MMSR Book Final-2017

Minimum Medical Standards Requirements
MMSR Manual
Emergency Medical Services

Remote Area Clinics Administration Unit
© Copyright 2017, JHAH. All rights reserved. No part of this manual may be reproduced in any form
or by any means without the express written consent of JHAH.
Disclaimer of Liability: The information enclosed in this manual is intended as a reference guide
only, and if implemented, it should enhance the Remote Area Medical Facilities standard of care.
Medical standards of care and practice are dynamic and it is therefore critical that facilities
providing medical services keep up-to-date with current clinical and Industry Standards and
Practices. Information provided in this manual is accurate at the time of publishing, but JHAH
emphasizes that it does not assume any legal liability or responsibility for the accuracy,
completeness, or usefulness of any information disclosed in herewith and that no guarantees,
expressed or implied are made.
MINIMUM MEDICAL STANDARDS REQUIREMENTS MANUAL (MMSR)
Introduction
To ensure safe practice and delivery of quality health care to all patients receiving medical care at the
work site, RAC Administration Unit / MMSR Team, have assembled this Manual to be used as
a reference to assist Aramco Proponents, Contractor Companies and JHAH approved Healthcare
Providers to assess, plan, implement and evaluate the standards of patient care at all Saudi Aramco
work sites.
The requirements within this manual are based on the Ministry of Health (MOH) regulations,
Ministry of Labor (MOL) / Saudi Labor Law and Saudi Aramco (SA) Standards including:
Saudi Aramco’s Contractors Safety Administrative Requirements Manual (CSAR section 9).
This MMSR manual is mandated to be followed by all SA Proponent Organizations (SAPO), Contractor
Companies (CC), and Healthcare Providers (HCP) performing work at Saudi Aramco Remote,
Industrial work sites.
Should you require help with the technical aspects of this manual, please contact the RAC / MMSR
Coordinator or the RAC Admin Supervisor.
Hamed J. Said
Reviewed:
RAC -MMSR Team Leader
Ali M. Hammoud
Concurred:
RAC Administration Supervisor
Dr. Ata H. Smadi

Concurred:
Chief, Department of Emergency Medicine
Dr. Daniele Rigamonti

Approved:
CEO, Johns Hopkins Aramco Healthcare Date
1
Table of Contents
1. Definitions 03-00
2. Category / Level of
Medical Facilities 04-05
3. Healthcare Provisions /
General Regulations 06-08
4. MMSR Standards. 9-162
2
Introduction
Definitions
Definitions:
1.Minimum Medical Standard Requirements – Are the minimum acceptable standards for first aid
services and medical facilities at SA work sites as specified in the Ministry of Health (MOH)
mandatory regulations, Cooperative Health Insurance Law, Saudi Aramco CSAR Manual, SA
General Instructions and policies and the Saudi Labor Law.
2.Contractor Urgent Care Facilities - Are medical facilities operating at SA project sites, and able to
provide first aid, urgent care, pre-hospital care, and stabilization including prompt transfer of sick
and injured employees to the nearest definitive care facility and occupational medicine services.
They are also able to provide medical assistance in the event of disaster.
3.Industrial / Remote Areas - Any area of Saudi Aramco operations, which by distance, topography
or lack of prompt access to medical healthcare. These include but are not limited to the following
examples:
1. Any SA project site where outside medical agencies are unable to respond in a timely manner
due to limited access to healthcare and or because of a limited definitive system of
communication and or dispatch of the emergency response is not available.
2. Oil and gas facilities such as Producing, Separation, Refining, Storage, Distribution plants,
Offshore Exploration, Onshore active Drilling operations and Water injection facilities.
3. Construction sites, Support services and residential camps associated with the operations
mentioned above.
4.Minimum Stock Level (MSL):

1. MSL will be the number specified for each clinic item (Equipment, medication, supplies).
2. Quantity will be determined for each Facility by utilization review to ensure compliance with
Facility MSL at all times.
3. MSL stored at the Clinic must be adequate to cover at least 3 months’ supply requirements for
the Facility.
4. There is no maximum stock level.
5. Records and analysis are required to support policies and procedures and justify the stock
levels.
3
Category / Level of Medical Facilities:
For selection of clinic category / level, refer to the following appendix:
1. It is recommended that all parties (SAPO, CC and HCP) are involved in the assessment,
planning, selecting and implementation of the most appropriate level of Medical Facility.
2. The determining factors must be looked at collectively before a final category is selected.
3. Where there is uncertainty of the selected category of the clinic, the final decision
must be decided by SAPO with the advice from JHAH/RAC staff as required.
Medical Facility Criteria: The following factors are used to determine the category
(level) of Medical Facility required to meet the health needs of the
employees at the work site.
1. Employee population exceeds 2000 + workers in a single camp and associated work
Category/Level A site location(s).
Physician operated 2. Access to medical care: The Company operates in an area / location where inpatient
facility, large size medical facilities are not available to refer patients for definitive care and / or timely
transfer of patients for definitive care is not possible.
with laboratory and
radiology services 3. Risk factors: The work site is potentially high risk for accidents, disasters or
explosions. Possibility of mass casualties is high.
4. *Specialized services: In view of the remoteness of company operations, providing
on-site specialized medical procedures, diagnostic or otherwise, will be
cost-effective and benefit the Company operations.
1. Employee population exceeds 1000-2000 workers in a single camp and associated

Category/Level B work site location(s).
Physician operated 2. Access to medical care: The Company operates in an area / location where only a
facility, small size limited number of inpatient medical facilities are available to refer patients for
without laborato- definitive care and / or timely transfer of patients for definitive care may be difficult.
ry and radiology 3. Risk factors: The work site is potentially high risk for accidents, disasters or
services explosions with the possibility of mass casualties.
4. Specialized services: Providing on-site specialized medical procedures, diagnostic or
otherwise, will be cost-effective and benefit the Company operations.
4
Category / Level of Medical Facilities:
Criteria: The following factors are used to determine the category

(level) of Medical Facility required to meet the health needs of the
Medical Facility employees at the work site.
Category/Level C 1. Employee population amounts 50-1000 workers in a single camp and associated work
site location(s).
Nurse operated
2. Access to medical care: The Company operates in an area / location where inpatient
facility
medical facilities are available to refer patients for definitive care and timely transfer
of patients for definitive care is possible. The company has an established medical
support and logistic network, e.g., a referral system for the duty nurse to
immediately consult a physician for advice and treatment as well as the capability to
arrange an immediate transfer or MEDIVAC.
1. Employee population amounts 50 workers or more in a single camp and associated
Category/Level D work site location(s).
2. Access to medical care: The Company operates in an area / location which is
Nurse operated non-industrial and non-remote, where there is access to inpatient medical facilities
facility and that it is possible to refer patients for definitive care and / or timely transfer of
patients for definitive care.
CIVIL 3. The clinic is operated by a JHAH approved Healthcare Provider or other MOH licensed
Non-Industrial medical facility recommended in writing and as determined by JHAH / RAC
Administration Unit Staff to establish the required range of services.
Non-Remote
4. If approved in writing by the SAPO, the contractor for a non-construction contract is
not required to provide a work site medical facility for office personnel (e.g., working
in an office building within a major metropolitan area) if the contractor has contrac-
tually arranged for emergency response and medical care with a nearby hospital that
is operated 24-hours a day, seven days a week and is capable of responding to the
office building within a maximum travel time of fifteen (15) minutes.
Category/Level E 1. Employer with less than 50 workers, shall provide at work site a First Aid cabinet and
assign an appropriate number of First Aid trained employees.
*Specialized Services include Radiology, Laboratory, physicals, and other tests / procedures performed as part of the company’s
health prevention screening program, e.g., fit to work, hearing screening and Pulmonary Function Tests etc.
5
Health Care Provisions
General Regulations

1. Every CC which operates within Saudi Aramco remote area work sites shall provide medical care
to all employees in accordance with Section 9 of the Saudi Aramco CSAR Manual and Schedule D
of the contract.
2. Every CC who employs less than fifty (50) workmen shall provide at the work site a first aid
cabinet. Refer to Level E category.
3. Any CC who employs fifty (50) or more laborers at a minimum shall provide its employees with
the following:
a. A first aid clinic; this can range from a single room portable facility to a multi-room
facility (depending on needs)
b. A ‘Full-Service’ Contract with an approved Healthcare Provider (HCP) to operate the
clinic in accordance with CSAR and MMSR.
4. All Contractor’s medical facilities located at SA project sites shall be fully operated by a JHAH
approved HCP or other MOH licensed medical facility recommended in writing and as
determined by the JHAH / RAC Administration Unit to establish the required range of services
needed to operate one or more work site medical facility.
5. Every SAPO, CC & HCP shall have a copy of the MMSR manual at the work site medical facility for
implementation, compliance and reference purposes.
6. Every SAPO, CC & HCP shall provide healthcare as per the mandatory Cooperative Health
Insurance Laws in the Kingdom of Saudi Arabia:
a. There is evidence that all employees, including subcontractor employees, are regis
tered in a 24 hour a day, seven days a week (24/7), inpatient hospital.
b. There is evidence that all employees and subcontractor employees are provided with
health insurance coverage for emergency and inpatient care including appropriate
investigations.
c. There is evidence that the organization designated an inpatient hospital where a
physician (specialist or otherwise) can be consulted by the work site medical facility
staff for further advice, referral and/or transfer of patients as needed.
d. There is evidence that the organization maintains adequate funds at all times in the
proposed inpatient hospital. Current documentation of advanced payment of agreed
funds is available upon request.
6
7. SAPO to ensure that every CC and HCP has a database system that at a minimum includes, but
is not limited to, the following information:
a. Employee’s name, employee’s ID number & medical registration (MR) number.

b. Medical insurance card number and level of medical coverage.
c. Contact number of Saudi Aramco Supervisor overseeing the contractor work.
d. SAPO 24 hour on-site representative and head office contact number.
e. Name, contact number / address of the operating HCP and nearest Medical Facility.
f. Input into file pre-employment screening and yearly comprehensive medical exam.
g. Ensuring that all information above is kept current at all times.
8. SAPO shall ensure that the CC has adequately trained crew members per shift with basic levels
of medical care awarded by a recognized BLS training program such as Saudi Heart, American
Heart Associations or Heart Saver (CPR/FA/AED) trained by JHAH / HS & E.
Refer to Saudi Aramco GI-150.002
9. The HCP shall ensure that their medical facilities’ healthcare professionals have the required
Government license to practice their profession in the Kingdom prior to assignment. At
a minimum, all professional staff are registered and licensed by the following government
bodies:
1. Saudi Commission for Health Specialties / SCHS Card.
2. Ministry of Health / MOH Licensing (within 3 months from the SCHS Registration).
10. Manpower Requirements / Hours of operation as per the following:
1. The HCP shall deploy an adequate number of medical staff at their clinic;
the required number of medical staff depends on the operational needs and the
level of clinic.
2. The HCP has a backup plan in place to provide coverage for education, unplanned
emergencies, holidays, sickness, off-duty days, absences and all other planned /
unplanned events.
3. The HCP shall have a policy stating the criteria to determine its manpower require
ments to ensure that their medical facilities have adequate coverage at all times.
4. The HCP shall ensure that for all matters pertaining to clinic operation, all clinic staff
are under the direct supervision of a senior RN or a physician.Distant supervision is
acceptable. Contact for advice/consultation shall be available 24 hours a day, seven
days a week (24/7).
5. A work schedule detailing staff duty hours to cover a 24/7 clinic operation is available
and posted.
6. An on-call schedule for off-duty hours must be available and posted with respective
contact numbers.
7
11. The HCP at a minimum shall define their organizational values as follows:
1. A vision, a statement about what the organization wants to become.

2. A mission, translated into written form. It materializes the management's view of the
direction and purpose of the organization.
3. Both Vision and Mission statements are available and posted.
12. The contractor company shall ensure that their staff medical accommodation facilities are
provided with the following necessities/standards. At a minimum includes, but are not limite to:
1. Room size shall be no less than 4.6 meter2 (50 feet2) per individual occupancy.
2. Air conditioning
3. Refrigerator
4. Smoke detector
5. Bathroom provided with the following:
1. Shower with hot and cold running water
2. Sinks (washbasin)
3. Toilet with toilet paper
13. The Contractor Company shall ensure that the medical staff are provided with appropriate
accommodation, located within close proximity of the facility or in the camp.
If the accommodation is provided in camp, the CC shall ensure that the location is very near to
the medical facility building to enable prompt emergency or disaster response.
14. Every HCP shall ensure that their medical facilities have a quality improvement (QI) study in
progress. The purpose of a QI study is to achieve the following:
1. Improve patient outcomes and clinical process through continuous quality assessment.
2. Improve safety of patient delivery system processes.
3. Support the vision and optimally utilize resources.
4. Provide evidence upon request.
8
MMSR Manual Introduction
STANDARD 1
BUILDING SPECIFICATIONS.
• FIGURE 1-1 for Cat Level A Clinic

• FIGURE 1-2 for Cat Level B facility
• FIGURE 1-3 for Cat Level C Large Nurse Op facility with Accommodation
• FIGURE 1-3 for Cat Level C Large Nurse Op facility
• FIGURE 1-3 for Cat Level C& D, Small, One Nurse Op facility
• FIGURE 1-3 for Cat Level C, Mobile Facility
• FIGURE 1-4 First Aid Cabinet, First Aid Kit and Safety Devices
9
10
SURVEY AND COMPLIANCE REVIEW REPORT
Instructions: Tick ()Yes or No or Write “NA” Where not Applicable
Item Standards Responsible Date: Comments
Code Yes No NA
1.0 BUILDING SPECIFICATIONS
GENERAL STANDARDS
A. The Contractor Company and HCP shall ensure that their medical facilities have signage available CC
as follows:
1. Signage is clear and concise. CC
2. At a minimum, signage contains the following information/details in both English and Arabic: HCP
a. Hours of operation. HCP
b. Staff contact details including regular and emergency contact details. HCP
c. Signage is posted at the entrance of the facility. CC/HCP
B. The contractor company shall ensure that their medical facilities’ buildings are provided with CC
following necessities. At a minimum these include, but are not limited to:
1. Each room has Air Conditioning. (Split AC units recommended). CC
2. Floors are covered with seamless, non-slip vinyl flooring. CC
3. Walls are painted with washable paint. CC
4. All patients care areas have sufficient electrical power outlets with ELCB (Earth Leakage Circuit Breakers). CC
5. All electrical power outlets are ground protected. CC
6. All doors are fire-rated. CC
7. Floor mounted base cupboard units with seamless laminated benchtop / worktop, as needed. CC
8. Wall mounted cupboards in quality laminate finish, as needed. CC
9. Sinks (wash basins) are available in the following areas: CC
a. Patient care areas.
b. Bathrooms.
c. Physician’s Office / examination room.
10. Sinks (wash basins) are available with the following: CC
a. Hot and cold water.
b. Liquid soap dispenser.
c. Disposable single paper towel dispenser.
11
Instructions: Tick () Yes or No or Write “NA” Where not Applicable
Code Yes No NA
1.0 BUILDING SPECIFICATIONS
GENERAL STANDARDS
11. Trash bins are available in all patient care areas. CC/HCP
b. Exit signs are well illuminated.
13. Evacuation map is available and displayed at all times CC
12. Facility has emergency exit(s) available as follows: CC/HCP
a. Exits are not obstructed, kept clear at all times.
14. Facilities that have an ambulance bay, shall provide the following: CC
a. A double entrance door with sufficient width to enable easy-access of ambulance stretcher.
b. An ambulance bay as follows:
1. Sheltered.
2. With wall mounted power outlet to connect the ambulance auxiliary air condition unit.
3. With water tap and hose pipe.
4. An ambulance ramp is available and the ramp is correctly positioned and leveled.
15. Computers and Telephone lines are available in: Business office, Nurse station and Treatment areas. CC
16. Internally facility is illuminated with acceptable intensity light. Areas include but are not limited to: CC
a. Patient examination area.
b. Treatment areas.
c. There are emergency lights strategically placed for power failure.
17. Externally facility is well illuminated. CC
18. Entire facility’s internal and external materials are well maintained. CC
12
Iteam Standards Responsible Date: Comments
Code Yes No NA
1.0 BUILDING SPECIFICATIONS / GENERAL STANDARDS

CATEGORY/LEVEL “A” FACILITIES
A. Level A facilities shall be a fixed land-based or a portable building with multiple rooms. The floor CC
plan must satisfy traffic flow and functional needs (e.g., easy patient observation, facility access
and utilization).
Refer to Figure 1-1 sample for Category/ Level A facility.
B. The contractor company in this category shall ensure that their medical facilities have the CC
following areas of operation:
1. Business office with reception. CC
2. Patient waiting area. CC
3. Emergency / Treatment / Examination /Observation area. CC
4. Pharmacy area (dispensing and storage). CC
5. Separate bathrooms with toilet paper as follows: CC
a. Patients/visitors.
b. Staff only.
6. Staff room. CC
7. Nurses’ station area CC
8. Physician’s room. CC
9. Screening and Triage room. CC
10. Store room with level shelving. CC
11. Disaster supply store CC
12. Decontamination / Eye wash station CC
13. Janitor room with the following: CC
a. Floor sink. For Floor sink sample, refer to Figure 8-3
b. Water tap.
c. Storage facility (shelving/steel cabinet).
14. Laboratory area CC
15. Radiology area. CC
Laboratory and Radiology Services: These services must be in compliance with all the building specifications and
13 standards in relation to Safety, Environmental Health and Infection Control as specified by MOH regulations.
Code Yes No NA
CATEGORY/LEVEL “B” FACILITIES
A. The contractor company in this category shall ensure that their medical facilities have the follow- CC
ing areas of operation: Refer to Figure 1-2 sample for Category/ Level B facility.
1. Business office with reception. CC
2. Patient waiting area. CC
3. Emergency / Treatment /Examination /Observation area. CC
4. Pharmacy room (dispensing and storage). CC
5. Separate bathrooms with toilet paper as follows: CC
b. Staff, only.
6. Staff room. CC
7. Nurse station area CC
8. Physician’s room. CC
9. Screening and Triage room. CC
10. Store room with level shelving. CC
11. Disaster supply store CC
12. Decontamination/ Eye wash station CC
13. Janitor room with the following: CC
a. Floor Sink
b. Water tap.
14
Code Yes No NA
CATEGORY/ LEVEL “C + D” FACILITIES
A. All facilities in this category have a fixed land-based or portable building with one or more rooms. CC
The selection of the clinic plan/ layout depends on the scope of service and the functional needs.
For samples of Category/ Level C& D facilities (different size/ layout). Refer to Figure 1-3
B. The contractor company in this category shall ensure that their medical facilities have the following areas of CC
operation: (the single room clinics in offshore rigs are exempt)
1. Patient waiting area.
2. Nurse screening and examination area.
3. Separate bathrooms with toilet paper as follows:
b. Staff, only.
4. Store room with level shelving.
5. Staff room.
6. Janitor room with the following:
a. Floor sink.
b. Water tap.
15
Code Yes No NA
CATEGORY/ LEVEL “ E” / FIRST AID PROVISION
A. Each CC operates within Saudi Aramco remote industrial work sites and employs less than fifty 50 CC
workers, shall provide at work site a First Aid kit / cabinet at the worksite in strategic location(s).
B. Provide a certified First Aid / BLS attendant on duty 24 hours a day, seven days a week (24/7) as CC
custodian.
C. The CC shall ensure that at least one (1) crew member per shift has the basic level of medical care CC
awarded by a recognized training Heart Saver (CPR/FA/AED) program from the Saudi Heart or
American Heart Associations. Heart Saver card (CPR/FA/AED) by JHAH / HS & E is acceptable.
Refer to Saudi Aramco GI-150.002.
At a minimum training for the assigned FA employee (s) includes, but is not limited to:
1. Basic Life Support (BLS).
2. First Aid (FA).
3. Current certificate available upon request.
4. The CC shall ensure that staff in their medical facilities attends a BLS / First Aid refresher class
every two (2) years. Evidence is available upon request.
D. The CC shall ensure that their first aid cabinet where applicable, is as follows: CC
1. Laminated with a quality finish that’s easy to clean.
2. Dimensions: no less than 85 cm long x 45 cm wide x 30 cm deep.
3. FA cabinets must be dust tight and fitted with a lock and shelves.
4. Have the Red Crescent insignia and/or marked as “First Aid Cabinet”.
5. Always be ready for use, restocked after each use.
6. Placed on a strategic location, accessible at all times.
7. For the minimum contents & supplies of FA cabinet, First Aid kits and Safety Devices: Refer to Figure 1-4.
E. The CC shall ensure that the following safety devices are available at work locations:
1. Fire blanket.
2. Limb splints, ready to use, various types: thigh, leg, arm, etc.
3. Rescue type stretcher (to move injured patients), folding, 72 inches long and 10 inches wide.
16
Iteam Responsible Date: Comments
Standards
Code Yes No NA
CATEGORY/ LEVEL “ E” / FIRST AID PROVISION
4. Splint Stretcher, basket type litter; 4 straps; to carry patient in any position without danger; 24 inches
width 8.5 inches high.
F. The CC shall ensure that signs indicating the location of the first aid kits/cabinets are posted. CC
G. The CC shall ensure that there is an inventory system in place to replenish FA kit supplies and to CC
monitor expiry dates. Applicable evidence shall be available upon request.
H. The CC shall ensure that a patient log must be kept by the first aid attendant to register all CC
injuries/illness treated.
I. The CC shall ensure that the person in charge of first aid program have the following available CC
and posted:
1. Contact number (24 hours) of all first aid attendants in his area of responsibility.
2. Name(s) and contact number of the nearest medical referral/ evacuation facility.
3. Other emergency telephone numbers to call for emergency medical assistance including Security
and Red Crescent.
17
SA
MP
LE
Figurea: 1-1
18
19 Figurea: 1-2
Figurea: 1-3 20
21 Figurea: 1-3:1
9.00
1.30 1.50 1.20 5.00
SCREENING DRESSING EMERGENCY

CART CART CART
HK FLOOR WATER TAP OXYGEN ON CART
IV STAND/PUMP
W/WHEELS
MOP SINK
WATER
CLOSET
DISPOSABLE PAPER
TOWEL DISPERNSER
JANITOR RM. STORAGE RM
1.70
WASH EAS W/ STRETCHER
HOT & COLD WATER
NURSE
STATION
STEEL
LIQUID SOAP
WASH BASIN
CABINET DISPENSER
FILING CABINET
4.00
OXYGEN ON CART
W/WHEELS
CHAIR
TREATMENT AREA
5m. x 3m
WALL MOUNTED CABINEET
FLOOR MOUNTED CABINEET
2.30
WAITING AREA
CLINIC ENTRANCE
SCALE FRIDGE
CHAIR CHAIR
2.80 2.12 1.40 2.68

9.00
EMERGENCY ENTRANCE
RAMP W/ HAND RAILS
LEVEL C& D PLAN ONE NURSE OPERATED CLINIC
Figurea: 1-3:2
22
23
Specific Category/ Level C Facilities
For Mobile Facilities ONLY
such as Drilling Rigs
Table of Contents:
1 Purpose 23
2 Definitions 24
3 Design 25
3.1 Location Requirements 25
3.2 Layout Requirements 26
3.3 Materials & Fittings 27
3.4 Communications, Electrical and
Lighting Requirements 27
3.5 Treatment Area Requirements 27
4 Offshore Drilling Facilities 29
5 Design Drawing 29
24
25
1 Purpose
This document is a guideline for the design of drilling rig medical clinics and health care
facilities.
2 Definitions

CLINIC: Refers to the rig facility where patients are diagnosed and treated.
MEDIC ACCOMMODATION: The nurse / medic’s / doctor’s private sleeping room.
NURSES’ STATION: The medic’s working desk / office and screening area.
TREATMENT AREA: The areas were patients are examined and treated.
STRETCHER: A medical device used to carry casualties or an incapacitated person from one
place to another.
EXAMINATION TABLE: The bench on which patients are examined, treated, and monitored.
26
3 Design
3.1 Location Requirements
• The clinic should be situated in a location that does not obstruct ambulance access in case of
emergencies.
• The clinic should be located in a manner that enables quick evacuation in case of emergencies.
• It shall be located in an area easily accessible by personnel.
• The medic accommodation must be located adjacent to the clinic.
• The clinic shall be located away from wastewater and sewage systems.
• The clinic should have a metal flag / sign board placed on top of its roof on each end.
The flags should be fixed at an elevation of 1.8 meters in order to distinguish the clinic
easily from other portables. It should be a minimum 70 cm x 70 cm in dimensions.
(Please check Figure 1 for clarification)
27
• The clinic shall be located away from wastewater and sewage systems.
• The clinic should have a metal flag / sign board placed on top of its roof on each end. The
flags should be fixed at an elevation of 1.8 meters in order to distinguish the clinic easily from
other portables. It should be a minimum 70 cm x 70 cm in dimensions.
(Please check Figure 1 for clarification)
3.2 Layout Requirements
3.2 Layout Requirements
• The clinic should have an emergency entrance with a minimum width of 1.10 meters.
• • Theshould
The clinic emergency entrance
have an shall be
emergency provided
entrance with
with a ramp and
a minimum sideofhandrails.
width 1.10 meters.
• • In case the
The emergency clinic has
entrance one
shall beentrance, the entrance
provided with must
a ramp and be handrails.
side suitable for emergency use and shall
follow emergency entrance requirements mentioned (minimum width of 1.10 meters).
• In case the clinic has one entrance, the entrance must be suitable for emergency use and
shall follow emergency entrance requirements mentioned (minimum width of 1.10 meters).
0.7 m
1.8 m
Figure 1: Clinic sign board details

Figure 1: Clinic sign board details
• The clinic should have a lockable store room with level shelves suitable to store medical
supplies (minimum of 2.0 square meters).
• The clinic should have a lockable store room with level shelves suitable to store medical supplies
• The clinic should have
(minimum a square
of 2.0 lockablemeters).
janitor room including a floor sink, sufficient area for the
janitor trolley, and a wall mounted cabinet for storage (minimum of 1.2 square meters).
• The clinic should have a lockable janitor room including a floor sink, sufficient area for the
• The clinic should
janitor have and
trolley, a fully functional
a wall mounted toilet for patient’s
cabinet use. (minimum of 1.2 square meters).
for storage
The toilet
• The shall beshould
clinic equipped
havewith a wash
a fully basin, toilet
functional and a for
shower/bath with hot and cold water.
patient’s use.
The toilet
• The must beshall
toilet accessible through
be equipped withthea treatment
wash basin,area
and(minimum of 1.2 with
a shower/bath square
hotmeters).
and cold water.
• Themust
The clinic toilet must
have be accessible
a waiting through
area (for the treatment
one patient at least).area (minimum of 1.2 square meters).
• The clinic must have a waiting area (for one patient at least).
28
3.3 Materials & Fittings
• Provide seamless non-slip vinyl flooring.
• Floor cabinets, wall mounted cabinets, shelves, walls, and flooring shall be laminated with a quality
finish that is easy to clean.
• All cabinets must be dust tight.
• All medicine cabinets must be lockable.
• All chairs in the clinic must have easy to clean surfaces.
3.4 Communications, Electrical and Lighting Requirements

• Provide a minimum of four double electrical sockets above the floor cabinets in the treatment
area for powering equipment.
• Provide a minimum of two double electrical sockets behind the emergency stretcher.
• Provide electrical sockets in the nurses’ station and screening area ( a minimum of two electrical
sockets).
• Provide exit signs and emergency light units.
• Provide adequate lighting in the clinic.
• Provide adequate spot lights in the treatment area to facilitate examinations.
• Provide adequate light units under wall mounted cabinets.
• Clinic entrance and emergency entrance must be properly lit.
• The clinic shall be sufficiently air conditioned.
• The nurses’ station should be equipped with a telephone with direct dial access and data
connection.
3.5 Treatment Area Requirements

• The treatment area should have a minimum of 15.0 square meters.
• The treatment area should have a fully functioning hand washbasin with cold and hot water.
• The treatment area and the waiting area must be separated with retractable curtains / screening
for patient privacy.
• The treatment area must be equipped with floor cabinets having a depth of 50cm.
• The treatment area must be equipped with kitchen like wall-mounted cabinets to store medicine.
The cabinets shall be 30cm in depth and should have internal partitions in order to prevent
medicine from falling during rig moves.
(Please check figure 2 for clarification)
29
Figure 2: Clarification on cabinet’s layout and dimensions
Figure
Figure2:
2:Clarification
Clarification onon cabinet’s
cabinet’s layout
layout and dimensions
and dimensions
nt area and the medic/nurse station must be separated with curtains/screening

rivacy
he treatment area • and
Thethe
treatment area and
medic/nurse themust
station medic/nurse
be separatedstationwithmust be separated with curtains/screening for
curtains/screening
or patient privacy patient privacy
er/examination table should be placed in a position that does not obstruct the
e’s
heaccess.
• The stretcher/examination
The stretcher/examination
stretcher/examination table shouldtable
table
should
be placed inbe
should be
positioned
a position
placed
thatindoes
in a position that does not obstruct the
a location
not obstruct the
s the medic to access. medic/nurse’s
treat theThe
patient access. The
freely from both sidesstretcher/examination table should be positioned in a location that
medic/nurse’s stretcher/examination tablee.g. it hasbetopositioned
should be in a location
ar toenables
the wallthe
having enables
the the medic to treat the patient freely from both sides e.g. it has to be perpendicular to
hat medic to patient’s
treat the head
patientadjacent to the
freely from wall.
both Thee.g.
sides it has to be
amination should theface
also wallthe
having the patient’s head adjacent
emergency to the wall. The stretcher/examination should also
erpendicular to the wall having the patient’sentrance/exit
head adjacent in order
to theto provide
wall. The easy
mergency face
cases (Please the emergency
see also
figure entrance/exit
3 forthe
clarification) in order to provide easy access in emergency cases (Please see
tretcher/examination should face emergency entrance/exit in order to provide easy
figure 3 for clarification)
ccess in emergency cases (Please see figure 3 for clarification)
Figure
r/examination table 3:correct
is in the The stretcher/examination table istointhe
orientation and position adjacent the correct orientation and position adjacent to the
Emergency
Entrance/Exit as described above.
Emergency Entrance/Exit as described above.
The stretcher/examination table is in the correct orientation and position adjacent to the Emergency
Entrance/Exit as described above.
hall have a bed for • patients

The clinic shalltreatment
under have a bed for patients
if space permits.under treatment
In cases that if space permits. In cases that require
ents to beshall
closely
patients or
monitored
to resting
be closely monitored
in the clinic,
or resting in
the stretcher
the clinic, the stretcher / examination table shall
/ examination
he clinic have a bed for patients under treatment if space permits. In cases that
e free for the use
be
of any
free for
other
the use of
potential or
any other
patient.
potential patient.
equire patients to be closely monitored resting in the clinic, the stretcher / examination
able shall be free for the use of any other potential patient.
30
4
4
4 Offshore Drilling Facilities
The minimum clinic requirements mentioned in this document do not apply to offshore rigs when
it comes to layout and location. However, offshore rigs shall comply with Chapter 3.3 Materials and
Fittings, Chapter 3.4 Communication, Electrical and Lighting Requirements and the MMSR.
5 Design Drawing
Please check figure 4 for an illustration of the clinic layout
Wall-mounted
Floor Cabinet
Cabinet
Wash Basin
Stand/Pump
IV
Fridge
Treatment Area
Weight
Scale
Stretcher
5m x 3m
Oxygen
Emergency Cart
Emergency Entrance
Aluminum Ramp
w/ Hand Rails
Dressing
Cart
9m
Equipment Cart
Screening
Station
Nurse
Cabinet
Filing
1.2m x 1.5m
Toilet
1.5m x 1.5m
Store Room
Janitor Room
Waiting
1.3 m x 1.5m
Area
Clinic Entrance
3m
Figure 4: Example for the layout of an inland clinic

31
Figure : 1-4
First Aid Cabinet and Contents

Specification:
1. Must be ready for use and accessible at all times.
2. Must be restocked after each use.
Number List of Contents Unit Quantity

1 Oral Airways, Medium and Large. Each 2 of Each
2 Non-sterile Exam gloves. 100 Box 1 Box
3 Sterile gloves, sizes: 7.5 and 8. Pair 2 of Each
LE
4 Band aids. 100 per box 2 Boxes
5 Alcohol swabs. 100 per box 100 Boxes
6 Iodine swabs. 100 per box 1 Box
7 Bacitracin ointment. Tube 1 Tube
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8 2” x 2” (5 cm x 5 cm) sterile gauze. 12 Packets per box 1 Box
9 4” x 4” (10 cm x 10 cm) sterile gauze. 12 Packets per box 1 Box
10 Roller gauze, sizes: 2, 3 and 4 inch. Roll 3 Rolls of Each
11 Adhesive tape roll, 1 inch. Roll 2 Rolls
SA
12 Eye Pad. 6 per box 1 Box

13 Ace Bandage, sizes: 2, 3, 4 and 6 inch. Each 4 of Each
14 Triangular bandage. Each Six (6)
15 Safety pins. Each Twelve (12)
16 Bandage scissors. Each One (1)
17 Burn sheet. Each Four (4)
18 Abdominal dressing pad, 5 inch x 9 inch. 6 per box 1 Box
19 Multi-trauma dressing pad. Each Four (4)
20 Cold pack. Each 2 Packet
21 Ammonia inhalant. 6 per box 1 Box
22 Padded arm board. Each Four (4)
32
First Aid Kit
First Aid Kit (36 unit size) shall be available with the following supplies.
SAP Material No: Description

1000132516 Bandage: Compress, 5 cm
Bandage: compress; per ANSI Z308.1-1978; 5 cm square non-adherent; packaged; in 1 unit size package; 4 per package.
1000132519 Bandage: Compress, 10 cm

Bandage: compress; per ANSI Z308.1-1978; 10 cm square non-adherent; packaged; in 1 unit size package;
1 per package.
1000132543 Bandage: Gauze
Bandage: gauze roller; per ANSI Z308.1-1978; 5 cm x 550 cm; packaged in 1 unit size package; 2 per package.
1000132547 Bandage: Plastic, Adhesive

Bandage: plastic adhesive; per ANSI Z308.1-1978; 2.5 cm x 7.5 cm; packaged in 1 unit size package; 16 per package.
1000132600 Bandage: Triangular
Bandage: triangular; sterile; per ANSI Z308.1-1978; 100 cm x 100 cm x 140 cm; packaged in 1 unit size package;
1 per package.
1000132605 Cold Pack
Cold Pack: in plastic pouch with chemicals in two sections that provide a cold chemical reaction when squeezed;
packaged in 1 unit size package; 1 per package per ANSI Z308.1-1978; 1 per package.
1000132609 Compress: Gauze
Compress: gauze per ANSI Z308.1-1978; 60 cm x 180 cm; packaged in 1 unit size package; 1 per package.
1000132612 Forceps and Scissors

Forceps and scissors: steel, sharp, pointed forceps; blunt nosed; steel scissors for cutting gauze; packaged in 1 unit size package;
1 per package per ANSI Z308.1-1978; 1 each per package.
1000132615 Iodine: PVP Ampules
Iodine: PVP (Polyvinyl Povidone); crushable ampules filled with 0.5 cc PVP Iodine with cotton-tipped applicator at
one end; packaged in 1 unit size package per ANSI Z308.1-1978; 10 per package.
1000132618 Green Soap Swabs
Swabs: Green Soap crushable; 0.5 ml; width 2 x 51 mm (2 inch) gauze pad.
1000132641 Tourniquet
Tourniquet: per ANSI Z308.1-1978; supplied with a separate card to note the time tourniquet was applied and the
location of tourniquet; packaged in 1 unit size package; 1 per package.
1000132600 First Aid Booklet (Arabic)
Subjects: bleeding, bandaging, splinting, resuscitation, heat stroke, heat exhaustion and poisoning:
Author - Asmund S. Laerdal, Stavanger.
1000132169 First Aid Booklet (English)
Subjects: bleeding, bandaging, splinting, resuscitation, heat stroke, heat exhaustion and poisoning: Author - Asmund
S. Laerdal, Stavanger.
33
Safety Devices
At a minimum, the following safety devices shall be available:
SAP Material No: Description
1000128476 Rescue Type Stretcher
Folding; synthetic with nonferrous alloy supports; foam filled pad; capable of carrying patient in
any position; 1,829 millimeter (72 inch) long and 245 millimeter (10 inch) wide.
1000128490 Splint Stretcher
Basket type litter; wire netting reinforced with iron braces; 4 straps; to carry patient in any position
without danger; stokes pattern; 2.1 meter (6.75 feet) long; 610 millimeter (24 inch) width; 216
millimeter (8.5 inch) height.
1000124087 Fire Blanket
Fire Blanket: 1,574.8 millimeter (62 inch) width by 2,082.8 millimeter (82 inch) long; flame
proofed wool, pleated and grommet, with steel case, window in case and a fireproofed loop rope.
Not suitable for use as a welding fire blanket. This roller mounted blanket is intended to protect the
body from extreme heat while exiting a fire area. This blanket can also be used for self-extinguish-
ment of clothing fires.
1000124087 First Aid Kit (10 unit size)
First Aid Kit (10 unit size); white finish; includes the following components listed in the Aramco
Material Stock (AMS) Catalog; complete in steel carrying case approximately 22 centimeters by 15
centimeters by 8.3 centimeters.
Per ANSI Z308.1-1978. PKS description SAMS 1 bandage: compress, 5 cm S/N 21-586-505 one (1)
bandage: compress, 10 cm S/N 21-586-507 three (3) bandages: Plastic adhesive S/N 21-586-511
two (2) bandages: Triangular S/N 21-586-513 one (1) compress: Gauze S/N 21-586-519 one (1)
iodine: PVP ampules S/N 21-586-529 one (1) Soap S/N 21-586-533.
1000124087 First Aid Kit (36 unit size)
First Aid Kit (36 unit size); white finish; includes the following components listed in the Aramco
Material Stock (AMS) Catalog; complete in steel carrying case approximately 36 centimeters by 27
centimeters by 8.3 centimeters.
Per ANSI Z308.1-1978. PKS description SAMS 3 bandage: compress, 5 cm 21-586-505 five (5)
bandages: compress, 10cm 21-586-507 three (3) bandages: Gauze 21-586-509 six (6) band-
ages: Plastic, adhesive 21-586-511 three (3) bandages: Triangular 21-586-513 four (4) cold packs
21-586-513 three (3) compresses: Gauze 21-586-519 one (1) forceps and scissors 21-586-523 three
(3) iodine: PVP ampules 21-586-529 one (1)Tourniquet 21-586-560.
34
STANDARD 2
STAFF QUALIFICATIONS, EXPERIENCE,

COMPETENCY, CONTINUING EDUCATION
Attachments:
• FIGURE 2-1 Employee Orientation

• FIGURE 2-2 Continuing Medical Education and Training
• FIGURE 2-3 CV Approval Process
• FIGURE 2-4 Staff Competency Assessment and Development
35
36
Code Yes No NA
2.0 STAFF QUALIFICATIONS, EXPERIENCE, COMPETENCY, CONTINUING EDUCATION

2.1 General standards
1. The HCP shall ensure that there is an appropriate recruitment system in place to select
HCP
medical staff.
2. There is evidence that their recruitment system has a process for reviewing and approving
HCP
Resumes / CVs and carrying out pre-hire interviews as required.
3. There is an employee New Hire Orientation (NHO) program in place. Refer to Figure 2-1 HCP
4. All documents (certificates) relating to employees past experience, professional qualifica-
HCP
tions and references must be available for verification upon request by SCFHS and MOH.
5. Each employee has a personnel file containing all documents related to his employment
(i.e., personal details, professional licensing, certificates, training history, Continuing
Education and performance appraisals, disciplinary actions and communications) Kept HCP
with his HCP.
For Continuing Medical Education and Training: Refer to Figure 2-2
6. Resumes / CVs of healthcare candidates require approval by JHAH / MMSR team prior to
deployment at SA remote industrial sites. For CV review / approval process: Refer to HCP
Figure 2-3
2.2 Staff Education and Competency
1. There is an established mechanism in place to provide all staff with Continuing Medical
HCP
Education.
2. There is a mechanism in place to provide all staff with periodic mandatory education. At
HCP
a minimum this includes, but is not limited to:
a) Basic Life Support (BLS), every two (2) years. HCP
b) Fire safety, annually. HCP
c) Infection control, annually. HCP
3. All mandatory education shall remain current; there should be supporting documents for
all completed educational courses, CMEs and skill competencies. The document should be HCP
available in the employees’ personnel portfolio.
37
Code No NA NA
4. Where special clinical tests and procedures are carried out, staff shall receive appropriate train-
ing and certified competent to perform these and/or competent to use associated equipment HCP
including performing the manufacturer’s required calibrations.
5. The HCP / Contractor Company shall ensure that their staff has access to reference/education
materials to keep them current with clinical standards and practices and with their professional/
CC/ HCP
education requirements. A minimum of one (1) book (latest edition) for each of the following
categories shall be made available:
a. Nursing Practice
b. Emergency Care
c. Anatomy and Physiology
d. EKG Interpretation
e. Pharmacology
f. Clinical Practice
g. Basic Life Support (BLS)
h. First Aid (FA)
i. Trauma Care
j. Merck Manual
k. Physician’s Desk Reference
For Level A and B facilities only.
2.3 Staff Specific Qualifications
Physician Requirements:
1. General practitioner with five (5) years’ experience in a hospital setting and a minimum of one
HCP
(1) year emergency room experience.
2. Evidence of recent practice, less than 2 years. HCP
3. To practice his profession in the Kingdom, the physician is registered and licensed by the
HCP
following government bodies:
a. Saudi Commission for Health Specialties (SCHS) registration, prior to work site
assignment.
b. Saudi MOH license within 3 months of registration.
38
Item Responsible Date: Comments
Standards
Code Yes No NA
4. Physicians have the basic level of medical care from a recognized training program / institution
HCP
prior to work assignment. At a minimum this includes, but is not limited to:
a. Basic Life Support (BLS), current certificate from the Saudi Heart Association or the
American Heart Association.
b. First Aid (FA), current certificate
c. Airway Management
d. Advanced Trauma Life Support (within 6 months of employment)
e. Advanced Cardio Life Support (within 3 months of employment)
f. Good oral and written English language skills.
Nurses Requirements:
1. To practice his profession in the Kingdom, a nurse must be registered and licensed by the
HCP
following government bodies:
a. Saudi Commission for Health Specialties (SCHS) registration, prior to work site
assignment.
b. Saudi MOH license within 3 months of SCHS registration.
2. Must be graduated from an approved University or nursing school, 3-4 years program/ basic
HCP
course and registered in their country of origin.
3. Able to operate emergency medical equipment. At a minimum includes, but is not limited to: HCP
a. Automatic Electronic Defibrillator (AED)
b. Intravenous (IV) pump
c. Airway management adjuncts
4. Nurse has basic level of medical care from a recognized training program/institution (Saudi
HCP
Heart) or at a minimum this includes, but not limited to:
a. Basic Life Support (BLS), current certificate from Saudi Heart or American Heart/ AHA
b. First Aid (FA), current certificate
5. Must have minimum 2 years Emergency Room experience with evidence of recent practice. HCP
6. The HCP shall ensure that their staff completed an emergency skills competency assessment prior
to being assigned to work independently. Competency assessment determines the employee’s
HCP
readiness to practice independently At a minimum assessment includes, but is not limited to
following skills, which must be tested yearly. For more information: Refer to Figure 2-4
39
Standards
Code Yes No NA
a. Ability to administer BLS.
b. Airway Management
c. Ability to use all types of emergency equipment.
d. Ability to manage all first aid/ non-urgent cases.
e. Ability to manage all kinds of emergencies.
f. Ability to activate a disaster response.
g. Ability to complete a pharmaceutical, drug familiarization program.
h. Good oral and written English language skills.
Pharmacists Requirements:
1. A degree in pharmacy (Bachelor of Science [B.S.] in Pharmacy and/or Master of Science [M.S.] degree), HCP
recognized by the Saudi Arabian Government as eligible for licensing.
2. Valid MOH pharmacist license to practice in Saudi Arabia.
3. Minimum of two (2) years of experience in hospital or clinical pharmacy.
4. Good oral and written English language skills.
Ambulance Drivers Requirements:
1. Ambulance driver at a minimum must meet the following requirements: CC/HCP
a. Driving license with minimum of one (1) year driving experience.
b. A good driving record.
c. Secondary school certificate, diploma or equivalent.
2. Ambulance driver has the basic level of medical care from a recognized training program / Association
such as: Saudi Heart / American Heart / AHA or Heart Saver (CPR, FA and AED) prior to work assignment. CC/HCP
At a minimum this includes, but is not limited to:
a. Basic Life Support (BLS), current certificate. Course in Arabic is acceptable.
b. First Aid (FA), current. Course in Arabic is acceptable.
3. Good command of English language skills preferred. CC/HCP
4. Within two (2) weeks of site assignment, completed a specific orientation and on-the-job training (OJT)
program, on the following: (Evidence of completion available upon request.) CC/HCP
Refer to FIGURE 2-1 for Ambulance Driver Specific Orientation:
40

Standards
Code Yes No NA
a. Familiarization with ambulance equipment/devices & how to perform some basic
CC/HCP
functions.
b. Site location orientation. CC/HCP
c. Role and responsibilities in the event of an emergency and/or disaster response. HCP
d. Ambulance routine checks and maintenance. HCP
Laboratory Technicians Requirements:
1. Bachelor of Science degree in Medical Technology or equivalent. HCP
2. Valid MOH license to practice in Saudi Arabia. HCP
3. Two (2) years practical experience in a medical laboratory. HCP
4. Good oral and written English language skills. HCP
Radiology Technicians Requirements:
1. Diploma in radiology technology. HCP
2. Valid MOH license to practice in Saudi Arabia. HCP
3. Two (2) years general practical experience. HCP
4. Good oral and written English language skills. HCP
41
Figure 2-1
Employee Orientation
Orientation is a comprehensive process that introduces new hires to the organization and to their roles
and responsibilities within the facility.
Types of Orientation
1. General Orientation
2. Unit/Area-Specific Orientation
General Orientation – Benefits:

1. Helps new hires to adapt and perform well in their jobs by providing them with a general
LE
orientation to their organization/facility and his/her role in it.
2. Welcomes new hires to the facility and promotes a positive attitude at the start of their
employment.
3. Helps new hires develop pride in the facility by explaining the goals, responsibilities, mission and
vision in providing excellent patient care.
MP
4. Familiarizes new employees with the facility’s structure and lines and forms of communication
within the system.
Effective two-way communication is stressed so that participants will know where to go with
questions, concerns and suggestions.
5. Provides new hires with information they should know at the start of their employment.
SA
Core Elements of General Orientation include but

are not limited to:
1. Infection Control.
2. Environment of Care Program (Security, Fire, Hazmat, Disaster, etc.).
3. Confidentiality/privacy of health/patient information.
4. Patients’ Rights and Responsibilities.
5. Organization’s Mission and Vision, operation, organizational chart and chain of command.
6. Reporting occurrences/incidents.
7. Official forms of communication (policies and procedures, operating manuals, etc.).
8. Prevention of injuries in the work place.
9. Familiarization of new employees with general work rules and contract agreement as applicable.
42
When Should New Hires Receive General
Orientation?
New hires shall be provided with a general orientation within the first month of their employment.
Unit/Area-Specific Orientation
An “on-site” specific orientation designed to introduce new nurses to their new work environment,
area of medical response, local policies and procedures as well as the day-to-day specific activities of
the facility they are assigned to.
Unit/Area-Specific – Benefits:
1. Introduces new employees to all aspects of their work.
LE
2. Provides job-specific orientation to the individual’s specific job description, provided in his/
her assigned area.
3. Helps new employees become acquainted with the correct way to perform their job and help
him/her know what to expect as well as what is expected of him/her in their new job.
4. Acquaints new employees with individuals and resources available to help them perform
MP
their jobs more effectively.
Core Elements of Unit/Area Specific

Orientation include but are not limited to:
1. Job responsibilities and work practices.
SA
2. Facility’s policies and procedures.

3. Necessary requirements to maintain professional status.
4. Work schedule and work distribution.
5. Environment of Care Program:
a. Disaster Plan.
b. Fire safety and fire plan.
c. Equipment handling safety.
d. Material Safety Data Sheets (MSDS).
e. Preventive maintenance.
f. Occurrence reporting.
6. Quality Improvement Activities:
a. QI/QA/QC programs.
b. Annual Competency requirements.
c. Performance appraisals.
43
7. General infection control practices:
a. Cleaning.
b. Waste management.
c. Personal protective equipment (PPE).
d. Standard precautions.
e. Hand washing.
Ambulance Driver Specific Orientation

All items listed below shall be completed within two (2) weeks of site assignment, except for
items marked with an asterisk (*), which must be successfully completed prior to site assignment.
The company will implement and administer an ambulance driver orientation and competency
program to include the following:
Item Minimum Requirements Date Completed Remarks
LE
1. Facility orientation.
2. Work site orientation.
3. *First aid.
4. *Basic Life Support (BLS).
5. Basic Ambulance operation:
MP
a. Use of communication device.
b. Use of siren and flashing lights.
6. Ambulance equipment
familiarization and basic operation:
a. Oxygen.
b. Suction machine.
c. Collapsible/other stretchers.
SA
d. Kendrick extrication device (KED).

e. Hare traction.
f. Other.
7. Standard precautions.
8. Patient and scene safety.
9. Ambulance maintenance:
a. Cleaning.
b. Daily vehicle condition checks.
c. Preventing maintenance schedule.
Emergency/disaster response,
10.
role and responsibilities.
11. Safety:
a. General road safety/speed limits.
b. Use of safety triangle.
12. Other.
44
Figure 2-2
Continuing Medical Education and Training

Education and training provide employees with the knowledge and skills necessary to provide a high
standard of patient care.
Types of Education and Training Programs

1. Ongoing Education and Training
2. Continuing Medical Education (CME)
LE
Ongoing Education and Training
Ongoing orientation and training is a continuing program, which provides educational and training
MP
activities necessary to meet the mandatory health and safety requirements, such as fire safety and
infection control. These training activities must be organized jointly with infection control and fire
safety subject matter experts (SMEs) and/or other services as applicable. The following educational
activities are required as specified:
1. Infection control and fire safety, annually.

2. Resuscitation techniques, Basic Life Support and first aid, every two years.
SA
3. Environment of Care Program (Fire, Security, Hazmat (Hazardous materials/waste), disaster,

etc.), annually.
4. When applicable, staff shall be trained to ensure proper, efficient and safe use of equipment/
tools.
Note: All educational activities shall be documented in the employee’s personnel record as applicable.
Continuing Medical Education (CME)

Continuing Medical Education refers to the provision of special education necessary to either obtain
credits required to maintain a license, or as means to acquire additional certification(s). Continuous
learning and education is required to stay abreast of new developments in the relevant field, enhance
personal knowledge and skills, and to serve patients in the most effective manner possible.
45
46
Purpose
The CME program is intended to maintain and improve the knowledge and skills of certified medical
candidates (i.e., nurses, doctors), therefore enhancing the quality of service provided to patients.
Therefore, it is necessary that every HCP establish a CME service design to provide administrative
oversight and program coordination for continuing medical education.
Benefits of Establishing a Continuing

Education Program
LE
1. Promote professional development.
2. Enhance clinical skills and practice behaviors required for excellence in patient care.
3. Enrich knowledge.
MP
4. Support the medical and nursing professions.
5. Meet SCFHS and MOH licensing requirements.
Channels Which Provide CME include:

SA
1. In-Services Program: Designed to provide classes on general requirements.

2. Conferences and Symposiums are planned, publicized gatherings that provide professional staff with the opportunity to
share information and network with other professionals.
3. Web-based programs.
4. Education brings this learning into the work area to facilitate learning at their own pace, at their own time and at their own
convenience. With a wide range of courses, tests and exams offered online, staff can develop their skills and gain
certifications quickly and easily.
47
Figure 2-3
CV Approval Process
The approved HCP Healthcare Provider /HCP representative to complete the following required data:
1. Applicants Name:

2. Position applied for:
3. Type of Clinic: Physician clinic: Nurse only clinic :
4. Clinic Commissioning date:
5. Name and Contact Number of the CC:
6. Name of Approved HCP operating the clinic:
7. Name of SA Proponent Organization:
8. Clinic Location: Rig: Construction site : Refinery/GOSP:
Camp: Other: Specify :

9. Employee population/number of employees including sub-contractors this clinic will serve:
10. Distance (KMs)of the nearest medical facility where emergency cases will be transferred:

CV approval process for Medical Candidates:

CV review and approval process for (Doctors, Nurses and Ambulance drivers) shall comply with the
following instructions:
1. Approved HCP must submit the completed CVs directly to JHAH – EMS / RAC /
MMSR Coordinator. Submitted CVs are completed and reviewed by an HCP senior supervisor or
instructor.
2. Requests for CV review and approvals will not be accepted directly from the CC.
3. It is the HCPs responsibility to verify that all required support documents are attached and
compiled in the same order as specified in the MMSR-02 PQD form.
4. CC and Proponent Department (PM, D&WO, Community Services, Exploration, Pipeline, etc.)
must ensure that all the CVs for medical candidates are approved by the MMSR team prior to
their assignment at work sites / clinics.
5. Candidate check list is included in Section 6 of MMSR-02 PQD form, specifying the support
documents required to process the CV.
6. Only the MMSR -02 PQD forms and Cover Sheet will be accepted.
7. CVs submitted on any other form(s) will NOT be reviewed.
8. Any missing document(s) will result in the CV being rejected.
48
Figure 2-4
Staff Competency Assessment and Development

The provision of patient care in healthcare is a very challenging and dynamic profession. Therefore,
each proponent organization shall only accept medical candidates from an approved HCP and their
CVs are already approved by JHAH, in order to ensure that their facilities’ employees have the
required qualifications, knowledge, skills, to perform task(s) correctly and skillfully and capable to
provide quality care to all patients. Since employees are required to demonstrate their competency
levels, the HCP must conduct competency assessment before the employee is assigned to the task(s)
and on an annual basis.
A training plan shall be developed based on individual assessment outcome(s).
LE
Assessing the knowledge, skills, and abilities of an employee requires more than the use of a
checklist and a test. It entails the assessment, maintenance, demonstration, tracking, and
improving/correcting the competence of the target staff. As an ongoing process, competency
assessment must have the initial development, maintenance of knowledge and skills, educational/
training sessions and correction of the deficiency.
MP
The Staff Competency program is a comprehensive program that begins with the hiring of competent
staff and continues with a competency-based orientation. This is made up of general orientation
competencies, specific competencies, mandatory and annual competencies. Continuing education
and annual competency evaluation for medical staff provides a means of improving and reinforcing
their abilities.
• General Competencies – are competencies which are common to all medical positions in the
SA
remote area clinics (RACs) and which start at the education unit and continue in the assigned
medical facility.
• Specific Competencies – are competencies which are unique to the facility where the nurse
and other healthcare providers are assigned. These include: Emergency skills competencies,
ambulance equipment familiarization and basic operation for ambulance drivers. This
involves teaching new skills required to perform the job safely and effectively.
• Mandatory Competencies – are topics of high importance and for which periodic training
is mandatory and without which employee cannot continue to practice, such as Basic Life
Support (BLS) certification.
• Annual Competencies – are competencies based on each clinic needs and are mandatory for
each employee. These include fire safety, infection control, etc.
49
Competency Assessment and Development Guidelines
HCP shall arrange for a qualified personnel to conduct staff competency assessments as follows:
1. Conduct a competency assessment by completing a performance appraisal checklist prior to
on-site assignment, for more details see the following samples of Skill Competency Assessment.
2. Ensure new hires meet the minimum qualifications for clinical practice and that nurse
demonstrates competency in all privilege areas. The assignment to specified areas of clinical
practice and the type of frequency of clinical supervision is decided by the review of the
employee’s background and experience.
3. Reevaluate the clinical competence factors, should a change in job function/assignment and/or a
new/additional area of practice be added.
LE
4. Develop a training and development plan based on the results of individual evaluation(s) with
specific target dates for completion.
5. Apply the following methods for correcting deficiencies, taking into account the extent and
seriousness of the determined deficiency:
a. In-service education.
MP
b. Consultation.
c. Change in type of supervision of employee.
d. Change in clinical practice area.
6. Incorporate additional activities to assist in ensuring continued competence. These include:
review of approved nursing standards/practices, nurse's attendance of workshops/seminars for
continuing education and in-service education programs.
7. Maintain records of the completed plans/training in the personnel file.
SA
50
Emergency Skills Competency Assessment
Competency Assessment
Employee’s Name: ________________ Position: ________________ I.D. No.: ___________
No.: Item to Assess - Nurse shows competency by demonstrating the following: YES NO
1 Airway Management:
1-1 Able to use Naso and Oropharyngeal Airway.
1-2 Able to use pocket mask and bag-valve mask resuscitator/ Ambu bag.
1-3 Able to perform suctioning.
1-4 Able to perform laryngeal mask airway (LMA) insertion.
1-5 Able to administer oxygen with different type of masks.
2 Able to administer basic life support (BLS).
3 Able to use automated external defibrillator (AED).
4 Electrocardiogram (ECG) Management:
4-1 Able to use a 12 lead ECG machine.
LE
4-2 Able to differentiate between normal and abnormal rhythms.
5 Able to inset IV line, administer IV fluids, IV medications and use an infusion pump.
6 Able to apply immobilization techniques (neck/limbs/spine).
7 Able to apply hare traction.
8 Able to use a Kendrick extrication device.
MP
9 Able to manage external bleeding.
10 Able to administer Entonox.
11 Able to manage anaphylactic shock.
12 Able to manage acute chest pain – chest pain protocol.
13 Able to manage the initial management of burns – burn protocol.
14 Able to activate a disaster response.
15 Able to complete the pharmaceutical, drug familiarization program.
SA
Yes Scores 7.1 Points No Scores 0 Total Score

Note: Passing Score is 95%
Result:  Pass  Fail
Remarks:
Action Plan:
Action in the event of failure is to enroll the employee into the appropriate competency development program and
conduct a second competency assessment exactly one month from the initial assessment.
Employee’s Signature: ________________________________________ Date: ____________________
Supervisor’s Name: ___________________________________________ I.D. No.: __________________
Supervisor’s Signature: ________________________________________ Date: ____________________
51
Ambulance Driver Competency Assessment
Competency Assessment
Employee’s Name: ______________________ Position: ________________ I.D. No.: ___________
No.: Item to Assess - Driver shows competency by demonstrating the following: YES NO
1 Able to administer basic life support (BLS).
2 Able to administer first aid (FA).
3 Able to operate ambulance communication device(s).
4 Able to operate ambulance siren and flashing lights.
5 Able to perform basic operation of the following ambulance equipment:
5-1 Oxygen.
5-2 Suction machine.
5-3 Collapsible/other stretchers.
5-4 Kendrick extrication device (KED).
5-5 Hare traction.
LE
6 Able to apply standard precautions.
7 Able to apply patient and scene safety.
8 Ambulance maintenance:
8-1 Able to properly clean the ambulance, interior and exterior.
8-2 Able to perform daily vehicle condition checks.
MP
8-3 Able to conduct ambulance preventive maintenance.
9 Able to verbalize his role and responsibilities in the event of emergency/disaster response.
10 Safety: Management:
10-1 Able to apply general road safety/speed limits.
10-2 Able to appropriately use safety triangle.
Yes Scores 10 Points No Scores 0 Total Score
Note: Passing Score is 90%
SA
Result:  Pass  Fail
Remarks:
Action Plan:
Action in the event of failure is to enroll the employee into the appropriate competency development program
and conduct a second competency assessment exactly one month from the initial assessment.
Employee’s Signature: ________________________________________ Date: ____________________
Supervisor’s Name: ___________________________________________ I.D. No.: __________________
Supervisor’s Signature: ________________________________________ Date: ____________________
52
Standard 3
MEDICAL EQUIPMENT AND

MEDICAL SUPPLIES REQUIREMENTS
Attachments:
• FIGURE 3-1 Standard Medical Equipment
• FIGURE 3-2 Physician operated Clinic Crash Cart
• FIGURE 3-3 Nurse operated Clinic Crash Cart
• FIGURE 3-4 Emergency Response Bag Contents & Checklist
• FIGURE 3-5 Standard Supplies
• FIGURE 3-6 Linen Supplies
• FIGURE 3-7 Office Supplies
53
54
Instructions: Tick () Yes or No or Write “NA” Where not Applicble
Code
Yes No NA
3.0 MEDICAL EQUIPMENT AND MEDICAL SUPPLIES REQUIREMENTS
The HCP shall ensure that their medical facilities depending on their category
and operational needs have adequate quantity of medical equipment.
3.1 HCP/CC
At a minimum equipment includes, but is not limited to:
For list of medical equipment refer to Figure 3-1
1. Bag valve mask (BVM), disposable. HCP
2. Backboard, long with straps. HCP
3. Crash Cart HCP
a. Physician operated Clinic Crash Cart. Refer to Figure 3-2
b. Large Nurse operated Clinic Crash Cart. Refer to Figure 3-3
4. Dressing Cart (trolley). HCP
5. Drug cupboard, lockable. HCP
6. Wheel chair, as applicable HCP
7. Automated external defibrillator (AED), portable with monitoring capabilities as
HCP
the followings:
a. Continuous Cardiac Monitoring.
b. Able to print strip.
c. Blood pressure measurement.
d. Oxygen saturation measurement.PSO2 monitoring
Separate pulse oximeter is acceptable
8. Emergency response bag.
HCP
For more information on contents and checklist refer to Figure 3-4
9. Exam/emergency bed stretcher with lockable wheels.
HCP
Stretcher without wheels acceptable at single room portable facilities.
10. Entonox/ Nitronox unit, portable. HCP
11. Examination light, wall mounted. HCP
12. Refrigerators dedicated as follows: HCP
a. For staff, small, medium or large.
b. For chilled items/drugs, small, medium or large.
55 13. Hare traction unit. HCP

56
Instructions: Tick () Yes or No or Write “NA” Where not Applica-
ble
Code
Yes No NA
3.0 MEDICAL EQUIPMENT AND MEDICAL SUPPLIES REQUIREMENTS (Cont.)
14. Infusion pump. HCP
15. Intravenous (IV) pole/stand, mobile. HCP
16. Ophthalmoscope/otoscope, wall mounted. HCP
17. Oxygen cylinder D size, wall secured or cart. HCP
18. Oxygen cylinder E size, wall secured or cart. HCP
19. Oxygen Resuscitation unit (e.g., Robert Shaw or Oxy-Viva Resuscitator). HCP
20. Portable emergency eye irrigation unit. HCP
21. Stretcher emergency, disposable (e.g., Life lite emergency), five (5) per box. HCP
22. Stretcher, basket. In single room facility, to be part of operation emergency
HCP
response supplies.
23. Weight/ Height scale. HCP
24. Ring cutter. HCP
25. Scissors bandage. HCP
26. Sharps disposable box for disposal of contaminated sharp. HCP
27. Sphygmomanometer, aneroid type, desk top or wall mounted. HCP
28. Stethoscope. HCP
29. Suction: portable suction, Laerdal, with rechargeable batteries. HCP
30. Thermometer: electronic thermometer. HCP
31. Visual acuity chart. HCP
32. Scoop stretcher with straps. HCP
33. Glucometer portable, calibration safe. HCP
34. Pocket mask with oxygen nipple/inlet. HCP
The HCP shall ensure that their medical facilities depending on their category and
operational needs have adequate quantity of standard medical supplies. At a minimum
supplies include, but are not limited to:
3.2 HCP
For Medical Supplies sample list, Refer to Figure 3-5
For Linen Supplies (disposable). Refer to Figure 3-6
For Stationary (Office Supplies). Refer to Figure 3-7
56
Figure 3-1
Standard List of
Unit POC NOC
Medical Equipment
ACLS Bag / Nurse Bag ( Thomas Pack) EA 1 1
Ambu Bag, Disposable EA 3 2
Audiogram Unit EA 1 0
Defibrillator w/ Monitoring Capability EA 2 1
Backboard long - Plastic w/ Strap EA 2 1
Backboard short - Aluminum w/ Strap EA 2 1
Crash Cart EA 1 1
LE
Spot V/S ( Integrated w/ Pulse Oximeter , BP , Thermometer) EA 1 1
Disaster Bag - W/ Wheels by L.L. Bean EA 2 1
Dressing Cart w/ Drawers EA 1 1
Electrocardiograph EA 1 0
MP
Entonox Unit EA 2 1
Entonox Cylinder EA 4 3
Examination Light, Floor Model ( Halogen Type) EA 1 0
Examination Light, Wall Mounted ( Halogen Type) EA 1 1

SA
Flashlight, Pro Polymer 4AA LED EA 2 1
Flashlight, Pro Polymer 3 N LED EA 2 1
Foot Stool EA 1 1
Foot Stool, Step EA 1 0
Hammer Percussion EA 1 1
Hare Traction, Adult EA 2 1

Head Immobilizer EA 2 1
I.V. stand, Mobile (Five wheels) EA 2 1
Mayo Stand EA 1 1
Microwave Oven EA 1 1
Minilator EA 1 1
57
Standard List of
Unit POC NOC
Medical Equipment
Minilator Hose EA
1 1
Narcotic Box, Double Lock EA

1 0
Optivisor EA
1 1
Otoscope /Ophthalmoscope Wall Mount EA

2 1
Otoscope Specula Holder EA

2 1
Oxygen Cylinder Multi- Rack for D/E (Accommodate Cylinders) EA 1 1
LE
Oxygen Cylinder Mobile Stand for Size D/E EA 2 1
Oxygen Cylinder Mobile Stand for Size G EA 2 1
Oxygen Flowmeter/Regulator Size D/E EA 4 2
Oxygen Flowmeter/Reg. Size G, EA 4 2

MP
Oxygen Pre-Set Regulator Size - G Cylinders for Ambulance EA 2 1
Oxygen Flowmeter, Wall Type Ambulance EA 2 0
Paramedic Shears EA 2 1
Pocket Mask EA 3 1
SA
Rain Suit EA 3 1
Reflective Safety Vest EA 3 1
Refrigerator for Chilled Meds w/ built-in Temperature Gauge EA 1 1
Refrigerator Staff EA 1 1
Response Jacket EA 3 1
Ring Cutter EA 2 1
Safety Triangle EA 1 0
Scale, Weighing Manual Type EA 1 1
Shelves Utility EA 1 1
Sphygmomanometer, Wall Mounted EA 2 1
Sphygmomanometer, Aneroid Portable EA 2 1
58
Standard List of
Unit POC NOC
Medical Equipment
Spirometer EA 1 0
Staff Locker EA 3 1
Stethoscope, Littman Type EA 3 1
Stretcher, Examination (such as Bed Stryker or Gentron Type) EA 2 1
Stretcher, Lite and Life EA 5 2
Stretcher, Scoop EA 1 1
Stretcher, Basket EA 1 1
Suction Unit, Portable (Laerdal) EA 2 1
LE
Tonometer EA 1 0
Television LCD EA 1 1
Thermometer, Digital EA 2 1
MP
Transport Box, Bio-Hazard (Igloo) EA 2 1
Tuning Fork EA 2 1
Visual Acuity Chart EA 1 1
Water Cooler EA 1 1
SA
Wheel Chair EA 1 1
Wrench, Adjustable 6 inch. EA 2 1
Wrench, Adjustable 10 inch. EA 2 1
Pedal Type, Trash Bin EA 2 1
Chair Blood Collection EA 1 0
Utility Cart EA 1 1
Book Case Steel Type EA 1 1
Book Case Wooden Type EA 1 1
Book Case Built In (Optional) EA 1 1
Bulletin Board Magnetic Type 2" X 3" EA 1 1
Bulletin Board magnetic Type 4" X 3" EA 1 0
59
Standard List of
Unit POC NOC
Medical Equipment
Cabinet Filling Steel Type with Drawers EA 1 1
Cabinet, Medication Metal with Glass Cover EA 1 1
Cabinet Medication Built in (Optional) EA 1 0
Cabinet Supplies and Equipment EA 1 1
Chair, Office Type EA 2 1
Chair,Vinyl Type Patient waiting area - Washable with Soap & H20 EA 4 2
Desk, Wooden EA 2 1
Desk , Steel Type with Drawers EA 2 1
Desk Lamp
Emergency Light
Literature Rack
LE EA
EA
EA
2
1
1
1
MP
Table, Center EA 2 1
Table, Side EA 2 1
Table, Utility EA 2 1
Water Cooler EA 1 1
SA
Transport Aluminum Case EA 2 1
LEGEND:
POC- Physician Operated Clinic
NOC- Nurse Operated Clinic

60
Figure 3-2
Physician Clinic Crash Cart List
TOP SHELF Contents to be checked WEEKLY or after use.
Items Quantity PM Date Remarks
* AED 1 ea
* lifepack 10 / 12Philips
* Disposable Gloves 1 bx
1st Drawer
Emergency Drugs Quantity Expiry Remarks
* Adenosine 6mg 5 ampoules
* Amiodarone Inj 50mg/ml 3ml 4 amps
* Atropine Sulphate 0.5 mg 6 abboject
* Benadryl 50mgm 2 vials
LE
* Calcium Chloride 1 g 2 Amps
* Dextrose 50% 25 gms 2 abboject
* Dopamine 400 mg 2 vials
* Epinephrine 1:1,000 1mg 6 ampules
* Epinephrine 1:10,000 1mg 6 abboject
*Glucagon injection 1 injection
MP
* Inderal ( Propanolol ) 3 amps
* Verapamil 5 mg / 2mls 3 amps
* Naloxone 0.4 mg ( Narcan ) 4 amps
* Nitroglycerin 50 mg 2 vial
* Nitroglycerin 0.4 mg tab 1 Bot
* N / Saline 5 vials
* Sodium Bicarbonate 50 mEq 2 abboject
SA
* Xylocard 2% (20mg/ml) 2 abboject

*Lidocaine 2 gm in 250 ml D5W
pre-mixed bag (8 mg/ml) 2 bags
* Xylocaine Spray 10% 1

* Additive Labels 4
2nd Drawer
Items Quantity Expiry Remarks
* IV infusion set 2 set
* D5W 250 mls 1 bag
* Imed infusion set 2 ea
* Lactated Ringers 1L 1 bag
* 0.9%Nacl 250mls IVI 2
* 0.9% Nacl 500 mls IVI 2
* IV Cannula 14, 16, 18, 20 1 each
* Tape + Tegaderms
* Gauze
61
Physician Clinic Crash Cart List (continued)
3rd Drawer
* Mannitol 20% 2 Bots
* 3M Red Dot Electrode 1 pkts
* Syringes/Needles Assorted sizes/gauges
* AED Pads 2 pkt
* Pacing Pads 1
* Electrode Gel 1 tube
* KY Jelly 5 tubes
4th Drawer
Paediatric Medication if appropriate
LE
Paediatric Airway Management if appropriate
5th Drawer
MP
* Laryngoscope handle 1
* Laryngoscope blades 3
* Laryngoscope bulbs 2
* Magill Forceps 1
* Naso Gastric Tubes 16 + 18 2
* Velcro ET Holder 1
SA
* Stylet 1
* Endotracheal Tubes 1 each Size 7.5+ 8 + 8.5
6th Drawer
* Metriset 1/2 set 1 set
* Oral Airway Small Medium Large 1 each
* Nasal Pharyngeal Airways 4
* LMA size 3+4 1 each
* Face Mask, Adult 1
* Low absorbsion Imed set 1
* Nasal Cannula O2 3 each
* Non Rebreathing Mask 3 each
* BVM + Mask 1
* Suction Connecting Tube 1
* Yankauer suction tip 4 tip
62
Figure 3-3
Large Nurse Clinic Crash Cart List

TOP SHELF Contents to be checked WEEKLY or after use.
Items Quantity Week 1 Week 2 Week 3 Week 4 Remarks / Expiry
* HeartStream AED 1 each
* Disposable Gloves 1 box
1st Drawer
Emergency Drugs Quantity Week 1 Week 2 Week 3 Week 4 Remarks / Expiry
* Adenosine 6mg 5 ampoules
LE
* Amiodarone Inj. 50mg./3ml 4 amps
* Atropine Sulphate 1 mg 6 abboject
* Benadryl 50mgm 2 amps
* Dextrose 50% 25 gms 2 abboject
* Epinephrine 1:10,000 1mg 6 abboject
* Epinephrine 1: 1,000
* Glucagon Injection
MP
4 amps
1 injection
* Inderal ( Propanolol ) 2 Amps
* Nitroglycerin inj. 50mg. 2 vials
* Nitroglycerin 0.4 mg tabs 1 bottle
* Sodium Bicarbonate 50 mEq 2 abboject

SA
* Additive Labels 4
2nd Drawer
* Lactated Ringers 1L 1 bag
* Sodium Chloride 0.9% 500mls 1 bag
* 1L 1 bag
* D5W 250 mls 1 bag
* Imed infusion set 2 each
* IV infusion set 1 set
63
Large Nurse Clinic Crash Cart List
3rd Drawer
* Airway (L,M & S) asstd
* Mask, Adult 2 each
* LMA size 3 + 4 1 each
* Yankauer suction tip 4 tip
* Face Mask, Adult 2 each
* Nasal Cannula 2 each
* Non Rebreathing Mask 2 each
* BVM + Mask 2 each
* Suction Connecting Tube 1
* Stylet 1
LE
* Endotracheal tube Holder 1
* 30mls syringe 2
* Metriset 1 set
4th Drawer
MP
* 3M Red Dot Electrode 1 pkts
* AED Pads 2 pkt
* Electrode Gel 1 tube
* KY Jelly 5 tubes
SA
5th Drawer
* Syringes 2ml 5ml 10ml 20ml 3 each
* Assorted Needles 10
* Saline for Injection 10
* IV Cannula 14, 16, 18, 20 10each
* Alcohol Swabs 1 Box 1
6th Drawer
* Goggles 1
Date:
Initials:
Badge #:
64
Figure 3-4
Emergency Response Bag Contents (THOMAS)
Month/Year :
No. Pocket 1 1st 2nd 3rd 4th Exp.Date Remarks
1 BP Cuff
1 Stethoscope
1 Paramedic shears
1 Flashlight
No. Pocket II 1st 2nd 3rd 4th Exp.Date Remarks
2 Ace Bandages, 4”, 6”

4 Gauze Squares,3’ x 3’; 4” x 4” (4 ea)
3 Triangular Bandages.
No. Pocket III 1st 2nd 3rd 4th Exp.Date Remarks
1 Abdo pack
1 Trauma pack
No. Pocket IV 1st 2nd 3rd 4th Exp.Date Remarks
2 Yellow hazard material bags

2 General waste bags (blue, black or white)
2 Waxed Paper Bag
1 Small sharps container (use expired Multi stick

container with label removed.)
No. Pocket V 1st 2nd 3rd 4th Exp.Date Remarks
1 Pair of goggles
8 Pairs of disposable gloves medium

in small plastic bag.
2 Plastic aprons
5 Assessment forms
5 Transport forms
5 Release from Liability forms
2 Black pens
5 Disaster tags
65
Emergency Response Bag Contents(THOMAS) Continued
Month/Year :
Inside the Side Support Areas 1st 2nd 3rd 4th Exp.Date Remarks
1 Padded short arm board

1 Long arm board
1 Wire splint for support of the Thomas pack
1 Yankeur suction handle
No. Pouch I 1st 2nd 3rd 4th Exp.Date Remarks
6 Non-adhesive dressings - 7.5 cm x 20 cm

2 Tender sat Combines 19 cm x 20 cm
2 Tender sat combines 11 cm x 10 cm
1 1” Micropore
1 1” Zinc tape
No. Pouch II 1st 2nd 3rd 4th Exp.Date Remarks
1 Bottle Povidine 10% solution

2 Instant Ice pack
1 Tube Bacitracin Ointment
No. I.V. Compartments I & III (Orange) 1st 2nd 3rd 4th Exp.Date Remarks
1 Pair Examination gloves, Size 7.5
1 Liter I.V. 0.9% N/Saline
1 Giving set
1 Tourniquet or Penrose drain
5 Alcohol swabs
2 ea IV Cannulas 14 g - 20 g
1 22G Cannula
3 Tegaderm
1 ½” Micropore tape
1 3” bandage
7 Bandaids
3 Gauze sponges (2” x 2”)
No. IV Compartment II (Centre orange) 1st 2nd 3rd 4th Exp.Date Remarks
1 Pair Examination gloves Size 7.5

1 LiterRingers Lactate
1 Giving set
1 Tourniquet or Penrose drain
66
Emergency Response Bag Contents (THOMAS) Continued
Month/Year :
5 Alcohol swabs
2 ea IV Cannulas 14 g - 20 g
1 22G Cannula
3 Tegaderm
1 ½” Micropore tape
1 3” bandage
7 Bandaids
1 Pressure Infuser bag ( Disposable)
3 Gauze sponges (2” x 2”)
No. Pouch III and V (Blue) 1st 2nd 3rd 4th Exp.Date Remarks
1 Adult Non-rebreather mask
1 Nebulization set
1 Nasal Cannula tubing
1 Standard mask
1 Suction Cannula 14 or 16 FG
No. Pouch IV (Blue) 1st 2nd 3rd 4th Exp.Date Remarks

1 Ambu bag, collapsed inside itself.
1 CO2 adaptor / detector
1 Oral airways small, medium, large (3,4,5)
1 Nasal Airway sizes 30, 33 and 34
1 Larangeal mask, small, medium, large (3,4,5)
2 Tongue depressors
1 30 ml syringe
1 1” bandage or ET tube holder
1 Disposable water soluble gel dispenser
No. Yellow Medication Compartment 1st 2nd 3rd 4th Exp.Date Remarks
3 Ampoule Amiodorone 150 mg / 3 mls
2 Ampoules Epinephrine 1:1,000
2 Abbojects of Epinephrine 1:10,000
1 EpiPen 0.3 mg auto-injector
2 Abbojects of Atropine Sulphate
4 10 mls N/Saline 0.9%
Replace Voltaren
1 Ketorolac (Toradol) 30mg/ml ampoule
75mg injection
2 1 ml Insulin syringe
67
Emergency Response Bag Contents (THOMAS) Continued
10 Alcohol swabs
2 5 ml syringe
4 10 ml syringe
1 30 ml syringe
5 Needles 23 gauge
5 Needles 20 gauge
1 Aspirin 300 mg Tablets
1 Bottle Nitroglycerin Tablets
1 Bottle Albuterol 20ml Resp solution
2 10 ml Water for Injection
1 Glucagon Injection
1 Glucose powder
Attached to Outside handles
1 Cervical Collar : Adjustable Fits All Sizes ( Stiff Neck)
Security Seal Number
Initials:
Badge #
NOTE: All items are to be checked weekly and after use. Do not add additional items to the Nurse’s Bag
as it rapidly becomes too bulky and makes it difficult to find anything! More is not always better.
68
Figure 3-5
Standard Supplies Unit Levels (A&B) Levels (C&D)
Abdominal pads EA 20 5
Adhesive tape
½", 1" and 2" EA 15 5
Alcohol preps BX 10 3
Aluminum foil, roll RO 5 2
Ambu bag disposable, Child EA 3 0
Ambu bag disposable, Infant EA 3 0
Ambu bag and mask with co2 indicator , Adult disposable EA 10 2
Anal Scope - disposable EA 10 0
Applicators sterile, 6" EA 100 20
Applicators, non-sterile, 3" EA 100 20
Apron plastic EA 50 10
Audiometer Recording Paper RO 20 0
Arm slings
LE
Medium and Large EA 10 5
Arm boards 3" x 18" EA 20 5
Bag Drainage Urimeter 2000 cc EA 10 5
Bag- paper bag waxed EA 20 5
Bag- plastic bags, Ziploc PK 20 5
MP
Band aids BX 10 5
Bandages -Stockinette
2" and 4" RL 20 5
Bandages - Ace
2", 3", 4" and 6" RL 20 10
Bandages-Triangular bandages EA 20 5
Basin, Emesis (Kidney Shape- Disposable EA 10 2
Basin, Disposable -large EA 5 2
SA
Batteries, 1.5 Volts( D cell) EA 12 6

Batteries, 1.5 Volts (AA) EA 12 6
Batteries, 1.5 Volts (AAA) EA 12 6
Battery, Monitor/Defibrillator Nickel Cadnium EA 4 2
Battery, Chargeable for Vital Signs Machine EA 4 2
Battery, Chargeable ECG Machine EA 1 0
Battery, Chargeable for Suction Unit EA 2 0
Battery, Chargeable for Desk Type Otos / Opthalmoscope Unit EA 4 0
Battery, Chargeable Hand Held Radio EA 2 1
Battery, Mobile Phone EA 2 1
Battery, Thuraya Phone EA 2 1
Bandage Scissor EA 4 2
Betadine scrub brushes EA 20 5
Betadine swabs or soln. sticks Ea 50 10
Blood spill kit made up of :
one two compartment plastic pail EA 1 1
Disposable gloves EA 12 4
Shoe covers EA 6 2
69
Two trigger sprayers or perri bottles , labelled 1 2 EA 4 2
One measuring Cylinder or glass EA 2 1
Container of detergent/disinfectant mixed to correct EA 2 1
dilution rate
Container of Undiluted Cholox Solution or 5.25% Sodium hypo chlorite EA 4 2
One roll/packet of paper towels or disposable cleaning PK 2 1
cloths ( J-cloths) EA 13 2
One roll of color coded Yellow plastic bags for disposal of
infectious waste RL 2 1
Wet floor sign EA 1 1
Body Bags EA 8 4
Bubble Wrap / Air Cushion (Large Roll-Bulk) RL 2 0
Burn Dressing: Multi-Trauma Sterile EA 20 4
LE
Burn Dressing: Sterile Clothes Burn Sheet, Large EA 20 4
Burn Dressing: Sterile Burn Sheet EA 20 4
Bulb syringes EA 4 1
Burn pack, Small EA 20 10
Butterfly cannula 19 ga., 21 ga. and 23 ga. EA 10 5
MP
Cardboard splint 24", 18" and 12" EA 15 5
Catheter, Central Venous ( Central Line) 16 GA, PK 2 0
Catheter, Nasal
Catheter, nasal #18 Fr, 16 Fr EA 10 EA 5
Catheter, suction #14 Fr, #16 Fr EA 10 EA 5
Catheterization set, urethral # 14 Fr (disposable) EA 10 2
Catheter, Foley # 12 Fr ( 5cc) EA 10 2
SA
Cervical Collar : Adjustable Fits All Sizes ( Stiff Neck) EA 10 2

Chin strap for safety hat EA 10 2
Cotton balls, sterile 10 / pk PK 10 2
CPR Board EA 2 1
Crutches
Small, Medium and Large PR 5 2
Disaster response bag, X Large with Wheels ( Red Color) EA 2 1
Drain- Penrose drain, ½", 1" EA 10 EA 2
Drain Chest Single Lumen PK 2 0
Drain Chest Thoracic # 28 Fr PK 2 0
Drain Chest Double Lumen PK 2 0
Dressing - release, non-adhering dressing. EA 20 10
Dressing pack, disposable EA 20 10
Dressing -Tegaderm, 6 cm x 7 cm EA 20 10
Dressing-Multi-Trauma dressing sterile EA 20 10
EAR Speculum Dispenser EA 2 1
EAR Speculum 100/Box BX 2 1
70
ECG Patient Cable , 12 Lead SET 2 0
ECG Disposable Electrodes PK 10 0
ECG Adapter for Tab-electrodes PK 4 0
ECG Recording Chart Paper (A4 Paper Size) PD 6 0
ECG Lead Wire Multi-Link Universal, Mixed Length SET 2 0
ECG Adaptor Clips PK 2 0
ECG Electrodes Contact Spray CN 1 0
Elastoplast 1/2'", 1" , 3" Ea 10 Ea 2
Emergency Blanket, Aluminum Polymer Ret. Body Heat EA 10 2
Emergency Blanket 58" x 90", Disposable EA 10 2
Emergency Eye Wash Solution 16 OZ BOT BT 10 4
Endo-tracheal Introducer (Adult) EA 2 0
Endo-tracheal tube holder (Adult) EA 4 0
Endo tracheal tube :
LE
5.5, 6.0, 7.0, 7.5 and 8.0 EA 5 0
Eye pads, sterile EA 20 10
Filter, Pocket mask EA 10 2
Flash light, using 6 volt battery EA 3 1
Flashlight: Propolymer Flashlight 4AA LED. Ea 3 1
MP
Flat cups PK 50 10
Forcep Kelly Disposable, Dressing pack PK 10 2
Forcep Mcgill Disposable EA 2 0
Forcep, splinter, fine tip Disposable EA 2 1
Gauge- Roller gauze, non-sterile
1", 2", 3" and 4" RL 10 4
Gauge- Sponges, non-sterile
SA
2 X 2, 3 X 3 and 4 X 4 PK 10 2
Gauge- Sponges, sterile
2 X 2, 3 X 3 and 4 X 4 PK 10 2
Gloves leather, heavy duty PR 10 2
Gloves, exam, non-sterile Latex Bx
Gloves, exam, sterile Latex
Size 7, Size 7½ and Size 8 PR 10 4
Lancets, Finger-stick BX 10 0
Glucometer Work Station Tray ( Portable) EA 2 1
Goggles safety EA 10 2
Hammer, Percussion EA 2 1
Head Immobilizer EA 3 1
Humidifier disposable with adapter -"Aquapak" 500mls EA 10 2
Infuser Bag Pressure 1000 cc EA 2 1
Irrigation tray - Eye EA 2 1
IV Catheters Jelco
14 ga., 16 ga.,18 ga., 20 ga. and 22 ga. EA 20 4
IV tubing, 15gtt set EA 10 4
71
Irrigation tray - Eye EA 2 1
IV Catheters Jelco
14 ga., 16 ga.,18 ga., 20 ga. and 22 ga. EA 20 4
IV tubing, Metriset EA 10 4
Kerlix rolls RL 10 4
Kleenex BX 10 4
Kwik-cold paks PK 10 4
Labels, Hazardous Waste Comply with EPA Regulation EA 8 2
Labels, Oxygen Cylinder Shoulder EA 10 2
Labels, Infectious Waste ( Yellow Sticker) EA 3 2
Labels, General Waste ( Blue Sticker ) EA 3 2
Labels, Toilet ( Red Sticker) EA 2 1
LE
Laryngeal mask size 3,4,5 disposable EA 3 EA 2
LMA Holder EA 4 2
Defibrillator, Test Load EA 1 1
Defibrillator Quick-Combo Therapy Cable EA 2 1
Defibrillator Fast Patch Adapter Cable EA 4 1
MP
Quick-Combo Disposable Defibrillation Electrodes PK 4 1
Defibrillator SP02 Adult Re-Usable Sensor EA 2 1
Defibrillator SP02 Patient Cable (Masimo Set) EA 2 1
Defibrillator Pre-gelled Adult Clear large Electrodes PK 10 1
Defibrillator, NIBP Hose 12 Foot EA 2 1
Defibrillator, NIBP Tuff Cuff Adult Size 14X37.5 cm EA 3 1
Defibrillator, NIBP Tuff Cuff Large Adult Size 16X 42 cm EA 3 1
SA
Suction Unit Disposable Connection Tubing EA 4 1

Suction Unit Disposable Canister 1200 ml EA 4 1
Mask - pocket masks w/ Oxygen Nipple EA 4 1
Mask- N 95 EA 6 1
Mask face disposable BX 10 2
Morgans Lens EA 4 4
Medicine cups EA 100 20
Micropore tape
½", 1" and 2" RO/ EA 10 2
Minilator Assembly Including Hose - 6 feet EA 1 1
Mouthpiece for spirometer 200/BOX Bx 100 0
Nasal pharyngeal airway Size 30 & 32 EA 4 2
Nebulizer sets EA 2 1
Needles
18 ga. 1-½" , 20 ga. 1" and 22 ga. 1-½" EA 100 20
Optivisor EA 1 1
Oral Airways - Guedal disposable
Small, Medium and Large EA 4 2
72
Ophthalmoscope Head ( illuminated Head) EA 2 1
Ophthalmoscope Bulb EA 2 1
Otoscope Bulb EA 2 1
Otoscope Head (illuminated head) EA 2 1
Oxygen connecting tubes EA 4 1
Oxygen Flow-meter (to fit size D/E cylinder) EA 2 1
Oxygen Flow-meter (to fit ambulance size-G cylinder) EA 2 1
Oxygen Flow-meter (fit size G cylinder ) EA 2 1
Oxygen Flow-meter (fit to ambulance wall type ) EA 2 1
Oxygen masks Adult , Peds simple EA 6 2
Oxygen Masks (Non-Rebreather, Adult) EA 10 2
Oxygen nasal cannulas Adult, Peds EA 10 2
Padlock Seals for Crash Cart / Disaster Bags Numeric Type PK 100 20
Penlight torch EA 3 1
Chest tube drainage device EA 2 0
LE
Probe covers for electronic thermometer BX 10 2
Reflective Safety Vest, Physician EA 2 0
Reflective Safety Vest, Nurse EA 3 1
Reflective Safety Vest, Ambulance Driver EA 2 1
Rain suit EA 6 1
Response Jacket, Small EA 3 1
MP
Response Jacket, Medium EA 3 1
Response Jacket, Large EA 3 1
Ring cutter EA 2 1
Safety pins, large EA 10 2
Safety glasses tinted EA 3 1
Safety hat, hard ( size to fit ) EA 4 1
Sanitizer Rico ( For ambulance suction liner ) PK 1 1
SA
Scalpel handle, disposable with blades #11 & 20 EA 10 2

Scissor paramedic EA 2 1
Shroud Kit EA 10 1
Sharps box with wall brackets - large EA 4 1
Sharps box with large brackets - small EA 2 1
Sharps box, small Ambulance EA 2 1
Shave prep kits PK 10 1
Spandage, sizes 1 - 7 EA 4 1
Spirometer, Roll Paper RO 20 0
Sphygmomanometer, Cuff Tycos - Adult Large EA 4 1
Sphygmomanometer, Cuff Tycos - Adult EA 4 1
Sphygmomanometer, Bulb EA 4 1
Sphygmomanometer, Cuff Basket EA 4 1
Splint, Cardboard, Leg Splint 24" EA 10 2
Splint, Cardboard, Arm Splint 18" EA 10 2
Splint, Cardboard, Arm Splint 12" EA 10 2
SPLINT -SAM splint size 1.5cm x 11.5cm x 11.5cm flat EA 6 2
73
SPLINT -SAM splint size 46cm x 11cm flat EA 6 2
SPLINT SAM splint size 91.5cm x 11.5cm x 11.5cm roll EA 6 2
SPLINT- SAM splint size 91.5cm x 11cm roll grey EA 6 2
SPLINT-SAM splint size 23cm x 11cm flat EA 6 2
Stretcher: Lite and Life (Disposable) 5/Box BX 6 2
Stretcher: Straps 2 pieces EA 6 2
Stretcher: Basket 2 piece Model 71-S EA 1 1
Sterile saline, irrigation, 1000 cc BT 10 2
Sterile towels EA 10 2
Sterile water, irrigation, 2000 cc BT 5 1
Steri-strip ¼" & 1/8" BX 10 2
Stethoscope set, Littman EA 3 1
Stethoscope set, Ear pieces EA 4 2
Suction connecting tubes EA 10 2
Suture, Ethilon 4/0 W1612T NDL BX 10 0
LE
Suture, Ethilon 5/0 W1616T NDL BX 10 0
Suture, Mersilk 4/0 W329 NDL BX 10 0
Suture, Vicryl 5/0 W9106 NDL BX 10 0
Suture tray, disposable EA 10 0
Suturing materials, 4-0 silk/polypropylens BX 10 0
Syringes with needles, disposable EA 50 10
MP
2-½ cc. 20 ga. 1"
EA 50 10
2-½ cc. 22 ga. 1"
2-½ cc. 22 ga. 1½" EA 50 10
Insulin, 50 unit/cc EA 50 10
Syringes, disposable
5 cc, 10 cc, 20 cc and 50 cc EA 25 10
Tamper Proof Seal Lock ( Nurse Bag) 100/ PK PK 5 1
Tape measure, paper, disposable EA 10 2
Test strips for glucose in blood - 25's (HAEMOGLUKOTEST) BT 10 2
SA
Test strips for glucose in urine - 25's (KETODIABUR TEST) BT 10 2

Thermometer / temperature gauge - Fridge EA 3 1
Triage Tag (Disaster Management System) PK 2 PK 12 pcs
Tire gauge EA 1 1
Tongue blades, non-sterile BX 2 BX 50 pcs
Towel, polyethylene disposable EA 100 10
Triangle- reflective safety triangle EA 1 1
Urinals EA 4 1
Urinary Drainage Bag EA 10 1
Vanco paper roll RL 20 2
Vaseline gauze ( By CM) Sterile 7 " X 7 " / 4" x 4 " and 3" X 18" EA 10 EA 4
Visual acuity chart Appropriate size based on available clinic
space EA 1 1
Wrench/ Plastic Type to Open Size D/E Cylinder EA 2 1
Wrench Adjustable Metal Type Size 12 to Open Size G Cylinder EA 1 0
Waxed Paper, Liner EA 20 5
Walking Stick (Cane) EA 10 2
Adhesive remover BX 1 BX 20 pcs
Yankhauer suction Tip EA 10 4
74
75
Figure 3-6
Level A&B and Level C&D Linen Supplies
BED TOWELS PILLOWS

CLINIC TYPE SHEETS BLANKETS & COVER PILLOW PATIENT PROTECTIVE WASH
BATH HAND CASES GOWNS GOWNS CLOTHS
LEVEL A&B 20 15 15 15 20 20 20 20 20
LEVEL C&D 10 5 5 5 10 10 10 10 10
Note :
LE
Quantity for each level indicates “minimum” stock level.
All linen items must be hypoallergenic and disposable
MP
SA
76
OFFICE SUPPLIES BY CONTACTOR
Figure 3-7 CONTRACT NO. 6600015341
Office Supplies
LEVEL A&B LEVELS C&D
ITEM DESCRIPTION UNIT
MIN. QTY.
White board Size 2 ft X 3 ft EA 3 2
White board, 8 ft x 12 ft EA 1 1
White board Markers, Four (4) Color set EA 1 1
White Board Marker, Black (extra outside of the sets) EA 1 1
LE
Clock - battery operated with date EA 3 2
Computer Printer Toner Cartridge EA 2 1
Cooler (for shipping chilled items) -
medium size EA 2 2
Date stamp EA 2 1
MP
Double binder Clips (small,medium & large):
EA 10 5
19 mm
41 mm EA 10 5
1-1/4 “ EA 10 5
Envelopes, Inter - Office (large) EA 50 50
Envelopes, Inter - Office (small) EA 50 50
Eraser (pen/ink) EA 4 4
Eraser, White Board EA 4 4
SA
Eyesight saver EA 3 2
Eyesight saver dispenser EA 3 2
Facsimile machine toner EA 1 1
Copy/Fax paper - plain 8.5” x 11” Pk 6 6
File folders Manila - legal size (Oxford) EA 10 10
File folders Manila - letter size (Oxford) EA 10 10
Fly swatter EA 2 2
Paper Cutter Ea 1 1
Gum eraser EA 2 2
Hanging folders, letter size (Pendaflex) EA 10 10
Letter pad - Ruled paper, letter size PD 4 4
Permanent marker, Black Wide Tip EA 4 4
Permanent marker, Red Wide Tip EA 4 4
Masking tape, 3” RL 4 4
Paper bags, large EA 50 50
77
OFFICE SUPPLIES BY CONTACTOR
CONTRACT NO. 6600015341
Office Supplies
LEVEL A&B LEVELS C&D
ITEM DESCRIPTION UNIT
MIN. QTY.
Paper bags, small EA 50 50
Paper clips BX 2 2
Paper fasteners - 2” capacity / 2 3/4” center BX 2 2
Paper photocopy - 80gms 216mm x 279mm Pk 4 4
Pencil sharpener EA 2 1
LE
Pencils EA 12 6
Pens, ballpoint, black EA 12 6
Marker, Semi Transparent Yellow (Hi-liter type) EA 8 4
Plastic ruler, 12” with Inches and Centimeters EA 2 1
Power strip EA 4 2
Printer ribbons (For printers as needed) EA 2 2
MP
Punch, 2-hole EA 2 1
Punch, 3-hole EA 2 1
Refrigeration Thermometer EA 1 1
Rubber bands BX 2 2
Scotch Tape Dispenser EA 2 2
Scotch Tape, ½” clear EA 2 2
Scratch Pads EA 2 2
SA
Stamp pad EA 2 1
Staple remover EA 2 1
Stapler - standard size ( manual ) EA 2 1
Staples BX 2 1
Thumb tacks BX 2 1
Typewriter Ribbon BX 2 1
Wall rack, Patient Education Leaflets, Magazine Rack EA 1 1
78 78
Standard 4
PHARMACEUTICAL SERVICES
• FIGURE 4-1 Drug Formulary
• FIGURE 4-2 ACLS Drugs List
• FIGURE 4-3 Standing Orders Guidelines for Nurses
• FIGURE 4-4 Examination & Treatment Protocol for Nurses
79
80
Instructions: Tick ()) Yes or NO = Does not Meet Standards or write “NA” where not Applicable

Code Yes No NA
4.0 PHARMACEUTICAL SERVICES

4.A DRUG FORMULARY
The HCP shall ensure that their medical facilities have a drug formulary. HCP
This formulary shall contain a wide spectrum of drugs enabling patients
4.A.1
to be treated for minor ailments, emergencies, and stabilization prior to
transfer to definitive medical care facility.
The selection of drugs and quantity for each DRUG CATEGORY depends on HCP
the facility’s operational needs and it is determined by the responsible
4.A.2
physician. At a minimum the drug formulary include, but are not limited
to:For more information, Refer to Figure 4-1.
1. Analgesic (non-narcotic) agents at a minimum include, but are not HCP
limited to:
a. Oral analgesic/antipyretic tablets (e.g., acetaminophen).
b. Oral analgesic/anti-inflammatory, non-steroidal anti-inflamma-
tory drug (NSAID), tablets/capsules.
c. Injectable analgesic/anti-inflammatory, NSAID.
d. Analgesic topical cream and/or ointment.
2. Muscle relaxant, tablets. HCP
3. Urinary tract infection (UTI), analgesic/anesthetic agents, oral HCP
tablets/capsules.
4. Antibiotic agents at a minimum include, but are not limited to the HCP
followings:
a. Oral antibiotic agent tablets/capsules.
b. Topical antibiotic ointment for cuts, scrapes, abrasions, insect
bites, scratches, etc.
c. Topical antibiotic ointment for burns.
5. Antacid oral agents at a minimum include, but are not limited to: HCP
a. Antacid chewable tablets.
81

Code Yes No NA

b. Antacid suspension.
6. Gastric (stomach) acid control agents at a minimum include,: HCP
a. Oral H2 blocker, tablets.
b. Injectable H2 blocker (IV and/or IM use).
7. Antidiarrheal oral agent, capsules. HCP
8. Antispasmodic agents at a minimum include, but are not limited to: HCP
a. Oral antispasmodic, tablets.
b. Injectable antispasmodic, IM, IV.
9. Antiemetic’s (treat nausea and vomiting) agents at a minimum include: HCP
a. Oral antiemetic, tablets.
b. Injectable antiemetic, vial.
10 Ant parasitic chewable tablets. HCP
11 Laxative oral tablets/liquid. HCP
12 Bronchodilators agents at a minimum include, but are not limited to: HCP
a. Nebulizer aerosol delivery solution.
b. Inhalers.
13 Stimulant (crushable ampule, respiratory stimulant for inhalation HCP
only).
14 Beclomethasone disproportionate, oral inhalation agent. HCP
15 Nasal agents at a minimum include, but are not limited to: HCP
a. Antihistamine nose drops and/or spray.
b. Anti-infective steroid combination drops.
16 Nasal decongestant tablets/capsules. HCP
17 Beta Blocker agent, tablets. HCP
18 Antitussive (cough suppressant) agent, syrup, bottle. HCP
19 Antihistamine agents at a minimum include, but are not limited to: HCP
82

Code Yes No NA

a. Oral, tablets/capsules.
b. Injectable to relieve severe allergic reaction(s).
20 Steroidal anti-inflammatory agents at a minimum include, but are not HCP
limited to:
a. Oral steroid, tablets.
b. Injectable steroid, IV and/or IM use.
21 Anesthetic agents at a minimum include, but are not limited to: HCP
a. Injectable local anesthetic solution.
b. Topical local anesthetic ointment, tube.
c. Oral (gel) local anesthetic, bottle.
22. Anticonvulsants (non-controlled) agent, IV and/or IM use. HCP
23. Anticoagulant, vial. HCP
24. Vasodilator (Nitrate) agent, sublingual, tablets. HCP
25. Antidiabetic (diabetes control) agents at a minimum include,: HCP
a. Oral glucose powder.
b. Injectable dextrose 50%, prefilled syringe.
c. Injectable ant hypoglycemic agent (glucagon).
d. Injectable hyperglycemic agents (insulin).
d.1 Insulin Regular 100 U/ml 10 ml vials.
d.2 Insulin Human Isophane suspension.
d.3 Oral hypoglycemic tablets (Glucophage).
26. Ophthalmic agents at a minimum include, but are not limited to: HCP
a. Antibiotic ophthalmic agents at a minimum include:
a.1 Eye drops.
a.2 Eye ointment.
b. Antihistamine eye drops.
c. Anesthetic eye drops.
83

Code Yes No NA

d. Diagnostic agents eye drops, Myotic/ Mydriatic
(e.g., Pilocarpine HCL-2%).
e. Other eye drops (i.e., irrigation, dry eye, eye wash).
0.27 27. Vaccination agents at a minimum include, but are not limited to: HCP
a. Tetanus immunoglobulin, IM use.
b. Tetanus toxoid, IM use.
28. Intravenous (IV) fluids at a minimum include, but are not limited to: HCP
a. Dextrose infusion, bag.
b. Lactate Ringer (LR) infusion
c. Sodium Chloride (NS) infusion.
29. Rehydration oral agent, sachet. HCP

30. Diuretics (treat water retention) agents at a minimum include: HCP
a. Oral diuretic, tablets.
b. Injectable diuretics.
c. Infusible diuretic solution, bag.
31. External/topical agents at a minimum include, but are not limited to: HCP
a. Antibiotic-anesthetic-steroid, hemorrhoid ointment/cream.
b. Corticosteroid topical cream, tube.
c. Antipruritic topical cream and/or lotion, tube and/or bottle.
d. Antifungal topical cream, solution and/or powder
e. Antiseptic cleanse/scrub topical solution, bottle.
f. Antiseptic skin cleanser/scrub (i.e., surgical hand scrub).
g. Antiseptic topical solution (i.e., isopropyl alcohol, betadine,
povidone-iodine, etc.).
h. Antiseptic swab (alcohol sachet).
i. Emollient/lubricant, white petroleum KY jelly, tube.
84

Code Yes No NA

j. Optic drops (cleanser ear drops).
32. Diluents agents at a minimum include, but are not limited to: HCP
a. Sodium Chloride (NS), 10/20 ml ampules.
b. Sterile water for injection, 10/20 ml ampules.
33. Miscellaneous agents at a minimum include, but are not limited to: HCP
a. Adhesive remover for surgical/regular tape or dressing removal.
b. Silver nitrate applicators.
c. Throat lozenges.
d. Glycerin bottle.
(For list of ACLS drugs. Refer to Figure 4-2)
4.B DRUG ADMINISTRATION
The HCP shall ensure that their medical facilities have a drug dispensing HCP
guidelines (written in a clear format) for nurses who are authorized to
4.B.1
administer and dispense certain drugs in the absence of a physician and
at a minimum it include the following:
1. A list of all medications/drugs that clearly stipulate which medi- HCP
cations can be administered by the nurse as standing order (SO) or
routine order (RO), and which ones require a physician’s consultation
telephone order (TO).
2. Standing order guidelines for nurses. HCP
For more information, Refer to Figure 4-3 and Figure 4-4.
3. Specific procedures to be followed for all TOs including documentation HCP
process.
4. Specific criteria for privileging nurses to administer and dispense HCP
medications listed in the drug formulary and to administer the drugs
in the emergency response bag. At a minimum:
a. There is evidence that the nurse successfully completed a drug
familiarization competency program.
85

Code Yes No NA

b. There is a drug information reference system available on-site or
remotely (e.g., physician/ pharmacist consultation/online drug
information site/drug inserts file/pharmacology book).
4.C DRUG DISPENSING
The HCP shall ensure that their medical facilities dispense all medications/ HCP
4.C.1
drugs as follows:
1. In a suitable container. HCP
2. At a minimum, labeled with the following information: HCP
a. Patient’s name and ID number.
b. Date.
c. Drug’s name and strength.
d. Dispensing instructions (e.g., one (1) tablet three times a day
after meals).
4.D DRUG STORAGE

The HCP shall ensure that their medical facilities have an adequate storage HCP
and inventory control system with appropriate checklists in place to
4.D.1
facilitate the dispensing and inventory control of all medications/ drugs in
stock, as follows:
1. Ensure that all drugs/medications listed are: Available and Current HCP
2. Minimum Stock Levels (MSL) are maintained at all times. HCP
3. Rotated (arrange shorter expiry date in front). HCP
4. Inventory/expiration check date is conducted on monthly basis. Log HCP
is available upon request.
5. All medications/drugs shall be stored according to manufacturer's HCP
recommendations, as follows:
86
Code Yes No NA
4.0 PHARMACEUTICAL SERVICES (Cont.)

a. In an air conditioned room.
b. On shelves above floor level or in a lockable cupboard.
c. Appropriately organized and identified in a systematic way
(alphabetic order or drug group).
d. Oral Medications and external use medications are stored
separately.
e. Narcotics/controlled substances, if available, are stored under
double lock.
6. Temperature sensitive drugs are stored in a dedicated fridge as HCP
follows:
a. Temperature is maintained at: 2 to 8 Celsius (C):
[36-45 Fahrenheit (F)].
b. Temperature is monitored and recorded twice daily.
c. Fridge is cleaned twice a month.
4.E DRUG DISPOSAL
The HCP shall ensure that their medical facilities have a system in place HCP
4.E.1
for the safe disposal of expired drugs and it is implemented as follows:
1. Expired medications/drugs are handled as follows: HCP
a. Placed into a box.
b. Box is labeled “expired.”
c. Stored separately from other medications/drugs.
There is evidence that expired medications/drugs were sent to supplier HCP
4.E.2 for proper disposal or other disposal system that meets MOH regulations.
Documentation is available upon request.
The HCP shall ensure that their medical facilities’ staff is familiar with HCP
and adhere to MOH regulations in regards to transportation, dispensing,
4.E.3
administration and disposal of Narcotics/Controlled substances, where
applicable.
87
DRUG FORMULARY - Figure 4-1
Level A&B Level C&D
Generic Dosage Order Class Use Minimum Qty Minimum Qty
Absorbable gelatin 2 cm by 6 cm by 7 mm sponge, 4 per BT. SO Hemostatic Topical hemostatic 10 x
Acetaminophen 350 mg suppository SO Rectal medication Analgesic 10 6
Acetaminophen 500 mg tablet SO Analgesic Analgesic 3,000 1,000
Acetaminophen with Codeine 500 mg A / 10 mg C tablet TO Analgesic Analgesic 200 100
Acetylcysteine 200 mg / ml, 10 ml ampule for iv infusion TO Miscellaneous Antidote (Tylenol) 5 x

Analgesic/Ant-inflam-
Acetylsalicylic Acid 325 or 500 mg tablet SO NSAID 300 100
matory
Adhesive Remover Spray SO First Aid Supplies Miscellaneous 2 1
Aerochamber Aerosol delivery chamber TO Miscellaneous Miscellaneous 5 2
Albuterol Sulfate 2 mg tablet TO Bronchodilator Anti-Asthmatic 300 x
Albuterol Sulfate
Albuterol Sulfate
20 ml respirator solution
Oral Inhaler
TO
TO
Bronchodilator
Bronchodilator
LE Anti-Asthmatic
Anti-Asthmatic
6
30
2
Alcohol Isopropyl 70% solution, 250 ml bottle SO Antiseptic Miscellaneous 6 4
Alcohol Isopropyl
Algesal
Large sachet swabs
40 gm tube
SO
SO
Antiseptic
Other Agents
P Miscellaneous
Miscellaneous
500
50
300
20
Ammonia 0.3 ml crushable ampoule SO Miscellaneous Stimulant 6 6
Amoxicillin
Antacid Tablet
250 mg capsule
Chewable tablets
A M TO
SO
Antibiotic
Antacid
Antibiotic
Antacid
500
200
200
200
Anusol suppository SO Rectal medication Anesthetic 100 30
Atenolol
Augmentin
50 mg tablet
375 mg capsule
S TO
TO
Cardiovascular
Antibiotic
Beta Blocker
Antibiotic
300
500
x
200
Azithromycin 250mg tablets TO Antibiotic Antibiotic 120 60
Bacitracin Zinc ointment, 500 units / gm SO Anti-infectives Antibiotic 40 10
Benylin expectorant 120 ml bottle SO Expectorant Cough Syrup 60 30
88
Level A&B Level C&D
Betamethasone valerate 0.1% cream, 30 gm tube TO Corticosteroid Steroid 20 10
Bisacodyl suppository SO Rectal medication Laxative 10 10
Bisacodyl 5 mg tablet SO Laxative Laxative 100 100
Blood test strip Blood glucose test strip SO Miscellaneous Diagnostic agents 150 100
Cafergot caffeine100 mg/ ergotamine 1mg TO Analgesic Anti-Migraine 60 x
Calamine Lotion 100 ml bottle SO Other Anti-pruritic 12 6
Carbamide peroxide 6.5% otic drops SO Cleanser Cleanser 12 4
Cefaclor 250 mg capsule TO Cephalosporin Antibiotic 600 200
Cefazolin sodium 500 mg/vial for iv or im use TO Cephalosporin Antibiotic 4 2
Ceftriaxone 1 gram vial for im or iv use TO Cephalosporin Antibiotic 6 x
Cetrizine 10 mg tablet SO Antihistamine Antihistamine 400 200
Chlorhexidine gluconate
Cinchocaine HCl
4% scrub, 500 ml bottle
1% ointment, 20 gm tube
SO
SO
Antiseptic
L
Rectal medication
E Cleanser
Anesthetic
6
10
6
10
Ciprofloxacin 250 mg tablet TO Fluoroquinolone Antibiotic 300 x
Cloramphenicol
Clotrimazole
0.5% ophthalmic drops, 10 ml dispenser
1% cream, 20 gm tube
M TO
SO
Ophthalmic
Anti-infective
P Antibiotic
Anti-fungal
5
20
5
10
Clotrimazole 1% solution, 20 ml bottle SO Anti-infective Antifungal 10 10
Colchicine 0.5 mg tablet TO Analgesic Anti-Gout 60 x
Cromolyn sodium
Cromolyn sodium
2 % solution, 10 ml dispenser
2% solution, 30 ml spray bottle

S A TO
TO
Ophthalmic
Nasal Preparation
Antihistamine
Antihistamine
20
12
x
Daktacort cream 2% miconazole/1%hydrocortisone, 15g tube TO Combination Antifungal/steroid 10 6

Dextromethorphan HBr 100 ml bottle SO Antitussive Cough Syrup 100 25
Dextrose 5% 1 Litre Bottle/Bag TO Caloric Agent Replacement Fluid IV 5 3
Dextrose 50% 50 % IV solution, 50 ml Pre-filled syringe TO Caloric Agent Carbohydrate 5 3

89
Level A&B Level C&D
Analgesic/Anti-inflam-
Diclofenac 50 mg tablet TO NSAID 600 100
matory
Diclofenac suppository TO NSAID 20 10
matory
Dextromethorphan HBr 100 ml bottle SO Antitussive Cough Syrup 50 25
Dimenhydrinate 50 mg tablet TO Anti-vertigo Anticholinergic 200 60
Diphenhydramine HCL 25 mg capsule TO Antihistamine Antihistamine 200 60
Doxycycline 100 mg tablets or capsules TO Anti-infective Antibiotic 200 x
Dyazide 50 mg triamterene/25 mg hydrochlorthiazide TO Diuretic Diuretic, K Sparing 40 x
Erythromycin 0.5% ophthalmic ointment, 3.5 gm tube TO Ophthalmic Antibiotic 50 4
Erythromycin 250 mg tablet TO Antibiotic Antibiotic 200 x
Famotidine
Fleet enema
40 mg tablet
133 ml squeeze bottle

TO
TO
Ulcer Disease
L
Rectal medication
E H2 blocker
Laxative
100
6
30
Fluorescein sodium single use applicator SO Ophthalmic Diagnostic agents 50 20
Fluticasone
Fluticasone
Oral Inhaler 50mcg/actuation
nasal spray
M TO
TO
Bronchodilator
Corticosteroid
P Anti-Asthmatic
Anti-inflammatory
10
12
x
x
Folic acid 5 mg tablet TO Anti-anemic Anemia 100 x
Fosphenytoin sodium 50 mg/ml, 10 ml ampule, for iv or im use TO Anticonvulsant Anticonvulsant 10 2
Framycetin sulfate
Furosemide
1% impregnated gauze pads 10x10 cm
10 mg / ml vial, 2 ml amp
S A SO
TO
Anti-infective
Diuretic
Antibiotic
Diuretic
10
10
10
Furosemide 40 mg tablet TO Cardiovascular Diuretic 200
Glucometer Control agent Control solution (high, med, low) SO Miscellaneous Diagnostic agents 5 3
Glucometer Lancets 100/box SO Miscellaneous Diagnostic agents 200 100
Glucometer Reagent sticks Reagent sticks, 25 per pack SO Miscellaneous Diagnostic agents 200 100
Glucophage 500 mg tablet TO Biguanide Diabetes 200 100
90
Level A&B Level C&D
Glucose powder As directed SO Miscellaneous Hypoglycemia 3 2
Glyburide 5 mg tablet TO Sulfonylurea Diabetes 300 x
Glycerin 4 Oz bottle SO Powders Solvents Miscellaneous 4 4
Guaifenesin syrup 200 ml bottle SO Antitussive Cough Syrup 60 25
Histoacryl (Dermabond) 0.5ml crushable ampoule TO Skin Adhesive Wound closure 6 4
Haloperidol 5mg tablets TO Psychotropic Antipsychotic 10 x
Haloperidol 5mg/ml Inj. TO Psychotropic Antipsychotic 10 x
Heparin Inj. 5,000 units/ml - 10 ml vial TO Anticoagulant Anticoagulant 4 x
Hydrocortisone 100mgm for IV, IM Use TO Corticosteroid Steroid injection 5 3
Hyoscine-N-butylbromide 10 mg tablet TO Antispasmodic Antispasmodic 800 200
Hyoscine-N-Butylbromide
Ibuprofen
20 mg/ml, 1 ml amp for im, iv or sc use
400 mg tablet
TO
SO
Antispasmodics
NSAID
LE Antispasmodic
matory
20
1,000
6
200
Ibuprofen 600 mg tablet TO NSAID 600 200
matory
Indomethacin 25 mg tablet TO NSAID

P Analgesic/Anti-inflam-
matory
100 x
Indomethacin 75 mg Sustained Release capsule TO NSAID 100 x
Insulin Human Isophane
Insulin Regular
100 U/ml Isophane suspension,10 ml vial
100 U/ml / 10 ml vial

A M TO
TO
Insulin
Insulin
matory
Diabetes
Diabetes
5
5
2
Ipatropium bromide Nebulizer sol 0.025% 2ml unit dose vial TO Bronchodilator Anti-Asthmatic 6 6
Isosorbide Dinitrate
Kenacomb
10 mg Tablet
S
nystatin,n'mycin, gramicidin, tr'cinilone cream
TO
TO
Nitrate
Combination
Vasodilator
Steroid/Anti-infective
100
20
x
x
Analgesic/Anti-Inflam-
Ketorolac Tromethamine 30mg/ml amp. FOR IV ONLY TO NSAID 20 10
matory
91
Level A&B Level C&D
Ketotifen hydrogen fumarate 1 mg tablet TO Mast Cell Stabilizer Anti-asthmatic 300 x
KY Jelly 5 gm tube SO Other Lubricant 12 10
Lactated Ringers 1000 ml for infusion TO Nutritional products Replacement fluid IV 30 10
Lactulose 10 grams/15ml, 200 ml bottle TO Miscellaneous Laxatives 6 4
Lidocaine HCl 1% solution, 20 ml multi dose vial TO Anesthetics Anesthetic (local) 10 2
Lidocaine HCl 10% solution, 80gmspray bottle TO Anesthetic Anesthetic 2 1
Lidocaine HCl 2% jelly, 20 gm tube TO Other Anesthetic 6 2
Lidocaine HCl 2% solution, 20 ml multi dose vial TO Anesthetics Anesthetic (local) 10 2
Lidocaine HCl Oral viscous 2%, 122 ml bottle TO Anesthetic Anesthetic 6 1
Lip Balm
Loperamide HCl
Applicator tubes
2 mg capsule
SO
SO
Other
Antidiarrheal
LE Miscellaneous
Antidiarrheal
30
500
12
200
Lorazepam 1mg Tabs TO Psychotropic Anxiolytic/Sedative 10 x
Maalox Suspension 200 ml bottle SO Antacid Antacid 50 20
Mannitol
Mebendazole
20 % solution, 500 ml bag for iv infusion
100 mg tablet (chewable)

M TO
TO Anthelmintic
P
Cardiovascular Diuretic (Osmotic)
Anti-parasitic
5
30
2
20
Methocarbamol 500 mg tablet TO Muscle Relaxants Skeletal Muscle Relaxant 1,000 200
Metoclopramide HCl 10 mg tablet TO Anti-emetic Anti-emetic 200 30
Metoclopramide HCl
Miconazole Nitrate
5 mg / ml injection
2% powder, 20 gm container
S A TO
SO
Anti-emetic
Anti-infective
Anti-emetic
Anti-fungal
20
10
6
Midazolam 15mg/3ml Inj. TO Psychotropic Anxiolytic/Sedative 10 x
Morphine Sulfate 15mg/ml Inj. TO Narcotic Analgesic 10 x

Multi sticks Reagent Urine
Urine test strip for multiple agents SO Miscellaneous Diagnostic agents 200 100
test
Analgesic/Anti-inflam
Naproxen 250 mg tablet TO NSAID 300 x
matory
92
Level A&B Level C&D
Nitrous Oxide/Oxygen 50/50 mixture in miniature cylinder TO Analgesic Analgesic 6 3
Oral Rehydration salts 14 gm sachet SO Electrolyte/mineral Rehydration 50 10
Otosporin polymixin, n'mycin, hydrocortisone 5 ml BT SO Otic Preparation Steroid/anti-infective 20 6
Oxybuprocaine HCl 0.4% ophthalmic solution, 10 ml dropper BT SO Ophthalmic Anesthetic 10 5
Oxymetazoline HCl 0.05% solution, 10 ml nasal spray SO Otic Preparation Decongestant 40 20
Penicillin VK 600 mg tablet TO Antibiotic Antibiotic 200 100
Petrolatum, white ointment, 30 gm tube SO Lubricant Emollient 20 10
Phenazopyridine HCl 100 mg tablet TO Genitourinary Anesthetic (Urinary) 120 60
Pilocarpine HCl 2% ophthalmic solution, 15 ml dropper bottle TO Ophthalmic Meiotic 5 2
Potassium Chloride 40 mEq ampule, 20 ml vial for iv infusion TO Electrolyte/Mineral Hypokalemia 5 x
Povidine Iodine 10% solution, 120 ml bottle (douche) SO Anti-infective Cleanser 10 10
Prednisone
Prefrin-A
5mg tablet
15 ml dropper
TO
TO
Anti-inflammatory
Ophthalmic
LE Steroid
Decongestant
100
20
x
10
Pseudoephedrine HCl 120 mg sustained release tablet SO Decongestant Decongestant 500 300
Psyllium
Ranitidine
100 gm bottle
150 mg tablet
M TO
TO
Laxatives
H2 Blocker
P Laxative
H2 blocker
20
600
x
100
Ranitidine 25 mg/ml, 2ml ampule for iv or im use TO Peptic Ulcer drugs H2 blocker 6 x
Retaplase 10 Million Units per vial (2 vials per kit) TO Thrombolytic Anti-thrombus 2 x
Salicylic Acid /Lactic Acid
Silver Nitrate
Topical Solution 10ml bottle.
applicators
S A SO
TO
Other
Other
Keratolytic
Keratolytic
6
50
6
20
Sodium chloride 0.9% eye drops, 15 ml dispenser SO Ophthalmic Miscellaneous 20 10
Sodium chloride 0.9% nasal spray, SO Nasal Preparation Miscellaneous 20 10
Sodium chloride 10 or 20 ml ampule for iv or sc use SO Electrolyte Diluent 20 20
93
Level A&B Level C&D
Sodium chloride 1000 ml 0.9% solution TO Electrolyte/Mineral Fluid replacement 30 15
Sodium sulfacetamide 15% ophthalmic solution, 15 ml dropper TO Ophthalmic Anti-infective 20 10
Tears naturale ophthalmic solution, 15 ml dispenser SO Ophthalmic Miscellaneous 25 15
Tetanus immune globulin 250 units/syringe for im use TO Immune serum Tetanus passive immunity 5 5
Tetanus Toxoid 0.5 ml dose for im injection SO Vaccine Tetanus Td Prophylaxis 20 10
Throat Lozenges As directed SO Miscellaneous Miscellaneous 1,000 500
Topical Nasal solution non-narcotic solution SO Nasal Preparation Anesthetic 5 x
Triamcinolone acetonide 0.1% oral paste, 10 gm tube TO Corticosteroid Steroid 20 10
Triamcinolone acetonide 40 mg/ml, 1 ml vial for im use only TO Corticosteroid Steroid 4 x
Water for injection 10 ml ampule SO Unclassified

LE Diluent 20 20
Note:
SO = Standing Order
M P
TO = Telephone Order
S A
94
(Figure 4-2)
ACLS Drug List

Qty. Name of Drug 1st week 2nd week 3rd week 4th week Exp Date Remarks
5 vials Adenosine 6 mg. Inj. Vial
3 amps Amiodarone 150 mg. / 3mls
10 tabs Aspirin 325 mgm tab
1 Flumazenil 5mg./ 5mls
4 Atropine SO4 1MG. Abboject
1 Benadryl 50mgm vial
1 Calcium Chloride 10% injection
LE
1 Dextrose 50% Abboject
1 5% Dextrose injection. 500 mls
2 Dopamine 400 mg. Vial
3 EPI 1: 10,000(.1mg/10ml) Abboject
2 EPI 1: 1,000 (1mg/ml ) amp.
MP
2 Heparin 5,000 U/ml
1 Lasix 20mg / 2ml ampules
3 Lidocaine 2% (20 mgm / 5mls) Abboject
1 Lidocaine 20% (200mg / 1mls) Abboject
2 Magnesium S04 50% 1 g
2 Narcan Ampules
1 Nitroglycerin 50mg. (5mg. / ml.)
SA
1 bottle Nitrostat 0.4 mg. tabs

1 Potassium Chloride 10 ml ampule
2 Plasil 10mg / 2mls
2 Sodium Bicarbonate 50mg Abboject
4 Sodium Chloride 0.9% inj.10mls
1 Ventolin Inhaler
1 bottle Ventolin solution
4 Water for Injection - 10mls
Retaplase to be taken separately
Narcotics to be taken separately
Nurse Signature:
Badge Number:
95
(Figure 4-3)
Standing Orders Guidelines for Nurses
In the event nurses are authorized to administer and dispense drugs in the absence of a physician or
pharmacist, clear written administration and dispensing guidelines in line with MOH regulations must
be in place. This could be in the form of a “standing order” or a “routine order” from the responsible
physician.
Note: The guidelines listed below are to be used as a reference to assist you in developing your own
standing orders/ protocols.
Standing Orders (SO) Refer to Physician

Treatment/Education
Refer if headache is associated with
LE
any of the following: high blood
Refer to facility’s Nursing Protocol.
pressure, high fever, nausea, vom
Always take patient’s blood pressure.
iting, history of injury and acute
severe headache.
Headache Headache of recent onset with normal vital signs and no other
Refer if persistent headache.
complaints, give Panadol per schedule dosage.
MP
Headache associated with sore throat or common cold, give
Refer if history of head trauma.
Panadol per schedule dosage.
Headache with dizziness, give Panadol per schedule dosage and Dramamine requires a physician’s
1 tablet of Dramamine three times a day (tid). order.
Chest Pain Follow facility’s Nursing Protocol if chest pain is not associated
with the typical symptoms of heartburn and/or indigestion.
Notify the physician.
ASA 300mg PO X 1
SA
Nitroglycerine SL 0.4 mg tab, repeat every 5 min X 3

Start IV to keep vein open. ALWAYS REFER ALL CASES
Give Morphine sulfate per physician’s order. IV fluids and morphine require a
Place patient in semi-fowler’s position. physician’s order.
Start oxygen 6 liters per minute.
Place on Life Pak monitor, if available.
Twelve lead EKG, if available.
Take vital signs as often as necessary and document.
Transport by the quickest method to the nearest medical
facility.
Accompany patient during transportation.
Refer to facility’s Nursing Protocol.
Apply analgesic balm.
Backache Mild or recent onset without any associated complaints, give Refer all other cases.
Panadol per schedule dosage. If no improvement in two days,
refer to physician.
96
Treatment/Education
Common cold associated with any
of the following: Temperature over
Mild cold without any associated complaints (i.e., fever, produc 38 Celsius (104.4 Fahrenheit), loose
Common Cold tive cough, etc.), give Panadol per schedule dosage. productive cough with purulent
sputum, earache, sinus pain or
rhinorrhea.
Give Isoptocetamide eye drops every 4 hours. Refer severe cases.
Check G6PD status.
Conjunctivitis (mild) Give erythromycin eye ointment to be applied at bedtime. Erythromycin and Isoptocetamide
If no improvement in 48 hours, refer to physician. require a physician’s order.
Refer all cases.
Patch the affected eye with an eye pad.
Flash Burn of Eye If indicated, apply analgesic.
Analgesics require a physician’s
order.
Check vision on eye chart and record prior to eye examination.
LE
If simple foreign body, apply Novesine 0.4%, 2 drops; remove
foreign body with sterile cotton bud. Refer all cases Stat.
Foreign Body in Eye Use normal saline as eyewash after removal. Novesine requires a physician’s
Other foreign objects: perform first aid treatment only, apply order.
Novesine 0.4%, 2 drops, cover eye with eye patch.
Reevaluate in two hours.
MP
If no evidence of acute irritation, recommend cold compress 3
times a day.
Itching Sensation in Prefrin-A requires a physician’s
Give Prefrin-A 1-2 drops, every 6 hours.
Eyes order.
Advise patient to return If no improvement in 48 hours, refer to
physician.
Apply warm, moist compressed for 15 minutes four times a day
(qid).
SA
Give Isoptocetamide eye drops every four hours and Erythromy

Sties cin eye ointment at bedtime.
Check G6PD status.
Advise patient to return if condition worsens or persists longer
than 3 days.
Give first aid treatment.
Cover both eyes with normal saline pads.
Trauma to Eyes Immobilize impaled object.
Refer all cases.
Check tetanus status.

Refer if foreign body appears impact
If foreign body (such as fly) appears easy to remove, irrigate
Foreign Body in Ear with warm normal saline solution using bulb syringe.
ed (such as a bean or small stone) or
is difficult to remove by irrigation.
Other Eye Complaints Refer all cases.
Apply Otosporin ear drops every (q) 6 hours.
Never plug ears with cotton.
Ear Discharge, Ear Pain Give Panadol per schedule dosage for pain.
Refer all cases.
Give Auralgan ear drops for earache.

Refer if not previously diagnosed.
If this is the first instance of allergy, give antihistamine and
Allergic Rhinitis refer to a physician.
Refer if no improvement after taking
medication.
97
Treatment/Education
Examine nasal passages.
Keep patient’s head erect, pinch side of nose against septum for
Epistaxis (minor) five (5) minutes.
May apply vaseline gauze nasal packing if necessary.
Check and record blood pressure & pulse prior to referral.
Mild Throat Irritation
with Normal Tempera- Recommend warm saline gargles or mouth spray.
ture
Mild Sore Throat with Give Panadol per schedule dosage.
Temperature of 38 °C Recommend warm saline gargles or mouth spray.
Tonsillitis with Temper- Recommend warm saline gargles or mouth spray.

Refer all cases.
ature of 38 °C Give Panadol per schedule dosage.
Refer if persistent or recurrent
cough.
LE
Give Romilar expectorant, 2 teaspoon (tsp) every 4-6 hours, as
Cough Associated with Refer if cough is associated with any
needed.
Common Cold See nursing protocol for upper respiratory infection.
of the following: weight loss, ele
vated temperature, purulent sputum
or hemoptysis.
Give liquid Maalox (antacid) 2 teaspoon every 4 hours or Maalox
tablets, 2 tablets every 4 hours. Refer recurrent cases.
MP
Heartburn/ Indiges- Provide dietary advice: reduce spices, fried foods, etc.
tion Refer if chest pain remains a possi
bility.
Nothing by mouth (NPO) till evaluated.
Monitor vital signs.
Vomiting Refer all cases.
Give anti-emetic for severe cases.
Close observation.
SA
Refer in sickle cell disease and if

severe cases associated with any of
Abdominal Pain Refer to facility’s Nursing Protocol. the following: nausea, vomiting,
fever, tenderness and abdominal
guarding.
Refer to facility’s Nursing Protocol. Refer severe diarrhea.
Refer all severe cases associated with
Give Imodium (Loperamide HCL), 2 capsules (4 mg) initially,
Diarrhea any of the following: nausea, vomit
then 1 capsule every bowel movement; maximum of 8 capsules
ing, fever, blood in stool and dehy
(16 mg) in 24 hours.
dration.
Give milk of magnesia 2 tablespoons (tbsp) (2 oz) or Dulcolax
Refer constipation associated with
1-2 tablets at bed time.
Constipation Advise patient to increase fluid intake, fruit and vegetables in
abdominal pain, nausea and/or
vomiting.
diet and moderate exercise.
Give Anusol suppository and advise sits baths, 20-25 minutes
Hemorrhoids daily. Repeat process every day until relief is obtained.
Refer all cases.
Rectal Bleeding Refer all cases.

Burning and Frequency
Refer to facility’s Nursing Protocol on Urinary Tract Infection. Refer all cases.
of Urination
98
Treatment/Education
Pain Suggestive of
Refer all cases.
Renal colic
Urethral Discharge Refer to facility’s Nursing Protocol on Urinary Tract Infection. Refer all cases.
Gross Hematuria Refer all cases.
Acute Scrotal
Refer all cases.
Swelling and Pain
Refer if more than two days dura
Apply analgesic balm and give Panadol per schedule dosage.
Generalized Musculo- tion.
If associated with common cold or sore throat, treat as common
skeletal Ache or Pain cold or sore throat.
Refer if temperature is elevated over
38 °C.
Localized with no redness or swelling, give Panadol per schedule Refer if associated with any of the
dosage and analgesic balm for local application. following: redness, swelling, elevat
Joint Pains Advice hot compresses or sitting in hot bath. ed temperature.
LE
If associated with common cold or sore throat, treat as common Refer if condition worsens or per
cold or sore throat. sists.
Apply Vaseline ointment.
Dry Skin Give lanolin, ½ ounce (oz).
Dry Lips Give Vaseline ointment.
MP
Apply calamine lotion locally.
Heat Rash Advice patient to keep skin dry, bathe only once a day, avoid
bathing in hot water, and wear lightweight clothing.
Advise warm water or saline compresses.
Give bacitracin ointment four times a day (qid) if lesion not Refer if boil is on nose or upper lip.
ready for incision and discharge (I&D).
Boils
Give Panadol to relieve pain per schedule dosage. Refer if signs of cellulitis.
Refer if multiple boils, recurrent or
SA
Change dressing daily.

with abscess formation.
Refer if acute with maceration or
In chronic phase with scaling, give Daktarin powder or Canesten infected.
Athlete’s Foot cream and advise good hygiene. Medication requires physician’s
order.
For removal of corns apply 1 drop of Collomack solution in the
Corns morning and evening. After a few days of treatment, soak foot Refer if diabetes or infection.
in hot bath to loosen the corn for removal.
Apply 1 ounce of Kwell shampoo and rub vigorously for 4 min Kwell shampoo requires a physi
Lice (Head) utes, then wet hair with warm water and rinse thoroughly. cian’s order.
Repeat treatment in one week.
Give Kwell cream or lotion.
Apply a thin layer to hairy infected areas and adjacent areas.
Leave on overnight (8-12 hours) then wash off. Kwell shampoo requires a physi
Lice (Body) Repeat application in one week. cian’s order.
Discuss hygiene/contagion.
Family members may need treatment
Apply povidone-iodine 10% (clonidine) or 70% alcohol to the
Herpes Simplex affected area.
Requires a physician’s order.
99
Treatment/Education
Report all on/off-the-job injuries as per your organization
guidelines.
Injuries Evaluate need for tetanus immunization and immunize as Refer all cases.
indicated.
Initiate immediate first aid treatment for all injuries.
Elevate affected part.
Contusion(s) Apply cold compresses to diminish edema. Refer if contusion(s) severe.
Apply ace bandage as appropriate.
Elevate and rest affected part.
Apply cold compresses or ice bag for first 12 to 36 hours.
Refer if severe, gross swelling, frac
Sprains Give Panadol for pain per schedule dosage.
ture and/or loss of function.
Apply ace bandage.
Apply heat after 36 hours.
Cleanse with soap and water or saline.
LE
Irrigate thoroughly.
Abrasions and Superfi-
May apply antiseptic ointment or Vaseline dressing.
cial Punctures Evaluate need for tetanus toxoid immunization and immunize
as indicated.
If minor, such as nail wound:
Clean and apply dry, sterile dressing.
MP
Evaluate need for tetanus toxoid immunization and immunize Refer if patient returns with persis
Lacerations (if Minor) as indicated. tent pain or signs of infection.
Advise patient to return if pain persists or signs of infection
appear.
Refer to burns treatment protocol.
Remove clothing. Refer if more extensive or severe
Flush vigorously with several liters of water; shower if possible. burns.
Chemical Burns Do not waste time looking for s specific neutralizing agent. Refer if burns involving face, hands,
SA
(except of eyes) Treat as thermal burns. soles of feet or perineum.

Monitor breathing closely for signs of pharyngeal swelling and Refer if all circumferential burns.
airway occlusion. Refer if any signs of sepsis.
Obtain name of chemical and MSDS instructions.
Refer to minor burn treatment protocol.
Wash affected area gently with detergent soap (povidone-iodine
detergent is recommended).
Refer if more extensive or severe
Rinse thoroughly.
burns.
Minor Burns (first Do not apply ice. Ice has the theoretical disadvantage of
Refer if burns involving face, hands,
degree or small second vasoconstriction and possible ischemia of tissue in and adjacent
soles of feet or perineum.
degree burns) to the burn.
Refer if all circumferential burns.
Apply bacitracin dressing and change every 48 hours.
Refer if any signs of sepsis.
Give Panadol per schedule dosage.
Evaluate need for tetanus toxoid immunization and immunize
as indicated.
100
(Figure 4-4)
Examination and Treatment Protocol (TP) for Nurses
Backache
Body Parts Involved: Vertebrae, Spine ______________________________________________
Name: ___________________________ Badge No.: ________________ MR No.: ____________

Date: _____________________ Time in: ________________
History and Physical Examination
1. Is onset of pain sudden  Yes  No History trauma  Yes  No

Is pain referred  Yes  No History of renal calculus  Yes  No
Recent heavy lifting  Yes  No Movement restriction  Yes  No
History of spondylosis  Yes  No History of disc prolapsed  Yes  No
LE
History of rheumatoid  Yes  No
History of arthritis  Yes  No
2. Is pain Mechanical: Made worse by prolonged sitting or standing, relieved by movement or inflammatory agent or prolonged
early morning stiffness and is relieved by exercise _____________________________________
MP
3. Are there any sensory or motor symptoms?  Yes  No If yes, describe: _________________
4. Any change in bowel or bladder function?  Yes  No If yes, list: _____________________
5. Vital Signs: Temperature: _________ BP: _________ Pulse: _________ Respiration: ________
SA
6. Urinalysis:  Yes  No If yes, list result: _____________________________________
Guidelines for Treating Nurse
1. Prior history of long standing backache and normally on prescribed medication, this should be given to the patient if
available (with no other presenting symptoms) otherwise:
In all cases of persistent backache the patient should be seen or referred to a clinician with the following
instructions:
• Used of proper body mechanics when moving or lifting heavy objects.
• Bend at the knees and hips when lifting and use the feet to pivot. Keeping the spine perfectly straight, do not bend or
twist the back.
• Keep loads close to the body when lifting.
• Avoid aggressive exercises when in pain.
• Note: Give patient education guidelines for safe lifting techniques.
2. If back pain is work-related, prepare and submit QI-30.

• History of work-related injury to company employee or contractor.
• History of injury to general public resulting directly from company operations or on company premises.
101
(Figure 4-4)
Examination and Treatment Protocol (TP) for Nurses
Headache
Body Parts Involved: Neurological System ______________________________________________

Name: ___________________________ Badge No.: ________________ MR No.: ____________
Date: _____________________ Time in: ________________
History and Physical Examination
1. History of recurrent headache  Yes  No Migraine  Yes  No

2. Trauma recent (within 24 hours)  Yes  No Within last 7 days  Yes  No
3. High velocity  Yes  No Blunt injury  Yes  No
4. Sudden onset  Yes  No Loss of consciousness  Yes  No
LE
5. Fully alert and orientated  Yes  No Photophobia  Yes  No
6. Pyrexia  Yes  No Neck Rigidity  Yes  No
7. General Malaise  Yes  No Drowsiness  Yes  No
8. Nausea and vomiting  Yes  No Impaired vision  Yes  No
9. Sinusitis  Yes  No Flu like symptoms  Yes  No
MP
10. Earache  Yes  No
11. Hypertension  Yes  No Hypotension  Yes  No
12. Epilepsy  Yes  No
13. Psychiatric illness  Yes  No Stress  Yes  No
14. History of alcohol abuse  Yes  No Drug or solvent abuse  Yes  No
15. Severe pain  Yes  No Localized pain  Yes  No
16. Trigeminal neuralgia  Yes  No
SA
Guidelines for Treating Nurse

In the event of sudden onset of severe headache with or without neurological symptoms, the patient
must be seen by a clinician as soon as possible.
1. Where history of head trauma, baseline observations, such as: temperature, pulse, blood pressure, respirations, and pulse
oximeter must be performed and recorded.
2. If there is any loss of consciousness or disturbance of conscious level, ensure that the patient’s airway is protected at all
times.
3. A Glasgow coma scale and neurological status must be obtained and recorded.
4. If a patient presents with neck rigidity, photophobia, nausea, vomiting, and/or dizziness, he must be seen by a clinician and
referred to hospital as soon as possible.
5. If a patient presents with hypotension or hypertension, with no prior history, he must be seen by a clinician as soon as
possible.
6. Patients with prior history of migraine or longstanding headache, normally on prescribed medication; the patient shall be
asked when medications were last consumed/taken.
7. A patient presenting with associated common cold or influenza, treat as instructed by the clinician.
8. Prolonged history of recurrent headache, with no prior investigations should always be referred to a clinician for evaluation.
9. If a patient presents with any neurological disturbance he shall immediately be examined by a clinician.
102
Standard 5
DISASTER RESPONSE PLAN

Attachments:
• FIGURE 5-1 Disaster Response Bag - 5 Victims
• FIGURE 5-2 Disaster Response Bag - 2 Victims (Off-shore clinics only)
• FIGURE 5-3 SALT Triage sample
• FIGURE 5-4 Example of Triaging patients at EMS.
103 103
104
Instructions: Tick ()) Yes or NO or write “NA” where not Applicable
Item
Standards
Code Responsible Date: Comments
Yes No NA
5.0 DISASTER RESPONSE PLAN
The Medical facilities have a quick reference Medical Emergency and Disaster
5.1 Response plan (DRP) available. At a minimum, plan outlines the following CC/HCP
information:
1. Communication chain list of key personnel and various services (i.e.,
security, firefighting and support services) and show how chain is activated
(e.g., ring-down-system flow chart). This is strategically posted at nursing
station/ safety notice board.
2. Role of each medical personnel is clearly defined on role cards and carried by
the staff in the event of medical emergency and disaster response.
The medical facilities must be provided with an appropriate and dedicated
5.2 communication device with the right frequency in line with its company’s safety/ CC/HCP
Emergency Response Policies/Procedures. (Mobile GSM, Thuraya etc.)
The medical facilities have a 24 hour emergency and key personnel telephone
numbers available and that it is properly displayed in the clinic to facilitate proper
5.3 / timely response in the event of medical emergencies, disasters, transfers and CC/HCP
Medivacs.
At a minimum the list includes the following telephone numbers:
1. Company Security Operations.
2. Saudi Aramco Security Operation.
3. Police.
4. Red Crescent.
5. Nearest healthcare facilities including MOH hospitals.
6. Company designated hospitals.
7. On-call company representative or alternate (construction Manager / Admin
Manager/Health or Safety Advisor).
8. First Aid Trained employees, list updated and displayed.
9. Evacuation group leader, where applicable.
The medical facilities at a minimum have the following Disaster Bag (s) available:
5.4 HCP
(each bag for 5 victims): Refer to Figure 5-1
105
Item
Standards
Yes No NA
5.0 DISASTER RESPONSE PLAN
1. At least two (2) bags in Category “A and B” facilities.
2. At least one (1) bag in Category “C and D” facilities.
3. At least one (1) bag for 2 Victims (Off-Shore clinics only).
Refer to Figure 5-2
The medical facilities at a minimum have the following Emergency Response
5.5 CC/ HCP
Bag(s) available:
1. At least two (2) bags in Category “A and B” facilities.
2. At least one (1) bag in Category “C and D” facilities.
The Emergency Response Bag(s) have the required medical supplies.
5.6 HCP
For the contents of Emergency Response Bag: Refer to Figure 3-4
EMERGENCY DRUGS FOR EMERGENCY RESPONSE BAG at a minimum include, the
5.7 following drugs:Staff must be certified competent to administer these drugs.Refer HCP
to Figure 4-2.
HCP shall ensure that their medical facilities emergency response bag(s) and
5.8 Disaster Bags are appropriately checked as follows: Evidence of completion is HCP
available upon request.
1. On monthly basis and/or after use.
2. Quantity is checked and recorded.
3. Validity is checked and recorded.
Every proponent organization must ensure that staff has periodic disaster training
5.9 SAPO/ HCP
as follows:
1. Training includes the application of a commonly used triage system/
Algorithm in disaster management such as:
• S.T.A.R.T. = Simple Triage and Rapid Transport
• M.A.S.S. = Move, Assess, Sort and Send
• SALT = Triage, Adapted for a very Large Radiation Emergency /
Mass Casualty = Sort, Assess, Lifesaving Interventions, Treatment /
Transport. Refer to Figure 5-3
106
Item
Standards
Yes No NA
2. Training is conducted yearly. Evidence of completion is available upon
request.
3. Staff takes part in at least two (2) disaster drills a year.
4. Completion of training both theoretical and practical is documented on the
staff’s training record. Evidence is available upon request.
5. Staff should be familiar with EMS Triaging. Refer to Figure 5-4
5.0 Emergency/ DISASTER RESPONSE PLAN
The CC, HCP & SAPO shall ensure that the medical facilities have approved
emergency response protocol in place. At a minimum, the following emergency SAPO/CC/
5.10
response requirements shall be implemented to ensure timely emergency response HCP
in the event of a disaster.
1. There is a disaster response plan in place and it is implemented.
2. There is evidence that all staff are trained and oriented on disaster response
procedures.
3. Disaster response plan is posted in a strategic location, at all times.
4. Staff shows/verbalizes location of disaster response plan.
5. There is a current disaster call-out list of key personnel.
6. Disaster call-out list is posted in a strategic location, at all times.
7. Staff shows/verbalizes location of the disaster call-out list.
107
108
109
Figure 5-1
Disaster Response Bag - 5 Victims Year:

Description Expiration Date Quantiry Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Sterile burn packs, disposable 5

Sterile blankets, disposable 5
Disposable Gloves 5
Goggles 2
Plastic Aprons 2
Lactated Ringers (LR), 1000cc 5
Sterile Water 1 litre 1
Normal Saline (0.9 Nacl),
3
1000cc
Adhesive tape 1 + 2 inches 2
LE
Cling Film Small 1
IV tubing, 15 drops/ml set 6
IV canula gauge 14 2
MP
Alcohol preps 1/2 box
Tourniquet 1 or 1/2 inch 2
Tegaderm 6cm X 7cm 10
2X2 non-sterile gauze 1/2 pack
10, 20, 30 mls Syringes 2 each
BVM mask, adult 1
SA
LMA Size 3 + 4 1
Suction connecting tubes 2
Yankauer suction catheter 4
Oral Airway, Small, Medium
1 each
Large
Pocket mask, adult 1
Oxygen mask, rebreather 4
Pressure Infuser Bag ( Dispos-
2
able)
Remarks:
Badge No.
Signature
110
Figure 5-1
Disaster Response Bag - 5 Victims YEAR:

Description Expiration Date Quantiry Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Nasal Cannula 2
Trauma dressing 5
Abdominal pad 4
4X4 sterile gauze (1box) 1
Vaseline gauze 3X18 inches 3
Triangular bandage 2
Kerlix rolls 6
Ace bandages 3 inches 3
Ace wrap 4 inches 3
LE
Ace wrap 6 inches 3
Cervical collar, Hard: small 1
Cervical collar, Hard: medium 1
Cervical collar, Hard large 1
Disposable splint: short 1
Disposable splint: long
Pneumatic splint
MP 1
as
available
Hare traction, adult 1
ADDITIONAL ITEMS
Reflective Vest Doctor 1
Reflective Vest Nurse 1
Reflective Vest Driver 1
SA
Safety Hats 1 Each
Safety Glasses shaded 1 Each
Flashlight + Batteries 1
Sharps Box 1
Paper Bags Large Waxed 2
Oxygen Flow Meters D+E 1 each
Multi-Outlet Oxygen port system 1
Clipboards 2
Continuation Sheets 5
Writing Pads 2
Pens / Pencils 2 each
Disaster Response Labels 5 each
Red/Yellow/Green/Black
Remarks:
Badge No.
Signature
111
Figure 5-2

(Off-shore clinics use only)
Description Quantity Expiration Date Week-1 Week-2 Week-3 Week-4 Remarks
Shelf - 1 (Top left side)

Small Ace Bandages - 2» 02
Alcohol Swabs 20
Gauze Swabs (Pagacomb) 2x2 (9
1 Pk
pcs.)
Kerlix Rolls 02
Shelf - 2
Ace Bandages - 6» 02
Angiocath (G-18 & G-20) 04 ea
LE
Paramedic shears 01
Shelf - 3
Angiocath (G-14 & G-16) 04 ea
IV Tubing 15 gtts./min 01
Tiangular bandages 02
MP
Pressure Infuser Bag ( Disposable) 01
Shelf - 1 (Top Right side)
Roller bandages 02
Tegaderm 10
Plasters (Band-Aid) 10
Zinc Oxide Tape (½» & 1») 01 ea
SA
Shelf - 2
Adhesive tapes 02
Abdominal dressings 05
Shelf - 3
Examination Gloves 03 pairs
Kerlix Rolls 02
Ace bandages (4») 02
Remarks:
Badge No.
Signature
112
Figure 5-2
(Off-shore clinics use only)
Description Quantity Expiration Date Week-1 Week-2 Week-3 Week-4 Remarks
Shelf - 4
IV Tubing (15 gtts./min) 02
Triangular bandages 02
Penrose drinage tubing (1›) 02
Upper Compartment
Burn pack 02
02 pairs
Gloves (7», 7.5», & 8»)
ea
Multi Trauma dressings 02
Plastic aprons 04
LE
Masks 06
Goggles 06
Gauze (4x4) 09 pcs.
Cervical collars (Medium & Large) 01 ea
MP
Lower Compartment
Emergency blankets 02
Sterile burn sheets 01
Sterile NSS Irrigation - 1 lit. 01
IVF - Ringers Lactate - 1 lit. 02
Aull arm air splints 04
Full leg air splints 03
SA
Padded arm boards 04

IVF - Normal saline - 1 lit. 02
ADDITIONAL ITEMS
Remarks:
Badge No.
Signature
113
Figure 5-3 SALT Triage
114
Figure 5-3 SALT Triage
115
Figure 5-4 Triaging patients at EMS.
Triage Reassessment
Category Level Acuity Waiting Times Examples
Closed or insecure airway
Life Threatening Immediate life, limb or N/A Absent or inadequate breathing
sight threatening Absent pulse
I Shock
Exsanguinating Hemorrhage
Seizing
Unresponsive
Severe pain 4-5/5 Acutely short of breath
Critical Requires prompt medical N/A 02 sat <95% on 02 therapy or <90% on room air
/ nursing attention by EMS Cardiac pain (see flow sheet)
II Uncontrollable Hemorrhage
Altered conscious level Hyperthermia (> 40.5 °C)
> 39 °C immunosuppressed / toxic
> 38.5 °C < 3 months age
Hypothermia (< 32 °C)
Limbs- vascular compromise
Moderate pain 3/5
Emergent Requires medical / nursing 30 - 60 02 Sat < 95%
by EMS but may care may minutes Uncontrollable minor hemorrhage
III be delayed briefly History of unconsciousness /
new neuro symptoms
Pregnancy with pain / bleeding
Black stools
Crying child inconsolable by parents
History of vomiting blood
Signs of dehydration
Pregnant with PV bleed / pain
Vomiting
Urgent Non-emergent problem 120 Pain
but patient in some distress minutes Injury
IV - should be cared for in 02 sat >95% on room air
Clinics or UCU. Temp >38.5 non-toxic
(symptomatic vs asymptomatic)
PV bleeding not pregnant
Dysuria
Wound bleeding controlled
NIA Constipation without acute pain
Non-Urgent No acute complaint - URI – Simple Coryza
patient should be cared for Cough without wheezing
V in clinics Dressing changes
Lab test reviews
Medication refill
Skin conditions / chronic
Suture removal
Time off requests / renewals
Note: Please view the adapted Triage Manual flowcharts for full criteria for above categories.* Pain scores alone are not used to
allocate category. Supporting objective data and symptoms must also be considered.
116
Standard 6
AMBULANCE SERVICE
Attachments:
• FIGURE 6-1 Ambulance - Vehicle Specs
• FIGURE 6-2 Ambulance Daily checklist (Van Type)
• FIGURE 6-3 Vehicle (Ambulance) Condition Report – Daily Checks
• FIGURE 6-4 Ambulance Movement Log
• FIGURE 6-5 Monthly Ambulance Statistics
117
118

Code Yes No NA
6.0 Ambulance Service
The CC/ HCP shall ensure that their medical facilities provide, or make
6.1 arrangements to provide, a dedicated emergency AMBULANCE vehicle to transport CC/HCP
the sick and injured to a hospital facility for further management.
The CC/ HCP shall ensure that their AMBULANCE is a two-wheel or four-wheel
6.2 (2WD/4WD) drive vehicle depending on location and terrain condition (e.g., CC/HCP
tracks, dirt roads, etc.). 4x4WD is recommended for all off road areas.
The CC/ HCP shall ensure that every AMBULANCE vehicle specifications is
6.3 CC/ HCP
provided at a minimum with the followings: OfficinaSerITCStd
1. Proper warning flashlights.
2. Purpose markings as follows:
a. Red Crescent Insignia.
b. AMBULANCE signs painted on the outside.
1. Air conditioning unit in the patient compartment.
2. Fire extinguisher ABC, small type.
3. Appropriate communication device (radio, cellular and/or satellite phone)
with available network and appropriate frequency.
AMBULANCE essential medical emergency and resuscitation supplies at
a minimum include, but are not limited to:
6.4 Some additional items have been included in order to back up the emergency HCP
response bag supplies. The items marked with an *asterisk, are loaded-up at the
time of dispatch.
1. *Emergency Response Bag.
2. *Automated External Defibrillator (AED).
3. *Suction machine (portable) with the following accessories:
a. Suction catheters.
b. Tubing.
4. *Portable oxygen resuscitation unit (e.g., Robert Shaw unit or other).
5. *Entonox/ Nitronox unit
119

Code Yes No NA
6. Stretcher collapsible (Ferno or other).
7. Backboard short with straps.
8. Long board with straps .
9. Hare traction. HCP
10. Kendrick Extrication Device (KED). HCP
11. Oxygen cylinder, large size (modular and van type only). HCP
12. At a minimum, the following oxygen supplies accessories are available: HCP
a. Rebreathing mask.
b. Nasal cannulas.
c. Tubing.
13. Oxygen cylinder key. HCP
14. Rigid cervical collar, sizes as follow or flexible size: HCP
a. Small.
b. Medium.
c. Large.
15. Infection/Environmental control items and Personal Protective Equipment
HCP
(PPE) include, but not limited to:
a. Goggles.
b. Surgical mask.
c. Plastic apron.
d. Examination gloves (sterile).
e. Examination gloves (unsterile).
f. Small sharps container.
g. Infectious waste plastic bag.
h. Plastic trash bag.
i. Heavy duty gloves.
j. Safety hard hat.
k. Safety shoes.
120

Code Yes No NA
16. First aid kit - unit size 36 & FA supplies as follows: Refer to Figure 1-4 HCP
a. Ace bandages
b. Kerlix bandages
c. Cold packs.
d. Scissors
17. First aid kit - unit size 36 & FA supplies as follows: Refer to Figure 1-4 HCP
a. Ace bandages
b. Kerlix bandages
c. Cold packs.
d. Scissors
18. Miscellaneous items include, but are not limited to: HCP
a. Notepad.
b. Pen.
c. Flash light, 9 volt.
d. Tire gauge.
e. Kleenex tissue.
f. Safety triangle.
The HCP shall ensure that the AMBULANCE equipment and supplies are checked
6.5 daily, or after each patient trip. Inspections are recorded and available upon HCP
request. Refer to Figure 6-2
The HCP shall ensure that the AMBULANCE is taken for a test run on a daily
6.6 basis. The vehicle condition is checked and recorded and available upon HCP
request. Refer to Figure 6-3
The HCP shall ensure that their AMBULANCE is thoroughly cleaned inside and
6.7 washed outside on a weekly basis or after a patient run, if necessary and the HCP
Ambulance Movement Log is completed. Refer to Figure 6-4
121

Code Yes No NA
The HCP shall ensure that their AMBULANCE (s) have valid (quarterly) periodic
6.8 maintenance and the required Government Periodic Inspection with HCP
Documentation evidence is available upon request.
The CC and HCP shall ensure that each AMBULANCE is covered with valid
6.9 CC/HCP
Comprehensive Insurance and valid registration.
The VEHICLE REGISTRATION card (Isthimara) indicates that the used vehicle is
6.10 CC/HCP
registered as an AMBULANCE.
Complete Ambulance Statistics forms at the end of each month.
6.11 Refer to Figure 6-5
122
Figure 6-1
AMBULANCE – MINIMAL VEHICLE SPECIFICATIONS
SN REQUIRED ITEMS MINIMUM SPECIFICATIONS REMARKS (√)
1. Engine 6 cylinder minimum
2. Transmission Automatic
3. Steering Power steering with tilt column
4. Brakes Power Assisted
Safety
(a) Air bags Driver and front passenger
(b) Fire Fire extinguisher – type ABC small.
(c) Triangles Holders/Brackets for portable equipment
(oxygen/suction)
5.
(d) Equipment Overhead IV holder/hook
(e) Warning i. Lights - Beacon & dome light * With available network and the
ii. Siren system, amplifier & microphone. appropriate frequency.
iii. Communication device (Radio/cell phone/
satellite)*
Factory installed. Driver & patient’s cabin.
6. Air Conditioning
Roof type ventilation fan.
Front bench seats.
Patient’s cabin. Attendant’s seat with storage
7. Seating
compartment underneath. Final height
must not be higher than 36 cms.
Tires Radial sand tires with speed rating of 120 KPH
8.
minimum.
9. Spare tire Full size spare tire.
Floor High grade embossed vinyl flooring.
Partition Half or full wall partition behind driver. If full with
sliding window.
Storage Cabinet with sliding door on the left side of the
ambulance.
10. Tow hooks Front, attached to chassis.
Glass Tinted. 70% transparent heat film (V-cool or 3M).
11. Color White, single color.
a. Complete light system in driver’s and patient’s
14. Lights cabin
b. Scene/spot light mounted at rear top of vehicle.
Oxygen system Individual cylinder** secured with brackets or ** size ”E” or 680L (volume)
15.
centralized system.
16. Suction system Portable machine or centralized system.
External. Reflective with “AMBULANCE” *** in *** Inverted
17. Signage
English & Arabic & Red Crescent insignia.
**** E.g. Suburban, GMC Yukon,
Ford Expedition,
In case of a carryall vehicle****, the roof must be
Toyota, etc. Conversion shall be by
18. Roof conversion raised 10 inches (minimum) above regular height.
manufacturer or the vehicle is
The raised area shall be reinforced fiberglass.
imported and registered as an
ambulance.
123
Figure 6-2
Daily Ambulance Checklist (Van Type)
Month & Year:__________________________ Ambulance # ____________________ Clinic:__________________________
Equipment Qty 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
LEFT REAR SIDE

Oxygen Tank 1
Short backboard with 3 straps 1
Hare Traction 1
st
LEFT TOP 1 COMPARTMENT
Ambu-bag 1
Non-rebreather mask & nasal cannula 2 ea
O2 Tubing 2
Minilator with connector & Tube 1
(2 meters)
O2 Nipples 10 Liters 5
Oxygen Flow meter D&E
LEFT TOP 2 nd
COMPARTMENT
1 ea
LE
Ambu-bag 1
Non-rebreather mask & nasal cannula 2 ea
Suction Catheters size 10 & 14
Suction connecting tubing
2 ea
1
P
Yankeur Sucker 1
LEFT MIDDLE SHELF-TOP
Arm Sling & Swath 1
A M
Arm-boards (Adult & Pediatric) 2 ea
Cold Pack 2
Kerlix Bandages
Non Sterile Gauze (100 / pack)
Sterile Abdominal Pads
4
2
4
S
Sterile saline (1000ml) 1
Multi-Trauma Pack 4
Burn Pack 2
124
Daily Ambulance Checklist (Van Type)
Month & Year:__________________________ Ambulance # ____________________ Clinic:__________________________
Equipment Qty 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
LEFT MIDDLE SHELF-BOTTOM

C-Collar (Hard)Fits all size 2
Tissues(Box) 1
Gloves (large, medium & small) 1 ea
Face shield (Goggles) 3
Plastic Gown 3
Yellow Infectious Waste Bags(Roll) 1
UNDER BENCH SEAT
Scoop Stretcher 1
Urinal / Bedpan 1 ea
ON BENCH SEAT
Long Backboard with 4 Straps 1
LE
DRIVER CABINET
Helmet 3
Reflective Vest (Nurse x 2, Driver x 1)
BACK SIDED NURSE SEAT
Igloo Water Cooler
3
1
M P
Ferno Collapsible Stretcher 1
Portable Air Compressor 1
Missing Item Replaced: Yes or No Y/N
Problems/ Action Date

S A
Any missing items should be replaced immediately or explain below and report.
Initials of Checker
125
Figure 6-3
Vehicle (Ambulance) Condition Report – Daily Checks
Medical Facility: ____________________ Vehicle No.: ____________________
Day Checked and Initials Remarks if Deficient
Item Code Items Checked
1 2 3 4 5 6 7
A.1 General cleaning inside and outside.
A.2 Air conditioning.
A.3 Directional lights.
A.4 Fuel gauge.
A.5 Horn.
A.6 Siren.
A.7 Mirrors.
A.8 Steering wheel.
A.9 Seat belts.
A.10 Hand brake.
A.11 Foot brake.
A.12 Radio communication.
A.13 Engine oil/Transmission oil.
A.14
A.15
A.16
Fan belts.
Radiator.
Wiper water reservoir level.
LE
A.17 Battery.
A.18 Flashers.
A.19
A.20
Head lights, low and high beam.
Tail lights.
P
A.21 Stop lights and parking lights.
A.22
A.23
Muffler.
Tire condition and pressure.
A M
A.24 Spare tire and tire changing tools.
A.25 Triangle.
A.26 Fire extinguisher.
Daily Test Run Mileage Record (km)
S
1 2 3 4 5 6 7
Mileage - Out
Mileage - In
Vehicle (Ambulance) Condition Report – Daily Checks 126
Figure 6-4
AMBULANCE MOVEMENT LOG Location:
Ambulance
110 or Patient’s Name & Signature &
Date Time Nature of Incident Incident Location Mileage Outcome
Regular call Badge # Time out Time in Mileage in Badge #
out
P LE
A M
S
Note: 1. Enter all calls, to include False Alarms, Ambulance runs, and MEDEVACs; 2. Enter patient’s condition at the time of turnover under OUTCOME,
i.e., Stable, Unstable, or Expired; 3. Enter N/A for items that are not applicable.
127
Figure 6-5
Monthly Ambulance Statistics
Month & Year__________________________ Clinic_______________________________
Vehicle # Next Aramco ∆ Curent Month Last month Mileage done # of Runs
PM Service Sticker Mileage reading Mileage reading this month this month
# of Garage visits REMARKS
Due Date Exp. Date (A) Kms (B) Kms (A-B) Kms
Date B PM RP Lost PT O
hours
B-Breakdown, P.M - Preventive Maintenace, RP - Repair,

PT - Patient related trips (Real emergencies, Fire Alarms, Fire & Disaster drills) O - Other trips (Orientation, Garage visits & Gasoline refill, Standby)

Prepared by & Badge #_____________________________________________ Tel #__________________ Date_______________________
128
Standard 7
EOC/SAFETY
1.FIRE SAFETY
2.EYE WASH STATION
3.DECONTAMINATION SHOWER
4.HAZARDOUS SUBSTANCES SAFETY
5.COMPRESSED GAS CYLINDERS
6.ELECTRICAL EQUIPMENT SAFETY
7.MEDICAL EQUIPMENT SAFETY
129
130
Item Date: Comments
Standards Responsible
Code
Yes No NA
7.0 EOC/SAFETY
1. FIRE SAFETY
The CC shall ensure that their medical facilities have fire safety equipment
CC
available. At a minimum this includes, but is not limited to:
1. Fire Extinguishers as follows: CC
a. Appropriate fire extinguishers (A, B, C). CC
b. Clearly identified. CC
c. Placed in strategic locations. CC
d. Labeled with proof of periodic inspection, usually quarterly. CC
2. Smoke detectors. CC
3. Scott Air Pak (At location where exposure to H2S is a risk). CC
The CC & HCP shall ensure that their medical facilities have approved fire
safety protocols in place. At a minimum, the following safety requirements
CC/HCP
shall be implemented to ensure the safety of patients/family, staff and
visitors:
1. There is evidence that all staff is oriented on fire safety (R.A.C.E. and
P.A.S.S.).
2. Staff verbalizes what to do in the event of a fire: Rescue injured per-
son(s) from immediate danger, Activate nearest fire alarm pull station,
Confine the fire by closing all doors/windows, Extinguish if fire is small
or evacuate.
3. Staff shows/verbalizes location of the nearest fire alarm.
4. Staff shows/verbalizes location of the nearest fire exit and evacuation
protocol.
5. Staff is able to operate fire alarm, in theory.
6. Staff shows/verbalizes location of the nearest fire extinguisher.
7. Staff demonstrates/verbalizes knowledge of the types of fire extinguish-
ers (A, B, C).
131
Item Date: Comments
Code
Yes No NA
7.0 EOC/SAFETY
8. Staff is able to verbalize how to properly operate fire extinguisher:
Pull the pin at the top of the fire extinguisher.
Aim the nozzle at the base of the fire.
Squeeze the handle of the fire extinguisher together.
Sweep the nozzle from side to side (P. A. S. S.).
9. In the event of a fire staff knows/verbalizes the proper fire evacuation
procedures. Able to put into action, in theory.
10. Fire evacuation procedures are posted in appropriate/ strategic
locations, at all times.
2. EYE WASH STATION
The contractor company shall ensure that their medical facilities have
CC
eyewash station available as follows:
1. Unit is outside the facility building in proper working order.
2. There is evidence that unit is regularly tested/inspected.
3. Water is maintained at a tepid temperature and to ensure that the unit is
in proper working order.
4. Portable eye wash is acceptable for one Nurse operated facility “level C
and D”.
3. DECONTAMINATION SHOWER
The CC shall ensure that their medical facilities have decontamination shower
CC
available as follows:
1. Unit is located outside the facility building in a “well ventilated area” in
close proximity to the emergency entrance and provided with curtains
and shelter.
2. There is evidence that unit is regularly tested/inspected, Water is main-
tained at a tepid temperature and to ensure that the unit is in proper
working order.
132
Item Date: Comments
Code
Yes No NA
7.0 EOC/SAFETY
4. HAZARDOUS SUBSTANCES SAFETY
The HCP shall ensure that their medical facilities have a system in place for
HCP
the safe management/storage of hazardous substances as follows:
1. There is a Material Safety Data Sheet (MSDS) Manual available.
2. There is a current MSDS for each hazardous substances/ products
used.
3. Manual is placed on a strategic location, easy to see and reach
4. Staff is able to quickly locate the MSDS manual.
5. Facility has appropriate antidotes for handling chemical exposure.
5. COMPRESSED GAS CYLINDERS
The HCP shall ensure that their medical facilities properly manage their
compressed gas cylinders. At a minimum, the following precautions and
HCP
safety regulations shall be observed when storing, handling, and using com
pressed gas cylinders in order to keep the hazards to a minimum:
1. Pressure is checked and logged daily, log sheet available.
2. Cylinders are replaced when content reaches 500 pressure per square
inch (psi). Hydro test to be completed and current
3. Cylinders are securely stored as follows:
a. Either on oxygen delivery carts, walls, or in a secure storage cage.
b. In an upright position (valve end up), on a level floor.

c. Well ventilated and dry storage area.
d. In a storage room free from flammable substances
(i.e., oil and/or volatile liquids).
e. Away from direct sunlight and from other sources of heat as cylinder
temperatures must not exceed 50 °C (122 °F).
133
Item Date: Comments
Code
Yes No NA
7.0 EOC/SAFETY
f. Sources of ignition (i.e., motors, generators, communication sys-
tems, etc.) are removed from the storage room.
g. Empty cylinders are stored separate from full cylinders.
h. Empty cylinders are marked empty.
4. No smoking signs are available and posted in areas where gas cylinders
are located and/or stored.
6. ELECTRICAL EQUIPMENT SAFETY
At a minimum, the following precautions and safety regulations are observed
by HCP and CC when handling electrical equipment in order to prevent HCP/ CC
injuries:
1. All electrical equipment is in proper working condition and safe for use,
does not tingle, shock, spark or get overheated.
2. Case or body of the item is not cracked, chipped or broken.
3. There are no exposed internal parts.
4. The controls (buttons) are complete and functional.
5. There is an off switch, when used, equipment turns off.
6. Unit’s cord is intact (not damaged), has no cracks and/or breaks.
7. Plug is not damaged.
8. Plug is directly secured to wall socket.
9. There is evidence that equipment is periodically checked for obvious
defects or hazards.
10. There is evidence that defective equipment is removed from service,
has tags so that no other staff will attempt to use it.
11. Microwave Oven, if available at the clinic, shall be managed by the HCP
as the followings:
a. Have operating instructions posted nearby.
b. Maintained, clean and in good working order.
134
Item Date: Comments
Code
Yes No NA
7.0 EOC/SAFETY
12. All electrical equipment is ground protected.
7. MEDICAL EQUIPMENT SAFETY
The HCP shall ensure that their medical facilities have a system in place for
the management of their medical equipment. At a minimum, the following
precautions and safety regulations shall be implemented to ensure that the HCP
medical devices meet appropriate standards of safety, quality and
performance:
1. There is a process in place for maintenance/ service/ acceptance test
of medical equipment performed/ arranged by the HCP. A record of this
test is available upon request.
2. All patient care equipment must undergo periodic preventive mainte-
nance (PM) checks. This includes testing and calibration as per man-
ufacturer and local policy. PM stickers or log are placed to indicate PM
completion and next due date.
3. There is evidence that there is a backup system in place for repairing
medical equipment.
4. All equipment shall be checked daily for normal function and findings
and recorded in a log. Log is available upon request.
135
136
Standard 8
INFECTION CONTROL AND HOUSEKEEPING
Attachments:
• FIGURE 8-1 Tetanus Vaccine Report
• FIGURE 8-2Cleaning of Blood Spills
• FIGURE 8-3 Floor sink
• FIGURE 8-4 Housekeeping Equip & Supplies
137
FIGURE 8-3
Floor sink
138
Code Yes No NA
8.0 INFECTION CONTROL AND HOUSEKEEPING
1. VACCINATION PROGRAM CC/HCP
The HCP shall ensure that their medical facilities have a vaccination program
HCP
in place as follows:
1. There is a vaccination program for all open wound injuries and is
implemented.
2. Administered vaccines are appropriately logged in a book or database.
Refer to Figure 8-1
3. As per MOH regulations, all staff before site assignment, shall be
CC/HCP
screened and immunized as follows:
a. Chest X-ray.
b. Tuberculosis skin test (tuberculin or PPD test).
c. Hepatitis B (HBV) and Hepatitis C (HCV).
d. Human Immunodeficiency Virus (HIV).
e. There is evidence that screening and immunization were
completed.
f. Chest X-ray.
2. INFECTION CONTROL
1. The HCP shall ensure that staff knows and complies with the following
HCP
standard precautions:
g. Hand washing.
h. Gloves.
i. Mask.
j. Handling sharps.
k. Disposal of contaminated waste.
l. Cleaning of spills.
m. Patient placement (isolation).
139

Code Yes No NA
2. The HCP shall ensure that personal protective equipment (PPE) is always
HCP
available. At a minimum this includes, but is not limited to:
a. Disposable masks.
b. Gloves.
c. Goggles.
d. Gowns.
e. Plastic aprons.
f. Safety shoes.
3. The HCP ensures that sterilization is not performed by soaking in
HCP
liquids, boiling and/or steaming. This is not an acceptable practice.
4. STERILIZERS are not present at the remote industrial medical facilities.
The HCP shall ensure that all CSS supplies (instruments & packs) in their
HCP
medical facilities are disposable. At a minimum these include, but are
not limited to:
a. Dressing packs.
b. Suture pack.
c. Forceps.
d. Tongue depressors.
e. Dressing scissors (individual pack).
5. Clinical areas have sinks (wash basins) available with the
CC
following:
a. Hot and cold water.
b. Antiseptic liquid soap.
c. Wall mounted single paper towel dispensers.
d. Trash bins.
6. The HCP shall ensure that their medical facilities have approved
HCP
alcohol-based hand-rub.
7. Staff knows and is able to demonstrate appropriate hand sanitizing/
HCP
Hand washing
140

Code Yes No NA
8. Hand washing technique as per established hand washing policy. HCP
9. Examination tables are protected with disposable cover sheets or paper
HCP
rolls.
10. The HCP shall ensure that their medical facilities have appropriate
HCP
bactericidal available and that it is used to disinfect hard surfaces.
11. Disposable linen stored in a protected clean area. HCP
12. Soiled linen placed (deposited) into covered, leak proof bags, as per
HCP
established criteria.
13. There are adequate puncture resistant, leak-proof sharp containers in
HCP
all clinical areas, as follows:
a. All clinical areas have sharp containers.
b. Sharp containers are wall-mounted.
c. Replaced when they are three quarters (¾) full.
14. There is no recapping of needles. If used needles are recapped, the
HCP
scoop method is used.
15. Healthcare providers are able to verbalize what to do in the event of a
HCP
needle stick/sharps injury.
16. Housekeepers are able to verbalize what to do in the event of a needle
HCP
stick/sharps injury.
17. The HCP shall ensure that their medical facilities have a system in
place for the safe management (identification, segregation, collection,
HCP
storage, transportation, treatment and disposal) of infectious wastes/
biomedical waste, as follows:
a. System is in compliance with Infection Control (IC) guidelines and
is in accordance with MOH regulations.
b. Staff is familiar with and is able to verbalize the disposal protocol
(i.e., all sharps boxes are securely taped shut, double boxed and
transported to an approved agent for disposal).
18. The HCP shall ensure that their medical facilities have adequate
HCP
color-coded foot-operated waste bins, as follows:
141

Code Yes No NA
a. For regular waste.
b. For infectious waste.
c. Bins are labeled.
19. Laboratory specimens are handled, stored and transported in
HCP
accordance with established policy/protocol.
20. The HCP shall ensure that their medical facility have blood spill kits
HCP
available. For cleaning of blood spills and contents. Refer to Figure 8-2
21. There is evidence that personnel responsible for cleaning and
HCP
disinfecting blood and body fluids spills are adequate trained.
22. The HCP & CC shall ensure that their medical facilities have two (2)
HCP/ CC
dedicated refrigerators available, as follows:
a. Medication refrigerator is used for medications only. HCP
b. Refrigerator is used for staff’s food only. HCP
c. Temperature is maintained between 2-8 degrees Celsius
HCP
d. (36-46 degrees Fahrenheit).
e. There is a thermometer available in each refrigerator. HCP
f. Refrigerator’s temperature is recorded twice a day in a log sheet.
HCP
Log is available upon request.
g. Refrigerators are cleaned inside and out on a regular basis, and
HCP
when applicable, defrosted as needed.
3. JANITORIAL SERVICES
1. The CC shall ensure that their medical facilities have a dedicated
part-time (at least 4 hours in morning shift and 1-2 hours in evening
CC
shift) for one Nurse operated Clinic or full day shift for large Nurse
Clinic. Full-time janitor available every shift for Level A and B clinics.
2. The HCP and CC shall ensure that their medical facilities are cleaned
HCP/CC
inside and outside to acceptable healthcare standards.
3. The CC & HCP shall ensure that their medical facilities’ janitor receives
training/orientation in medical housekeeping. On-site orientation
HCP/CC
performed by a nurse and/or a senior janitor is acceptable. Evidence of
the orientation period/ training completion available upon request. 142
Code Yes No NA
4. The CC & HCP shall ensure that their medical facilities’ janitor attended
HCP/CC
an infection control training/ class.
5. The CC & HCP shall ensure that their medical facilities’ janitor is appro-
priately immunized prior to medical facility assignment. Evidence of HCP/CC
immunization is available upon request.
6. The HCP shall ensure that their medical facilities’ janitor closet is clean
HCP
and tidy. For Floor sink sample Refer to Figure 8-3
7. The HCP shall ensure that their medical facilities’ cleaning agents and
HCP
disinfectants are appropriately labeled and stored.
8. The HCP shall ensure that their medical facilities’ color coded mops are
HCP
cleaned and disinfected on a daily basis. Evidence is available.
9. The HCP shall ensure that their medical facilities’ janitors use separate
HCP
cleaning equipment for toilet areas. This shall be in evidence.
10. The HCP shall ensure that their medical facilities according to their size
and needs have sufficient housekeeping equipment and supplies. At a HCP
minimum these include, but are not limited to: Refer to Figure 8-4.
11. The CC & HCP shall ensure that there is a regular (twice daily and as
HCP/CC
necessary) removal of trash from all clinical areas.
12. The HCP shall ensure that their medical facilities have a procedure for
HCP
cleaning blood spills and that it is posted. This shall be in evidence
13. Janitor and other staff know/verbalize the blood spill cleaning proce-
HCP/CC
dures and cleaning fluid dilution ratios, as per guidelines.
14. The CC & HCP shall ensure that their medical facilities’ are cleaned on
a daily basis, cleaning is in evidence. At a minimum cleaning includes, HCP/CC
but is not limited to:
a. Damp dusting.
b. Polishing floors and/or furniture as applicable.
c. Vacuuming.
d. Mopping of floor.
e. Cleaning toilet areas.
143
Figure 8-1
Tetanus Vaccine Report
Medical Facility:________________________________________________

Date Given Patient Name Company ID Batch/Lot No. Nurse Signature ID No.
P LE
A M
S
144
Figure 8-2
Cleaning of Blood Spills
Spills of blood can occur in your medical facility. So, it is essential to keep in mind that it is not
possible to identify patients with Hepatitis B virus (HBV) and/or Human Immunodeficiency Virus
(HIV). Therefore, all blood and blood borne pathogens “shall be considered infectious.”
A Blood Spill Kit shall be placed in all areas where blood spills are likely to occur, including medical
facilities in remote areas.
Each Spill Kit shall have the following items and supplies:
• One two-compartment plastic pail (dual bucket).
• Disposable shoe covers.
• Disposable safety glasses or plastic goggles.
• Disposable mask.
• Disposable gloves.
• Two (2) trigger sprayers or peri-bottles, labeled #1 and #2.
LE
• One (1) measuring glass.
• Container of detergent/disinfectant mixed to correct ratio.
• Container of 5.25% sodium hypochlorite (Clorox).
• One (1) roll paper towel or disposable cleaning cloths (J-cloths).
• One (1) roll color-coded plastic bags for disposable of infectious waste.
•
•
One “WET FLOOR” sign.
MP
One (1) laminated copy of these instructions.
Cleaning Procedure:
1. Place “WET FLOOR” sign near to the spill.

2. Wear disposable gloves and mask.
SA
3. If splashing is anticipated, protective eye wear, such as disposable goggles should be worn.
Wear disposable coverall/gown if soiling of clothes is likely.
4. If there is a chance that shoes could become contaminated, wear shoe covers.
5. Prepare the disinfectant/detergent solution according to the following prescribed ratio:
a. One 1 ounce of Beaucoup solution per one (1) gallon of sweet water.
b. One 1 ounce of Clorox solution per nine (9) ounces of sweet water.
Note: For other chemical dilution ratios, see page 97.
6. Arrange the required color coded (yellow) bio-hazardous plastic waste bags, so they are ready
to receive contaminated waste.
7. Use disposable paper towels to soak up and remove all spilled blood or body fluid. Place soiled
disposable paper towels in the color coded (yellow) bio-hazardous bag. Repeat until all spilled
blood or body fluid has been removed.
8. Spray or apply adequate approved disinfectant solution (Beaucoup) on the spillage area. Clean
the area with fresh paper towels, being sure to remove all visible blood or body fluid. Dry with
fresh paper towels. Place soiled disposable paper towels in the color coded (yellow)
bio-hazardous waste bag.
145
Spray or apply adequate Clorox solution on the spill area, ensuring that the entire spillage area is
covered with Clorox solution. Allow a two minute contact time and then wipe the area thoroughly with
disposable paper towels. Dry with fresh paper towels. Place soiled disposable paper towels in the color
coded (yellow) bio-hazardous bag.
9. Wait for the area to completely dry before removing the WET FLOOR sign.
10. Clean and disinfect the trigger spray bottles and other non-disposable items, as these items
are considered potentially contaminated.
11. On completion of the task, place all disposable protective garments, such as gloves, shoe
covers, goggles and mask in the yellow plastic bag. Wash hands thoroughly using antiseptic
soap, such as Scrub stat.
12. Replenish all disposable items in the spill kit and ensure it is ready for future use.
Spills/Splashing of Walls:
1. Wear disposable gloves and mask.
LE
2. If splashing is anticipated, protective eye wear (goggles) should be worn. Wear gown if soiling of
clothes is likely.
3. Wear shoe covers if there is a chance of shoes becoming contaminated.
4. Prepare the disinfectant/detergent solution according to prescribed ratio.
MP
a. One 1 ounce of Beaucoup solution per one (1) gallon of sweet water.
b. One 1 ounce of Clorox solution per nine (9) ounces of sweet water.
5. Arrange the required color coded (yellow) bio-hazardous plastic waste bags, so they are ready to
receive contaminated waste.
6. Use disposable paper towels to soak up and remove all of the spilled blood or body fluid. Place soiled
disposable paper towels in the color coded (yellow) bio-hazardous waste bag.
7. Spray or apply adequate SAMSO approved disinfectant solution (Beaucoup) on the spillage area.
SA
Clean the area with fresh paper towels, being sure to remove all visible blood or body fluid. Dry with
fresh paper towels. Place soiled disposable paper towels in the color coded (yellow) bio-hazardous
waste bag.
8. Spray or apply adequate Clorox solution on the spill area, ensuring that the entire spillage area is
covered with Clorox solution. Allow a two minute contact time and then wipe the area thoroughly
with disposable paper towels. Dry with fresh paper towels. Place soiled disposable paper towels in
the color coded (yellow) bio-hazardous waste bag.
9. If it is found absolutely necessary to use a yellow scouring pad, this scouring pad should then be
treated as infectious waste.
10. Double bag the scouring pad in yellow color plastic bag for disposal.
11. Clean and disinfect the trigger spray bottles and other non-disposable items, as these items are
considered to be potentially contaminated.
12. On completion of the task, place all disposable protective garments, such as gloves, shoe covers,
goggles and mask in the yellow plastic bag. Wash hands thoroughly using antiseptic soap, such as
scrub stat.
13. Replenish all disposable items in the spill kit and ensure it is ready for future use.
146
Chemical Dilution Ratios
Beaucoup Phenolic Germicidal Detergent

One (1) ounce (30 milliliter) of Beaucoup per 1 gallon (3.7 liters) of sweet water.
Floor Maintainer Non-Ionic Surfactant Diethylene Glycol Mono Ethyl

Ether
LE
Three (3) ounce (30 milliliter) of Floor Maintainer per one (1) gallon (3.7 liters) of sweet water.
Six (6) ounce (60 milliliter) of Floor Maintainer per two (2) gallons (7.5 liters) of sweet water.
Upgrade Quarternary Ammonium Germicidal Detergent

MP
One (1) ounce (30 milliliter) of Upgrade per three (3) gallons (11.3 liters) of sweet water.
Biotek Quarternary Ammonium Germicidal Detergent

One (1) ounce (30 milliliter) of Biotek per three (3) gallons (11.3 liters) of sweet water.
SA
Clorox Liquid Bleach

One (1) ounce (30 milliliter) of Clorox per nine (9) ounces of sweet water.
Breaker Alkaline Detergent

One (1) ounce (30 milliliter) of Breaker per three (3) gallons (11.3 liters) of sweet water.
147
Figure 8-4
Housekeeping Equipment and Supplies Minimum Requirement
The quantity of each listed below depends on the medical facility category and utilization rate.
Description Check (√) Remarks

Mops, two (2) different colors.
Trolley with dual mop bucket and wringer/portable bucket with wringer for small clinic.
J cloth.
Sodium hypochlorite (Clorox bleach).
Antiseptic scrub for sinks (hibi-scrub/ hro-scrub 4).
Trigger spray bottle.
Detergent, upgrade or similar, e.g., beaucoup for patient area.
Plastic bags for rubbish, color coded for infectious waste.
Paper towels for sinks and spills.
Paper towel dispenser.
Wet Floor sign.
Blood Spill Kit.
Floor polish.
LE
Window cleaner.
Furniture polish.
General multi-cleaner with bleach for sinks, etc.
Toilet bowl and urinal cleaner.
M P
Soap, liquid and dispenser.
Waste bin, pedal type with lid for clinical waste.
Waste basket, general purpose.
Hand brush and dust pan.
Gloves rubber, heavy duty.
S A
Hand sanitizer, ethyl alcohol 70% base, Sani-gel or Septo-gel.
Housekeeping Equipment and Supplies Minimum Requirement
148
Standard 9
MEDICAL RECORDS, POLICIES AND PROCEDURES
Attachments:
• FIGURE 9-1 Patient Treatment Daily Log
• FIGURE 9-2 Injury Summary Report
• FIGURE 9-3 Policies & Procedures
• FIGURE 9-4 Scope 0of Service
• FIGURE 9-5 Consult & Transfer to RAC
149
150
Code Yes No NA
9.0 MEDICAL RECORDS , POLICIES AND PROCEDURES
1. PATIENT PROCESSING AND MEDICAL RECORDS
1. The HCP shall ensure that their medical facilities have dedicated medical
HCP
record/ file available for every patient/ Electronic filing recommended.
2. The HCP shall ensure that their medical facilities have a tetanus immuni-
HCP
zation record available in the patient’s medical record/file.
3. The HCP shall ensure that their medical facilities have a process availa-
ble (e.g., log book) for documenting patient’s attendance. Information
HCP
listed is generally nonclinical and is kept for statistics purposes and for
periodic report to management. Refer to Figure 9-1
4. The HCP shall ensure that their medical facilities have a process
HCP
available for reporting patient Off-Duty status.
5. The HCP shall ensure that their medical facilities have printed education
HCP
materials/posters available.
6. The HCP shall ensure that their medical staff document each and
every encounter into the medical record. At a minimum, the following HCP
information is included:
a. Patient’s name and ID number.
b. Date of visit
c. Time in and time out.
d. History.
e. Examination and assessment results.
f. Diagnosis or impression.
g. Treatment given, medications, etc
h. Discharge status/sick leave/work restriction/referral.
i. Discharge instructions.
j. Significant Medical Data Sheet (SMDS),
i.e. ordinary / occupational / work injuries.
151
Code Yes No NA
2. REPORTING ON-THE-JOB/OFF-THE-JOB INJURIES
The CC & HCP shall ensure that their medical facilities have a system in place
for reporting on-the-job/off-the-job injuries. Injuries shall be documented
recorded in a log book Refer to Figure 9-2, and all injuries are reported as per
HCP/CC
established regulations of MOH, MOL Law & Saudi Aramco Loss Prevention.
Refer to GI 6.0005….. link
3. HEALTH CARE POLICIES, PROCEDURES AND GUIDELINES

1. Medical Staff are familiar with the location of their Health Care Policies, HCP
Procedures and Guidelines.
For the required Policies and Procedures. Refer to Figure 9-3
2. The HCP shall ensure that their policies and procedures are accessible HCP
to all staff. At a minimum, includes but not limited to the followings
Health Care Policies and Procedures:
A. SCOPE OF SERVICE
The HCP shall ensure that each medical facilities has a policy that defines
their scope of service: Refer to Figure 9-4
1. Type of care and treatment offered at the facility. HCP
2. Eligibility of service. HCP
3. Investigations, tests and clinical procedures (diagnostic or otherwise) HCP
performed in the facility.
4. Hours of operation. HCP
B. MEDICAL EMERGENCY AND DRP/ MEDIVAC GUIDELINES
at a minimum include, the following policies and procedures:
1. Medical Evacuation (Medivac) for medical/traumatic emergencies from CC/ HCP
Saudi Aramco Aviation.
Compliance to Saudi Aramco GI-1321.015.
2. Medical Emergency(s) Response. HCP
3. Disaster Response. CC/ HCP
152
Code Yes No NA
C. INFECTION CONTROL POLICIES AND PROCEDURES
at minimum include the following policies and procedures: HCP
1. Infection Control in Medical Facility Personnel. HCP
2. Blood and Infectious Fluid Exposure. HCP
3. Employee Screening and Immunization Program. HCP
4. Hand Hygiene. HCP
5. Handling of Soiled and Clean Linen. HCP
6. Specimen Collection and Transport, where applicable. HCP
7. Cleaning of Spills. HCP
8. Sharp Injuries, what to do in the event and reporting. HCP
9. Reporting Occupational Illness/ Communicable diseases HCP
(i.e., Hepatitis B/C, Tuberculosis, Chicken pox, etc.).
D. GENERAL POLICIES AND PROCEDURES
at a minimum include the following policies and procedures:
1. Waste Management. HCP
2. Protocols for consultation and for patient referral to the nearest CC/HCP
hospital, or to an inpatient medical facility.
3. The HCP has a patient consultation, referral and transfer policy to Saudi CC/HCP
Aramco remote urgent care facilities. Contractor/ HCP shall comply with
the attached RAC consultation and Transfer policy Refer to Figure 9-5
4. The HCP shall ensure that their medical facilities have a policy that HCP
describes a reliable alternative system of transfer in place in the
absence of an ambulance.
5. The HCP shall ensure that a policy on Occupational Health Services HCP
(physicals and conservation program, i.e., hearing, pulmonary, etc.) is
available for their employees.
153
Code Yes No NA
E. SAFETY POLICIES AND PROCEDURES
1. Fire Drills and Fire Response. CC/HCP
2. Equipment Maintenance HCP
3. Adherence to GI-150.002 (First Aid Training for Employees). CC/HCP
F. PATIENT CARE GUIDELINES (EXAMINATION AND TREATMENT PROTOCOL FOR NURSES)
at a minimum include, the following policies and procedures: HCP
1. Protocols (steps to follow) for the treatment of common illness HCP
and emergencies, from a common cold to chest pain, burns, etc.
Refer to Figure 4.3 and Figure 4.4
2. Protocols for consultation and for patient referral to the nearest HCP
hospital, or to an inpatient medical facility.
3. Nursing Procedures and Work Practice. HCP
4. Management of Death. HCP
5. Patient and Family Rights. HCP
6. Confidentiality of Patient Information. HCP
7. Medication Guidelines HCP
a. Medication Requisition. HCP
b. Prescribing, administration and dispensing of medication/ drugs in HCP
the absence of a physician or pharmacist, in accordance with MOH
regulation.
c. Shipping and Receiving of Drugs. HCP
d. Storing and Disposal of Drugs. HCP
e. Prescription storage and administration of narcotics and controlled HCP
drugs.
154
Code Yes No NA
G. COMMUNICATIONS
1. The HCP shall ensure that their medical staff keep a communication HCP
book/file available at the medical facilities to maintain effective
internal and external communication.
2. The HCP/CC shall ensure that their medical facilities have a notice CC/HCP
board(s) available and that it contain current relevant information,
e.g., safety, infection control, etc.
3. The contractor company shall ensure that their medical facilities have CC
the following communication devices available:
a. A landline phone with internal and external access, including direct
access to emergency services.
b. Global system for mobile communications (GSM) and/or other
communication devices with available network and appropriate
frequency for field communication.
4. The CC shall ensure that their medical facilities have a dedicated CC
telephone available for internal communication and with appropriate
dial access to communicate directly with the nearby Medical Designat-
ed Facilities to request external medical assistance, consultation and
advice.
5. The CC shall ensure that their medical facilities have a fax machine CC
available either in the medical facility or in a nearby administrative
office.
6. The CC shall ensure that their medical facilities have a dedicaed CC
emergency communication device (110 or similar), for receiving
expedient information/instructions regarding fire and/or other
disaster in the camp and/or surrounding construction area.
7. The HCP shall ensure that their medical facilities where applicable, have CC
all their communication equipment checked per shift. Findings must be
documented and available upon request.
155
Figure 9-1
Patient Treatment Daily Log
Medical Facility: _______________________________________________________ Date: _______________________________
Date Name and Badge Number Time In Time Out Treatment Comments
P LE
A M
Report prepared by:
Name: ________________________________
S Badge No.: __________________ Signature: _______________ Date: ____________
156
Figure 9-2
Injury Summary Report
Medical Facility: _____________________________ Project No.: _____________________ Page: _________ of _________
Propo-
________________________________ File No.: _____________________ Date: _____________________
nent:
Carry Brief Description

Nature of Injury
Injury Date of Acci- Over Days Lost of Accident. State
Name Injured Badge Number Craft and Body Part
No. dent this Month What, Where, How
Yes/No Affected
and Why.
P LE
A M
# of injuries this
Total days lost
month
Report prepared by:

Title:
S Signature
Telephone
157
Figure 9-3
Polices and Procedures
Policies and procedures are facility specific instructions and guidelines which concern the day-to-day
activities / operation of the medical facility.
General Guidelines
1. Each organization is responsible for developing specific policies and procedures for its medical facility.
These policies must be updated and revised every three (3) years. Revisions are approved by an
authorized medical representative, and dated to identify the review date.
2. Policies and procedures shall be available to all concern staff.
These policies include but are not limited to:
Required Policies and Procedures
Organization
1-1 Organization Chart.
1.
1-2 Roles and Responsibilities.
1-3 Mission and Vision.
Administrative
2-1 Job descriptions.
2.
2-2
2-3
2-4
2-5
Manpower Requirements.
Staff Qualifications.
Staff Recruitment Process.
Licensing.
Staff Education Program
LE
MP
3-1 New Hire Orientation.
3-2 Staff Competency.
3. Safety and Loss Prevention:
2-1 Fire Safety.
2-2 HAZCOM.
2-3 Disaster Response Plan.
4. Infection Control and Environmental Health.
5. Quality Improvement Program.
SA
Operation
6-1 Scope of Service.
6-2 Patient Eligibility of Care.
6.
6-3 Patient Registration and Health Insurance.
6-4 Consultation.
6-5 Referral and Transfer.
7. Medical Records Patient, Documentation and Confidentiality of Information.
8. Patient Care/Nursing Practice.
9. Treatment Protocol.
10. Equipment Management and Supplies.
11. Drugs: Prescription, Ordering, Storage, Administration, Dispensing, Shipping and Receiving of Drugs.
12. Communication.
13. Transportation: Patient’s transfer and Medivac Procedures.
14. Laboratory specimens: Handling, Storage and Transportation.
Note: Should you require a sample of any of the above policies, please contact the RAC Admin. /
MMSR Coordinator.
158
Figure 9-4
Scope of Services
Care Provided
Care includes triage, assessment, diagnosis, first aid, treatment, stabilization and transfer or Medivac
to an inpatient hospital for definitive care and response to disaster situations.
Treatment
Includes treatment of encounters of varying complexities, such as acute trauma, medical emergencies
and prescribing medicines.
Basic BLS and other first aid intervention. Use of AED, incorporating life saving measures with
stabilization techniques.
Investigations
Investigations include any tests/procedures that can be undertaken, e.g.:

1. Dip stick urine test.
2. Test strip blood test.
3. Hearing test.
4. Pulmonary function test (PFT).
5. 12 Lead EKG/Chest lead monitoring.
6. Pulse Oximeter and SPO2.
7. Visual Acuity (Snellen chart).
8. Employees Physicals.
9. Radiology.
10. Laboratory.
Patient Eligibility
Clear policy statement regarding who is eligible for care and what are they eligible for, e.g.:
a. For all employees.
b. For general public or non-employee with potentially serious or life threatening condition.
159
Figure 9-5
Request For Emergency Consultation and Patient
Transfer from Contractor Clinic
1. POLICIES
A. The Private Contractor Medical Facility is the primary responder to all medical emergencies
occurring to its work force.
B. Primary response includes: initial triage, assessment, emergency care and stabilization of
the patient as appropriate.
C. All private contractor companies will ensure that all employees are registered for care at a
hospital offering in-patient and specialist care before they enter the work-site .This
medical insurance cover should include first aid, emergency care, investigations and in-
patient treatment and ambulance transfer. This shall be regularly verified by the Saudi
Aramco Contract proponent department.
D. Private Contractor Medical Facilities will maintain up to date data detailing relevant
personal, medical and employment information on all employees.
E. Private Contractor Medical Facilities will transfer all patients identified as life-threatening or
critical expediently and directly to the nearest hospital facility. In the event that access to
the nearest hospital facility is difficult or not available, when requested, RACs will provide
emergency medical support, including assistance with transfer as appropriate. The patient's
transportation and escort to the RAC remains the responsibility of the Contractor clinic.
F. Private Contractor Medical Facilities will utilize their on-site medical facilities and resources
for the management of urgent, emergent and non-urgent patients prior to transferring them
to another medical facility for further care if appropriate.
G. Patients requiring definitive care should be transferred directly to the private company's
designated in-patient medical facility.
H. When a medivac is required for a Contractor patient from a RAC, the RAC Facility staff will be
responsible for making flight arrangements with Saudi Aramco Aviation.
I. Prior notice of transfer of any patient from a Private Contractor Medical Facility to a RAC
must (circumstances permitting) be pre-arranged with the receiving RAC.
160
2. RESPONSIBILITIES
A. RAC Supervisor shall be responsible for the implementation and periodic review of this
OM.
B. RAC Contractor Medical and Nursing Staff shall implement this OM and orient
Contractor Medical staff to the requirements and procedures outlined in this OM.
C. Contractor Medical Staff shall:

1) Consult the RAC physician/nurse prior to transferring a patient to a RAC to discuss
the case and appropriateness of transfer. The Contractor nurse or physician must
have all assessment and clinical details including initial care given and patient's
response available.
2) Provide an escort for Contractor patients if in the judgment of the RAC physician,
this is required for onward transfer from the RAC to definitive care.
3) Complete appropriate clinical records including triage notes, vital signs and
stabilization measures. Documentation including lqama and medical insurance card
and other documents as appropriate should accompany the patient.
4) Be responsible for all post transfer follow-ups with its designated medical facilities.
5) Keep a database at the clinic with details of each of the contractor employee's
medical registration and insurance. This must include medical insurance number,
name and contact details of hospitals designated to provide care to the employee.
D. The Contractor Company shall:

1) Ensure Contractor Medical Facilities staff is familiar with and comply with the
contents of this OM.
2) Ensure all their employees; have appropriate medical insurance cover including sub
contractor employees under their responsibility.
3) Where RACS assume responsibility for transferring a contractor patient onwards to
a hospital facility, ensure the private company's medical designated facility is
notified, is prepared to accept the patient and is aware of the ETA.
Note: RAC staff is responsible for requesting Air medical evacuation per GI 1321.15.
4) Contractor Medical Facilities shall be responsible for arranging all transfer logistics,
including flight manifest formalities, of all their routine transfers or referrals to
another facility.
5) Where air transportation is involved, arrange for the receiving hospital to provide an
appropriate ambulance and staff to meet the plane.
6) Ensure the Contractor Medical Facility ambulance is used where patient transfer by
road is required.
7) Ensure a Contractor nurse or physician escort all their patients transferring out of
RACs unless otherwise agreed by RAC.
8) When responding to off-site emergencies involving a Contractor death official
certification and clearance to move the body is necessary. Company medical staff is
responsible for staying with the body until it is officially released can be moved.
161
Important Links:
• MOH, Saudi Government National Portal
http://www.moh.gov.sa/en/Pages/Default.aspx
• Saudi Commission for Health Specialties

http://english.scfhs.org.sa/en/pages/default.aspx
• Saudi Food and Drug Authority

http://old.sfda.gov.sa/ar/Pages/default.aspx
• Council of Cooperative Health Insurance

http://www.cchi.gov.sa/en/Pages/default.aspx
• Saudi Central Board for Accreditation of Healthcare

Institutions
http://cbahi.securehostsite.biz/arabic/home
• Saudi Health Council

http://www.chs.gov.sa/En/default.htm
• Ministry of Labor/ MOL law

http://portal.mol.gov.sa/ar/DocLib1/%D9%86%D8%B8%D8%A7%D9%85%20
%D8%A7%D9%84%D8%B9%D9%85%D9%84%20%D8%A7%D9%84%D8%AC%D8%AF%D
9%8A%D8%AF%20%D8%A7%D9%84%D9%86%D8%B3%D8%AE%D8%A9%20%D8%A7%
D9%84%D9%85%D8%B9%D8%AA%D9%85%D8%AF%D8%A9_v3.0.pdf
• Protection Against Occupational Hazards, Major In

dustrial Accidents and Work Injuries and Health and
Social Services
http://www.sagia.gov.sa/Documents/Laws/labor_law_en.pdf
162

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Minimum Medical Standards Requirements

Emergency Medical Services

Dr. Ata H. Smadi

Dr. Daniele Rigamonti

4. MMSR Standards. 9-162

4.Minimum Stock Level (MSL):

1. Employee population exceeds 1000-2000 workers in a single camp and associated

Criteria: The following factors are used to determine the category

a. Employee’s name, employee’s ID number & medical registration (MR) number.

10. Manpower Requirements / Hours of operation as per the following:

1. A vision, a statement about what the organization wants to become.

• FIGURE 1-1 for Cat Level A Clinic

1.0 BUILDING SPECIFICATIONS / GENERAL STANDARDS

1.30 1.50 1.20 5.00

SCREENING DRESSING EMERGENCY

FLOOR MOUNTED CABINEET

2.80 2.12 1.40 2.68

LEVEL C& D PLAN ONE NURSE OPERATED CLINIC

Figure 1: Clinic sign board details

3.4 Communications, Electrical and Lighting Requirements

3.5 Treatment Area Requirements

nt area and the medic/nurse station must be separated with curtains/screening

hall have a bed for • patients

Figure 4: Example for the layout of an inland clinic

First Aid Cabinet and Contents

Number List of Contents Unit Quantity

12 Eye Pad. 6 per box 1 Box

SAP Material No: Description

1000132519 Bandage: Compress, 10 cm

1000132547 Bandage: Plastic, Adhesive

1000132612 Forceps and Scissors

SAP Material No: Description

1000128476 Rescue Type Stretcher

1000128490 Splint Stretcher

1000124087 Fire Blanket

STAFF QUALIFICATIONS, EXPERIENCE,

• FIGURE 2-1 Employee Orientation

2.0 STAFF QUALIFICATIONS, EXPERIENCE, COMPETENCY, CONTINUING EDUCATION

Item Responsible Date: Comments

General Orientation – Benefits:

Core Elements of General Orientation include but

Core Elements of Unit/Area Specific

2. Facility’s policies and procedures.

Ambulance Driver Specific Orientation

Item Minimum Requirements Date Completed Remarks

d. Kendrick extrication device (KED).

Continuing Medical Education and Training

Types of Education and Training Programs

1. Infection control and fire safety, annually.

3. Environment of Care Program (Fire, Security, Hazmat (Hazardous materials/waste), disaster,

Continuing Medical Education (CME)

Benefits of Establishing a Continuing

Channels Which Provide CME include:

1. In-Services Program: Designed to provide classes on general requirements.

1. Applicants Name:

Camp: Other: Specify :

CV approval process for Medical Candidates:

Staff Competency Assessment and Development

Yes Scores 7.1 Points No Scores 0 Total Score

Result:  Pass  Fail

Supervisor’s Name: ___________________________________________ I.D. No.: __________________

Supervisor’s Signature: ________________________________________ Date: ____________________

MEDICAL EQUIPMENT AND

Supervisor’s Name: _________________________ I.D. No.:

Supervisor’s Signature: ____________________ Date: