Memorandum of Understanding Between The Manatee County Department of Public Safety And The Southern Manatee Fire Rescue District, City of Bradenton Fire Department, West Manatee Fire & Rescue District, North River Fire District, Parrish Fire District, Duette Fire & Rescue District, Cedar Hammock Fire Control District, East Manatee Fire Rescue District, Trailer Estates Fire Control District and Myakka City Fire Control District EMS MOU 05/02/2018
I. Introduction Memorandum of Understanding This Memorandum of Understanding (MOU) is entered into between the Manatee County Department of Public Safety as the licensed emergency medical service (EMS) provider and the various Fire Agencies this day of, 2018 pursuant to requirements detailed in Section 401.435 Florida Statutes. The Florida Legislature has determined that the interest of public safety will be served by cooperation between Emergency Medical Responder agencies and EMS licensees serving the public in the same region. Therefore, the Florida Statutes were amended to strongly encourage Emergency Medical Responder agencies to enter into an MOU with applicable EMS licensees. Firefighters from the various Fire Agencies, as members of the Fire Agency, may render patient care before the arrival of EMS, and are thus defined by statute as First Responders (Emergency Medical Responders). II. Definitions 1. Automatic External Defibrillator (AED) means a device that detects treatable life-threatening cardiac arrhythmias (ventricular fibrillation and ventricular tachycardia) and delivers the appropriate electrical shock to the patient. 2. Fire Agency - is defined as one of the ten (10) Fire Departments/Districts operating in Manatee County. 3. Dispatch - means the Manatee County Emergency Communications Center (ECC). 4. First Responder For the purpose of this MOU means any individual regardless of certification who acts as a First Responder that has successfully completed and maintains certification as a Emergency Medical Responder, Emergency Medical Technician or a Paramedic approved by the United States Department of Transportation or the State of Florida to render initial care to an ill or injured person but who does not have the primary responsibility of treating and transporting ill or injured persons. 5. Firefighter - means a member of the Fire Agency who is certified by the State of Florida as a Minimum Standards Firefighter II and is Florida Certified as an Emergency Medical Technician or Paramedic. 6. Infection Control Kit - means a kit containing barrier protection items 1
required by The Occupational Safety and Health Administration (OSHA) 29 CFR Part 1910.1030, titled: Occupational Blood-borne Pathogens. 7. Landline - means a telephone, cellular or wired, capable of accessing the Manatee County 9-1-1 system. 8. OSHA 29 CFR Part 1910.1030, titled: Occupational Blood-borne Pathogens - a standard promulgated under section 6(b) of the OSHA act of 1970, 29 U.S.C. 655 to eliminate or minimize occupational exposure to Hepatitis B Virus (HBV), Human Immunodeficiency Virus (HIV) and other bloodborne pathogens. This standard requires record keeping, development of an Infection Control Plan, understanding universal precautions, housekeeping guide, development of engineering and work practice controls, personal protective equipment, hepatitis B vaccination, employee education and training, post exposure evaluation and follow-up treatment. 9. Patient Any individual who calls 9-1-1 for themselves, any individual with an injury or illness, any individual with a medical or traumatic complaint, any individual with an altered mental status, any individual who experienced any loss of consciousness, any individual who requires medical personnel to come in direct contact to assist (lift assist, transfer) and any individual whom law enforcement requests Fire/EMS to evaluate. 10. Patient Care Report (PCR) means for every patient contact, all applicable information obtained or related to treatment prior to the arrival of the transport unit s crew assuming responsibility of the patient should be documented on the Fire Agencies Patient Care Report. 11. Primary Assessment - means the initial patient evaluation taught in the Emergency Medical Responder or Emergency Medical Technician Course, which determines the patient's level of consciousness, presence of spontaneous respirations, presence of pulse, and general condition of the patient. 12. Protocols a set of medical treatments and procedures as developed by the Manatee County Emergency Medical Services Medical Director, also known as the Manatee County EMS System Community Protocols Standards and Practice for the assessment and treatments of patients in Manatee County. 13. Radio - means a transceiver, VHF, UHF, 700 MHz (P25) or 800-MHz, capable of transmitting to and receiving information from Dispatch. 2
III. First Responder Training Requirements 1. All First Responders shall hold a valid Emergency Medical Responder Course certification or be currently licensed as an Emergency Medical Technician or Paramedic in the State of Florida. 2. All First Responders will be trained in the OSHA Blood-borne Pathogen Ruling and in the latest edition of the Protocols as approved by the Medical Director. Each participating First Responder agency must have an Exposure Control Plan. 3. All First Responders who will be using an AED shall maintain the American Heart Association (AHA) BLS for Healthcare Providers Course or equivalent. The District shall complete a refresher course and examination at two (2) year intervals at their own expense. Certification records shall be maintained in personnel files by the Fire Agency and shall be available for inspection. 4. All First Responders shall, pursuant to rules, regulations, and policies that from time to time may be developed by the Fire Agency, attend and successfully complete in-service training programs in conjunction with Manatee County EMS. 5. All First Responders of the Fire Agencies shall maintain required certification in accordance to Florida Statute Chapter 401 and 64J of the Florida Administrative Code. 6. The Fire Agencies shall maintain training records on all of its personnel for a period of at least five (5) years. IV. Dispatch Procedure 1. The Emergency Communications Center (ECC), a division of the Manatee County Department of Public Safety, is responsible for the receiving and handling of all 9-1-1 calls, processing the information for dispatch to the appropriate agencies, dispatching appropriate EMS and/or fire agencies and handling all other agency requests. ECC processes all 911 calls utilizing the Medical, Fire & Police Priority Dispatch System (MPDS, FPDS & PPDS) protocols written and supported by the International Academies of Emergency Dispatch (IAED). 2. Emergency Communications Center (ECC) provides dispatch services for Fire and EMS utilizing the county-owned 800 MHz EDACS radio system. All fire and EMS agencies are dispatched on the same frequency and then assigned a tactical frequency to handle their incident. Fire and EMS units are also informed of call assignment by a variety of other notification 3
methods supported by CAD: automatic text pages, rip n run printers, invehicle mobile data terminals, and Manatee County Radio Shop approved station alert system. 3. Emergency Communications Center (ECC) utilizes a CAD system, supported by GIS, that enhances the processing and dispatching of Fire and EMS units to calls for service. 4. Fire personnel/units are dispatched to medical emergencies, along with EMS, based upon the specific nature of the event, as determined by IAED protocols. Each MPDS subtype is assigned a standard response (always respond fire, respond fire if EMS has an extended response or no fire response). Response assignment decisions are made by the Dispatch Steering Committee responsible for oversight of MPDS & FPDS administration for ECC. EMS units are dispatched to calls based upon the location of the closest available unit, regardless of local city or fire jurisdictions. 5. Any First Responder arriving first at a scene where a medical emergency is suspected or confirmed will relay patient status information directly to the responding EMS unit via radio, or to ECC via landline if radio communications are not possible. If an EMS unit has not yet been dispatched (due to the original nature of the call), the responder on scene may request immediate dispatch of an EMS unit. V. Roles and Responsibilities of First Responders at Medical Emergencies before the arrival of EMS 1. When EMS has not arrived on scene yet, the First Responder shall be responsible for: a) Scene safety and initial crowd control at the scene of a medical emergency; b) Initial assessment, treatment and/or resuscitation of patient(s) on the scene; and c) Provide the extrication of patients from entrapment or from a dangerous environment. 2. Upon arrival at an EMS Incident, take appropriate barrier precautions prescribed by OSHA in the Blood-borne Pathogens Standard whenever exposure to blood or body fluids is likely. 3. The First Responder shall perform a primary assessment. As defined by protocol, stabilization of the cervical spine shall be undertaken when the mechanism of injury reasonably suggests the possibility of cervical injury. When in doubt, stabilize the cervical spine. Initiate BLS in accordance 4
with the most current standards promulgated by the American Heart Association when indicated and other BLS treatments as outlined in the latest edition of the Manatee County EMS System Community Protocols as approved by the Medical Director. 4. In accordance with the Manatee County Protocols and with the most current American Heart Association Guidelines, apply and activate an AED for all patients suffering from sudden cardiac arrest. 5. Assist, support, and cooperate with Manatee County EMS personnel. Upon arrival of the Paramedic from Manatee County EMS, the First Responder of the Fire Agency will transfer care of the patient to the Manatee County Charge Paramedic. At that time the Manatee County Charge Paramedic will take responsibility for the patient s continued care, treatment and the transportation of the patient. Fire Agency personnel will assist as requested under the direct supervision of Manatee County EMS personnel. VI. Documentation of Patient Care 1. The First Responder if on scene first, shall make an attempt to provide available patient information, assessment and treatment information on the Fire Agency Patient Care Report (PCR) for each patient attended. Such patient care reports shall be maintained by the fire district and made available to Manatee County EMS upon request. 2. The Fire Agencies shall have policies and procedures to assure that each report is legible, complete, and is signed by the First Responder providing patient care for all EMS Patients. Documentation of Patient Care will be in accordance to the Manatee County EMS System Community Policy titled Documentation of a Patient Care Report as approved by the Medical Director. 3. The Fire Agencies shall supply Manatee County EMS Medic units with the names of the Fire Agency personnel that provided the Emergency Medical Care. 4. The Fire Agencies shall maintain all patient care reports in accordance to the records retention laws of Florida. VII. Equipment Requirements 1. The Fire Agencies shall establish policies and procedures to regularly check all medical equipment to assure its readiness for emergency use. All equipment must be tested and maintained in accordance with the manufacturer s policies and guidelines and is the responsibility of the Fire 5
Agency. 2. The minimum required equipment list for a Fire Agency will be as follows: a. Disposable bag-valve-mask device, adult and child b. Oropharyngeal and nasopharyngeal airways, assorted sizes c. I-gel Supra-glottic Airway assorted sizes d. Battery operated suction device with rigid catheters e. Pulse oximeter f. Glucometer g. Oxygen cylinder (size D), DOT approved, with valve h. Oxygen tubing, oxygen masks, oxygen cannulas (adult and child) i. Infection control kits & O.B. Kits j. Trauma box (gauze, bandages, trauma dressings) k. Blood pressure kits (adult, child) l. Cervical collars (adult, child) as approved by the Medical Director m. Spine board and straps n. Disposable splints o. START Triage Ribbons p. An AED with Adult and Child AED Pads maintained and tested in accordance with manufacturer s policies and guidelines. q. Tourniquet (C.A.T. or M.A.T.) VIII. Responsibility for Implementation 1. The responsibility for implementation of this MOU rests with the Chiefs of the Fire Agencies and the Director of Public Safety. 2. The Fire Agencies will initiate this First Responder MOU upon signature of this MOU and may be terminated upon thirty (30) days written notice of either party to the other. 6
COUNTY ATTEST: ANGELINA COLONNESO CLERK OF THE CIRCUIT COURT AND COMPTROLLER By: Deputy Clerk MANATEE COUNTY, a political subdivision of the State of Florida By: it s Board of County Commissioners By: Chairperson Date: FIRE DISTRICTS NORTH RIVER FIRE DISTRICT, Attest: SOUTHERN MANATEE FIRE RESCUE DISTRICT, Attest: 7
WEST MANATEE FIRE & RESCUE DISTRICT, Attest: EAST MANATEE FIRE RESCUE DISTRICT, Attest: PARRISH FIRE DISTRICT, Attest: CEDAR HAMMOCK FIRE CONTROL DISTRICT, Attest: DUETTE FIRE & RESCUE DISTRICT, Attest: 8
TRAILER ESTATES FIRE CONTROL DISTRICT, Attest: MYAKKA CITY FIRE CONTROL DISTRICT, a dependent fire district located in Manatee County, Florida Attest: By: 9