Lisbon Fire Department Standard Operating Guidelines and Policies
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5. The lieutenant at each station is responsible for daily oversight and enforcement of all standards related to work practices. D. Housekeeping 1. Nondisposible laryngoscope blades and other metal objects (e.g. scissors) will be cleaned as soon as feasible after use by scrubbing with detergent under running water to remove any tissue or fluids, then soaked in Metricide 28 sterilizing solution or other comparable solution provided by The Lisbon Fire Department for this purpose, following label directions. 2. The ambulance patient compartment will be maintained in a clean and sanitary condition at all times. a. Contaminated work areas will be wiped up immediately with germicidal disposable wipes and decontaminated as soon as feasible with Cavicide or other suitable surface disinfectant provided by City of Brookfield Fire Department. The work area must be decontaminated before the unit can respond to another call. b. In addition to appropriate cleaning of the patient compartment and equipment after each run, there will be a generalized cleaning: (1) Weekly (a) Vehicle interior (exterior cabinets, open shelves, ceiling, walls, floor, chairs, benches) (b) Stretcher (c) Stair chair (d) Backboards, KED (e) Splints (f) In-station EMS clean up area (2) Monthly (a) Interior compartment of all kits (b) Interior compartments of the vehicle c. All bins, pails, cans and other cleaning receptacles will be inspected after use and decontaminated as necessary with Cavicide or other suitable surface disinfectant provided by The Lisbon Fire Department.. d. Contaminated broken glass will not be picked up directly with hands. 3. Laundry a. Contaminated laundry is defined as containing blood or other potentially infectious material in a sufficient quantity so that the contaminating substance drips from, pours from, is released by squeezing or wringing the laundry or releases dried flakes of the contaminating substance. b. Contaminated laundry will be bagged in color-coded red containers at the point of use and transported as soon as feasible to Elmbrook Memorial Hospital for decontamination. c. Gloves will be worn when handling contaminated linen. d. Uniforms, turnout gear, EMS jackets and other clothing soiled with blood or other potentially infectious material less than the “contaminated” level will be removed as soon as feasible and laundered at the department. No contaminated clothing will be taken home for cleaning. Personnel will follow laundry procedures posted at each station. e. Employees are to shower as soon as feasible following removal of contaminated clothing. 4. The lieutenant at each station is responsible for daily oversight and enforcement of all standards related to housekeeping. VI. There are no HIV or HBV Research Laboratories or Production Facilities in the response area of Lisbon Fire Department
B. Hepatitis B vaccination will be made available to new employees following the training program and within 10 working days of assignment to tasks where there is a potential for bloodborne pathogen exposure. The vaccination will be: 1. Made available at no cost to the employee. 2. Made available at a reasonable time and place. 3. Performed by an appropriated health care professional appointed by the fire department 4. Provided according to the current U.S. Public Health Service recommendations. C. The employee has the right to refuse Hepatitis B vaccination by signing the waiver presented by the department. If, at a later date, the employee elects to receive the vaccination, the employer will provide it at that time as outlined in VII-B above. D. Employees who have ongoing contact with patients or blood/other potentially infectious material or who are at risk for injuries with contaminated sharp instruments or needle sticks will be tested for antibody to Hepatitis B surface antigen 30 to 60 days after completion of the vaccination series. 1. Employees who do not respond to the primary vaccination series will be revaccinated with a second series and titer levels rechecked 30 to 60 days after the second series is completed.
E. Employees who have previously received the Hepatitis B vaccination series and/or have antibody testing indicating the employee is immune do not need to be revaccinated. F. Future recommendations for Hepatitis B from the U.S. Public Health Service will be instituted by Lisbon Fire Department.
B. Upon receipt of a report of a potential exposure, the employee’s immediate supervisor will arrange for the employee to report within one hour to Community Memorial Hospital Emergency Department for medical evaluation. 1. The exposed employee will complete: (Note: All forms included in the Exposure Packet located at Station 1. Copies are carried on all fire department apparatus.)
b. “Employee Work Related Incident Report” c. Follow Up of Employee Exposure to Blood/Body Fluids d. “Employee Restriction Responsibility Form” e. “Medical and Worker’s Compensation Claim Authorization” 2. The supervisor of the exposed employee will complete a. “Employer’s First Report of Injury or Disease for Wausau Insurance Co.” b. “Employee Work Related Incident Investigation Report” 3. If the employee seeks medical attention as a result of the injury/exposure, the following forms must also be completed and submitted. a. Health Care Professional Written Opinion Post Exposure Follow Up Evaluation b. “Attending Physician’s Report – Return to Work Recommendations” c. “Job Function Evaluation Form” (back side of Return to Work Recommendations) Note: An Attending Physician’s Report – Return to Work Recommendations” must be .completed at the end of each follow-up medical appointment 4. The exposed employee will notify the attending physician of the current location of the individual who was the source of the blood or other potentially infectious material. a. If the source individual was transported to Community Memorial Hospital Emergency Department, the attending physician will be asked to obtain consent and test the source patient for Hepatitis B, Hepatitis C, HIV and any other potentially communicable diseases that the physician may suspect. b. If the source individual was transported to another emergency department, the Officer on the transporting unit will notify the source individual’s attending physician and request testing of the source patient for Hepatitis B, Hepatitis C, HIV and any other potentially communicable disease that the physician may suspect. The attending physician will be given the name of the exposed employee and a telephone number where the employee can be contacted. The results of that testing should be forwarded to the exposed employee by the source individual’s attending physician or his/her designee. c. If the source individual is not transported to a hospital, the Officer on the scene will explain the situation and request the source individual consent (or request consent from an individual able to provide consent for the source) to testing for HBV, HCV and HIV. Consent forms for the blood draw and testing will be carried on all ambulances in the exposure packet. The blood tube and consent form(s) will be labeled and transported to Community Memorial Hospital with the exposed employee for testing. d. If the source individual is deceased, the Waukesha County Medical Examiner will be contacted from the scene by the Officer in charge, notified that the deceased is the source individual for a significant exposure and permission sought to draw blood for testing. The Medical Examiner may elect to transport the body and arrange for testing at another facility. The results of the test will be given to the exposed employee as outlined in section VIII (B) (4) (b) above by the medical examiner or the attending physician of the source individual or designee. e. Any problems with obtaining consent from the source individual should be reported as soon as feasible to the Director of EMS who will attempt to contact the individual or appropriate authority and gain consent for testing for bloodborne pathogens. 3. The attending physician at Community Memorial will evaluate the exposed employee and: a. Provide counseling to the employee on recommended medical care. b. Prescribe the appropriate medical care. c. Provide a copy of his/her written opinion following exposure to blood/other potentially infectious material including: (1) Recommendation for post exposure Hepatitis B vaccination. (2) Documentation that the exposed person has obtained appropriate information about bloodborne pathogens, results of the evaluation and signs/symptoms to report if they occur. d. Complete the “Attending Physicians Return to Work Recommendations Form” if appropriate 4. The exposed employee may obtain appropriate follow-up medical care and screening as ordered by the attending physician from: a. Community Memorial Hospital. b. Medical Associates Occupational Health Department or the agency contracted by Lisbon Fire Department for employee health issues. c. Personal physician. IX. Labeling A. All contaminated materials will be placed in appropriate receptacles marked with the biohazard legend and/or in red-colored bag/containers. B. Any bag/container that contains contaminated waste will be taken to Community Memorial Hospital for appropriate decontamination/disposal.
A. All new employees will receive training in bloodborne pathogens and personal protective equipment at the time of assignment to department apparatus. B. All employees of the Lisbon Fire Department will receive annual training on bloodborne pathogens. Content will include: 1. Location of the department copy of 29 CFR 1910.1030 and the Lisbon Fire Department Exposure Control Plan. 2. General review of epidemiology, signs and symptoms of bloodborne pathogens 3. Modes of transmission of bloodborne pathogens. 4. Recognition of tasks that may involve exposure to blood or other potentially infectious material. 5. Methods to reduce or eliminate exposure to blood or other potentially infectious material to include: a. Engineering controls. b. Work practices. c. Personal protective equipment (selection, types, use, location, removal, handling, decontamination, disposal). d. Hepatitis B vaccination program. e. Procedure following a significant exposure. f. Post exposure evaluation and follow-up. g. Use of labeling on contaminated equipment and supplies. C. Training will be conducted by the Director of EMS or a designee knowledgeable in the subject and matter and will include opportunities for questions. XI. Records A. The Lisbon will maintain records of employee occupational exposures for the duration of employment plus 30 years as required by rule, containing: 1. Name 2. Social security number 3. Vaccination status 4. Results of examination, testing and follow-up related to employee health maintenance 5. Significant exposure incidents B. The hospital/agency providing medical evaluation, follow-up and treatment of employees with occupational exposure to blood or other potentially infectious material will maintain confidential medical records of examinations, medical testing and follow-up procedures for the duration of the employee’s career plus 30 years. Should the agency’s contract not be renewed or the agency cease doing business, those records will be transferred to the new agency named by the Lisbon Fire Department. C. Training records for all employees of the Lisbon Fire Department will include: 1. Date of training. 2. Curriculum outline for each presentation. 3. Instructor for each presentation and his/her qualifications. 4. Employees attending each presentation, including job title. D. All records will be made available upon request to the Assistant Secretary of Labor for Occupational Safety and Health Director of the National Institute for Occupational Safety and Health, Department of Health and Human Services, or designee. E. The Director of EMS is responsible for annual review and appropriate updates of the Lisbon Fire Department Exposure Control Plan as required by rule.
Revised October of 2009 The Lisbon Fire Department provides a very high quality of service by relying heavily on the skills and commitment of its members. The most valuable resource the department deploys is the individuals who make up the membership. All those who graduate to full member status must understand that they are placing themselves in a very special situation; they deliver emergency services to the Lisbon citizens in need and in most cases are not backed up by any other agency. The fire department personnel are the only and often the final line of aid people can call on. As full members of this organization you are promising that you are aware of the seriousness of this vocation and are willing to commit to the challenge of being prepared for the days you will be called upon to perform your duties. This probationary test is a right of passage and is a significant milestone in your Lisbon careers. The probationary testing is given to assure the fire and EMS service providers are ready to participate in their full capacity, exercising their acquired skills and knowledge. In order to qualify for the test the candidate must complete and be certified in at least two categories, depending on the career path choice. An example would be completing Firefighter I and EMT basic classes. EMS only personnel would be expected to complete EMT basic and IV tech. The fire only candidate would be expected to have completed Firefighter I, II or MPO. The testing process is divided into two parts, a written and a practical. The written is again divided into 3 components. Component I is a general test focusing on our SOG’s, procedures, expected conduct, rules, radios, our geographical area, and general knowledge about the department. Component II is on fire, consisting of fire science and specific equipment related to Lisbon questions, Component III is EMS, also from the EMT curriculums and specific Lisbon criteria questions. The practical is divided into two parts as well, one focusing on EMS, the other on fire, but there is much cross-over as we all need to be proficient in tasks in both areas. The candidate should also have completed the four hour driving experiences on each of the vehicles. Much of that practice relates to the hands-on-test. This testing is designed to be a positive learning experience; there will be some remediation during the practical portion to promote a successful completion. The written will be graded to accommodate the different levels of certified personnel taking the exam. Example; The EMS test passing grade of 75% for the EMT basic/fire person and a required 85% passing grade for the EMS only candidate. The following list of subjects will be seen on the tests and can be used as a general guide for the candidate to prepare for. General Fire Department Component:
Fire Component:
EMS Component:
LISBON FIRE DEPARTMENT
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