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HomeMy WebLinkAboutRes1987-036 . . . Sponsored by: Garzini CITY OF SEWARD, ALASKA RESOLUTION NO. 87-036 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, APPROVING AN AGREEMENT WITH SEWARD GENERAL HOSPITAL AND SEWARD VOLUNTEER AMBULANCE CORPS FOR THE PROVISION OF EMERGENCY MEDICAL SERVICES WHEREAS, the city of Seward retains health and public safety powers within its corporate limits; and WHEREAS, the Seward Volunteer Ambulance Corps (SVAC) has historically operated without the benefit of a formal agreement with the city of Seward for the provision of emergency medical services within the city; and WHEREAS, substantial liability exposure to the city and SVAC is present without an agreement setting forth the delegation of powers and providing for specific performance; and WHEREAS, the Seward City Council finds it to be in the interest of public health and safety to approve an agreement with Seward General Hospital and SVAC for the provision of emergency medical services to the residents of Seward; and WHEREAS, the Community Hospital Board and the Seward Volunteer Ambulance Corps Board of Directors have ratified the Agreement providing for emergency medical services; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, that: Section 1. The City Manager is hereby authorized to execute the attached Agreement, incorporated herein by reference, with Seward General Hospital and Seward Volunteer Ambulance Corps for the provision of emergency medical services. Section 2. This resolution shall take effect immedi- ately upon its adoption. PASSED AND APPROVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, this 8th day of June , 19 87 -l- . . . CITY OF SEWARD, ALASKA RESOLUTION NO. 87-036 THE CITY OF SEWARD, ALASKA AYES: NOES: ABSENT: ABSTAIN: BOOHER, DUNHAM, GIESELER, HILTON, MEEHAN, NOLL & SIMUTIS NONE NONE NONE ATTEST: (City Seal) APPROVED AS TO FORM: HUGHES, THORSNESS, GANTZ, POWELL & BRUNDIN, Attorneys for the City of Seward, AK 7~ f7/~ Fred B. Arvidson City Attorney -2- . MEMORANll)4 OF AGREEMENT DRAFT 5/19/87 THIS MEMORANDUM OF AGREEMENT by and between the City of Seward. hereinafter called "CITY". and the Seward General Hospital Association. Inc.. hereinafter called "HOSPITAL". and the Seward Volunteer Ambulance Corps. Inc.. hereinafter called "CORPS". is entered into for the purpose of providing emergency medical services within the City of Seward. A. The CORPS agrees as follows: 1. The CORPS shall furnish emergency medical services at a minimum level of EMT-I. All emergency medical service requirements of the State of Alaska for EMT-I level of service shall be met by the CORPS. . 2. All responders of the CORPS will maintain current CPR status. 3. Each CORPS member, with the exception of those members with "driver only" status. will participate in a minimum requirement of 48 hours' continuing education/inservice training every two (2) years. after the initial llD-hour EMT-I certification. as prescribed by the State of Alaska. 4. The CORPS shall, to the extent practicable. provide all other services recommended as its responsibility as set forth in the written guidelines for Level III Communities. . CITY OF SEWARD. ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL 5. The CORPS shall keep. maintain and preserve accurate. complete records which include. but are not necessarily limited to. ambulance run reports which meet minimum State data requirements. equipment records. and records of all transactions of a financial nature. The CORPS shall adopt and maintain an annual budget and. at least semi-annually. provide the HOSPITAL and CITY with a report of the financial status of the CORPS. At least annually an independent audit shall be made of all accounts of the CORPS. The annual audit shall be made by certified publiC accountants employed by the CORPS. and shall be completed within ninety (90) days following close of the CORPS' fiscal year. A copy of the certified audit report shall be prOVided the HOSPITAL and CITY when completed. 6. The CORPS shall provide statistical reports to t HOSPITAL and CITY at least annually, documenting services provided during that year. Other records and information in the possession of the CORPS shall promptly be made available to the HOSPITAL and CITY at the request of the HOSPITAL or CITY. except for records of a strictly confidential nature, such as personnel files and trip run reports containing medical information; however, the CORPS shall not unreasonably withhold consent to CITY or HOSPITAL access to records of a confidential nature if access to such records is required to answer or defend a Cause of Action brought against, or in any way involving. the HOSPITAL or CITY. -2- CITY OF SEWARD, ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL . 7. The CORPS shall provide standby ambulance service at all fires. as directed by the CITY. and shall provide maximum support during all disaster emergencies as di rected by the CITY. In the event of a state of disaster or state of extreme emergency. the City Manager. or his designee. pursuant to the provisions of Chapter 7 of the Seward Code of Ordinances and City of Seward Emergency Preparedness Plan, may waive. suspend or modify any provision of this Agreement until the state of disaster or state of extreme emergency shall no longer exist. 8. The CORPS shall maintain all equipment in a state of readiness and shall immediately notify the HOSPITAL and CITY if any equipment is out of service or of any situation that may temporarily, or otherwise, . lower the level of service available. The CORPS shall, with the assistance of the HOSPITAL and CITY, diligently work to promptly correct any reduction in service. 9. The CORPS may provide ground transportation via ambulance when such service is deemed necessary by the physician in charge. A driver and EMT-I or EMT-II will be provided, depending on the patient's condition and availability of CORPS members. Any service required by the patient that is above and beyond the level of the available crew will necessitate the presence of a nurse during transport. . -3- CITY OF SEWARD. ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL 10. The CORPS, as consideration for the services to performed pursuant to this Agreement. shall establ ish such rates as are reasonable and fair for the service rendered and shall retain all monies it collects for its services. The CORPS shall collect all montes for services and shall not look to the HOSPITAL or CITY for collection. 11. The CORPS agrees to indemnify and save harmless the CITY and HOSPITAL, their officers. agents. and employees from and against any and all claims. demands. losses. defense costs. or liability of any kind or nature which the CITY and HOSPITAL, their officers. agents and employees may sustain. or damage to property as a result of. arising out of. or in any manner connected with the CORPS' performance under the terms of the Agreement. excepting only liability arising out of the sole negligence of tf CITY and HOSPITAL. and excepting the express coverages provided the CORPS by the HOSPITAL and CITY under the terms of this Agreement. 12. The CORPS shall obtain the prior approval of the Seward City Council of all mutual aid agreements with other agencies. or any other binding agreements which would affect the level of EMS service provided to the CITY. 13. The CORPS. at no charge. does hereby lease to the CITY a 1979 Chevrolet Ambulance, Serial No. CCS3398163679, and the CITY hereby grants to the CORPS the exclusive use of the ambulance. The CITY agrees to -4- CITY OF SEWARD, ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL . maintain liability. auto medical payments. uninsured motorist, comprehensive and collision insurance. with coverage limits at the sole discretion of the CITY. 8. The HOSPITAL agrees as follows: 1. The HOSPITAL President/CEO shall be res~onsible for coordinating EMS activities pursuant to this Agreement. 2. The HOSPITAL shall, to the extent practicable. provide for medical control as set forth in the written guidel ines for Level III Commu n it ies. . 3. The HOSPITAL shall. to the extent practicable, provide all other services recommended as its responsibil ity as set forth in the written guidelines for Level III Communities. 4. The HOSPITAL shall procure and maintain medical malpractice insurance and such policy shall contain an endorsement showing the CORPS and the CITY as additional insureds. The HOSPITAL shall provide the CORPS and CITY with certificates or copies of the policy promptly after issuance thereof. The policy shall contain an agreement by the insurer that such policy shall not be cancelled, limited or non-renewed until after thirty (30) days' written not ice has been given to the CORPS and CITY. . -5- CITY OF SEWARD, ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL 5. The HOSPITAL shall endeavor to provide adequate suppo to the CORPS to assist the CORPS in implementing and maintaining the follow- ing administrative procedures: Planning Risk Analysis Budgeting Reporting Evaluation Operational Procedures Certification Records Keeping Risk Management Training Bill ing Accounting C. The CITY agrees as follows: 1. The CITY shall. to the extent practicable. provide all services recommended in its responsibility as set forth in the written guidelines for Level III Communities. 2. The CITY shall, at no cost to the CORPS, provide space in the fire station for housing the ambulances, EMS equipment and office space for the CORPS. The aforementioned space provided shall be as currently -6- CITY OF SEWARD. ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL . provided and shall not obl igate the CITY or HOSPITAL to provide additional space for use of the CORPS. No ambulances or equipment shall be relocated from the fire station without the prior written approval of the CITY. 3. The CITY shall provide fuel and maintenance for the ambul ances for a fee of TWO HUNDRED and NO/lOO ($200) DOLLARS per month. payab 1 e by the CORPS to the CITY. In return for this consideration, the CORPS will adhere to the maintenance schedule provided by the CITY and shall coordinate all maintenance of the ambulances with the City Shop. 4. The CITY shall provide auto liability. uninsured motorist. non-owned and hired auto and scheduled physical damage and medical . payments insurance for all ambulances. This coverage is limited to operations of the ambulances. and no coverage is provided to CORPS members while responding to or from ambulance calls in personal vehicles, except as provided by the CITY's Worker's Compensation and Employers Liability PoliCY. 5. The CITY shall provide Worker's Compensation and Employer's Liability Insurance for CORPS members in their capacities as EMS volunteers. 6. All insurance pol icies obtained by the CITY under this Agreement shall be open to inspection by the HOSPITAL and CORPS, and shall provide that such policies may not be cancelled without thirty (30) days' . prior written notice to the HOSPITAL and CORPS. -7- CITY OF SEWARD, ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL 7. The CITY shall provide a 1984 Ford Ambulance. Serial ~ 2FDKF37ECD20978, and certain ancillary equipment described in Appendix "B" to this Agreement. to the CORPS for its exclusive use. and the CITY agrees to maintain liability. auto medical payments. uninsured motorist. comprehensive and collision insurance. with coverage limits to be at the sole discretion of the CITY. If this Agreement is terminated. the CORPS shall return to the CITY possession of the ambulance and related equipment purchased with the ambul ance, and as set forth in Append ix "B", in good cond it10n. except for normal wear, on or before the date of intended termination. D. Term: This Agreement is for a period of one (1) year. commencing on the day of . 1987. and shall be renewed automatically for successive one-year periods. unless one of t parties hereto gives notice of interest to terminate not less than thirty (30) days before the expiration of a one-year term. This Agreement may be cancelled by any party without cause thirty (30) days after giving written notice of termination to the other parties. In the event of cancellation by any party. the CITY reserves the exclusive right to take any or all steps available to the CITY. at the CITY's full discretion. pursuant to the ordinances of the CITY or laws of the state of Alaska, necessary to preserve the interests of the City. E. Applicable Law: This Agreement shall be governed by the laws of the State of Alaska. -8- CITY OF SEWARD, ALASKA MEMORANDUM OF AGREEMENT CITY/CORPS/HOSPITAL F. Assignment: This Agreement may not be assigned without the written permission of the City Council of the City of Seward. Alaska. The Agreement will be binding on all successor or assigns. G. Notice: Any notice required to be given by one party to the others under this Agreement shall be deemed given when delivered in writing by one party to the other upon the expiration of three (3) days following the deposit of such written notice in the United States mail. postage prepaid. by certified mail. return receipt requested. to the following address of the parties: CITY HOSPITAL CORPS City Cl erk President/CEO President P.O. Box 167 P.O. Box 365 P. O. Box 1136 Seward. AK 99664 Seward. AK 99664 Seward, AK 99664 H. Exhibits: There is attached as Exhibit A to this Agreement the State of Alaska EMS Guidelines for Level III Communities. IN WITNESS WHEREOF. the parties hereto have set their seals this day of . 1987. -9- CITY OF SEWARD. ALASKA MEMORANDUM OF AGREEMENT r'\TTV '''''OOe- JunC'OTTAI d ~i ;.~;J, LEVEL III: REGIONAL CENTERS . ~ .~ -- j i j ~ ~ , I , 11 .1 j 1 ] Level IlI-l . - -- AlASKA e 00t\LS LEVEL III alKlNITIES I. AIMINISTRATlON I:11ery Level III cOlIIIUIity should have: A. A designated person to coordinate EMS activities. B. A local EMS <:buncH to oversee EMS functions, which meets at least quarterly to review responsibilities and coordinate activities. C. .Pn annual plan of action based on local EMS objectives. D. ~ter1y contact with regional or sub-area ai) Coordinator. E. Input into regional/sub-area EMS plan. I I. E.VAll1ATlOO' M EMS Q:)lIIIIUZ1ity Olecklist providing evaluation should be cOIIIpleted amually by every Level III cc:JlII1Ulity. I II. MEDICAL cmTROL Every E'IIlergency ~ical Service in a Level III cOlIIIUIity should have: A. A physician or group of physicians to serve as Physician Spon80r(s). B. Capability for receiving direct physician supervision by phone or radio. C. 8Dergency medical records reviewed by the Physician Sponsor monthly. D. Written guidelines for prehospital patient care reconmended by the Physician Sponsor(s), in at least the following critical care areas: 1. Tra\.lD& a) Head, neck and spinal injuries b) Olest and abdominal injuries c) Extremity injuries d) .Pmputations The recommend.tions listed on these pages are not to be interpreted .. regulations; they have not been .dopted under the Alaska Administrative Procedure. Act. A.S. Chapter 44.64. nor .re they intended for future adoption as regulations. T,.".....Q' T'TT_" - .'- '" ---'.. -'---_.~-------- . . . 2. Cardiac 3. Burns 4. Near-dr0wU.n8 5. Hypothermia and frostbite 6. R:lisonlng and overdoses 7. Emergency childbirth 8. High risk infant and neWom resuacitation 9. Pediatric emergencies 10. Behavor1al emergencies 11. Victims of domestic violence. sexual assault 12. Individuals of danger to self and others. 13. Dive emergencies (where appropriate) and child abuse IV. ~'IRAINOO A. Fwry level III Coam.nity soould maintain a current EM) msnpowr listing. B. Pl.blic Safety Personnel 1. All search and rescue personnel should be trained to at least a Basic First Aid level. 2. All police and firefighters soould be trained to at least Emer- gency Trauna Technician (E'IT) level. C. Pre-fbspital EMS Providers 1. Brery level III cOl1llU1ity should have a state-certified emergency medical service. 2. arery emergency medical service ~se coverage area frequently requires transport times of over 1 5 minutes should be certified at the hivanced Ufe &1pport level (EMl'-I II or higher). 3. All emergency medical dispatchers should receive dispatcher training according to the standards of the u.s. D:!pt. of 'Iran- portation program: "Emergency Medical Services Dispatcher: Nltional Standard Curri- culUD." 4. All active EMrs in the emergency medical service should be trained in Prehospital Trauna Life Support. The reeo...ndations listed on these pages are not to be interpreted as regulations; they have not been adopted under the Alaska Administrative Proeedures Aet, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. Level 1II-3 _....1;: ...... -- -...a>."........_.. '8;-"" "._'........_ - D. Medevac Persomel Every r.vel III cOlllllLl'1ity should have: 1. tesignated emergency care personnel trained to at least EMT- I level, wich medevac escort training, available to accOmpany ill or injured patients during air transport to and fr<XII che hospital. 2. For medevacs wich seriously ill or injured patients, designated emergency care personnel trained to at least aorr-II level, with medevac escort training. 3. <h every medevac with a patient requiring advanced respiratorY or cardiac support, an attendant who is an MD, RN, fbysician Assistant (PA) or paramedic wich critical care skills, and mede- vac escort training. E. Prerospital U"aining Programs Every level III caJlllUnity should have: 1. AI:. least ~ active State-certified EH1' Instructors. 2. Training and continuing education programs for all responders in the coommity, adequate to meet the manpower needs of che cOOIII1Il'\ity. 3. U"aining aids essential to course presentation, as recamnended in chese guidelines. [See page X-19 thro~h 23.] The recommendations listed on these pages are not to be interpreted a. regulations; they have not been adopted under the Alaska Administrative Procedures Act t A.S. Chapter 44.64, nor are they intended for future adoption as regulations. 1A!vel II 1-4 . . . .... 1 F. }i)spita! Providers 1. FNery acute care hospital in a level III COlIIIIlI'lity should have: a. Twenty-four hour, seven day-a-week on-call coverage of the emergency roaD, within 15 minutes, by a physician cer~ified in Advanced 'lraUDa Ufe &1pport and Advanced Cardiac Life Support (ATI$ and ActS). b. Twenty-four hour, seven day-a-week coverage of the emergency room by nurses trained in trauaa nursing and certified in ACLS. c. All hospital employees certified in CPR. d. Personnel present at all deliveries capable of resuscitating new- boms. i ..' e. Olgoing in-service education on emergency nursing skills for all nurses with emergency deparODent responsibilities. f. Irl ongoing program of education for local physicians, to familia- rize them with the critical care guidelines and procedures for transferring patients, recommended by receiving hospitals. g. A formal ongoing continuing medical education progran for person- nel in the following critical care areas: 1. Trauna , . r " ~' I I i ~ 4, I: ~ a) Head, neck and spinal injuries b) Olest and abdaninal injuries c) Extremity injuries d) ~tations 2. 1hermal injuries 3. Cardiac emergencies 4. Respiratory emergencies 5. Cbstetrical emergencies 6. Neonatal emergencies 7. Pediatric emergencies 8. ~isons and d~ overdoses 9. 1hvi1,\Jllw",:utal emergencies 10. Behavorial emergencies 11. Victims of sexual assault 12. Diabetic crises ~\ ~i The recommendations listed on these pages are not to be interpreted a. regulations; they have not been adopted under the Alaska A~ini.trativ. Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. Level I Il- 5 h. Actual resuscitations or resuscitation drills at least three time8 a year, for all appropriate staff. i. 111 on-going program to familiarize emergency staff with local social and paraDedical resource agencies and their appropriate usage; Le. mental health, crisis response, substance abuse, family violence agencies; poison control; disaster coordina- tion; etc. j. A plan to mobilize personnel and equipllent for emergency situ- ations that overtax routine staffing. 2. !M!ry hospital with surgical capabilities should have anesthesia services in-house or on-call on a twenty-four hour basis. V. CXHtJNlCATlOO A. 8lery Level III COlIIIU1ity should have: 1. An up-to-date inventory of camJUl'1ications equipnent used in the EMS system. 2. <he telephone nunber, well-advertised and toll free, preferably "911," to access fire, police, and emergency medical services. 3. BDergency llIOnitors or dispatchers able to alert first responders 24 hours a day. 4. ~-way conmmications between emergency medical service and local medical supervisor. 5. ~-way ambulance-to-hospital coum.mications with tone alert. 6. .4mbulances with mobile radio access to on-duty state troopers or police. 7. ~-way cOllllU1ications among search and rescue personnel. 8. Predetermined procedures for maintaining all emergency ccmnunica- tians equiIDent. The recommendation. li.ted on the.e page. are not to be interpreted a. regulation.; they have not been adopted under the Ala.ka A~ini.trative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. Level I II-6 . . . B. 8lery acute care hospital in a IBvel III COIIIIU'lity should have: 1. 'l\o-w.y l'nInlW'\ications with health providers in the outlying cOlllllJl1ities it serves. 2. OI.pability to page on-cal.l staff outside the hospital. 3. A code to notify other hospital staff of an emergency situation. 4. OI.pability of biO-way air-ground c.-.qfllDlications with primary air services carrying patients to the hospital. 5. A back-up COIIIIIJnications systm or procedures for COIIIIllllications during power failures. 6. (blllllJllications equipuent consolidated in one area for constant monitoring. 7. Orientation and in-service training in use of cOlllllJnications gear. VI. PATIEm' 'IlV\NSPORT/'IlV\NSFER . II ~ ~ ~ ~ A. Every Level III ccmnunity shoold have: 1. ilirrent map books. 2. ~ least one state certified emergency medical service with ambulance(s) meeting U.S. IRpar1JDent of 'lIansportation standards for patient care capabilities; and a back-up vehicle. [See page X-5.] -~~ ... ., 'I i ;,(.1 , 3. Imbulance perSOl'U'lel able to arrive at the scene within 8 minutes of call for 90% of emergencies occurring within major population areas . 4. First responders with Basic Life &lpport training at the scene within 4 minutes of call for 90% of emergencies occurring within major population areas. 5. Wi thin 1 5 minutes of the hospi tal, a landing area with lighting capability for helicopters and for fixed wing aircraft. 6. Established procedures for emergency air transport. '" ~:l The recommendations listed on these pages are not to be interpreted as regulations; they have not been adopted under the Alaska Administrative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. Level I!I-7 B. a.rery acute care hospital in a Level III COIIIlUlity should have: 1. A directory of facilities with critical care capabilities avail- able to receive transferred patients. 2. Specific procedures es.tablished with referring hospitals and ac- cepting hospitals for preparation and transport of= patients in each critical care category. 3. R>r the person(s) assigned to coordinate transfers, a checklist of actions required to prepare any patient for transfer. 4. Available at all times, prepared kits of air transport supplies and a set of basic patient transport equipnent, as re......._ided by these guidelines. [See page X-24 and X-28.] 5. A current schedule of air carriers serving the cClIIlU'lity, and a list of their requirements for boarding stretcher patients or other emergency patients. 6. A list of air taxis for bringing in patients from outlying CCXIIIL1- nities, with information on how they may be contacted, when they are available, and each plane's transport capabilities. 7. en every hospital-to-hospital transfer, a record of patient's preh08pital condition, as well as initial condition and treat- ment in hospital. 8. en all hospital-to-hospital transfers, a qualified attendant as prescribed by the physician in charge. 9. A means to support respiration artificially with high levels of oxygen during transfer to another facility. The recommendation. listed on the.e page. are not to be interpreted a. regulation.; they have not been adopted under the Alaska Administrative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. lA!vel I II-a ,: J , , j I . I I I I I 1 '. ~ ~ VII. FACIUTl~/QJ1PHENT Every acute care hospital in a ~l III COlIIIU1ity should have: A. In emergency room with i1IIDediate access to lab, (including blood al- cohol analysis), blood bank (walking), blood gas and x-ray capabili- ties at all times. = B. ,Gn operating roan available, staffed and functioning within 30 min- uces, including anesthesia. C. M. least one roan designated and equipped for intensive care of critically ill patients. D. ,Gn area equipped to receive a cardiac patient, with oxygen, monitor/ defibrillator, oral suction, and a resuscitation crash cart; and a system to check equipllent at least every 24 hours. E. Equipllent for adult and infant resuscitation, and a plan for its maintenance . F. A maternity area physically separated frm patients with illness. G. Centralized storage of appropriate pediatric-sized equipllent for trauua care. H. Centralized storage of pediatric resuscitation equipllent ready for transport to any area of the haspi tal. I. kcess to a transport isolette. J. 1b be detemined by medical staff, appropriate equipllent for moni- toring and rewarming hypothermic patients. K. In identified area with shower, appropriate for isolation and treat- ment of radiation contamination victims. L. A security roaD or a procedure for keeping confused patients under observation, and to help ensure safety of staff and other patients. M. A procedure and alarm system for protection of staff in the event of a behavorial emergency. N. In emergency pcM!r source for care of critical patients in the event of pcM!r failure. O. A system for returning equiIXDent received with patients from outly- ing ('QIID.lnities; and retrieving equipuent sent with patients to otner facilities. The recommendations listed on these paBes are not to be interpreted as reBulations; they have not been adopted under the Alaska Ac.inistrative PToceduTes Act, A.S. Chapter 44.64, nOT aTe they intended for futuTe adoption as reBulations. Level I II-9 -. ....... - .~ , ~,.. JIll VII I. aUnCAL CARE GUIDELINES. Every acute care ~spital in a Level III CCXIIIII.I'lity should have: A. A program for familiarizing emergency departJ1lent staff with the standing orders and field techniques of the pre-hospitlll emergency care providers. B. Writ~uidelines for treatment and transfer of patients in at leaat followir1R cd tical care catejlOries: 1. 'lrauna a) Head, neck and spinal injuries b) Olest and abdominal injuries c) Extremity injuries d) Amputations 2. ~ock 3. &.1ms 4. Cardiac emergencies S. Respiratory emergencies 6. Obstetrical emergencies 7. Pediatric emergencies 8. Neonatal emergencies 9. Poisons and drug overdoses 10. Behavorial emergencies 11. Diabetic crises and other medical emergencies 12. GOld water near drowning 13. Hypothermia 14. Frostbite ) C. Readily available names and phone nunbers of consultants utilized in each critical care area. D. Written patient care standing orders for emergency departJDent nurs- ing staff for all life- or limb-threatening emergencies, to be approved by the emergency department medical director. E. A written resuscitation protocol, identifying responders and their responsibilities. The recommendations listed on these pale. are not to be interpreted a. relulations; they have not been adopted under the Alaska Administrative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. Level !tI-l0 I I. I I I I l I I. I I I I I I '. , , F. Written procedures for: 1. amiling legal evidence in the emergency departlDent. 2. ldDission and treatment of a patient for alcohol detoxif- ication. 3. Ikawing of blood alcohol levels so that hospital staff and patients are legally protected. 4. Dealing with patients with self-inflicted injuries. 5. Dealing with victims of sexual assault, child abuse, domestic violence. 6. IDgging poison information calls and making routine follow-up calls. G. Iumediately available information: 1. List of local mental health resource nunbers (crisis lines, rape cOU1seling, alcohol counseling, etc.) 2. Updated charts in the delivery room, nursery and on crash carts, of emergency drugs for infants. 3. A Poison Information Center nuuber posted for professional consul- tation; and alternate nuubers to call in special emergencies. 4. Readily available, treatment information and medication for those agents mst frequently causing overdose, as reconmended by a Poi- son Information Center. IX. CRITICAL CARE: CAPABILITIES A. arery acute care hospital in a Level III coom.nity should have capa- bility to: 1. Provide endotracheal intubation and perform cricothyroidotomies. 2 Idminister oxygen and monitor oxygen concentrations. 3. ~pport respiration artifically, both manually and mechanically through a respirator. The recommendations listed on these pages are not to be interpreted as regulations; they have not been adopted under the Alaska Administrative Procedures Act, 'A.S".' Chapter 44.64, nor are they intended for future adoption as regulations. Level I II-ll -- -4 4. PerfOt'll pleural de<:oq)ression by needle thoracentesis utilizing flutter valves, and by chest tube insertiats. 5. Provide Advanced Cardiac Ufe &1pport according to the stand- ards of the lmerican Heart Association. 6. Insert a cardiac pacemaker on an emergency basis. 7. Perform pericardiocentesis. 8. Stop continuous bleeding with pressure and inatnments. 9. Insert peripheral, central and cutdown IVs and utilize Phe~tic Anti-Shock Garments. 10. M:mitor fluid resuscitation, including Fbley catheterization. 11. Imoobilize a spinal injury until evaluation can be caapleted. 12. Evaluate abdominal hEmJrrhage with peritoneal lavage. 13. Perform limited (single view, AP, extremities, spine and chest) x-ray exaninations. 14. Perform gastric lavage. 15. Perform peritoneal dialysis. 16. MJdify a patient's core temperature. 17. Splint extremities definitively. 18. Debride wounds of the extremities. 19. Perform escharotaDies. 20. Care for complicated perinatal cases when transfer is impracti- calor impossible, including: a). BDergency Caesarian Section within one hour on a 24 hour basis. b). Fetal monitoring. C. fuspitals with surgical capabilities should have the capability to: 1. Perform emergency intracranial decompressica 2. Perform emergency ~bdominal. chest and vascular surgery The recommendations listed on these pages are not to be interpreted as regulations; they have not been adopted under the Alaska Administrative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. "'___, TTT 1" ~ ~ I. ~ I I I I I I. t t I I I. , :. , X. anmlNATID MEDICAL REXnUJCmlUC Every Level III caaunity should have: A. Patient records covering the pre-hospital, emergency rocn, in-hosp- ital and transfer phases of patient care, llIhich are coordinated so that an individual patient's condition and treatment can be traced easily throughout the system. _ B. ltDbulance run report forms llIhich meet miniDun state data require- ments. [See sample on page XI-6.] XI. ACCESSIBIU1Y TO CARE Every Level III camunity should ensure that all patients are provided emergency care and transportation without regard to race, creed, colol:, sex, national origin or ability to pay. XI I. PUBUC INFURMATION AND EI:llr.ATION 8l1ery Level III cOIIIIU1ity should have: A. I'll on-going program to inform residents and visitors about emergency resources available to them; how they may be accessed; and their appropriate use. B. 'l\lIenty-five % of the population trained in CPR. C. CPR and First Aid classes offered to all students before high school graduation. D. At. least one CPR-InstrUCtor for every 500 people, and at least one i!'irst Aid instructor for every 500 people, actively engaged in COlIIII- unity instrUCtion. E. ~aining aids necessary fOl: CPR and First Aid training, as reca&- mended in these guidelines. [See page X-17.] F. A coordinator to schedule and oversee CPR and First Aid training in the ct"1llllll.,ity. G. BDergency Trauoa Training available. H. Active programs to educate the public on driving safety, ATV safety, boating safety, water safety and survival, hunting safety, cold weather safety and survival, home accident prevention, fire prev- ention, poison prevention and other areas of local importance, through cooperative planning and implementation by all appropriate agencies. The recommendations listed on these pages are not to be interpreted as regulations; they have not been adopted under the Alaska A~inistrative Procedures Act, A.S. Chapter 44.64, nor are they intended for future adoption as regulations. lA!vel 111-13 ..... XIII. DlSAS'l'ER PINIUH;/KmJAL AID Every Level III cQIIIIUl'lity should have: A. TC'itten agreEllllmts with tOOse agencies and providers it ~uld rely upon in emergency situations over-taxing routine procedures and resources. B. A disaster plan. reviewed and updated armually by all agencies in- volved. C. Disaster plans of local entities (airport. hospital. industries) incorporated into the cCIIIILV'Iity disaster plan. D. A yearly disaster drill baaed on the written disaster plan. E. Pre-stocked disaster supplies available in case of lD8BS casualty disasters. as recoomended in these guidelines. [See page X-14.] The recommendation. listed on the.e page. are not to be interpreted a. regulations; they have not been adopted under the Ala.ka Administrative Procedures Act. A.S. Chapter 44.64, nor are they intended for future adoption as regulation.. Level IlI-14 . . . CITY OF SEWARD, ALASKA RESOLUTION NO. 85-36 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, AMENDING RESOLUTION NO. 85-32 BY APPROVING A PURCHASE ORDER TO DYNA-MED, INC. FOR THE PURCHASE OF MEDICAL EQUIPMENT WHEREAS, at its regular meeting of March 27, 1985, the City Council approved Resolution No. 85-32, appropriating $77,120 for the purchase of a fully equipped ambulance; and WHEREAS, Resolution No. 85-32 authorized the City Manager to issue a purchase order not-to-exceed $74,120 to Becker Fire Equipment Company for the purchase of the ambulance and attendant medical supplies and equipment; and WHEREAS, some of the equipment and supplies included in the approved package is to be purchased from Dyna-Med, Inc.; and WHEREAS. since this purchase exceeds $5,000, separate approval of the Council must be obtainedJ NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, that: Section 1. The City Council finds that the public interest would be best served by the purchase of medical equipment from Dyna-Med, Inc., without full utilization of the bid procedures set forth in Section 10-8 of the Seward City Code. Section 2. The City Manager is hereby authorized to issue a purchase order not-to-exceed $5,503.50 to Dyna-Med, Inc., for the purchase of medical equipment. Section 3. This resolution shall take effect immediately upon its adoption. PASSED AND APPROVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA. this 8 day of April ,19 85. THE CITY OF SEWARD, ALASKA ., - , . Jo~n F. Gillespie Acting Mayor -1- CITY OF SEWARD, ALASKA RESOLUTION NO. 85-36 AYES: NOES: ABSENT: ABSTAIN: ATTEST: (City Seal) GILLESPIE, HILTON, SCHOLL, SIMUTIS & WILLIAMS NONE CRIPPS & MEEHAN NONE APPROVED AS TO FORM: HUGHES, TBORSNESS, GANTZ, POWELL AND BRUNDIN, Attorneys for the City of Seward, Alaska Fred B. Arvidson, City Attorney -2- . . . CITY OF SEWARD, ALASKA RESOLUTION NO. 85-32 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, APPROPRIATING FUNDS FOR THE PURCHASE OF A NEW AMBULANCE AND AUTHORIZING ITS PURCHASE WITHOUT UTILIZATION OF THE BID PROCEDURES OUTLINED IN SECTION 10-8 OF THE SEWARD CITY CODE WHEREAS, the Seward Volunteer Ambulance Corps (SVAC) is in need of a new ambulance to better meet the needs of the citizens of Seward; and WHEREAS, the City Council has removed its request for funds for a new ambulance from the City's Capital Improvements Project request list; and WHEREAS, SVAC has requested City funding for the purchase of the ambulance; and WHEREAS, both SVAC and City of Seward Fire Chief John Gage have independently researched the needs of SVAC and the availability of equipment to meet those needs; and WHEREAS, several suppliers of emergency vehicles were contacted for price quotes on the needed vehicle and equipment; aud WHEREAS, Becker Fire Equipment Company has an available ambulance which meets the immediate and projected needs of SVAC; and WHEREAS, it would be costly and time consuming to follow the bid procedures outlined in Section 10-8 of the Seward City Code; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, that: Section 1. The City Council finds it in the public interest to waive the bid procedures outlined in Section 10~8 of the Seward City Code. Section 2. The City Manager is hereby authorized to transfer $77,120 from the General Fund-Fund Balance Account No. 101-000-271-00-00 to Special Projects Account No. 207-000-368-04-00 for the purchase of a new ambulance. Section 3. purchase order to not-to-exceed $74,120 The City Manager is further authorized Becker Fire Equipment company in for the purchase of an ambulance. to issue a an amoun t Section 4. This resolution shall take effect immediately upon its adoption. -1- 2/ / CITY OF SEWARD, ALASKA RESOLUTION NO. 85-32 PASSED AND APPROVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, this 27th day of March , 19 85 SEWARD, ALASKA AYES: NOES: ABSENT: ABSTAIN: Cripps, Gillespie, Hilton, Meehan, Scholl, Simutis, Williams None None None ATTEST: APPROVED AS TO FORM: HUGHES, THORSNESS, GANTZ, POWELL AND BRUNDIN, At torneys for the City of Seward, Alaska Fred B. Arvidson, City Attorney (City Seal) -2- CITY OF SEWARD ? --- -.~ '''1. ,. .. dE ...s ;f~li ~-.,. :..",;\ 1(A9-~ · Main Office (907) 224-3331 . Police (907) 224-3338 . Harbor (907) 224-3341 . Telecopier (907) 224-3248 1.0. lOX ." SEWARD, ALASKA 9CJ664 .. .MEMOlWIDUM AGREEMENT APPENDL"{ "A" . . ",./ "....-- .~ -../ " - - ...., <..1.. ,~ .~ March 20, 1985 MEMORANDUM TO: HONORABLE MAYOR AND MEMBERS OF CITY COUNCIL THRU: RONALD A. GARZINI, CITY MANAGER JOHN GAGE, FIRE CHIEF 11.Jf PURCHASE OF AN AMBULANCE AND EQUIPMENT FOR USE BY THE SEWARD VOLUN'l'EER AMBULANCE CORP (SVAC) FROM: SUBJ: - . At the request of the City Manager, I have reviewea price quotations obtained by the Seward Volunteer Ambulance Corp (SVAC) for the purchase of a new ambulance and equi~nt. The equipment price quotations meet the quidelines for purchasing as specified by City Code. I believe the loose equipment purchases should be made as recommended by SVAC. Although there were several manufacturers contacted by SVAC, Yankee Coach was the only one who responded. While contacting two (2) other manufacturers for a comparison price, Becker Fire Equipment was found to have an ambulance of equal quality in stock. After consulting with the ambulance corp on compatibility of this unit with their needs, it was decided to recommend purchase of the Becker Fire Equipment unit. Total cost of the equipment and ambulance unit is not-to-exceed $74,120.00. For a detailed cost breakdown of the complete package, F.O.B. Seward, please see the attached. Note: For the ambulance to have the same radio capabilities as the present ambulance, approximately $3,200.00 worth of radio components must be installed. Attachment f2.sso 1;S'- 3.1. ~~ ~1z,:rlrr A-ifti B' t:l l' l,;;.;;" f) The following is a breakdown of cost for the proposed ambulance and equipaaen't: AMBULANCE A. Manufacturer: Road Rescue, Inc.7 St. Paul, .lldianesota B. Dealer: Becker Pire Equipmen't7 Casper, Wyoming C. Cost of l. 2. 3. 4. Unit: As is Compartment dividers Undercoating (Z-Bart) 4X4 conversion SOB-TOTAL P .0. B. Denver D. Destination Expenses 1. Trave~ (airfare for 1) Anchorage to Denver Sea'ttle to Anchorage 2. Motels and meals (expenses) 3. Fuel cos't (Denver to Seattle) 4. Shipping to Seward SOB-'!OTAL $46,659.00 200.00 500.00 5,800.00 $53,159.00 $ 542.00 540.00 250.00 2,061.00 $ 3,393.00 EQUIPMEN'r Prices listed were quoted from Dyna-Med, Inc. and includes the cost of shipping. A. 1 - Bare traction splint adult B. 1 - Bare traction splint pediatric C. 2 - Kendrick extrication device (K.E.D.) D. 2 - Long spine boards - x-ray transparent E. 1 - BP trauma air pants with gauge (adult) $ 225.00 225.00 337.00 200.00 414.00 P. 1 -.BP trauma air pants with gauge (pediatric) 401.00 G. 2 - Adjustable backrest stretcher with telescoping feature and wheels .642.00 . . . E~OIPMENT (continued) H. 1 - Tyco. wall aneriod sphygmomanometer 97.50 I. 3 - Rechargeable flood lantern with AC-DC charge 300.00 J. 1 - Folding scoop stretcher 234.00 K. 1 - Two piece basket stretcher 264.00 L. 1 - Laerdal Bag Resuscitator, adult 109723 90.00 M. 1 - Laerdal Bag Resuscitator, child 109721 85.00 N. 1 - Hare-Blder portable resuscitator with triqger arm demand valve 141051 525.00 o. 1 - Laerdal Bag Resuscitator, infant 109719 80.00 P. 2 - Hare-Blder demand valve with triqger arm face mask and 6' oxygen hose 288.00 Q. 1 - Suction unit (portable) 109400 359.00 R. 1 - Ambulance all level cot 111521 689.00 S. 1 - Nu-foam ambulance cot mattress .UR) IU319 48.00 $ 5,503.50 SUB-TOTAL PHYSIO CONTROL A. 1 - BeG monitor module B. 1 - BCG/Voice recorder module C. 1 - Defibrillator module D. 1 - ECG modulator B. 1 - Bat~enr !I~P9rt ;!lYs~ SUB-TOTAL $ 2,845.00 1,500.00 3,555.00 400.00 1.400.00 $ 9,700.00 \.1 ~f R2 CORPORATION A. 1- R2 electrode defibrillation unit $ 1.076.00 (complete) SUB-TOTAL $ 1,076.00 L.N.CURTIS A. 1- Laerdal Modulaide Emergency Lite $ 700.00 Sapport ~l.t SUB-TOTAL $ 700.00 ESTDKATED SHIPPING CHARGES TOTAL $ 169.00 $17,148.00 WARRANTY ESP PLUS PLAN (5 year/36,000 miles) from FORD MOTOR CO. $ 420.00 TOTAL COST OF AMBULANCE, EQUIPPED AND DELIVERED TO SEWARD AMBULANCE UNIT TOTAL $53,159.00 3,393.00 17,148.00 420.00 $74,120.00