The document outlines the equipment fundamentals and competencies required for a crew chief candidate at McGregor Memorial EMS. It describes how to properly use various equipment including stretchers, stair chairs, car seats, pediatric immobilizers, traction splints, vacuum splints, cardiac monitors, tablet computers, radios, and suction devices. It also outlines how competency will be demonstrated through a presentation, hands-on practice, and self-study guide.

1. Equipment Fundamentals for the Crew Chief McGregor Memorial EMS

2. Objectives Upon completion of this module the crew chief candidate will demonstrate competency with : Use of stretchers (both Stryker and Ferno) Use of stair chairs (both Stryker and Ferno) Use of car seats Use of the pediatric immobilizer Use of traction splints (both Hare and Sager) Use of vacuum Splints Use of the LifePak 12 (including obtaining and transmitting a 12 lead, pulse oximetry, capnography, NIBP, and interfacing with the TEMSIS Field Bridge Use of the tablet computers in each ambulance including the TEMSIS Field Bridge Radio communications including the use of mobile radios and portable radios Use of suction (both onboard and portable)

3. How will we do this? Brief PowerPoint presentation outlining expectations Hands on demonstration and practice Self study guide

4. Stretchers We currently have two types in service Ferno-Washington Model 35P Operates manually Stryker Power-Pro™ XT Model 6500 Raising and lowering of undercarriage is powered All other functions manual

5. You will be expected to demonstrate: Proper loading and unloading technique Ability to collapse and extend the head section Proper operation of side rails Proper procedure for height adjustment Ability to raise and lower the foot Proper cleaning and decontamination Proper replacement of straps Maneuvering in tight quarters Procedure for use of the Manual override (Stryker only) Procedure of battery change (Stryker only)

6. Car Seats NH RSA 265:107 requires all children to be properly restrained when riding in a vehicle. This also applies to sick children in ambulances. NH Patient Care Protocol 6.9 addresses Pediatric Restraint for Transportation “ The method of restraint will be determined by various circumstances including the child’s medical condition and weight.”

7. Car Seats All patients are required to be secured to the stretcher, even children. Car seats or specialty harnesses should be used for all patients who are not tall enough to have the stretcher straps secure them without falling across their head or neck. It is NEVER OK to have anyone just hold onto a child while the vehicle is in motion.

8. Using a car seat Children under 20 pounds always need to be in a rear facing car seat. Other children need to be restrained in car seats, 5 point harnesses, or using stretcher straps depending on their weight and medical condition. Generally it is best to use the patient’s own car seat if available and appropriate.

9. Securing the car seat Must be installed and secured per manufacturers instructions If the patient’s car seat cannot be secured properly use the McGregor car seat. (Where is it stored?) Practice is a much better teacher than words. We’ll practice this.

10. Using the patient’s own car seat Generally preferable Patient is familiar, comfortable The patient has a car seat to go home in The car seat must: Not have any cracks or deformities The vehicle the car seat was in must be capable of being driven from the scene The vehicle door nearest the car seat must be undamaged The air bags must not have been deployed Other things to think about

11. What if the child is not a patient? Transport in another vehicle is best No completely appropriate place for them to ride. Possibilities if no other options: Forward facing captains chair Front seat (front facing car seats only) Not possibilities: Held by the person on the stretcher In a car seat on the bench seat or the CPR seat

12. Stair Chair McGregor has 2 types Stryker StairPro 6252 in both front line ambulances Ferno Model 40 in the reserve ambulance Stair chairs can be very useful for moving patients who can sit upright down stairs or from tight situations. Not so useful if the patient can’t sit upright on their own.

13. You will be expected to Demonstrate proper lifting mechanics for carrying patients downstairs Demonstrate the proper method of securing a patient in the stair chair Demonstrate proper technique for rolling a patient Demonstrate proper technique for “gliding” downstairs (Stryker only) Proper procedure for strap replacement Proper decontamination procedures

14. Pedi-Pac® Serves as both a spinal immobilization device and restraint device Patients must be between 20 and 90 pounds and 28” to 54”. Practice

15. You will be expected to: Demonstrate proper usage technique Demonstrate proper decontamination technique

16. Traction Splints Each ambulance is equipped with two types of traction splints Hare Splint Sager Splint Both accomplish the same thing but use different technique Practice

17. You will be expected to: Demonstrate an understanding of differences between the two splints Demonstrate an understanding of when each splint would be appropriate Demonstrate proper use of each splint for unilateral use Demonstrate proper use of the Sager Splint for bilateral use Demonstrate proper decontamination procedure.

18. Vacuum Splints Vacuum splints are essentially bags of glass beads that become rigid when air is evacuated from the inside. Excellent at splinting extremities that are not completely straight. Frequently more comfortable for the patient.

19. You will be expected to: Demonstrate proper size selection Demonstrate proper application technique Demonstrate proper decontamination procedures

20. Cardiac Monitors McGregor currently utilizes four Physio-Control LifePak 12 monitors. Able to be utilized as manual defib for or AED Can obtain and transmit 12 lead ECGs Pulse Oximetry, Capnography, NIBP

21. You will be expected to: Demonstrate proper procedure to apply monitoring leads Demonstrated proper procedure to obtain a 12 lead ECG Demonstrate proper procedure to transmit a 12 lead ECG to the ED Demonstrate changing the printer paper Demonstrate changing batteries Demonstrate transmitting ECG, vital sign data and event markers to TEMSIS Field Bridge Demonstrate proper procedure for switching to AED mode and back to manual mode Demonstrate proper use of various types of pulse ox probes Demonstrate proper use of NIBP Demonstrate proper BP cuff selection Demonstrate setup for use of capnography with intubated and non-intubated patients

22. Tablet Computers Each ambulance and the paramedic intercept unit are equipped with tablet computers Each computer is equipped with TEMSIS Field Bridge software for patient documentation, mapping software It is expected that Field Bridge use will decrease the amount of time needed to complete the PCR after the call and allow for electronic note taking at the bedside.

23. Tablet Computers (cont.) Docking stations in ambulances and intercept have keyboards with integrated track pads Coming soon, HazMat references, additional mapping software, medical references, and more Each tablet is equipped with 802.11g wireless networking for data transfer Additional capabilities will be added over the next several months

24. You will be expected to: Properly log into the tablet Properly log into the Field Bridge Properly complete the shift setup Properly create a new run using the included templates Demonstrate proper procedure for signature capture Properly post calls to TEMSIS

25. Communications Each ambulance is equipped with a dual head VHF radio Each ambulance also has two portable radios that transmit directly to Fire Alarm. Due to longstanding and consistent operation problems, vehicle repeaters have been disabled.

26. You will be expected to: Mobile Properly change banks and channels Properly change channels to contact Durham Fire, mutual aid dispatch centers, and hospitals Properly switch control of the radio from front to rear and back. Properly use the scan, home, and programmed “speed dial” buttons Portable Demonstrates ability to change portable frequencies Demonstrates the ability to change portable batteries

27. Suction Suction units operated by McGregor are two types. Hard mounted in the ambulance or battery powered portable devices Needs to be brought in on any call where an airway problem might occur Hard catheter used for most applications Soft catheter used for suctioning through airway adjuncts

28. You will be expected to: Demonstrate the ability to activate the onboard and portable suction units Demonstrate the ability to change suction canisters both onboard and portable Demonstrates the ability to change batteries or recharge the portable suction unit Demonstrates the ability to decontaminate the onboard and portable suction unit after use.