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

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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.

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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

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

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Preparing for Pandemic Influenza: Recommendations for Protocol Development for 9-1-1 Personnel and Public Safety Answering Points (PSAPs)

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Recommendations for Protocol Development 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

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Call Taking & Dispatching

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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.

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PSAP: Public Safety Answering Points.

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

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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

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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.

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

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MPD Pandemic Protocol

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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)

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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)

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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

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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

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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.)

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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.)

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Points to Ponder Managing Entry Points

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CONTAGION

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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

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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?

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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

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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

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Out of Hospital Provider Education

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