Temple University EMS Standard Operating Guidelines V.12

Transcription

1 Standard Operating Guidelines V.12 Revised May 4 th, 2017

2 Mission Statement Temple University Emergency Medical Services (TUEMS) is an organization dedicated to supplementing and enhancing already existing safety measures at Temple University s flagship campus in North Philadelphia, Pennsylvania. Working in conjunction with Temple University Police Department (TUPD), the Temple University Health System (TUHS), Temple University Student Health Services (SHS), Temple University Department of Emergency Management (DEM), Philadelphia Police Department (PPD), Philadelphia Fire Department (PFD), and the Philadelphia Regional EMS Council, Temple University Emergency Medical Services hopes to accomplish the following goals: 1. Provide the campus community with specially trained individuals to provide the highest quality of medical care on the Basic Life Support (BLS) level to students and associates of the University Community within minutes of illness or injury. 2. Maintain and exercise the highest level of professionalism to ensure only the finest service is rendered. 3. Engage in Quality Assurance measures and Medical Oversight to ensure the highest standard of care is provided. 4. Provide laypersons of the university community with educational opportunities. 5. Allow our members to gain firsthand experience in the medical profession, as well as provide community service and volunteer opportunities to our members. Standard Operating Guidelines ii

3 Table of Contents 1.0 Scope Personnel Policies Anti-Discrimination/Harassment Policy Sexual Harassment Policy Alcohol/Drug Policy EMS Providers and Convictions Off-Duty Apparel Policy OPPHS Reporting Territory Crews and Hours Beginning, During, and Ending a Shift Beginning a Shift During a Shift Breaks and Meals Computers Emergency Cell Phones (MedComm Phones) Concluding a Shift Responding to Emergency Calls Responding to a Dispatched Call Automatic Responses Response Zones Hazardous Situations On Scene of Emergency Call 10 Standard Operating Guidelines iii

4 7.1 Medical Call On Scene Additional Duties Evacuation Assist Traffic Control Automatic Fire Alarms Response Outcomes: Patient Contact Response Outcomes: No Patient Contact Terminating a Call Documentation Patient Care Reports (PCRs) Patient Refusal No Patient Found Releasing PCRs Hospital Patient Record Keeping House and Grounds Policy Uniform Policy Uniform Description Uniform Restrictions Minimum Hourly Commitment Scheduling Call Out Policy Tardiness Patient Confidentially Critical Incidents and CISD 20 Standard Operating Guidelines iv

5 18.0 Incident of Exposure and Injury Media and Press Release Disciplinary Procedures Appeals Executive Officer Disciplinary Procedure New Member Process and Precepting New Member Process Precepting Certification Maintenance Monthly Meetings Radio Communications Radio Operations After Action Reports Resignation Fully Precepted Members (Officer/EMT/FR) Training Members (EMT/FR) Officer Positions Director Associate Director Chief of Operations Captain of Operations Supply Officer Chief of Administration Captain of Administration Infection Control Officer Education Officer 36 Standard Operating Guidelines v

6 27.10 Membership Officer TSG Officer Fundraising Officer Historian Emeritus Field Training Officer (FTO) Chain of Command Operational Chain of Command Executive Chain of Command 39 Appendix 40 Contact Information Update 41 SOG/Radio Waiver 42 Supplemental Map 1: TUPD Original Patrol Zone Map 43 Supplemental Map 2: TUPD Current Patrol Zone Map 1 44 Supplemental Map 3: TUPD Current Patrol Zone Map 2 45 Standard Operating Guidelines vi

7 1.0 Scope These Standard Operating Guidelines (SOGs) shall govern the actions of all members of TUEMS. The Standard Operating Procedures of the Temple University Police Department in regards to EMS operations will supersede any instructions in this document in the event of an inadvertent contradiction. A copy of the TUPD SOGs will also be provided to all members and will available to all members at TUEMS Headquarters. 2.0 Personnel Policies 2.1 Anti-Discrimination/Harassment Policy TUEMS will not tolerate unlawful discrimination or harassment in the workplace, academic setting or at any affiliated programs or activities based on individual s age, color, disability, marital status, national or ethnic origin, race, religion, sex (including pregnancy), sexual orientation, gender identity, genetic information, or veteran status. This policy is intended to be consistent with applicable federal, state, and local laws, as well as all other anti-discrimination policies dictated by Temple University. This policy does not allow curtailment or censorship of constitutionally protected expression and will not be applied in a way that infringes upon an individual s constitutional rights of freedom of expression. 2.2 Sexual Harassment Policy TUEMS takes all reports or suspicions of sexual harassment seriously. TUEMS uses Temple University s Sexual Harassment policy (Policy Number: , Issuing Authority: Office of the President) in response to any complaint, report, or suspicion of sexual harassment. This policy can be found in the Temple University Policies and Procedures Manual, located online at Alcohol/Drug Policy At no time while on duty is a member to consume any type of alcohol or drug or be under the influence of any type of mind-altering substance. There will be no consumption of alcoholic beverages while on duty or within the twelve hours prior to the start of that member s shift. There will be no consumption or purchase of alcoholic beverages while wearing any part of the uniform that bears TUEMS name or logo. Unless responding to an emergency call, members will not wear clothing that identifies them as a member of TUEMS while in establishments that serve primarily alcohol (i.e. bars and taverns), while attending parties at which alcohol is served, or while consuming alcohol in general. Members shall not be intoxicated while wearing any part of the TUEMS official uniform. Any member who is taking a prescription medication with warning labels (may cause drowsiness, do not operate heavy machinery, etc.) shall notify TUEMS Administration before they are to be on duty. No member shall use or be under the influence of any illegal narcotic/drug. Any member found to be in violation of any of these requirements will be immediately suspended pending an investigation by TUEMS and TUPD, and will be reported to the Pennsylvania Department of Health for a possible revoking of one s certification. 2.4 EMS Providers and Convictions If an EMS-providing member is convicted of a misdemeanor or any higher offence, they must report conviction or plea of no contest to the Pennsylvania Department of Health (DoH) and to TUEMS within 30 days of the conviction. Action on an individual provider's certification and/or Standard Operating Guidelines 1

8 ability to work depends on the judgment of the DoH. TUEMS reserves the right to suspend the individual until the DoH issues their judgment. Summary offenses do NOT need to be reported. All misdemeanor or higher offenses must be reported. References: Off-Duty Apparel Policy Any official off-duty apparel designed or approved by TUEMS Administration may include the TUEMS logo, name of the organization, patches, and/or name of members. Off-duty apparel is to only be paid for with money provided by the member and is not to be purchased by TUEMS Administration with any TUEMS funds. TUEMS Administration will coordinate the ordering of off-duty apparel by collecting money from the members wanting apparel and placing an order with a preferred uniform store. Apparel is in reference to anything that can be worn as clothing and is appropriate. Examples of apparel include job shirts, jackets, t-shirts, etc. TUEMS members may not go out, create, and/or purchase apparel that uses TUEMS name, abbreviation, or logo. However, the member may suggest or create a design for future apparel and submit it to TUEMS Administration for approval. Apparel will not be worn in replacement of uniform while on shift. It may be worn under the uniform, but the outer most layer of clothing on the on duty must be either the standard uniform polo with reflective lettering or standard uniform jacket with reflective lettering. Apparel is meant to be worn casually. TUEMS apparel may not be worn to any rally or demonstration that endorses political or social beliefs which could be deemed inflammatory and/or not in compliance with the mission statement of TUEMS. Once the member leaves the organization they may keep and continue to wear the apparel. Off-Duty Apparel does not represent a current affiliation with Temple University EMS. 2.6 OPPHS Reporting At the end of each Fall and Spring semester, TUEMS Administration will evaluate each current member (regardless of precepting status) and recommend them for the following categories based on the following criteria: Poor Standing: Did not meet 16 hour/month minimum requirement Did not properly maintain all current certifications Did not attend all mandatory monthly trainings Has received at least two formal disciplinary reports Good Standing: Met 16 hour/month minimum requirement Properly maintained all current certifications Attended all mandatory monthly trainings Standard Operating Guidelines 2

9 Has received no more than one formal disciplinary reports Excellent Status: Went above 16 hour/month minimum volunteer time by at least 8 hours (24 hours/month) Properly maintained all current certifications Attended all mandatory and optional monthly trainings Has received no more than one formal disciplinary report Has obtained an Executive Officer and/or Field Training Officer Position (Optional) Upon approval of these recommendations by TUEMS Administration, the TUEMS Director will submit the list of recommendations to the Office of Pre-Professional Health Studies (OPPHS) for their use in evaluating students utilizing their pre-health professions resources. All current members of TUEMS will be submitted to OPPHS for the given semester regardless of whether or not they are affiliated with the office. 3.0 Territory TUEMS primary territory consists of all property owned or used by Temple University on its Main Campus. TUEMS will respond to calls off campus but only if TUPD has secured the scene and then requests TUEMS to the scene. The response zone map (Supplemental Map 1) is located in the appendix. The Primary Response Zone is as follows: o W Susquehanna Ave to W Jefferson St. o N 16 th St to N 10 th St. As Temple University continues to expand the boundaries of Main Campus, TUEMS Administration reserves the right to reevaluate what boundaries are best for the safety of TUEMS members and have them reapproved by TUPD. 4.0 Crews and Hours Each crew will consist of at least one precepted Emergency Medical Technician (EMT) and precepted Emergency Medical Responder (EMR, or First Responder/FR) in accordance to Pennsylvania State Basic Life Support (BLS) Protocols. One crew may have a maximum of three members but must meet the minimum state requirements stated above. If there is an EMT or FR who is on training and is on the shift, then the required precepted EMT must be a Field Training Officer. The typical shift will begin at 19:30 and run until 03:30, seven nights a week during both fall and spring semesters. Shifts outside of the normal nightly shift, such as day shifts, summer shifts, teaching opportunities, and special events, may be scheduled as requested and/or as TUEMS Administration sees fit. 5.0 Beginning, During, and End of A Shift The following processes outline the procedure a member should follow for the duration of their shift: 5.1 Beginning of a Shift The member should arrive at least 15 minutes prior to the start of his scheduled shift. The member should have an entire uniform with him or her. Standard Operating Guidelines 3

10 The member should complete an Online Bike Checkout Form on the TUEMS Staff Page ( and include an inspection of both: o Medical Supplies Any medical supplies that are missing should be restocked. The oxygen should be checked and if inadequate pressure is found, the cylinder should be replaced. The Supply Officer must be notified via the online Empty O2 Tank Notification Form on the TUEMS Staff Page. All empty oxygen tanks must be tagged with the appropriate tags supplied by TUEMS Operations and placed in appropriate location in the Supply Closet or Administrative Office. o Mechanical Components of the given bike The member should place properly sized rubber gloves on their bike or keep them in their possession (i.e. in the pockets of their EMT pants or jacket). The member shall obtain and size their designated helmet, a reflective vest, and an EMS jacket if warranted. EMS Jackets are only to be warn as the outermost layer while a provider is on shift and are to be returned at the end of the given shift. The member will pick up a flashlight with a radio and a holster. These items are only to be in a member s possession while he or she is on shift and are to be returned at the end of the given shift. The member will obtain appropriate and approved eye protection. The member and his or her partner(s) will pick up the emergency cell phone (or MedComm phone) and any authorized elevator keys. The member should sign the log books indicating receipt of food coupons if they are eligible to do so. The member should clock in utilizing the scheduling software. o The current scheduling software being used by TUEMS is called Shiftplanning, and is accessed either through the TUEMS Staff page or at Shiftplanning does not require members to clock in before each shift, but TUEMS Administration reserves the right to alter Shiftplanning to reinstate this policy as they see fit. At the start of the scheduled shift time, the member will contact TUPD Dispatch (or Radio) and place the crew in service. o Additional crew members should contact Radio for a radio check to ensure all radios are fully-functioning prior to placing the entire crew into service. 5.2 During a Shift During a shift, all members of the crew should remain together with the exception of an approved Duty Supervisor or Field Training Officer who has been granted authority to do otherwise. The crew will continuously monitor the radio for EMS dispatches and respond as outlined in Section 6.0: Responding to Calls. Patient Care Reports (PCRs) must be completed as soon as possible following an EMS response, in accordance with Section 9.0: Documentation. The duty crew is free to move about Temple University s Main Campus, with the exception of restricted locations as defined below: Any location outside of the primary zone of response (as displayed on the attached supplemental map) Standard Operating Guidelines 4

11 Any establishment serving alcoholic beverages, with the exception of commercial establishments where the crew is specifically picking up takeout food. The crew should leave the establishment immediately after picking up their food order. An apartment or dorm room belonging to themselves, another member, or any other person. Members may quickly retrieve something from an apartment or dorm room (such as leisure or study materials), but they must return to their crew as quickly as possible. Members may not stand by or stage in a dorm room or apartment. Members may stage in the lobby of dorms or apartment complexes. Any location that would impede the on-duty crew from responding to an emergency in a timely manner Any location specifically selected by TUEMS Administration that does not approve of TUEMS use of the location and/or would impede the on-duty crew from responding in a timely manner In the event of an emergency that requires the retrieval of supplies located at TUPD Headquarters, TUEMS may request through Radio that an officer with a vehicle retrieve those supplies. If an oxygen tank is emptied while treating a patient, TUEMS may request through Radio that an officer with a vehicle responds to the scene and allows TUEMS to use the oxygen tank in the vehicle s jump bag. At no time is TUPD obligated to provide this service to TUEMS, however, a member may still ask for it if need be. In the event that any high-profile or large-scale incident occurs while on shift (including but not limited to patient death, multi-systems trauma, MCIs), the crew on duty must notify the Director of TUEMS as soon as feasibly possible. If the TUEMS Director cannot be reached after several attempts, the member must begin to contact the remaining officers within the TUEMS Chain of Command. For more information, please see Section 17.0: Critical Incidents and CISD and Section 28.0: Chain of Command Breaks and Meals When not responding to an emergency, the members of the duty crew may alternate in taking a break from actively monitoring the radio. At least one member of the duty crew must be monitoring the radio at all times, and all members of the duty crew must be ready to respond to any calls regardless of whether they are taking a break or not. Examples of activities performed during a break include using the restroom, resting in the EMS Lounge, or taking a smoke break. At no time should a member who is taking a smoke break smoke in a building and/or near the EMS equipment. At no time should a break be taken to spend excessive time in a dorm or apartment (in accordance with Section 5.2: During a Shift.) At no time should a break activity supersede a member s on-duty responsibilities. All breaks must be discussed and agreed upon by the members of the duty crew. All breaks should be taken for as little time as possible. Standard Operating Guidelines 5

12 Any crews working an 8+ hour shift may also eat a meal at the Johnson & Hardwick Cafeteria free of charge only by use of meal tickets provided by TUEMS Administration. The meal ticket log should be signed before the meal ticket is removed from the meal ticket binder. When eating at the cafeteria, bikes should be staged at the Johnson & Hardwick Security desk for easy access. The duty crew should obtain the permission and consent of the security staff on duty. The bikes should be staged in a way that does not impede movement into and out of the building and/or are least likely to fall over Computers Each member will have access to a desktop computer located at TUEMS Headquarters while they are on duty. The computer may be used in the following ways: To complete any approved online paperwork for TUEMS (such as online bike check forms, online end-of-shift check out forms, incident reports, empty oxygen tank notification, etc.) To review any BLS skills or answer any medically-related calls using the Google search function or approved applications installed by TUEMS Administration To complete any school or work-related assignments To engage in any appropriate leisurely activities (including but not limited to engaging in social media, watching videos or television online, and listening to music) To perform any appropriate general searches using the Google search function (such as looking at the menu of a restaurant, finding directions to a location, etc.) When using any application that involves the internet or data usage, the member is asked to utilize an on-campus wireless network by logging onto one with their personal AccessNet username and password provided by Temple University. It is not mandatory, but it is preferred since it is the simplest way to access the internet through the computers. The computers may not be used to search for any information that one would consider inappropriate. It is up to the member to use good judgment in his or her use of the computers. If TUEMS Administration finds that the computers were used inappropriately, disciplinary actions will be taken. These actions include but are not limited to a verbal consultation with the member in question where the inappropriate usage is discussed and the member has an opportunity to explain the usage if necessary. The computers and any applications installed on it will be set up and maintained by TUEMS Administration. At no time is a member allowed to alter or remove the components of this set up. However, a member may suggest a change or addition to the setup for approval and execution by TUEMS Administration. Any passwords or passcodes associated with the computers may not be distributed to anyone outside of TUEMS Emergency Cell Phones (MedComm Phones) Each crew will have access to one Samsung Galaxy S5 Smartphone provided by TUPD to be used as a MedComm Phone. The MedComm Phones may be used in the following ways: To contact Medical Command at Temple University Hospital To call Campus Safety or 911 in the event of an emergency Standard Operating Guidelines 6

13 To complete any approved online paperwork for TUEMS (such as online bike check forms, online end-of-shift check out forms, incident reports, empty oxygen tank notification, etc.) To use a third-party push-to-talk application installed by TUEMS Administration (such as Zello) to communicate between crews or with a supervisor. To review any BLS skills or answer any medically-related calls using the Google search function or approved applications installed by TUEMS Administration. To perform any quick, appropriate general searches using the Google search function (such as looking at the menu of a restaurant, using the navigation features, etc.) The MedComm Phones must be used as the primary method of contacting Medical Command at Temple University Hospital. If for some reason the MedComm Phones cannot be accessed during a call, a personal phone may be used to call Medical Command, but the reasoning for and usage of the personal phone must be documented. When using any application that involves the internet or data usage, the member is asked to utilize an on-campus wireless network by logging onto one with their personal AccessNet username and password provided by Temple University. It is not mandatory, but it is preferred (especially when performing leisurely activities on the MedComm Phones because it will help prevent the overuse of data on TUPD s cellular data plan). The MedComm Phones may not be used to search for any information that one would consider inappropriate. It is up to the member to use good judgment in his or her use of the Smartphones. If TUEMS Administration finds that the Smartphones were used inappropriately, disciplinary actions will be taken. These actions include but are not limited to a verbal consultation with the member in question where the inappropriate usage is discussed and the member has an opportunity to explain the usage if necessary. The MedComm Phones and any applications installed on it will be set up and maintained by TUEMS Administration. At no time is a member allowed to alter or remove the components of this set up. However, a member may suggest a change or addition to the setup for approval and execution by TUEMS Administration. The telephone number and/or any passwords or passcodes associated with the MedComm Phones may not be distributed to anyone outside of TUEMS. 5.3 Concluding a Shift At the conclusion of a shift, the on-duty crew must complete all of the following items before they are relieved of their duties: The crew must ensure that all PCRs and patient refusal forms are finished completely and have been photocopied. (For more information on completing a PCR, see Section 9.0, Documentation.) Photocopies must be turned in to the police supervisor on duty at the new Police Station, located at 1801 N. 11 th St, Philadelphia, PA, Original copies of PCRs must be placed in the PCR box located outside the Administrative office. Patient refusal forms must be stapled to the patient report, with the patient report on top. An End-of-Shift Bike Checkout Form must be completed online on the TUEMS Staff Page. Standard Operating Guidelines 7

14 Following the completion of all paperwork, the crew should contact Radio and report that they are off duty. The bikes should be returned to their designated bike room. All gloves should be removed from the bikes with the exception of the any designated bags of spare gloves. All personal items should be removed from the bikes. If needed, suction units should be removed and placed on charger. All gloves should be removed from the EMS jackets and the EMS jackets should be returned to their designated place. Helmets may be either taken home or stored in designated helmet storage space. Radios and flashlights should be returned to their respective chargers. Any borrowed eye protection should be returned to its appropriate location. All House and Grounds responsibilities must be attended to in accordance with Section 10.0: House and Grounds. 6.0 Responding to Emergency Calls The following process outlines how an on duty EMS crew should respond to an emergency call, as well as specific scenarios where an EMS crew may automatically respond. 6.1 Responding to a Dispatched Call When dispatched by Radio to respond to an emergency call, the EMS crew should acknowledge their receipt of the call and inform radio that they are responding. The EMS crew should respond quickly, but safely to any dispatched calls. Responding crews should adhere to all Pennsylvania Traffic Regulations. Crews should be aware and extra vigilant of pedestrians when responding to emergency calls. Crews should also be alert to changing weather patterns and road conditions that may jeopardize their safety and adjust their response accordingly. At no point should two available EMS crews dispatch to the same scene unless the nature of the call require additional resources. Whenever possible, a crew containing a preceptee or preceptees should be the first crew to respond to a call, unless told otherwise by TUEMS Administration. If both crews have preceptees, at the start of the shift the two FTOs must designate which crew will be the first crew to respond for the evening. Upon arrival on scene, crews should first ensure that the scene is safe. Crews should notify radio that they are on scene. The bikes should be placed in a location that does not impede movement of additional emergency personnel. The bikes should also be positioned so they do not present a risk of falling. If the scene is safe, care should be initiated according to Pennsylvania Basic Life Support Guidelines. If any question to care arises, the EMT should contact Medical Command. If the situation requires ambulance transport, the crew should contact Radio and ensure a PFD ambulance has been dispatched to their location. At the conclusion of a call, patient care should either be transferred to the arriving ambulance or a patient refusal (if appropriate) should be obtained. (See Section 9.2: Patient Refusal) 6.2 Automatic Responses The on-duty crew shall automatically respond to any of the following dispatches: Standard Operating Guidelines 8

15 Automatic fire alarm with multiple alarms or smoke/flames showing (see Section 7.3 Automatic Fire Alarms On Scene) Any medical emergency within TUEMS primary response zone (See Section 6.3: Response Zones) Any active Mass Casualty Incident (MCI) within TUEMS response zone using the rules and regulations put forward by the TUEMS MCI Plan. (The TUEMS MCI Plan is posted online via Shiftplanning documents and physically via paper copies located in equally accessible space at TUEMS Headquarters. 6.3 Response Zones If a medical call arises that falls within the Primary Response Area (Green Zone) area as defined by the supplemental map and the scene is deemed safe, then the crew should respond to that location immediately. Police radio traffic should take priority. Once the airways are clear, the crew should contact radio to let them know they are in route to a scene and/or have arrived at the scene (or are on scene). In the event that the on-duty crew arrives prior to TUPD, it is upon the crew to use their best discretion and knowledge of scene safety when approaching and/or providing treatment to any patients. Once contact with TUPD is established, the crew should continue with any care provided and cooperate with TUPD to formulate a definitive plan of care. For any medical emergency where the scene is deemed unsafe, the crew should stage at an appropriate distance from the scene and notify radio of their position and the situation. The crew should make every attempt to make contact with TUPD during any response as long as communications are possible without interrupting priority police traffic. 6.4 Hazardous Situations If a report or dispatch is made of an incident that may require EMS but could be potentially dangerous, the crew should not proceed to the incident location. Examples include but are not limited to: Assaults Shootings Stabbings Fights in progress Psychiatric disturbance A situation involving hazardous materials or explosives Situations with large groups of individuals Any situation in which the EMS crew may potentially suffer an injury as a result of an unsecured scene Instead, the crew should monitor the radio and select a close but safe location to stage. The crew should notify Radio of their staging location and that they are standing by if appropriate to do so and without interfering with police transmissions. Police radio traffic may be very heavy depending on the nature of the call. Under no circumstances should the crew proceed to the scene unless directed by Radio. Once directed to respond, the crew should resume the response as outlined in Section 6.1: Responding to a Dispatched Call. Standard Operating Guidelines 9

16 7.0 On Scene of Emergency Call The following protocols outline the usage of the TUEMS Chain of Command and the actions members of TUEMS should take while on scene of an emergency call. 7.1 Medical Emergency When on scene, the most senior TUPD Officer will assume command of the scene and will give the final say regarding actions taken by EMS crews, including patient transport decisions. If the on-duty crew consists of two EMTs, one EMT will act as the primary attendant. o The primary attendant has the ability to direct all patient care. o o The decision of the TUPD supersedes decision the primary attendant. If one EMT is still on precepting, this individual may act as the primary attendant and direct patient care, but only under the constant supervision of the Field Training Officer. If the crew consists of one EMT and one First Responder, the EMT will act as the primary attendant. If an EMS Supervisor is on duty and on scene, the EMS Supervisor will direct the activity of the crew in accordance with the orders of TUPD. The on-duty crew will always act in accordance with Pennsylvania State BLS protocol. For any call located on a busy street (such as Broad St.), EMS personnel should wear the yellow safety vests provided as their outermost layer. If the crew is unsure of how to proceed at a given scene and a supervisor is not present, they may contact the appropriate personnel within the TUEMS Chain of Command. 7.2 On Scene Additional Duties In certain situations, TUEMS may arrive on scene and find medical care is not required or already in progress by a more highly trained official. In which case, the following protocols should be executed: The crew should make contact with the TUPD officer in charge to obtain any orders. Potential orders include but are not limited to: o Escorting additional response units to the patient o Assisting ambulance crews with lifting or moving the patient and/or carrying equipment o Assisting in the control of traffic o Assisting in the evacuation of an area or structure o Assisting any new patients created by the circumstances of the scene Evacuation Assist The crew cannot assist in an evacuation unless they have received orders from TUPD or Temple University officials such as housing staff and resident assistants and consider the scene safe. A member should never enter a building with any structural concerns, until PFD, L&I, and TUPD deem the building safe to enter. Extra care should be exercised when evacuating people across an active roadway. Safety wands should be implemented and crews should wear yellow safety vests when on Broad St. The crew will continue to assist the evacuation until the evacuation is complete, they are relieved of their duties by PFD or TUPD, or the scene becomes unsafe. Standard Operating Guidelines 10

17 7.2.2 Traffic Control If instructed to assist in controlling traffic, TUEMS should demonstrate extreme caution and utilize safety wands. Yellow safety vests should be worn as the outermost layer when on Broad St. The crew will continue to assist the traffic control until the incident is complete, they are relieved of their duties by PFD or TUPD, or the scene becomes unsafe. 7.3 Automatic Fire Alarms When responding to an automatic fire alarm, the crew should stage nearby the building or fire scene, and not enter until they are instructed to do so. Bikes should be positioned in a way that does not obstruct bystanders or emergency personnel, as well as in a way where they constantly remain in sight to prevent theft. The crew should ascertain that there are no patients in need of treatment. If treatment is needed, once the scene is safe, care should be initiated following the SOGs for medical care. If no treatment is required, the crew should make contact with TUPD for additional orders. The crew should always maintain a clear passage way for any additional responding units. 7.4 Response Outcomes: Patient Contact Responses to medical emergencies in which patient contact was made have two possible outcomes: 1.Transport by ambulance a.if a patient wishes to be transported by ambulance, the crew will remain with the patient until a verbal report is provided to the responding ambulance attendants and care is transferred to those attendants. b.if possible, the ambulance staff should sign the Patient Care Report. 2.Patient refusal (See Section 9.2: Patient Refusal) 7.5 Response Outcomes: No Patient Contact If a crew responds to a medical emergency and no patient contact is made, the crew should still write a proper PCR indicating what the initial response was for and that no patient contact was made. 8.0 Terminating a Call Following an emergency response, the crew should attempt to become available as soon as possible. If the patient was transported by ambulance, the crew may politely request to restock any disposable supplies that were used from the ambulance. If the ambulance crew denies this request, do not continue to request supplies. Soiled and non-disposable equipment should be decontaminated according to manufacturer guidelines. Disposable supplies can be restocked once the crew is back in service, as long as there are still spares of those supplies to be used. If the crew runs out of a particular supply, they may not go back into service until the supply is restocked. Once the crew is ready, they should notify Radio that they are available again. The PCR for the previous call should be completed immediately after. An incident number for the PCR must be obtained by calling the dispatch room on a personal phone, or on the provided cell phone. Once the PCR is complete, a photocopy of the PCR (and refusal form and/or additional narrative if applicable) should be made at TUPD Headquarters. All paperwork should be submitted to the Standard Operating Guidelines 11

18 Supervising Police Officer. Paperwork should be completed as soon as possible to ensure that the all EMS documents are properly filed with police documents pertaining to the incident. 9.0 Documentation 9.1 Patient Care Reports (PCRs) A Patient Care Report (PCR) must be accurately completed for each requested response to a medical emergency. It must be filled out on the provided PCR form and contain as much of the information requested by the form as possible. PCRs must also be completed for non-emergent responses such as standbys and/or incidents where no patient contact is initiated. Documentation of all pertinent patient information required on PCRs is the solely the responsibility of the crew that provided care to that patient. Any inaccuracies or difficulty obtaining information must be discussed in the PCR narrative. Common medical abbreviations and acronyms may be used on the PCR and/or in the PCR narrative. Any TUEMS member that rendered care to the patient described on the PCR must review the PCR and sign the PCR, acknowledging that the information presented is as accurate and complete as possible. An incident number generated by TUPD should be obtained for every PCR. To obtain this number, a member involved in the writing of this PCR must contact Radio by phone at and tell Radio that they are with TUEMS and need incident numbers. The member will then describe each call to Radio using the time and location of the call and wait for Radio to find the appropriate number. If no incident number was generated for the call, the member may right N/A for incident number and make a note of it in their narrative. Completed PCRs may not be altered in any way by anyone other than the individual or individuals who originally completed the PCR. Any documentation error must be crossed out with one line and the correction and primary attendant s initials should follow the error. Each PCR must be accurately completed as soon as possible after an emergency response, and photocopies must be given to the Supervising Police Officer for TUPD. The longest amount of time a member or crew may take to complete a PCR is 24 hours. Failure to complete a PCR when required to do so or within the 24-hour time frame will result in disciplinary action. Each disciplinary incident will be reviewed on a case-by-case basis as a Quality Assurance mechanism and action will be taken accordingly. If an excusable incident arises where a member is unable to complete their PCR within the 24- hour time period, they must notify TUEMS Administration as soon as possible. TUEMS Administration will document their receipt of this notification and review any incident like this on a case-by-case basis. If a member has received two disciplinary reports in regards to their completion of PCRs and requires a third disciplinary action to be taken against them, the member will be suspended for an amount of time determined by TUEMS Administration. If after the suspension the problem persists, the member will again be suspended for an indefinite amount of time and reported to the Pennsylvania Department of Health for violations of Pennsylvania Code, Title 28, Chapter Standard Operating Guidelines 12

19 Upon response from the DoH, the member may be subjected to termination from TUEMS and/or revocation of their certification by the DoH. 9.2 Patient Refusal If a patient or a legal representative of a patient (such as a legal guardian or an individual with Power of Attorney over the patient) requests treatment and/or transport from TUEMS, their requests must be fulfilled to the best of the responding crew s ability. Under no circumstances may any TUEMS personnel deny or refuse any legal request for treatment or transportation. If a patient or legal representative of a patient wishes to refuse any aspect of our treatment or transportation, the patient must always be encouraged to seek higher medical care, particularly by ambulance transport to a hospital. The patient should be reminded of all implications of not seeking higher care before they are allowed to make their final decision on refusing treatment and transport. The crew must always follow Pennsylvania State BLS Protocols when determining if a patient is medically able to refuse treatment and transport. If a patient is not fully alert and oriented, they may not refuse treatment and transport. If a patient has the potential for any life-threatening injury (including but not limited to a head, neck, back, or chest injury, possible intoxication, a syncope episode, or an attempt at harming oneself), but the crew finds it appropriate for the patient to refuse treatment and transport, they must contact Medical Command. If the crew has any doubt about a patient s request to refuse treatment or transport they must contact Medical Command. A member of the crew may use their personal phone or the emergency cell phone provided to contact Medical Command. When speaking with Medical Command, the member may follow the MedComm Call guideline sheet provided in the PCR clipboard as a script. If Medical Command says the patient is not able to refuse treatment and transport, the patient must be transported to the hospital regardless of their wishes. If Medical Command says the patient is able to refuse, then the TUEMS refusal form must be completed and signed by the patient, primary attendant, and any available witness (preferably a TUPD officer). The name of the physician spoken to and any instructions provided for the patient must be documented on both the PCR and on the refusal form in the appropriate locations. The following is a list of specific scenarios that may complicate a patient refusal and the best response to each of them: Patients in Law Enforcement Custody: Law Enforcement may mandate transportation of a patient in custody to the hospital regardless of the patient s wishes. If the patient is in custody and needs to be transported the Law Enforcement involved shall provide an officer to ride in the transporting ambulance, follow the transporting ambulance, or to transport the patient themselves via their police vehicle Mentally Handicapped Adult Patients: Any patient that suffers from a condition that effects their mental alertness may not refuse treatment or transport for themselves. If the patient is with their Power of Attorney, the Power of Attorney may refuse treatment or transport. If a Power of Attorney contact cannot be provided, the crew Standard Operating Guidelines 13

20 must consult Medical Command for the refusal. If the patient s situation is urgent, the patient should be transported before a Power of Attorney is contacted. Emancipated Minor: An emancipated minor is defined as a person of age 17 or younger who is legally separated from his or her legal guardians and recognized by their state of residence as a legal adult. In addition, pregnant minors and minors enlisted in the United States Military are considered legal adults. In any case, these minors will be treated as adults and are able to make decisions regarding their care by themselves. Minor Patient with Guardian Present: The parent or legal guardian of a minor must make the final decision in that minor s medical care. The parent or legal guardian may refuse treatment and transport on behalf of the minor. Proper refusal protocol must still be followed if a guardian initiates a refusal for the minor. The parent or legal guardian will provide all necessary signatures. If the crew is unsure of who the parent or legal guardian is for the patient, Law Enforcement may be utilized to determine the true parent or legal guardian. If any form of abuse by the parent or legal guardian to the minor is suspected, Law Enforcement must be notified immediately. Law Enforcement will be able to determine if there is enough evidence present to take the child into protective custody and/or impose medical care against the parent or legal guardian s wishes. Minor Patient with No Guardian Present: If a minor patient is found in critical condition, the patient must be transported immediately without attempting to contact a parent or legal guardian. If a minor patient is found not in critical condition, several attempts must be made to contact a parent or legal guardian. If the parent or legal guardian cannot be contacted, the minor patient must be transported to the hospital. 9.3 No Patient Found No Patient Found is defined as: A scenario in which no patient was found on scene at the arrival time of the responding crew A scenario in which a call for EMS was accidentally made A scenario in which a person or persons on scene did not request an ambulance, deny any physical complaint, is alert and oriented, and all EMS personnel cannot visualize any evidence of injury or illness. If a person found does not completely fit any of these scenarios then the No Patient Found label is inapplicable. 9.4 Releasing PCRs Completed PCRs are confidential patient medical records under protection of the rules and regulations of HIPAA. Access to these records is limited to the patient in question, any personnel involved the patient s care, TUEMS Administrative authorities completing Quality Assurance, Pennsylvania State EMS Authorities as part of any investigative process, and any authorized medical facilities that received the patient if they were transported. Copies of completed PCRs Standard Operating Guidelines 14

21 may be provided to other people with legal permission granted only by the patient. TUEMS Administration will be responsible for the proper release of PCRs and/or any other pertinent patient information Hospital A hospital that received a patient originally being cared for by TUEMS may contact TUEMS for a PCR after PFD has transported the patient. TUEMS Administration will be responsible for the proper release of PCRs and/or any other pertinent patient information. If a hospital contacts TUEMS they must provide several pieces of information before the PCR maybe released to them, including: 1. Patient Name 2. Patient Age 3. Patient DOB 4. Date of Incident 5. Name, Position, and Department of the hospital representative If hospital contacts TUEMS by , TUEMS Administration must make sure that the address is an official from that hospital and to receive the required preliminary information. If hospital contacts TUEMS by phone, TUEMS Administration must make sure to document receipt of the call and to receive the required preliminary information. Once the information is confirmed, a copy of the PCR maybe hand delivered by TUEMS Administration or securely faxed to the hospital Patient TUEMS Administration may release a copy of a PCR to a patient as long as the patient s identity is confirmed and a PCR release form is filled out and signed by the patient. A copy of the patient s identification must be obtained and placed with the PCR release form. Proper identification includes a Driver s License or State Identification Card, as well as a Temple University ID Card when applicable. TUEMS Administration will be responsible for the proper release of PCRs and/or any other pertinent patient information. 9.5 Record-Keeping TUEMS Administration will maintain an organized and accurate storage of all PCRs, as well as all information on its members for a minimum of seven years, as dictated with legal regulations. Realistically, all records should be kept for as long as possible, beyond the seven year minimum. However, if a record must be destroyed for a legitimate reason, it must be properly shredded using an office shredder located at either of TUPD s Headquarters. Paper records of bike checks must be kept for a minimum of one semester, and then may be destroyed via shredding as well House and Grounds Policy All members of TUEMS have access to several designated spaces and various equipment within TUPD Administrative Headquarters (1101 W. Montgomery Ave, Philadelphia, PA, 19122). These designated spaces (including storage rooms, conference rooms, locker rooms, EMS lounge space, and administrative office space) and this equipment (including copiers and other office equipment) ultimately comprise TUEMS Headquarters. TUEMS usage of this space is a privilege granted to the membership by TUPD and should always be treated as such. TUPD will Standard Operating Guidelines 15

22 always maintain priority over TUEMS in the usage of these spaces, should a conflict arise. Access to the TUEMS Administrative Office is granted to members of TUEMS Administration only. TUEMS Headquarters space may be used either on or off duty as long as the space is kept as clean as possible before, during, and after its usage. The duty crew will always have priority in usage of the space over any off duty personnel, should a conflict arise. It is ultimately the responsibility of the on duty crew to make sure all space and equipment is clean and/or fit for use before the end of their shift. Similarly, if a member wishes to use these spaces or equipment while off duty, it is his or her responsibility to care for the space and/or equipment as if they were ending a shift prior to finishing his or her usage of the spacre and/or equipment. Failure to do so will result in disciplinary action from TUEMS Administration. Additionally, inappropriate usage of designated space or equipment will result in disciplinary action from both TUEMS and TUPD Administration, including the possibility of termination and criminal prosecution as seen fit by both administrations. If a member of TUEMS is issued a TUEMS key, door code, or password, then it is implied that it is intended only for use by that member. TUEMS Administration will provide all doors, passwords, and keys to members as necessary. If a member requires access to something and does not have access, he or she should contact an EMS Supervisor or member of TUEMS Administration. At no time should a member give out a key, door code, or password to anyone outside of TUEMS, unless it is requested by TUPD or it is designated for a person pre-approved by TUEMS Administration. In addition, if TUEMS Membership is granted access to additional space or equipment outside of that which they can normally access as a Temple University student, faculty member, or employee (including Allied Barton Stations and other administrative spaces within Temple University buildings), the house and grounds policies outlined in this section apply to that member. If a member of TUEMS is using a Temple University facility while on duty, the House and Grounds policies of both TUEMS and Temple University apply to that member Uniform Policy The following uniform policy apples to all members of TUEMS: 11.1 Uniform Description Short-sleeved Cherry Polo Shirt with a TUEMS Patch over the left breast and reflective writing on the rear of the jacket [issued] Long-sleeved Cherry Winter Coat with Liner, with a TUEMS Patch over the left breast and reflective writing on the rear of the jacket [issued] Temple University EMS Jackets are shared jackets used by every member. They are to be used on shift, when completing administrative duties, or during training. The on-duty crew have priority in terms of jacket selection. Jackets are to be returned at the end of shift. Jackets are not allowed to be taken home at the end of shift. Black or Blue EMT pants, or EMT shorts in excessively hot weather. [personal] Black belt [personal] Standard Operating Guidelines 16

23 Black boots or all black sneakers [personal] Helmet [issued] A bike helmet is issued to each person by TUEMS Administration. Members are to bring their issued helmet with them to station and report for duty. If a member forgets their helmet they are unprepared for shift and will be subjected to disciplinary action. Unprepared members are not allowed to borrow another member s helmet that is left at the station, unless the unprepared member contacts the helmet s owner and receives permission. Riding gloves [personal] 11.2 Uniform Restrictions Due to the possibility of damage or loss, TUEMS personnel will not wear jewelry other than a watch, engagement/wedding ring, or class ring. Earrings will be non-hoop. The uniform should only be worn while on duty, coming to duty, or leaving duty. If a member has a prior engagement before duty, it is acceptable to wear the uniform to that engagement so long as it does not conflict with any other policies outlined in the SOGs. The uniform should not be worn to any of the following locations or events: Any business that serves or sells alcohol with the exception of businesses that offer take out or to go food in which case the member may enter the establishment to pick up an order. Any party or social gathering of a private nature or non-university sponsored. Any rally or demonstration that endorses political or social beliefs which could be deemed inflammatory and/or not pursuant to the mission statement of TUEMS unless operating in an official capacity. The uniform should be neat and clean, free from stains or extraneous markings. The member should be clean and well groomed: Facial hair should be neatly groomed. Long hair should be tied back. Finger nails should be an appropriate length. Piercings should be minimal and placed in a way that does not interfere with responding to emergencies via bicycle or providing patient care. The uniform shirt and helmet are the property of TUEMS. TUEMS Administration reserves the right to recollect a uniform shirt and helmet at any time, and will do so upon the termination or resignation of a member. The member will have one week to return the uniform shirt and helmet to TUEMS Administration following receipt of their Letter of Resignation or following their university diploma date, whichever occurs first Minimum Hourly Commitment For an Undergraduate-level member to remain in good standing with the organization, the Undergraduate member must complete a minimum of 16 hours of volunteering per Calendar Month or defined calendar month period. For a Graduate-level member, non-matriculated member, or university employee to remain in good standing with the organization, the Graduatelevel member must complete a minimum of 8 hours of volunteering per Calendar Month or defined calendar month period. Temple University Hospital Physicians are not held to an hourly Standard Operating Guidelines 17

24 commitment but may work whenever available. Failure to maintain the minimum hourly commitment will result in disciplinary action and/or termination. TUEMS provides its preliminary coverage based on the Temple University academic calendar, with the first day of shifts starting on the Monday of the Fall semester move-in week. If the academic calendar calls for a month that is less than four weeks long, the expected hourly commitments for that month alone will be decreased accordingly. There is no hourly requirement during the academic summer even if shifts are held. If for any reason a member feels they cannot meet the monthly commitment for a particular month, he or she may apply for a Monthly Commitment Waiver. The request must be written and submitted to TUEMS Administration as soon as possible. The request must provide justification behind why the member will not be able to fulfill their commitment, as well as how they plan to fulfill their commitment in the future. Request will not be considered if submitted within 10 calendar days from the end of the month for the current month. The request will be reviewed by TUEMS Administration and the member will be notified of a decision within five business days. A member cannot apply for a waiver for two months in a row or after failing to meet the minimum commitment for the previous month. A member cannot exceed more than two waivers for an academic year. If for any reason a member feels they cannot meet the monthly commitment for a particular semester (such as if the member is studying abroad, leaving Temple University for a semester, facing a personal problem, etc.), he or she may apply for a Leave of Absence. The request must be written and submitted to TUEMS Administration as soon as possible. The request must provide justification behind why the member will not be able to fulfill their commitment, as well as how they plan to fulfill their commitment in the future. Request will not be considered if they are not submitted before the semester in question. The request will be reviewed by TUEMS Administration and the member will be notified of a decision within five business days. A member cannot apply for two consecutive Leaves of Absence. If a Leave of Absence is not granted, the member may request to resign from TUEMS. If a Leave of Absence granted, when the member returns he or she may be asked to complete a light precepting period to ensure that he or she is still familiar with TUEMS operations and EMS in general. TUEMS Administration will decide whether the member must complete this light precepting period upon the return of the member from their Leave of Absence. Failure to work due to a last-minute call-out will not be counted towards monthly hours and will result in disciplinary action. Individuals scheduled to work a shift that is cancelled because of weather or an inability to fully staff the shift will be credited time towards their monthly commitment. Individuals that work events outside of the normal EMS shift, including but not limited to Public Relations events, unpaid teaching events, and officers meetings will be credited time towards their monthly commitment Scheduling Only members who have completed the entirety of the new member process will be allowed to work with TUEMS and may begin scheduling themselves. Standard Operating Guidelines 18

25 The Operations Staff will be responsible for the scheduling of crews, but all changes to the schedule and/or organization of crews are subject to approval by the Chief of Operations. A maximum of three TUEMS personnel may make up a crew: Spot 1: FTO/EMT Spot 2: EMT/FR/Trainee Spot 3: EMT/FR/Trainee Two trainees may work with one FTO for a given shift, unless the FTO requests otherwise. All members must input their availability into the Shiftplanning scheduling software and keep their availability as up to date as possible. Availability should be updated at the start of each week when applicable and/or possible. Members who are completing their precepting period may be automatically scheduled for training shifts based on their availability if they do not sign up for shifts on their own. Members who have completed their precepting period may sign up for shifts as they please on a first-come, first-served basis. All members must continue to maintain their hourly commitment regardless of their precepting status. Failure to provide accurate availability on Shiftplanning may result in scheduling conflicts that the member is responsible for correcting. If the member is scheduled improperly due to inaccurate availability, the member must find coverage for the scheduled shift. (See Section 14.0: Call-Out Policy) A provider may not exceed 24 consecutive hours of on-duty shift work, regardless of rank within the organization. A minimum of 12 hours of off-duty time must be provided to the member prior to returning to work Call-Out Policy If for any reason, an individual cannot attend their assigned shift, the member must notify the member is required to find a suitable replacement for the shift as soon as possible. The member may utilize the Shift Trade function on Shiftplanning with another member or may ask the Chief or Operations or Captain of Operations to initiate the trade if they have found a replacement. The scheduled personnel will face disciplinary action if the shift is left uncovered. Any cancellation within one week of the scheduled shift will be considered a call-out and are only allowed in the event of an emergency. To call-out, the member must notify the Chief of Operations or the Captain of Operations as soon as possible. If a member calls-out under nonemergent circumstances, they will be subjected to disciplinary action. Excessive call-outs will not be tolerated and will result in disciplinary action and possible termination. If a personal emergency occurs during a shift, the affected personnel must contact any available EMS Supervisor, the Captain of Operations, the Chief of Operations, the Associate Director, and/or the Director to help them find coverage during their emergency. Standard Operating Guidelines 19

26 15.0 Tardiness All members are expected to arrive a minimum 15 minutes prior to the start of their shift so that the crew may put itself in service at the scheduled start time. Individuals that are not prepared to go into service at their scheduled start time will receive disciplinary action. If a member expects to be late to their assigned shift but is capable of notifying someone, they must notify the members of their crew, any available EMS Supervisor, and/or the Chief of Operations of the Captain of Operations Patient Confidentially TUEMS takes patient confidentiality very seriously and follows all patient confidentiality guidelines outlined by HIPPA. Patient information should not be discussed or shared with anyone that does not need to know that patient s information. Patient information should not be discussed in public areas or transmitted via any type of communication device (including but not limited to , phone, text message and/or social media). Any member found violating a patient s right to confidentiality will be automatically suspended. During the suspension, the member s case will be reviewed by TUEMS Administration and a decision will be made to determine the length of the suspension and/or any further appropriate disciplinary measures Critical Incidents and CISD A Critical Incident is defined as any incident that inflicts or has the potential to inflict a negative response on a member, either psychologically or physically. Incidents that may negatively impact EMS providers include but are not limited to Mass Casualty Incidents (MCIs), traumatic injuries, pediatric emergencies, and emergencies involving friends and/or family of the provider. Specific protocols have been established by TUEMS Administration for all TUEMS Personnel to follow in the event of certain Critical Incidents. These protocols include but are not limited to a Mass Casualty Incident Response Plan (MCI Plan), an Exposure Control Plan, and a Pandemic Response Plan. All specific Critical Incident protocols are distributed to the TUEMS membership online via Shiftplanning s Documents section, and physically via paper copies located in equally accessible space at TUEMS Headquarters. All Critical Incidents should be reported to the TUEMS Director as soon as feasibly possible. If after several attempts the on duty crew cannot reach the TUEMS Director, they must then attempt to contact TUEMS Administration via the TUEMS Chain of Command until an available administrator is reached. A Critical Incident Stress Debriefing (CISD) is highly recommended for all members who are subjected to a Critical Incident. If no CISD team from TUPD is available to perform a debriefing, or additional help is required, a member of TUEMS Administration will contact the Temple University Tuttleman Counseling Services and request further assistance for that member. If at any time a member feels they are in need of any outside assistance in regards to any scenario that they have encountered, the member is encouraged to utilize TUEMS Administration to help acquire those additional resources for them. Standard Operating Guidelines 20

27 18.0 Incident of Exposure and Injury In the event of an injury to a member while he or she is on duty, the member should be transported to Temple University Hospital for evaluation. In the event of an exposure to any hazardous material, the TUEMS member should immediately notify the FTO (if applicable), the Supervising Police Officer at TUPD, as well as the Infection Control Officer for TUEMS. A Worker s Compensation form with TUPD should be on file. The member should immediately report to the hospital where the patient was transported or the closest hospital if the patient was not transported. The hospital must have the capability to perform rapid HIV testing. If the hospital does not, the member should report to Temple University Hospital. If the source patient involved was not transported to a hospital, the Supervising Police Officer should attempt to obtain consent from the source patient for testing at the hospital. Upon arrival, the member should advise the Emergency Department Charge Nurse or Attending Physician of what they were possibly exposed to and their need for rapid assessment. The appropriate hospital staff will review the background to the exposure and obtain serum testing as deemed necessary. HIV testing must be performed by the hospital using a rapid HIV antibody assay. If the rapid HIV test is found to be positive or if the hospital is unable to test the source patient, the member should be counseled on their treatment options by the hospital staff, started immediately on post-exposure prophylaxis, and be provided a three day supply of medication with definitive follow up scheduled. The entirety of the procedure is outlined in the Exposure Control Plan, which is kept on file by the Infection Control Officer in the TUEMS Administrative Office. During any incident of exposure or injury, the Infection Control Officer must write an Exposure Control report, as outlined in the Exposure Control Plan. TUEMS Administration must also be notified of the exposure and the member s plan to seek treatment Media and Press Release No member of TUEMS should make any statement to the press or news media without the consent of the TUEMS Director. The TUEMS Director will seek out appropriate permissions from TUPD Administration, SHS, DEM, and/or the TUEMS Medical Director prior to any consultation with the media. The TUEMS Director will then brief any TUEMS members approved to speak to the press or news media on what can and cannot be discussed and will supervise all media encounters Disciplinary Procedures This section outlines the disciplinary procedures to be performed by TUEMS for internal disciplinary incidents. Each member will sign a release form stating that they have received the Standard Operating Guidelines 21

28 TUEMS SOGs, that they understand the disciplinary actions that may be taken against them when they are in violation of the SOGs, and that further action beyond what is written can be pursued by TUPD, SHS, DEM, TUEMS Medical Director, or the Temple University Disciplinary Committee. TUEMS Administration (including the Director, Associate Director, Chief of Administration, Chief of Operations, Captain of Administration, and Captain of Operations) may discipline any member for operational infractions by means of immediate and/or delayed action. Disciplinary procedures for operational issues will consist of the following process: 1. Violation observed or brought to the attention of TUEMS Administration 2. Incident Report form with any applicable witness statements completed 3. Meeting with the alleged violator and two TUEMS Officers (one of which must be the accuser within the list above) to discuss the incident with them and listen to their perspective on the incident 4. Investigation by TUEMS Administration 5. Decision made by the TUEMS Director, Associate Director, Chief of Operations, and/or Chief of Administration 6. Disciplinary action against the member implemented (if applicable) 7. Report made to TUPD, the TUEMS Medical Director, SHS, and/or DEM (if applicable and/or requested) Violations may fall within the following categories: Operational Violations (Major and Minor): A violation of any of the rules brought forth in the SOGs. Medical Misconduct (Minor): A minor violation of the Pennsylvania Department of Health BLS Protocols that may not have caused serious harm to a patient. Medical Misconduct (Major): A major violation of the Pennsylvania Department of Health BLS Protocols that may have cause serious harm to a patient. (This includes the inability to perform standard BLS procedures, such as vital signs.) Unprofessional Conduct: Any offense other than those outlined above as determined by TUEMS Administration to be a poor representation of the organization. Disciplinary actions are determined by the type of violation and include but are not limited to: For Minor Operational Violations or Medical Misconduct: Verbal or written warning Remediation of applicable skills Suspension of membership/operational privileges for up to two weeks For Major Operational Violations or Medical Misconduct: Verbal or written warning Remediation of applicable skills Suspension of membership/operational privileges for up to one month Termination of membership Issue presented to Temple University Disciplinary Committee Issue to be reviewed with TUPD, TUEMS Medical Director, and Student Health Services For Unprofessional Conduct: Verbal or written warning Standard Operating Guidelines 22

29 Suspension of membership privileges for up to two weeks Possible termination Issue turned over to Temple University Disciplinary Committee Issue to be reviewed with TUPD, TUEMS Medical Director, SHS, and DEM Disciplinary actions will be based on the severity of the violation, the number of previous violations, and the severity of previous violations. If a member receives two disciplinary reports within a given semester for any reason, they will be placed on probation and will be considered for suspension and/or termination by TUEMS Administration. If warranted, the member may also be reported to the Pennsylvania Department of Health for violations of the Pennsylvania Code, Title 28, Part VII, and/or Pennsylvania State BLS Protocols. The member may be subjected to suspension or termination from TUEMS, as well as revocation of their certification by the State of Pennsylvania. TUEMS will keep a record of all disciplinary actions against members in the member s personal file, and will forward copies of these records to TUPD, TUEMS Medical Director, SHS, and DEM as needed. TUPD, TUEMS Medical Director, SHS, and DEM will be notified of any pending disciplinary action resulting in the suspension or termination of a member. The Medical Director and/or SHS reserves the right to take disciplinary action immediately for any infractions related to the quality of patient care Appeals Members who have been suspended or terminated may appeal this decision. Should an appeal be requested, any operational privileges revoked by TUEMS will remain revoked until the outcome of the appeal has been determined. Additionally, TUPD, TUEMS Medical Director, SHS, and DEM shall preside over a closed hearing, with the following stipulations: A hearing must take place. The TUEMS Director is responsible for scheduling as well as attending and notifying TUPD, TUEMS Medical Director, SHS, and DEM of the hearing. The TUPD Captain of Patrol, TUEMS Medical Director, Student Health Services Director, and the appellant must be present in order to hold the hearing. The TUPD Director and Temple University Director of Emergency Management are also encouraged to be present at the hearing. The TUEMS Director, Associate Director, Chief of Administration, and Chief Operations may present appropriate evidence and documentation as to the reasoning behind the initial disciplinary action, but may not vote on the outcome of the appeal. The appellant must be present at the hearing to address any questions. He or she may also present appropriate evidence and documentation to support their case against the decision. Official minutes of the appeal shall be recorded by a member of TUEMS Administration. Immediately after the conclusion of the hearing, the appellant shall be excused and the TUPD Captain of Patrol, TUEMS Medical Director, Student Health Services Director (and the TUPD Director and Temple University Director of Emergency Standard Operating Guidelines 23

30 Management, if present) shall discuss the situation and render a verbal and written verdict within one business day of the hearing. The decision rendered by the above governing bodies is final and therefore cannot be appealed any further Executive Officer Disciplinary Procedure The following procedure outlines the necessary steps for the removal of a member of TUEMS Administration: a. Vote of No Confidence A member of TUEMS Administration (Director, Associate Director, Chief of Administration, Chief of Operations, Captain of Administration, and Captain of Operations) may be considered for removal by a vote by the Executive Board for any of the following reasons: Failure to meet minimum qualifications for membership of TUEMS Failure to adequately meet responsibilities of job description Conduct unbecoming directed towards staff or outside organizations Any serious or repeated violation of Standard Operating Guidelines Based upon past performance, citing a minimum of two instances of feedback reviews and/or disciplinary reports, verbal or written, an official Board Meeting can be called. b. Procedures and Requirements for Calling a Board Meeting Executive board members may call a Board Meeting to vote on the removal of Director, Associate Director, Chief of Administration, Chief of Operations, Captain of Administration, and Captain of Operations only. Executive board members will be required to have 8 out of 11 votes in favor of the removal of the officer in question in order to remove the Director, Associate Director, Chief of Administration, Chief of Operations, Captain of Administration and Captain of Operations. The officer in question will not be permitted to have a vote. A minimum of four Executive Board Members must agree to the necessity of a Vote of No Confidence board meeting in order to call an executive board meeting to vote on the officer in question. These board members must then hold a formal disciplinary meeting with the officer in question to place him or her on an immediate suspension and to state the reasons behind their decision to call the Board Meeting. Immediately following the suspension of the officer in question, the TUEMS Supply Officer or any member of TUEMS Administration will change all passcodes and passwords as necessary. The officer in question will have a 3-7 day period between their notice of suspension and their Board Meeting to resign from their officer position in good standing with the organization. Any actions that the officer in question takes during their suspension, including attempts at persuading members of the Executive Board before their Board Meeting, can be held against them at their Board Meeting. The four original Executive Officers will generate an to the executive board requesting their availability over the following 3-7 days. The will not include the identity of the officer in question. Once an appropriate time is agreed upon, the Executive Board Meeting will be set for that date and time. If an officer is unable to attend the Executive Board Meeting, they may be electronically present via phone call, Skype, Facetime, or any other means of two-way Standard Operating Guidelines 24

31 communication that allows the executive officer to effectively participate in the executive board meeting. At the Executive Board Meeting, meeting minutes must be collected. Performance reviews and subsequent behaviors or actions will be reviewed as evidence to indicate why the officer in question should potentially be removed. After the board presents all evidence against the officer in question, the board will take up to a 30-minute recess in which time the officer in question will be allowed to prepare his or her defense. During this time, the officer in question may not lobby support from the other board members. Once 30 minutes is up, or the officer in question is prepared to give their defense, the board will reconvene. The officer in question will be permitted to speak for no longer than 10 minutes to the board defending his or her position and reasons the officer in question feels it is appropriate to stay in office. Members of the Executive Board may provide clarifying statements or ask clarifying questions at any time during the presentation of evidence or during the officer in question s defense. All facts presented by all parties present will be recorded in the official meeting minutes. The executive board will subsequently be required to vote upon removal of the officer in question. The officer in question will be required to leave the room during voting. 8 votes out of 11 will be required for the subsequent removal of the officer in question. Votes will be collected anonymously on paper ballots and counted in the presence of all Executive Officers. Upon completion of the counting, the officer in question will be called back in and the results will be delivered to them. The ballots will be placed in the officer in question s file as proof of the official Executive Board Meeting vote. Additionally, a copy of the meeting minutes will be placed in the officer in question s file. c. Vote of No Confidence Results If at least 8 votes of no confidence are obtained, the officer in question will be immediately relieved of his or her position. The officer in question may then utilize the appeal process as outlined in Section 20.1 if they feel it is necessary. If 8 votes of no confidence out of 11 are not obtained, the officer in question will be required to work with the Director, Associate Director, Chiefs and Captains in order to develop an action plan of how to mitigate negative effects of actions and behaviors in the future. d. Interim Officers In the event that an Executive Officer is removed before the end of his or her term, an officer will be placed to act as an Interim Officer for the position that is vacant. Interim Officers may be nominated or nominate themselves at the original Board Meeting and will be put to a simple majority vote (6 out of 11). If no one nominee is able to obtain a simple majority, the nominee with the lowest total votes will be eliminated, and a second vote will be held. The process will continue until a majority is granted to a nominee. The officer wishing to fulfill the interim position will need to give verbal intent as application and assurance that he or she is capable of fulfilling all duties of the position in addition to his or her current officer duties. The interim officer may not remain in the position past the interim Standard Operating Guidelines 25

32 period, unless elected by due process. The interim term will be determined at the original Board Meeting. The interim should be a natural promotion to the position, therefore: For Captains the applicant may be any officer position For Chiefs the applicant may be any officer position (preferably the captain of the vacant chief s department) For Associate Director the applicant must be a chief or a captain For Director the applicant must be a chief or captain. The interim period may only may only last for a maximum of 30 days. In this time period the Executive Board will be required to actively search for and vote upon an officer to permanently replace the position being held by an interim officer. Applicants will be required to comply with a shortened application process due to the urgency of the situation. A shortened application process in this situation would include an interview with the Executive Board and a verbal and written statement of intent submitted to the Executive Board New Member Process and Precepting 21.1 New Member Process The following process outlines the steps required to become an active member of TUEMS: Initially, the applicant will complete an official application and provide a photocopy of his or her Driver s License or State Identification Card, Temple University ID Card, CPR card, and EMT or First Responder card. Next, the applicant will be instructed to complete a number of online courses through the Centrelearn Learning Management System and provide documentation to TUEMS of proof of successful completion. These courses are: o Bloodborne Pathogens (most current version) o Hazard Communications o HIPAA Compliance (most current version) o High-Functioning CPR Team: Science Lecture o Naloxone Administration by EMR and EMT o BLS Protocol Update (most current version) o IS-100.b (ICS 100) Introduction to the Incident Command System o IS-200.b (ICS 200) ICS for Single Resources and Initial Action Incidents o IS-700.a National Incident Management System (NIMS), An Introduction o Any additional training updates as necessary While the applicant is completing their online coursework, they will be scheduled for a preliminary interview with a minimum of two officers. Of the two officers performing the interviews, one must be at the rank of Captain or higher. o The applicant will be notified of their acceptance after the interview by being invited to complete their ER shadowing time and/or the IPMBA EMS Cyclist Course. Standard Operating Guidelines 26

33 While completing all other preliminary documents, the applicant will submit their immunization record to Temple University Student Health Services to be entered into the University Health Database and screened for any missing immunizations. After any missing immunizations have been administered, the applicant will obtain an official SHS Immunization Record printout to be submitted to TUEMS as proof of completion. Next, the applicant will spend a total of 16 hours in the Temple University Hospital Emergency Room (ER) shadowing, assessing vital signs, and helping the emergency room staff as needed. o Eight hours will be spent in triage o Eight hours will be spent in the ER with an attending or resident physician o Preceptor forms must be completed and signed by the proper ER staff. o Regulations, as outlined in the ER Precepting Form, will be followed. The applicant will then complete the IPMBA EMS cycling course. Lastly, the applicant will attend a New Member Orientation, where the member will do the following: o Review the SOGs in detail with TUEMS Administration o Review all operational procedures o Review radio usage procedures o Review any extra educational material deemed necessary by TUEMS Administration and/or the TUEMS Medical Director 21.2 Precepting Once completed, the new member will be officially on precepting and trained in accordance with the Field Training Program, until he or she completes at least ten patient contacts under the supervision of at least two Field Training Officers (FTOs). If possible, the member s first shift will be staffed with the preceptee as a third attendant. During the precepting period, members may also be asked to complete additional inhouse training modules as deemed necessary by the TUEMS Medical Director. All precepting requirements are outlined extensively in the Field Training Program document, which is available to all TUEMS personnel online via Shiftplaning s Documents section, and physically via paper copies located in equally accessible space at TUEMS Headquarters. Upon receipt of a minimum of ten patient contacts and a review of all FTO Reports by TUEMS Administration, the Chief of Operations will discuss with all active FTOs whether or not the preceptee is eligible to be removed from precepting. If at least three FTOs agree to remove the preceptee, he or she will be notified by the Chief of Operations via that they have officially graduated from the precepting program and is now a full general member of TUEMS. Upon completion of all the above, TUEMS Administration will review FTO reports written on the precepting member and determine whether the member is ready to be taken off of precepting. If the member is deemed ready, he or she will be notified by TUEMS Administration and will be allowed to work whichever shifts they please without the supervision of a FTO. If the member is deemed not ready, he or she may be asked to continue to work as a preceptee until a later date or to repeat the precepting process. Standard Operating Guidelines 27

34 Members that were previously certified at a lower certification level that have recently received a higher certification (i.e. FR to EMT), will precept again as follows: If the member was on precepting and had completed at least five calls prior to receiving their higher certification, the member will complete seven more at the higher certification. If the member was on precepting and had completed less than five calls prior to receiving their higher certification, the member will complete ten calls at the higher certification. If the member had completed precepting prior to receiving the higher certification, the member will precept for an additional five calls at the higher certification Certification Maintenance All members of TUEMS are responsible for maintaining a current EMT or EMR certification, as well as a current CPR certification. If a certification was recently renewed and the member received a new certification card, a copy of the front and back of that card must be given to TUEMS Administration as soon as possible. PPD testing and Bloodborne Pathogen training must be completely on a yearly basis. PPD testing will be provided free of charge, to all active members of TUEMS by SHS. Bloodborne Pathogens refresher training will also be conducted in a manner that is approved by the TUEMS Medical Director. If the refresher is completed as a training seminar, then attendance at the seminar is mandatory. Additionally, any Pennsylvania BLS protocol updates or operational changes that require additional training are mandatory and are expected to be completed in a timely manner. Failure to comply with any of the required certification maintenance will result in disciplinary action, as well as the suspension of the member until the situation is rectified in a manner approved by TUEMS Administration and/or the TUEMS Medical Director. Continued noncompliance in certification maintenance may result in extended disciplinary action, as well as potential reporting of the member to the Pennsylvania Department of Health Monthly Meetings TUEMS will hold monthly general body meetings three times a semester as scheduling permits. During the fall semester, meetings will typically be held in September, October, and November. During the spring semester, meetings will typically be held in February, March, and April. Meetings will discuss topics such as changes to SOGs, current issues within the organization, call safety and Quality Assurance (QA). An educational portion for continuing education credit may also be offered during the meeting. Members must attend four of the six meetings for the year to remain in good standing with the organization. However, if a meeting is deemed mandatory by TUEMS Administration, then the member must attend that meeting regardless of their past attendance. Standard Operating Guidelines 28

35 24.0 Radio Communications The use of the portable radio exists as an integral faucet of TUEMS Operations. Radio usage ensures that TUEMS can carry out its mission statement by providing appropriate care where needed, as well as ensures the safety of the TUEMS duty crew. All members should understand that carrying a portable radio entails a great deal of responsibility and that being sure to not lose the radio is of the utmost importance. Information transmitted over the radio for police purposes may be of a sensitive nature and this information should be treated as it if were patient information. Breaching the integrity of radio communications or revealing, retelling, or recounting information on the radio will result in an immediate termination from TUEMS and may also carry criminal penalties as deemed by TUPD. At no time will a member of TUEMS relay sensitive patient information, including name, address, or any other identifying features, over the radio except that which is necessary to maintain the continuity of care or to update Radio to a crew s location Radio Operations Temple University EMS Radio Identifiers: Radio Identifier Call Sign 4038 EMS EMS EMS EMS EMS EMS-6 TUEMS should always operate on Channel 1 unless advised by TUPD Officers, PPD, PFD and/or TUPD Dispatch to use another channel. TUEMS will not interrupt police radio traffic unless absolutely necessary. All frequencies used by TUPD and/or TUEMS are licensed under the FCC. Radio transmissions are to be brief, accurate, and free of non-essential chatter. No vulgarities or inappropriate radio traffic are to be transmitted. Disciplinary action shall be taken on any member not abiding by the FCC guidelines or by these SOGs. For any response, the following transmissions must be made: Standard Operating Guidelines 29

36 When EMS is en-route to an incident When EMS arrives at incident When EMS needs an Ambulance Ambulance Transport to Hospital When EMS is back in service EMS is en-route EMS is on location or EMS is on scene EMS to radio, Call fire-rescue for (age) (M/F) (Situation, Illness, Chief Complaint) EMS, Medic (#) to (Hospital) EMS Clear or EMS Back in service All radio communications shall be made in Standard English. No codes need to be used with the exception of the following: 201 Voluntary Commitment to Psych Hospital 302 Mentally Unstable Patient 5292 Dead Body The above codes are used to both protect the privacy of both the patient and the crew. At no time whatsoever will a member of TUEMS monitor the radio when he or she is not actively on duty. Doing so will may result in immediate termination and criminal penalties as determined by TUPD After Action Reports After any high-profile or large-scale event (including but not limited to Spring Fling, Graduation, or an MCI) an After Action Report (AAR) should be created by the TUEMS Director, Associate Director, Chiefs, and/or Captains. An AAR must be completed if TUEMS operations were stretched to their limits and/or a serious incident occurs during the event. The AAR is a document that summarizes the operations and incidents of the event, as well as includes an analysis of the operations and a potential improvement plan if a similar event were to occur in the future. Any relevant documents (including but not limited to the shift schedule for the day of the event and any documents from TUPD) should also be included in the document. Once the AAR is completed, it should be submitted to TUEMS Administration, TUPD Director, TUPD Captain of Patrol, TUEMS Medical Director, SHS Director, and the Temple University Director of Emergency Management for review Resignation This section will outline the procedures for the resignation of members of TUEMS Fully Precepted Members Any member who has completed his or her precepting period and wishes to leave TUEMS may do so at any time. To resign from TUEMS, he or she must submit a Letter of Resignation to the Standard Operating Guidelines 30

37 TUEMS Director, Associate Director, Chief of Administration, and Chief of Operations with a brief description of why they are leaving. TUEMS Administration must then approve the letter. Upon approval, the Director, Associate Director and/or the Chief of Administration and the resigning member must both sign and date the letter. The letter will be filed by the Chief of Administration in the member s file. Before the resignation is complete, the member s Uniform Shirt and Helmet must be returned to TUEMS one week following reception of the Letter of Resignation. If a precepted member is graduating in a given semester and does not plan to continue serving with TUEMS, he or she must notify TUEMS Administration of their final graduation date one week prior to the diploma date. He or she must then return their uniform shirt and helmet to TUEMS Administration within one week following the graduation date Precepting Members TUEMS developed a New Member Commitment Contract to compensate for the great amount of time and money that this training costs both TUPD and TUEMS. On the first day of the IPMBA EMS Cyclist course, a member of TUEMS Administration read the contract to each member of the class. He or she explained that by signing the document the class will be offered for free, but the terms and conditions must be met. These terms include the successful completion of the precepting period before a member is allowed to resign from TUEMS. Therefore, if a member has signed the New Member Commitment Contract, they may not resign from TUEMS until their precepting is complete. If they did not sign the IPMBA Waiver and Commitment Form, they have already paid for the IPMBA EMS Cyclist Course and may resign from TUEMS. The Director, Associate Director, Chief of Operations, and Chief of Administration will together have the ability to revoke the New Member Commitment Contract terms in special circumstances. The preceptee wishing to resign must first submit a Letter of Resignation to the Director, Associate Director, Chief of Administration, and Chief of Operations detailing the specific circumstances in which they feel their termination of their contract and resignation is justified. TUEMS Administration may take up to seven days to approve or disapprove of the Letter of Resignation. If the letter is disapproved, the preceptee will still be required to meet the responsibilities assigned to them, including the terms of their contract. The letter itself will not result in poor-standing with the organization, but failing to meet their duties following the decision may do so. To officially revoke the New Member Commitment Contract terms, TUEMS Administration must write a letter on official TUEMS letterhead stating the reasoning behind the excusal from the terms of the agreement. The letter must be signed by the Director, Associate Director, Chief of Operations, and Chief of Administration and filed in the member s file. If New Member Commitment Contract terms are revoked, the official letter, the original letter of resignation, and the original contract must all be filed in the member s file. Before the resignation is complete, the Uniform Shirt and Helmet must be returned to TUEMS within one week following filing of the letters or they will be reported as stolen. Standard Operating Guidelines 31

38 27.0 Officer Positions The following is a description of the responsibilities of all officer positions to be filled by the members of TUEMS. These responsibilities may be altered or reassigned by TUEMS Administration as needed, and all relevant personnel will be notified accordingly. The Executive Board consists of the following currently-filled officer positions: Executive Officers includes and is limited to the current Director, Associate Director, Chief of Administration, Chief of Operations, Captain of Administration, Captain of Operations, Supply Officer, Membership Officer, Infection Control Officer, Temple Student Government Officer, Education Officer, and Fundraising Officer. The Executive Board will meet approximately once a month (depending on availability) for an Officer s Meeting to discuss concerns and ideas, as well as to delegate assignments to each relevant officer. A FTO meeting may be held during the first portion of each Officer s Meeting to discuss concerns and ideas, as well as to evaluate the progress of the members who are currently on precepting. All Executive Officers are assigned an Officer Binder and are expected to maintain that binder throughout their time served at their position. The Officer Binders serve as a transition mechanism to help ensure the continuous operations of TUEMS during changes in leadership. They should contain as much information as the officer feels necessary to explain the specific operations behind their role. Examples of items included in the Officer Binders include but are not limited to descriptions on how to complete specific roles, processes someone at that position should be aware of, external contact information, accomplished and unaccomplished goals, etc. Ultimately, when an officer either graduates or ranks up to a higher position, they should be able to pass their Officer Binder on to whoever is assuming their previous position, and that new person should be able to pick up right where they left off. If an officer position will be vacant at the end of a given semester, TUEMS Administration must seek a new candidate to fill the position within the second month of their last semester served. Within the month following the selection, the old officer must transition the new officer into the position which they are vacating, and confirm with TUEMS Administration the transition has been completed. The old officer is also expected to have their Officer Binder completed prior to the start of the officer selection process so that it may be reviewed by the appropriate Chief or Captain and transitioned to the new officer as soon as possible. If the Associate Director position or a Chief or Captain position will be vacant at the end of a given semester, the TUEMS Director will consult with the Associate Director and nominate a candidate to fill the position from the current TUEMS Officers. The nomination must be made and voted on by TUEMS Administration, and the officer must accept the position within the first month of the last semester served. The officer position that the new Associate Director, Chief, or Captain is vacating must then be filled within the second month of the last semester served. The old officers are also expected to have their Officer Binder completed prior to the start of the officer selection process so that it may be reviewed by the appropriate member of TUEMS Administration and transitioned to the new officers as soon as possible. If the Director position will be vacant at the end of a given semester, the vacating Director with will complete the Director Selection Process by the end of the semester before his or her last Standard Operating Guidelines 32

39 semester served. The old Director will hold an application process for all TUEMS Executive Officers to determine who is interested in filling the position. Then, he or she will arrange for candidate interviews with the TUPD Captain of Patrol, TUPD Director, TUEMS Medical Director, SHS Director, and Temple University Director of Emergency Management. Upon completion of the interviews, the old Director will discuss the results of the interviews with each of the previously listed personnel, as well as with any members of TUEMS Administration who are not identified as candidates. With all of this information present, the old Director will make a decision and offer the position to the most qualified and approved of candidate. The old officers are also expected to have their Officer Binder completed prior to the start of the officer selection process so that it may be reviewed by the appropriate member of TUEMS Administration and transitioned to the new officers as soon as possible. During the time period following an officer selection but preceding the original officer s departure, the incoming officer may choose to begin serving as an Officer Elect. The current officer and the Officer Elect may work together to delegate tasks between the two of them as the position is transitioned. The general membership should be made aware of this distinction following the results of the appropriate officer selection process. The following is a list of all current TUEMS Officer Positions: 27.1 Director The Director shall oversee operations and procedures as executed by the Associate Director, Chief of Administration, and Chief of Operations. This includes, but is not limited to, writing official TUEMS protocols, selecting TUEMS officers, reviewing TUEMS financial decisions, providing educational opportunities, and insuring all certifications pertaining to the organization are maintained. The Director will also ensure that the organization is in compliance with all university-wide, local, state, and federal regulations. To ensure this compliance, the Director will consult regularly with the TUEMS Medical Director, TUPD Director, TUPD Captain of Patrol, Temple University Director of Emergency Management, and the Director of Student Health Services. The Director will also be responsible for long-term planning for the organization and/or organizational development. In doing so, the Director will coordinate meetings to communicate with appropriate local and university-wide representatives to facilitate the growth of TUEMS. The Director will inform other officers of organizational developments and ensure that the duties of each department are completed. At officer or staff meetings, the Director will be prepared to provide a summary of current endeavors outside of usual duty shifts. Finally, the Director will act as a liaison between TUEMS and other organizations, the media, and/or the public. Minimum level of certification: EMT 27.2 Associate Director The Associate Director will function as an extension of the duties of the Director with a primary focus on long-term projects, such as developing and implementing a Disaster Response and/or MCI Plan both for internal and university use. The Associate Director will accomplish his or her long-term goals by working closely with the TUEMS Director, Chief of Administration, Chief of Operations, and the Temple University Department of Emergency Management. Additionally, the Associate Director will oversee both the development and utilization of a Surge Capacity Standard Operating Guidelines 33

40 plan to address days when call volume on campus is predicted to be excessive and exceed the resources of a standard staffing plan. The Associate Director in utilizing the Surge Capacity Plan will be in charge of all duties related to the particular event and should be present for the duration of the event or delegate another appropriate officer to oversee the event. Likewise, the Associate Director will work with both the Chief of Administration and the Chief of Operations to ensure the publication of all necessary After Action Reports. The Associate Director will also be in charge of the acquisition of call data and/or interagency comparative data, as well as exploration into any large policy changes or restructuring. Lastly, the Associate Director will also oversee committees and outreach as requested by the Director, and may assist either Chief with their day-to-day operations. Minimum Level of Certification: EMT 27.3 Chief of Operations The Chief of Operations is responsible for the overall day-to-day operations of the organization. These responsibilities include maintaining and creating a schedule to ensure all shifts are staffed with adequate personnel. The Chief of Operations is also responsible for making sure all bikes and equipment are in working condition, as well as working in conjunction with the Supply Officer to ensure that adequate reserves of supplies are on hand. Additional responsibilities include overseeing the upkeep of TUEMS facilities. The Chief of Operations holds the responsibility of ensuring that Standard Operating Guidelines are adhered to, as well as addressing members who fail to adhere them with disciplinary action. The Chief of Operations will periodically review PCRs and incident reports to ensure adherence to safe operating policies. The Chief of Operations will facilitate interactions with TUPD to ensure that the concerns of TUPD and TUEMS are addressed. The Chief of Operations may be responsible for other duties as needed that pertain to operations. Lastly, the Chief of Operations will oversee the New Member Precepting program and will provide updates and analysis on the progress of new members precepting. Minimum level of certification: EMT 27.4 Captain of Operations The Captain of Operations will assist the Chief of Operations in all capacities of his or her job to ensure continued and uninterrupted operation of the organization. Specifically, these responsibilities include but are not limited to assisting the Chief of Operations in maintaining a schedule, upkeep of TUEMS facilities and supplies, overseeing the enforcement of the Standard Operating Guidelines, etc. The Captain of Operations will also assist in organizational safety evaluations and will help facilitate interactions with TUPD. The Captain of Operations may be responsible for other duties as needed that pertain to operations. Minimum level of certification: FR 27.5 Supply Officer The Supply Officer is responsible for keeping an accurate inventory of all supplies needed for the operation of the organization. These supplies includes but are not limited to medical supplies, uniforms, helmets, and bike accessories. The Supply Officer shall complete a monthly inventory of all medical supplies and provide a report on a Microsoft Excel spreadsheet to the Chief of Operations and the Captain of Operations. The Supply Officer shall complete a bimonthly inventory of all bike accessories and uniforms and provide a report in a Microsoft Excel spreadsheet to the Chief of Operations and the Captain of Operations. Additionally, the Supply Standard Operating Guidelines 34

41 Officer will maintain an accurate log of all products with expiration dates, as well as all oxygen tank levels. The Supply Officer will be responsible for coordinating the monthly AED inspection and retrieving supplies delivered to TUPD Headquarters. The Supply Officer shall work with the Chief of Administration and the Chief of Operations to order supplies, as well as to identify new products to enhance the preparedness of TUEMS. Finally, the Supply Officer may assist the Chief of Operations and the Captain of Operations with the upkeep of TUEMS facilities and equipment as needed, including annual maintenance of all TUEMS passcodes and passwords as necessary. Minimum level of certification: FR 27.6 Chief of Administration The Chief of Administration oversees all financial and administrative duties for the organization. Financial duties include tracking of all TUEMS finances, including the TUEMS bank accounts, coordinating with the Supply Officer, Captain of Operations, and Chief of Operations regarding the budgeting of supplies, acquiring meal tickets and/or other benefits for members to use while on duty, and overseeing all fundraising initiatives. Administrative duties include insuring that upto-date records for all members are maintained (including certification expirations and immunizations), performing Quality Assurance (QA) of PCRs, communicating with the TUEMS Medical Director regarding new policies or improvement to existing policies, and acting as liaison for conflicts between members and/or officers. The Chief of Administration also oversees all recruitment initiatives and public relations, as well as the New Member Process. Finally, the Chief of Administration interacts with the Director of Student Health ensure that the organization is in compliance with Temple Student Government guidelines and Workers Compensation guidelines. The Chief of Administration may be responsible for other duties as needed that pertain to administration and finances. Minimum level of certification: EMT 27.7 Captain of Administration The Captain of Administration will assist the Chief of Administration in all capacities of his or her job, with the exception of transferring funds from any TUEMS bank account. The Captain of Administration may assist in the completion of Quality Assurance (QA), preparation of the budget, overseeing fundraising initiatives, and/or the purchasing of supplies. The Captain of Administration will also assist in maintaining the members records and in enacting new policies as determined by the TUEMS Medical Director. The Captain of Administration will also be responsible for updating active members to EMS alerts and/or bulletins from the Department of Health as needed in conjunction with the Infection Control Officer. Finally, the Captain of Administration also serves as the primary HIPPA Compliance Officer for the organization. The Captain of Administration may be responsible for other duties as needed that pertain to administration and finance. Minimum level of certification: FR 27.8 Infection Control (IC) Officer The Infection Control (IC) Officer will adhere to the guidelines laid out in the Exposure Control Plan. In doing so, the IC officer will ensure that infectious materials are disposed of properly and appropriate disinfection equipment is available for all members. The IC Officer will monitor reports from the local and state Departments of Health and notify the members of TUEMS of any potential health threats. If a member is exposed to a hazardous material while on-duty, the IC Standard Operating Guidelines 35

42 Officer will facilitate post-exposure follow-up as appropriate for each situation in accordance with the Exposure Control Plan. Finally, the IC officer will maintain the employee certification database to ensure that all members certifications and immunizations are up-to-date and/or compliant organizational, local, and state regulations. Minimum level of certification: FR 27.9 Education Officer The Education Officer will coordinate monthly continuing education lectures for the members of TUEMS. In doing so, the Education Officer will prepare the lecture or practical accordingly and file the appropriate paperwork for continuing education credit with the local EMS Council. The Education Officer will also monitor for nearby continuing education opportunities to help members maintain and/or expand upon their certifications. Finally, the Education Officer will assist the Chief of Administration and the Captain of Administration with the completion of Quality Assurance (QA) reviewing, as well as with planning any necessary training opportunities for potential new members, such as the IPMBA EMS Cyclist Course, or the New Member Orientation. Minimum level of certification: FR Membership Officer The Membership Officer will be responsible for the recruitment and retention of both new and current members of TUEMS. As a recruitment officer, he or she will respond to all inquiries made by potential members and assist these new members in receiving the proper certifications to join and/or into the New Member Process as applicable. The Membership Officer will also assist with the New Member Process by scheduling preliminary interviews and ensuring that membership paperwork deadlines are met. He or she will work alongside the Infection Control (IC) Officer and the Education Officer to ensure that all new members receive the proper immunizations and educational opportunities required for membership. He or she will also advertise TUEMS to potential members by maintaining the company website and social media, as well as by discussing TUEMS with other relevant organizations. Finally, as a retention officer, the Membership Officer will work with the Chief of Administration and the Captain of Administration to secure any additional benefits for the general membership that are offered to EMS providers, as well as to help organize any social events for the general membership. Minimum level of certification: FR Temple Student Government (TSG) Officer The Temple Student Government (TSG) Officer is required to any necessary TSG meetings as outlined by the TSG student organization guidelines. The TSG Officer is also responsible for drafting proposals for TSG funding, maintaining organizational compliance with TSG guidelines and procedures, and following up on proposals from other student organizations for reimbursement for services provided by TUEMS. The TSG Officer will be responsible for turning in all receipts to the TSG office, as well as maintaining copies of all receipts submitted for reimbursement. Other duties that pertain to TSG may be added as needed. Minimum level of certification: FR Fundraising Officer The Fundraising Officer shall be responsible for creating and maintaining a viable fundraising program for TUEMS. The Fundraising Officer will research different avenues of potential Standard Operating Guidelines 36

43 revenue and contact the appropriate people to attempt to facilitate this fiscal growth. The Fundraising Officer will lead a Fundraising Task Force consisting of members of TUEMS to help brainstorm fundraising ideas and to accomplish his or her fundraising goals. The Fundraising Officer will also work closely with the Chief of Administration, Captain of Administration, and TSG Officer in setting and meeting these fiscal goals. Other duties that pertain to fundraising may be added as needed. Minimum level of certification: FR Historian The Historian will be responsible for the construction and maintenance of a professional historical record of TUEMS growth as an organization. The record should be as accurate as possible and should be updated at the end of each academic year. The record may mention influential leadership personnel, operational changes, and/or any significant events that helped define TUEMS. The record will never mention specific patient information and will always be in compliance with HIPAA regulations. Additionally, the Historian will maintain an alumni database and may use this database to coordinate pre-approved events between TUEMS alumni and the current membership. The Historian will ensure that all historical information and any alumni databases or forums created will be accessible to the entire membership for their benefit. Minimum level of certification: FR Emeritus The designation Emeritus may be affixed to any officer position if the member holding that position either enters a situation where they are no longer a student but are still affiliated with Temple University or who is still a student but resigns from their position in good standing with the organization. He or she will no longer be responsible for the direct duties of that position but will maintain the rank and privileges entitled to that position. If the member continues to serve as a general member of TUEMS, he or she is to be considered a supervisor in the same way that a current officer is considered a supervisor but will otherwise be held to the same standards as that of a general member. Emeritus officers that were also FTOs may continue to serve as FTOs for the duration of their affiliation with TUEMS. [No minimum level of certification] Field Training Officer (FTO) To become a Field Training Officer, a member must show skilled work in performing all aspects of their duties as an EMT. A FTO will assist TUEMS Administration in evaluating EMTs and FRs during their precepting periods. The specific duties of a FTO include continuous evaluation of assigned members patient care, general performance, and acclimation to TUEMS through direct instruction, observation, and/or skills testing. Under the direction of TUEMS Administration, the FTO may implement on-the-job training for new members and remedial training for members with performance deficiencies. Members in this position must possess the ability to rapidly assess situations and intercede on behalf of the patient when necessary. Considerable tact, courtesy, and firmness are required to provide useful feedback to both precepting members and the general public as necessary. Ultimately, the work performed by precepting members is evaluated by the FTO through verbal and written performance reports on each precepting member during periodic conferences. Minimum level of certification: EMT Standard Operating Guidelines 37

44 A member does not have to hold an officer position to become an FTO. Conversely, a member holding an officer position is not automatically declared a FTO. The FTO will train new members in accordance with the Field Training Program. To become a FTO: The member must be a fully precepted EMT The member must be in good standing with TUEMS and TUPD If the member originally joined TUEMS as a new EMT and does not regularly work for an EMS agency elsewhere, then he or she must have accumulated at least 55 patient contacts. If the member has previous experience with an EMS agency with proof of this experience, and/or continues to work with another EMS agency, then he or she must have accumulated 35 patient contacts. Working for a non-emergent medical transport company does not make the member eligible for this patient contact reduction. The member must demonstrate proper patient care procedures within their scope of practice, as well as an understanding of TUEMS Operations to current FTOs and TUEMS Administration. The member may be asked to complete a written assessment of TUEMS Operations and/or a FTO Training Program as indicated by TUEMS Administration. If the member meets all of these requirements, then FTO status will be considered after the Director, Chief of Operations, and Chief of Administration review the member s file. If FTO status is granted, it will go into effect immediately after the new FTO and TUEMS Administration sign the FTO Status Form. If FTO status is not granted, the member will be reconsidered for FTO Status after an additional 15 patient contacts Chain of Command 28.1 Operational Chain of Command The Operational Chain of Command serves as an official description of the officer hierarchy established within TUEMS Administration in an event where immediate contact must be made with TUEMS. The Operational Chain of Command is as follows: 1. Director 2. Associate Director 3. Chief of Operations 4. Chief of Administration 5. Captain of Operations 6. Captain of Administration 7. TUEMS Officers (in no particular order): Infection Control Officer, Education Officer, Membership Officer, Fundraising Officer, TSG Officer, Supply Officer 8. Field Training Officers (FTOs) 9. General Membership 10. Preceptees/New Members Standard Operating Guidelines 38

45 Deviations from the top-down model of the Operational Chain of Command by members of TUEMS for minor reports (such as scheduling conflicts or other miscellaneous issues) are encouraged as long as they are directed to the officer whose position description best fits the needs of the given issue. The best-fit officer can be more easily determined via the flow chart presented in Section 28.2: Executive Chain of Command. In no way does the Chain of Command justify or encourage hazing of or undisclosed privilege over any TUEMS personnel. It is primarily meant to serve as a contact tool for any Critical Incident that should arise, with the first point of contact being the TUEMS Director Executive Chain of Command The Executive Chain of Command is designed to describe the overall flow of information throughout the organization, and includes points of equal administrative influence and the external hierarchy in which TUEMS Administration reports to. The Executive Chain of Command is as follows: 29.0 Disbursement of Funds The Chief of Administration shall serve as the primary account holder of our PNC Business Checking Account. Funds should never be stored in anyone s personal bank account. The director shall also be authorized to have a business debit card and be on the account. Funds may not be withdrawn without permission from the Chief of Administration and Director. These are the only two positions authorized to use the bank account: Chief of Administration Director Bank statements will be presented monthly to the E-Board for review. Standard Operating Guidelines 39

46 Appendix Standard Operating Guidelines 40

47 Temple University Emergency Medical Services Contact Information Update Semester: Fall/Spring Year: Name: Current Local Address: Current Permanent Address: Phone Number: Carrier: Address: TUID: Anticipated Graduation Date: Emergency Contact 1 Name: Relation: Phone Number: Emergency Contact 2 Name: Relation: Phone Number: Standard Operating Guidelines 41

48 Temple University Emergency Medical Services SOG/Radio Waiver I, have received and read the most current copy of the Temple University Emergency Medical Services (TUEMS) Standard Operating Guidelines (SOGs). I was given the opportunity to ask questions about anything contained within the guidelines and any questions I posed were addressed and answered to my satisfaction. I understand and comprehend the guidelines as they are written. Should I have any further questions it is my responsibility to ask a Supervisor or TUEMS Officer, or consult the SOGs. I understand that a permanent copy of the SOGs and/or any other pertinent protocols are kept at TUEMS Headquarters and can be accessed at any time. I also understand that a digital copy of the SOGs and/or any other pertinent protocols are posted online and can be accessed at any time. Signature: Date: I, have received training regarding the appropriate use of the TUEMS portable radios and, as described above, read the policy regarding their usage. I understand that inappropriate use, whether transmitting sensitive information, revealing information I heard on the radio to outside parties, or monitoring the radio when I am not actively working will result in my immediate dismissal as well as possible criminal penalties. I have been given the opportunity to ask questions regarding this policy and I understand the radio usage policy. Signature: Date: Standard Operating Guidelines 42

49 Supplemental Map 1: TUPD Original Patrol Zone Map Standard Operating Guidelines 43

50 Supplemental Map 2: TUPD Current Patrol Zone Map 1 Standard Operating Guidelines 44

51 Supplemental Map 3: TUPD Current Patrol Zone Map 2 Standard Operating Guidelines 45