SEDGWICK COUNTY EMS SOG As of 11-02-99 POLICIES, PROCEDURES, AND GUIDELINES CHAPTER I MISSION STATEMENT 1 CHAPTER II EMS JOB DESCRIPTIONS & RESPONSIBILITIES A. Emergency Medical Technician (EMT) 2 B. Mobile Intensive Care Technician (MICT) 3 C. EMS Lieutenant 4 D. EMS Captain 7 CHAPTER III VEHICLE OPERATION POLICIES A. Vehicle Operation 9 B. Vehicle Accidents 11 C. Parking of Ambulances 12 CHAPTER IV UNIFORMS AND PROTECTIVE EQUIPMENT POLICIES A. Loss Policy 14 B. Required Items and Placement 15 C. Personal Protective Equipment 17 D. Wearing Uniforms Off-Duty 19 CHAPTER V OPERATIONAL POLICIES A. Absenteeism and Reporting Ill 20 B. Controlled Substances 21 C. Hostile Environment 23 D. Infection Control Guidelines 24 E. On-the-Job Injury/Infectious Disease Exposure 27 F. Shift Exchanges 29 G. Types of Leave 30 H. Visitation at Posts 31 I. Court Time Compensation 32 J. Shift Change Request Guidelines 33 K. Vacation Selection 36 L. Cot Policy 37 M. Maximum Weight Capacities of Patient Transport Equipment 38 N. 10-37 Response on Code Green Patients 39 O. Restraining Patients 40 CHAPTER VI VEHICLE MAINTENANCE PROCEDURES A. Cleaning Schedule 41 B. Shift Cleaning Checklist 44 C. Drug Box Standardization 45 D. Airway Bag Standardization 46 E. E Cylinder Standardization 47 F. Portable Suction Standardization 47 G. Life Pack 10 Standardization 47 H. Nelcor N-20 Standardization 47 I. Vehicle Standardization(Inside Compartments) 48 J. Vehicle Standardization (Outside Compartments) 49 K. Vehicle Refueling 51 L. Oxygen Switch-Out 52 CHAPTER VII STATION MAINTENANCE PROCEDURES A. Cleaning Schedule 53

CHAPTER VIII EQUIPMENT MAINTENANCE PROCEDURES A. 10-7 Equipment 55 B. Normal or Routine Maintenance 58 C. LIFEPAK 10 Battery Maintenance 59 D. Pacemaker Check of LIFEPAK 10 61 CHAPTER IX RADIO PROCEDURES...............................................................62 A. Pager Policy 66 CHAPTER X PERFORMANCE APPRAISAL PROCEDURE 67 CHAPTER XI PROBATIONARY EMPLOYEE TRAINING PROCEDURES 69 CHAPTER XII DOCUMENTATION PROCEDURES.............................................76 A. Absence Report Form 79 B. Address Change Form 80 C. Auto Condition Report 81 D. Billing Form 82 E. Counseling Session 83 F. Shift Log 84 G. Release of Liability Form 85 H. EMS Data Collection System 86 I. EMS Inventory Order Form 87 J. Monthly Inventory of Expiring Drugs 88 K. Fluid Usage Sheet 89 L. Incident Report 90 M. Narcotic Log 91 N. Part-Time Availability 93 O. Patient Care Form 94 P. Request for Leave 95 Q. St. Francis Special Transfers 96 R. Shift Exchange Request 97 T. Vehicle Mechanical Checklist 98 U. Stand-by Forms 99 V. Written Reprimand 101 W. Mileage Report Form 102 X. Radio Shop Daily Log 103 Y. Acting Officer Pay Sheet 104 Z. Authorization for Medical Treatment Form 105 AA. On-The-Job Injury Accident Report Form 106 BB. Vehicle Accident Report Form 108 CHAPTER XIII OPERATIONAL PROCEDURES A. EMS Standbys 109 B. Lost and Found 110 C. News Media 112 D. Riders and Reserves 113 E. Severe Weather 114 CHAPTER XIV MASS CASUALTY INCIDENT (MCI) GUIDELINES A. Categories 115 CHAPTER XV RESPONSE PROFILE GUIDLINES A. Airport Emergencies 119

B. Operational Procedures 120 C. Kansas Turnpike Access 121 D. Helicopter Response 122 E. Mass Casualty Incident (MCI) 123 F. Pinned/Entrapped Patients 124 G. Patient Transportation 125 H. Type II Services 126 I. Crime Scene Preservation 127 J. Disregards 130 CHAPTER XVI EMPLOYEE ASSISTANCE GUIDELINES A. Critical Incident Stress Debriefing (CISD) 131 B. Employee Assistance Program (EAP)/Graystone 133 APPENDIX A. Billing Form CHAPTER I MISSION STATEMENT Your most precious commodity is life and good health, Sedgwick County Emergency Medical Service is dedicated to providing quality care and transportation for your well being. GOALS * Provide rapid advanced life support and transportation whenever and wherever needed. * Employ progressive methods in providing services. * Assure knowledge and courtesy of employees and their ability to convey trust and confidence. * Provide reliable and medically effective facilities and equipment to assure quality care and transportation. * Provide an environment where people desire to work. CHAPTER II EMS JOB DESCRIPTIONS & RESPONSIBILITIES A. Emergency Medical Technician (EMT) The EMT is responsible for: 1. Operational readiness of the medic unit. 2. Performing authorized patient care as directed and required. 3. Preparing accurate and complete records and reports. 4. Driving the medic unit. 5. Participating in training as directed.

6. Participating in public education programs. 7. Maintaining licensure and certification as required. 8. Demonstrating proficiency as determined by departmental testing. 9. Acquiring and maintaining the ability to perform physical requirements as demanded by the nature of EMS work. 10. Performing tasks as assigned by supervisory personnel. 11. Assisting in Incident Command functions as assigned. 12. Acquiring and maintaining sound knowledge of the geography of Wichita and Sedgwick County. 13. Providing for and maintaining good working relationships with allied agencies. 14. Station and facility cleaning and maintenance. Upon arrival at work, the EMT will report to his/her Lieutenant. Keys and pager may be issued from either the Lieutenant or a District Captain. Provided no special instructions are received, the EMT may proceed to the designated vehicle and begin preparing it for operation. Those areas of the vehicle to be checked and by whom may be determined in advance by joint agreement between the EMT and the Lieutenant. The Lieutenant is responsible for all equipment. Missing equipment, vehicle problems and other related concerns shall be reported to the Lieutenant immediately. CHAPTER II EMS JOB DESCRIPTIONS & RESPONSIBILITIES B. Mobile Intensive Care Technician (MICT) The MICT is responsible for: 1. Operational readiness of the medic unit. 2. Performing authorized patient care as directed and required. 3. Preparing accurate and complete records and reports. 4. Driving the medic unit. 5. Participating in training as directed. 6. Participating in public education programs conducted by the department. 7. Maintaining licensure and certification as required. 8. Demonstrating proficiency as determined by departmental testing. 9. Acquiring and maintaining the ability to perform physical requirements as demanded by the nature of EMS work. 10. Performing tasks as assigned by supervisory personnel. 11. Assisting in Incident Command functions as assigned. 12. Acquiring and maintaining sound knowledge of the geography of Wichita and Sedgwick County. 13. Providing for and maintaining good working relationships with allied agencies.

14. Temporarily fulfilling the roles and responsibilities of an EMS Lieutenant in their absence. 15. Station and facility cleaning and maintenance. Upon arrival at work, the MICT will report to his/her Lieutenant. Keys and pager may be issued from either the Lieutenant or a District Captain. Provided no special instructions are received, the MICT may proceed to the designated vehicle and begin preparing if for operation. Those areas of the vehicle to be checked and by whom may be determined in advance by joint agreement between the MICT and the Lieutenant. The Lieutenant is responsible for all equipment. Missing equipment, vehicle problems and other related concerns shall be reported to the Lieutenant immediately. CHAPTER II EMS JOB DESCRIPTIONS & RESPONSIBILITIES C. EMS Lieutenant The following duties are described to help you fulfill your responsibilities as a Lieutenant. The duties described are not all inclusive of your responsibilities. The EMS Lieutenant is responsible for: 1. Supervising subordinate personnel and participating in the delivery of authorized pre-hospital care. a. Ensure subordinate(s),students, is/are dressed appropriately. b. Standing orders and medical protocol are followed properly. c. Inform subordinate(s) of their job responsibilities. d. Ensure job performance is within the guidelines set forth by Sedgwick County Personnel Policies and Procedures Manual and EMS Standard Operations Guidelines. 2. Ensuring post maintenance and security. a. Responsible for post cleaning each shift. b. Ensure all windows and doors are locked prior to leaving the post. 3. Preparing, reviewing and submitting records and reports as required. a. Make sure requests are complete and submitted to your District Captain by the end of your assigned shift. b. Review all subordinates' documentation including run forms, billing forms, incident reports, and absence reports for accuracy and completeness. These are to be completed by the end of assigned shift. 4. Evaluating subordinates' job performance. a. Evaluations of subordinate personnel shall be submitted when required by Sedgwick County Personnel Department. b. Maintain records of subordinate's activities and progress. 5. Maintain proper discipline of subordinate personnel through issuance of disciplinary action as deemed necessary.

6. Developing and conducting training programs relevant to EMS Operations. a. Developing and participating in medical and navigational study. 7. Assisting in orientation and evaluations of new technicians, students and reserves. 8. Ensuring a correct and expedient routing to the scene of an emergency. a. Responsible for all navigational procedures. b. Responsible for safe vehicle operations. 9. Implementing Incident Command procedures and directing allied personnel when applicable. 10. Ensuring the Medic unit's response capability at all times. a. Change LP batteries and document defibrillation. Secure narcotics, portable radio, vehicle keys, pager, and paperwork. b. Check the shift Log Book for memos, policy changes, etc. c. Review the vehicle log book. d. The vehicle check shall be completed including, but not limited to: Medical and Trauma Kits, monitor/defibrillator , suction unit, oxygen levels, immobilization equipment, and fluid levels. (Unless otherwise directed) e. Report any discrepancies to your District Captain. f. All efforts shall be made to complete unit cleaning and restocking as rapidly as possible following a call. 11. All radio communications. This includes notification to dispatch when closer to call than the originally responded unit. a. Ensure all radio communications are clear and concise. 12. Maintaining certification as required. 13. Temporarily fulfilling the roles and responsibilities of an EMS Captain in their absence. 14. Participating in public education & training programs conducted by the department. 15. Maintaining the ability to perform physical requirements as demanded by the nature of EMS work. 16. Demonstrates proficiency as determined by department testing. 17. Providing for and maintaining good working relationships with allied agencies. 18. Ensuring the refueling and restocking of the unit as necessary. 19. Provide written and verbal reports to the oncoming Lieutenant regarding the status of the unit, post, and equipment. CHAPTER II EMS JOB DESCRIPTIONS & RESPONSIBILITIES

D. EMS Captain The EMS Captain is responsible for: 1. Supervising, managing and evaluating subordinate personnel. 2. Ensuring proper staffing and scheduling of personnel and units. 3. Assigning crews, vehicles and equipment in consideration of maintenance needs. 4. Ensuring operational availability of emergency response vehicles. 5. Submitting, reviewing and resolving records and reports as required. 6. Reviewing the daily non-emergent transport schedule. 7. Submitting and maintaining payroll records of operations personnel. 8. Ensure paperwork from the previous shift for the EMS Divisions of Operations, Training and Support Services, and are routed to the appropriate locations. 9. Maintaining and providing detailed personnel records of assigned crews. 10. Maintaining proper discipline of subordinate personnel through issuance of disciplinary action as deemed necessary. 11. Evaluating procedures and medical treatment rendered during the pre-hospital care phase. 12. Evaluating patient report forms for completeness and medical protocol compliance. 13. Ensuring all conduct is in compliance with the Sedgwick County Policy and Procedures Manual. 14. Providing status reports and/or updates to the Assistant Director. 15. Gathering and maintaining statistical data and preparing such reports as required. 16. Participating in periodic Captain's meetings. 17. Assisting in planning, developing and implementing departmental policies and procedures. 18. Assisting in hiring and orientation of new employees. 19. Assisting in educational and instructional programs with allied departments and agencies. 20. Developing teaching curriculum based on both individual and service wide needs. 21. Assisting in continuing education classes and tests as required.

22. Providing personalized classroom and/or on the job education/testing as needed for assigned crews. 23. Scheduling and participating in clinical review conferences. 24. Following up on critical patients. 25. Coordinating field internship rotations. 26. Coordinating clinical rotations at area hospitals. 27. Demonstrating proficiency as determined by departmental testing. 28. Instituting or assuming Incident Command Procedures and directing subordinate and allied personnel when applicable. 29. Participating as assigned in hazardous incident mitigation. 30. Participating in and coordination of public relations standby programs conducted by the department. 31. Maintaining certification as required. 32. Maintaining the ability to perform physical requirements as demanded by the nature of the EMS work. 33. Temporarily fulfilling the roles and responsibilities of the EMS Assistant Director in their absence. CHAPTER III VEHICLE OPERATION POLICIES A. Vehicle Operation I. PURPOSE: A. The purpose of this policy is to advise all permanent full time and part time employees of the policies used when operating an EMS vehicle. II. POLICY: A. Emergency Driving. When driving in the emergency mode you must: 1. Have all emergency lights and both sirens on. 2. Not exceed the posted speed limit by more than 10 m.p.h. Decrease speed as road conditions warrant. School zone limits must be obeyed as posted. 3. Routing will be the most direct route avoiding residential areas, one way streets, limited access roads, and construction areas. Travel will be in the inside lane.

4. A complete stop will be made at all red lights and stop signs. 5. Proceed with caution through open intersections with a green light. 6. Passing shall be done on the left of the vehicle being passed. This shall be done with caution and reduced speed in case the vehicle turns left. Passing shall almost never be done on the right. If this is done, use extreme caution. 7. Seat belts are to be worn anytime the vehicle is in motion. The only exception is when patient care is being done in the patient compartment. 8. Avoid backing as much as possible. When backing the audible back up alarm will be on and a backer will position themselves behind in plain view of the driver's side mirror. The only exception to the above is when the technician is occupied with patient care, then attempt to use alternate backers if available. 9. Minimal lighting shall be used on the scene. Use only what is necessary to protect the unit and crew. 10. SCFD and WFD personnel can be utilized to drive the ambulance at the discretion of the EMS Lieutenant. Only personnel that have completed the ambulance driver training course provided by SCEMS are permitted to drive the EMS unit. CHAPTER III VEHICLE OPERATION POLICIES B. Vehicle Accidents I. PURPOSE: A. The purpose of this policy is to advise all permanent full time and part time employees of the procedures to follow if they are involved in a motor vehicle accident while on duty. II. POLICY: In the event of an accident involving an EMS Ambulance the operator shall: A. Notify the 911 dispatcher and District Captain by radio. B. Check for injuries to persons in the patient compartment. If involved with another vehicle check for injuries to persons in that vehicle. C. Call for additional units to transport any patients. D. Fill out Vehicle Accident Report forms, Incident Report, and any Law Enforcement Accident Reports. E. An investigation of the accident will be done by the District Captain on the scene. The District Captain will forward his/her findings with recommendations for disciplinary action, if any, to the Department Head. F. Any vehicle involved in an accident is considered 10-7 and shall not be moved until its road worthiness can be verified by a Captain.

CHAPTER III VEHICLE OPERATIONAL POLICIES C. Parking of Ambulances I. PURPOSE: This policy outlines parking of EMS ambulances so as to decrease wake effect crashes and promote a safe scene environment. II. POLICY: EMS ambulances must be parked so that safe and efficient patient care can be delivered. When necessary a rapid egress must be maintained. Traffic flow shall not be interrupted unless absolutely necessary. II. PROCEDURE: A. Residential Streets: Park out of traffic, within three feet of the curb. Use driveways and parking lots as appropriate. B. Unpaved Roadways: Park as close to the ditch as possible so as not to restrict traffic. Do not allow wheels to slip into the ditch. C. Off-road: Firm surfaces are required for parking. Do not park on unstable or soft surfaces. D. High speed limited access traffic way: Park on the egress side of the crash site when possible. The approach side will be used by first responders and fire personnel. Do not block traffic lanes unnecessarily. Remember to park so that traffic, under the direction of the law enforcement, is allowed to move by the crash site. Traffic must be slowed so as to allow a safe work environment. E. Intersections: Do not park in any intersection unless there are no other alternatives. F. Low visibility: Leave emergency lights on during day or night operation. Park so the scene is clearly marked and protect the scene with emergency vehicles when possible. When possible, park out of the low visibility area. G. Icy/slippery/hazardous road conditions: Law enforcement should divert traffic around any hazardous road condition. Alert law enforcement personnel when hazards exist as soon as possible. H. Lighting while on the scene: When parked in traffic, secondary lighting will be deployed. When parked in legal parking areas out of traffic no lighting is needed. CHAPTER IV UNIFORMS AND PROTECTIVE EQUIPMENT POLICIES A. Loss Policy

Any EMS equipment issued to you personally which is lost or stolen is the responsibility of the employee to replace. Any issued equipment not available during working hours must be reported immediately to your supervisor. If the issued equipment is lost or stolen, an order form receipt or the replacement equipment itself must be viewed by your supervisor within 30 days of the loss report. This policy does not apply to items which are worn or damaged due to normal use. This policy applies to the following items: Safety Non-Safety Essential Reflective Vest Raincoats/Jackets Uniform Shirt/Pants Turnout Gear Uniform Brass Stethoscope Fire Gloves Holster Scissors Nomex Hood Pocket Mask Employees will not be allowed to work without having safety and essential equipment with them. Employees who leave the department will be required to return all items issued to them during their employment. CHAPTER IV UNIFORMS AND PROTECTIVE EQUIPMENT POLICIES B. Required Items and Placement 1. Dress Code - Employee will be in full uniform while on duty unless doing maintenance or wearing full protective gear. EMS Cap / Navy Stocking Cap (optional) Short sleeve shirts Long sleeve shirts

White crew neck T-shirts White turtle neck shirts (optional) Jacket with liner long and/or short Pro-tuff pocket pants Dress slacks for administration Black shoes or boots Dark socks with shoes The white turtle neck shirts may be worn with long sleeve shirts only Long underwear tops may be worn with long sleeve shirts only. Uniform articles will be clean and wrinkle free. Patches will be firmly attached and any damaged uniforms repaired at the earliest opportunity. All employees will have at least 1 (one) clean spare uniform (not including jacket and shoes) immediately available at the beginning of their duty shift. 2. Hair Hair will be kept clean and combed in a neat fashion at all times. Hair shall be restrained so as not to interfere with vision, safety or performance of duties.

Mustaches and beards will be kept neatly trimmed and of a reasonable length. 3. Jewelry Rings may be worn unless the number and/or size of such items interferes with the employees safety or performance of their duties. A watch is required. No neck wear that is visible may be worn. Small earrings with posts may be worn provided they are not of the dangling or wire type. 4. Required Brass Name tags are to be worn at the top boarder of the right shirt pocket, and on the right breast of the jacket. Paramedic pin is to be centered 1/2 inch above the name tag. 5. Rank Designation Any items worn as rank designation will be pinned on the shirt 1inch above and parallel to the bottom front seam of the collar. Pins on the jacket are to be worn 1 inch in from the outside of the epaulets parallel to shoulder seam. 6. Optional Brass The American flag or service pin may be worn above the left shirt pocket centered between the holds for the badge. 7. EMS Cap/Stocking Cap

The EMS Cap or stocking cap (optional) is to be worn with professionalism and discretion. It shall not be worn inside nor on calls. Exceptions include standbys of long duration or inclement weather. 8. Photo ID Cards

Photo ID cards are to be carried by the employees at all times for the purpose of identifying personnel at a controlled scene or an MCI. 9. Valid Kansas Driver's License CHAPTER IV UNIFORMS AND PROTECTIVE EQUIPMENT POLICIES C. Personal Protective Equipment 1. Protective Eye wear Eye wear is provided at all supply posts and is to be worn as described in the TPM. It is the responsibility of the employee to maintain his/her eye protection while on-duty, either with county provided eye wear or with personally owned prescription or non-prescription eye wear. Sunglasses (if worn) must be of a professional look and not be of a nature which will impair employee-patient eye contact. They shall not be loudly colored or styled. This will be determined by the Captain. Sunglasses shall be removed when conversing with the patient. Sunglasses shall not be suspended from the neck where they will be a hazard. 2. Face Shields Face shields are provided at all supply posts and are to be worn as described in theTPM. 3. Gloves Latex exam gloves are to be worn at all times when there is patient contact. They are provided by the Service and available at all supply posts. They shall also be worn routinely when cleaning the unit and equipment. Vinyl gloves are provided for those with latex allergy. 4. High Visibility Vest Vests must be worn when the employee is exposed to vehicular traffic on roads, streets and highways. This is in compliance with Sedgwick County Resolution No. 287-1989, with the exception of when the employee is wearing full protective gear or the high visibility yellow raincoat. 5. Full Protective Equipment

Full protective equipment will be worn at the scene of a HAZARDOUS incident. Specifically, required situations include:

a. 10-48 pin b. Structure fire (especially high-rise)

c. Haz-Mat calls d. As required by Incident Command e. Other scenes deemed dangerous by the EMS crew (individual preference) Full protective equipment will include: a helmet, nomex hood, bunker coat, bunker pants, fire gloves, and bunker boots. The uniform shirt may be removed while wearing full protective equipment. 6. Discretion Incident Command or EMS Captain may use discretion in altering the level of protective equipment required as the incident evolves. In all cases personnel shall be required to wear all protective equipment necessary to protect against all foreseeable hazards. 7. Body Armor Body armor is optional and must be approved by the Captain. Such equipment is to be worn underneath the uniform. CHAPTER IV UNIFORMS AND PROTECTIVE EQUIPMENT POLICIES D. Wearing Uniforms Off-Duty 1. The uniform may be worn to and from work, while on duty and at the discretion of the Director ONLY. CHAPTER V OPERATIONAL POLICIES A. Absenteeism and Reporting Ill I. PURPOSE: A. The intent of this policy is to assure understanding of the absenteeism policy and to assure proper reporting of any absence. II. POLICY: A. Employees are required to be at work by 0700 or 1900 or as assigned. III. PROCEDURE: A. If you will be unable to report to work on your duty day due to illness, dependent illness, spouse illness or unforeseen emergency, you must report this absence/illness to the District Captain or other EMS Officer via phone. This

must completed no later than one (1) hour prior to your report time. (0600 or 1800). CHAPTER V OPERATIONAL POLICIES B. Controlled Substances I. PURPOSE: A. The intent of this policy is to ensure that the narcotics are secure at all times. II. POLICY: A. Employees are required to check the narcotics and envelopes each shift to ensure that they are present and accounted for. III. PROCEDURE: A. The off going officer (Lieutenant or Acting Lieutenant) will exchange the narcotic "lock box" key with the oncoming Lieutenant or Acting Lieutenant. B. At the beginning of each shift, the officer (Lieutenant or Acting Lieutenant) will check the total of the Morphine and Valium in the narcotic "lock box". C. The officer (Lieutenant or Acting Lieutenant) will check the narcotic log sheet to ensure the used/received/total columns are correct and sign-on this sheet in the appropriate TECH ON column. D. If any narcotic is used, the technician that used the narcotic will fill out the narcotic envelope as described in SOG Chapter XII, including a physician's signature. This use needs to be reported to the District Captain so that it can be replaced. This needs to be "logged" in the narcotic log (on right hand side of the page). E. At the end of the duty shift, the officer (Lieutenant or Acting Lieutenant) will recheck the narcotics and the narcotic log. After assuring that everything is filled out properly and balances, the Lieutenant or Acting Lieutenant will sign-off in the appropriate TECH OFF column. F. If narcotics logs do not balance the District Captain shall be notified immediately. CHAPTER V OPERATIONAL POLICIES C. Hostile Environment I. PURPOSE:

A. The intent of this policy is to ensure the safety of all EMS personnel. II. POLICY: A. It is EMS policy to "stand off" at a safe distance from any possible hostile scene. III. PROCEDURE: A. When responding to any possible "hostile" call, i.e.; disturbance, shooting, stabbing, etc., the responding unit(s) will "stand off" at a safe distance not in the line of sight and report to Dispatch where this location is, e.g.; "standing off west" or "standing off at 2nd and Martinson". B. Your unit will remain at this location until Dispatch announces that Law Enforcement advises the scene is safe and you can move in. C. At the discretion of the officer (Lieutenant or Acting Lieutenant) on the unit, when PD is not available, the officer (Lieutenant or Acting Lieutenant) may elect to proceed to the scene. Extreme caution shall be exercised and the dispatcher shall be advised prior to the move. CHAPTER V OPERATIONAL POLICIES D. Infection Control Guidelines I. PURPOSE: A. The nature of EMS work often requires close contact with a patient's blood and/or body secretions. These guidelines have been developed to protect EMS personnel as well as our patients against communicable disease transmission without interfering with quick and efficient patient care. II. POLICY: A. EMS personnel will wear appropriate gear, use proper hand washing techniques, dispose of contaminated products, and clean contaminated/exposed equipment and areas properly. III. PROCEDURE: A. EXTRICATION Wear leather/canvas gloves during extrication to prevent injuries to yourself which may result in bleeding. Fresh wounds are most susceptible to infection through contamination. Wear latex/vinyl gloves to prevent skin contact with the patient's blood or body secretions. Any open sores on the body should be covered.

B. DISPOSING OF EQUIPMENT 1. Disposable syringes and needles, scalpel blades and other sharp items should be placed into puncture-resistant containers conveniently located. To prevent needle stick injuries, needles should NOT be recapped, purposefully bent, broken, removed from disposable syringes or otherwise manipulated by hand. If it is necessary to recap a needle, the one-handed technique should be used. 2. All disposable linen should be disposed of in the proper waste container after each call. 3. Clothing of EMS personnel which has become grossly contaminated with blood or body fluids should be exchanged for clean, fresh clothing. C. CLEANING CONTAMINATED EQUIPMENT/AREAS 1. Rubber/latex gloves should be worn while handling possibly infectious materials. 2. Contaminated inside surfaces of the transport vehicle & or equipment should be cleaned as soon as possible with soap and water, then sprayed down with Expose II. Mix fresh solution each shift as needed. 3. SUCTION PARTS

a. Wash particulate matter off with soap and water. b. Rinse thoroughly with water. c. Spray liberally with Expose II and let soak for 10 minutes. d. Rinse thoroughly with water and dry.

4. BLOOD PRESSURE CUFFS & CRAMER SPLINTS a. Wash particulate matter off with soap and water. b. Rinse thoroughly. c. Spray with Expose II and let soak for 10 minutes. d. Rinse with water and dry. 5. SPINEBOARDS, COT & STETHOSCOPES a. Wash particulate matter off with soap and water. b. Rinse thoroughly with water. c. Spray with Expose II and soak for 10 minutes. d. Rinse with water and dry. 6. LARYNGOSCOPE BLADES a. Wash particulate matter off with soap and water. b. Place blade in sterilization pouch. c. Write medic unit and crew #'s on the pouch. d. Give pouch to District Captain and obtain a replacement blade on a one-for-one basis.

Large-scale disinfection ie., station, unit, should be done with a 1:10 bleach solution and disposed of down a sink or toilet. D. VIGOROUS HAND WASHING

Hands should be washed thoroughly as soon as possible with an alcohol based hand detergent after providing patient care, after handling contaminated materials and following cleaning of the ambulance to avoid further possibility of the transmission of any diseases. Finish up by washing with soap and water as soon as possible. E. CLEANING SUPPLIES

To assist EMS personnel in performing cleaning duties, the following items have been placed on your vehicle: 1. Heavy-duty "double pail" 16 quart bucket. 2. Various sizes of plastic measuring cups. 3. 1/2 or 1 gallon Clorox bleach.

EMS personnel may wish to keep all cleaning/disinfecting supplies in the 16 quart bucket. When using these items, use the "1 cup" measuring cup to measure the Clorox solution. For a 1:10 solution, place 1 part Clorox/9 parts water in the 16 quart double pail bucket. After cleaning, dispose of the Clorox solution down a sink or toilet. The Clorox solution my be mixed in any fashion you feel necessary, depending on how large the cleaning project is. Some common equivalencies are:

1:10 SOLUTION

1 oz. (1/8 cup) : 9 oz. (1 1/8 cups) 2 oz. (1/4 cup) : 18 oz. ( 2 1/4 cups) 4 oz. (1/2 cup) : 36 oz. (4 1/2 cups) 6 oz. (3/4 cup) : 54 oz. (6 3/4 cups) 8 oz. (1 cup) : 72 oz. ( 9 cups)

F. Exposures shall follow procedures for an on-the-job injury. CHAPTER V OPERATIONAL POLICIES E. On-the-Job Injury/Infectious Disease Exposure I. PURPOSE: A. The intent of this policy is that EMS employees understand On-the-Job injuries and reporting such injuries. II. POLICY: A. When an EMS employee is injured while on duty for Sedgwick County EMS, he/she will report the injury and circumstances to his/her District Captain at the earliest possible time after the injury.

III. PROCEDURE: A. Upon reporting the injury/exposure to your District Captain, an on- the-job injury Report (exposure form 15 by the employee and exposure form 16 by the captain) will be filled out as documentation of the injury or whether the employee needs to be seen by a physician. The report will be filled out as documentation of injury, whether or not employee needs to be seen by a physician B. If it is determined that the employee will be seen by a physician, the unit will be placed 10-7 and will report to the nearest MEC, if open, or to St. Joseph ER if an MEC is not open. C. The District Captain will meet the unit/employee at the appropriate facility with the appropriate paperwork, i.e. On-the-Job Injury Form, Consent to Treat Form. Each employee/witness will fill out the appropriate sections of each. 1. Captain: Consent Form, and back section of the On-the-Job Injury Form. 2. Injured Employee: Describe accident/injury; appropriate portions of the On-the-Job Injury Form. 3. Witness(es) (2nd and/or 3rd person): Incident Report, describing the accident/injury. D. After the injured employee is given the results/diagnosis of the injury and recommendations by the physician, the outcome will be reported to the District Captain. 1. If released to work, the employee will give the work release to the District Captain and return to work. 2. If NOT released to work, the injured employee will report the outcome/restrictions and recheck instructions to the District Captain, along with all other paperwork concerning the injury. a. The injured employee will report to a District Captain with updates of his/her progress and when he/she will be released to work. b. When released to work, the injured employee must turn the work release into a District Captain or EMS Administrative Office prior to reporting to work. CHAPTER V OPERATIONAL POLICIES F. Shift Exchanges I. PURPOSE: A. Shift exchanges are an agreement between two employees that are exchanging duty shifts or parts of a shift. II. POLICY:

A. This is an agreement between two employees of the same rank. Neither the County nor this Department is a part of this contract. If no one is present for duty at this time, the employee initiating the request is responsible to the County and this Department. III. PROCEDURE: A. This form shall be submitted on the duty shift prior to the request unless it is an emergency shift exchange. In this event, it must be verbally approved by a District Captain and the paperwork completed as soon as possible. B. The initiating employee will fill out the appropriate sections of this form. C. The relief employee will sign the appropriate line. (NOTE: Each employee must sign for himself/herself.) D. If the District Captain approves the Shift Exchange, he/she will sign the appropriate line and advise the initiating employee. CHAPTER V OPERATIONAL POLICIES G. Types of Leave

See Leave Benefits section of the Sedgwick County Personnel Policies and Procedures Manual. CHAPTER V OPERATIONAL POLICIES H. Visitation at Posts I. PURPOSE: A. The purpose of a visitation policy is to allow Sedgwick County EMS personnel (full-time and part-time) the ability to have visitors during their duty shift. II. POLICY: A. EMS personnel will be allowed visitors during a formatted time frame. Visitors will not be permitted to remain at any Post other than the allowed times.

III. PROCEDURE: A. Visitation shall be open during the following time schedule: 1. Day shifts: 1000 - 1400 2. Night shifts: 2000 - 0200 B. Exception to this schedule may be made upon Captain's approval. C. Conditions or extraordinary circumstances: 1. Request may be made for immediate adult family to remain at the Post, if the unit is dispatched to a call until the unit returns. The person remaining must restrict activity to the day room or a prearranged room. 2. At NO time may a friend or a general acquaintance remain at a Post when a unit is dispatched to a call. CHAPTER V OPERATIONAL POLICIES I. Court Time Compensation I. PURPOSE: A. This policy outlines procedures for compensation of time spent at court for EMS related activities. II. POLICY: A. Time spent by EMS personnel for interviews, depositions, and court testimony related to EMS calls is compensable. III. PROCEDURE: A. Employees shall report time spent on interviews, depositions, and court testimony related to EMS calls to the District Captain. B. Interviews and depositions shall be scheduled during on-duty time. C. The District Captain shall be advised of court times so that duty hours will allow adequate off-duty time between shifts. D. Any monies received for court testimony, interviews or depositions must be turned in to the District Captain. E. EMS employees shall wear their uniform for court appearances.

CHAPTER V OPERATIONAL POLICIES J. Shift Change Request Guidelines I. PURPOSE

Throughout employment with Sedgwick County EMS an employee is subject to changes in his/her family/lifestyle needs and therefore, may need to change work shifts to better facilitate the employee's new lifestyle. To better serve the needs of its employees, SCEMS makes every attempt to ensure an employee's work schedule is conducive to that of the employee's personal life. These guidelines establish the required steps necessary to make a request for a different shift. II. POLICY

There are four phases to the request. The phases are: 1. Making a request to move shifts. 2. Submitting the requests. 3. Consideration of the requests. 4. Changing shifts when approved. III. PROCEDURE Phase I. A) All requests must be written via 'PROFS' system on county computer terminals. B). All requests must state a reason for the request. (i.e. health, family, education, etc.) The reason may become a factor in determining who is considered for moving. NOTE: if the reason for request is due to health conditions, the request must be accompanied with a letter of medical necessity signed by a licensed physician. C). A request for a specific station/rotation, captain, or partner will not be accepted at the same time a request for a change in shift is submitted. These requests must be submitted to the assigned district captains of the shift in question. D). The request shall include the specific shift requested. The following are the only acceptable requests: .1. Days- any day slot/ first available. .2. Nights- any night slot/ first available .3. X days .4. X nights .5. O days .6. O nights .7. M-23 Phase II. A) All requests shall be submitted to the employee's assigned Captain. A computer 'carbon copy' shall be sent to the assistant director. The EMS Captain

shall acknowledge and confirm the request with the employee within seven days of receipt of request. This confirmation will be achieved via computer. B). Upon receiving notification an opening exists on the requested shift, the employee may accept or decline the offer. If the offer is declined, the employee's request shall be labeled 'denied' and be removed from requests. If the same employee wishes to renew the request, a new request must be submitted following the shift change request guidelines. C). If the employee is offered a shift change that was not part of the request, the employee shall not be subject to denial of the request clause as stated above. Phase III. A). Health reasons take priority over all requests. The priority of reasons shall be left to the discretion of the assistant director. Generally, the priority of reasons are: health, family, educational, etc. B) Health reason requests aside, typically, the priority will be given to the employee with the oldest request for the specified shift. C). If the moving of employees is necessary due to administrative reasons, these changes will take place and be considered before all other requests are considered. (i.e. emergency health reasons, discip linary action, personnel problems) Phase IV. A). Once an employee is selected to move, the appropriate Captain shall notify the employee of the change. B). Upon changing shifts, the employee must follow the established SCEMS vacation policy except for administrative changes. Therefore, if the moving employee has vacation scheduled for time periods already allotted to other employees of the new shift, the moving employee will be required to reschedule vacation time for available vacation days. This will be done while following the established vacation policy. C). The change in shift shall commence with beginning of the pay period following the notification of shift change. In rare circumstances, moving may be postponed for a reasonable time period giving primary consideration to the overall operational integrity of SCEMS. Postponement shall be at the assistant director's discretion. All non-administrative shift changes must follow these guidelines. The direct 'trading' of shifts is strictly prohibited so a fair and equitable system of shift changes is available to all SCEMS employees. There are no time limits on requests, however, if an employee decides not to move before an opening is available, a notification of such decision is requested so as not to fill the request file with unnecessary requests. CHAPTER V

OPERATIONAL POLICIES K. Vacation Selection I PURPOSE: The purpose of this policy is to advise all permanent full time EMS employees of the policies used for vacation selection. II. POLICY 1. One must select and use enough vacation hours to offset your annual accumulation so vacation is not lost at the end of the year. You may not carry over more than 168 hours. Vacation hours are accrued with each payroll worked according to the following schedule: Initially 3.8769 hours per full payroll (100.79 hrs annually), after 5 years 4.8462 hrs (126 hrs annually), after 10 years 5.8154 hrs (1151.2 hrs annually), after 15 years 6.7846 (176 hrs annually), and after 20 years 7.7538 hrs (201.6 hrs annually). 2. You must select vacation hours based on the column entitled " Minimum to

be scheduled". This delineates hours accrued and considers accrual according to seniority. Two full weeks are the maximum selection for any given selection round. Several selection rounds may be necessary for some employees.

3. Once scheduled, vacation time cannot be canceled unless another week or segment of unassigned time is submitted with the cancellation. 4. Unscheduled vacation (emergency vacation) will only be allowed for personal emergencies. 5. You must have 24 hours of accumulated vacation hours on January 1, in order to be eligible for vacation selection. If you have less than 24 hrs you may select vacation at the end of this process from the weeks available after April 1, when sufficient hours should be accumulated for that time. CHAPTER V OPERATIONAL POLICIES L. Cot Policy I. PURPOSE: A. This policy outlines procedures for patient safety while being transported on the cot, daily check of the cot and cot cleaning II. POLICY: A. The cot will be checked daily for proper mechanical working condition and cleanliness. All patients transported on the cot will be secured. The cot will be cleaned after each patient use and put back in service with clean linen.

III. PROCEDURE: A. The cot will be checked at the start of each shift for cleanliness and proper mechanical working condition. (If a mechanical defect is discovered refer to SOG Chapter VII, Section II, Paragraph B) B. All patients being transported on the cot will be secured with three straps (if size allows). C. The cot will be disinfected after each use according to procedures outlined in the Sedgwick County TPM. D. Disposable linen will be placed on the cot prior to being put back in service. E. All cot operations when a patient is being transported will be supervised by EMS personnel. CHAPTER V OPERATIONAL POLICIES M. Maximum Weight Capacities of Patient Transport Equipment I. PURPOSE: This policy outlines the maximum weight capacities of patient transport equipment used by Sedgwick County EMS and other allied agencies and procedures for proper evaluation of this equipment when it has exceeded it's intended weight capacity. II. POLICY: All patient transport equipment shall be examined before it is placed back in service by support service team members after it has been subjected to use over its weight capacity. If a cot is deemed 10-7, refer to Chapter VIII, Procedure B. III. PROCEDURE: The following is a list of maximum weight capacities of patient transport equipment: Equipment Weight Capacity

Stryker EZ Pro

500 LBS.

Ferno 93ES Cot

500 LBS.

Ferno 93EX Cot

500 LBS.

Ferno 29M Cot

400 LBS.

Ferno 30 Cot

400 LBS.

Ferno Model 60 Spine board

350 LBS.

Ferno # 107 Stair chair

350 LBS.

Ferno # 12 Auxiliary Stretcher

350 LBS.

Ferno # 125 KED

350 LBS.

Allied Stabilizer Spine board

350 LBS

CHAPTER V OPERATIONAL POLICIES N. 10-37 Response on Code Green Patients I. PURPOSE: A. This policy outlines procedures for 10-37 response on patients triaged code green by law enforcement officers. II. POLICY:

A. Requests for transport of code green patients by a Law Enforcement Officer may be responded to with 10-37 traffic. The Officer must be on scene with the patient and request that the EMS vehicle make a silent approach.

III. PROCEDURE: A. Units will respond 10-37 to code green patients when requested by law enforcement officers on the scene. B. Patients that have injuries or medical problems in addition to their code green status, should continue to be handled with 10-39 traffic to the scene. CHAPTER V OPERATIONAL POLICIES O. Restraining Patients I. PURPOSE: A. This policy outlines procedures for restraining psychiatric patients. II. POLICY: A. All psychiatric patients that the MICT believes is a threat for injuring themselves or others may be restrained. III. PROCEDURE: A. The MICT should always try to transport any psychiatric disturbed patient without restraints, if possible. B. If the patient is a threat to injuring him or herself or others, he/she may be restrained with the least amount of force necessary. C. The patient will be restrained with four point soft humane restraints supine on the cot. Hand cuffs will not be used unless requested by law enforcement. D. If patient was restrained by law enforcement authorization, law enforcement must accompany or meet the ambulance at the receiving facility. E. All restrained patients will remain restrained until they are released to the proper authorities at the receiving facility. F. Circulation of the extremities distal to the restraints shall be evaluated frequently during the use of the restraints. CHAPTER VI VEHICLE MAINTENANCE PROCEDURES A. Cleaning Schedule

I. PURPOSE: A. The purpose of the Shift Vehicle Maintenance Checklist is to ensure the cleanliness, response readiness, and proper mechanical function of our equipment before the need arises. It will also help to keep part-time personnel and reserves familiar with the location and proper use of equipment we may not use on a daily basis. B. This maintenance schedule remains constant. As our shifts rotate around it, this will keep the repetition of the cleaning down to only two times a month per crew. The reasoning behind the different schedules for day and night is if a crew is too busy to complete their cleaning, it will be less than a week until the opposite shift can do it. C. Fill out the proper daily checklist, ACR, or Incident Report as needed, and report any problems to your supervisor. 1. Shift Check of Vehicle and Required Cleaning a. Unit is to be started and the engine running to insure the operational readiness of vehicle's ability to complete transport. b. Shift mechanical checklist is to be done. c. Shift equipment and inventory check is to be done. Unit must meet the standardization guidelines that are provided. d. Shift vehicle maintenance is to be done. Checklist is to be initialed. e. Unit is to be washed or wiped down at the start of each shift. (Weather permitting) f. Cab of unit to be inspected and cleaned as needed. g. Patient compartment walls, overhead rails, and action shelf will be wiped down with appropriate cleaner at the start of each shift. Floor of box to be swept and mopped. (Above repeated PRN) h. Check floor brackets, walls, etc. for loose or missing screws. I. Use the time light in the patient compartment when checking the unit. If the batteries are on, the engine must be running. j. Armor All may be used on exterior surfaces and dash only. 2. Monthly Check of Vehicle - to be done the 1st shift of each month. a. Check unit for expired drugs. (All Shifts) b. Replace oxygen humidifier. (Day) c. Discharge/recharge portable suction. (Night) d. Cycle LIFEPAK batteries per protocol. (Night) 3. Monthly Cleaning of Vehicle a. Coordinate with the other crews to wax the cab and box of the unit.

b. Shift and monthly checklists are provided for the above and are to be filled out and initialed as required. Fill out ACR's, Incident Report, etc. as needed.

4. Shift Vehicle Maintenance a. Shift 1 - Drug/Trauma Boxes: 1. Contents removed from boxes and boxes cleaned and inspected for proper function (hinges, clasps). 2. Trays and contents cleaned and inspected.

b. Shift 2 - LIFEPAK/Long Padded Splints: 1. LIFEPAK cleaned and inspected. 2. Case cleaned and inspected for cracks. 3. Cables cleaned. 4. LIFEPAK 10 covers inspected for tears and zipper function. c. Shift 3 - Cramers: 1. Inspect Cramer splints for leaks and clean. d. Shift 4 - Cot/Suctions: 1. Cot cleaned and inspected for function (including brackets in the unit). 2. Inspect onboard portable suction, clean PRN. e. Shift 5 - Hare Traction/KED's: 1. Hare Traction to be cleaned and assembled to insure proper mechanical function. 2. KED's to be cleaned and checked (especially straps and buckles). f. Shift 6 - Spine boards/C-Collars: 1. Spine boards to be cleaned and inspected. 2. C-Collars and headbeds checked to make sure the correct sizes and amounts are available. g. Shift 7 - Stair Chair/Auxiliary Stretcher: 1. Assemble stair chair and clean as needed. 2. Clean and inspect auxiliary stretcher. 3. Clean the compartment that is storing the equipment as needed. 4. Check the fire extinguishes in the inside/outside compartments and behind the passenger seat of the cab on the day you clean the inside/outside compartment. CHAPTER VI VEHICLE MAINTENANCE PROCEDURES B.Shift Cleaning Checklist - Week of _____________________________ SUN MON TUES WED

THURS FRI SAT DAYS 1 2 3 4 5 6 7 Cleaning NIGHTS 4 5 6 7 1 2 3 Initials 1. Drug/Trauma Kits 2. LifePak/padded long splints 3. Cramers 4. Cot/Suction (portable and on-board) 5. Hare Traction/KED's 6. Spineboards 7. Stair Chair/Auxiliary Stretcher

Refer to the SOG for detailed cleaning guide. Report any discrepancies or malfunctions to your supervisor and fill out the proper reports if necessary. C. Drug Box Standardization Medications IV Supplies Tape 1 Adult Stylet 5 Adenocard 2 250cc LR 1 2" Dermicel Tape 1 Ped Stylet 2 Alubuterol 1 1000cc LR 1 1" Dermicel Tape 1 Adult CO2 Detector 2 Aspirin 2 Micro Drip Sets 1 1" Transpore Tape 1 Ped CO2 Detector 3 Atropine 1 Macro Drip Set 1 1" Zonas Tape 1 Magill Forceps 4 Bretylium 2 Tourniquets Airway Supplies 1 Bite Stick 1 Dextrose

Alcohol Preps Adult 1 Ea. Size BVM/Masks KY Jelly 2 Diphenhydramine 5 14g IV Catheters Ped 1 Ea. Size BVM/Masks 1 Nebulizer 1 Dopamine 5 16g IV Catheters 2 NS Bullets 4 Epi 1:10,000 5 18g IV Catheters 1 Laryngoscope Handle 1 Infant Suction 1 Epi 1:1000 30cc 5 20g IV Catheters 1 #3 Miller Blade Bandages 1 Furosemide 3 22g IV Catheters 1 #2 Miller Blade 2" Kling 1 Glucagon 3 24g IV Catheters 1 #1 Miller Blade 4" Kling 1 Glutose Intraosseous 1 16ga,1 18ga 1 #0 Miller Blade

4 x 4 Dressings 2 Hydrocortisone 3 Each size straight needle 1 #3 Mac Blade Band Aids 1 Ipecac 2 Vacutainer Needles Surgipads 1 Ketorolac 1 Vacutainer Holder 1 Laryngoscope Bulb 1 Vasoline Gauze 1 Labetalol 2 Lavender Top Blood Tubes 2 #8 ET Tubes Diagnostic 3 Lidocaine 1% 2 Red Top Blood Tubes 2 #6 ET Tubes 1 Adult B/P Cuff (blue) 1 Lidocaine 4% 1 35cc Syringe 1 #5 Cuffed ET Tube 1 Glucometer 2 Mag Sulfate 3 12cc Syringes 1 #5 Uncuffed Miscellaneous

2 Narcan 1 Tubex Injector 1 #4.5 ET Tube 2 Cord Clamps 1 Nitro Spray Drug Drip Labels 1 #4 ET Tube 1 Small Bio Bag 2 Propranolol 1 Sharp Shuttle 1 #3.5 ET Tube 1 Convenience Bag 0 Sodium Bicarb 1 Long Arm Board 1 #3 ET Tube Release Forms 1 Verapamil 1 Short Arm Board 1 #2.5 ET Tube 1 Thiamine EGTA W/Mask D. Airway Bag Standardization Trauma Pouch BVM Pouch Lid Inserts Cylinder Compartment Airway Pouch 4x4 Adult BVM W/ Mask

Stethoscope Jumbo D O2 Tank Laryngoscope Handle Surgipads Ped BVM W/ Mask Adult & Ped B/P Cuff Pulse Oximeter Miller 3,2,1,0 Blades Kling 2"&4" Infant BVM W/ Mask Bandage Scissors Adult O2 Mask x2 Macintosh 3 Blade Vasoline Guaze Oral Airways 5.5mm-12mm Small Bio Bag Nasal Cannula x2 KY Jelly Transpore Tape Nebulizer Ped O2 Mask x1 EGTA W/ Mask Bandaids Nebu-Mask Infant O2 Mask x1 35cc Syringe Convenience Bag Med-Drafter Head Bed x1 Stylets Adult & Ped Proventil x 2 Trauma Dressing x1

Co2 Detectors Adult & Peds Adult Ets 8,6,5 Ped Ets 5,4.5,4,3.5,3,2.5 12cc Syringes x2 1" Dermicel Tape E. E Cylinder Standardization F. Portable Suction Standardization G. Life Pack 10 Standardization H. Nelcor N-20 Standardization 1 CANNULA 1 YANKAUER 2 ADULT ELECTRODE 3-PACK 1 N-20 PAPER 1 ADULT MASK SUCTION TUBING 1 PED ELECTRODE 3-PACK 1 ADULT OXISENSOR 1 SUPPLY TUBING 1 BOTTLE STERILE H2O 3 ADULT SINGLE ELECTRODES 1 PED OXISENSOR 1 PED MASK 1 EA SZ SUCTION CATH 2 EKG CABLES 1 INFANT OXISENSOR 1 INFANT MASK 1 EA SZ NG TUBE 1 PACING CABLE

1 EXTENSION CABLE O2 WRENCH 2 BENZOINE SWABS 5 Nail Polish Remover Swabs 1 O2 REGULATOR 1 LP10 PAPER 1 VINYL SUPPLY BAG 1 DEFIB GEL 2 FAST PATCH SETS 1 QUICK PACE SET 2 PED PADDLES 1 RAZOR 1 AED MODULE I. Vehicle Standardization(Inside Compartments) MEDICATIONS MEDICATIONS IV SUPPLIES AIRWAY SUPPLIES 2 Actidose 4 Narcan 2 Red blood tubes 1 #3 Miller Blade 5 Adenocard 1 Nitro Spray 2 35cc syringes 1 #2 Miller Blade 2 Albuterol 2 Propranolol

3 12cc syringes 1 #3 Mac Blade 2 Aminophylline 5 Sodium Bicarb 3 1cc syringes 2 Ea size ET tubes 5 Aspirin 2 Verapamil 1 Tubex injector 1 Adult stylet 3 Atropine 1 Thiamine Drug drip labels 1 Ped stylet 4 Bretylium IV SUPPLIES Sharp shuttles 2 Adult BVM w/ mask 2 Calcium 4 LR 1000cc 3 Long arm boards 1 Ped BVM w/ mask 2 Dextrose 4 LR 250cc 3 Short arm boards 2 Adult CO2 detectors 2 Diazepam 4 Macro drip sets

1 Wayne Cath Kit 1 Ped CO2 detector 2 Diphenhydramine 4 Micro drip sets TAPE Sterilization pouches 2 Dopamine 2 Buretrols 2 2" dermicel tape KY jelly 5 Epi 1:10,000 2 Blood tubings 2 1" dermicel tape NS Bullets 1 Epi 1:1,000 (30cc) 3 Tourniquets 2 1" transpore tape 1 EGTA Kit w/mask 2 Furosemide Alcohol preps 1 1" zonas tape 4 Bite Sticks 1 Glucagon 6 14g IV caths O2 SUPPLIES 1 Infant BVM w/Mask 2 Glutose 6 16g IV caths 1 Med-Drafter

SUCTION SUPPLIES 2 Hydrocortisone 6 18g IV caths 5 Adult O2 masks 2 Ea sz NG tubes 2 Ipecac 6 20g IV caths 5 Ped O2 masks 2 Ea sz suction caths 2 Isuprel 3 22g IV caths 5 Infant O2 masks Rico suction liners 1 Ketorolac 3 24g IV caths 5 Nasal cannulas 2 Yankauers 1 Labetalol 2 Intra osseous 2 O2 tubing 2 Suction Tubing 3 Lidocaine 1% 4 ea sz straight needles 2 Nebulizers 2 Infant suction sets 1 Lidocaine 4% 4 Vacutainer needles 2 Nebu-Masks

2 Infant blub syringe 2 Mag Sulfate 2 Vacutainer holders AIRWAY 2 Morphine 2 Lavender blood tubes 1 Ea. Size Oral Airway Vehicle Standardization (Inside Compartments) BANDAGES 1 Ped N-20 oxisensor 1 Rain Sheet 6 Quik colds 4" Kling 1 Infant N-20 oxisensor Clean Linen 2 OB kits 2" Kling 1 N-20 paper 4 Heavy Blankets Iodine swabs Surgipads 5 Nail Polish Remover Swabs Spare cot straps 4 x 4 dressings Personal Protective Equipment MCI EQUIPMENT Spare LSB straps 1 Box Bandaids

1 Box ea. Size latex gloves 1 MCI Vest w/ tape 1 refective EMS vest 4 Trauma Dressings 1 Box vinyl gloves 1 Roll blue barrier tape Mop 4 Triangular Bandages 2 Ea size sterile gloves Triage Tags 1 48" Pry bar 2 Large Burn Dressings Safety sheilds 1 Reusable body bag Trash bags 2 Small Burn Dressings Surgi-masks 2 Disposable body bags Large bio bags 1 Roll Aluminum Foil Disposable gowns Small bio bags BATTERIES 1 Padded splint kit EKG SUPPLIES IRRIGATION FLUIDS 1 9 volt battery 6 Lancets 5 Adult EKG 3-pk

4 Sterile H2o 1 AAA battery 1 Bottle Glucose monitor strips 2 Ped EKG 3-pk 4 NSS 4 C-cell batteries 2 Adult EKG 1-pk 3 D-cell batteries 2 Fast Patch PATIENT CONVENIENCE ITEMS 2 Quick Pace Convenience bags BOOKS 2 Razors Emesis Basins, disposable 1 Set county map book 1 LP10 Paper 2 Kleenex 1 Apartment book 4 Benzoine swabs Large emesis basin 1 Topaz book 1 Defib gel 1 Urinal 1 Fracture Pan MISCELLANEOUS OXISENSOR SUPPLIES Blue Pads

1 Black marker 1 Adult N-20 Sensor 1 Spare Pillow 1 Red marker J. Vehicle Standardization (Outside Compartments) 4 Long spine boards 1 Hand broom 2 Adult HARE traction splints Reflective road markers 1 Stair chair 1 Ped HARE traction splint Tool kit 1 Soft cot 2 Large disposable splints Tire iron 2 Tall c-collars 2 Small disposable splints 2 Jumbo 'D' cylinders 3 Regular c-collars 2 Large Cramer splints Laerdal suction 3 Short c-collars 1 Small Cramer splint 1 V-vac with canister 3 No neck c-collars 4 Ladder splints 1 LIFEPAK 10

2 Pediatric c-collars 2 Sandbags 1 Nellcor N-20 2 Infant c-collars Jumper cables 1 Med box 1 Package headbeds Soiled linen bucket 1 Airway Bag 1 Set wedges Cleaning Bucket 1 2" dermicel tape Cleaning Supplies 3 Adult KED's CHAPTER VI VEHICLE MAINTENANCE PROCEDURES K. Vehicle Refueling I. PURPOSE: A. This policy outlines the procedure for refueling EMS vehicles. II. PROCEDURE: A. The 24-hour refueling station is B-3, Stillwell and Handley. B. Alternate refueling stations (weekdays only). Use only in an emergent situation with permission of a District Captain : Andale Yards: 5858 North 247th West 445-2311 Clearwater Yards: 205 South Ross 584-6391 East Yards: 2200 South Webb 684-9392 North Yards: 10530 East 37th North 636-4028 Oatville Yards: 5210 West 39th South 522-1221 NOTE: Oil and other additives only available at B-3.

C. Vehicles must be refueled any time the tank capacity registers less than half full. CHAPTER VI VEHICLE MAINTENANCE PROCEDURES L. Oxygen Switch-Out I. Purpose A. To maintain adequate levels of oxygen on the ambulance. II. Policy A. "M" & Jumbo "D" oxygen cylinders will be exchanged with new full tanks once they reach 500psi. CHAPTER VII STATION MAINTENANCE PROCEDURES A. Cleaning Schedule Due to the nature of our job we are usually at several stations during one shift. It is therefore very important that all crews take responsibility for maintaining and cleaning all posts that they are stationed at regardless if it is for one day or one month. I. Shift Cleaning Responsibilities A. Bathrooms shall be cleaned every shift and P.R.N. This includes the sink, toilet bowl, shower, walls, floors, windows, mirror and other fixtures. Supplies to accomplish this shall be at all stations. B. Floors shall be cleaned every shift and P.R.N. This includes the living quarters as well as the garage floor. Vacuum cleaners, mops and brooms are supplied at all stations. C. Trash shall be collected and taken out as necessary during the shift. No trash shall be left on tables or floors. D. Kitchen areas shall be cleaned after each use. This includes dishes, utensils, microwave ovens, counter tops, burners, pots, pans, cups and whatever else was used to prepare the meal. Dishes shall be thoroughly cleaned and stored neatly in the kitchen cabinets. Kitchen cabinets shall be cleaned as necessary. The refrigerators shall be cleaned as necessary and all food shall be taken home at the end of each shift. Any food left in the refrigerator will be disposed of on Sunday evenings. Kitchen counter tops and tables shall be cleaned P.R.N.

E. Dayroom areas shall be cleaned as necessary. End tables, T.V.'s, chairs and lamps shall be dusted and cleaned. F. Outside areas need to be checked and cleaned. This includes trash lying around the station and those who smoke are required to pick up their cigarette butts after they are finished smoking and dispose of them in a proper receptacle. G. Yard work shall be done on the weekends. Lawn mowers are supplied at the stations with yards. Mowers shall be cleaned after each use. Oil and gas levels need to be checked prior to starting the mower. Gas must be supplied by your captain with his gas card. Shift cleaning is the responsibility of each and every crew member. Since we never know when a call is coming in, we cannot set up a time table for the above items. It is your responsibility to complete the tasks assigned above in a timely manner during your duty shift. If for some reason you are unable to complete all the items listed above, contact your Captain and also notify your relief crew and note it in the log. It will take all of us working as a team to keep our stations clean and livable. Thank you for your effort in this task. II. Supply Stock vs. Captain Restock A. All stock shall be rotated with the older stock being used first. B. If a supply post is low on stock or over stocked notify your captain and logistics by computer and phone. C. When crews restock it is very important to keep everything neat and clean. Dispose of trash as necessary at the supply post. D. Non-supply posts are not to have any supplies other than those needed for paperwork and cleaning. E. Units are to be kept stocked and any overstock shall be taken off and left at the supply post. F. Captain restock items shall be asked for as needed. G. See last page for inventory listings. III. Station Security A. Station shall be locked when personnel are not present. B. Blinds shall be pulled down and closed or turned to keep outside visibility down. CHAPTER VIII EQUIPMENT MAINTENANCE PROCEDURES

A. 10-7 Equipment I. PURPOSE: A. This policy outlines the procedure for handling 10-7 equipment. II. PROCEDURE:

NOTE: Any piece of equipment which is found 10-7 at shift check or becomes 10-7 (out of service) during your shift should be turned in for repair or replacement, or as directed by your shift supervisor. Contact your shift supervisor when appropriate. Every piece of equipment that is turned in shall be fully cleaned and decontaminated prior to it being turned in. Any item turned in dirty or contaminated will be returned to you for cleaning.

Any piece of equipment turned in for repair or replacement shall have a manila wire tag attached to it describing briefly what is wrong with it. It shall include the date, what vehicle or Medic Unit it belongs to, and who is turning it in (EMS Radio #). Along with the piece of equipment but NOT attached to it shall be an Incident Report describing fully and in detail what is wrong with the item and how, if known, it became 10-7. Wire tags are available at the supply posts.

Unless otherwise specified, the above NOTE shall be followed. A. Electronic and/or Biomedical Equipment .1. Mobiles, portables and pagers are repaired at B7. Vehicles with mobile problems shall proceed to B7 unless otherwise directed. Portables and pagers shall be switched out with your shift supervisor. .2. Electric portable suctions shall be switched out with your shift supervisor. If the charging cord is determined to the problem, the vehicle shall be driven to B7 unless otherwise directed. .3. Monitor/Defibrillator a. Physio Control LP10's should be switched out with the supervisor or taken to B1 as directed. b. Physio Control Battery Support Systems should be switched out with the supervisor or taken to B1 as directed. NOTE: Whenever a LifePak problem occurs, leave the current batteries in it or as directed. This will ensure accurate diagnosis of the equipment by the servicing vendor. 1.) Lifepak accessories should be switched out with your shift supervisor. This includes ECG cables, Pacing cables, fast patch adaptor, peds paddles. 2.) Follow SOG Chapter VIII.B.II.C for LifePak batteries. B. PATIENT TRANSPORT EQUIPMENT 1. Cots should be switched out at B4 with a 10-8 cot which is covered by a blue cover. Leave all sheets, cot straps, pillow and any other item currently

on the cot with the 10-7 cot. Only when directed by the supervisor should you taken a cot off another vehicle. 2. Spineboards, stair chairs and auxillary stretchers shall be turned into the supervisor or dropped off at B1 as directed. C. DIAGNOSTIC EQUIPMENT 1. BP cuffs should be turned into B1 for repair, replacement or calibration. Temporary replacement of BP cuffs are normally unnecessary since each ambulance carries three BP cuffs. 2. Pulse oximeters should be switched out with your shift supervisor. 3. Stethoscopes should be turned into B1. D. PERSONAL EQUIPMENT 1. Uniform shirts, pants, jackets, boots, shoes and other related items are replaced through annual replacement funds. During the year any worn out or unserviceable uniform items can be turned into B1. All issued items are kept on record. Do not throw any issued items away. Whenever possible a temporary replacement item can be received if needed. 2. Scissors and holsters should be turned into B1. 3. Vests and pocket masks are identified by an 4. EMS ID number. A 10-7 vest or pocket mask should be turned into B1. Temporary replacements will be issued as needed. 4. Bunker gear includes coat, pants, suspenders, boots, helmet, gloves, nomex hood and gear bag. Each of these items should be marked to identify who they have been issued to. Any of these items should be turned into B1. Temporary replacement items will be issued as needed. E. SPLINTING EQUIPMENT 1. Splints including Hare traction, KED, ladder, sandbags, board and vacuum should be turned into B1. 2. Missing or 10-7 accessory items such as KED head pad, straps or ankle hitch should be turned into B1. 3. Cervical collars should be replaced after each use. F. OXYGEN EQUIPMENT 1. Portable O2 cylinders should be tagged and placed in the "EMPTY" section of a green storage box. 2. Oxygen regulators or supply bags should be switched with your shift supervisor.

G. MISCELLANEOUS EQUIPMENT 1. Miscellaneous equipment such as: Posey restraint, storage trays, 16 quart bucket, measuring cup, mop, spray bottles, should be turned into B1. 2. Miscellaneous equipment such as: drug box, trauma box, body bag, flashlight, lantern, ticket book, map book, apartment book, vehicle keys, pop key, gas cards should be switched with your shift supervisor. B. NORMAL OR ROUTINE MAINTENANCE I. PURPOSE: A. This policy outlines how to handle equipment that needs routine maintenance. II. PROCEDURE: A. Any item that needs routine maintenance meaning: calibration, adjusting, re-tensioned, etc. shall be tagged with a manila wire tag and routed to B1. Wire tag shall be dated, a brief description what maintenance is needed, what vehicle the item came off of, Medic Unit or employee the item belongs to and the EMS Radio number of who is turning it in. No Incident Report is required for routine maintenance. B. Any item turned in for routine maintenance shall be cleaned or decontaminated prior to being sent in. Any item found to be otherwise will be returned to the person sending it in for cleaning first. CHAPTER VIII EQUIPMENT MAINTENANCE PROCEDURES C. LIFEPAK 10 BATTERY MAINTENANCE PURPOSE: This policy will ensure effective use and maintenance of Life Pak batteries. This information was developed in accordance with PhysioControl recommendations/guidelines. POLICY: This policy outlines how Life Pak batteries are to be rotated through the Life Pak and charging instruments. This policy must be strictly adhered to in order to prevent damage to batteries and ensure reliable performance from the Life Pak. PROCEDURE: Battery Rotation - The battery rotation is an important factor in providing reliable, fresh batteries for use in your Life Pak. All batteries are assigned a letter and a medic # which identifies this battery from others. When rotating

batteries it is essential that they be kept in alphabetical order. The rotation pattern is as follows: LP 10 Rotation : PRN, only when position 1 registers low. Position 1 6 4 3 6 5 3 2 5 4 2 1 Charging/Exercise Each Life Pak battery should be placed in the charger only when the rotation pattern indicates they should be there. It is essential that Life Pak batteries be reconditioned on a regular basis so the battery does not develop a "memory." There are two types of reconditioning procedures: Monthly Reconditioning: Each battery should be reconditioned monthly. Battery A on the 1st day of the month, battery B on the 2nd and so on. The procedures is as follows: 1. Place the battery in the discharge position (#6). 2. Wait for the "ready" indicator to light. 3. Press the "Discharge" control. 4. The battery is ready for use when, the "ready" is lit and the "% Batt Cap" will be displayed. 5. Record the battery capacity value on the battery report form. Quarterly Reconditioning: Once a quarter a triple reconditioning cycle should be completed. It should be done as a part of the monthly reconditioning. The procedure for this reconditioning is as follows: 1. Perform two discharge/charge cycles. After the second charge cycle, let the battery "rest" unloaded for one hour. 2. Perform one additional discharge/charge cycle. 3. Chart each battery capacity value on the battery report form. Record keeping: Use the Life Pak Battery Report Form to record results of all reconditioning tests. Also, record the date, condition of the battery clip, and your radio number. See attachment for details. Battery Replacement: A battery meeting any one of the following criteria should be replaced: 1. A capacity value of less than 70%. 2. A battery greater than 2 years old. 3. A battery with a defective clip. 4. Any battery which reads "faulty" during a charge cycle.

NOTE: Defibrillator checks should be done each shift and recorded on the daily log. This includes a six second sample strip. CHAPTER VIII EQUIPMENT MAINTENANCE PROCEDURES D. Pacemaker Check of LIFEPAK 10 I. PURPOSE To ensure operational readiness of the Lifepak 10 external pacing unit. II. POLICY The Lifepack 10 pacing unit will be checked at the beginning of each shift with documentation recorded in the daily log. III. PROCEDURE A) Pacemaker check using the Pacemate unit. 1. Attach patient leads and pacemaker cables as indicated on the Pacemate unit. 2. Turn the power on both the Pacemate unit and the Lifepack10. 3. Ensure Pacemate is set at 40. Start pacing and increase Lifepack 10 rate to 60. 4. Verify QRS complex's are sensed. 5. Increase pacing current until there is capture on the monitor. (100-125 mA) 6. Switch rate from 40 to 80 on the Pacemate unit and verify pacing is inhibited. Document capture on the daily log. CHAPTER IX RADIO PROCEDURES I. PURPOSE: A. To establish a uniform system of radio operations in order to maintain a professional demeanor, decrease misunderstandings and air time and increase efficiency. II. POLICY A. Personnel shall be brief using the "10 codes" whenever possible following the procedures below. III. PROCEDURE: A. There are portable (WT) and mobile (unit) radios, they have differences and similarities. There will be very few "dead spots" or areas where reception will not be possible, however, this is more likely on a WT than on a unit radio.

If this occurs the radio will emit a solid tone to indicate that you are not hitting the tower. 1. There are towers located throughout the county: a. Courthouse - Main System b. Epic Center - Backup System (the change is transparent) c. Goddard - West Repeater (Rpt) / Talk Around (TA) Phone interconnect available. d. 71st S. / Turnpike - South Rpt / TA e. 85th N. / Broadway - North Rpt / TA 2. To get a conventional tower either Rpt or TA: a. STX821-Unlock, push "menu" x 2, then scroll down with the "step" button to the desired system. The number corresponding to that position in the radio may also be used to switch systems. b. MTS2000- Push right arrow, select zone icon, press 6,use channel knob to select appropriate repeater. 3. Phone capabilities exist for both WT and unit radios. The procedure is different for WT and unit radios. 4. WT - STX821 a. Push "phon" button b. Enter number c. Press Push to Talk (PTT) button. The phone interconnect will open and number dialed. d. Press menu button to hang-up. WT MTS2000 1. Press forward arrow key 2. Press corresponding number beneath the "PHON" icon on the LCD display 3. Enter number 4. Press Push to Talk (PTT) button. 5. Press Home button to hang-up. 5. Unit - a. push "phon" button b. enter number c. push "sel" button- The phone interconnect will open and the number dialed. d. To hang up hang up, press the "home" button. e. Previously stored numbers may be recalled. 6. Emergency Buttons a. When pushed an alert tone is sounded to indicate to you that it has been activated. This also sends an alert tone to every dispatcher at the 911 center. They can identify who has sent the alarm based on radio ID numbers. After the alert tone has stopped a repeater is dedicated to your radio for 30 sec. for you to give any emergency traffic that may be necessary. If the emergency button is pushed accidentally then the term "Code 99" shall be used to indicate that an emergency does NOT exist. Any other traffic from that radio, including stating that you are okay or everything is 10-4 will not alter the response of officers

to your location (cross referenced with your last location known to the dispatcher). b. The emergency button can be cleared, after giving "code 99" or completing the incident, by pushing and holding it in for several seconds and another tone will indicate that it has been reset. 7. Radio Check a. Mobile and hand held radios should be checked each shift. 8. Receiving Calls a. Calls are received via the radio with Medic #, alert tone, (Three tones for emergency calls and one tone for transfers) Medic #, location of unit, type of call, location of call. This shall be acknowledged immediately "Medic # 10-4". Current location shall be given whenever addressed by medic # without further traffic. Units closer to a call shall volunteer for the call by notifying the Dispatcher on the dispatch channel. Pagers are alerted for all calls. 9. Enroute to Calls a. To check enroute to a call: medic #, mode of driving, location of call and location responding from. 10. Triaging a. Triage with destination shall routinely be given as soon as it is feasible to accomplish. Additional units may be requested, if needed, and shall be requested as soon as it is determined that additional units are needed. 11. Staging a. When more than one unit responds to the same scene all units after the first shall stage away from the scene and advise the dispatcher "10-23 staged West" (indicating the direction you are from the scene) unless specific instructions have been received from the first arriving unit. 12. Trauma Alerts a. A system for early notification of hospitals, to allow them to assemble appropriate staff, has been established. Information needs to be relayed to them through the dispatcher as soon as possible. This shall include: Medic #, Trauma/Burn/OB Alert, Hospital, Number of Patients, Type of Injury (i.e. multi-systems trauma or 50% burn 2nd/3rd degree), CRAMS, ETA, age. 13. 10-89 a. After requesting a 10-89, contact with the Medical Director is made on the all hospital channel . 14. Patient Information a. When relaying patient information to the medical director or hospital utilize the "break" format. Only give the patients name if specifically

requested to do so by the hospital staff. Radio traffic on "Code White" patients shall be abbreviated to decrease radio time and time constraints on ER staff, i.e. 25 y/o male pt from 10-48 c/o neck pain, vital signs normal, c-collar KED, LSB, ETA 10 min. 15. Assigning Hospital Channels a. The dispatcher will usually designate the hospital channel as available upon checking enroute to the hospital. If this is not done it is possible to go to the appropriate channel and if there is not traffic for several minutes then it can be used. When going from a hospital channel back to the dispatch channel listen before talking to eliminate "walking" on someone else's traffic. 16. WT Maintenance a. There are two WTs, two chargers, and five batteries per unit. The batteries should last an entire shift without recharging. Batteries shall not be placed into the charger attached to the radio with the radio on. Lapel mics are to remain attached to the radios. Damaged or faulty radio equipment is to be reported immediately. 17. Unit Radio Maintenance a. In the event of an electrical problem on the unit or jump starting, the radio as well as the master switch on the console shall be OFF. The antenna mount is designed to break away. Do not transmit if the antenna is in contact with anything or if it is missing. 18. MCI/Disaster a. Minimal and essential use only. CHAPTER IX Radio Procedures A. Pager Policy I. PURPOSE: A. This policy outlines procedures for the use of alpha-numeric pagers. II. POLICY: A. The pager will be carried by the second technician rather than the Lieutenant or acting Lieutenant. III. PROCEDURE:

A. Pagers will be kept in the tone alert mode. B. Pagers will be carried by the second technician for the entire shif C. Pagers will be carried in the issued protective case.

CHAPTER X PERFORMANCE APPRAISAL PROCEDURE I. PURPOSE: A. The purpose of the evaluation program is to evaluate an employee's performance on a regular basis allowing supervisors to know where employees stand in terms of job satisfaction, career goals, and training needs. See Sedgwick County Policies and Procedures Manual, Policy No. 4.903. II. POLICY: A. All permanent full time or permanent part time employees shall have their performance reviewed. B. Interim Review (Six Months) The Interim Review is mandatory and will be completed for all employees at six month intervals. It is designed to: 1. Give feedback to employees regarding job performance 2. Allow supervisors to discuss issues and problems before the Performance Review. C. Performance Review (12 or 18 Months) 1. The performance review is used every twelve to eighteen months, depending on the employee's placement in the pay matrix or either at the employee's or supervisor's request. 2. Performance Reviews must have a copy of each Interim Review attached. The Performance Review will not be processed and the employee will not receive a salary adjustment until it has been received with the Interim Reviews attached. 3. Suggested guidelines have been established for evaluations. They may not be applicable to each individual, and each of the criteria in the categories may not necessarily have the same performance value, depending on each individual's job responsibilities.

D. Step increases will only be granted at the time of the employee's evaluation date. Out of cycle or additional step increases must be authorized and approved by the County Manager and/or the Board of County Commissioners.

III. Procedure: A. Utilize the procedures set forth in the Sedgwick County Policies and Procedure Manual, Policy No. 4.903

CHAPTER XI PROBATIONARY EMPLOYEE TRAINING PROCEDURES I. PURPOSE: A. During the first months, there are specific areas that should be mastered to prepare you to perform your tasks in an efficient manner which translate into improved patient care. You will be given the objectives for each of the areas of study and be tested to ensure that you have gained the knowledge necessary for that unit. The following will be essential to the development of the new MICT. The one year probationary period will serve to offer the new employee opportunities to learn new skills and refine practical skills while under the supervision of an EMS Lieutenant. Awareness of the responsibilities on the street and the realization of new goals can be expected. This also offers the new employee and the Lieutenant the latitude to practice on-the-job training where it can be fairly evaluated in its proper environment. A passing score for the first 5 modules will be considered to be 75%. For the 6th/final module, a passing score will be 80%. The following objectives will be introduced and completed during the first six months of your probation period. Module I TPM Module II COMPUTER KNOWLEDGE, 800 RADIO, DOCUMENTATION/PAPERWORK Module III CHECKING AND CLEANING OF THE UNIT AND EQUIPMENT, STATION DUTIES Module IV INCIDENT COMMAND, HELICOPTER, GENERAL, & OPERATIONS Module V NAVIGATION/MAPS Module VI FINAL EXAMINATION (over all material) Module I (month 1) Summary: This unit will encompass the first month of probation. During this time, the employee will be expected to increase their knowledge of EMS Training Policy Manual. At the end of the first month, the employee will demonstrate a sufficient proficiency level of knowledge. I. Training Policy Manual A. Know each drug and how to figure dosages for each drug. B. Know pediatric Dopamine and Lidocaine conversions. C. Know adult Dopamine, Bretylium and Isuprel bolus' and conversions.

D. Know trauma destinations; Code Red/Blue, Code Gray, non-trauma alerts, Burn alerts, Rapid Fetal. Assessments and destination priorities. E. Know the Policies and Procedures within the TPM. Module II (month 2) Summary:

This unit involves learning about entering computer entry tickets and how "CICS" works. And what functions you can utilize. You will also learn how the "PROFS" side of the computer works. A user ID should already be assigned to you. This unit also covers the 800 radio system; what channels EMS uses, how to access them, talk with the hospitals, 10-codes, 10-88 and 10-89's, and how to make phone calls on the WT and unit radio, etc. During this time, the employee will be expected to obtain a further knowledge of day to day operational requirements of maintaining a response-ready ambulance. In addition, the employee will gain knowledge about scheduled transfers; including the paperwork/computer work that is associated with these.

I. Computer Knowledge A. Know how to "log on" CICS to enter call data; including the "LHS", patient care, billing information, etc. B. Know the functions that are accessible to the employee on CICS. C. Know how to "log on" PROFS with your assigned userid. D. Know how to send messages and notes in PROFS. E. Know how to access the Incident report and other documents in PROFS. F. Know how to set up your author profile. G. Know how to access the calendar and use the functions on PROFS. H. Know how to access documents and file them in Profs. I. Become familiar with software. II. 800 RADIOS A. Know how to conduct hospital traffic; Know hospital sub-fleet channels and how to access each hospital. B. Know how and when to utilize 10-88 and 10-89.

C. Know all appropriate 10-Codes D. Know TAC/SYSTEM channels and conventional tower locations. E. Know how to make phone calls on the walkie and the unit radio. F. Know how to conduct general Dispatch traffic. III. EMS DOCUMENTATION/PAPERWORK A. Know how to complete ALL EMS paperwork completely and accurately. B. Know how to document Voice Order correctly. C. Know how to correctly complete the computerized "ticket", including billing information. IV. SCHEDULED TRANSFERS A. Know what constitutes a scheduled transfer. B. Know how to correctly document the computerized ticket for the different types of transfers. C. Know the procedure for "delayed" transfers. D. Know the procedure if the patient condition changes enroute to your destination. Module 3 (month 3) Summary:

This unit involves operation of the ambulance and becoming familiar with the equipment carried on the unit. You will learn what supplies are carried and in what quantities. You will be acquainted with the oxygen replacement system. It will also encompass learning the station and unit duties. I. CHECKING AND CLEANING OF THE UNIT AND THE EQUIPMENT A. Know equipment on the unit-how to troubleshoot it, how it works, when to clean it. B. Know supplies carried on board. C. Know how to utilize the vehicle checklist. D. Know where the oxygen and supply posts are located. E. Know who to contact in case of mechanical difficulty with the unit. F. Know the fueling sites and where to get oil and other needed fluids. G. Know when and how to replace the OXYGEN.

II. STATION DUTIES A. Know the cleaning requirements of the station and unit. B. Know what is needed to maintain station/unit security. Module 4 (month 4) Summary:

This unit will involve study of the basic components of dealing with an MCI and the method of Incident Command that is utilized by emergency response personnel. You should become familiar with these principles during this month of employment. Also covered in this module is information concerning helicopter calls. The employee needs to become familiar with all components that effect these calls. General EMS Operations will be reviewed. This will include billing information that is not related to computer entry and scenario based operational questions will be included in this section. The employee needs to know material related to EMS history and background and response guidelines. I. INCIDENT COMMAND A. Knowledge of Airport emergency procedures. B. Know the components and procedures of MCI's. Understand Extrication, Triage, Treatment and Transport sectors C. Know the Safety/Protective equipment that is issued or available to you and when to wear it. II. HELICOPTER RESPONSE A. Know the criteria for launching helicopter and who can launch and cancel it. B. Know where helicopter can be used. C. Understand what components are involved in selecting a Landing Zone (LZ). D. Understand the helicopter crew member procedures. III. GENERAL OPERATIONS A. Have a general understanding of EMS background and history; including when Sedgwick County EMS began, tax based vs user fee revenue.

B. Have an understanding of general billing information; including rates, different type of transfers, signature criteria, etc. C. Become familiar with the different types of responses as lined out in the Sedgwick County EMS SOG. Module 5 (month 5) Summary:

This unit will encompass the fifth month. During this time, you will be expected to add to your geographical knowledge to include a 1 mile radius surrounding each EMS post, Building1 and 4 and the hospitals in Sedgwick County. It is important to know the location of the nursing homes in Sedgwick County. I. NAVIGATIONAL OVERVIEW A. Know main streets North/South from Edgemoor to Hoover. B. Know diagonals, mile markers and half mile markers. C. Know all area hospitals and care home locations. D. Know the 1 mile radius around each EMS Post, Building 1 and 4 and each Wichita hospital. E. Know main East/West streets Central to Pawnee F. Know the intersecting mile markers of the surrounding small towns in Sedgwick County. Module 6 (month 6) Summary:

During this month, you will be expected to display a thorough knowledge in each of the previous units of study. An examination will be administered at the close of the probationary period. A score of 80% or more must be evidenced for the employee to be released from probationary status. A. Comprehensive test over modules 1-5 to be completed during 1st 5 months of employment. CHAPTER XII DOCUMENTATION PROCEDURES I. PURPOSE: A. The purpose of the different documents used by Sedgwick County EMS is to provide a means of communication between Technicians, administration, departments within EMS and within Sedgwick County, and allied agencies outside of Sedgwick County. Documents are also used to provide a permanent record of

EMS calls, incidents, to report damaged or worn equipment, supply request, billing information, and signatures. Although the format of the documents may change, the basis of them remain the same. All forms are to be completed. Unless requested, documents which are completed on the computer, (i.e. ACR, Incident Report, Inventory Request, Counseling Session) do not need to be done on a paper form. When completing paperwork on the computer, DO NOT use apostrophes or other symbols (i.e. ", #, *). 1. Absence Report Form 2. Address Change Form 3. Auto Condition Report Form (ACR) (computer) 4. BEMS C.E. Course Attendance Record 5. Billing Form (computer) 6. Certificate of Attendance (BEMS) 7. Counseling Session (computer) 8. Shift Station Log 9. Release of Liability Form (computer) 10. EMS Data Collection System (computer) 11. Employee Performance Evaluation Form 12. EMS Inventory Order Form (Computer) 13. Expired Drug Survey (Computer) 14. Fluid Usage Sheet 15. Fire Rehabilitation Form 16. Incident Report Form (computer) 17. Memo's 18. Narcotics Log a. Narcotic Log Sheet b. Prescriptions and Envelopes 19. On-the-Job Injury Accident Report Form 20. Part-time Availability Sheet/OT Availability Sheet 21. Patient Care Form (Computer) 22. Request for Leave Form

23. Rider Release Form 24. Shift Exchange Form 25. Special Procedure Review Form (Deleted) 26. Stand-by Form 27. St. Francis Special Transfer Form (computer) 28. VA Authorization Form 29. Vehicle Accident Report Form 30. Vehicle Mechanical Checklist 31. Written Reprimand B. Captain's Forms 1. Acting Officers Pay Form 2. Authorization for Medical Treatment Form 3. Captain's Daily Log 4. Facility/Unit/Personnel Inspection Sheet 5. Mileage Report Form 6. Exposure Forms 15 & 16 CHAPTER XII DOCUMENTATION PROCEDURES A. Absence Report Form I. PURPOSE: A. The Absence Report Form is used to document when a technician is absent from work for any reason. The Absence Report Form is to be completed the first day a technician returns to work. II. PROCEDURE: A. Place your name at the top and check the appropriate type of leave. Give the date and time absent. Under narrative, give a reason why you were absent. Sign and date form and turn in to your District Captain. The Absence Report Form will then be placed in your personnel file.

CHAPTER XII DOCUMENTATION PROCEDURES B. Address Change Form I. PURPOSE: A. The purpose of the address change form is to communicate to the office personnel and to the personnel department of an employee's current address and phone number. The address change form is to be completed within thirty (30) days following the day your address or phone number changes. CHAPTER XII DOCUMENTATION PROCEDURES C. Auto Condition Report I. PURPOSE: A. The purpose of the Auto Condition Report (ACR) form is to communicate problems and the need of repair of SCEMS vehicles. II. PROCEDURE: A. The ACR will be done on the computer. It is to be completed for any item which is not operating properly on a vehicle. The vehicle number shall be the 6 digit number located on the right rear area of the vehicle. The make, model, year, current mileage, date of last service, and the mileage of the next service due, shall be completed. Next, check the appropriate box of the item not properly working. In the remarks section, describe in detail what the problem is. If a failure occurs while on a call, check the appropriate box below the remarks section. B. A brief report shall also be included in the Station Shift Log. When completed, turn the form in to your District Captain. CHAPTER XII DOCUMENTATION PROCEDURES D. Billing Form

I. PURPOSE: A. The purpose of the billing form is to provide the billing department with the information needed to file for reimbursements, for services provided, from patients and insurance companies. A billing form is to be completed on every patient that is transported by SCEMS, or in which supplies were used in the treatment of the patient, except for St. Francis Special Transfers. II. PROCEDURE: A. See Appendix A CHAPTER XII DOCUMENTATION PROCEDURES E. Counseling Session I. PURPOSE: A. The Counseling Session is a progressive step of disciplinary action used when an employee's actions are against policies and procedures, standing orders, and conduct as set by Sedgwick County and EMS. All disciplinary action is to conform to Sedgwick County's Policy and Procedure (No. 4.501). II. PROCEDURE: A. The Counseling Session Form should be completed on paper or the computer. The date, employee, and supervisor must be completed. The subject shall contain a brief description of why the employee is receiving the counseling session. Next, list in detail the steps the employee shall take to correct their action. The employee may then make comments as he/she so desires in the "Employee Comments" section. The employee must sign the form to show receipt of the counseling session. The signature is to show receipt and does not necessarily represent agreement with the counseling session. It is then signed by the supervisor. When completed, the counseling session form is to be sent to the office for filing in the employee's personnel file. If the counseling session form is completed on the computer, a paper copy must be made for the signatures and any employee comments as needed. CHAPTER XII DOCUMENTATION PROCEDURES F. Shift Log I. PURPOSE:

A. The purpose of the Shift Log is to facilitate communication between crew members and other co-workers. The Shift Log is also used to keep track of equipment left at hospitals, memos issued, oxygen levels, etc. II. PROCEDURE: A. The Shift Log is to be completed for each shift. Information to be included is the Medic number, Vehicle number, Date, Crew numbers, and Shift. A summary area is included to record information of concern, or interest of station or vehicle activity. The equipment, which hospital and the patient's name shall be recorded in the appropriate area and then marked off when the equipment is returned to the vehicle. The oxygen levels and an EKG test strip with a test defibrillation and pacer check on it shall be recorded for each shift. The Shift Logs are to be kept at the station for a period of one year from its date before disposing of. CHAPTER XII DOCUMENTATION PROCEDURES G. Release of Liability Form I. PURPOSE: The purpose of the Dry Run Form is to provide a written legal document of a call in which SCEMS received but a patient was not transported, i.e. patient refused, DOA, no patient; or in which a call was not completed, i.e. disregarded, vehicle failure, etc. As with all forms, the Dry Run Form is to be completed in its entirety including vitals and the narrative, when the call is completed. A signature (or explanation as to why you are unable to obtain a patient's signature) is to be obtained for all patients refusing SCEMS services. A. Release of Liability: The Release of Liability Statement is to be read and explained as needed by the technician and the patient shall acknowledge understanding of the statement before signing the form. The form shall also be signed by two witnesses, preferably by other emergency service personnel. If the patient is a minor, or unable to sign, the person signing the form for the patient shall write their relationship to the patient on the line under the signature line. B. When any law enforcement officer has a patient in custody and refuses to let us treat/transport the patient-they can do this-they have the ultimate jurisdiction. They must, however, have the release of liability read to them and they must sign it. If they refuse to sign it, we will take the patient if the patient wishes to go. If they sign the release, they have now taken on the responsibility of the patient's outcome upon themselves.

CHAPTER XII DOCUMENTATION PROCEDURES H. EMS Data Collection System I. PURPOSE: A. The EMS Data Collection System is the computerized version of the Patient Care Forms and the Billing Form. The EMS Data Collection System is designed to replace the paper forms of the Patient Care Form, Dry Run Form, St. Francis Special Transfer Form, Billing Form. As with the paper forms, the computer forms are to be completed in their entirety as applicable. II. POLICY A. A patient care report and billing report (if applicable) will be completed on each call. It is encouraged that the report be completed at the hospital destinations, if possible or applicable. B. If conditions do not permit the report to be immediately completed post-call, it is a priority to complete the report as soon as possible. C. Captains approval is required for any reports not completed during the shift they occurred on. CHAPTER XII DOCUMENTATION PROCEDURES I. EMS Inventory Order Form I. PURPOSE: A. The purpose of the EMS Inventory Order Form is for technicians to order needed supplies for the station and vehicle. The quantity of each item shall be listed. The order form shall be turned into Support Services by Thursday for delivery on Friday. B. Supply posts inventory orders shall be completed by night shift personnel assigned to the supply posts (1, 4, 13, 10). They shall be done on computer and sent to Support Services by 0700 every Thursday. A Master Inventory List shall be supplied at each supply post for reference. Fill in each blank that needs supplies with an integer only. Do not use "ea" or "bx". Be sure to fill in the Account (Post) and date. Do not use apostrophes or periods when using the computer form. To access a computer form, press PF5 from PROFS main menu. Press PF2 to list the available EMS document forms. Select the appropriate form by pressing the PF key. The form now appears on the screen to be fill out. Note: Except for the posts listed as supply posts (1, 13, 4, 10), supplies ordered shall be based on need and not on basis of stocking of supply posts.

CHAPTER XII DOCUMENTATION PROCEDURES J. Monthly Inventory of Expiring Drugs I. PURPOSE: A. The purpose of this being a monthly assignment is to better facilitate exchange of expiring medications in a timely manner and to control our inventory. II. PROCEDURE: A. The Lieutenant that works the first day of the month will be responsible for sending Support Services a Profs Document (not a NOTE) on how many of each medication will expire in the next three (3) months. Please use a "BOND +" format for your document. Support Services will be responsible for inspecting the spare vehicles not being used on the street. Please list the EXACT date on the box, vial, or ampule you are inspecting. It may be listed as "1/97" or "1/1/97" or "1/30/97". Please state in the "SUBJECT" section the vehicle number and current month. List the medication name <tab over> expiration date <tab over> quantity. B. Example: Atropine 1/1/99 3 Bretylium 2/99 6 Calcium 1/30/99 2 CHAPTER XII DOCUMENTATION PROCEDURES K. Fluid Usage Sheet I. PURPOSE: A. The purpose of the Fluid Usage Sheet is to assist Support Services and Central Motor Pool in keeping track of the fluids used by each SCEMS vehicle. Except for fuel obtained and recorded by computer at BLD. 3, the Fluid Usage Sheet is to be completed whenever any fluid is added to a vehicle. II. PROCEDURE: A. When documenting the fluid used, give the vehicle's four-digit number, type of fluid and quantity. Sign the form and give the agency in which you work

for. If the computer and pumps are out of service at BLD. 3, the Fluid Usage Sheet located in the small building at BLD. 4 shall be completed. CHAPTER XII DOCUMENTATION PROCEDURES L. Incident Report I. PURPOSE: A. The Incident Report Form is a general form used to document in detail any unusual occurrences, special requests, and anything which requires documentation in which there is no other form to be used. It could also be used to document a particular incident of a call, an incident with a citizen, and vehicle or equipment failure, injury or accident. II. PROCEDURE: A. Check the appropriate box at the left and right corners. Complete the Date, Time of Writing, Shift, Medic number, Vehicle's four-digit number, and Pages. Under Incident Type, give brief description of the report. Under narrative, give the information about the incident in detail. Give names, run numbers, etc. Sign the form at the bottom and give your employee number. The paper copy need not be completed if form is completed on the computer. CHAPTER XII DOCUMENTATION PROCEDURES M. Narcotic Log I. PURPOSE: A. The purpose of the Narcotic Log is to provide a check sheet for the strict control of controlled substances carried by SCEMS as outlined by the FDA. The Lieutenant (or acting Lieutenant) will "sign on" the drugs at the beginning of each shift, then "sign off" their drugs at the end of their shift. The Lieutenant will also fill in the blanks for the number of controlled substances used, replaced and the remaining balance on the unit. II. PROCEDURE: A. When a controlled substance is used on a patient, it is to be recorded on the right hand side of the narcotic log. Information needed is the date,

patient's last name, the drug given, the amount given, gram number and the employee number of the technician which administered the drug. B. Whenever a technician receives an order and administers a controlled substance, a physician signature is required. A narcotic envelope (supplied by the District Captains), is to be used and the information on the front is to be completed. The drug used, amount administered, and the hospital is to be completed. The "Authorized By" is the area for the Physician who ordered the drug to sign. If, for an uncontrolled reason, the physician is unable or not available to sign the envelope, another physician may sign the form with an explanation included. The patient's name, incident number, date, technician signature must also be completed. The District Captain is to sign under "Supervisor". If only a partial amount of the drug is given, the amount wasted by the District Captain is to be completed and initialed by the District Captain and the technician who witnessed the wasting of the drug. If all of the drug is used, the empty syringes should be saved and verified by the District Captain, and then be discarded with the regular contaminated syringes. The narcotic envelope is then given to the District Captain and to Support Services for replacement. C. Due to the consequences which may be imposed upon SCEMS by the FDA for failure to follow this policy, this policy will be strictly enforced. CHAPTER XII DOCUMENTATION PROCEDURES N. Part -Time Availability /OT Availability I. PURPOSE: A. The purpose of part-time and OT availability is to provide the District Captains with a list of dates and shifts in which part-time/full-time employees are available to work when full-time employees are unable to work due to vacations, sick, maternity, paternity, etc. II. PROCEDURE: A. All information shall be completed including phone numbers where you can be reached (i.e. at another job, pager number, etc.). Indicate if available day or night only, or available all shifts. The availability is to be sent via PROFS or e-mail to District Captains by the 15th of the current month for availability of the following month. If your availability changes during the month, contact a District Captain. CHAPTER XII DOCUMENTATION PROCEDURES O. Patient Care Form

I. PURPOSE: A. The purpose of the Patient Care Form is to provide a written legal document of care and treatment of all patients evaluated by SCEMS. The Patient Care Form is to be completed in full and before the end of your working shift. The Patient Care Form shall be completed as soon as possible after the call and a copy faxed to the hospital. B. Voice orders received from a nurse for a physician shall be documented per TPM . II. PROCEDURE: A. For detailed instructions of inputting the Patient Care Form, see SCEMS run report instruction booklet. CHAPTER XII DOCUMENTATION PROCEDURES P. Request for Leave I. PURPOSE: A. The purpose of the Request for Leave Form is for employees to request time off of work, (other than scheduled vacations), as needed and still provide adequate staffing of EMS units. The types of leave are vacation, sick, maternity, paternity, military, civil, funeral, leave of absence without pay. II. PROCEDURE: A. A Request for Leave shall be completed and given to your District Captain at least 14 days prior to your first day of requested leave. The 14 day requirement may be waived in emergency situations, and will be determined on an individual basis. Check the type of leave requesting and if other, give type. Give the days requesting and list the individual dates. A reason must be given for consideration of the leave request. The Request for Leave must be signed by the employee and dated in the right upper corner. B. The date of when received by the District Captain will be placed in the upper right hand corner of the supervisor's section and signed by the District Captain. The request will then be either approved or denied, and if denied, a reason will be given. If approved, the request will then be sent to the Director or his designee for approval or denial and his signature. A copy of all approved requests will be placed in the employee's personnel file and a copy given to the employee. C. If several employees request the same days off, the Request for Leave dated the earliest shall be given the approval over the later dated request.

All leave of absences will be according to the current Sedgwick County Personnel Policies and Procedures Manual. Policies #4.700-4.711. CHAPTER XII DOCUMENTATION PROCEDURES Q. St. Francis Special Transfers I. PURPOSE: A. The St. Francis Special Transfer is completed as a regular transport form with the exception of selecting "F" for St Francis special at the call type selection screen. These transfers are Heliport transfers. CHAPTER XII DOCUMENTATION PROCEDURES R. Shift Exchange Request (see SOG Chapter V.F.) CHAPTER XII DOCUMENTATION PROCEDURES T. Vehicle Mechanical Checklist I. PURPOSE: A. The purpose of the Vehicle Mechanical Checklist is to document the shift checks of each SCEMS vehicle, to help maintain the response readiness and proper mechanical functioning of the vehicles, improve the vehicle's life and overall condition, reduce liability during vehicle failures, and help aid in finding recurring vehicle problems. II. PROCEDURE: A. The Vehicle Mechanical Checklist is to be completed by each shift Lieutenant/Acting Lieutenant daily and initialed and EMS number placed at the bottom of the form. The vehicle's four-digit number is to be placed in the upper left corner, and the date of the Sunday beginning the week in which the form is to be completed. Except under tire pressure and fuel, an "X" is to be placed in each area checked indicating that particular item is operating correctly and fluid levels are full. If an item is not operating correctly, place an "O" in that particular position and complete an ACR, and log it in the station Shift Log. If any fluid (except fuel) is added, place an "A" and amount added in that particular position and log it in the station Shift Log. For tire pressures, give the actual pressure for all tires. Write the amount of fuel in the vehicle, closest to the 1/4 mark.

B. The Vehicle Mechanical Checklist is to be completed for each vehicle from Sunday through Saturday and then turned in to your District Captain for filing. CHAPTER XII DOCUMENTATION PROCEDURES U. Stand-by Forms I. PURPOSE: A. There are two forms to be completed on each stand-by. The first one is the Employee Sign-In Sheet. This form is designed to keep track of the man hours expended on stand-bys. The second form is the Patient Registry Form. It is developed to have a log of all patients that are evaluated and/or treated by SCEMS at all stand-by events. II. PROCEDURE: A. Employee's Sign-In Sheet: The Employee's Sign-In Sheet is to be filled out for all stand-by events. The name of the event and Incident number (issued by dispatch) shall be filled in. The date, starting, time, and medic unit number shall then be filled in. As employees show up for the stand-by event, they shall sign their name, EMS employee number, and the time they arrive at the event. When they leave, they shall fill in the "Time Off" and total their hours worked to the nearest 1/4 hour. When stand-by has ended and all employees have signed off, the technician in charge shall tally up the number of patients treated, number transported, total number of patients seen, total paid employee hours, total reserve and Type II service hours, and then total the two. This form is also utilized for controlled substances signatures. The form is then initialed by the captain who records the paid employees on the payroll and place a "y" for yes and "n" for no if the employee receives shift differential. Shift differential is given for any event which begins at 1500 hours or later. The form is then sent to BLD. 1 for billing of the stand-by to appropriate persons. B. Patient Registry Form: The Patient Registry Form is a form to document all patients evaluated and/or treated by SCEMS at stand-by events, but did not want to be transported to a local hospital. The Incident number, medic number and date shall be recorded in the upper right hand corner of the form. When a patient arrives, the time, their name, address and age shall be recorded. If the patient is a minor, the time the parent is contacted shall be recorded. When the patient leaves the treatment area, the time and disposition of the patient shall be recorded. If the technician feels the patient shall be transported but the patient refuses, a ROL Form shall be completed for the patient. The ROL Form shall also be completed any time the technician feels an incident needs to be documented. If a patient is transported to a hospital, a Run Form shall be completed as a regular emergency call. CHAPTER XII

DOCUMENTATION PROCEDURES V. Written Reprimand ..I. PURPOSE: A. The Written Reprimand is a form used to document a formal disciplinary action given to an employee for inappropriate job performance or conduct. The Written Reprimand is a progressive form of disciplinary action following Verbal and Written Counseling sessions. .II. PROCEDURE: A. The Written Reprimand Form is a triplicate copy form. A single copy may be used to write out the form and then typed onto the official form. The Date of the Incident, and Date of Action shall be completed. The employee's name, department, and duration of suspension (if applicable) shall then be completed. A detailed description of the incident prompting the disciplinary action and corrective action required shall then be given. The Department Head shall then sign the form if the employee is suspended. The supervisor shall then discuss the Written Reprimand with the employee and the employee shall sign the form acknowledging receipt. the employee's signature constitutes receipt of the Written Reprimand, but not necessarily agreement of the reprimand. The employee may, if desired, make comments on the bottom of the form and must sign under his/her comments. B. When completed, the white copy is to be sent to the Office of Personnel Services, the canary copy to the employee, and the pink copy to be filed in the department. C. Disciplinary action is to be followed according to the Sedgwick County Policy and Procedure Manual Policy No. 4.501. CHAPTER XII DOCUMENTATION PROCEDURES W. Mileage Report Form I. PURPOSE: A. The Mileage Report Form is a Support Service's form to record each EMS vehicle's current mileage, the service due mileage and the cot number. The mileages are to be recorded each Sunday and sent to Support Services on Monday. The Mileage Report Form is used to schedule when vehicle's receive preventative maintenance and replacement will be due. CHAPTER XII DOCUMENTATION PROCEDURES

X. Radio Shop Daily Log I. PURPOSE: A. The Radio Shop Log is used by the Radio Shop to record when a piece of equipment is brought in for repair, who brought it in, and by whom and when it as picked up following being repaired. The number on the metal county ID band is used to identify the item to be repaired. When logging an item in or out, the date, time and initials are to be logged. If any questions, contact Support Services or anyone at the Radio Shop. CHAPTER XII DOCUMENTATION PROCEDURES Y. Acting Officer Pay Sheet I. PURPOSE: A. The Acting Officer Pay Sheet is used to list, on one sheet, those technicians who are entitled to additional benefits for their role as an acting officer, whether acting as a Lieutenant or Captain. II. PROCEDURE: A. The employee's name, as listed on the payroll sheets, and their SSN shall be listed. The appropriate amount shall then be placed in the box corresponding to the correct day of the pay period for which the employee was an acting officer. At the end of the pay period, and after the payroll is completed on the computer, the Acting Officer Pay Sheet is then filed at BLD. 1. B. Scales 1. Less than 2 hours - $ 0.00 2. 2 - 6 hours - $ 5.00 3. 6 - 12 hours - $10.00 CHAPTER XII DOCUMENTATION PROCEDURES Z. Authorization for Medical Treatment Form

I. PURPOSE: A. The Authorization for Medical Treatment Form is required to receive medical treatment at St. Joseph Medical Center or any Minor Emergency Center (MEC) for treatment for any on-the-job injury requiring medical examination or treatment. II. PROCEDURE: A. The Authorization for Medical Treatment Form is to be completed by the District Captain and given to the physician for completion and then turned in with the On-the-Job Injury Form to BLD. 1 to be forwarded to Risk Management. B. The box corresponding to the treating facility shall be checked. The top part of the form shall be completed as appropriate. CHAPTER XII DOCUMENTATION PROCEDURES AA. On-The-Job Injury Accident Report Form I. PURPOSE: A. The purpose of the On-The-Job Injury Accident Report Form is to report and document an accident and/or injury of a Sedgwick County employee. The On-The-Job Injury Accident Report Form is to be completed for any vehicle or personnel accident, injury, or exposure to hazardous material or biological agent. II. PROCEDURE: A. The On-The-Job Injury Accident Form is to be completed immediately after the accident or as soon as possible afterwards, but must be reported within 24 hours per Sedgwick County Policy and Procedure Manual Policy No. #4.702. B. The employee shall complete the front of the form completely, including describing in detail the events of the accident or injury, any witnesses, the cause of the accident, and if anything could have been done to prevent any such accidents or injuries. The employee must sign the bottom of the form. Upon completion, the employee shall give the form to his or her Captain, who in turn will investigate the accident or injury and complete the supervisor's section on the back. The Captain shall then check the appropriate box as to whether or not the accident or injury was preventable and list any disciplinary action taken if needed. The Captain shall then sign the form. After the form is completed, the employee shall read the Captain's comments and may make comments if desired. The employee is required to sign the back of the form after reading the supervisor's comments. The signature does not imply agreement, but acknowledgment of reading the supervisor's comments.

C. Upon completion of the form, it shall be received by the Office of Risk Management within 24 hours of the accident or injury being reported to the employer. CHAPTER XII DOCUMENTATION PROCEDURES BB. Vehicle Accident Report Form I. PURPOSE: A. The purpose of the Vehicle Accident Report Form is to document the driver and the events of accidents involving Sedgwick County vehicles. II. PROCEDURE: A. The Vehicle Accident Report Form is to be completed by the driver of the vehicle immediately following the accident or as soon a possible after the accident, but within 24 hours. The driver shall complete the front of the form including a description of the accident in detail, the cause of the accident, and information of the driver of other vehicles involved in the accident. The form shall then be given to your Captain, who will investigate the accident and determine if the accident was preventable or not, and if any disciplinary action is needed. B. After completing the back of the form, the employee shall read the back and may make comments if desired. The employee must then sign the back to acknowledge that he/she has read the supervisor's report. The employee's signature does not constitute agreement, but acknowledgment of reading the supervisor's comments. C. After the form is completed, it is to be returned to the Office of Risk Management within 24 hours of the notification of the accident to the employer. CHAPTER XIII OPERATIONAL PROCEDURES A. EMS Standbys I. PURPOSE: A. The intent of this procedure is to outline responsibilities of EMS Personnel assigned to provide medical care at a public event (Standby). II. PROCEDURE:

A. Paid employees are required to report for Standby duty at the scheduled time. Tardiness will be recorded as a lateness. Sickness must be reported to the District Captain at least 1 hour prior to start of standby. B. Standby personnel must wear the EMS uniform and have all safety and essential equipment, except bunker gear unless otherwise advised. C. EMS vehicles used for Standbys must be checked for operational readiness. D. A run number will be assigned to each EMS Standby event. E. Standby personnel shall anticipate and preplan for medical emergencies based on crowd and location factors unique to each Standby event. F. All standby's must have a Standby Form completed and turned in to the District Captain following the event. CHAPTER XIII OPERATIONAL PROCEDURES B. Lost and Found I. PURPOSE: A. This procedure will establish a depository for lost and found items. II. POLICY: A. Any unclaimed personal belongings will be turned over to a District Captain. This shall be noted in the station shift log book. III. PROCEDURE: A. Unclaimed personal belongings will be stored in the Lost and Found locker at Medic 1 or Medic 2's office. A record of the description, date and location found shall be kept in the locker. DATE TIME ARTICLE LOCATION FOUND DISPOSITION DATE

CHAPTER XIII OPERATIONAL PROCEDURES C. News Media I. PURPOSE: A. The intent of this policy is to control the release of information to the news media to protect EMS, employees and patients. II. POLICY: A. Interviews with the media concerning EMS operations must be approved by a District Captain. B. Release of patient information is limited to types of injuries or condition. The patient name is not to be given. III. PROCEDURE: A. Briefly discuss and limit the topic of the interview with the media representative before recording begins. B. Be polite, courteous and helpful at all times. CHAPTER XIII OPERATIONAL PROCEDURES D. Riders and Reserves I. PURPOSE: A. The purpose of this policy is to regulate activities of persons observing on EMS units. II. POLICY: A. Riders must be approved by an EMS Assistant Director or Division Officer. B. Riders will be required to read and sign a release of liability prior to their observation tour. Reserves, Derby and Valley Center EMS Personnel do not require a Rider Release Form, but must be scheduled through an EMS Assistant Director or Volunteer Director.

III. PROCEDURE: A. The Rider shall contact the Assistant Director and complete the Rider Release Form (Reserves, Derby and Valley Center EMS personnel exempt). B. The Rider must report to the assigned station at the assigned time. C. Dress Code for Riders: 1. White or pastel color dress shirt. 2. Dark blue or black slacks. 3. Dark color leather or heavy soled shoes. 4. Lab coat when available. D. Dress Code for Reserves, Derby and Valley Center EMS Personnel is complete uniform as issued. E. Riders shall be neat and well groomed. F. The Lieutenant must be advised of the riders whereabouts at all times. G. The Rider must record run numbers of calls responded to on the Release Form. The form is to be returned to the Assistant Director. H. Unprofessional conduct of any kind will result in immediate dismissal. CHAPTER XIII OPERATIONAL PROCEDURES E. Severe Weather I. PURPOSE: A. Extreme weather conditions may result in high demand for EMS services during severe weather. This policy outlines special considerations for EMS workers during these situations. II. POLICY: A. EMS employees may be required to report to duty before regular shift hours and/or remain on the job after regular shift hours to meet the demand for services. III. PROCEDURE: A. During severe weather, employees shall anticipate situations requiring EMS and remain aware of community need through local media.

B. EMS employees shall not call EMS offices or 911 to inquire about service manpower needs. Instead, employees should report in uniform to Bldg.1 and wait for assignment. C. During heavy rain or flooding, snow storm or other extreme weather conditions, checking stalled vehicles may be more efficient if blue disaster tape is secured to the door handle or antenna to indicate that the vehicle has been found without occupants. D. EMS crews shall maintain temperatures inside ambulances to preserve medications as needed. CHAPTER XIV MASS CASUALTY INCIDENT (MCI) GUIDELINES The Mass Casualty Incident Guidelines are designed to categorize Command Incidents according to the number of victims and/or time factors. The guidelines identify specific considerations for a given level of response. They are divided into on-scene and service support considerations. A. Categories

Generally speaking, the levels of response described below will require flagging; triage utilizing white, gray, red and yellow tape. The response levels are defined as follows: Level I 7-20 casualties, or one-hour duration Level II 20-50 casualties, less than or equal to two hours Level III greater than 50 casualties, or greater than two hours General considerations for all levels of response are: On-Scene: 1. Command post shall be readily identifiable. 2. Consider Support Services for immediate scene security, personnel resources, etc. Service Support: 1. Units assigned to an MCI will load and take disaster supplies. 2. Units used for fills shall load and take disaster supplies to those more centralized locations. B. Response Level I: 1. Initial commitment of less than or equal to 50% of normal operating resources.

2. Declare a Level I MCI utilizing the Major Response Tone.

a. On-Scene: 1. Consider potential need for additional personnel, supplies and units (helicopter dependent on scene location, weather, hazard) 2. Consider need for specialized personnel and equipment.

b. Service Support: 1. An on-duty Captain shall implement Operational Control. To provide overall service and act as a resource for Incident Command (Medical Operations). 2. Non-emergent transfers shall be suspended until Operational Control directs otherwise. 3. Operational Control shall alert area hospitals and determine their status. (ER, Critical Care, and Surgery available immediately). Updates will be provided to Operational Control every 30 minutes by the hospitals. Specific patient information will follow from the Transport Sector when appropriate. 4. Consider call back of on-coming supervisory personnel. 5. Operational control shall alert area volunteer services and determine their status (coordinate communication and activity with Operational Control). C. Response Level II: 1. Initial or early commitment of equal to or less than 75% of normal operating resources. 2. Declare a Level II MCI utilizing the Major Response Tone. a. On-Scene: 1. Consider potential for additional personnel, supplies and units (helicopter crews on stand-by). 2. Consider need for specialized personnel and equipment. 3. Physician assignment to Treatment Sector shall be considered. 4. Consider request for disaster bus, 1 MTA bus, and/or School District.

c. Service Support: 1. The duty Assistant Director shall respond and the non-committed Captain may establish Operational Control until relieved by a higher ranking officer. 2. Non-emergent and emergent transfers shall be suspended until otherwise directed by Operational Control. Operational Control may elect to direct all transports be made 10-39 (consider dictating closest hospital). 3. Operational control shall alert area hospitals and determine their status. (ER, Critical Care, and Surgery available immediately). Updates will be provided to Operational Control every 30 minutes. Specific patient information to hospitals will follow from the Transport Sector when appropriate. Appendix B. 4. Initiate call back of off-duty Assistant Directors, Captains and crews (3-person) for 4 to 6 units; Support Services (logistics, administrative aides) as deemed necessary by Operational Control (or Command or Medical Operations). 5. Logistics personnel to determine readiness of spare units and additional supplies for airway, O2, bandaging, splitting and IVS. 6. Operational Control shall contact area volunteer services to determine status and request fills for 4 quadrants of the City of Wichita. Consider contact of mutual aid services. Appendix C. D. Response Level III:

1. Initial or early commitment of less than or equal to 100% of normal operating resources. 2. Declare a Level III MCI utilizing the Disaster Tone.

a. On-Scene: 1. Consider potential need for additional personnel, supplies and units (helicopter units shall be staffed and standing by). 2. Consider need for specialized personnel and equipment. 3. Physician assignment to Treatment Sector shall be considered. 4. Consider request for disaster bus, 1 MTA bus, and/or bus companies.

b. Service Support: 1. The on-duty Assistant Director responds and the uncommitted Captain establishes Operational Control until relieved by a higher ranking officer. 2. Non-emergent and emergent transfers shall be suspended until otherwise directed by Operational Control. Operational Control may elect to direct all transports to be made 10-39. 3. Operational control shall alert area hospitals and determine their status. (ER, Critical Care, and Surgery available immediately). Updates shall be provided to Operational Control every 30 minutes. Specific patient information will be relayed by Transport Sector when appropriate. 4. Initiate call back of off-duty supervisors, logistics support and administrative support. Further call back shall consist of at least six 3-person crews. 5. Operational Control shall alert area volunteers to request their units be staffed and request units to fill 4 quadrants of Wichita. Contact area Type I services and request a Type I unit to be sent to cover the 4 quadrants of the County. 6. Contact additional resources for personnel, supplies, and equipment (area services, supply houses, etc.). 7. Logistics personnel to determine readiness of spare units and additional supplies for airway, O2, bandaging, splinting and IVs. 8. Director or his designee shall report to the EOC if activated. CHAPTER XV RESPONSE PROFILE GUIDELINES A. Airport Emergencies I. PURPOSE: A. The purpose of this policy is to provide necessary EMS resources needed at Wichita Mid Continent Airport. II. PROCEDURE: A. Medical Emergency involving single patient. 1. Closest EMS unit will respond as directed by Airport Safety Department.

B. Impending or actual aircraft crash situation: 1. Closest 2 units and 1 District Captain respond 10-39. Each ambulance shall bring a Disaster Kit and Disaster Spine boards when possible. 2. Units shall stage at location designated by Airport Safety Department. 3. The first arriving EMS unit shall establish Medical Operations, assign a tactical channel, and conduct a radio roll call. 4. The District Captain will assume Medical Operations upon arrival. 5. Medical Operations may assign specific task sectors as needed. (i.e., extrication, treatment, transport) 6. MCI operational guidelines are delineated in SOG Chapter XIV. CHAPTER XV RESPONSE PROFILE GUIDELINES B. HAZ-MAT Operational Procedures I. PURPOSE: A. The purpose of this policy is to insure safety of EMS employees when working at a Hazardous Material Scene. II. POLICY: A. Safety of EMS personnel is of the highest priority. Actions involving hazardous material will include decontamination of patients, rescue workers and ambulance equipment. III. PROCEDURES: A. Approach known Haz-Mat scenes from upwind, uphill, and at a safe distance. B. If possible to do so safely, recognize and identify precisely what the hazardous material is. C. Identify what health problems accompany exposure to the hazardous material. D. Determine what is necessary to thoroughly decontaminate the patient. E. EMS personnel must use all appropriate protective barriers to avoid contamination during patient care. F. Any patient must be thoroughly decontaminated PRIOR to entering any EMS vehicle. G. All patients examined at Haz-Mat scenes must be documented.

CHAPTER XV RESPONSE PROFILE GUIDELINES C. Kansas Turnpike Access I. PURPOSE: A. The purpose of this policy is to provide information to EMS employees about the use of the Kansas Turnpike by EMS vehicle. II. PROCEDURE: A. EMS vehicles operating 10-39 may enter the Turnpike without stopping to obtain an entry ticket. There is no toll for emergency traffic. B. EMS Ambulances planning to enter the Turnpike 10-37 must obtain approval from a District Captain. Any vehicle receiving an entry ticket will be charged a toll. CHAPTER XV RESPONSE PROFILE GUIDELINES D. Helicopter Response I. PURPOSE: A. The purpose of this policy is to outline procedures for the use of an aeromedical helicopter. II. PROCEDURES: A. EMS may utilize a helicopter to transport Code Red Trauma patients in the event that air transportation can reduce transport time when compared to ground units. B. Helicopters may be used in areas of Sedgwick County outside of the Wichita city limits. EMS Director approval is required for use of an aeromedical helicopter inside the Wichita city limits. C. EMS units responding to trauma emergencies may request dispatch to "place a helicopter on standby" if aeromedical transport may be required. D. Prior to arrival of any Sedgwick County EMS unit, a helicopter may be launched by District Captain for the triage of a code red or blue trauma patient from any on scene law enforcement, fire or ambulance agency.

E. Helicopters must be advised of an "LZ" landing zone (100X100 feet) and any adjacent overhead wires. F. All personnel must use extreme caution when approaching the helicopter. Anticipate hazards of the rotational wing, tail rotor, and flying dust or debris. Do not approach the helicopter until signaled to do so by the aeromedical crew. G. Every effort must be made to package the patient prior to the arrival of a helicopter. CHAPTER XV RESPONSE PROFILE GUIDELINES E. Mass Casualty Incident (MCI) I. PURPOSE: A. The purpose of this policy is to provide a framework for the response of EMS resources in the event of a disaster or mass casualty incident. II. PROCEDURES: A. See SOG Chapter XIV - MCI Guidelines B. Additional considerations: 1. 800 MHZ radio channels and links with other agencies. 2. Role/Function of EOC. CHAPTER XV RESPONSE PROFILE GUIDELINES F. Pinned/Entrapped Patients I. PURPOSE: A. This policy outlines procedures for EMS workers when patients are pinned or trapped and special tools or techniques are necessary to provide patient access or egress. II. POLICY: A. EMS personnel must wear full protective equipment necessary to protect against all foreseeable hazards.

B. Definition 1. Full protective equipment shall consist of a helmet with a face-shield, protective hood, turnout coat, turnout pants, boots, and gloves. III. PROCEDURE: A. Every effort shall be made to provide protection for the patient during extrication efforts. B. Vehicles shall be stabilized prior to entry by EMS workers. C. Every effort shall be made to initiate patient assessment and care during extrication operations. D. Incident Command or an EMS Captain may use discretion in altering the level of protective equipment required as the incident evolves. CHAPTER XV RESPONSE PROFILE GUIDELINES G. Patient Transportation I. PURPOSE: A. This policy defines types of calls and criteria for patient transportation. II. POLICY: A. All calls for EMS will be handled through 911 Emergency Communications. Calls will be classified as Emergency Calls, Immediate Transfers and Scheduled transfers. III. PROCEDURES: A. Emergency calls are defined as any indication from the calling party that a medical or traumatic emergency exists. The closest (by time) EMS unit will respond to emergency calls 10-39. B. Immediate Transfers are non-emergency situations where EMS transport is requested as soon as possible. The closest (by time) EMS unit will respond to Immediate Transfers 10-37 or 10-39 as directed. C. Scheduled Transfers are non-emergency situations where the transfer can be scheduled with 2 hours advance notice. Scheduled Transfers may be answered with less than 2 hours notice as unit status permits. D. Patients may be transported to any destination within Sedgwick County. (Excluding critical medical situations. See TPM) Patients may also be transported to the following area hospitals:

1. Halstead 2. Augusta 3. Newton 4. Kingman Other transport destinations require approval of a District Captain. E. Personal valuables transported with a patient shall be documented in the narrative. F. EMS personnel shall provide a report of patient condition to the receiving personnel. CHAPTER XV RESPONSE PROFILE GUIDELINES H. Type II Services I. PURPOSE: A. This policy outlines the procedures for responding with Type II Services. II. PROCEDURE: A. Sedgwick County EMS units will respond with Type II Services when requested or as designated by inter-agency agreements. B. Patients requiring ALS procedures, shall be transported in the Sedgwick County EMS unit unless the patient is already on board the Type II unit. In this case, one full time MICT shall accompany the patient to the hospital taking all necessary ALS equipment. C. When responding with Derby or Valley Center EMS, and you are a two full time MICT crew, you shall split crews leaving one personnel from each agency on both units. The available unit shall return to the post in Derby or Valley Center and remain available as a Type I unit. (Valley Center will need to contact a District Captain to obtain necessary equipment) CHAPTER XV RESPONSE PROFILE GUIDELINES I. Crime Scene Preservation I. Purpose:

A. The purpose of this criteria is to leave the suspected crime scene as undisturbed as possible while delivering the needed patient care. Treat each public death as a possible crime scene. II. Procedure: A. EMS will stage near the scene waiting for law enforcement to give "scene safe" if necessary. 1. Technicians will enter the scene with the appropriate equipment and will wear latex gloves prior to entering the scene. A. Place equipment out of the way of the immediate suspected crime scene, if possible, until patient assessment is completed. B. Note blood stains, blood patterns and patient position and advise law enforcement as soon as possible.

Note: If a triage of Code Yellow has already been given prior to EMS arrival, ONLY THE SENIOR SUPERVISOR will enter the area to assess the patient. 2. Assess pulse/breathing and brief history of occurrence without unnecessary movement of objects or patient. A. If the patient is Code Yellow-leave the patient without disturbing the scene. Try to leave "in the same footsteps" that you entered, as much as possible. 1. If anything must be moved for better assessment, advise law enforcement what was moved and where it was moved. Document this in your ticket. 2. If anything was turned on or off, i.e. TV, lights, etc., notify law enforcement at your first possible opportunity. Document this in your ticket. B. If the patient is Code Blue/Code Red-begin resuscitative measures without disturbing the scene any more than necessary. 1. Technicians will note position of the patient prior to implementation of resuscitative measures and advise law enforcement as soon as appropriate. 2. If objects must be moved for better assessment/patient care, law enforcement will be advised what was moved and where it was moved to as soon as appropriate. Document this in your ticket. 3. If clothing must be removed, DO NOT cut through holes present in the fabric. Cut along seams of clothing, whenever possible, unless weapon holes are present in seams. Leave clothing, laid as flat as possible to preserve blood patterns, etc., at the scene and notify law enforcement. If clothing is removed and transported with the patient, preserve it as much as possible. If you are unable to leave clothing flat, bag the clothing and label the bag in a manner that will identify the patient, i.e. patient name, description of patient, identifying marks, etc. Give the property to law enforcement upon arrival to the hospital. Document this in your ticket. 4. Pick up any debris from the scene when possible (i.e. needles, IV/medication boxes, Oxygen plastic bags, etc.)

5. Mark any IV or IM injection sites you make during the resuscitation efforts by circling with an ink pen, initialing and dating them and document them in your report. 6. Make an effort not to walk or track through blood/body tissues at the crime scene. 7. Bag sheets used during patient contact and give to law enforcement at the ER.

NOTE: Upon entering, while present and when leaving the suspected crime scene, remember the following: 1. Limit the number of personnel inside the scene. 2. Keep activity minimal. 3. DO NOT cover the body with any objects. 4. Try NOT to touch any surfaces (i.e., walls, counter tops, doorknobs, door casings, etc.) 5. Leave the scene as much as possible in your own footsteps. DO NOT track through blood/body tissues. 6. Always wear latex gloves to avoid contaminating yourself and the crime scene. III. DOCUMENTATION:

Be as descriptive as you can about the patient position, observations made at the scene and your patient assessment, etc.

Document any comments made by the patient concerning the scene/call. (Also report these to law enforcement) CHAPTER XV RESPONSE PROFILE GUIDELINES J. Disregards I. PURPOSE: A. This policy outlines procedures for EMS units to follow when given a disregard while en route to a call. II. PROCEDURE: A. An EMS unit en route to an emergency call that receives a triage of code white refusing service or no patient, may be disregarded by an on scene fire unit or Type II Service. B. An EMS unit may be disregarded by a Sedgwick County EMS unit that is on the scene. C. Law Enforcement agencies may disregard an EMS unit when they have checked the scene and find no patient.

CHAPTER XVI EMPLOYEE ASSISTANCE GUIDELINES A. Critical Incident Stress Debriefing (CISD)

Paramedics may encounter "Critical Incident Stress" while performing their duties. A "Critical Incident" is any event which has sufficient emotional power to overwhelm an individual's usual ability to cope. "Critical Incident Stress" is a normal response to an abnormal situation.

Sedgwick County EMS is part of a multi-agency team whose goal is to assist emergency responders deal with this problem. The "Critical Incident Stress Debriefing" team is made up of members of each agency involved. Team members function as "peers" and as part of the notification - organizational process. Each agency sets independent policy on some aspects of the CISD team use within it's own ranks and guidelines exist to govern activity if more than one agency is involved.

The "Critical Incident Stress Debriefing" team can be utilized primarily for three functions - Defusings, Debriefings, and On-Scene Support.

The need for any of these functions may be expressed by EMS crewmembers involved in an event, CISD team members aware of an event, or District Captains that are aware of an event. Certain circumstances may dictate the need for CISD team activity. Notification that this need exists is done through the District Captain. CISD team members not involved in an event shall not make initial contact with the involved persons directly. The District Captain will contact the appropriate CISD team member(s) who will determine what activity will occur. 1. DEFUSINGS: Performed 1-3 hours post event. The purpose is to offer information, support, and allow initial ventilation of feelings. This is not a critique of operations. Only those crews involved in the event are involved. CISD team members of equal or higher rank will defuse captains. Captains will not be involved in the defusing of crewmembers. This will be done in a comfortable atmosphere, free from distractions and interference, with the crews out of service and radios off. Peers will conduct the defusing. Usually this will include members of just our service but on occasions persons of other agencies involved in the call may attend. These usually last around 45 minutes. 2. FORMAL DEBRIEFINGS: Usually 24-72 hours post event. Persons from multiple agencies may participate. The meeting is led by a Mental Health Professional and assistance is provided by peers. This will be done in a comfortable atmosphere, free from distractions and interference, with the persons attending out of service and preferably off duty. The formal debriefing provides stress education and provides a mechanism for ventilation of feelings before they can do harm. These meetings may last 2-3 hours. During debriefings and defusings, strict confidentiality is imperative, and no statements made leave the room. No recording devices, notes, or media are allowed. This is not a critique, so there is no reason to discuss the ideas brought out after the meeting.

3. ON SCENE SUPPORT: Usually at a major or time intensive incident. CISD team members may be mobilized to provide support, encouragement, and to help resting personnel deal with stress reactions. There are other functions of the CISD team, but these are the major activities If you are interested in joining the CISD team, contact a team member and ask that your name be forwarded to the membership committee. Periodically, potential new members are interviewed and screened by Mental Health Professionals. New members are required to attend initial training, and all members attend periodic meetings. CHAPTER XVI EMPLOYEE ASSISTANCE GUIDELINES B. Employee Assistance Program (EAP)/Graystone

The purpose of the Employee Assistance Program (EAP) is to assist employees to cope effectively with personal and/or job stress. In addition, the EAP aims to retain valued employees, increase job effectiveness, and encourage a positive work climate.

Sedgwick County recognizes that personal problems such as alcoholism, drug dependency, marital and family stress, psychological conditions, and/or other human concerns can be treated successfully.

The County is concerned with the health and well being of employees. While the County has no intention of interfering in an employee's private life, it will become involved and endeavor to help when an employee requests help and/or when an employee's job performance is adversely affected.

Employee referral to and participation in the EAP, as well as all records and discussions of personal issues, are and shall be treated in a confidential manner.

Participation in the EAP is voluntary and shall not jeopardize an employee's job security, promotional opportunity, and/or reputation.

Self-referral to the EAP by employees is encouraged. The EAP services are available to all employees and their families.

It is recognized that Department supervisors do not have the professional qualifications to make any judgment as to whether or not an employee is addicted to alcohol or drugs, nor are they qualified to diagnose any other personal problem. Referral to the EAP must be based strictly on job performance.

As an adjunct to existing administrative policies, all levels of management shall be responsible for utilizing the EAP when appropriate to assist in resolving job performance problems.

Participation in the EAP does not relieve an employee of the responsibility of satisfactorily meeting job performance standards.

Referral may be made by self-referral or supervisory referral. An

employee or family member may make self-referral to the EAP office. Supervisory-referral may be made after an employee requests assistance through their supervisor because of a job related incident or job performance problems, or as an alternative to serious disciplinary action.

Contact the EAP office at 262-6622. Literature is available describing policy and procedures in more detail. Your supervisor may also obtain this literature for you.