HomeMy WebLinkAboutAgenda Statement 1979/02/08 Item 01cCITY OF CHULA VISTA
COUNCIL AGENDA STATEMEiVT
Item No, lc
For meeting of 2-8-79
ITEM TITLE Resolution fl/9~- Approving agreement with Hartson's Ambulance Service
dba Bay Cities Ambulance, to provide paramedic
services
SUBMITTED BY City Manager
ITEM EXPLANATION (4/5TH'S VOTE REQUIRED YES NO X )
At present, the City of Chula Vista contracts with Bay Cities Ambulance (owner,
0. Stephen Ballard) to provide paramedic services to this City, Imperial Beach, the
Montgomery Fire Protection District and the Bonita-Sunnyside Fire Protection District.
In essence, this private sub-contractor fulfills many of the obligations the City has
under its agreement with the County of San Diego (Resolution No. 8510).
If Mr. Ballard's business is assumed by Mr. Hartson, the attached revised agreement
should be approved by the City Council. It incorporates the major provisions of our
existing contract (Resolution No. 9296), the only changes involving housekeeping
language or increased flexibility to expand operations. There is no cost to the City
and fee schedules remain the same at this time.
All parties to the "Memorandum of Understanding to Provide Paramedic Services" have
been informed of the related public hearing and possess copies of this agenda material.
The County Emergency Medical Services Division is aware of the situation and has no
difficulty with the contemplated change.
tXliltSl I J
Agreement X Resolution X Ordinance Plat Notification List
Other ENVIRONMENTAL DOCUMENT: Attached Submitted on
FINANCIAL IMPACT
N.A.
STAFF RECOMMENDATION
Adopt resolution.
BOARD/COMMISSION RECOMMENDATION
ati:,
AI~PRO~Fi:;~
~9 the
COUNCIL ACTION City Co~neiT
of
_-~la 'H'is ta, CarlJifornia
~.ted - / 9
i
AGREEMENT TO PROVIDE PARAMEDIC
SERVICES TO THE CITY OF CHULA VISTA
AND SPECIFIED ADJACENT AREAS
This Agreement is made and entered into this 8th day of February
1879, by and between the City of Chula Vista, a municipal corporation, herein-
after called "City/Contractor" and Hartson's Ambulance Service, Inc., DBA Bay
Cities Ambulance, a corporation, hereinafter called "Sub-Contractor".
W I T N E S S E T H
4JHEREAS, the County of San Diego has responsibility for ensuring the
delivery of quality emergency medical services; and
WHEREAS, the City/Contractor has been designated by the County to supply
subject services; and
~,JHEREAS, Sub-Contractor possesses professional qualifications to provide
specified contingent services;
NOW, THEREFORE, the parties do mutually agree as follows:
1. Term - This Agreement shall commence upon execution of this document
and extend two (2) years unless otherwise stipulated below.
Page 1 of 8
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2. Administration - City/Contractor designates the City Manager,
276 Fourth Avenue, Chula Vista, California 92010, or his designated repre-
sentative to administer the Agreement on behalf of the City/Contractor.
Sub-Contractor designates Robert L. Hartson, President, Hartson's
Ambulance Service, Inc., DBA Bay Cities Ambulance, 4318 47th Street, San Diego,
CA 92115, or his designated representative to administer this Agreement on
behalf of the Sub-Contractor.
All reports, proposals, letters, notices and/or other correspondence
shall be sent to the attention of the designated representatives at their
respective addresses.
3. Service Area - Responses to calls for emergency medical assistance
shall be made in a territory consisting of the incorporated limits of the
City of Chula Vista, the City of Imperial Beach, and the boundaries of the
Bonita-Sunnyside Fire Protection District and the Montgomery Fire Protection
District. Total service area equals approximately thirty-six (36) square
miles and includes some 125,000 residents.
4. City/Contractor Furnished Equipment and Services - Subject to per-
formance by the Sub-Contractor in a manner acceptable to the City/Contractor,
City/Contractor as an agent of the County agrees to provide to the Sub-Contractor
the following:
A. One Mobile Intensive Care Unit (hereinafter MICU) and certain
items of medical equipment described by -~ on Attachment B.
B. Necessary communication equipment to operate the paramedic
service as described by -~ on Attachment B.
Said vehicle and/or equipment may be declined by Sub-Contractor if approved
substitutes are other~~lise obtained.
5. Sub-Contractor Furnished Personnel and Equipment - Subject to perform-
ance in a manner acceptable to the City/Contractor, Sub-Contractor agrees to:
Page 2 of 8
ps/~/
A. Maintain and operate at least one (1) fully equipped and supplied
MICU available for providing paramedic services seven (7) days a
week, twenty-four (24) hours per day on a year-round basis. Said
operations shall be in accordance with County Criteria for Mobile
Intensive Care Services (Attachment A).
B. Staff at least one (1) Mobile Intensive Care Unit (MICU) with at
least two (2) paramedics, seven (7) days a week, twenty-four (24)
hours a day on a year-round basis.
For purposes of this Agreement, paramedics shall be individuals
certified by the County's Health Officer to operate as paramedics
in San Diego County pursuant to Section 1480 et, seq, of the State
Health and Safety Code.
C. Insure that all certified paramedics complete continuing education
as required by the County of San Diego.
D. Acquire, maintain and replace all medical equipment items for
t!~~!o (2) MICUs as described in Attachment B.
E. Provide all medical equipment items for two (2) additional
ambulances as described by ** in Attachment 6.
6. Other Sub-Contractor Responsibilities - Sub-Contractor further agrees
to:
A. Maintain the MICU ambulances in a fully operational condition.
B. Notify the City/Contractor immediately whenever any condition
exists which adversely affects providing satisfactory ambulance
service.
°age 3 of 8 R
y~/
7. Compensation and Fee Schedule - This is a no-cost Agreement and
City/Contractor will make no reimbursements as a result thereof. Charges for
ambulance services shall conform with Chula Vista City Council Resolution
No. 8062. In addition, an additional charge of X50 per patient may be
made whenever any or all of the follotiving paramedic procedures and/or
equipment are utilized:
A. Cardipversion
B. Defibrillation
C. EKG Monitoring
D. Esophageal Airway
E. External IV or Injection
F. Nasogastric Tube
G. Nasotracheal Suctioning
H. ~lagill Forceps
I. Mast Suit
J. Rotating Tourniquet
K. Venipuncture
Billing shall be made directly to persons utilizing the service(s) and
City/Contractor ~•~ill in no way act as collection agent.
8. Independent Contractor - Sub-Contractor is, for all purposes arising
out of this Agreement, an inde~~endent Contractor, and no employee or agent of
Sub-Contractor is, for any purpose arising out of this Agreement, an employee
of the City/Contractor.
~~, Page 4 of 8
9. Interest of Sub-Contractor - Sub-Contractor covenants that he
presently has no interest, including but not limited to, other projects or
independent contracts, and shall not acquire any interest, direct or indirect,
which would conflict in any manner or degree tivith the performance of services
required to be performed under this Agreement. Sub-Contractor further covenants
that in the performance of this Agreement no persons having any such interest
shall be employed~or retained by Sub-Contractor under this Agreement.
10. Modifications and Extensions - The Agreement may be modified at any
time by the written consent of the parties. This document, however, fully ex-
presses all understandings of the parties concerning the matters covered
herein. No addition to or alteration of the terms of this Agreement, and
no verbal understanding of the parties, its officers, agents or employees,
shall be valid unless made in the form of a written amendment to this Agree-
ment, and duly approved and executed by the parties' authorized representatives.
11. Property Title - Title to expendable property whose cost vas borne
in whole by the County of San Diego under this Agreement will remain vested
in the County upon termination of this Agreement.
12. Assignability - The Sub-Contractor shall not assign any interest in
the Agreement, and shall not transfer any interest in the same without prior
written consent of City/Contractor thereto.
13. Termination and Default -
A. This Agreement may be tern-~inated for any reason by either
party giving sixty (60) days' ~•rritten notice to other
party's designated representative, except as defined in
"13.Q" and "14"below.
Page 5 of 8
-491
B. City/Contractor may terminate this Agreement for default upon
five (5) days' written notice if Sub-Contractor breaches this
Agreement or if Sub-Contractor refuses or fails to timely perform
any of its duties under this Agreement.
14. Indemnity - Sub-Contractor agrees to indemnify and hold harmless
City/Contractor, its officers, agents and employees from and against all loss
or expense (including costs and attorney's fees) due to bodily injury, personal
injury, professional/medical malpractice, including death at any time resulting
therefrom, sustained by any person or persons or on account of damages to
property, including loss or use thereof, arising out of or in consequence of
the performance of this Agreement, provided such injuries to persons or
damages to property are due or claimed to be due to negligence of the Sub-
contractor, its officers, agents or employees. Sub-Contractor shall have
Workers' Compensation coverage for its employees under this Agreement.
15. Affirmative Action - City/Contractor and any subcontractors performing
under this Agreement shall comply with the .Affirmative Action Program for
Vendors, as set forth in Article fll (commencing at Section 84) of the San
Diego County Administrative Code. A copy of this Affirmative Action Program
is included as Attachment C.
Page 6 of 8
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16, Records - Sub-Contractor shall maintain accurate books and accounting
records relative to this Agreement. Such books and records shall be open for
inspection and/or copying at any reasonable time by the City/Contractor's
designated representative(s), the Auditor of the County of San Diego, or
their designated representatives.
17, Reports -
A. Sub-Contractor shall comply with the ambulance report system
of San Diego County by completing a Prehospital Report Form
on every call made by the MICU or ambulances.
B. Sub-Contractor shall be responsible for submission of
completed Prehospital Report Forms on the first and fifteenth
of every month to the:
Department of Public Health
County of San Diego
Division of Emergency Medical Services (D-222)
1375 Pacific Highway
San Diego, California 92101
18, Attachments - The following attachments incorporated herein are
part of this Agreement:
A. San Diego County Emergency Medical Services Criteria for
flobile Intensive Care Services (revised 8/22/78).
Q. ~'edical and communication items to be provided in each f~1ICU.
C. Affirmative Action Program for Vendors.
C~/~/~ Page 7 of 8
IN WITNESS WHEREOF, the parties have caused this Agreement to be duly
executed by their duly authorized representatives.
HARTSON'S AMBULANCE SERVICE, INC.
DBA BAY CITIES AMBULANCE
,~
Robert L. Hartson, President
CITY OF CHULA VISTA
BY
Lane F. Cole, City Manager
Page 8 of 8
y9f
ATTACHMENT "A"
SAN DIEGO COUNTY
EMERGENCY MEDICAL SERVICES CRITERIA
FOR
MOBILE INTENSIVE CARE SERVICES
1. Criteria for Agency Approval to Provide
Paramedic Services
2. Criteria for Selection of Base Station
Hospital
3. Mobile Intensive Care Physician
Certification
4. Mobile Intensive Care Nurse Certification
5. Criteria for the Designation of a Mobile
Intensive Care Unit
6. Medication List
7. Guidelines for Selection of Paramedic
Trainees
8. Paramedic Certif ication Criteria
9. Paramedic Challenge Criteria
(Rev. 8/22/78)
., ~. .
SAN DIEGO COUNTY
CRITEP,IA FOR AGENCY APPROVAL TO
PROVIDE PAP.PS~.EDIC SERVICES
1. Offer 24-hour, 365-day service.
2. Agree to provide sufficient manpower to have two paramedics
assigned to each Mobile Intensive Care Unit (MICU) at all
times.
3. Be selected by a local jurisdiction as the agency to pro-
vide paramedic services for a set geographical area within
that jurisdiction.*
4. Agree to abide by County Paramedic Program Criteria.
5. Agree to respond to emergency calls, or to situations in
which a medical emergency may occur.
6. Insure that a fir st responder and a backup system of basic
life s upport will be available to the MICU' s.
7. Enter into mutual aid agreements with adjoi ning paramedic
units.
8. Provide for a planned maximum response time of 15 minutes
in rural areas and 10 minutes in urban areas.
9. Insure that paramedic services will continue to be pro-
vided as stipulated for a minimum of two years following
certification.
10. Cooperate with the County in the provision of field
internship locations for future classes.
11. Agree to participate in community education programs to
teach the public access to paramedic service and CPR.
12. Agree to orient first responder agencies to paramedic
functions and role.
13. Designate Paramedic Coordinator(s) for the agency.
*Local Jurisdiction: Cities, districts authorized to provide
emergency medical services.
(Rev. 8/22/78) 1-1
SAP1 DIEGO COUNTY
CRITERIA FOR SELECTION OF
BASE STATION HOSPITAL
To be designated as a base station hospital, the following
criteria must be met:
1. Must be classified and remain classified at least as a
Basic Emergency Medical Service (Title 22, California
Administrative Code).
2. Have the approval of both administrative and medical staffs
of the hospital.
3. Procure operational radio and biomedical communications
equipment specified by San Diego County.
4. Accept responsibility for replenishing medical supplies
and equipment expended by the mobile units during the
treatment of a patient who is transported to the hospital.
5. Agree to cooperate with San Diego County in gathering
statistical data on patients from mobile intensive care
units and maintain accurate patient care records, ensuring
patient confidentiality, on all MICU runs. Complete patient
disposition reports.
6. Have a County-Certified Mobile Intensive Care Physician or
Mobile Intensive Care Nurse available at all times to com-
municate immediately with the Mobile Intensive Care Paramedic
in the field.
7. Appoint a MIC Physician to be in charge of overall direction
and coordination of units and satellite hospitals.
8. Appoint a Hospital Staff Physician as Paramedic Project
Liaison Officer.
9. Appoint a Mobile Intensive Care Nurse as Paramedic Clinical
Training Coordinator.
10. Agree to provide clinical facilities for supervision, and
instruction as part of the paramedic core training course
and paramedic continuing education requirements approved
by the County Certifying Officer.
11. Agree to provide a minimum of four hours per month of
formal tape review for MIC Physicians, Nurses, and Paramedics.
(Rev. 8/22/78) 2-1
/ . K .
12. Appoint a Base Station Committee to meet monthly, TZember-
ship shall be composed of one voting representative from
each of the following:
A. Each Area Receiving Hospital (exclude if also a
Base Station Hospital)
B. Each Area Paramedic Service Provider.
C. The Base Station MIC Physician (see Item 7 above).
D. The Base Station D'IIC Nurse (see Item 9 above) .
E. Base Station Administrator.
F. Each Area First Responder (Exclude if also a paramedic
service or ambulance provider).
G. Each Ambulance Provider (Exclude if also a paramedic
service provider)
Representatives of the following agencies should also attend
meetings as non-voting technical advisors:
A. U.C.S.D. EMS Training Division.
B. San Diego County Emergency Medical Services.
C. A Para~•nedic from each Paramedic Service Provider,
unless representing "B" above.
D. Representatives from the Public.
13. Enter into a contract with the County of San Diego to
provide services utilizing certified I~~obile Intensive
Care Paramedics.
14, Agree to communicate all patient medical management infor-
mation to receiving hospital when patient in the field is
directed to that hospital.
15. Accept such Countywide protocols for paramedic procedures
as are approved by the County Health Officer.
16. P.gree to provide orientation regarding rlobile Intensive
Care to appropriate employees of the hospital.
17. Participants in Emergency r4edical Services area planning:
a) Clinical Conditions (trauma, cardiac, etc.), b) Disaster
Planning, and c) Direct patients to facilities in accordance
with the Area's Plan.
Criteria for Selection
(Rev. 8/22/78} 2-2 of Base Station Hospital
SAN DIEGO COUNTY
MOBILE INTENSIVE CARE PHYSICIAN CERTIFICATION
Comply with American College of Emergency Physicians (ACEP)
standards for certification and recertification for Mobile
Intensive Care (MIC) Physicians when such standards are de-
veloped and implemented. Until that time, the following
criteria will be in effect.
A. Requirements for Certification:
1. Be an emergency. department physician practicing
in a Base Station Hospital.
2. Be certified in Advanced Life Support by the
American Heart Association.
3. Observe on a paramedic unit for a minimum of
four paramedic responses.
4. Attend orientation program on San Diego County
paramedic system by Base Hospital MIC Physician
or Nurse Coordinator.
B. Recertification
1. Certification will be valid for two years.
2. Physician must attend 16 hours per year of
continuing education relative to paramedic
functions. (Tape reviews, paramedic or MIC
Nurse teaching.)
(Rev. 8/22/78)
3-1
~.... ,
SAN DIEGO COUNTY
MIC NURSE CERTIFICATION CRITERIA
I. Basic Requirements for Certification:
A. Candidate must be a current California Registered
Nurse,
B. Candidate must be a permanent employee of either:
1. A Base Station Hospital, assigned
a. Full-time in a paramedic receiving
area, or
b. Part-time with a minimum of 16 hours
per week in a paramedic receiving area,
or
c. In a critical care area and attend a
monthly orientation including eight
hours of Emergency Room assignment
with specific emphasis on acutely ill
patients, or
d. To a critical care area and monitor
and/or participate in at least two MICU
radio calls per month, or
e. As paramedic nurse coordinator
2, The Paramedic Training Office
C. Candidate must pass a written MICU exam with a minimum
of 80o knowledge in all areas,*
D. Candidate must observe paramedic functions on a minimum
of eight paramedic responses.
E. Candidate must attend an orientation to Base Station
responsibilities.
II. Recertification:
A. Candidate must annually attend 16 hours of continuing
education relative to paramedic functions. Eight hours
of this requirement may be fulfilled at formal tape
review.
B. It is recommended that the candidate respond with an
MICU to a minimum of four emergency calls every six
months.
*See note at bcttom of page 4-2.
(Rev. 8/22/72) 4-1
C. Qualified candidates must pass a written recertifica-
tion exam every two years, with a minimum of 800
knowledge in all areas.*
III. Revocation of Certification:
A. If for any reason an individual fails to meet the
criteria for a period of three months, said certifi-
cation may be revoked by the County Health Officer.
B. Certification may be questioned at any time for any
of the following reasons:
1. Inadequate clinical knowledge
2. Lack of proficiency with technical skills
3. Lack of judgment or responsibility
4. Inability to meet recertification
requirements
C. Certification may be questioned by an involved party,
but investigation procedure must be initiated by a
representative of the Base Hospital, the Training
Agency, or the County Health Officer.
D. Procedure for investigating certification shall be as
follows:
1. Party initiating action shall submit a
written request for investigation including
all pertinent data (facts, dates, names, wit-
nesses, etc.) to the County Health Officer.
2. County Health Officer shall inform subject
of the proceedings and request any informa-
tion pertinent to the claim.
3. County Health Officer shall call a panel of
three, one of whom shall be a member of the
EMS Training Office, to review all material
and employ whatever testing devices deemed
necessary to reach a conclusion. The person
being considered for decertification should
have an opportunity to speak and to appear
before the panel.
4. The panel shall make written recommendation of
the decision to the County Health Officer. -
5. The County Health Officer will notify Base
Hospital and subject. Health Officer will
contact the person lodging the complaint.
*In the event of failure of an MIC Nurse exam, candidate may be
allowed to repeat exam following additional study. Exam may
not be repeated a second time within 12 months. A minimum of
85o is the required pass level on repeat exams.
5) Provide sufficient clear floor space
(not less than 18 inches) on one side
of the stretcher to allow a person to
perform Cardiopulmonary Resuscitation
(CPR) while kneeling
6) Provide an inside height of at least
54 inches
4. Be operated by a private or public agency authorized
by the County Health Officer to provide DZICU services.
(Rev. 8/22/78) 5_2 Criteria for Designation
of a MICU
SAN DIEGO COUNTY
GUIDELINES FOR THE
SELECTION OF PARAMEDIC TRAINEES
1. Candidate must be employed by, or have a commitment for
employment by an agency authorized to provide paramedic
services.
2. Candidate must enter training voluntarily and be willing
to commit 100% time to the training program.
3. Candidate shou ld have at least one year experience in the
provision of emergency care in the prehospital setting or
current EMT-I Certificate.
4. Candidate must be recommended by current employer.
5. Candidate must be a high school graduate or produce a GED
Certificate.
6. Candidate must have at least Advanced American Red Cross
First Aid Training.
7. Candidate must be in good health and must comply with the
physical requirements of the employing agency.
8. Candidate must have the elementary skills to communicate
orally and in writing.
9. Candidate must hold a current CPR card.
10. Candidate must pass preliminary screening by the San Diego
County EMS Training Office for elementary skills in reading,
comprehension, and arithmetic.
11. Candidate must pass an oral examination by San Diego County
EMS Training Office which evaluates motivation, reasoning,
and potential to succeed in the training program.
(Rev. 8/22/78) 7-1
URUC
Aminophylline
Atropine
Benadryl
Calcium Chloride
Dextrose, 50%
Dopamine
Epinephrine
Glucola
Inderal
Instant Glucose
Ipecac
Isuprel
Isusprel Inhalant
Lasix
Lidocaine
Morphine Sulfate
Narcan
Nitroglycerine
Pitocin
Sodium Bicarbonate
Valium
IV Solutions
P.in~er's Lactate
5% De~;trose/G]ater
Salt Poor Albumin
_ .. .. ~~...v .i ...a ... .. .. ~~. il. ._ ['.flirt(: .."1
i,[iDIC:1TI0iI i.ISTJ
eLfectiv~ 31%76 (1/25/78 Rev.)
IND7 ~,'1TIO;d~ DOSAGE ROUTE
bronchospasm
bradycardias
organophosphate
poisonings
allergic reactions
asystole
electro-mechanical
dissociation
diabetics
unconsciousness
seizure of unknown
origin
hypotension
asystole, severe
bradyarihythmias
bronchospasm
alert diabetics
supraventricular
tachycardias
diabetics
drug overdose
(alert patient)
heart blocks
bronchospasm
pulmonary edema
ventricular
irritability
pre IV insertion
pain- MI,burns;
pulmonary edema
narcotic & unknown
overdoses
unconsciousness
angina
post-partum
hemorrhage
acidosis
250-500mg/
20m1. D5W
0.5-1.Omg,
2mg, (may repeat)
25-50 mg.
1 GM/lOm1,
25 gms/SOml.
200-400mg. /250x1. DSi~
0.5-lmg. .(lOml.
1:10,000)
0 .3rn1 . of 1 : 1 , 000
7 oz. Bottle
(75gms.)
1-4nrg.(0.5mg. increments)
status epilepticus
severe an;•:iety reaction
precardioversion
1000m1. Bag
250-500m1. Bag,
12.5 gms/50n;1. Bottle
1975; revised 1/76
Corrected 2/76
Corrected (,i %G
Neviscd % %; % (;.ci~.•~ai_ne-:cute)
'i,., .
1/2 tube (12.5gms.)
15-30m1.
1-2mg./250-500m1. D5W
1-2 breaths
20-80mg. (up to 200mg.)
50-100mg
1-2gm/250-500m1. D5i,1
0.1 cc
2-15mg, in 2mg. increments
5-15mg.
0.4mg. (may repeat)
0.4mg (gr. 1/150)
3-10 u.
10-20 u./500m1, D5[J
i m%q /kg X 2 dcses ,
then 1 mEq/kg q 10 min.
2.5-20mo. (up to 4Gmg.)
(in small increments)
^liscellaneous
IV drip/20 min.
volutrole
IV Push
I?~1, IV Push
IM, IV Push
IV Push,' IC
IV Push
IV drip (titrate to B/P)
IV Push, IC
SQ
p.o.
IV Push (titrate to pulse)
between gum and cheek
p.o.
IV drip (titrate to pulse)
inhalation
IV push
IV Push
IV drip
intradermal
IV Push
IM
IV Push, IM
sublingual
IM
iV drip
IV Push
IV Push
Ammonia Ampules- i to 2 deep inhalations
tvormal Saline for Irrigation (1000m1.)
Antibiotic Ointment (Folysporin)
Disinfectant (Zenhcrin or Betadine)
Liquid Detergent (i'i~isohe::)
(,_,
SAN DIEGO COUNTY
PARAMEDIC CHALLENGE CRITERIA
The purpose of the Paramedic Challenge Exam process is to
establish a list, which is renewed annually, of individuals
eligible for employment and potential certification as a
Mobile Intensive Care (MIC) Paramedic within San Diego
County.
I. Candidate Qualifications:
A. Must meet all requirements of Section 1102(a)
(1)(C) of Title 13, California Administrative
Code, which prohibits sex offenders, narcotics
users,`alcohol abusers, felons, etc., from
operating an ambulance.
B. Nlust be qualified paramedic (meeting standards
of HEk7-DOT Curriculum) .
C. An individual failing the San Diego County Chal-
lenge Examination may repeat this examination
only if documentation of additional paramedic-
level education is submitted with the registra-
tion questionnaire. The EMS Training Office
will review applications on an individual basis
to determine eligibility for reexamination.
D. Candidates who are eligible for employment, but
fail to obtain a commitment for employment dur-
ing the time frame of the eligiblity list, must
retake the Challenge Exam to remain eligible
for employment.
E. A Challenge fee may be charged to each candi-
date to recover costs of providing the chal-
lenge process. Such fee to be established by
the organization conducting the examination.
II. Candidate Certification:
Certification as a San Diego County DZIC Paramedic will be
contingent upon:
A. Demonstration of competency in paramedic-level
knowledge and skills on a four-part written
exam, a practical exam, and an oral exam.
Each section must be passed with at least 800
in order to proceed to other exam sections,
and
(Rev. 8/22/78) 9-1
B. Certification may be questioned at any time for any of
the following reasons:
1. Inadequate clinical knowledge
2. Lack of proficiency with technical skills
3. Lack of judgment or responsibility
4. Inability to meet recertification requirements
C. Certification may be questioned by any involved party,
but investigation procedure must be initiated by a
representative of the Base Hospital, the Training
Agency, or the County Health Officer.
D. Procedure for investigating certification shall be as
follows:
1. Party initiating action shall submit a
written request for investigation, including
all pertinent data (facts, dates, names,
witnesses, etc.) to the Cour_ty Health Officer.
2. County Health Officer shall inform subject
of the proceedings and request any informa-
tion aertinent to the claim.
3. County Health Officer shall call a panel of
three, one of :whom shall be a member of the
Training Agency%, to review all material and
employ ;whatever testing devices deemed neces-
sary to reach a decision. The person being
considered for decertification should have
an opportunity to speak and to appear before
the panel.
4. The panel shall make a written recommendation
to the County Health Officer.
~. The County Health Officer will notify Base
Hospital, sponsoring agency, Training~Agency,
and the individual involved. Health Officer
will contact the person lodging the complaint.
(Rev. 8/22/78)
8-3 Paramedic Certification
Criteria
~i.... .
SAN DIEGO COUNTY
PAF.AI~:EDIC CERTIFICATION CRITERIA
I. Base Requirements for Certification:
A. Successful completion of the San Diego County Paramedic
Training Program, or
B. Successful completion of the San Diego County Paramedic
Challenge process
C. Employed by an agency which has contracted with the
County of San Diego to provide paramedic services
II. Recertification: '
A. In order to qualify for recertification, the candidate
must complete all of the following each year:
*1. ~•;ork on a Mobile Intensive Care Unit at least
80 hours every month, or participate in a min-
imum of 50 medical r-uns every month.
2. Accrue at least five hours of clinical exper-
ience every three months, beginning the month
of graduation. A maximum of two hours every
three months can be accrued at a hos_oital
other than the assigned Base Station Hospital
if prior permission is given by both hospitals.
3. Accrue at least two hours of tape review at the
assigned Base Hospital during ten of the 12
months, beginning the month of graduation.
4. P.ttend at least 18 hours of related continuing
education classes per year, at least eight hours
of which must be classes offered by the Training
Office. (This means that ten of the 18 hours
can be accrued from outside sources, as long as
they are paramedic-related; although, it is
acceptable to get all 18 hours from the Training
Office if desired.)
The Training Office will offer monthly classes of
four hours each on subjects requested by the certi-
fied paramedics, the base hospitals, or the train-
ing staff. The schedule c•:ill be prepared a year
in advance, but the topics gill be chosen about
three months in advance to accommodate requests.
*Or show satisfactory equivalent to e}:cuse vacation or illness.
(Rev. 8/22/78) 8- 1
4Q~
B. Employment by an agency authorized to provide
riICU service within San Diego County, and
C. Successful completion of a field internship of
no less than 72 hours and no more than 480 hours,
during which the candidate must demonstrate compe-
tency in each of the areas defined as necessary
for the paramedic role.
(Rev. 2/22/7) 9-2 Paramedic Challenge
Criteria
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ATTACHMENT B
Page 1
*SUI'PLIED BY EMERGL'NCY P1EllICAL SERVICES
Piinimum 41
Per vehicle
Non-Disposable Items
2 each
1.
2. ABS Trauma Box
Backboard (spine board set short) 1 each
3, Defibrillator (combination scope 1 each
and defibrillator) 1 each
4.
5. Drug Box
Hare traction splint (adult) 1
1 each
each
6 Hare traction splint (pediatric)
.
7, Mast Suit (received) (Standard anti-shock 1 each
8 airpants)
Resuscitator - Robert Shaw with aspirator
h
.
9, Scoop stretcher
m (set of 5
V 1 eac
10. acuu
Splints: Instaform 1 set
individual splints) 1 each
11. Splint: Instaform Vacuum-hand pump
12. Splint: Instaform Vacuum Velcro straps:
"
" 1 each
x36
1"x18"; 1"x24"; 1"x30"; 1 1 each
_
13. Splint Instaform Vacuum-Repair Kit
Communications:
1 each
1. Handie Talkie 1 each
2. Mobile Radio
3. COR telemetry Radio and Battery Charger 1 each
'y9l
ATTACHi"ENT B
Pagel
**SUPPI;II:D BY BAY CI'T'IES A*iBULANCE
1•finimum Ik
Non-Disposable Items_ per Vehicle
1. Ambu Bas (Laerdal Resusci Folding Bag
IZ complete with case) 1 each
2. Bandage Scissors (7 1/4" Stainless) 2 each
3. Bedding top-sheet 1 sct
4. Beddins-bottom sheet 1 set
5. Beddins-pillow case 1 set
6. Bedding- pillow (cot ambulance) 2 each
7. Bedding- blanket (cot blanket - med. gray) 2 each
8. Blankets - Disposable (KCD disposablanket) 1 package
9. Blood pressure cuff - adult 1 each
10. Oral Airways (package of six assorted
sizes) 1 package
11. Bite sticks - Ipistick 1 box
12. Burn sheets 1 box
13. Cardboard splints - combination 12", 18",
24" splints 1 package
14. Cotton applicators 1 box
15. Cold Packs - Kwik Kold 2 boxes
16. Emesis basin (disposal) 6 each
-- 17. Gloves (sterile) 2 each
' 18. OB Kit ~ 2 each
19. Oxygen Mask (clear Vinyl with 84" tube) 3 each
20. Nose prongs (nasal cannula vinyl with
tube) 3 each
21. Connective tubing (Oxygen soft plastic
tubing 84") 6 each
22. Urinal 1 each
23. Bedpan 1 each
T ~l _ _ - -
ATTACHf1ENT B
Page 3
'~~`* & ** SUPPLIED BY AMBULANCE SERVICE OR BASE STATION HOSPITAL, AS APPLICABLE:
Minimum 4l
Non-Disposable Items per vehicle
1. Blood pressure cuff - pediatric 1 each
2. Electrodes (long term 4 electrodes
per package) 1 box
3. Electrode Wires (40" long life) 2 sets
4. Esophageal airway (Kit) 2 each
5. Hemostats (Kelly 5 1/2" straight) 2 each
6. Laryngoscope - Hook on handle 1 each
7. Laryngoscope - Adult Curved stainless
steel blade, size 4 1 each
8. Laryngoscope - Adult (straight chrome
blade, size 4) 1 each
9. Larynogoscope - child (straight chrome
blade, size 3) 1 each
10. Laryngoscope - Infant (straight chrome
blade, size 2) 1 each
11. Rotating tourniquets 1 set
12. Sandbags (assorted sizes) 1 set
13. Stethoscope (Bard Parker Duosonic) 2 each
14. Thermometer - Oral 2 each
15. Thermometer - rectal 2 each
16. Magill Tonsil Forceps 1 each
17. Adhesi~~e tape (1/2"x 10 yards) 2 rolls
18. Adhesive tape (1"x 10 yards) 2 rolls
19. Adhesive tape (2"x 5 yards) 2 rolls
20. Alcohol Swabs (100 swabs per box) 1 box
21. Armboard: Long 6 each
22. Armboard: Short 6 each
23. Bandages:
- a. 4"x4" - sterile 1 box
b. 5"x9" 2 trays
c. Gauze Rolls - 4"x5 yards - Kerlix,
Kling 2 packages
d. Elastic Bandages (3"x5 yards) 1 box
e. Eye patches (oval eye pads) 1 box
f. Triangular bandages 1 packages
g. Bandaids (3/4" x 3") 1 box
24. Cardboard Splints - Arm 6 each
25. Cardboard Splints - leg 6 each
26. Electrode Paste "EKG Sol" 2 bottles
27. IV Administration Sets: Plexitron
Macrodrip 12 each
Plexitron ;iicrodrip 6 each
Plexitron 1`ficro drip with Volutrole 6 each
28. Nasogastric Intubation Set-up 18fr. 45" 1 each
29. Needles:
IV scalp vein - 19 gauge 8 each
IV scalp vein - 21 gauge 6 each
IV scalp vein - 23 gauge 6 cacti
IV cannula - medicut - 18G 8 each
IV cannula - medicut - 16G 6 each
IV cannula - medicut - 20 6 each
y9~
• -'Bay General Communit }lospital -2
Non-Disposable Items - continued
Needles:
IM 21Gx1"
S.C. 23 G. x 3/8"
Vacutainer Needles 21 G. x 1"
30. Penlights - disposable
31. Razors
32. Scalpels
33. Suction catheters (14fr.)
34. Tourniquets (1/2" Penrose Tubing)
35. Vacutainer Holders
36. Vacutainer Tubes
.ATTP.CHtiENT B
Page 4
1•iinimum 11
per vehicle
6 each
4 each
4 each
2 packages
2 each
2 each
3 each
2 each
2 each
6 each
77~