Specifications include, but are not limited to: A. Medical Director services shall be provided for the San Juan County Fire & Rescue (SJCFR), the San Juan County Sheriff’s Department (SJCSD), the San Juan County Communication Authority (SJCCA), and the San Juan Regional Medical Center Emergency Medicine Services (SJRMC EMS) ambulance service; B. Medical Director services for SJCSD shall routinely be coordinated through the SJCFR Emergency Medical Services (EMS) coordinator, or when needed, directly with the SJCSD. C. Medical Director services for additional smaller agencies, operating within the County or the immediate border of San Juan County, can be extended by mutual agreement between SJC & the Medical Director. Such additional medical director services shall be coordinated through the SJCFR Medical Services (EMS) coordinator. D. Medical Director services shall be represented equally by one or all of its contracting members in its communication and actions while acting as medical director, as described in items (A) through (D) above. E. The Medical Director shall spend approximately 210 hours per quarter (including commuting travel time) attending to multiple tasks, including, but not limited to, items (I) through (XV) listed below. However, as the needs of the above agencies listed in item (A) above evolve, additional tasks may become necessary: I. Continually review, and revise as necessary, existing treatment algorithms and guidelines for BLS & ILS Fire/Rescue governing the medical aspects of patient triage, treatment, transport, transfer, dispatch, extrication, rescue and communication; II. Continually review, and revise as necessary, existing treatment algorithms and guidelines for ALS & ILS Rescue governing the medical aspects of patient triage, treatment, transport, transfer, dispatch, extrication, rescue and communication; III. Create, as become necessary, new treatment algorithms and guidelines for BLS & ILS Fire/Rescue governing the medical aspects of patient triage, treatment, transport, transfer, dispatch, extrication, rescue and communication; IV. Create, as become necessary, new treatment algorithms and guidelines for ALS & ILS Rescue governing the medical aspects of patient triage, treatment, transport, transfer, dispatch, extrication, rescue and communication; V. Continually review, and revise, or create new, as necessary, existing treatment algorithms and guidelines for: a) Handling emergency treatment of a minor, especially in cases where that patient refuses treatment and transport; b) Interaction with an intervening health care provider at the scene of an emergency; c) Not beginning or terminating life support measures in patients with valid EMS do not resuscitate (DNR) orders, hospice protocols, other legally recognized advanced directives, and obvious signs of death; VI. Establish and monitor the BLS & ILS Fire/Rescue training standards for initial and continuing medical education as submitted by the SJCFR EMS Coordinator; VII. Establish and monitor the ALS & ILS Rescue training standards for initial and continuing medical education as submitted by the SJRMC EMS Director and the SJCFR EMS Coordinator; VIII. Provide targeted BLS & ILS Fire/Rescue EMS education for personnel within the SJCFR and associated services; IX. Provide targeted ALS & ILS Rescue EMS education for personnel within the SJRMC EMS ambulance service, and as applicable to those within the SJCFR service, as described in items (A) and (B) above; X. Establish and monitor field performance standards for SJCFR and associated fire department EMS personnel by meeting at least quarterly with District EMS officers; XI. Establish and monitor field performance standards for SJRMC EMS personnel by meeting at least bimonthly with SJRMC EMS director, supervisors, and staff; XII. Develop and implement a system for ongoing medical audit of BLS & ILS Fire/Rescue prehospital patient care including: a) Writing and promulgating a mechanism for receipt, investigation and resolution of medically related complaints about the EMS service; b) Conduct reviews and discussions with Fire/Rescue personnel operating within the service by attending the monthly districts’ EMS officers’ meetings;
