# Checklist - Infection Control and Medical Response > Fire Service Safety Management System, version 0.3.3 (2026-10-25). The Human Factor. Document FSSMS-AUD-P08b. > > Canonical: https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response > > Licence: CC BY-NC-SA 4.0 with the Adopting Agency Grant (https://creativecommons.org/licenses/by-nc-sa/4.0/) > > General information only, not legal, medical or other professional advice. Verify every requirement against the current official text of the law, standards and manufacturer instructions that apply to you. Obtain your own legal review and consult your joint health and safety committee before adopting anything. You adopt, adapt, implement and rely on this material entirely at your own risk and on your own responsibility. Full terms: Terms of Use, thehumanfactor.ca. ## Scope This category audits [Infection Control and Medical Response Safety Program](https://thehumanfactor.ca/library/fire-service-safety/infection-control-and-medical-response-safety-program): the written program and designated officer, routine practices and PPE for patient contact, sharps, exposure response and the post-exposure clocks, immunization, cleaning and facilities, outbreak readiness, naloxone and opioid scene safety, patient handling, medical first response governance, and the program’s accountability loop. It is audited annually by internal audit and every three years by independent review, under [01 Audit Program](https://thehumanfactor.ca/library/fire-service-safety/audit-program). Items marked “MFR” apply only where the department provides medical first response; score them “n.a.” otherwise and exclude them from the mean. ## Criteria The criteria come from [NFPA 1580 (2025)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-nfpa-1580), which consolidated the infection control standard NFPA 1581; NFPA 1550 (2024, s. 4.13) on the health and safety officer as infection control officer; the Public Health Agency of Canada’s routine practices and additional precautions [(Public Health Agency of Canada, 2017)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2017); the Canadian Immunization Guide on worker immunization and hepatitis B post-exposure management [(Public Health Agency of Canada, 2024)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2024); CSA Z94.4 on respirator fit testing (CSA Z94.4-18) and CSA Z316.6 on sharps containers (CSA Z316.6-20); CSA Z1004 on ergonomics (CSA Z1004:24); the occupational health and safety, emergency health services, workers’ compensation and privacy legislation of the department’s province or territory, summarized on the topic pages listed under Jurisdiction requirements ([J08 Incident Reporting and Investigation](https://thehumanfactor.ca/library/fire-service-safety/j08-incident-reporting-and-investigation); [J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information); [J25 Infection Control and Medical First Response](https://thehumanfactor.ca/library/fire-service-safety/j25-infection-control-and-medical-first-response)); and the accreditation criteria the program answers: infection prevention procedures with an improvement process, exposure records, medical evaluations, and for medical first response the protocols, medical control, patient care record, privacy program, quality improvement and annual appraisal [(CPSE, 2019, criteria 11A.4, 11A.10, CC 11B.1, CC 5F.2, CC 5F.4, CC 5F.5, CC 5F.6, 5F.7, CC 5F.9)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019). ## Scoring **0** not in place; **1** documented, not implemented; **2** implemented, not verified effective; **3** implemented and effective with evidence. The category score is the mean of scored items; the program score is reported by category, never as one number ([02 Audit Checklist Master Index](https://thehumanfactor.ca/library/fire-service-safety/audit-checklist-master-index)). Score from evidence seen, not described. Where the auditor can only find a document, the ceiling is 1. Where the practice is seen or sampled but no one has checked it works, the ceiling is 2. ## Checklist | \# | Item | Stage | Evidence expected | Score (0-3) | Finding | Owner | Due | |:---|:---|:---|:---|:---|:---|:---|:---| | 1 | A written infection control program is adopted, signed by the fire chief, consulted on with the JOHSC, and reviewed within the last three years [(NFPA 1580, 2025)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-nfpa-1580) | S1 | Signed program; revision log; JOHSC minutes | | | | | | 2 | A designated infection control officer and an alternate are appointed in writing with authority to direct post-exposure follow-up and remove contaminated equipment from service | S1 | Appointment memo; the officer can describe the authority | | | | | | 3 | A 24/7 exposure reporting number is posted in every station and on every apparatus exposure kit, and someone answers it | S1 | Posted number seen at two stations and on three apparatus; test call or call log | | | | | | 4 | A written risk assessment by task sets route, likelihood, controls and PPE, reviewed within 12 months and after each exposure | S1 | Completed PPE matrix with review dates | | | | | | 5 | Members apply routine practices: hand hygiene, point-of-care risk assessment, gloves before any patient contact [(Public Health Agency of Canada, 2017)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2017) | S1 | Observation at a drill or call; hand rub in kits; members can state the three questions | | | | | | 6 | Eye protection is worn for all airway work and splash-risk tasks; goggles or shields are usable (not scratched or missing) | S1 | Kit inspection on three apparatus; observation | | | | | | 7 | A fit-tested N95 or elastomeric P100 is worn for aerosol-generating procedures, suspected respiratory infection and declared outbreaks; the stocked model matches the fit-tested model | S1 | Kit model against fit-test register | | | | | | 8 | Every member who may do airway work holds an N95 fit test inside 12 months (CSA Z94.4-18, cl. 9) | S1 | Fit-test register; sample five members | | | | | | 9 | Only safety-engineered needles and lancets are stocked; no recapping policy is known to members (CSA Z316.6-20) | S1 | Kit inspection; supply standard; interview three members | | | | | | 10 | A sharps container is in every kit and secured on every apparatus, used at point of care, replaced at three-quarters full | S1 | Inspection of three apparatus; kit check sheets | | | | | | 11 | Exposure first aid (wash, flush) and the one-hour report are known to members and officers | S1 | Interview; SWP sign-off records | | | | | | 12 | Exposure files show first aid, the report time, clinic contact, source testing request and the prophylaxis decision inside the clocks [(Public Health Agency of Canada, 2024)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2024) | S1 | Last three exposure files reviewed by the auditor with the designated officer (de-identified) | | | | | | 13 | Source patient testing is requested through an agreed path with the receiving hospitals or EHS provider | S1 | Agreement or correspondence; exposure files | | | | | | 14 | Follow-up serology schedules are set and completed; the member is told who will contact them | S1 | Exposure files; follow-up dates and completion | | | | | | 15 | Workers’ compensation reports for exposures are filed within the deadline the applicable compensation statute sets ([J08 Incident Reporting and Investigation](https://thehumanfactor.ca/library/fire-service-safety/j08-incident-reporting-and-investigation)) | S1 | Report dates against exposure dates | | | | | | 16 | Hepatitis B immunity status (immune, non-responder, declined) is documented for every member, with post-series antibody testing [(Public Health Agency of Canada, 2024)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2024) | S1 | Immunity register (status only); sample ten members | | | | | | 17 | Influenza, tetanus-diphtheria-pertussis, MMR, varicella and COVID-19 are offered at employer cost on duty time; declinations are in writing ([Public Health Agency of Canada, 2024](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-public-health-agency-of-canada-2024); [National Advisory Committee on Immunization, 2025](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-national-advisory-committee-on-immunization-2025)) | S1 | Campaign records; declination forms | | | | | | 18 | Tuberculosis screening is done on hire and after exposure [(NFPA 1580, 2025)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-nfpa-1580) | S1 | Candidate medical records (status only); exposure files | | | | | | 19 | Immunity and exposure records are held as health information, separate from personnel files, access limited, retained for service plus 30 years | S1 | Records location; access list; retention schedule | | | | | | 20 | Equipment used on a patient is cleaned with a DIN disinfectant for the labelled contact time and logged before the apparatus returns to service | S1 | Disinfection logs for the last ten patient contacts on two apparatus; product list posted | | | | | | 21 | Disinfectant data sheets are on file and products are in date | S1 | WHMIS binder or system; stock check | | | | | | 22 | Each station has a decon area with a sink and a laundry separate from kitchen, dormitory and living areas; contaminated uniforms are never laundered at home | S1 | Station walk-through; interview; no-home-laundering rule posted | | | | | | 23 | Biomedical waste goes to a licensed contractor or receiving hospital by agreement; sharps containers are never in station garbage | S1 | Contract; collection records | | | | | | 24 | Kit checks are completed weekly and after use on every apparatus, sampled over 90 days | S1 | Kit check sheets; 98 percent or better | | | | | | 25 | A written respiratory outbreak protocol exists with triggers, PPE escalation, dispatch screening, cohorting, access limits, cleaning frequency, sick-leave rule and return-to-work criteria | S1 | Protocol; readiness checklist dated inside 12 months | | | | | | 26 | A 90-day PPE reserve is held and counted quarterly with expiry rotated | S1 | Count records; stock seen | | | | | | 27 | The outbreak protocol has been exercised in the last 12 months or the last activation was reviewed at Tier 2 with actions closed | S2 | Exercise record or review; register entries | | | | | | 28 | Naloxone (where carried) is in date on every kit and members are trained to the provincial protocol | S1 | Kit checks; certification records | | | | | | 29 | Opioid scene safety training reflects current evidence on dermal exposure and post-reversal agitation; members do not report “touch overdose” beliefs [(American College of Medical Toxicology, 2017)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-american-college-of-medical-toxicology-2017) | S1 | Training content; interview three members | | | | | | 30 | Lifting aids (stair chair, scoop, slide sheets, powered cot where provided) are on apparatus and serviceable; the two-person lift rule and the bariatric plan are known | S1 | Inspection; interview | | | | | | 31 | Patient handling training is delivered annually as a practical; lift injuries are investigated with a learning-team session | S1 practical; S2 ergonomics process | Training records; injury files | | | | | | 32 | Patient handling is managed under an ergonomics process consistent with CSA Z1004 (CSA Z1004:24) | S2 | Ergonomics assessment; action records | | | | | | 33 | Violence staging is applied on medical calls flagged violent or unknown-safety; assaults and threats on medical calls are reported | S1 | Dispatch records; violence register | | | | | | 34 | MFR: a written agreement with the provincial EHS provider sets clinical scope, protocols, medical oversight, certification and reporting [(CPSE, 2019, criteria CC 5F.2, CC 5F.4)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019) | S1 | Agreement on file; protocols current | | | | | | 35 | MFR: certifications are current for every medical first responder | S1 | Certification register; sample five | | | | | | 36 | MFR: a patient care record is completed for every patient, protected from public access and retained to law; members are trained in the privacy legislation [(CPSE, 2019, criteria CC 5F.5, CC 5F.6)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019) | S1 | Records system; training records; access controls | | | | | | 37 | MFR: a quality review process exists and its findings reach the team without member names [(CPSE, 2019, criterion 5F.7)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019) | S2 | Quality review summaries in quarterly updates | | | | | | 38 | MFR: AED and oxygen are checked daily (career) or weekly (volunteer) and after use; oxygen cylinders are secured and handled as compressed gas | S1 | Apparatus check sheets; inspection | | | | | | 39 | Calls involving children, deaths, violence or multiple casualties trigger the check-in and support path | S1 | Dispatch flags; peer support aggregate records | | | | | | 40 | Training and competency records show recruit and annual refresher for every member, officer module for every company officer, and designated officer training | S1 | Sign-off table; sample ten members and three officers | | | | | | 41 | Indicators are tracked quarterly with baseline and target and reported to the senior team and the JOHSC within 15 days of quarter end | S2 | Last four quarterly updates | | | | | | 42 | Exposures are reported within one hour in 95 percent of cases, and members say on the culture survey that they would report a needle-stick or splash without fear (psychological safety) [(Edmondson, 1999)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-edmondson-1999) | S2 | Quarterly indicator; survey result; interview three members: “What would happen if you reported a needle-stick tonight?” | | | | | | 43 | Member concerns about infection control or patient handling are answered back to the member within five working days | S2 | Concern log; reply dates; interview | | | | | | 44 | **Accountability loop:** the program names one line owner, doers, verifiers with intervals, a feedback path with cycle time, and a closure rule with escalation; deficiencies are in the [Corrective Action Register](https://thehumanfactor.ca/library/fire-service-safety/corrective-action-register) within five working days with a priority from P1 (Imminent) to P4 (Improvement), and overdue items are escalated on the schedule their priority sets; the loop test can be walked with a real example | S1 | Section 11 of the program completed with department titles; register entries; the owner can walk a recent example end to end | | | | | | 45 | The annual program appraisal was completed on schedule and presented, with exposure, lift injury, outbreak and violence events reviewed [(CPSE, 2019, criteria CC 5F.9, 11A.4)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019) | S2 | Appraisal; presentation record; JOHSC minutes | | | | | | 46 | Exposure records are collected and kept to law and current research, and the exposure history is linked to the member’s record for later claims [(CPSE, 2019, criterion 11A.10)](https://thehumanfactor.ca/library/fire-service-safety/checklist-infection-control-and-medical-response#ref-cpse-2019) | S1 | Exposure register; link to [Form - Exposure Report](https://thehumanfactor.ca/library/fire-service-safety/form-exposure-report) | | | | | ## Effectiveness questions These cannot be answered from documents. Observation or interview only. 1. **Ride or drill with a crew.** On a simulated cardiac arrest, do gloves, goggles and the N95 go on before the bag-valve-mask is used, without a prompt? Who cued whom? 2. **Ask three members at a volunteer station**: “You got splashed in the eye at 23:00 on Saturday. What do you do in the next hour, and who do you call?” Do the answers match the program, and does the number they give answer? 3. **Ask the designated officer to walk the last exposure** from first aid to the follow-up schedule, with times. Did every clock hold, and if one slipped, what changed afterward and who was told? ## Category result | Items scored | Items n.a. | Category mean | Items at 0 or 1 | Findings raised | Date | Auditor (role) | |:---|:---|:---|:---|:---|:---|:---| | | | | | | | | Findings go to the [Corrective Action Register](https://thehumanfactor.ca/library/fire-service-safety/corrective-action-register) with owner and due date; the category result goes to the program’s quarterly update and to [Management Review](https://thehumanfactor.ca/library/fire-service-safety/management-review). ## Jurisdiction requirements This chapter relies on the following legal requirements, which differ by province and territory. Check your jurisdiction’s section on each topic page before adopting it. | Topic | What to check in your jurisdiction | Page | |:---|:---|:---| | Incident Reporting and Investigation | The employer’s deadline to report a work injury or exposure to the workers’ compensation board, and whether that report also counts as notice to the OHS regulator (item 15) | [J08 Incident Reporting and Investigation](https://thehumanfactor.ca/library/fire-service-safety/j08-incident-reporting-and-investigation) | | Privacy and Health Information | Which access-to-information and privacy statute governs exposure, immunization and patient care records, and whether the department or its clinicians are custodians under the health information statute (items 19, 36) | [J10 Privacy and Health Information](https://thehumanfactor.ca/library/fire-service-safety/j10-privacy-and-health-information) | | Infection Control and Medical First Response | Any bloodborne pathogen or sharps rule, the post-exposure protocol, source-person testing law and occupational immunization rules, and the framework that governs medical first response, including agency agreements, clinical scope and naloxone (items 9 to 17, 28, 34 to 38) | [J25 Infection Control and Medical First Response](https://thehumanfactor.ca/library/fire-service-safety/j25-infection-control-and-medical-first-response) | ## References American College of Medical Toxicology. (2017). ACMT and AACT position statement: Preventing occupational fentanyl and fentanyl analog exposure to emergency responders (M. J. Moss et al., with the American Academy of Clinical Toxicology). *Journal of Medical Toxicology, 13*(4), 347–351. https://doi.org/10.1007/s13181-017-0628-2 Center for Public Safety Excellence \[CPSE\]. (2019). *Fire and emergency service self-assessment manual* (10th ed.). Commission on Fire Accreditation International. CSA Group. (2018). *CAN/CSA-Z94.4-18 (R2023), Selection, use, and care of respirators* (5th ed.). CSA Group. (2020). *CSA Z316.6:20 (R2025), Sharps injury protection: Requirements and test methods*. CSA Group. (2024). *CSA Z1004:24, Workplace ergonomics: A management and implementation standard* (2nd ed.). Edmondson, A. C. (1999). Psychological safety and learning behavior in work teams. *Administrative Science Quarterly, 44*(2), 350–383. https://doi.org/10.2307/2666999 National Advisory Committee on Immunization. (2025). *Statement on seasonal influenza vaccines for 2025–2026*. Public Health Agency of Canada. National Fire Protection Association. (2024). *NFPA 1550, Standard for emergency responder health and safety* (consolidates NFPA 1500, 1521 and 1561). National Fire Protection Association. (2025). *NFPA 1580, Standard for emergency responder occupational health and wellness* (consolidates NFPA 1581, 1582, 1583 and 1584). Public Health Agency of Canada. (2017). *Routine practices and additional precautions for preventing the transmission of infection in healthcare settings*. Public Health Agency of Canada. (2024). *Canadian immunization guide* (Part 3, Immunization of workers; Part 4, Hepatitis B vaccines).