Introduction 1

History & Background 1

Organizational History 1

Creed 2

Organization 2

Primary Role 2

Secondary Role 2

EMS Office 2

Crew Quarters 3

Organization of Offices 3

Operations Chain of Command 4

Performance Testing 4

Didactic Knowledge 4

Scenario-Based Skills Testing 4

Call Evaluations 5

Local Procedures 5

Duty Shifts 6

Hospital/Treatment Options 6

Student Health Center/Health Service 6

Chester County Hospital 7

Brandywine Hospital 7

Paoli Memorial Hospital 7

Medical/Legal Concerns 7

Negligence 7

Consent 8

Confidentiality 10

Crime Scene Preservation 10

Patient Assessment 11

Dispatch 11

Scene Survey 12

Primary Assessment 13

Trauma Assessment 14

Patient History 16

Vital Signs 17

Reassessment 17

Medical Alert Tags 18

Documentation 18

Radio Communications 18

Use of the Radio 19

Radio Care 19

Radio Operating Procedure 20

Battery Charging & Care 21

Radio Codes 21

"Ten codes:" 21

Contacting Medical Command 21

Contacting Chester County Fire Board 22

Proper Medical Report Format 22

History of Present Illness 23

Past Medical History 23

Documentation 23

On-scene form 24

Refusal form 24

Call files & Call Log 24

Incident Report Form 24

Personnel Files 24

State Tripsheets 25

EMMA 25

Sample Narrative 28

Equipment 29

Forms of Identification 29

Medical Equipment 29

Personal Protective Equipment 29

Airway Devices 30

Manual Airway Management 30

Airway Adjuncts 30

Suction 31

Oxygen 32

Oxygen Tanks and Regulators 32

Oxygen Delivery Systems 33

Oxygen Masks 33

Ventilation Devices 34

Spinal Immobilization 35

Manual Stabilization 36

Applying a Cervical Collar 36

Backboarding 37

Notes 38

Bloodborne Pathogens 38

Radio-Related Details 39

Frequently Asked Questions 40

The Repeater 41

PL and Tone Paging 41

Channel Assignments 42

WCU Mobile Radio 42

County Mobile Radio 42

HT1000 Portable Radios 42

International Phonetic Alphabet 43

Introduction

Purpose

The West Chester University Emergency Medical Service [WCU EMS] Training Manual is designed to acquaint new members and re-acquaint old members with the policies, operating procedures, and functions of the organization. It should not necessarily be used as a "source of rules and regulations" when there are official questions in relation to the organization. However, it may be used as a source of guidance. Further, the manual is not intended to replace medical training courses or the WCU EMS training lectures, but rather function as a supplement.

Completion

After completion of the classroom and practical portions of the training program, the preceptee must schedule an interview to assess their knowledge concerning policies, bylaws, and patient assessment with the Training Officer and Director. If the interview is satisfactory, the preceptee may be considered for primary EMTship.

Note: At any time, should situations warrant, the Training Officer or Director may revoke certification in any one or more areas. At that time, the member must once again complete those areas in order to regain proficiency.

Superseding Documents

We have attempted to make the Training Manual as accurate as possible. However, the official policies of WCU EMS are specified in the Bylaws, Operating Policies, and Treatment Protocols. In the event of a conflict, those documents, Pennsylvania Act 45 (also known as the Emergency Services Act), and Pennsylvania Department of Health Rules and Regulations supersede the Training Manual.

Background Information

WCU EMS is officially known as West Chester University Emergency Medical Service and provides medical coverage and training for the West Chester University campus. Funded by West Chester University Health Center, WCU EMS receives authority to act on campus through the West Chester Department of Security, Emergency Medical Service Institute, and Commonwealth of Pennsylvania Act 45 (Emergency Services Act).

History & Background

Organizational History

Creed

Organization

Primary Role

The primary role of WCU EMS is response to campus medical emergencies. WCU EMS is dispatched by Campus Police to campus medical emergencies via two-way radio 24 hours a day, 7 days a week, when school is in session and during breaks as personnel allow. We provide a vital and life-saving service to the campus community.

Secondary Role

The secondary role of WCU EMS is the provision of training in EMS and related fields to the campus community, and education in injury and illness prevention. To this end, we provide our members and the campus community with classes in Cardiopulmonary Resuscitation [CPR]. Furthermore, WCU EMS helps make others on campus aware of classes that are available at the Good Fellowship Training Institute [GFACTI], the Chester County Department of Emergency Services [DES], and other locations in the West Chester area. Classes are available in areas such as Cardiopulmonary Resuscitation [CPR], First Responder [FR], Emergency Medical Technician-Basic [EMT-B], Emergency Medical Technician-Paramedic [EMT-P], rescue, hazardous materials [HazMat], and other specialized certifications.

Members are encouraged both to receive a certification that accurately reflects their ability, and to maintain and improve skills through volunteer or paid work either locally or at home. Members certified in Pennsylvania are eligible to act up to the Pennsylvania EMT-Basic standard of care. Members not certified in any capacity, or certified in another state or area, must either attend classes for certification or apply for reciprocity to be eligible to run calls with WCU EMS.

EMS Office

The EMS office is located on the ground floor of Tyson Hall, room 020. That room is the central equipment storage place and may contain notices of meetings, upcoming classes, or other events of interest. The rear half of the office contains two bunk beds. All primary EMTs are encouraged to obtain a key to the office by submitting a request to the Equipment Officer. Precepting members can borrow an office key from the WCUPD dispatcher when they need access to the office; to borrow a key, you may need to show your WCU EMS ID or WCU student ID.

The office phone may be used for personal (local and on-campus) calls; however, long distance and local long distance calls cannot be made from it without the use of a phone card. Please don't tie up the office phone for hours at a time with personal calls. Since we get business calls at the office, don't be a clown when answering the phone. Answer the phone "EMS" or "STATION 58," and state your name. If someone calls to request medical advice, they should be referred to Health Services; we do not give out medical advice over the phone. Should someone call the office with an emergency, have them contact WCUPD.

Crew Quarters

The EMS crew quarters are located in Tyson Hall, room 020. The crew quarters are intended for use by on-duty crew, to facilitate response to calls at night. The crew quarters have access to a bathroom with shower, a kitchen, two bunk beds, a TV and VCR. While all members are welcome to drop by the crew quarters at any time, it should be stressed that the quarters exist for the primary use of the on-duty crew, and any members or visitors which disrupt crew operations may be asked to leave.

Organization of Offices

WCU EMS is administered by the Director/Advisor.

The Director's main responsibilities include representing the organization to outside interests and managing all administrative concerns. The Director is also ultimately responsible for all aspects of the organization, including operations, and reports to the Assistant Dean of Students (Health Center Director).

Operations Chain of Command

The Director is ultimately responsible for all operational concerns. The Supervisor represents the Director on incident scenes, and controls response efforts of EMS for the campus. The three supervisors report to the Director. Each Supervisor has shared duties and specific duties assigned to each one. The primary EMTs are responsible for their on-duty crew, along with patient care. Secondary EMTs work under the Primaries for guidance and evaluation for obtaining Primary status. Attendants assist the rest of the crew as needed.

Performance Testing

In order to best determine the competency of each precepting member, the organization has established an evaluation system that assesses the performance of normal EMS duties, in addition to didactic knowledge and scenario-based skill evaluation. There are three areas of skills testing: didactic knowledge, scenario-based skills testing, and evaluation on actual calls. This evaluation system is described in the Primary EMT Standard, which enumerates the requirements for becoming a primary EMT. Note that simply completing the requirements in the Primary EMT Standard does not automatically make you a primary EMT; those are simply the minimum requirements.

Didactic Knowledge

There are numerous pieces of "book knowledge" that you will need to be familiar with in order to be an effective member of WCU EMS. This knowledge is tested through the verbal quiz section of the Primary EMT Standard and through the membership interview. Most of the didactic questions are answered in this training manual; if you have questions about any piece of information, feel free to ask any primary EMT, the Training Officer, or the Operations Manager.

Scenario-Based Skills Testing

You are expected to complete several training scenarios as part of the performance testing. The aim of these scenarios is to test skills that would otherwise not be exercised frequently on actual calls, to familiarize you with calls that they may not encounter on a regular basis, and to enable you to make mistakes without endangering yourself, your crew, or your patient.

Most scenarios can be completed successfully by one person working alone, but you may be given crew members depending on the scenario and the availability of other people at the time you run the scenario. (Note that additional crew members can be both a help and a hindrance. If you don't have crew members, you don't have to worry about giving them instructions...) Crew members for a scenario will usually function at the level of a (relatively new) precepting member, meaning that you can give them specific instructions and they will usually carry them out appropriately, but they cannot assess the patient or make treatment decisions. If you would like a "ghost person" to hold C-spine, you must first apply the cervical collar, at which point the ghost person can take over. (Ghost medics are only available at the discretion of the evaluator, of course.)

A scenario begins with the evaluator giving you the dispatch information. You can ask the evaluator any questions that you have (what does the scene look like, is Campus Police on the scene/on the way, etc.), and then enter the scene and begin treating the patient(s). Since one of the goals of scenario testing is to exercise your skills, you should treat the scenario as an actual call, and physically perform any skills or actions that you would on a real call. For example, if you want to know the patient's blood pressure, you should actually take the blood pressure (or have a crew member take it); if you would bandage the patient's injury on the actual call, you should also bandage the simulated patient during the scenario. During the scenario you should interact primarily with the patient, with the evaluator only stepping in to change vital signs as necessary and tell you what you "see."

Scenarios are evaluated according to objective and subjective criteria. You need to score at least an 85% in order to pass the scenario. Once the scenario is over, the evaluator will give you feedback about your performance and tell you whether or not you passed the scenario. Remember to keep all aspects of the call in mind when you run a scenario; the scenario may test skills other than patient assessment and treatment (such as scene safety/management, patient interaction, and so forth). If you disagree with the grading of a scenario that you ran, contact the Training Officer or the Operations Manager.

Call Evaluations

In addition to scenarios, you will also be evaluated on every call for which you direct care or in which you have a major role. Some members have argued that this puts an unfair amount of pressure on you, the precepting member, especially considering that some portions of the call evaluation are cumulative and negative scores count against you. However, it's important to remember that regardless of whether you are being evaluated by another WCU EMS member, you are always being evaluated by someone whose opinion matters even more than theirs: the patient. For this reason, we feel it is important that every member constantly be mindful of their performance on calls, and evaluations on every call help reinforce that for precepting members.

The call evaluation should be filled out by the crew chief on the scene. The evaluation form is fairly self-explanatory; if you have questions about it, contact the Training Officer. If you have any problems with a call evaluation, they can be referred to the Training Officer, the Operations Manager, and finally the Quality Assurance Board.

Local Procedures

Duty Shifts

Precepting members are eligible to be on duty and complete shifts with WCU EMS after completion of the requirements set out in the Prec

	Emergency Medical Services Tyson Hall Basement West Chester, Pennsylvania 19383	Emergency: (610)436-3311 Office: (610)436-3138 http://ems.wcupa.edu/