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TFS Designated Officer Program

TFS Designated Officer Manual

DO Program Role

What is a Designated Officer?

A Designated Officer (DO) is an on call TFS personnel who is to be contacted immediately when a TFS personnel has a confirmed or suspected exposure to a communicable disease while on duty. The DO is your only route for information as they work within a structure to maintain patient and firefighter confidentiality. Confidentiality rules apply at all times and are stringent.

The DO can be of great assistance in a very stressful time. In addition to the above responsibilities they will assist with all the necessary reporting forms, offer support, education, treatment options and contacts for assistance at the firefighter’s request.

When a TFS employee is concerned about a possible or known exposure to a selected disease he/she shall contact their Designated Officer. The Designated Officer will assess the situation and seek assistance from the TFS Chief Medical Officer and/or the Chief Medical Officer of Health (Toronto Public Health) or designate as needed. Designated Officers will be available through TFS Communications 24 hrs/day. Communications should be reached at 416.338.9000.

History and Objectives

The Ministry of Health of Ontario introduced the Designated Officer Program in 1994. It was developed to address concerns of Emergency Service Workers, who routinely dealt with sick and injured clients, but were not classed as health care workers. The program directly identifies police, firefighters and paramedics as high-risk exposure groups and the intent is education of emergency service workers and establishment of exposure protocols (MOH, 1994. An Information Manual for Designated Officers).

The Toronto Fire Services is North America’s fifth largest fire service, employing 3,300 firefighters and serving a city of over two million residents. As part of a tiered response agreement with Toronto Emergency Medical Services, TFS is dispatched to all “Delta and Echo” (high priority) 911 medical calls. This dispatch agreement results in almost 100,000 patient contacts per year by Toronto firefighters (TFS 2000 run report). These contacts are often with high-risk patients, in high-risk situations and in uncontrolled working environments.

It is the goal of the Toronto Fire Services’ EMS Section to implement a proactive, educational, infection control program. Through program development, flexible delivery initiatives, and a comprehensive education component, the infection control program will help to reduce the number of firefighter exposures. In addition, we will maintain a reactive policy that encourages firefighters to report their exposures in order to provide appropriate follow up treatment and counseling.

Following the implementation of these initiatives it is hoped that firefighters with the TFS will have an awareness of:

  • The Designated Officer (DO) program and its significance to them;
  • How to activate the program/contact a DO;
  • Their legal rights;
  • The source patient’s legal rights;
  • The availability of vaccines (Hep B, etc.) and understand the need to keep immunizations up to date.

    In addition, the firefighter should:

  • Understand the need for patient confidentiality (firefighter’s and patient’s);
  • Understand specific disease transmission routes and the use of appropriate Personal Protective Equipment (PPE);
  • Appreciate the need for timely reporting of exposures in relation to immediate health needs (Post Exposure Prophylaxis (PEP) and other treatments) as well as filing of appropriate paper work (WSIB, etc.);
  • With the above information be able to determine a legitimate exposure that requires a DO.