FANWOOD RESCUE SQUAD STANDARD OPERATING PROCEDURES

REVISED JANUARY 1, 2006 ©2006 Fanwood Rescue Squad

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TABLE OF CONTENTS

I. GENERAL OPERATIONS ................................ 4 II. DISPATCHING MOBILE INTENSIVE CARE UNITS (MICU’S) 6 III. FIRE CALLS.................................................... 8 IV. TRAUMA TRIAGE PROTOCOL................. 11 V. SEMI-AUTOMATIC DEFIBRILLATORS (SAED’S) 12 VI. HOSPITAL PROCEDURES.......................... 13 VII. VEHICLE OPERATION.............................. 13 VIII. SCOTCH PLAINS-FANWOOD JOINT MUTUAL AID PROCEDURES 16 IX. GUIDELINES FOR PAGING SQUAD AND CALLING FOR MUTUAL AID 17 Addendum #1: NJ MOTOR VEHICLE STATUTES 18

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FANWOOD RESCUE SQUAD STANDARD OPERATING PROCEDURES

I. GENERAL OPERATIONS

1. The Ambulance shall not be used for other than an official squad activity (calls, parades, stand-bys, etc.) unless cleared with the Captain in advance. 2. When either vehicle is not to be used, the ignition key is to be removed from the vehicle and placed in the office. Any squad member can take a vehicle out of service. However, that member must notify a line officer and the rig maintenance committee chairperson ASAP. 3. Drivers of the ambulance must be checked out in advance and approved by the Captain or a line officer designated by the Captain. If you are not approved you will not drive. 4. Snow tire chains are available for both rigs. Chains will be installed at the discretion of the ambulance maintenance chairperson and a line officer. If chains have only been installed on one rig the first responder to headquarters shall determine if weather conditions dictate the use of the chain-equipped ambulance. 5. For Two Vehicle Operations the following procedures are to be followed: A. Daytime (0600-2300HRS)

• Upon pager message for an emergency call, the ambulance will respond to the scene. • The vehicle will not leave headquarters until a crew (minimum of 2 EMTs) is on board or available EMT members are at the

scene. Use caution when leaving headquarters as additional members are likely to be responding. • The first member arriving at headquarters and finding the ambulance out will assume responsibility to stand-by at headquarters

and shall contact the responding rig by radio advising the availability of the secondary rig and request instructions. This particularly applies to auto accident or structure fire calls where there may be multiple victims.

B. Nighttime (2300-0600HRS)

• The Night Crew will be responsible for responding to calls between these hours. In case of an automobile accident or structure fire, as many additional members who can, will respond to the scene.

• In the case of a pager message “call for the Second Rig”, any available non- night crew members are expected to respond to Headquarters to take the second ambulance to the call.

6. Members shall adhere to the provisions of Title 39 of the Statutes of the State of New Jersey when responding to calls (see end of booklet).

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7. When responding to the scene in personal vehicles, members shall safely park them in such a way so as to not interfere with the operations of the call, or interfere with the flow of traffic or damage or block property of residents in the area. Members may display “blue lights” in accordance with the provision of Title 39, statutes 3-54.7 thru 12. No other flashing lights on personal vehicles are permitted under the NJ motor vehicle code and the Fanwood Rescue Squad supports the letter of the law in this regard. 8. Children shall not accompany rescue squad members when responding to calls of any nature. 9. When members are operating the ambulance in response to an emergency call or for any other reason they shall at all times adhere to the provisions of Title 39 of the Statutes of the State of New Jersey, all other laws and regulations of the State of New Jersey, and the rules and regulations of the Fanwood Rescue Squad. Transports of patients with non-life threatening illnesses or injuries shall be made without the use of lights and sirens. Violations of this SOP may result in suspension of your driving privileges. Copies of the following paragraphs from Title 39 are at the end of this booklet for your information:

• 39:3-54.19 • 39:4-91 • 39:4-92 • 39:3-54.7, 8, 9,10 and 12

Regardless of the patient’s condition or directives given by the officer-in-charge or crew chief, the Driver is responsible for the safety of the vehicle and the lives of all on board. Therefore, do not drive at a greater rate of speed that that at which you feel you can safely handle the vehicle. 10. Upon arrival at the scene, the rig shall be parked, if possible, so that it does not pose a hazard or cause unnecessary disruption to the safe flow of traffic. 11. The ambulance driver shall remain with the ambulance at the scene, unless needed to assist with the patient or is relieved by the officer. 12. Whenever possible, the ambulance driver shall be assisted by another member outside the vehicle in backing up the ambulance. 13. On fire calls, the driver shall park the rig well clear of hydrants and fire apparatus and in such a location to not interfere with firefighting operations, and shall be able to leave the scene at any time if necessary. If the squad pager has not been activated for a fire call, the ambulance will not leave headquarters until the Police Desk has toned squad pager. NOTE: Procedures outlined in Part III (fire calls) must also be followed at all times. 14. Any difficulties, deficiencies, maintenance or repairs to the rigs or equipment shall be noted in the logbook for that vehicle, initialed and dated by the person making the entry. The rig maintenance chairperson should also be notified.

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15. Upon returning from each call, it is the responsibility of the Crew Chief (officer or senior Member) to ensure the ambulance is properly garaged (shore-line in, ignition battery switches, lights off, etc.), that the call sheet is complete, filed in the call box and that all supplies are replenished, cot made up and interior policed, and cleaned. 16. Any question regarding the fitness (physical or otherwise) of any member to serve as an active member will be referred to the Captain and resolved as follows:

• A committee consisting of the four Line Officers and three other squad members chosen by the Line Officers will be formed. • The issue will be reviewed and actions taken based on the decision of the majority of this Committee.

17. Members will comply with the New Jersey PE-OSHA Blood borne Pathogens Standard and the Fanwood Rescue Squad Exposure Control Plan (attached and posted in the Building). It is the responsibility of each member to ensure his or her familiarity with equipment location and use of all equipment carried in each vehicle. Because of our operations where no schedule crews are assigned, except for the Night Crews and schedule calls, it is impossible to have pre-assigned operators and/or tasks. It is necessary that each member know each specific operation of both vehicles, to be able to fill in and anticipate each other’s actions. A good Rescue Squad is made up of responsible, thoroughly trained and dedicated members.

II. DISPATCHING MOBILE INTENSIVE CARE UNITS (MICU’S) 1. When the Squad is dispatched to any of the following emergencies, the MICU should be requested simultaneously:

• Chest Pain • Difficulty Breathing • Unconscious Person • Severe Burn • Multiple Casualty Incident • Trauma or Industrial Accident • MVA with Entrapment, Rollover, or Ejection • Any incident involving MedEvac helicopter • Stroke or CVA • Seizure or Convulsion • Overdose • Allergic Reaction or Anaphylactic Shock • Poisoning • Maternity with complications

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2. When requesting MICU, the following information should be given to the dispatcher: • Municipality requesting the MICU • Nature of call • Address of the call • Cross Streets/Directions/Escort Point

3. If none of the above conditions are initially evident, subsequent decision to contact MICU will be made by any EMT member on the basis of vital signs, level of consciousness, anatomy of injury, mechanisms of injury, and previous medical history. 4. Measure vital signs and level of consciousness. If the patient has one or more of the following contact MICU:

• Glasgow Coma Scale <13 • Systolic BP <90 • Respiratory Rate <10 or >29 • Revised Trauma Score <11 • Pediatric Trauma Score <9

5. If none of the above vital signs exist, assess the anatomy of the injury, and if any of the following conditions exist, contact MICU:

• All penetrating injuries to the head, neck, torso, and extremities proximal to the elbow and knee • Flail chest • Combination trauma with burns of 10% or inhalation injuries • Two or more proximal long-bone fractures • Pelvic fractures • Limb paralysis • Amputation proximal to the wrist and ankle

6. If none of the above conditions exist, evaluate for evidence of mechanism of injury and high-energy impact and contact MICU if one or more of the following conditions occurred:

• Ejection from automobile • Death in the same passenger compartment • Extraction time >20 minutes • Falls >20 feet • Roll over • High speed automobile crash • Auto-pedestrian injury • Pedestrian thrown or run over • Motorcycle crash with separation of rider and bike

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7. If none of the above conditions occurred, the patient’s medical history should be evaluated. The EMT member may decide to contact MICU if the patient is:

• <5 or >55 years • Is know to have cardiac disease • Respiratory disease, or on medication for psychotic condition • Diabetic taking insulin, cirrhosis, malignancy, obesity, or coagulopathy

III. FIRE CALLS

1. The Rescue Squad is to be called for all fire alarms involving a structure, heavy smoke condition or any other situation deemed necessary by the senior Incident Commander at the scene. 2. The ambulance is not to leave headquarters until the fire engines have left headquarters unless specifically instructed otherwise by the Fire Department or the Police. 3. The ambulance shall not leave headquarters or respond to a fire call until the squad has been paged out by the Police. 4. The ambulance is not to respond with fewer than two EMTs on board or available at the scene. 5. All normal squad operating procedures are to be observed enroute to the call. 6. Upon arrival at the scene the ambulance shall be parked so that it will not interfere with firefighting operations and not block the arrival of other emergency equipment. If possible, the ambulance should be parked upwind from the fire and in an area free of exhaust fumes from apparatus or equipment. NOTE: Be sure to park the ambulance so that it will not be blocked in and can be gotten out in an emergency. Be especially aware to not block fire hydrants. The ambulance crew should coordinate the parking of the rig with the police and fire officers. 7. Upon arrival at the scene, the ranking Squad Officer, or in the absence of an officer the Senior Member, shall report to the Fire Incident Commander and advise him/her of the squad’s availability and location. 8. The ranking Squad Officer should wear the yellow helmet for identification. 9. The driver, or member designated, will remain with the ambulance at all times to monitor the radio, and to move the ambulance if it becomes necessary.

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10. The portable radios in the ambulance are to be assigned to a senior crew member to communicate with the Fire Incident Commander, Police and any other EMS agencies involved with the call. 11. When parked at the scene, the engine should be shut off unless needed, and the outside lights turned off WITH THESE EXCEPTIONS:

• If the ambulance is parked in such a way as to possibly be hit by traffic (such as assisting in the blocking off of traffic) then the 4-way flashers and/or the side and rear running lights shall be left on.

• When the ambulance flood lights are being used to assist in the lighting of the scene. • When weather conditions are such that heat or cooling is necessary for members or victims.

12. Unless directed by the Fire Incident Commander, squad members are not to go into a burning building unless they are also a fireman and wearing the required turnout gear. 13. In a working fire situation, a first aid station should be set up as soon as possible at a location designated by the Fire Incident Commander and ranking Squad Officer. 14. The first aid station should have the following: portable O2 unit, a portable suction unit, a portable radio, flash lights, drinking water/activity beverages such as Gatorade, first aid kit, a blanket, wet towels, the stretcher, ice, cups, and tarps or awnings/tents. 15. The rehab area shall provide suitable protection from the prevailing environment conditions. During hot weather, rehab should be in a cool shaded area. The shaded area can be under trees or under a tent or tarp. Fire fighters should not go from a hot environment into an air conditioned environment. An air conditioned environment is acceptable after a cool down period at ambient temperature with sufficient air movement. During cold weather, the rehab should be in a warm, dry area. All rehab stations should be large enough to accommodate multiple crews. 16. If necessary, and if manpower permits, a second first aid station may be set up at the other side of the incident with the same equipment as above. 17. A primary function of the Rescue Squad shall be to rehabilitate (rehab) firefighters by providing them with fresh water, oxygen and a place to rest for brief periods. As part of rehab, the squad members shall measure each firefighter’s basic vital signs (BP, pulse, respiration, skin condition, and complaints) and observe for signs of exhaustion or other distress. For each firefighter rehabbed, an entry will be made on the fire fighter rehab form detailing the firefighter’s name, age, basic vital signs and final disposition (returned to duty, transported, etc.). A copy of this record should be made available to Fire Command and should be attached to the call sheet. 18. Hydration/Nourishment: Fire fighters should consume at least 1 quart of water per hour during heat stress. This should either be water or a 50/50 solution of water and an activity beverage even in cold weather. Caffeine and carbonated beverages should be

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avoided. After 3 hours of work time, firefighters should have such foods as soup, broth, or stew, apples, oranges, and bananas. No fatty or salty foods should be provided. 19. Firefighters shall rehab after the “two air bottle rule” or 45 minutes of work time. Firefighters should re-hydrate with at least 8 ounces of water or 50/50 mixture of water & activity beverage while SCBA cylinders are being changed. Rest time should be at least 10 minutes and may exceed an hour based on the firefighter’s vitals and the rehab officer’s decision. 20. If a squad officer/crew chief feels that a firefighter is in no condition to return to fighting the fire, whether due to injury, too much smoke or heat or exhaustion, the ranking squad officer/crew chief shall advise the Fire Incident Commander, whether directly or through the Safety Officer, the condition of the firefighter and the Squad’s recommendation of action for the firefighter (made to rest, taken to the hospital, etc.). Squad officer/crew chief will document on the sheet what action, if any, was ordered by Fire Command. 21. Squad members may be requested by the Fire Incident Commander in charge to assist in dragging hoses or setting up equipment. This may be done as long as there is nothing requiring the attention of these squad persons, there are no injured to be taken care of, and there are enough squad members to staff the first aid station and/or ambulance. 22. In the event the Squad is summoned to another call, the Fire Incident Commander shall be advised as to the status prior to departure and be consulted as to what aid facilities are needed to remain at the scene. 23. Squad operations shall not be secured until released by the Fire Incident Commander.

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IV. TRAUMA TRIAGE PROTOCOL The following trauma triage guidelines are provided to assist in determining the disposition of adult traumatized patients. It is

understood that these are guidelines only and are to be used whenever possible in communication with a base physician.

PHYSIOLOGY -AVPU= U or P -GCS < 12 -PULSE< 60 OR > 130 / min -RESPIRATION<10 OR >29 /min

YES

To TRAUMA

Center With ALS if Available

NO ANATOMY -PENETRATING INJURIES (e.g. gunshot wounds, stab wounds) to HEAD, NECK, TORSO, EXTREMETIES (above the elbow or knee) -FLAIL CHEST -FRACTURES: more than one (1) fracture involving Humerus and Femur -PELVIC FRACTURES -PARALYSIS or evidence of SPINAL CORD INJURY -AMPUTATION above wrist or ankle -BURNS when combined w/ other major injury -HIGH VOLTAGE electrical injury

YES

To TRAUMA Center

With ALS if Available

NO MECHANISH OF INJURY (Required Consult w/ Medical Command, when avail.) EJECTION from vehicle EXTRICATION time >20 min w/ injury FALLS > 20 ft UNRESTRAINED PASSENGER in ROLLOVER Pedestrian, Motorcyclist or Bicyclist

YES

To TRAUMA Center

With ALS if Available

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NO TO LOCAL HOSPITAL Adopted: MICU Advisory Committee, 8 June 1992

V. SEMI-AUTOMATIC DEFIBRILLATORS (SAED’S) 1. SAED’s may only be operated by those members who hold a current EMT-B and current CPR certification. Any use of this equipment by persons not holding these certifications will result in immediate suspension of the member involved. 2. SAED’s will be used according to the protocols set forth by the Muhlenberg Regional Medical Center. 3. An ALS unit will be dispatched simultaneously with the Fanwood Rescue Squad for all potential defibrillation calls. The inability to deploy an ALS unit due to unavailability shall not preclude the invoking of defibrillation services by the Squad. 4. Each patient for whom the SAED is utilized and is transported by the squad must be accompanied by a minimum of one EMT, MICP or MICN in the patient compartment of the vehicle. Should transport be initiated prior to the arrival of the ALS unit at the scene of the incident, the patient must be accompanied by an EMT and every effort must be made to meet with the ALS unit on route to the hospital. 5. Upon completion of a call requiring utilization of the SAED unit and prior to leaving the receiving facility, the EMT responsible for the call shall complete the required run report and an event summary shall be printed. A copy of both these documents should be retained for the squad files. In the event the patient is not transported to the hospital, the completed run report and the event summary printout shall be taken to Muhlenberg Regional Medical Center. The event summary must be printed and the run report presented within 24 hours of the call. This function is the responsibility of the EMT responsible for the call. 6. If the patient is transported to a facility other than Muhlenberg, a run report and event summary will be left at the receiving facility with the patient record. Two copies of the event summary and the SAED run report must be made, for the squad record and for the Muhlenberg records. Muhlenberg must be provided with their copies within 24 hours of the call. This function is the responsibility of the EMT responsible for the call. 7. The squad copies of the event summary printout and the call sheet are to be attached to the squad copy of the call sheet. 8. All EMT members on the rig after a call involving the use of the SAED unit are responsible jointly for ensuring that the unit is properly stored, stocked and ready for the next call.

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9. Any problems with the SAED unit are to be reported immediately to the Captain or available senior officer. 10. During rig checks, the SAED will be inspected for a good battery and two sets of defib pads for adult and child. Should the unit’s battery fail, a notation describing the failure will be made and the Captain or available senior member will be notified immediately. This is to be done even if the failure can be overcome (e.g. dead or weak battery, etc.). If the SAED test shows no dysfunction, the notation “OK” will be made. The completed sheet will be placed in the call box. 12. Members holding EMT certification will comply with all rules, regulations and policies set forth in NJAC 8:41A and a promulgated by the DOH and the Project Sponsor (MRMC).

VI. HOSPITAL PROCEDURES 1. The primary response hospitals for our patients, based on Primary Physician affiliation, are Muhlenberg Regional Medical Center (MRMC), Overlook, Rahway, Union, and JFK. Patients with no primary physician locally and no hospital preference should be transported to MRMC if possible. 2. In cases where patients with other hospital/primary physician affiliations and/or cases of chronic illness with prolonged treatment at another facility, the officer or senior crew member at the call has the discretion to transport to such a facility, based on crew availability and time of day. 3. In cases of trauma, a patient should be transported to an appropriate facility which includes:

• Robert Wood Johnson, New Brunswick – Trauma • UMDNJ, Newark – Trauma • Morristown Memorial- Trauma • St. Barnabas, Livingston - Burns

4. In cases of extreme medical emergencies, with or without a MICU, transport may be made to the closest facility. 5. In cases of adverse weather conditions, transport may only be offered to MRMC. This decision will be made by the officer or senior crew member at the call. 6. In the case where a patient was not transported to the hospital of his choice, the Fanwood Rescue Squad will offer to transfer the patient to his hospital of choice, after 6:00pm if a crew is available and the patient has physician approval.

VII. VEHICLE OPERATION

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According to the insurance industry, a person’s driving record is a good indication of future accident rates. Young and Perry Insurance have identified characteristics of drivers who tend to be more at risk for potential accidents. Drivers of emergency vehicles whose records reflect these characteristics have an increased likelihood of being involved in an accident while operating said vehicle, thus, escalating the danger to our members, patients and the general public. Additionally, an accident involving a driver with a poor record is difficult to defend in a legal venue no matter which party was actually at fault. This could result in publicity reflecting poorly on our organization. The following SOP is in effect for Fanwood Rescue Squad members with respect to the rules and policies for operation our ambulances: 1. The FRS will implement a motor vehicle reporting policy as recommended by Young and Perry Insurance. Our Squad will follow the attached policy in the implementation of this Standard Operating Procedure. All members must follow the attached motor vehicle record (MVR) policy. Failure to comply could result in temporary or permanent loss of squad vehicle driving privileges, suspension or expulsion. 2. Any member who wishes to drive an emergency vehicle will be subject to a motor vehicle check on his/her driving record. On an annual basis, the Line Officers will submit each member’s driver’s license number to our insurance company to run a record investigation of each potential driver. This information will be held confidential and be used only for the purposes described in this SOP. 3. In a further effort to provide the best possible pre-hospital care for our patients, all members who wish to drive an emergency vehicle will be required to pass the Driver Training program implemented by the FRS. This program will test each member’s driving ability and knowledge of the ambulance and the road. A certified emergency vehicle operator instructor will teach the program. In the event that the squad does not have an instructor, the Line Officers of the FRS will implement the program until such time that an instructor is available. Current members will be requested to retake portions of the program if deemed necessary based on the individual’s driving performance and driving record. MOTOR VEHICLE RECORD (MVR) POLICY It is widely known in the risk management industry that motor vehicle reports (MVR), which detail a driver’s past performance, provide a useful means of predicting future performances. Many industries are required by law to check the driving record of their drivers. While we are not required by law to perform this review, studies have shown that this is a valid source of determining driving behaviors and performance. In addition, if a department vehicle is involved in an accident and the driver has a poor record, legal defense becomes difficult, no matter who is actually at fault, and the resulting publicity will reflect poorly upon this organization. It therefore shall be the policy of this Rescue Squad that every member who may drive Squad vehicles in the course of their duties maintain a motor vehicle record (MVR) meeting the requirements set forth in the table below. It shall be the duty of the member to notify their superiors of any of the following changes in their status:

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• Suspended or revoked license • Change from Acceptable status to Borderline or Poor • Change from Borderline to Poor

The standards for MVR’s are as follows:

• All operators must have a current valid driver’s license. • No member may be added to the driver’s list with a “Borderline” or “Poor” MVR graded by the table below as minimum

requirements. • Any driver whose grading falls into the “Borderline” category must have their driving record reviewed by an officer or board

set up for such reviews. • No one whose MVR grading is “Poor” may drive a department vehicle.

Any exceptions to these guidelines must be referred to senior staff officers for approval. While exemptions to this procedure may be made internally, ESIP must be notified, in writing, of anyone permitted to drive with a poor MVR, explaining the reason for the exemption.

Violations (last 3 yrs)

Number of At Fault Accidents (last 3 yrs) 1 2 3 4

0 Clear Acceptable Borderline Poor 1 Acceptable Acceptable Borderline Poor 2 Acceptable Borderline Poor Poor 3 Borderline Poor Poor Poor 4 Poor Poor Poor Poor Any major violation

Poor Poor Poor Poor

Minor Violations: Any moving violation other than a major except:

• Motor vehicle equipment, load or size requirements • Improper failure to display license plates • Failure to sign or display registration • Failure to have driver’s license in possession (if valid license exists)

Major Violations: Any moving violation other than a major except:

• Driving under the influence of alcohol/drugs • Failure to stop/report an accident • Reckless driving/speeding contest

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• Driving while impaired • Homicide, manslaughter or assault arising out the use of a vehicle • Making a false accident report • Driving with a suspended/revoked license • Attempting to elude a police officer • Careless driving

Since breach of this policy could place members and civilian motorists in danger, any member in violation of these procedures shall be subject to departmental action which could result in temporary or permanent loss of department vehicle driving privileges, suspension, or expulsion.

VIII. SCOTCH PLAINS-FANWOOD JOINT MUTUAL AID PROCEDURES GENERAL PROCEDURES FOR ALL MUTUAL AID CALLS

• Members should not respond directly to the scene of a mutual aid call in their own vehicles unless they are in the immediate vicinity of the call.

• Members should meet at building. • Line officer or senior member should pick crew; other members remain in town to answer Fanwood calls.

FANWOOD CALLS

• Squad will be paged out by Police a total of two times. • If there is an insufficient crew to respond from Fanwood following the two pages, the call will go to Scotch Plains for mutual aid. • If Scotch Plains has a crew, they will respond to the Fanwood call without any help needed from Fanwood. • If Fanwood has a member at the building, the member should stay at the building until such time as Scotch Plains calls in service (monitor

the Scotch Plains radio frequency). • If Scotch Plains should need help from the Fanwood member, they will call the Fanwood building (322-9000) and communicate directly

with the Fanwood member. • Appropriate decisions will then be made as to which rig will respond, location and nature of the call, etc.

SCOTCH PLAINS CALLS

• Squad will be paged out by Police a total of two times. • If there is an insufficient crew to respond from Scotch Plains following the two pages, the call will go to Fanwood for mutual aid. • If Fanwood has a crew, they will respond to the Scotch Plains call without any help needed from Scotch Plains. • If Scotch Plains has a member at the building, the member should stay at the building until such time as Fanwood calls in service (monitor

the Fanwood radio frequency). • If Fanwood should need help from the Scotch Plains member, they will call the Scotch Plains building (322- 4120) and communicate

directly with the Scotch Plains member. • Appropriate decisions will then be made as to which rig will respond, location and nature of the call, etc.

GENERAL INFORMATION

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In all cases, the member who is responsible for patient care will be in charge of the call, whether the call is located in Scotch Plains or Fanwood and regardless of which ambulance is in use. The member in charge of patient care must be comfortable with the number of people on the crew and it will be the decision of that member whether or not to request a medic unit. Call sheets will remain with the responding ambulance. We have a good working relationship between our squads and we sincerely hope that the procedures outlined above will enable each squad to respond to 100% of calls within Scotch Plains and Fanwood, especially daytime calls.

IX. GUIDELINES FOR PAGING SQUAD AND CALLING FOR MUTUAL AID PAGING THE SQUAD AND WHEN TO GO TO MUTUAL AID:

• The Fanwood Rescue Squad (FRS) will be paged out by the Fanwood Police Department (PD) for all medical assistance within the Borough or when requested by surrounding communities for mutual aid.

• Responding squad officers (with portable radios) should call in to the PD/FRS ambulance on their way to the Squad building or to the scene of the incident. This will provide a quicker assessment for ambulance crew availability.

• The first driver to the building should pull the ambulance out and radio the PD HQ to inform them they are awaiting a crew. • If there is not a sufficient crew within 5 minutes from dispatch, the PD should initiate a 2nd page for the same call. • After a total of 8 minutes from the initial dispatch time and there is an insufficient crew to respond from Fanwood, the PD should request

EMS mutual aid from the following towns in the order specified; Scotch Plains Rescue Squad (SPRS) – allow 5 minutes then move to next squad Westfield Rescue Squad – allow 5 minutes and then request a squad from CENCOM.

• If the PD Desk Officer is monitoring the neighboring radio communications and knows that these other town squads are unavailable or on a call, the PD can jump to the next available squad.

• In some cases, the SPRS and FRS will combine crews to ensure a Fanwood call is answered. This should be accomplished with the assistance/coordination of the Fanwood PD and the Scotch Plains PD.

• If mutual aid is responding to a Fanwood call, any available members should respond to the scene to assist the in-coming squad with the patient(s).

NIGHT CREW: With regard to calls between 2300-0600 hours, the wait time should be approximately 8 minutes before the 2nd tone and 12 minutes to request mutual aid. MUTUAL AID TO NEARBY TOWNS: The FRS will only assist the Plainfield Rescue Squad on mass casualty incidents and on Advanced life Support (ALS) calls, where the paramedics are responding or on-scene. The FRS will assist all other surrounding towns on an as-needed basis. TIME STAMPING: The FRS is required to account for time stamps during a call. The Squad will call the PD Desk Officer to request times for the arrival/departure at the scene, hospital and building. Specific times required are: time of call, on scene, leaving the scene, at hospital, and a building. The Squad will be responsible for logging these times.

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Addendum #1: NJ MOTOR VEHICLE STATUTES

39:3-54.19. Subject to traffic laws; right-of-way or sirens; yielding right of way This act shall not grant to any chief or first assistant chief of a volunteer fire company any privileges or exemptions denied to the drivers of other vehicles, and persons displaying red emergency warning lights, sirens, or both, shall drive with due regard for the safety of all persons and shall obey the traffic laws of this State; but drivers of non-emergency vehicles upon any highway shall yield the right of way to the vehicle of any chief or first assistant chief of a volunteer fire company displaying red emergency warning lights, sirens, or both, in the same manner as is provided for authorized emergency vehicles pursuant to R.S. 39:4-92. 39:4-91. Right of way of emergency vehicles; liability of drivers. a. The driver of a vehicle upon a highway shall yield the right of way to any authorized emergency vehicle when it is operated on official business, or in the exercise of the driver's profession or calling, in response to an emergency call or in the pursuit of an actual or suspected violator of the law and when an audible signal by bell, siren, exhaust whistle or other means is sounded from the authorized emergency vehicle and when the authorized emergency vehicle, except a police vehicle, is equipped with at least one lighted lamp displaying a red light visible under normal atmospheric conditions from a distance of at least five hundred feet to the front of the vehicle.

b. This section shall not relieve the driver of any authorized emergency vehicle from the duty to drive with due regard for the safety of all persons, nor shall it protect the driver from the consequences of his reckless disregard for the safety of others. Nothing in this section shall be construed to limit any immunity or defense otherwise provided by law. 39:4-92. Authorized emergency vehicles; clearance for; following or parking near Upon the immediate approach of an authorized emergency vehicle giving audible signal, and equipped, as required by section 39:4-91 of this Title, and unless otherwise directed by a police or traffic officer, (a) The driver of every vehicle shall immediately drive to a position as near as possible and parallel to the right-hand edge or curb of the highway, clear of an intersection of highways, and shall stop and remain in that position until the authorized emergency vehicle has passed and (b) The driver or person in control of a street car shall immediately stop the car clear of an intersection of highways and keep it stationary until the authorized emergency vehicle has passed. No driver of any vehicle other than one on official business shall follow any authorized emergency vehicle, traveling in response to an emergency call, closer than 300 feet, or drive nearer to, or park the vehicle within 200 feet of, where any fire apparatus has stopped

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in answer to a fire alarm. 39:3-54.7 Mounting and operation of emergency warning lights.

a. An active member in good standing of any of the following organizations may mount and operate, on a motor vehicle operated by that member, an emergency warning light or lights as provided in P.L.1977, c.223 (C.39:3-54.7 et seq.):

(1) a volunteer fire company or a volunteer first aid or rescue squad recognized by and rendering service in any municipality; or

(2) any county or municipal volunteer Office of Emergency Management recognized by and rendering service in any county or municipality, provided the member's official duties include responding to a fire or emergency call.

b. The Chief Administrator of the New Jersey Motor Vehicle Commission shall not require the member to specify on which motor vehicles the emergency warning light or lights may be mounted. 39:3-54.8. Time of operation Emergency warning lights may be operated only while the vehicle is being used in answering a fire or emergency call. 39:3-54.9 Specifications.

3. Emergency warning lights shall be removable or permanently attached, of the flashing or revolving type, equipped with a blue lens and controlled by a switch installed inside the vehicle or shall be blue of the light bar type, in accordance with the specifications prescribed by the chief administrator. 39:3-54.10 Placement of motor vehicle, types of lights.

4. No more than two emergency warning lights shall be installed on a vehicle. If one light is used it shall be installed in the center of the roof of the car, or on the front of the vehicle so that the top of the emergency warning light is no higher than the top of the vehicle's headlights, or in the center of the dashboard. It may be a low profile light bar of the strobe, halogen or incandescent type, or a combination thereof. If two lights are used they may be placed on the windshield columns on each side of the vehicle where spotlights are normally mounted, or on either side of the roof at the front of the vehicle directly back of the top of the windshield. Under no circumstances may one light be placed on the roof and one on the windshield column in the spotlight position. Light elements shall be shielded from direct sight or view of the driver.

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39:3-54.12 Rights of motor vehicle with emergency lights in operation.

6. Nothing contained herein is intended to grant to any member of a volunteer fire company, a volunteer first aid or rescue squad or a volunteer Office of Emergency Management any privileges or exemptions denied to the drivers of other vehicles, and such members operating emergency warning lights shall drive with due regard for the safety of all persons and shall obey all the traffic laws of this State including R.S.39:4-81, provided, however, that the drivers of non-emergency vehicles upon any highway shall yield the right of way to the vehicle of any member of a volunteer fire company, a volunteer first aid or rescue squad or a volunteer Office of Emergency Management operating emergency warning lights in the same manner as is provided for authorized emergency vehicles pursuant to R.S.39:4-92. 39:3-54.13 Violation of act; penalty.

7. Any person authorized to operate emergency warning lights pursuant to P.L.1977, c.223 (C.39:3-54.7 et seq.) who willfully operates such emergency warning lights in violation of the provisions of P.L.1977, c.223 (C.39:3-54.7 et seq.) shall be liable to a penalty of not more than $100 and the person's privilege to operate such emergency warning lights may be suspended or revoked by the Chief Administrator of the New Jersey Motor Vehicle Commission. A person who is not authorized to operate emergency warning lights who willfully operates such emergency warning lights shall be liable to a penalty of not more than $200.

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