HomeMy WebLinkAboutCC RESO 14,1461111.0.011
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RESOLUTION NO. 14,146
RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF NATIONAL CITY, CALIFORNIA
AUTHORIZING EXECUTION OF CONTRACT WITH
COUNTY OF SAN DIEGO FOR PARAMEDIC SERVICES
BE IT RESOLVED by the City Council of the City of
National City, California, that the City Manager is hereby
authorized and directed to enter into that certain contract
with the County of San Diego, effective the 1st day of
October, 1983, for the express purpose of providing advanced
life support services (Paramedic Service) to the citizens of
National City.
PASSED AND ADOPTED this 20th day of September, 1983.
ATTEST:
L
CITY CLERK
ATTACHYENT II
Agreement:
THIS AGEEMENT is made between the COUNTY OF SAN DIEGO hereinafter referred to as
COUNTY and: NATIONAL LITY
(Corporate name of party)
_ 1241 National city Pnur-Puy A siatyinm1 Ci+Y. Ca 92050
(Street address, (City/State) (zip)
hereinafter referred to as CONTRACTOR for PARIMFHJ SFRVICES
services.
WITNESSETH:
WHEREAS CONTRACTOR possesses certain skills, experience, education or competency to
perform certain special services, and COUNTY desires to engage CONTRACTOR for such
special services upon the terms provided and,
WHEREAS pursuant to the provisions of California Government Code Section 26227, The
Board of Supervisors of COUNTY is authorized to enter a contract for such services.
NOW THEREFORE the parties hereto do mutually agree to the terms and conditions as
attached and set forth in:
EXHIBIT TITLE
A StandErFfovisions
B Special Provisionsolud€ng Scope of
Attachment A County Criteria For Services
ALS Services
IN WITNESS THEREOF COUNTY AND CONTRACTOR have executed this AGREEMENT to be
effective: (check one) ( ) Upon the Date authorized by the Board of Supervisors
of COUNTY:
OR 0(X) (enter effective date) October 1, 1983
CONTRACTOR: COUNTY:
BY BY
NAME Tom G. McCabe
TITLE CITY MANAGER
Clerk of the board of Supervisors
Contractor:
By
, City Clerk
(Reserved for County Counsel Approval)
(Reserved for Auditor -Controller
assignment of County Contract Number)
(Reserved for Clerk of the Board of
Supervisors Posting of Minute Order
Citation)
DHS 605 (2/82)
(Reserved for Civil Service Commission
determination required by County Charter)
F-23
COUNTY OF SAN DIEGO
DEPARTMENT OF HEATH SERVICES
STANDARD PROVISIONS
EXHIBIT A-1
1. ADMINISTRATION: COUNTY'S (designate official title) Coordinator, Emergency Med-
ical Services , herinafter called COUNTY'S ADMINISTRATOR, shall represent COUNTY
in all matters pertaining to services rendered pursuant to this Agreement and
shall administer this Agreement on behalf of COUNTY. CONTRACTOR'S (designate
official title) City Manager shall be in charge of
performing this Agreement and shall administer this Agreement on behalf of CON-
TRACTOR.
2. TERMS OF AGREEMENT: The term of this Agreement shall become effective on
October 1, 1983 and continue ltX1H6W0i#idKXii/09VIdc Bill UNTIL TERMINATED
during which time CONTRACTOR shall perform the services provided here-
in.
3. COMPENSATION: COUNTY agrees to pay CONTRACTOR a total sum not to exceed (specify
in both words and numbers) NOT APPLICABLE
dollars (S _O_ ) tor services performed during
the term of this Agreement in accord with the Method of Payment stipulated in
Exhibits B & C.
4. NOTICE: Any notice or notices required or permitted to be given pursuant to this
Agreement may be personally served on the other party -by the party giving such
notice, or may be served by certified mail, postage prepaid, return receipt re-
quested, to the Officials cited in paragraph 1 above, for CONTRACTOR at the ad-
dress cited above, and for COUNTY at "County of San Diego, Department of Health
Services, Division of EMERGENCY MEDICAL SERVICES
at 6255 Mission Gore Road, San Diego, California 92120
(Street Address) (City/State) (Zip Code)
5. NOTICE OF DELAY: CONTRACTOR shall, within five (5) days of beginning of any
delay in the performance of this Agreement, notify the COUNTY'S ADMINISTRATOR in
writing of said delay causes, and remedial action to be taken by CONTRACTOR.
6. CONTRACTOR'S MANUAL PROVISIONS [ ] Applicable [X] Not Applicable
Reference is hereby made to the Department of Health Services Division of
N/A Contractor's Manual (Dated)
a copy of r+hicn is on file with the COUNTY'S ADMINISTRATOR, and which may be
amended from time to time in accord with provisions for its amendment contained
in said Contractor's Manual. CONTRACTOR will comply with all applicable provi-
sions contained in said Contractor's Manual including, but not limited to, budget
and claims. Said provisions of said Contractor's Manual are incorporated in this
Agreement by Reference.
DHS 605 (2/82) -1-
F-24
COUNTY OF SAN DIEGO
DEPARTMENT OF HEALTH SERVICES
STANDARD PROVISIONS
EXHIBIT A-2
1. INDEPE.NDENT CONTRACTOR
It is agreed that CONTRACTOR shall perform as an independent contractor under
this Agreement. CONTRACTOR is, for all purposes arising out of this Agreement,
an independent contractor, and shall not be deemed an employee of COUNTY. It is
expressly understood and agreed that CONTRACTOR shall in no event be entitled to
any benefits to which COUNTY employees are entitled, including, but not limited
to, overtime, any retirement benefits, workers' compensation benefits, and leave
benefits.
2. INTERESTS OF CONTRACTOR
a. Assignability - CONTRACTOR shall not assign any interest in this Agreement,
and shall not transfer any interest in the same without the prior written
consent of COUNTY thereto.
b. Sub -Contract - All sub -contracts entered into by CONTRACTOR shall be in
writing and shall have prior written approval of COUNTY'S ADMINISTRATOR
unless waived. No such sub -contract shall act to terminate any legal
responsibility of CONTRACTOR to COUNTY to assure complete performance of all
activities and functions required of CONTRACT under this Contract, as described
in Exhibit B.
c. Defend, Indemnify and Hold Harmless - CONTRACTOR agrees that its performance
under this Agreement is at its own sole risk and that it shall indemnify the
COUNTY of San Diego, its agents, and employees, against and hold them harm-
less from any and all liabilities both real and alleged for damages, cost,
losses and legal and investigative expenses resulting from arising out of or
in any way connected with CONTRACTOR'S alleged negligence, wrongful perfor-
mance, or failure to perform fully under this Agreement.
d. Contractor's Employees and Equipment - CONTRACTOR agrees to secure or will
secure at CONTRACTOR'S own expense all persons, employees and equipment
required to perform the services required under this Agreement and that all
such services will be performed by CONTRACTOR, or under CONTRACTOR'S super-
vision, by persons authorized by law to perform such services as described in
Exhibit B.
e. Responsibility for Equipment - County shall not be responsible nor be held
liable for any damage to person or property consequent upon the use, misuse,
or failure of any equipment used by CONTRACTOR, or CONTRACTOR'S employees,
even though such equipment be furnished, rented or loaned to CONTRACTOR by
COUNTY. The acceptance or use of any such equipment by CONTRACTOR or CON-
TRACTOR'S employee shall be construed to mean that CONTRACTOR accepts full
responsibility for and agrees to exonerate, indemnify and hold harmless
COUNTY from and against any and all claims for any damage whatsoever result-
ing from the use, misuse, or failure of such equipment, whether such damage
be to the employee or property of CONTRACTOR, COUNTY, or of other persons.
Equipment includes, but is not limited to material, tools, or other things,
as described in Exhibit B.
3. COMPLIANCE WITH LAWS AND REGULATIONS
a. COUNTY Affirmative Action Program - The Contractor is exempted from comply-
ing with the requirements of the County's Affirmative Action Program for
-2-
vendors as set forth in Article III K of the Administrative Code of the
County of San Diego.
(1) Equal Opportunity - CONTRACTOR will comply with the provisions of Title
VI of the Civil Rights Act of 1964 (42 USC 2000 as amended by the Equal
Opportunity Act of March 24, 1972, Public Law No. 92-261) in that it
will not discriminate against any employee, or against any applicant
of such employment because of age, race, color, religion, sex, physical
handicap, ancestry or national origin. This provision shall include
but not be limited to the following: employment, upgrading, demotion,
or transfer; recruitment advertising; layoff or termination; rates of
pay or other forms of compensation; and selection for training, includ-
ing apprenticeship.
(2) Nondiscrimination - CONTRACTOR shall ensure that services and benefits
are provided without regard to race, color, religion, sex, age or na-
tional origin in accordance with Title VI of the Civil Rights Act of
1964. CONTRACTOR shall comply with Section 504 of the Rehabilitation
Act of 1973, as amended (29 USC 794), pertaining to the prohibition cf
discrimination against qualified handicapped persons under any program
or activity which receives or benefits from Federal financial assis-
tance. CONTRACTOR shall comply with California Government Code, Sec-
tion 11135. CONTRACTOR shall ensure that no person shall, on the basis
of ethnic group, identification, religion, age, sex, color, or physical
or mental disability, be unlawfully denied the benefits of, or be un-
lawfully subjected to discrimination under, any program or activity
that is funded directly by the State or receives any financial assis-
tance from the State. Section 11135 of the California Government Code
is incorporated herein by reference.
b. Conformance to Laws and Reaulations - CONTRACTOR shall perform this Agree-
ment in Accordance with all applicable Federal, State, local and municipal
laws, rules and regulations, including applicable facility and professional
licensure and/or certification laws.
4. AUDIT AND INSPECTION OF RECORDS
CONTRACTOR agrees to maintain and/or make available within San Diego County ac-
curate books and accounting records relative to all its activities. CONTRACTOR
will permit COUNTY to audit, examine and make excerpts or transcripts from such
data and records, and to make audits of all invoices, materials, payrolls, rec-
ords or personnel and other data relating to all matters covered by this Agree-
ment. The aforementioned data and records shall include client records. CON-
TRACTOR shall maintain all data and records for as long as may be required by
applicable laws and regulations. The State of California or any Federal agency
having an interest in the subject of this Agreement shall have the same rights
conferred upon COUNTY by this paragraph.
5. AMENDMENTS AND TERMINATION
a. Termination of Agreement for Cause - Upon breach of this Agreement,
COUNTY shall have the right to terminate this Agreement, by giving written
notice to CONTRACTOR of such termination and specifying the effective date
thereof, at least five (5) days before the effective date of such termina-
tion. In that event, all finished or unfinished documents, and other mate-
rials, prepared by CONTRACTOR under this Agreement shall become the sole and
exclusive property of COUNTY.
b. Termination for Convenience of Parties - Either party may terminate this
Agreement at any time by giving written notices to the other's representa-
tive of such termination and specifying the effective date thereof at least
thirty (30) days before the effective date of such termination. In that
event, all finished or unfinished documents and other materials shall become
the sole and exclusive property of COUNTY.
-4-
County of San Diego NATIONAL CITY
Department of Health Services (Contractor)
Paramedic Services
(Type of Service)
EXHIBIT B. SPECIAL PROVISIONS REQUIRED LANGUAGE
1. General Information
On February 6, 1981, the County Board of Supervisors designated the Department
of Health Services as their local Emergency Medical Services (EMS) Agency.
With that designation and the subsequent adoption of County Policy
well as the requirements established by the Health and Safety Code
1260, Division 2.5, and Sections 1797.200 and 1797.201, the office
Medical Services has been given the primary responsibility for the
administration of emergency medical system in the County including
tion of paramedic programs.
K-12, as
Chapter
of Emergency
overall
the designa-
2. Area of Services
The City shall provide paramedic services within the CITY LIMITS OF NATIONAL
CITY and within adjoining areas as specified by agreements with adjoining
paramedic services.
3. Scope of Services
The City shall have overall responsibility for the development and operation
of paramedic services in accordance with County Criteria described in Attach-
ment A. The City may subcontract all or a portion of these services. However,
the City is responsible for insuring that any and all subcontractors provide
services in accordance with the County Criteria, and shall notify the County
prior to entering into such subcontract agreements.
4. City -Furnished Personnel, Equipment and Reports
The
City agrees to:
A. Maintain and operate at least one fully equipped, supplied, and staffed
MICU, seven days a week, twenty-four hours a day, in accordance with the
Criteria established by San Diego County.
B. Staff each MICU with at least two paramedics at all times. For the purpose
of this Agreement, paramedics are individuals certified by the San Diego
County Health Officer to operate as paramedics in San Diego County
pursuant to Section 1797 et seq. of the Health and Safety Code.
C. Provide the citizens of the City with information on:
1) The appropriate telephone number(s) to call for all medical
emergencies.
2) Where and how to obtain Cardiopulmonary Resuscitation (CPR)
training.
D. Provide, maintain and replace, as needed, all medical items described
in the County Criteria for Advanced Life Support services for each MICU.
E. Ensure that all certified paramedics complete the continuing education
required by the County Criteria.
F. Submit reports in accordance with Section 11 of this Agreement.
5. Other City Responsibilities
City further agrees to:
A. Provide suitable facilities for housing the MICU ambulances.
B. Maintain MICU ambulances in a fully operational condition.
C. Develop mutual aid and/or call-up plans for providing paramedic service
in an area in the event the ambulance assigned to the area is not opera-
ble, or is away from the area for other reasons. Automatic response
plans may be developed by City with concurrence of adjoining paramedic
services.
D. Notify the Director of Health Services, or his/her designee, immediately
whenever any condition exists which adversely affects the City's ability
to meet the conditions of this Agreement.
6. Records; Maintenance -- Three Years; Review of Services
A. City 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 Ccunty's designated representative(s),
the Auditor of the County of San Diego, or their designated representatives.
Such books and records shall be preserved until the expiration of three (3)
years from the date of termination of this Agreement, and if audit by County
or its designated representative(s) has begun, but has not been completed
at the end of the three-year period, the records shall be retained until
resolution of the audit findings.
B. County shall review paramedic services provided by City to insure that
they continue to meet County Criteria and other County Regulations per-
taining to the delivery of paramedic services in National City prior
to renewal of this Contract.
7. Reports
A. City shall comply with the San Diego County Ambulance Report System by
completing a prehospital report form on each response made by a mobile
intensive care unit and basic life support ambulance operated by the City
B. City shall submit completed prehospital report forms monthly to:
Department of Health Services
County of San Diego
Emergency Medical Services (S-22, Grantville)
6255 Mission Gorge Road
San Diego, California 92120
8-2
8. County -Furnished Equipment and Services
County agrees to provide the City with one mobile radio for the Mobile Inten-
sive Care Unit (MICU) in accordance with Board of Supervisors Policy K12.
County also agrees to provide, under its authority of Section 1797 of the
Health and Safety Code, the following services:
A. Certification of the paramedic curriculum and training program for the
County of San Diego.
B. Standards for certification and recertification of MIC Paramedics in
San Diego County.
C. Certification and recertification of those individuals meeting the
Advanced Life Support Criteria established in San Diego County.
D. Standards for certification and recertification of MIC Nurses in San
Diego County.
E. A data collection and reporting system which is appropriate and necessary
to evaluate all MICU activities within San Diego County. Periodic, regu-
lar reports shall be provided to the City by the County. The County,
upon receipt of request by the City, will provide the City with special
reports, provided that the special report is within the capability of
the data collection system.
F. A contract with a designated Base Station Hospital to provide medical
control to the MICU's operating within the District boundary.
9. Modifications and Extensions
The Agreement may be modified at any time by the written consent of the parties.
This document, however, fully expresses all understandings of the parties con-
cerning 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 Agreement, and duly approved and executed by the parties'
authorized representatives.
10. Property Title
Title to expendable and non -expendable property whose cost was borne in whole
by County under this Agreement will remain vested in the County upon termination
of this Agreement.
B- 3
SAN DIEGO COUNTY
EMERGENCY MEDICAL SERVICES CRITERIA
FOR
ADVANCED LIFE SCP?C;RT SERVICES
DONALD G. RAMRAS, M.D.
Medical Director
San Diego County EMS Agency
March 1982
COUNTY OF SAN DIEGO
DEPARTMENT OF HEALTH SERVICES
1700 Pacific Highway, San Diego, CA 92101
JAMES A. FORDE, Director
EMERGENCY ME ICAL SER\
-'255 Mission Gorge Road
.,ar. Diego, California 92120
(619) 563-2556
June 6, 1953
TC: DISTR2z TION LIST
FROM: MEDIDAL DIRECTOR, Sim DIEGO CC_NTY EMS AGENCY
SEVISI'JNS TC 5=..''; ✓IEGC Co'71:7-'_ E!•�`-'.RGENCY ^'+.'DICAL SZR'.'ICES CRIT-rP'A _'CR A V.7+'''v`TO
:T E s.:PFCRT
Enclosed are revisions to the referenced Criteria which have been reviewed by
the Emergency Medical Care Committee and approved by me to be effective as cf
July 1, 1963. Please advise your staff and all paramedic personnel in your
employ of these revisions. Also enclosed is a for for signature by each cf
the paramedics in your employ stating that they have read the revisions and
that they understand the revisions; especially, those criteria applying to
continuing education requirements, recertification requirements and disciplinary
procedures. You may have all employees sign and return the enclosed form or
you ray reproduce the form for individual signatures. Please return the fcrr.'s)
to E.O erce`Medi-a_ Services, 62=5 Mission Gorce Road, San Ties.), CA 92120 no
later than:une 27, 1963. Thank you for your cooperation..
Following are the changes
Face
.r.
Criteria Subiect
Table of Contents
Definitions
the cited revised pages:
3-2 Authorized Recistered
Nurse Certification
3-3 Authorized Recistered
Nurse Certification
3-4 Authorized Registered
Nurse Certification
3-5 Authorized Registered
Nurse Certification
5-1 Paramedic Certification
Chances)
Addition
No. 5 --
II.B. --
II.D.
of Attachment C.
First Res under definition.
Tape Review; Quarters.
Yearly Certification Cards.
III.B. -- Recertification Exam (Failure).
No changes -- just rearranged to
accommodate other changes.
IV.C.6. -- Local Hearing Officer.
V.D. -- Deletion of Hardship Extension.
(Note: Present V and VI were previously
numbered VI and VII in Criteria in error-)
No changes -- just rearranged to
accommodate other changes.
II.A.3. -- Tape Review; Quarters.
II.A.4. -- Continuing Education Classes.
II.B. -- Yearly Certification Cards.
Distribution List
June E, 19E3
Page 2
Pace
5-2
Criteria
Paramedic Certification
5-3 Paramedic Certification
5-4 Paramedic Certification
5-5 and Paramedic Certification
B-1 Attachment B -- CE
5-E
C-1
Attachr.:en.. C Defir.-ion:
of -Paramedic Patient Contact
Chance(s)
III.B. -- Tape Review; Quarters.
III.D. -- Continuing Education Gasses.
III.F. -- Yearly Certification Cards.
IV.A. Recertification. Exam (Failure).
No changes -- just rearranged to
accommodate ether chances.
V.C.6. -- Local Hearing Officer.
VI.E. -- Deletion of Hardship Extension.
No chances -- just rearranged to
accommodate other changes.
Category A. "16" Hours.
Category B. Last Line -- Deleted
"by t+.e primary evaluator".
Addition: to Criteria Attachments.
If you have ar.y questions regarding any of the revisions, please cor.ttct
Gail Coo_er, Coordinator, Emergency Medical Services at 560-2556.
Sincerely,
D:NALD G. P. 1'1RAS, M.D.
Medical ,- -tcr
San Diego County EMS Agency
enclosures: Revisions to Criteria
Form to be signed and returned to EMS
co: Members, EMCC
Cocr..inetcr, `" Medical Se.", —ices, County cf San Diego
Ft"'.=. Paramedic, County cf San i egc
RE.-IS__NS TT CR -FIAT 1SSUDD IN Div.: 19E3, 1..Y. =Cl:VE j',:LY 1, 19S3
I (We) have read the Revisions to the San Diego County Emergency Medical
Services Criteria for Advanced Life L poort Services and do fully under5tend
the Criteria; especially, those sections relating to continuing education
requirer..erts, recertification requirements and disciplinary procedures.
I understand further that the revisions distributed in June 1983 are
effective as cf July 1, 1983.
S,anm-ire cf .__a..edic()
Date Signed
NTE: This for:' is to be signed and returned to Emergency Medical Services,
6255 Missior. Gorge Road, San Diego, CA 92120 no later than June 27, 19E3.
SAN DIG CC1:NTY
E"._RGENCY MEDICAL SERVICES CRITERIA
FOR
ADVANCED LIFE SUPPORT SERVICES
TABLE CF CONTENTS
DEFINITIONS i
AEEREVIATICNS
1. CRica_A FOR LOCAL ,IUR:SD:CT:ON TO PROVIDE
ADVANCED LIFE SUPPORT SERVICES 1-1
CR:TERIA FOR SELECTION OF RASE STATION
HOSPITAL
-1 -2-2
3. CRITERIA FOR A;;TF.CR_--_ R::ISTERED NURSE
CERTIFICATION 3-1 - 3-3
cR:::F:A FOR SELECTION _. PARAMEDIC INTERNS
5 CR:TERIA FOR PARAMEDIC CERTIFICATION 5-1 - 5-6
6. SAN DIEGO COUNTY PARAMEDIC PROGRAM MEDICATION
LIST 6-1 - 6-2
SA. DIEGO COUNTY niNI1UX MEDICAL AND COMM NI-
CAT:ON ITEMS (IN AvDITICN TO BASIC REQUIRE-
MENTS EY 'OH? -- ATTACFE:!) TO BE PROVIDED :N
EACF. ADVANCED LIFE SUP?3RT UNIT 7-1 - .-3
ATTAR :E C:
A. ..--,JnD OF CL_NyCAL C:. T:Nu_NG-..UCATICN FORM
E. AP? RCVED CCNTIW,,ING EL' .TI_0NAL ACT: :T:Es FOR
C. ✓:F::;I717.)N CF ?AFAEC:C PA._:ENT CCNTACT
Revise".. E S3
.117'F=v1ATIONc
ACTS Advanced Cardiac Life Support
ALS Advanced Life Support
BLS Basic Life Support
CE Continuing Education
CPR Cardiopulmonary Resuscitation
EMSTO Emergency Medical Services Training Office
EMT Emergency Medical Technician
GED General Education Development
MIC Mobile Intensive Care
`'_C. Mobile Intensive Care Parar_ed_c
MICU Mobile Intensive Care Unit
SCAT School and College Ability Test
TB Tuberculosis
ii
:routhct_ the attached Criteria for the San Diego County Advanced Life x :.
System, the _`allowing definitions apply.
1. Advanced life Suatort means special services designed to provide definitive
prehospitai emergency medical care including, but not limited to, cardio-
pulmonary resuscitation, cardiac monitoring, cardiac defibrillation, advanced
airway management, intravenous therapy, administration of specified drugs
and other medicinal preparations, and other specified techniques and pro-
cedures administered by authorized personnel under the direct supervision
of the Base Station Hospital. Frehospital personnel in the advanced life
support system are commonly referred to as "paramedics".
Authorized Registered _Nurse means a registered nurse who meets the qualifi-
cations specified in the Wedworth-Townsend Paramedic Act, Article 3 of
Chapter 2.5, Division 2 (commencing with Section 1480). An authorized TBgle-
tered raarse is commonly referred to as a mobile intensive care n'.. r e
(u-cN)
3. Base Statics ..^c'"'*a' means a hospital or hospitals which, Upon desigr.a:ian
5y the Local EMS Agency and with a written contractual agreement with the
Local EMS Agency, is responsible for directing the advanced life support
system cr limited advanced life support system assigned to it or them Sy
the Local EMS Agency.
.. Basic Life Srli✓-J: means e`S,erzenc_; first aid and cardiopulmonary resuscita-
tian procedures which, as a minimum, include recognizing respiratory and
cardiac arrest and starting the proper application of cardiopulmonary re-
S"c- '^^- tc maintain life wi_:..ut invasive toahn:cues until ...E ViCt.=
..c c_ans'c.t2_ Dr email advanced life support is available.
S. First Res,`.ncc_ means a ,-Cif: safety acencv which re spc ds to the scene
of medical e^ter:encies with or without transportation cap 'a'ac, but
with persana who have been trained in administering cardiopulmonary
resuuscitaaion (CPR) and first ei.: .
E. Fc_a,.e___ nurse Coordinator means an Authorized Registered Nurse who is
respansi=__ far the Advanced ..i_e Support (Paramedi:)
`ta'__.. ^°' -al cr to an w..E provider der agency.
t..J...c..:, at a Base
ra-3'C.____ .
Coordinator
_ ___ .:,Earls a ndivid.icl, whether a CE_ _ified rain..^..e...-_
or no:, .Ga isaG.:._'._St_ ati'El_ restansible for the paramedic unitls)
caeraae= by an authorized agen__.
Revised D'
1.11.14
SAN 2IE C CO..' TY CRITERIA FCR
SELECTION OF EASE STATION HOSPITAL
To be designated as a as Station Hospital, the following criteria must be met by
the hospital:
1. Be classified and retain classified at least as a Basic Emergency Medical Service
(Title 22, California Administrative Code).
2. Enter into a contract with the County of San Diego to direct the advanced life
support paramedics assigned to it by the local EMS Agency.
3. Establish an exchange and replacement system for medical supplies and equipment
used by the ALS transport unit during :he treatment of a patient who is transported
to a hospital.
4. Have a base station emergency department physician or authorized registered nurse
available at all times tc comet-nicate immediately with the advanced life support
personnel in the field.
5. Appoint az emergency department physician to be Paramedic Liaison Officer.
6. Appoint an, authorized registered nurse as the Paramedic Nurse Coordinator.
7. Provide clinical facilities necessary to support those parts of the advanced
life support care trainin_ course and the advanced life support continuing educa-
tion requirements approved by the local EMS Medical Director which require the
use of clinical facilities at the Base Station hospital for supervision and
instruction.
8 rcvide a minimum of f=.. (4) hours per month of formal tape review f'r emergency
department physician_ nurses and advanced life support personnel.
9. Appoint a Base Station Committee which shall meet at least quarterly and be com-
posed of at least seven (7) members who participate in the EMS system of the Base
Station Hospital. It is suggested that membership be drawn from the followinr
agencies, but that no one person represent more than one of these agencies:
a. The Local Jurisdiction
b. Each Area Receiving Hospital
c. Each Area Advanced life Support Service Provider
d. The Emergency Department Physician Liaison Officer
e. The Base Station Paramedic Nurse Coordinator
f. The Base Station Administrator
g•
Each Area First Responder
h. Each Local BLS Ambulance Provider
i. UCSD EMS Training Office -- Ex Officio Member
J•
San Diego County Emergency Medical Services -- Ex Officio Member
3/82 2-1
SAN DIEGO CC_NT.'i CRITERLA FOR
S:3ISD:LION TO PROVIDE <D .kSCED LIFE SUPPORT SERVICES
1. Be a 1o:el jurisdiction* which has the authority to provide ambulance services
and which has been approved by the County to provide Advanced Life Support
Service.
2. Assure that the provider agency provides at least two (2) paramedics on each
advanced life support responding unit and provides at least two (2) paramedics
when transporting a patient(s) in an advanced life support transport unit. An 1,
advanced life support team may temporarily separate when both of the following —
criteria are met:
a. More than one patient requires ACLS care and transportation.
b. The Base Station Hospital approves.
1/ The preferred procedure is to transport two patients in the advanced
life support transport unit. However, this authorization provides
for the temporary separation of the advances life support team if,
in, the opinion of the Base Station Hospital, such separation is
necessary,
3. Require that paramedics contact the Base Station Hospital on each ambulance call
which results in patient contact.
4. Require that paramedics are annually certified in basic CPR.
5. Respond only to emergency medical calls.
5. Provide a fir_: responder system.
7. Enter into mutual aid agreements with adjoining paramedic units.
8. Provide for a planned maximum response time of no more then fifteen (15) minutes
in rural areas and no more than ten (10) minutes in urban areas.
9. Cooperate with the Paramedic Training Institution in providing field internship
locations for paramedic interns.
10. Provide orientation for first responder agencies to advanced life support functions
and role.
Al. Insure that each advanced life support provider designates one paramedic
coordinator.
12. Provide a backup driver to allow the two advanced life support personnel or one
advanced life support personnel and one authorized registered nurse or physician
to be in the patient compartment with the patient during transportation whenever
such requirement is deemed necessary by the Base Station Hospital.
13. Prepare and submit prehospitai reports.
14. Participate in local EMS planning activities.
15. Agree to participate in community education programs to teach the public access
to paramedic service and CPR.
*Local jurisdiction is the County, a city, water district, fire protection district,
base station hospital or County Service Area.
3/E: 1-1
SAN DIEGO COUNTY CR?_ERiA FOR
A'•THORIZED REGISTERED N "RSE CERTIFICATION
I. Requirements_ for Certification:
A. Candidate must be a currently licensed California Registered Nurse.
B. Candidate must be recommended by the Base Station Hospital Paramedic
Nurse Coordinator if employed at or contracted by the hospital, or
Director of the EMS Training Office for certification.
C. Certificatior. Examination Process:
1. Candidate must pass an Authorized Registered Nurse Exam admin-
istered by EMSTO with a minimum of 80 percent in all areas. A
fee may be charged for this exam. (Refer to EMSTO Fee Schedule.)
2. In the event of failure of any section(s) of an Authori:._d
Registered Nurse Exam, candidate may be allowed to repeat that
section(s) following a minimum of two weeks additional study
time and pass with 80 percent. The exam may not be repeated
a second time within six (6) months. At that time, the
candidate must repeat and pass all sections of the exam with
8:; percent.
D. Candidate must observe paramedic functions on a minim.0 of six
paramedic ALS responses.
E. Candidate must attend an orientation to Base Station Hospital
responsibilities.
II. Continuing Certification Requirements:
A. Candidate must be employed or contracted by either:
1. A Base Station Hospital
a. As an Authorized Registered Nurse
*1) With a minimum of four 8-hour shifts per month in
the base Station Hospital Emergency Department and
a) a minimum of two 8-hour shifts per month assigned
to the paramedic radio or
b) direct four paramedic calls per month
*Base Statior. Hospital Paramedic Nurse Coordinator will
be responsible for monitoring this requirement and
reporting compliance or. a yearly basis to EMSTO.
OR 2. The Emergency Medical Services Training Office (EMSTO)
3/82 3-1
10. Communicate patient medical management information to receiving hospital wen
patient in the field is directed to that hospital.
11. Develop and utilize a system of communications to determine the capability of
each area receiving hospital to provide appropriate medical care to patients
transported to that receiving hospital.
12. Accept and utilize such Advanced Life Support System Treatment Guidelines as are
approved by the County EMS Medical Director
13. Provide to appropriate employees of the hospital orientation regarding advanced
life support care.
14. Participate in Emergency Medical Services area planning activities.
r
3/E2 2-2
. Revocation cf
A. A complaint may be filed by any person with the local EMS Medical Director.
Investigation of the complaint and a determination that disciplinary action
is or is not appropriate will be made by the local EMS Medical Director.
B. An Aut}crized Registered Nurse may be disciplined, including revocation of
certification, for any of the following reasons:
1. Fraud in the procurement of any certification.
2. Gross negligence.
3. Repeated negligent acts.
4. Incompetence, which includes inadequate clinical knowledge, and lack
of proficiency with technical skills.
5. The commission of any fraudulent, dishonest or corrupt act which is
substantially related to the qualifications, functions and duties
of prehospital personnel.
6. Conviction cf any crime which is substantially related to the quali-
fications, functions and duties of prehospital personnel. The record
of conviction or ce- ~ F;Ad copy thereof shall be conclusive evidence
of such conviction.
Violating cr attpting to violate directly cr indirectly, or assist-
ing in cr a Ate* the violation of, or conspiring to violate, any
provision of the -<aitc and Safety Code or the regulations procc1-
gated by the authority pertaining to prehospital personnel.
8. Vioiatinz or attempting to violate any federal or state statute or
regulation which regulates narcotics, dangerous drugs or controlled
substances.
9. Add:-- to the excessive use cf, or the misuse of, alcoholic bev-
erages, narcotics, dangerous drugs or controlled substances.
10. Functioning outside the supervision of medical control in the field
care system operating at the local level, except as authorized by
any other license or certification.
C. The procedure for ir':estieatine potential disciplinary action shall be
a5 follows:
1. Party initiating action snail submit a written request for investi-
gation, including all pertinent data (facts, dates, names, witnesses,
etc.) to the local EMS Medical Director.
2 The EMS Medical Director shall notify the subject of the investigation
that an investigation is being conducted. Subject shall be given an
opportunity to provide pertinent information.
3. The local EMS Medical Director may convene a panel of three certified
or licensed Health Professionals with expertise in the provision of
prehospital emergency care to review all material and employ whatever
testing devices are deemed necessary to arrive at a recomnendation(s).
The person being investigated should have an opportunity to speak and
to appear before the panel. The panel shall make written recommendation(s)
to the local EMS Medical Director.
Revised c - E3 3-3
CF 3. - a_ a .odic Pro. _der Acency
a. As Paramedic Coordinator
l) With a minimum of 16 `.curs/month wcrking in a Base
Station Hospital -merger,:-_ Department as an Authorized
Registered Nurse and
2) Attend tape critic.:es relating to agency operations
B. An Authorized Registered Nurse must accrue at least 4 hours of tape
review quarterly each Certification Year. Quarters as fellows:
December, Oanuarv, F r'.iary
March, April, May
.'une , July, August
September, October, November
Ar Authorized Registered Nurse ...st respond with a `:IC.`.. to a mini..._..
cf _ gnus _= _ nee __on__se
ar.nuall;•.
D. Yearly cer__fi_aticn cards w:_1 be issued upon satisfactory corieticr
cf csntinuing certlflcat_c rc:"'cements. Recertification testing snail
be •'red every 2 years. If fcr any reason other than an authorized
leave cf E_ r-{G{ed *•-_•N fails to maintain continuing cert.-
eat ,._ a..__r:ce, a CE_ --
f..-em=,-.ts, a recer -"-at.cn cr continuing certification
car. will nct be reissued until continuing education delinquencies are
}'r- - _ _ tc date. !`SI N' s may return to active status upon proof cf
:cmtleticn cf continuing educatic.. requirements.
R ece - - - I.X...._ tat:,^... Process:
A.
Authorized Registered Nurses must pass a recertification exam
at least every twc years, with a minirur. cf 83 percent in all areas. A
fee ray be charged for this exam. (Refer to L STO Fee Schedule.)
B. In the ever: cf failure cf any section(s) cf the recertificatic. exam.
(written or practical), the nurse may be allowed to repeat the exa.. Cr
that Sec (a) c,- -,w. a minimum cf two weeks additional study time:..
Passing score is ES percent for each. secticn. If retake examination is
certification is for a one-year period. If unsuccessful,
the nurse, after six mcnths and appropriate additional study, must
reta::_ tie entire exam.. If still unsuccessful, the nurse must ccm_iete
the e ire m:cn Course of Study and successfully complete the Reentry
E.xam..
C. If an individual is shcwn to lack competence in any given area, as
demonstrated by failure on any exam cr part cf an exam., that individual
shall not perfcrm in an Authorized Registered Nurse capacity until such
time. as competency is again demonstrated on a repeat exam.
D. It will be the reSpon_ibility of each individual Authorized Registered
Nurse to prepare for the exam by self -study and attendance at appropriate
lecture sessions.
Revised 6/63 3-2
2. rxa^:-at=on Process:
a. Attend an orientation at the Base Station Hospital to become
familiar with any charges in County Criteria and Treatment
Guidelines.
b. Pass a comprehensive examination (written and practical) with
a minimum grade of 80 percent on each section.
c. The reentry examination may be repeated as often as desired
by an individual with written approval of the local EMS
Medical Director.
d. The EMSTO will schedule the reentry examination and may charge
a fee for this process. (Refer to EDSSTO Fee Schedule.)
•
3/82 3-5
SAN n1E17 Cam'.'?STY CRITERIA FOR
SELECTION CF cp 'r:`_C INTERNS
1. Candidate must enter training voluntarily and be willing to commit 100
percent time to the training program.
2. Candidate must be currently certified as an EMT -I.
3. Candidate crust have at least six (6) months experience in the provision of
emergency care in the prehospital setting as an EMT -I.
4. Candidate -must be a high school graduate er produce a GED Certificate.
5. Candidate must submit a transcript from high school and from any institution
cf higher education.
6. Candidate must hold a current CPR card.
Candidate must be in good health, have a recent TB test and/or a chest x-ray
and have a recent physical examination by a physician.
8. Candidate must submit two personal references.
S. Candidate must pass a SCAT screening test for reading comprehension and math
skills at the twelfth grade level and be in the 50 percantile or above.
10. Exemptions to these requirements may be granted by' the EMS Medical Director
upon kitten request of the applicant and written support for such exemption.
3/82 4-1
CA L-IGC-C __ _1 Y CS:TERIA S_-R
P. ____ Ct _
I. Recuire-en s for Certification:
Successfully ^_ _ete the Sara Diego County Paramedic raining Program. or
.. the San leg Count Paramedic Challenge Process and become employed as
a paramedic by an authorized ArS agency. (Refel to EMST3 Fee Schedule.)
II. Continuing Certification Requirements:
A. The paramedic rust complete all the following each year, beginning
the month following certifcation:
1. wcr:. on a Mobile Intensive Care Jnit at least 96 hours, 10
I on_.s out of each certification year.
2. Coni.lete the Clinical Skills Tally Sheet (Attachment A) once
=a= . Pont. nui nc education: year to the satisfaction of the Ease
Static.. Hospital Paramedic :.`se Coordinator.
3. Accrue at least 4 hours cf tare review quarterly, with a r..ini-
-;a.:. cf 22 heirs_ each certification year, at assigned Base
Hospital. Exception may be authorized to attend tape critiques
at other than paramedic's assigned Base Station Ho
spital bi the
Paramedic Nurse
Coordinator at assigned Base icsp_tal.
Quarters as fellows:
December, January, February
March, April, May
tune, July, August
S c : e
t2-.:�cL, October, .`;,c .. c.bcL
4. Attend at least 16 hours of related continuing education classes
per certification year. (Attacnier.t E outlines examples of
a,--=-tabie continuing education activities.)
5. Perform to the satisfaction of the Base Station Hospital, the
e:-r_ _ _ _ agen=y, and the L*-STO. Each paramedic .Rust have at
leas_ cne sa'is=actcry field evaluation on file per year. The
E_E'0 will be required tc perform one field evaluation per year
for eaoh paramedic. Additional field evaluations may be completed
ry either the E:S 0 staff or the Paramedic Nurse Coordinators at
the Base Station Hospitals.
Yearly certification cards will be issued upon satisfactory completion
cf cc..'n__uing certification requirements. Recertification testing
shall =_ brequired every 2 years. If for any reason other than an
authorized leave of absence, a Certified Paramedic fails to maintain
contir.uino certification requirements, a recertification or continuing
cer-"'-=tion card will not be reissued until continuing education de-
iinz.:encies are brought up to date. Paramedics may return to active
status upon Proof of completion of continuing education requirements.
Revised 6/63 5-1
5 The ..__....:ss:on of any fraud. €-t, dishonest or corrupt act which
is substantially related to the qualifications, functions,and duties
cf greoospital personnel.
E. Conviction of ar.y crime which is substantially related to the quali-
fications, functions and duties of prehospital personnel. The record
of convict.on or certified CO?' thereof shall be conclusive evidence
cI such conviction.
7. Violating or attempting to violate directly or indirectly, or assist-
ing in or abetting the violation of, or conspiring to violate, any
provision of this part or the regulations promulgated by the authority
pertaining to prehospital personnel.
8. Violating or attempting to violate any federal or state statute or
reg.';.lation which regulates narcotics, dangerous drugs or controlled
substances.
9. A;= -ion to the excessive use cf, or the misuse of, alcoholic bev-
erages, narcotics, dangerous drugs or controlled substances.
IC. Fuhttionirg outside the supervision of medical control in the field
care system operating at the local level, except as authorized by
any ether license or certification. (Health and Safety Code, S 17798.200).
C. The procedure for investigating potential disciplinary action shall be as
follows:
1. Party initiating action shall submit a written request for investi-
gation, including all pertinent data (facts, dates, names, witnesses,
ett. to the local EMS Medical Director.
The ='"S Medical Director shall notify the subject of the investigation
that an investigation is being conducted. Subject shall be given an
opportunity to provide pertinent information.
3. The local EMS Medical Director may convene a panel of three certified
or licensed Health Professionals with expertise in the provision of
prehospital emergency care to review all material and employ whatever
testing devices are deemed necessary to arrive at recommendation(s).
The person being investigated should have an opportunity to speak and
to appear before the panel. The panel shall make written recommendation(s)
to t1e local EMS Medical Director.
Tne Medical Director shall review the gathered information and decide
if disciplinary action is warranted. Should the Director decide that
action is warranted, the Director shall prepare an Accusation, a Notice
of Accusation and a Notice of Defense. When prepared, these documents
are filed with the Board of Supervisors and sent to the respondent.
(Gc•:. Code, S 11503.)
5. The respondent must request a hearing within 15 days of the accusation
being served if he or she wants to contest the disciplinary action.
If the written request for hearing is not trade, the Medical Director
may act upon the accusation without a hearing. (Gov. Code, S 11505.)
3/82 5-3
I_` an individual is shown to lack competence in any given area, as de=on-
Stratec ty failure on ariv exam or Tart of an exam, that individual shall
Trot perform in a paramedic capacity until such time as cot=petencj• is again
demonstrated cn a repeat exam.
C. It will he the resper.s'- ±ty of ea=h individual paramedic to prepare for
the exam., by self -study and attendance at appropriate iecutre sessions.
V. Revocation of Certification:
A. A complaint Way to filed by any person with the local EMS Medical Director.
Investigation of the complaint and a determination that a disciplinary
action is or is not appropriate will be made by the local EMS Medical
Director.
3. A cep'"°'e^ paramedic may be disciplined, including revocation cf
certification, for any cf the following reasons:
1. Fraud in the procurement of any certification.
Gross negligence.
3. Repeacecl negligent acts.
L,
Incompetence, which includes inadequate clinical knowledge, and
lack cf proficiency with technical skills.
5 The commission of any fraudulent, dishonest or corrupt act which
is substantially related to the qualifications, functions and duties
cf prenospltal personnel.
6. Ionviotion o: any :rime which is suosta^.tla__t' related to _'.e quali-
fications., functions and duties of pre:`.osp:tar personnel. The record
of conviction or certified copy thereof shall be conclusive evidence
of suc.. conviction.
7. Violating or attempting to violate directly or indirectly, or assist -
in or abetting the violation of, cr conspiring to violate, any
provision of this part or the regulations promulgated by the authority
pertaining to prehospitai personnel.
5. Violating or attempting to violate any federal or state statute cr
regu:aticn wri:n regulates naI:odds, dangerous drugs or controlled
substances.
9. -_d_c.__n to the excessive use cf, cr the misuse of, alcoholic bev-
era_e , narcotics, dangerous drugs cr controlled substances.
1D. Functioning outside the supervision of medical control in the field
care system operating at the local level, except as authorized by
any other license or cer " '',atio^.. (Health and Safety Code, S :798.200).
C. The procedure for investigating potential disciplinary action Shall be as
follows:
1. Fart initiating action small submit a written request for investi-
gation, includin£ all pertinent data (facts, dates, names, witnesses,
etc.) to the local EMS Medical Director.
.e!.15 c /S3 6-3
III. C_n __..:i.' _ ne :uiremen-!-s for . araredics Who Are Agency _
For a.:.=d:
Coord- nat..rs : aran_e Supervisors:
A. Attain. ninety-six (96) hours on an ALS transport unit and/or partici-
pate in c_ lea_ Six (F) ALS runs ten (ID) months out of eac.. Certifi-
catio:. Year and document on a continuing education record fo^'I.
B. Accrue at least four (4) hours of tape review per quarter, with a mini-
mum of twenty (20) hours each Certification Year. Quarters as listed
previously in II.A.3.
C. Complete the Clinical Skills Tally Sheet (Attachment A) once each con-
tiru= c education year to the satisfaction of the Base Station Hospital
Paramedic Nurse Coordinator.
D. Attend at least sixteen (16) hours cf related continuing education
classes per Certification Year. (Attachment B outlines examples cf
a--A-`at:E Cv.'.t _.._-ng eA--=-on activities.)
E. Perform t, the Satisfaction of the Base Station Hospital, the e'-_cying
agency. and theX_ mach paramedic must have at least two satis-
factory field evaluations on file per two-year cycle (cne per year).
The r''STC will be remaired to perform one field evaluation per year
for each paramedic. Additional field evaluations may be completed by
either the _MSTC staff or the Paramedic purse Coordinators at the Base
Static-. Hospitals.
F. Yearly certification cards will be issued upon satisfactory completion
of cont__.-ino certification recliirements. Recertification testing
shall be required every two (2) years. If for ar.v reason other than
an a':.t.._-ized _c_:e .._ abCer:e, a Certified Paramedic fails to maintain
continuing cert_f:talkn recuiremerts, a recertification cr continuing
cer-'-ation card will not be reissued until continuing education de-
linquencies are :.ro'.1cr.t up to date. Paramedics may return to active
status upan proof of completion cf continuing education requirements.
IV. Recertificatio.. Examination Process:
Recertification will be re-:" red every two years in the months_ of March
and September. Those certifying the first six months of the year will
recertify in Starch, and those certifying the last six months of the year
will recertify in September. A fee may be charged for this exam. (Refer
tc EXEC: Fee SCne•_'u'_e . )
In the event cf failure cf any section(s) of the recertification exam.
(written or practical), the paramedic may be allowed to repeat the
exam cn that section(s) following a minimum of two weeks additional
stud_." time. Passing score is 5D percent for each section. If the
retake examination is succecc'v', certification is for a one-year period.
If unsuccessful, the paramedic, after six months with appropriate addi-
tional study, must repeat the entire exam. If still unsuccessful, the
paramedic must complete the reentry examination process.
Revised 6/83 5-2
=xa=i:;ration ?recess:
a. Attend an orientation at the Ease Station hospital to become
familiar with any zhanges i,. County Criteria and Treatment
Guidelines.
b. ?ass a comprehensive written examination with a minimum grade
of 60 percent on each section.
c. Pass a comprehensive practical examination.
d. Successfully complete a minimum of three up to a maximum of
ten 24-hour shifts of field internship as assigned by the
Director cf EM_=0.
e. The reentry examination may be repeated as often as desired
by an individual with written approval of the local EMS
Medical Director.
The 7-"_ST3 wiii s::?edule the reen.__, examination and may charm_
a tee for this process. (Refer to EMETC rEi Schedule.)
v 1i:. ?aramedi: Challenge Process:
A. ThE purpose of the Paramedic Challenge Exam is to establish annually a
list _f individuals eligible for employment and potential certification
as a Mobile Intensive Care ?a:a7 C_. (MP_. within Ean Diego County.
E. Candidate Qualifications:
r
Must meet al _ redJiremer.ts eF Section ll�_�2r a) s)'r) cf Title 13.
_aliforn.a Administrative CCGE, wniCh nr OC. "'O SeX offend___,
narcotics users, alcohol abusers, felons, et:., from operating
an. ambulance.
2. Must be licensed or certified physician, physician's assistant,
registered nurse, or paramedic (meeting standa:Cs cf HEW -DOT
Curriculum).
3. An individual failing the San Diego County Challenge Examination
may repeat this examination only if documentation of additional
paramedic -level education is submitted with the registration
questionnaire. The EMS Training Office will review applications
on an individual basis to determine elicibilty for reexamination.
C. Candidate Certification:
Cen' 'cation as a Sar. Diego County Paramedic will tE issued upon
completion of the following:
1. Demonstration of competency in paramedic -level knowledge and
skills on a four-part written exam, a practical exam and an
oral exam. Each section cf the written exam must be passed
with at least 80 percent, and each section of t`e process must
be passed in order to proceed to other exam sections.
2. Obtain commitment for employment.
3/82 5-5
2. he EMS Medical Director s}.a1i notify the subject of the investigation
that an investigation is being conducted. Subject shall be given an
opportunity to provide pertinent information.
The local EMS Medical Director may convene a panel of three certified
or licensed Health Professionals with expertise in the provision of
prehospital emergency care to review all material and employ whatever
testing devices are deemed necessary to arrive at recommendation(s).
The person being investigated should have an opportunity to speak and
to appear before the panel. The panel shall make written recommendation(s)
to the local EMS Medical Director.
4. The Medical Director shall review the gathered information and decide
if disciplinary action is warranted. Should the Director decide that
action is warranted, the Director shall prepare an Accusation, a Notice
of Accusation and a Notice cf Defense. ;4hen prepared, these documents
are filed with the Board of Supervisors and sent to the respondent.
(Gov. Code, S 11503.)
5. The respondent must request a hearing within 15 days of the accusation
being served if he or she wants to contest the disciplinary action.
If the written request for hearing is not made, the Medical Director
may act upon the accusation without a hearing. (Gov. Code, S 11505.)
6. per. notification that a fearing has been requested, the County
-Beard of Super.-iscrs will assigned a local hearing officer to con-
duct the hearing. The County is required to notify all parties at
least ten (13) days : tc the hearing. (Gov. Code, S 11_29).
7. The hearing shall be presided over by the hearing officer. The pro-
ceedings shall be reported by a phonographic reporter. The respondent
has a right to be represented by an attorney. The decision as to the
type cf discipline must be "ace by the Board of Supervisors, based
upon recommendation cf the hearing officer or upon oral argument by
the parties. (Gov. Code, SS 11512, 11513, 11514 and 11516; Health
and Safety Code, S 1798.200.)
VI. Authorized Leave of Absence:
A. After one year of employment, a Certified San Diego County Paramedic may
take a leave of absence for up to 90 days in any two-year certification
period without having to take a reentry examination.
B. A certified paramedic, who is requesting an authorized leave of absence,
must notify the local County EMS Medical Director in writing as to the
dates of the intended leave, reason for leave, date of original certifi-
cation or recertification and dates and length of any prior leaves cf
absence.
C. A paramedic who is on authorized leave of absence cannot function as a
E.
paramedic during the leave of absence.
Vnile or. an authorized leave cf absence, a paramedic does not have to
attend tape critiques or accrue rig time. However, the clinical tally
sheet and didactic hours'nust be completed as required.
While en an authorized leave of absence, if a paramedic is due to
recertify, he/she must take the recertification exam as scheduled.
F:e': i sew F
ii.. :Reentry Process .. Decert_._:ati_n•
:�. 3n:e desert an individual _..:.f: complete the f:11:wing reentry : ::es5
1. C a' ndi d a t e Qu a l i f i cations :
a. Previously certified as a paramedic in San Diego County, or
b. Successful completion of the San Diego County Paramedic
Training Program, or
c. Previously certified Sar. 1�. iego County paramedic, who vas
decertified fcr disciplinary reasons. These individuals
may not apply for reentry until 6 months after their de-
certification date. However, individuals decertified under
Section, 11C1 of the Vehicle Code are not eligible for reentry.
2. Examination Process:
a. Attend an orientation at the Ease Station Hospital to become
fa__1iar with any changes in County and Treatment
Guidelines.
5. Pass a comprehensive written examination wit. a minimum grade
of E3 percent ,.n each section.
?ass a comprehensive practical examination.
d. Succe"=='Iiy complete a minimum of three up to a maximum of
ten 24-hour shifts of field internship as assigned by the
Director of rut-O.
The reentry examination may be repeated as often .s desired
b": an _..div:dual with written approval of the local EMS
Medi:ai Director.
f. The :'`:STD will schedule the reentry examination and may charge
a fee for this process. Refer to E.uSTC Fee Schedule.)
II:. Paramedic Challenge Process:
A. The purpose of the Paramedic Challenge Exam is to establish annually a
,_ eligible f:r employment and potential certification
as a Mobile Intensive Care Paramedic (N:CF) within San Diego County.
E. Candidate Qualifications:
1. >:_s: meet all requirements of Section 11C2(a)(s)(C) of Title 13,
California Administrative Code, which prohibits sex offenders,
narcotics users, alcohol abusers, felons, etc., from operating
an ambulance.
M1st 5e licensed or certified physician, physician's assistant,
registered nurse, c.r paramedic (meeting standards of HEW -DC.
An individual failing the San Diego County Challenge Examination
may repeat this examination only if documentation of additional
paramedic -level education is submitted with the registration
questionnaire. The EMS Training Office will review applications
on an individual basis to determine eligiblity for reexamination.
IA)r D:tco CDiP':Ty PAR—vet:IC foOGRAM MtDICAT1Ow LIST
Drug Indication Dosage Route
A1upent
asthma 1-2 deep Inhalations inhalstlon
COPD
Aalnophy111ns broneh 2-0 mq/kq in min. of IV vclutrol
20 •1 D5W over 2f minutes
Ansonia Ampule unconsciousness
1-2 deep inhalations Inhalation
Atropine *systole
brsdycardlas
up to 2 mg initially IV push
0.5-lag (up to 2 mg) 1V push
organophcaphsts poisoning
ag (say repeat) IY pusn, In
Isnadryl snaphylasta
25-50 mg IV push
allergic reactions
25-SO mg IV push, 11.4
estrapyras:dal reactions
25-iri mq 1% pusn. Ir.
Iretyllus
recurrent V-fib after S mg/kg may repeat
Lidoceine in 5-10 sin, at 10 mg/kg
refractory V-tlb after CPR, up to 30 sq/kq maximum
Ilcarb, [pi a defibrillation
rapid IV push
Calcium Chloride
&systole
idtoventrleular
electromec`ar.:cal
dissociation
1 G•/10 ■1 IV push
Dextrose, 501
diab*tics
unconsciousness
sslxurs of unknown origin
CVA
25 pas/50 al IV push
Dopamine hypotension
100 mg/250 m1 DSW IV Drip
tpinephrine asystole
0.5-1 mg of 1:10,000 IV pusn, IC
severe btadycardias
0.5-1 mg of 1:10,914 1V push
asthma 0.3 mg of 111,000 SO
anaphylaxis
•1largle reaction
anaphylaxis
11.1-0.5 mgZ:l0,as0 IV pull
clucagon
known diabetic with 1 cc 1-1 un.tl
altered level of consciousness
In whom an IV cannot be
started
Ild
Glucola alert diabetics
behavioral emergencies
75 gam P.o
3/82
6-1
C. Cand. date Corr' --a:ion.
Ce `ation as a San Diegn County Paramedic will to issued
or•�n .f the f
upon
Demonstration of competency in paramedic -level Knowledge and
skills cm a four-part written exam, a practical exam and an
oral exam. Each section of the written exam must be passed
with at least 80 percent, and each section of the process must
be passed it order to proceed to other exam sections.
2. Obtain commitment for employment.
3. Once employed, complete a field of internship of no less than
72 hours and no more than 240 }:ours, during which the candidate
mist demonstrate competency in each of the areas defined as
necessary for the paramedic role in order to become certified.
' . Candidates who fail to obtain a commitment for employment during
the time frame of the eligibility list must retake the Challenge
Exam.
D. Fees:
A challenge fee may be charged to each candidate to recover costs of
providing the Challenge Process. ( Refer to EMol'C Fe ..t:c.'..::ie.)
c
Inderel
uncosperseted
supraventriculsr
tachycardia*
•.25-* •q in IV pus'+
•.:5-4.5 mq increments titres* to pulse
Ipecac drug overdoes (alert peti'nt) 15-31 ■1
p.o.
Isuprel
heart blocks 1-2 mg 25•/5411 ■1 DSW
TV Drip
tittat, to, pulse
Las::
pulmonary seems 21-414 K (up to 21• mg) IV pub
Lidocaine
ventricular Irritability
prophylactically In the
presence of chest pain
1 mg/kg initial bolus
additional 50 mg boluses
e t 5 stn. Intervals
• am. 225 mg or
1-2gm.'251-5011 m1 DSW
started at 2 mg/sin.
IV push
IV Drip
Morphine Sulfate
nor-trsu•atle chest pain 2-15 mg In 2 mg Increments IV push
burns OR
pulmonary seems 5-IS mq IM
isolated ir.;uries
Narcan
narcotic ► unknown
overdoses
onconcto_sness
5.4-4.11mq (may ripest) IV push, Ir
Nitroglycerine
nen-traumatic cheat pain 11.4mq (qr. 1/154) ss:lingual
pulmonary 'dome-ep'ri5i may repeat
systolic
►itoein
post-partus hemsorhage 3-19 u. IM
10-211 u./1••4 •I t/R IV drip
Sodlu• _:carbonate csrdioculsorary arrest
1 maS'kg initially, •
then 9.5 ■eg every
1• elnut's
IV push
tricyclic overdose
with tachyarrhythmiaa
1 meg/kg IV push
Vsli us
recurrent Grand Mal
seizures
status eptlapticus
scut* stress reaction
prscard)ovtrslon
2.5-211 mq (up to 41.5)
in 2.5 mg increments
IV push
TV Solutions
Ringer's Lactate 1••• •1 bag
2541-5011 al bag
51 D'strose/Math
3182
6-2
tOSTo
1CJo1
A-;,:.BML1tT A
Paramecia
RECORD OF CLINICAL CONTINUING EDUCATION
C.E. Year
Recertification Date
The following listed skills are to be observed and checked off by the Base Station
Hospital Paramedic Nurse Coordinator or her designee. Each skill oust be performed
each year to the satisfaction of the nurse coordinator, but must be perfomred at
intervals of not less than nine months. *The Paramedic Nurse Coordinator may require
tr.at a skill be performed more van once.
SKILL
DATE
,
AUTHORIZED
SIGNATURE
COh71ENTS
I. -Perform a nistcry ana physical in the
clinical setting and discuss your
findings with the Base Station Hospfta
Nurse Coordinator cr her desienee.*
2. CSserve ana critique an ALS Nurse or
co..rnunicating on the radio with a
field MIC Unit.*
3. Demonstrate proper IV injection
techrieue and calculate drip rates.*
4. uernonstrate proper technique for
aaministering medications.*
IV push
IV volutrol
IM
S.C.
The following may be simulated or performed
S. Intracardiac injection.*
on a patient.
6. CPR Protocol.*
7. External technique*
,,uaular IV echnique
8. Carotid sinus massage.•
9. Rotating tourniquets.*
10. Cardioversion.*
11. Airway management.*
12. Defibrillation.*
.
13. Other skills as determined by
Nurse Coordinator.*
3/82
A — 1
The continuing educational activities 8p:roved for didactic credit are as
follows:
Category A: Classes, workshops, lectures and seminars relevant
to job performance
Although all 16 hours cf Yearly dldacticc may be obtained in this
category, a minimum of ter hours must be obtained. unsup=rvised,
self -instructional aids, such as video-tapes and filmstrlis, will
not be granted CE credit unless accompanied by a completec and
graded pest test.
Category A Credit:
The length of the educational program
determines the number of hours of CE
credit given. For example, a class cf
one hour is equivalent to one hour of
CE credit. however, for a college level
cot.rse, one unit is equal to one hour of
CE credit.
Cat_go_. P Eier_ercy Care Instruction
A ma?:/mom i_ four hours CE credit per Year m-- be obtained in this
category whiz: encompasses the paramedic's participation as an in-
structor in :re- spitat emergency care programs. The prehc pital
emergency_ care instruction tLLst snow written evidence cf pr para-
tier. and be delivered within a recognized formal setting. :his
category also includes evaluationof n. paramedic interns.
Cates , E Credit:
One educational pres_entation of one hour
is equal to one hour of CE credit. An•
program presented more than once can earn
CE credit only once.
Category C: Professional Publications
A maximum. of two hours CE credit per year r.av be obtained in this
category which encompasses the publication of content relative to
pre..tsp'_tai er.erge-:cv medical care. The content must be published
in a recognized ournal or t,- a recognized publishing house durinz
the `.:E period. ThE format shall be an article, book and/or research
paper.
Cetepc:;: C Credit: One publication is equal to two hours of
CE credit.
Category L: Preparation of Formal Tape Review
A maxi -um of two hours CE credit per year may be obtained in this
cagegcry which encompasses the preparation of a formal tape review
session (two hours duration). it must be held in conjunction with
a par_ie.dic base station hospital and have the approval of the base
station paramedic nurse coordinator.
3/62
B-1
C
'1^ _ _ ._ _ _ _ \ 1 =•TA ^T
Sar. :Diego County Criteria for Advanced Life Support Services rec,:ires all
cara_:e i_ patient contacts to be called in to the Base Station Hospital.
Excetticns are as fc1_ows fo_ Base Station contact regarding patient
encounters ty ALS perso^ne1:
1. Patients who recuire only Basic First Aid.
Definition: Basic first aid, as a working definition that
arolies to this issue, is a patient whose complaint
would not necessitate ENT cr paramedic -level training
an.d!cr intervention.
2. Patient_ who are orier.ted to person, place and time, with no obvious
or suspected chief complaint and are refusing an assessment. See note
regard ._-'A.
A>_- .;cte: In the event of patient refusal by a person who
has a chief con 1a:nt, sustains a . injury, or might
reasonably be sus: ected to have sustainer: an in' :zy,
a conscientious attempt must be made to determine the
coherency cf the patient and to explain the:
a. Significance cf mechanism of injury.
b. Possible related complications.
o. Ctnsecuences of chief nt
The Base Station. must be contacted and proper docu-
mentation provided. Once the Base Station agrees with
the release, the patient should be handled as an "Against
Medical Advice", and a release signed.
In all patient enccurter situations, cc�..�cn sense and good _,:dgment must
prevail and when in doubt, Base Static:. contact should be made.
June 1923 C-1
SAh D __• D GNNT'Y 1.=D1 cr.I AND C.. ^`_N'_Cn_ _Jh 1 __MS
(IN AD :T1CN TO BASIC F_EQ:"In-YTS BY CEP -- ATTA'IH `)
BE Ric _:2.., IN EACH: VII\CE.D, iIFC S:_PCRT flIT
Medical items
1. Trauma Bcx/Rack
2. Ambu Bag
3. Pediatric Am'.:u Bag
4. Back`'.ard (Spine Board Set Short)
5. blood Pressure Cuff - Pedia:ric
6. C Collars, Rigid, Adult
7. C Collars, Rigid, Child
E. Defi`- ;'atcr (Comm:ir.a:ion SCc;e and Defibrillator)
S. Drug Scx
12. Electrodes
1]. Electrodes -Wires
12. Esophageal Airway (Kit)
13. Traction Splint - Pediatric
1A. Laryngoscope - handle, Adult and Child
15. Laryng sccpe - blade, Adult. Child and Infant
16. Anti -Shock Trousers (Adult)
17. Nasal Airways, Assorted Sizes
1S. Positive Pressure Breathing Valve
19. Thermometer - Oral, Rectal
20. Magill Tonsil Forceps
21. Armbcard: Long
22. Ar board: Short
23. Cold Packs
2... Conductive Gel
.5. 1. V. Ad_.ir.istraticn Sets: 1!acrodrip
Microdrip
Microdrip with Volutrole
26. Nasogastric Intubation Set -Up, 18 fr. 46"
27. Needles:
1. V. Scalp Vein - 19 Gauge
I. V. Scalp Vein - 21 Gauge
I. V. Scalp Vein - 23 Gauge
6/62 7-1
T ins•:..^ No.
Per Vehicle
2 each
1 each
1 each
. each
1 each
3 each
2 each
1 each
1 each
1 box
2 sets
2 ea:l
1 eac',
1 each
1 eac::
1 each
1 packa_
1 each
1 each
1 each
2 each
2 each
2 bores
2 bottles
6 each
3 each
3 each
1 each
8 each
6 each
6 each
Zi. N€ les: (ccrt'd from /-1) I. V. Cahnula - :L Gage E each
I. V. Ca .:u,a - 16 Ca.,ge E each
I. V. Ca,nula - 14 Gauge. 2 ea:`
I. V. Ca-_.;:1a - 20 Cauge 6 each
I. Y. .1 Gauge x 1" 6 each
S. C. 23 Gauge a 3/6" 4 each
t'acutair.er Needles 21 Gauge x 1" 4 each
26. Suction. Catheters (14 fr.) 3 each
29. S.:tior. Catheters, Tc si1 Ti_ 3 ea:.^.
3C. TGurric ets (1" Penrose TuEi g, L:'.i=um 18") 4 each
32. Vacutainer E:'.de_ 2 rs etc..
Vacutairer L:2ces 6 each
Cc,=.._h.:at_cn .tem_ .
1. Agency Radio
i. Station "X"Telemecry
1 ea•
each
1 eac..
6/E2 7-2
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