Penn Medical Emergency Response Team Protocols

Procedures and Protocols
University of Pennsylvania
Medical Emergency Response Team
Last Revision Date 04-08-2013
This document is the property of the University of Pennsylvania Medical Emergency Response Team. No portion of it may be redistributed or copied under any circumstances.
Standard Operating Procedures

University of Pennsylvania Medical Emergency Response Team
Table of Contents
General Membership
100.10 100.20 100.30 100.40 100.50 Mission Statement Membership Functional Position Description Member in Good Standing Leave of Absence
Member Expectations and Conduct

200.10 200.11 200.12 200.13 200.14 200.15 200.20 200.30 200.40 200.50 200.60 200.61 200.62 200.70 200.80 200.90 Member Code of Conduct Harassment Alcohol and Controlled Substances Disciplinary Policy Off-Duty Membership Influenza Vaccination Membership Meetings Member Appearance Public Information Squad Room Management Property and Equipment Placement of Bikes Drug Security Identification and Building Access Minimum Duty Requirements Shift Exchanges and Cancelations
Operations and Response

300.10 300.20 300.21 300.30 300.31 Shift Changes Crew Configuration Clinical Chain of Command Dispatch and Response Radio Communication
300.32 300.33 300.40 300.41 300.50 300.60 300.70
Atypical Dispatch Special Event Procedure Scene Safety Transport Safety Jurisdiction Patient Transport Reporting of Accident or Injury to a MERT Member
Clinical Advancement
400.10 400.20 400.30 400.40 Crew Chief Advancement Lead EMT Advancement EMT Advancement Accommodations for Prior EMS Experience
Provisions of Care
500.10 500.20 500.30 500.40 500.50 500.60 500.70 500.80 HIPAA Compliance and Patient Confidentiality Patient Consent for Medical Treatment Patient Refusal of Medical Treatment Transfer of Care Patient Care Report Supplemental Incident Report Infection Control Critical Incident Stress Management
Administrative Management
600.10 600.11 600.12 600.13 600.14 600.15 600.16 600.17 600.18 600.19 600.20 600.21 Executive Structure Chief - Basic Functions and Responsibilities Operations Captain - Basic Functions and Responsibilities Operations Lieutenant - Basic Functions and Responsibilities Administrative Director - Basic Functions and Responsibilities Scheduling Officer - Basic Functions and Responsibilities Training Officer - Basic Functions and Responsibilities Equipment Officer - Basic Functions and Responsibilities Disaster Response Team Officer - Basic Functions and Responsibilities Internal Communications Officer - Basic Functions and Responsibilities BLS Officer - Basic Functions and Responsibilities Community Outreach Officer - Basic Functions and Responsibilities
600.30 600.40 600.50
Chain of Command Internal Investigations Quality Assurance / Quality Improvement
Standard Operating Procedure

Mission Statement
Protocol Number: Effective Date: Revised Date: 100.10 09-12-2007 08-10-2008
100.10.1 The University of Pennsylvania Medical Emergency Response Team (MERT) is a student-run, volunteer organization with the primary purpose of providing professional, timely, and high-quality emergency medical services to the University community. The secondary purpose of the organization is to provide valuable educational opportunities for its members as well as the community.

Membership
100.20.1 All members of MERT must be currently enrolled students of the University of Pennsylvania. All members must be certified by the Commonwealth of Pennsylvania at a level of EMT Basic or higher and possess a current CPR for the Healthcare Provider/Professional Rescuer certification.
100.20.2 A member will be considered Active once they have successfully completed new member orientation and all required prerequisite trainings. An Active member may be placed on Inactive status for an approved leave of absence.
100.20.3 All members must be able to fulfill the requirements outlined in the Functional Position Description SOP.

Functional Position Description

100.30.1 All members of MERT acting as emergency care providers must be able to meet the following position requirements: 1. 2. 3. 4. 5. Ability to read, write and speak the English language Ability to communicate verbally Ability to interpret written and oral instructions Ability to exercise good judgment and remain calm in high-stress situations Ability to lift, carry and balance up to 50 pounds

Member in Good Standing

100.40.1 Requirements for Member in Good Standing: 1. Fulfills requirements of Active member 2. Hold a valid certification of EMT Basic or higher in the Commonwealth of Pennsylvania 3. Hold a valid American Heart Association CPR for the Healthcare Provider or American Red Cross CPR for the Professional Rescuer card 4. Fulfill the requirements outlined in the Minimum Duty SOP (200.80) 5. Fulfill all mandatory training requirements 6. Attend all required meetings outlined in the Membership Meetings SOP (200.20)
100.40.2 Exceptions to Requirements: 1. A member may be excused from a required meeting with a valid reason submitted to and approved by the Chief prior to the start of the meeting. 2. A member may be excused from Minimum Duty if an illness or injury prevents the member from riding. 100.40.3 Members who fail to maintain the requirements for a Member in Good Standing may be placed on inactive status at the discretion of the Board. A member who fails to regain Good Standing within one semester may be removed from the organization. Inactive members are not eligible to hold Board positions.

Leave of Absence
100.50.1 Certain circumstances may permit a member to take a leave of absence from MERT for up to one year. A valid reason for a leave of absence includes extended illness, study abroad, or a family emergency. All other forms of time away from MERT will require the member to resign from the organization and reapply for membership if he or she chooses to return. In the event that an individual takes a leave of absence or reapplies for membership, he or she will be demoted one clinical rank and may seek expedited promotion at the discretion of the Operations Lieutenant.
100.50.2 If the member currently holds a position on the Board and will be absent for the duration of one semester or longer, the individual may not retain the Board position and will be replaced. If the member will be absent for less than a full semester, it will be left up to the discretion of the Board.

Member Code of Conduct

200.10.1 All members are expected to conduct themselves in a professional manner at all times both on-duty and off-duty. Any member who violates the SOPs, University policy or engages in unethical conduct will be subject to disciplinary action.
200.10.2 Examples of violations of the Member Code of Conduct: 1. 2. 3. 4. 5. 6. Failure to follow the Chain of Command Falsifying information on membership application, patient care report, incident report, etc. Unauthorized use of MERT equipment or office space Dishonesty or false representation Operating outside of the EMT Basic Scope of Practice Failure to maintain proper certifications
200.10.3 MERT personnel are not permitted to carry weapons of any type while on duty.

Harassment
Protocol Number: Effective Date: Revised Date: 200.11 09-12-2007
200.11.1 In accordance with federal law, MERT has adopted and maintains strict enforcement of this policy against unlawful harassment. Unlawful harassment is behavior which creates an environment that is hostile, offensive, demeaning or intimidating to a member and is done on the basis of their gender, sexual orientation, marital status, age, race, color, religion, national or ethnic origin, or disability. Any discrepancies in adherence to this policy should be reported to the Operations Captain.

Alcohol and Controlled Substances

200.12.1 No member may consume or be under the influence of alcohol or controlled substances while on duty. No member may consume alcohol within twelve hours prior to duty.
200.12.2 Members receiving a prescription for a medication should inquire with the prescribing physician about possible impairment to judgment or motion as a result of medication use and forward such information to the Medical Director who will make a determination whether or not a member is able to work. Members using an over-the-counter medication which indicates possible impairment of judgment or motion as a potential side effect should forward such information to the Medical Director, who will make a determination whether or not a member is able to work or must be placed on medical leave.
200.12.3 If any member has reason to suspect another member is under the influence of alcohol or a controlled substance that member must immediately contact the Operations Captain and UPPD Supervisor. A member who is suspected to be under the influence of alcohol or a controlled substance while on duty may be asked to consent to medical testing. Refusing consent to the medical tests will be interpreted as a positive result. A positive result will result in the expulsion of the member.

Disciplinary Policy
200.13.1 Internal discipline is the responsibility of the Chief in conjunction with the Board of Directors. The Medical Director and Department of Public Safety Liaison will be involved as needed.
200.13.2 The disciplinary process may be initiated by any Crew Chief, Supervisor or Board Member. That member will document the incident using an incident report and notify the Chief within twenty-four hours of the incident. If a member feels that disciplinary action is necessary against another member, they may ask a Crew Chief, Supervisor or Board Member to initiate disciplinary action. The Chief, or appointed designee, will conduct an investigation into the incident in a timely manner. Upon completion of the investigation, the Chief can either determine no violation has occurred or forward his/her findings of the violation to the Board. Disciplinary matters are assessed and determined to be of one of three levels. Level one violations are considered the most severe offences, level two violations are considered midlevel offences and level three violations are considered the most minor offences. For confirmed level one and level two violations, the Board will decide on the appropriate consequences for the members actions. All confirmed violations will be documented in the members record. It is the ultimate goal of the disciplinary policy to provide fair and timely warning to members who have violated expected conduct so they understand how their actions have negatively affected the organization as well as prevent future offences.
A members disciplinary history may be taken into account when a member is up for promotion. Members who are removed from the organization as a result of disciplinary action may at no point in the future reapply for membership.
Examples of each type of offence and possible consequences are provided below, though it is the ultimate decision and interpretation of the Board as to what constitutes an offence and what a reasonable consequence of that offense will be.
200.13.3 Examples of Level One Violations: 1. 2. 3. 4. 5. 6. 7. 8. Negligence resulting in the harm or death of a patient, crew member or bystander Deliberate violation of the SOPs Acting outside the definition of ones current rank Theft or deliberate damage of MERT property Having detectable amounts of alcohol or illicit drugs in ones body while on duty Falsification of documentation Repeat level two violations for the same offence Six or more of any level offences
Confirmed level one violations may result in reduction in rank, suspension or removal from MERT.
200.13.4 Examples of Level Two Violations: 1. 2. 3. 4. 5. 6. Missing shifts without prior notification Missing General Body meetings or required training without authorization Failure to follow the Chain of Command Inappropriate actions towards a patient, crew member or bystander Failure to meet minimum duty Repeat level three violations for the same offence
Confirmed level two Violations may result in written warning or suspension of member privileges. 200.13.5 Examples of Level Three Violations: 1. Arriving late to shift 2. Violations of the Member Appearance SOP 3. Misuse of MERT property Confirmed level three violations may result in a verbal warning from the Chief.

Off-Duty Membership
200.14.1 All members, when they are not on shift with MERT, are not active members of MERT. As such, if an emergency arises, an off-duty member should immediately follow the appropriate emergency notification procedures by calling 911 (nine- one-one) or the University of Pennsylvanias emergency notification system. 200.14.2 If an off-duty member of MERT has followed the appropriate emergency response procedures, the member may assist the patient in question, as covered by the Good Samaritan law. However, the member must be cognizant of the facts that: 1. They are not affiliated with MERT when off-duty 2. They may not operate outside the EMTs Scope of Practice A MERT member should not attempt to assist a patient if the member is: 1. Under the influence of alcohol or other drugs 2. Not in their full mental capacity 200.14.3 An off-duty member may not wear his or her MERT uniform under any circumstances. Additionally, MERT members are not allowed to wear any MERT apparel when alcohol is present. Violation of this policy will result in a level one violation, and the Board will review the offenders membership.

Influenza Vaccination
200.15.1 In accordance with Joint Commission Standard IC.02.04.01 for staff in healthcare, it is recommended for all members to be immunized against the flu every year. 200.15.2 Every member is required to have received the influenza vaccination by the first day back from winter break of every year. All members are also required to complete and turn in the MERT Influenza Vaccination Declaration form to the Administrative Director. Members who are not in accordance will be ineligible to take shifts. 200.15.3 A member may decline the influenza vaccination requirement if it conflicts with religious beliefs, or is medically contraindicated. In the event a member declines to receive the influenza vaccination, they will be required to wear a mask when working within 6 feet of a patient until April 1st of that year.
MERT Influenza Vaccination Declaration

Fall 2013 Winter 2014
The University of Pennsylvania Medical Emergency Response Team INFLUENZA FACTS Influenza is a serious respiratory disease that kills, on average, 36,000 Americans every year. Influenza can be transmitted up to 48 hours before symptoms begin. Up to 30% of people with influenza have no symptoms but are still contagious to others. Influenza virus changes often, making annual vaccination necessary. Immunity following vaccination is strongest for 2 to 6 months. For more influenza information go to www.cdc.gov\flu. Influenza vaccine cannot transmit influenza. It does, however, prevent disease. Influenza vaccination is recommended by the Centers for Disease Control and Prevention (CDC) for all health care employees to prevent infection from and transmission of influenza and its complications, including death, to patients, coworkers, family and community. In order to protect our vulnerable patients, and fellow members, we ask all MERT members to be immunized against flu every year. The MERT members flu vaccine practice meets Joint Commission Standard IC 02.04.01. As per MERT protocol 200.15, all MERT members are required to have annual flu vaccine. Please choose one of the following statements: I have had an influenza vaccination this year. Location Date__________
Knowing the facts set forth above, I choose to decline vaccination at this time for the following reason: ____________________________________________________________ MERT Member: I have read and fully understand the information on this declaration form. Print Name ____________________________________ Signature Date
Healthcare Provider: As state above I confirm that the said person has received the influenza vaccination. Print Name ____________________________________ Signature Date ______ Your participation in this process is required. The protection of our members and patients is important to our organization.

Membership Meetings
200.20.1 All members are required to attend a minimum of two-thirds of scheduled General Body meetings.
200.20.2 A member may be excused from a required meeting with a valid reason submitted to and approved by the Chief prior to the start of the meeting.

Member Appearance
Protocol Number: Effective Date: Revised Date: 200.30.1 MERT members are expected to take pride in themselves and their uniform. Accordingly, all members will maintain high standards of physical appearance, hygiene, grooming, and uniform. Members will wear the designated uniform only when on duty, while attending an approved function or in transit to and from their residence to any of the above. Members may not loan or give MERT uniforms to anyone except other members without the permission of the Chief. While some articles bearing the MERT logo are property of the private purchaser, members displaying the MERT logo are expected to act in a professional manner. 200.30.2 Members will wear their uniform within the following guidelines: 1. Red MERT polo shirt neatly tucked in. If a long sleeved shirt is worn under the MERT polo, the sleeves must be a solid color that is free of design. 2. Red MERT Jacket. Personal sweatshirts, jackets or other MERT apparel may not be worn on calls. During extremely cold weather however, it is permissible to wear a personal fleece, design free sweatshirt, sweater or jacket provided that they are covered by a MERT polo or MERT jacket at all times when on a call or visible in public. 3. Navy blue or black pants including khaki, cargo or EMS style. No scrub pants, sweat pants, jeans, shorts or athletic pants may be worn unless completely covered by approved pants. 4. Dark colored belt 5. Black shoes, boots or dark colored sneakers 6. Functional digital watch or watch with second hand 7. Dangling or hoop earrings or other piercings will not be allowed 8. Long hair must be secured in a bun or pony tail 9. Members are not permitted to wear clothing from other EMS, Fire or Public Safety agencies while on duty.
200.30 09-12-2007 11-17-2007

Public Information
200.40.1 MERT members are not to speak to any member(s) of the press or other related individuals about MERT without permission from the Chief. In the event that the press asks for information regarding a specific incident, they are to be directed to the Chief for public informational purposes.

Office Management
200.50.1 The MERT office in shared by many people, and as such, everyone must do their part to keep the office clean. It is the responsibility of the Crew Chief to ensure the office is clean at the end of his/her shift. Examples of office maintenance include: 1. 2. 3. 4. Vacuum carpet Clean tables/desks Straighten up equipment Take out trash
200.50.2 The on-duty crew has priority use of the office and office equipment. The Crew Chief may ask members not on-duty to leave the office if it interferes with the usage by the on-duty crew. A Board member may supersede the authority of the Crew Chief over office use for official business. No non-members may be in the office unaccompanied without approval from a Board member.

Squad Room Management

200.50.1 The MERT squad room is shared by many people, and, as such, everyone must do their part to keep the squad room clean. It is the responsibility of the Crew Chief to ensure the rooms are clean at the end of his/her shift. Examples of squad room maintenance include: 1. 2. 3. 4. Vacuuming carpets Cleaning tables/desks Straightening up equipment Taking out trash
200.50.2 The on-duty crew has priority use of the squad room and equipment. The Crew Chief may ask members not on-duty to leave if it interferes with the usage by the on-duty crew. A Board member may supersede the authority of the Crew Chief over squad room use for official business. No non-members may be in the squad room unaccompanied without approval from a Board member.

Property and Equipment

200.60.1 It is the responsibility of the on-duty crew to ensure the security of all the equipment necessary for a shift. At the beginning and end of each shift it is the responsibility of the Crew Chief to check the equipment and ensure that it is present and functioning properly. To ensure the readiness at the start of the shift, members must arrive for duty 15 minutes prior to the start of the scheduled shift.
200.60.2 The crew will utilize the appropriate check sheet when inspecting equipment. The Crew Chief is ultimately responsible for the completion of the check sheet however all members are expected to take part in checking the equipment. If any equipment is found to be missing or damaged an incident report should be filed and if necessary the Equipment Officer notified. If damage or loss is due to grossly negligent conduct, the member will be responsible for repair or replacement. No equipment may be used by members other than the on-duty crew without prior approval from the Operations Captain.

Placement of Bikes
200.61.1 While MERT is not in service, MERT bikes are to be kept in the bike room at the Lower Quad Gate. 200.61.2 While MERT is in service, MERT bikes will be kept in a protected area where they will not be exposed to the elements, including but not limited to rain, snow, ice, and heavy winds. MERT personnel will ensure that the bikes are kept within eyesight of themselves, Penn Security, or Penn Police officers at all times.

Identification and Building Access

200.70.1 MERT members are required to carry their University of Pennsylvania identification card (Penn Card), Commonwealth of Pennsylvania EMT Basic card, and CPR card at all times while on duty.
200.70.2 MERT members will have their Penn Cards encoded to provide twenty-four hour access to all University of Pennsylvania residence halls. Should the crew be dispatched to a building with restricted access, the crew will notify dispatch of the situation. Each member is liable for his/her own access card. Misuse of this privilege will result in disciplinary action.

Minimum Duty Requirements

200.80.1 All members are expected to perform twenty-four hours of regular duty per month during the academic year. Additionally each member is expected to fulfill one athletic shift per semester during the academic year. Any duty hours that a member receives compensation for such as teaching do not count towards minimum duty hours. Furthermore it is expected that all members attend at least 2/3 of GBMs each month unless a valid excuse is presented.
200.80.2 In order to facilitate compliance with the minimum duty requirement, all members must submit a minimum of thirty-six hours availability each month. The total availability submitted may not fall within seven consecutive days.
200.80.3 The Scheduling Officer has the authority to modify or suspend minimum duty requirements for months where MERT service is not continuous.

Shift Exchanges and Cancellations

200.90.1 If a member needs to cancel a shift due to medical and/or personal reasons forty-eight hours or more prior to the shift, they must notify the Scheduling Officer via e-mail and attempt to find coverage for their shift. If the Scheduling Officer cannot be contacted, the member must notify the Chief. If the cancellation is less than forty-eight hours before the shift, they must call the Scheduling Officer. If no contact has been made, and the member does not show up for his/her shift, he/she will face disciplinary action. If a member needs to switch a shift with someone, they may do so with another member of equal or higher rank. Both members must then notify the Scheduling Officer via e-mail.

Shift Changes
300.10.1 MERT will operate from 17:00 07:00 seven days a week during the academic year. Shifts will operate on the following schedule: A Shift: 17:00 23:00 (6 hours) B Shift: 23:00 07:00 (8 hours)
300.10.2 The shift change will occur 15 minutes prior to the start of the shift. Lateness is defined as arriving more than 5 minutes after the shift change without notifying the Crew Chief on the shift. Members who are late to shift may face disciplinary action.

Crew Configuration
300.20.1 The on-duty crew will consist of a Crew Chief and at least one other member. Two members with the designation of Lead EMT may function in lieu of a Crew Chief. At no time will a responding crew consist of more than three members without prior approval of the Operations Captain or Chief. The Crew Chief has the overall responsibility and authority over the crew. At no time will an EMT or Probationary EMT respond without a Crew Chief or Lead EMT on-duty. 300.20.3 At no time should an off-duty member present or represent themselves as MERT personnel.

Clinical Chain of Command

300.21.1 The Clinical Chain of Command is a fixed hierarchy independent of crew configuration. The Chief is the highest-ranked clinical officer on MERT. The Operations Captain is the second highest-ranked clinical officer on MERT. The Operations Lieutenant is the third highest-ranked clinical officer on MERT. 300.21.2 The Clinical Chain of Command should be utilized during any of the following circumstances: 1. Confusion by the on-call crew regarding the correct treatment or procedure to follow during a call. 2. Unresolved conflict with another agency 3. Problems that affect the crew's ability to respond or deliver care 4. Treatment of a patient with a serious illness/injury (e.g. major trauma, respiratory or cardiac arrest) 5. Large volume of calls
300.21.3 The officers included in the Clinical Chain of Command should be contacted in order (first through third) by cellular telephone during any of the aforementioned circumstances. In the unlikely event that the Chief, Operations Captain, and Operations Lieutenant are unable to be reached, any other crew chief should be contacted for additional assistance.

On-Duty Supervisor
300.21.1 The on-duty Supervisor will be designated by the Operations Lieutenant.
300.21.2 The on-duty Supervisor should be notified for any of the following circumstances: 1. 2. 3. 4. Member fails to report for duty and is unreachable by the Crew Chief Unresolved conflict with another agency Problems that effects the crew's ability to respond or deliver care Treatment of a patient with serious illness/injury (e.g. major trauma, respiratory or cardiac arrest) 5. Large volume of calls
300.21.3 The on-duty Supervisor must be able to be contacted by cellular telephone at all times when a crew is in-service.

Dispatch and Response

300.30.1 When PennComm receives a request for emergency medical assistance, PennComm will gather vital information and dispatch MERT using the radio. PennComm will inform MERT of vital information including location, nature of call and dispatch time. The Crew Chief or designee should acknowledge the dispatch and inform PennComm that MERT is in route to the scene. Once responding, the crew will travel to the location of the incident by taking the safest and most direct route. PennComm should be notified upon the crews arrival on scene. The crew should be familiar enough with the service area so they can modify their route as needed without the use of maps or directions. 300.30.2 Lead patient care will be delegated by the Crew Chief. Refer to the MERT Medical Treatment Protocols for patient care procedures. If the patient requires transport by ambulance, the crew is to notify PennComm to dispatch PFD. Patient contact will be maintained until patient care and patient information has been transferred to the transporting agency or receiving facility (See Transfer of Care). If the patient does not want to be treated or transported a Refusal of Medical Assistance (RMA) should be completed and signed before leaving the scene (See Patient Refusal of Medical Treatment). Upon completion of the incident, the crew should confirm that all equipment is secured and nothing is left on the scene. When the crew becomes available, they should notify PennComm that the crew is clear of the scene and available for response. 300.30.3 In the event the crew is dispatched to a second incident while on scene, the Crew Chief will respond at his/her discretion provided a member of the crew with the rank of EMT or higher remains on scene with the first patient. If the crew is unable to respond, PennComm must be notified to dispatch PFD to the second scene.
300.30.4 All crew members must remain within MERTs jurisdictional boundaries at all times and be able to respond within two minutes. 300.30.5 In the event the crew is in an accident or an equipment malfunction prevents or delays the arrival of the crew to the scene, the Crew Chief or highest ranking able member is to notify PennComm of the crew's inability to respond and request any assistance required by the crew. The on-duty Supervisor should be contacted and an incident report filed as soon as possible.

Radio Communication
300.31.1 All information transmitted over the radio should be kept professional and concise. No patient identifying information should be transmitted over the radio. Each crew member is responsible for his/her own radio and carrying it with them at all times.
300.31.2 MERT members should utilize the following designations when communicating over the radio: Supervisor Crew Chief EMT Probationary MERT Command MERT 1a MERT 1b MERT 1c
The crew may collectively refer to themselves as MERT 1 when on a scene. If multiple crews are in service, crew numbers will be assigned sequentially by the Supervisor. The designation for PennComm is Radio.
300.31.3 The Crew Chief should inform PennComm via the radio at the start of the shift that MERT is in service.

Procedures for Atypical Dispatch

300.32.1 When MERT is requested by a party other than PennComm, such as a Resident Advisor an individual, a bystander, or other person to evaluate an individual, the Crew Chief or designee will inform PennComm of the nature of the call, location of the call, and dispatch time. PennComm will acknowledge the receipt of this information. Both PennComm and MERT will follow their usual Dispatch/Treatment protocols after this exchange of information. 300.32.2 In the event that MERT crew comes upon a potential patient without being dispatched by PennComm or flagged down by another individual, the Crew Chief or designee will inform PennComm of the nature of the call and the location of the call and then proceed to provide care. If no Penn Security or Penn Police officers are near the scene, the MERT crew will request their presence on the call. PennComm will acknowledge the receipt of this information. Both PennComm and MERT will follow their usual Dispatch/Treatment protocols after this exchange.

Special Event Protocol

300.33.1 MERT provides on-site medical coverage at special events, such as Spring Fling, Hey Day, sporting events, and other large scale events. The number of EMTs and crews staffing these events will be determined by the size and nature of the event. At the start of such events, MERT will inform PennComm of the number of crews that are in service and the expected duration of the event. 300.33.2 If MERT is working stand-by at a special event, MERT will notify PennComm of any emergencies in which a patient requests or requires transport to a hospital. MERT will inform PennComm of the nature of the call, location, and dispatch time. PennComm will acknowledge the receipt of this information. PennComm and MERT will then adhere to their usual Dispatch/Treatment protocol. 300.33.3 In the event that MERT is working a special event in which individuals unaffiliated with the University of Pennsylvania are present, MERT will treat individuals regardless of their university affiliation if they request care or care is deemed appropriate. 300.33.4 In the event that MERT is providing standby coverage at a pool event, MERT personnel will not operate outside of the Scope of Practice of an EMT and will not perform any water rescue. All water rescue should be performed by qualified lifeguard personnel. If an individual must be rescued from the water, MERT personnel will begin treatment once the patient has been safely removed to dry land.

Scene Safety
300.40.1 MERT members must use extreme caution whenever responding to a scene that is potentially unsecure or unsafe. The Crew Chief is responsible for ensuring the safety and security of all scenes prior to assessing the patient and initiating care. If a potential danger is perceived by any member of the crew, the crew will immediately evacuate the danger zone and move to safe ground. The Crew Chief or designee will notify PennComm via radio of the perceived danger and request the necessary resources. Potential dangers include, but are not limited to: Weapons Explosives Violent individuals Natural disasters Hazardous materials Roadways Fires Any other potential scenario, which may endanger the crew
The crew will only reenter the scene and begin patient care once the scene has been deemed safe by police and all other agencies.

Transport Safety
300.41.1 The safety of MERT personnel is paramount. Under no circumstances should MERT risk biking or walking to a scene if conditions may result in the injury of MERT personnel or damage of MERT property. In the event of inclement weather, such as heavy rain, snow, ice, high winds, flooding, or other circumstances, the MERT crew on shift will request transportation by Penn Police to all calls. The Crew Chief or designee will notify PennComm at the beginning of the inclement weather that they will be requesting transport to all calls for the duration of the adverse conditions. When requesting transport to a call, MERT will notify PennComm of both the pick-up and drop-off locations. 300.41.2 It is the responsibility of the Crew Chief to ensure that conditions are safe for bike transport, and if any member of the crew feels uncomfortable biking in the conditions, the Crew Chief shall request transport for the duration of the adverse conditions.

Jurisdiction
300.50.1 MERT is responsible to provide emergency medical services to any call which they are dispatched. In general, MERT will respond to incidents from 30th Street to 43rd Street (east to west) and Market Street to Baltimore Avenue (north to south).
300.50.2 MERT operates within the jurisdiction of the Philadelphia Fire Department (PFD). When PFD is on scene, they have primary medical jurisdiction.
300.50.3 MERT will utilize the following Zone designations in documenting locations: Zone 1 North: Market Street, South - South Street, East: I-76, West: 33rd Street Zone 2 North: South Street, South: University Avenue, East: I-76, West: Civic Center Boulevard Zone 3 North: Market Street, South: Walnut Street, East: 33rd Street, West: 38th Street Zone 4 North: Walnut Street, South: University Avenue, East: 33rd Street, West: 38th Street Zone 5 North: Market Street, South: Walnut Street, East: 38th Street, West: 42nd Street Zone 6 North: Walnut Street, South: Baltimore Avenue, East: 38th Street, West: 42nd Street

Patient Transport
300.60.1 Any patient who requires ALS treatment, spinal immobilization, oxygen or has potential life threatening injuries must be transported via PFD ambulance. If a patient requires transport by PFD, confirmation that PFD is responding should be made with PennComm. Upon arrival of PFD, a complete report of prior assessment and treatment should be given to the receiving crew.
300.60.2 Non-critical patients with stable vital signs and no signs of immediate distress may be transported via UPPD. The patient transport must be approved by the UPPD Supervisor and a member of the crew with the rank of EMT or higher must accompany the patient in the UPPD vehicle with medical equipment. Patients transported to the University of Pennsylvania Hospital or Penn Presbyterian Medical Center should be triaged and the name of the triage nurse obtained and recorded on the PCR.

Reporting of Accident or Injury to a MERT Member

300.70 In the event that a MERT member is involved in any accident while on shift, which results in member injury or fatality, the following steps will be adhered to in the order that they are written. 1. The Crew Chief or designee will immediately notify PennComm of the incident and request the necessary resources to provide immediate medical treatment to that member. Fellow crew members will provide emergency care until the arrival of the Philadelphia Fire Department for transport. If Penn Police is not already on scene, their presence will be requested. If the injury of the member will prevent the crew from responding to a call, the Crew Chief or designee will notify PennComm that the MERT crew will be unable to respond to the previous call. 2. The Crew Chief or designee will notify the Operations Captain and Chief of the incident as soon as care of the injured member has been transferred to a higher level of medical care. 3. A Special Report detailing the incident will be written on EMScharts.com by the Crew Chief or designee and by the injured member if he or she is capable. 4. The incident will be reviewed by the Chief and Operations Captain, who will consult with the Department of Public Safety and Student Health Services to ensure that adequate follow-up is provided to the victim and all other MERT members present at the incident.

Crew Chief Advancement

400.10.1 In order for a Lead EMT to be promoted to the rank of Crew Chief, the following requirements must be met: 1. Successful completion of at least one shift review and two reviewed calls by different Crew Chiefs 2. Demonstrate competency in MERT operations, SOPs, and campus building locations 3. Completion of ICS 200 (NIMS) After the above requirements have been met, the candidate will be granted an interview with the Operations Lieutenant. Any of these individual requirements may be waived by the Operations Lieutenant at his or her discretion.

Lead EMT Advancement

400.20.1 In order for an EMT to be promoted to the rank of Lead EMT, the following requirements must be met: 1. Minimum of 8 patient contacts 2. Successful completion of three patient care scenarios (medical, trauma and cardiac arrest) with the Operations Lieutenant held to NREMT standards 3. Demonstrate familiarity of MERT operations, SOPs, and campus building locations 4. Successful completion of at least one shift review and one reviewed call by a Crew Chief After the above requirements have been met, the candidate will be granted an interview with the Operations Lieutenant. Any of these individual requirements may be waived by the Operations Lieutenant at his or her discretion.

EMT Advancement
400.30.1 In order for a Probationary member to be promoted to the rank of EMT, the following requirements must be met: 1. 24 hours of on-duty time 2. Successful completion of the Equipment Location Exam with the Training Officer or Crew Chief a. This includes that the Training Officer or Crew Chief ensures the zip-tied bags are opened and reviewed 3. Successful completion of the Basic Skills Exam with the Training Officer or Crew Chief 4. Familiarization with radio communication After the above requirements have been met, the candidate will be granted the rank of EMT. Any of these individual requirements may be waived by the Operations Lieutenant at his or her discretion.

Accommodations for Prior EMS Experience

400.40.1 Members with significant prior 911 or equivalent EMS experience are eligible to be promoted directly from EMT to Lead provided after the following requirements have been met: 1. 2. 3. 4. Submit at least one reference of a previous EMS supervisor Successful completion of the Equipment Location Exam with a Crew Chief Successful completion of the Basic Skills Exam with a Crew Chief Successful completion of three patient care scenarios (medical, trauma and cardiac arrest) with the Operations Lieutenant held to NREMT standards 5. Successful completion of at least one shift review and one reviewed call by the Chief, Operations Captain, or Operations Lieutenant 6. Demonstrate competency in MERT operations, SOPs, and campus building locations After the above requirements have been met, the candidate will be granted an interview with the Operations Lieutenant.

HIPAA Compliance and Patient Confidentiality

500.10.1 The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 and covers numerous issues in health care. Title II, Subtitle F establishes regulations for the use and disclosure of Protected Health Information (PHI). PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual. In order to protect MERTs professional integrity, it is imperative that all members strictly adhere to laws regarding confidentiality. Medical information, including the patients PCR, is considered confidential protected health information and may only be transferred to the next medical professional caring for the patient. MERT members should not discuss the specifics of an incident except for the purpose of call review.
500.10.2 The Operations Captain will serve as the privacy officer for MERT. Any suspected privacy violations must be immediately reported to the Operations Captain.

Patient Consent for Medical Treatment

500.20.1 The provision of emergency medical care requires the consent of the patient. Any touching of the patients body without the patients consent could result in charges of assault and battery. Consent may either by expressed or implied. Expressed consent (or actual consent) is the type of consent in which the patient speaks or acknowledges that he/she wants care provided. The patient must be informed of the potential risks, benefits and alternatives to treatment. The patient must be a legal adult and able to make a rational decision. When a person is unconscious and unable to give consent or when a serious threat to life or limb exists, the law assumes that the patient would consent to care. Implied consent is limited to life-threatening emergency situations and is appropriate when the patient is unconscious, delusional, impaired as a result of drug or alcohol use or otherwise physically unable to give expressed consent.
500.20.2 In the case of minors or adults who are mentally incompetent, consent must be obtained from the parent or legal guardian. If the parent or legal guardian is not available, the consent for emergency treatment is implied.
500.20.3 Persons in the custody of a law enforcement officer may be treated at the request of the officer without the need to obtain the patients expressed consent.

Patient Refusal of Medical Treatment

500.30.1 In order to refuse treatment, the patient must be competent. Competency is defined as being alert, awake and oriented to person, place, time and event, and not suspected to be under the influence of any substances such as alcohol or drugs. The patient is not competent when under temporary but severe stress or depression or having possible temporary psychosis or chronic mental disorder.
500.30.2 If a competent patient states that he/she does not want to be treated, the crew must not initiate treatment. The crew must explain the consequences of refusing medical care and again offer treatment. If the patient still refuses treatment, a Refusal of Medical Treatment form should be completed and the patient should sign the form acknowledging refusal of further treatment. If the patient refuses to sign a witness or law enforcement official should sign and the incident documented on the PCR. In situations where the patient is refusing against the medical advice of MERT personnel or there is ambiguity in the severity of the patients condition, patient care should be transferred to PFD for refusal purposes.

Transfer of Care
500.40.1 Patient care may only be transferred to a provider of equal or higher level. Upon transfer of patient care, a complete verbal report of prior assessment and treatment should be given to the receiving provider. The unit number and/or name of the accepting agency should be documented on the PCR.

Patient Care Report

500.50.1 A patient care report (PCR) is completed for every call for which MERT is dispatched. The PCR is a legal document and part of the patients medical record. PCRs will be completed and signed electronically using EMSCharts Inc. charting software. Two MERT members are required to sign each chart prior to locking.

Supplemental Incident Report

500.60.1 A supplemental incident report is an internal document that explains a deviation from normal operations. Any member with a rank of EMT or higher can write an incident report. The report should be a clear and concise narrative that explains the situation, the problem encountered, and any actions taken in response by the crew. If a report references a specific call, no information should be included that could identify the patient. The Operations Captain should be notified within twenty-four hours. An incident report should be filed for any of the following reasons: 1. 2. 3. 4. 5. Violation of MERT SOPs Unusual circumstances in providing patient care Difficulties in interacting with UPPD, PFD or other agencies that regularly work with MERT Equipment loss, damage, or malfunction Member conduct warranting disciplinary action
500.60.2 Supplemental incident reports will be filed using EMSCharts Inc. charting software Special Reports.

Infection Control
Protocol Number: Effective Date: Revised Date: 500.70.1 The following scenarios should be considered an exposure: 1. Patient blood or bodily fluid comes in contact with a providers mucous membrane or skin 2. Needle sticks with a used needle or other sharp medical instrument 3. Unprotected exposure to a patient with a known or highly suspected airborne pathogen 500.70.2 Immediately following an exposure, the Crew Chief should notify the Operations Captain. The member should seek medical treatment for the exposure at Student Health Services during operating hours or at the closest emergency medical facility 500.70.3 MERT members will always take appropriate personal isolation precautions when treating patients. This may include but is not limited to: 1. 2. 3. 4. 500.70.4 If a MERT member treats a patient who is symptomatic of an infectious disease, he/she should report the incident to the Operations Captain. If the MERT member is concerned that he/she may have been exposed to the infectious disease, the member should seek medical treatment and testing at Student Health Services during operating hours or at the closest emergency medical facility and notify the Operations Captain of the incident.
500.70 09-12-2007 02-28-2012
Wearing a face mask Wearing gloves Wearing personal isolation sleeves Wearing safety goggles.

Critical Incident Stress Management

500.80.1 This operational procedure provides guidelines for recognizing and implementing a Critical Incident Debriefing, thereby attempting to manage and prevent injuries/illnesses to our members from problems associated with stress. 500.80.2 The following definitions shall apply in this document: 1. Critical Incident A critical incident is one in which a member(s) is experiencing situations with strong emotional involvements that are generally outside the range of usual human experiences. 2. Critical Incident Debriefing Critical Incident Debriefing is an organized approach designed to assist emergency service personnel in understanding and dealing with the effects of stress. 3. Debriefing Debriefing is a process that provides a format where personnel can discuss their fears and reactions thereby reducing the stress resulting from exposure to a critical incident. Debriefing is not a critique of MERT operations that occurred during the incident. Performance issues will not be discussed during the debriefing. All debriefings are totally confidential. Debriefings may be conducted on an individual one-on-one basis or, more typically, in small groups. 4. Stress Stress is a normal reaction to disaster/emergency operations. It gears our bodies for immediate action and sustains us for long periods of intense and strenuous activity. However, too much stress can be harmful. During and following disaster/emergency
operations, members may experience the effects of excessive stress.
5. Triggering Events A triggering event is one in which a situation has occurred of such magnitude that its occurrence alone has the potential to effect personnel present at the scene of a disaster/emergency operation. The following have been identified as triggering events and indicate the need for Critical Incident Debriefing. This is by no means an exhaustive or comprehensive list. a. b. c. d. e. f. g. h. i. j. k. l. On-duty death of member(s) Severe duty related Injuries to member(s) Mass casualties Suicide by a member Shooting situations Death or serious injury of civilians during MERT operations Traumatic deaths of children Traumatic injuries of children Events with excessive media interest Incidents when victims or patients are known by or related to MERT members Suspected contamination of members involving toxic materials Dangerous or hazardous environments that MERT is dispatched to, or that materialize after MERT is on scene
500.80.3 1. Upon any of the above events, or any other situation in which a member of MERT feels a debriefing is necessary, this member or his/her appointee shall approach the Chief with the request of a debriefing for the member(s) involved. a. If the Chief is not immediately available, the Operations Captain shall be the next person of which to request a debriefing, followed by the Operations Lieutenant, and finally, the on duty supervisor for the week of which the incident took place. If all of these resources are unavailable, the request can be made directly as described in 500.80.3.4. If the request is made directly, the Chief must be informed as soon as is possible after the request is made. 2. If at any point during the QA process, a lead or crew chief finds a call chart that represents an event where a triggering event or critical incident may have occurred, the QA personnel shall notify the Operations Captain. The Operations Captain shall determine, in conjunction with the Chief, the need for Critical Incident Debriefing for the affected crewmembers.
3. The MERT Chief, MERT Operations Captain, DPS Chief of Fire and Emergency Services, and the DPS Director of Special Services shall have the authority to mandate Critical Incident Debriefing for MERT members or crews involved in critical incidents at any of their discretions. Failure to comply can result in disciplinary action, which can include removal from MERT. The need for follow-up debriefings shall be determined after the initial debriefing. If Penns Critical Incident Stress Management Team feels that additional counseling is needed, they shall refer the affected member(s) to Counseling and Psychological Services. Although this referral cannot be mandated, MERT strongly recommends affected member(s) to take advantage of any and all referrals given. 4. Once the need for a debriefing is established, the request shall be channeled through PennComm at the emergency number, 215-573-3333. 500.80.4 MERT members participating in a CID are assured confidentiality. CID records shall not be used in any matters regarding MERT discipline, advancement, etc., and shall not become a part of any record that MERT personally maintains. MERT recognizes that there may be times when documents involved in a CID may be subpoenaed or legally required. Generally speaking, communications with mental health professionals are privileged and will remain confidential. There may however, be legal exceptions to this confidentiality over which MERT has no control.

Executive Structure
600.10.1 MERT receives medical direction from the University of Pennsylvania Student Health Services (SHS) and operation oversight from the Division of Public Safety (DPS) of the University of Pennsylvania. The Board will consult with these departments for any major changes within the organization that require their authorization, signature and/or approval.
600.10.2 The MERT Board of Directors will consist of the Chief, Operations Captain, Operations Lieutenant, Administrative Director, Equipment Officer, Scheduling Officer, Training Officer, Disaster Response Team Officer, Athletics Scheduling Officer, Bicycle Engineer, Internal Communications Officer, BLS Officer, Community Outreach Officer, Social Coordinator and CPR Coordinator.
600.10.3 The Chief may choose to add additional staff at his or her discretion after consultation with the Board of Directors.

Chief - Basic Functions and Responsibilities

600.11.1 Basic Functions and Responsibilities: 1. The Chief will be the highest-ranked clinical officer 2. The Chief will serve as Chairman of the Board 3. The Chief will ensure compliance with the SOPs of the organization and review all disciplinary matters 4. The Chief will communicate concerns or recommendations for improving the delivery of emergency medical services to the Board 5. The Chief will meet, as necessary, with the DPS Liaison and Medical Director 6. The Chief will organize and oversee the operations for all major University events 7. The Chief will be the primary media contact for the organization 8. After the term has ended the ex-Chief will be expected fill the role of student advisor by attending the first half of board meetings in the first semester to provide advice and information to the new board.
600.11.2 Qualifications: 1. 2. 3. 4. Candidate is a Crew Chief in Good Standing Candidate is nominated and elected by the previous Board Candidate receives a vote of confidence by the Active Membership Candidate has held a previous Board position

Operations Captain - Basic Functions and Responsibilities

600.12.1 Basic Functions and Responsibilities: 1. 2. 3. 4. 5. 6. The Operations Captain will be the second highest-ranked clinical officer The Operations Captain will oversee daily operations and ensure good medical practice The Operations Captain will review all Incident Reports The Operations Captain will serve as the HIPAA compliance officer The Operations Captain will organize, staff, and plan special events The Operations Captain will facilitate communication via the Chain of Command
600.12.2 Qualifications: 1. 2. 3. 4. Candidate is a Crew Chief in Good Standing Candidate is nominated and elected by the previous Board Candidate receives a vote of confidence by the Active Membership Candidate has been an Active Member for a minimum of one year

Operations Lieutenant - Basic Functions and Responsibilities

600.13.1 Basic Functions and Responsibilities: 7. The Operations Lieutenant will be the third highest-ranked clinical officer 8. The Operations Lieutenant shall be responsible for supporting the objectives of the Operations Captain in absence of that captain 9. The Operations Lieutenant shall identify members in need of advancement 10. The Operations Lieutenant is in charge of conducting advancement tests for Probationary, Lead, and Crew Chief 11. The Operations Lieutenant is responsible for maintaining, revising, and updating all advancement documents 12. The Operations Lieutenant is in charge of maintain and updating MERT Standard Operation Procedures and Protocols 13. The Operations Lieutenant is in responsible for oversight of the supervisor program 14. The Operations Lieutenant will facilitate communication via the Chain of Command 600.13.2 Qualifications: 5. 6. 7. 8. Candidate is a Crew Chief in Good Standing Candidate is nominated and elected by the previous Board Candidate receives a vote of confidence by the Active Membership Candidate has been an Active Member for a minimum of one year

Administrative Director - Basic Functions and Responsibilities

600.14.1 Basic Functions and Responsibilities: 15. 16. 17. 18. 19. 20. 21. 22. The Administrative Director will maintain accurate records of all active members The Administrative Director will maintain all call statistics The Administrative Director will coordinate the new member application process The Administrative Director will create the SAC budget and manage non-operational MERT funds The Administrative Director will attend all SAC meetings The Administrative Director is in charge of applying for all awards and grants The Administrative Director is the NCEMSF liaison The Administrative Director will facilitate communication via the Chain of Command
600.14.2 Qualifications: 9. Candidate is nominated and elected by the previous Board 10. Candidate receives a vote of confidence by the Active Membership

Scheduling Officer - Basic Functions and Responsibilities

600.15.1 Basic Functions and Responsibilities: 23. 24. 25. 26. 27. 28. 29. The Scheduling Officer will schedule all duty crews for daily shifts and special events The Scheduling Officer will maintain all shift records and duty statistics The Scheduling Officer confirms service availability for events The Scheduling Officer maintains contacts with MERT clients vital to scheduling tasks The Scheduling Officer relays information about delinquent members to Operations Captain The Scheduling Officer oversees Athletics Scheduling Coordinator The Scheduling Officer will facilitate communication via the Chain of Command

Training Officer - Basic Functions and Responsibilities

600.16.1 Basic Functions and Responsibilities: 30. The Training Officer will schedule and organize all MERT membership meetings, and continuing medical education training 31. The Training Officer will ensure all new members are familiar with the SOPs and medical protocols before certifying them for active duty 32. The Training Officer is in charge of organizing and conducting bicycle-training classes 33. The Training Officer will facilitate communication via the Chain of Command

Equipment Officer - Basic Functions and Responsibilities

600.17.1 Basic Functions and Responsibilities: 34. 35. 36. 37. 38. 39. 40. The Equipment Officer will be responsible for all equipment and supplies The Equipment Officer will administer operational funds The Equipment Officer will be responsible for conducting safety reviews of the organization The Equipment Officer will be responsible for all bike and equipment maintenance The Equipment Officer will advise the Bicycle Engineer The Equipment Officer will oversee and maintain Butcher station The Equipment Officer will facilitate communication via the Chain of Command

Disaster Response Team Officer - Basic Functions and Responsibilities

600.18.1 Basic Functions and Responsibilities: 41. The Disaster Response Team Officer will organize training for the MERT Disaster Response Team (DRT) 42. The Disaster Response Team Officer will develop and implement DRT specific policies and procedures 43. The Disaster Response Team Officer will organize and implement DRT drills 44. The Disaster Response Team Officer will manage funds and equipment specific to the DRT 45. The Disaster Response Team Officer will facilitate communication with mutual aid partners 46. The Disaster Response Team Officer will facilitate communication via the Chain of Command

Internal Communications Officer - Basic Functions and Responsibilities

600.19.1 Basic Functions and Responsibilities: 47. The Internal Communications Officer will manage MERT publications and the MERT website 48. The Internal Communications Officer will manage electronic mailing lists and approve messages sent over listservs 49. The Internal Communications Officer will act as secretary for General Body and Board meetings and take minutes at those meetings 50. The Internal Communications Officer will manage the quarterly MERT newsletter 51. The Internal Communications Officer is in charge of developing and managing the alumni relationship 52. The Internal Communications Officer will facilitate communication via the Chain of Command

BLS Officer - Basic Functions and Responsibilities

600.20.1 Basic Functions and Responsibilities: 53. The BLS Officer will maintain MERTs certifications with the City of Philadelphia and/or the State of Pennsylvania 54. The BLS Officer will maintain equipment for EMT classes offered by MERT 55. The BLS Officer will manage payment for EMT classes offered by MERT 56. The BLS Officer will manage applications for EMT classes offered by MERT 57. The BLS Officer will negotiate and maintain contracts with EMT instructors employed by MERT 58. The BLS Officer will administer classroom policies for EMT classes offered by MERT 59. The BLS Officer will conduct quality assurance of EMT classes offered by MERT 60. The BLS officer is chiefly responsible for recruitment (activities fairs) of students for EMT classes offered by MERT 61. The BLS Officer will facilitate communication via the Chain of Command

Community Outreach Officer - Basic Functions and Responsibilities

600.21.1 Basic Functions and Responsibilities: 62. The Community Outreach Officer will conduct public health programming 63. The Community Outreach Officer will organize special events including Flu Clinic and EMS Week among others 64. The Community Outreach Officer coordinates healthcare conferences 65. The Community Outreach Officer develops and manages relationships with Penn and West Philadelphia communities 66. The Community Outreach Officer develops and implements poster campaigning with the Office of Alcohol and Other Drug Initiatives 67. The Community Outreach Officer manages community first aid classes 68. The Community Outreach Officer will facilitate communication via the Chain of Command

Chain of Command
600.30.1 The flow diagram below outlines the MERT Chain of Command. All members are expected to follow the Chain of Command. If a member has a specific issue with the individual next in the Chain of Command, that member may address the individual directly above them in the Chain of Command.
Operational Oversight: Division of Public Safety Medical Oversight: Student Health Services
MERT Advisory Board
Chief
Student Advisor
Operations Captain
Administrative Director
Operations Lieutenant
Scheduling Officer
Training Officer
Equipment Officer
Disaster Response Team Officer
Internal Communications Officer
BLS Officer
Community Outreach Officer
Athletics Scheduling Coordinator
Bicycle Engineer
Social Coordinator
CPR Coordinator
600.30.2 Any issues unable to be resolved by the MERT Board will be directed to the MERT Advisory Board.

Internal Investigations
600.30.1 When a member of MERT takes an action that may be detrimental to the patient care provided by, the property of, the members in, or the reputation of the group, or in any way hinders the ability of the group to achieve its goals he or she is subject to an investigation. The Chief will be responsible for initiating and conducting all internal investigations.
600.30.2 Any MERT member subject to an investigation will have an opportunity to defend his or her actions before the conclusion of the investigation and before final action is taken with regard to status within the organization.

Quality Assurance/Quality Improvement

600.50.1 The Quality Assurance/Quality Improvement (QA/QI) process is intended to identify weaknesses and errors both in the writing of narrative reports, and during patient contacts. The QA/QI process is also used as a tool to identify exemplary members skills, knowledge, and abilities. Through careful review of written patient care reports, MERT members will learn from their mistakes and successes, and continue to improve their skills. This process also serves as an additional training tool and assessment.
600.50.2 The QA/QI process will be implemented as follows: 1. By the end of every month during the academic year, the Operations Lieutenant (or designee such as a Crew Chief) will review every PCR. The Operations Lieutenant will record any points of confusion or inconsistency with the SOPs. 2. The Chief will meet with the Medical Director to review the findings of the QA/QI process. 3. In situations where significant errors in patient care or policy have occurred, the Chief, Operations Captain and, if necessary, Medical Director will meet with the individual(s) to discuss the issue. 600.50.3 MERTs Medical Director at Student Health Services (SHS) may access the patient care reports written by MERT personnel through EMSCharts Inc. SHS may use this access for Quality Assurance purposes and to provide follow up care to patients who are Penn students.

Penn Medical Emergency Response Team Protocols

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Penn Medical Emergency Response Team Protocols

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Procedures and Protocols

Medical Emergency Response Team

Last Revision Date 04-08-2013

Standard Operating Procedures

Member Expectations and Conduct

Operations and Response

300.32 300.33 300.40 300.41 300.50 300.60 300.70

600.30 600.40 600.50

Chain of Command Internal Investigations Quality Assurance / Quality Improvement

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Functional Position Description

Standard Operating Procedure

Member in Good Standing

Standard Operating Procedure

Standard Operating Procedure

Member Code of Conduct

Standard Operating Procedure

Standard Operating Procedure

Alcohol and Controlled Substances

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

MERT Influenza Vaccination Declaration

Standard Operating Procedure

Standard Operating Procedure

200.30 09-12-2007 11-17-2007

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Squad Room Management

Standard Operating Procedure

Property and Equipment

Standard Operating Procedure

Standard Operating Procedure

Identification and Building Access

Standard Operating Procedure

Minimum Duty Requirements

Standard Operating Procedure

Shift Exchanges and Cancellations

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Clinical Chain of Command

Standard Operating Procedure

300.21.1 The on-duty Supervisor will be designated by the Operations Lieutenant.

Standard Operating Procedure

Dispatch and Response

Standard Operating Procedure

Standard Operating Procedure

Procedures for Atypical Dispatch

Standard Operating Procedure

Special Event Protocol

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Standard Operating Procedure

Reporting of Accident or Injury to a MERT Member

Standard Operating Procedure

Crew Chief Advancement

Standard Operating Procedure

Lead EMT Advancement