[Our first SOPs, drafted in 1995]
Standard Operating Procedures Manual
Introduction
These are the Standard Operating Procedures for Trinity College Emergency Response Team. All TCERT personnel are expected to act in accordance with these guidelines while on duty and/or responding to emergency calls. The SOP's are designed to provide the best possible emergency care for patients while staying within the limits of Federal, Connecticut, and regional standards and laws. These guidelines also comply with those of Trinity College and Campus Safety. The safety of TCERT personnel and patients was given the utmost consideration in the creation of these SOP's.
The SOP's and addendi are the guidelines and standards that every TCERT member will be held accountable to. It is important to note that these guidelines are not absolute. Guidelines cannot be created to cover every possible emergency or procedural situation. TCERT personnel will be given the latitude to break these guidelines if it is the reasonable and prudent decision in a given situation; however, TCERT personnel must keep in mind that they may be called upon to justify their actions.
Please Note: The TCERT SOPs and Constitution included within these web pages are drafts and conflicts between the two may exist. We are currently working to bring the two into agreement. The SOPs are heavily based upon the Tufts EMS SOPs. In many cases the original text was used for the sake of clarity. However, they have been appropriately modified to suit our specific operations and regulations.
I. Point of Entry
1. The Primary Service area of Trinity College Emergency Response Team includes the following: all offices, buildings and residence halls of the Trinity College campus, off-campus houses, and fraternity and sorority houses that are affiliated with Trinity College. The population served by Trinity College Emergency Response Team is limited to those persons who live, work or study at Trinity College and its affiliates, although in emergency situations any person ill or injured within the primary service area is eligible for services without prior evidence that he or she is a member of that group.
2. In addition to emergency medical service, TCERT may be called upon during times of campus-wide emergency to assist the Trinity College Campus Safety in responding to alarms of fire, securing the scene of downed wires, and evacuation.
3. The Emergency number by which TCERT may be reached is 297-2222 (x2222 from within the campus), and said number shall be made available to the community that is serviced.
4. At the beginning of each year, TCERT members, with the cooperation of the Office of Residential Life, shall conduct an informational session in all residence halls in order to outline TCERT's responsibilities and services.
II. Requirements for Membership/Staffing
1. In order to qualify as a responding member of TCERT, the applicant must possess the
following:
A. EMT certification
B. Current American Heart Association or American Red Cross CPR certification at the level appropriate to the professional rescuer.
Xerox copies of the above must be on file with the Training Officer before the member is available for shifts. Members will notify the Training Officer of any discrepancies in certification which would prohibit them from covering shifts.
2. TCERT will not discriminate against any member on the basis of race, color, religion, national origin or sexual orientation.
3. No TCERT members will function as EMT's if they have any physical or mental impairment or disease which could reasonably be expected to either impair their ability to function as an EMT or jeopardize the health and safety of their patients. If such a disease or impairment exists, the member will immediately inform the Asst. Director.
4. All EMT's are required to attend a 1 hour orientation program given by the Training Officer prior to becoming responding members of TCERT. All members may participate when the program is offered.
5. Appointment to the level of Responder is made at the discretion of the Officer Council, and is made through the consideration of experience, comprehensive knowledge of TCERT's Standard Operating Procedures, and overall skill level.
6. If at any time a TCERT member looses their state EMT certification or CPR certification, whatever the reason, said member shall immediately notify the Asst. Director and will be removed from the schedule until said certifications are renewed. It is the responsibility of said member to find replacements for any shifts lost.
7. All General Meetings are assumed to be mandatory. If a TCERT member is unable to attend a meeting at the announced date and time, it is his or her responsibility to notify the Director or Asst. Director before the meeting. Individuals with two unexcused absences will be removed from the schedule until such time that he or she attends a meeting. Individuals already removed from the schedule for other reasons are still obligated to make General Meetings.
8. Failure to attend a General Meeting while on disciplinary status may result in dismissal from TCERT.
9. If a General Meeting is to include in-service training on a new piece of equipment, the General Membership shall be notified in advance. If an EMT is unable to make said training, it is his or her responsibility to meet with a member of the Officer Council to be briefed on the use of the equipment prior to his or her next shift. If said individual is unable to do this, it is his or her responsibility to find a suitable replacement for any shifts that will be missed prior to completion of in-service training on the item.
III. Elections/Elected Positions
1. Elections to the Officer Council will be held during the April General Meeting, and shall be announced to the General Membership prior to the date of the meeting. Elected positions are:
Director- The Director serves as the overall liaison between all agencies that interact with TCERT, including, but not limited to the following: Campus Safety, Dean of Students Office, the Medical Office, the Student Government Association, and the Trinity Community at large. The Director is also responsible for conducting all Officer Council meetings and General Meetings on a monthly basis, and is responsible for drafting an agenda for said meetings. The Director is also responsible to make any decisions regarding the operation of TCERT when convening the Officer Council is either impractical or impossible given outside constraints.
Assistant Director- The Asst. Director serves as the personnel manager for TCERT. This includes, but is not necessarily limited to: scheduling crews and distributing said schedule prior to the first of every week; and locating emergency replacements in order to cover a shift when a TCERT member is physically unable to find his or her own replacement. Additionally the Asst. Director is responsible for maintaining and tracking all run forms. The Asst. Director may assist the Director in meetings with outside and internal agencies.
Training Officer- Is responsible for collecting and recording all necessary copies of certification and other training requirements. Other responsibilities include contacting the Office of Emergency Medical Services for a listing of all continuing education courses, posting notices of continuing education events, and creating orientation and continuing education programs for TCERT members.
Equipment/Communications Officer- The Equipment/Communications Officer is responsible for the continuing upkeep of all equipment that is owned and operated by TCERT. This includes the following areas: stocking of medical equipment, radio maintenance and repair, and the stocking of the extra equipment located in the TCERT office. The Equipment/Communications Officer also serves as liaison to all repair and maintenance services.
2. In order to qualify for a position on the Officer Council, the nominee must be a member in good standing, and must have been a member of TCERT for at least two semesters. Exceptions may be made to the two-semester requirement if no other members are interested in the position.
3. Officers will be elected by majority vote. All members in good standing will be allowed to vote.
4. Candidates will be nominated on the night of elections either by self or by another member in good standing. All nominations must be seconded. Nominees may decline the nomination.
5. Nominees running with opposition must give a short speech on the night of elections, outlining their qualifications so that all members may be familiar with how the candidate may benefit TCERT.
6. All new positions become active upon the first day of classes after the summer break, and it is the responsibility of the acting Officers to train the newly elected members in the responsibilities of the position.
7. In the event that any Officer is unable to fulfill the responsibilities of office, the Officer shall be replaced by decision of the Officer Council. An exception is made when the Director is unable to meet his or her obligations.
8. In the event that the Director is unable to fulfill his or her obligations of office, the acting Asst. Director shall assume the responsibilities of Director. A new Asst. Director shall be appointed by the Officer Council.
IV. Shift Responsibilities
1. All TCERT members will be notified of their shift responsibilities by the Asst. Director before the beginning of each week.
2. Each crew will consist of a Primary EMT and at least one Secondary EMT. One member will be designated Crew Chief. While medical decisions should be made by the agreement of all EMT's on scene, the Crew Chief has the final say in patient care. In addition to the two EMT's, a TCERT Officer will be on call 24 hours a day, 7 days a week while TCERT is in service. The Officer on-call is responsible for the entire shift.
3. Assigned shifts will cover the following hours:
Monday-Friday days: hourly.
Sunday-Saturday nights: 1800-0800 hrs.
Saturday day, Sunday day: 0800-1800 hrs.
These hours may be altered at the consent of those EMT's affected.
4. Once assigned a shift, it is that member's responsibility to arrive on time to receive or exchange equipment.
5. When a member is unable to cover an assigned shift, it is his or her responsibility to locate a suitable replacement. Once a replacement has been located, the EMT must approve the swap with the Asst. Director, and should call any EMT's scheduled before or after the swap who may be affected. The swap should also be recorded on the shift schedule posted in the office.
6. While covering a shift, the EMT's are responsible for being on campus in order to guarantee a reasonable response time. In the event that an EMT must leave the area for any length of time, it is his or her responsibility to find a suitable replacement.
7. If TCERT must go out of service for any reason at any time, the Officer on-call must notify the Director and Campus Safety.
8. As it is imperative that TCERT EMT's uphold a professional attitude and appearance
that is exemplary of our organization and our affiliates, Trinity College, Trinity College
Campus Safety, and Trinity College Health Services, it is imperative that all on call
EMT's:
A. Not drink alcohol.
B. Not use recreational drugs.
C. Not be in any environment whose primary activity is either of the above.
*Penalties for violating the above policies are severe and can result in permanent suspension from member status.
D. Not be in any environment which would prevent the EMT from hearing the radio.
E. Dress in the official TCERT uniform
9. Any crew member or officer who arrives on a scene intoxicated shall be suspended immediately by the authority of the Directors and will be reviewed by the Officer Council at a later date.
10. While on call, TCERT members are required to adhere to the following uniform:
A. Pants or jeans must be worn while on duty.
B. Socks and shoes must be worn. Open toed shoes and sandals are unsafe and unacceptable.
C. The official T-shirt or vest must be worn on a TCERT scene, and must be displayed prominently to facilitate identification of on-duty members.
D. The TCERT ID must be displayed while on scene.
11. The EMT's on duty must:
A. Respond to all transmissions by Campus Safety and verify that they have received the call properly.
B. Complete the Equipment Log at the beginning and the end of every shift.
C. Be certain that all paperwork (i.e. incident reports, patient care reports and logs) is turned into the proper location before the end of the shift.
D. Make certain that all non-disposable equipment that is left with the patient at a hospital is either retrieved prior to the end of the shift, or make certain that the Officer on the next shift and the Equipment/Communications Officer are aware of the equipment's location.
12. There will be one medical kit in each Campus Safety car at all times.
13. All medical supplies used at a call must be restocked immediately after the call.
14. TCERT members shall not ride with or be permitted to ride with the ambulance anywhere. TCERT members are NOT allowed to accompany the patient to the hospital at any time.
V. Detail Policy
1. Details are scheduled through the Asst. Director. They are handed out as they become available based on several factors including: experience, number of shifts taken every month, and number of details already held for the month.
2. When given a detail, the EMT will receive the location and time of the detail, as well as the contact person to speak with on their arrival at the location.
3. TCERT members should arrive at the detail location at least ten minutes prior to the scheduled start time. Upon arrival, they should conduct a radio check with the Officer. They should not leave until the event is over, or they are dismissed by the Officer.
4. TCERT members will be in official TCERT uniform upon arrival at the detail.
5. Detail equipment may be found in the TCERT office. For each detail, a detail equipment checklist must be completed. TCERT members should bring a radio to all details.
6. Patient care is provided at the discretion of the EMT at the detail. If an ambulance is required for transport, the EMT shall contact Campus Safety and request the necessary personnel.
7. TCERT members must fill out a Detail Worksheet, found in the TCERT office. It must be signed by the event Officer and turned into the Secretary's box.
8. All details are volunteer. Staffing of details will be decided by the Asst. Director.
9. TCERT members providing detail coverage are not to leave in order to respond to calls outside of their area.
VI. Dispatch Protocol
1. Campus Safety will dispatch TCERT and the duty officer to all requests for emergency medical assistance, reports of working fire, or reports of chemical or industrial accident within the TCERT primary service area. Campus Safety and TCERT will ALWAYS be dispatched together. Campus Safety shall be known as "Base" on the radio.
2. TCERT will not, as a general rule, render emergency services onto the city streets for routine medical situations. TCERT shall render whatever assistance is appropriate and wait for the proper city agency, which will be immediately notified of any such incident TCERT may encounter.
3. Should TCERT members come upon a case of critical or unknown illness, injury or other medical situation, they shall take whatever steps are necessary and employ any equipment at their disposal to respond to the incident. The proper jurisdiction will be notified immediately of all action taken by TCERT members, and TCERT will cooperate fully with the wishes of said jurisdiction.
4. Should Campus Safety receive a call for help on a city street, and the patient's status as a Trinity student, staff or faculty member is unknown, he or she shall dispatch TCERT and immediately notify the proper city agency of the location and nature of the incident, such that said agency may respond.
5. When a call relating to a critical or unknown illness or injury is received and the dispatcher has reason to believe that TCERT will not be available for dispatch within the next five minutes, he or she shall immediately notify the appropriate ambulance service, and shall in any event notify that service when for any reason TCERT is unavailable for dispatch within five minutes after the receipt of the call.
6. Upon receiving a request for emergency medical assistance the dispatcher shall
elicit the following information:
A. Location of the incident.
B. Number of ill or injured parties.
C. Nature of injuries or chief complaint.
D. Potential hazards at the scene.
E. Nature of any treatment being rendered.
F. Call back number if available.
7. In addition to dispatching TCERT, an Advanced life support ambulance shall be
requested when the chief complaint is one of the following:
Heart attack/Chest pain
Unconscious/Unresponsive
Stroke/CVA
Shock
Gun shot/Stabbing
Suicide
Sudden Death
Drug overdose/Reaction
Electrocution
Choking
Diabetic emergencies
Pedestrians or bicyclists struck by motor vehicles
Drowning
Industrial machinery accidents
Severe burns
Difficulty breathing
All other calls will result in the dispatch of TCERT and the Duty Officer. TCERT will notify dispatch if another ambulance is required.
8. In cases of the above calls, the dispatcher shall notify TCERT as to whether or not ALS is en route.
9. Upon receiving a call for emergency assistance, the dispatcher will notify TCERT to "Stand-by for a call". He or she will then dispatch the Duty officer and the primary crew to the scene.
10. Upon dispatching TCERT, the Campus Safety Dispatcher will give the following
information:
A. Location.
B. Nature of call/Chief complaint.
C. Any known on-scene hazards.
D. Any ambulances inbound to the scene.
E. Any fire apparatus inbound to the scene.
11. The Campus Safety Dispatcher will maintain a log of the following times: A. Time call received. B. Time of dispatch. C. Time of arrival for TCERT. D. Time of arrival for the ambulance. E. Time of departure from the scene. F. Time of return to service. 12. The Dispatcher shall participate in a radio check, to be completed by the on duty crew at the beginning of the shift. See section VII, number 8. 13. The words "Priority Message" will be used to clear the air in an emergency. 14. Only plain language will be used on the radio except for 10-4. 15. The Dispatcher shall run a test tone at 1800 every night. The on duty crew should acknowledge the tone.
VII. Radio Operations/Equipment Handling
1. Radio equipment must be signed out at the beginning of each shift, and signed back in when the equipment is returned at the end of the shift, using the Equipment Log.
2. If a fully charged battery is removed from the charger but is not put to use, it should be clearly marked as charged, with the date, time, and initials of the EMT who removed it.
3. EMT's using Motorola GP300's must use an extra battery when on an over-night shift.
4. As it is imperative that all radios and batteries are properly charged, the radios and batteries should be returned to the charger. Batteries and radios are fully charged when the green indicator light is lit.
5. On-call EMT's should keep radio transmissions to a minimum. At no time should a name be stated over the air. EMT's should use their TCERT numbers when communicating with each other over the radios.
6. The Campus Safety Dispatcher retains control over the length and priority of transmissions at all times.
7. During EMS related activities, EMT's will:
A. Repeat the call location back to the Dispatcher in order to reduce the chance of misunderstandings.
B. Notify dispatch upon arrival at the scene.
C. Update dispatch after arrival with approximate on-scene times and requests for additional help when necessary. If requesting an ambulance, the EMT's on scene must request at which priority they want it dispatched (One: Emergency; Two: Not an emergency, but do not waste time; Three: Non- emergency ). EMT's will also notify dispatch of on-scene hazards or location changes so that inbound units are aware.
D. Notify dispatch if ambulance transports to a hospital or Health Services.
E. Notify dispatch when clear of scene and returning to service.
8. It is the responsibility of TCERT and the Officer on-call to insure that there is 24 hour coverage by at least 2 EMT's. Campus Safety need not be notified of shift changes.
9. If any unit receives a poor transmission, they should let the Officer on-call know, and consider having the Equipment/Communications Officer check the radio. If any unit fails to answer, an attempt should be made to contact them by other means.
10. The TCERT radio system is for TCERT business only. At no time shall any member conduct personal business or act in an unprofessional manner on the radio.
VIII. On Scene Procedures/Ambulance Interface
1. While on scene at an emergency, TCERT personnel will maintain a professional attitude and appearance.
2. EMT's will provide care in accordance with the level of their certification. No procedure that is beyond the EMT's level of certification may be attempted. TCERT members who hold out of state certification at a level higher than EMT are not permitted to act at such a level.
3. TCERT personnel are in charge of patient care at all times while on scene with Campus Safety. Officers are solely responsible for scene management. The Crew Chief or Officer on scene shall set up "EMS Command" and shall be in charge of the medical scene. The Officer on-call shall have ultimate control over TCERT operations unless released by a superior Officer.
4. Should a patient require an ambulance, the Officer on scene shall notify Campus Safety of the necessity, as well as give all pertinent information, including dispatch priority. Requests for Advanced Life Support should be made when necessary.
5. When an ambulance arrives on scene, TCERT personnel should briefly identify themselves and give the history of the patient, as well as any care rendered. The names and the ambulance number of the crew to whom care is transferred should be recorded.
6. If a patient care dispute exists with members of a responding ambulance, it should not be aired in front of the patient. Any disagreements in patient care should be noted and an incident report should be filed if necessary. The Director should be notified of any disagreements between TCERT personnel and ambulance personnel as soon as possible after a call.
7. If TCERT personnel feel that patient care is being seriously compromised, another ambulance may be called, provided the delay in transport will not further compromise patient care. The reasons for such actions must be carefully documented and an incident report must be filed. The Director should be notified as soon as possible after such an event.
8. If a medical professional of higher certification (EMT-P, Registered Nurse, or MD) is present on scene with valid identification and proof of certification, and said individual wishes to be in charge of patient care, then they must accompany the patient to the receiving facility.
9. While on scene with a Basic Life Support ambulance from an outside agency, TCERT maintains control of patient care until such time that said patient is transferred onto the ambulance company's equipment. This includes, but is not necessarily limited to the following: long spine board, scoop stretcher, stair chair, stretcher, and ambulance. If the responding ambulance is at the Advanced Life Support level, said ambulance crew assumes total control over patient care upon arrival on scene.
10. While interfacing with an outside ambulance, whether it is at the ALS or BLS level, TCERT personnel are responsible for any negligent care up to their level of certification and training; i.e. if the patient requires C-spine immobilization, TCERT personnel are just as responsible to see that the patient is immobilized properly as the EMT's or Paramedics that arrived with the ambulance. Failure to perform up to one's level of training constitutes negligence.
11. When interfacing with advanced levels of care, TCERT personnel are not authorized at any time to complete a skill that is outside of their level of training.
12. If a physician is on scene directing medical care, the patient shall be transported per the physician's orders, with the physician accompanying the patient. This includes transport outside of TCERT's usual service area.
13. In cases when a patient or bystanders are violent or abusive towards TCERT members, the TCERT members should exit the scene until such time that the situation is resolved by Campus Safety. Charges may be filed if an individual assaults a TCERT member on scene, or if an individual compromises the patient by obstructing or impairing TCERT personnel in the completion of their duties.
14. In situations in which the scene may be unstable or unsafe, such as a chemical spill or fire, TCERT members are not to enter the scene. If victims are trapped in a building or an area that cannot be entered or reached, TCERT personnel on scene should notify Base. Rescue is the responsibility of the Fire Department, and TCERT members should coordinate efforts with the Fire Commander on scene accordingly.
IX. Protective Custody Agreement
1. Per Connecticut General Law, patients with altered mental status as a result of drugs, alcohol or medical condition are not judged to be competent in giving informed consent. Therefore all patients presenting with altered mental status as a result of drugs, alcohol or other medical condition must be treated under implied consent. Such patients may not sign refusals, and may not be left to their own recognizance or that of a friend.
2. If after completing his or her physical exam a TCERT member determines that a patient with altered mental status must be transported, has explained the situation to the patient, and the patient refuses care and/or transportation, the TCERT member may approach the Duty Officer and request that the patient be placed in protective custody. The TCERT member must give the Duty Officer clear and valid medical evidence as to why the patient must be placed in protective custody.
3. TCERT members may also request protective custody when the patient is violent or abusive, and thus obstructs or impairs treatment or transportation when such care is required.
4. Once approached, it is the sole decision of the Duty Officer as to whether or not the patient is placed in protective custody. Refusal to place the patient in protective custody may not be disputed by the TCERT members on scene. If necessary, an incident report may be filed.
5. At no time shall a TCERT member physically restrain a patient while awaiting the arrival of a Campus Safety officer, unless failure to do so presents an immediate threat to the patient's life. If a TCERT member is forced to restrain a patient under such circumstances, an incident report detailing the actions of the EMT must be filed.
6. All patients placed under protective custody must be transported by ambulance or in a Campus Safety cruiser at the discretion of the officer at the scene.
Last Modified: April 21, 2000