Disaster Medical System

Patient Dispersal

 

 

Function 4: Coordination of Patient Distribution and Medical Evacuations

 

Element 4.1: Patient dispersal system

Guideline 4.1.1: Support Movement of Casualties from Scene to Facility

Guideline 4.1.2: Assist Transfers among Facilities

Guideline 4.1.3: Coordinate Transport from Medical Facilities

Guideline 4.1.4: Evacuate and Receive Casualties

 

 

PATIENT DISPERSAL

 

I.          PURPOSE

 

The purpose of this policy is to provide a process for coordinating the dispersal of patients during multiple casualty incidents or disaster.

 

II.        AUTHORITY

 

Division 2.5, Health and Safety Code, Section 1797.220

 

III.       DEFINITIONS

 

A.                 Answering Point means the dispatch agency or facility designated to receive requests for medical and health resources or assistance and/or communications intended for the Medical/Health OAC, 24 hours/day, 7 days/week.

 

B.                 Central Point means the facility or agency designated in the Medical/Health Disaster Plan to respond to requests for patient dispersal during multiple casualty incidents or disasters.

 

C.                 Multiple Casualty Incident (MCI) means an incident where the number of victims overwhelms currently available resources or requires a higher level of coordination for patient dispersal.

 

D.        Medical/Health Operational Area Coordinator (MHOAC, M/H OAC, or Medical/Health OAC) means the individual responsible for the coordination of medical and health resources and activities within the operational area.

 

E.         Operational Area means the county and all political subdivisions within the county.

 

IV.       POLICY

 

A.                 Medical/Health plans shall specify aThe central point or control facility shall control dispersal of patients or a method for determining a central point in the event of a disaster or MCI.

 

B.         Patient Dispersal (field to initial receiving facility) during MCIs or Disaster

 

1.                  All communication related to initial patient dispersal shall be between a single designated field position and the designated central point, whether the communication originates from within the Operational Area or comes from outside of the Operational Area.

2.                  Only limited patient-condition reports or special treatment needs shall be provided from the field and only through the Central Point.

3.                  Limited patient reports shall include only the following information:

a.                   Triage Categorycategory

b.                  Major Injury(ies)illness or injury

c.                   Age if pediatric patient

4.         Field personnel shall provide medical treatment based on standing orders as specified in the Medical/Health Disaster plan.

 

C.        Evacuation or Transfer of Patients (initial receiving facility to secondary or tertiary facility)

 

1.         Evacuation of a hospital or a portion of a hospital or transfer of patients from the initial receiving hospital to another hospital, whether the transfer is within the Operational Area or involves facilities outside of the Operational Area, must should not occur without involvement or notification of the Medical/Health OAC.

2.                  The Medical/Health OAC shall be contacted inis involved for the following purposescircumstances:

a.                   To consult regarding the decision to evacuate or to receive evacuated patients, as the Medical/HealthM/H OAC may provide assistance that may mitigate issues requiring evacuation;

b.                  To assure that up-to-date bed availability/status remains current within the region; and

c.                   To maximize the use of available transportation resources.

 

V.        PROCEDURES

 

A.                 Patient Dispersal

 

1.                  Field personnel should contact the Central Point for patient dispersal when the number or types of patients reaches a threshold established in the local MCI plan.  Thresholds may relate to the following situations:

a.                   Number of patients stresses or exceeds field resources

b.                  Number of patients stresses or exceeds usual immediate receiving hospital capacity(ies)

c.                   Type of patient injuries require a higher than usual level of coordination among receiving facilities

d.                  Desired patient distribution is not usual for that system

2.         Should the number of patients exceed available beds, the Medical/Health OAC should be contacted to facilitate regional dispersal and coordination.

3.         No direct field to receiving hospital communications should be conducted during an MCI or disaster.  All communications should be conducted through the Central Point.

 

B.                 Evacuation or Transfer of Patients

 

1.                  Transferring or evacuating facilities are encouraged to determine appropriate patient destination based on medical considerations according to pre-existing agreements with other facilities if time and circumstance allow.

2.                  Transportation resources that will be utilized for transfer or evacuation of patients will likely be under the control of the Medical/Health Branch of the Operational Area EOC or the Medical/Health DOC.  Procedures for accessing transportation will be detailed in the local Medical/Health plan.