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CHAPTERCHAPTER
Management of EMS
EMS Special Operations
19
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Learning Objectives
19.1 Explain the new mission of customer service in an all-hazards environment.
19.2 Describe the risk analysis process.
19.3 Describe the mitigation role of local community officials as it relates to EMS response.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Learning Objectives (Cont.)
19.4 Define an all-hazards approach and apply a checklist to preparing special events.
19.5 Given a medical evacuation of a patient by helicopter, identify the elements that affect or support local EMS special operations.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Learning Objectives (Cont.)
19.6 Identify existing documentation resources to use for special operations during a special event.
19.7 Identify the methods for developing and accessing state or statewide regional resource pools.
19.8 Contrast the missions of tactical EMS.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Learning Objectives (Cont.)
19.9 Analyze the role of EMS in a special- operations environment as it relates to the medical support of hazardous materials operations.
19.10 Explain the medical-legal issues involved in spectator care at mass gatherings.
19.11 Discuss the process for implementing care systems at mass gatherings.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Importance of Special Operations
• Often EMS is asked to provide care at events that require unique resources, system management, and control
• EMS managers need to prepare their organizations to respond to such events by:– Identifying potential hazards– Determining potential resource needs
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Importance of Special Operations (Cont.)
• EMS managers need to prepare their organizations to respond to such events by:– Determining how those resources may be
acquired– Developing a plan that enables the
effective, specialized control of these events in concert with law enforcement and fire services resources
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Special Operations
• When creating special operations within an organization, three common characteristics must be identified:– Purpose
Will require a tremendous commitment of personnel and money
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Special Operations (Cont.)
• When creating special operations within an organization, three common characteristics must be identified:– Resources
Are human, physical, or financial
– Structure Incident Command System (ICS) Pre developed response plans Ability to form unified command structures
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Emergency Medical Services Pre-Event Planning
• EMS pre-event planning activities– Hazard
A situation or event that can cause a loss
– Vulnerability The people, places, or things likely to incur a
loss, should the hazard actually occur, if no protective action is taken to minimize or eliminate the loss
– Risk Risk is that vulnerability that remains
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Risk Assessment
• Hazard/risk assessment– The analysis of hazards, vulnerabilities, and
risks– Determination is made as to who is
vulnerable and the likelihood of harm is assessed
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Managing EMS Special Operations
• Four steps for managing the effect of hazards upon communities:– Mitigation
Proactive, protective measures used to reduce the vulnerabilities or potentials for loss
– Preparedness Identifying at-risk populations, prioritizing their
EMS needs, and developing, in advance, the resources necessary to meet those needs
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Managing EMS Special Operations (Cont.)
• Four steps for managing the effect of hazards upon communities:– Response
Activities that we implement as a direct result of the occurrence of the hazard
– Recovery Restore the infrastructure and social and
economic stability to the community after the effect of the hazard
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS "All-Hazards" Approach
• All-hazards approach is a process by which we identify within our communities the hazards that we will face
• Identify and quantify those persons or segments of the population that are vulnerable to the hazards
• Refine the projected vulnerabilities after mitigation actions have been identified
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Pre-Event Planning Matrix
• Choose the risks, hazards, or functions that are likely to be required by an event– Assign each to a primary agency (P) or a
secondary or support agency (S)– The functions and responsibility
assignments must be discussed and decided in the planning stages, not when an incident occurs
– Additional room is provided in the matrix to add agencies or risks/functions as they may apply
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.1Pre-Event Matrix Worksheet.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.1 (Cont.)Pre-Event Matrix Worksheet.
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
TABLE 19.1 Legal Influences on EMS Response to Special Operations
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Plan Components
• Plans have common characteristics that include:– Hazards analysis;– Vulnerability analysis;– Basic plan consideration;– Resource identification;– Support functions or mechanisms for
resource deployment; – Recovery activities
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Customer Expectations
• Demands upon organizational resources are constantly increasing because of increased customer expectations
• There is a requirement to assemble greater and greater resources to manage special operations and unique events that may occur in our communities
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Customer Expectations (Cont.)
• We must identify in advance additional resources that we can bring to bear on virtually any type of event to which we may be called to assist
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Customer Expectations (Cont.)
• In order to accomplish this, EMS leadership must:– Identify potential hazards– Determine the at-risk populations for each
of those hazards– Identify the resources that would be
required to manage events caused by those hazards
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Customer Expectations (Cont.)
• In order to accomplish this, EMS leadership must:– Determine what assets and voids are in the
resources we have– Find resources to fill those voids– Develop a methodology for deploying those
resources to a particular event
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Mutual-Aid Agreements
• Mutual aid– Command officers required to make
specific requests for special-operations equipment In many areas these resources will take time to
assemble or will have to travel long distances to get to the scene
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Mutual-Aid Agreements (Cont.)
• Automatic aid– Inter-local or mutual-aid agreement in
which the dispatch center without a command officer’s input can send or request equipment based on the information from the call to the public-safety answering point
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Disaster Condition
• A disaster or emergency may overwhelm the capabilities of a state and its local governments, preventing them from providing a timely and effective response to meet the needs of the situation
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Disaster Conditions (Cont.)
• A disaster or emergency has the potential to cause substantial health and medical problems, with hundreds or thousands of deaths and injuries, depending on factors such as time of occurrence, severity of impact, existing weather conditions, area demographics, and the nature of building construction
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Disaster Conditions (Cont.)
• A disaster or emergency may cause significant damage particularly to the economic and physical infrastructure
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Level of Care
• Levels of care at special events or mass gatherings may include: – Basic first-aid or pre-EMS certifications – Intermediate first aid plus IV therapy and
oxygen– Advanced care and life support and early
management of severe trauma– Site hospital full monitoring and ventilation;
a surgical facility may be required depending on the level/type of event
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Level of Care (Cont.)
• Other level-of-care concerns including training staff, specialized rescue teams (i.e., Justin Sports Medicine for PRCA rodeo events, paramedic standby for the International Speed Boat Racing Association, extrication team for CART professional racing)
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Main Concerns in Planning Medical Care
• Factors to be considered in an event setting: – Indoor versus outdoor – Access routes to and from the site– Size of the crowd– Duration of the event
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Main Concerns in Planning Medical Care (Cont.)
• Factors to be considered in an event setting: – Extremes in temperature– Mobility of the crowd– Number and visibility of the aid stations and
medical-treatment facilities
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Logistics
• Consider staffing a medical logistics position when planning a large event– Arrangements for facilities will be needed
for medical personnel to operate in an environment in which the injured must make their way to that location
– Make sure medical teams that patrol spectator areas are clearly identifiable
– Alternative vehicles need to be available to transport spectators to the medical facility
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Logistics (Cont.)
• Consider staffing a medical logistics position when planning a large event– Determine how medical personnel will be
notified of, or summoned to, spectators requiring assistance in public areas
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Access to Venue
• Agreements must be reached among medical service providers on how medical teams will be able to locate individuals in need of attention
• Agree on the use of a common reference map or grid system
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Access to Venue (Cont.)
• Determine how medical teams will reach or rescue individuals in distress; for example, in crowded areas or through fixed seating
• The mechanism of how patients will be transported on site should be worked out
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Requirements
• Should prepare for the most critical injury or illness foreseeable, such as cardiac arrest
• Assessments should be made for the needs for a mobile team– Mobile teams may require pre-packed
medical kits– A determination should be made as to
which mobile teams will provide care for the audience, any VIPs, and performers
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Requirements (Cont.)
• The boundaries of what kind of care and services will be provided to the event should be defined
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical-Aid Stations
• Mobile teams will often move patients to the medical-aid stations prior to the arrival of a transport vehicle
• Consider the establishment of medical- aid posts at large events or events that may take a significant amount of time for an ambulance to arrive
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.4Characteristics of a Medical-Aid Station
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Site Hospital
• Depending on the nature of the event, a site or field hospital may be needed to provide care for the number of casualties anticipated
• You should also make contingency plans in case of a major incident, for which the resources of the field hospital may not be sufficient
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Site Hospital (Cont.)
• Failure to plan for large numbers of casualties or severely injured patrons can result in long delays in providing medical treatment
• It is important to provide a communications link between the site hospital and local hospitals
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Equipment
• The requirement for basic or advanced life support equipment depends on the type of event and the assessed risk of illness or injury
• Equipment considerations include identifying where the equipment should be mobile versus fixed and arrangements to resupply aid posts as required
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Medical Equipment (Cont.)
• Compatibility of on-site equipment with equipment used by ambulance and other health-care providers should be evaluated for inter-operability
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Documentation
• A post incident analysis of the event and review of the number of requests for medical assistance that occurred at the event should be completed by EMS management
• Tracking should be done of biological, chemical, and infectious-disease exposures should they occur
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Documentation (Cont.)
• Medical-legal issues, which must be addressed prior to the preparation of any documents, are as follows:– Who has access to records?– Who keeps the data and for how long?– Who can give consent for treatment?
• Every patient contact should be documented and recorded
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Legal Issues
• Legislation usually governs or restricts public events or aspects of them
• Some events that are extremely large or high impact require special state or local legislation
• Local ordinances provide health and medical guidelines
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Legal Issues (Cont.)
• An event should cover a variety of liabilities that warrant consideration, including:– Liability for injuries– Liability for acts or omissions– Liability for financial obligations incurred in
responding to major emergencies occasioned by the event
– Potential liability for the resultant effects of the event on normal emergency operations
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Site
• Finding a suitable venue or set of venues can be difficult; the following questions will aid in the selection of an appropriate event site:– Will staging the event require multiple
venues?– Is this kind of event normally conducted at a
fixed facility?– Will a fixed facility be used in ways that may
not be considered normal for that facility?
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Site (Cont.)
– Is the event regularly conducted at a temporary venue?
– Is the event a “one-of-a-kind” project at a temporary venue?
– What services/utilities are available at the venue?
– What additional services and utilities will be required at the venue?
– Is there a need for backup services or utilities?
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Site (Cont.)
– What shelter facilities are available at the following locations: Transport pick up and drop off areas Spectator and official viewing areas Seated eating areas Pedestrian thoroughfares First aid and medical centers Marshaling areas for competitors and officials
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Contingency Planning
• Unfortunately, not every event runs smoothly
• Incidents occur that are beyond the control of the planning team– Contingency plans for every event should
be in place
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Contingency Planning (Cont.)
• An emergency-response plan requires a comprehensive hazard and vulnerability analysis
• Consultation among all parties who may respond to an emergency situation during the event is essential
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.6Factors Influencing ICS Planning At Events
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.7 (Con't)Sample Special Events Registration Form. (Source: County of Santa Clara Emergency Medical Services
Agency.)
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Mass-Gathering Crush Load
• Crush load is the assembly of persons inside or outside a facility that overwhelms the capacity of a given area, resulting in gridlock, limited access, and a surge in the crowd, which pins people against a fixed object, compromising life safety
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS Operations at Mass- Gathering Events
• Supplies and equipment to provide immediate emergency medical treatment to all should be staged or pre positioned at the scene
• Mobile rescue and medical teams, the American Red Cross, and security services need to work in conjunction for maximum safety
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS Operations at Mass- Gathering Events (Cont.)
• EMS personnel operating in this environment should have special training, equipment, policies, and procedures and have previously practiced the techniques needed to accomplish this mission
• EMS organizations should develop their plans using an established incident command system (ICS) compliant with NIMS
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Minimizing EMS System Burdens
• Cooperative planning by both EMS and OES can greatly reduce the planning burden on any one agency
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Minimizing EMS System Burdens (Cont.)
• Partner with local agencies to develop a People with Special Needs (PSN) program– Allows for people with specific medical
needs to register with local EMS or emergency-management officials well in advance of the need to shelter
– Resources and needs that will be required in a disaster situation can be assessed better
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS Special Teams
• Tactical Emergency Medical Support– The comprehensive out-of-hospital medical
support of law enforcement's tactical teams during training and special operations
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS Special Teams (Cont.)
• Bike teams and alternative response programs– Bike medics have been incorporated in to a
variety of agencies including county and city fire agencies, villages, military bases, colleges, and hospital-based EMS
• Protective operations– Dignitary protection
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FIGURE 19.13Types of Dignitary Protection
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Organization of Protective Details
• The purpose of the protective detail is to safeguard the protectee from harm and from situations likely to endanger his or her person or liberty
• Concentric ring of safety
• At each security perimeter, a check point should be established to ensure proper access
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Organization of Protective Details (Cont.)
• Screening at the checkpoint can be as restrictive as requiring a person to:– Provide positive identification– Submit to a name check through police
records or a visitor list– Undergo a search by a walk‑through or
hand-held metal detector
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Organization of Protective Details (Cont.)
• Security for the protectee in residence– Greatest opportunity to control the
environment
• The command post– EMS will be managed by a team in the
command post or residence that is a self‑contained room in the protectee's residence, which serves as the perimeter ring
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Organization of Protective Details (Cont.)
• The safe haven– Another room in the residence within the
perimeter of security Provides temporary refuge to the protectee and
family when additional time is needed for police or security personnel to respond to the residence under attack
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Figure 19.14Safe Haven Criteria
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Direct Contact with the President or VIP
• President of the United States, in addition to traveling with a physician and a nurse, is afforded 24-hour EMS protection
• Vice president is generally provided EMS stand by only when in public places or when threat levels are high
• EMS may be asked to provide any variety of protective arrangements
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Direct Contact with the President or VIP (Cont.)
• Secret Service advance team – Will do everything possible to ensure that
local community concerns are addressed– Response routes, availability of resources,
impact of motorcades on traffic can all be identified
– EMS must remember to pay strict attention to the orders of the Secret Service to ensure their own personal safety
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
General Dignitary Protection
• Keys to successful involvement– Communicate with the Secret Service to let
them know your goals early– Never sacrifice your level of service to the
community– Make sure your personnel are well-briefed
and know the rules– When the protectee is near, it is “all
business”
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
EMS Special Teams
• Helicopter teams
• Medical support in hazmat operations
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
USAR and Technical Rescue
• There are nine classifications of technical-rescue incidents according to the National Fire Protection Association – Water rescue– Rope rescue – Rescue from confined spaces – Wilderness search and rescue – Trench rescue
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
USAR and Technical Rescue (Cont.)
– Vehicle and machinery rescue – Dive search and rescue – Collapse rescue – Any other rescue operations requiring
specialized training
• It is important to establish interagency cooperation and train with technical- rescue teams before an incident
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
USAR and Technical Rescue (Cont.)
• Minimum qualifications require rescuers to be certified at the BLS level and have rescue-awareness training
• All personnel at the site must operate under an incident-management system
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
FEMA Rescue Resources
(Reprinted with permission of City of Vernon Fire Department.)
USAR and Technical Rescue (Cont.)
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Summary
• EMS is constantly being challenged to provide services in environments as part of a special-operations team
• The all-hazards approach to emergency services is now creating an expectation that EMS can deliver services to patients during events that require technical rescue, hazardous materials response, and law-enforcement scenarios
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Summary (Cont.)
• More specialty teams will be needed in the future, and as it becomes necessary to regionalize these resources, EMS managers will be required to design and implement services within these units and establish procedures for interfacing with special operations
Bruce E. Evans • Jeff T. Dyar — Management of EMS Copyright © 2010 by Pearson Education, Inc. Upper Saddle River, NJ 07458
Summary (Cont.)
• Today’s EMS leadership must have some knowledge of EMS special operations
• Planning is the key to success in special events; the better the plan, the less chance for problems