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100.00 INTRODUCTION
100.01 ABOUT THE SOG MANUAL
Congratulations with your employment here at Breck Central EMS! We hope you find
our company rewarding and demanding in the field of pre-hospital emergency medical
services. We strive to offer you a fair and harmonious working condition during your
employment with us. Together as a team it is our goal to provide one of the very best
EMS systems in the Commonwealth.
The purpose of these Standard Operating Guidelines is to give you, as the employee, an
overall view of Breck Central EMS guidelines. These guidelines shall be a tool as to what
is expected of the employees while on duty. It should be understood that this manual
couldn’t address every specific situation you may encounter during your employment
here. This SOG manual shall be changed as the need arises. Employees shall be held
responsible for any changes or additions made to rules and procedures by normal
company memos in addition to the SOG manual.
Breck Central EMS main focus is to provide quality patient care to the citizens and
visitors of Breckinridge County, Kentucky and the first rule of EMS is to do NO HARM.
In providing such care, it is considered a VERY SERIOUS offense to cause harm, or
potential harm, whether intentional or un-intentional.
Any acts of disrespect expressed towards patients, their family, medical facility
personnel, colleagues, or the general public reflect poorly upon the image of Breck
Central EMS and its goal of quality patient care. Any such acts of disrespect shall result
in severe disciplinary action.
Any acts of disrespect expressed towards the Company, its Directors or the Command
Staff shall be considered an act of insubordination and will result in disciplinary action.
VIOLATIONS OF ANY OF THE LISTED SOG’S MAY RESULT IN DISCIPLINARY
ACTION, WHICH MAY INCLUDE, BUT NOT LIMITED TO, VERBAL OR
WRITTEN WARNINGS, SUSPENSIONS WITHOUT PAY, AND TERMINATION.
___________________________________
Colonel Raleigh H. Shelton, IV, NREMT-P
Chief Executive Officer / Paramedic
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100.02 HISTORY OF BRECK CENTRAL EMS
Breck Central EMS began operations under the current owners in July 1999. This was
after Trent-Dowell Ambulance Service decided the service was growing and needed
more full time attention than they could offer. Trent-Dowell is a local funeral home and
was one of the last ambulances services in the state to be operating a funeral home based
EMS system. After much consideration local fire departments in the county meet and had
representatives to form a Board of Directors. They chose Mr. Timmy Simmons to head
the operations as service director. In 1999 they got there initial inspection once the
license was transformed and thus Breck Central EMS began.
At the time Breck Central EMS only offered basic life support services on a volunteer
basis. And with 3 other EMS services in the county they didn’t see much growth ahead.
They were mistaken. It wasn’t long after the start of the company they realized the need
for full time personnel to ensure runs were being met. Also, Breck Central EMS focused
on the benefit of having only one EMS system in the county and pursued this idea with
other services. It didn’t take long and Irvington Area EMS and Cloverport City EMS
consolidated with Breck Central EMS.
This gave Breck Central EMS much more volume, runs, and responsibility. They soon
saw the need to upgrade to offer Advanced Life Support. In 2001 Breck Central EMS
was granted the licenses to operate Advanced Life Support. Since that time Breck Central
EMS has been experience nothing but growth and advancements. It was then, in 2005
McDaniels EMS saw that the benefit was too much not to consolidate, thus, giving Breck
Central EMS the entire county to cover.
Breck Central EMS is a not for profit 501(c) charitable organization. We are licensed by
the Kentucky Board of EMS to provide a Class I advanced life support and basic life
support ground ambulance service to Breckinridge County, Kentucky. Breck Central
EMS is owned by a Board of Directors that receive no compensation for there function
on the Board.
Breck Central EMS is also proud members of the Kentucky Ambulance Providers
Association and the Breckinridge County Greater Chamber of Commerce. Breck Central
EMS is an equal opportunity employer.
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100.03 BRECK CENTRAL EMS MISSION STATEMENT
It is the mission of Breckinridge Central Emergency Medical Services and its
employees to provide quality pre-hospital, advanced life support and basic life
support emergency medical care to the citizens and visitors of Breckinridge County,
Kentucky twenty-four hours a day, seven days a week.
100.04 CHAIN OF COMMAND
Decision making will occur in day-to-day operations and will be made jointly between
you and your partner. Should there be questions or a disagreement the below Chain of
Command will be followed. Once a decision has been made, personnel will then carry out
the decision unless you feel strongly that this will cause severe injury or death to you,
your partner, or any other personnel.
The chain of command shall be used as a streamline channel of communications for
various actions or activities.
In a disaster or mass casualty situation the first crew on the scene will be in charge until
relieved by the next person in the Chain of Command. In NO circumstances or situations
will the EMS Command be turned over to some outside of Breck Central EMS.
COMMAND STAFF
Colonel (EMS Chief)
Lt. Colonel(s) (Deputy EMS Chief)
Major(s) (Supervisors)
Captains(s) (Supervisors)
FIELD PERSONNEL
Shift Leader (Senior EMT-B or EMT-P with the greatest seniority with Breck
Central EMS)
Paramedic
EMT
First Responder
Medical Director (Will be in charge of patient care and protocols changes as deemed
necessary)
Sergeants (Will serve as an accessory limb to the command staff. They are appointed
based on extracurricular activities they perform)
In this manual you will see the term “command” used frequently. Breck Central EMS
utilizes standard military ranking to identify and rank the supervisors of the company.
The commander is appointed by the Board of Directors and he or she will then appoint
their own command staff under them.
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200.00 WORKING AT BRECK CENTRAL EMS
200.01 WHAT YOU CAN EXPECT FROM BRECK CENTRAL EMS
Breck Central EMS believes that the work conditions, wages, and benefits it offers to its
employees are competitive with those offered by other employers in this area and in this
industry. If employees have concerns about work conditions or compensation, they are
strongly recommended to voice these concerns openly and directly to the command staff.
It is highly recommended that such concerns not be openly discussed among other co-
workers.
Breck Central EMS believes in creating a harmonious working relationship between all
employees. In pursuit of this goal, Breck Central EMS has created the following
employee relations objectives:
1. Providing an exciting, challenging, and rewarding workplace and experience.
2. Select people on the basis of skill, training, ability, attitude, and character without
discrimination with regard to age, sex, color, race, creed, national origin, religious
persuasion, marital status, political beliefs, or a disability that does not prohibit
performance of essential job functions.
3. Compensate all employees according to their effort and contribution to the
business success.
4. Provide vacation, health benefits, and yearly raises if capable of doing so.
5. Assure employees, after talking with someone of the command staff, an
opportunity to discuss any issue or problem with the EMS Chief of Breck Central
EMS.
6. Take prompt and fair action of any complaint, which may arise in the everyday
conduct of the service, to the extent that is reasonable.
7. Respect individual rights, and treat all employees with courtesy and consideration.
8. Maintain mutual respect in the EMS working relationship.
9. Provide building, vehicles, equipment, and supplies that are comfortable, orderly,
and safe.
10. Make promotions to fill vacancies from within Breck Central EMS whenever
practical.
11. Keep all employees informed of the progress of Breck Central EMS, as well as
the company’s overall goals and objectives.
12. Promote an atmosphere in keeping with Breck Central EMS vision, mission,
education, and goals.
13. Maintain an On-Going Quality Assurance Program with the Medical Director.
14. Counseling and debriefing for critical stress incidents.
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200.02 WHAT BRECK CENTRAL EMS EXPECTS FROM YOU
Breck Central EMS needs your help in making each working day enjoyable and
rewarding. Your first responsibility is to know your own duties and how to do them
promptly, correctly, professionally, and pleasantly. Secondly, you are expected to
cooperate with management and your fellow employees and to maintain a good team
attitude. Thirdly, you are expected to treat all persons, patients, patient’s families, and
medical and/or rescue teams with dignity, consideration, pleasantness, confidently,
professionally, confidentially, and care. Fourthly, employees shall refrain from using
coarse, violent, profane, insolent, or disrespectful language, and shall not make
derogatory statements of any nationality, sex, race, sexual orientation, or religion. Violent
language or threats of violence directed toward anyone during the course of one’s
employment could result in immediate termination.
How you interact with fellow employees and those whom Breck Central EMS serves, and
how you accept direction can affect the success of your career. In turn, the performance
of one crew can impact the entire service offered by Breck Central EMS. Consequently,
whatever your position, you have an important assignment: Perform every task to the best
of your ability and knowledge.
You are encouraged to grasp opportunities for personal development offered to you. This
manual offers insight on how you can perform positively and to the best of you ability
and knowledge to meet and exceed Breck Central EMS expectations.
You are expected to maintain all National, State, and Local requirements that are
enforced to maintain license or certifications as your position of First Responder, EMT,
or Paramedic.
We strongly believe you should have the right to make your own choices in matters that
control your life. We believe in direct access to management. We are dedicated to making
Breck Central EMS a company where you can approach your supervisor to discuss any
problem or question. We expect you to voice your opinions and contribute your
suggestion to improve the quality of Breck Central EMS. We’re all humans, so please
communicate with each other and with management.
Remember, you help create the pleasant and safe working conditions that Breck Central
EMS intends for you. The result will be better performance for the company overall, and
personal satisfaction and gratification for you.
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200.03 EQUAL EMPLOYEMENT OPPORTUNITY
In order to provide equal employment and advancement opportunities to all individuals,
employment decisions at Breck Central EMS will be based on merit, qualifications as
established by the Kentucky Board of Emergency Medical Services, and abilities. Breck
Central EMS does not discriminate in employment opportunities or practices on the basis
of race, color, religion, sex, national origin, age, disability, or any other characteristic
protected by law.
Any employee with questions or concerns about any type of discrimination in the
workplace is encouraged to bring these issues to the attention of the EMS Chief.
Employees can raise concerns and make reports without fear of reprisal. Any found to be
engaging in any type of unlawful discrimination will be subject to disciplinary action, up
to and including termination of employment.
200.04 IMMIGRATION LAW COMPLIANCE
Breck Central EMS is committed to employing only United States citizens and aliens
who are authorized to work in the United States and does not unlawfully discriminate on
basis of citizenship or national origin.
In compliance with the Immigration Reform and Control Act of 1986, each new
employee, as a condition of the employment, must complete the Employment Eligibility
verification Form I-9 and present documentation establishing identity and employment
eligibility. Former employees who are rehired must also complete it if they have not
completed an I-9 with Breck Central EMS within the past three years, or if their previous
I-9 is no longer retrained or valid.
Employees with questions or seeking more information on immigration law issues are
encouraged to contact the EMS Chief. Employees may raise questions or complaints
about immigration law compliance without fear of reprisal.
200.05 AT-WILL EMPLOYMENT
Your employment with Breck Central EMS is at-will. This means that neither you nor
Breck Central EMS has entered into a contract regarding the duration of your
employment. You are free to terminate your employment with Breck Central EMS at any
time, with or without reason. Likewise, Breck Central EMS has the right to terminate
your employment, or otherwise discipline, transfer, or demote you at any time.
No employee of Breck Central EMS can enter into an employment contract for a
specified period of time, or make any agreement contrary to this policy.
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200.6 CONFLICTS OF INTEREST
Employees have an obligation to conduct business within the guidelines that prohibit
actual or potential conflicts of interest. This policy establishes only the framework within
which Breck Central EMS wishes the business to operate. The purpose of these
guidelines is to provide general direction so that employees can seek further clarification
on issues related to the subject of acceptable standards of operation. Contact the EMS
Chief or anyone on the command staff for more information or questions regarding
conflicts of interest.
Transactions with outside firms must be conducted within a framework established and
controlled by the executive level of Breck Central EMS. Business dealings with bribes;
product bonuses, special fringe benefits, unusual price breaks, and other windfalls
designed to ultimately benefit the employer, the employee, or both. Promotional plans
that could be interpreted to involve unusual gain require specific executive-level
approval.
An actual or potential conflict of interest occurs when an employee is in a position to
influence a decision that may result in personal gain for that employee or for a relative as
a result of Breck Central EMS’s business dealings. For the purpose of this policy, a
relative is any person who is related by blood or marriage, or whose relationship with the
employee is similar to that of persons who are related by blood or marriage.
No “Presumption of guilt” is created by the mere existence of a relationship with outside
firms. However, if employees have any influence on transactions involving purchases,
contracts, or leases, it is imperative that they disclose to the EMS Chief or anyone on the
command staff as soon as possible the existence of any actual or potential conflict of
interest so that safeguards can be established to protect all parties.
Personal gain may result not only in cases where an employee or relative has a significant
ownership in a firm with which Breck Central EMS does business, but also when an
employee or relative receives any kickback, bribe, substantial gift, or special
consideration as a result of any transaction or business dealings involving Breck Central
EMS.
200.07 ARBITRATION POLICY
If an employment dispute arises while you are employed at Breck Central EMS. Breck
Central EMS requests that you agree to submit any dispute arising out of your
employment or the termination of your employment (including, but not limited to, claims
or unlawful termination based on race, sex, age, national origin, disability, breach of
contract or any other bias prohibited by law) exclusively to binding arbitration under
federal Arbitration Act, 9 U.S. C., Section 1. Similarly, any disputes arising during your
employment involving claims of unlawful discrimination or harassment under the above
provisions. This arbitration shall be the exclusively to binding resolving any dispute
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arising out of your employment or termination from employment by Breck Central EMS
or you, and employees in any court or any forum can bring no other action.
200.08 OPEN COMMUNICATION POLICY
Breck Central EMS encourages you to discuss any issue you may have with a co-worker
directly with that person. If a resolution is not reached, please arrange a meeting with the
EMS Chief to discuss any concern, problem, or issue that arises during the course of your
employment. Any information discussed in an open communication meeting is
considered confidential. Retaliation against any employee for appropriate usage of open
communication channels is unacceptable. Please remember it is counterproductive to a
harmonious workplace for employees to create or repeat corporate rumors or other
ambulance service gossip. It is more constructive for an employee to consult Breck
Central EMS Chief immediately with any questions. If there is a conflict between the
EMS Chief and the employee or the employee feels he/she did not receive fair time,
he/she may follow the chain of command and meet with other members of the command
staff and address the matter.
200.9 OUTSIDE EMPLOYMENT
An employee may hold a job with another organization as long as he or she satisfactorily
performs his or her job responsibilities with Breck Central EMS. All employees will be
judged by the same performance standards and will be subject to Breck Central EMS’s
scheduling demands, regardless of any existing outside work requirements. Regular Full-
Time employees will be expected to adhere to scheduling demands and are highly
encouraged not to reschedule regarding to outside work requirements.
If the command staff of Breck Central EMS determine that an employee’s performance
outside work interferes with performance, attitude, alertness, or ability to meet the
requirements of Breck Central EMS as they are modified from time to time, the employee
may be asked to terminate the outside employment or may be give an ultimatum if he or
she wishes to remain with Breck Central EMS and reward from all benefits offered.
OUTSIDE EMPLOYMENT WILL PRESENT A CONFLICT OF INTEREST IF IT
HAS AN ADVERSE IMPACT ON BRECK CENTRAL EMS.
200.10 SUGGESTIONS
We encourage all employees to bring forward their suggestions and good ideas about
how our company can be made a better place to work, our products improved, and our
service to patients enhanced. When you see an opportunity for improvement, please talk
it over with the EMS Chief or someone on the command staff. He/she can help you bring
your ideas to the attention of the people in the company who will be responsible for
possibly implementing it. All suggestions are valued and listened to. When a suggestion
from an employee has particular merit, we will investigate the cost and get a poll from
staff meetings in order to progress and to bring the idea to a reality.
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200.11 SEXUAL HARASSMENT
It is a violation of both state and federal law for any employee to sexually harass any
other employee. The company will not tolerate verbal or physical conduct of a sexual
nature, which harasses, disrupts or interferes with another’s work performance or creates
an intimidating, offensive, or hostile environment for any employee or for anyone else
including, by example, non-employee contractors, vendors, suppliers, sales
representatives, student riders, and customers. This includes any unwelcome or offensive
sexual advances, requests for sexual favors, or other unwelcome verbal or physical
conduct of a sexual nature by manager, supervisor, or fellow employee, nor will the
company tolerate such conduct by a non-employee (such as a vendor, delivery person or
the general public) who has contact with our employees.
Any employee who feels that he or she is being sexually harassed should promptly report
the matter to the EMS Chief or to anyone else in the command staff with which the
employee feels comfortable discussing the matter. When a report of sexual harassment is
made, a thorough, professional, and impartial investigation will be conducted to aid in
resolving the situation. The confidentiality and privacy of all employees involved will be
respected to the highest extent possible. Moreover, no retaliation of any nature by
anyone will be tolerated against any employee making such a report, and the company
will take no action whatsoever against any employee making such a report in good faith.
Because some conduct may be considered offensive by some and not by others, if you are
unsure whether sexual harassment has occurred, you may wish (but not required) to
advise your fellow employees or supervisors if you are offended by their conduct or
comments. If your concerns are not addressed to your satisfaction, or if the conduct or
comments continue, if you prefer to first address your concerns to someone other than
your fellow employee or supervisors, then you should follow policy and promptly bring
the matter which you believe may be construed and sexual harassment to the attention of
the EMS Chief.
Any employee of the company who is found, after appropriate investigation, to have
engaged in any manner of sexual harassment will be subject to severe but appropriate
disciplinary action, which may include termination of employment.
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300.00 EMPLOYMENT STANDARDS, CATEGORIES, INFORMATION
300.01 EMPLOYMENT CATEGORIES
It is the intent of Breck Central EMS to clarify the definitions of employment
classifications so that employees understand their employment status and benefit
eligibility. These classifications do not guarantee employment for any period of time.
Accordingly, the right to terminate the employment relationship at-will at any time is
retained by both the employee and Breck Central EMS.
Each employee is designated as either NONEXEMPT or EXEMPT from federal and state
wage and hour laws. NONEXEMPT employees are entitled to overtime pay under
specific provisions of federal and state laws. EXEMPT employees are excluded from
specific provisions of federal and state wage and hour laws. An employee’s EXEMPT or
NONEXEMPT classification may be changed only upon written notification by Breck
Central EMS management.
In addition to the above categories, each employee will belong to one other employment
category:
REGULAR FULL TIME employees are those who are not in a temporary or
introductory status and who are regularly scheduled to work Breck Central EMS’s full
time schedule and adhere to their requirements, education, conditions, and limitations
required for employment with Breck Central EMS. Generally, they are eligible for Breck
Central EMS’s benefit package, subject to the terms, conditions, and limitations.
PART-TIME employees are regularly scheduled to work less than 36 hours per week
and adhere to the requirements, education, conditions, and limitations required for
employment with Breck Central EMS. They do receive all legally mandated benefits
such as Social Security, Workers Compensation Insurance, over time wages when
applicable, and also uniforms.
INTRODUCTORY employees are those whose performance is being evaluated to
determine whether further employment in a specific position or with Breck Central EMS
is appropriate. Employees who satisfactorily complete the introductory period and
adhere to the requirements, education, conditions, and limitations required for
employment with Breck Central EMS will be notified of their new employment
classification. They do receive all legally mandated benefits such as Social Security,
Workers Compensation Insurance, over time wages when applicable, and also uniforms.
CASUAL employees are those who have established an employment relationship with
Breck Central EMS but who are assigned to work on intermittent and/or unpredictable
basis. These employees adhere to the requirements, education, conditions, and
limitations required for employment with Breck Central EMS. Their hourly wage begins
as they notify dispatch en-route status to a call that has been dispatched to them. Their
hourly wage ends when they alert dispatch that they are complete with the call and ready
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for the next call. Also, this applies when they come into the station for stand-by. They
do receive all legally mandated benefits such as Social Security, Workers Compensation
Insurance, and over time wages when applicable, and also uniforms.
CONTRACT LABOR is a courtesy compensation to persons contracted as Non-
Employees to serve quick-call hours to accommodate the staffing levels of the units
should Breck Central EMS goes out of town on a run or are busy. Contracted labor
compensators are recommended to post schedules to expedite the response of 911-
emergency call. These persons are not limited to a specific location, activities, or
mandated hours other than being in Breckinridge County. They are free at-will and are
free to be home, eat, sleep, shop, etc. The only limitation that a contract laborer has is
they must not have indulged in alcoholic beverages or mind altering drugs 12 hours prior
to their on-call schedule. These employees adhere to the requirements, education,
conditions, and limitations required for employment with Breck Central EMS. They do
receive all legally mandated benefits such as Social Security, Workers Compensation
Insurance, over time wages when applicable, and also uniforms.
300.02 ACCESS TO PERSONNEL FILES
Breck Central EMS maintains a personnel file on each employee. The personnel file
includes such information as the employee’s job application, current credentials such as
EMT-FR, EMT-B or EMT-P cards with corresponding numbers and expiration dates,
current CPR and/or ACLS credentials, current Blood Borne Pathogens certificate, a copy
of current drivers license, a copy of pre-employment criminal and Department of
Transportation driver’s record check, work related health records, records of training,
documentation of performance appraisals, copy of TB skin test result annually, copy of
Hepatitis B Vaccination or verification of denial of the vaccine, Defensive Driving
Course verification, copy of incident reports and other work related documents.
Personnel files are the property of Breck Central EMS, and access to the information they
contain is restricted. Only the command staff has legitimate reason to review information
in a file and is allowed to do so. The Kentucky Board of Emergency Medical Services
Regional Inspector will be allowed to view personnel files due to regulations for license
of the ambulance service.
Employees who wish to review their own file should contact the EMS Chief. With
reasonable advance notice, employees may review only their own personnel file in Breck
Central EMS’s Offices and in the presence of an individual appointed by Breck Central
EMS to maintain files.
300.03 EMPLOYMENT CRIMINAL BACKGROUND CHECK
Each new employee of an ambulance service, therefore Breck Central EMS must pursue
due to HB126, any record of conviction of a felony crime by a person identified as an
employee. The information shall be released to Breck Central EMS and the individual
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pursuant. The pursuant has the right to inspect the criminal history record and to request
correction of any inaccurate information.
Each new employee must be free and not subject to disciplinary action pursuant to 202
KAR 7:501. If criminal history check finds faults that call for disciplinary action to be
pursued, the employee will be forced to terminate his/her position with Breck Central
EMS until resolution is met.
300.04 DIVISION OF CHILD SUPPORT ENHANCEMENT
The Kentucky New Hire Reporting Program is a confidential and secure program that
receives and processes data regarding new employees. The Kentucky Division of Child
Support Enforcement uses new hire information to locate non-custodial parents and
establishes, collects, and enforces child support collects and lowering welfare cost.
Breck Central EMS has a responsibility, by law, to report all new hires. 787 KAR 1:010
have been in effect since 1995. Each new employee with Breck Central EMS is required
to provide information for the Kentucky New Hire Reporting Center.
300.05 EMPLOYMENT APPLICATION
Breck Central EMS relies upon accuracy of information contained in the employment
application, as well as the accuracy of other data presented throughout the hiring process
and employment. Any misrepresentation, falsifications, or material omissions in any of
this information or data may result in Breck Central EMS’s exclusion of the individual
from further consideration for employment, or if the person has been hired they will be
terminated from employment.
300.06 EMPLOYMENT MEDICAL DOCUMENT REQUIREMENT
Each employee must keep a current negative Tuberculosis Skin Test annually or
documentation equivalent of. Breck Central EMS will provide annual screenings. If you
have a positive reaction or are allergic to the TB serum you must obtain a clear chest x-
ray.
Each employee of Breck Central EMS is required by OSHA and the Kentucky Board of
Emergency Medical Services to be vaccinated for Hepatitis B (HBV). We provide the
HBV vaccine through Breckinridge County Health Department. You will need to call the
health department and make an appointment to receive the vaccine, or you may provide
proof that you have received the HBV vaccine through another agency. If for some
reason you choose not to receive the vaccine, you will need to specify the reason in
writing and add it to your personnel file within 15 days of your hire date.
Each employee that has been away from Breck Central EMS due to injury or illness must
have a doctor’s release freeing the employee of restrictions that would alter their work
with Breck Central EMS as an EMT-FR, EMT-B, or EMT-P.
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300.07 EMPLOMENT CREDENTIALS AND LICENSE REQUIREMENTS
Each employee has the sole responsibility to keep current credentials with corresponding
numbers and expiration date. Failure to comply with current credentials and/or license as
in 202 KAR 7:501 will be relieved of his/her duties with Breck Central EMS.
All personnel will be required upon employment to show proof of certification in
Defense Driving and Blood Born Pathogens Course. EMT-FR and EMT-B must show
proof of BLS provider course with AED certification. Blood Born Pathogens certification
is good for 10 years. All employees must renew defense driving every two years.
Breck Central EMS tries to provide continuing education that will assist each EMT-FR,
EMT-B, and EMT-P with re-certification requirements as in 202 KAR 7:501.
300.08 NEW EMPLOYMENT TRAINING / ORIENTATION
Each new employee shall undergo a training period of a maximum 40 hours. During this
training period the employee will be under the guidance of the shift leader and will be
required to learn proper procedures for documenting information on each run, correct
operation of all medical equipment that is provided by Breck Central EMS, lifting,
loading and unloading patients from the vehicle, carrying the stretcher up and down stairs
properly, in house guidelines and duties. The employee shall be able to operate a mobile
radio with proper and thorough call-ins to dispatch and the hospital. The new employee
shall become familiar with all the policies and procedures of Breck Central EMS. The
employee shall be aware of all Fire Extinguishers on the units; BCEMS Response
standards as outlined in this SOG manual; Map reading and geographic orientation of
Breckinridge County; Mutual Aid Agreements; and Completion of Run Reports. Before
driving the new employee must undergo a Defensive Drivers Training course that
includes driving regulation and obstacle course for backing, turning, and Emergency
Response guidelines. The driver must have a valid KY Operators License.
Each new employee will be evaluated and considered for recommendation after the
maximum of 40 hours training period by the Shift leader and Command. The evaluations
and recommendations will be reported to the EMS Chief where they will be taken into
consideration to allow for additional training, employment of probationary period of 90
days, or dismissal of the new employee. This training period shall apply to any former
employee who has been inactive for twelve (12) months.
300.09 PERSONNEL DATA CHANGE
It is the responsibility of each employee to promptly notify Breck Central EMS, in
writing, of any change in personnel data. Personal mailing addresses, e-mail addresses,
telephone numbers, number and names of dependants, number and name of dependants
for health insurance, individuals to be contacted in the event of an emergency,
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educational accomplishment, and other such status reports should be accurate and current
at all times. If any data has changed notify the administrative office.
300.10 PERFORMANCE EVALUATION
Supervisors and employees are strongly encouraged to discuss job performance and goals
on an informal, day-to-day basis. A formal written performance evaluation will be
conducted at the end of any employee’s initial period of hire, know as the introductory
period. Additional formal performance evaluations are conducted to provide both the
supervisors and employees the opportunity to discuss job tasks, identify and correct
weaknesses, encourage and recognize strengths, and discuss positive, purposeful
approaches for meetings.
Breck Central EMS will look for the following in the evaluation:
Knowledge and application of skills based on level of training.
Attitude and Professionalism
Neatness and Appearance
Adherence to Policies
Initiative
Willingness to seek and advance education skills.
300.11 EMPLOYEE BENEFIT PACKAGE
Eligible employees at Breck Central EMS are provided a wide range of benefits. A
number of programs (such as Social Security, workers compensations insurance, state
disability, unemployment insurance and professional liability insurance) cover all
employees in the manner prescribed by law.
Benefits eligibility is dependent upon a variety of factors, including employee
classification. The EMS Chief can identify the programs for which you are eligible. The
following are the benefits currently offered.
1. Allowance up to $300 per month on the employee health plan after 30 days of
employment for street providers & $500 per month for administrative.
2. Uniforms
3. Vacation Benefits, 48 hours after the first year, 60 hours after the second, and
70 hours after the third.
4. Flextime Scheduling
5. Raises: Cost of living 3% for street providers & 6% for administrative.
6. Paid Holidays: 12 hours of time and half during the following holidays:
a. New Years Day
b. Memorial Day
c. Independence Day
d. Labor Day
e. Thanksgiving Day
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f. Christmas Day
Vacation time off is paid at the employee’s base rate at the time of vacation. Employees
should request written advanced approval within 4 weeks of the requested vacation date.
Request will be reviewed based on a number of factors, including business needs and
staffing. Employees are encouraged to use available paid vacation time for rest,
relaxation, and personal pursuits. In the event that available vacation is not used by the
end of the benefit year, the employees will lose that paid vacation time.
Breck Central EMS Board of Directors holds the discretion of the availability to give
yearly cost of living raises based on a number of factors. Raises will be decided and
awarded each December.
300.12 FLEXTIME SCHEDULING
Flexible trading of scheduled shifts is granted. It is understood that any employee may
need to make shift or on-call trades due to engagements that you have already committed
to or due to illness. Trades must be worked out with a supervisor and the employees
involved in the trade. A supervisor must approve any trade.
Consideration for the approval will be based on the time involved. Under normal
circumstances employees will not be allowed to schedule more than a 36-hour shift
without a break of at least 12 hours. Another factor will be the frequency of shift trades.
In the incident an employee cannot retain another employee to work the hours needed off.
The employee will be responsible to work the scheduled hours unless it has been excused
by a physician. Appropriate paperwork can be obtained by command for requesting a
trade.
300.13 WORKERS COMPENSATION INSURANCE
Breck Central EMS provides workers compensation insurance program at not cost to the
employees. The program covers any injury or illness sustained in the course of
employment. This insurance is through KEMI.
Employees who sustained work-related injuries or illnesses should inform their shift
leader or someone on command immediately. An incident report must be filed, no
matter how minor an on the job injury may appear, it is important that it be
reported immediately. Injured employees requiring medical attention are to be sent
to the nearest appropriate facility. This will enable an eligible employee to qualify
for coverage as quickly as possible.
Neither Breck Central EMS nor the insurance carrier will be liable for the payment of
worker’s compensation benefits for injuries that occur during employee’s voluntary
participation in any off-duty recreational or social event sponsored by Breck Central
EMS.
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300.14 MILITARY LEAVE
A military leave of absence will be granted to employees, except those occupying
temporary position, to attend scheduled drill or training or if called to active duty with the
U.S. armed forces.
The leave will be unpaid. Subject to the terms, conditions and limitations of the
applicable places for which the employee is otherwise eligible, health insurance benefits
will be provided by Breck Central EMS with the employee amount to still be paid by the
employee for the durations of the health benefit while the employee is on military leave.
Benefits accruals, such as vacation time will be suspended during the leave and will
resume upon return of the employee to active employment.
Every reasonable effort will be made to return eligible employees to their previous
position or a comparable one. Reasonable effort is interpreted as not jeopardizing another
employee’s status or regular scheduling to make accommodations for the return of an
employee returning from the military leave.
300.15 BEREAVEMENT LEAVE
Employees who wish to take off time due to the death of an immediate family member
should notify a supervisor immediately. Unpaid time off will be granted to allow the
employee to attend the funeral and make any necessary arrangements associated with the
death.
Approval of bereavement leave will occur in the absence of unusual operating
requirements. Employees may, with the supervisor’s approval and a written request to use
any available paid leave for additional time off as necessary.
300.16 FAMILY LEAVE
Breck Central EMS provides family leaves of absence without pay to eligible employees
who wish to take time off from work duties to fulfill family obligations relating directly
to childbirth, adoption, or placement of a foster child; or to care for a child, spouse or
parent with a serious health condition. A serious health condition means an illness, injury,
impairment, or physical or mental condition that involves inpatient care in a hospital,
hospice, or residential medical care facility; or continuing treatment by a health care
provider.
Eligible employees may request family leave only after having completing 90 calendar
days of service. Requests should be made, in writing, in advance time and an estimated
time of return is required. The maximum amount of family leave without proven
sufficient consideration will be a total of two weeks within a 12-month period. Married
employee couples with Breck Central EMS may be restricted to a combined total of two
weeks leave due to hardship and staffing within the company.
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Breck Central EMS will continue to provide health insurance benefits for the full period
of the approved family leave with the employee still paying his/her portion of the set
benefits.
Every reasonable effort will be made to return eligible employees to their previous
position or a comparable one. They will be treated as though they were continuously
employed.
300.17 BENEFITS CONTINUATION (COBRA)
The Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) gives
employees and their qualified beneficiaries the opportunity to continue health insurance
coverage under Breck Central EMS health plan while a “qualifying event” would
normally result in loss of eligibility. Some common qualifying events are resignation,
termination of employment, or death of an employee; a reduction in an employee’s hours
or leave of absence; and employee’s divorce or legal separation; a dependent child no
longer meeting eligibility requirements.
Under COBRA, the employee or beneficiary pays the full cost of coverage at Breck
Central EMS group rates plus an administration fee. Breck Central EMS provides
notification to the insurance companies that the insurance status has changed. The
insurance companies will then contact the employee or beneficiary for amounts that are
due to continue coverage.
300.18 TIME TO VOTE
Breck Central EMS encourages employees to fulfill their civic responsibilities by
participating in elections. Generally, employees are able to find time to vote either before
or after their regular work schedule. If employees are unable to vote in an election during
their nonworking hours, Breck Central EMS will grant up to one hour of unpaid time off
to vote, or an employee from within Breckinridge County may vote while on the clock if
they can do so during their scheduled work day, in between runs.
Employees should request time off to vote from the command staff at least two working
days prior to Election Day. Advance notice is required so that the necessary time off can
be scheduled at the beginning or end of the work shift; whichever provides the least
disruptions to the normal work schedule.
300.19 JURY DUTY
Breck Central EMS encourages employees to fulfill their civic responsibilities by serving
jury duty when required. Employees may request unpaid jury duty leave for the length of
absence.
Employees must show their jury duty summons to a supervisor as soon as possible so that
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arrangements can be made to accommodate their absence. Of course, employees are
expected to report to work whenever the court schedule permits.
Either Breck Central EMS or the employee may request an excuse from jury duty, if in
Breck Central EMS judgment the employee’s absence would create serious operational
difficulties.
Breck Central EMS will continue to provide health insurance benefits and will secure
employment status for the full term of the jury duty absence.
300.20 WORK SCHEDULES
Work schedules for employees vary throughout our organization. The command staff will
advise employees of their individual work schedules. Staffing needs and operations
demands may necessitate variations in starting and ending times, as well as variations in
the total hours that may be scheduled each day and week. Employees need to understand
that scheduling overtime is a privilege and at times a necessity but is never a guarantee.
300.21 TIMEKEEPING
Accurately recording time worked is the responsibility of every employee. Federal and
state laws require Breck Central EMS to keep accurate record of time worked in order to
calculate employee pay and benefits. Time worked is all the time actually spent of the job
performing assigned duties.
Altering, falsifying, tampering with the time records, or recording time not actually
worked or recording on another employee’s time record may result in disciplinary action,
up to and including termination of employment.
If corrections or modifications are made to the time record, both the employee and the
supervisor must verify the accuracy of the changes by initialing the time record.
300.22 PAYDAYS
Employees are paid bi-monthly every other Friday. The paychecks will be available for
collection only after 1200 hours off the payday Friday. In the event that a regular
scheduled payday falls on a day off such as holidays, employees will be able to collect
their paychecks on the following Monday after 1200 hours. If a regular payday falls
during an employee’s vacations, the employee’s paycheck will be available upon his or
her return form vacation.
300.23 ADMINISTRATIVE PAY CORRECTIONS
Breck Central EMS takes all reasonable steps to ensure that employees receive the
correct amount of pay in each paycheck and that employees are paid promptly on the
scheduled payday.
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In the event that there is an error in the amount of pay, the employee should promptly
bring the discrepancy to the attention of a supervisor so that corrections can be made as
quickly as possible.
300.24 EMPLOYMENT TERMINATION
Termination of employment is an inevitable part of personnel activity within any
organization, and many of the reasons for terminations are routine. Below are examples
of some of the most common circumstances under which employment is terminated.
RESIGNATION – voluntary employment termination initiated by an employee.
DISCHARGE – involuntary employment termination initiated by the employer.
LAYOFF - involuntary employment termination initiated by the employer for non-
disciplinary reasons.
RETIREMENT – voluntary employment termination initiated by the employee meeting
the age, length of service, and any other criteria for retirement.
Since employment with Breck Central EMS is based on mutual consent, both the
employee and Breck Central EMS have the right to terminate employment at will, with
our without cause, at any time. At the time an employee ceases employment whether
voluntarily or involuntarily, all uniforms, radios, and equipment will become an expense
that the former employee will be charged for at set value until the items have been
returned in good condition or claims judgment is set via court.
300.25 PAY DEDUCTIONS
The law requires that Breck Central EMS make certain deductions from every
employee’s compensation. Among these are applicable federal, state, and local income
taxes. Breck Central EMS also must deduct Social Security “wage base”. Breck Central
EMS matches the amount of Social Security taxes paid by each employee.
Breck Central EMS offers programs and benefits beyond those required by law. Eligible
employees may voluntarily authorize deductions from their paychecks to cover the costs
of participation in these programs.
If you have any questions concerning why deductions were made from your paycheck or
how they were calculated, a supervisor can assist in having your questions answered.
300.26 ATTENDANCE AND PUNCTUALITY
To maintain a safe and productive work environment, Breck Central EMS expects
employees to be reliable and to be punctual in reporting for scheduled work. Absenteeism
and tardiness place a burden on other employees and on Breck Central EMS. In the rare
instances when employees cannot avoid being late to work or are unable to work as
scheduled, they should notify a supervisor as soon as possible in advance of the
anticipated tardiness or absence.
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Poor attendance and excessive tardiness are disruptive. Either may lead to disciplinary
action, up to and including termination of employment.
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400.00 STANDARD PROCEDURES AND POLICIES
400.01 SAFETY
To assist in providing a safe and healthful work environment for employees, patients, and
visitors, Breck Central EMS has established a workplace safety program. This program is
top priority for Breck Central EMS. Command has a responsibility for implementing,
administering, monitoring, and evaluating the safety program. Its success depends on the
alertness and personal commitment of all.
Breck Central EMS provides information to employees about workplace safety and
health issues through regular internal communication channels such as administrative
meetings, employee meetings, bulletin board postings, memos, or other written
communication.
Employees and the leaders receive periodic workplace safety training. The training
covers potential safety and health hazards and safe work practices and procedures to
eliminate or minimize hazards.
Each employee is expected to obey safety rules and to exercise caution in all work
activities. Employees must immediately report any unsafe conditions to the appropriate
shift leader or supervisor. Employees who violate safety standards, who cause hazardous
or dangerous situations, or who fail to report or where appropriate, remedy such
situations, may be subject to disciplinary action, up to and including termination of
employment.
In the case of accidents that result in injury, regardless of how insignificant the injury
may appear employees should immediately notify s supervisor. In the case of health
related hazards, appropriate reports should be documented and procedures of “Exposure”
should be followed. Such reports are necessary to comply with the laws and initiate
insurance and worker’s compensation benefits procedure.
400.02 USE OF PHONE, CELL PHONE, MAILING SYSTEM, COMPUTER
Personal use of telephones for long-distance and toll calls is permitted only when charges
are reverse or a personal calling card is used. Employees should practice discretion in
using company telephones when making personal calls and may be required to reimburse
Breck Central EMS for any charges resulting form their personal use of the telephone.
Personal use of incoming and outgoing calls from the telephones should be kept to a
minimum.
Cell phones are allowed with discretion, Breck Central EMS reserves the right to ask an
employee to leave his/her cell phone in their private vehicle while working if certain
regulations are not followed.
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1. While transporting or caring for a patient in the back of an ambulance, the use
of ringing cell phones are not permitted.
2. While driving the ambulance especially Code 3, cell phones by the driver is
not permitted.
Turn them on silent, voice mail or pager, and follow-up with messages when it is
convenient not while caring for a patient or while in their presence. If the capabilities are
not available to the employee then the alternative is to turn the cell phone off.
The use of Breck Central EMS postage for personal correspondence is not permitted.
The use of Breck Central EMS computers is only permitted by supervisors.
To ensure effective telephone communications, employees should always use the
approved greeting and speak in a courteous and professional manner. Please confirm
information received from the caller, and hang up after the caller has done so.
400.03 SMOKING POLICY
In keeping with Breck Central EMS intent to provide a safe and healthful work
environment, smoking inside the work place is prohibited except in a designated area.
Smoking in Breck Central EMS vehicles is PROHIBITED. In situations where the
preferences of smokers and non-smokers are in direct conflict, the preferences of the non-
smokers will prevail.
This policy applies equally to all employees, customers, and visitors.
400.04 USE OF EQUIPMENT AND VEHICLES
Equipment and vehicles essential in accomplishing job duties are expensive and may be
difficult to replace. Using property employees are expected to exercise care, respect,
perform required maintenance, and follow all operating instructions, safety standards and
guidelines.
Notification to a supervisor is expected if any equipment, machines, tools or vehicles
appear to be damaged, defective, or in need of repair. Prompt reporting of damages,
defects, and the need for repairs could prevent deterioration of equipment and possible
injury to employees or others. Equipment in need of immediate repairs such as batteries
replaced, or light bulbs replaced should be given to a supervisor and he/she will have
them repaired and get them back in service during their shift is possible.
A supervisor can answer any questions about employee’s responsibility for maintenance
and care of equipment or vehicles used on the job.
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The improper, careless, negligent, destructive, or unsafe use or operation of equipment or
vehicles, as well as excessive or avoidable traffic and parking violations, can result in
disciplinary action, up to and including termination of employment.
400.05 TRAFFIC AND PARKING VIOLATIONS
Breck Central EMS will not be held responsible for any traffic or parking violations that
are charged to an employee while driving any of Breck Central EMS vehicles. All
employees are responsible adults and are to adhere to all driving and safety rules and
regulations set forth by the Commonwealth of Kentucky.
In the circumstances that an employee has his/her driver’s operating license revoked
he/she will be unable to fulfill all the necessary responsibilities and requirements to be an
employee of Breck Central EMS and will be asked to resign his/her position as an
employee.
Breck Central EMS employees are required to attend a Defensive Driving Course at the
time of employment and every two years. The course will be instructive, descriptive, and
skilled driving thru an obstacle course that is standard for defensive driving testing.
400.06 VISITORS IN THE WORKPLACE
To provide for the safety and security of employees and facilities at Breck Central EMS a
minimum of personal visitors are allowed in the workplace. Restricting visitors helps
maintain safety standards, protects against theft, ensures security of equipment, protects
confidential information, safeguards employee welfare, and avoids potential distractions
and disturbances.
All personal visitors that enter Breck Central EMS are the responsibility of the employee
they are visiting. The employee is responsible for conduct, safety and security of their
visitors.
If a personal visitor should discriminate Breck Central EMS, breech confidentiality, fail
to meet safety or security standards set by Breck Central EMS, the employee will be held
responsible and will endure disciplinary action from employment.
400.07 INCURRING EXPENSE TO THE COMPANY
Employees shall not incur any expense or liability to the company without the approval
of a supervisor. Any unreported claim to the company could result in immediate
dismissal.
400.08 FOUND PROPERTY
Employees shall not convert to their own use, or have any claim on, any property found
during the course of their time on duty. Found property shall be given to a supervisor.
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400.09 CONFIDENTIALITY
Employees shall not reveal any information concerning matters brought to their attention
in performance of their duty. Employees shall not discuss patients or patient’s records
with any person not directly concerned with the medical care of the patient. Any violation
of confidentiality shall be considered a serious violation of the company policy that may
result in termination. All employees shall be orientated and knowledgeable to Breck
Central EMS’s policy on the Health Insurance Portability Accountability Act.
400.10 FALSE REPORTS
Employees shall not knowingly make a false report, either written or verbal. Making such
a false report will result in immediate disciplinary action.
400.11 ALCHOLIC BEVRAGES
No employee shall drink any alcoholic beverage while on duty or twelve (12) hours prior
to your shift. Drinking alcoholic beverages on duty shall be considered a serious act of
misconduct and will subject the employee to immediate dismissal. No employee shall
report for duty when there is evidence of prior consumption either of alcoholic beverages,
doing so will subject the employee to immediate termination. Employees that are not on
duty shall refrain from entering the company property when alcohol has been consumed.
In doing so shall subject the employee(s) to immediate dismissal.
400.12 USE OF ILLEGAL DRUGS
Employees will neither use nor possess illegal drugs while on company property or in
company vehicles. Employees will not report for duty when there is evidence of prior use
of illegal drugs or stimulants, the buying or selling of illegal substances will not be
allowed on or near company property. The use, possession, or being under the influence
of any illegal drugs shall be ground for immediate dismissal, and/or required participation
in a substance abuse rehabilitation or treatment program at the employee’s expense. The
legal prescribed drugs are permitted only if it does not endanger his/her partner or the
patients during the course of his/her shift.
Under the Drug-Free Workplace Act, an employee who performs services for a
government contract or grant and is in charge of a human life must notify Breck Central
EMS of a criminal conviction for drug-related activity occurring in the workplace. The
report must be made in 5 (five) days of the conviction.
The conviction will be submitted to the Kentucky Board of Emergency Medical Services
where disciplinary actions will be enforced negatively effecting the certification of the
employee.
BRECK CENTRAL EMS IS A DRUG FREE WORKPLACE
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400.13 EMPLOYEES ARRESTED OR CHARGED WITH A CRIME
Employee’s arrested or charged with any crime while on or off duty during their
employment at Breck Central EMS may be suspended without pay until the outcome of
the charges have been determined. The employee may then be terminated depending on
the outcome of the charges and their nature.
400.14 EMPLOYEE PARKING
Breck Central EMS is not responsible for the employee’s vehicle or personal property
while parked or on company premises.
400.15 UNAUTHORIZED RIDERS
Employees shall not allow unauthorized persons or employees to ride or sit in company
equipment without the authorization of a supervisor.
400.16 TRANSPORTING PRISONER
Breck Central EMS requires that a deputy jailer, jailer, or peace officer be in the patient
compartment of the unit if transporting prisoner or patients whom are in custody.
400.17 VEHICLES OR EQUIPMENT FAILURE
Malfunctions with a unit or specialized equipment while on an emergency transport or
during inter-facility transport should be reported and a request for a second unit should be
made immediately. Malfunctions that happened outside of the county should be reported
to the dispatch along with the exact locations and the need for another unit and/or Mutual
Aid. Supervisors should also be promptly advised of the situation.
400.18 EQUIPMENT RETRIEVAL
Equipment is used on a day-to-day basis and should be cared for, guarded, maintained,
and disinfected routinely. At times when equipment is left behind at the local hospital, it
will be the responsibility of the crew to retrieve the equipment before the next date if
possible.
400.19 POLICIES FOR PASSENGERS
Passengers other than patients will be limited to one adult and they will be required to
ride in the cab are of the unit. Seat Belts must be worn. One adult passenger with a small
child may request to ride in the rear and this can be allowed, but only through the
discretion of the crew and only in the jump seat with the seat belt on during transport.
Passenger will only be permitted at the discretion of the crew and only up to one
passenger can be permitted.
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400.20 EXCHANGING SUPPLIES WITH FIRE SERVICES
All crews exchange supplies that Fire Service has used on any patient. Only those
supplies actually used on the patient shall be exchanged.
400.21 EATING ON DUTY
Due to the nature of an ambulance service specific meal times cannot be guaranteed.
However, we do encourage employees to take advantage of any slot time or down time to
utilize for a meal break.
If an employee is out of their unit for a meal the crew must maintain radio contact and are
subject to any available runs.
400.22 QUALITY ASSESSMENT
The medical standards committee consisting of the EMS Chief, The Medical Director,
and designees shall conduct by audit of investigation a periodic review of ambulance run
reports and evaluation of staff performance related to patient care. The following will be
addressed:
1. Employee health and safety.
2. Compliance with protocols and operating procedures.
3. Assessment of dispatch procedures.
4. Vehicle operations or vehicle safety.
5. Equipment selection process.
6. Equipment preventative maintenance.
7. Resolution of Customer Complaints through a written report of the audit.
Runs involving Cardiopulmonary Arrest, Intubation, Multiple Pharmacological Therapy,
Cardioversion or Overdrive Demand Pacing, use of an air ambulance, runs involving
more than our ambulance service, and/or violations of approved procedures in caring for
patients will be reviewed by the Medical Director and EMS Chief.
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500.00 ROLES AND RESPONSIBILITES OF THE EMPLOYEE
500.01 EXPECTATIONS
Along with the professional duties within the Scope of Practice as the certified first
responder, certified EMT and licensed paramedic, Breck Central EMS also has
expectations (but not limited to) on a day-to-day basis within the EMS system which
include:
a. Make Runs
b. Complete Run Reports and patient billing information.
c. Wash, Clean and disinfect vehicles.
d. Wash, Clean and disinfect vehicles at hospital after each run.
e. Restock equipment and supplies.
f. Disinfect any equipment that is to be restocked (i.e. spine boards, etc.)
g. Refill Oxygen Tanks (Portable and Main at no less than 500lbs)
h. Refuel Unites (after each out-of town run and no less than ¾ tank at all times)
i. Complete duty chore list.
j. Clean up after yourself.
k. Take Part in Special Events (i.e. Sporting Events, Details, Parades, etc.)
l. Complete Inventory every shift.
m. Complete Vehicle Maintenance every shift.
n. Maintain a clean work environment including the services buildings and
grounds.
o. Turn in daily paperwork and receipts in the proper assigned area at the end of
shift.
p. Continue to make this one of the best EMS services in the Commonwealth.
It is expected that all duties will be completed during your regularly scheduled on duty
shift. It is not acceptable to clean you unit, restock or engage in any other work related
activities while you are off duty. Failure to comply with the above said duties can result
in immediate suspension and termination for a repeated offense.
500.02 GENERAL CONDUCT
All company employees shall conduct themselves in a professional manner as to avoid
bringing discredit upon him or her to the company. Employees shall, at all time be
courteous and civil to the public, other health care professionals, patients and their
families, and to one another.
Employees shall refrain from using coarse, violent, profane, insolent or disrespectful
language and shall not make derogatory statements of any nationality, sex, race, sexual
orientation or religion. Violent language or threats of violence directed toward anyone
during the course of one’s employment could result in immediate termination.
Employees on duty shall devote their entire time and energies to the duties and
responsibilities of their assigned positions.
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500.03 SLEEPING ON DUTY
Sleeping while on duty is necessary for those employees pulling a twenty four hour or a
greater tour of duty but only allowed after all duties have been done and the run volume
is slow. It is encouraged to take advantage of slow down times. Sleeping on duty
however, should be done in the dormitories. Sleeping is discouraged for anyone working
a twelve hour shift or less.
500.04 UNITS ROAMING
Units assigned to a station may want to roam in that division. Roaming is restricted to the
crew’s assigned division. Roaming should be kept at a minimum keeping in mind that
there are numerous phone calls at each division.
500.05 PAPERWORK
Run forms must be thoroughly completed on all runs where the unit arrives on scene,
including standbys, and special events. Any section or box that does not apply should be
marked N/A or have a line drawn through it. To leave any box open blank assumes the
patient was not assessed or checked for that particular area. Pickup and destination
address must be entered and accurate. All times and mileages must be on the run form.
Narrative must be complete and detailed on all runs. The only exception being cancelled
en route. All procedures performed must be listed on the run form. Paperwork must be
done completely for each segment of a round trip. One set of paperwork is not sufficient
for roundtrips.
The inability to properly bill and collect for runs made directly relates to the service’s
ability to pay wages, purchase and replace equipment, and to conduct the normal
functions of Breck Central EMS. All runs must have billing forms fully complete. This
includes the following: Date, patient information, responsible party information,
signatures, and all insurance information. Each transported patient is to receive a copy of
the HIPAA form. Other paperwork should be completed as needed including Medicaid
vouchers, physician certification statements, etc. If you have questions concerning
appropriate paperwork needed contact a supervisor.
The failure to complete all appropriate paperwork is a serious problem and will be
corrected promptly. Multiple occurrences of this could result in disciplinary action.
500.06 INCIDENT REPORT
Employees shall fill out an incident report as soon as an infraction of this handbook is
done, anytime when the employee becomes ill or injured no matter how small the
situation is or any other time the employee feels that the a circumstance needs to be
documented. Incident reports can be obtained from a supervisor and should promptly be
turned into a supervisor once completed.
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500.07 UNIFORMS AND APPEARANCE POLICY
Uniformity of dress within Breck Central EMS is important to project a professional
image of all personnel by requiring them to wear the official uniform in a similar manner.
The appearance of company personnel relays much to the general public on the
professionalism of Breck Central EMS.
All personnel shall wear the official uniform at all times while on duty as noted in this
policy. Only those items issued or approved shall be considered part of the official
uniform, and must be worn as indicated.
All personnel shall strictly adhere to the Department’s uniform dress code as established
within this procedure.
Possession and Maintenance of Uniforms
With the exception of boots and belts, the uniforms are provided at no cost to you
therefore they are to be cleaned and in a good state to ensure their acceptability to
service at your expense.
All personnel shall wear the acceptable uniform at the start of their duty shift,
during shift hours, during department activities (i.e. public relations, training,
meetings, etc.), on emergency response, and at anytime as may be deemed proper
by the EMS Chief as outlined in this policy.
A “Dress Down” time is permitted from 1900 hours to then end of your shift or
the start of a new one. “Dress Down” is only permissible inside the confines of
the Stations. You must be in your full uniform anytime outside of that.
Disregard to policy is only acceptable in situations where you must come in to
complete an emergency call and are not scheduled to work.
Respect the uniform and company shield and wear it with pride. Sloppiness, dirty,
wrinkled or torn uniforms are a disgrace to EMS and to you as a professional.
Disciplinary actions will be addressed if you report to you report to a shift in such
a manner.
If a portion of your uniform is damaged beyond repair, lost or stolen or destroyed
in any “line of duty” incident, (i.e. Biohazard, tear from automobile accident, etc.)
The discretion will be up to a supervisor on what constitutes an in the line of duty
replacement.
Type of Uniform
Class A – Dress Uniform. Consists of white button shirt, straight trousers, hi gloss shoes,
hi gloss belt, tie, hardware, hat, jacket, and white gloves. These uniforms are provided to
the Breck Central EMS Honor Guard members.
Class B – Duty Uniform. Consists of burgundy polo shirts, navy trousers, belt, and boots.
These uniforms shall be worn while working a scheduled shift.
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Class C – Auxiliary Uniform. Consists of either company polo or tee shirts. These
uniforms are allowed at special events, details, or call-ins, backup runs, or emergency
runs.
For the Duty Uniform:
Approved footwear shall be made of Black Leather. The style of footwear is left to
employee preference; however, the footwear shall be plain bearing no logos or emblems.
Steal toes is not a requirement. Encouragement is given to quarter of full length boots.
Approved belts shall be plain and made of Black Leather. The style of belt is left to the
employee preference. Both boots and belts are to be provided by the employee and shall
be clean and polished. At any time the EMS Chief may deem footwear and belts unfit for
duty and require a replacement. A belt shall be worn with the trousers at all times.
The use of an undershirt is required and shall be white or navy in color bearing no
graphics to prevent writing or graphics bleeding through the duty shirt. Jackets will be
issued and may be worn at the desire of the employee.
General Uniform Standards
Any part of the official uniform will not be worn off duty except.
o While traveling to or from a duty shift, EMS response, department
function or training drill.
o When attending a function or activity where the appearance of the official
uniform is deemed proper and socially acceptable and with the EMS
Chiefs approval.
o No part of the official uniform will be worn into bars, taverns or the bar
area of a restaurant.
Shirts shall be buttoned up completely with the exception of the top collar buttons
and tucked completely into the trousers.
Pants should not be allowed to rid up on boots or with the cuffs tucked into the
boots.
Socks shall be navy blue or black if visible over the top of the footwear.
Caps
o Only department issued or approved caps or headwear with the approved
insignia or lettering shall be worn. Said caps or headwear may be worn at
any time unless specified by the EMS Chief.
o Black stocking “nightwatch” caps may be worn during inclement weather.
Appearance
Only department issued pins, buttons, badges, patches etc may be worn.
Otherwise you must have the EMS Chief’s approval.
Only conservative, professional appearing sunglasses may be worn while
representing the department. Frames shall not contain any neon type colors.
Jewelry shall be limited to:
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o A watch
o One ring on one finger of only one hand. (Exception is given to a wedding
set)
o Necklaces may be worn if kept inside the T-shirt at all times.
o Earrings are allowed but must be stud style. No loop or earrings that
dangle are allowed. Only one piercing per ear is allowed at anytime. Any
other body piercing that employees may have must be covered or removed
if visible while on shift or any other time uniform is worn.
Employees must be conscious of body odor and cleanliness and should not have
to be lectured on personal hygiene habits.
Fingernails will be clean and neatly trimmed.
Should visible body are such as tattoos become a distraction the EMS Chief may
require additional individual policy to conceal such art.
Acceptable hair styles will be determined by the following guidelines.
o Males:
The length, bulk, or appearance of the hair will not be excessive,
ragged or unkempt.
Hair will be neatly groomed and will not hang over the collar.
Hair in front will be groomed so that it does not fall below the
band of properly worn headgear.
The hair may be worn slightly over the ears but in no case will the
bulk or length of the hair interfere with the proper wearing of any
authorized headgear.
The acceptability of a member’s hairstyle will be based upon the
criteria in this procedure and not upon the style in which members
choose to wear their hair.
Sideburns, if worn, shall be neatly trimmed, not extending below
the lowest part of the ear, not flared, of even width and ending with
a clean-shaven horizontal line.
Mustaches, if worn, will be short and neatly trimmed and shall not
extend lower than the top of the upper lip or beyond the corners of
the mouth.
Beards and goatees if worn will be short and neatly trimmed.
Breck Central EMS strongly discourages this practice. The EMS
Chief at any time may deem a beard and goatee a distraction and
require individual action to correct such problem.
Hairpieces or wigs worn on duty must conform to the same
standards as stipulated for natural hair.
Hair coloring, if used, must look natural.
o Females:
The length, bulk, or appearance of the hair will not be excessive,
ragged or unkempt.
Hair will be neatly groomed and will not hang over the collar. Hair
in front will be groomed so that it doesn’t not fall below the back
of properly worn headgear.
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The hair may be worn slightly over the ears but in no case will the
bulk or length of the hair interfere with the proper wearing of any
authorized headgear.
Hairpieces or wigs worn on duty must conform to the same
standards as stipulated for natural hair.
Hair coloring, if used, must look natural.
No ribbons or ornaments shall be worn I the hair except for neat
and inconspicuous bobby pins, and conservative unadorned
barrettes. An elastic type band maybe used to maintain a ponytail.
Cosmetics, when worn, will be in good taste using conservative,
natural looking cosmetics.
Special consideration shall apply to the needs of the employee’s that have a problem due
to health reason, pregnancy, or other reasons the EMS Chief may see fit to alter the
uniform apparel.
Dispense of Uniforms
Dispense of company uniforms will based o the employment status of the employee
along with the strict discretion of the EMS Chief.
Part Time Employees: Will receive an initial uniform set of 1-2 pairs of pants, 1-2
long sleeve shirts, 1-2 short sleeve shirts and a jacket. The exact number will be
left to the discretion of the EMS Chief.
Part Time Employees: Will receive a yearly uniform maintenance of 1-2 pairs of
pants, 1-2 long sleeve shirts, and 1-2 short sleeve shirts at the discretion of the
EMS Chief.
Full Time Employees: Will receive an initial uniform set of 3-4 pairs of pants, 3-4
long sleeve shirts, 3-4 short sleeve shirts, and a jacket. The exact number will be
left to the discretion of the EMS Chief.
Full Time Employees: Will receive a yearly uniform maintenance of 2-3 pairs of
pants, 2-3 long sleeve shirts, and 2-3 short sleeve shirts at the discretion of the
EMS Chief.
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600.00 RUN CLASSIFICATION, COMMUNICATIONS, RESPONSE
600.01 RUN CLASSIFICATION
1. Emergency Run: A life threatening situation exists which requires immediate
medical care and transport or transfer. Life or limb threatening.
2. Non Emergency Run: A situation in which treatment, transport or transfer is
required but not on an immediate basis. One that can wait 60 minutes or be
scheduled without complications to the patient.
3. Scheduled Run: A transport or transfer in which arrangements have been made in
advance or scheduled.
Breck Central EMS shall not refuse an emergency request if a unit is available in the
county. If non emergency runs are requested, at least one unit should be held in reserve in
the county to respond to emergency calls.
LEVEL OF CARE:
1. ALS: Advanced Life Support, Paramedic on board and ALS procedures are
used. Also hospital staff or paramedics on board during inter-facility transfers.
2. BLS: Basic Life Support, we provide on all transports and transfers.
SERVICE AREA:
1. Emergency Runs: All of Breckinridge County / Mutual Aid through adjoining
counties.
2. Non-Emergency Runs: Origin of service in Breckinridge County unless prior
arrangements have been made through the office.
Transfers, originating outside of Breckinridge Count require documentation expressing
good faith effort was made to utilize the provider that is licensed in that area.
600.02 TRANSPORT OF PATIENTS
A patient shall be transported to the hospital chosen by: (1) the patient or the patient’s
Physician. (2): Protocol (3): Dr. on the scene (4): Closet Facility (5): On-Line Medical
Control (6): Law Enforcement or (7): Managed Care. Decision will need to be made on a
case-by-case basis.
If the patient is air lifted and the decision was made by one of our EMT or Paramedics
that the transport was necessary to save a patient’s life or limb, then the EMT or
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Paramedic must document the medical necessity of the transport on the EMS form’s case
narrative.
600.03 RUN ORDER FOR EMS CREWS
Run order will be at the discretion, in conjunction of the dispatcher and shift leader. If
any questions are raised that can’t be answered a supervisor should be contacted.
Response to runs originating in the outlying areas shall be, in normal circumstances, done
so by the crew that is closet to the call.
Response to runs should be done so, in normal circumstances, by the squad that is closet
to the runs originating.
1. Inter-facility transfer will be made as long as there is at least one EMS crew
left in the county to respond to emergency calls.
2. Mutual Aid will be provided as long as one EMS crew is left in the county to
respond to emergency calls.
3. When a mass casualty incident has occurred (Tornado, plane crash, bus crash,
explosion, or any incident involving four or more patients or casualties) the
first EMS crew on the scene should quickly:
a. Access the situation and advise dispatch of the immediate disaster
situation.
b. Designate a staged triage are for all other emergency departments that will
be arriving soon.
c. At this time ALL EMS personnel will be notified and expected to respond
to their designated station as soon as possible.
d. Further instructions and designated staging are will be explained to the
crews by command.
e. The dispatch will also alert Fire Departments, Law Enforcements,
Hospitals, Air Ambulances, and Mutual Aid for assistance.
4. EMS will respond to fire department calls as requested. Stand-by requests will
be obliged, providing it will not hamper transport or transfer of any patients.
5. Response to calls that apparent death is found the EMS crew will contact the
dispatch to relay need for coroner to respond to the scene. If the death appears
to seem odd, answers to questions seem vague or is the result of a crime,
contact dispatch to cause the law enforcement agency of that jurisdiction to
respond. Remember forensics and do not destroy evidence on the scene. The
body will be transported at the discretion of the coroner. No EMS personnel
shall leave a deceased body at a scene without another EMS employee in
EMS uniform is on the scene, or until relieved by the coroner.
6. Crews from time-to-time shall cover special events. Command will determine
which vehicle and crew will cover such events.
7. When the fire departments are needed on a scene for rescue, manpower,
equipment or other reasons, the dispatch should be notified to contact the
closet department to the scene.
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8. Command should be notified of all criminal incidences. Law enforcement
officers should be called to respond to all cries scenes. (I.e. shooting, stabbing,
domestic disputes, physical abuse, MVC fatality, rapes, suicides, etc.)
600.04 RESPONSE TO CALLS
Emergency calls should have a maximum of a five (5) minute response time. Response
time is registered from the time the call is receive to dispatch and the time the EMS crew
notifies dispatch that they are en route to the scene.
Non Emergency Runs that are not scheduled calls will be responded to as quickly as
possible and at the discretion of the urgency in the calls.
Scheduled calls should be responded to on time to keep the schedules running smoothly
for everyone involved. If there is going to be a delay notify the dispatch or station to call
and notify the facilities or families that the delay will involve or inconvenience.
Transfers, origination outside of Breckinridge County required documentation expressing
good faith effort was made to utilize the provider that is licensed in that area.
Responses to all calls should be done so in a manner that is orderly, professional, safe and
in a uniform and with a pleasant attitude.
Breck Central EMS shall not refuse any emergency request if a unit is available in
Breckinridge County.
Non-Emergency Runs are requested; at least one unit shall be held in reserve in the
county to respond to emergency calls within Breckinridge County.
If a unit transporting leaves the county and is unsure if a crew is on standby, have the
dispatch page for another unit to come on standby.
600.05 RESPONSE TO CALLS BY ON-CALL CREWS
The on-call crews shall follow the above guidelines 600.04 when called upon.
The on-call crew shall be deemed the first out crew if the on-duty crew is busy on another
call or has to leave the county.
The on-call crew must be in the county to be eligible for call-in runs.
600.06 RADIO COMMUNICATIONS
The Federal Communication Commission Rules and Regulations specifically prohibits a
radiotelephone operator (dispatch) from divulging to any person, other than members of
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the company administrative staff, those authorized by the company, or the person to
whom the message is intended, the contents of radio messages.
All employees are expected to monitor the air continually while on duty, and are prepared
to copy a run when called. All employees are expected to answer the radio after the
FIRST call, and receive the information by the dispatcher. Failing to respond to radio
calls shall be considered a serious punishable offense.
Radio transmission is to be limited to necessary information only. If it does not appear to
be necessary to use the radio, or if a prolonged discussion is necessary, then the telephone
should be used. Radio transmission to the hospital should be to the point and only
pertinent information transmitted for the aid of on-line medical orders. Breckinridge
Memorial Hospital serves as our on line medical control.
All employees should try to speak on the radio clearly and concisely, and in a
professional tone of voice. Sarcastic responses and display of unprofessional behavior
over the air are not acceptable behavior on the part of the dispatcher or the crews. Voice
tone inflections or use of profanity over the air, shall be considered as conduct
unbecoming an employee and will be considered a serious offense subject to disciplinary
action.
While not involving the spoken word, mike clicking is also considered to be an action
which is unbecoming an employee of the company. Besides causing momentary power
surges to the unit’s transmitter, which can damage the unit, the practice is disruptive to
the radio channel and considered to be a form of harassment, which may lead to
dismissal.
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700.00 EMERGENCY VEHICLE OPERATIONS
700.01 INTRODUCTION
The proper operation of the company’s emergency vehicles on the streets of Breckinridge
County is important to the safety of our community’s residents and to the comfort of our
patients. Good emergency vehicle driving habits insure your quick and safe arrival on the
scene or the hospital and reflect well on all of us. Materials presented below are intended
to guide your actions and conduct while making runs. Through knowledge of its
principals it could help prevent a serious accident in the future when someone’s life may
be at stake.
700.02 PRIORITY RUNS
Priority codes are numbers that are given pertaining to the situation or the even. The
number 1-3 shall be used to assign a situation a priority code.
Priority – 1 Non-emergency; normal vehicle operations
Priority – 2 Special Code, see below
Priority – 3 Emergency (life or limb threatening)
Priority – (Code 1):
A code one run shall be defined as on “non-emergency” or “non urgent” situation where
no threat to the life of the patient is apparent.
Priority – (Code 2):
A code two run is essentially red lights turned on but not siren. Kentucky Revised Statues
189.949 Section 5;(c) states that if the vehicles are an ambulance and the driver is opinion
that the sounding of the siren, bell, or exhaust whistle would be detrimental to the
victim’s health. In the event the driver of an ambulance elects not to use the sire, bell, or
exhaust whistle he shall not proceed past red lights or drive in the opposite direction of a
one-way street or in oncoming lanes of traffic unless no other vehicles are within five
hundred (500) feet of the front of the ambulance. The driver shall not extinguish the
warning lights during the period of the emergency. Breck Central EMS strongly
discourages the use of a code two run.
Priority – (Code 3):
A code three run shall be defined as an “emergency” situation where there is a life or
limb threatening situation present, or apparent.
With a code three run, it should be noted that there is a sense of “emergency” about the
run or response, and time does appear to be a critical factor to the patient’s survival.
Vehicles shall be operated in a safe manner with due regard for the safety of all persons
and property upon the highway. All red warning lights and siren shall be turned on
continuously during a code three run. Headlights shall also be turned on.
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Code three runs from the scene to the hospital are at the discretion of the unit transporting
based on the criteria above.
It shall be considered s serious offense to recklessly and hazardously operate any vehicle
of this company. This can result in immediate suspension or termination.
All personnel are expected to obey all rules and regulations of the company and all laws
regulation the use of emergency vehicles.
Any personnel shall be aware of existing weather conditions, and are expected to adjust
their speed to allow for these factors.
700.03 KENTUCKY REVISED STATUTES 189.940
(1) The speed limitation set fourth in the Kentucky Revised Statutes does not
apply to emergency vehicles:
(a) When responding to emergency calls; or
(b) To police vehicles when in pursuit of an actual suspected violator of
the law; or
(c) To ambulances when transporting to medical care facilities; and
(d) The driver thereof is given the warning required by subsection (5) (a)
and (b) of this section. No portion of this subsection the vehicle with due
regard for the safety of all person using the street or highway.
(2) The driver of an emergency vehicle, when responding to an emergency call, or
of a police vehicle in pursuit of an actual or suspected violator of the law, or of an
ambulance transporting a patient to a medical care facility and giving the earning
required by subsection (5) of this section, upon approaching any red light or stop
signal or any stop sign shall slow down as necessary for safety to traffic, but may
proceed past such red or stop light or stop sign with due regard for the safety of
persons using the street or highway.
(3) The driver of an emergency vehicle, when responding to an emergency call, or
of a police vehicle in pursuit of an actual violator of law, or of an ambulance
transporting a patient to a medical care facility and giving warning required by
subsection (5) of this section, may drive on the left side of any highway or on the
opposite direction of a one-way street provided the normal lanes of traffic are
blocked and he does so with due regard for the safety of all person using the street
or highway.
(4) The driver of an emergency or public safety vehicle may stop or park his
vehicle upon any street or highway without regard to the provisions of KRS
189.390 and 189.450, provided that, during the time the vehicle is parked at the
scene of an emergency, that at least one (1) warning light is in operation at all
times.
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(5) The driver of an emergency vehicle desiring the use of any option granted by
subsections (1) through (5) of this section shall give warning in the following
manner:
(a) By illuminating the vehicle warning lights continuously during the
period of emergency.
(b) By continuous sounding of the vehicle’s siren, bell, or exhaust whistle,
unless
(c) The vehicle is an ambulance and the driver if of opinion that the
sounding of the siren, bell, or exhaust whistle would be detrimental to the
victim’s health. In the even the driver of an ambulance elects not to use
the siren, bell or exhaust whistle he shall not proceed past red lights or
drive in the opposite direction of a one-way street or in oncoming lanes of
traffic unless no other vehicles are within five hundred (500) feet of the
front of the ambulance. The driver shall not extinguish the warning light
during the period of the emergency.
(6) No driver or operator of any emergency or public safety or other vehicle shall
use the warning lights or siren, bell or exhaust whistle of his vehicle for any
purpose or under any circumstances other than those permitted by KRS 189.910
to 189.950.
(7) KRS 189.910 to 185.950 does not relieve the driver of any emergency or
public safety vehicle from the duty to drive with due regard for the safety of all
persons and property upon the highway.
700.04 LEAVING VEHICLE UNATTENDED
Hospital Air Ventilation Systems can pull vehicle fumes into the hospital’s building
affecting the functions of the hospital. We must be conscious of our effect upon their
operations and turn off our vehicles while at the hospital.
700.05 SAFETY BELT USAGE
Seat belts are mandatory at all times by all passengers on emergency and non-emergency
runs. The only exception shall be when the rendering of patient care in the rear of the
ambulance by the attendant.
All stretcher patients, including full arrest victims, shall be strapped to the stretcher by at
least two appropriate cross belts and safety harness on the stretcher. Failure to use proper
belts, including safety harnesses, shall be a serious violation of company policy.
700.06 BACKING PROCEDURES
It is highly recommended at Breck Central EMS when backing with no patient on board,
the non-driver attendant on board will get out of the vehicle and serves as a “backer” or a
spotter, to help direct the driver in backing the vehicle safely.
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700.07 AMBULANCE ACCIDENT PROCEDURES
NO COMMENTS SHALL BE MADE TO ANYONE REGARDING THE
ACCIDENT EXCEPT TO THE POLICE OR COMMAND STAFF.
!!!!!!DETERMINE INJURIES!!!!!
General Guidelines
1. Ambulance personnel will call 911 and request the KY State Police at the scene.
2. Ambulance personnel will contact Breck Co. Dispatch and advise them of the situation
and ask them to notify a supervisor.
3. Get additional unit en route for the completion of the transport of a patient if loaded.
4. Ambulance personnel will leave the ambulance exactly as is (i.e. lights, sirens). This
will be at the discretion of the crew – depending upon the patient that is being
transported.
5. Ambulance personnel will complete triage on patients at the scene, and notify dispatch
of additional resources needed.
6. Ambulance personnel will do there best to survey the scene and document as much as
possible.
7. Ambulance personnel will request a breathalyzer for the driver from the state police,
and may be requested for toxicology tests at a hospital.
8. If severe, Ambulance personnel will request accident reconstruction at the scene.
9. If a paramedic is being transported to a hospital he will turn over the narcotics to the
police on scene.
10. If at all possible the ambulance will not be moved until a supervisor arrives at the
scene.
Actions
1. Is the accident an injury accident?
a. If the accident is not an injury, the EMS Chief will follow-up with the
ambulance personnel next date or at Headquarters.
b. If the accident is an injury accident the EMS Chief will do the following:
1. Contact another crew to be on call.
2. Notify the insurance agency KACO
3. Notify the judge executive office.
4. Notify the workers compensation KEMI
2. Is the accident severe?
a. If no, the EMS Chief will have the ambulance personnel’s family called.
b. If yes, the EMS Chief will do the following:
1. Have the ambulance personnel’s family notified in person.
2. Contact Counselors for ambulance personnel. (If local counselor is
unavailable, the state agency will be contacted the morning of day two.)
3. Go to the scene
4. Take pictures and gather information at the scene
5. Retrieve the narcotics form the police
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6. Receive information from the police
7. Got to the hospital to check on patient and ambulance personnel
8. Make copies of all information and reports gathered
9. Take all copies to the Judge Executive Office for them to file insurance
10. Contact the Chairman of the Board of Directors
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800.00 EMPLOYEE CONDUCT, ETHICS, AND DISCIPLINE
800.01 CONDUCT AND WORK ETHICS
To ensure orderly operations and provide the best possible work environment, Breck
Central EMS expects employees to follow rules and conduct that will protect the interests
and safety of all employees and the organization.
It isn’t possible to list all the forms of behavior that are considered unacceptable in the
workplace. The following are examples of infractions of rules of conduct that may result
in disciplinary action, up to and including termination of employment:
Theft or inappropriate removal or possessions of property
Falsifications of documentations and timekeeping records
Failure to deem authorization for schedule changes along with signed requisitions.
Working under the influence of alcohol or illegal drugs
Possession, distribution, sale, transfer, or use of alcohol or illegal drugs in the
workplace, while in an EMS owned vehicle or uniform.
Fighting or threatening violence in the workplace
Boisterous or disruptive activity in the workplace
Negligence or improper conduct leading to damage of EMS owned vehicles,
property, or equipment
Insubordination or other disrespectful conduct
Violation of safety or health rules
Smoking in EMS vehicles or in smoking prohibited areas
Failure to comply with the EMS dress code, ill personal hygiene, negligence or
abusive care of EMS uniform
Sexual or other unwelcome harassment
Possessions of dangerous or unauthorized material, such as explosives or firearms
in the workplace
Excessive absenteeism or any absence without notice
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Unauthorized absence from work during the scheduled workday
Unauthorized use of telephones, mail systems, or other EMS owned equipment
Frequent personal visitors on premises of EMS, unauthorized personnel in the
lounging quarters after 23:00 hours, or allowing unauthorized personnel to ride in
the ambulance.
Unauthorized disclosure of business “secrets” or confidential information
regarding fellow employees, management, or patients.
Disrespect or discrimination against patients or patient families or representatives.
Violation of personnel policies
Unsatisfactory performance or conduct
Failure to accumulate designated in-service training hours required for
recertification or re-licensure.
Failure to comply with demand required as Job Classification Titles
Responding to calls in personal vehicles without authorization
Failure to file incident reports (minor or major)
Failure to notify dispatch of unusual situations at a scene that require extra EMS
units or administrative persons to be notified.
Failure to notify the proper authorities in case of injury or accident in EMS
vehicles.
Failure to consult with the EMS Chief for any expenditure directly charged to
Breck Central EMS.
Failure to restock, clean, and disinfect squads during each shift and /or between
each run.
Failure to check unit at the beginning of each shift to ensure inventory.
Failure to retrieve equipment at facilities.
Failure to refuel EMS vehicles after each out of town run or no less than ¾ tank at
all times.
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Failure to complete and fill all paperwork and run forms for patient confidentiality
and for purposes of billing for each run.
Failure to direct questions of billing to the business office.
Failure to allow patient’s rights to be transported to the hospital of choice for
personal reasons (i.e. it’s late and you want to get back to sleep).
Poor attendance and excessive tardiness when reporting to work.
800.02 DISCIPLINARY POLICY
The service is tasked to establish the standards for supervision, discipline, and
termination of personnel working at Breck Central EMS. It is the service’s policy to
impose disciplinary action fairly and impartially and to offer adequate appeal procedures
to ensure that the rights of employees are protected. Discipline is the process of imposing
formal sanctions, which will help train or develop the employee, preferably through
constructive rather than punitive measure, Discipline in counseling, and as a last resort,
punitive action.
Breck Central EMS abides by the philosophy that discipline must be applied consistently
and uniformly. This order provides discussion of employee recognition and penalties for
various infractions.
Breck Central EMS does not provide employees with a list of specifically prohibited
behavior. Examples of such behavior appear in policy, but no list can be all-inclusive.
Employees are expected to have a reasonable perception of what constitutes proper
behavior, based on training and the observance of the proper behavior in general.
An individual of Breck Central EMS is expected to conduct him or herself in a manner
that serious corrective measures are unnecessary. A personal knowledge of Breck Central
EMS policies and procedures is expected to assure a professional level of conduct from
all employees. Employees are expected to report infractions of law or Breck Central EMS
policies and procedures in order to ensure integrity of Breck Central EMS is maintained.
800.03 COMMAND
Command is accountable for the actions of their subordinates. Command shall be
thoroughly familiar with Breck Central EMS policies and procedures, and apply the
highest ethical concern to their responsibilities and those of their subordinates. In this
regard, command’s responsibilities include, but are not necessarily limited to:
Orientation of new employees in Breck Central EMS policies and procedures and
expected standards of performance and conduct;
Implementation of Breck Central EMS policies and procedures; and
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When necessary, the imposing of suitable disciplinary measures to ensure
adherence to Breck Central EMS procedures.
800.04 DISCIPLINARY ACTION
Failure or refusal by an employee to comply with Breck Central EMS policies or
procedures shall result in disciplinary action against that member. Disciplinary action is
intended to be corrective and progressive in nature.
Generally, discipline shall be designed to encourage the member to conform to the
established standards of performance or conduct, except those instances where the actions
of the employee are not conductive to rehabilitation or make continued employment with
Breck Central EMS clearly unacceptable.
The imposition of discipline shall be determined on an individual basis, and shall take
into account such factors as the seriousness of the infraction and the employee’s record of
service with Breck Central EMS.
In order to ensure fairness and impartiality in disciplinary matters, no members may
interfere with Breck Central EMS disciplinary procedures, nor may any member exert or
attempt to exert any influence on any participants in the disciplinary process except as
permitted by provisions of the process.
Types of disciplinary actions include:
Counseling: Process where a supervisor and an employee review specific procedures or
forms of conduct, discussing what is proper and expected. This process is equivalent to
training and/or review of the procedures and conduct. Training and counseling will be
used interchangeably.
Command is expected to counsel employees regularly without oral reprimands. Most
counseling is informal, positive, supportive, and does not necessarily require
documentation.
Oral Reprimand: Oral reprimands may be informal, but does require documentation
with an employee’s acknowledgement of such action and record imposed. The following
procedures shall be observed:
At the time of oral reprimand, the employee receiving the reprimand shall be
counseled as to correct behavior, and further advised that a written record shall be
maintained concerning the reprimand, and that the employees may read the
record.
The employee shall be further advised that they have the right to file a statement
in their personnel file setting forth their position, in case of a disagreement.
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The reprimanding supervisor shall record the reprimand in memorandum forward
to the personnel record.
The oral reprimand may involve remedial training. Such training may be deemed
necessary to rectify the improper behavior. Remedial training may include attendance of
basic training classes, in-service, or other training specially created to accomplish the
commands recommendations to correct or modify the employee’s behavior. All training
shall be documented, according to normal requirements and procedures.
If the employee has not behaved improperly following the oral reprimand for one year,
the record of the oral reprimand shall be expunged from the employee’s personnel file.
Accumulation of three or more oral reprimands in one year shall result in a written
reprimand or suspension, depending on the circumstances of the infraction.
Written Reprimands: A written reprimand, issued by the EMS Chief cautions an
employee about poor behavior, sets forth the corrected or modified behavior mandated by
the service and specifies the penalty in case of recurrent poor behavior. A written
reprimand becomes a permanent part of the employee’s personnel record.
An employee may appeal a written reprimand in writing within ten (10) days of its
receipt. The appeal is to the Breck Central EMS Board of Directors who shall be the final
arbiter.
Administrative Probation: The purpose of administrative probation is to provide a
mechanism for structured correction of performance deficiencies. The procedure will
provide the employee with specific goals to be met within a specific time period. The
procedure will also provide command and the employee with benchmarks to measure
improvement according to a pre-defined schedule.
An employee will be placed on administrative probation when the performance of the
employee does not meet the necessary standards set forth by the service. The
probationary period will be no less than six (6) weeks and no more than twenty four (24)
weeks.
At the time an employee is placed on probation, the employee will be given specific
performance goals, which shall be met by the end of the probationary period. The
employee and the EMS Chief shall also agree on an outline of corrective measures to
meet these performance goals.
The EMS Chief shall have periodic evaluation conference with the employee to
benchmark the progress of the employee and to evaluate the effectiveness of the
corrective measures. The evaluation shall be written with the employee having the right
and responsibility to document their responses in writing. Any modification of the outline
of corrective measures shall also be in writing. Copies of the evaluation conference shall
go to the employee and employee’s personnel file.
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During and at the end of the probationary period, the EMS Chief shall make one of the
following decisions:
The employee has successfully completed the probationary period by meeting all
of the performance goals originally set forth.
The employee has made significant progress toward meeting the performance
goals originally set forth and the probationary period should have a one-time
extension of no more than four weeks to meet the goals.
The employee has not met the performance goals originally set forth and has not
made significant progress to merit an extension of the probationary period and
further disciplinary action should be considered by the EMS Chief.
Administrative probation is a one-time corrective measure for specific problems.
Reoccurrence of the same problem after administrative probation would result in direct
disciplinary action. Disciplinary options are; Suspensions without pay or dismissal.
Suspension Without Pay: If the situation warrants, command, with the approval of the
EMS Chief, may suspend an employee without pay.
Suspension without pay will normally apply to a period of up to eight (80) hours, as
determined by the command and the EMS Chief. If an employee shall become a
candidate for suspension a second time within one year after the first suspension, the
employee will be eligible for dismissal form the service.
Suspensions resulting form criminal investigations may be prolonged beyond eighty (80)
hours pending court action. In no case shall an employee convicted of a felony continue
to work for the service. If an employee is acquitted of criminal charges, the employee
may be disciplined, at the discretions of the EMS Chief, or reinstated with full or partial
back pay.
During a suspension, the employee shall not undertake any official duties with the
service. Any employee shall not come onto the ground or interfere with the operations of
the service in anyway during his/her suspension.
An employee may protest a suspension within ten (10) days of notice of suspension. The
appeal is to Breck Central EMS Board of Directors who shall be the final arbiter.
Dismissal: Dismissals are made in cases of extreme misfeasance, malfeasance, or
nonfeasance of duty. All person(s) having knowledge of the misbehavior shall make a
complete record of the circumstances of the misbehavior.
The EMS Chief has the authority to impact any disciplinary action set forth in this
manual. If it becomes necessary to permanently remove an employee from their duties at
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Breck Central EMS, the EMS Chief will inform the Board of Directors of his or her
actions.
800.05 CATEGORIES OF INFRACTIONS AND PUNISHMENTS
Except in matters of gross malfeasance, command should attempt to begin employee
discipline with the least punitive measure. If the least punitive measure does not work
then increasingly more severe measures may be required. It is important that each
employee be dealt with justly, and in a manner that clearly indicated that positive,
constructive measures to change behavior or performance preceded the imposition of
more negative sanctions.
Unacceptable conduct is divided into three categories according to the severity of the
misbehavior.
Category I
Infractions of minor severity yet require correction in the interest of maintaining a
productive well-managed center.
Unauthorized absences, tardiness
Abuse of duty time
Abusive of obscene language, which offends another
Inadequate or unsatisfactory job performance
Disruptive Behavior
Category II
Category II offenses include more severe acts and misbehavior. Category II offenses
normal result, on the first instance, an issuance of a written reprimand. But repeated
offenses could lead up to a suspension of up to eighty (80) hours of dismissal.
Failures to follow commands instructions, perform assigned work, or otherwise
comply with policy.
Violating safety rules without a threat to life.
Unauthorized time away from work assignments without permissions during duty
hours.
Failure to report to work without proper notice to command.
Unauthorized use or misuse of company property.
Category III
Category III offenses include acts of such severity as to merit suspension or dismissal at a
single occurrence. Category III offenses may result in criminal charges being placed
against the employee as may be appropriate or may be punished by suspension for eighty
(80) hours or longer in accordance to with the procedures set forth in this manual.
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Absence in excess of two (2) days without notice to command.
Use of alcohol or unlawful possession of use of a controlled substance while on
duty.
Reporting to work under the influence of intoxicants or when the ability is
impaired by alcohol or the unlawful use of controlled substances.
Insubordination or serious breach of discipline that could have resulted or did
result in safety, operation, and/or security risks.
Falsification of any reports such as, but not necessarily limited to: vouchers,
official reports, time records, leave records, criminal history, and information
records.
Willful or negligent damage to company property.
Theft or unauthorized removal or destruction of company or employee property.
Violating procedures in a meaner that creates a threat to human life.
Unauthorized possession or use of firearms, deadly weapons or explosives.
Threatening or coercing employees or command.
Criminal convictions for acts of conducts occurring on duty or off duty which
plainly related to job performance or are such that to continue the employee in the
assigned position could constitute negligence in regard to Breck Central EMS
duties to the public.
Failure to take physical or mental examination as required. The EMS Chief may
require mental or physical examinations of a member or employee by a
designated psychiatrist, psychologist, or physician when the EMS Chief is in
opinion; it is in the best interest of a member, employee, or Breck Central EMS.
Using the official position and status for private gain.
Engaging in criminal activity on duty.
Engaging in dishonest or immoral conduct that undermines the effectiveness of
Breck Central EMS activities or employee performance.
Willful disobedience of a lawful command of a supervisor.
Disclosure of confidential information to any person except those who may be
entitled to such information.
Taking any action, this will impair the efficiency or reputation of Breck Central
EMS, its members or employees.
Acceptance of any bribe, gift, token, money or other things of value intended as
an inducement to perform or refrain from performing any official act, or any
action of extortion or other means of obtaining money or anything of value
through their position.
Failure to answer questions specifically related to official duties of job fitness
when directed by the employee’s supervisor.
800.06 INTRODUCTORY EMPLOYEES
Introductory employees shall be dismissed according to the foregoing. The only
difference is that an introductory employee has no right of appeal. The official record will
merely indicate that the person was dismissed during the introductory employment
period.
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800.07 SEXUAL HARASSMENT AND OTHER DISCRIMINATION
Employees found to have engaged in discrimination on the basis of race, color, religion,
national origin, political affiliation, handicap, age, or sex, may be counseled or
disciplined with Category I, II, or III offences depending upon the specific facts and
circumstances surrounding the incident.
800.08 FILING A REPORT
If an employee desires to file a report of grievance on a punishment they may get the
appropriate paperwork through command.
If an employee wishes to file a report of misconduct or complaint against another
colleague, command staff, or facility they may do such by going through command. Each
complaint or report will be taken, investigated, and have action taken if needed. The EMS
Chief can call a hearing on the matter with the Board of Directors if needed and the
employee reporting can request a hearing with the Board of Directors if they feel like the
issue was not handled properly.
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900.00 EXPOSURE, HAZ-MAT, MASS CASUALTY POLICIES, AND
CRIMINAL POLICY
900.01 INFECTIOUS DISEASE PRECAUTIONS
Intent: The purpose of this is to establish precautions to be used by Breck central EMS
employees to reduce the risk of exposure to blood and or body fluid infectious diseases.
General: In the pre-hospital setting, it is not always possible to know if a patient has a
blood and/or body fluid infectious disease, therefore, universal precautions shall be
followed when treating and or transporting all patients on emergency and non-emergency
runs.
Prevention: Breck Central EMS employees engaging in any patient care and/or
transportation shall have on latex or vinyl gloves prior to initiating care and/or
transportation. Gloves shall be changed after contact with each patient.
Breck Central EMS employees shall not eat, drink, or smoke while in the ambulance or
while wearing medical gloves.
Medical gloves shall be removed as soon as possible after termination of patient care
and/or transportation, taking care to avoid skin contact with the exterior surface and shall
be disposed of in accordance with disposal of contaminated materials as set forth in these
guidelines.
In addition to medical gloves, masks, and protective eyewear and/or face shields shall be
worn during airway care procedures and any other patient care procedures that are likely
to generate droplets of blood, sputum, or any other body fluids that could come into
contact with the EMS employee’s mucous membranes of the mouth, nose, and eyes.
If uniforms become soiled with blood or body fluids they must be removed as soon as
possible and laundered separate from any other article of clothing.
Artificial respiration equipment, such as disposable pocket masks and disposable bag
valve mask shall be used when providing rescue breathing. Upon termination of the
resuscitation effort, the disposable respiratory care equipment shall be placed in an
approved infectious medical waste container for proper disposal.
Breck Central EMS employees with extensive skin lesions or severe dermatitis on hands,
arms, head, face, or neck should not engage in direct patient contact, handled patient care
equipment and/or handle medical waste.
Hand Washing: Breck Central EMS employees should wash with soap and warm water
immediately after medical gloves are removed and prior to eating, drinking, or smoking.
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Hands shall be washed after each EMS run, after cleaning and disinfecting equipment,
after any cleaning function, before and after using the bathroom facilities, before and
after handling food, food utensils, cooking utensils and before and after handling cleaned
and disinfected emergency medical equipment.
If soap and warm water are not immediately available, EMS employees should use
alcohol or other skin cleanser that have been provided in each EMS unit that do not
require water, until soap and water are aging available.
Hands and other exposed skin surfaced shall be washed with soap and warm water by
lathering the skin and vigorously rubbing together all lathered surfaces for at lest 15
seconds, followed by thorough rinsing under warm water.
Disposal of Contaminated Material: Contaminated disposable medical supplies and/or
equipment, contaminated disposable infection control garments and contaminated soiled
linens and waste shall be placed in an approved, leak proof bag provided by Breck
Central EMS in each unit. He bag should be sealed and disposed of as an infectious
medical waste through the local hospital.
Exposures: An exposure shall be defined as a dirty needle stick, blood or body fluid
contact through broken or non-intact, chapped, abraded, weeping skin or skin having
rashes or eruption, and blood and/or body fluid contact with the mucous membranes of
the eyes, nose, or mouth.
If any exposure occurs, the exposed area shall be thoroughly washed immediately using
water on mucus surfaces and soap and water on skin surfaces. If soap and warm water
are not available, alcohol, or other waterless cleansing disinfectant agents that have been
provided in each Breck Central EMS unit shall be used until soap and warm water
become available.
Notification of the exposure should be immediately reported to the Shift Leader,
Supervisor and the Medical Director. In all cases the exposure will be handled in a
confidential manner. Only those who are directly involved in arranging medical
guidance, evaluation, and treatment shall be informed of the exposure.
When notified of any exposure, an investigation will be carried through to ensure similar
incidence do not happen again. Any Breck Central EMS employee that was potentially
exposed during the exposure incident will be notified.
The EMS Chief shall ensure that all employees who sustained exposure shall receive
medical guidance, evaluation and where appropriate, prophylactic treatment as soon as
prophylactic, but at least within 48 hours. Appropriate, confidential, post exposure
counseling and testing shall be made available.
The exposed Breck Central EMS employee using the standard exposure form shall record
all exposures in writing as soon as possible. Included in the record shall be a description
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of the tasks being performed when the exposure occurred, the means of transmission, the
port of entry, the infection control garments and equipment utilized and the disposition of
medical management.
The record of exposure shall become part of Breck Central EMS employee’s confidential
permanent health file.
A complete record of the employee’s exposure shall be available to the employee upon
request.
900.02 HAZARDOUS MATERIAL INCIDNETS:
This policy is intended to serve only as a guide for Breck Central EMS personnel. An
emergency plan of action within the Emergency Services of Breckinridge County is set
and our intent is to follow incident command and respecting the following plan.
A) RESPONSE
1. Upon arrival and/or through dispatch information, in Breck Central EMS
personnel determine that a Hazardous Material Incident exists, the crew shall
immediately notify dispatch of a HAZ-MAT incident including the size up to
include number of patients, if know, and to request additional Emergency
Departments to respond. Fire Departments, Law Enforcement, EMS Command,
or Emergency Management.
2. Breck Central EMS vehicle and crew shall position themselves:
A. Upwind and out of harm’s way of the incident.
B. Respectively leave access for other emergency vehicles.
C. Allow easy access to enter and exit the scene.
3. Upon arrival of the Fire Department they shall serve as Incident command for
the HAZ-MAT Incident and shall be responsible for establishing “hot, warm,
and cold zones.”
B) TRIAGE AND TREATMENT OF PATIENTS
1. All and/or any contaminated patients shall be removed from the “hot zone” by
designees who are properly trained and equipped for the hazardous materials.
2. Designees who are properly trained in decontamination efforts for HAZ-MAT
Incidences shall decontaminate all and/or any contaminated patients in the “warm
zone.”
3. After decontamination by personnel and/or their designee in the “warm zone”,
patients will be brought to the “cold zone” where they will be received by Breck
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Central EMS personnel who shall wrap the patient and/or patients in blankets
and/or disposable sheets for movement to the triage area.
4. A triage area shall be established to triage patients for treatment. The triage
area should be:
A. In the “Cold Zone”, upwind of the incident and out of harm’s
way.
B. The area should be dry and if possible out of weather with ease
of entry, re-entry, and exit for personnel and EMS vehicles
without blocking access to the scene.
5. Breck Central Ambulance personnel triaging and/or treating patient shall wear
a minimum of the regular BSI, disposable gloves, eye, mouth, and nose
protection.
6. Unless otherwise indicated by the MSDS, unusual and customary treatment
from the standing protocols shall be administered.
C) TRANSPORTATION
1 If possible, the floor of the ambulance should be covered with disposable
blankets.
2 Prior to placing the patient on the ambulance cot, the cot mattress should be
wrapped with plastic or a disposable blanket. The patient should be wrapped
in a disposable sheet, and then placed on the cot and wrapped with a
disposable blanket.
3 Breck Central Ambulance personnel transporting patients from a Haz-Mat
incident shall wear a minimum of the regular BSI of disposable gloves, eye,
mouth, and nose protection.
4 Breck Central Ambulance personnel transporting patients from a Haz-Mat
incident shall communicate with the receiving hospital:
A. To confirm the hospital’s preparedness to receive Haz-Mat
incident patients
B. To relay the amount of patients that is being transported to their
facility.
C. To relay patient condition and care.
D. To request delivery location as this may be a different location
other than normal to avoid the possible contamination of the
Emergency Department.
E. After delivery of patient(s), Breck Central Ambulance vehicle
and crew shall return to the scene of the incident for additional
patient transportation if needed or to be decontaminated.
D) DECONTAMINATION
1. Breck Central Ambulance vehicle and equipment shall be
decontaminated at the incident site. Per the authority and under
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the supervision of personnel properly trained and equipped for
Hazardous Material Decontamination.
2. Contaminated clothing and other items shall be bagged and
disposed of at the incident site.
900.03 MASS CASUALTY AND DISASTER INCIDENTS
The county of Breckinridge has established an Emergency Operations Plan Manual.
Breck Central Ambulance Service seeks guidance from the manual in Appendix M-1 that
follows National Guidelines for National Disaster and Medical Systems.
DIRECTION AND CONTROL
In the event of a Mass Casualty and/or Disaster in Breckinridge County the following
procedures will be guidelines to follow:
A. Determination of Disaster or Mechanism of Injury for Casualties.
B. All EMS personnel to respond to there assigned station.
C. Colonel and command will respond to the scene.
D. Personnel will receive guidance and direction from command.
E. Mutual Aid will be notified for assistance, Air Ambulance is notified as well
as surrounding hospitals.
F. School systems will be utilized in case of evacuation or need for extra holding
area accommodations for the sick and injured.
G. American Red Cross will be notified for extra supplies and to assist with
persons being evacuated or treated in the holding area.
ON THE SCENE
A. First crew on scene, assesses the scene, determines factors, approximates
amount of patients, need for assistance from EMS or other Emergency
Departments and need for additional supplies and/or equipment.
B. Set up a route for easy entry and departure of Emergency Vehicles.
C. Appoint EMS personnel to be the communicating liaison between dispatch
and scene.
D. Make contact with dispatch for holding accommodation information.
E. Determine a triage area, preferable under cover, rope off the area, appoint a
senior EMT-P as triage command officer.
F. Triage: RED TAGS (Immediate Care)
YELLOW TAGS (Delayed transport can treated in holding
area, with plans soon for transport.)
GREEN TAGS (Ambulatory can be treated in Holding
Area)
BLACK TAGS (Deceased)
G. Upon Colonel or command arrival on scene they will serve as Incident
command, liaison, and coordinators of transportation, in the medical division.
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During times of Disaster and/or Mass Casualties, transportation to outline hospitals will
be necessary. It is important to transfer patients to holding areas that have been set up so
that medical care can be given to them during stabilization process. EMT-FRs, EMT-Bs
and EMT-Ps will be needed in the holding area as well as in the field. Nurses and
Doctors will respond to the holding areas for assistance. Follow Directors Of Incident
Command Officers.
900.04 CRIMINAL AND POTENTIAL TERRORIST
Responding to criminal incidents as EMS providers is unfortunate but often required
from time to time. However, you must consider yourself and your crew member’s safety
first and foremost during each and every incident.
If responding to a call that you feel has a sense of urgency for police to be there you shall
notify dispatch to cause the appropriate law enforcement agency to respond. If law
enforcement is responding you should assume all scenes are unsafe and standby at a safe
distance until the scene is secured by police.
If you are on a scene which becomes hostile, you shall notify dispatch for police backup
and leave the scene at once ensuring the safety or yourself, your crew member, and
others. Standby at a safe location and wait for police to secure the scene.
If you are transporting a patient that becomes violent, pull off the road, notify dispatch
and cause police to respond. With both crew members if it is safe to attempt restraining
the patient do so, otherwise, leave patient in unit and leave scene with whatever means
available.
Police should be automatically dispatched with you on ALL:
1. Domestic or Assault with Injuries
2. Suicide Attempts
3. Injuries resulting from a firearm or knife.
4. Psychiatric Disorders
If you are dispatched to one of the above, assure with dispatch that police is also
responding.
A few safety tips while on scene:
1. When possible never walk in front of someone at a residence, always ask where and
FOLLOW them to the patient.
2. Always identify yourself.
3. In an unsure situation, never leave your partner alone.
4. Always keep scene well lit, with scene lights and headlights.
5. ALWAYS KEEP A PORTABLE RADIO WITH YOU WHEN OUT OF
AMBULANCE.
6. ALWAYS KEEP DISPATCHED INFORMED OR YOU EXACT LOCATION.
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