If, at any time, something goes awry or a member has a concern about something, please consider the following, in the dictated order:
(1) Maintain Scene Control and Take Care of the Patient
Scene/rescuer safety is always the primary concern; next, of course, is patient care. Please also try to maintain a professional manner. Consider utilizing Colby Security, CER Medical Control, Delta Ambulance, Waterville Fire/Rescue, Waterville PD, etc, as appropriate.
(2) Maintain Appropriate CER Operation
However appropriate, even by temporary means if necessary; if adequate CER operation is compromised, sign CER Out of Service with Colby Security.
(3) Contact the CER Rescue Chief
If cannot be reached, please leave a message, always.
(3a) If the situation effects the immediate function of CER, contact an Officer or R1 (if the Rescue Chief cannot be reached)
(3b) If the situation does not effect the immediate operation of CER, please wait to talk to the Rescue Chief.
(3c) If the situation involves the Rescue Chief, please contact the Faculty Advisor
(4) Document the specifics of the situation as soon as possible, if appropriate (Incident Report).
*You can always contact your Rescue-1 on duty if you have any questions or concerns
**Matters taken to the Rescue Chief will initially be confidential; if deemed appropriate, they may be taken to the CER Faculty Advisor or the appropriate authority (Colby Security, Delta Ambulance, Colby Dean, etc).
***If there is a specific issue or question about a particular call, a full review may be initiated involving the CER Rescue Chief, the Health Center and any personnel (within or outside of CER) involved in the situation.
(required to leave campus while on duty or no longer capable of running):
If a personal emergency, injury or other unforeseen event requires you to leave campus while on duty; obviously, do what is needed to take care of your self. However, also be responsible to the CER gear and other rescuers – however appropriate. Obviously, if you fall and break your leg while on duty, it is not possible to carry out all of the following; just be aware of all that is being asked and do what you can. If something comes up that requires you to leave campus while on duty (such as a forgotten doctor's appointment, etc) please do the following before leaving campus.
(1) Find a Replacement Rescuer
If possible given the situation.
(2) Inform the R1 that you will be Leaving Campus
Again, this may not be possible. You can also let Security know and they can page the R1 and in order to inform him/her of the situation.
(3) Be Sure that the Radio and Pack are Secure in a Safe Location, If Not Given to a Replacement Rescuer
Preferably in the CER office, however, if necessary lock in your room, leave with an off-duty rescuer, etc. If it is a dire immediate emergency (such as one that requires an ambulance), take the pack with you. Make sure that people are informed where the pack is, as soon as possible.
(4) When Possible, Please Document the Event and Actions Taken
(5) If you are Informed of an On-Duty Rescuer having to Leave Campus, Please Contact the Rescue Chief or a R1 ASAP
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Every rescuer is required to wear Nitrile gloves when working with patients. Additional PPE (such as gowns, goggles, masks, etc) is available upon request. If you are not equipped (with the needed PPE) for a particular call, do not approach the scene until you have the right gear. Never put yourself at risk – rescuer safety is always the first priority – however, please be responsible for ensuring your own safety (make sure you have gloves in your pack, wear long pants, etc).
Exposure can include: needle or any sharps stick; getting a patient's blood, vomit, mucous or any other bodily fluid in or on a mucous membrane or cut; having someone spit or cough directly onto your face; close contact with someone you suspect of having a dangerous infectious condition; exposure (by contact, inhalation, etc) with a potentially dangerous substance on scene; or any time that you feel your health was jeopardized by an exposure/contact while on duty.
(1) Immediately Wash the Exposed Site with Soap and Warm Water.
If in your eyes, flush vigorously with water, eye wash or sterile saline. In the event of an exposure, do not use the water-less hand sanitizer in place of washing with soap and water.
(2) Seek the Necessary Medical Attention Immediately.
It is recommended that you go straight to the emergency room (Thayer), however, you may also be treated at the Colby Health Center if preferred. Do not abandon your patient (make sure to leave the patient with another EMT, etc).
(3) Once All Needed Medical Attention has been Obtained, Please Complete an Exposure Report and Inform the CER Rescue Chief.
This is a very important bit of documentation, for both your safety and to evaluate CER. Exposure reports are confidential (seen only by the CER Rescue Chief and James Woodlees, P.A. and are in no way judiciary.
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Any rescuer present (CER, Security, Delta or Waterville Fire/Rescuer personnel, etc) can deem the scene to be unsafe for any reason – aggravated/dangerous bystander, potential for fire, possible chemical spill, etc…
(1) Leave Scene, Remain At a Safe Distance
(2) Contact Appropriate Agency
Such as: let Colby Security handle the scene first, request Waterville Fire, or PD, etc…
(3) Only Once the Scene Has Been Deemed Safe, May you Proceed with Patient Care
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Involving another CER member or rescuer, by standers, hall staff, Colby Security, Health Center staff, Delta Ambulance or Waterville Fire/Rescue personnel, etc... Keep in mind that CER does have medical authority on scene, however, Security has their own protocols to follow they may decide that the Health Center, Delta Ambulance, Waterville Fire/Rescue, Waterville PD, etc, need to be contacted independent of CER. Furthermore, any rescuer on scene (CER or other) can deem the scene unsafe at any time. Also keep in mind that once patient care has been transferred (or on scene) the Health Center, Delta, Waterville Fire/Rescue, etc, has the authority (any complaints, concerns, comments or conflicts should still be documented, however, after the call).
(1) Maintain Scene Control and Take Care of the Patient
Rescuer safety, public safety and care of the patient always come before and personal or individual issues. Please remember to act in a professional manner when on scene, in front of patients, Security, Health Center staff, Delta Ambulance or Waterville Fire/Rescue personnel, etc... Personal conflict on scene is never good for patient care or scene control so put aside until the call is over.
(2) If Possible/Appropriate Attempt to Resolve the Situation and/or Communicate with the Individual
Once the call is over and when in a more private setting; if initial attempts at communication are not productive, contact the Rescue Chief. Remember: it is the job of the Rescue Chief to review and resolve situation and carry-out disciplinary actions, please do not take it upon yourself.
(3) Document the Specifics of the Situation in an Incident Report.
You may also contact the Rescue Chief at any time to discuss the matter. Please keep in mind: in order to action to be taken or changes made for CER, things must be documented as close to the incident as possible.
(4) Contact the CER Rescue Chief, or if pertaining to the Rescue Chief, Contact Jim Woodlee, P.A.
Note, if it is a small concern, comment, complaint, etc, about the Rescue Chief, discuss the matter with an Officer/R1 before contacting Jim Woodlee.
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Whether on or off duty...
(1) Immediately Initiate Patient Care
Like any CER call. Keep in mind: BSI precautions and scene safety, etc... Please maintain scene control - avoid panic.
(2) Request CER
If on duty, make request via radio (example: "R2 to Central, I am on scene, requesting CER in Olin 223, for a male patient who has hit his head"). If unable to make request by radio (or off-duty), use a phone (872 3911 or x 3911) or ask a bystander to make the call (again, avoid panic, and inform the bystander of whom to call and what to say).
(3) Continue Patient Care, As Appropriate, Until CER/R1 Arrives
Once present, inform the R1 of what happened, what you know, what you've done, etc... (Example: "This is Nigel, he's 19 years old, he slipped on the wet floor and hit his head on that desk. He is AOx3, no LOC, but this cut has been bleeding quite a bit. He has no medical history, takes no medications and is allergic to Sulfa drugs. I've been taking spinal precautions and having him hold direct pressure on the laceration.") From there, it proceeds as any other CER call (the R1 makes the transport decision).
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(1) If First On-Scene, Inform Security/Other Rescuers Via Radio
Example: "R2 is on scene in Drummond with Security"
(2) Initiate Patient Care, Provided Scene is Safe
If possible/relevant, please let Security enter the scene first. Starting patient care may be as simple as taking spinal precautions or gaining access to the patient (getting into their locked dorm room, getting them to open the bathroom stall that they are in, etc). Find out/do what you can before the R1 gets there - you may get a full SAMPLE history done, you may only get access to the patient.
(3) Once Present, Inform the R1 of What you Know, What You¹ve Done, etc...
Example: "This is Nigel, he's 19 years old, he slipped on the wet floor and hit his head on that desk. He is AOx3, no LOC, but this cut has been bleeding quite a bit. He has no medical history, takes no medications and is allergic to Sulfa drugs. I've been taking spinal precautions and having him hold direct pressure on the laceration." Or "I just got here, I think the patient's name is Fiona, she won¹t let us into her dorm room to treat her, Security is working to unlock it now."
(4) Once Informed, the R1 Takes Control of the Scene
This does not necessarily mean that the R1 pushes you aside and re-takes the SAMPLE history; however, please let them take control of the scene. Remember: the R1 is the only person who can make the transport decision.
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(1) Initiate Patient Care, Provided Scene is Safe - Like Normal 1st On Scene Procedures
(2) Attempt to Contact the R1 by Radio (or have Security do this)
Example: "R3 to R1, what¹s your 20?" or "Central to R1, 10-20?"
(3) If No Radio Contact with the R1, Make Other Attempts to Reach Him/Her, As Appropriate
You can request that Security re-page for CER, try calling or having Security call (the R1 names and phone numbers are in the Resource Cards on all the packs), etc... How and for how long you attempt to contact the R1 is up to your discretion - you must at least attempt to reach them by radio.
(4) If No Contact with the R1, You Must Dispatch Delta Ambulance (or have Security dispatch Delta)
You are required to remain with the patient until Delta arrives, and takes over patient care.
(5) After the Call, Complete a Run form and an Incident Report.
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Of equipment, supplies, personal belongings (like a tee-shirt)... Note, it is up to PPD to clean-up stuff on scene (they are specially trained and equipped to decontaminate carpet, bathrooms, etc) and it is up to Security to clean out their truck. Contamination is exposure to any bodily fluid. Please wear gloves when cleaning up!
(1) All Disposable Materials Should be Placed in Red Bags
Red bags should be disposed of into a bio-waste bin at the Health Center
(2) Any Disposable Materials that are Soiled, but not "Contaminated" may be Put in the Normal Trash
(3) All Sharps Need to be Put in a Sharps Shuttle and Left at the Health Center
Sharps include things like broken glass, contaminated needles, etc... Basically anything that is sharp and could be contaminated
(4) All Non-Disposable Contaminated Gear Needs to be Cleaned Immediately
Preferably, leave stuff to be cleaned at the Health Center - especially linens, clothing, packs, etc... Anything left at the Health Center needs to be replaced in the duty-pack, and make note of it in the office (equipment board and log) so that people know where it is. Some stuff may be cleaned using the Bio Clean-up kit in the CER office
(4a) Clean-off Visible Material (using a paper towel, dispose of into a red bag)
(4b) Spray Soiled Gear with the Disinfectant Provided (or use 10% bleach solution) and Let Stand for at least 5 Minutes.
(4c) Wipe Equipment with a Paper Towel and let Dry
(4d) Clothing, etc, Should be Cleaned in Hot Water with Bleach
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(1) Maintain Scene Control and Take Care of the Patient, If Relevant
(2) Maintain Appropriate CER Operation By Replacing Gear or Improvising a Replacement in the Active Duty Pack
There are extra supplies in the office (there is a CER office key on each pack). If you cannot find an exact replacement, try to locate something that will work similarly. There is a lot more extra stuff in the closet - contact an Officer or R1.
(3) Label the Broken Gear and Leave it in the Office
There is a role of white tape you can use to label the gear, including the date and your initials (example: "10-7 2º broken - RHN 1/13/03"). There is an orange wire bin near the battery charger - it is best to put the label broken equipment there.
(4) Leave a Message in the Appropriate Spot on the Equipment Whiteboard and Inform the Equipment & Supplies Officer
(5) Complete an Incident Report, If Relevant
Please complete an Incident Report if broken/malfunctioning gear interfered with patient care, you broke it, etc...
(6) Make a Note in the CER Log
Please include a description and the actions taken. Example: "Radio #1 is 10-7 2º won't transmit, it is labeled and in the orange bin in the office, Ian has been informed".
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Spare radio batteries are available in the office (there is an office key on each pack). Please remember to sign-out any batteries taken in the log. If you suspect that your radio is broken...
(1) Contact Security and Request a Test Page
Preferable, this can be done via radio, however, you can also do it by phone (x3000). If this does not work or does not eliminate your suspicion, proceed to following steps.
(2) Inform Security and Your R1 that your Radio is Malfunctioning
(3) Contact an Officer or R1 to Get a Spare Radio from the Closet
Be sure to make note in the log that you are now signed out with a different radio
(4) Document, Specifically, How the Radio is Malfunctioning/How it Got Broken
Inform the Equipment and Supplies Officer, if not done already. Label the radio (same as above for other broken gear) and leave in the office
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(1) Maintain Scene Control and Take Care of the Patient, If Relevant
(2) Maintain Appropriate CER Operation By Replacing Gear or Improvising a Replacement in the Active Duty Pack
There are extra supplies in the office (there is a CER office key on each pack). If you cannot find an exact replacement, try to locate something that will work similarly. There is a lot more extra stuff in the closet - contact an Officer or R1.
(3) Leave a Message in the Appropriate Spot on the Equipment Whiteboard and Inform the Equipment & Supplies Officer
(4) Inform Security, If Suspected Stolen
(5) Complete an Incident Report, If Relevant
(6) Make a Note in the CER Log
Please include a description and the actions taken. Example: "A stethoscope from the R3 pack is missing, Security and the Equpiment and Supplies Officer have been informed".
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Go to the scheduling page
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There is more specific info about what to do if someone is a no-show in the purple binder in the office. It is in the "Handoff, No-Show @ Handoff" section.
(1) Try Calling the Person
If no answer, leave a message informing them of the time and that they have missed handoff. Often you can leave him/her a message saying that the pack and radio are in the office (a key can be obtained from Security).
(2) Note the Absence in the Log
Name, time, no-show for handoff, called dorm room, etc. Make sure that those on-duty are signed-in correctly
(3) Track Down A Replacement Rescuer, If Needed
Using the Roster and the Reserve Roster
(4) Write an Incident Report, If Appropriate
Specifically, if this person often misses hand-off or other specifics of the situation that are concerning.
(5) If the R1 is a No-Show, and No Replacement can be Found, CER MUST GO OUT OF SERVICE
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If, for some reason, you need to move the time of handoff...
(1) Please Ensure That Everyone Involved is Informed
(2) Note Time of Drop Off/Pick Up in Log
Also, note the status of the batteries in the radio and pack. Example: "Friday, 1/12/03 @ 1700 - Robin Nesbeda dropping off as R3 early 2º working tonight. Pack and radio are in office, batteries in pack are charged, put battery in radio at 0900". Person picking-up should sign-in normally.
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If, for some reason, you need to move the time of handoff...
(1) Please Ensure That Everyone Involved is Informed
(2) Please Make The Drop-off/Pick-up Convenient for Other Rescuer
Make sure that the pack is in good condition, complete with new batteries. Also, exchange to pack and radio where it is convenient for other rescuer (like, bring pack to his/her dorm).
(3) Note Time of Drop Off/Pick Up in Log as Well as on the Sign-In Sheet
Also, note the status of the batteries in the radio and pack. Example of log entry: "Friday, 1/12/03 @ 2100 - Robin Nesbeda dropping off as R3 late 2º meeting. Jennie Jackson held pack late".
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Sometimes, CER is required to go out of service. When this happens, all medical emergencies are diverted directly to Delta Ambulance. Occasions when CER must go out of service include: certain breaks/vacations (winter break, thanksgiving break, summer vacation, etc); during final exam periods; whenever there is no R1 on duty (due to a scheduling issue or personal emergency, etc). Whenever CER is to be out of service (whether for an hour or a month) Security must be notified. Please also inform the CER Rescue Chief and the Health Center, if possible.
(1) Complete an Out of Service notice and give it to Security/Dispatch
Include the time and date when CER will no longer be available, and the time and date when CER will be back in service (if not know, circle "TFN" for 'Till Further Notice). Print and sign your name, the date and circle the appropriate rank (R1, R2, Officer).
(2) Contact/Leave a Message for Both the CER Rescue Chief and the Health Center
(3) It is the Responsibility of the Person Who Signs CER Out of Service to Notify Security When CER is Running Again
Even if it was indicated on the slip, please stop by Dispatch and tell them directly when we are in service again
