EMS operations division

Policy

• Establishes uniform guidelines for the EMS Operations Division.

Definitions

• The EMS Operations Division is the division within the Philadelphia Fire Department responsible for emergency medical care and transportation for residents and visitors of Philadelphia.
• The EMS Branch Director is responsible for implementing the Incident Action Plan, including directing and executing branch planning and resource assignment.
• The EMS Branch Director reports to the Operations Section Chief and supervises the Medical Group and Patient Transportation Group Supervisors; the highest-ranking EMS Officer on the scene assumes this role.

Responsibility

EMS Operations Division Staff

• All members provide leadership and medical oversight, contribute to excellent patient care, professional conduct, departmental goals, and working groups.

EMS Medical Branch Director

• Responsible for implementing the Incident Action Plan within the Branch.
• Is the final decision-maker for medical issues as the highest medical authority on scene.
• Ensures adequate span of control over EMS activities.
• Ensures Forward First Aid (FFA), REST, Rehabilitation, and Refuge (RRR) stations are on scene.
• Establishes and manages a Temporary Shelter Station (TSS) with the Office of Emergency Management (OEM) for displaced persons if needed.
• Ensures an ALS ambulance is assigned to the RIT team.
• Monitors communications, requests a separate EMS operations Tac channel if needed, and completes NFIRS documentation for assignment.

EMS Deputy Chief (ES-1)

• The Fire Paramedic Deputy Chief is overall responsible for day to day activities of EMS operations.

Operational Responses and Duties

• Responds when a Division Chief is dispatched.
• Responds on all declared Level 3 or higher mass casualty incidents (MCI).
• Reports to the Incident Command Post.
• Performs duties as required by the Incident Commander.

Administrative

• Develops and implements Department-wide EMS goals across platoons and divisions.
• Serves as EMS Operations liaison for internal PFD units, (Philadelphia Regional Office, EMS Administration, Planning, Logistics, Finance/Administration).
• Approves and hires overtime for EMS Officers.
• Reviews EMS Staffing Office for accuracy, accountability, transparence and maintains minimum staffing levels of EMS ambulances and EMS Operations command offices.
• Approves/disapproves emergency holiday requests and out-of-season vacation requests for EMS personnel.
• Communicates EMS staffing needs to Fire Suppression Division Chiefs, when applicable.
• Produces and coordinates EMS field level field training in consultation with EMS Training.
• Reviews/approves the development of performance improvement plans for all EMS members/units under command/platoon.
• Collects and distributes payroll from the Fire Administration Building.
• Represents the Philadelphia Fire Department at external stakeholder meetings.
• Builds relationships with City partners (PDPH, DBHIDS, PPD, OEM, etc.).
• Performs duties as assigned by the Deputy Commissioner of EMS/Fire Operations, the Assistant Deputy Commissioner of EMS, and/or the Assistant Chiefs.

EMS Operations Chief (ES-3)

• Responsible for the day-to-day operation of all EMS units under command.

Operational Responses and Duties

• Responds on all Box assignments with “ALL HANDS” in service.
• Responds when six or more ambulances are on a single response.
• Responds on all incidents requiring more than one EMS Operations Officer.
• Responds to the Philadelphia International and Northeast Airports upon an Alert 2 response.
• Responds to the Police Command Post for any Civil Disturbance or Riot response.
• Responds on any Rapid Assessment Medical Support Team (RAMS) dispatch.
• Responds on any HazMat Incident where the HazMat Team dons protective equipment.
• Responds on report of “Building Collapse” with report of entrapment or evacuations.
• Responds on all MIRA Incidents.
• Responds on Founded Device dispatch with a report of evacuations.
• Responds on confirmed High Angle, Confined Space, or Industrial Accidents.
• Receives notification from FCC between 2000-0800 HRS when below 10 ambulances and facilitates ambulance availability.
• Performs any other duties as required by the Incident Commander.

Administrative

• Coordinates administrative/training tasks amongst EMS Operations Officers.
• Reviews, approves, and forwards overtime paperwork for ambulances & EMS Operations Officers.
• Receives, processes, and forwards information received from company officers, including Jury Duty notices, Leave of Absence requests, Requests for Outside Employment, Trial Board Charge Sheets, Acting Out or Rank report, Complaint Reports, Medic Unit Roll Calls, etc.
• Monitors EMS system ambulance availability in coordination with the FCC supervisor and ES-7, also coordinates all scheduled ambulance out of service time.
• Coordinates, reviews, and tracks monthly Accident and Injury Prevention Plans (AIPP).
• Reviews and forwards for approval the development of performance improvement plans from EMS Operations Officers.
• Conducts audits of the narcotics held by the EMS Operations Officers and Apparatus & Equipment.
• Monitors Electronic Patient Care Report completion and provides direction and counseling to ensure member compliance.

EMS Operations Officers (ES-8, 9, 10, 11, and 12)

• The primary focus is on-scene medical supervision; responds with units in their area and notifies FCC when responding.
• Ensures members provide appropriate patient care according to PA Statewide protocols (ALS and BLS) and the rules/regulations of the Philadelphia Fire Department.
• The Captain manages all aspects of the company and assigned apparatus, maintains records, directs/coordinates activities, and communicates within the chain of command.

EMS Operations Officer Dispatch Criteria

• Box alarms with a report of “2 & 2 in service.”
• Three or more ambulances are on a single response.
• The 2ND EMCO responds when the RIT is placed in service.
• Mass Casualty Incidents or Hazardous Materials (Haz-Mat) incidents.
• Philadelphia International Airport upon an Alert 1 or greater.
• Philadelphia Northeast Airport Alert 2 response.
• Reports of "Civil Disturbance”, “Riot” or “Barricaded Persons”.
• MIRA dispatch or Philadelphia Prison with a Riot, Mass Casualty, and/or Hostage Situation.
• Rapid Assessment Medical Support Team (RAMs) dispatch.
• Dispatch of “Founded Device” or “River Observation Team”.
• Reports of "Building Collapse” or motor vehicle accidents with a report of entrapment.
• Incidents involving a Mass Transit Vehicle with passengers.
• Dispatch of a Special Operations Command (SOC) unit for high angle, confined space, or industrial accident rescue.
• Responds to a “Police Assist” call from any PFD unit or air evacuation requests.
• Cardiac Arrest Dispatches in which CPR is confirmed to be in progress
• Dispatches involving a communicable disease requiring personal protective equipment
• When the Bariatric Task Force or “Surgical Response Team” is requested/activated.
• Dispatches for penetrating trauma (GSW or Stabbing).

Duties of the EMS Operations Officer on all PFD Incidents

• Reports to the EMS Medical Branch Director or, if not present, the Operations Section Chief.
• Coordinates and facilitates all EMS activity and resources.
• Maintains patient accountability and transport status.
• Assumes the role of HAZ-MAT Medical Officer on hazardous material responses.
• Performs all duties deemed necessary by the EMS Branch Director or Incident Commander.
• Performs administrative duties (roll calls, overtime, MXTs, AOR, etc.) for assigned personnel.
• Conducts FSP and FSE training, including review of CQI, orientation to new equipment and procedures.
• Monitors/evaluates driver qualifications for newly hired FSPs and FSEs.
• Identifies performance concerns and assists in developing/monitoring performance improvement plans.
• Conducts audits of narcotics in ambulances, as directed.
• Monitors progress of new FSEs/FSPs; cadets, students, and personnel undergoing "Return to Service" evaluations, forwards Field Evaluation forms to EMS training.
• Monitors and assists observers on PFD EMS apparatus.
• Facilitates mandatory reporting on suspected child abuse/neglect (PA form CY-47).
• Receives EMS Complaints, completes forms, and forwards to the EMS Special Investigation Officer, with copies to ES-3 and ES-1.
• Investigates and documents all EMS incidents, then forwards to EMS Administration.
• Maintains records, logs, and reports according to Departmental policy for daily platoon operations (e.g., vehicle and equipment checklists).
• Performs annual Employee Performance Ratings and addresses EMS-related issues designated by the EMS Operations Chief and/or EMS Deputy Chief.

EMS Operations FCC Officer (ES-7)

• The primary focus is to facilitate ambulance availability and the Medical Priority Dispatch System.

Duties

• Monitors and maintains ambulance availability.
• Coordinates ambulance out-of-service time for training, maintenance, supply, or other issues while maintaining adequate emergency resources.
• Monitors and assists the Fire Communications Center Supervisor with dispatch issues.
• Ensures DETAIL INCIDENTs are created for Special Events and maintains accountability.
• Approves/denies inter-facility transports based on system status with ES-3 approval.
• Receives complaints that enter the system through the FCC and forwards them to SIO.
• Facilitates requests from ES Officers/Ambulances and outside entities (PPD, Septa, etc.).
• Facilitates EMCO requests for CY-47s, and raises the American Flag.
• Notifies the FCC Supervisor of any ALS unit downgrades and ES-3 when the system reaches zero ambulances available.
• Notifies ES-3 on any issue impacting EMS-OOS, Injury, or Accident.
• Fills out an Opioid overdose (3-0-1-8) tracker, and transfers it to the FCC Supervisor at the end of the shift.

EMS Staffing Officer (ES-14)

• The primary focus is ensuring minimum staffing levels for all ambulances and operations offices.

Duties

• Handles overtime hiring for all ALS and BLS ambulances staffed by Fire Service EMTs, adhering to contractual and management rules for overtime distribution.
• Manages details of EMS providers for training, special events, court appearances, investigations, and other staffing needs, and makes appropriate notifications of member details.
• Maintains a tracking system for equitable distribution of overtime opportunities and member details.
• Responds with ES-1 on Mass Casualty Incidents and functions as a Medical Communications Coordinator.
• Manages the Everbridge technology notification system.
• Completes and distributes weekly and daily headcounts.
• Maintains IOD/LAD/Sick/Detail (long term process).