Disaster Medical System

Coordination of Pre-Hospital Emergency Services

 

(This is a new draft, not previously provided.)

 

Function 7: Coordination of Pre-Hospital Emergency Services

 

Element 7.1 Pre-Hospital system transformation to disaster status

Guideline 7.1.1: Pre-Hospital System Transformation to Disaster


 

COORDINATION OF PRE-HOSPITAL EMERGENCY SERVICES

 

I.                   PURPOSE

 

The purpose of this policy is to summarize provisions present in communication, transportation, and/or disaster plans within the Operational Area that provide guidelines for the coordination of pre-hospital emergency services during the progression from “normal” pre-hospital care to disaster status.

 

II.                AUTHORITY

 

Health and Safety Code, Division 2.5, Sections 1797.150-152

 

III.             DEFINITIONS

 

A.                 Normal Operations are defined as the day-to-day way in which the system functions to provide dispatch, response, field and hospital care.

 

B.                 Multi-Casualty Operations augment normal operations to provide care to an increased number of patients.  The number of patients necessary to trigger this level of activity will vary and is dependent on the geography and number and type of resources normally available for deployment.  (Within each Operational Area, the criteria for escalation of operations should be clearly defined.)

 

C.                 Disaster Operations represent responses that are further augmented, to provide care to a number of patients that exceeds the capacity of the Operational Area.  (Within each Operational Area, the criteria for escalation of operations to this level should be clearly defined.)

 

D.                 Austere Medical Care is the level of medical care, modified from the expected standard of care, that is provided when hospital resources, medical supplies and medical personnel are limited or unavailable for an extended response period.

 

IV.              POLICY

 

A.                 The interconnectedness of response and communication plans is critical to assure the following:

 

1.                  Clarity among providers as to the extent and limitations of existing plans.

2.                  The extent or severity of response that dictates escalation or de-escalation of a response or activation of another plan.  (This is individual to each system and may vary geographically within a system.)

3.                  Plans are based on Firescope, HEICS, or other SEMS-based management structure.

4.                  That terminology between and among existing plans is consistent.

 

B.                 Fire, medical transport, law enforcement, hospitals, dispatch agencies and local OES agencies should participate with LEMSAs to assure unity in planning, training and response efforts.

 

V.        PROCEDURES

 

For each level of response established by an Operational Area, the following items should be addressed in this policy:

 

A.                 Specific definition of the level (definition section)

 

B.                 Individual(s) authorized to declare or activate that level of response (policy section)

 

C.                 The declaration or activation process (procedure section)

1.                  Includes responsibility for notifications using Answering Point

2.                  Includes list of individuals or agencies to be notified at different levels

 

D.                 Expectations of activation for each group of providers (law, dispatch, fire, medical transport, hospital, LEMSA, M/H OAC) as applicable

1.                  Includes responsibilities of Central Point

2.                  Includes shift in roles (for example, dispatch and ambulance priorities)

 

E.                  Individual(s) authorized to de-escalate or de-activate that level of response (policy section)

 

F.                  The implementation of austere medical care within all or some of the permanent or temporary treatment facilities

1.                  Includes standard of care specifics, treatment guidelines

2.                  Includes responsibilities for activation and deactivation of status

3.                  Includes list of individuals or agencies to be notified of need for implementation

4.                  Includes alternatives to be employed to avoid implementation of austere care