MEFD - User contributions [en]

Airway Bags

2025-06-11T19:59:18Z

Zarvanitis: Add acetaminophen to airway kit inventory

This page details the standard setup and minimum inventory of the green airway bags carried on MEFD apparatus.
[[File:Airway bag exterior with labels.jpg|thumb]]
[[File:Airway bag interior main compartment.jpg|thumb|Interior of main compartment (not all items shown)]]
[[File:Airway bag interior top flap pockets.jpg|thumb|Top flap with left and right zip pockets]]

== Inventory ==
[[File:Naloxone kit contents.jpg|thumb|Naloxone/Narcan kit contents]]
[[File:Epi kit contents.jpg|thumb|epi kit contents]]

* (1) CO Monitor - connected to exterior of bag

=== Front Compartment ===

* (1) iGel size 3 - yellow - '''expires'''
* (1) iGel size 4 - green - '''expires'''
* (1) iGel size 5 - orange - '''expires'''
* (1) OPA kit - 8 sizes
* (1) NPA kit - 5 sizes plus lubricant - '''expires'''

=== Right Compartment ===

* (1) Bulb suction kit - 1 bulb suction device, 2 yellow adapters, 2 solid tips

=== Rear Compartment ===

* (1) Sharps container
* (3) Biohazard bags - red
* (2) Eye protection
* (2) N95 mask - regular
* (2) N95 mask - small
* (1) Tyvek suit
* (1) Tyvek suit - 2XL
* (4) SaniCloth wipe - Super
* (2) Convenience/Emesis bag

=== Main Compartment ===

* (1) [[Glucometry Kits|Glucometry kit]] - '''expires'''
* (1) BP Cuff - adult
* (1) Stethoscope
* (1) SpO2 sensor
* (1) BVM - adult
* (1) BP kit
* (1) O2 bottle with wrench - replace at 1000PSI or less
* (2) Shears - in back loops
* (1) IR thermometer - in back pocket
* (2 Nasal canula - in back pockets
* (2) Non-rebreather (NRB) mask - adult - in front pockets
* (2) 2" Medical tape roll - in front pockets
* (2) Permanent marker - in front pockets
* (2) Pen light - in front pockets

=== Main Compartment - Top Flap - Left Zip Pocket ===
* (3) Glucose gel tube - '''expires'''
*(1) Naloxone/Narcan kit - 2 doses naloxone, 2 MAD - '''expires'''
=== Main Compartment - Top Flap - Right Zip Pocket ===

* (1) Aspirin - 81mg chewable - '''expires'''
* (6) Diphenhydramine/Benadryl pill - for MEFD personnel only - '''expires'''
* (1) Epinephrine kit - dose card; 4 alcohol wipes; 2 1mg/mL epi vials; 4 bandaids; 2 Epirite syringes; 2 - 25 gauge needles - '''expires'''
*(?) Acetaminophen - individual packets, together in a zip top bag - '''expires'''

Trauma Bags

2025-05-13T23:44:43Z

Zarvanitis: minor 11-22-specific updates

[[File:Blue med bag outer.jpg|thumb]]
[[File:Trauma bag with annotations.png|thumb]]
This page details the standard setup and minimum inventory of the blue trauma bags carried on MEFD apparatus.

== Inventory ==
Note that the bag on 11-22 is structured differently from other trauma kits, with compartments B and C switched and "right compartment" below actually appearing in the rear.

=== Left Compartment ===

* (4) Instant Cold Pack
* (4) Instant Hot Pack

=== Right Compartment ===

* (2) Sterile Burn Dressing 60"x96"
* (2) Sterile Trauma Dressing 12"x30"

=== Front Compartment ===

* (2) N95 Mask - Regular
* (2) N95 Mask - Small
* (2) Safety glasses
* (5) Sani-Cloth Wipes - Super
* (5) Biohazard bags - red
* (1) Tyvek suit - Large
* (1) Tyvek suit

=== Main Compartment - Top Flap ===

* (20) Bandaids 1"x3" - inside zipper pocket
* (1) Nose clip - attached to loops

=== Main Compartment - Section A ===

* (2) Blood stopper bandage
* (2) Triangle bandage
* (4) 3.75" Roller gauze/Kerlix

=== Main Compartment - Section B ===

* (2) 3" Flexwrap/Coban
* (2) Sam splint
* (2) 2" Medical tape
* (1) Pen light
* (2) Shears

=== Main Compartment - Section C ===

* (1) Irrigation cap
* (2) Sterile water - 500mL -- ignore expiration
* (1) Eye wash
* (1) Ring cutter
* (2) Tourniquet w/ marker
* (1) SAM pelvic sling -- note this is in right compartment in 11-22's kit
* (2) Chest seal -- '''expires'''

=== Main Compartment - Section D ===

* (30) 4"x4" gauze pads
* (5) 5"x9" abdominal compress
* (1) 8"x10" Combine ABD pad
* (1) Blood pressure cuff - adult
* (1) Stethoscope

EMS

2025-03-11T21:40:22Z

Zarvanitis: /* Tools and Equipment */ add over the hill bag link

== District EMS Policies ==
[[SOPs and SOGs|EMS SOPS]]

== Skagit County BLS Protocols ==
[[Skagit County BLS Protocols]]

== Tools and Equipment ==
*[[Airway Bags]]
*[[Burn Kit]]
*[[CT6 Traction Splint]]
*[[ESO]]
*[[Extrication Collar Bags|Extrication/C-Collar Bags]]
*[[Glucometry Kits]]
*[[KED - Kendrick Extrication Device]]
*[[Nitrile Gloves]]
*[[Over the hill bags]]
*[[Trauma Bags]]
*[[Pediatric Bags]]
*[[Target Solutions]] aka Vector Solutions
*[[Vacuum Splints]]
* [[Ventilations and End Tidal CO2]]
* [[Zoll AED Pro]]

== Processes ==

* [[EMS Radio Report]]
* [[EMT Recertification]]

== Quick reference ==

* [[Common prescription medications]]

11-24

2025-03-11T21:39:55Z

Zarvanitis: Fix over the hill link

{| class="wikitable mw-collapsible" style="float:right"
|+[[File:1124 Apparatus Large.jpg|thumb]]Apparatus Info
|-
|Make||Ford
|-
|Model||F550
|-
|Year||2005
|-
|Builder||Fout's Brothers
|-
|Purchased||2006
|-
| ||
|-
|Water||300 gallons
|}

11-24 serves a dual role as a BLS rescue unit and Type 6 wildland fire engine. It carries rescue tools for car accidents, including the 'Jaws of Life', and a full set of medical equipment. A fire pump and 300 gallon water tank give it a firefighting capability. This unit was purchased in August of 2006 and is housed at Station 2.

== Compartments ==

=== Cab ===

=== Driver's Side Front ===

* [[Over the hill bags]]

=== Driver's Side Middle (EMS) ===
[[File:11-24 EMS Cabinet.jpg|none|thumb|11-24 Driver Middle Cabinet - EMS - All bags loaded.]]

==== Top Shelf ====

* [[KED - Kendrick Extrication Device|KED - Kendrick extrication device]]
* [[CT6 Traction Splint|Traction splint]]
* [[Extrication Collar Bags|C-Collar bag]]
* [[Vacuum Splints|Vacuum splint bag]]
* [[Burn Kit|Burn kit]]

==== Bottom Shelf ====

* [[Pediatrics Bags|Pediatric Bag]]
* [[Trauma Bags|Trauma Bag]]
* [[Airway Bags|Airway Bag]]
* [[Zoll AED Pro|AED]]
* (10+) Decon Wipes
* (2) Tyvek Suits

=== Driver's Side Back ===

=== In Front of Pump ===

=== Driver's Side Top Box ===

=== Pump Area and Deck ===

=== Officer's Side Top Box ===

=== Officer's Side Rear ([[Wildland Hand Tools|Wildland Tools]]) ===
[[File:1124 Officer Rear Cabinet Back.jpg|thumb|11-24 Officer Rear Cabinet - Back wildland brackets loaded.]]
[[File:1124 Officer Rear Cabinet Middle.jpg|thumb|11-24 Officer Rear Cabinet - Front wildland brackets loaded.]]
[[File:1124 Officer Rear Cabinet Front.jpg|thumb|11-24 Officer Rear Cabinet - Fully loaded]]
* (2) Stop/slow signs (front)
* (2) Traffic wands (right wall)
* (1) Water Key - 3ft residential (back wall)
* (2) Wildland tool sharpening guides (left wall)

==== Left-Rear Bracket ====

* (2) McLeod/Wilson
* (2) Super-P

==== Right-Rear Bracket ====

* (3) Wildland #1 shovel
* (2) Combi-tool

==== Left-Front Bracket ====

* (3) Pulaski

==== Right-Front Bracket ====

* (2) Rogue hoe
* (1) Brush axe

=== Officer's Side Middle ===

==== Top shelf ====

* (1) Set of spare wildland gloves. Sizes: S, M, L, XL
* (1) Pair of bolt cutters
* (1) Pair of loppers
* (3) Tarps
* (1) Machete in sheath
* (1) Utility rope in throw bag
* (1) Set of plastic wheel chocks - yellow
* (1) hand axe
* (1) Come-along
* (1) Mill bastard file with handle in sheath
* (1) Sharpening bar (brass colored)
* (2) Spare hose roll bands (black, rubber)

==== Bottom Shelf ====

* (1) Wildland hose trunk line pack
* (2) [[Progressive Hoselay Packs|Widlland hose progressive hose lay pack]]
* (1) Chainsaw oil and fuel bottle set
* (1) Chainsaw (Stihl MS290) with red bar cover containing spare chain, round file, scrench
* (1) [[Chaps Bag Inventory|Chaps bag]]

=== Officer's Side Front ===
[[File:1124 Officer Front Cabinet.jpg|thumb|11-24 Officer Front Cabinet]]
* Holmatro spreaders
* Holmatro cutters
* [[MVA Crash Kit|MVA Crash kit]]

Top-Left Shelf

* (1) Set all purpose reciprocating saw blades (in tube)
* (1) Set metal-only reciprocating saw blades (in tube)
* (1) Angle grinder disk - blue
* (1) Angle grinder handle
* (1) Angle grinder wrench

Left Wall

* (1) Reciprocating saw with blade and battery
* (1) Angle grinder with disk and battery

Top-Right Shelf

* (2) U bolts/shackles
* (1) Tow rope

Right Wall

* (1) Tube light
* (1) Set Irons: Pink Badaxe + Halligan

== Owner's Manual ==
[[File:2005 Ford F550 Owners Manual.pdf|left|thumb]]

Over the hill bags

2025-03-11T21:38:50Z

Zarvanitis: Add some images

[[File:Over the hill bag.jpg|thumb|Over the hill bag]]
This page details the standard setup and minimum inventory of the red "over the hill" medical bags carried on 11-24 and 11-17 for trail rescue.

== Inventory ==

=== Outside/attached ===
* (1) Roll of flagging tape
* (1) [[Garmin eTrex 22x GPS]] (turn on and press power/light button to check battery)
* (1) Sewn sling out of red webbing
* (1) Whistle

=== Bottom Compartment ===

* (4) Bloodstopper bandage
* (2) 3" Flexwrap/Coban
* (10) 4x4 gauze pads (plus 2x2s until we run out – we are not restocking them)
* (2) 3.75" Roller gauze/Kerlix
* (handful) bandaids
* (2) Triangle bandage
* (2) 2" tape
* (2+) Sani-Cloth Wipes - Super
* (10) 5"x9" abdominal compress

=== Front Pocket ===
[[File:Over the hill front pocket.jpg|thumb|Front pocket detail]]
*(1) Naloxone/Narcan kit - 2 doses naloxone, 2 MAD - '''expires'''
* (1) Epinephrine kit - dose card; 4 alcohol wipes; 2 1mg/mL epi vials; 4 bandaids; 2 Epirite syringes; 2 - 25 gauge needles - '''expires'''
* (1) Aspirin - 81mg chewable - '''expires'''
* (6) Diphenhydramine/Benadryl pill - for MEFD personnel only - '''expires'''
* (3) Glucose gel tube - expires
* (5) Acetaminophen packets - '''expires'''
* (1) Sharps container
* Vitals pouch:
** (1) [[Glucometry Kits]] - '''expires'''
** (1) BP cuff
** (1) Stethoscope
** (1) SpO2 monitor
** (1) pen light
** (1) IR thermometer

=== Main Pocket ===
[[File:Over the hill main pocket.jpg|thumb|Main pocket detail]]
* (1) Sterile Burn Dressing 60"x96"
* (3) Sterile Trauma Dressing 12"x30"
* (2) SAM splint
* (1) Biohazard bags - red
* (2) Tourniquet
* (2) Trauma shears
* (4) 8"x10" Combine ABD pad
* (4) Glow stick
* (1) Permanent marker
* (1) Notepad

File:Over the hill main pocket.jpg

2025-03-11T21:37:55Z

Zarvanitis:

Main pocket of the over the hill med bag

File:Over the hill front pocket.jpg

2025-03-11T21:36:40Z

Zarvanitis:

Detailed view of the contents of the front pocket

File:Over the hill bag.jpg

2025-03-11T18:15:20Z

Zarvanitis:

Overview pic of the OTH med kit

11-24

2025-03-11T18:06:42Z

Zarvanitis: /* Bottom Shelf */ Add over the hill bag link (working on the article itself now)

{| class="wikitable mw-collapsible" style="float:right"
|+[[File:1124 Apparatus Large.jpg|thumb]]Apparatus Info
|-
|Make||Ford
|-
|Model||F550
|-
|Year||2005
|-
|Builder||Fout's Brothers
|-
|Purchased||2006
|-
| ||
|-
|Water||300 gallons
|}

11-24 serves a dual role as a BLS rescue unit and Type 6 wildland fire engine. It carries rescue tools for car accidents, including the 'Jaws of Life', and a full set of medical equipment. A fire pump and 300 gallon water tank give it a firefighting capability. This unit was purchased in August of 2006 and is housed at Station 2.

== Compartments ==

=== Cab ===

=== Driver's Side Front ===

* [[Over the hill bag]]

=== Driver's Side Middle (EMS) ===
[[File:11-24 EMS Cabinet.jpg|none|thumb|11-24 Driver Middle Cabinet - EMS - All bags loaded.]]

==== Top Shelf ====

* [[KED - Kendrick Extrication Device|KED - Kendrick extrication device]]
* [[CT6 Traction Splint|Traction splint]]
* [[Extrication Collar Bags|C-Collar bag]]
* [[Vacuum Splints|Vacuum splint bag]]
* [[Burn Kit|Burn kit]]

==== Bottom Shelf ====

* [[Pediatrics Bags|Pediatric Bag]]
* [[Trauma Bags|Trauma Bag]]
* [[Airway Bags|Airway Bag]]
* [[Zoll AED Pro|AED]]
* (10+) Decon Wipes
* (2) Tyvek Suits

=== Driver's Side Back ===

=== In Front of Pump ===

=== Driver's Side Top Box ===

=== Pump Area and Deck ===

=== Officer's Side Top Box ===

=== Officer's Side Rear ([[Wildland Hand Tools|Wildland Tools]]) ===
[[File:1124 Officer Rear Cabinet Back.jpg|thumb|11-24 Officer Rear Cabinet - Back wildland brackets loaded.]]
[[File:1124 Officer Rear Cabinet Middle.jpg|thumb|11-24 Officer Rear Cabinet - Front wildland brackets loaded.]]
[[File:1124 Officer Rear Cabinet Front.jpg|thumb|11-24 Officer Rear Cabinet - Fully loaded]]
* (2) Stop/slow signs (front)
* (2) Traffic wands (right wall)
* (1) Water Key - 3ft residential (back wall)
* (2) Wildland tool sharpening guides (left wall)

==== Left-Rear Bracket ====

* (2) McLeod/Wilson
* (2) Super-P

==== Right-Rear Bracket ====

* (3) Wildland #1 shovel
* (2) Combi-tool

==== Left-Front Bracket ====

* (3) Pulaski

==== Right-Front Bracket ====

* (2) Rogue hoe
* (1) Brush axe

=== Officer's Side Middle ===

==== Top shelf ====

* (1) Set of spare wildland gloves. Sizes: S, M, L, XL
* (1) Pair of bolt cutters
* (1) Pair of loppers
* (3) Tarps
* (1) Machete in sheath
* (1) Utility rope in throw bag
* (1) Set of plastic wheel chocks - yellow
* (1) hand axe
* (1) Come-along
* (1) Mill bastard file with handle in sheath
* (1) Sharpening bar (brass colored)
* (2) Spare hose roll bands (black, rubber)

==== Bottom Shelf ====

* (1) Wildland hose trunk line pack
* (2) [[Progressive Hoselay Packs|Widlland hose progressive hose lay pack]]
* (1) Chainsaw oil and fuel bottle set
* (1) Chainsaw (Stihl MS290) with red bar cover containing spare chain, round file, scrench
* (1) [[Chaps Bag Inventory|Chaps bag]]

=== Officer's Side Front ===
[[File:1124 Officer Front Cabinet.jpg|thumb|11-24 Officer Front Cabinet]]
* Holmatro spreaders
* Holmatro cutters
* [[MVA Crash Kit|MVA Crash kit]]

Top-Left Shelf

* (1) Set all purpose reciprocating saw blades (in tube)
* (1) Set metal-only reciprocating saw blades (in tube)
* (1) Angle grinder disk - blue
* (1) Angle grinder handle
* (1) Angle grinder wrench

Left Wall

* (1) Reciprocating saw with blade and battery
* (1) Angle grinder with disk and battery

Top-Right Shelf

* (2) U bolts/shackles
* (1) Tow rope

Right Wall

* (1) Tube light
* (1) Set Irons: Pink Badaxe + Halligan

== Owner's Manual ==
[[File:2005 Ford F550 Owners Manual.pdf|left|thumb]]

Trauma Bags

2025-03-11T18:03:04Z

Zarvanitis: Remove SpO2 from trauma bag as they're not in there anymore!

[[File:Blue med bag outer.jpg|thumb]]
[[File:Trauma bag with annotations.png|thumb]]
This page details the standard setup and minimum inventory of the blue trauma bags carried on MEFD apparatus.

== Inventory ==

=== Left Compartment ===

* (4) Instant Cold Pack
* (4) Instant Hot Pack

=== Right Compartment ===

* (2) Sterile Burn Dressing 60"x96"
* (2) Sterile Trauma Dressing 12"x30"

=== Front Compartment ===

* (2) N95 Mask - Regular
* (2) N95 Mask - Small
* (2) Safety glasses
* (5) Sani-Cloth Wipes - Super
* (5) Biohazard bags - red
* (1) Tyvek suit - Large
* (1) Tyvek suit

=== Main Compartment - Top Flap ===

* (20) Bandaids 1"x3" - inside zipper pocket
* (1) Nose clip - attached to loops

=== Main Compartment - Section A ===

* (2) Blood stopper bandage
* (2) Triangle bandage
* (4) 3.75" Roller gauze/Kerlix

=== Main Compartment - Section B ===

* (2) 3" Flexwrap/Coban
* (2) Sam splint
* (2) 2" Medical tape
* (1) Pen light
* (2) Shears

=== Main Compartment - Section C ===

* (1) Irrigation cap
* (2) Sterile water - 500mL -- ignore expiration
* (1) Eye wash
* (1) Ring cutter
* (2) Tourniquet w/ marker
* (1) SAM pelvic sling
* (2) Chest seal -- '''expires'''

=== Main Compartment - Section D ===

* (30) 4"x4" gauze pads
* (5) 5"x9" abdominal compress
* (1) 8"x10" Combine ABD pad
* (1) Blood pressure cuff - adult
* (1) Stethoscope

Firefighter Health and Safety

2025-02-14T22:15:56Z

Zarvanitis: Add DRD schematic, with attribution.

== Mental Health ==
The things we see and do can have an impact on our mental health. Sometimes the issues are obvious and sometimes they build up over time. We encourage you to reach out to a chief officer if you have anything you'd like to discuss. We are here to help and can connect you with whatever help you need. Everything is kept confidential and free of judgement. There are additional resources available, some of which are listed below.

=== Suicide and Crisis Hotline: ===
* Crisis Text Line: Text HOME to 741741
* National Suicide Prevention Lifeline: 1-800-273-8255

=== Critical Incident Stress Management (CISM) ===
CISM is a group of trained volunteers that help support first responders deal with the stress we deal with before, during, and after our responses. They offer group debriefings, one-to-one assistance, and connections for first responders with a variety of services. CISM is usually activated by a chief officer, but anyone can request assistance. To do so, contact dispatch (911) and ask them to activate the CISM team.

=== Support Officers ===
Support officers work primarily in support of the community members. But if you need someone to talk to they are available and they can connect you with resources that you need.

=== Code4NW ===
[https://code4nw.org/ Cocde4NW] is a volunteer organization supporting first responders with confidential crisis response and other resources. They are available 24/7 at 425-243-5092.

== Reducing exposure risks ==
We know that firefighters have a high risk of exposure to certain carcinogens. To reduce this, we have rigorous decontamination procedures.

=== Bunker gear decontamination ===
If you're based out of Station 1, there's a good chance Chief Mike will wash your bunker gear!

If you're based out of Station 2, use the following steps:

# Perform a gross decon on scene using the toy hose we can hook up to a 2.5" discharge on our engines.
# Back at the station, take off your gear and hose it off on the ground with the pressure washer
# Separate your shells + liners and empty out your pockets
# Spray the shells with hose and gear cleaner (with dilution as specified over the sink at the back of the station), with special emphasis on areas that are visibly dirty
#* Let it sit for 15 minutes to loosen up the gunk
# Wash your shells in the station 2 washing machine:
#* Use the heavy-duty cycle
#* Fill the detergent bin (pull out drawer at top left of the washer) with hose + gear cleaner to the "max fill line"
# Dry the shells
#* Zip and velcro all closures before starting
#* 60 minutes on medium heat
# Wash your soft goods, including liners, hood, gloves, suspenders
#* Regular detergent
#* Regular cycle
# Dry your liners:
## Hang and drain for 20 minutes
## Then dry for 60 min in the dryer on medium heat
# Reassemble, with special attention to your DRD strap
[[File:DRD.png|none|thumb|Correct arrangement of your DRD strap between shell and liner, with thanks to https://belt-tech.com/en/realisation/safety-harness-and-rescue-device-drd/]]

Firefighter Health and Safety

2025-02-14T22:14:46Z

Zarvanitis: Add station 2 decon steps per Chief Mike, 2025-02-14

File:DRD.png

2025-02-14T22:13:39Z

Zarvanitis: Image source: https://belt-tech.com/en/realisation/safety-harness-and-rescue-device-drd/

== Summary ==
Image source: https://belt-tech.com/en/realisation/safety-harness-and-rescue-device-drd/

Garmin eTrex 22x GPS

2024-09-19T00:36:40Z

Zarvanitis: Link OTH med bag inventory

We carry Garmin eTrex 22x GPS in each of our [[Over the hill bags]]. They are to be used in locating patients with known coordinates and providing coordinates to other rescuers when patients are found.
[[File:Garmin eTrex 22x.png|thumb]]

== Basic Operations ==
=== Power on and off ===
* Press and hold the power button for 1-2 sec.

=== Go to map mode ===
* Select ‘Map’ from the main menu. Map will snap to your position once satellites have been found.
* Use arrows (top-left) to zoom in and out.
* Use thumb stick to move around the map.

=== Get current coordinates ===
* From the map screen press and hold the thumb stick. This will start the ‘create way point’ function and display current coordinates.
* If you are exploring the map (arrow is displayed) press back button first otherwise coordinates will be for arrow and not for you.

=== Go to coordinate ===
* From the map, press the ‘Back’ button to get to main menu if necessary.
* Select ‘Where to?’.
* Select ‘Coordinates’.
* Enter coordinates using left/right arrow to move between digits.

=== View current route on map ===
* The GPS will automatically record your track as soon as it connects to the satellites.
* From the map, press the ‘Back’ button to get to main menu if necessary.
* Select ‘Track Manager’.
* Select ‘Current Track’.
* Select ‘View Map’.

Over the hill bags

2024-09-19T00:35:58Z

Zarvanitis: Create initial over the hill inventory

This page details the standard setup and minimum inventory of the red "over the hill" medical bags carried on 11-24 and 11-17 for trail rescue.

== Inventory ==

=== Outside/attached ===
* (1) Roll of flagging tape
* (1) [[Garmin eTrex 22x GPS]] (turn on and press power/light button to check battery)
* (1) Sewn sling out of red webbing
* (1) Whistle

=== Bottom Compartment ===

* (4) Bloodstopper bandage
* (2) 3" Flexwrap/Coban
* (10) 4x4 gauze pads (plus 2x2s until we run out – we are not restocking them)
* (2) 3.75" Roller gauze/Kerlix
* (handful) bandaids
* (2) Triangle bandage
* (2) 2" tape
* (2+) Sani-Cloth Wipes - Super
* (10) 5"x9" abdominal compress

=== Front Pocket ===

* (1) Naloxone/Narcan kit - 2 doses naloxone, 2 MAD - '''expires'''
* (1) Epinephrine kit - dose card; 4 alcohol wipes; 2 1mg/mL epi vials; 4 bandaids; 2 Epirite syringes; 2 - 25 gauge needles - '''expires'''
* (1) Aspirin - 81mg chewable - '''expires'''
* (6) Diphenhydramine/Benadryl pill - for MEFD personnel only - '''expires'''
* (3) Glucose gel tube - expires
* (5) Acetaminophen packets - '''expires'''
* (1) Sharps container
* Vitals pouch:
** (1) [[Glucometry Kits]] - '''expires'''
** (1) BP cuff
** (1) Stethoscope
** (1) SpO2 monitor
** (1) pen light
** (1) IR thermometer

=== Main Pocket ===

* (1) Sterile Burn Dressing 60"x96"
* (3) Sterile Trauma Dressing 12"x30"
* (2) SAM splint
* (1) Biohazard bags - red
* (2) Tourniquet
* (2) Trauma shears
* (4) 8"x10" Combine ABD pad
* (4) Glow stick
* (1) Permanent marker
* (1) Notepad

Airway Bags

2023-12-28T20:59:26Z

Zarvanitis: /* Main Compartment - Top Flap - Right Zip Pocket */

This page details the standard setup and minimum inventory of the green airway bags carried on MEFD apparatus.
[[File:Airway bag exterior with labels.jpg|thumb]]
[[File:Airway bag interior main compartment.jpg|thumb|Interior of main compartment (not all items shown)]]
[[File:Airway bag interior top flap pockets.jpg|thumb|Top flap with left and right zip pockets]]

== Inventory ==
[[File:Naloxone kit contents.jpg|thumb|Naloxone/Narcan kit contents]]
[[File:Epi kit contents.jpg|thumb|epi kit contents]]

* (1) CO Monitor - connected to exterior of bag

=== Front Compartment ===

* (1) iGel size 3 - yellow - '''expires'''
* (1) iGel size 4 - green - '''expires'''
* (1) iGel size 5 - orange - '''expires'''
* (1) OPA kit - 8 sizes
* (1) NPA kit - 5 sizes plus lubricant - '''expires'''

=== Right Compartment ===

* (1) Bulb suction kit - 1 bulb suction device, 2 yellow adapters, 2 solid tips

=== Rear Compartment ===

* (1) Sharps container
* (3) Biohazard bags - red
* (2) Eye protection
* (2) N95 mask - regular
* (2) N95 mask - small
* (1) Tyvek suit
* (1) Tyvek suit - 2XL
* (4) SaniCloth wipe - Super
* (2) Convenience/Emesis bag

=== Main Compartment ===

* (1) [[Glucometry Kits|Glucometry kit]] - '''expires'''
* (1) BP Cuff - adult
* (1) Stethoscope
* (1) SpO2 sensor
* (1) BVM - adult
* (1) BP kit
* (1) O2 bottle with wrench - replace at 1000PSI or less
* (2) Shears - in back loops
* (1) IR thermometer - in back pocket
* (4) Nasal canula - in back pockets
* (4) Non-rebreather mask - adult - in front pockets
* (2) 2" Medical tape roll - in front pockets
* (2) Permanent marker - in front pockets
* (2) Pen light - in front pockets

=== Main Compartment - Top Flap - Left Zip Pocket ===
* (3) Glucose gel tube - '''expires'''
*(1) Naloxone/Narcan kit - 2 doses naloxone, 2 MAD - '''expires'''
=== Main Compartment - Top Flap - Right Zip Pocket ===

* (1) Aspirin - 81mg chewable - '''expires'''
* (6) Diphenhydramine/Benadryl pill - for MEFD personnel only - '''expires'''
* (1) Epinephrine kit - dose card; 4 alcohol wipes; 2 1mg/mL epi vials; 4 bandaids; 2 Epirite syringes; 2 - 25 gauge needles - '''expires'''

Refilling SCBA Bottles

2023-11-05T21:59:14Z

Zarvanitis: Added subsection about the RIT adapter, since I feel bad for dragging Chief Mike to the station on a Sunday

This process should only be used by trained + authorized people – if you're not sure, don't do it! Consequences for getting this wrong can be high.

Our compressor and fill tanks are located in the apparatus bay at Station 1.

In general, we consider bottles in need of refill any time we see them below 4000 psi.

===Documentation===
It's crucial that we document every bottle we fill. Some of the many reasons:
*If we ever find that the compressor was malfunctioning and putting something undesirable in the air during some period of time (or if air quality was just really bad one day), we need to know which bottles to take out of service until we can refill them with air we actually want to breathe. (We test the air quality periodically to ensure we're filling bottles with breathable air.)

*It forces us to check that the bottle is within its hydro test validity – a hydro test is only good for five years, after which we '''do not fill the bottle until it can be hydro tested again'''. This is a safety issue.
To document the bottles you're filling, you'll need:
*the date

*the bottle number (this is the big ol' MEFD number on the side of the bottle, usually three digits)

*the bottle brand – most will be Luxfer, but not all (RIT bottles are different, possibly?)

*manufacture date – printed right near the bottle brand, I believe

*last hydro test date – if I'm remembering right, this will be in small font on an official-looking sticker. ''MUST'' be within the last five years.

*department – "MEFD" for our bottles, but list other departments if we're filling up for others as part of a large training or incident.
After you fill, you'll also list the pressure you filled to and your name.
===Getting started===

# Do a quick inspection of the bottle for dings, flaking fiberglass, or other issues. Don't fill bottles you don't 100% trust.
# Fill in the start of our documentation sheet for the bottle by finding the info listed above.
# Push down on the safety bar and open the filling compartment.
# Put the bottle into the obvious slot with the connections and gauge upward.
# Connect the fill line and ensure it's actually attached. Same connection as when you're replacing the bottle on a pack, so just knock it into place and confirm it's on.
#*For RIT bottles, see notes below on the necessary adapter.
# Ensure the line bleed valve is closed! Otherwise you'll be pumping air out into the hall instead of into the bottle.
# Once the bleed valve is closed, fully open the bottle valve. You'll hear a gentle hiss as the pressure in the fill line increases to equalize with the tank.
# Close the filling compartment and jiggle to ensure it's locked shut.

===== Connecting a RIT bottle =====
[[File:RIT fill adapter.jpg|thumb|200x200px|RIT fill adapter]]
Our RIT bottles have a screw-on attachment rather than the quick-disconnect attachment on our pack bottles. You'll need an adapter, which should live near the compressor somewhere. See the image at right for what it looks like. It is often found on the wood bench or in a small box on that bench to the right of the fill station. The fill adapter screws on to the RIT bottle. Give it a ''very'' gentle tighten with a 15/16" wrench, and then use the quick connect attached to the fill station. Remember to disconnect the adapter afterward, or you'll have trouble setting up the RIT pack!

Note that this adapter is different from the inverse adapter we use to fill our pack cylinders from threaded fill stations like those used by Anacortes. ''That'' adapter lives in the SCBA battery pack on 11-12 so that it's available for our use on long calls.
[[File:RIT fill adapter location.jpg|thumb|200x200px|Where to find the RIT adapter]]

===Preparing to fill===

# Ensure all the storage tanks' connections to the fill station are open.
# Set the fill station to fill from storage (or from compressor if the highest-pressure storage bank is filled to less than 4500 psi).
# Open the lowest-pressure storage bank (conventionally, we use Bank #1 first, then #2, and so on) to give yourself some inlet pressure. To do so, turn the knob under the desired bank all the way to the left, then back off a quarter turn. You should see the inlet pressure gauge at bottom left equalize with the open bank.
# Set the desired fill pressure (4500 psi unless otherwise noted) by adjusting the regulator knob (between inlet + fill pressure gauges). Note that if the set fill pressure is lower than the inlet pressure, there will be a loud hiss as the fill station bleeds off excess air.

===Fill===
In general, we'll fill from the storage tanks until we need to top them off with the compressor. The compressor should be set to turn on when any of the banks drop below a certain pressure.
====From storage tanks====

# You should already have one storage tank valve open.
# Open the fill valve for the bottle(s) you want to fill. Do so slowly! Filling too fast results in really warm bottles, which will require additional top-off later once they've cooled and the pressure has dropped. Some departments also say that filling too fast can lead to bottle failure, so let's definitely avoid that. Ideal fill rates seem to be 200-400 psi per minute.
# If the lowest-pressure storage tank equalizes with the bottles you're filling below 4500 psi, you'll need to shift to the next storage tank. To do so:
## Turn off the fill valve for your bottle(s). This will allow you to adjust the fill rate once the higher-pressure storage tank is opened – otherwise you might hot fill your bottles without meaning to.
## Turn off the storage tank you're currently filling from.
## Open the next-lowest-pressure storage tank. (As before, open all the way, then back off a quarter turn.)
## Open the fill valve for your bottle(s), again aiming for 200-400 psi per minute.

For an explanation of why we start with the lowest-pressure storage tank, see the video below for a discussion of cascade fill systems. It's really quite clever.
====From compressor====
NOTE: If the compressor kicks on, you and everyone in earshot will need ear protection.

If the lowest-pressure storage tank ''still'' isn't enough to get your bottles up to 4500 psi, it's time to switch over to the compressor.
===Wrap up the process===

# Turn off the fill knobs (bottom right) to cut off additional air to the bottles you're filling.
# Turn off the bank you're currently filling from.
# Open the filling compartment to reveal your newly-filled bottles.
# Close the main valve on the newly-filled bottles (the one you use to open/close the bottle when it's on your pack).
# Bleed off excess pressure in the fill lines using the bleeder valves. As a courtesy to the next person filling bottles, close the valves when you've finished (just finger tight, no need to torque down too much). Ensure nobody has their face too close to the bleeder valve as there will be very high-pressure air whooshing out.
# Disconnect the bottles. If you've filled fast, be careful as the bottle will be warm.
# Finish documenting the bottles you've filled by entering the pressure you filled 'em to and your name.

== Other resources ==
*[https://www.youtube.com/watch?v=1zJfOjqy5tY Decent explanation of how a cascade filling system works (SCUBA, but same idea as SCBA)]

*To do: find and link manual for the compressor (CFS 5.5)

File:RIT fill adapter location.jpg

2023-11-05T21:53:53Z

Zarvanitis:

Look for the RIT fill adapter on the bench to the right of the fill station. The circled box is also a known home for it.

File:RIT fill adapter.jpg

2023-11-05T21:47:30Z

Zarvanitis:

RIT fill adapter and 15/16 wrench, located at station 1

Wildland Hand Tools

2023-07-21T05:17:44Z

Zarvanitis: Make minor edits for smoother flow

== Tools We Carry ==

=== Shovel ===
Shovels are good for digging, scraping, tamping, and throwing dirt. They can also be used to de-limb lower branches on trees to reduce ladder fuels. They tend to be heavy, but have a long handle.
[[File:Wildland Shovel.jpg|center|thumb|Wildland Shovel]]

==== Sharpening ====
Sharpen the blade of a shovel starting 1.5 in. (38 mm) from the heel on each side of the blade until a subtle point is formed at the tip of the blade. Do the same number of strokes — and with the same amount of pressure — with a 12-in. flat bastard file on each side so that the shovel point does not drift from the center line.

See this video for a shovel sharpening demonstration: https://youtu.be/3TrehiITIYM?t=209

=== Pulaski ===
The Pulaski is a grubbing and cutting tool. It is made with a standard axe handle. The axe side can be used for cutting trees, shrubs, and roots. The adz end can be used for scraping and grubbing in line construction.
[[File:Pulaski.jpg|center|thumb|Pulaski]]

==== Sharpening ====

* Taper the cutting edge 2 in. (50 mm) wide with an even bevel on each side.
* Bevel the grubbing edge 3/8 in. (10 mm) wide straight across on a 45-degree angle on one side of the head only.

See a video here: https://youtu.be/3TrehiITIYM?t=13

=== McLeod/Wilson ===
A long handled tool, the McLeod has tines on one side for pulling brush and a hoe edge on the other. These are sometimes called Wilsons due to their resemblance to Tom Hanks's volleyball in Cast Away. Our McLeods have been cut down so they are narrower, because the wide profile made pulling blackberries and other shrubs very difficult. It is primarily a scraping tool, but can also cut small shrubs and limbs.
[[File:Mcleod.jpg|center|thumb|McLeod]]

==== Sharpening ====
The hoe blade portion of the McLeod should be beveled to 45-degree angle with the 12-in. flat bastard file on the outside face of the blade making sure the blade stays straight. The tines are not sharpened.

See this video: https://youtu.be/3TrehiITIYM?t=305

=== Rogue Hoe ===
The rogue hoe is a grubbing and scraping tool. It has a medium length handle and is one of the lighter line construction tools. The wide side can be used to cut limbs or small shrubs as well as for scraping. The narrow edge can get between rocks and other narrow areas. Both ends are sharpened.
[[File:Rogue hoe.jpg|center|thumb|Rogue Hoe]]

==== Sharpening ====
Sharpen the narrow end one one side at a 45 degree angle. The wide end is sharpened along its long edge and both short edges. Only on one side and at a 45 degree angle.

=== Super P ===
The Super P has an axe blade like a Pulaski on one side and a hoe like a rogue hoe on the other. This makes it a versatile cutting as well as grubbing tool. The wider hoe moves more dirt than the adz of a Pulaski. It has a longer handle, but also weighs more than a Pulaski.
[[File:Superp.jpg|center|thumb|Super P]]

==== Sharpening ====
Sharpening is done like a Pulaski.

* Taper the cutting edge 2 in. (50 mm) wide with an even bevel on each side.
* Bevel the grubbing edge 3/8 in. (10 mm) wide straight across on a 45-degree angle on one side of the head only.

=== Combi Tool ===
The combi tool has a long handle and a locking collar that allows you to open and close the mini shovel on one side and a long pick on the other. It can be setup like a shovel, like a hoe, like a pick, or some combination. It is one of the most versatile tools, but also the most fragile. Proper cleaning and maintenance of the collar are very important. The long pick can be extremely useful on Fidalgo Island because of the cracked rocks in which we often fight fire. Be careful prying with the pick as it isn't as strong as fixed tools.
[[File:Combi.jpg|center|thumb|Combi tool with pick and hoe]]

==== Sharpening ====
Sharpen the shovel like a shovel: Sharpen the blade of a shovel starting 1.5 in. (38 mm) from the heel on each side of the blade until a subtle point is formed at the tip of the blade. Do the same number of strokes — and with the same amount of pressure — with a 12-in. flat bastard file on each side so that the shovel point does not drift from the center line.

Sharpen the pick at a 45 degree angle on edge.

=== Brush Hook ===
Also called a brush axe, the brush hook can be used for clearing brush and small trees. You swing the brush hook much like you would swing an axe. When not in use the brush hook must be sheathed as the cutting edge is very sharp.
[[File:Brush hook.jpg|center|thumb|Brush Hook]]

==== Sharpening ====
A sharpened cutting edge is on the inside of the head. Sharpen all the cutting edges from 1 in. (25.4 mm) at the base to 3/4 in. (19 mm) at the tip.

== Sharpening Tools ==
Each hand tool must be kept sharpened to make cutting and grubbing more efficient. The sharpened edge and technique is different on each tool.

On short duration fires sharpening may happen only after we have returned to the station in that case consider using the vice on the workbench to hold the tool during sharpening. On longer operations you may need to file your tool in the field to keep it as efficient and useful as possible.

The most important tool you need is a 12 inch mill bastard file . The file must have a handle to prevent puncturing your palm with the 'spike' end of the file.

The department has several aluminum sharpening guides which provide correct edge angles for a number of the tools. Please use these guides, but know they are difficult to come by so don't lose them or loan them out (we'll never see them again).

=== PPE While Sharpening ===
The following PPE must be worn while sharpening in the field or at the station:

# Leather wildland gloves
# Safety glasses
# Long sleeve shirt or jacket

=== Sharpening Technique ===
When using a mill bastard file for sharpening use long strokes in one direction only. Do not go 'back and forth' with the file. Move the file so your hands are moving away from the cutting edge.

This video covers sharpening of a shovel, Pulaski, and McLeod: https://www.youtube.com/watch?v=3TrehiITIYM

Jump to particular tools:

* Pulaski: https://youtu.be/3TrehiITIYM?t=13
* Shovel: https://youtu.be/3TrehiITIYM?t=209
* McLeod: https://youtu.be/3TrehiITIYM?t=305

== Handle Maintenance ==
Wooden handles need special care. Be sure to clean and dry all handles before returning to the apparatus or storage. All handles should be smooth and free of rough spots and splinters. If the handle is not smooth, use sand paper to smooth out any rough areas. Afterward apply linseed oil with a rag and wipe away excess. Used rags must be placed in flam buckets (as they can autoignite) and linseed oil must be kept in the flam cabinet.

If a handle is cracked or loose in the tool head they must be replaced. Put the tool out of service until it can be repaired or replaced.

Four Gas Detector

2023-06-13T02:24:25Z

Zarvanitis: Add configuration info, including hackery

MEFD uses Industrial Scientific Ventis MX4 gas detectors. These detectors are easy to use. They provide measurements of oxygen level, carbon monoxide, hydrocarbon lower explosive level, and hydrogen sulfide in the air. They are not leak detectors. The detector will alert (alarm, flashing lights, vibration) when limits of any gas are exceeded. They also record peak values detected for each gas.

[[File:Ventis MX4 Gas Detector.jpg|thumb]]

The detectors are kept in chargers on 11-12, 11-17, 11-21, and 11-24.

==What Is Being Measured==
===Oxygen (O2)===

This is the amount of oxygen in the air. At sea level we expect an oxygen level of about 20.9%. A level lower than that indicates the oxygen is being displaced by another gas. The gas displacing the oxygen may or may not be detected by the gas detector. Any drop in oxygen level is cause for concern and requires the use of SCBA.

*Low alarm set-point: 19.5%
*High alarm set-point: 23.5%

===Carbon Monoxide (CO)===
Carbon monoxide is an odorless, colorless, gas that is often the result of incomplete combustion of fossil fuels. We find CO in house fires, faulty furnaces, and car exhaust. CO is slightly less dense than air, but because it is so close in density it will mix with the air in a room.

The detector reports CO in PPM. A reading of over 35PPM is considered dangerous.

Carbon monoxide is dangerous for at least two reasons:
*Carbon monoxide is flammable at between 12.5% and 74%. We see this when smoke 'flashes over' in house fires. That works out to a flammable range of approximately 125,000PPM to 740,000PPM.
*Carbon monoxide binds to hemoglobin in our blood and prevents the blood from carrying oxygen from our lungs. The carbon monoxide binds more strongly than oxygen, so even after leaving the exposure area it can be some time before oxygen levels return to normal. Symptoms of CO poisoning include tiredness, headache, and flushed face. It is essentially oxygen deprivation. Suspect CO when in confined spaces especially when you have multiple patients.
'''Note:''' Our pulse-oxymetry devices cannot tell the difference between bound oxygen and bound CO. If the pulse-ox is giving a very high reading (near or at 100%) CO poisoning should be suspected.
*Low alarm set-point: 35 PPM
*High alarm set-point: 70 PPM
===Lower Explosive Level (LEL)===
This measures the amount of flammable hydrocarbons in the air and displays it as a percentage of the LEL. A reading of 0% LEL suggests no hydrocarbons while 100% LEL is an environment where the gas has just reached its lower flammable range.

Different gases are flammable in different ranges. The detector measures methane/natural gas (CH4) which has a flammable range of 5-15% by volume (not 5-15% LEL).

*Low alarm set-point: 10% of LEL
*High alarm set-point: 20% of LEL

===Hydrogen Sulfide (H2S)===
Hydrogen sulfide is a colorless gas that smells like rotten eggs. It is both highly toxic and highly flammable. It is heavier than air and tends to pool in low places.

It causes eye irritation at the 10-20ppm level and can begin causing eye damage at 50-100ppm.

*Low alarm set-point: 10 PPM
*High alarm set-point: 20 PPM
'''Note:''' At 100-150ppm or higher you lose your sense of smell and may not be aware the gas is present.

==Using The Detector==
*Press and hold the power button for 3-5 seconds.
*Wait for the detector to go through the 20 second countdown and to get to the ready screen (displays all 4 gas levels).
*Zero out the detector.[[File:Gas zero screen.png|thumb|Zero Screen]]
**Press the power/mode button multiple times until you get to the Zero screen.
**In open air away from suspected hazards and apparatus press the enter button to begin the zero process.
**If you get a check mark the zero passed. If you get an exclamation point it failed. If the zero process fails the repeat the zero process.

* Clear out the peak readings[[File:Gas peak screen.png|border|thumb|Peak Levels Screen]]
** Press the power/mode button until the peak readings screen is shown.
** Press the enter button to clear the peak values.

*Power off detector by pressing and holding the power button for the duration of the countdown (5 seconds). It is normal for it to beep and flash.

== Calibrating The Detector ==
'''Note:''' The Ventis MX4 gas detectors should be calibrated once a month and after significant exposure.

# Setup the DSX docking station.
# Place detector in docking station, face forward. The orange light below the detector should light.
# Close the lid.
# Let docking station go through automatic bump test.
# Press the return button on docking station (center, bottom).
# Select 'Instrument' and press return.
# Select 'Calibrate' and press return.
# Select 'Yes' on 'Are you sure?' and press return.
'''Error handling''': In some cases, calibration may take longer than usual and then display “Calibration error.” If this occurs, remove the detector and power it on - likely it will beep at you and notify you that one of its sensors is no longer working. In this case, notify an officer, who will likely pull it out of service until we can order a replacement sensor and replace the malfunctioning one. (One of the things we love about this specific gas detector is that the sensors can be individually replaced as needed and with very little effort.)

== Configuring the detector ==
WARNING: do not do this without express permission from an officer. You can make changes that could be quite dangerous to yourself and your fellow volunteers.

=== Help! It's not reading gas levels ===
Symptom: instead of reading gas levels after turning on, the detector just shows four lowercase Bs.

Reason: the detector likely has a bump test frequency set, and it's set to a maximum of 7 days. After that time, it refuses to read gas levels until it's bump tested. This is infuriating.

Fix: See the manual for how to configure the detector. Specifically you'll want to set the bump test value to zero instead of one.

=== Help! I can't configure because a passcode is set ===
You can remove the passcode by entering 421 for the passcode (press and hold to increment by 10 at a time instead of one), then ''instead of entering the passcode'', press and hold both the on/off button and the enter button for a second. It will remove the passcode and reset the detector to factory default settings. Now you can configure the detector as needed.

== Manual ==
The instruction manual can be found here:
[[File:Ventis MX4 Product Manual.pdf|thumb|left]]

Four Gas Detector

2023-05-02T06:09:10Z

Zarvanitis: Add note about what a failed sensor looks like and what to do about it

MEFD uses Industrial Scientific Ventis MX4 gas detectors. These detectors are easy to use. They provide measurements of oxygen level, carbon monoxide, hydrocarbon lower explosive level, and hydrogen sulfide in the air. They are not leak detectors. The detector will alert (alarm, flashing lights, vibration) when limits of any gas are exceeded. They also record peak values detected for each gas.

[[File:Ventis MX4 Gas Detector.jpg|thumb]]

The detectors are kept in chargers on 11-12, 11-17, 11-21, and 11-24.

==What Is Being Measured==
===Oxygen (O2)===

This is the amount of oxygen in the air. At sea level we expect an oxygen level of about 20.9%. A level lower than that indicates the oxygen is being displaced by another gas. The gas displacing the oxygen may or may not be detected by the gas detector. Any drop in oxygen level is cause for concern and requires the use of SCBA.

*Low alarm set-point: 19.5%
*High alarm set-point: 23.5%

===Carbon Monoxide (CO)===
Carbon monoxide is an odorless, colorless, gas that is often the result of incomplete combustion of fossil fuels. We find CO in house fires, faulty furnaces, and car exhaust. CO is slightly less dense than air, but because it is so close in density it will mix with the air in a room.

The detector reports CO in PPM. A reading of over 35PPM is considered dangerous.

Carbon monoxide is dangerous for at least two reasons:
*Carbon monoxide is flammable at between 12.5% and 74%. We see this when smoke 'flashes over' in house fires. That works out to a flammable range of approximately 125,000PPM to 740,000PPM.
*Carbon monoxide binds to hemoglobin in our blood and prevents the blood from carrying oxygen from our lungs. The carbon monoxide binds more strongly than oxygen, so even after leaving the exposure area it can be some time before oxygen levels return to normal. Symptoms of CO poisoning include tiredness, headache, and flushed face. It is essentially oxygen deprivation. Suspect CO when in confined spaces especially when you have multiple patients.
'''Note:''' Our pulse-oxymetry devices cannot tell the difference between bound oxygen and bound CO. If the pulse-ox is giving a very high reading (near or at 100%) CO poisoning should be suspected.
*Low alarm set-point: 35 PPM
*High alarm set-point: 70 PPM
===Lower Explosive Level (LEL)===
This measures the amount of flammable hydrocarbons in the air and displays it as a percentage of the LEL. A reading of 0% LEL suggests no hydrocarbons while 100% LEL is an environment where the gas has just reached its lower flammable range.

Different gases are flammable in different ranges. The detector measures methane/natural gas (CH4) which has a flammable range of 5-15% by volume (not 5-15% LEL).

*Low alarm set-point: 10% of LEL
*High alarm set-point: 20% of LEL

===Hydrogen Sulfide (H2S)===
Hydrogen sulfide is a colorless gas that smells like rotten eggs. It is both highly toxic and highly flammable. It is heavier than air and tends to pool in low places.

It causes eye irritation at the 10-20ppm level and can begin causing eye damage at 50-100ppm.

*Low alarm set-point: 10 PPM
*High alarm set-point: 20 PPM
'''Note:''' At 100-150ppm or higher you lose your sense of smell and may not be aware the gas is present.

==Using The Detector==
*Press and hold the power button for 3-5 seconds.
*Wait for the detector to go through the 20 second countdown and to get to the ready screen (displays all 4 gas levels).
*Zero out the detector.[[File:Gas zero screen.png|thumb|Zero Screen]]
**Press the power/mode button multiple times until you get to the Zero screen.
**In open air away from suspected hazards and apparatus press the enter button to begin the zero process.
**If you get a check mark the zero passed. If you get an exclamation point it failed. If the zero process fails the repeat the zero process.

* Clear out the peak readings[[File:Gas peak screen.png|border|thumb|Peak Levels Screen]]
** Press the power/mode button until the peak readings screen is shown.
** Press the enter button to clear the peak values.

*Power off detector by pressing and holding the power button for the duration of the countdown (5 seconds). It is normal for it to beep and flash.

== Calibrating The Detector ==
'''Note:''' The Ventis MX4 gas detectors should be calibrated once a month and after significant exposure.

# Setup the DSX docking station.
# Place detector in docking station, face forward. The orange light below the detector should light.
# Close the lid.
# Let docking station go through automatic bump test.
# Press the return button on docking station (center, bottom).
# Select 'Instrument' and press return.
# Select 'Calibrate' and press return.
# Select 'Yes' on 'Are you sure?' and press return.
'''Error handling''': In some cases, calibration may take longer than usual and then display “Calibration error.” If this occurs, remove the detector and power it on - likely it will beep at you and notify you that one of its sensors is no longer working. In this case, notify an officer, who will likely pull it out of service until we can order a replacement sensor and replace the malfunctioning one. (One of the things we love about this specific gas detector is that the sensors can be individually replaced as needed and with very little effort.)

== Manual ==
The instruction manual can be found here:
[[File:Ventis MX4 Product Manual.pdf|thumb|left]]

Honda EU2200i Generator

2023-05-02T03:04:39Z

Zarvanitis:

Location: [[11-21]]

In Service Date: January 2023

Fuel: Straight Gas - NO MIX

note: to check oil levels you will need to remove the maintenance cover on the side to access the dipstick.

== Manuals ==
[[File:Honda EU2200i Generator Manual.pdf|thumb]]

Refilling SCBA Bottles

2023-03-31T15:37:32Z

Zarvanitis: Fix hydro test frequency

This process should only be used by trained + authorized people – if you're not sure, don't do it! Consequences for getting this wrong can be high.

Our compressor and fill tanks are located in the apparatus bay at Station 1.

In general, we consider bottles in need of refill any time we see them below 4000 psi.

===Documentation===
It's crucial that we document every bottle we fill. Some of the many reasons:
*If we ever find that the compressor was malfunctioning and putting something undesirable in the air during some period of time (or if air quality was just really bad one day), we need to know which bottles to take out of service until we can refill them with air we actually want to breathe. (We test the air quality periodically to ensure we're filling bottles with breathable air.)

*It forces us to check that the bottle is within its hydro test validity – a hydro test is only good for five years, after which we '''do not fill the bottle until it can be hydro tested again'''. This is a safety issue.
To document the bottles you're filling, you'll need:
*the date

*the bottle number (this is the big ol' MEFD number on the side of the bottle, usually three digits)

*the bottle brand – most will be Luxfer, but not all (RIT bottles are different, possibly?)

*manufacture date – printed right near the bottle brand, I believe

*last hydro test date – if I'm remembering right, this will be in small font on an official-looking sticker. ''MUST'' be within the last five years.

*department – "MEFD" for our bottles, but list other departments if we're filling up for others as part of a large training or incident.
After you fill, you'll also list the pressure you filled to and your name.
===Getting started===

# Do a quick inspection of the bottle for dings, flaking fiberglass, or other issues. Don't fill bottles you don't 100% trust.
# Fill in the start of our documentation sheet for the bottle by finding the info listed above.
# Push down on the safety bar and open the filling compartment.
# Put the bottle into the obvious slot with the connections and gauge upward.
# Connect the fill line and ensure it's actually attached. Same connection as when you're replacing the bottle on a pack, so just knock it into place and confirm it's on.
#* Our RIT bottles have a screw-on attachment rather than the quick-disconnect attachment on our pack bottles. You'll need an adapter, which should live near the compressor somewhere.
# Ensure the line bleed valve is closed! Otherwise you'll be pumping air out into the hall instead of into the bottle.
# Once the bleed valve is closed, fully open the bottle valve. You'll hear a gentle hiss as the pressure in the fill line increases to equalize with the tank.
# Close the filling compartment and jiggle to ensure it's locked shut.

===Preparing to fill===

# Ensure all the storage tanks' connections to the fill station are open.
# Set the fill station to fill from storage (or from compressor if the highest-pressure storage bank is filled to less than 4500 psi).
# Open the lowest-pressure storage bank (conventionally, we use Bank #1 first, then #2, and so on) to give yourself some inlet pressure. To do so, turn the knob under the desired bank all the way to the left, then back off a quarter turn. You should see the inlet pressure gauge at bottom left equalize with the open bank.
# Set the desired fill pressure (4500 psi unless otherwise noted) by adjusting the regulator knob (between inlet + fill pressure gauges). Note that if the set fill pressure is lower than the inlet pressure, there will be a loud hiss as the fill station bleeds off excess air.

===Fill===
In general, we'll fill from the storage tanks until we need to top them off with the compressor. The compressor should be set to turn on when any of the banks drop below a certain pressure.
====From storage tanks====

# You should already have one storage tank valve open.
# Open the fill valve for the bottle(s) you want to fill. Do so slowly! Filling too fast results in really warm bottles, which will require additional top-off later once they've cooled and the pressure has dropped. Some departments also say that filling too fast can lead to bottle failure, so let's definitely avoid that. Ideal fill rates seem to be 200-400 psi per minute.
# If the lowest-pressure storage tank equalizes with the bottles you're filling below 4500 psi, you'll need to shift to the next storage tank. To do so:
## Turn off the fill valve for your bottle(s). This will allow you to adjust the fill rate once the higher-pressure storage tank is opened – otherwise you might hot fill your bottles without meaning to.
## Turn off the storage tank you're currently filling from.
## Open the next-lowest-pressure storage tank. (As before, open all the way, then back off a quarter turn.)
## Open the fill valve for your bottle(s), again aiming for 200-400 psi per minute.

For an explanation of why we start with the lowest-pressure storage tank, see the video below for a discussion of cascade fill systems. It's really quite clever.
====From compressor====
NOTE: If the compressor kicks on, you and everyone in earshot will need ear protection.

If the lowest-pressure storage tank ''still'' isn't enough to get your bottles up to 4500 psi, it's time to switch over to the compressor.
===Wrap up the process===

# Turn off the fill knobs (bottom right) to cut off additional air to the bottles you're filling.
# Turn off the bank you're currently filling from.
# Open the filling compartment to reveal your newly-filled bottles.
# Close the main valve on the newly-filled bottles (the one you use to open/close the bottle when it's on your pack).
# Bleed off excess pressure in the fill lines using the bleeder valves. As a courtesy to the next person filling bottles, close the valves when you've finished (just finger tight, no need to torque down too much). Ensure nobody has their face too close to the bleeder valve as there will be very high-pressure air whooshing out.
# Disconnect the bottles. If you've filled fast, be careful as the bottle will be warm.
# Finish documenting the bottles you've filled by entering the pressure you filled 'em to and your name.

== Other resources ==
*[https://www.youtube.com/watch?v=1zJfOjqy5tY Decent explanation of how a cascade filling system works (SCUBA, but same idea as SCBA)]

*To do: find and link manual for the compressor (CFS 5.5)

Structure Fire

2023-02-22T06:11:52Z

Zarvanitis: Link to SCBA bottle fill page

==General information==

*[[Helmet Colors]]
*[[Building side labeling]]
*[[Fire Service Terms]]

==Specific tasks==

*[[Establishing Tender Water Supply]]
*[[LUNARS]] (for mayday/firefighter emergencies)
*[[Refilling SCBA Bottles]]

Refilling SCBA Bottles

2023-02-22T06:11:41Z

Zarvanitis: Add page on how to refill SCBA bottles

This process should only be used by trained + authorized people – if you're not sure, don't do it! Consequences for getting this wrong can be high.

Our compressor and fill tanks are located in the apparatus bay at Station 1.

In general, we consider bottles in need of refill any time we see them below 4000 psi.

===Documentation===
It's crucial that we document every bottle we fill. Some of the many reasons:
*If we ever find that the compressor was malfunctioning and putting something undesirable in the air during some period of time (or if air quality was just really bad one day), we need to know which bottles to take out of service until we can refill them with air we actually want to breathe. (We test the air quality periodically to ensure we're filling bottles with breathable air.)

*It forces us to check that the bottle is within its hydro test validity – a hydro test is only good for three years, after which we '''do not fill the bottle until it can be hydro tested again'''. This is a safety issue.
To document the bottles you're filling, you'll need:
*the date

*the bottle number (this is the big ol' MEFD number on the side of the bottle, usually three digits)

*the bottle brand – most will be Luxfer, but not all (RIT bottles are different, possibly?)

*manufacture date – printed right near the bottle brand, I believe

*last hydro test date – if I'm remembering right, this will be in small font on an official-looking sticker. ''MUST'' be within the last three years.

*department – "MEFD" for our bottles, but list other departments if we're filling up for others as part of a large training or incident.
After you fill, you'll also list the pressure you filled to and your name.
===Getting started===

# Do a quick inspection of the bottle for dings, flaking fiberglass, or other issues. Don't fill bottles you don't 100% trust.
# Fill in the start of our documentation sheet for the bottle by finding the info listed above.
# Push down on the safety bar and open the filling compartment.
# Put the bottle into the obvious slot with the connections and gauge upward.
# Connect the fill line and ensure it's actually attached. Same connection as when you're replacing the bottle on a pack, so just knock it into place and confirm it's on.
#* Our RIT bottles have a screw-on attachment rather than the quick-disconnect attachment on our pack bottles. You'll need an adapter, which should live near the compressor somewhere.
# Ensure the line bleed valve is closed! Otherwise you'll be pumping air out into the hall instead of into the bottle.
# Once the bleed valve is closed, fully open the bottle valve. You'll hear a gentle hiss as the pressure in the fill line increases to equalize with the tank.
# Close the filling compartment and jiggle to ensure it's locked shut.

===Preparing to fill===

# Ensure all the storage tanks' connections to the fill station are open.
# Set the fill station to fill from storage (or from compressor if the highest-pressure storage bank is filled to less than 4500 psi).
# Open the lowest-pressure storage bank (conventionally, we use Bank #1 first, then #2, and so on) to give yourself some inlet pressure. To do so, turn the knob under the desired bank all the way to the left, then back off a quarter turn. You should see the inlet pressure gauge at bottom left equalize with the open bank.
# Set the desired fill pressure (4500 psi unless otherwise noted) by adjusting the regulator knob (between inlet + fill pressure gauges). Note that if the set fill pressure is lower than the inlet pressure, there will be a loud hiss as the fill station bleeds off excess air.

===Fill===
In general, we'll fill from the storage tanks until we need to top them off with the compressor. The compressor should be set to turn on when any of the banks drop below a certain pressure.
====From storage tanks====

# You should already have one storage tank valve open.
# Open the fill valve for the bottle(s) you want to fill. Do so slowly! Filling too fast results in really warm bottles, which will require additional top-off later once they've cooled and the pressure has dropped. Some departments also say that filling too fast can lead to bottle failure, so let's definitely avoid that. Ideal fill rates seem to be 200-400 psi per minute.
# If the lowest-pressure storage tank equalizes with the bottles you're filling below 4500 psi, you'll need to shift to the next storage tank. To do so:
## Turn off the fill valve for your bottle(s). This will allow you to adjust the fill rate once the higher-pressure storage tank is opened – otherwise you might hot fill your bottles without meaning to.
## Turn off the storage tank you're currently filling from.
## Open the next-lowest-pressure storage tank. (As before, open all the way, then back off a quarter turn.)
## Open the fill valve for your bottle(s), again aiming for 200-400 psi per minute.

For an explanation of why we start with the lowest-pressure storage tank, see the video below for a discussion of cascade fill systems. It's really quite clever.
====From compressor====
NOTE: If the compressor kicks on, you and everyone in earshot will need ear protection.

If the lowest-pressure storage tank ''still'' isn't enough to get your bottles up to 4500 psi, it's time to switch over to the compressor.
===Wrap up the process===

# Turn off the fill knobs (bottom right) to cut off additional air to the bottles you're filling.
# Turn off the bank you're currently filling from.
# Open the filling compartment to reveal your newly-filled bottles.
# Close the main valve on the newly-filled bottles (the one you use to open/close the bottle when it's on your pack).
# Bleed off excess pressure in the fill lines using the bleeder valves. As a courtesy to the next person filling bottles, close the valves when you've finished (just finger tight, no need to torque down too much). Ensure nobody has their face too close to the bleeder valve as there will be very high-pressure air whooshing out.
# Disconnect the bottles. If you've filled fast, be careful as the bottle will be warm.
# Finish documenting the bottles you've filled by entering the pressure you filled 'em to and your name.

== Other resources ==
*[https://www.youtube.com/watch?v=1zJfOjqy5tY Decent explanation of how a cascade filling system works (SCUBA, but same idea as SCBA)]

*To do: find and link manual for the compressor (CFS 5.5)

Skagit County BLS Protocols

2023-02-21T23:43:05Z

Zarvanitis: Add new ED diversion policy

These are copies of the Skagit County BLS Protocols placed here to make them readily available without having to login. The most current version are available to EMTs in their [[Target Solutions|Vector Solutions]] account in the File Center. If you find a new version of a protocol or a new protocol please let Chief Hunter know.

=== Protocol Book ===
At one point all of the protocols were produced as a single document. This is no longer the case with new protocols and updates to existing protocols being released as individual documents. The protocols in this book are still in effect unless superseded by another protocol below.

[[Media:BLS Protocols v3.2.pdf|BLS Protocols v3.2.pdf]]

=== ALS Indicators ===
[[Media:ALS Indicators v1.28.pdf|ALS Indicators v1.28.pdf]]

=== Approved Abbreviations ===
[[Media:Approved Abbreviations v1.5.pdf|Approved Abbreviations v1.5.pdf]]

=== Aspirin for Cardiac ===
[[Media:BLS Cardiovascular Aspirin 08-2014.pdf|BLS Cardiovascular Aspirin 08-2014.pdf]] - This is noted as replacing page 7 of protocols book.

=== Epinephrine for Anaphylaxis ===
[[Media:BLS Epinephrine for Anaphylaxis.pdf|BLS Epinephrine for Anaphylaxis.pdf]] - 2010

=== Glucometry ===
[[Media:BLS Glucometry v1.21.pdf|BLS Glucometry v1.21.pdf]]

=== Skagit County High Performance CPR ===
[[Media:High Performance CPR 6-1-17.pdf|High Performance CPR 6-1-17.pdf]]

=== Naloxone/Narcan ===
* [[Media:BLS Naloxone v1.06.pdf|BLS Naloxone v1.06.pdf]]
* [[Media:Naloxone Leave Behind Program v1.31.pdf|Naloxone Leave Behind Program v1.31.pdf]]
=== Oxygenation ===
[[Media:BLS Oxygenation v1.03.pdf|BLS Oxygenation v1.03.pdf]]

=== Spinal Immobilization ===
* [[Media:Spine Assessment and Motion Restriction Protocol v1.26.pdf|Spine Assessment and Motion Restriction Protocol v1.26.pdf]]
* [[Media:Spinal Assessment Algorithm.pdf|Spinal Assessment Algorithm.pdf]]
* [[Media:Spinal Assessment Checklist.pdf|Spinal Assessment Checklist.pdf]]

=== iGel Supraglottic Airway ===
[[Media:IGel Supraglottic Airway Protocol v1.06.pdf|IGel Supraglottic Airway Protocol v1.06.pdf]]

=== Tourniquets ===
[[Media:Tourniquets.pdf|tourniquets.pdf]]

=== BLS Transport of ALS Patients ===
[[Media:BLS Transport of ALS Patients v1.04.pdf|BLS Transport of ALS Patients v1.04.pdf]]

NB: MEFD does not transport.

=== COVID-19 ===
[[Media:Covid19 Protocols v4.0.pdf|Covid19 Protocols v4.0.pdf]]

=== Sentinel Events ===
These events require notification of MEFD Chief AND County EMS:

[[Media:Sentinel Events v1.22.pdf|Sentinel Events v1.22.pdf]]

=== UGH Bypass Criteria ===
[[Media:UGH Bypass Criteria v1.05.pdf|UGH Bypass Criteria v1.05.pdf]]

NB: These aren't applicable to MEFD both because we don't work near UGH and because we don't transport.

=== Diversion Policy Update - Feb 2023 ===
[[:File:Feb-2023-EMS-diversion-policy.pdf|Feb 2023 EMS diversion policy.pdf]]

NB: This isn't applicable to MEFD because we don't transport, but it affects our frequent mutual aid partners in Anacortes.

File:25F6279E-F1CA-6235-3543-62820AC924F1.pdf

2023-02-21T23:41:44Z

Zarvanitis: Zarvanitis moved page File:25F6279E-F1CA-6235-3543-62820AC924F1.pdf to File:Feb-2023-EMS-diversion-policy.pdf: Default name not helpful

#REDIRECT [[File:Feb-2023-EMS-diversion-policy.pdf]]

File:Feb-2023-EMS-diversion-policy.pdf

2023-02-21T23:41:43Z

Zarvanitis: Zarvanitis moved page File:25F6279E-F1CA-6235-3543-62820AC924F1.pdf to File:Feb-2023-EMS-diversion-policy.pdf: Default name not helpful

== Summary ==
Updated policy on hospitals' ability to divert incoming EMS units – emergency department saturation is no longer a valid diversion reason.

File:Feb-2023-EMS-diversion-policy.pdf

2023-02-21T23:40:21Z

Zarvanitis: Updated policy on hospitals' ability to divert incoming EMS units – emergency department saturation is no longer a valid diversion reason.

== Summary ==
Updated policy on hospitals' ability to divert incoming EMS units – emergency department saturation is no longer a valid diversion reason.

EMS Operations

2023-02-20T18:40:47Z

Zarvanitis: /* Record keeping */ Add link to ESO how-to

== SOP ==
'''EMS OPERATIONS'''

Adopted 2020

Ref: Skagit County BLS care protocols

=== Definitions: ===
'''ALS:''' Advance Life Support - Paramedic

'''BLS:''' Basic Life Support – EMT or EMR

'''EMT:''' Emergency Medical Technician

'''EMR:''' Emergency Medical Responder (First Responder)

'''Implied Consent:''' When a patient is unconscious or for some other reason unable to give you their actual consent and if the patient has what you believe to be a life-threatening illness or injury, the law assumes that the patient, if able to do so, would want to receive treatment. This also applies to patients who are mentally ill, emotionally disturbed, or developmentally disabled who have a life-threatening problem.

=== Procedure ===
All personnel will provide patient care to the level consistent with their level of training and certification. EMT and EMR shall follow the most current edition on the Skagit County BLS protocols. All operations at the emergency incident shall be carried out in such a manner to provide for the safety of all personnel involved. Appropriate universal precautions and PPE shall be used with all patients. Minimum PPE to be used is nitrile medical exam gloves with ANSI approved safety glasses. Additional protective equipment shall be used according to District procedures.

The District officer or senior EMS person shall function as the Incident Commander.

The IC will request Law Enforcement (Sheriff) when a patient is found deceased or has the high probability of death. Law Enforcement will contact the Skagit County Corner. All members shall make every attempt to preserve any evidence and move only necessary items. All items moved shall be documented and provided to law enforcement. Weapons found at the scene shall not be moved unless removal is necessary to insure the safety of the EMS provider and/or provide proper patient care. Law enforcement shall be notified of weapon movement.

=== Oral and Written Disclosure of Health Care Information: ===
Limited health care information may be disclosed. The following health care information may be disclosed orally, without authorization, to the general public and news media.

* a. Number and where the patient/s were transported.
* b. Time of transport.

Oral disclosure of health care information may be made to other on scene responders, law enforcement, and immediate family members or care givers of the patient. Members violating this will be subject to discipline according to District policy.

=== Record keeping ===
All actions and patient care information shall be documented. First aid certified personnel shall us the Skagit County EMS BLS form.

The top copy shall be given to the ALS / transport unit. The remainder shall be returned to the station a placed in a secure location for further input to data storage. Copies shall be shredded after data entry.

EMT and EMR personnel shall use the [[ESO|ESO reporting software]] and devices to document all actions. This report shall be completed within 24 hours of the call for approval and QA.

If a patient with obvious injury or illness refuses treatment, the senior EMS person or Officer shall ensure the ALS unit is dispatched for evaluation and refusal of care documentation. This action shall be recorded on a Skagit EMS BLS report form.

== PDF ==
[[File:EMS-operations.pdf|left|thumb]]
[[Category:SOP-SOG]]

Common prescription medications

2023-02-20T18:31:30Z

Zarvanitis:

It's frequently helpful to check what a prescription medication does. Some ways to figure it out:

* Our patients will usually be able to explain what their medications do
* It doesn't hurt to just search the name – that's what our medics do too!
*There are apps out there that can serve as offline references – check with fellow volunteers for what they use.
* Check this list!

''Note: brand names are capitalized below, while the name for the drug itself is lowercase. For instance: "ibuprofen (Advil)"''

== Anti-Coagulants (Blood Thinners) ==
''Note: These medications increase our index of suspicion for internal bleeding, brain bleeds, etc. ALS evaluation is required.''
* warfarin (Coumadin)
* dabigatran (Pradaxa)
* clopidogrel (Plavix)
* apixaban (Eliquis)
* rivaroxaban (Xarelto)
* enoxaparin (Lovenox)
* heparin

== Erectile Dysfunction (ED) ==
''Note: Recent ED medication use may limit our ability to provide nitro. Check with patient and consult [[Skagit County BLS Protocols|BLS protocols]].''
*sildenafil (Viagra)
* tadalafil (Cialis)
* vardenafil (Levitra)
* avanafil (Stendra)
* Additionally, most drugs ending in:
** -afil

== Anti-Hypertensives (High BP) ==
'''Mechanisms'''

* Beta Blockers
* Calcium Channel Blockers
* Thiazide Diuretics
* Angiotensin II receptor blockers
* ACE (angiotensin - converting enzyme inhibitors)

'''Medications'''

* amlodipine (Norvasc) = calcium channel blocker
* benazepril (Lotensin) = ACE inhibitor
* hydrochlorothiazide/HCTZ = thiazide diuretic
* valsartan (Diovan) = Angiotensin II Blocker
* metoprolol (Lopressor) = beta blocker
* lisinopril (Prinivil, Zestril) = ACE inhibitor
* In addition, most medications ending in:
** -pril
** -olol
** -thiazide
** -tan

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== High Cholesterol ==
(reminder: most people want lower triglycerides; lower LDL; higher HDL)

'''Medications'''

* atorvastatin (Liptor)
* simvastatin (Zocor)
* rosuvastatin (Crestor)
* ezetimibe (Zetia)
* In addition, most medications ending in:
** -statin
** or trade names ending in -tor

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== Diuretics ==
'''Mechanisms'''

* Loop-acting (Reduce Water/Salt)
* Potassium-Sparing (Reduce water; No B/P Support; Saves Potassium)
* Thiazides (Lowers B/P; Widens Vessels; Reduces Salt/Water)

'''Medications'''

* bumetanide (Bumex) = loop
* furosemide (Lasix) = loop
* spironolactone (Aldactone) = potassium sparing
* amiloride (Midamor) = potassium sparing
* hydrocholothiazide (HTCZ) = thiazide
* chlortalidone (Hygroton) = thiazide

== Insulins ==
Injectable insulin is categorized by how quickly it takes effect:

* Rapid-acting
** insulin aspart (Novolog)
** insulin lispro (Humalog)
** insulin glulisine (Apidra)
** or medications ending in:
*** -olog
*** -alog
* Regular/short-acting
** insulin (Humulin, Novolin)
** or medications ending in:
*** -lin
* Intermediate-acting
** insulin isophane (Humulin N, Novolin N)
* Long-acting
** insulin glargine (Lantus)
** insulin detemir (Levemir)

'''Oral medications (type 2 diabetes only)'''

* metformin (Glucophage)
* glipizide (Glucotrol)
* pioglitazone (Actos)
* glyburide/glibencalmide (Diabeta)
* sitagliptin (Januvia)
* linagliptin (Tradjenta)
* dulaglutide (Trulicity)
* liraglutide (Victoza)
* dapagliflozin (Farxiga)
* empagliflozin (Jardiance)
* gabapentin (Neurontin)
** Specifically for Neuropathy, epilepsy & nerve pain
** People who are diabetic will take for neuropathy (i.e. nerve damage – numb, burning, prickling)
* semaglutide (Ozempic)

== Mental Health ==

=== Bipolar ===

* lithium compounds

=== Schizophrenia ===

* clozapine (Clozaril)
* aripiprazole (Abilify)
* ziprasidone (Geodon)
* risperidone (Risperdal)
* quetiapine (Seroquel)
* paliperidone (Invega)
* olanzapine (Zyprexa)
* lurasidone (Latuda)
* haloperidol (Haldol)

=== Dementia/Alzheimers ===

* donepezil (Aricept)
* memantine (Namenda)

=== Anxiety ===

* alprazolam (Xanax)
* clonazepam (Klonopin)
* Additionally, medications ending in:
** -lam

=== Depression ===

* sertraline (Zoloft)
* citalopram (Celexa)
* escitalopram (Lexapro, Cipralex)
* aripiprazole (Abilify)
* trazodone
* Additionally, medications ending in:
** -zole
** -pram

== Anti-Convulsants (Seizure Meds) ==

* levetiracetam (Keppra)
* valproate/VPA (Depakote)
* phenytoin/PHT (Dilantin)
* lamotrigine (Lamictal)
* topiramate (Topamax)
* carbamazepine (Tegretol)
* phenobarbital (Luminol)

== Pain ==

* Non-steroidal anti-inflammatory drugs (NSAIDs)
** ibuprofen (Advil/Motrin)
** naproxen (Aleve)
** aspirin (Bayer Aspirin)
* acetaminophen/paracetamol (Tylenol)
* Anti-depressants/anti-convulsants
**Chronic pain is often caused by nerve things, and anti-depressants/anti-convulsants can help with that flavor of pain
* Narcotics
** codeine
** morphine (Statex)
** oxycodone (OxyContin)
** methadone (Dolophine)
** fentanyl (Actiq)
** hydrocodone
** hydromorphone
** tramadol (Ultram)
** Anything ending in -done

== Insomnia ==

* melatonin (available over the counter)
* zolpidem (Ambien)
* eszopiclone (Lunestra)
* zaleplon (Sonata)

== Nausea ==
Zofran - anti nausea

Common prescription medications

2023-02-20T18:29:33Z

Zarvanitis: add protocol link

It's frequently helpful to check what a prescription medication does. Some ways to figure it out:

* Our patients will usually be able to explain what their medications do
* It doesn't hurt to just search the name – that's what our medics do too!
* Check this list!

''Note: brand names are capitalized below, while the name for the drug itself is lowercase. For instance: "ibuprofen (Advil)"''

== Anti-Coagulants (Blood Thinners) ==
''Note: These medications increase our index of suspicion for internal bleeding, brain bleeds, etc. ALS evaluation is required.''
* warfarin (Coumadin)
* dabigatran (Pradaxa)
* clopidogrel (Plavix)
* apixaban (Eliquis)
* rivaroxaban (Xarelto)
* enoxaparin (Lovenox)
* heparin

== Erectile Dysfunction (ED) ==
''Note: Recent ED medication use may limit our ability to provide nitro. Check with patient and consult [[Skagit County BLS Protocols|BLS protocols]].''
*sildenafil (Viagra)
* tadalafil (Cialis)
* vardenafil (Levitra)
* avanafil (Stendra)
* Additionally, most drugs ending in:
** -afil

== Anti-Hypertensives (High BP) ==
'''Mechanisms'''

* Beta Blockers
* Calcium Channel Blockers
* Thiazide Diuretics
* Angiotensin II receptor blockers
* ACE (angiotensin - converting enzyme inhibitors)

'''Medications'''

* amlodipine (Norvasc) = calcium channel blocker
* benazepril (Lotensin) = ACE inhibitor
* hydrochlorothiazide/HCTZ = thiazide diuretic
* valsartan (Diovan) = Angiotensin II Blocker
* metoprolol (Lopressor) = beta blocker
* lisinopril (Prinivil, Zestril) = ACE inhibitor
* In addition, most medications ending in:
** -pril
** -olol
** -thiazide
** -tan

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== High Cholesterol ==
(reminder: most people want lower triglycerides; lower LDL; higher HDL)

'''Medications'''

* atorvastatin (Liptor)
* simvastatin (Zocor)
* rosuvastatin (Crestor)
* ezetimibe (Zetia)
* In addition, most medications ending in:
** -statin
** or trade names ending in -tor

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== Diuretics ==
'''Mechanisms'''

* Loop-acting (Reduce Water/Salt)
* Potassium-Sparing (Reduce water; No B/P Support; Saves Potassium)
* Thiazides (Lowers B/P; Widens Vessels; Reduces Salt/Water)

'''Medications'''

* bumetanide (Bumex) = loop
* furosemide (Lasix) = loop
* spironolactone (Aldactone) = potassium sparing
* amiloride (Midamor) = potassium sparing
* hydrocholothiazide (HTCZ) = thiazide
* chlortalidone (Hygroton) = thiazide

== Insulins ==
Injectable insulin is categorized by how quickly it takes effect:

* Rapid-acting
** insulin aspart (Novolog)
** insulin lispro (Humalog)
** insulin glulisine (Apidra)
** or medications ending in:
*** -olog
*** -alog
* Regular/short-acting
** insulin (Humulin, Novolin)
** or medications ending in:
*** -lin
* Intermediate-acting
** insulin isophane (Humulin N, Novolin N)
* Long-acting
** insulin glargine (Lantus)
** insulin detemir (Levemir)

'''Oral medications (type 2 diabetes only)'''

* metformin (Glucophage)
* glipizide (Glucotrol)
* pioglitazone (Actos)
* glyburide/glibencalmide (Diabeta)
* sitagliptin (Januvia)
* linagliptin (Tradjenta)
* dulaglutide (Trulicity)
* liraglutide (Victoza)
* dapagliflozin (Farxiga)
* empagliflozin (Jardiance)
* gabapentin (Neurontin)
** Specifically for Neuropathy, epilepsy & nerve pain
** People who are diabetic will take for neuropathy (i.e. nerve damage – numb, burning, prickling)
* semaglutide (Ozempic)

== Mental Health ==

=== Bipolar ===

* lithium compounds

=== Schizophrenia ===

* clozapine (Clozaril)
* aripiprazole (Abilify)
* ziprasidone (Geodon)
* risperidone (Risperdal)
* quetiapine (Seroquel)
* paliperidone (Invega)
* olanzapine (Zyprexa)
* lurasidone (Latuda)
* haloperidol (Haldol)

=== Dementia/Alzheimers ===

* donepezil (Aricept)
* memantine (Namenda)

=== Anxiety ===

* alprazolam (Xanax)
* clonazepam (Klonopin)
* Additionally, medications ending in:
** -lam

=== Depression ===

* sertraline (Zoloft)
* citalopram (Celexa)
* escitalopram (Lexapro, Cipralex)
* aripiprazole (Abilify)
* trazodone
* Additionally, medications ending in:
** -zole
** -pram

== Anti-Convulsants (Seizure Meds) ==

* levetiracetam (Keppra)
* valproate/VPA (Depakote)
* phenytoin/PHT (Dilantin)
* lamotrigine (Lamictal)
* topiramate (Topamax)
* carbamazepine (Tegretol)
* phenobarbital (Luminol)

== Pain ==

* Non-steroidal anti-inflammatory drugs (NSAIDs)
** ibuprofen (Advil/Motrin)
** naproxen (Aleve)
** aspirin (Bayer Aspirin)
* acetaminophen/paracetamol (Tylenol)
* Anti-depressants/anti-convulsants
**Chronic pain is often caused by nerve things, and anti-depressants/anti-convulsants can help with that flavor of pain
* Narcotics
** codeine
** morphine (Statex)
** oxycodone (OxyContin)
** methadone (Dolophine)
** fentanyl (Actiq)
** hydrocodone
** hydromorphone
** tramadol (Ultram)
** Anything ending in -done

== Insomnia ==

* melatonin (available over the counter)
* zolpidem (Ambien)
* eszopiclone (Lunestra)
* zaleplon (Sonata)

== Nausea ==
Zofran - anti nausea

Common prescription medications

2023-02-20T17:35:32Z

Zarvanitis: Add note on other meds that can treat chronic pain

It's frequently helpful to check what a prescription medication does. Some ways to figure it out:

* Our patients will usually be able to explain what their medications do
* It doesn't hurt to just search the name – that's what our medics do too!
* Check this list!

''Note: brand names are capitalized below, while the name for the drug itself is lowercase. For instance: "ibuprofen (Advil)"''

== Anti-Coagulants (Blood Thinners) ==

* warfarin (Coumadin)
* dabigatran (Pradaxa)
* clopidogrel (Plavix)
* apixaban (Eliquis)
* rivaroxaban (Xarelto)
* enoxaparin (Lovenox)
* heparin

== Erectile Dysfunction ==

* sildenafil (Viagra)
* tadalafil (Cialis)
* vardenafil (Levitra)
* avanafil (Stendra)
* Additionally, most drugs ending in:
** -afil

== Anti-Hypertensives (High BP) ==
'''Mechanisms'''

* Beta Blockers
* Calcium Channel Blockers
* Thiazide Diuretics
* Angiotensin II receptor blockers
* ACE (angiotensin - converting enzyme inhibitors)

'''Medications'''

* amlodipine (Norvasc) = calcium channel blocker
* benazepril (Lotensin) = ACE inhibitor
* hydrochlorothiazide/HCTZ = thiazide diuretic
* valsartan (Diovan) = Angiotensin II Blocker
* metoprolol (Lopressor) = beta blocker
* lisinopril (Prinivil, Zestril) = ACE inhibitor
* In addition, most medications ending in:
** -pril
** -olol
** -thiazide
** -tan

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== High Cholesterol ==
(reminder: most people want lower triglycerides; lower LDL; higher HDL)

'''Medications'''

* atorvastatin (Liptor)
* simvastatin (Zocor)
* rosuvastatin (Crestor)
* ezetimibe (Zetia)
* In addition, most medications ending in:
** -statin
** or trade names ending in -tor

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== Diuretics ==
'''Mechanisms'''

* Loop-acting (Reduce Water/Salt)
* Potassium-Sparing (Reduce water; No B/P Support; Saves Potassium)
* Thiazides (Lowers B/P; Widens Vessels; Reduces Salt/Water)

'''Medications'''

* bumetanide (Bumex) = loop
* furosemide (Lasix) = loop
* spironolactone (Aldactone) = potassium sparing
* amiloride (Midamor) = potassium sparing
* hydrocholothiazide (HTCZ) = thiazide
* chlortalidone (Hygroton) = thiazide

== Insulins ==
Injectable insulin is categorized by how quickly it takes effect:

* Rapid-acting
** insulin aspart (Novolog)
** insulin lispro (Humalog)
** insulin glulisine (Apidra)
** or medications ending in:
*** -olog
*** -alog
* Regular/short-acting
** insulin (Humulin, Novolin)
** or medications ending in:
*** -lin
* Intermediate-acting
** insulin isophane (Humulin N, Novolin N)
* Long-acting
** insulin glargine (Lantus)
** insulin detemir (Levemir)

'''Oral medications (type 2 diabetes only)'''

* metformin (Glucophage)
* glipizide (Glucotrol)
* pioglitazone (Actos)
* glyburide/glibencalmide (Diabeta)
* sitagliptin (Januvia)
* linagliptin (Tradjenta)
* dulaglutide (Trulicity)
* liraglutide (Victoza)
* dapagliflozin (Farxiga)
* empagliflozin (Jardiance)
* gabapentin (Neurontin)
** Specifically for Neuropathy, epilepsy & nerve pain
** People who are diabetic will take for neuropathy (i.e. nerve damage – numb, burning, prickling)
* semaglutide (Ozempic)

== Mental Health ==

=== Bipolar ===

* lithium compounds

=== Schizophrenia ===

* clozapine (Clozaril)
* aripiprazole (Abilify)
* ziprasidone (Geodon)
* risperidone (Risperdal)
* quetiapine (Seroquel)
* paliperidone (Invega)
* olanzapine (Zyprexa)
* lurasidone (Latuda)
* haloperidol (Haldol)

=== Dementia/Alzheimers ===

* donepezil (Aricept)
* memantine (Namenda)

=== Anxiety ===

* alprazolam (Xanax)
* clonazepam (Klonopin)
* Additionally, medications ending in:
** -lam

=== Depression ===

* sertraline (Zoloft)
* citalopram (Celexa)
* escitalopram (Lexapro, Cipralex)
* aripiprazole (Abilify)
* trazodone
* Additionally, medications ending in:
** -zole
** -pram

== Anti-Convulsants (Seizure Meds) ==

* levetiracetam (Keppra)
* valproate/VPA (Depakote)
* phenytoin/PHT (Dilantin)
* lamotrigine (Lamictal)
* topiramate (Topamax)
* carbamazepine (Tegretol)
* phenobarbital (Luminol)

== Pain ==

* Non-steroidal anti-inflammatory drugs (NSAIDs)
** ibuprofen (Advil/Motrin)
** naproxen (Aleve)
** aspirin (Bayer Aspirin)
* acetaminophen/paracetamol (Tylenol)
* Anti-depressants/anti-convulsants
**Chronic pain is often caused by nerve things, and anti-depressants/anti-convulsants can help with that flavor of pain
* Narcotics
** codeine
** morphine (Statex)
** oxycodone (OxyContin)
** methadone (Dolophine)
** fentanyl (Actiq)
** hydrocodone
** hydromorphone
** tramadol (Ultram)
** Anything ending in -done

== Insomnia ==

* melatonin (available over the counter)
* zolpidem (Ambien)
* eszopiclone (Lunestra)
* zaleplon (Sonata)

== Nausea ==
Zofran - anti nausea

EMS

2023-02-20T17:19:01Z

Zarvanitis: Add link to common meds page

== District EMS Policies ==
[[SOPs and SOGs|EMS SOPS]]

== Skagit County BLS Protocols ==
[[Skagit County BLS Protocols]]

== Tools and Equipment ==
*[[ESO]]
*[[Nitrile Gloves]]
* [[Target Solutions]] aka Vector Solutions
* [[Ventilations and End Tidal CO2]]
* [[Zoll AED Pro]]
* [[CT6 Traction Splint]]

== Processes ==

* [[EMS Radio Report]]
* [[EMT Recertification]]

== Quick reference ==

* [[Common prescription medications]]

Common prescription medications

2023-02-20T17:18:48Z

Zarvanitis: Create common medications page

It's frequently helpful to check what a prescription medication does. Some ways to figure it out:

* Our patients will usually be able to explain what their medications do
* It doesn't hurt to just search the name – that's what our medics do too!
* Check this list!

''Note: brand names are capitalized below, while the name for the drug itself is lowercase. For instance: "ibuprofen (Advil)"''

== Anti-Coagulants (Blood Thinners) ==

* warfarin (Coumadin)
* dabigatran (Pradaxa)
* clopidogrel (Plavix)
* apixaban (Eliquis)
* rivaroxaban (Xarelto)
* enoxaparin (Lovenox)
* heparin

== Erectile Dysfunction ==

* sildenafil (Viagra)
* tadalafil (Cialis)
* vardenafil (Levitra)
* avanafil (Stendra)
* Additionally, most drugs ending in:
** -afil

== Anti-Hypertensives (High BP) ==
'''Mechanisms'''

* Beta Blockers
* Calcium Channel Blockers
* Thiazide Diuretics
* Angiotensin II receptor blockers
* ACE (angiotensin - converting enzyme inhibitors)

'''Medications'''

* amlodipine (Norvasc) = calcium channel blocker
* benazepril (Lotensin) = ACE inhibitor
* hydrochlorothiazide/HCTZ = thiazide diuretic
* valsartan (Diovan) = Angiotensin II Blocker
* metoprolol (Lopressor) = beta blocker
* lisinopril (Prinivil, Zestril) = ACE inhibitor
* In addition, most medications ending in:
** -pril
** -olol
** -thiazide
** -tan

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== High Cholesterol ==
(reminder: most people want lower triglycerides; lower LDL; higher HDL)

'''Medications'''

* atorvastatin (Liptor)
* simvastatin (Zocor)
* rosuvastatin (Crestor)
* ezetimibe (Zetia)
* In addition, most medications ending in:
** -statin
** or trade names ending in -tor

''note: Caduet is a fixed-dose combination of amlodipine (for high blood pressure) and atorvastatin (for high cholesterol)''

== Diuretics ==
'''Mechanisms'''

* Loop-acting (Reduce Water/Salt)
* Potassium-Sparing (Reduce water; No B/P Support; Saves Potassium)
* Thiazides (Lowers B/P; Widens Vessels; Reduces Salt/Water)

'''Medications'''

* bumetanide (Bumex) = loop
* furosemide (Lasix) = loop
* spironolactone (Aldactone) = potassium sparing
* amiloride (Midamor) = potassium sparing
* hydrocholothiazide (HTCZ) = thiazide
* chlortalidone (Hygroton) = thiazide

== Insulins ==
Injectable insulin is categorized by how quickly it takes effect:

* Rapid-acting
** insulin aspart (Novolog)
** insulin lispro (Humalog)
** insulin glulisine (Apidra)
** or medications ending in:
*** -olog
*** -alog
* Regular/short-acting
** insulin (Humulin, Novolin)
** or medications ending in:
*** -lin
* Intermediate-acting
** insulin isophane (Humulin N, Novolin N)
* Long-acting
** insulin glargine (Lantus)
** insulin detemir (Levemir)

'''Oral medications (type 2 diabetes only)'''

* metformin (Glucophage)
* glipizide (Glucotrol)
* pioglitazone (Actos)
* glyburide/glibencalmide (Diabeta)
* sitagliptin (Januvia)
* linagliptin (Tradjenta)
* dulaglutide (Trulicity)
* liraglutide (Victoza)
* dapagliflozin (Farxiga)
* empagliflozin (Jardiance)
* gabapentin (Neurontin)
** Specifically for Neuropathy, epilepsy & nerve pain
** People who are diabetic will take for neuropathy (i.e. nerve damage – numb, burning, prickling)
* semaglutide (Ozempic)

== Mental Health ==

=== Bipolar ===

* lithium compounds

=== Schizophrenia ===

* clozapine (Clozaril)
* aripiprazole (Abilify)
* ziprasidone (Geodon)
* risperidone (Risperdal)
* quetiapine (Seroquel)
* paliperidone (Invega)
* olanzapine (Zyprexa)
* lurasidone (Latuda)
* haloperidol (Haldol)

=== Dementia/Alzheimers ===

* donepezil (Aricept)
* memantine (Namenda)

=== Anxiety ===

* alprazolam (Xanax)
* clonazepam (Klonopin)
* Additionally, medications ending in:
** -lam

=== Depression ===

* sertraline (Zoloft)
* citalopram (Celexa)
* escitalopram (Lexapro, Cipralex)
* aripiprazole (Abilify)
* trazodone
* Additionally, medications ending in:
** -zole
** -pram

== Anti-Convulsants (Seizure Meds) ==

* levetiracetam (Keppra)
* valproate/VPA (Depakote)
* phenytoin/PHT (Dilantin)
* lamotrigine (Lamictal)
* topiramate (Topamax)
* carbamazepine (Tegretol)
* phenobarbital (Luminol)

== Pain ==

* Non-steroidal anti-inflammatory drugs (NSAIDs)
** ibuprofen (Advil/Motrin)
** naproxen (Aleve)
** aspirin (Bayer Aspirin)
* acetaminophen/paracetamol (Tylenol)
* Anti-depressants/anti-convulsants
* Narcotics
** codeine
** morphine (Statex)
** oxycodone (OxyContin)
** methadone (Dolophine)
** fentanyl (Actiq)
** hydrocodone
** hydromorphone
** tramadol (Ultram)
** Anything ending in -done

== Insomnia ==

* melatonin (available over the counter)
* zolpidem (Ambien)
* eszopiclone (Lunestra)
* zaleplon (Sonata)

== Nausea ==
Zofran - anti nausea

Fire Service Terms

2023-02-06T21:02:01Z

Zarvanitis: Add a few terms, including building side labeling terms

This is a non-exhaustive list of abbreviations, acronyms, and terms used in the fire service and EMS. Some are in wide use, some may be more local.

For approved Skagit County EMS abbreviations, see: [[Skagit_County_BLS_Protocols#Approved_Abbreviations]]

== A ==

* '''AFA''' - Automatic fire alarm
* '''Alpha side''' - the front (or established by convention to be the front for an incident) side of a structure. See [[Building side labeling]]

== B ==

* '''Bravo side''' - See [[Building side labeling]]

== C ==

* '''Charlie side''' - See [[Building side labeling]]

== D ==

* '''Delta side''' - See [[Building side labeling]]

== F ==
* '''FIB''' - Fire in a building; structure fire
* '''FIBR''' - Fire in a building, residential; house fire

== H ==
* '''HBD''' - Has been drinking

== J ==

* '''JEO''' - Just east of; often used when describing a location: JEO landmark
* '''JNO''' - Just north of
* '''JSO''' - Just south of
* '''JWO''' - Just west of

== L ==

* '''LDH''' - Large diameter hose (usually considered 3" or larger)

== M ==
* '''MCI''' - Mass casualty incident; an event with multiple patients that overwhelms your current resources
* '''MCO''' - Multi-company operation; an event that involves multiple units possibly from different departments
*'''MDT''' - Mobile data terminal; computer in apparatus providing dispatch information and mapping
* '''MVA''' - Motor vehicle accident

== N ==

* '''NWCG''' - National Wildfire Coordinating Group

== O ==

* '''OVES''' - Oriented vent, enter, & search

== P ==

* '''PCR''' - Patient care report

== R ==

* '''RP''' - Reporting party
*'''RIT''' - Rapid intervention team, sometimes also RIC

== S ==

* '''SCSO''' - Skagit County Sheriff's Office
*'''Status 4''' - in a condition where no aid from law enforcement is required (e.g. "Cascade, 11-24, all Mount Erie units are status four"). Note: this isn't exactly clear text (that is, receivers need to know in advance what status four means), so avoid using where possible.

== V ==
* '''VES''' - Vent, enter, & search
*'''VUCSA''' - Violation of the Uniform Controlled Substances Act; under the influence of illegal drugs

Structure Fire

2023-02-06T20:57:10Z

Zarvanitis:

LUNARS

2023-02-06T20:56:39Z

Zarvanitis: Add link to building side labeling.

LUNARS is an acronym to help you remember the information you need to transmit on the radio when requesting emergency assistance on the fireground.

* '''L''' - Location
* '''U''' - Unit
* '''N''' - Name (or ID#)
* '''A''' - Assignment
* '''R''' - Resources Needed
* '''S''' - Situation

For instance, if you were trapped you might say the following:

Command from 11-21 with EMERGENCY TRAFFIC

All companies from Command clear the air for EMERGENCY TRAFFIC, all companies from Command clear the air for EMERGENCY TRAFFIC;

Go ahead 11-21

Command from 11-21. MAYDAY - MAYDAY - MAYDAY. This is Firefighter Jones, I am lost during primary search and low on air, I think I am in the Charlie / Bravo corner in the basement with low visibility and high heat. I need air and help getting out.

* L = Charlie/Bravo corner in the basement (see [[Building side labeling]])
* U = 11-21
* N = Firefighter Jones
* A = primary search
* R = air and help getting out
* S = lost, low on air, low visibility, high heat

Building side labeling

2023-02-06T20:41:28Z

Zarvanitis: Add info about what the sides of a building are called

On the fireground you'll often hear terms like "alpha side", "charlie-delta corner", "bravo exposure". This is a standard way of describing buildings so that we all know we're talking about the same part of the building.

The alpha side is usually the front, the side facing the street, the side with the helpful blue address label, the side with the obvious front entrance, where the command post is located. If not all of those are the same side (it's fairly rare), the incident commander will declare an alpha side by announcing (for example) “alpha side is where 11-12 is parked” or something like that.

From there, bravo, charlie, and delta are the sides counting clockwise from alpha:

[[File:Alpha Bravo Charlie Delta sides.png|thumb]]

File:Alpha Bravo Charlie Delta sides.png

2023-02-06T20:40:40Z

Zarvanitis:

Show definitions of sides of a building

Structure Fire

2023-02-06T20:34:21Z

Zarvanitis: Add link to page for alpha/bravo/charlie labeling

==General information==

*[[Helmet Colors]]
*[[Building side labeling]]

==Specific tasks==

*[[Establishing Tender Water Supply]]
*[[LUNARS]] (for mayday/firefighter emergencies)

11-21

2023-01-27T06:15:41Z

Zarvanitis: Fix link to manual

== How to==
===How to update clock===
The radio unit above eye level for the driver of 11-21 has a clock independent of the rest of the apparatus. Page 7 of the [[:File:JHD1635BT Manual.pdf|JHD1635BT Manual]] has instructions for setting the clock:

#Ensure the apparatus is on
#Long press the large circular knob on the left to turn the radio on
#Press and hold the MENU button until the first menu item appears
#Use the TUNE/SEEK buttons to navigate to the "Set Clock" menu item
#Hit the INFO/ENTER button to view the clock set screen
#Use the TUNE/SEEK buttons to increase/decrease the selected digit, then the INFO/ENTER to proceed to the next digit
#Leave the radio alone for 5 seconds and the clock will be set
#Long press the large circular knob on the left to turn the unit off

==Assigned Equipment==
[[Honda EU2200i Generator]]

File:JHD1635BT Manual.pdf

2023-01-27T06:13:15Z

Zarvanitis:

11-21

2023-01-27T06:12:00Z

Zarvanitis: Add info on how to update the clock

== How to==
===How to update clock===
The radio unit above eye level for the driver of 11-21 has a clock independent of the rest of the apparatus. Page 7 of the [[JHD1635BT Manual]] has instructions for setting the clock:

#Ensure the apparatus is on
#Long press the large circular knob on the left to turn the radio on
#Press and hold the MENU button until the first menu item appears
#Use the TUNE/SEEK buttons to navigate to the "Set Clock" menu item
#Hit the INFO/ENTER button to view the clock set screen
#Use the TUNE/SEEK buttons to increase/decrease the selected digit, then the INFO/ENTER to proceed to the next digit
#Leave the radio alone for 5 seconds and the clock will be set
#Long press the large circular knob on the left to turn the unit off

==Assigned Equipment==
[[Honda EU2200i Generator]]

EMS Exposure Control Plan (ECP)

2023-01-22T03:44:57Z

Zarvanitis: Update formatting of Fire/EMS reportable exposure. is its own definition in the attached PDF.

= SOP =
EMS Exposure Control Plan (ECP)

ADOPTED - June 2006 REVISED – March 2020

WAC 296-305-02501

It is the intent of the District to promote safe work practices to minimize the incidence of illness or injury by exposure to infectious disease. This plan is to reduce occupational exposure to airborne or bloodborne pathogens the member may encounter.

Copies of the Exposure Control Plan are kept in the following locations:
*Fire Chief’s Office
*Equipment cleaning areas
*All BLS protocol manuals
*All District SOP manuals and database

This plan will be reviewed and updated under the following circumstances:
* Annually
* Whenever new or modified tasks and procedures are implemented which affect occupational exposure of our members.
* Whenever new instances of occupational exposure may occur.
* Establishment of new functional positions within our District that may involve exposure to bloodborne pathogens.

There are several general principles that shall be followed when working in an area with potential infectious disease.
* Exposure to infectious disease or materials should never be underestimated
* Minimize all exposure to infectious situations or materials
* The District shall institute, where practical, as many engineering and work practice controls to limit or eliminate exposure to infectious materials

The Objective of this plan is to:
* Universal precautions shall be observed for all patients and expanded appropriately for increasing risks or occurrence of infectious material.
* To provide emergency services to the public without regard to known or suspected diagnosis of communicable disease in any patient.
* To regard all patients contacts as potentially infectious.
* To provide all members the necessary training, equipment, immunizations, and personal protective equipment.
* To provide the appropriate counseling and treatment for members who are exposed or have had a significant exposure.
* To recognize the need for participation restrictions for members based on exposure concerns.

== Exposure Determination ==
These positions in the District where members may be exposed to potentially infectious material, which may result in possible exposure to infectious disease
* Firefighter
* First Responder
* Emergency Medical Technician
* Lieutenant
* Assistant Chief
* Fire Chief

== Terms and Definitions ==
'''Bloodborne pathogens:''' pathogenic microorganisms that may be present in human blood or blood products and can cause disease in humans. These pathogens include but are not limited to hepatitis B virus (HBV) and human immunodeficiency virus (HIV).

'''Confidentiality:''' The protection of medical information and record of employees, members, or patients as defined in medical ethics, federal and state law, which prohibits the release of such information without the consent from the individual the information or record it pertains to. Washington State addresses the confidentiality of all persons with a sexually transmitted disease (STD including HIV/AIDS and all bloodborne forms of hepatitis in chapter 70.24-105 RCW and WAC 246-100-016. Disclosure of STD status is prohibited, except for health care providers, including licensed EMS personnel).

'''Contaminated:''' The presence of or the reasonably anticipated presence of blood, body fluid or other potentially infectious materials on an item or surface.

'''Exposure:''' Contact with infectious agents, such as blood and body fluids, through inhalation, percutaneous inoculation, or contact with an open wound, non-intact skin, or mucous membrane that results from the performance of an employee/member’s duties

'''Fire/EMS reportable exposure:''' A direct introduction of a potentially infectious material (PIM) agent from a patient into the EMS provider’s body.

'''Hospital reportable exposure (unsuspected exposure):''' A hospital reportable or unsuspected exposure to occurs if EMS employees/members treat or transport a patient who is later diagnosed as having a serious communicable disease that could have been
transmitted by a respiratory route. Hospital reportable disease includes tuberculosis and meningococcal meningitis.

'''Mucocutaneous exposure:''' (through the eye mouth or nose) a mucocutaneous event occurs when blood or body fluid is splashed or sprayed into the eye, nose, or mouth.

'''Percutaneous exposure:''' (through the skin) a percutaneous event occurs when blood or body fluid is introduced through the skin. Examples – needle stick with a bloody needle; sustaining a cut by a sharp object contaminated with blood or body fluids; entrance of blood or body fluids through an open wound, abrasion, broken cuticle or chapped skin.

'''Potentially Infectious Materials (PIM):''' Any body fluid or items contaminated with fluids that might contain pathogenic microorganisms that may be present in human blood or body fluids that are known to cause disease in humans.
== Training ==
All new district personnel shall attend initial pathogens training program within 90 days of hire (First Aid certification class). This may be waived if the member can prove this training was completed before becoming a member of the District.

All members shall attend an annual refresher training (HAZCOM) that covers any new PIM and changes in policies or procedures.

== Plan management ==
The following personnel have responsibilities for the implementation and control of the plan:

=== Fire Chief ===
The Chief shall have the overall responsibility for the plan and ensuring overall management and support of the Bloodborne Pathogens Program.
* Shall function as the District Infection Control Officer
* Shall ensure all new personnel are offered immunization and TB testing.
* Ensure that all members attend an initial Bloodborne Pathogens class before assuming any response duties.
* Ensure that an exposure record for each member is maintained.
* Maintain confidentiality of all medical and exposure records.
* Schedule Annual Bloodborne Pathogens Training and documentation of Exposure Control Training
* Shall be the contact person for all exposures
* Shall contact the member and inform them of the results of any exposure and arrange any follow-up treatment or counseling.
* Shall establish personnel exposure protocols so that a process for dealing with exposures is in writing and available to all personnel.
* Working with other members to develop and administer any additional bloodborne pathogens related policies and practices needed to support the effective implementation of this plan.
* Collecting and maintaining reference materials on the Bloodborne Pathogens Standard and Bloodborne Pathogens Safety and Health Information.
* Knowing current legal requirements concerning bloodborne pathogens.
* Develop an infection control training program.

=== Assistant Fire Chief / Safety Committee ===
* Conduct periodic department audits to maintain an up-to-date Exposure Control Plan and ensure compliance with the current program.

=== Skagit County Emergency Medical Services / Medical Control ===
* Provide technical assistance and guidance to the Infection Control Program, and in the development of appropriate infection control training.
* Periodically review the continuing medical education program (CME) and include changes made by the Department of Health (DOH)-EMS/Trauma Systems with regards to Infection Control training.

=== Incident Commander ===
* Ensuring EMS Personnel on scene are complying with the safeguards outlined in the Exposure Control Plan.
* Correct any unsafe practices or acts immediately.
* Ensure that a Medical Report is correctly filled out and filed for all medical responses.
• Ensure items utilized at the scene are decontaminated or disposed of properly.

=== Members ===
Members have the most important role in our Bloodborne Pathogens Compliance Program, for the ultimate execution of much of our Exposure Control Plan rests in their hands. In this role they shall do the following:
* Properly use all PPE available to them to prevent exposure.
* Know what tasks they perform that have occupational Exposure.
* Report any suspected Occupation Exposure to infectious or potentially infectious disease to the Incident Commander, Fire Chief or Assistant Chief IMMEDIATELY!
* Complete all appropriate forms with the Fire Chief
* Receive immunization for exposure to PIM. If the member refuses immunization, then they shall acknowledge the risk in writing of the possible exposure.
* Attend the Bloodborne Pathogens training sessions.
* Plan and conduct all operations in accordance with our work practice controls.
* Immediately notify the Fire Chief diagnosis of communicable disease.

== Activities involving potential exposure to airborne and bloodborne pathogens ==
Below are the listed tasks and procedures in our District which may result in exposure to PIM:
* Emergency medical care to injured or ill patients.
* Rescue of victims from hostile environments.
* Extrication of persons from vehicles, machinery or collapsed excavations or structures.
* Recovery and removal of bodies from the above situations.
* Response to hazardous materials emergencies, both transportation and fixed site, involving potentially infectious substances.
* Patient assessment and scene assessments.
* Ventilation techniques
* Oxygen Administration
* CPR
* Bleeding Control
* Bandaging
* Obstetrical Care
* Spinal Immobilization
* Defibrillation
* Assisting in IV initiation
* Assisting in advanced airway maneuvers
* Administration of medications
* Placement of airways

== Methods for controlling exposure ==
In order to minimize or eliminate the exposure to PIM, the following practices shall be
implemented for use in the District.

Universal precautions, Personal protective equipment, Engineering controls, Work practice controls

'''Universal precautions''' are the practice of considering all body fluids to contain potentially infectious materials (PIM) and to use barriers to reduce or eliminate contamination.

All members shall have available to them a full complement of '''Personal Protective Equipment''' (PPE). All members shall wear as a minimum for patient contact nitrile examination gloves and safety glasses. Other PPE shall be available in each BLS unit
and in supply cabinets in each station.

All contaminated equipment that is disposable shall be double bagged in a red BIOHAZARD bag, labeled with the type of contaminate, and disposed of at an appropriate facility.

'''Medical Exam Gloves:''' Nitrile (NO LATEX) exam gloves shall be worn by all personnel involved in patient treatment. When one provider may handle multiple patients, members shall don a fresh pair of gloves to prevent possible cross contamination of other patients. All sizes of gloves shall be available to all members. Gloves are in all apparatus, cleaning areas, and near first aid stations in District facilities.

Gloves contaminated with PIM shall be disposed of in the BIOHARZARD waste container in the responding Medic unit or in a BIOHAZARD waste bag and taken to Island Hospital for disposal.

'''Safety glasses''' Safety glasses shall be issued to all personnel during their initial issue of equipment. They are intended to be used for all patient contacts.

'''HEPA (N95) mask''' All EMS personnel are to be fit tested for HEPA masks during annual testing for SCBA. Containers marked EXPOSURE CONTROL/BlO-HAZARD shall be place on licensed BLS aid units. Masks shall be used for airway procedures, or
the potential of airborne PIM.

'''TYVEK Coveralls with shoe covers''' Coveralls shall be of Tyvek construction with a hood attached. Coveralls will be in the containers marked EXPOSURE CONTROL/BIOHAZARD. These are not to be used during extrication of patients from areas that might pose a fire hazard or have sharp exposures that might compromise the integrity of the garment. For those instances, structural firefighters protective clothing shall be used in conjunction with medical gloves mask and safety glasses

'''Engineering controls''' are a means that isolates or removes the hazard from the work environment. The use of handwashing areas, sharps containers, designated decontamination areas and a commercial washing machine are some engineering controls in place.
* Handwashing facilities areas are in all the station apparatus bays, bathroom facilities, and agents are available on the apparatus for field handwashing.
* Sharps containers are in each green airway bag on apparatus. Containers are leakproof, puncture resistant and labeled for BIOHAZARD. These containers shall be emptied as soon as practicable when a sharp is place in the container at Island Hospital ER. The containers shall be decontaminated at the hospital.
* Single use needles with protective covers (no recapping needed) shall be used for the administration of medications

'''Decontamination''' areas have been established at both fire stations in the apparatus bay. All appropriate cleaning agents are available in this area with the proper concentrations posted on the wall. A copy of this plan shall also be posted for reference.
A commercial washing machine is in place at Station 1. This machine is for the washing of PPE. A chart on the machine shows the procedures for washing PPE contaminated by PIM. All PPE washed shall be inspected after being washed to ensure PIM has been
removed. If it is unsure whether the PIM has been removed, the PPE shall be removed from service and disposed of accordingly. All diagnostic equipment shall be wiped down after use before storing back in equipment bags.

'''Work Practice Controls''' are procedures that reduce the likelihood of exposure by altering the way a task is performed. The District shall promote work practice controls such as:
* Washing hands after patient contact, using bathroom facilities, cleaning equipment or as required by the officer in charge.
* Using PPE for all task that may contain PIM

The District shall provide at no cost to the member, immunization against the HBV, MMR, annual influenza inoculation, and TB exposure testing. HBV and TB immunization and testing shall occur in the first 90 days.

A member may refuse the inoculations. If a member refuses immunization, they shall again be informed of the potential for exposure to PIM and asked to sign a refusal form to be kept on file indefinitely in the member’s record. A member may later decide to
receive the immunization and will receive the proper inoculations. A refusal may limit the members participation in EMS operations.

TB testing shall be conducted when a member joins the District and after any potential exposure.

== DECON solutions ==
=== Fire operations ===
==== HOSE AND TURNOUT CLEANER ====
16 oz of concentrate rest of 32 oz spray bottle with water. Spray on equipment and leave for 5 minutes. Scrub and dry

Use on:
* SCBA (NOT FACEPIECE/MASK), structural and wildland equipment and gear.
* Tools and interior of apparatus post fire.

==== EMS operations and general housekeeping ====
On scene - use decon wipes for equipment and personnel in cabinets

SIMPLE GREEN D – 22 oz of concentrate – rest of 32oz spray bottle with water.
Spray on equipment and leave for 15 min. Rinse thoroughly with water and dry.
Bags and clothing – Wash after 15 min in machine with laundry soap and hot
water.
* Post incident cleaning of equipment and clothing exposed or contaminated.
* General purpose cleaning of DECON areas and interior of apparatus
* For obvious or highly suspected contaminated equipment

==== SCBA Mask cleaning ====
SCBA mask (Confidence plus) 2 oz of concentrate to 1 gallon of water in a bucket
* Spray with hose and turnout cleaner and clean mask and harness with soft rag. Rinse well
* Immerse mask in bucket in water and remove allowing to drip dry for 10 min before rinsing in warm water. Use paper towel to remove water and hang to dry.

= PDF =
[[File:EMS-Exposure-Control-Plan-ECP.pdf|thumb|left]]
[[Category:SOP-SOG]]

Training

2023-01-18T06:07:18Z

Zarvanitis: /* Red Card */ add minor details about annual red card refresher

Part of being a member of the Mt. Erie Fire Department is having a strong commitment to ongoing training. In order to perform our job safely and efficiently we have to learn new skills and then continue to practice them. Training never ends. It is key to saving lives and getting everyone home safely.

The department meets nearly every Monday from 7p-9p (often later) for regular training. In addition training is held several weekends a year (one or both days). Some of the training is optional, others is required. We cover topics and skills for safely handling medical emergencies, wildland fire, structure fire, and motor vehicle accidents.

All required and approved training costs are payed by the department.

==Minimum Training Requirements==
While all members are encouraged to get as much training as they can, we do have basic requirements that all members must meet in a timely manner.

* First Aid for First Responders
* CPR for First Responders
*Blood Borne Pathogens
* Incident Command
** [https://training.fema.gov/is/courseoverview.aspx?code=IS-100.c IS 100] (required)
** [https://training.fema.gov/is/courseoverview.aspx?code=IS-700.b IS 700] (required)

* [https://learning.respondersafety.com/Clusters/National-TIM-Training-Certificate.aspx Traffic Incident Management Safety (TIMS)]

==Medical Training==
All members are required to have first responder-level first aid and CPR training. This is different than the first aid and CPR training given to the general public. We hold this training at least once per year and it may be available at a local department in the meantime. Non-EMTs must renew their certifications each year.

In addition, we encourage all members to get their EMT-B certification. EMT-B covers Basic Life Support (BLS) level skills for medical and trauma incidents. This is an intense 3-4 month long course given by the County EMS and is usually offered twice per year (depending on demand and instructor availability). Currently classes are held two nights a week, most Saturdays, and several Sundays during the class period. There are written and skills tests that must be passed in order to be certified by the State. This is a big commitment.

Once you receive your EMT-B you must attend ongoing training and complete online training sessions to maintain your certification.

==Structure Fire Training==
Much of our regular Monday night training is designed to improve our ability to handle structure fires. But the basic knowledge and skills is usually taught as some part of a fire academy. Depending on the number of people needing training and the availability of training in the county we will either hold an in-house academy or send you academy. The training will usually be two nights per week, plus Saturdays, for approximately 8-10 weeks. During this time you will learn the basics of structural firefighting (hoses, ladders, fire behavior, PPE, etc) and will get live fire training.

In addition you may choose to get your IFSAC Firefighter 1 (FF1) certification. You do this by challenging a skills and written test given by approved proctors. This may be at your fire academy or held at another department. You must be 18 in order to get your FF1. Having your FF1 is a requirement to fight mutual aid structure fires.

==Wildland Training==
The Mt. Erie Fire Department has a proud tradition of excellent wildland fire capabilities. We train to levels meeting or exceeding all other departments (payed and volunteer) in the county.

===Red Card===
The initial wildland fire training is called 'guard school' or 'red card'. It consists of classroom and outdoor skills training over two weekends. It is usually held in Spring or early Summer each year. This training is required for all department members and you will not be allowed to respond to a brush or wildland fire without it.

During subsequent years, all members will go through a half or full day refresher course to keep their skills fresh.

===Sawyer===
Approximately every-other year, red-carded members will have the opportunity to take a basic sawyer class. This two day class provides the skills necessary to maintain and operate a chainsaw safely. It covers creating fireline, swamping, and bucking. It does not cover felling.

===Wildland Urban Interface===
Much of our district (nearly all of it) lies in the wildland-urban interface, the area where natural areas meet structures. This two day class is held every-other year (opposite sawyer) and covers the strategies we will use to protect structures in our district during a wildland fire. While technically an officer-level class, all members are encourage to take this training at least once.

==Incident Command==
* [https://training.fema.gov/is/courseoverview.aspx?code=IS-100.c IS 100] (required)
* [https://training.fema.gov/is/courseoverview.aspx?code=IS-700.b IS 700] (required)
* [https://training.fema.gov/is/courseoverview.aspx?code=IS-200.c IS 200] (recommended)
* [https://training.fema.gov/is/courseoverview.aspx?code=IS-800.d IS 800] (recommended)

==Driving and Pumping==
The engineer is responsible for driving and pumping the apparatus.

===Driver Training===
Driving the apparatus requires training because they do not turn or stop like a normal passenger vehicle. We train drivers during maintenance night, en route to other drills and training, and by arrangement with a station officer. You must be 18, have a valid drivers license, a clean driving abstract, and auto insurance to drive department vehicles.

===EVIP===
Anyone wishing to drive the apparatus must complete the EVIP (emergency vehicle incident prevention) requirements.

* A one day EVIP class is required. After which a written test must be completed.
* Driving rodeo (a driving course through which skills can be demonstrated).
* Check-ride with one or more officers demonstrating driving ability on the road.

The rodeo and check-ride must be done for each type of apparatus (rescue/brush, tender, engine).

===Pump Operations===
You can get trained to run the pump in three ways:

* We train on this during normal Monday drill nights (though the amount of time we can spend is limited)
* Weekend/Evening training. Ask an officer and arrange a time to learn to run the pump.
* There is a pump operations class held in the county about once per year. Notice will be sent out prior to the class.

==Additional Training==
If you have an idea for training that you would like to attend or think would be good for department members, please talk to your station officers.

[[Training Ideas]]

ESO

2023-01-15T11:22:17Z

Zarvanitis: Add info on writing a PCR

ESO is the EHR (Electronic Health Record)/PCR (Patient Care Record) software that we use. It is used county-wide and by both ALS and BLS organizations.

== Logging In ==
ESO can be accessed via the app on the department tablets or any modern browser. While every member of the department is listed as a responder in ESO, only EMTs have logins to the system so that they can create and submit PCRs for each patient contact.

Browser access: https://www.esosuite.net

Every time you login via a browser and the first time after a system update you will need to enter our agency code: MEFD

If you have forgotten your username or password (or if you wish to change your password) please use the link on the login page or contact an officer.

== Filling in the PCR ==
The ESO system is complex and dynamic. Which data is required is dependent on other options you have selected and data you may have entered. If you do not have the information that is required it may be necessary to change some previous selection and include that information in your narrative instead. It is better to do this than to make up information just make the system 'happy'.

The following is a page-by-page and section-by-section breakdown of how to fill in a PCR. This absolutely does NOT cover every possible option, but it should help with common issues and usage.

=== Who fills out the PCR? ===
The PCR will be filled out by the lead EMT for a patient. Typically that is the first Mt. Erie EMT to arrive on scene, but if a later-arriving EMT has more patient contact they may take the lead role. Coordinate when leaving a scene so that all involved know who’s writing the report.

=== Incident ===

==== Response ====
'''CAD Import''': Click this button to select the record for your apparatus from the County's CAD system. This will prefill some information such as address and en route times. Each incident will have a unique CAD number, but more than one patient on the same incident can share the same CAD number.

'''Run Number''': Leave blank.

'''Run Type''': 911 Response, unless there is a very good reason not to.

'''Response Mode to Scene''': Select the option that matches how your unit responded.

'''Response Mode Lights and Sirens Use''': Again, select the best match.

'''Station''': Optional, but you can select as appropriate. We don't currently do anything with this data.

'''Shift''': Leave blank.

'''Unit''': Select your apparatus. If multiple units arrived, select the apparatus that the lead EMT responded in.

'''Unit's Level of Care''': This will almost always be BLS-Basic/EMT

'''Vehicle''': Select the same apparatus as 'Unit' above.

'''EMD Complaint''': This is the 'Emergency Medical Dispatch' complaint. The issue as indicated to us by our dispatch. For example it may come in as cardiac arrest, but turn out to be an anxiety attack. You would select cardiac arrest here as that is what we were dispatched to.

'''EMD Performed''': Dispatchers are able to provide over the phone first aid instructions, such as hands only CPR. This should always be 'Yes, Unknown' unless you know otherwise. For instance dispatch may mention that caller hung up before they could be provided with CPR instructions.

'''Dispatch Priority''': Based on dispatch, what is the priority of this call? This lines up roughly with the ProQA values we typically get:
{| class="wikitable"
!ProQA Code
!ESO Priority
|-
|alpha
|4
|-
|bravo
|3
|-
|charlie
|2
|-
|delta, echo
|1
|-
|omega
|4
|}
'''Requested by''': Who was the initial caller to 911? If you aren't 85% sure, select 'Other'.

'''First Unit On Scene:''' Select as appropriate.

==== Scene ====
'''Predefined/Address:''' If not already handled by CAD Import, select 'Address'. We don't have any 'Predefined' options.

'''Location Type:''' You will need to pick this even if CAD Import has filled the rest of the address information.

'''Address:''' Fill in the address information for the scene. 'Location Name' can be left blank unless you are some place specific like 'Harolds Market'. Don't worry about 'Zone'.

'''Mass Casualty''': Did we (or should we have) declare an MCI? 99.9% of the time this will be 'no'.

'''Triage Classification''': This is optional, but can be filled if you did actual triage or just a mental triage of the patient.

==== Personnel ====
Add every person from the department that made it to the scene, whether they had patient contact or not.

There can be only one 'lead'. That should be the EMT filling out the PCR. If the lead also drove, they must be selected as 'lead'. If the lead didn't drive, indicate the driver. Everyone else will be 'Other' (including drivers of other apparatus).

For each person indicate their level of PPE (gloves, glasses, n95 are expected) and if they had any injury or exposures. All injuries and exposures must be communicated to your officer and/or a chief as soon as possible.

==== Disposition ====
'''Disposition:''' This is sort of the level of care we provided. Select wisely. Different dispositions have different required fields that must be provided. If you provided patient care prior to the med unit, 'Patient Treated, Transferred Care...' is probably the correct choice. If you arrived immediately before or after the med unit, 'Assist Unit' which has a minimum of required fields is often a good choice. Otherwise select the best choice from the list.

'''Refusal Reason:''' Only select if the patient refused.

'''Transport Method:''' Select how the patient was transported to the hospital. Typically 'Ambulance'.

'''Transport Due To:''' Only some dispositions. Leave blank.

'''Transferred To''': Only some dispositions. Choose either ground or air.

'''Transferred Unit''': Select the agency or leave blank if not listed and record in your narrative.

==== Destination ====
Leave all of this blank. We don't transport.

==== Times ====
Many of the times will be filled by the CAD import. If not, use dispatch times to provide your best estimates. The 'At Patient' time should be 1 minute after the arrival time unless there was difficulty in locating or reaching the patient.

'''Dispatch Delays:''' Leave blank or select None/No Delay. We don't have this information.

'''Response and Scene Delays''': Select as appropriate.

'''Transport and Turn Around Delays''': Leave blank. We don't transport.

==== Mileage ====
Leave this section blank. We do not track mileage.

==== Additional ====
These are all optional. Select the options that best help describe the incident and care provided.

=== Patient ===

==== Demographics ====
The most important pieces of information, which we try to get for every patient, are name and birth date. With those, we’re able to look up any recent encounters we’ve had with this patient and import medications, history, and the like.

==== Contact ====

==== History ====

==== Allergies ====

==== Medications ====

==== Belongings ====

=== Vitals ===

=== Flow Chart ===

=== Assessments ===

=== Narrative ===

==== Impression ====

==== Signs/Symptoms ====

==== Complaint ====

==== Injuries ====

==== Factors ====

==== Transport ====

==== Narrative ====

=== Forms ===

=== Billing ===
Leave this alone. We don't bill. Be glad.

=== Signatures ===
'''Provider Signatures:''' At least the lead provider, must be selected and sign the PCR before it can be finalized and submitted. As many providers as want to can sign, but only the lead is required.

'''Refusal:''' If at all possible we let ALS handle refusals. In the rare case that they are not able to respond, use this form to have the patient and/or caregiver sign indicating that they do not wish transport.

== Multiple Patients ==
You can have multiple patients on the same ESO report. This happens frequently on MVAs for example. To add a patient select the patient name dropdown from the top navbar and click the new patient button.
[[File:ESO add new patient.png|center|frame]]
This creates a second patient record and you can switch between the records using the same dropdown. Some, but not all of the call-specific information will be copied to the new PCR. You will need to finalize and submit each PCR separately. Note: in cases where patients are treated by different providers, the first person creating the report should make sure to add other providers to the report, then each EMT can log in via a web browser, access the existing PCR for the call, and enter their patient and care info.

== Transferring Data ==
We can transfer a snapshot of our current data to another agency. Likewise we can receive a snapshot of the data on another agency's tablet. These snapshots are in no way tied together and any new data is not automatically sent or received.

To make or accept a transfer you will need to have the tablet connected to wifi. Note that a transfer doesn’t need to be accepted immediately - it’s often worth getting a transfer code from our medic units even if we can’t accept the transfer until we get back to the station.

11-16

2023-01-14T19:00:22Z

Zarvanitis: Add relevant link to 11-16's page

[[File:1116.jpg|thumb|11-16]]

==Related pages==
*[[Establishing Tender Water Supply]]

Passport Accountability System

2023-01-14T18:57:29Z

Zarvanitis: /* Officers: */ add mnemonic for passport destinations

MEFD utilizes a Passport Accountability System (PAS) based on tags and passports. The same system is used by most if not all departments in the county.

==Components==
The system is built on two pieces: Tags and Passports

===Tags:===
[[File:Pas tags.jpg|thumb|PAS Tags]]
Tags are simply small plastic rectangles with the firefighter's name on the front and velcro on the back. The color of the tag indicates rank: yellow for firefighters, red for officers, white for chiefs.

Each firefighter gets at least 5 tags. Two go on your structure helmet, two go on your wildland helmet. The remaining tag goes on the status board at your station.

===Passports:===
[[File:Passports.jpg|thumb|Passports]]
The passports are larger plastic rectangles with velcro and the apparatus number on their front.

There are two sets of passports attached to the dash of each apparatus. A primary set and a bravo set. The bravo set is used in the case that crews are to be split. Each set consists of a red passport and a white passport.

==Using PAS:==
Three groups use the PAS system. Each a little differently.

===Firefighters:===
[[File:Helmet shield.jpg|thumb|Helmet shield]]
As a firefighter all you have to do is provide your PAS tag to your officer as you enter the apparatus. Take and apply a helmet shield to your helmet. At the end of the call, remove your shield and retrieve your tags.

Get in the habit of passing up your tags every time you get in an apparatus.

===Officers:===
As an officer (or firefighter in the officer seat) you will tag in just like your crew. In addition you must collect two PAS tags from everyone on the apparatus and place one on a red passport and one on a white passport.

When you arrive on scene leave the red passport in the apparatus and bring the white passport to command. In the case where command and/or accountability are not set up yet, leave both passports on the dash where an IC can get them later.

''(Helpful mnemonic: "white tags to the white hat (chief/command), '''r'''ed stays with the '''r'''ig")''

When you leave a scene remember to collect your crew's passport.

===Incident Commander:===
[[File:Command board.jpg|thumb|Command board]]
As an incident commander you will collect passports from all crews as they arrive on scene. You will use your command board to track their current location/task (staging, interior, rehab, etc).

This is where the accountability part really comes in. As IC you should be able to tell where all personnel are on the scene.

'''Note:''' On larger events (such as wildland fires) IC may not handle accountability directly, but will assign one or more reports to do so.

==Strengths and Weaknesses==

===Strengths:===
*No electronics, software, or batteries
*Can't really fail
*Portable
*Easy to use
*Widely used

===Weaknesses:===
*It requires firefighters to be compliant
*No tracking (position, times, etc)
*The velcro tends to fall off