Charge Section

Prepare your unit and manage calls effectively as charge personnel. Follow these structured steps to ensure your unit is ready for service and your response is efficient.

Preparing the Unit for Service: Start-of-Shift Checklist

Use this interactive checklist to prepare your unit at the beginning of each shift:

Check Radio Batteries
Ensure the batteries are charged and secure the radio in its strap.
Inspect Oxygen Supply
Check the PSI level and replace or refill if necessary.
Complete a Full Unit Checkout
Inspect all equipment with your team but take personal responsibility for readiness.
Log Into the Mobile Data Computer (MDC)
Sign in to place your unit in service and confirm dispatch availability.
Log Into the ePCR System
Assign your crew and verify all entered information.

Handling Calls as Charge Personnel

Master your responsibilities as charge personnel with this structured guide:

Receive the Dispatch: Check the Mobile Data Computer (MDC) for details and accept the call to acknowledge it.
Prepare for Enroute Status: Update your MDC status to “Enroute” and switch the radio channel to 7A1 OPS1.
Brief the Crew: Communicate key call details and equipment needs (e.g., stretcher, jump bag).
Navigate to the Scene: Use GPS for route guidance and provide turn-by-turn directions to the driver.
Assist the Driver: Help with situational awareness (e.g., airhorn usage, hazard spotting).
Arrive on Scene: Update the MDC status to “On Scene” and ensure all necessary equipment is grabbed.

Patient Interaction Guide

Effective patient interaction is crucial for ensuring safety, gathering accurate information, and providing compassionate care. Follow this structured guide to optimize every interaction.

Approach the Scene Safely

Ensure safety by checking the scene for hazards and planning a clear path for patient transport:

Scene Safety: Observe surroundings for hazards such as animals, structural risks, or hostile individuals.
Clear Path: Ensure the path to the patient is free of obstructions, making it safe for stretcher movement.
Initial Observations: Look for clues outside the residence (e.g., broken windows, unusual smells) that may indicate dangers or provide context about the situation.

Gather Patient Information

Use the following structured tools to obtain thorough patient information:

SAMPLE Assessment

S: Symptoms – What’s bothering you the most right now?
A: Allergies – Do you have any allergies?
M: Medications – What medications do you take?
P: Past Medical History – Do you have any medical conditions?
L: Last Oral Intake – When did you last eat or drink?
E: Events Leading to the Incident – What were you doing when this started?

OPQRST Assessment

O: Onset – What were you doing when the pain started?
P: Provocation – What makes it better or worse?
Q: Quality – What does the pain feel like (e.g., sharp, dull)?
R: Radiation – Does the pain move to other areas?
S: Severity – On a scale of 1–10, how bad is it?
T: Time – Around what time did this pain begin?

Managing Patient Care Inside the Ambulance

Providing patient care during transport requires ongoing monitoring, clear communication, and efficient preparation for hospital arrival. Follow these steps to ensure a smooth and effective process.

Monitor and Reassess the Patient

Take Vital Signs: Use onboard equipment to monitor heart rate, blood pressure, respiratory rate, and SpO₂.
Ask for Updates: Regularly ask the patient about their symptoms: "Are your symptoms changing?" or "How is your pain now?"
Adjust Treatment: Modify oxygen delivery, medication, or patient positioning based on their condition.

Document and Communicate

Fill Out the ePCR: Start documenting patient demographics, clinical impressions, and interventions provided during transport.
Notify the Hospital: Use EMRC or the designated radio channel to give the hospital an accurate patient report:
- Priority level (1–4).
- Chief complaint and clinical impression.
- Vital signs and treatment details.

Prepare for Arrival

Organize Equipment: Ensure all necessary items (e.g., jump bag, medication list) are ready for the handoff.
Update the ePCR: Finalize as much of the report as possible before arriving at the hospital.
Communicate with the Patient: Reassure them about what will happen next: "When we arrive, the doctors will continue your care."

Managing the Patient at the Hospital

Ensuring a smooth transition of care at the hospital is essential for patient outcomes and operational efficiency. Follow these guidelines to complete the process effectively.

Check the Patient In

Escort the Patient: Safely bring the patient into the emergency department on the stretcher.
Provide Identification: Share the patient's name, ID, and chief complaint with the hospital's check-in staff.
Vital Signs: Update the patient's vital signs using hospital equipment and share any significant changes.

Report to the Charge Nurse

Summarize the Case: Provide the charge nurse with a concise report, including:
- Age, sex, and chief complaint.
- Vital signs and medical history.
- Interventions provided and patient response.
Answer Questions: Be prepared to clarify any details about the patient's condition or care.

Finalize Transfer of Care

Obtain Signatures: Have the charge nurse and patient (if applicable) sign the ePCR to confirm transfer of care.
Finalize the ePCR: Complete any remaining sections of the report, ensuring accuracy and completeness.
Restock and Sanitize: Replenish supplies and clean the stretcher and ambulance interior before returning to service.

End-of-Shift Checklist

After your shift, ensure your unit is restocked, cleaned, and fully operational for the next crew. Follow these steps:

Steps to Complete Before End of Shift

Clean the stretcher and ambulance interior.
Restock supplies (e.g., oxygen masks, gloves, medications).
Finalize and submit all ePCRs from the shift.
Ensure radios and other electronic equipment are charging.
Log out of the Mobile Data Computer (MDC).

Advanced Communication Techniques

Clear and concise communication with your crew and other stakeholders ensures patient safety and operational efficiency. Practice key techniques here.

Radio Communication Etiquette

Use standard codes and protocols for clarity (e.g., "10-4" or "Copy that").
Keep messages brief and to the point: "A706 to Montgomery, we are en route to [location]."
Pause between messages to allow others to communicate.

Crew Coordination During Emergencies

Delegate Roles: Assign tasks based on each crew member's strengths and training.
Conduct Quick Briefings: Share information on the patient's condition, location, and equipment needed.
Use Non-Verbal Cues: Hand signals and eye contact can improve efficiency in noisy environments.

Exceptional Situations

Some emergencies require exceptional decisions or actions beyond routine protocols. Learn how to handle these scenarios:

Mass Casualty Incidents (MCI)

Communication: Coordinate with EMRC to prioritize patient care and allocate resources effectively.
Patient Triage: Use START (Simple Triage and Rapid Treatment) to classify patients by severity:
- Green: Minor injuries.
- Yellow: Non-life-threatening injuries.
- Red: Immediate life-saving interventions required.
- Black: Deceased or non-salvageable.
Documentation: Record triage tags and communicate updates with dispatch and the hospital.

Exceptional Calls

When unable to consult with EMRC or follow standard protocols:

Document the situation as an "Exceptional Call" in the ePCR.
Follow standing orders and protocols as closely as possible while improvising solutions.
Provide a detailed report to supervisors post-call for review.

Key Metrics for Performance Improvement

Tracking metrics helps identify areas for improvement and ensures high standards of care.

Personal Metrics

Average time from dispatch to arrival on scene.
Accuracy and completeness of ePCR documentation.
Patient satisfaction feedback (if available).

Crew Metrics

Response times compared to local benchmarks.
Team coordination during high-stress calls.
Equipment readiness at the start and end of shifts.