H003-EMT/Paramedic/Firefighter

Job description

CITY AND COUNTY OF SAN FRANCISCO

DEPARTMENT OF HUMAN RESOURCES

Title: EMT/Paramedic/Firefighter

Job Code: H-3

INTRODUCTION

This specification defines and describes the full range of duties included within the

levels of the deep class of H3 EMT/Paramedic/Firefighter. Depending on the

appointment level within this deep class, incumbents may perform basic life support

duties on an ambulance (Level 1 EMT ); perform advanced life support duties on an

ambulance (Level II Paramedic); or respond to fire alarms and engage in firefighting

activities (Level III Firefighter Paramedic) for the saving of life and property; perform fire

prevention duties; maintain station quarters and equipment; staff an ambulance to

provide initial emergency medical care in a pre-hospital setting; evaluate and administer

advanced first aid, life support and life maintenance measures in accordance with

Emergency Medical Service Agency policies and procedures, including CPR, definitive

and therapeutic care at the scene or during transport of persons; perform duties of

either fire suppression, ambulance driver, paramedic attendant, dispatcher, or other

related duties as required.

The three levels are summarized below:

I EMT Certified and Locally Accredited EMT -- Performs basic life support duties on

ambulance with Level II Paramedic.

II Paramedic Licensed and Locally Accredited EMT-P -- Performs advanced life

support duties on ambulance with Level I EMT or Level II Paramedic.

III Firefighter/Paramedic Licensed and Locally Accredited EMT-P and fully trained

firefighter -- Works on fire apparatus as a fully qualified Firefighter and Paramedic

assigned to a SFFD suppression unit or on ambulance with Level I EMT or Level II

Paramedic.

DISTINGUISHING FEATURES

This class utilizes the deep class concept and encompasses multiple levels of

responsibility from entry through the fully experienced journey level. Incumbents report

to the respective Engine Company Officer or Fire/Paramedic Captain in the Emergency

Medical Services Division.

This class is distinguished from the H 2 Firefighter in that most H 2 Firefighters have

EMT certification and perform basic life support duties but are typically assigned to a

suppression unit rather than medical transport.

SUPERVISION EXERCISED: None

MAJOR, IMPORTANT, AND ESSENTIAL DUTIES

According to Civil Service Commission Rule 309, the duties specified below are representative of the range of duties

assigned to this job code/class and are not intended to be an inclusive list.

Note that the duties listed below are cumulative. For example, Level III incumbents

may be directed to perform any of the duties described in Level I and Level II.

Level I

Interactions with Patients, Families, Police and Co-workers

1. Responds to medical and traumatic emergencies.

2. Provides medical support for rescue activities in a variety of situations.

3. Performs primary examination of patients to assess condition.

4. Performs secondary examination of patients to assess condition.

5. Performs assigned ICS role in multi casualty or disaster situations.

6. Administers proper emergency treatment in accordance with protocol and patient

assessment.

7. Administers or ensures basic life support (including cardiac pulmonary

resuscitation and defibrillation) to stabilize patient conditions.

8. Transports all persons in need of medical care in accordance with County policy

and Department performance standards to approved facilities within San

Francisco and to authorized out-of-county sites.

9. Extricates patients from scene of incident (e.g., damaged vehicle) to ambulance

for transport.

10. With assistance of a partner, lifts patient on stretcher to gurney height level for

transport through building.

11. Ascends stairways to location of patient to provide treatment.

12. Loads and unloads patient on gurney into and from the ambulance.

13. Pushes or pulls patient on gurney on uneven surfaces, up or down inclines, and

around obstacles to get patient to and from ambulance.

14. With assistance, carries and balances a stair chair with patient on uneven

surfaces, up and down inclines, and around obstacles to transport patient to

gurney.

15. Questions patients to obtain information to determine nature of injury or illness.

16. Establishes rapport with patients to gain cooperation and acquire information.

17. Answers questions from patients and provides information regarding the injury or

illness and status.

18. Calms and reassures patients who are confused, frightened or in distress.

19. Interacts with diverse members of the public, many of whom have communication

challenges (limited English, altered states).

20. Participates in department supported events and incidents (health fairs, parades,

standby at public events, police critical incidents, fire incidents).

Administrative

21. Testifies in court of law regarding EMS activities, as required.

22. Completes and submits post accident report.

23. Completes Patient Care Report (PCR) to document, for example, patient history,

actions taken, and observations made at scene of incident until patient is no longer

under paramedic's care.

24. Completes all documentation as required, vehicle/equipment check-out logs,

journal entries, etc.

Training

25. Participates in company drills, training, and other fitness programs.

26. Conducts EMS training as assigned.

27. Serves as mentor for Department Personnel assigned to ambulances.

28. Successfully completes training to maintain required certifications.

29. Successfully completes required in-service training.

30. Completes EVOC training.

Equipment, Supplies and Vehicle Operation

31. Assists paramedic in the inventory of medical supplies related to Advance Life

Support (ALS).

32. Maintains the inventory of medical supplies in the emergency vehicle related to

Basic Life Support (BLS) by conducting inventories and restocking as necessary.

33. Cleans emergency vehicle to ensure medical cleanliness.

34. Checks mechanical equipment on emergency vehicle to ensure that it is fully

operational.

35. Performs routine preventive maintenance of equipment on emergency vehicle.

36. Carries equipment (e.g., monitor/jump bag, defibrillator) in each hand from

emergency vehicle to location of patient.

37. With assistance, lifts 75-pound or 150-pound oxygen cylinder (on board air) into

ambulance.

38. Safely but expeditiously drives emergency vehicle to the scene, using lights and

sirens in accordance with department policies.

39. Deals effectively with traffic congestion by considering different routes and

maneuvering vehicle through jams.

40. Uses City and maps to respond efficiently to scenes, including those in obscure

locations (e.g., alleyways, undeveloped areas)

41. Properly uses Personal Protective Equipment (PPE) (gown, goggles, mask, etc.)

when interacting with patients.

42. Receives and responds to messages transmitted via text and radio transmissions.

Communication and Notifications

43. Interacts with outside agencies such as Coast Guard, Medical Examiner, Animal

Control, Mobile Assistance Patrol.

44. Informs the Fire/Paramedic Captain of unusual incidents.

45. Coordinates multiple medical and disaster situations via radio and/or telephone as

prescribed by protocol or as directed.

46. Briefs emergency room staff regarding condition of patient, history, and treatment

administered so that ER staff have an understanding of the situation.

47. Reports findings at emergency scene to appropriate personnel in accordance with

Department policy.

48. Interviews witnesses at scene of incident to gather information about patient

(patient history) and how the incident took place.

49. Provides allied health professionals with a detailed patient report prior to the

transfer of care in accordance with Department, EMSA, and Statutory

requirements.

50. Communicates unit status, situational updates, receiving hospital / trauma

notifications, base hospital medical doctor (BHMD) consultation/medical direction,

and resource requests via computer in accordance with Department policy.

51. Communicates unit status, situational updates, receiving hospital/trauma

notifications, base hospital medical doctor (BHMD) consultation/medical direction,

and resource requests via radio/landline/cellular telephone in accordance with

Department policy.

Level II

52. Required to provide advanced emergency medical care to victims of fire and

activities for saving lives and property, including medical scene size-up,

establishing medical command post, reporting to incident commander or EMS

Captain and implementing medical Incident Command System (ICS); supports

rescue activities in a variety of situations; renders first aid, treatment for shock,

cardiac compression, resuscitation, and prevention of blood loss.

53. Responds to trauma or medical emergencies; performs primary and secondary

evaluation of patients to assess conditions, triages in major disasters; administers

proper procedural emergency treatment; institutes emergency care and/or

advanced life support to stabilize patient conditions, including cardiac pulmonary

resuscitation, defibrillation, drug administration, invasive procedures and definitive

therapy.

54. As part of EMS response, conducts hazard assessment of residences, places of

business, public assemblage, schools, and hospitals to ensure compliance with

fire codes, ordinances, laws and regulations, and refers potential hazards

/violations to appropriate Fire Department division.

55. Participates in training and physical fitness programs as required. Incumbents

must maintain superior physical strength, agility and stamina to carry out the

intense physical duties of the position.

Level III

56. Responds to fire alarms and other emergencies; operates a variety of firefighter

vehicular equipment at the scene of fires, including ladders, pumps, hoses,

nozzles, gauges and other firefighting or emergency equipment.

57. Maintains inventory of fire fighting equipment; ensures that the emergency vehicle

is fully equipped and prepared for service; conducts tests of biological equipment,

checks and restocks medical supplies and cleans the vehicles.

58. Participates in rescue activities in a variety of situations; renders first aid, including

treatment for shock, cardiac compression, resuscitation and prevention of blood

loss.

59. Performs salvage duties to protect property from damage by fire, water or other

causes; inspects residences, places of business, public assemblage, schools, and

hospitals to insure compliance with fire codes, ordinances, laws and regulations;

participates in fire prevention activities to ensure fire and life safety.

60. Maintains security watch at fire stations and records fire alarms, monitors

communications equipment; conducts tests, operates and monitors radio, lighting,

alarm systems and other related equipment; dispatches fire units; participates in

company drills, training and physical fitness programs.

61. When assigned to the fireboat crew, maintains, inspects, tests and operates

firefighting equipment aboard the boat; participates in lifeboat drills and firefighting

duties.

IMPORTANT AND ESSENTIAL KNOWLEDGES, SKILLS, AND ABILITIES

Note that the qualifications listed below are cumulative. For example, incumbents at

Level III are expected to meet the qualifications listed for Level I and Level II.

Level I

Knowledge of:

" Department EMS training bulletins.

" Current EMT techniques in field and hospital settings.

" Ambulance mechanical equipment and routine preventative maintenance.

" The SFFD Radio Communications manual.

" City streets and direct routes to scene.

" Maps and Thomas guides to the City.

" Traffic patterns at various times of the day.

" Title 22 of the EMS Authority.

" Department rules, regulations, and General Orders.

" Local EMS agency policies / procedures.

" EMS agency BLS treatment protocols.

" Department procedures / practices on fire ground.

" The Incident Command System.

" START triage.

" Best practices regarding operational and safety procedures.

" Fire Department policies and procedures related to EMS operations.

Ability to:

" Quickly and accurately evaluate emergency situations.

" Use medical equipment to administer proper life support and life saving measures.

" Safely and expeditiously drive an ambulance vehicle.

" Communicate clearly and logically in written form.

" Work in hazardous/dangerous situations.

" Maintain superior physical strength, agility, and stamina to carry out job duties in

inclement weather, from heights, tunnels, water, or other potentially hazardous

conditions.

" Make critical decisions in stressful situations.

" Determine the fastest route to the scene and to the receiving hospital.

" Elicit information from patients in order to determine the correct treatment for the

patient.

" Elicit information from witnesses to an incident.

" Control the scene of an incident to ensure your own safety as well as that of the

patient.

" Assess and evaluate the risk involved in EMS operations, and to perform

accordingly.

" Quickly perform primary and secondary assessments of patients.

" Correctly complete Patient Care Report forms.

" Communicate effectively in oral form with peers and supervisors from different

cultures and backgrounds.

" Calm and comfort sick and injured persons, relatives, friends, and bystanders at

emergency incidents.

" Make appropriate destination decisions depending on patient condition.

" Lift (with assistance) patient on stretcher to gurney height for 30- to 60-second

transport through building, down stairs, to gurney.

" Lift 35 pounds in each hand to transport equipment from ambulance to location of

patient.

" Ascend and descend stairways carrying 35 pounds in each hand to get to patient

location to provide treatment.

" Load and unload patient on gurney into and from ambulance.

" Push or pull patient on gurney on uneven surfaces, up and down inclines, and

around obstacles to get patient to and from the ambulance.

" Push and pull stair chair with patient on uneven surfaces, up and down inclines, and

around obstacles to relocate patient.

" Lift (with assistance) a 75 to 150-pound oxygen cylinder into the ambulance.

" Perform CPR correctly (in accordance with AHA standards) for 60 seconds.

" Push or pull a patient to assist other EMS providers in extricating patient from

locations such as closed upright vehicles, closed over-turned vehicles, and beneath

vehicles.

" Climb and balance while ascending or descending with equipment or patients along

stairs, ramps, or hillsides.

" Conduct patient care tasks while stooping, kneeling, crouching, or crawling.

" Communicate verbally to patients, dispatchers, physicians, and coworkers in

transmitting and gathering information.

" Hear information transmitted verbally by phone or radio.

" See in order to drive safely to scene of emergency or other assignment, to visually

inspect patient surroundings, read maps, read medication instructions, and read

street, vehicle, or building markings.

" Employ near acuity, far acuity, depth perception, accommodation, color vision, and

fields of vision to perform job functions.

" Anticipate the needs of the patient before they occur.

Level II

Knowledge of: Procedures and practices in emergency rescue; current paramedic

techniques in both field and hospital settings.

Ability to: Perform advanced life support duties required of paramedics.

Level III

Knowledge of: Methods and techniques in firefighting; procedures and practices in fire

rescue; fire prevention, housing and building codes.

Ability to: Apply rules and procedures prescribed in the fire fighter manuals; quickly

evaluate emergency situations; administer proper life support and life saving measures;

safely drive a fire or ambulance vehicle; operate a wide variety of fire tools,

communicate clearly and logically in written and oral form.

MINIMUM QUALIFICATIONS

These minimum qualifications are to be used as a guide for establishing the education, training, experience, special

skills and/or license(s) which are required for employment in the classification. Please note, additional

qualifications (i.e., special conditions) may apply to a particular position and will be stated on the exam/job

announcement.

All Levels

High school diploma or an equivalent (e.g., GED)

Minimum 19 years of age to apply, 20 years of age at time of appointment.

Level I:

Possession and maintenance of a valid California Emergency Medical Technician 1

(EMT1) Certification issued by the State of California or local EMS Agency and the

accredit with local EMS Authority.

Possession and maintenance of valid California Drivers License with Ambulance Driver

certificate / endorsement.

Any combination of 500 hours of verifiable work experience as an EMT (on an

ambulance or first responder vehicle) or hours of documented ambulance ride-alongs

as member of the San Francisco Fire Reserve within the last three years; OR any

combination of 1000 hours of verifiable work experience as an EMT (on an ambulance

or first responder vehicle) or hours of documented ambulance ride-alongs as member

of the San Francisco Fire Reserve within the last five years

Level II:

Possession and maintenance of a valid California Emergency Medical Technician

Paramedic (Paramedic) license issued by the State of California and the ability to

accredit with local EMS Agency.

Possession and maintenance of valid California Drivers License with Ambulance Driver

certificate / endorsement.

Successful completion of a San Francisco Fire Department Physical Ability Test (PAT)

designed for ambulance transport personnel.

1000 hours verifiable work experience as a Paramedic (on an ambulance or first

responder vehicle) within the last three years; OR 1500 hours verifiable work

experience as a Paramedic (on an ambulance or first responder vehicle) within the last

five years.

Level III:

Possession and maintenance of a valid California Emergency Medical Technician

Paramedic (Paramedic) license issued by the State of California and the ability to

accredit with local EMS Authority.

Possession and maintenance of valid California Driver License with Restricted Class B

Fire Apparatus certificate / endorsement.

Successful completion of a certified Candidate Physical Ability Test (CPAT) designed

for the fire suppression personnel.

Successful completion of the San Francisco Fire Department Fire Academy and

completion of the San Francisco Fire Department Firefighter Promotional probationary

period.

Satisfactory service as Level II H3, OR current employment as H-2 Firefighter OR one

year of service as a firefighter/paramedic in a paid, professional Fire Department

LICENSE AND CERTIFICATION

IMPORTANT NOTES:

Level III H3 Firefighter / Paramedics may apply for assignment as Level II H3 Firefighter

/ Paramedics. Approval of this assignment is at the discretion of the Chief of

Department and members accepting reassignment will be re-salaried at Level II- Step 5

(and eligible for any applicable premium pay attachments)

Depending on the type of appointment, incumbents will serve a performance

assessment period not to exceed one year in accordance with the Civil Service Rules

and the bargaining agreement with IAFF / Local 798.

Promotion through the levels of this deep class is not automatic and will be determined

by the operational needs of the Fire Department and funding availability.

ORIGINATION DATE: 3/17/97

AMENDED DATE: 2/24/06; 3/10/11

REASON FOR AMENDMENT: To accurately reflect the current tasks, knowledge, skills and abilities

defined in the most recent job analysis conducted for this job code.

BUSINESS UNIT(S): COMMN

Standard information

Disaster service work

All City and County of San Francisco employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the City requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

Historic and future compensation