Download EMT Operational Guide 2016-2017

EMT Operational Guide
Illini Emergency Medical Services
EMT Operational Guide
Illini Emergency Medical Services offers a unique service to the university by providing
emergency medical care for nearly 250 campus events annually. As EMT-Basics, you are the
highest level of care patients receive prior to hospital transport and, as such, you are held to strict
standards to ensure proper patient care and safety.
It is understood that, as students, the amount of time spent utilizing Basic Life Support skills is
not as extensive as individuals working full-time on an ambulance, however, this is no excuse for
care quality discrepancies. All Illini EMS EMT-Bs are expected to maintain a high level of
proficiency regarding life-saving knowledge and techniques. Therefore, the Critical Skills
Assessment has been initiated in order to accurately assess each EMT prior to clearance for
service.
This document was designed in conjunction with the Illini EMS Education Department as a
means of not only providing EMTs with a study guide for their annual Critical Skills
Assessment, but also as a concise outline highlighting the most important and frequently used
skills on which EMTs rely. It is strongly advised that all EMTs utilize this document as content
review prior to staffing each event.
Those who have taken the EMT class through Illini EMS will recognize the following
informational display is in the style of their EMT Check-Offs, however, be advised that a few
points have been altered in order to accommodate Illinois EMS Region 6 Protocols as opposed to
protocols followed by the National Registry. These adjustments are minor and mostly pertain to
how medications are administered within Illinois EMS Region 6, which is the region under
which Illini EMS operates.
It is our hope that this document, along with the Critical Skills Assessment, will facilitate a
smooth transition into Region 6 for EMTs new to Illini EMS, as well as provide a beneficial
refresher for returning EMTs.
If any information presented in this document is unclear, or you have questions regarding
expectations of Illini EMS EMTs, patient care delivery, and/or the organization’s role within the
community emergency medical response system, please feel free to contact the Illini EMS
Director of Operations, Jennifer Main, at [email protected]
Thank you for your hard work and dedication,
Operations Department
Illini Emergency Medical Services
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EMT Operational Guide
Table of Contents
General
Page Number
Requirements for Active EMT Status ............................................................3
How the Critical Skills Assessment Works ...................................................4-5
NIMS Training ...............................................................................................6
Key Elements for Operating Within Illini EMS ............................................7-10
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EMT Operational Guide
Requirements for Active EMT Status Within Illini EMS
In order to function as an EMT-Basic within Illini EMS, all EMTs must:
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Be a University of Illinois student, staff member, or faculty member
Sign the Illini EMS Membership Agreement Form
Sign the Hepatitis-B Vaccine Waiver and fulfill HIPAA
Be in good standing with Illini EMS
Have their current Illinois Department of Public Health State EMT License photocopied
in the IEMS office to be kept on file
Have their current AHA Healthcare Provider or Red Cross for the Professional Rescuer
CPR card photocopied in the IEMS office to be kept on file
Pass the Critical Skills Assessment each year
Complete the NIMS 100 and NIMS 700 online training courses and send copies of their
certificates of completion to the current Director of Operations
Fulfill the Operational Hour Requirement each semester as outline in the Standard
Operating Guidelines
Be well-versed in and adhere to the contents of this document, Region 6 Protocols and
Care Guidelines, and Standard Operating Guidelines*
All three of these documents may be found under the Documents tab of the Illini EMS website
Please download these and refer to them frequently throughout your involvement in Illini
Emergency Medical Services.
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EMT Operational Guide
How the Critical Skills Assessment Works
To volunteer as an Emergency Medical Technician for Illini EMS, successful completion of the
Critical Skills Assessment is required once per academic year. This assessment is intended for
currently licensed EMTs as well as individuals who have completed their EMT class but are still
in the process of obtaining their license.
The Critical Skills Assessment will be held at least three times at the beginning of each semester.
The Operations Department will send out an email when dates/locations have been finalized and
the event is available on iBoards. All EMTs and soon-to-be EMTs who haven’t completed their
assessment for the current year must sign up for one of the available days (each day is conducted
the exactly same way, so sign up for whichever date is most convenient). The Critical Skills
Assessment consists of two parts – a Region 6 Protocol Exam and a hands-on skills assessment:
1.) Region 6 Protocol Exam
Everyone must pass the Region 6 Protocol Exam once per academic year. The exam consists of
multiple-choice questions based on Standard Operating Guidelines, Region 6 Protocols and Care
Guidelines, and this document (EMT Operational Guide). All three of these documents may be
found under the “Documents” tab of the Illini EMS website. EMTs are allotted 30 minutes to
complete the exam and must receive a score of 80% or higher to pass. If an EMT fails to achieve
the required score and needs to retake the protocol exam, he/she has one attempt to retake the
exam and this can be completed at an alternative Critical Skills sessions or during the office
hours of an Illini EMS Operations Department member. In the case of achieving below an 80%
on the second attempt, he/she can retake the exam at a Critical Skills session in a following
semester.
2.) Hands-On Skills Assessment
This portion of Critical Skills consists of five stations:
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Medical Assessment & Medication Administration
Trauma Assessment & Spinal Immobilization
Airway Management
Cardiopulmonary Resuscitation
Cot & Stair-chair Mechanics
EMTs will be randomly paired up and will travel through each station together. Each station will
be proctored by an Illini EMS Supervisor and/or qualified member of the EMS community. In
the case of a large amount of people, some may begin with the hands-on portion and test second.
Some stations are designed to run as a practice scenario, highlighting skills pertaining to the
topic of that particular station (for example, the Trauma Assessment station may be a scenario in
which someone fell down a set of stairs and broke their arm – it would be you and your partner’s
duty to show how you would properly assess and treat the patient). Other stations are designed to
be more of a verbal quiz – the proctor will ask both of you questions pertaining to the station’s
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EMT Operational Guide
topic and perhaps request brief demonstrations. Individuals acting as patients may be utilized in
some stations, while others may involve the use of mannequins.
*The stair-chair portion of the hands-on assessment will be a teaching station in which you will
be shown how to utilize Illini EMS stair-chairs. We understand not all EMTs took their EMT
course through Illini EMS, so if this is your first time completing the Critical Skills Assessment
and there are pieces of equipment that you are unfamiliar with, proctors will gladly demonstrate
its proper usage and ensure you are competent with the equipment prior to working.
Your performance will be evaluated through the Region 6 Protocol Exam and over the course of
the hands-on stations. Feedback will be provided either in person or via email. If you know the
skills outlined in this document, you will do exceedingly well throughout the entire Critical
Skills Assessment. Familiarity with the Standard Operating Guidelines and Region 6 Protocols is
equally as important and will be tested on.
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EMT Operational Guide
NIMS Training
Because Illini EMS is an operational part of the University in emergency situations, the Federal
Emergency Management Agency (FEMA) requires all Illini EMS EMTs to complete National
Incident Command Training (NIMS 100 and NIMS 700). You only have to complete this once
for the duration of your membership with Illini EMS. These courses are taken online through
FEMA’s website. To complete this requirement you must:
1. Access the classes online
http://training.fema.gov/emiweb/is/is100b.asp
http://training.fema.gov/emiweb/is/is700a.asp
2. Take/Click through the online course.
3. Pass the online-based Final Exam.
4. Receive a certificate of completion via email. This may take a few business days.
5. Upload your certificates to your profile on the IEMS website. Scroll to the bottom and upload
under “Cards,” indicating what you are uploading. Make sure all changes are saved.
You will not be able to function as an EMT within Illini EMS until both certificates of completion
are on file.
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EMT Operational Guide
Key Elements for Operating Within Illini EMS
As previously stated, Illini EMS operates according to Illinois EMS Region 6 Protocols.
Specifically, Illini EMS is a branch of the Provena Regional Emergency Medical Services
System (PREMSS), and as such, Illini EMS’ Medical Control is Provena Covenant Medical
Center. Listed below are key elements to know when operating within Illini EMS:
Who do I notify?
If on a call, someone must contact the Supervisor in charge of your team. The Supervisor will
then respond appropriately to the call.
If your patient is in need of immediate transport to the hospital and your Supervisor has not yet
arrived on scene, a member of the team must call 911 and request an ambulance be sent to your
location prior to notifying the Supervisor. If your Supervisor is already on scene, your Supervisor
will notify 911.
If you need to make a refusal or receive orders to administer medications, you must contact
Medical Control. For Illini EMS, this is Provena Covenant Medical Center (217) 337-2197.
Save this phone number in your cellphone so that you have access to it at all times. This
particular phone number is also listed on all refusal forms as well as the back of the Region 6
Booklets found in each jumppack.
Medications
Provided all indications and no contraindications are present, some medications have standing
offline-orders for administration per Region 6 Protocol (meaning you do not need to contact
Medical Control for approval prior to administration). These five medications are:
 Duo Neb
 Nitroglycerin (for chest pain)
 Aspirin
 Epinephrine auto-injector
 Oral glucose
The two medications that always require Medical Control approval (online-orders) prior to
administration are:
 Patient’s prescribed metered-dose inhaler
 Patient’s prescribed nitroglycerin (for hypertensive crisis)
Notice both of these drugs require that the particular medication is prescribed to the patient – you
would simply assist in its administration provided Medical Control approves. More details
regarding medications may be found in the Medicine Administration portion of this document.
You may only administer a medication for its stated indication(s) per Region 6 protocol. For
example, this means you may not administer aspirin to an individual complaining of a headache
since the indication for aspirin is “chest discomfort suggestive of a heart attack.”
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EMT Operational Guide
Run Reports, Refusals, and Unusual Incident Forms
Make sure all information on run reports are filled out appropriately and handed to your
Supervisor after each event. That means you need to have the name and contact information of
your patient. If you make a mistake, make sure to always cross it out with one line and
initial/date it.
Refusals must be called in to Medical Control if the patient does not meet the criteria for a field
refusal (criteria is stated on each refusal form). For any refusal, the team must:
 Obtain the patient’s signature.
 Obtain a witness’ signature (preferably not an Illini EMS member, such as the patient’s
friend or an employee of the particular venue).
 Obtain the name of the Medical Control doctor who granted the refusal (if applicable).
 Make sure that both the refusal form and run form are filled out to their entirety.
Any deviation from this protocol must be documented on the run form and an Unusual Incident
Report Form must be filled out. If unsure, follow the instructions outlined on the refusal form
and/or contact your Supervisor.
Abbreviating when filling out forms is by no means required, but if you choose to do so, the
following is a list of PREMSS approved abbreviations. Common units of measurement (lb, kg,
ml, oz, etc.) have been omitted to diminish redundancy:
Abbrev.
A&O x4
AED
AIDS
AM
AMA
ASA
BM
bpm
BP
BS
BSA
BVM
cc
C/C
CHF
CNS
c/o
CO
CO2
COPD
CPR
C-section
CSF
C-spine
Definition
alert and oriented to time, place, person, and events
automated external defibrillator
acquired immune deficiency syndrome
morning
against medical advice
aspirin
bowel movement
beats per minute
blood pressure
blood sugar, breath sounds, bowel sounds (in context)
body surface area
bag valve mask device
cubic centimeter
chief complaint
congestive heart failure
central nervous system
complains of
carbon monoxide
carbon dioxide
chronic obstructive pulmonary disease
cardio-pulmonary resuscitation
Cesarean section
cerebral spinal fluid
cervical spine
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EMT Operational Guide
CVA
DM
DNR
DOA
DOB
Dr.
DVT
Dx
ECG / EKG
ED
EMT
ER
ETA
ETOH
GCS
GSW
H2O
ICU
IM
IO
IV
JVD
L1-L5
LMP
LOC
LPM
LPN
mcg / g
MD
mg
MI
mmHg
MVA
N/A
NaCl / NS
NC
NPO
NTG
N&V
O2
O2 sat
OD
OTC
PERL
PM
PMH
PO
cerebrovascular accident (stroke)
diabetes mellitus
do not resuscitate
dead on arrival
date of birth
doctor
deep vein thrombosis
diagnosis
electrocardiogram
emergency department
emergency medical technician
emergency room
estimated time of arrival
alcohol (ethanol)
Glascow Coma Scale
gun shot wound
water
intensive care unit
intramuscular
intraosseous
intravenous
jugular vein distention
lumbar vertebrae 1-5
last menstrual period
loss of consciousness, level of consciousness (in context)
liters per minute
licensed practical nurse
microgram
medical doctor
milligram
myocardial infarction
millimeters of mercury
motor vehicle accident
not applicable
normal saline
nasal cannula
nothing by mouth
nitroglycerin
nausea and vomiting
oxygen
oxygen saturation
overdose
over the counter medication
pupils equal and react to light
afternoon/evening
past medical history
by mouth
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EMT Operational Guide
prn
psi
pt
RN
ROM
SIDS
SL
SOB
SQ / SubQ
S/S
STAT / stat
Sx
T1-T12
TB
TIA
Tx
UTI
yo / y/o
‘
“
1
2
3
↑
↓
>
<
≈
=
≠

as needed
pounds per square inch
patient
registered nurse
range of motion
sudden infant death syndrome
sublingual
short of breath
subcutaneous
signs and symptoms
immediately
symptoms
thoracic vertebrae 1-12
tuberculosis
transient ischemic attack
treatment
urinary tract infection
year old
feet
inches
first degree
second degree
third degree
increase
decrease
greater than
less than
approximately
equal
not equal
change
Who is the Illini EMS Operations Department?
The current four members of the 2016-2017 Operations Department are:
Jennifer Main
Dir. of Operations
Connor Rachford
Asst. Dir. of Operations
Jess Endres
Training Officer
Vanessa Belknap
Equipment Officer
Contact info for all officers may be found under the “Officers” tab of the Illini EMS website.
Where can I find more information?
The Illini EMS Standard Operating Guidelines and Region 6 Protocols are crucial resources for
all Illini EMS EMTs. However, when in doubt, always feel free to contact the current Director of
Operations with any questions or concerns. Please refer to the Region 6 Care Guidelines also
available on our website.
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