This page contains information on EMS operations including System approved abbreviations, sharps and medication info, ambulance inspections, patient care reporting, and commonly used operations FORMS with links to the IDPH website.
SYSTEM APPROVED LIST OF ABBREVIATIONS:
Per the request of our EMS Personnel, we have a list of System approved ABBREVIATIONS. Please feel free to view or print for training.
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.
https://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 outside sharps for return/waste.
DESIGNATED INFECTION CONTROL OFFICER: Many System Coordinators found this site helpful for an online D.I.C.O. class option:
PATIENT CARE REPORTING:
All SCEMSS agencies are now required to be fully electronic in their data collection and submission. PCRs are required by law to be left at the receiving facility on every EMS run.
SILVER CROSS HOSPITAL PRINTERS:
Silver Cross Hospital has 1 HP M602 printer with a USB cord for our laptop/toughbook users to plug into for direct printing. Here are the HP M602 drivers. We also have 1 HP LaserJet Pro M203dw AIR PRINTER for our iPad users. Air print/iPad providers must set-up our secured Wi-Fi network prior to attempting to print to our air printer. Contact the Operations Coordinator for the network information OR for the Silver Cross PCR fax and/or email. For print information at other hospitals, please contact them direct.
IDPH NEMSIS COMPLIANCE:
Agencies, it is up to you to ensure your software vendors are compliant with the State’s current data set. Visit the IDPH website for current information.
ZOLL SOFTWARE USERS:
Agencies using Zoll are NEMSIS compliant, have an established user group with Will County 9-1-1, and meet regularly. The Will County 9-1-1 user group and its entities shall ensure all runs are submitted to the State.
IMAGE TREND SOFTWARE USERS:
Agencies using Image Trend are NEMSIS compliant, have a user user group and are meet regularly. Image Trend and its users shall ensure all runs are submitted to the State.
ESO/FIREHOUSE AND OTHER SOFTWARE USERS:
Agencies using ESO and other software vendors shall ensure NEMSIS compliance and that all runs are submitted to the State.
IDPH performs in-person inspections for all new vehicles and vehicles returning to service after lengthy out-of-service periods. Agencies are required to notify the System Operations Coordinator of all inspection dates prior to the inspection in case the State inspectors fail to make notification to the System.
Click here for the IDPH INSPECTION FORMS AND FEE PAYMENT WEBSITE.
ANNUAL TRANSPORT INSPECTIONS: IDPH inspectors typically contact Agency Coordinators direct to schedule annual transport vehicle inspections 2-3 months prior to the annual license expiration date. If you have not heard anything 3 weeks prior to your vehicle license expiration send an email to the System’s Operations Coordinator requesting assistance. Once the inspection is scheduled, it’s required that the Agency EMS Coordinator send an email to the Operations Coordinator with the inspection date and time prior to the inspection. The System will try to attend inspections as schedules allow. PLEASE REMEMBER TO PAY YOUR TRANSPORT AMBULANCE RENEWAL FEES PRIOR TO THE INSPECTION WHEN POSSIBLE. Click here for the IDPH PAY VEHICLE FEE(s) link. Enter your 4 digit provider number then click enter. A list of vehicles in need of payment will present. If you need your agency PIN or if something looks incorrect, contact the System Operations Coordinator. Pay your vehicle renewal fees early so that your licenses will renew and print once the inspectors enter your inspections into the IDPH database. Pay online at the IDPH WEBSITE. Type your 4 digit provider number then hit enter. A list of vehicles due for payment will present. If you need your PIN, contact the System Operations Coordinator.
ANNUAL NON-TRANSPORT INSPECTIONS: IDPH typically allows agencies to self-inspect their own non-transport vehicles for annual renewals. ALL NEW VEHICLES MUST BE INSPECTED BY A STATE INSPECTOR REGARDLESS OF TRANSPORT OR NON-TRANSPORT. All Silver Cross non-transport vehicles expire July 31st every year. You will need to use the IDPH Non-Transport Self Inspection form directly from the IDPH website link below. Fill out/type in all information into the PDF fillable document prior to printing. Do not leave any fields blank as all info is required. In the comments section type “10+ triage tages present, 2 Narcan expiration dates are ___ and ___, and ALS ONLY include 2 Epi Expiration dates are ___ and ___”. IDPH does not allow hand written forms and only forms from their website will be accepted. Make sure your NT number is correct by looking at your actual license that was printed the year prior. Your non-transport provider number is your transport license number with the letters NT after it (example 7123NT). Sign only in the space that states “Pre-Hospital Care Provider/Owner or Representative”. Please DO NOT sign on the “EMS System Coordinator” line. Send completed forms to the System BEFORE July 1st. The System has to have time to review, sign, and submit to IDPH for processing prior to the license expiring.
NEW VEHICLE INSPECTIONS: When putting a new vehicle into service remember to allow enough notice for scheduling the inspection prior to the new rig’s arrival. Fill out the PDF fillable Sys-Mod Form (from above IDPH website), taking the old vehicle OOS (if applicable) and adding the new vehicle. Do not leave any of the drop-downs blank as all info is required. If you are ever unsure which drop-down is appropriate, list OTHER then type into the notes section. IDPH does not allow hand written forms and only forms from their website will be accepted. Email the completed Sys-Mod to the Operations Coordinator with the assumed date the vehicle will be ready for inspection. The System will sign and forward the form to IDPH with the ready dates you list. Prior to IDPH coming out, print the appropriate Inspection form from the IDPH website above (to ensure the most recent form is used for reference) and pre-inspect your vehicle to make sure it is ready. Review the System policies below to ensure all System required equipment is present as well.
VERY IMPORTANT INFO REGARDING IDPH FORMS:
The IDPH EMS WEBSITE is the ONLY location where IDPH forms shall be printed. Using saved/stored forms from anywhere else will cause delays. Visit the website to find commonly used forms for Inspections, Vehicle changes “Sys-Mod” forms, EMS Personnel Renewal Notices and Vehicle Licensing forms. IDPH updates these forms without notice and will not accept old/outdated forms.
Most forms used in daily EMS operations are located on the POLICY PAGE, however some of the more frequently requested forms may be found below:
PRINT THESE IDPH FORMS FROM THE IDPH WEBSITE: http://dph.illinois.gov/topics-services/emergency-preparedness-response/ems/prov-vehLic then scroll down to the desired form.
REFRESH YOUR BROWSER TO ENSURE YOU HAVE THE MOST CURRENT FORM.
If you have trouble printing the form, try downloading it first.
Some browsers hold onto prior data links which may cause you to pull an old form. IDPH will NOT accept outdated forms.
Here is a list of some of the most commonly accessed forms:
IDPH Ambulance Inspection Form
IDPH Non-transport Vehicle Inspection Form
IDPH EMS System Plan Modification Form AKA: “Sys-Mod”
IDPH Equipment/Vehicle Waiver Request Form
IDPH Special Events Request Application
SCROLL DOWN TO “EMS Testing & Education” for this form:
IDPH TRAINING PROGRAM APPLICATION (a.k.a. Site Code App)
Send completed Site Code Apps to the Education Coordinator.
All other forms above should be sent to the Operations Coordinator.
COMMONLY ACCESSED SYSTEM POLICIES LINKED TO POLICY PAGE:
Ambulance Requirements Policy 300-39
BLS Required Equipment Policy 300-4 Revised 3/1/22
ALS Required Equipment Policy 300-6 Revised 3/1/22
Non-Transport Policy 300-9 Revised 3/1/22
Medication Policy 300-37 Revised 3/1/22
NEW Pharmacy Order Form REVISED 3/1/2022
PLEASE DO NOT alter this pharmacy form and only email one form per email.
Monthly Controlled Substance Inventory Log
NEW Monthly Controlled Substance Inventory Log (MS removed) Revised 3/1/22
PYXIS Policy & Instructions Policy 300-69
DNR/POLST Policy 300-50 Link to Instructions and DNR/POLST FORM
Multiple Patient Refusal/Release Policy 300-65
Refusal Policy 300-55 with Release Form
Out-of-Service Ambulance Form Policy 300-13
Link to Illinois ADULT petition:
Link to Illinois MINOR petition:
Contact email@example.com Operations Coordinator for questions regarding SCEMSS Operations.