Silver Cross Hospital ∙ 1200 Maple Road ∙ Joliet, IL 60432 ∙ 815-300-7130 ∙ Fax 815-300-7917

OPERATIONS

This page contains information on EMS operations including commonly used Forms and contact information for our IDPH Regional EMS Coordinator. The System CME Program now has its own page titled "System CME" and the "QA/QI" now has its own page as well. Click on the buttons to the left to access either page.

SYSTEM APPROVED LIST OF ABBREVIATIONS

Per the request of our providers, we have a list of System approved ABBREVIATIONS. Please feel free to view here or print for future trainings and rig placement.

PATIENT MEDICATION DROP-OFF

One of our agencies had a family bring some medications to the firehouse that belonged to a recently deceased family member. The paramedics then attempted to turn the medications into the hospital they usually transport to. Fire departments should not accept unused unwanted medications, and instead direct families to the following websites to locate appropriate facilities that will take unwanted prescriptions…http://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html Then click on the link "Find a collection site near you " they can type in their zip code and find a nearby location that accepts medications.

Some local pharmacies and police stations take unused medications, but call first to ask if they do and how.

I have included here another web site with information on where people can drop-off medication and other medicated products except DEA listed narcotics. http://www.willcountygreen.com/greenguide/pharm.aspx

Pharmacies recommend to dispose of DEA narcotics by emptying capsules or disposing of tablets and liquids into damp kitty litter or coffee grounds, then discarding in the trash, if you are unable to find a drop-off location.

ILLINOIS PCR FORMS

In transitioning to the new NEMSIS (National Emergency Medical Services Information System) national standards for data collection, IDPH changed "bubble sheets and narratives" as ofl October 29, 2010. Electronic data submitters had until April 29, 2011 to ensure their software was compliant with the new NEMSIS data standards. Be sure your electronic third party software vendors (ie: Firehouse, Zoll, etc) are NEMSIS compliant and re-validated by 4-29-11.

The manual for completing the EMS run report form, or “bubble sheet,” has been updated, including additional clarification in the Element-by-element Guidance section and the addition of two new EMS Systems to the list in Appendix C. The most current version of the manual can always be viewed and downloaded from this Web page: http://www.emsdata-2.com/ILNEMSIS/scanforms.htm

To order the 1-part or 3-part Illinois PCR (Ambulance Run) forms contact Mike Rubinsky with Scantron by phone 800-735-2566 ext 1347, fax 717-684-1312, or email michael_rubinsky@scantron.com Be sure you are ordering new forms.

The new 3 part form (277608-1) is $24.38 per pack of 100. The three part form contains the bubble and narrative.

The new 1 part form (285611-1) is $9.37 per pack of 100. The one part form is the bubble part only.

IDPH created a web based system of their own called KeyData Web. Agencies may use our System's 1-page face sheet to gather data and leave a copy of it with the patient in the ER, then input their call data into IDPH's KeyData Web program via the internet back at their station. There would also be an option to print a run form after entering data if the crew decided to access KeyData Web while still at the hospital (if the hospital has a computer with access to it). This would eliminate the need to use the paper PCR forms (bubble sheets). The State says it is free to users. Obviously it does NOT have the same capabilities as a third party software vendor such as Zoll, Firehouse, or ImageTrend for QA purposes, but offers a reduction in paperwork and error kick-backs.

IDPH KeyData Web: https://webdata.emsdata.com/Illinois/Login.aspx?ReturnUrl=%2fIllinois%2fdefault.aspx

KeyData Web Administrator Manual KeyData Web User Manual KeyData Web Start-Up Instructions

INSPECTIONS

For ambulance inspections allow enough notice for scheduling prior to new rig arrival and expirations. Inspection forms may be printed below for you to use as reference. When authorized to self-inspect, print and send the completed form to the System (we will sign and forward to IDPH). All self-inspections are subject to System spot-checks. Our Regional EMS Coordinator for Region 7, Shannon Wilson, should be contacted direct to schedule your inspections. Email me the date and time of your inspection and I will make every effort to attend to assist and also to review the ALS equipment and medications. Shannon may be reached at 630-293-6899 or at shannon.wilson@illinois.gov.

ROUTINE SYSTEM OPERATIONS

Marilyn MacBlane handles most of the daily routine operations in this System such as ambulance inspections, supplies, pyxis, system entry, licensure, events, website maintenance, and data collection. For questions please contact her at 815-300-7130#2.

Most of the forms used in daily operations are located in the Silver Cross EMS Policy Manual, however we have provided some of the more frequently requested forms here:

BLS Required Equipment Policy Rev.10/11	New Rig KKK Form for Ambulances
ILS Required Equipment Policy	IDPH Ambulance Inspection Form
ALS Required Equipment Policy Rev.10/11	IDPH Non-transport Vehicle Inspection Form
Non-Transport Policy Rev.12/11	IDPH Initial Response Vehicle Inspection Form
Drug Replacement Policy including Pharmacy Order Form & Monthly Controlled Sub Log Rev.11/11	IDPH Request to Modify/Amend System Plan Form Commonly referred to as "Sys-Mod" Form
DNR Policy Link to Instructions and DNR FORM	IDPH Equipment/Vehicle Waiver Request Form
Refusal Policy	IDPH Off-Road/SEMSV Inspection Form
Multiple Patient Refusal/Release Policy	IDPH Special Events Form
Release of Liability - Refusal Form	PYXIS Policy & Instructions
New 2011 Petition for Involuntary Admission	Out-of-Service Ambulance Form