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done with the patient’s best interest in mind and backed by documented clinical
reasoning and judgment. Whenever possible, prior approval by direct verbal order
from the receiving hospital physician should be sought. Additionally, all variance
from protocol should be documented and submitted for review by agency Medical
Director within 24 hours of the event. (Boulder County EMS Protocols)

The medical director and county protocols state that only paramedics, or those with higher-level
medical certifications, are authorized to medically clear a patient. Therefore, when a patient is
injured or ill and consents to care, the city’s contracted ambulance service needs to respond and
determine if the patient requires further treatment; rangers are not allowed to treat and release
patients. If the patient declines further treatment and/or transport to the hospital, the contracted
ambulance service will follow their refusal protocols.

For injuries that are superficial in nature with no underlying injury present, e.g., a minor cut on
the knee, rangers may provide Band-Aids, ice packs, and so on, to assist patients. If rangers
believe a patient needs further care but does not consent to treatment and leaves the scene, it is not
necessary to request a medical response.

Medical Equipment
Each patrol truck is equipped with a standard response first-aid backpack that contains supplies to
handle a wide variety of injuries and illnesses. Every first-aid backpack contains the same
equipment (slight variations apply for EMT-certified rangers), packed alike to ensure all rangers
can quickly and efficiently find the medical equipment they need, regardless which vehicle pack
is used. A list of required items and where they are stored is provided in Appendix IV.

When supplies are used during medical calls, rangers are responsible for restocking the standard
response backpack as soon as possible. A medical cache with supplies for restocking is
maintained at ranger headquarters; when restocking supplies, rangers must fill out the inventory
form and alert the medical officer when supplies are low or out of stock.

Each patrol truck is equipped with an oxygen tank and automated external defibrillator (AED).
When responding to a medical call, rangers must determine if deploying oxygen and/or the AED
is appropriate based on the best information at the time.

Used oxygen tanks can be refilled by either the Boulder Fire Department or exchanged through
the city’s contracted ambulance service. When in service, oxygen tanks must be completely filled;
therefore, partially used tanks must be filled before being repacked into vehicles. Oxygen tanks
must be stored in a secure location inside the cab so they do not become a hazard in the event of a
vehicle accident.

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