95 Questions
According to the text, who can refuse medical care and/or transport?
Competent Adult Patient
What is the age range for an adult as per the text?
Eighteen (18) years or older
In which situation should the refusal of care procedure be utilized?
When a patient refuses evaluation, treatment, and/or transportation by pre-hospital personnel
Who should be assessed for competency to make decisions affecting their medical care?
Any person refusing medical care and/or transportation
In which scenario should resuscitation on a trauma victim NOT be attempted?
If the patient is apneic, with asystole, and fixed and dilated pupils
Under what conditions may EMS personnel decide not to resuscitate an adult or pediatric patient?
If at least one of the following conditions is present: lividity, rigor mortis, tissue decomposition
When should resuscitation on a patient with suspected hypothermia, barbiturate overdose, or electrocution be required?
If they have injuries incompatible with life or tissue decomposition
Under what circumstances should EMS personnel contact medical direction for a 'determination of death'?
Whenever support in the field is desired
What is the purpose of the Refusal of Care form?
To document that the patient is refusing medical care against medical advice
What does the Health and Safety committee aim to promote?
Safety and health in the workplace
What are some benefits of the Behavioral Health Access Program (BHAP)?
Reduced absenteeism
What types of incidents require BHAP response?
Large Scale/Long Term Event with or without loss of life
What does CISM stand for?
Critical Incident Stress Management
When is Small group debriefing recommended?
12-72 hours post-critical incident
What does Florida Statute 401.30(4) (e) protect during CISM intervention?
Discussions held during a CISM intervention
What are some benefits of the Behavioral Health Access Program (BHAP)?
Reduced absenteeism
What types of incidents require BHAP response?
Large Scale/Long Term Event with or without loss of life
What does CISM stand for?
Critical Incident Stress Management
What does BHAP provide for first responders and their families?
Emotional and mental wellness support
What is the main focus of BHAP's early intervention efforts?
Diffusing mental health problems to prevent personal crises
What do Chaplains provide as part of BHAP?
Spiritual crisis intervention and grief counseling
What is the role of the Clinician Response Team (CRT) within BHAP?
Offering first responder-specific culture and treatment
What do Family support programs aim to enhance?
Caregiver knowledge of stress injuries and mental health issues
What is recommended for the organizational mental health needs of fire departments?
BHAP
What should mental wellness programs be extended to include?
Retirees
What should effective insurance coverage be inclusive of?
First responder-specific providers
What is the aim of the Employee Assistance Programs mentioned in the overview?
Cultural awareness and knowledge in first responder mental health
What do Evaluated Recovery Centers provide first responder-specific treatment programs for?
Substance abuse and PTSD
What does BHAP foster the development of dual certified Peer/CISM members for?
Peer support
What does BHAP identify and recommend appropriate resources for?
Immediate member needs
Who can be considered incompetent to refuse medical care and/or transportation?
A person with altered consciousness
In the absence of a parent or guardian, who can assume responsibility for a minor with traumatic injuries and sign the patient refusal form?
An adult willing to sign the patient refusal form
When should consultation with the supervising officer or medical direction be considered for patients refusing transport?
When patients adamantly refuse transport to the closest appropriate facility
When does implied consent allow for the treatment and transportation of an incompetent person?
Treatment and transportation with reasonable measures taken to ensure safe transport
What should prompt contact with Medical Direction for high-risk refusals?
High-risk refusals, such as those involving minors or significant risk to the patient or EMS system/agency
Under what conditions can diabetic patients sign a Patient Refusal Form?
When their glucose levels have returned to acceptable levels and they understand the risks and benefits of refusal
Can multiple patients be combined on a single EMS Run Report if they refuse all assistance?
No, each refusal requires a separate report
What is important to determine before considering refusal of care or transport for a single patient?
Their involvement in the incident, mental status, and the extent and history of their injury
When should Medical Direction be contacted for further guidance?
If questions on the assessment of competency or refusal of care arise
What is important to document in cases of multiple participants in an incident?
All names, addresses, and witnesses
What color should the Florida DNRO form be printed on?
Yellow paper
Who can sign the patient identification device?
The patient's physician, the patient, or the patient’s healthcare surrogate or proxy
What should accompany the live patient during each transport?
A copy of the DNRO form or the patient identification device
Who can revoke a DNRO?
The patient or their healthcare surrogate, proxy, or guardian
What will Florida be adopting in the near future for advance care planning?
POLST (Physician Orders for Life Sustaining Treatment Paradigm)
What does the POLST form assure patients?
Healthcare professionals will provide only the care they wish to receive
What is the purpose of the POLST program?
To emphasize advance care planning conversations and shared decision-making
What are the names of similar forms used by other states?
MOLST (Medical Orders for Life Sustaining Treatment), MOST (Medical Orders for Scope of Treatment), and POST (Physician Orders for Scope of Treatment)
What was revised on December 22, 2021, regarding the Do Not Resuscitate Order and Determination of Death?
Specific authorities and laws
What does the document provide for EMS providers?
Detailed instructions and guidelines to follow in honoring DNRO orders and ensuring patient care aligns with the patient's wishes and legal requirements
What should EMS do upon the presentation of an original or completed copy of DH Form 1896 or the patient identification device?
Withhold or withdraw cardiopulmonary resuscitation
What is the prime consideration for the CSFD Dive Rescue Team?
Constant assessment of risk/benefit factors in all operations
What does the SOP apply to?
All members of the Coral Springs Fire Department
What are the team goals outlined in the text?
Provide public safety and rescue diving services, provide services professionally, encourage education and training, rescue victims within 'The Golden Hour'
What does the SOP aim to establish guidelines for?
The CSFD Dive Rescue Team
Who is responsible for ensuring the currency of SCUBA tanks?
The Dive Team Coordinator
What is the frequency of the hydrostatic test for SCUBA tanks?
Every five years
Who is authorized to work on SCUBA regulators?
Only authorized personnel
What action should be taken if any equipment malfunctions during a dive?
Terminate the dive and report the malfunction to the On-Site Supervisor
What should be done if there is an injury or death from equipment malfunction during a dive?
Keep the equipment intact and report to the most senior fire officer on scene
What is the requirement for the first visual inspection of a new SCUBA tank?
Prior to initial purchase
What should be done with a tank that has a boot?
Remove the boot at least every six months and check for local corrosion
Who should be notified if there is an apparent problem with any SCUBA tank?
The Captain/supervisor
Who is ultimately responsible for the actions of the Dive Team?
The Fire Chief of the Coral Springs Fire Department
What is the role of the Deputy Chief of Operations in relation to the Dive Team?
Overall responsibility for the team
What is the responsibility of the Dive Team Commander?
Immediate direction of activities
Who is designated for each dive site as an On-Site Supervisor?
Sworn officers from law enforcement agencies
What paperwork must be turned in to the Dive Commander within 24 hours of the call?
Operations worksheets
What is the purpose of the Surface support personnel within the Dive Team?
Specific roles and qualifications
What is the main responsibility of the Dive Team Shift Coordinator?
Coordination of team divers
Who established the Dive Team for the Coral Springs Fire Department?
The Fire Chief
What do volunteers offer their services for within the Dive Team?
Public Safety Diving
What is encouraged for mutual aid and greater flexibility in responding to crime scenes?
Participation of sworn officers from law enforcement agencies
What is used to track and document dive operations?
Dive call reports
Who has overall responsibility for the Dive Team?
The Deputy Chief of Operations
Who is responsible for ensuring the currency of SCUBA tanks?
The Dive Team Coordinator
How often must a SCUBA tank undergo a hydrostatic test?
Every five years
Who is authorized to work on SCUBA regulators?
Only authorized personnel
What should be done if any equipment malfunctions during a dive?
The dive operation will be terminated and the malfunction reported to the On-Site Supervisor
What should be done if injury or death results from equipment malfunction?
The equipment will be kept intact and not disassembled
How often should the boot of a SCUBA tank be removed for inspection?
At least every six months
Who is responsible for maintaining the warrantee of SCUBA regulators?
Authorized personnel
What must be submitted to the Supervisor/Coordinator prior to using malfunctioning equipment in further dives?
A copy of the repair work
Who is ultimately responsible for any action or inaction on the part of the Coral Springs-Parkland Fire Department (CSPFD) Dive Team?
The Fire Chief of the Coral Springs Fire Department
Who will be responsible for the immediate direction of all activities of the Dive Team?
The Dive Team Commander
Who will be responsible for overall direction of the team's activities at each dive site?
The On-Site Supervisor
Who will assume the position of On-Site Supervisor in the absence of the Dive Team Commander?
The most senior diver
Who will be responsible for coordinating activities of team divers?
The Shift Coordinator
Who will provide the required support for the Officer to conduct the investigation at a scene requiring criminal or potential criminal investigation?
The Investigating Officer
Who will be responsible for filling out the Operations worksheet to track the divers' time in the water including their PSI and depths?
The surface support personnel
Where can all the required forms for dive operations be found?
In f/data/fire/dive/forms
When should the paperwork for dive operations be turned in?
Within 24 hours of the call
What must be completed within 24 hours of the call for dive operations?
All of the above
What is the purpose of the Pre-dive checklist form?
To ensure that all dive equipment is in working order prior to any dives
Who is responsible for turning in the paperwork for dive operations?
The Dive Team Leader
Study Notes
Florida Do Not Resuscitate Order (DNRO) Form and Patient Identification Device
- The Florida DNRO form is the only form approved in the State of Florida.
- EMS shall withhold or withdraw cardiopulmonary resuscitation upon the presentation of an original or completed copy of DH Form 1896, Florida Do Not Resuscitate Order Form, or upon the presentation or observation of a Do Not Resuscitate Order patient identification device.
- The DNRO form should be printed on yellow paper with the words "DO NOT RESUSCITATE ORDER" displayed across the top in black.
- The patient identification device is a miniature version of DH Form 1896, intended to provide a portable DNRO which travels with the patient, and must be signed by the patient’s physician, the patient, or the patient’s healthcare surrogate or proxy.
- EMS should verify the identity of the patient through a driver’s license, photo identification, or witness documentation.
- During each transport, a copy of the DNRO form or the patient identification device must accompany the live patient, and EMS should provide comforting and pain-relieving care.
- A DNRO may be revoked at any time by the patient or their healthcare surrogate, proxy, or guardian, and oral orders from nonphysician staff members or absent physician requests are not acceptable.
- Florida will be adopting POLST (Physician Orders for Life Sustaining Treatment Paradigm) in the near future, emphasizing advance care planning conversations and shared decision-making between patients and healthcare professionals.
- The POLST form assures patients that healthcare professionals will provide only the care they wish to receive and is not for everyone, only for patients with serious illness or frailty.
- The POLST program is used by several states, and there are other similar forms used by these states, such as Medical Orders for Life Sustaining Treatment (MOLST), Medical Orders for Scope of Treatment (MOST), and the Physician Orders for Scope of Treatment (POST) form.
- Specific authorities and laws are implemented for the Do Not Resuscitate Order and Determination of Death, with revisions made on December 22, 2021.
- The document provides detailed instructions and guidelines for EMS providers to follow in honoring DNRO orders and ensuring patient care aligns with the patient's wishes and legal requirements.
Coral Springs-Parkland Fire Department Dive Team Procedures
- The Golden Hour starts at the time of dispatch for the Dive Team.
- The team is composed of volunteers who offer their services for Public Safety Diving and contribute unique skills, knowledge, and time to the team.
- Surface support personnel and diving personnel have specific roles and qualifications within the team.
- Sworn officers from law enforcement agencies are encouraged to participate, allowing for mutual aid and greater flexibility in responding to crime scenes.
- The Fire Chief of the Coral Springs Fire Department established the Dive Team and is ultimately responsible for its actions.
- The Deputy Chief of Operations has overall responsibility for the team, and the Dive Team Commander is responsible for immediate direction of activities.
- An On-Site Supervisor is designated for each dive site, and a Dive Team Shift Coordinator coordinates activities of team divers.
- Forms such as operations worksheets, dive call reports, dive call narratives, and pre-dive checklists are used to track and document dive operations.
- All forms can be found in the specified location and must be filled out on every dive operation.
- After completion, paperwork must be turned in to the Dive Commander within 24 hours of the call.
Test your knowledge of the Florida Do Not Resuscitate Order (DNRO) form and Patient Identification Device with this quiz. Explore the requirements, guidelines, and legal aspects of DNRO orders, patient identification devices, and the upcoming adoption of POLST in Florida.
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