Function 7
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Coordinate Pre-Hospital Emergency Services |
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LEMSA Roles: Preparedness - Response - Recovery |
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Function Objective Develop plans, policies and procedures to: (1) dispatch medical response resources, (2) continue the provision of EMS services during a response to disasters, (3) and manage field medical care and operations. |
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Function Elements Element
7.1 Pre-hospital system transformation
to disaster
status Element 7.2 Triage systems and methods Element
7.3 Austere medical care Element
7.4 Field operations management Element 7.5 Command / tactical communications |
Element 7.1 Pre-hospital system
transformation to disaster status
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Standard: |
EMSAs shall develop plans to ensure the
continuation of EMS services during disasters to the extent possible. |
LEMSAs should ensure
development of plans and procedures for the continuation of 9-1-1 EMS services during
the response to disasters. The plans
and procedures should address:
·
Assessment of current resources and projections for the time of their
depletion.
·
Allocation of existing resources and acquisition of initial, immediate,
and planned resources.
·
Coordination among EMS providers and other system participants in
transforming pre-hospital system to disaster status.
·
Criteria to be applied during disasters for determining the level of
9-1-1 response. that can be maintaine
·
Adjustment of 9-1-1
triage criteria to ensure resources are available to respond to life
threatening emergencies.
·
Adjustment of ambulance
coverage criteria.
·
Communication failure
protocols.
·
Utilization of
ambulances for interfacility transfers.
·
Utilization and
assignment of out-of-area personnel.
Element 7.2 Triage
systems and methods
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Standard: |
LEMSAs
shall ensure designation of the START Triage System as the method of initial
triage for all incidents with multiple casualties. |
LEMSAs
should adopt a policy for initial field triage in disasters that incorporates
the following provisions:
1.
Triage categories for initial triage shall be defined as:
·
Immediate
·
Delayed
·
Minor
·
Deceased
2.
Field responders will employ a triage tag with the following
characteristics for initial triage:
(a)
Tag will include perforated tabs of the following colors
and corresponding triage categories:
Green = Minor
Yellow = Delayed
Red = Immediate
Black = Deceased
(b)
Tag will include an indicator for decontamination.
(c)
Each tag will have a unique identification number printed
on both sides of the tag and on the left and right corners which are
perforated.
(1)
Tag will have dimensions of approximately 4 ½ inches by 9 ¼
inches.
(2)
Tag will include provisions for recording the following
information:
a)
Time of triage.
b)
Date of triage.
c)
Name of the patient.
d)
Home address of the patient.
e)
Home city and state of the patient.
f)
Other important information (medical treatment, history, decontamination,
etc.)
g)
Caregiver number.
h)
Injuries / Exposures.
i)
Vital signs and the time taken.
j)
IVs and any drugs
given.
Element 7.3 Austere medical care
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Standard: |
LEMSAs shall develop plans and policies for implementation
of austere medical care procedures when response resources are overwhelmed. |
LEMSAs
should promote the development of procedures and the availability of training to
assist physicians and EMS responders to manage mass casualty events when
hospital resources, medical supplies, and medical personnel are limited or
unavailable for an extended response period.
Procedures should address:
·
Appropriate modification of the standard of care.
·
Alternative receiving facilities including clinics and urgent care
facilities.
Element 7.4 Field operations management
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Standard: |
Local EMS Systems shall
designate the organization structure, position names, and position descriptions
for field responses to incidents with multiple casualties as defined in the
Multiple Casualty Incident Plan Section of the FIRESCOPE Field Operations
Guide (April, 1999). |
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Position |
Definition |
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Multi-Casualty Branch Director |
Responsible for the implementation of the Incident Action Plan within the Branch. This includes the direction and execution of branch planning for the assignment of resources within the Branch. The Branch Director reports to the Operations Section Chief and supervises the Medical Group/Division and Patient Transportation Group Supervisors. |
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Medical Group/Division Supervisor |
Reports to the Multi-Casualty Branch Director and supervises the Triage Unit Leader, Treatment Unit Leader and Medical Supply Coordinator. Establishes command and controls the activities within a Medical Group/Division, in order to assure the best possible emergency medical care to patients during a multi-casualty event. |
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Medical Supply Coordinator |
Reports to the Medical Group/Division Supervisor and acquires and maintains control of appropriate medical equipment and supplies from units assigned to the Medical Group |
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Triage Unit Leader |
Reports to the Medical Group/Division Supervisor and supervises Triage Personnel/Litter Bearers and the Morgue Manager. The Triage Unit Leader assumes responsibility for providing triage management and movement of patients from the triage area. |
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Triage Personnel |
Report to the Triage Unit Leader and triage patients on-scene and assign them to appropriate treatment areas. |
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Morgue Manager |
Reports to the Triage Unit Leader and assumes responsibility for Morgue Area activities until relieved of that responsibility by the Office of the Coroner. |
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Treatment Unit Leader |
Reports to the Medical Group/Division Supervisor and supervises the Treatment Managers and the Treatment Dispatch Manager. Assumes responsibility for treatment, preparation for transport, and coordination of patient treatment in the Treatment Areas and directs movement of patients to loading location(s). |
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Treatment Dispatch Manager |
Reports to the Treatment Unit Leader and is responsible for coordinating with Patient Transportation Group, the transportation of patients out of the Treatment Area. |
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Immediate Treatment Manager |
Reports to the Treatment Unit Leader and is responsible for Treatment and re-triage of patients assigned to Immediate Treatment Area. |
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Delayed Treatment Manager |
Reports to the Treatment Unit Leader and is responsible for Treatment and re-triage of patients assigned to Delayed Treatment Area. |
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Minor Treatment Manager |
Reports to the Treatment Unit Leader and is responsible for Treatment and re-triage of patients assigned to Minor Treatment Area. |
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Patient Transportation Group Supervisor |
Reports to the Multi-Casualty Branch Director and supervises the Medical Communications Coordinator and the Air and Ground Ambulance Coordinators and is responsible for the coordination of patient transportation and maintenance of records relating to patient identification, injuries, mode of off-incident transportation and destination. |
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Medical Communications Coordinator |
Reports to the Patient Transportation Group Supervisor and supervises the Transportation Recorder and maintains communications with the hospital alert system and/or other medical facilities to assure proper patient transportation and destination and coordinates information through Patient Transportation Group Supervisor and The Transportation Recorder. |
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Air/Ground Ambulance Coordinators |
Report to the Patient Transportation Group Supervisor and manage the Air/Ground Ambulance Staging Areas and dispatch ambulances as requested. |
Element 7.5 Command / tactical
communications
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Standard: |
LEMSAs shall work with other response agencies to
develop plans and procedures to ensure tactical communications among medical
resources responding to a disaster. |
LEMSAs should encourage the involvement of the following local agencies and organizations should in the development of tactical disaster communications policies, plans and procedures: fire, ambulance, law, hospitals, PSAPs and OES.