These are the Standard Operating Procedures for the Wake Forest University Emergency Response Team. All WFERT personnel are expected to act in accordance with these guidelines while on duty and/or responding to emergency calls. The SOP’s are designed to provide the best possible emergency care for patients while remaining within the limits of Federal, North Carolina, and regional standards and laws. The safety of WFERT personnel and patients was given the utmost consideration in creation of these SOP’s.

The SOP’s are the guidelines and standards that every WFERT member will be held accountable to. It is important that these guidelines are not held to be absolute. As every emergency is unique, guidelines cannot be created to cover every possible situation or incident. WFERT personnel will be given the latitude to interpret and work beyond these guidelines providing that they maintain the safety of their fellow responders and a high standard of care and professionalism with regard to the patient as a priority. WFERT personnel should be mindful of the fact that they may be called upon to justify their actions.

1. Point of Entry

1. The primary service area of the Wake Forest Emergency Response Team includes all offices, buildings, and residence halls on the Reynolda Campus, 1834 Wake Forest Road. WFERT will also respond to Polo Road theme housing, Faculty Drive, and the staff residential facilities on Allen Easley Drive, with the understanding that responses to these locations may be delayed due to distance. The population served by the Wake Forest Emergency Response Team is limited to those persons who live, work, or study at Wake Forest University and its affiliates, although in emergency situations any person ill or injured within the primary service area is eligible for services without prior evidence that he or she is a member of that group.

2. In addition to emergency medical service, WFERT may be called upon for stand-by during times of campus-wide emergency to assist the Wake Forest University Police Department in distributing urgent information, responding to alarms of fire, assisting with evacuations, etc. provided that the safety of the WFERT member is not compromised at any time.
3. The Wake Forest Emergency Response Team is to be considered a part of the Wake Forest Emergency Medical System. WFERT aids the University Police in responding to calls provided that the University is in session. The University Police will respond to any and all calls during the year. WFERT provides enhanced care at the EMT level during times when it is in service. The emergency squad will be in service during the regular academic year, from 4pm-7am on weeknights, and 24 hours during the weekends. All additional services in the EMS system will be notified as to the times we are in service, or if we must go out of service due to an emergency. These include the Wake Forest University dispatcher and police force and Forsyth County EMS. Since this squad is considered an aid to the present EMS system, in times out of service the University Police will respond, with the Winston Salem Rescue Squad, Forsyth County Emergency Medical Services, the Student Health Services, and the Physical Facilities Rescue Team as additional resources.
4. The emergency number by which WFERT may be reached is 911 using the campus telephone system, or by activating an emergency call box.

2. Requirements for Membership/ Staffing

1. In order to qualify as a responding member of WFERT (basic member status), the applicant must:

1. possess a current North Carolina EMT certification (national registry certification is also sufficient)
2. possess a current American Heart Association CPR certification at the level appropriate to the professional rescuer
3. demonstrate leadership and the ability to provide a high standard of emergency medical care

2. WFERT members will not discriminate against any member for any reason. All members of the Wake Forest community are equally eligible for membership.

3. No WFERT members will function as EMT’s if they have any physical or mental impairment or disease which could reasonably be expected to either impair their ability to function as an Emergency Medical Technician or jeopardize the health and safety of their patients. If such a condition exists, the member will immediately notify the Personnel Officer.

4. All EMT’s are required to attend the training and orientation sessions organized by the executive board, and must demonstrate proficiency in EMT/BLS and related skills prior to becoming responding members of WFERT.
5. If at any time a WFERT member looses their EMT or CPR certification, for whatever reason, they must immediately notify the Captain and Personnel Officer and will be removed from service until certifications have been renewed. It is the responsibility of the member to find replacements for any shifts lost.
6. All General Meetings are assumed to be mandatory. If a WFERT member is unable to attend a meeting at the announced date and time, it is his or her responsibility to notify the Captain and/or Personnel Officer prior to the meeting. Individuals with two unexcused absences will be removed from service pending review of their status by the executive board. Individuals already removed from service for other reasons are still obligated to attend General Meetings
7. Failure to attend a General Meeting while on disciplinary status may result in dismissal from WFERT.
8. If a General Meeting is to include in-service training on a new piece of equipment, the General Membership shall be notified in advance. If an EMT is unable to attend the session, it is his or her responsibility to meet with a member of the executive board, preferably the training officer, to be briefed on the use of the equipment prior to his or her next shift. If he or she is unable to do so, it is his or her responsibility to find a suitable replacement for any shifts that will be missed prior to completion of in-service training on the item.

3. Elections/Elected Positions

1. Elections for WFERT shall be held during the first meeting in the month of April for the next school year. All officer positions are in effect starting the day after the Wake Forest spring graduation date, and they shall hold that office until the close of the next academic year. Candidates for all offices are subject to the approval of the Director of the Health Service.
2. Officers’ titles and responsibilities are as follows:

1. CAPTAIN/ PRESIDENT: The captain must be a basic member of WFERT, and have one or more years experience served on the emergency squad. The captain shall be the chief executive officer of WFERT and is responsible for overseeing the executive board’s meetings. The captain shall also call general and executive meetings and preside over all emergency squad meetings. He/she also will act as the official liaison between WFERT and any other external organization including, but not limited to, University Police, Student Health Services, Student Government, and the Physical Facilities Rescue Team. The captain shall also be responsible for disciplinary measures of misconduct or irresponsibility. The main function of the Captain is to maintain the organization and ensure that the other officers are fulfilling their responsibilities. The captain may be referred to the president of the Wake Forest Emergency Response Team. The captain will have signature power.
2. PERSONNEL OFFICER: The personnel officer must be a basic member of WFERT and must have one or more semesters of experience served on the emergency squad. The personnel officer shall be a member of the executive board. This officer serves as the personnel manager for WFERT and is responsible for collecting and recording all necessary copies of certification and training requirements; scheduling crews and distributing the schedule prior to the date of the change of crews; locating emergency replacements to cover a shift when a member is physically unable to do it on his/her own. He/she also ensures that members fulfill their training requirements. The personal officer will be in charge of the "Reward and Recognition Program."

1. EQUIPMENT AND COMMUNICATIONS OFFICER: The equipment and communications officer must be a member of WFERT minimally at the basic level with one or more semesters of experience served on the emergency squad. The equipment and communications officer must hold a current Emergency Medical Technician certificate. This officer will be a member of the executive board. This officer is responsible for maintaining equipment and the communications system. He/she is also responsible for keeping track of supplies used and ordering new supplies as needed by submitting requests to the treasurer. The equipment and communications officer is also responsible for orienting members to new equipment.
2. TREASURER : The treasurer must be a member of WFERT. The treasurer is a member of the executive board. This officer serves as the treasurer and liaison between WFERT and it’s financial sponsor(s). This includes an understanding and balancing of the WFERT budget, as well as overseeing all financial transactions and completing purchase orders for all required equipment. This officer is also responsible for submitting a budget summary at each meeting, with a comprehensive record of all financial transactions at the first and last meeting of each semester. In addition, the treasurer is the coordinator of fund-raising activities. He/she has signature power.
3. TRAINING OFFICER: The training officer must be a member of WFERT at the basic level. The training officer is a member of the executive board. This officer is responsible for overseeing the EMT class on campus, organizing CPR recertification classes to all members, organizing the alcohol awareness certification for all members, organizing EMT continuing education classes, and developing and executing new training classes for the members of WFERT. The training officer is also responsible for orienting new members to the squad. The training officer has the power to delegate an OSHA officer, whose position will be directed by the training officer.

4. A vote of ¾ of all members is required for the deposition of an officer.

1. The executive board consists of the Captain, Personnel Officer, Equipment and Communications Officer, Treasurer, Training Officer, Officer of Special Projects, Secretary/PR Officer.

2. The executive board has the following responsibilities and powers:

1. to review all applications for membership and to vote such persons into basic member status. This must be met with 75% approval of the board.

1. to approve a suspension of any member as initiated by the captain, ¾ of the board must assent
4. to set productive goals for the emergency response team
5. any unforeseen need not delegated to any other specific person shall be the responsibility of the executive board at the discretion of the captain.

The hours of operation when WFERT is in service shall be:

Monday-Thursday night: 4:30pm-8am

Friday night: 4:30pm-11am

Saturday day: 11am-8pm

Saturday night: 8pm-11am

Sunday day: 11am-8pm

Sunday night: 8pm-8am

2) The optimal shift will be two EMT’s and one observer. If an emergency arises, it is permissible to run with one EMT, as long as that EMT has demonstrated his/her ability as a competent emergency care provider.

1. Each crew will consist at least one Basic Member.
2. Assigned shifts will cover the following hours:

Monday-Friday (08:00-16:30hrs): Physical Facilities

Monday-Friday (16:30-08:00hrs): WFERT

Saturday-Monday morning (8:00-8:00hrs): WFERT

These hours may be altered at the agreement of the Wake Forest EMS system and affected EMT’s, as long as adequate coverage of the campus is maintained.

3. Once assigned to a shift, it is that member’s responsibility to arrive on time to receive or exchange equipment. If a member does not arrive on time to receive their equipment the status of that EMT may be reviewed by the executive board.
4. When a member is unable to cover an assigned shift, it is his or her responsibility to locate a suitable replacement. Once a replacement has been located, the EMT must call any EMT’s scheduled before or after the switch who may be affected and the Personnel Officer must be notified of the change. The swap should also be recorded on the shift schedule posted in the University Police Communications office.
5. While covering a shift, the EMT’s are responsible for being on campus in order to guarantee a reasonable response time. In the event that an EMT must leave the area for any length of time, it is his or her responsibility to find a suitable replacement.
6. If WFERT must go out of service for any reason, one of the EMT’s on call must notify the captain, and the University Police communications officer.
7. As it is imperative that WFERT EMT’s uphold a professional attitude and appearance that reflects positively on WFERT and our affiliates, Wake Forest University, University Police, and Health Services. It is imperative that all on-call EMT’s:

• Not consume or be in any way under the influence of alcohol
• Not use recreational drugs at any time
• Not be in an environment whose primary activity is either of the above
• Penalties for violating the above policies are severe and may result in permanent suspension from WFERT, as well as referral to the University judicial system
• Not be in an environment which would prevent the EMT from hearing the radio or pager
• Dress in the official WFERT uniform when responding to calls

9. Any member who arrives on a scene impaired due to the effects of alcohol or drugs shall be suspended immediately and pending review by the executive board at a later date.

10. While responding to calls, WFERT members are required to adhere to the following uniform:

• Long pants (dark) must be worn
• Shoes and socks must be worn. Open-toed shoes and sandals are unsafe and unacceptable
• The official uniform shirt or jacket must be worn on a WFERT scene, and must be displayed prominently to facilitate identification of on-duty members

11. The EMT’s on duty must:

1. Respond to all pages by Campus Police and must verify that they have received the call properly
2. Complete the Equipment Log at the beginning and end of every shift
3. Be certain that all paperwork (incident reports, patient care reports, logs, etc.) is turned-in to the proper location before the end of the shift
4. Make certain that all non-disposable equipment that is left with the patient at a hospital or with a transport agency is either retrieved prior to the end of the shift. If the equipment is not recoverable, make sure that the Equipment and Communications Officer is aware of its location.
5. All medical supplies used at a call must be restocked immediately after completing the call.
6. If any member does not complete the above list of requirements then they are subject to the review of the executive board.

1. The Campus Police communications officer will dispatch WFERT to all requests for emergency medical assistance, reports of a working fire, or reports of industrial accident within the WFERT primary service area. Campus police and WFERT should be dispatched together whenever possible, to ensure the safety of WFERT members at the scene. Campus Police shall be known as "Control" on the radio.

2. WFERT will not, as a general rule, render emergency services onto the city streets for routine medical situations.

3. If WFERT members encounter a medical emergency outside the primary service area, the members shall provide an appropriate level of service until the proper city or county agency arrives to take control of the scene. WFERT members will cooperate fully with the wishes and directions of the city or county agency.

4. When a call relating to a critical or unknown illness or injury is received and the dispatcher has reason to believe that WFERT will not be available for dispatch within the next few minutes, he or she shall immediately notify Forsyth County EMS or the appropriate ambulance service.
5. Upon receiving a request for emergency medical assistance the dispatcher will attempt to elicit the following information:

• Location of incident
• Number of ill or injured parties
• Nature of injuries or chief complaint
• Potential hazards at the scene
• Nature of any treatment being rendered
• Call-back number if available

6. In addition to dispatching WFERT, an Advanced Life Support ambulance shall be requested when the chief complaint is one of the following:

• Heart attack/ Chest pain
• Unconscious/ Unresponsive
• Stroke/ CVA
• Shock
• Gun shot/ stabbing
• Suicide
• Sudden death
• Drug overdose/ reaction
• Electrocution
• Choking
• Diabetic emergencies
• Pedestrians or bicyclists struck by motor vehicles
• Drownings
• Industrial machinery accidents
• Severe burns
• Difficulty breathing
• Unknown medicals

For minor calls where the communications officer believes ambulance transport will not be necessary, WFERT and a police officer will be dispatched, and the EMT’s on the scene will notify control if an ambulance is required. The EMTs are also able to use the University Police to transport patients to Student Health Services, when appropriate. The EMT must ride along with the patient in the police vehicle.

7. In cases of the above calls, the dispatcher will notify WFERT as to whether or not ALS is en route.
8. Upon dispatching WFERT, the University Police communications officer will attempt to provide the following information:

• Location
• Nature of call/ chief complaint
• Any known on-scene hazards
• Any ambulances or rescue units inbound to scene

10. The campus police dispatcher will try to maintain a log of the following times (understanding that he or she may be tied up communicating between local, county, and/or campus units): a) time call received (b) time of dispatch (c ) time of arrival for WFERT (d) time of arrival for ambulance (e) time ambulance departs scene (f) time WFERT returns to service.

11. The communications officer shall participate in a radio check, to be completed by the on-duty crew at the beginning of the shift.

12. WFERT members will attempt to conform to the existing radio protocols of University Police and local agencies, including the use of Ten Codes where applicable (see appendix for a list of ten codes), keeping in mind that we are guests on the campus police radio system.

6. Radio Operations/ Equipment Handling

1. Radio equipment, jump bags, and other equipment must be signed out at the beginning of each shift, and must be signed back in at the conclusion of each shift.

2. It is imperative that all radios, pagers, and batteries are properly charged; the radios and batteries should be returned to the charger after use.

3. On-call EMT’s should keep radio transmissions to a minimum. Names should not be stated over the air. EMT’s should use their WFERT numbers when communicating with each other over the radios.

4. The campus police communications officer retains control over the length and priority of transmissions at all times.

5. During EMS-related activities, EMT’s will:

• Repeat the call location back to the dispatcher in order to reduce the chance of misunderstandings
• Notify control upon arrival at the scene
• Update control after arrival with approximate on-scene times and requests for additional assistance when necessary. If requesting an ambulance, the EMT’s on scene must request at which priority they want it dispatched (Urgent, Emergency but not life threatening, Non-emergency transport, etc.) using ten codes where applicable.
• EMT’s will notify control of any on-scene hazards or location changes so that inbound units are aware.
• Notify control if the ambulance will be transporting and to which hospital
• Notify control when clear of the scene and back in service

6. It is the responsibility of WFERT to ensure that there is coverage by at least 1 EMT. This is not the responsibility of campus police.

7. If any radio or pager receives a poor transmission, the WFERT personnel should notify the Equipment and Communications Officer and attempt to locate alternate equipment. If any unit fails to answer a page or call, an attempt should be made to contact them by other means, after all other appropriate units and agencies have been dispatched.

8. The radio system is for WFERT business only. At no time shall any member conduct personal business or act in an unprofessional manner on the radio.

7. On Scene Procedures/ F.C. EMS Interface

1. While on scene at an emergency, WFERT personnel will maintain a professional attitude and appearance.

2. EMT’s will provide care in accordance with the level of their certification. No procedure that is beyond the EMT’s level of certification may be attempted. WFERT members who hold out-of-state certification at a level higher than EMT-A are not permitted to act at such a level.

3. WFERT personnel are in charge of patient care at all times while on scene with campus police. Police officers are solely responsible for scene management and safety. The EMT will be in charge of the medical scene.

4. Should a patient require an ambulance, an EMT on the scene will notify control of the necessity, as well as give pertinent information, including dispatch priority. Requests for Advanced Life Support should be made when necessary.

5. When an ambulance arrives on the scene, WFERT personnel should briefly identify themselves and give the history of the patient, as well as any care rendered. The names and the ambulance number of the crew to whom care is transferred should be recorded.

6. If a patient care dispute exists with members of a responding ambulance, it should not be aired in front of the patient. Any disagreements in patient care should be noted and an incident report and be filed if necessary. The captain should be notified of any disagreements between WFERT personnel and ambulance personnel as soon as possible after a call.

7. Any responding agency or transport organization assumes total responsibility for the patient after they have initiated care, provided that said agency is certified at a level equal to or above that of WFERT personnel (such as with Forsyth County paramedics).

8. In cases where patients or bystanders are violent or abusive toward WFERT members, the WFERT members should exit the scene until such time as the situation is resolved by University and/or Winston-Salem Police. Charges may be filed if an individual assaults a WFERT member on scene, or if an individual compromises the well-being of the patient by obstructing or impairing WFERT personnel in the completion of their duties.

9. In situations in which the scene may be unstable or unsafe, such as a chemical spill or fire, WFERT members are not to approach the scene. If victims are trapped in a building that cannot be entered or reached, WFERT personnel should notify control. Rescue is the responsibility of the Fire Department and/ City Rescue Squad, and WFERT members should coordinate efforts with the Fire Commander on scene accordingly.

8. Protective Custody Agreement

1. Per North Carolina Law, patients with altered mental status as a result of drugs, alcohol, or medical condition are not judged to be competent in giving informed consent. Therefore, all patients presenting with altered mental status as a result of drugs, alcohol, or other medical condition must be treated under implied consent. Such patients may not sign refusals, and may not be left to their own recognizance or that of a friend.

2. If, after completing his or her physical exam, a WFERT member determines that a patient with altered mental status must be transported and the patient refuses care after the EMT has explained the situation to the patient, the WFERT member may approach the police officer on the scene and request that the patent be placed in protective custody. The WFERT member must provide the police officer with clear and valid medical evidence as to why the patient must be placed in protective custody, and the situation must be documented accordingly.

3. The WFERT members may also request protective custody when the patient is violent or abusive, and thus obstructs or impairs treatment or transportation when such care is required.

4. Once approached, it is the sole decision of the police officer as to whether or not the patient is placed into protective custody. Refusal to place the patient into protective custody may not be disputed by the WFERT members on the scene. If necessary, an incident report may be filed.

5. At not time shall a WFERT member physically restrain a patient while awaiting the arrival of campus police, unless failure to do so presents an immediate threat to the patient’s life or to the welfare of the EMT. If a WFERT member is forced to restrain a patient under such circumstances, an incident report detailing the actions of the EMT must be filed.

6. All patients placed under protective custody must be transported by ambulance or in a University or Winston-Salem Police cruiser at the discretion of the officer at the scene.