HomeMy WebLinkAboutResolution No. 5849RESOLUTION NO. 5849
A RESOLUTION AUTHORIZING THE SIGNING OF A
CONTRACT, LEASE OR AGREEMENT
THE CITY COUNCIL OF THE CITY OF SAN RAFAEL RESOLVES as follows:
The MAYOR and CITY CLERK are authorized to execute, on behalf of the
City of San Rafael a contract, lease or agreement with
MARINWOOD COMMUNITY SERVICES DISTRICT Re ADVANCE LIFE
SUPPORT EMERGENCY AMBULANCE SERVICE
a copy of which is hereby attached and by this reference made a part hereof.
I, JEANNE M. LEONCINI, City Clerk of the City of San Rafael, hereby
certify that the foregoing resolution was duly and regularly introduced and
adopted at a regular meeting of the City Council of said City held on
Monday the twenty -f irst day of January 1980 by the
following vote, to wit:
AYES: COUNCILMEMBERS: Breiner, Jensen, Miskimen, Nixon & Mayor
Mulryan
NOES: COUNCILMEMBERS: None
ABSENT: COUNCILMEMBERS: None
EAWNE M-)LEONCINTJ City Clerk
AGREEMEN_-ETWEEN MARINWOOD COMMUNITY SEI CES
DISTRICT AND CITY OF SAN RAFAEL RELATING TO
ADVANCE LIFE SUPPORT EMERGENCY AMBULANCE SERVICE
THIS AGREEMENT made and entered into this 21st day of _ January
1980, by and between the Marinwood Community Services District of the County of
Marin, State of California, hereinafter referred to as "District", and the City
of San Rafael, hereinafter referred to as "Contractor";
W I T N E S S E T H:
FOR AND IN CONSIDERATION of the mutual promises and covenants hereinafter
contained, the parties hereto do hereby agree as follows:
Section 1: Contractor shall provide advance life support emergency
ambulance service to the residents of District as described in Exhibit A attached
hereto and by this reference incorporated herein.
Section 2: In consideration of the provision of such services without
charge to the residents of District, District will pay to Contractor the sum -of
twelve (12) dollars for each living unit per year for provision of the service
from January 1, 1980, to December 31, 1980, and hereby authorizes the Auditor -
Controller of the County of Marin to pay such sum to Contractor out of the
proceeds of the assessment authorized by the voters of District in November, 1979.
Section 3: If the money is unable to be collected through the County, the
agreement will be null and void.
IN WITNESS WHEREOF the parties hereto have set their hand the date and
year first above written.
ATTEST:
Secretary
ATTEST :.
City Clerk
MARINWOOD COMMUNITY SERVICES DISTRICT
By-4
Chr�"a anof thei d of Directors
"DISTRICT"
CITY OF SAN RAFAEL
-kayor of the City of San Rafael
"CONTRACTOR"
MI PI IMUM REQUIREMENTS
WON COU?I FY PARAMEDIC SERV I Cr
1 . Cove: rndle Requ i remen is
A. Rust provide continuous 24-hour, 365 -clary coveragf_ of all urgent (Codt?)
and cmGryent (Code 3) madical cmergencir_s in assigned serviccc arca.
I3. Must provide ALS erre and transport and provide for dedicated emergency
BLS care and transport to all patients regardless of their ability to
pay. Contractor shall assume costs of delivery of indigt_nt circ and
dry runs.
C. Must quZ,rantee a maximum response time for ALS units and BLS ambulances
of ten minutes to 90; of.calls originating in assigned service arca.
D. i•lust agree to respond available ALS units and/or BLS ambulances in a mutual
aid eapaeity outside: assigned arca of responsibility iF directed to do :o
by County Cor Mull i ca t i ons Center.
E. Must provide ALS care and transport when of rected Lo do ;o by the Uric
Station Hospital.
F: Must not utilize an ALS unit to transport non -ALS patients unless pro-
vision
ro-
vision has been made for back-up ALS service. This back-up may not
come from another service area.
G. In the event that the ALS unit is in service on an authorized emergency
call, Contractor must guarantee that the BLS ambulance responsible for
the assigned service area will respond to all urgent (Code 2) and
emergent (Code 3) calls when directed to do so by County Co,i.nunications.
11. BLS ambulance must be dedicated solely'for emergency use anti may not.
respond to private calls in or out of assigned service area.
1. In the event that a BLS ambulance from another service arca roust respond
into Contractor's service area for back-up, Contractor must assum-_ respon-
sibility for payment of any dry runs or uncollectibles incurred -
Ma npowe r/ -F ra i
ncurred_
Manpower/Trai n nq
A. Advanced Life Support Units roust be staffed at all times by two, Marin
County -certified Fiobi le intensive Care Paramedics trained to levels
defined by the 1.fedwor th/To:msend Act, with the exception that the f i cl d
internship portion of their training is at least_ 360 hours.
B. Paramedics must meat Marin County certification criteria through co;n-
pl i ince with the following rcqui rements.
1. Successful completion of a course of instruction in i•lobile Inten-
sive Care Paramzadi c training approved by the. Marin County Ilezl th
Officer.
2. Successful completion of written, performance and oral examinations
approved by the Marin County health Officer.
3. Certification as an Advanced Cardiac Life Support provider accord-
ing to the standards of the American heart Association.
Ir. Employment and recomm::ndati on by an approved Marin County paramz!d i c
provider agency and the paramccl i c -training agency.
5. Certi fi cation will be valid For two years provided the eandid�ric
flllFillS the continuous service (1), continuing education (2),
and skill: (3), requirements.
6. Individuals dcnied certification 1-1111 be informed in wr-itincq of
the reason fcr dl:: n i a 1 . The individual will be granted, ishan
rcqucst, a hearing before the County licalth Officer-
- 1 -
C. Paramedic pe nnel are eligible for challerr, •.rtificaLion in
Marin County , f: the fol lo,.-ri ng has been accu� i shed.
I.- Submit verification of employment wil th an approved Marin County
paramedic provider agency- -
2. Successful completion of training program approved by L -he Marin
County Health Officer.
3. Submit transcripts.from training institution.
jr. Certification as an Advanced Cardiac Life Support provider
according to the standards of the Am�-ricanHeart Association_
5. Successful completion of written, performance:, and oral exami-
nations approved by the Marin County health Officer.
6. Comipletion of five field shifts supervised by a Marin County
Mobile Intensive Care Param:!dic or Mobile lraensivc: Care Nurse_
R. Paramedic personnel -must maintain eligibility through compliance
with the following recertification criteria:
1. Satisfactory completion of continuing education, continuous
service, and skills requirements sct forth by the County Health
Officer.
2. Recommendation by the following:
a. Candidate's employer
b. Base Hospital Pled i cal Director and the [base llosp i t,-rl MI CH
Coordinator.
3. Satisfactory completion of written, perFormancc, and oral exami-
nation aphrovc--d by the County Health Officer.
Ir. Current certification as an Advanced Cardiac Life Support pro-
vider
ro-
vider according to the standards of the American 11c. -art /Assoc i a -
tion.
5. Rccertification will be valid for t% -.,c) years provided the candidate
fulfills the continuous service, continuing education, and
skills requirements-
G.
equir-ements-
6. Individuals denied recertification will be informed in writing
bf the reason for denial. The individual will be granted, upon
request, a hearing before the County licalth Officer.
E. Paramedic personnel are required to be assigned to paramedic units
for not less than 72 hours per month, excluding vacation and sick
1 cave. If the liob i 1 c Intensive Care Paramedic works less than 72 hour
per month for t%:n consecutive months or for three months within a cal-
endar year, certification may be suspended by the Ilcid th Officer.
CertificaLion may be re-established by the HcalLh Officcr upon satis-
factory completion of skills perfornkince exam, plus oral and/or
t -mitten exams if indieatcd.
F. Paramedic personnel must meet minimum continuing education requirenr_nts-
A minimum rcquiremcnt of sixty (60) hours of continuing ccfucation PE -r
calender year has been established for all certified personnel_ (A
minimum of b5 hours must be completed during the first year of the t,,o--
year certification period.) Credit hours nkiy be earned in the follo:-1ing
I -rays that relaLe to emergency nr dical care:
1 . Lectures at hospitals (1 hour lecture for 1 hour credi t)
2. faun review experience at hospitals. 1'linimunr of 10 credit hours/
ye.rr. (1 iIOur ci i tiquc fur 1 hour cred i t) .
3- SLI pervisc•d study (l_ hours of study for- 1 IIOUI_ cre(Iit)
- 2 -
Ir. fcactiing �;ic life support) (1 hour cla,'.
5. Pro Fess! o. , lectures, t•rorkshops and semi
(1 hour lecture for 1 hour credit)
6. Cl i nical. Minimu;n of 30 credi t hour../year.
individuai basis.)
. 11o+ir credit)
approved in advancc.
(Credit awarded on
7. Academic courses - approved in advance. (One course unit for a
quarter course: Will equal 10 credit hours, semester units equal
15 credit hours.)
G. Pararrrzdic personnel must participate in skills test twice par year as
directed by the EMS Training CoardillaLor and the health Officer_
11. Basic Life Suppo►-t Uni L ; roust be staffed at ,11 time_. by Lwo, Ern-rgency
Medical Technician -1's (ENT's) currently certified as specified in
Section 6755.1, 6755.2 or 6755.3 of Title 13, California Administrative::
Code.
1. At least annually, EMT -I's shall participate in a minimum of t% -.,o hour--
of
oursof refresher course training in Cardiopulmonary Resuscitation and
demonstrate proficiency in the techniques according to the standard:
of the American Heart Association.
J. Driver must have in his possession al all times a valid California
Driver's License, and a current Ambulance Driver's Certificate issued
by California Department of Motor Vehicles, if not exempt by Statela,.-)_
Communication and Dispatch Requirements
A. Contractor must agree to install, utilize and maintain the appropriate
radio equipment as follows:
1. All ALS units and BLS ambulances used for emergency medical
response must b;: equ i pped tri th tv.,o-way radios on f requenc i es
designated by County Communications for the purpose of dispatch-
ing by, and status -keeping with, County COMIlUnications.
2. Radio equipment, approved by County Sheriff, must ba installed prior
to assignment of a vehicle for zone coverage.
3. Tvo-way radios must be operated in conformance with all applicable
rules and regulations of the Federal Communications Commission,
and in conformance with all applicable County rules and operating
procedures.
1r. All UHF- radio equipment used for biomedical information and the
sending of medical telemetry information shall he provided at con-
tractor's expense. All patient monitoring equipmrcnt shall b;- provided
at contractor's expense.
5. A11 mob ilc and porLab le radio equipment used must be app roved 'by
the County Sheriff.
6. County will agree to service contractor-owncd radio equipment at
the current County time and material rate, provide-cl a signed mainte-
nance agreement is in force.
7. Contractor must maintain at contractor's expense, a direct tele-
phone line between Common i ca t i ons and his ALS and BLS dispatch
offices) within Marin County.
S. All emergency calls requiring a Code 3 response vihieh contractor
receives from sources other than County Communication; will bu
reported imrry--cliately to County Communications. County Communica-
tions shall assume the responsibility for dispatching the nearest
avai fable amhulancc.
- 3 -
U. Cotitrlctor mu, gree, to abide by centralized l)atch procedures
monitored by h- -in County Communications inclt. ng:
L. All ALS units and GLS arnbulance s involved in emerctency rnedieal
care under this agreement shell be directly dispatched by County
Communications and shall be given an authorization numher at the
time of di spatch.
2- Upon receipt of verbal Code Eleven authorization, as promptly as
pos-,iblc.•, Contractor roust dispatch the appropriatr_ vc:hicicr and crew
to the designated location proceeding there in a manner specified
by Communications•
3. Contractor shall inform Communications of any changes in avail-
ability, location, and status of ALS units and GLS ambulances,
in or out of service. * Those vehicles which do not have the requirccl
on-cluty personnel shall bs considered out of service and shall b��-
reported as such to Communications and to the County health Officer_
All ALS units and isLS ambulances must use the unit number designated
by County Sheriff.-.
IV. Equiprnent and Supply Requirements
A. Vehicles
1. Ambulance vcchicics shall meet standards specified in Title 13,
Chapter 2, California Administrative Code, and each shall possess
a valid Emergency Vehicle Permit issued by California iligh:day
Petrol.
2. Vellicles will be maintained cleanly and in good mwchanieal and
body condition at all times.
B. Safety Equipment: Safety Equipment to be carried on ALS and ULS unit--
and
nit,and maintained in good working order shall include the fol lo-oi ng :
1. An approved siren
2. An approved steady -burning, reel -warning lamp, Mounted as specified
in Section 808 of California Administrative Code, shall provide
adequate warning for at least 500 feet ahead of the vehicle in -day-
light under normal atmospheric conditions.
3. Approved safety balts installed for the driver and for a passenger
in the front seat if a seat is providcd-
Ir. A fire ext i nqui shcr of the dry the -l" cal or carbon dioxide type
with a minimum 11-G:C rating. The use of vaporizing liquid
ext i nqu i shers i s p rolli bi ted .
5. A portable, battery-operated light
6. A spare tire
%. A jack and tirc tools
B. it,-ips covering the areas in I•rhich the ambulancc provides service_
C. Emergency Medical Equipment and Supplies
All cquipm-:!nt and supplies are to be carried on ALS and BLS units at
all times and maintaincd in clean condition and good working order.
(Title 13, California Administrative Code):
1. An ambulance cot and collapsible stretcher; or two stretc.hers, on=
of t•rhich is collapsible.
2. Str0pS to :rr.uri: tf,c patient to Lhc Strckchc:- or tambulancc cot, and
mens Of securing the stretcher or ambulance cot in the vehicle-
- 4 -
3_ /Ankle an jrist restraints. Sort tits a Ntjble_
4. She.ts, pillow cases, blankets, and towtfls for each stretcher or
ambulance cot, and two pillows for each ambulance.
5. Three, rN.lutIi- to-rnouth r e s u s c i tat ion or oro, h,ryndeal <ri rw-iys, on;.
each of a size for adults, children, and infants.
G. At least three, 3" by 15" arm splints and three, 3" x 3G" or longer
lcg and thiclli splints with a soft or cushioned surracc or roll
material for padding for immobilizing and protecting fractured
extromi ties. Equivalent padded board, wraparound, wire ladd•sr,
i of latable, or cardboard spl ints wi 11 meet this requi remerrt.
7. A resuscitator that meets the requirement: of Vehicle Code Section
2.418.5. ll hand -operated, bard -valve -mask unit with clear masks
of adul t, chi ld, and i nfant sizes capable. of use wi th oxygen Vii 11
meet this requirement.
b. Portable oxygen (USP),' regulator, and means for- administering
oxygen, including adequate tubing and semiopen, valveless, trans-
parent: masks in adult, child, and infant sizes. Oxygen may be
administered by resuscitator, bag mask unit', or inhalator,
9. Clean bandages and bandaging supplies:
12, ►t" sterile bandage comoresses or equivalent
Four 3" by 3" sterile guaze pads
Six 2" or 3" roller bandages
Four 40" triangular bandag-as
Two rolls of 1", 2" or 3" adhesive tape
Tvro tourniquets
Bandage shears
Six tongue depressors
Large safety pins
T%,D additional streets
T►•xr universal dressings 10" x 30" or larger
10. fvn padded r.outh gags either commercial or made of three tongue
blades taped together and paddad.
11. An emesis basis, or disposable bags and covered waste container_
12. Portable suction equipment.
13. Tv:o sandkigs, loosely filled, or equivalent material to restrict
movement.
llr. Two rigid spino boards approximately 111" or more. Aide, one: 32" or
more lonD, and one approxiwrtely 72" long, with straps for inimobi l i-
zation of suspK-cte'd spinel or back injuries. Combination short -long
boards are acceptable.
15. }gal f -r incl traction splint for lower extremity with 1 irnb-support
slings, padded ankle hitch traction strap, and heel rest -
Wood pressure m�rnometer, cuff, and stethoscope.
17. Sterile ob%tetrical supplies including as a minimum: gloves,
umbi 1 iced cord tape or clamps, dressings, towels, bull, syringes,
and cicon pl�ist is bads.
18. A gallon or more of clean vater in covered, secured, plastic
coil taltic r.
D. In addition to HIC cCIu i pment listed above, County rcclu i r-e:s that all
11P_S tend L'l.S inn i t= ba cqu i ppcd with:
1. Universal clrc•!,%incls, approxirnrrtcly 10" by 36", comp-Ictly Fol(lr•rl
and packaged in convenient size.
2. Str.ri lc du,:,: c pads, h" by Jill
-- 5 -
j. Soft 11dnE:r 1 m LYjJ i)<lnujyus, r .... i.ry , r!1 d
Ir. Roll of .lni nun foil, 18" by 2.5' , stcri cd turd wrapped
5. 7r.t� st�ri lu 1.,urn sheets
G. Cervical collars for chi lel and adult use_
7. Poison kit
B. Morrr4il saline irrigation solution
9. Scoop stretcher
10. Cold packs
C. In addition to the equipment listed in C and l) above, all ALS units
mus L• carry the fol 1o,.ii ng: (Items marled With a stri sl: s ('-:) arc to he
used only with specific orders of a Base Station llo :p i tnl MI C11 or
Emergency Physician):
*1 . IV sets vii til pedi drip (60 drops per cc)
*2.• IV sets with solution drip (15 drops per cc)
3. Sterile alcohol wipes
*li. IV cannulae and short needles, various sizes
*5. Blood tubes (red, purple and grey tops)
*G. Maso-gastric tubes
7. Demand valve
---B. Esophageal obturator airways - two
"9. Cardiac monitor and defibrillator
*10. HAST - trousers
ll. Sterile normal saline for irrigation
-12 5% Dextrose in enter IV solution - 500 cc (Four bottles)
'-13. Norm -ll Saline IV solution - 1000 cc (four bottles)
-`•lit. Lactated Ringers IV solution - 1000 cc (four bottles)
15: Locked d rug box conta i n i ng Lhc fol Iowi ng
a. Aminophylline - 250 mg/10 cc
b. /Atropine - 1 mg/1 cc
C. Bcnad ry 1 (D i phcn hyd rami nc) 50 mg/1 cc
d. Cillcium Chloride 10%; - 1 Gm/10 cc
C. Doinerol (tleper i d i nc) - 100 my/ l cc
f. Dextrose: 50% - 25 Gm/50 cc
g. Epin�tphrinc - 1:10,000 and 1:1,000
h. Glucose, oral
i. Ipecac Syrup - 4 o= -
j. I_.ripr(tl (Isr)prot:cronol) - 2 rn(1/10 cc
k. Lasix (Fiirc)scmj de) - 20 m9/7 cc
1. L i Boca i rlc - 100 rnc_J/ 1 Occ and 2 Gnrs/50 cc
rn. Morphine SulphaLc - 15 mg/1 cc
n. 111\11CO3 (Sodium l)icarbonLO-O 50 mc9/50 cc
o. 1J.rrc.an - 0.11 n19/ 1 cc
P_ Mit:r-ocllyccrirlc - 0.4 wq tablets
q. p i toc i n- 10 units/ l c:c
r. val ium - 10 ing/2 cc
6
V. Hu Io t i ansh i p
:-i th Co y Department of 11val th and HU, •I Sftrvi ccs
A. Committees
i.
Contractor agrees to designate: an 11ICII a a uu.mbYr on the Var:un!�-clic
Advisory Committee.
2.
Contractor agrees to designate a representative Lu the Ambulance
Commit tee
B. Data
Collection
1.
Contractor agrees to utilize such standardized ambulance records
a> County deems necessary for data collection.
2.
Contractor agrees to supply County with other ambulance and hIICP
information as nctcessary Cor statistical rehorLing_
C. System Coordination
1.
Contractor agrees to work with County in planning for and imple-
mentating coordinated and integrated emergency medical services_
2.
The County Health OFFicer or his designee shall have the right to
make inspections of vehicles and personnel, during normal busine=ss
hours, without prior notice to determine whether contractor is
complying with the terms and conditions of this agreement_
3.
Contractor must designate a single MICP as a liaison between the
County EMS Unit, the Base Hospital and the provider agency_
1). Public Education
1.
Contractor shall be responsible for providing public education to
the community it serves.
2.
Public education programs wi 1 1 be coordinated with and consistent
%-Ii th objectives estab 1 i shed by the Public EdueC►t ion Sub-Com1.1i tte(_
of the Emergency Medical Care Committee.
- 7 -
OPERATIONAL GUIDELINES
Thu Contractor must agree to abide by the following operational procedures:
A. Local Fi rct Ueepa rtmen ts wi 1 1 be d i spa tch--d as f i rst responders Lo
all Code 3 medical ernergencius.
11. The ALS Unit a :signed to the Service Area %ri 1 i be dispatched on a]]
Code 3 rn`dical emergencies.
C. The MCP attendant will talc charge of the patient(s) upon reaching
the scene.
U. The BLS Unit assigned to the Service Area will be dispaLclrcd on
all Code 2 medical emergencies.
E. Ambulance personnel %-ri 1 1 take charge of the patient (s) when released
by the M1CP or Fire Department El1T-1 .
F. Each person requiring medical attention will be evaluated, and
Riven CLS care as required. Radio contacL• wi 1 1 be made with the
Base Station Hospital for all ALS orders when ALS care is deemed
necessary by either of the attending MICP's.
C. Any person receiving ALS care will be transported by the ALS Unit
to the Receiving Hospital designated by the Base Station Hospital in
accordance with County "friayc.• Protocols.
r
11. In t:hosc cases ti•rhere ALS care is not deemed necessary, the M I CP will
request Communications to dispatch the BLS ambulance responsible for
that Service Area,and the patient (s) will be attended until the 131_S
ambulance arrives on the scene and assumes responsibility for the
patient(s).
1. ALS units and BLS Z-1111bulances will proceed to the Rcceiving Hospital
designated by the Base Station Hospital in accordance with County
Triage Protocols in the manner (Code 2 or 3) deemed appropriate by
the person in charge (attcnJant).
J. Whenever conflicts arise regarding a patient, his condition, hospital
destination, the code of travel, the method of handling, or other
matters of diverse opinion which might result in delay of treatment
or other potential harm to the patient, the person in charge (at tcn-
dant) shzrll communicate immediately with the Base Station Hospital
to receive instructions from the Emergency Physician on duty_
K. Whenever any doubt exists as to the patient bEeing alive, or dead, the
patient is to be considered to be alive and appropriate emergency
Procedures are to be carried out.
L. In an officially declared State of Emergency, either within or
outside of Marin County, County Communications, on authority of fire
County Administrator or Chairman of the Board of Sup-ervisors may
request BLS ambulances and/or ALS units to provide assistance_
County %•rill provide reasonable reimbursement for service rendered.
- R
COUNTY OF MAR1N
rIALL OF JUSTICE
civic cizmrEIi
JAN riA}AEL-, CAt_IrUHNIA
rMuliE 47'x-1 loco
TRIAGE PROTOCOLS -- BLS AVID ALS
1979
PLIU10SE: To insure that patients suffering frorn medical emergencies are tziken
to the nearest facility appropriate to their medical nE:eds_ Fol lo:-ri ncq
stabilization, interhospital transfer guidelines will insure that the
patient is transported, when indicated, to the hospital of critical
care center appropriate to his needs.
These
guidelines are based upon catcgor i 7a Lion profiles which reveal the
iullowinrl:
1. ilar i n County his four Ilosp i tal Lmergz iicy Dcpartrrents cat:cyor i zc-(l 0S
- Basic (Cal i forn i a gu i del i nes) or General (Cl sass 11 1 AMA giJ i clel i nes) .
2. All of these Hospital-, are equipped and staffed twenty-four hours a day
to provide resuscitation and stabilization of all nr-dical emergencies_
3. 1•lith the exception of the Intensive Care Nursery (Heonatal) at Marin
General Hospital, there are no other regional Critical Care Specialty
Centers in Marin County (Trauma, Burn, Spinal*Cord, Poison) _
PROTOCOLS:
All ambulance transports t•ii 11 be either Code 11 indicating the patient's condi-
tion
ondi-
tion is stabilized o r Code Ill indicating the rnccl i cell emergency has riot been stabl i zee
zinc] thore exists a threat to the patient's life or limb_ The determination of Code 11
or Code 1 1 1 transport is made by the senior attending ambulance personnel _ Consul to -
tion rlay Esc provided by the physician in charge of the Base Station or Receiving
Hospital Emctrgency Department.
CODE 11 l•
Any patient being transported Code 111 t•rhosc medical condition, in the opinion
of 1.11,- senior attending ambulance personnel, Lias not been stabilized toi ll bc. tran .poo
to the nearest Basic Emergency -Facility. The accompanying map may be us d to �issi t
in the determination of the nE-arest facility.
CUDE 11
Th;: destination of the patient is determined. by: '
1. The decision of the patient or the patient's family_
2. The decision of the patient's personal physician_ _
;. Kaiser members will be taken to Kaiser llospitai_ "
1�. I n the event that the patient does not mare a choice or is incapable o -E
making a choice, the patient tili11 be transported to the ncarest Basic:
facility_
�. Exceptions (non -}:wiser only) - Code 11 transport of obstetric or neonatal
patients will follow the following guidelines; _.
�) ts from West, Central and Southern-11<irin
All obstetric, neon=ltal patien
will b- transported to Marin General Hospital-
b)
lospitel_b) All obstetric, neonatal patients from the Movato Fire District will bc-
transported to tlovato Community llo-1pi tal
9
L)IVISIUN OF HEALTH --,EFtVICL'-;
COUNTY 01-7 MARIN
IIALL of jtjSricE
CIVIC LENTIS4
S -AH I?PS;AEL. C-AL-WOHNIA
TRTAGE 11;ZOTOCLS, DLS AND ALS
1970
llaticnt 'evaluation hy senior attending ambulance personnel
ric,i-: ntabilized r. tab: I i- cd
.life Lir lilra.) at ruck
CODE 111 CODE 11
nearest
nearest Category 111 (Basic)
tIEnerginncracility
Ino ::;pit ll
Choice
(patient, family)
KAISM melfber
Ldo cdc;
Xncapzibli
ChO'L(
HOSPITIU, Or CHOICE I:AIS.Y-.R 110SPITALAS
P
ECY
[FACT Ty
n=
11- 117,711 P-I-ti-c-rdt -Ohs t f - tri r P7, t- i r f -
Novato Fire District All other Marin County
v
1170VATC) C:0v1*-Mr1T.TY HOSPITAIL MT- T1QqPXTA1j
- 10 -
•! �� -�� Y - I •, � t -`yam' • •• ` •,' •
133o
•yam •' �} ,fir �.� � .
7130 �,. •�. � �� i / r .
' ... 116011 I l t�.I?•���
lY _ ' - , ; tam ,-- —� l �y►_jZ��L.1�:_
i t s z '`• l��-'--
t',!7—s12 2 0 _
41 —`� j -- U•t��To Co
- — 1101
•( Wit.\. t
r