Daily Operations

It is the policy of Brown University and University Health Services that all crews include an EMS Supervisor employed by Brown. Supervisors oversee all EMS operations and delegate to crews at their discretion. The emergency vehicle should not respond to calls in the absence of a Supervisor. EMTs may function autonomously as first responders during special details and patrols but may not respond to emergency calls independent of the supervised crew unless requested to do so by the On-duty Supervisor.

Radios and Communications

EMS is dispatched via portable radio by DPS dispatchers. Each crew member carries a radio during shift and is responsible for the assigned unit and must be alert to radio communications at all times.

Batteries should be changed at the start of each 12 hour shift and rotated batteries should be placed in the appropriate charger. Crews will be oriented to radio use and care at the start of each year.

It is inappropriate to refer to personnel by their proper name over the air. Therefore, radio designations are assigned for each crew or staff member:

Radio procedures are under revision.  A temporary policy will be shared with all EMTs at the semester meeting.

 


Patient Care and Transport

Patient care and transport decisions are dictated by the State of Rhode Island and Providence Plantations Prehospital Care Protocols and Standing Orders.

All licensed providers are expected to be thoroughly familiar with the governing protocols and any updates published by the RI Department of Health.

Personnel should also be familiar with the laws governing EMS and pre-hospital licensing in the State of Rhode Island.

Transports to Local Hospitals: Emergencies and After Hours

  • Students/others should routinely be transported to either Rhode Island Hospital (RIH) or The Miriam Hospital. RIH includes the Hasbro Children’s Hospital.
  • Athletic Department physicians are affiliated with RIH, so ill or injured athletes should be transported there whenever possible.
  • Patients may be transported to any Providence area hospitals by request or as necessitated by hospital diversions.
  • All major traumas should go to RIH which is a Level I Trauma Center.
  • OBGYN concerns should go to Women and Infants Hospital
  • Suspected Alcohol or drug intoxication must be properly documented on the Patient Safety Form, which is then attached to the State Run Form.

All calls terminating at an ER are documented on the State Run Form.

Transports to University Health Services: Non-Emergencies and Routine Care

  • Brown students may be transported to UHS for non-emergencies when a receiving physician is available and an appointment has been made. Appointments may be made ahead of time by students, requested by physicians (follow up) or booked by EMS on scene.

All calls terminating at University Health Services are documented on the University Health Services EMS Ambulance Transport Form.

Inter-facility Transports: Direct Admits

  • Brown students may be transported to a hospital or other medical facility for a scheduled admit when requested by the treating physician at UHS

All calls terminating at a hospital or other medical facility (non-ED) are documented on the University Health Services EMS Ambulance Transport Form.

Non-Transports

  • Patients who are competent enough to sign a refusal of care or transport may do so by signing the appropriate line on the RI State Run Form.
  • Signed refusals must be witnessed whenever possible.
  • Refusals that are signed Against Medical Advice (AMA) should be documented and communicated to DPS as such.
  • Suspected Alcohol or drug intoxication must be properly documented on the Patient Safety Form, which is then attached to the State Run Form.

All refusals are documented on the State Run Form.

Policy for Dealing with Combative Patients

When combative patients must be physically restrained as a last resort, EMS should obtain authorization from medical control if possible and enlist assistance from Brown Police. An officer should be requested to accompany EMS during patient transport. In most cases, patient care and documentation should be managed by the on duty Supervisor.

Policy with Providence Fire Department

Providence is the jurisdiction of the Providence Fire Department. Brown EMS, unless unavailable, responds to all calls involving persons on Brown affiliated academic or residential property or if the Brown emergency system is activated. (3-4111). If 911 has been activated and Providence Fire Department arrives on scene, Brown EMS must transfer care to Providence unless the Providence OIC (officer in charge) decides not to assume command.

Brown EMS does not respond to Motor Vehicle Incidents. That is the sole jurisdiction of PFD.

In the event that a call requires more manpower than the available crew can provide or the EMS vehicle is out of service, Brown EMS may request assistance from the Providence Fire Department. Fire Department personnel may transport with Brown EMS and/or assist on scene or assume care of the patient as needed.

Emergency Vehicle Operations

Drivers

Crew members must complete all driver training requirements and have a Driver Authorization Form on file at the Office of Insurance and Risk before driving the emergency vehicle for any purpose other than initial training.

A 10+ hour Emergency Vehicle Driver Training (EVDT) course is mandatory for all EMS personnel unless proof of similar certification is furnished.

Volunteers who do not have a driver’s license or have valid reasons for not becoming driver trained will not be eligible for paid shifts or the Primary EMT designation.

In the event of an accident, DPS must be notified and, if necessary, the proper steps must be taken to manage patient transport. The EMS Manager or Assistant Manager should be notified as soon as possible and an Accident Report must be completed and faxed to The Office of Insurance and Risk within 48 hours. Drivers who are involved in an accident must undergo a driver training refresher (extent based on circumstances of accident) before they can drive again. Drivers who have multiple accidents will be reviewed by the management staff and may lose the privilege of driving.

Unauthorized drivers are not covered by our insurance policy; unauthorized driving will result in disciplinary actions for supervisor and student.

Responding to Calls

Emergency responses are undertaken at the EMS Supervisor’s discretion based on dispatch information. The emergency vehicle should always be driven safely at posted or reasonable speeds as the situation dictates, and traffic laws are to be obeyed at all times with the exception of proceeding through a red light after coming to a complete stop.

It is the policy of Brown EMS that the emergency vehicle must come to a complete stop at all traffic stop signals before proceeding. Lights and sirens MUST be in use if emergency vehicle proceeds through a red light.

Although codes are used less widely now, dispatch may request a response with one of the following codes. Supervisors must use judgment when responding.

  • Code 1: High Priority. Use lights and sirens.
  • Code 2: Priority. Lights only, with sirens at intersections.
  • Code 3: Non-priority. No lights or sirens.

 

Note: In the State of RI only vehicles employing both lights and sirens are allowed the rights of emergency vehicles.

Clearing Calls

At the completion of a rescue call, all equipment is to be returned to its proper place and the emergency vehicle cleaned/disinfected as necessary. After a transport, all supplies and medications used for patient care are to be exchanged at the receiving hospital per policy of the State of RI. It is the responsibility of the EMS Supervisor to ensure that the emergency vehicle has been properly re-supplied, cleaned, and organized. Dispatch is to be notified by the EMS Supervisor or his/her designee when the emergency vehicle is back in service.

It is the policy of Brown EMS that the vehicle be locked at all times when parked without personnel nearby.

Notifications, Confidentiality, and Media Requests

During regular hours at Health Services, Nursing is to be notified as soon as possible by the on-duty Supervisor after a student transport. In the event of something serious or catastrophic after hours, the on call physician and EMS Manager or Assistant Manager should be notified. Patient information not specific to patient condition (demographics) may be shared with DPS. Information should not be given to parents of students 16 or older, deans, or other administrators and never to the media.

All requests for information following a call should be referred to the EMS Manager, Assistant Manager, or on duty Supervisor. Volunteers should never handle these requests. Requests from the press should be referred to the EMS Manager who will confer with the Medical Director and other appropriate authorities.