Santa Clara County EMS Exam
incidents that result in a threat to public
Policy 108 - System Variance Reporting safety, patient, by-stander, or responder
harm
any incident that results in a threat to
public safety, patient, by-stander or re-
sponder harm
1. gross negligence
2. fraud of certifications
3. repeated negligence
4. incompetence
A. any deviation from an EMS Agency
policy or treatment protocol with patient
harm
What types of incidents are considered
Level A variances? B. medication or procedural errors with
patient harm
C. failure or refusal to respond to request
for aid, whether from the public or anoth-
er system provider
D. equipment failure or malfunction with
patient harm
E. any significant EMS-related event that
would be reported to another regulatory
agency
What is the maximum time you must re-
within 24 hours
port a Level A variance?
Who must be notified ASAP of a Level A EMS On-Duty Chief via County Commu-
variance? nications
any incident that does NOT result in pa-
tient harm, but is a deviation from EMS
agency policies, procedures, and proto-
cols
, Santa Clara County EMS Exam
A. potential clinical care variance
B. potential policy variance
What type of incidents are considered
C. poor interagency coordination
Level B variances?
D. general complaint (public)
E. communications system variance
F. equipment failure or malfunction
What is the maximum time you must re-
within five (5) business days
port a Level B variance?
incidents where the responders provided
outstanding care and went above and
beyond the normal expectations of re-
sponders; compliments
What type of incidents are considered
A. good patient outcome
Level C variances?
B. outstanding customer service
C. positive provider agency/hospital co-
operation
D. field supervisor went above and be-
yond normal expectations
What form would you use to file a vari- EMS Form #903
ance report? (System Performance Variance Report)
standards for creation, revision, and im-
Policy 109 - Policy Development and Im- plementation of SCC Pre-Hospital Care
plementation Policy (including plans, protocols, proce-
dures, etc.)
How will policy implementation be dis-
EMS Program Manager
seminated to you?
-county EMS website
What other resources do you have to find -county EMS app
new policies and updates? -electronic/social media
-hardcopy
Which policy addressed allocation and
Policy #109
implementation of resources?
Policy 500 - Electronic Patient Care
, Santa Clara County EMS Exam
minimum standard criteria for the com-
pletion and submission of electronic pa-
tient care record (ePCR)
No; the EMS Agency may temporarily
suspend the requirement to complete an
When an MCI alert occurs with five (5) or
ePCR in certain times of mass causality
more patients, is a PCR required?
incidents, large scale disasters, or EMS
Data System failure.
What would you use in lieu of an ePCR
when an MCI alert occurs with five (5) or triage tags
more patients?
standard hospital radio report format for
prehospital care providers to inform a
Policy 501 - Hospital Radio Reports
hospital of pending arrival and when
communicating with the Base Hospital
-Major Trauma Victim (MTV)
-STEMI
-Stroke
What alerts (hospital report/ringdown)
-critical patient transports, transporting
require use of the county radio?
with red lights and sirens (RLS/code 3)
-when cell phone/landline contact is NOT
possible
What channel do you use for major alerts
via the county radio when cell phone EMS Command 92
contact is NOT possible?
NOT to occur on SCC EMS Communica-
For interfacility transports, what form of tions System frequencies; is the respon-
communication us used for ringdowns? sibility private ambulance service DIS-
PATCH center
1. state "DECON ALERT"
2. identify that patient has been decont-
aminated
What information is required when giving
3. chemical name
a DECON ALERT ringdown?
4. decontamination methods used
on-scene
5. DOT reference number
incidents that result in a threat to public
Policy 108 - System Variance Reporting safety, patient, by-stander, or responder
harm
any incident that results in a threat to
public safety, patient, by-stander or re-
sponder harm
1. gross negligence
2. fraud of certifications
3. repeated negligence
4. incompetence
A. any deviation from an EMS Agency
policy or treatment protocol with patient
harm
What types of incidents are considered
Level A variances? B. medication or procedural errors with
patient harm
C. failure or refusal to respond to request
for aid, whether from the public or anoth-
er system provider
D. equipment failure or malfunction with
patient harm
E. any significant EMS-related event that
would be reported to another regulatory
agency
What is the maximum time you must re-
within 24 hours
port a Level A variance?
Who must be notified ASAP of a Level A EMS On-Duty Chief via County Commu-
variance? nications
any incident that does NOT result in pa-
tient harm, but is a deviation from EMS
agency policies, procedures, and proto-
cols
, Santa Clara County EMS Exam
A. potential clinical care variance
B. potential policy variance
What type of incidents are considered
C. poor interagency coordination
Level B variances?
D. general complaint (public)
E. communications system variance
F. equipment failure or malfunction
What is the maximum time you must re-
within five (5) business days
port a Level B variance?
incidents where the responders provided
outstanding care and went above and
beyond the normal expectations of re-
sponders; compliments
What type of incidents are considered
A. good patient outcome
Level C variances?
B. outstanding customer service
C. positive provider agency/hospital co-
operation
D. field supervisor went above and be-
yond normal expectations
What form would you use to file a vari- EMS Form #903
ance report? (System Performance Variance Report)
standards for creation, revision, and im-
Policy 109 - Policy Development and Im- plementation of SCC Pre-Hospital Care
plementation Policy (including plans, protocols, proce-
dures, etc.)
How will policy implementation be dis-
EMS Program Manager
seminated to you?
-county EMS website
What other resources do you have to find -county EMS app
new policies and updates? -electronic/social media
-hardcopy
Which policy addressed allocation and
Policy #109
implementation of resources?
Policy 500 - Electronic Patient Care
, Santa Clara County EMS Exam
minimum standard criteria for the com-
pletion and submission of electronic pa-
tient care record (ePCR)
No; the EMS Agency may temporarily
suspend the requirement to complete an
When an MCI alert occurs with five (5) or
ePCR in certain times of mass causality
more patients, is a PCR required?
incidents, large scale disasters, or EMS
Data System failure.
What would you use in lieu of an ePCR
when an MCI alert occurs with five (5) or triage tags
more patients?
standard hospital radio report format for
prehospital care providers to inform a
Policy 501 - Hospital Radio Reports
hospital of pending arrival and when
communicating with the Base Hospital
-Major Trauma Victim (MTV)
-STEMI
-Stroke
What alerts (hospital report/ringdown)
-critical patient transports, transporting
require use of the county radio?
with red lights and sirens (RLS/code 3)
-when cell phone/landline contact is NOT
possible
What channel do you use for major alerts
via the county radio when cell phone EMS Command 92
contact is NOT possible?
NOT to occur on SCC EMS Communica-
For interfacility transports, what form of tions System frequencies; is the respon-
communication us used for ringdowns? sibility private ambulance service DIS-
PATCH center
1. state "DECON ALERT"
2. identify that patient has been decont-
aminated
What information is required when giving
3. chemical name
a DECON ALERT ringdown?
4. decontamination methods used
on-scene
5. DOT reference number
