San Andreas Medical Department

Standard Operating Procedures

Table of Contents

  1. Ethics and Standards

  2. Professional Conduct

  3. Chain of Command/Open Door Policy

  4. Disciplinary Procedures

  5. On Duty/Off Duty Staffing Policy

  6. Shootings

  7. Department Values

  8. Attendance Policy

  9. Ride-Along Policy

  10. Training Academy

  11. Equipment for Duty

  12. Radio Communications

  13. Angel 1 Certification

  14. Terms and Conditions

  15. General Addendum

1. Ethics and Standards

Professional Behavior

  • Conduct: Members must not engage in any behavior, whether in or out of RedSky, that disturbs peace, neglects duties, undermines the operation, effectiveness, or discipline of the San Andreas Medical Department (SAMD), or brings discredit to SAMD or its members.

  • Harassment and Assault: Threats, harassment, or assault of any nature towards any member are strictly prohibited. Members who contribute to, encourage, or provoke conflicts will be held accountable.

  • Public Interaction: Members must greet the public with professionalism and kindness. Interactions should be respectful, polite, and use clear language without slang or offensive words. When asked, members must provide authorized information, including name, title, and callsign.

Legal Compliance

  • Criminal Associations: Members are prohibited from joining or associating with individuals, groups, clubs, societies, or organizations whose activities involve breaking the law. Violations may result in dismissal or disciplinary measures.

  • Criminal Activity: Members must not engage in any criminal activity or break any laws, whether on or off duty.

Emergency Calls

  • Obligation to Respond: Members shall not refuse any emergency call, except if:

    • The patient is married to or in a known romantic relationship with a SAMD member.

    • The patient is requesting or repeatedly requesting a specific SAMD member.

Non-Discrimination

  • Equal Treatment: Members must not discriminate against any individual based on race, gender, religion, political affiliation, nationality, sexual orientation, or gang/organization affiliation.

Privacy and Confidentiality

  • Recording Prohibition: Recording, photographing, or live streaming interactions with patients is strictly prohibited, as it violates the Health Insurance Portability and Accountability Act (HIPAA). This applies in both hospital settings and emergency response scenes.

Relationships Among Members

  • Romantic Relationships: Members may form romantic partnerships with other SAMD members but must report the relationship to a High Command member as soon as both parties acknowledge their intentions.

  • Restrictions:

    • Couples may ride together but cannot provide FTO training to each other.

    • If the relationship ends, both parties must notify High Command and agree to work together professionally or risk termination.

Use of Medic Abilities and Equipment

  • On-Duty Usage Only: Medic abilities and equipment are to be used exclusively while officially clocked in and performing EMS duties.

  • No Exceptions: There are no exceptions to this rule. Off-duty members must not provide medical assistance under any circumstances.

  • Disciplinary Action: Unauthorized use will result in immediate disciplinary action, up to and including termination.

2. Professional Conduct

Behavior and Communication

  • Respectful Behavior: Members are expected to conduct themselves with professionalism and respect towards colleagues, other departments, emergency personnel, patients, and the public.

  • Compliance with Orders: Members must promptly adhere to all orders and instructions given by Command. Concerns should be addressed through the Chain of Command (CoC) respectfully.

  • Language: Derogatory, disrespectful, or critical language is prohibited. Communication should be clear, courteous, and professional.

  • Conflict Resolution: Conflicts should be resolved through the CoC and constructive dialogue. Physical or verbal altercations are unacceptable and may result in disciplinary action.

Confidentiality and Privacy

  • Sensitive Information: Members must maintain the confidentiality of patient records and departmental matters. Violations will result in severe consequences.

Professional Appearance

  • Uniform Guidelines:

    • Standard Work Week (Monday - Thursday): Wear the button-up uniform.

    • Weekend (Friday - Sunday): "Weekend Uniform" and shorts are permitted.

    • Exceptions: Members in Tactical Emergency Medical Support (TEMS) or piloting aircraft.

Accountability and Integrity

  • Honesty and Integrity: Members must act with honesty, integrity, and accountability. Unethical behavior will be investigated and may lead to termination.

Representing SAMD

  • Upholding Values: Members must uphold the department's values and reputation on and off duty. Actions that reflect negatively on SAMD are prohibited.

Common Sense and Standard Protocol

  • Expectations: Members are expected to exercise good judgment, common sense, and adhere strictly to established protocols.

  • Unusual Situations: Default to the safest and most ethical course of action aligned with departmental values.

  • Seeking Guidance: When in doubt, seek guidance from a higher-ranking member unless immediate action is required to prevent loss of life.

3. Chain of Command/Open Door Policy

Respecting the Chain of Command

  • Hierarchy Recognition: Members must recognize and respect the chain of command in all official communications.

  • Expedited Communication: Immediate command members may bypass the chain if justified by necessity.

Roles and Responsibilities

  • High Command Members (E-01 to E-07): Authorized to make final decisions on departmental matters, policies, and exceptions.

    • E-01 | Chief: Oversees the entire department and manages all personnel and activities.

    • E-02 | Deputy Chief: Manages human resources, employee relations, and disciplinary actions.

    • E-03 | Assistant Chief: Oversees administrations, training programs, and protocol development.

    • E-04 to E-05 | Captain: Directs operations, oversees day-to-day activities, and assists in training.

    • E-06 to E-07 | Lieutenant: Understands team strengths and weaknesses, serves as communication conduits.

  • Command Members (E-08 to E-15): Include Senior Doctors and Doctors who provide advanced medical care and assume leadership roles.

  • SAMD Members (E-16 to E-38): Nurses, Paramedics, EMT Advanced, and EMS who provide fundamental life support and assist in patient care.

  • Probationary Members (E-39 to E-42): New hires undergoing training to become certified EMTs.

Authority and Decision-Making

  • High Command Exclusivity: Only High Command can make final decisions. Authority cannot be delegated.

  • Respecting Decisions: Members must comply with High Command decisions without attempting to circumvent or undermine authority.

  • Regular Chain of Command: For routine matters, follow the standard chain of command.

Absence of Command

  • Default to "No": If no High Command members are available, requests for exceptions are automatically denied.

  • Adherence to Protocol: Continue following standard protocols. Unauthorized decisions may result in disciplinary action.

Promoting a Supportive Environment

  • Open Communication: Encourage transparency regarding personal needs or challenges.

  • Mutual Respect: Handle conflicts respectfully, listening actively, and collaborating on solutions.

  • Active Support: Support colleagues professionally and personally.

  • Cultivating Collaboration: Strengthen bonds through collaboration and open dialogue.

  • Valuing Diversity: Embrace diversity to enrich the work environment.

Complaints Procedure

  • Initiation: Any SAMD member, LEO, or civilian may file a complaint.

  • Logging: Complaints are logged using appropriate channels in the SAMD Discord.

  • Investigation: The highest command member on duty initiates an investigation and notifies High Command.

  • Resolution: Determined based on findings, with feedback provided to all parties.

  • Documentation: Complaints are documented and filed for future reference.

  • Interdepartmental Complaints: Addressed by High Command with the respective department's leadership.

4. Disciplinary Procedures

High Command Authority

  • Rights to Remove: High Command reserves the right to remove employees at any point with proper documentation or reasoning.

Major Offenses of Misconduct

  • Immediate Dismissal: Members may face dismissal for:

    • Harassment, intimidation, or threatening behavior.

    • Use of force, violence, or unlawful tactics.

    • Conduct inconsistent with duty, eroding public confidence, or disrupting internal harmony.

Minor Offenses of Misconduct

  • Progressive Discipline: For minor infractions such as:

    • Citizen or facility complaints.

    • Being clocked on without performing duties.

    • Unprofessional behavior.

Progressive Discipline Steps

  1. First Strike: Verbal Warning (Documented) - Possible up to 2 days of unpaid administrative leave.

  2. Second Strike: Written Warning - Disciplinary action determined by the Chief, may include demotion and up to 2 weeks of unpaid leave.

  3. Third Strike: Minimum of 2 weeks unpaid leave or possible termination.

  • Issuing Warnings: Lieutenants and above may issue minor disciplinary actions. All warnings are documented and forwarded to High Command.

Zero Tolerance for Loopholes

  • Strict Enforcement: All rules are enforced without exception. Attempts to exploit loopholes are not tolerated.

  • Edge Cases: In unspecified situations, adhere to the spirit and intent of the rules.

  • Circumvention Prohibited: Efforts to undermine policies result in disciplinary action.

5. On Duty/Off Duty Staffing Policy

Clocking In/Out

  • Time Logging: Clock in/out using the “SAMD Time Clock” channel in Discord.

  • Proper Uniform: Members must be in the prescribed uniform when clocking in.

  • Secondary Job: Obtain a secondary civilian job and switch to it when off duty.

Off-Duty Protocol

  • No Medical Assistance: Off-duty personnel must not provide medical assistance or use medical equipment.

  • No Response to Calls: Do not respond to personal requests or intervene in medical situations while off duty. Direct individuals to official channels (e.g., 311).

  • Equipment Usage: Off-duty personnel are not permitted to carry or use medical equipment. Store all equipment securely.

  • Radio Channels: Do not access SAMD or emergency radio channels when off duty.

  • Substance Use: Substance use is strictly prohibited on duty. Off-duty personnel may drink responsibly.

6. Shootings

Safety Protocols

  • Avoid Active Shootouts: Do not enter areas with active shootings. Leave immediately if a shootout arises.

  • Threats: If threatened while treating someone, stop immediately and leave.

  • Scene Clearance: Wait for confirmation via phone call or 311 that a scene is clear before responding.

  • Red Zones and Prohibited Areas: Do not respond to Red Zones, Cayo Perico, Mount Chiliad, or Boilingbrook (unless accompanied by PD).

7. Department Values

  • Integrity: Uphold honesty and fairness in all interactions.

  • Compassion: Demonstrate kindness and empathy towards all citizens.

  • Responsibility and Accountability: Own your actions and accept consequences.

  • Respect: Treat everyone with dignity, regardless of differences.

  • Commitment: Dedicate yourself to duties with professionalism.

  • Teamwork: Foster collaboration, unity, and support among team members.

8. Attendance Policy

Attendance Requirements

  • Minimum Hours:

    • Command/High Command: 4 hours per week

    • Senior Doctor/Doctor: 4 hours per month

    • Paramedic-EMS: 4 hours per month

    • Trainee: 4 hours per month

  • Time Logging: Use the SAMD Time Clock form.

  • Communication: If unable to meet requirements, communicate intentions or request a Leave of Absence (LOA) via the “LOA-Request” channel in Discord.

Leave of Absence (LOA) Clause

  • LOA Duration: Any absence exceeding three (3) days results in temporary removal from the position.

  • Reinstatement Process: Upon return, undergo a re-onboarding procedure similar to initial hiring, including a review of current protocols and SOP updates.

  • No Rehiring Process Required: Reinstatement does not require reapplication but must demonstrate competency and compliance.

  • Communication Requirement: Notify High Command prior to taking leave. Failure to communicate may result in additional disciplinary action.

Termination Policy

  • Failure to Meet Hours: Without communication or LOA, termination will occur.

  • Rehiring Eligibility:

    • First Termination: Eligible after 14 days.

    • Second Termination: Eligible after 30 days.

    • Third Termination: Rehiring is not permitted.

9. Ride-Along Policy

Authorization

  • Permission Required: Ride-alongs are permitted only with High Command approval.

Restrictions

  • Attire: Civilians must not wear kuttes or organization-affiliated clothing.

  • Non-Interference: Civilians cannot get involved in EMS matters during the ride-along.

10. Training Academy

Trainee Requirements

  • Training Hours: At least 6 hours of training with an FTO or High Command member before approval to work alone.

Field Training Officers (FTOs)

  • Role: Provide comprehensive training, guidance, and assessment to new recruits.

  • Selection: Carefully chosen based on passion for teaching and dedication.

  • Lead FTO: Oversees FTOs, ensures proper training, maintains paperwork, and updates forms.

11. Equipment for Duty

Required Items

  • Medical Bag

  • Medicine Box

  • LEO GPS

  • Saline

  • X-ray Machine

  • Neck Braces

  • Leg Braces

  • Arm Braces

  • First Aid Kits

  • Bandages

  • Wheelchair

  • Stretcher

  • Body Bandages

  • Morphine

  • Syringes

  • Radio

  • Driver's License

  • Pilot’s License (if applicable)

Medical Bag

  • Usage: Primary tool for treating patients in the field.

  • Contents:

    • Saline

    • X-ray Scanner

    • Neck Brace

    • Body Bandage

    • Arm Brace

    • Leg Brace

    • Stretcher

    • Wheelchair

  • On-Duty Use Only: Use only while on shift. Unauthorized off-duty use may result in disciplinary action.

Medicine Box

  • Usage: Holds medical supplies for field treatment.

  • Contents:

    • Bandages

    • Medkit

    • Morphine 30mg

    • Syringe

  • Prohibited Items: Paracetamol and Morphine 5mg tablets are unauthorized.

Control and Use

  • Authorized Use Only: Equipment is for official EMS duties while on duty.

  • Prohibited Distribution: Do not provide or distribute equipment or medications to unauthorized individuals.

  • Accountability: Responsible for the security and proper use of assigned equipment.

12. Radio Communications

Communication Etiquette

  • Clarity and Respect: Speak clearly, concisely, and respectfully.

  • Discretion with Humor: Avoid remarks that may offend or lead to complaints.

  • Respect for Command: Extend respect to Command Team members.

Channel Usage

  • Channels:

    • Channel 1: PD (EMS should not use)

    • Channel 2: EMS (Primary channel)

    • Channel 3: Fire Department

  • Protocol: Upon clocking in, switch to Channel 2. Do not access PD channels.

Radio Protocol

  • Highest-Ranking Member: Handles incoming calls from LEOs. If unavailable, the next highest assumes communication.

  • Communication Format: Use the "hey you, it's me" approach.

    • Example: “E-03 to E-01” or “E-01 from E-03”

  • Minimize Traffic: Avoid unnecessary conversations; use alternative communication methods for non-urgent matters.

13. Angel 1 Certification

Purpose

  • Specialized Training: Equips EMS providers with skills for specific emergency situations like mountain rescues.

Eligibility

  • Ranks: Designed for EMT Advanced and above.

Training and Requirements

  • Rigorous Training: Includes wilderness medicine, technical rescue techniques, navigation, and patient extrication.

  • Certifications:

    • Obtain Pilot’s License

    • Pass SAMD Angel 1 flight test

    • Complete practical assessments and simulations

Deployment and Utilization

  • Conditions:

    • Must have at least 4 EMS on duty to use AIR 1.

  • Responsibilities: Respond to challenging environments, providing advanced care.

14. Terms and Conditions

Compliance

  • Mandatory Adherence: All EMS personnel must comply with the SOPs. Failure may result in disciplinary action.

Confidentiality

  • HIPAA Compliance: Patient information must be handled with utmost confidentiality.

Professionalism

  • Mandatory Conduct: Maintain high professionalism in all interactions.

Safety

  • Priority: Safety of patients, personnel, and the public is paramount.

Equipment Care

  • Responsibility: Proper care and maintenance of equipment and vehicles.

  • Prohibition: Do not hand out medical equipment under any circumstances, except up to 5 regular bandages.

Modification of SOPs

  • Updates: SOPs may be updated periodically. Personnel are responsible for staying informed.

Acknowledgment

  • Understanding and Agreement: By using the SOPs, you acknowledge that you have read, understood, and agree to abide by them.

Consequences

  • Non-Compliance: May result in disciplinary action, termination, or legal consequences.

Acknowledgment of No Loopholes

  • Understanding: Policies are comprehensive; attempts to find loopholes are unacceptable.

  • Violations: Will lead to disciplinary action as outlined.

15. General Addendum

Final Authority Clause

  • High Command Decisions Are Final: No appeal process outside the established chain of command.

  • No Exceptions Without Approval: Follow standard SOPs unless explicit approval from High Command is obtained.

Common Sense Compliance

  • Personal Responsibility: Understand and comply with all SOPs.

  • Due Diligence: Seek clarification when unsure.

  • Ethical Conduct: Act ethically and in the best interest of patient care and departmental integrity at all times.