EMS Dispatch and Education During a Pandemic Event

1. EMS Dispatch and Education During a Pandemic Event Alicia Wiren LP, FP-C (+ all those other EMS related letters)

2. EMS Pandemic Influenza Guidelines for Statewide Adoption • National Guidelines published in 2007 from the U.S. D.O.T. • It is 178 pages of insight and guidelines outlined to states and individual EMS agencies for responding to a Pandemic Flu Disaster.

3. EMS Pandemic Influenza Guidelines for Statewide Adoption • EMS Planning • Roll of EMS in Surveillance and Mitigation • Maintaining EMS Operation • Legal Authority • Clinical Treatment Protocols • Workforce Protection

4. Emphasis in the Plans • Protection • Identification • Triage • Treat and maybe… • Transport • Alternate Standard of Care Enroute • Alternate Care Sites • Hospital

5. Preparing for Pandemic Influenza: Recommendations for ProtocolDevelopment for 9-1-1 Personnel and Public Safety Answering Points (PSAPs)

6. Recommendations for ProtocolDevelopment for 9-1-1 Personnel and Public Safety Answering Points • Guiding Principles • Information to the Public • Facilitation of Call Screening • Assistance with Priority Dispatch with Limited Resources • Other Considerations

7. Call Taking & Dispatching

8. Challenges • EMS and Dispatch Center Regulations • Vast differences in care provided and access to pre-hospital care. • Resources and funding. • Medical Director involvement. • Perceived vs. actual liability in disasters.

9. PSAP: Public Safety Answering Points.

12. EMS Dispatching • Types of Dispatch Centers • Ring Down Lines • Other Party Dispatch (PD, FD) • EMS Dispatch • EMS Dispatch with Pre-arrival Instructions

13. National Dispatching Standards • National Academy of EMD • PowerPhone, • Association of Public Safety Officials International • NCI • All of these systems gives detailed, lay person, questions and instructions for pre-arrival care that can be provided by lay persons to the patient

14. State of Texas EMD Instructor • “The adoption of Rule 157.49 in November1999 by the Board of Health established standards for implementing emergency medical dispatch systems in Texas. Based on provisions in a law passed by the 76th Legislature, the new rule sets the criteria for EMD course approval, creates a new EMS certification category for EMD Instructor, and establishes the requirements for the development of the Protocol Reference System to be used by the dispatchers.”

15. National Academy of EMD Medical Priority Dispatch • Founded in Salt Lake City, Utah • Their Pandemic Protocol follows the Utah and National Guidelines

16. MPD Pandemic Protocol

17. National Pandemic Dispatching Plan • Classification 1 Confirmed/Suspected Cardiac Arrest (Not Breathing, Unresponsive per 911 call) • Standard Response: Closest AED Unit; Closest 1st Responder; Closest ALS Ambulance (HOT) • Category I: Closest AED Unit; Closest 1st BLS ) Responder; Closest Ambulance if available (HOT • Category II: Closest AED Unit (HOT); Closest 1st Responder if available (HOT) • Category II or III: Closest AED Unit if available (HOT)

18. National Pandemic Dispatching Plan • Classification 2 Life Threatening Emergency/Potentially Life Threatening/Confirmed Unstable Patient(s) • Standard Response: Closest 1st Responder; Closest ALS Ambulance (HOT) • Category I: Closest 1st Responder; Closest ALS Ambulance if available; BLS ambulance if ALS unit not available (HOT) • Category II: Closest 1st Responder; Closest Ambulance available (ALS or BLS) (HOT) • Category II or III: Closest 1st Responder if available; Closest Ambulance available (ALS or BLS) (HOT)

19. National Pandemic Dispatching Plan • Classification 3 Non-Critical/Currently Stable Patient(s) Requiring ALS Assessment • Standard Response: Closest ALS Ambulance (COLD) • Category I: Closest Ambulance available (ALS or BLS)(COLD) • Category II: Closest Ambulance Available (ALS or BLS) (COLD) • Category II or III: Referral to Alternate call center; or advise self-transport to Alternate Treatment Site

20. National Pandemic Dispatching Plan • Classification 4 BLS Assessment for unknown/possibly dangerous scenes • Standard Response: Closest 1st Responder (HOT); Closest BLS Ambulance (COLD) • Category I: Closest 1st Responder (HOT); Closest BLS Ambulance if available • Category II: Closest 1st Responder (HOT) • Category II or III: Closest 1st Responder if available; or Closest stand-in responder unit

21. National Pandemic Dispatching Plan • Classification 5 BLS Treatment • Standard Response: BLS Ambulance (COLD) • Category I: BLS Ambulance (COLD) • Category II: Alternate call center (such as Poison Control Center, Nurse advice line, health care call center, etc.) • Category II or III: Alternate call center (such as Poison Control Center, Nurse advice line, health care call center, etc.)

22. National Pandemic Dispatching Plan • Classification 6 Non Ambulance Care • All Categories: Alternate call center (such as Poison Control Center, Nurse advice line, health care call center, etc.)

23. Points to Ponder • Managing Entry Points

24. Contagion

25. Points to Ponder • Integration with tracking systems in place • Follow up • Roll to identify and triage and keep hospitals overburdened. • Integration with Public Health • Staffing

26. Points to Ponder • To evaluate and/or treat….. then leave at home or send POV to an alternate site for treatment. • Legal ramifications for agencies and Medical Directors • Regional Call Centers?

27. Points to Ponder • Expanding tracking to healthcare workers • Alternate sites for living quarters off duty • Downtime requirements • Equipment needs • Out of Hospital Fatality Management • Training Options

28. Things to examine • U.S. D.O.T. Guidelines • State and City EMS Plans • Ohio • Utah • Arizona • Alabama • MPD Pandemic Dispatch Card • Texas EMD Instructor Options

29. Out of Hospital ProviderEducation

30. Thank You! • Questions? • What is your local community doing? • Contact Information • Alicia Wiren LP, FP-C • awiren@earthlink.net