Illini Emergency Medical Services EMT Operational Guide

Transcription

1 Illini Emergency Medical Services EMT Operational Guide Illini Emergency Medical Services offers a unique service to the university by providing emergency medical care for nearly 250 campus events annually. As EMT-Basics, you are the highest level of care patients receive prior to hospital transport and, as such, you are held to strict standards to ensure proper patient care and safety. It is understood that, as students, the amount of time spent utilizing Basic Life Support skills is not as extensive as individuals working full-time on an ambulance, however, this is no excuse for care quality discrepancies. All Illini EMS EMT-Bs are expected to maintain a high level of proficiency regarding life-saving knowledge and techniques. Therefore, the Critical Skills Assessment has been initiated in order to accurately assess each EMT prior to clearance for service. This document was designed in conjunction with the Illini EMS Education Department as a means of not only providing EMTs with a study guide for their annual Critical Skills Assessment, but also as a concise outline highlighting the most important and frequently used skills on which EMTs rely. It is strongly advised that all EMTs utilize this document as content review prior to staffing each event. Those who have taken the EMT class through Illini EMS will recognize the following informational display is in the style of their EMT Check-Offs, however, be advised that a few points have been altered in order to accommodate Illinois EMS Region 6 Protocols as opposed to protocols followed by the National Registry. These adjustments are minor and mostly pertain to how medications are administered within Illinois EMS Region 6, which is the region under which Illini EMS operates. It is our hope that this document, along with the Critical Skills Assessment, will facilitate a smooth transition into Region 6 for EMTs new to Illini EMS, as well as provide a beneficial refresher for returning EMTs. If any information presented in this document is unclear, or you have questions regarding expectations of Illini EMS EMTs, patient care delivery, and/or the organization s role within the community emergency medical response system, please feel free to contact the Illini EMS Director of Operations, Jennifer Main, at jmain2@illinois.edu Thank you for your hard work and dedication, Operations Department Illini Emergency Medical Services 1

2 Table of Contents General Page Number Requirements for Active EMT Status...3 How the Critical Skills Assessment Works NIMS Training...6 Key Elements for Operating Within Illini EMS

3 Requirements for Active EMT Status Within Illini EMS In order to function as an EMT-Basic within Illini EMS, all EMTs must: Be a University of Illinois student, staff member, or faculty member Sign the Illini EMS Membership Agreement Form Sign the Hepatitis-B Vaccine Waiver and fulfill HIPAA Be in good standing with Illini EMS Have their current Illinois Department of Public Health State EMT License photocopied in the IEMS office to be kept on file Have their current AHA Healthcare Provider or Red Cross for the Professional Rescuer CPR card photocopied in the IEMS office to be kept on file Pass the Critical Skills Assessment each year Complete the NIMS 100 and NIMS 700 online training courses and send copies of their certificates of completion to the current Director of Operations Fulfill the Operational Hour Requirement each semester as outline in the Standard Operating Guidelines Be well-versed in and adhere to the contents of this document, Region 6 Protocols and Care Guidelines, and Standard Operating Guidelines* All three of these documents may be found under the Documents tab of the Illini EMS website Please download these and refer to them frequently throughout your involvement in Illini Emergency Medical Services. 3

4 How the Critical Skills Assessment Works To volunteer as an Emergency Medical Technician for Illini EMS, successful completion of the Critical Skills Assessment is required once per academic year. This assessment is intended for currently licensed EMTs as well as individuals who have completed their EMT class but are still in the process of obtaining their license. The Critical Skills Assessment will be held at least three times at the beginning of each semester. The Operations Department will send out an when dates/locations have been finalized and the event is available on iboards. All EMTs and soon-to-be EMTs who haven t completed their assessment for the current year must sign up for one of the available days (each day is conducted the exactly same way, so sign up for whichever date is most convenient). The Critical Skills Assessment consists of two parts a Region 6 Protocol Exam and a hands-on skills assessment: 1.) Region 6 Protocol Exam Everyone must pass the Region 6 Protocol Exam once per academic year. The exam consists of multiple-choice questions based on Standard Operating Guidelines, Region 6 Protocols and Care Guidelines, and this document (EMT Operational Guide). All three of these documents may be found under the Documents tab of the Illini EMS website. EMTs are allotted 30 minutes to complete the exam and must receive a score of 80% or higher to pass. If an EMT fails to achieve the required score and needs to retake the protocol exam, he/she has one attempt to retake the exam and this can be completed at an alternative Critical Skills sessions or during the office hours of an Illini EMS Operations Department member. In the case of achieving below an 80% on the second attempt, he/she can retake the exam at a Critical Skills session in a following semester. 2.) Hands-On Skills Assessment This portion of Critical Skills consists of five stations: Medical Assessment & Medication Administration Trauma Assessment & Spinal Immobilization Airway Management Cardiopulmonary Resuscitation Cot & Stair-chair Mechanics EMTs will be randomly paired up and will travel through each station together. Each station will be proctored by an Illini EMS Supervisor and/or qualified member of the EMS community. In the case of a large amount of people, some may begin with the hands-on portion and test second. Some stations are designed to run as a practice scenario, highlighting skills pertaining to the topic of that particular station (for example, the Trauma Assessment station may be a scenario in which someone fell down a set of stairs and broke their arm it would be you and your partner s duty to show how you would properly assess and treat the patient). Other stations are designed to be more of a verbal quiz the proctor will ask both of you questions pertaining to the station s 4

5 topic and perhaps request brief demonstrations. Individuals acting as patients may be utilized in some stations, while others may involve the use of mannequins. *The stair-chair portion of the hands-on assessment will be a teaching station in which you will be shown how to utilize Illini EMS stair-chairs. We understand not all EMTs took their EMT course through Illini EMS, so if this is your first time completing the Critical Skills Assessment and there are pieces of equipment that you are unfamiliar with, proctors will gladly demonstrate its proper usage and ensure you are competent with the equipment prior to working. Your performance will be evaluated through the Region 6 Protocol Exam and over the course of the hands-on stations. Feedback will be provided either in person or via . If you know the skills outlined in this document, you will do exceedingly well throughout the entire Critical Skills Assessment. Familiarity with the Standard Operating Guidelines and Region 6 Protocols is equally as important and will be tested on. 5

6 NIMS Training Because Illini EMS is an operational part of the University in emergency situations, the Federal Emergency Management Agency (FEMA) requires all Illini EMS EMTs to complete National Incident Command Training (NIMS 100 and NIMS 700). You only have to complete this once for the duration of your membership with Illini EMS. These courses are taken online through FEMA s website. To complete this requirement you must: 1. Access the classes online Take/Click through the online course. 3. Pass the online-based Final Exam. 4. Receive a certificate of completion via . This may take a few business days. 5. Upload your certificates to your profile on the IEMS website. Scroll to the bottom and upload under Cards, indicating what you are uploading. Make sure all changes are saved. You will not be able to function as an EMT within Illini EMS until both certificates of completion are on file. 6

7 Key Elements for Operating Within Illini EMS As previously stated, Illini EMS operates according to Illinois EMS Region 6 Protocols. Specifically, Illini EMS is a branch of the Provena Regional Emergency Medical Services System (PREMSS), and as such, Illini EMS Medical Control is Provena Covenant Medical Center. Listed below are key elements to know when operating within Illini EMS: Who do I notify? If on a call, someone must contact the Supervisor in charge of your team. The Supervisor will then respond appropriately to the call. If your patient is in need of immediate transport to the hospital and your Supervisor has not yet arrived on scene, a member of the team must call 911 and request an ambulance be sent to your location prior to notifying the Supervisor. If your Supervisor is already on scene, your Supervisor will notify 911. If you need to make a refusal or receive orders to administer medications, you must contact Medical Control. For Illini EMS, this is Provena Covenant Medical Center (217) Save this phone number in your cellphone so that you have access to it at all times. This particular phone number is also listed on all refusal forms as well as the back of the Region 6 Booklets found in each jumppack. Medications Provided all indications and no contraindications are present, some medications have standing offline-orders for administration per Region 6 Protocol (meaning you do not need to contact Medical Control for approval prior to administration). These five medications are: Duo Neb Nitroglycerin (for chest pain) Aspirin Epinephrine auto-injector Oral glucose The two medications that always require Medical Control approval (online-orders) prior to administration are: Patient s prescribed metered-dose inhaler Patient s prescribed nitroglycerin (for hypertensive crisis) Notice both of these drugs require that the particular medication is prescribed to the patient you would simply assist in its administration provided Medical Control approves. More details regarding medications may be found in the Medicine Administration portion of this document. You may only administer a medication for its stated indication(s) per Region 6 protocol. For example, this means you may not administer aspirin to an individual complaining of a headache since the indication for aspirin is chest discomfort suggestive of a heart attack. 7

8 Run Reports, Refusals, and Unusual Incident Forms Make sure all information on run reports are filled out appropriately and handed to your Supervisor after each event. That means you need to have the name and contact information of your patient. If you make a mistake, make sure to always cross it out with one line and initial/date it. Refusals must be called in to Medical Control if the patient does not meet the criteria for a field refusal (criteria is stated on each refusal form). For any refusal, the team must: Obtain the patient s signature. Obtain a witness signature (preferably not an Illini EMS member, such as the patient s friend or an employee of the particular venue). Obtain the name of the Medical Control doctor who granted the refusal (if applicable). Make sure that both the refusal form and run form are filled out to their entirety. Any deviation from this protocol must be documented on the run form and an Unusual Incident Report Form must be filled out. If unsure, follow the instructions outlined on the refusal form and/or contact your Supervisor. Abbreviating when filling out forms is by no means required, but if you choose to do so, the following is a list of PREMSS approved abbreviations. Common units of measurement (lb, kg, ml, oz, etc.) have been omitted to diminish redundancy: Abbrev. A&O x4 AED AIDS AM AMA ASA BM bpm BP BS BSA BVM cc C/C CHF CNS c/o CO CO2 COPD CPR C-section CSF C-spine Definition alert and oriented to time, place, person, and events automated external defibrillator acquired immune deficiency syndrome morning against medical advice aspirin bowel movement beats per minute blood pressure blood sugar, breath sounds, bowel sounds (in context) body surface area bag valve mask device cubic centimeter chief complaint congestive heart failure central nervous system complains of carbon monoxide carbon dioxide chronic obstructive pulmonary disease cardio-pulmonary resuscitation Cesarean section cerebral spinal fluid cervical spine 8

9 CVA cerebrovascular accident (stroke) DM diabetes mellitus DNR do not resuscitate DOA dead on arrival DOB date of birth Dr. doctor DVT deep vein thrombosis Dx diagnosis ECG / EKG electrocardiogram ED emergency department EMT emergency medical technician ER emergency room ETA estimated time of arrival ETOH alcohol (ethanol) GCS Glascow Coma Scale GSW gun shot wound H2O water ICU intensive care unit IM intramuscular IO intraosseous IV intravenous JVD jugular vein distention L1-L5 lumbar vertebrae 1-5 LMP last menstrual period LOC loss of consciousness, level of consciousness (in context) LPM liters per minute LPN licensed practical nurse mcg / g microgram MD medical doctor mg milligram MI myocardial infarction mmhg millimeters of mercury MVA motor vehicle accident N/A not applicable NaCl / NS normal saline NC nasal cannula NPO nothing by mouth NTG nitroglycerin N&V nausea and vomiting O2 oxygen O2 sat oxygen saturation OD overdose OTC over the counter medication PERL pupils equal and react to light PM afternoon/evening PMH past medical history PO by mouth 9

10 prn as needed psi pounds per square inch pt patient RN registered nurse ROM range of motion SIDS sudden infant death syndrome SL sublingual SOB short of breath SQ / SubQ subcutaneous S/S signs and symptoms STAT / stat immediately Sx symptoms T1-T12 thoracic vertebrae 1-12 TB tuberculosis TIA transient ischemic attack Tx treatment UTI urinary tract infection yo / y/o year old feet inches 1 first degree 2 second degree 3 third degree increase decrease > greater than < less than approximately = equal not equal change Who is the Illini EMS Operations Department? The current four members of the Operations Department are: Jennifer Main Connor Rachford Jess Endres Vanessa Belknap Dir. of Operations Asst. Dir. of Operations Training Officer Equipment Officer Contact info for all officers may be found under the Officers tab of the Illini EMS website. Where can I find more information? The Illini EMS Standard Operating Guidelines and Region 6 Protocols are crucial resources for all Illini EMS EMTs. However, when in doubt, always feel free to contact the current Director of Operations with any questions or concerns. Please refer to the Region 6 Care Guidelines also available on our website. 10