Lisbon Fire Department Standard Operating Guidelines and Policies

Blood alcohol testing is authorized only in the following circumstances:

The Town has established its anti-drug program through its “Drug-Free Workplace Policy” which strictly prohibits the unlawful manufacture, distribution, dispensing, possession, or unauthorized use of a controlled substance in the workplace. Furthermore, any abnormal manner that may infer an employee is under the influence of a controlled substance is addressed in the “Probable Cause Testing” section described previously.

For purposes of this policy, the Town will utilize, at a minimum, a five (5) panel drug screen consisting of the following drugs:
1. Tetrahydrocannabinol (Marijuana drug);

2. Cocaine;

3. Anphetamines;

4. Opiates (including Heroine);

5. Phencyclidine (PCP)
Drug testing is conducted by analyzing an employee’s urine specimen (through a certified testing lab). This procedure will include a split specimen. Each urine specimen is subdivided into two (2) bottles labeled “primary” and a “split” specimen. Both bottles are sent to a lab. Only the “primary” is opened and used for the urinalysis. The “split” specimen bottle remains sealed and is stored at the lab. If the analysis of the primary specimen confirms the presence of illegal controlled substances, the employee has seventy-two (72) hours to request the split specimen be sent to another certified laboratory for analysis.

In some cases, the employee may be unable to provide a urine specimen. After a reasonable waiting period, not to exceed one (1) hour, the supervisor may terminate the testing procedure. The Town will proceed with laboratory testing based on blood testing alone.

1. When the employee enters the collection site, the employee will be required to provide positive identification (i.e., photo I.D. or employee identification).

As with an alcohol misuse violation, the Town is required to act upon a positive drug test result in the following manner:

Any employee having questions with respect to the scope of this policy and it’s contents may contact the Department Liaison.

________________________________________________________________________

I acknowledge receipt of the Town of Lisbon Drug and Alcohol Testing Policy on the date indicated below.

SIGNED: _______________________________________

Lisbon Fire Department

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  Class A uniform; dark blue dress jacket, blue/white long sleeve uniform shirt, black tie, T-shirt, dark blue dress pants, black belt, plain black socks (white sox are acceptable if boots are worn) and black leather shoes/boots. T-shirt logos, designs or text shall not be visible through the uniform shirt. Shall be worn at formal functions as authorized by the Fire Chief.
  
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  Class B uniform; blue/white uniform shirt - long sleeve (with black tie) or short sleeve (no tie), T-shirt, work pants (dark blue Dickies/EMS pants), dark blue or black belt, plain black, white or dark blue socks and black leather boots/work shoes. Officers wear black pants & socks. T-shirt logos, designs or text shall not be visible through the uniform shirt. Shall be worn at monthly business meetings, public events and as authorized by the Fire Chief.
  
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  Class C (work) uniform; dark blue shirt/T-shirt with Lisbon Fire Department name and/or patch, work pants ( dark blue Dickies/EMS pants) or dark blue shorts, dark blue or black belt, plain black, white or dark blue socks and black leather boots/work shoes. Shall be worn when on duty and more formal uniforms are not required.
  
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  Turnout gear; helmet, Nomex hood, safety glasses, structural firefighting coat, structural firefighting gloves, bunkers, suspenders, socks and structural firefighting boots. Worn as per SOG 2-1 for all fire calls, motor vehicle crashes, other calls for service, approved training and as directed by the Fire Chief.
  

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  Uniforms shall be clean and pressed at all times.
  
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  Uniform and work shirts shall either be tucked in or completely cover the midriff area and back at all times.
  
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  Blue/white uniform shirt:
  
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    LFD patch on left shoulder
    
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    Wisconsin EMT or FF patch (FF patch only for non-EMTs) on right shoulder
    
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    Lapel pins with edge on collar stitching and bottom of insignia/bugle toward point of collar
    
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    Badge left chest of shirt
    
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    Name plate just above right pocket flap
    
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    Other acceptable pins:
    
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      One Length of Service Award - left flap, inner
      
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      One Wisconsin EMT, FF or Nurse pin - right flap, inner
      
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      Use of Uniforms and Garments Bearing the LFD Name and/or Patch
      

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  Members shall wear their Class C (work) uniform or at a minimum an outer garment bearing the name and/or patch of the Lisbon Fire Department when responding to calls and not wearing their turnout gear. Members should keep a shirt and/or jacket in their locker and/or personal vehicle to put over other civilian clothing when unexpectedly responding to calls.
  
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  Turnout gear shall be worn for the authorized activities above only and shall ordinarily be kept at the member's assigned station. Members authorized to direct respond to calls and other members authorized to carry their turnout gear may do so but shall be responsible for its maintenance and security.
  
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  Members wearing apparel that displays the name and/or patch of the Lisbon Fire Department shall conduct themselves in accordance with the code of ethics at all times.
  
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  Apparel that displays the name and/or patch of the Lisbon Fire Department shall not be worn in places where alcoholic beverages are sold/served without the approval of the Fire Chief.
  
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  Alcoholic beverages shall not be consumed while wearing department uniforms without the permission of the Fire Chief.
  
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  Members working full and/or part time shall be attired in their Class C (work) uniform unless activities require other attire. In such cases they shall have their work uniform or turnout gear readily available to don prior to responding to a call.
  
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  Members purchasing their own garments with the name and/or patch of the Lisbon Fire Department are encouraged to buy garments that are dark blue and can be worn in conjunction with the uniform and this dress code.
  

Personal Appearance

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  All members are to maintain a clean and professional appearance. Hair will be clean, well-groomed and safe. Any hairstyle considered unsafe shall be trimmed accordingly or bound to eliminate the hazard. Males shall be clean shaven other than approved facial hair which does not interfere with the performance of the face piece as per SOG 2-1 and personal hygiene shall be such that perfume, breath, body odor and/or other smells are not offensive.
  
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  Members shall not wear jewelry, other than a watch with the following exceptions. Simple stud earrings, necklaces that are completely concealed beneath a garment at all times and rings that do not interfere with the wear and proper performance of firefighting and BSI gloves are acceptable.
  
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  Tattoos shall be covered at all times while wearing apparel that displays the name and/or patch of the Lisbon Fire Department as well as when on duty at department facilities and in view of the public. Small, innocuous tattoos may be left uncovered with the permission of the Fire Chief.
  
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  Appropriate under garments shall be worn at all times and these garments shall not be visible. Firefighters should remember that 100% cotton undergarments afford the best safety during firefighting operations.
  
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  Members shall ensure that garments fit and appear modest in any and all physical positions such that all private body parts are completely covered, including female cleavage and that they are not so tight as to be unnecessarily revealing. Ease of motion while performing firefighting and EMS duties without fear of unnecessary exposure is essential to the successful completion of our duties.
  

Violations of the dress code may result in discipline up to and including dismissal.

1-10-05
Memo: Policy Change
To: Lisbon Fire Department Personnel
From: Chief Douglas Brahm
The priority response system implemented, with WCC dispatch, has been in use since October of 2004. In evaluating the responses, for this period, it is determined some changes are required.

Changes now in affect (modified 1-10-05)

1. Omega All vehicles respond non-emergent

2. Alpha 1st vehicle emergent, following vehicles non-emergent

3. Bravo 1^st two vehicles emergent, following vehicles non-emergent

4. Charlie All vehicles respond emergent

5. Delta All vehicles respond emergent

6. Echo All vehicles respond emergent
Douglas J. Brahm

Lisbon Fire Chief

NUMBER	GUIDELINE/STANDARD	PAGE
	SECTION I – DRUG PROFILES
001	Adenosine	I-6
002	Albuterol	I-7
003	Amiodarone	I-8
004	Aspirin	I-9
005	Atropine	I-10
006	Dextrose	I-11
007	Diazepam (Valium)	I-12
008	Diphenhydramine (Benadryl)	I-13
009	Epinephrine	I-14
010	Furosemide (Lasix)	I-15
011	Glucagon	I-16
012	Lidocaine	I-17
013	Morphine Sulphate	I-18
014	Naloxone(Narcan)	I-19
015	Nitroglycerin	I-20
016	Procainamide	I-21
017	Sodium Bicarbonate	I-22
018	Ammonia Inhalants	I-23
019	Atrovent (Ipratropium)	I-24
020	Vasopressin	I-25
021	Calcium Chloride	I-26
022	Thiamine	I-27
023	Midazolam (Versed)	I-28
024	Dopamine	I-29
025	Flumazenil (Romazicon)	I-30
026	Magnesium Sulfate	I-31
027	Methylprednisolone (Solu-Medrol)	I-32
028	Metoclopramide (Reglan)	I-33
029	Activated Charcoal without Sorbitol	I-34
030	Butorphanol Tartrate (Stadol)	I-35
031	Diltiazem (Cardizem)	I-36
032	Etomidate (Amidate)	I-37
033	Fentanyl Citrate	I-38
034	Hydromorphone (Dilaudid)	I-39
035	Ketorolac (Toradol)	I-40
036	Lorazepam (Ativan)	I-41
037	Meperidine (Demerol)	I-42
038	Nalbuphine (Nubain)	I-43
039	Nitrous Oxide	I-44
040	Promethazine (Phenergan)	I-45
041	Succinylcholine	I-46
042	Vecuronium	I-47
043	Mark-1 Auto-Injectors	I-48
044	Ondansetron Hydrochloride (Zofran)	I-49
045	Nitroglycerin Drip	I-50
046	Levalbuterol Hydrochloride (Xopenex)	I-52
047	Ziprasidone Hydrochloride (Geodon)	I-53
048	Propofol (Diprivan)	I-54
049	Metoprolol (Lopressor)	I-55
050	Ketamine (Ketalar, Ketanest, Ketaset)	I-56
051	Enalapril (Vasotec)	I-57
052	Cyanokit	I-58
	SECTION II – GENERAL GUIDELINES FOR CARE
101	Assessment Parameters	II-1
102	Documentation	II-4
103	History and Physical Examination	II-8
104	Medication Administration	II-10
105	Oxygen Administration	II-15
106	Routine Medical Care	II-16
107	Universal Precautions	II-17
108	Physical and Chemical Restraint	II-19
109	Refusal of Care	II-21
110	Medical Control Interaction	II-24
111	Transfer of Care	II-25
112	Analgesia	II-27
113	Sedation	II-29
114	Hospital Destination / Transport / Bypass	II-30
115	Hospital Diversion	II-31
116	Tactical Environment	II-33
117	Red Light and Siren Safe Transport Recommendations	II-35
	SECTION III – AIRWAY AND RESPIRATORY PROBLEMS
201	Airway Obstruction	III-1
202	Bronchial Asthma	III-3
203	Chronic Obstructive Pulmonary Disease	III-4
204	Inhalation Injury	III-5
205	Respiratory Arrest	III-6
206	Respiratory Distress	III-7
	SECTION IV – CARDIAC PROBLEMS
301	Cardiac Dysrhythmias	IV-1
302	Cardiopulmonary Arrest	IV-2
302a	Cardiopulmonary Arrest CCR	IV-4
303	Chest Pain/Discomfort	IV-5
304	Congestive Heart Failure	IV-7
305	Do Not Resuscitate (DNR), Obvious Death	IV-8
	SECTION V – MEDICAL PROBLEMS
401	Abdominal Pain, Problems	V-1
402	Allergic Reactions	V-2
403	Altered Level of Consciousness	V-3
404	Behavioral/Psychiatric Problems	V-4
405	Bites and Stings	V-5
406	Diabetes Mellitus	V-7
407	Headache	V-8
408	Hypertension	V-9
409	Hyperthermia, Fever	V-10
410	Hypothermia	V-11
411	Intoxication, Substance Abuse	V-12
412	Poisoning, Overdose, Toxins	V-13
413	Seizure	V-14
414	Stroke, Cerebral Vascular Accident, Transient Ischemic Attack	V-15
415	Syncope	V-16
416	Cyanide Poisoning	V-17
	SECTION VI – TRAUMA PROBLEMS
501	Abuse, Assault	VI-1
502	Burns	VI-2
503	Drowning	VI-3
504	Electrocution	VI-4
505	Hypotension/Shock	VI-5
506	Blunt, Penetrating, Lacerating Trauma	VI-6
507	Major/Multiple Trauma	VI-7
508	Crush Syndrome	VI-13
	SECTION VII – OBSTETRICAL, GYNECOLOGICAL PROBLEMS
601	Obstetrical, Gynecological Complaints	VII – 1
	GUIDELINES FOR PRACTICAL SKILLS
	SECTION VIII – GENERAL SKILLS
1001	Physical Assessment	VIII-1
1002	Blood Pressure Auscultation / Orthostatic Blood Pressure	VIII-4
	SECTION IX - AIRWAY INTERVENTIONS
2001	Oxygen Equipment Preparation	IX-1
2002	Suctioning	IX-3
2003	Pocket Mask Ventilation	IX-6
2004	Bag-Valve-Mask Ventilation	IX-8
2005	Magill Forceps	IX-10
2006	Oral Airway	IX-12
2007	Nasopharyngeal Airway	IX-13
2008	Combi-Tube and King LTS-D	IX-14
2009	Endotracheal Intubation	IX-19
2010	Nasotracheal Intubation	IX-21
2011	Positive End Expiratory Pressure (PEEP)	IX-23
2012	Extubation	IX-25
2013	Nasogastric Tube Placement	IX-27
2014	Tracheostomy Care	IX-29
2015	Thoracentesis	IX-32
2016	Cricothyroidotomy	IX-34
2017	Continuous Positive Airway Pressure (CPAP)	IX-36
2018	Rapid Sequence Intubation	IX-38
2019	Impedance Threshold Device (ResQPOD)	IX-40
2020	Laryngeal Mask Airway (LMA)	IX-42
	SECTION X – CIRCULATORY INTERVENTIONS
3001	Blood Samples	X-1
3002	Peripheral IV Lines	X-3
3003	External Jugular IV Lines	X-6
3004	Intraosseous Infusion	X-8
2005	Pericardiocentesis	X-10
3006	Defibrillation	X-12
3007	Synchronized Cardioversion	X-15
3008	12 Lead Electrocardiogram	X-17
3009	ECG Monitoring	X-19
3010	Transcutaneous Pacing	X-21
3011	Accessing Existing Central Lines	X-23
3012	EZ-IO Insertion	X-25
3013	AED Guidelines	X-27
3014	Auto-Pulse CPR Device	X-30
3015	Inducing Hypothermia after ROSC	X-32
	SECTION XI – MEDICATION ADMINISTRATION SKILLS
4001	Blood Glucose Measurement	XI-1
4002	Preparation of Medication for Administration	XI-2
4003	IV Bolus Administration	XI-5
4004	IV Drip Administration	XI-7
4005	Nebulized Medication	XI-9
4006	Endotracheal Administration	XI-12
4007	Intramuscular Administration	XI-14
4008	Subcutaneous Administration	XI-16
4009	Rectal Administration	XI-18
4010	Oral/Sublingual Administration	XI-20
4011	Mark-1 Auto-Injector	XI-22
4012	Intranasal Administration	XI-24
	SECTION XII – TRAUMA SKILLS
5001	Hemorrhage Control, Bandaging	XII-1
5002	Eye Injuries	XII-3
5003	Seated-Patient Extrication Device	XII-5
5004	Pneumatic Anti-Shock Garment	XII-7
5005	Spinal Stabilization	XII-9
5006	Board Splint	XII-13
5007	Rigid Board Splint, Joint Injuries	XII-15
5008	Pro Splints	XII-17
5009	Sling and Swathe	XII-19
5010	Traction Splint	XII-21
5011	Thoracic Injuries	XII-23
5012	Helmet Removal	XII-25
5013	Tourniquet Application	XII-27
5014	Hemostatic Agents	XII-29
	SECTION XIII – OBSTETRICAL SKILLS
6001	Obstetrical Delivery	XIII-1
6002	Newborn Assessment and Intervention	XIII-4
	SECTION XIV – STATE STANDARDS	XIV-1
	SECTION XV – EMSC PEDIATRIC PROTOCOLS	XV-1
	BLS ALS
	Index