who meets or exceeds the following qualifications.
A. Have successfully completed the introductory probation period.
B. Be free from pending disciplinary action(s).
C. Have been a certified paramedic practicing for three (3) consecutive years.
D. Have been cleared for service through the All-County Medical Director.
E. Be certified as an instructor in any one of the following disciplines;
a. BLS for Healthcare Providers
b. ACLS
c. PALS
F. Pass a written protocol and cardiac rhythm recognition test with a score of 99% or
greater.
G. Pass a practical scenario with no critical failure(s).
H. Complete an interview process with the Fire Captain, EMS Lieutenant and EMS
Coordinator.
All successful candidates chosen to fill the position of EMS FTO will be subject to a one (1) year
probation period and will report directly to the EMS Lieutenant in regard to EMS Division functions
only. All other reporting areas will be to his/her shift Lieutenant.
7-1
City of Mount Dora Fire Department
STANDARD OPERATING PROCEDURES
EMS DIVISION
Routine Operations
S.O.P. #
4-8
EFFECTIVE: 01/07
EMS Student Internship
REVISED:
PAGE: 1 of 1
Authorized:
8.01 PURPOSE
To provide policies, procedures and guidelines for facilitation of the Paramedic and EMT
Internship Program.
8.02 LEGISLATION
F.S. 64E-2.036 provides regulations governing EMS training programs. Should any question arise
that are not covered by this document, this legislation should be referenced.
8.03 FIRE DEPARTMENT PERSONNEL
Employees of Mount Dora Fire Department that are currently enrolled as students of an approved
EMS training program may ride as interns of that program while on duty under the following
conditions.
NOTE: If during the employee’s clinical internship the situation arises that these conditions
cannot be met or at the discretion of the Fire Chief, Captain, or Lieutenant/OIC, the internship will
be suspended until the conditions can be met or the shift has ended.
A.
The intern functions under the direct supervision of a department FTO or Clinical
Preceptor.
B.
The intern is dressed in attire associated with and required by their training facility,
which clearly identifies them as a student/intern.
C.
The intern’s presence or absence does not affect minimum staffing levels.
D.
Interns will not be permitted to engage in firefighting, extrication or other FD activity
that is not associated with Emergency Medical Care.
E.
The Shift Coverage Log must reflect the employee/intern’s status as “SCHOOL”
during the hours of clinical internship. If at anytime the internship is suspended, the
Log must reflect the change to “ODC”, and then back to “SCHOOL” if/when the
internship resumes.
8.04 NON-FIRE DEPARTMENT PERSONNEL
Students of approved EMS programs that are not employees of the City of Mount Dora may ride
as interns of that program under the following conditions.
A.
The intern must have a completed City of Mount Dora Liability Waiver on file with the
department.
B.
The intern functions under the direct supervision of a department FTO or Clinical
Preceptor.
C.
The intern is dressed in attire associated with and required by their training facility,
which clearly identifies them as a student/intern.
D.
The intern’s presence or absence does not affect the function of Fire Department
operations, or hinder the day to day operations of the department.
E.
Interns will not be permitted to engage in firefighting, extrication or other FD activity
that is not associated with Emergency Medical Care.
F.
Interns not employed by the City of Mount Dora will not be permitted to drive or
operate any fire department apparatus or equipment, under any circumstance, unless
that action is necessary to protect the lives and/or safety of themselves or the crew.
G.
All interns will be required to follow the rules & regulations of the Mount Dora Fire
Dept. All disciplinary issues will be reported to the Lieutenant/OIC, who may elect to
suspend the internship. Any disciplinary acts will be documented by the FTO or
Clinical Preceptor on the intern’s Daily Observation Form, and/or reported directly to
the programs administrator through training center faculty.
H.
Clinical internships will last no longer than twelve (12) hours without the approval of
the Lieutenant/OIC and the EMS program’s administrator.
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