EMS Uniform and Appearance Policy

Uniforms, Image and Appearance Policy

• This policy aims to maintain a professional image for EMS personnel at Gila River Health Care.

Uniform Definitions

• Class A Uniform: A dress uniform used for formal meetings or when directed by the EMS Chief/designee.
• Class B Uniform: A dress uniform for informal meetings or when directed by the EMS Chief/designee.
• Standard Work Uniform: The department's daily attire, varying by activity and rank.
• Brass: Shields, nameplates, and collar insignias appropriate for the personnel's rank.
• Standard Shield: An EMS Department Shield indicating only certification level or officer rank.
• Personalized Shield: An EMS Department Shield with the individual's AZDHS certification number engraved.
• Insignia: Department-approved logos, graphics, wording, and patches.
• Chief Officer: Any personnel with the title "Chief."
• Officer: Captain or higher in a supervisory role.
• MIH-CP Personnel: Personnel responsible for administering the Mobile Integrated Health-Community Paramedic program.
• Field Personnel: EMTs and Paramedics who provide pre-hospital acute medical care and transport.
• Uniformed FTE: A full-time Gila River Health Care EMS employee with AZDHS certification, whose job requires them to Act in an emergency.

Uniform Procedures

• EMS personnel must wear appropriate uniforms for their assignment.
• Personnel are responsible for acquiring required uniform items.
• A spare uniform must be kept on duty.
• Faded, worn, or damaged uniforms are not allowed.
• Officers must ensure field personnel maintain a positive public image through adherence to the uniform policy.
• EMS personnel must be appropriately dressed, including tucked-in shirts and tied/zipped shoes, while wearing personal protective equipment.
• EMS personnel receive a uniform allotment with amounts, types, and timeframes decided by the EMS Chief/designee.
• Uniform replacement at departmental expense is at the EMS Chief/designee's discretion.
• Full-time personnel representing the department in legal or judicial activities wear the Class B uniform.
• Uniforms are prohibited outside the course of representing EMS.
• Additional uniform items beyond the allotment must be approved.
• Unauthorized use of the organization's insignias is prohibited.
• Faded, worn, or damaged items must be rendered unusable before disposal.
• All uniform styles, types, and designs require pre-approval by the EMS Chief/designee.
• Items with GRHC EMS logos must be returned to the logistics chief or rendered unusable upon separation of employment.

Uniform Details for Field Personnel, MIH-CP Personnel, Captain, Battalion Chief, Navigator, and Cadet

• Shirts:
  • Dark navy blue polo shirts for field personnel and Battalion Chiefs
  • Royal blue polo shirts for navigators
  • Gray polo shirts for cadets
  • Shirts can be long or short-sleeved
  • All shirts require approved insignia.
• Pants/Shorts:
  • Dark navy station/EMS style pants
  • Dark navy tactical/BDU style pants (without drawstring closure or tucked into boots)
  • Shorts must be no shorter than one inch above the knee
  • Shorts are prohibited on EMS calls, except under brush/barrier pants
  • Shorts are not permitted with broken skin or during special events.
• Belt: Can be black, plain/basket weave leather, or rescue/tactical style nylon.
• Footwear:
  • Plain black safety/composite toe boots
  • Boots must be securely fastened, cleaned, and polished
  • EMS/Tactical Type with standard to high top height.
• Socks: Can be black, dark gray, navy blue, or white; only black or white crew socks are allowed with shorts.
• Caps: Approved insignia, navy blue baseball or "boonie" style cap, or navy blue knitted watch cap.
• Brush/Barrier Wear:
  • Must be navy blue, used only on EMS calls (reference EMS.210.11 for personal protective equipment), and cleaned regularly.
  • Not worn in stations, brush/barrier pants may be utilized by employees as an extra layer of protection.
• Jackets: Approved insignia, navy blue hoodie (pullover or zipper), rain jacket/parka, or navy blue job shirt.

Physical Training/Station Wear Uniform

• Physical training uniforms are exclusive to physical fitness activities.
• Shirts and shorts are dark navy blue and have an approved insignia, PT style shorts can be worn.
• Sweats are navy blue (if available they have an approved insignia).
• Shoes must provide good ankle support.

Training Instructor Uniform

• Shirts includes an approved insignia, can be black screened or embroderied polo
• Can be Class A or B uniform shirts as described below.
• Beige/Tan/Khaki tactical pants or slacks.
• Must have a Black plain or basket weave leather, or rescue/tactical style Nylon belt
• Boots: Plain black safety/composite toe, securely fastened, clean and polished, EMS/tactical type that is standard height or high tops.
• Alternate uniform boot is tan or brown tactical style boot, securely fastened, and clean.
• Non-hazard environment shoe is Oxford type
• Socks are limited to black

TEMS Members, Tactical Instructors Uniform

• Tactical or Combat shirts include green, Multicam, tan, coyote, or black with removable approved insignia
• Tactical or combat style paints are green, Multicam, tan, coyote, or black
• Belts are rescue or tactical style and include green, tan, coyote, or black
• Boots are tan, coyote, black tactical style boot that securely fastened
• Socks include green, tan, coyote, black, and dark grey.
• Hats are Green, Multicam, tan, coyote, black
• Jackets are tactical, green, Multicam, tan, cyote, black and have removeable approved insignia
• Flight suits are green, Multicam, tan, coyote, black and approved insigna.
• Eye protection: Shooting or goggle protective style can be clear or color tinted
• Helmets include a protective style in green, Multicam, tan, coyote, black
• Gloves include protective, tactical style in green, Multicam, tan, coyote, black
• Knee and elbow pads are protective and tactical in green, Multicam, tan, coyote, black
• Vest and Carriers: NIJ Level II-IV with the ability to add ballistic plates in reen, Multicam, tan, coyote, black

Office Coordinator Uniform

• Tops: Must include various colors screened or embroideried polo style and approved insignia
• Tops: They must be any sleeve length
• Tops: Must use professional buisness shirts
• Tops: Include tops and blouses that are business professional and moderate styles
• Pants: Classic tailors slacks, pants or trouser and all acceptable pant styles
• Pants: Must be no shorter that mid-calf in length and use professional dresses with modest necklines and hemlines
• Skirts and dresses: Must be no shorted that 2 inches above the knee with hosesry that must be of an acceptable style for the workplace.
• Footwear: Buisiness professional shows in good, clean condition include pump, flats, backless slides, espadrilles, boots, loafers, and other leather shows with the option ot use dress showing with modern heels less than 3"

Program Manager Uniform

• Shirts need approved insigna, various colored screened or embroiderd polo style and can have short sleeves.
• Pants are tactical style, with the option of slacks and jeans (casual friday)
• Must use Black plain or basket weave leather, or rescue/tactical style Nylon
• Footwear: Boots include plain black safety/composite toe.
• Boots must be securely fastened, clean and polished at all times while being worn
• EMS/tactical type of standard height to high tops
• Alternate Uniform Boot must be tan or brown tactical style boot and clean.
• Use Oxford type shoe for non-hazard environments with socks in black, dark gray, navy blue and white.
• Cap: Use approved insigna and navy, tan, or black in baseball style cap, boonie etc.

Chief, Deputy and Division Chief Uniform

• Shirts must always be an appoved Insigna
• Must ware White or dark navy polo style for general wear
• Long or short sleeve
• Alternate uniform is a Various colored screened or embroidered polo style when at offsite meetings and casual Friday.
• Pants dark navy station / EMS style pant
• Dark navy tactical / BDU Style
• Dark navy blue slacks alternative for offsite meets and casual Friday
• Tactical style / Slack / Jeans ( Casual Friday)
• Belt Black, Plain or basket weave leather, Rescue / tactical style Nylon
• Footwear plain black boots or boots must be securely fastened, clean and polished at all times
• must ware Standard height to high tops / EMS tactical type
• Alternate Uniform Boot tan or brown tactical style boot

Class B Uniform Specs

• Department patch on left shoulder, a certification patch on the right shoulder, and a color appropriate to the rank
• the rank depends on Field Personnell - Navy blue or Chief Officers - White - matching shirt, brass, appropriae to rank.
• Short or long sleeves and a Collared button down shirt with Dark navy station/EMS style pant
• Belt: Black Plain or basket weave leather of boots and
• Plain black safety/composite toe has to be - Boots must be securely fastened, clean and polished at all times while being worn and must be EMS/tactical type standing at standard height to high tops.

Class A uniform Specs

• the department patch on left shoulder and certification patch on the right shoulder with brass and a insignia appropriae to the rank.
• Color appropriate to rank and can range from Field Personnell and Navy blue or Chief Officers honor guard members and white.
• matching undershirt is required and has long sleeves
• Navy blue, Dress style, Plain front with plane leather belt or Gold Chief Officers

Caps Specs

• Caps are a chief, deputy and division chief with a shield
• There is a battalion chief with a navy cap, a gold chest strap and a hat shield
• There is the Honor guard members
• with a white cap & chest strap of gold chiefs silver and block and a black shield
• The field crew has a navy cap.

Brass and Insigna Specs

• Gold and Silver shields, name plates made with gold and silver with ranks displayed
• They also have other shirts with org pins and Caduceus

Jacket

• Chiefs also have buttons and shields with 5 gold stirpes on both sleeves with stars for years of service.

Shield Issuance

• A standard shield is given to new Uniformed FTEs upon taking the Oath of Office.
• A personalized shield is given after 5 years of service and meeting specific guidelines.
• A standard shield is given for practitioner level upgrades.
• A personalized shield is given for employees with over 5 years of service after the introductory period.
• A standard shield is given upon promotion.
• A personalized shield is given after completing the introductory period following a promotion.
• Standard shields are returned upon employment completion, upgrade, or promotion.
• Personalized shields may be kept as a token of appreciation after service, upgrade, or promotion.

Image and Appearance Guidelines

• All personnel must maintain clean, trimmed hair for a professional appearance; extreme styles like Mohawks are not allowed.
• Mustaches and goatees must be neatly trimmed to ensure proper sealing of protective masks.
• Sideburns should also be cleanly trimmed to allow a proper face mask seal.
• Beards are not permitted.
• Necklaces must be worn under the uniform shirt.
• Earrings are limited to stud-type ear wear for safety reasons.
• Tattoos should not be sexually explicit, immoral, or express radical sentiments.
• Uncertain tattoos should be reviewed by a supervisor prior to the permanent artwork
• Unacceptable tattoos must be covered at all times during duty.

Exceptions to the Policy

• The EMS Chief or designee has the authority to grant exceptions to the uniform and appearance policy.

Mandatory Hold Policy

• Mandatory hold is implemented to maintain uninterrupted emergent and non-emergent services in the Community.

Mandatory Hold Definitions

• An Officer is an EMS Chief, Deputy Chief, Medical Director, Division Chief, Battalion Chief, or Captain.

Mandatory Hold Procedures

• Personnel required to hold will be contacted by an Officer as soon as possible.
• EMS personnel are subject to mandatory holds for up to 3 hours, when needed
• Holds are enacted based on operational needs to ensure staffing.
• Minimum staffing is maintained with EMS.140.03 Scheduling Coordination.

Scheduling Coordination Policy

• Scheduling is done to maximize staffing and reduce unscheduled overtime.

Definitions for Scheduling:

• ESO: GRHC EMS Dept online scheduling software available 24/7 at: https://scheduling.esosuite.net/Default.aspx?DB=gilariverems
• Scheduler: The Officer/designee managing the ESO scheduling software.
• Officer: Captain or higher
• FTE: Full Time Employee
• Pool Employe: Non FTE
• Unscheduled Overtime:
  • Any work hours outside of FTE shifts.
  • Pool employees working over 40 hours a week.
• Excess OT: Overtime exceeding 72 total hours in Pay Week.
• PTO: Paid Time Off
• EI: Extended Illness
• LWOP: Leave without pay
• IWS: Incomplete work shift, missing over 7 minutes to 51% of a shift
• Pay Week: Begins Sunday @ 0730
• Tour: Normal Shift Rotation
• Optimal staffing is 10 ALS Ambulances, 2 ALS EMS Units, 2 Battalion Chiefs, 2 Captains.

Areas of Responsibilities for Scheduling:

• A scheduler is the Officer given "Full System Privileges"

Scheduler duties

• ESO utilization to maintain daily schedules projected and staffed up to two pay periods ahead.
• Update staffing templates upon notice of shift bids, promotions, or reassignments, manually adjusting active pay periods.
• PTO and shift trade requests monitoring through the ESO to ensure proper approval/denial by Battalion Chiefs.

Battalion Chief duties are approval/denial of PTO and shift trade requests.

• Staffing shift vacancies arising from call outs or last-minute PTO approvals.
• Creating/altering schedule items for payroll accuracy.
• Handling all items on assigned OT Shifts; approve employee timecards by 0800 on Mondays.

Captain Duties and repsonbilities:

• Filling vacancies if Battalion Chief on PTO, with "Battalion Chief" system privileges when designated.

Division Cheif Duties and Responsiblities

• Managing special assignments plus FTE in light duty.

Field Personnel Duties and Reponsibilities

• Approving timecards by Saturday 1200 hrs
• Responsible for shift attendance, while overtime opportunities are to be picked up on the shift availability section.

Field Personnel - FTE Duty

• FTE are pickup shifts to bid on overtime, standby or training shift.
• Responsible for submitting and following up on

Personell Duty - Pool Personell

• Personnel is given a 48 hour shift on any week without overtime
• Must work a minimum of 18 hour per month
• Duty to approve the time card to 1200 hours on saturday.
• Responsible for Bidding on pickup shift to win open shifts

Restrictions of Peronnel

• There is some overtime to not have 3rd Rider, where employees cant have more than 48 hours unless chief
• Then there is 10 hours after 48 hour before re-shift or limit of 72 hours.
• the authorization is only obtained when working in training or on call.

All Employees

• No being 3rd driver cancel shift to avoid / 48 hrs Min 10 hrs after / 72 limit for Pay Week unless training, covered, Department limit and EMS
• POOL may Work Unit or EM431 / 432, less h = prior when Offices All open, provide Battalion single personnel is officer, Certification level 1st>Rank /

Schedule Maintaince

• The scheduler task includes: Review" shift to get shifts or approve those for guidelines to
• Operation is informed by chiefs of min staff so OT as needed, cancel needed items templates to pending items auto to un-P units PTO

Shift trades

• Are only between personell of same rank of cert in same work week and can't work over 48 hours before 10 break.
• Both personal sign off for this shift trade.

Exceptions

• The Exceptions are for
• Training to special events

Shift Bids

• Its a formal position for staff and dept
• Field staff do tasks under supervisions and FTE are full time
• EMS may start this, employee disciplinary may not be part.
• Silent, dept. EMS to shift is at a time and calls EMS to do

###Shift Bids and Award to Seniors

• The employee must have date for EMS
• in the cases to be in position is for a certain about months.
• Chiefs can always transfer the person if so needed.

CISM - Critical Incident Stress Management Procedure Details

• Procedures provide intervention designed to help minimize work-related stress injury to the employee and the team.

Critical Incdent Stress definitions

• CISM is defined as : A process, led by trained facilitators, that integrates crisis intervention strategies and educational techniques designed to mitigate the impact of a critical incident, and to assist personnel in recovering as quickly as possible from the stress associated with that critical incident.
• Critical Incident Stress Management Team: A team comprised of peer members (e.g., police officers, EMS personnel, nurses), and advisory members (e.g., supervisors, managers, and EAP specialists).
• Critical Incident: any sudden or powerful event that has a stressful impact sufficient enough to overwhelm the usually effective coping skills of an individual/group; including such examples as: hostage or riot incidents; catastrophic accidents; offender suicide or death; pediatric events; staff assault or death in the line of duty; incidents that attract extremely unusual or critical news media coverage; incidents involving the use of deadly force, serious escapes or attempted escapes; or other acts of violence in the workplace.

Actions and Responsibilities

• GRHC EMS response to incidents that cause personnel unusually strong emotional involvement will qualify for some form of a critical incident stress intervention :*

These incidents include

• crew member needing personal support
• a public safety personnel dieing, suicide or violence
• Mass casualty and also death to a child.
• The result of action and Prolonged physical or emotional energy

Additional actions include

• hindered or complicated goals, as well as drowninings
• New Coverage by media
• The critical incident is handled by the CISM and handled, one by one to reduce any stress over from the situation
• The Batalion chief has chart to look at cases for quick notifcations.
• Can be done 121 and over time or debriefed within hours after.
• These need to be kept confidential

CISM actions

Attendance is mandatory of all that were involed.

• 121 defus all crew is out of service.
• This is constured ad critical.
• CISM is for 20 mins defused with team, CISM defusing, after hours team member is used over time or by chart.

Vehicle Securing Procedures

• Intended for all Gila River Health Care EMS vehicles, for a variety reasons.

Vehicle Securing Procedures Definitions

• There is no given definition in the material

Key main points

• A response is two sets of keys for the unit, both should have them with them. Report any if missing to investigation
• Replcaements keys for the Service Divison Chief with the crew and portable radios.
• Chargers
• The Vehicle is locked in all situation.

Drug Box Policy key notes

• Box Chain of Custody Define roles Compliance with Arizona Administrative Code R9-25-201, F. 2.b and Hu Hu Kam Memorial Hospital (HHKM) ED.PH120.13 Pre-Hospital Drug Box Usage and Security.

Drug Box Policy Definitions

• ALS provider: a Paramedic, and they regulate substances.
• The captain is a supervisor. BC are the same.
• It's a washabke wayr for safe storage that helps emts to have meds.
• Number seals are important. Keep the details up

Durg Box Procedures

• Each drug box inspection is verified from form to see a match.
• This is to allow the seal to be placed.

EMS Service time Notes

• to allow coverage within 30 mins

Service and Time to work Details

• It’s the time for an EMS unit and that units job to be back on when destination is made clear.
• 1st priority is to have staff and to transfer the patience as good coverage. and do it to keep service times right.

Incident response Notes

• response for all
• Must be up to 90 seconds, any time over will result in disciplinary situations.