EMS DIVISION

       Standard Operating Guidelines

      6 RADIOS
      7 UNIFORMS

      16 RUN FORMS
      17 ALS MEMBERS

      23 REFUELING

       24 FIRE STANDBY


37TableOfContents.doc 07/07
        On February 13th 1978, the town of Barrington established the Barrington
Emergency Medical Services (BEMS). Over the years the service has evolved from a
transport service to one of pre-hospital care, and from Emergency Medical Technicians
and First Responders to Advanced EMTs, Intermediates and Paramedics. This advanced
training has changed the entire scope of care that our service can provide for our
community. The Barrington Fire & Rescue, EMS Division will endeavor continue to
provide this level of care.

        In 1998, the town Selectmen elected to change the BEMS ambulance/association
into a Town Department with one spokesperson, chosen by them, and one spokesperson
for the Association, chosen by the Association. The division produced the Barrington
Ambulance Department headed by a Chief, and the Barrington Emergency Medical
Services Association headed by a President. Association members are voted in by the
Association and do not have to hold current pre-hospital certifications, (EMT/CPR).
Ambulance members can be a part of the Association, if they so choose. The Ambulance
members are approved by the Chief and must maintain current certifications.

        On July 11, 2007 a Memorandum of Understanding was signed outlined the
changes in Barrington‟s Fire and Ambulance Departments, which we expect to be fully
implemented as of September 30, 2007. The intent was to have a seamless installation of
the Ambulance Department into the Fire Department as a separate Division. The new
Barrington Fire & Rescue Department (BF&R) will have two Divisions, one Fire Division
and one EMS Division, under the Fire Chief. Both of the original structures of the separate
Departments will stay intact under the Division organization structure. All Officers, Lines
of Command and Procedures/Guidelines will remain in force for each Division. Each
Divisions Members will be considered fully vested Members in both Divisions and be
entitled to the associated benefits and responsibilities of Membership in accordance with
each Divisions Procedures and Guidelines.

The Fire Chief will have the ultimate responsibility for both Divisions of the Fire &
Rescue Department, but will delegate all of the operations of the EMS Division to the
EMS Chief. All EMS related communication will go through the EMS Chief to
disseminate, as appropriate.

This evolution of the Town‟s Emergency Services is a natural one and, with everyone‟s
cooperation, will go smoothly. Please feel free to contact either the Fire Chief or the EMS
Chief if you have any questions.

The above described changes are contingent on final approval of the Board of Selectmen.
        Barrington Ambulance is primarily staffed by Volunteers. The Town, in 2007,
hired one daytime EMT in the position of Fire Chief to anchor the day time response. In
2008 we are requesting the Town hire one additional EMT/Firefighter to work for the Fire
Chief to better assure both EMS and Fire coverage during the daytime hours.

        We work from a pager system and are dispatched through Strafford County
Dispatch in Dover. We work hand in hand with Fire and Police personnel. When there are
no Responders available a mutual-aid system has been established with the surrounding
communities. The Ambulance Responders follow established State and Local protocols.
The Division also has its own established Standard Operating Guidelines. As the title
suggests, these are operating guidelines that are followed by the members. Not every
situation or event is listed in the SOGs and it is expected that all members use common
sense when handling situations or events. Remember that you are a Barrington
“Employee”, even though you are volunteering your time, you still are representing the
Town of Barrington. The SOGs are guidelines that provide general information and are
updated as warranted.

        The following sections are the current Standard Operating Guidelines. Every new
member is on a temporary Six Month Probation. They are not allowed to use warning
devices, as stated in the guidelines. During this time the member is evaluated on his/her
performance. Any time during this period the EMS Chief may terminate the probationary
member. After the probationary period, any member can be terminated by the EMS Chief
for cause, such as not following the SOGs, and/or State/Local Protocols. At that time the
member will surrender all property owned by the Department.

        The guidelines outlined in this booklet are designed to help everyone understand
how we operate. The SOGs contain outlines on how to use specific equipment and how to
respond to specific events. By not following the outlined SOGs a Responder will lose the
rights associated with them.

Introduction.doc 01/08
            EMS DIVISION

                   MANAGEMENT STRUCTURE

        Any problems with or within the Division shall be addressed with the
EMS Chief, currently Tony Maggio.
        If it is an emergency and the EMS Chief is not reachable, contact the
EMS Captain, currently Nick Roun.
        If the EMS Chief or Captain can not be reached, contact the Fire
Chief, currently Rick Walker.
        If none of the above personnel can be reached contact Carol Reilly,
Town Administrator.

                            Work               Cell              Home

EMS Chief
  Tony Maggio              335-2535          969-4361           942-8334

EMS Captain
  Nick Roun                994-8032          973-2479           664-5066

Fire Chief
   Rick Walker             664-2241          396-4469            332-3944

Town Administrator
  Carol Reilly     942-5568                  396-4463            664-5715

39Management.doc   07/07


To be used:

        For official use only, you are responsible for your guests.
        No working on personal vehicles in the bay.
        No unnecessary use the ambulance, IT IS EXPENSIVE.
        No unnecessary driving (cruising) without reason, such as Driver training, etc.

Before leaving the building:

        Turn the lights, TV/Box, computer, etc off in the office, meeting rooms and Bay.
        Pick up any mess that you have created.
        Make sure that the doors are locked before leaving the building.

1UseOfBuilding.doc   07/07


        All perspective members shall fill out and submit an application to the EMS Chief.
All perspective members will be placed on a six month probation during which time the
EMS Chief will decide to accept the member or ask them to leave. A motor vehicle
background check may be done on perspective members. Any time during the probation
period the EMS Chief can terminate a perspective member for any reason. The perspective
member will be given a copy of the most current Standard Operating Guidelines. The
prospective member will read, understand and follow the SOG‟s. If at any time a member
is asked to leave, all equipment that has been issued will be returned to the EMS Chief in
the same condition it was issued, excluding normal wear.

       For any member to be considered active and in good standing or be eligible for
reimbursements they must attend at least 70% of all business meetings and all mandatory
meetings unless excused by the EMS Chief and meet the “response” requirements below.

        The EMS Division holds its Business meetings on the second Sunday of the month
at 19:00, except during the summer. Training is usually available on the second Tuesday of
the month at WDH, on the third Tuesday of the month at FMH and at various times at the
PSB. Most communication of EMS Division business will be conducted via E-mail.

       Members are responsible for reading all E-mails and handouts that may be kept at
the PSB. The member may not always be notified when there are handouts to read, but
should stop by the bay at least once a week to review any new postings.

         It is imperative that all members respond to calls whenever available. It is the EMS
Division‟s goal that each member responds to at least 15% of all calls in any three month
period. At a minimum all members are required to respond and be available to transport on
at least three (3) calls per quarter. Members that do not meet this requirement will be
notified of the deficiency and will have the next quarter to catch up on the missed calls,
during that period the Member will not be eligible to accrue Incentive Points. At the end
of the second deficient quarter the EMS Chief will reassess the member‟s performance and
either terminate the member or take other appropriate action.

2Membership.doc 07/07


        If at any time a DISAGREEMENT OR COMPLAINT arises between Barrington EMS
Division Members and another Service or Department, notify the EMS Chief and/or Captain,
immediately. Do not take it up with the other service/department at that time. The Barrington EMS
Chief and /or Captain shall meet and discuss if any action will be taken. Under no circumstances
shall any member take it upon themselves to resolve any disputes between Barrington EMS
Division and another service/department on their own without the EMS Chiefs approval.
        All complaints shall be presented to the EMS Chief in writing. The EMS Chief will
investigate and establish if Corrective Action shall be taken. The Barrington Town Policy for
Dispute/Grievance will be implemented if the EMS Chief cannot resolve the issue.

3InterDeptDisputes.doc 07/07


Unprofessional Acts and Poor Judgments
        An act that is at variance with professional standards or ethics.
        Using poor judgment that endanger EMS personnel and/or patients.
        Any member found to use poor or unprofessional judgment that endangers another EMS
Provider, bystander or patient will be put on Probation. After further investigation into the event,
the EMS Chief will determine if that member will be terminated or kept on probation. During that
time, the member will not respond to any Ambulance calls or represent the Department in any way.
Final decision will be made by the EMS Chief. Decisions can be reviewed per the Division‟s
Disciplinary Action SOG.

                   All Disciplinary Actions will be handled by the EMS Chief as
          referenced in the Town‟s Personnel Policy Manual. (XIII. Disciplinary Action).
          The Fire Chief may review the Division‟s Action and the Selectmen may review the
          Department‟s decision, the Selectman‟s decision will be final. All decisions will be in
4DisciplinaryAction.doc   07/07


                    If at any time a member of the Fire & Rescue Department, EMS Division, has a
          complaint not resolvable by the EMS Chief, The Member may appeal to the Fire Chief, if
          still not satisfied the Member will follow the Grievance Procedure outlined in the Town‟s
          Personnel Policy (XIV. Grievance Procedure). All decisions will be in writing.

5Grievances.doc   07/07


                    All radio communication, on Strafford County and Barrington Local,
                    will be used for Barrington Fire & Rescue Department purposes only.
                    The Barrington Police Chief will oversee the use of the frequencies.

                    Those members who are found using the radios for other than official
                    communications will lose the right to use them and the radios will be
                    returned to the Department, if Department property.

                    All members who use personal or Department radios may be required to
                    complete and return the Radio Agreement Form with Strafford County
                    Dispatch. Failure to do so forfeits the member‟s right to use the radio.

                    A list of those members authorized to use radios, and their call number, will
                    be updated with dispatch every three months.

                    A list will also be given to the BPD and each member within the Division.

6Radios.doc 07/07

7. Uniforms

                      All clothing and equipment be it personal or Division property shall
                      be kept clean and serviceable.
                      All members are responsible for all issued equipment and will
                      surrender upon termination of membership.
                      All equipment/uniforms with the Barrington logo are to be used for
                      Department purposes only. All items must be kept clean and neat
                      with minimum patches.

                      A Royal Blue vest, with reflective trim, and the Department patch
                      will be issued to all Responders. This vest is to be worn over your
                      “civilian” clothing for safety and identification purposes.

                      The Barrington patch (on the left sleeve) and National Registry
                      patch (on the right sleeve) should be sewn on the sleeves of the
                      Department jackets.

                      The current dress uniform is a pair of navy blue trousers with a light
                      blue shirt. The Department patch should be on the left sleeve and
                      your National Registry EMT/First Responder patch on the right
                      sleeve. A nametag over your left pocket is also required.

                      The Chief and Captain may wear a white shirt instead of light blue.

7Uniforms.doc 07/07


                           Recognizing the lifesaving value of seatbelts, Patients are to be
                           secured at all times.

                           The Patient‟s family or friends who ride to the hospital in the
                           ambulance are to ride up front and wear seatbelts.

                           The Driver is required to wear a seatbelt at all times. All Providers
                           are required to wear their seat belts, unless they interfere with
                           Patient care.

                           We strongly encourage all Members to wear their seatbelts in their
                           personal vehicles when responding to all calls.

8SEATBELTS.doc    07/07


       The Barrington EMS Division follows all State RSA‟s regarding the Operation of
Emergency Vehicles, be it private or Town owned. RSA 259:28; 265:8, 265:33, 265:61,
266:73, 266:74

        Use of Emergency visual and audible warning devices on private vehicles is limited
to WITHIN THE TOWN OF BARRINGTON. Sirens/horns are to be used when necessary
to warn on coming traffic. Both audible and visual warning devices will be used when
entering an intersection and when the need to proceed into oncoming traffic. The operator
is to have total control of their vehicle at all times.

        Lights are to be red and/or white. They can either be flash or strobe type. Front
strobes are to be controlled with a dimmer switch. Wig-wag headlights are permitted. The
lights can be mounted either in or on the vehicle, 360 visibility is recommended. The EMS
Division does not take responsibility for lost or damaged equipment.

        During a Members Probationary/Observer period (usually six months) they shall
not use warning devices and fully follow all posted speed limits and signage.

9Lights&Sirens.doc 07/07


                      After the tones:
                      If you have a portable/mobile radio, sign on with Dispatch.
                      Tell dispatch your Call Sign (900#) and destination (PSB or
                       the scene).
                      If you must pass the Building to get to the scene, check and make sure someone
                      has already picked up the Ambulance.

                      In the Ambulance:
                      Notify Dispatch that the Ambulance is on the air at the “Basic”, “Intermediate” or
                      “Paramedic” level and ask if anyone else is en-route to the bay.
                      If only one EMT signs on ask Dispatch to re-tone, per Protocol.
                      After a crew of at least TWO LICENSED Providers is confirmed, proceed to the
                      scene with the ambulance using the appropriate response.
                      Ask Dispatch, or any on scene Responder, for an update on the patient‟s
                      In order to TRANSPORT a patient there must be two licensed Providers,
                      including at least ONE EMT on board to supervise patient care.
                      If additional help is needed, RADIO AHEAD OF TIME, it can always be
                      cancelled. Reference our INTERCEPT PROTOCOL.

                      Frisbie and McGregor Paramedics are under an agreement to respond to
                      Barrington daytime calls. If we have a crew, we can cancel them. They most
                      likely will go to the scene to evaluate the patient.

                      If we call for an Intercept, the Paramedics will usually work in our ambulance
                      with their equipment.

             If no crew is available:
                      Mutual Aid will be notified, per our Dispatch Protocols, that there are no
                      responders and they are to take the call. Barrington Police (for medical) or
                      Barrington Fire (for MVAs) will act as first responders, if they are available.

          If there is only one responder:
                       They are to take their personal vehicle to the scene to assist with medical care
                       until the Mutual Aid ambulance arrives.
                       Do not respond with the ambulance, unless a full crew is expected.

             If a Fire Officer or Police Officer request a Mutual Aid Ambulance:
                       Do not cancel the Mutual Aid service until you have the entire story. There may
                       be a good reason for the request.
                       Radio the Officer on Town Local and ask for an update.
                       The Mutual Aid service is not to be canceled until the situation is evaluated and
                       the need for the other service is assessed.
                       Act professionally, the Officers are looking out for the patient and the care they

                      10RespondingWamb.doc 07/07

             Hold a valid Drivers license.
             Have been trained and familiarized in operating the Ambulance and it‟s warning
             Complete continuing education/refresher course designed by the Division on
             driving ability and familiarization with the ambulance.
             Have a documented authorization to drive the ambulance from a Division Officer.
             The DRIVER;
             Is to make sure the vehicle is fully operational before leaving on a call and
             is to make sure that the power is turned on in the Patient compartment.
             Is to notify dispatch that the ambulance is en-route to the call (10-1).
             Is expected to use good judgement on choosing the correct response Code for the
             type of call.
             Is to make sure the Ambulance is under control at ALL TIMES.
             Maximum speed to be used at any time is 10 mph over posted limits, conditions
             Lights and Sirens REQUEST the right of way. DON‟T trust the other driver to
             give you the right of way.
             The driver is to notify dispatch that they are on scene (10-2) .
             The Ambulance shall be placed to protect the patient/scene, if needed, at the scene
             of an IN-THE-ROADWAY EMERGENCY.
             The Ambulance shall be parked for easy access to equipment and EXIT to the
             Hospital, keeping in mind FIRE/POLICE vehicles may also need to enter the
             The driver is to establish traffic/crowd control if not already established.
             After establishing SCENE SAFETY for responders and patient(s), the DRIVER
             will help with patient care.
             If at any time the AMBULANCE driver is first on scene, before the other
             Responders, they are to tend to the Patients.
             Upon being notified of cancellation of a call by radio or pager:
                      a. Turn off visual/audible warning devices
                      b. Blend into flow of traffic.
                      c. Change direction of travel by using intersections or side streets.
                      d. Return to the Public Safety Building with the flow of traffic.
                      e. Document the run on TEMSIS and with a Run Log.

               11Driver.doc 07/07

12. Accidents involving the ambulance:

                   1. Ambulance will remain at the accident scene until
                            released by police investigators.
                   2. Render care to any and all injured parties.
                            a. If you already have a patient in the
                            ambulance, a licensed member must remain
                            with them at all times. (NEVER leave a
                            patient unattended)
                   3. Request additional ambulances for transport.
                   4. Request Police and Fire support.
                   5. If any fuel leaks, turn off engine, batteries, and oxygen.
                            a. If necessary, remove patient(s) via
                            stretcher/backboard to safe area.
                            b. Remove extinguishers and have ready.
                            c. Remove portable oxygen tanks.
                   6. Give statements only to the police, do not discuss the
                   accident at the scene or outside of the Division. Official
                   statements shall come from the EMS Chief.
                   7. If there is any personal injury, the Driver will be required to immediately
                   submit to a drug and alcohol test.

12Accident.doc   07/07


     A. On a response
           1. Assist Driver in clarifying directions to the scene and
           navigate if necessary. Contact Dispatch if further
           information/directions are needed.
           2. Monitor cross traffic on the passenger side of the
           ambulance, but don't obstruct the Driver's view.
           3. Shall perform a windshield assessment upon approaching
           the scene to determine the need for support activities
           (Police/Fire/additional ambulances or ALS).

     B. At the scene
            1. Shall select the appropriate Equipment and Jump Kits.
            2. If at a residence, SCM will observe the entrance and path
            to the patient to assess the need for transfer devices and/or
            the moving of furniture for clear access.
            3. Have the highest level Provider assess the patient and
            coordinate treatment.
                     a. If already initiated, accept report from the
                     first responder on scene and evaluate
                     effectiveness of patient treatment.
                     b. If the first responder on scene is not able to
                     accompany patient to hospital, assure that
                     adequate patient care continues.
            4. If multiple victims/patients, initiate triage and assign
            responsibilities to other Responders/bystanders.
                     a. Differentiate between Multiple injured
                     patients and Mass Casualty situation.
                     b. After triage, supervise overall scene and
                     transport priorities
                     c. Notify nearest hospitals and request they
                     notify others and determine their capabilities
                     d. Work with Police/Fire/and other officials
                     when they are involved in the emergency.
             5. After the initial assessment is completed, contact the
            receiving hospital with estimated number of patients and
            their status only. If at a house, ask to use the phone and call
            the hospital ED with an initial report. Provide the Patient‟s
            name and DoB so their records can be accessed.
        6.After the patient is loaded and the Ambulance is en-route to the hospital,
       the remainder of the responders are to attempt to shuffle the remaining
       vehicles to the Public Safety Building. If at all possible, the scene
       is to be cleared of all vehicles and responders as soon as possible.
       No loitering

       7. Any personal problems are not to be argued at the scene,
       do it later and elsewhere. If not resolved, contact the EMS

       8. If a patient is a minor, an attempt shall be made to contact
       a parent and have the parent contact the receiving hospital
       with consent to treat.
               a. If a minor's injuries are life or limb
                   threatening, do not delay transport to
                   contact a parent. (Delegate someone else
                   to contact the parents.)
               b. If a parent accompanies a minor patient,
                   both must wear appropriate restraint
               c. All infants/children MUST be in a child
                        restraint device.
               d. All minors must be transported to the ED or a
                  sign-off completed by a parent or guardian per our Refusal of
                  Care SOG.

C. On route to the hospital
       1. All patients will have an appropriate safety restraint
       device utilized. (Seatbelt, stretcher straps, etc)
       2. Continue to monitor, stabilize, and support the patient(s).
       3. Contact the appropriate hospital by radio and provide
       pertinent information about the patient(s) as per the current
       Protocol. (Keep it short)
               a. If possible, transport to the hospital of the
               patient's choice. If not possible, or not in the
               patient's best interest, SCM will decide what
               is the most appropriate medical facility and
               advise patient/family of this.
               4. If patient refuses transport, SCM will
               ensure that a refusal of transport is signed and
               witnessed, per our Refusal of Care SOG.
       5. If the family wishes to follow to the hospital, the SCM
       will DIRECT them NOT to follow the ambulance, and give
       them directions or someone to lead them to the hospital.
         D. At the hospital
                1. Shall remove patient from the ambulance and accompany
                patient into the ED and assist transferring patient onto the
                ED stretcher, continuing care until responsibility assumed by
                ED staff.
                2. The highest level Provider shall brief the ED nurse and
                Physician as to patient's complaint, pertinent history, care
                given, and response to treatment, and answer any questions
                from the doctor or nurse.
                3. Shall assist the ED staff with the patient as needed.
                4. Shall assure that the TEMSIS Form (ePCR) is filled out
                as completely as possible by the Primary Care Attendent and
                place the hospital's copy with the patient's chart.
                5. Shall assist with the clean up and restocking of the

         E. Upon returning to quarters
               1. Shall ensure that TEMSIS Form (ePCR) and Run Log are
               complete and put under the EMS Chief‟s door.
               2. Shall restock any supplies/equipment used and not
               restocked at the hospital.
                       a. If any expendable supplies are lacking,
                       SCM shall take steps to notify the Supply
               3. Shall ensure that the ambulance interior is clean, neat and
               ready for the next run.
               4. Vehicle equipment problems shall be bought to the
               attention of the Supply Officer or the Fire Chief as
               appropriate. Note deficiencies on the PSB White Board next
               to the Ambulance.

13SeniorCrewMember.doc 07/07


        Member in charge of controlling the Emergency Medical activities at a scene.
        Is comfortable in controlling and organizing single or multiple patient events.
        Is not directly involved with patient care.
        Answers to the ranking Fire Officer on MVA and Fire scenes.
        Will be the Ambulance driver or designated Senior Crew Member, as appropriate.
        Will help organize Multiple Casualty Incidents.

      When the first qualified responder or ambulance signs off at a multiple patient or accident scene
      designate MEDICAL COMMAND by radioing over the Dispatch frequency: “(location), Medical
      Command is being established by 9XX”

        If the driver, or First Responder, chooses to give Command to another member that member will use
        “(location), Medical Command, “ as their call sign and answer all Medical Command

        The ambulance will still use 950 as its call sign.
        (When the ambulance leaves the scene Medical Command will not be disrupted)
        The Medical Commander is to:
                Assess the scene for dangers to patients and responders.
                Determines the number of patients.
                Assesses need for additional personnel or agencies
                Address all dangers. Reports dangers to Dispatch or the appropriate Department.
                          Fire uses LOCAL for scene communication operations.
                          Police use STRAFFORD for all communications.
                Notifies Mutual Aid departments when indicated.
                Determines the safest egress to and from scene.
                Positions ambulance such that, when loaded it will not have to back up.
                Gets report from first responders, bystanders, family or appropriate dept.
                Helps with patient care when needed until further responders arrive.
                Controls responder parking such that it will not interfere with traffic or damage property,
                ie. lawns and driveways.
                Attempts to minimize the number of personal vehicles left on scene by having other
                members, fire or ambulance, drive them to the Public Safety Building.
                Attempts to limit the number of responders that enter a dwelling, as needed.
                Makes sure all equipment is accounted for.
                Makes sure all compartments are closed on the ambulance.
                Speaks with family/friends about following the ambulance and the dangers in doing so.
                Give directions to family/friends on how to get to the hospital.
                Encourage them to go ahead of the ambulance.

             When the ambulance is ready to leave the scene, the Medical Commander will:
                    Assign a driver for the ambulance, or terminate command and drive.
                    Notify dispatch that the patient is loaded and being transported to the appropriate
                    Inform Dispatch that all members have cleared the scene and termination of

14MedicalCommand.doc 07/07


                  The patient‟s condition and recommended response Code is given to the
                  DRIVER by the Primary Care Attendant. The driver will choose the
                  appropriate response Code to use on route to the hospital based Patient
                  condition, qualifications of the crew and road conditions.
                  The driver will notify dispatch when leaving the scene (“on route to XXH”)
                  and upon arrival at the hospital (“off at XXH”).
                  Family members, if any, are to ride up front and wear seatbelts.
                  If they are going to follow the ambulance to the hospital, explain to them
                  not to follow the ambulance through intersections or through stop signs.
                  Suggest that they to go ahead and meet the ambulance at the hospital.

                  AT THE HOSPITAL, the driver will secure the Ambulance to prevent
                  rolling and then will authorize opening the patient doors.
                  The driver is the only one to authorize opening the rear doors, for only
                  he/she knows that the ambulance is stopped.
                  The driver will assist with unloading.
                  After the patient is transferred over to hospital care, the driver will assist in
                  cleaning and restocking the ambulance.
                  The patient billing information slip can be picked up from the Hospital
                  Receptionist and the driver can help complete the Billing section of the

15EnRouteToHosp.doc   07/07


        All members, on the call, are responsible for the completion of the State required
Run Form after every incident. The Form to be filled out is the NH State TEMSIS form
(ePCR) available on line in each Hospital‟s EMS Room. The Primary Care Attendant
(assigned by the Senior Crew Member) will complete the Form at the hospital, if possible.
If the Form cannot be completed at that time, log on and save a Run Number by
completing and submitting the first page. The fully completed and signed ePCR must be
faxed to the Receiving Hospital within 24 hours of the call.

        The Hospital gets one, signed, copy and one, signed, copy is placed under the EMS
Chief‟s office door for secure filing. A Run Logs will also be completed to assure the crew
gets credit for the call.

          If any “Verbal Orders” are given by Medical Control the Doctor must sign the
appropriate block.
       Make sure that the Run Form is completely filled out, including billing information,
and signed. Have a second Attendant review the form before submitting them. Attempt to
get the Patient‟s signature indicating that they are aware of our HIPPA Policy (on line) and
their authorization for billing.
        If there is an interesting call that a member would like reviewed, Frisbie‟s EMS
Training Coordinator will review Pre-hospital calls. They will research and review the call
at a Training Meetings, as appropriate.
        All calls must be recorded on a Run Log Form, even cancellations, no transports,
Mutual Aid, etc. A Run Form must be completed for all Transports, Sign offs, Mutual Aid
hand offs and Intercepts, even as individual Responders.

16RunForms. doc   07/07

         Members who have Advanced Life Support skills i.e., EMT - Intermediate or Paramedic,
shall be responsible for restocking supplies used, filling out the Run Form for the Patient that
received ALS Care and keeping up with all ALS Certifications. Supplies shall be replaced at the
hospital per the current Drug Policy. The Run Form shall be filled out by following the appropriate
SOG. When reporting to the hospital via radio, USE YOUR ALS NUMBER and your affiliation
with BARRINGTON EMS. Make sure the Doctor on duty signs the Run Form, as appropriate.

        If at any time an ALS PROVIDER performs QUESTIONABLE CARE on a Patient, that
member shall have their ALS Protocols suspended until further investigation by the Department
and the Questioning Hospital. Their Protocols shall be reinstated, contingent upon the ALS
provider being cleared of any and all questionable care, or terminated by the EMS Chief following
the outcome of the investigation.

17ALSmembers.doc      07/07


                      AT A RESIDENCE
                            Assess the patient.
                            Focus on primary complaint.
                            Attempt to educate the patient on their condition and what might happen if
                            not transported.
                             If the Patient refuses Ambulance transport, suggest the patient go by POV,
                            possibly a family member can bring them.
                            Fill out an “old” State Run Form with the patients name and address.
                            Fill in your assessment, vitals and all pertinent information, including
                            pertinent negatives.
                            Document that the patient chooses not to be transported.
                            Sign the front of the “old” State Run Form.
                            Have the patient sign the back statement on the “old” State Run Form.
                            Have someone other than a Provider sign as witness.
                            If there is no other witnesses, a Provider can sign.
                            If the patient is going by POV, ask if they need help to the vehicle, and
                            assist them.
                            Document all times from Dispatch.
                            Place completed „old” Run Form under the EMS Chief‟s door and
                            complete the appropriate ePCR on line.

                      JUVENILE CASES
                           All juvenile cases need to be “signed off” by a guardian or parent.
                           If parent/guardian cannot be reached, transport the juvenile to the
                           Try all possible options to reach them. Involve the Police in telephone
                           approvals of “sign-offs”.
                           An “old” State Run form will be completed and signed by the
                           parent/guardian, if possible, or document the telephone conversation and
                           note “signed-off per telephone conversation” next to their printed name.
18RefusalOfCare.doc    07/07


                   RESIDENCE (10-54)

                               Barrington BLS Members shall not pronounce anyone deceased.
                               Confirm that there are no respirations and pulse.
                               Examine for “obvious conditions incompatible with life”.
                               No excessive movement of the body, just enough for a though
                               assessment and determination of their current condition.
                               Get history from bystanders and determine down time.
                               Determine if the person has a Living Will or Advanced
                               Directives and follow them per State Protocol.
                               Contact Medical Control on the telephone, explain the
                               situation and ask for their determination and direction.
                               When it is determined that nothing can be done for the patient,
                               notify Dispatch, “confirmed 10-54. Please notify PD.”
                               (Current ten code for 10-54 A= Accidental, D= Drowning,
                               N= Natural, S= Suicide)
                               Barrington Police should do the following;
                                       Notify patient‟s next of kin, if not already notified.
                                       Notify the Medical Examiner.
                                       Notify the appropriate Funeral Home.

                               After BPD arrives, turn over the scene to them and leave the area.
                               Document all that was done on an ePCR, including times.

                       MOTOR VEHICLE ACCIDENT (10-26)

                               In addition to the above applicable items:
                               Attempt to shelter decedent from by-standers and the weather.
                               Care for other patients.
                               If asked for information by the Press, just say “you have no
                               comment on the Patient‟s condition.”
                               Barrington PD will handle follow up as above.

19UntimelyDeaths.doc   07/07


           AT THE HOSPITAL:
                       The Primary Care Attendant will complete the on line State Run Form (ePCR) and
                       leave the appropriate copy at the hospital.
                       He/she will give a list of supplies to the other attendants that need to be replaced
                       at the hospital.
                       The other attendants will clean and restock the ambulance with the provided
                       supplies and cleaning agents.
                       The back of the ambulance should be swept out, mopped and disinfected, as
                       necessary. The back benches and walls should be inspected for fluid/stains.
                       The stretcher should be cleaned of any fluid or stains and disinfected.
                       Any equipment used should be wiped down with cleaning solution, including BP
                       cuffs, Stethoscopes ,Pulse Ox unit, etc.
                       Equipment should be returned to its compartment.
                       Oxygen levels should be checked and O2 tanks should be changed at 300psi.
                       Pick up any equipment left at the Hospital from previous calls.

                       The Driver shall advise Dispatch of clearing the hospital and
                      whether the ambulance is in service, available for another call
                      (10-1) or out of service (10-2) unavailable for another call.
                      The Driver shall note any deficiencies and notify the Fire Chief,
                      if he is unable to correct them.
                      The Ambulance Log Book (in the center consol) will be used to document
                      equipment left at the hospital, as well as Ambulance mechanical issues. The same
                      should be noted on the White Board next to the Ambulance in the PSB.

                      The fuel level should be checked when returning to Town.
                      If less then ½ a tank the fuel should be filled at the Town Shed.
                      (REFUELING SOG)
                      IN THE WINTERTIME; rinse the outside down when possible.
                      Assure that the Ambulance is plugged in and all equipment is cleaned and
                      replaced. Backboards should be replaced at the bay.
                       Assure that the back of the ambulance is orderly and clean.
                      List the equipment left at the hospital in the Ambulance Log Book along with any
                      maintenance issues.
                      Any empty O2 tanks are to be placed with the other tanks and a full one goes on
                      the ambulance.
                      If supplies are needed, note what should be replaced in the Ambulance Log Book
                      and on the White Board. Notify the Fire Chief of specific items that need
                      The Run Form(s)/ Billing Form(s) and Run Log(s) should be placed under the
                      EMS Chief‟s office door for secure filing.

20PostCall.doc 07/07

           Restocking of building supplies:
                  If you use the last one, replace it, i.e. toilet paper, hand towels, etc.
                  Items that cannot be replaced, notify someone who can
                          i.e., Chief, Captain or Supply Office

                   Restocking of personal equipment:
                          The Department will replace all disposable items used from personal
                          jump kits.
                          No restocking from the Ambulance.
                          Notify the Chief, Captain or Supply Office if you need supplies
                          There should be supplies in the EMS Supply closet.
                          Try and restock from the Hospital if possible.

                   Restocking the Ambulance:
                          Restock as much as possible from the Hospitals.
                          Notify the Chief or Supply Officer if equipment/supplies are needed
                          and need to be ordered.
                          All the members on a call are responsible for making sure the
                          Ambulance is restocked.

21Restocking.doc   07/07


                            Equipment on the ambulance should not be moved from
                            compartment to compartment without the EMS Chief‟s and/or
                            Captain‟s approval.
                            Any relocation of equipment will be made by consensus of the
                            Division Membership.
                            Final decisions will be made by the EMS Chief.

22AmbulanceEquipment.doc   07/07


                    There is a locked power switch on the outside of the Town Shed that
                    needs to be unlocked and the power turned on.
                    The key is on the Ambulance key ring.
                    The diesel tank is located on the other end of the parking lot. Record
                    the reading on the pump in the Ambulance Logbook.
                    Turn the pump on and start filling the tank.
                    When full, record the reading on the pump in the Ambulance Log.
                    Subtract the before reading from the after reading and note the
                    gallons filled on the Run Log Form
                    Turn the power off on the pump & Town Shed and lock it.

23Refueling.doc   07/07

             RESPONDING IN POV
                  Respond with the flow of traffic, no lights/sirens.
                  Watch out for responding Firemen in their POVs.
                  Park your vehicle in such a way as to not interfere with traffic flow.
                  Remember that Fire Apparatus and other vehicles must enter the scene.
                  Report off on scene to the Ranking Fire Officer.
                  The Fire Officer will tell you where to stage on scene.
                  Relay this info to the ambulance as it arrives.

                    Use lights and sirens when responding to a confirmed fire.
                    Be aware of Fire Department members responding to the call, let them go
                    Ask first responders or the Ranking Fire Officer on scene where to stage.
                    Position the Ambulance so no backing up is involved when leaving the
                    scene, do not get blocked in by apparatus. Set up a safe Rehab area to
                    check vitals in and to cool down the Firefighters.
                    Work with the assigned FD Safety Officer to assure that the Firefighters
                    take appropriate rests, FLUIDS and cool downs to prevent heat related
                    injuries. Watch the Firefighters for signs of heat exhaustion and report it to
                    the FD Safety Officer.
                    Watch out for Fire hose and where it is being laid down.
                    Never drive over a charged hose.
                    Follow MCI protocols if indicated.
                    If MCI situation, consider mutual aid for transportation.
                    The Ambulance is there for the Firefighters.
                    If another Ambulance call comes in while on scene;
                             Dispatch First Responders in POVs to the other scene.
                             Do not take equipment off the Ambulance.
                             Start a Mutual Aid Ambulance.
                    A full crew is to be left at the fire scene.
                    Ask the Fire Officer if the Ambulance is still needed.
                    The Ambulance is only to leave the scene when the Fire Officer
                    releases the Ambulance.
                    Mutual aid should be considered to cover the fire scene until the
                    Ambulance returns.
                    The Ambulance is there to care for the injured at the fire scene.
                    The EMS Providers have no obligation to fight the fire.
                    The EMS Providers should provide the first round of water at the scene.
                    Be sure to restock the drinking water supply at the PSB.
                    The Fire Officer will tell you what you can and cannot do on a fire scene.
                    If near the fire, full turnout clothing is to be worn.
                    The Fire Officer is in charge of the fire scene, and your safety is his
                    responsibility. Think responsibly.

                       24FireStandBy.doc   07/07


                            Fire Department personnel are in charge of all extrication situations.
                            They will gain access to the Patient and assist with extrication.
                            The Ranking Fire Officer will determine if it is safe to approach the
                            extrication scene.
                            All EMS Division members shall follow directions of the Fire
                            Officer, as related to extrication safety.
                            EMS Providers may request that the Fire Department personnel try a
                            particular direction of access to the Patient if feasible and safe.
                            EMS Providers are responsible for the treatment of the Patient.
                            Remember to work as a team.
                            If you are first on scene be sure the scene is safe before you access
                            the Patient.
                            REMEMBER – be part of the solution, not part of the problem.

25Extrication.doc   07/07


                             Any public announcements regarding the EMS Division will be
                             made by the EMS Chief or Captain.

                             If approached by any media person, refer them to the EMS Chief or

26MediaPR.doc       07/07


                      Patient information may only be released by the EMS Chief,
                      or Captain, after an official request, in writing, is reviewed.
                      At no time will any Provider disclose Patient information to any person
                      not directly involved in Patient care.
                      Release of information including State Run Forms, ePCRs, Invoices or PHI
                      based on attorney or press inquiries, Police department and other law
                      enforcement agencies requests will be reviewed by the EMS Chief.

                      The Department will adhere to the “Barrington Ambulance HIPAA Policy”
                      as posted and referenced on the Town of Barrington‟s web site.

                      All Patient care information will be appropriately secured in the PSB by the
                      EMS Chief.

PtInfoRelease.doc    07/07

                Any member cited on route to a Call will be immediately suspended.
                Any member suspected to be under the influence of alcohol and/or
                drugs while representing the Department shall not be allowed to
                leave the scene unattended.
                Any questionable event will be reported to the Chief or Captain
                The event will be investigated by the EMS Chief and Captain to
                determine if further corrective action is required.
                Any member positively found being under the influence of alcohol
                or drugs while representing the Department will be terminated.
28ETOH&Drugs 07/07


                    It is up the individual member to keep current with their NH State Provider
                    License status. The Department will pay for re-certification for those
                    members in good standing. A copy of all current EMS certifications (CPR,
                    National Registry EMT and Provider License) and Drivers License will be
                    provided to the EMS Chief and kept on file at the EMS Chief‟s Office.
                    All Responders will maintain their own continuing education records file
                    for National Registry recertification .

                    First Responders are required to maintain current CPR certification and
                    complete a 12 hour State approved recertification course, or 12 hours of
                    specific continuing education, within their two year certification period.

                    EMTs‟ are required to maintain current CPR certification, have 48 hours of
                    continuing education and complete a State approved, 24 hour, RTP course
                    and practical exam every two years.

29ProviderLicense.doc   07/07



         Probationary members are eligible to request a 50% reimbursement of their
successfully completed initial EMT, or First Responder, course after 6 months of active
service. After an additional 6 months of active service a member may apply for
reimbursement of the remained of their initial course costs, including testing. All requests
for reimbursement will be in writing and submitted to the EMS Chief for approval.


       Any active member in good standing, who re-certifies their current EMT/First
Responder/CPR certification, will be reimbursed for their RTP, and testing, after
successful completion of the course. All requests for reimbursement will be in writing and
submitted to the EMS Chief for approval.


        Any active member in good standing is eligible for 50% reimbursement of the cost
of any Advanced Level Course upon successful completion and the other 50% after 6
months of active service. The 6-month waiting period may be waived based on years of
service. Active members considering an Advanced Level Course must consult with the
EMS Chief prior applying for the Course to enable the EMS Chief to assess the benefit to
the Town and plan the reimbursement within the Town budget cycle.


        For continuing education courses and expenses, the request for reimbursement must
be in writing and submitted to the EMS Chief before the course begins. Each member may
be allotted up to an amount calculated by multiplying the number of Incentive Points
earned by $1.00, per calendar year (January to December). Additional reimbursements will
depend on the amount of available funds.
MILEAGE/EXPENSES (This Section may be deleted in 2008)

       All Licensed Providers are eligible for a fixed personal vehicle mileage

        Due to the variability in response patterns and routes the EMS Chief has made the
following “deemed reckoning” for expense reporting purposes based on the Town‟s
current (40.5 cents) per mile reimbursement.

         1.          All Responders on scene, ready, willing and able to perform as a Licensed
                     Provider will be logged with ten (10) miles, total round trip for the call.
         2.          All Responders transporting the Patient to the Hospital in the Ambulance
                     will be logged with twenty (20) miles, total round trip for the call.
         3.          The EMS Chief will rely on the Run Log Forms to document the
                     Responders on scene and transporting. The Reimbursement forms will be
                     completed by the Chief and be filed, individually, with the Town for
                     payment on a quarterly basis.

INCENTIVE PAYMENTS (This Section may be revised in 2008 to include a fixed
Point value of $15)

        Starting in 2006, and continuing as long as included in the Town approved budget,
all Members (excluding paid Staff) with current Providers Licenses will be eligible for
“Incentive Payments” based on the following Point System.

        1. One point will be recorded for each Responder on scene, ready, willing and
able to perform as a Licensed Provider.
        2. A second point will be recorded for each Responder on scene, ready,
willing and able to perform as a Licensed Provider on daytime calls
weekdays from 05:00 thru 17:00.
        3. One additional point will be recorded for each Responder transporting a
Patient to the Hospital in the Ambulance.
        4. Points will be accrued by the Responders from January 1st thru December 31st
of the current year and recorded by the EMS Chief based on Run Log form entries.
        5. The total number of points accrued by all Responders will be divided into the
current Incentive amount budgeted. The resultant will be multiplied by each
Responder‟s individual point accrual to calculate the Responder‟s payment.
        6. During the first week in January the EMS Chief will submit an individual
payment voucher to the Town for each eligible Responder.
        7. Any questions on the results of the above process shall be presented to the EMS
Chief in writing. If the question can not be resolved by the EMS Chief, the question shall
be forwarded to the Town Administrator for final disposition.
                     Barrington Ambulance Department
                             Dispatch Protocol

After Strafford Dispatch receives a direct call, or 911 request, for the Ambulance:

 a. Dispatch Barrington Ambulance (950) via Alphanumeric Pagers (please keep the message to
less than 80 characters) followed by the Tone pagers. (please trip tones twice prior to delivering
the message)

         BETWEEN 05:00 and 17:00 Monday thru Friday After paging 950,
                        immediately START the applicable Mutual Aid Service to the call.

- AFTER (5) five minutes, without a 950 Crew of two (2) Licensed Providers signing on,
                   RE-PAGE/Tone 950 and START the applicable Mutual Aid Service.
                             If Mutual Aid has been started note that as part of the re-tone.

 - If Barrington 950 has a crew, advise them which Mutual Aid Service was started, it will be up
to them to cancel the Mutual Aid Service based on the call and qualifications of the crew.

- When Barrington 950 goes 10-1 to the scene, inform the crew of any Hospitals on Diversion.

- If there is no available 950 crew, the Mutual Aid Service will take the call.

b. Critical Documentation: Time of FIRST Page, Time of FIRST Responder on scene, Time
ANY ambulance goes 10-1 in route, 10-2 on scene, 10-1 to the Hospital, off with ALS
Intercept, in route with ALS, 10-2 at the Hospital, 10-1 back to quarters and 10-2 in quarters.

c. Mutual Aid Services by EMS District (see attached Road Lists):
 1. Frisbie EMS Ambulance (450) will cover most of Barrington with ALS service.
 2. Dover Fire & Rescue Ambulance will cover Rte. 9 and Toland Road to Route 125
    if Frisbie EMS is not available, will also do ALS Intercepts with 950 going to WDH.
 3. Durham/McGregor Ambulance will cover Rte. 4 and Rte.125 south of Beauty Hill Road,
    some ALS and will do some ALS Intercepts.
 4. Nottingham Ambulance will cover the Rte. 4 area, some ALS, and has day time coverage.
 5. Northwood Ambulance will cover the west end of Rte. 202 and 9.
 6. Strafford Ambulance (650) may cover the Northwest quadrant of Barrington, evenings and
weekends, if Frisbee EMS Ambulances are unavailable.
 7. CarePlus, AMR, Great Bay Ambulance or other commercial services will take all Group
Home and non-emergency transports i.e. Pond View, unless it is an EMERGENCY call.
 8. Frisbie EMS will perform inter-facility transfers and transport their Patients from their
facility on Rte.125 to FMH without triggering the 911 system or signing on with Dispatch.

31DispatchProtocolT.doc   12/31/05
                     B.A.D. RADIO CALL-IN PROTOCOL

1.   Be sure you are on the correct MED frequency for your destination hospital.
2.   Speak into the mic clearly
3.   Convey the information required in an organized manner such as below:

     AHospital name...Hospital name Bthis is Barrington Ambulance on MED #          with
     status ____ traffic. How do you copy me?” (Wait for response or repeat until the
     hospital acknowledges you.)

     “We are currently inbound to your facility with a ____ year old male/female patient
     of Dr. ___________________ who has/has not been notified.

     The patient=s chief complaint is

     We found the patient _______________, or the history of the chief complaint is
     ________________, or the mechanism of injury was

     Vital signs are as follows:

     L.O.C., pulse rate/quality, BP, respiration rate/quality, lung sounds, pupils, skin
     color/temperature, SPO2, BGM (sugar at xxx Mg/dL), monitor (showing a non-
     shockable rhythm), etc. Check BGM, if used, and record on PCR.

     Past medical history is as follows:

     Allergies, medicines/doses, last meal-time/substance, pertinent medical history.

     List current treatment i.e. patient is resting comfortably on the stretcher, O2 applied
     at ____ lpm, current SPO2, monitor applied, 4 baby aspirins given at 00:00, collar,
     short board and long board applied, etc.

     Our ETA to your hospital is _____________ minutes. We are operating at the
     Basic/Intermediate/Paramedic level.

     Do you have any questions or instructions?” Acknowledge and plan to act on
     “Barrington Ambulance clear.”

4.   Hang up the mic and monitor the MED channel.
5.   Continue to treat the patient, put gear away and organize your notes to complete the
     ePCR at the receiving Hospital.
6.   Turn the radio and compartment lights off and clean up when the call is over.
32RadioProtocol.doc       07/07

                                  ALS INTERCEPT PROTOCOL

1.         The Primary Care Attendant may request an Intercept from an Advanced Life
           Support (ALS) service at anytime depending on the nature of the call, location or
           target hospital.

2.         ALS Intercepts from Frisbee Memorial Hospital (FMH) EMS for Patients going to
           FMH shall be requested on the FMH EMS radio channel or by calling the FMH-
           EMS Dispatcher at 332-3222.

3.         ALS Intercepts from Dover Fire Department (DF&R) for Patients going to
           Wentworth Douglas Hospital (WDH) shall be requested on the Dover Dispatch
           phone line 742-4646.

Note: Either ALS service will go to either hospital, as their protocols allow.

4.         Once initial contact is made:
           a. Identify yourself as ABarrington Ambulance.@
           b. State that you are requesting an ALS Intercept for a patient going to FMH or
           c. Provide a brief Patient status.
           d. Provide your route to the target hospital, a suggested rendezvous point and
                   estimated time of arrival (ETA).
           e. Ask for the responding ALS service to contact you on FMH EMS for FMH-EMS
                   or MED 4 for DF&R.
           f. Do not allow the Dispatcher to keep you Aon the line@ if it in any way interferes
                   with Patient care.

5.         Once the responding ALS service is on responding contact them on the appropriate
           radio frequency with a Patient update and your location.

6.         Once you have met the Intercept assist them in moving their equipment into our rig
           or in moving the Patient into their rig. Do not leave the Patient alone at any time.

7.         Proceed to the target hospital and complete the ePCR to include (at least) all
           information up to the point of Intercept, including the time ALS arrive.

33InterceptProtocol.doc   07/07
                        Barrington Fire & Rescue
                        EMS RESPONDER LIST
                             July 13, 2007

#       NAME                    PROVIDER LIC. #      PHONE / Pager
    Joel Sherburne,           Founder       276      664-5721 / 664-2231
940 Rick Walker,            Fire Chief    18773      396-4469 / 517-6627
951 Tony Maggio,            EMS Chief      4135      969-4361 / 376-6160
952 Nick Roun,               Captain      10558       973-2479 / 376-6164
953 Shawn Croteau,          Lt. Training 16857 P      868-1841 / 564-1117
954 Dan VanDusen                          18912       335-3754 / 376-6169
955 Mike Ferullo,            Lt. Supply 16343 I       817-8946 / 564-7270
956 Chris Lemelin                         19357 I     664-2812 / 376-6167
957 Bill Lee                              20227      303-5638 / 376-3436
958 John Boodey                           20747 I     664-5009 / 376-4406
959 Suzanne Dion                           20734 I    918-6312 / 376-4407
960 Will Lenharth                          12648       664-7647 / 517-1857
961 John Trumbull                          15256 I    817-2884 / 376-6162
963 Josh Gagnon                            21244 I     842-2825 / 376-6651
965 Nate Dionne                            22021       781-4295 / 376-3444

BF&R (request Strafford page a Driver thru Durham Dispatch ONLY if 2 Licensed Providers are on
scene and they request the Ambulance; OR if just a Lift Assist is required, request two Firefighters.)
 #     NAME        Provider Lic.#       #    NAME              Provider Lic.#
941 Phil Boodey         Driver            947 Pat Boodey                Driver
943 Don Millette        Driver            944 Jon Janelle               Driver
945 Tim Boodey           Driver           980 Paul Sanders              Driver
10C4 Eric Lenzi         15284 B                 Jim Lewis               Driver

    Strafford Dispatch 742-4968  Fax 743-4921 pager 376-3672
     Dover Dispatch – 742-4646 FMH Dispatch – 332-3222 Durham Dispatch – 862-1392

        950 NEXTEL Cell Phone # 817-0745 180*11*55075
PUBLIC SAFETY BUILDING (#249)          EMS Office 664-7394
         Fire Office 664-2241 fax 664-5417      Police Office 664-7679

FMH-ER 335-8132 fax 335-8135 FMH Med Control 335-8447
 WDH-ER 740-2163 fax 740-2246 PRH-ER 433-4042 Exeter Hosp. 778-6793
NH Poison Control (800)222-1222 NH State Police (800)525-5555
      Cemtrec (800) 424-9300         FMH Urgent Care 664-0955
       AMR 742-2117 (800) 424-9300         Care+ (800) 292-9177
                     DAC Nextel 396-9651/9653 * 34711/34710
DCYF Reporting (800) 894-5533               Elder Abuse Reporting (800) 351-1888
   Domestic Crisis Hot Line (800) 852-3388      PSNH (800) 386-4086

Tony - (w) 335-2535         Rick - (h) 332-3944


NH RSA # 259:28, 265:8, 265:33, 265:61, 266:73, 266:74 (attached)

NH Rules He-P 1200 Emergency Medical

NH Patient Care Protocols

Town Personnel Policy

TEMSIS System Overview

47References.doc   07/07

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