Silver Cross Hospital ∙ 1900 Silver Cross Blvd ∙ New Lenox, IL 60451 ∙ 815-300-7130 ∙ Fax 815-300-7917

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OPERATIONS

This page contains information on EMS operations including commonly used Forms and contact information for our IDPH Regional EMS Coordinator.

 

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

Fire departments should not accept unused unwanted medications for disposal, but 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.

 

PATIENT SHARPS/NEEDLE DISPOSAL

Please direct families looking to drop off "sharps" (used needles) to a nearby Walgreens for a sharps disposal kit or perhaps visit www.sharpsdisposal.com (or other sharps disposal site of their choice) for a medical waste return kit. Local hospitals will not take in outside sharps for return/waste.

 

ILLINOIS PCR FORMS

SCEMSS transitioned to electronic data collection 12/31/15.

Agencies, it is up to you to ensure your software vendors are NEMSIS 3 compliant by the State's deadline. See MEMO:

 

 

The above IDPH memo is copy and pasted above. To access the sites in this letter click on the desired link below:        

    http://www.emsdata-2.com/ILNEMSIS/index.htm          http://www.nemsis.org/v3/resources.html

 

IDPH link for EDC info: http://dph.illinois.gov/topics-services/emergency-preparedness-response/ems/preHospData

 

 

KEY-DATA WEB SOFTWARE USERS:

Anyone using the IDPH created web based system called KeyData Web will receive NEMSIS 3 updates directly from IDPH regarding the software. This software is free to users. Obviously it does NOT have the same capabilities as a third party software vendor such as Zoll or ImageTrend for QA purposes, but is the free alternative for electronic data collection.

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

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

 

FIREHOUSE SOFTWARE USERS:

Agencies using Firehouse EDC will need to transition away from the System's 1-page face sheet on paper for the narrative and begin inputting their narrative directly into Firehouse. Agencies will also need to follow-up with Firehouse to ensure NEMSIS 3 compliance.

 

ZOLL SOFTWARE USERS:

Agencies using Zoll have been meeting regularly regarding the NEMSIS 3 conversion and are already working with Zoll and IDPH to be ready.

 

IMAGE TREND/OTHER SOFTWARE USERS:

Agencies will need to follow-up with their respective software vendors to ensure NEMSIS 3 compliance.

 

 

 

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. IDPH should contact Agency Coordinators to schedule vehicle inspections. If you do not hear anything within 30 days prior to your vehicle license expiration send an email to the State Ambulance Chief Keith.Buhs@illinois.gov and Inspectors Louise.Roberts@Illinois.gov and  Emily.Doering@Illinois.gov as well as mzanelli@silvercross.org.  Once the inspection is scheduled, email Marilyn the date and time of your inspection for ALS equipment/medications. This information was revised 3/15 per the IDPH inspectors.

 

Pay your vehicle renewal fees early so once the inspections are logged in the IDPH database your licenses will renew and print. You may pay your vehicle renewal fees online at the NEW IDPH WEBSITE: http://dph.illinois.gov/.  From here you can chose the Forms & Publications tab to print inspection and renewal forms or the Licensing & Certification tab to renew licenses and vehicles online or look-up a license status.

 

 

ROUTINE SYSTEM OPERATIONS

The Operations Coordinator handles  the daily routine operations in the System such as ambulance inspections, supplies, pyxis, system entry, licensure, events, website maintenance, and data collection. For questions 815-300-2900.

 

 

VERY IMPORTANT INFO REGARDING IDPH FORMS

As IDPH EMS Provider and Vehicle Licensing forms are updated, they will be placed on the IDPH EMS website. I have attached the link where all current IDPH forms for EMS provider and vehicle licensing can be found in PDF file.  New forms in this link include the frequently used Transport and Non-Transport Inspection Forms and the "Sys-Mod" Form found on this site as the "Request to Modify/Amend System Plan" form. Use the fillable PDF drop down boxes to complete the form before printing it. EMS agencies MUST use and become familiar with these documents, given that the new forms will be the only forms accepted by the IDPH ambulance licensing section, beginning January 1st, 2016 per Keith Buhs, IDPH Ambulance Program Section Chief. http://dph.illinois.gov/forms-publications  OR

http://dph.illinois.gov/topics-services/emergency-preparedness-response/ems/prov-vehLic

 

Most of forms used in daily operations are located on the POLICY PAGE, however some of the more frequently requested forms may be found below:

                                                      

 IDPH FORMS MAY ONLY BE PRINTED FROM THE IDPH WEBSITE : http://dph.illinois.gov/forms-publications
IDPH Ambulance Inspection Form
IDPH Non-transport Vehicle Inspection Form
IDPH EMS System Plan Modification Form Commonly referred to as "Sys-Mod" Form
IDPH Equipment/Vehicle Waiver Request Form
IDPH Special Events Request Application
IDPH SITE CODE APPLICATION FORM

 

BELOW ARE A FEW OF THE MOST COMMONLY ACCESSED SYSTEM POLICIES.

THEY MAY ALSO BE FOUND ON THE POLICY PAGE OF THIS WEBSITE.

Ambulance Requirements: See Policy 300-39 5/7/13

BLS Required Equipment Policy 300-4 Revised 5/1/16

ALS Required Equipment Policy 300-6 Revised 1/10/17

Non-Transport Policy 300-9 Revised 12/20/16

Medication Policy 300-37 Revised 7/13/17

Pharmacy Order Form Revised 7/13/17

Monthly Controlled Substance Inventory Log 9/26/16

PYXIS Policy & Instructions Policy 300-69 Revised 7/18/16

DNR/POLST Policy 300-50  Revised 7/1/16  Link to Instructions and DNR FORM

Multiple Patient Refusal/Release Policy 300-65 Revised 11/15/11

Refusal Policy 300-55 with Release Form Revised 12/27/13

Reserve Vehicle Policy 300-36 Revised 12/6/12

Out-of-Service Ambulance Form Policy 300-13 Revised 11/22/11

Link to Illinois ADULT petition:

 http://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-2005.pdf

Link to Illinois MINOR petition:

 http://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-2206m.pdf