HomeMy WebLinkAboutReso 1978-9296RESOLUTION NO. 9296
reso.~ve as
R SOLUTION OF THE CITY COUNCIL OF THE CITY OF CHULA
V STA, APPROVING AGREEMENT BETWEEN THE CITY OF CHULA
V STA AND BAY CITIES AMBULANCE, INC., TO PROVIDE
P RAMEDIC SERVICES AND AUTHORIZING THE CITY MANAGER
T EXECUTE SAID AGREEMENT
e City Council of the City of Chula Vista does hereby
ollows:
N W, THEREFORE, BE IT RESOLVED that that certain agreement
betty en THE CITY OF CHULA VISTA, a municipal corporation, and
BAY ITIES BULANCE, INC., to provide paramedic services dated
the 5th da of September, 1978, a copy of which is attached hereto
and ~ncorpo ated herein, the same as though fully set forth herein
be, nd the same is hereby approved.
B IT FURTHER RESOLVED that the City r-tanager of the City
of C ula Vi to be, and he is hereby authorized and directed to
exec to sai agreement for and on behalf of the City of Chula
Vist .
Pres nted b Approved as to form by
~
i~~~~~
'i
`
L e F. Co zey
D. Lindberg, City Atttii
e, City Manager George
OPTED AND APPROVED by the CITY COUNCIL of the CITY OF
CHU VIST CALIFORNIA, this 26th day of September , 197 8
by he fol ,
owing vote, to-wit:
AYE ouncilmen Scott, Cox, Egdahl, Hyde, Gillow
NAY S: ouncilmen None
ABS NT: ouncilmen None
(~ ~ ~~~~~
.c~2.
~_-~ ~ ,, Mayor of the City of Chula Vista
A
STA E OF
CdU TY OF
CIT OF C
Cit of Ch
a f 11, tr
sam has n
ty~ Cler
IFORNIA)
N DIEGO) ss.
A VISTA)
City Clerk of the
1a Vista, California, DO HEREBY CERTIFY that the above is
e and correct copy of Resolution No. and that the
t been amended or repealed. DATED
City Clerk
AGREEMENT TO PROVIDE PARAMEDIC
SERVICES TO THE CITY OF CHULA VISTA
AND SPECIFIED ADJACENT AREAS
Th
19
att
her
Agreem
by a n
r calle
inafter
ant is made and entered into this 25th day of $ep-~en~ber
I between the City of Chula Vista, a municipal corporation, herein-
I "City/Contractor" and Bay Cities Ambulance, Inc., a corporation,
called "Sub-Contractor".
WITNESSETH:
WHEREA the County of San Diego has responsibility for ensuring the
delivery of quality emergency medical services and County and the Public Health
Se vice of he United States Department of Health, Education and Welfare, here-
inafter ref rred to as "HEW", have negotiated grants in-aid for expansion of
Em rgency M dical Services in San Diego County; and
WHEREA County, City/Contractor and other parties including Sub-Contractor
ha a entere into a Memorandum of Understanding effective September 25, 1978
re arding p ramedic services; and
WHEREA the City/Contractor has been designated by the County to supply
su ject ser ices; and
WHEREA Sub-Contractor possesses professional qualifications to provide
sp cified c ntingent services;
anc
C
NOW, T~iEREFORE, the parties do mutually agree as follows:
1. Te
I extend
- This Agreement shall commence upon execution of this document
(2) years unless otherwise stipulated below.
Page 1 of 8
2. Adr~inistration - City/Contractor designates the City Manager,
4. Ci /Contractor Furnished E ui ment and Services - Subject to per-
fo ance by the Sub-Contractor in a manner acceptable to the City/Contractor,
Ci /Contra for as an agent of the County agrees to provide to the Sub-Contractor
following:
A.
276
Fourth P~venue, Chula Vista, California 92010, or his designated repre-
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 vehicl~ and/or equipment may be declined by Sub-Contractor if approved
sublstitutesla re otherw%se obtained.
5. Su -Contractor Furnished Personnel and E ui ment - Subject to perform-
an a in a m nner acceptable to the City/Contractor, Sub-Contractor agrees to:
Page 2 of 8
sent
ative t administer the Agreement on behalf of the City/Contractor.
Sub-Co tractor designates 0. Stephen Ballard, President, Bay Cities
lance, nc., 642 Third Avenue, Chula Vista, CA 92010, or his designated
rep}~esentat~ve to administer this Agreement on behalf of the Sub-Contractor.
All re orts, proposals, letters, notices and/or other correspondence
sha 1 be se t to the attention of the designated representatives at their
respective addresses.
3. Se vice Area - Responses to calls for emergency medical assistance
sha 1 be ma a in a territory consisting of the incorporated limits of the
Cit of Chu a Vista, the City of Imperial Beach, and the boundaries of the
Bon'ta-Bunn side Fire Protection District and the Montgomery Fire Protection
Dis rict. otal service area equals approximately thirty-six (36) square
mil s and i cludes some 125,000 residents.
~~ ~
~~
N. Maintain and operate two fully equipped and supplied MICU's
av ilable for providing paramedic .services seven (7) days a week,
t enty-four (24) hours per day on a year-round basis. Said operations
shall be in accordance with County Criteria for Mobile Intensive
re Services (Attachment A).
B. S aff two (2) Mobile Intensive Care Units (MICU's) with at least
t o (2) paramedics, seven (7) days a week, twenty-four (24) hours a
d y on a year-round basis.
F r purposes of this Agreement, paramedics shall be individuals
c rtified by the County's Health Officer to operate as paramedics
i San Diego County pursuant to Section 1480 et. seq. of the State
H alth and Safety Code.
C. Insure that all certified paramedics complete continuing education
required by the County of San Diego.
to
D. A quire, maintain and replace all medical equipment items for
t o (2) MICU's as described in Attachment B.
E. P ovide all medical equipment items for two (2) additional
a bulances as described by ** in Attachment B.
Other Sub-Contractor Responsibilities - Sub-Contractor further agrees
A. M~intain the MICU ambulances in a fully operational condition.
B. N tify the City/Contractor immediately whenever any condition
e fists which adversely affects providing satisfactory ambulance
slervice.
~~ ~
Page 3 of 8
7. Co ensation and Fee Schedule - This is a no-cost Agreement and
Cit /Contra for will make no reimbursements as a result thereof. Charges for
ambulance s rvices shall conform with Chula Vista City Council Resolution
No. 8062. n addition, an additional charge of $50 per patient may be
made whenev r any or all of the following paramedic procedures and/or
equipment a e utilized:
A. Cardioversion
B. Defibrillation
C. EKG Monitoring
D. Esophageal Airway
E. External IV or Injection
F. Nasogastric Tube
G. Nasotracheal Suctioning
H. Magill Forceps
I. Mast Suit
J. Rotating Tourniquet
K. Venipuncture
Billing sha'
Ci /Contras
I1 be made directly to persons utilizing the service(s) and
:tor will in no way act as collection agent.
8. In a endent Contractor - Sub-Contractor is, for all purposes arising
ou of this Agreement, an independent Contractor, and no employee or agent of
Su -Contrac or is, for any purpose arising out of this Agreement, an employee
of the City Contractor.
~,
f,,Z`r
Page 4 of 8
9. In~erest'of Sub-Contractor - Sub-Contractor covenants that he
wri.
pre ently h~
find pendent
whi h would
req fired to
th.a in the
sha 1 be em[
s no interest, including but not limited to, other projects or
contracts, and shall not acquire any interest, direct or indirect,
conflict in any manner or degree with the performance of services
~e performed under this Agreement. Sub-Contractor further covenants
performance of this Agreement no persons having any such interest
toyed or retained 6y Sub-Contractor under this Agreement.
l0. Mo ifications and Extensions - The Agreement may be modified at any
tim by th.e written consent of the parties. This document, however, fully ex-
pre ses all
her in. No
understandings of the parties concerning the matters covered
addition to or alteration of the terms of this Agreement, and
no verbal u derstanding of the parties, its officers, agents or employees,
shall be va id unless made in the form of a written amendment to this Agree-
menu, and duly approved and executed by the parties' authorized representatives.
11. Property Title - Title to expendable property whose cost was borne
%n hole by the County of San Diego under this Agreement will remain vested
%n the Coun y upon termination of this Agreement.
12. Assignability - The Sub-Contractor shall not assign any interest in
Agreeme t, and shall not transfer any interest in the same without prior
ten con ent of C%ty/Contractor thereto.
13. Termination and Default -
A.
This Agreement may 6e terminated for any reason by either
party giving sixty (60) days' written notice to other
party's designated representative, except as defined in
"13.B" and "14"below.
Page 5 of 8
B.
I
City/Contractor may terminate. th.i.s 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. Termination of_HEW Award - In the event of termination by HEW of
rel vant gr nt award to County, funding provided to Sub-Contractor under this
Aqr ement s all likewise terminate at such time. In the event of such termina-
do City/ ontractor shall immediately inform Sub-Contractor's representative
by elephon and confirm such termination in writing.
15. In emnit -Sub-Contractor agrees to indemnify and hold harmless
Cit /Contra tor, its officers, agents and employees from and against all loss
or xpense including costs and attorney's fees) due to bodily injury, personal
inj ry, pro essional/medical malpractice, including death at any time resulting
the efrom, ustained by any person or persons or on account of damages to
pro erty, i cluding loss or use thereof, arising out of or in consequence of
of he perf rmance of this Agreement, provided such injuries to persons or
dam ges to roperty are due or claimed to be due to negligence of the Sub-
Con ractor, its officers, agents or employees. Sub-Contractor shall have
ers' Cor~pensation coverage for its employees under this Agreement.
16. A firmative Action - City/Contractor and any subcontractors performing
and r this greement shall comply with the Affirmative Action Program for
Ven ors, as set forth in Article III (commencing at Section 84) of the San
Diego Count Administrative Code. A copy of this Affirmative Action Program
i s i ncl uded
~'.~~~
as Attachment C.
Page 6 of 8
insF
des'
the'
17. R cords - Sub-Contractor shall maintain accurate books and accounting
Ards relative to this Agreement. Such books and records shall be open for
section nd/or copying at any reasonable time by the City/ Contractor's
gnated epresentative(s), the Auditor of the County of San Diego, HEW, or.
r desig ated representatives.
18.
A
B.
Department of Public Health
County of San Diego
Division of Emergency Medical Services (D-222)
1375 Pacific Highway
San Diego, California 92101
par
19. A tachments - The following attachments incorporated herein are
t of thi Agreement:
A,
B,
C.
orts -
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.
Sub-Contractor shall be responsible for submission of
completed Prehospital Report Forms on the first and fifteenth
of every month to the:
San Diego County Emergency Medical Services Criteria for
Mobile Intensive Care Services (revised 8/22/78).
Medical and communication items to be provided in each MICU.
Affirmative Action Program for Vendors.
Page 7 of 8
IN
S WHEREOF, the parties have caused this Agreement to be duly
executed by their duly authorized representatives.
BAY CITIES AMBULANCE, INC.
BY
0. Stephen Ba ard, President
CITY OF CHULA VISTA
BY
Lane F. Cole, City Manager
~~ ~/~ Page 8 of 8
SAN DIEGO COUNTY
CRITEP.IA FOR AGENCY APPROVAL TO
PROVIDE PARAP'iEDIC SERVICES
L. Off~r 24-hour, 365-day service.
Agr e to provide sufficient manpower to have two paramedics
ass'gned to each Mobile Intensive Care Unit (MICU) at all
tim s.
Be elected by a local jurisdiction as the agency to pro-
vid paramedic services for a set geographical area within
tha jurisdiction.*
Agr e to abide by County Paramedic Program Criteria.
Agr e to respond to emergency calls, or to situations in
whi h a medical emergency may occur.
Ins re that a first responder and a backup system of basic
lif support will be available to the MICU's.
Ent r into mutual aid agreements with adjoining paramedic
uni s.
~. Pro ide for a planned maximum response time of 15 minutes
in ural areas and 10 minutes in urban areas.
Ins re that paramedic services will continue to be pro-
vid d as stipulated for a minimum of two years following
cer if ication .
1 Coo erate with the County in the provision of field
int rnship locations for future classes.
1 Agr e to participate in community education programs to
tea h the public access to paramedic service and CPR.
1 Agr e to orient first responder agencies to paramedic
fun tions and role.
1 Des gnate Paramedic Coordinator(s) for the agency.
*I~ocal Jurisdiction: Cities, districts authorized to provide
emergency medical services.
(l~ev. 8/2/78) 1-1
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
Y
(Rev. 8/22/78}
~~y
1 Appc
shiF
eacY
A.
B.
C.
D.
E.
F.
1'
~~~~
1~.
G.
int a Base Station Committee to meet monthly. P~ember-
shall be composed of one voting representative from
of the following:
Each Area Receiving Hospital (exclude if also a
Base Station Hospital)
Each Area Paramedic Service Provider.
The Base Station MIC Physician (see Item 7 above).
The Base Station MIC Nurse (see Item 9 above).
Base Station Administrator.
Each Area First Responder (Exclude if also a paramedic
service or ambulance provider).
Each Ambulance Provider (Exclude if also a paramedic
service provider)
Rep esentatives of the following agencies should also attend
mee ings as non-voting technical advisors:
A.
B.
C.
D.
U.C.S.D. EMS Training Division.
San Diego County Emergency Medical Services.
A Paramedic from each Paramedic Service Provider,
unless representing "B" above.
Representatives from the Public.
Ent r into a contract with the County of San Diego to
pro ide services utilizing certified Mobile Intensive
Car Paramedics.
1 Agr e to communicate all patient medical management infor-
mat on to receiving hospital when patient in the field is
dir cted to that hospital.
1$. Acc~pt such Countywide protocols for paramedic procedures
as re approved by the County Health Officer.
1~. Agr~e to provide orientation regarding D'Iobile Intensive
Car to appropriate employees of the hospital.
'. Par icipants in Emergency 1`~edical Services area planning:
a) linical Conditions (trauma, cardiac, etc.), b) Disaster
Pla ning, and c) Direct patients to facilities in accordance
wit the Area's Plan.
(~
Criteria for Selection
. 8/ 2/78) 2-2 of Base Station Hospital
SAN 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
SAN DIEGO COUNTY
MOBILE INTENSIVE CARE PHYSICIAN CERTIFICATION
~omply ith American College of Emergency Physicians (ACEP)
~tandar s for certification and recertification for Mobile
Intensi e Care (MIC) Physicians when -such standards are de-
Jeloped and implemented. Until that time, the following
~riteri will be in effect.
uirements for Certification:
1.
2.
3.
4.
S. Rec
1.
2.
Be an emergency department physician practicing
in a Base Station Hospital.
Be certified in Advanced Life Support by the
American Heart Association.
Observe on a paramedic unit for a minimum of
four paramedic responses.
Attend orientation program on San Diego County
paramedic system by Base Hospital MIC Physician
or Nurse Coordinator.
~rtification
Certification will be valid for two years.
Physician must attend 16 hours per year of
continuing education relative to paramedic
functions. (Tape reviews, paramedic or MIC
Nurse teaching.)
(Rev. 8/2/78)
3-1
SAN DIEGO COUNTY
MIC NURSE CERT2FICATION 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 r1ICU exam with a minimum
of 80% 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 bottom of page 4-2.
~~~ (Rev. 8/22/78) 4-1
SAN DIEGO COUNTY
CRITERIA FOR THE DESIGNATION
OF A MOBILE INTENSIVE CARE UNIT
,. Def~.nition
Mob le Intensive Care Unit (MICU): A unit consisting of
Cer ified MIC Paramedics and appropriate equipment and
sup lies in order to provide prehospital emergency medical
car in compliance with the provisions of the California
Hea th and Safety Code, and the County of San Diego.
A ur
as
Med~
1.
2.
3.
it must meet the following criteria to be designated
MICU by the San Diego County Office of Emergency
cal Services.
Be staffed on all emergency responses by a minimum
of two MIC Paramedics Certified by the San Diego
County Health Officer. A MIC Nurse or MIC Physician
can substitute for a Certified Paramedic.
Have available in the vehicle:
a. A drug and solution supply inventory approved
by the County Health Officer. Such drugs and
solutions will include only those categories
authorized by Section 1482.3 (f) of the Health
and Safety Code.
b. Medical supplies and equipment approved by the
County Health Officer.
The vehicle must have:
a. A driver's compartment, separated by a bulkhead
or partition from the patient's compartment, but
providing visual and voice communications to the
patient's compartment.
b. A patient's compartment large enough to:
1) Accommodate one gurney patient and two
paramedics.
2) Provide at least 25 inches of space from
the head of the patient to the rear of the
attendant's chair.
3) Provide space for one 76-inch long stretcher.
4) Provide at least 15 inches of clear space at
the foot of the patient.
(Rev. 8,22/78) 5-1
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
EM° 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
85% is the required pass level on repeat exams.
~~ J ~+ ( REV . ~ ~ 2 7 ~ 7 R ~ ~ _ `> nr. T n rT, , ,.- ,... .„r, ,.-a-. ; r ; ,. -, a ,. ,., n ,,. ; +- ~ ,,. ; -,
DRUG
Aminophylli e
Atropine
Benadryl
Calcium Chl ride
Dextrose, 5
Dopamine
Epinephrine
Glucola
Inderal
Instant Glu ose
Ipecac
Isuprel
Isusprel In alant
Lasix
Lidocaine
Morphine Su fate
Narcan
Nitroglycer'ne
Pitocin
Sodium Bica bonate
Valium
IV Solution
Ringer's La tate
5% Dextrose iJater
ialt Poor A bumin
L975; revis d 1/76
;orrected 2/76
:orrected 6/76
revised 4/77 (Lidocai
'~~viSE'd 1/78 _~/'7Q
HLV ll1hC.U t,t~ I(~! 1 Y t':iKAP1hll1~; ti'KU(GKAM
rtEDICATI0C1 LIST
effective 31/76 (1/25/78 Rev.)
INDICATIONS DOSAGE ROUTE
bronchospasm
bradycardias
organophosphate
poisonings
allergic reactions
asystole
electro-mechanical
dissociation
diabetics
unconsciousness
seizure of unknown
origin
hypotension
asystole, severe
bradyarrhythmias
bronchospasm
alert diabetics
250-500mg/
20m1. DSW
0.5-1.Omg.
2mg. (may repeat)
25-50 mg.
1 GM/lOml.
25 gms/50m1.
200-400mg./250m1. D5W
0.5-lmg. (lOml.
1:10,000)
0.3rn1, of 1:1,000
7 oz. Bottle
(75gms.)
IV drip/20 min.
volutrole
IV Push
IM, IV Push
IM, IV Push
IV Push; IC
IV Push
IV drip (titrate to B/P)
IV Push, IC
SQ
p.o.
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
status epilepticus
severe anxiety reaction
precardioversion
1-4mg.(0.5mg, increments)
1/2 tube (12.5gms.)
15-30m1.
IV Push (titrate to pulse)
between gurn and cheek
p.o.
1-2mg./250-500m1. DSW IV drip (titrate to pulse)
1-2 breaths inhalation
20-80mg. (up to 200mg.) IV push
50-100mgg IV Push
1-2gm/250-500m1. D5W IV drip
0.1 cc intradermal
2-15mg, in 2mg, increments IV Push
5-15mg. IM
0.4mg. (may repeat) IV Push, IM
0.4mg (gr. 1/150) sublingual
3-10 u. IM
10-20 u./500m1. D5I+1 IV drip
1 mEq/kg X 2 dcses, IV Push
then mEq/kg q 10 min.
2.5-20mg. (up to 40mg.) IV Push
(in small increments)
Pliscellaneous
1000m1. Bag Ammonia Ampules- 1 to 2 deep inhalations
250-500m1. Bag Normal Saline for Irrigation (1000m1.)
12.5 gms/50m1. Bottle Antibiotic Ointment (Polysporin)
Disinfectant (Zepherin or Betadine)
Liquid Detergent (Phisoher.)
-RCUte)
6-1
5) Provide sufficient clear floor space
(not less than. l8 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 MICU services.
` (Rev. 8/22/78) 5_2 Criteria for Designation
of a MICU
~~G~
SAN DIEGO COUNTY
PARAMEDIC CERTIFICATION CRITERIA
. BasE
A.
B.
C.
C.
I.
~l. Work on a Mobile Intensive Care Unit at least
80 hours every month, or participate in a min-
imum of 50 medical runs 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 hospital
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. Attend 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
Off ice 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 will be prepared a year
in advance, but the topics will be chosen about
three months in advance to accommodate requests.
Requirements for Certification:
Successful completion of the San Diego County Paramedic
Training Program, or
Successful completion of the San Diego County Paramedic
Challenge process
Employed by an agency which has contracted with the
County of San Diego to provide paramedic services
Recertification:
A. In order to qualify for recertification, the candidate
must complete all of the following each year:
*Or s
satisfactory equivalent to excuse vacation or illness.
(Rev. 8/2/78) 8-1
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 1000 time to the training program.
3. Candidate should 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
/'~-~
C.
D.
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
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.
Procedure for investigating certification shall be as
f ollows:
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 pertinent 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.
5. 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. 8/2/78) 8-3 Paramedic Certification
Criteria
5. Perform to the satisfaction of the Base
Hospital, the sponsoring agency, and the Para-
medic Training Office. Each candidate must have
at least two satisfactory field evaluations
on file annually in order to qualify for re-
certification. Field. evaluations can be com-
pleted by either the training staff or the MIC
Coordinators at the Base Hospitals.
B. Recertification will be required every two years in the
months of March and September. Those graduating the
first six months of the year will recertify in March,
and those graduating the last six months of the year
will recertify in September.
1. If a candidate fails any part of the recerti-
fication exam, he/she must be retested on that
part within one month, and will be retested on
the entire exam again one year from that time.
Following successful performance at that time,
the individual will again be placed on a two-
year recertification schedule.
2. If a candidate fails more than one section on
the initial recertification exam, or fails any
retake exam, the records will be forwarded to
the Appeals and Review Committee, which will
determine whether that individual must be
formally retrained or should be decertified.
3. If an individual is shown to lack competence in
any given area as demonstrated by failure on any
exam or part of an exam, that individual shall
not perform in a paramedic capacity until such
time as competency is again demonstrated on a
repeat exam.
C. It will be the responsibility of each individual para-
medic to prepare for the exam by self-study and attendance
at appropriate lecture sessions..
D. Candidates who qualify and successfully pass the recerti-
fication exam will be recertified by the County Health
Officer.
III. Decertification:
A. If for any reason the individual fails to meet the basic
Continuing Education requirements for recertification
for a period of three months, certification may be
revoked by the County Health Officer.
8-2 Paramedic Certification
(Rev. 8/22/78} Criteria
~~y
SAN DIEGO COUNTY
PARAMEDIC CHALLENGE CRITERIA
one pur
~stabl i
~ligibl
Iobile
'ounty.
pose of the Paramedic Challenge Exam process is to
sh a list, which is renewed annually, of individuals
for employment and potential certification as a
=ntensive Care (MIC) Paramedic within San Diego
Can idate 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. Must be qualified paramedic (meeting standards
of HEW-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.
Can idate Certification:
Ce
co
A.
ification as a San Diego County MIC Paramedic will be
ingent upon:
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. 8V22/78) 9-1
B. Employment by an agency authorized to provide
MICU 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. 8/22/78) 9-2 Paramedic Challenge
Criteria
/ ~l .sue'
*SUP LIED BY
Non
EMERGENCY MEDICAL SERVICES
~sab e Items
1. ABS Trauma Box
2. Backboard (spine board set short)
3. Defibrillator (combination scope
and defibrillator)
4. Drug Box
5. Hare traction splint (adult)
6. Hare traction splint (pediatric)
7. Mast Suit (received) (Standard anti-shock
airpants)
8. Resuscitator - Robert Shaw with aspirator
9. Scoop stretcher
10. Splints: Instaform Vacuum (set of 5
individual splints)
11. Splint: Instaform Vacuum-hand pump
12. Splint: Instaform Vacuum Velcro straps:
1"x18"; 1"x24"; 1"x30"; 1"x36"
13. Splint Instaform Vacuum-Repair Kit
Co municati ns:
1. Handie Talkie
2. Mobile Radio
3. COR telemetry Radio and Battery Charger
~~ 9~
Minimum ~E
Per vehicle
2 each
1 each
1 each
1 each
1 each
1 each
1 each
1 each
1 each
1 set
1 each
1 each
1 each
1 each
1 each
1 each
ATTA.CHP4ENT B
Page 1
* SUPPLIE BY BAY CITIES AMBULANCE
on-Disposable Items
Tiinimum 4~
per Vehicle
ATTACHi1ENT B
Page 2
Ambu Bag (Laerdal Resusci Folding Bag
II complete with case) 1 each
Bandage Scissors (7 1/4" Stainless) 2 each
Bedding top-sheet 1 set
Bedding-bottom sheet 1 set
Bedding-pillow case 1 set
Bedding- pillow (cot ambulance) 2 each
Bedding- blanket (cot blanket - med. gray) 2 each
Blankets - Disposable (KCD disposablanket) 1 package
Blood pressure cuff - adult 1 each
1 Oral Airways (package of six assorted
sizes) 1 package
1 Bite sticks - Ipistick 1 box
1 Burn sheets 1 box
1 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
2 Connective tubing (Oxygen soft plastic
tubing 84") 6 each
22 . Urinal 1 each
23 . Bedpan 1 each
}.'"/ ~
~~~ & **
Nc
1.
2,
3,
4,
5.
6,
7.
8,
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21,
22.
23.
24.
25.
26.
27.
28.
29.
~i i ~•,
ATTACHPQENT B
Page 3
UPPLIED BY AMBULA-NCE SERVICE OR BASE STATION HOSPLTAL, AS APPLICABLE:
Minimum 0{
n-Disposable IteuLs
Blood pressure cuff -pediatric
Electrodes (long term 4 electrodes
per package)
Electrode Wires (40" long life)
Esophageal airway (Kit)
Hemostats (Kelly 5 1/2" straight)
Laryngoscope - Hook on handle
Laryngoscope - Adult Curved stainless
steel blade, size 4
Laryngoscope - Adult (straight chrome
blade, size 4)
Larynogoscope - child (straight chrome
blade, size 3)
Laryngoscope - Infant (straight chrome
blade, size 2)
Rotating tourniquets
Sandbags (assorted sizes)
Stethoscope (Bard Parker Duosonic)
Thermometer - Oral
Thermometer - rectal
Magill Tonsil Forceps
Adhesive tape (1/2"x IO yards)
Adhesive tape (1"x 10 yards)
Adhesive tape (2"x 5 yards)
Alcohol Swabs (100 swabs per box)
Armboard: Long
Armboard: Short
Bandages:
a. 4"x4" - sterile
b. 5"x9"
c. Gauze Rolls - 4"x5 yards - Kerlix,
Kling
d. Elastic Bandages (3"x5 yards)
e. Eye patches (oval eye pads)
f. Triangular bandages
g. Bandaids (3/4" x 3")
Cardboard Splints - Arm
Cardboard Splints - leg
Electrode Paste "EKG Sol"
IV Administration Sets: Plexitron
Macrodrip
Plexitron Macrodrip
Plexitron riicro drip with Volutrole
Nasogastric Intubation Set-up 18fr. 48"
Needles:
IV scalp vein - 19 gauge
IV scalp vein - 21 gauge
IV scalp vein - 23 gauge
• IV cannula - medicut - 18G
IV cannula - medicut - 16G
IV cannula - medicut - 20
per vehicle
1 each
1 box
2 sets
2 each
2 each
1 each
1 each
1 each
1 each
1 each
1 set
1 set
2 each
2 each
2 each
1 each
2 rolls
2 rolls
2 rolls
1 box
6 each
6 each
1 box
2 trays
2 packages
1 box
1 box
1 packages
1 box
6 each
6 each
2 bottles
12 each
6 each
6 each
1 each
8 each
6 each
6 each
8 each
6 each
6 each
~l~
General Community Hospital -2
Nbn-Disposable Items - continued
Needles:
IM 21Gx1"
S.C. 23 G. x 3/8"
Vacutainer Needles 21 G. x 1"
3 Penlights - disposable
3 Razors
3 Scalpels
3 Suction catheters (14fr.)
3 Tourniquets (1/2" Penrose Tubing)
3 Vacutainer Holders
3 Vacutainer Tubes
ATTI~,CHriENT g
Pane 4
Plinimum 11
per vehicle
6 each
4 each
4 each
2 packages
2 each
2 each
3 each
2 each
2 each
6 each