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HomeMy WebLinkAboutCC Resolution 8665 (EMT Defibrillation Program)RESOLUTION NO. 8665 A RESOLUTION AUTHORIZING THE CITY MANAGER TO SIGN AN AGREEMENT WITH DOCTOR MICHAEL SEXTON FOR SERVICES AS LIAISON PHYSICIAN FOR THE EMT -DEFIBRILLATION PROGRAM (4/2/92 - 4/1/95) RESOLVED, that the City Council of the City of San Rafael, does hereby authorize City Manager Pamela Nicola! to sign an Agreement with Doctor Michael Sexton for Services as the Liaison Physician for the Fire Department EMT -Defibrillation Program, copy of which is attached and by reference made a part hereof. I, JEANNE M. LEONCINI, Clerk of the City of San Rafael, hereby certify that the foregoing Resolution was duly and regu- larly introduced and adopted at a regular meeting of the City Council of said City held on Monday , the 18th day of May , 1992, by the following vote, to wit: AYES: COUNCILMEMBER: Breiner, Cohen, Thayer & Playor Boro NOES: COUNCILMF.MBER: None ABSENT: COUNCILMEMBER: Shippey J M. LEONCINI; City Clerk nu G I 'N"A I PROFESSIONAL SERVICES AGREEMENT THIS AGREEMENT made and entered into this 18th day of May , 1992, by and between the City of San Rafael, a municipal corporation, hereinafter referred to as "City" and Doctor Michael Sexton, hereinafter referred to as "Consultant". RECITALS WHEREAS, City desires to implement an EMT -Defibrilla- tion Program which requires a Liaison Physician who meets the requirements for a Base Hospital Physician as defined in County of Marin Emergency Medical Services Policy Reference #504. WHEREAS, Consultant is qualified as an emergency room physician to render such professional services as described below, on the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual cove- nants and conditions contained herein, the parties hereby agree as follows: 1. SCOPE OF SERVICES. Consultant agrees to perform those services as outlined in County of Marin, Department of Health and Human Services, EMS Agency's references, which are attached and incorporated herein as Exhibit A. 2. COMPENSATION. City agrees to pay Consultant a fee of one thousand ($1000) dollars a month for the Services as outlined in Paragraph 1 above. City shall pay an additional sum of ninety five ($95) dollars per hour if the Consultant's services exceed eight (8) hours in any single month. 3. INDEPENDENT CONTRACTOR. It is expressly understood and agreed to by all parties that Consultant is an Indepen- dent Contractor and not an employee of the City. The Consultant will not, at any time or in any manner, represent that he is an employee of the City. COP Y Page 2 4. NON -AGREEMENT. This Agreement contemplates the Profes- sional and unique services of the Consultant, and it is recognized by the parties hereto that a substantial inducement to the City for entering into this Agreement was and is the professional reputation and competence of the Consultant. Neither this Agreement nor any interest therein may be assigned by the Consultant and the Consultant shall not sub -contract any portion of the performance contemplated and provided for herein. 5. INSURANCE. During the term of this agreement, Consul- tant shall maintain Malpractice Insurance according to the terms and conditions outlined in Exhibit B, at- tached and incorporates by reverence herein. 6. INFORMATION AND REPORTS. Consultant shall provide all information and reports required by the County of Marin, Department of Health and Human Services, EMS Agency references (Exhibit A). 7. TERMINATION AND NOTICE. This Agreement may b e termi- nated by City or Consultant at any time upon sixty (60) days written notice to all parties to this Agreement. B. TERMS OF AGREEMENT. The terms of this Agreement shall be from 4/7/92 to 4/1/95 , at which time it shall be renewed. 9. WHOLE AGREEMENT. This constitutes the entire Agreement of the parties. No modification or amendment of this Agreement shall be valid unless it is in writing and executed by all parties. 10. ARBITRATION. Consultant and City agree to submit any clains arising under this Agreement or any dispute concerning the terms or provisions of this Agreement to binding arbitration pursuant to the current provisions of the California Code of Civil Procedure and any successor statutes. The Arbitrator is empowered to award attorney's fees to the prevailing party. Page 3 IN WITNESS WHEREOF, the parties have executed this Agreement as of the date first written above. CITY OF SAN RAFAEL ATTEST: BY k-ItyClerk . Cl APPROVED AS TO FORM: By: A[ Wa oj� "� pw, City Attorney DOCTOR MICHAEL SEXTON By � w EXHIBIT A COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.2 SUBJECT EKr-Defibrillation - Liaison Physician AUTHORITY Title 22, Division 9, Chapter 2 California Ad-ninistraticn Code REQUIREMINTS AND RESPONSIBILITIES OF EXT -D LIAISON PHYSICIAN 1. Requirements The EMT -D Liaison Physician (DLP) must: 1.1 meet the requirements for a Base Hospital Physician as defined in Policy Reference 1 504. 1.2 possess a working knowledge of prehospital EMS system and, in particular, EKT-D systems. 1.3 make a sufficient time commitment to actively participate in the review of individual cases and in the development and approval of all periodic trend reports. 2. Responsibilities The EMT -D Liaison Physician: 2.1 is responsible for the quality control of the program and the training the personnel for whom they have agreed to supervise in accordance with Policy Reference 1 403.3 and 403.4. 2.2 is required to attend or assist instruction in, at least one EMT -D training program. 2.3 is responsible for ensuring that persons under their supervision are retrained, and periodically evaluated, with sufficient frequency to maintain safe equipment operation and effective compliance with the standing orders. This responsibility may be delegated to qualified personnel with EMS Agency approval. 2.4 is responsible for ensuring that persons with defibrillation skills, under their sponsorship or direction, who demonstrate that they are not capable of safely and effectively carrying out the necessary duties of an EMT -D, be suspended from EYT-D service. The Physician must immediately notify the EMS Agency of action taken. An Page 1 of 2 EFFECTIVE DATE :o APPROVED BY F-1-il 1'i. ]9F • The ore D. Hiatt M.D. REPLACES: Kc} Marin County Health Officer EMS Medical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.1 SUBJECT FJTT-Defibrillation AUTHORITY Ti r 1 P 22. ni ori ni nn 4 _ rhaptpr 2 California Administration Code 4.1.3 Sufficient time for each student to practice and satisfactorily demonstrate the required skills to the instructor. 4.1.4 Marin County EY.S Policy and Procedure and performance standards regulating EMT Defibrillation. 4.2 The final written and practical evaluation. 4.3 The requirements in 4.1 and 4.2 may be waived if the training program is provided by a College or program approved by the Harin County EMS Agency. 5. only semi-automatic external defibrillators with rhythm assessment through adhesive monitor/defibrillation pads are acceptable. 6. The monitor/defibrillator must provide a computerized read out of rhythms, times of interventions and voice tape recordings. 7. EHT-D will treat ventricular fibrillation and pulseless ventricular tachycardia only. 8. EMT -D's will not apply the monitor/defibrillator to conscious patients with chest pain. 9. EMT -D's will adhere to other applicable Marin County Protocols. 10. Accreditation: 10.1 The program will be accredited for one'year initially, and reaccreditation will be according to established policies and procedures for EMT training programs. 10.2 EMT -D's will be accredited for one year and reaccreditation will be according to established policies and procedures. 10.3 All accreditations will be in writing from the EY.S Agency. 12. The EMS Agency will report annually to the EFS Authority on the application of the local EMT -D program(s) and patient outcomes. Page 2 of 2 EFFECTIVE DATE: April 13, 1989 APPROVED Dy / 'Theodore D. Hiatt. M.D. / REPLACES: NEW Marin County Health Officer EMS Medical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.2 SUBJECT EMT -Defibrillation - Liaison Physician AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code REQUIREKENTS AND RESPONSIBILITIES OF EMT -D LIAISON PHYSICIAN 1. Requirements The EXT -D Liaison Physician (DLP) must: 1.1 meet the requirements for a Base Hospital Physician as defined in Policy Reference 1 504. 1.2 possess a working knowledge of prehospital EMS system and, in particular, ENT -D systems. 1.3 make a sufficient time commitment to actively participate in the review of individual cases and in the development and approval of all periodic trend reports. 2. Responsibilities The EHT-D Liaison Physician: 2.1 is responsible for the quality control of the program and the training the personnel for whom they have agreed to supervise in accordance with Policy Reference 11 403.3 and 403.4. 2.2 is required to attend or assist instruction in, at least one EMT -D training program. 2.3 is responsible for ensuring that persons under their supervision are retrained, and periodically evaluated, with sufficient frequency to maintain safe equipment operation and effective compliance with the standing orders. This responsibility may be delegated to qualified personnel with EMS Agency approval. 2.4 is responsible for ensuring that persons with defibrillation skills, under their sponsorship or direction, who demonstrate that they are not capable of safely and effectively carrying out the necessary duties of an EMT -D, be suspended from ENT -D service. The Physician must immediately notify the EHS Agency of action taken. An Page 1 of 2 EFFECTIVE DATE: Pn•i 1 11, 19PQ APPROVED BYY"'< / T..o e e D. Hiatt. M.D. REPLACES: K Karin County Health Offlur EMS KeCicai Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE N0. 403.2 SUBJECT EMT -Defibrillation - Liaison Physician AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code organized plan of action will then be subnitted, in writing, for retraining and subsequent re-evaluation of the EMT -D. 2.5. must establish a standard for continued proficiency of an EHT-D. The demonstration of proficiency must be documented at the base hospital at least every six (6) months. EMT -D proficiency should include skills maintenance with the ability to defibrillate• correctly a defibrillation mannikin within 90 seconds of arrival at the mannikin's side, including pulse checks and recognition that a shock has been delivered. 2.6. must report, in writing, to the Paramedic advisory Committee (PAC) on an annual basis. EFFECTIVE DATE: April 13, 1989 REPLACES: NEW i Paso 9 n 2 APPROVED BY he ore D. H att. D. Marin County Health Offl u r` EMS Medical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.3 SUBJECT EIIT-Defibrillation - Qt:ality Assurance AUTHORITY Title 22, Division 9, Chanter 2 California Administration Code QUALITY ASSURANCE ENT -D SERVICE I. EHT-D quality assurance programs are required: 1.1 to assure timely and competent review of EMT -D managed cardiac arrest cases, accurate logging of required data, and timely accurate and informative statistical summaries of system performance over time, as well as recommendations, as indicated, for modifications of system design, performance protocols, or training standards designed to improve patient outcome. 1.2 to collect, store and analyze, at a minimum, the following data related to EHT-D management of cardiac arrest patients: 1.2.1 Patient Data: age: sex; whether arrest was witnessed, or unwitnessed; distance of collapse from ambulance; and initial cardiac rhythm. 1.2.2 EMS System Data: estimated time from collapse to call for help; estimated time from collapse to initiation of CPR; estimated time from collapse to initial defibrillation; ambulance response time; and scene to hospital transport time. 1.2.3 ENT -D Performance: accuracy of rhythm interpretations; time from arrival to initial defibrillation; time between defibrillation attempts; appropriateness of management for each rhythm encountered, and general. adherence to established protocol. r 1.2.4 Patient outcome: rhythm after each shock; return of pulse and/or spontaneous respirations in the field, whether the patient was admitted to the hospital; whether the patient was discharged from the hospital; and health status on discharge. EFFECTIVE DATE: April 13, 1989 REPLACES: Nt14 �1 Paae 1 /of 3 APPROVED BY:, Theodora D. Hiatt, M.D. Marin County Health Offlt r EMS Medical Director COUNTY OF KARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.3 SUBJECT F.MT-Defibrillation - Quality Assurance AUTHORITY Title 22, Division 9, Chapter 2 California Ackrinistration Code 2. Written patient care report forms and ECG/voice recordings or alternative forms of documentation of events, will be reviewed by the EMT -D Liaison Physician (or other qualified personnel designated on approval of EMS Agency), as soon as practical, following an emergency response requiring the use of an EMT -D skill. 3. The EMT -D Liaison Physician rhall submit quarterly written reports to the EMS Agency which will include a minimum of the following information: 3.1 The voice/ECG recorder, or other documentation device, was activated appropriately. 3.2 The personnel quickly and effectively set up the necessary equipment. 3.3 The patient's pulse was checked appropriately throughout the emergency response. 3.4 Defibrillation was performed within 90 seconds, excluding unsafe scene or extrication problems. 3.5 The amount of time spent at the scene was appropriate. 3.6 Adequate BLS was maintained. 3.7 The assessment of the need to deliver or not deliver a shock was correct. 3.8 Following each shock, the patient was assessed accurately, and treated appropriately. 9 3.9 The portable defibrillator was operated safely and correctly. 3.10 The care provided was in compliance with applicable protocols and standing orders. 4. EMS Agency Medical Director, upon cause, may disapprove the EMT -D Service or remove certificate of individual(s) certified to perform EMT -D. Page 2 of /3 EFFECTIVE DATE: April 13, 19e9 APPROVED Theodora D. Hlett. M. D. REPLACES: Nry Karin County Health Off, dr EMS Ked{cal Director COUNTY OF TSAR I N KM. GENCY K DICAL SERVICES AGENCY ENT DEFIBRILLATION PROGRAM DATA COLLECTION FORM This data collection fore is to be completed by the EMT -D whenever a defibrillator is applied to a patient in accordance to Policy Reference No. 403. The requested information is to be submitted to the Base Hospital along with the written patient care report forms and ECG/voice recordings for review by the EKT-D Liaison Physician. Patient Data: Patient Age Sex Initial Rhythm Arrest: Home Other Witnessed Unwitnessed Aprox. Distance of Collapse From Ambulance ft. ENS System Data: Authorization Number Defib Unit Estimated Time From Collapse to Call For Help min Estimated Time From Collapse to Initiation of CPR min Estimated Time From Collapse to Initial Defibrillation min Ambulance Response Time min Hospital Transport Time min (To be completed by the Base Hospital) EXT -D, Performance: Time From arrival to Initial Defibrillation min Time Between Defibrillation Attempts: 1st to 2nd series min 2nd to 3rd aeries min Was the Management for Each Rhythm Encountered Appropriate? Was Established Protocol ?adhered To? Number of Shocks: Scene Were Rhythm Interpretations Accurate? Enroute Comment Patient outcome: Rhythm After Each Shock Return of Pulse and/or Respirations In The Field? Patient Admitted? Patient Discharged from Hospital? Health Status on Discharge Page 3 of 3 COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFEUNCE NO. 403.4 SUBJECT FMT-Defibrillation - Performance standards AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code PERFORKANCE STANDARDS FOR EKr-D's 1. The EMT -D will perform emergency cardiac care in accordance with standing orders developed and/or approved by the EMS Agency Medical Director. 2. The EHT-D will be able to recognize that a patient is in cardiac arrest and that CPR and imnediate application of the automatic defibrillator is required. 3. The EMT -D will be able to perform Basic Life Support in accordance with American Heart Association Standards. 4. The EMT -D will be able to set up the defibrillator correctly. 5. The EHT-D will be able to record on the cassette voice/ECG recorder. 6. The EMT -D will be able to correctly apply the defibrillator pads. 7. The EHT-D will be able to deliver shocks for ventricular fibrillation in the shortest time possible following their arrival at the scene, ideally within 90 seconds. 8. The EMT -D will be able to ensure that the patient is not in contact with rescuers or bystanders prior to delivering a shock. 9. The EMT -D will be able to recognize that a shock was delivered to the patient. 10. The EMT -D will deliver no more that the number of shocks allowed in the standing orders. 11. The EHT-D will be able to provide supportive care to a patient who has been successfully defibrillated. 12. The EHT-D will be able to immediately recognize and respond, in accordance with the standing orders, to patients who refibrillate, whether at the scene or during transports. 13. The EMT -D will be able to prepare the patient for transport to the medical facility. Page 11 of 2 EFFECTIVE DATE,: Aril 13, 1499 APPROVED BY: X/ \ heodora D. Hiatt, M.D. REPLACES: til Marin County Health Offl r EMS Medical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.4 SUBJECT EXr-Defibrillation - Performance Standards AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code 14. The EHT-D will be able to communicate pertinent medical 19. EHT-D proficiency should include skills maintenance with the ability to defibrillate correctly a defibrillation mannikin within 90 seconds of arrival at the mannikin's side, including pulse checks and recognition that a shock has been delivered. EFFECTIVE DATE: April 13, 1989 REPLACES: NI -16 I Page 2 of 2 l APPROVED BY S / he Ore D. Hl.tt, M.O. Merin County Health Officer EMS Medical Director information to the receiving medical facility via radio. 15. The EMT -D will be able to record the pertinent events of the emergency response on the patients prehospital care report form. 16. The EMT -D will be able to prepare the monitor/defibrillator, and voice/ECG recorder or other documentation device for patient care following each use. 17. The EKT-D will be able to maintain the monitor/defibrillator and voice/ECG recorder or other documentation device in accordance with manufacturer's recommendations. 18. The EMT -D will maintain continued proficiency in the standards outlined in this policy. The EMT -D must demonstrate proficiency at least every six (6) months. 19. EHT-D proficiency should include skills maintenance with the ability to defibrillate correctly a defibrillation mannikin within 90 seconds of arrival at the mannikin's side, including pulse checks and recognition that a shock has been delivered. EFFECTIVE DATE: April 13, 1989 REPLACES: NI -16 I Page 2 of 2 l APPROVED BY S / he Ore D. Hl.tt, M.O. Merin County Health Officer EMS Medical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO_ 403.5 SUBJECT E"T-Defibrillation - Transport Units AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code EKT-D rxuiu�-ul,: CARDIAC ARREST TRANSPORT UNITS CONFIR}S: unconscious pulseless non -b eat_hina or has agonal respirations . CONFIRM: Not hypothermic Patient older than 12 years of age Body weight over 80 pounds (36 Kg) IF TRAUMA: Prepare patient for immediate transport. As time permits, prior to paramedic arrival, may initiate defibrillation protocol. PROCEDURE: 1. Initiate CPR/Set up defibrillator. (If alone, do not start chest compressions) 2. Have machine analyze rhythm, If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 3. Check carotid pulse and have machine analyze rhythm. If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 4. Check carotid pulse and have machine analyze rhythm. If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 5. If the patient remains unconscious and pulseless after the third shock, repeat a series of 3 shocks. 6. If the patient remains unconscious and pulseless after the sixth shock, -- REGARDLESS OF THE RHYTHM-- Continue CPR and Transport without delay.* Page 1 of 2 -� EFFECTIVE DATE: April 13, 1989 APPROVED BY/ w qe ore �. -)It-t M. REPLACES: NEW Marin County Health 0 41 EHS Medical Director COUNTY OF MAKIN DEPARTMENT OF HEALTH AND HUKAN SERVICES EMS AGENCY REFERENCE NO. 403.5 SUBJECT EMI -Defibrillation - Transport Units AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code If after any of the shocks, the rhythm has changed and there is a pulse, maintain airway and breathing, maintain oxygenation, check B/P and transport.* 7. If patient returns to a pulseless state, stop ambulance, have machine analyze rhythm. S. If shockable rhythm has occurred, and have not arrived at hospital, repeat a series of. three shocks. 9. May stop, analyze and do shock series twice. 10. No more than 9 shock/defibrillations may be given per call. 11. U the initial rhythm is HOT SHOO SLE; 11.1 Do CPR for one minute and re-evaluate. Check pulse and have machine analyze rhythm. 11.2 If unshockable rhythm remains, continue CPR and transport.■ 11.3 If shockable, follow shock series as above. 11.4 If pulse returns, maintain airway and breathing, maintain oxygenation, check B/P and transport.* * Transport to hospital may be delayed if the ETA of a paramedic unit to the scene is less than the total transport time to the hospital. Must also consider rendezvous with the paramedic unit after transport has been initiated. EFFECTIVE DATE: April 13, 1989 REPLACES: NEW r Pa�gc 2(of 2 APPROVED BY:,.-,�C/• J� / Theodore D. Hlatt, K.D�� Barin County Health Officer EKS Medical Director COUNTY OF KARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY CONFIRM: REFERENCE NO_ 403.6 SUBJECT EMT-Defibrillarinn - Nnn-7-angPW1 1Mir AUTHORITY Title 22, Division 9, Chapter 2 California Administration Code EXT -13 PROTOCOL: CARDIAC ARREST HON -TRANSPORT UNITS Not hypothermic Patient older than 12 years of age Body weight over 80 pounds (36 Kg) IF TRAUKA: Prepare patient for immediate transport. As time permits, prior to paramedic arrival, may initiate defibrillation protocol. 1. Initiate CPR/Set up defibrillator. (If alone, do not start chest compressions) 2. Have machine analyze rhythm. If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 3. Check carotid pulse and have machine analyze rhythm. If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 4. Check carotid pulse and have machine analyze rhythm. If machine determines that a shock is necessary, Press button to shock patient. Stand clear. 5. If the patient remains unconscious and pulseless after the third shock, -- Repeat the series of three shocks, twice or until Paramedics arrive. If after any of the shocks, the rhythm has changed and there is a pulse, maintain airway and breathing, maintain oxygenation, check B/P. EFFECTIVE DATE: April 13, 1989 REPLACES: NEW Paoe 1 of 2 _ �- APPROVED B�Ia\'t't �. /. D. � ( Karin County Health Offlcbr EMS Medical Director COUNTY OF KARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY REFERENCE NO. 403.6 SUBJECT Enr-Defibrillation - Non -Transport Uni AUTHORITY Title 22, Division 9, ChaQter 2 Caiifornia Administration Code 6. If patient returns to a pulseless state: 6.1 have machine analyze rhythm. 6.2 if shockable rhythm has occurred, repeat a series of three shocks. 7. If the initial rhythm is N T- SHnCXAAT,F: 7.1 do CPR for one minute and re-evaluate. 7.2 check pulse and have machine analyze rhythm. 7.3 if unshockable rhythm remains, continue CPR until paramedics arrive. 7.4 if shockable, follow shock series as above. 7.5 if pulse returns, maintain airway and breathing, maintain oxygenation, check B/P May analyze and do shock series a total of three times. No more than nine (9) shocks may be given per call. EFFECTIVE DATE: April 13, 1989 REPLACES: NEW Page 2 of 2 APPROVED DY• he ore 0. Hiatt, M.D. Marin County Health Offl r EMS Kedical Director COUNTY OF MARIN DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY I. PURPOSE REFERENCE NO. 5N SUBJECT BASE HOSPITAL PHySICIA.N RD?UIRE:-u;27TS AUTHORITY HEALTH OFFICER BASE HOSPITAL PHYSICIAN RSQUIREAE"ITS The Base Hospital is responsible for the direct medical control of EMT -P personnel in the prehospital setting as well as retrospectively through review and audit of prehospital patient care. The Base Hospital Physician is an essential component in an EELS system whose goal is the delivery of quality prehospital patient care. II. BASE HOSPITAL PHYSICIAN REQUIRE."22,7S All Base Hospital physicians must meet the following minimum requirements: 1. Board Certified, or Prepared, in Emergency Medicine; 2. Current certification as an ACLS provider according to the standards of the American Heart Association; 3. Complete an orientation to the Marin County E"LS System and the functions and responsibilities of the Base Hospital as defined in Policy Reference 1503, Base Hospital Minimum Requirements. Such orientation is to be provided by the Base Hospital Medical Director; 4. Complete an observation on an ALS unit, in Marin County, consisting of direct observation of an ALS patient contact or a minimum of 6 hours; and 5. Attendance at two (2) hours of prehospital care tape audit (Run Review) per year. EFFECTIVE DATE: June 9, 1988 REPLACES: April 22, 1985 l 1 \ APPROVED BY e ora D.kit, Marin County health Officar EMS Medical Director COUNTY OF MARIIJ DEPARTMENT OF HEALTH AND HUMAN SERVICES EMS AGENCY SUBJECT f AUTHORITY REFERENCE NO. 504 Base Hospital Physician Requirement Health Officer BASE HOSPITAL PHYSICIAN REQUIREMENTS - Continued B. In addition to "A" above, all full time Base Station Hospital physicians must meet the following: 1. Board certification or eligibility in: a. Family Practice or b. Surgery or c. Medicine or 2. Board certification or eligibility in Emergency Medicine or 3. Equivalent of two years of full time ED experience (2880 hours); and 4. a. Attendance at two Run Reviews per year; b. Successful completion of the CAL/ACEP Base Station Physician Course, or equivalent training, within eighteen months of hire (currently employed full time physicians must meet this requirement by January 1985; and c. Emergency Board eligibility by July, 1986; d. Emergency board certification by July, 1988. IV. Base Station Hospital Physician Staffing Requirements A. All Base Station Hospitals must be staffed twenty-four hours per day by a full time or active ED physician. B. All Base Station Hospitals must be staffed 900 of the time by full time ED physicians. Page 2 of 2 EFFECTIVE DATE: April 22. 1985 APPROVED BY:�_ llneodo�retD. Hiatt. M.D. Marin County Health Officer EMS Medical Director EXHIBIT E -Memo for Record DATE: March 20, 1990 Subject: Liabilitv Coverage While Working for the San Rafael Fire Department I was contacted by the Fire Chief Bob Marcucci last week discussing his inability to find a malpractice carrier to provide coverage for Dr. Sexton while Dr. Sexton trains paramedics and firemen. I have discussed this requirement with legal counsel, Bill Petrick, and he and I both agree that the liability is minimal in view of the public service nature of the work. The Medical Group will agree to assume any liability that arises out of Dr. Sexton's work with the Fire Department. I communicated this decision today to Chief Marcucci. _ter � Rich d\G i t, M.D., F.A.C.S. Physician -in Chief REG/dj cc: �Mi�chael Sextori�;r2i- LJ Personnel File'""`` William Petrick