EMS SUPERVISOR FIELD OPERATIONS GUIDEEMS Supervisor Field Operations Guide Page 8 of 69 (Operational...

Santa Clara County Emergency Medical Services EMS Supervisor Field Operations Guide

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EMS SUPERVISOR FIELD OPERATIONS GUIDE Effective Date: May 11, 2015 Review Date: November 1, 2018


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Table of Contents

EMS System Management Standards ..................................................... 3 Position Descriptions.................................................................................................... 4

Standing Medical/Health Mutual Aid Orders ................................................................ 6

Operational Area Mutual Aid ........................................................................................ 7

Public Health Personnel Assignments Fill Order .......................................................... 9

EMS Supervisor / Management Assignments Fill Order ............................................ 10

Expanded Medical-Health Dispatch ........................................................................... 11

EMS Standard Command Action Checklists ........................................ 12

Standard Initial Actions Checklist ............................................................................... 15

Common Considerations Checklist ............................................................................ 16

FAA Alert II and Alert IIL Checklist ............................................................................. 17

Hospital Internal Disaster Checklist ........................................................................... 19

Patient Care Facility Emergency Events/Evacuation Checklist .................................. 20

Ambulance Strike Team / Medical Task Force Leader Checklist ............................... 21

Policy Compliance / Deviation Checklist .................................................................... 23

Health Department Activation Checklist ..................................................................... 24

EMS Standby Checklist .............................................................................................. 25

Minor Earthquake EMS Response Checklist ............................................................. 26

Catastrophic Earthquake EMS Response Checklist .................................................. 27

Significant Weather Event Checklist .......................................................................... 28

Mobilization Center Activation Checklist .................................................................... 29

Communications Center Failure Checklist ................................................................. 30

Weather Emergencies Readiness Checklist .............................................................. 31

Mutual Aid Request From Outside Operational Area Checklist .................................. 32

Region II Mutual Aid Request Checklist ..................................................................... 33

Field Treatment Site Trailer Deployment Checklist .................................................... 34

Standard Dispatch Orders...................................................................... 35

Sample Standard Dispatch Orders Execution Form ................................................. 37

Standard Dispatch Order Checklists .......................................................................... 40


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EMS System

Management

Standards


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Position Descriptions The following positions are standard positions that either play a direct role in the management of the Santa Clara County EMS System or are representatives of partner agencies that regularly participate in the EMS System. In some cases and when authorized by law, various authorities may be delegated to private service EMS Field Supervisors or Fire/Law Enforcement partners in accordance with appropriate policies. The positions are listed in no particular order below: Accredited EMS Field Supervisors (EFS) Accredited EMS Field Supervisors are personnel who are responsible for the supervision of a permitted Santa Clara County ambulance agency’s field operations. They have met the minimum requirements that are set in Santa Clara County Prehospital Care Policy for the accreditation of EMS Field Supervisors. They may provide council to the EMS Duty Chief. However, they are not government employees, and therefore, hold no power or authority of the County. They are required to adhere to the National Incident Management System (NIMS) and Standard Emergency Management System (SEMS). Accredited County Ambulance EMS Field Supervisors (EFS) Accredited County Ambulance EMS Field Supervisors are personnel who are responsible for the supervision of the Santa Clara County 911 Exclusive Operating Area (EOA) ambulance provider’s activities. They have met the minimum requirements that are set in policy for the accreditation of EMS Field Supervisor in Santa Clara County. These managers provide council to the EMS Duty Chief. These managers are not government employees, and therefore, hold no power or authority of the County. However, they are required to adhere to the National Incident Management System (NIMS) and Standard Emergency Management System (SEMS). County Ambulance EMS Field Supervisors are responsible for the management of the 911 ambulance service’s daily operations. They implement orders or actions assigned by the EMS Duty Chief. They are able to serve in assigned incident management roles when on scene of an event. They coordinate 911 ambulance deployment, staffing, and coverage. They are responsible for developing incident action plans for approval by the EMS Duty Chief related to events occurring in the Santa Clara County Operational Area. They maintain situational awareness and report contractual performance requirements. County Ambulance Operations 1 and Operations 2 County Ambulance Operations 1 and Operations 2 are private service managers who are responsible for the management of the Santa Clara County 911 EOA contracted ambulance provider’s operations and supervise accredited County Ambulance EMS Field Supervisors. Fire/Law Enforcement Partners In most cases, the fire or law enforcement agency is charged with overall incident command and control activities. Individual service/department supervisors and managers are responsible for the daily management and mitigation of incidents occurring within their jurisdiction. These positions provide council to the EMS Duty Chief and are the key link to routine operational practices within the EMS System.


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(Position Descriptions cont.)

Santa Clara County EMS Director

The EMS Director reports to the Director of the Public Health Department and also serves cooperatively as the Medical/Health Operational Area Coordinator (MHOAC) with the Public Health Officer. The EMS Director is responsible for the executive management of the Santa Clara County Emergency Medical Services System. The EMS Director provides policy-level guidance and direction to the EMS Section Chief and consults with other executive managers in the County including staffing positions at the Operational Area level. Santa Clara County EMS Duty Chief

The EMS Duty Chief is a Santa Clara County EMS Specialist, which reports to the EMS Section Chief of the EMS Agency. EMS Duty Chief coverage is accomplished through a standard rotation of qualified personnel. When assigned to coverage, the EMS Duty Chief is the primary contact for all EMS and medical/health issues that are under the authority of the California Health and Safety Code. During this time, the EMS Duty Chief is required to be able to respond to inquiries within ten minutes of notification. One EMS Duty Chief is scheduled at all times. The EMS Duty Chief works closely with public and private responders and provides council to command as appropriate. They primarily serve as a facilitator, technical reference specialist, and agency representative. They may provide transportation and support to Health Department personnel (health officers, outbreak teams, public information, etc.), when necessary. The EMS Duty Chief may also staff other emergency/support vehicles and/or may be assigned to a department operations center, EOC, or other area to support a medical health mission.

Santa Clara County EMS Section Chief

The EMS Section Chief reports to the Director of the EMS Agency. The EMS Section Chief is responsible for providing oversight to the EMS Duty Chief/EMS Specialist, guiding the resolution of field response matters. The EMS Section Chief provides situation status briefings to the EMS Director, Director of Public Health, and other appropriate emergency response or management partners. In the absence of the EMS Section Chief, the EMS Director may fulfill assigned duties and areas of responsibility or an EMS Specialist may be temporarily assigned to this responsibility. In the absence of the EMS Director, the EMS Section Chief fulfills the duties of this position.

The EMS Section Chief has the ability to make Santa Clara County Prehospital Policy adjustments based on the needs of an emergency incident, coordinates medical-health mutual-aid, and staffs appropriate emergency operations centers. The EMS Section Chief has the authority to make mutual aid requests through the California Standardized Emergency Management System (SEMS) in order to sustain or meet the needs of the County’s medical health system.


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STANDING MEDICAL/HEALTH MUTUAL AID ORDERS

General Description

This document is designed to identify resources that may be deployed by the EMS Section

Chief. All resources may only be released if the Santa Clara County Operational Area will

remain solvent (is not impacted) and the request was made and filled in accordance with SEMS.

Resource Standing Order

Ambulances Up to (5) ALS ambulances (from EOA provider)

Up to (5) BLS/ALS ambulances from any provider

Up to (2) Critical Care Transport Units (nurse)

Accredited EMS Field Supervisors

Up to (2) Accredited EMS Supervisors

Field Treatment Site Trailers

Up to (2) Field Treatment Site trailers

Disaster Medical Support Units

Up to (1) Disaster Medical Support Unit

Nerve Agent Antidote Kits Upon immediate need request, an unlimited number may be released as long as adequate local supplies exist.

Multiple Patient Management Kits

Up to (5) kits

Satellite Telephones Up to (2) low-orbit satellite telephones


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OPERATIONAL AREA MUTUAL AID General Description

This document provides guidelines for using medical/health mutual aid within and external to the

Santa Clara County Operational Area. The use of these resources must be approved by the

EMS Section Chief or EMS Director.

Type Fill Order

ALS Ambulances (non-disaster state)

• The contracted 911 EOA providers shall have the first opportunity to fill any ALS ambulance requests.

• Other ambulance services with permitted ALS units will then be requested – both public and private.

• Municipalities with paramedic ambulances will be notified to use their ALS units as appropriate within their jurisdiction.

• When all of the above items have not resulted inadequate numbers of ALS units, a SEMS mutual aid request will be made.

ALS Ambulances (disaster state)

• All private ALS ambulances will be mandated to be placed into service, in accordance with County Ordinance, for assignment.

• When all actions above have been exhausted, a SEMS mutual aid request will be made as appropriate.

BLS Ambulances (non-disaster state)

• All requests for BLS ambulances use shall be made by the County to all of the private service providers. Those able to respond will be placed into the 911 System.


BLS Ambulances (disaster state)

• All private BLS ambulances will be mandated to be placed into service, in accordance with County Ordinance, for assignment.



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(Operational Area Mutual Aid cont.)

Type Fill Order

Hospital Support (personnel, equipment, and

supply)

• Hospitals shall implement provisions contained in existing disaster plans.

• Hospitals shall implement provisions contained in existing hospital mutual aid agreements.

• When these items are not adequate to meet the needs of the hospital, the County will assist in providing appropriate resources.

Medical Supply and Equipment

• Agencies shall exhaust all provisions for medical resources and equipment contained in their disaster and continuity of operations plans.

• If the need surpasses the provisions above, the County will attempt to fill the need through local caches and stores.

• If the need surpasses the resources available in the Operational Area, a SEMS mutual aid request will be made as appropriate.

Health Officer • Deputy Health Officers will be contacted in the absence of the Health Officer.

• If a Deputy Health Officer cannot be located, the EMS Section Chief will contact a Health Officer from a local Operational Area, if appropriate and in coordination with the EMS Director and Public Health Director.

• If an adjacent Operational Area Health Officer is not available, a SEMS request will be made.

Personnel (Medical/Health)

• Agencies shall exhaust all provisions for additional personnel/staffing contained in their disaster and continuity of operations plans.

• If the need surpasses the provisions above, the County will attempt to fill the need through local resources opportunities.

• If the need surpasses the resources available in the Operational Area, a SEMS mutual aid request will be made as appropriate.


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PUBLIC HEALTH PERSONNEL

ASSIGNMENTS FILL ORDER

General Description

In order to provide adequate support to various Medical/Health System events, the following

shall provide the standard recommended response compliments for filling various medical-

health positions (countywide).

Table: Medical Health Command Staff Assignments Recommended Fill Order

Type Fill Order

Field Events EMS Duty Chief (Field)

EMS Section Chief (Communications)

Field Event

with MHOC

Activation

EMS Duty Chief (Field)

EMS Section Chief (Communications)

EMS Director (MHOC)

EMS Agency staff (MHOC)

Additional staff as assigned (MHOC)

Field Event

with MHOC

and EOC

Activation

EMS Duty Chief (Communications)

EMS Section Chief (EOC)

EMS Director (MHOC)

EMS Agency staff (MHOC)

Additional staff as assigned (MHOC)

Ad

ditional staff as assigned (MHOC) EOC Only EMS Section Chief or EMS Director

Health Officer

MHOC Only EMS Director

EMS Section Chief

EMS Duty Chief

Health Officer


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EMS SUPERVISOR/MANAGEMENT ASSIGNMENTS FILL ORDER

General Description

In order to provide adequate support to various Medical-Health System events, the following shall

provide the standard recommended response compliments for filling various medical-health

positions in order.

Table: Supervisor/Management Assignments Fill Order

Type Fill Order

EMS Field Supervisors 1. County Ambulance accredited EMS Field Supervisor

2. Accredited EMS Field Supervisor from private providers

3. Fire Service Company Officer (intra-county mutual aid)

4. Non-Accredited EMS Field Supervisor

EMS Duty Chief 1. EMS Duty Chief

2. EMS Section Chief (immediate need) or Alternate EMS Duty Chief (non-time sensitive)

3. Designated EMS Specialist by the EMS Section Chief

4. EMS Agency staff (EMS 3-15), as recalled

EMS Section Chief 1. EMS Section Chief

2. Temporarily assigned EMS Specialist

3. If the EMS Section Chief is not able to assign an EMS Specialist, the EMS Director will make an assignment

EMS Director 1. EMS Director

2. EMS Section Chief

3. Other staff assigned by the Public Health Director

Health Officer 1. Health Officer

2. Deputy Health Officer (designated by the Health Officer)


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EXPANDED MEDICAL/HEALTH DISPATCH OPERATIONS

General Description

In order to maintain the sound operation of the Santa Clara County Medical/Health System, it

may be necessary for a representative of the EMS Agency to assist Santa Clara County

Communications personnel with the prioritization and allocation of medical/health resources

during times of system surge, when activated by the EMS Director or the EMS Section Chief. A

representative of the County EOA emergency ambulance service provider may respond to assist

the County and County Communications personnel with the coordination of EOA resources and

deployment.

System Management

The EMS Section Chief is responsible for executing expanded medical/health dispatch activities.

In most cases, the EMS Duty Chief will respond to County Communications and work with the

Watch Commander (or designee) to implement EMS System modifications. This may include

the implementation of Standard Dispatch Orders, use of intra/inter-County mutual aid, etc.

County EOA ambulance representatives may take actions to assist in increasing the number of

911 ambulances deployed by recalling personnel, reassigning personnel, modifying company

operations, etc.

The EMS Section Chief is responsible for executing expanded medical/health dispatch orders.

In most cases, the EMS Section Chief will respond to County Communications, assign an EMS

Agency staff member (EMS 3-15), or the EMS Duty Chief and work with the Watch Commander

(or designee) to implement EMS System modifications. Expanded Dispatch Criteria

Expanded medical/health dispatch shall be considered in any of the following circumstances:

1 Requested by the County Communications Watch Commander or EMS Duty Chief.

2 Multiple Standard Dispatch Orders are in effect.

3 When the EOA contractors actions have failed to meet system needs.

4 All levels of MPMP Activation.

5 Occurrence of a significant event that may/(has) impact/(impacted) the EMS System. May be in support of a scheduled activity or identified hazard.

6 When receiving out of county medical/health mutual aid.

7 When a city PSAP implements expanded dispatch.

8 When the fire or law enforcement mutual aid coordinators implement expanded dispatch.

9 When the operation Area EOC or MHOC is activated.


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EMS Standard Command Action Checklists


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Standard Command Action Checklists Purpose:

The following checklists are designed as guidance for EMS command staff for use in day to day response activities as well as in unusual occurrences. The checklists are not policy, rather they are a tool that serves as a reminder for users and to assist them in the management of EMS events. The actions and tasks in the checklists are not assigned in any specific order. They are designed so that when multiple staff are assigned to an event they can relay the number of each action item they have completed to other responders. This is done in order to reduce duplication of efforts and serve as a means of assuring task and action completion.

CHECKLIST SECTION A: RESPONSE CHECKLISTS

1. CHECKLIST A-1: STANDARD INITIAL ACTIONS

2. CHECKLIST A-2: COMMON CONSIDERATIONS

3. CHECKLIST A-3: FAA ALERT II and ALERT IIL

4. CHECKLIST A-4: FAA ALERT III and AIRCRAFT DOWN

5. CHECKLIST A-5: HOSPITAL INTERNAL DISASTER

6. CHECKLIST A-6: PATIENT CARE FACILITY EMERGENCY

EVENTS/EVACUATION

7. CHECKLIST A-7: AMBULANCE STRIKE TEAM (AST) / MEDICAL TASK

FORCE (MTF) LEADER

8. CHECKLIST A-8: POLICY COMPLIANCE/DEVIATION

9. CHECKLIST A-9: HEALTH DEPARTMENT ACTIVATION

10. CHECKLIST A-10: EMS STANDBYS

CHECKLIST SECTION B: LARGE SCALE AND COUNTY WIDE EVENTS

CHECKLISTS

1. CHECKLIST B-1: MINOR EARTHQUAKE EMS RESPONSE

2. CHECKLIST B-2: CATASTROPHIC EARTHQUAKE EMS RESPONSE

3. CHECKLIST B-3: SIGNIFICANT WEATHER EVENTS

4. CHECKLIST B-4: MOBILIZATION CENTER ACTIVATION

5. CHECKLIST B-5: COMMUNICATIONS CENTER FAILURE


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(Standard Command Action Checklist cont.)

CHECKLIST SECTION C: READINESS/PREPAREDNESS CHECKLISTS

1. CHECKLIST C-1: WEATHER EMERGENCIES READINESS

2. CHECKLIST C-2: MUTUAL AID REQUESTS FROM OUTSIDE

OPERATIONAL AREAS

3. CHECKLIST C-3: REGION II MUTUAL AID REQUEST CHECKLIST

4. CHECKLIST C-4: FIELD TREATMENT SITE TRAILER DEPLOYMENT


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CHECKLIST A-1: STANDARD INITIAL ACTIONS

Purpose: This checklist is to be used by EMS Command Staff initially when they are alerted of an incident or event. It is assumed that EMS command staff may become aware of events by three different means; (1) direct dispatch by County Communications, (2) when called by a stakeholder or partner, and (3) by passive monitoring. County Communications maintains a prescribed list in which they are required to dispatch EMS command staff. Frequently program managers or supervisory staff from partner entities contact EMS command staff regarding issues or events. EMS Command staff passively monitor radio channels, social media, etc. and sometimes discover events that require their attention through these means. Reports to: _______________________________________________________________________ Subordinate Position: ______________________________________________________________

Action # Tasks Time Initial

1. Acknowledge dispatch / receive information and collect the following:

Conditions/situational assessment/caller information:

Actions requested or needed:

Needs of the event:

2. Document all actions on the standard Event Management Record.

3. Determine the needed actions and notifications, considerations below:

Does the incident require a response?

What are the applicable policies or protocols?

What resources, if any, are assigned?

Does the incident require policy modification?

Assess the need for notifications (Provide CAN Report).

4. Provide regular updates throughout the event, if on going.

5. Submit all documentation within 24 hours of completion of shift.


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CHECKLIST A-2: COMMON CONSIDERATIONS CHECKLIST: ALL RESPONSES

Purpose: This checklist is to be used by EMS Command Staff initially when they are alerted to an incident or event. These are common considerations to think about regardless of the type of incident or response (in no particular order). Tasks Time Initial Tasks Time Initial

Hospital status: EMResource (queries/notices) EMS System levels: HAvBED & ED Bed Queries Command and tactical channels (needed or already assigned)

AlertSCC

Need for an assigned dispatcher?

Ambulance Query

Monitor command/tactical channel for event

Web EOC

Determine staging location If indicated, recommend MPMP Activation to IC

Determine ingress and egress Central Patient Routing

Ensure single point resource ordering

Request activation of the EOC or MHOC

Determine the need to conduct expanded dispatch

Mutual Aid

Determine the need to utilize Standard Dispatch Orders

Public Health Officer notification

Conduct regular Personnel Accountability Reports (PAR)

Using vehicles as command resources / dispatch resources

PIO duties Need for MVDR deployment UTL 125 and/or UTL 126 (DMSU)

Mass oxygen delivery systems

County Ambulance disaster vehicle

25-patient shelters

County Ambulance resupply vehicle

Heating and cooling tents

FTS trailer Misting supplies

Special operations trailer Field physician response kit Cabana & Cabana tender Additional PPE

Alternate Response Vehicles Body bags

Lighting resources Portable radio caches Generators Satellite phones SNS/priority prophylaxis Medical unit bag APRs with BIO canisters Strike team leader bag CHEMPACK Variance reports


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CHECKLIST A-3: FAA ALERT II AND ALERT IIL Purpose:

This checklist is to be used by EMS Command Staff when attached to an FAA Alert II or Alert IIL response at an airport.


1. Perform “Standard Initial Actions” (Checklist A-1).

2. Utilize “Common Considerations Checklist” based on information obtained about the response. (Checklist A-2).

3. Upon dispatch, determine the need to respond or to monitor, absent known risk factors (unknown if aircraft will make the field, hazmat cargo, etc.).

A field response for an ALERT II is not generally indicated.

It is expected that a field response will occur for an ALERT II-L.

4. Consider cause of Alert:

Hydraulic issues

Landing gear issues

Smoke in the cockpit/cabin

ETA of aircraft

Type of craft (passenger/cargo)

Number of souls on board

Approach direction

Visible signs of accident (smoke/fire)

Warning lights

Fire (engine or on board)

Wildlife strike

Blown tire

Diversion from another airport

Is fire department following the aircraft on landing?

5. Serve as agency representative to airport EOC/Operations, if activated.


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CHECKLIST A-4: FAA ALERT III AND AIRCRAFT

DOWN

Purpose:

This checklist is to be used by EMS Command Staff when attached to an FAA Alert III and aircraft down response.


1. Perform “Standard Initial Actions.” (Checklist A-1).

2. Determine the location of the incident (on airport, off site location)

Residential

Commercial

Rural

3. Determine if evacuations are taking place, and best location to stage EMS resources.

4. If possible, determine size of the aircraft, type of aircraft, and number of souls on board.


6. Serve as agency representative to airport EOC/Operations, if activated.


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CHECKLIST A-5: HOSPITAL INTERNAL DISASTER

Purpose:

This checklist is to be used by EMS Command Staff when notified of a hospital that has changed its status to Internal Disaster.

Action # Tasks Time Initial 1. Perform “Standard Initial Actions.” (Checklist A-1).


3. Contact ED Charge Nurse/House Supervisor for a situation report.

4. Determine if anticipated need for patient evacuation.

5. Request estimated time hospital expects to be in status.

6. Advise facility to contact their contracted ambulance provider to request standby resources, in the event of needing to transfer patients away from the facility.

7. One 911 System Ambulance and an EFS is dispatched to the facility any immediate need transfer patients. A physician from the facility must evaluate all patients and may use the 911 ambulance until the contracted provider arrives.

8. Ensure appropriate public safety agencies have been notified.

9. Determine if other EMS hospital status may be appropriate (recommendation made to the facility).

10. EMS Duty Chief, Facility, and EFS shall cooperatively develop a plan that addresses the need to assess walk-in and ambulance patients throughout the period of “Internal Disaster.”

11. Support hospital using existing policy and resources.


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CHECKLIST A-6: PATIENT CARE FACILITY EMERGENCY EVENTS/EVACUATION

Purpose:

This checklist is to be used by EMS Command Staff when notified of an emergency event/evacuation involving a patient care facility (Examples: fire, HAZMAT, multiple illnesses).




3. Make contact with facility’s lead manager / Agency Representative.

4. Advise facility to contact their contracted ambulance / transportation provider to request standby resources or in the event of the need to transfer patients away from the facility.

5. Determine need for patient evacuation.

6. Ensure appropriate local public safety agencies have been notified.

7. Support facility using existing policy and resources.

8. Consider requesting patient relocation assistance, through the MHOAC, from Region II and the State.

9. Determine a need for replacement staff if event will go longer than one operational period. Initiate steps to secure relief for next operational period.


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CHECKLIST A-7: AMBULANCE STRIKE TEAM

LEADER (ASTL) / MEDICAL TASK FORCE LEADER

(MTFL)

Purpose:

This checklist is to be used by EMS Command Staff when they are assigned to the position of Ambulance Strike Team Leader (ASTL) / Medical Task Force Leader (MTFL). Deployment Actions:




3. Respond to the assigned staging area, or to the scene if directed.

4. Ensure that all on-scene EMS units are staging in the designated area, on the assigned EMS radio channel.

5. Assure ambulances are fully operational with appropriate

supplies (fuel levels, safety gear, portable and mobile radios,

medical supplies, and ensure that the ambulance is in

operational status).

6. Conduct briefing:

Safety message

Travel Channel

Travel Route

7. Conduct radio check.

8. Go enroute to the event.

9. Maintain contact with units while traveling.


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On Scene Actions:

Demobilization Actions:


1. Stage as an AST/MTF and contact the incident command for

assignment. Only AST/MTF Leader should make contact with IC.

2. Provide T-Cards upon checking in with the ICP/Staging.

3. If needed, obtain the fire and/or law jurisdiction’s radio(s) and

switch to the command/tactical channel used for the event.

4. Obtain assignment.

5. Obtain situation status report, exclusion zone information, safe

staging location, event objectives, communication plan, and

expected actions.

6. Continually ensure assigned personnel accountability and safety.

Conduct PAR when appropriate.

7. Request medical supply/restock as needed.

8. Perform status updates to County Communications while on

mutual aid assignment. Report any change in operational

assignments, assigned location, or duration of need.


1. Debrief all AST/MTF units. Obtain all required paperwork (from the requesting provider).

2. Turn in all paperwork to the IC/ICP. Keep a copy for your records.

3. Conduct a demobilization check of all AST/MTF units.

4. Provide travel routes and travel expectations.

5. Conduct radio check.

6. Go enroute to home base.

7. Contact County Communications and inform them of the team’s release. Provide travel route and ETA back to County.

8. Notify County Communications when AST/MTF units are back in county.

9. Once back in county, conduct release of units from the event.

10. Advise County Communications that AST/MTF has been demobilized.

11. Update and collect ICS documentation (ICS 214, EMS event management record).


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CHECKLIST A-8: POLICY COMPLIANCE/DEVIATION

CHECKLIST Purpose:

This checklist is to be used by EMS Command Staff when advised of a deviation in compliance with Santa Clara County Prehospital Care Policy.




3. Consider creating a CAD event.

4. Identify issue and applicable Santa Clara County EMS Policies.

5. Confirm there is a need for deviation.

6. Request a System Variance Report in conjunction with EMS Agency Policy.

7. Provide notification and a copy of the event management record to the EMS Agency compliance officer for follow up.


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CHECKLIST A-9: HEALTH DEPARTMENT ACTIVATION Purpose:

This checklist is to be used by EMS Command Staff when advised of an activation initiated by the Health Department or Public Health Officer. This could include providing support for the following events:

Biowatch

Biological Defense System

Strategic National Stockpile

Point of Dispensing Operations (PODs)

Priority prophylaxis

Mass prophylaxis

Mass vaccinations




3. Assign staff to EOC or MHOC as needed.

4. Support Operations as needed.

5. Support PHD post event operations as requested and assigned.


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CHECKLIST A-10: EMS STANDBYS Purpose:

This checklist is to be used by EMS Command Staff when notified of or responding to a request for standby 911 EMS Resources. This includes:

Hazardous materials responses

Bomb squad requests

Law enforcement requests

Dive team responses

Structure fires

Civil disturbances

Wildland fires

Dignitary protection




3. Determine and assure that EMS resources have appropriate staging and access information.

4. If indicated, set up medical monitoring area.

5. Obtain local jurisdiction medical monitoring forms from the IC and discuss processes to be utilized for reporting of non-passing personnel.

6. If HAZMAT, assure all patients have been appropriately decontaminated prior to being transported and appropriate hospital notifications have been made.


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CHECKLIST B-1: MINOR EARTHQUAKE EMS

RESPONSE Purpose:

This checklist is to be used by EMS Command Staff when preparing for and responding to earthquakes that affect Santa Clara County. This includes the assessment of effects of small magnitude earthquakes.




3. Obtain situational status: A. Reported issues, injuries

B. County Communications Status

C. 911 call volume

D. Shelter location and capacity

E. Road closures

F. Potential events/issues that are currently being monitored that may involve a medical/health need

4. If activated, ensure communication with the COC, OA EOC, and the MHOC.

5. If a significant 911 surge occurs, consider call back and activation of EMS Field Supervisors, EMS Specialists and off duty County Ambulance personnel.


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CHECKLIST B-2: CATASTROPHIC EARTHQUAKE EMS

RESPONSE Purpose:

This checklist is to be used by EMS Command Staff when preparing for and responding to earthquakes that affect widespread areas throughout Santa Clara County. This includes the presence of heavy damage to infrastructure, utilities, and roadways.




3. Closest EFS and EMS Duty Chief begin response to County Communications for expanded dispatch roles. Other EFS respond to main deployment center.

4. Confirm the ability for County Communications to dispatch 911 calls.

5. Request that County Communications conduct SDO 9 “Conduct an EMS system resource roll call – Determine status and welfare”. Listen to responses of system units.

6. Contact PSAPS within Santa Clara County to obtain their ability to receive and dispatch 911 calls.

7. Query all Santa Clara County hospitals and obtain:

Their ability to receive patients from the 911 system.

Any damages to their structure or utilities.

Need to evacuate patients.

Any other issues that may hinder their ability to function as a 911 receiving facility.

8. Obtain situational status of the event from on-duty public safety, USGS website, and local news media:

Magnitude and location

Reported issues, injuries

911 reports

Damage reports (roadways and care facilities)

9. If established, ensure communication with the OA EOC and the MHOC.

10. Determine the need to make EMS system modifications (hospital diversions, SDO, and etc.)

11. Ensure that ambulance services and partners utilize internal disaster plans for the purposes of continuing operations.


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CHECKLIST B-3: SIGNIFICANT WEATHER EVENTS Purpose:

This checklist is to be used by EMS Command Staff when responding to significant weather events. This includes the following:

Extreme Heat / Extreme Cold / Snow / Ice

Tsunami / Sea Surge / Seiche / Flooding

Tornado




3. Obtain situational status by calling the OES on-call Duty Officer.

4. Contact all hospitals via AlertSCC and EMResource, have them turn their EMS Radios to “Command 92” and obtain: A. Current medical surge reports. B. Their ability to receive patients from the 911 system. C. Any issues, known or expected, that is a result of the

event. D. Any other issues, related to this event, which may hinder

their ability to function as a 911 receiving facility.

5. Notify/broadcast flooding areas to on duty 911 and non-911 ambulance crews and providers. Include road closures, evacuation routes, and other critical information.

6. If impact from event is significant, anticipate the need to give CAN (conditions, actions, needs) report to the OA EOC or MHOC.


8. If a significant 911 surge occurs, request call back and activation of EMS Specialists, EMS Field Supervisors, and off duty County Ambulance personnel.


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CHECKLIST B-4: MOBILIZATION CENTER ACTIVATION

Purpose:

This checklist is to be used by EMS Command Staff when Standard Dispatch Order 22 – Move EMS Units to Mobilization Centers has been activated.




3. Respond to assigned mobilization center or assigned location.

4. Establish communications with County Communications and EMS Command.

5. Upon arrival to assigned Mobilization Center: A. Inform County Communications.

B. Establish communications with County Communications.

C. Track all assigned resources.

D. Act as single point of communications for assigned Mobilization Center.

E. Dispatch and manage resources assigned to your Mobilization Center.

F. Ensure the safety of all EMS resources and personnel assigned to your Mobilization Center.

G. Report number of staging units to County Communications regularly.


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CHECKLIST B-5: COMMUNICATIONS CENTER FAILURE

Purpose:

This checklist is to be used by EMS Command Staff when there is a systems failure at Santa Clara County Communications.




3. Attempt to establish communications via radio, utilize secondary and alternate channels if needed.

4. Closest EFS and EMS Duty Chief respond to County

Communications.

5. Confirm the ability for County Communications to receive

and dispatch 911 calls, including any contingencies, or

routing of calls to other PSAPS.

6. Initiate SDO 9 “Conduct an EMS System Resource Roll

Call”.

7. Ascertain the time frame for the expected return to

normal operations of County Communications.

8. Contact PSAPS within Santa Clara County to obtain their

ability to receive and dispatch 911 calls.

9. If a significant 911 surge occurs, request call back and

activation of EMS Specialists, EMS Field Supervisors and

off duty County Ambulance personnel.


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CHECKLIST C-1: WEATHER EMERGENCIES READINESS

Purpose:

This checklist is to be used by EMS Command Staff when preparing for and responding to County wide weather emergencies.




3. Obtain situational status of the event from County OES, the Operational Area EOC, local EOCs, NWS website, Cal ISO Website, and local news media: A. Reported issues, injuries

B. 911 call volume

C. Cooling/warming center(s) location and capacity

D. Power outages (known and expected)

E. Potential events/issues that are currently being monitored that may involve a medical/health need



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CHECKLIST C-2: MUTUAL AID REQUESTS FROM

OUTSIDE OPERATIONAL AREAS

Purpose:

This checklist is to be used by EMS Command Staff when receiving a request for mutual aid from outside Operational Areas.




3. Obtain the following information in the request:

A. Person/agency making the request

B. Type/number of resources requested

C. Response location

D. Contact person

E. Applicable safety considerations

F. Local Tracking Number

4. Evaluate the current medical-health resources of the Santa Clara County OA and ensure the integrity of the countywide medical health response system.


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CHECKLIST C-3: REGION II MUTUAL AID REQUEST

CHECKLIST

Purpose:

This checklist is to be used by EMS Command Staff when requesting mutual aid from outside Operational Areas.




3. Determine what resources are required to ensure EMS system Sustainability.

4. The EMS Duty Chief shall notify EMS Section Chief, if the requested resources are not available within the OA.

5. If the requested resources are not available within the OA. The EMS Section Chief is responsible for authorization of out-of-County resource requests at the direction of the MHOAC.

6. Request a tracking number from OES Duty Officer.

7. Contact the RDMHS and provide the following: A. Local tracking number

B. Person/agency making request

C. Type/number of resources requested

D. Response location

E. Contact person

F. Resources support needs (e.g., fuel, water, food, lodging)

G. Applicable safety considerations

8. If needed, utilize ambulance mobilization centers for the purpose of receiving mutual aid resources.

9. Make position Assignments as needed in order to facilitate receiving resources.


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CHECKLIST C-4: FIELD TREATMENT SITE TRAILER DEPLOYMENT

Purpose:

This checklist is to be used by EMS Command Staff when responding to requests for a field treatment site deployment in Santa Clara County.




3. Obtain location in which the FTS is needed and if this is an immediate need or planned need.

A. Determine which FTS would be most appropriate based on location and accessibility.

B. Determine which EFS is closest to the FTS to be utilized. Have that EFS dispatched.

C. Inform County Communications of ETA for the FTS to be delivered.

D. Hook up the FTS to the vehicle.

Verify hitch connection.

Verify lighting connection.

Verify tire inflation.

Verify that the inside of the FTS is accessible (key present)

E. Go enroute to the incident staging area or location requested by the IC. Perform status keeping with County Communications. Give an updated ETA if necessary.

4. Upon demobilization: A. Document any missing inventory, and secure the trailer.

B. Return the trailer to its home staging location

C. Perform status keeping with County Communications

D. Report to the EMS agency any items that are missing from the FTS inventory.


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Standard Dispatch

Orders


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Introduction

Standard Dispatch Orders are used to augment the standing protocols and procedures the EMS System uses for normal operations. The use of Standard Dispatch Orders should be considered when normal system operations may not sustain the demand of the EMS System due to an unusual occurrence or event. The EMS Section Chief and EMS Duty Chief are responsible for the decision to use Standard Dispatch Orders. The EMS Duty Chief shall always notify the EMS Section Chief when considering the use of an SDO. Whenever available, the EMS Section Chief shall authorize the use of an SDO prior to being executed by the EMS Duty Chief. The only times an SDO shall be used prior to notification of the Section Chief shall be in instances of life safety (examples, roll call, mobilization centers, etc.) or when the EMS Section Chief is not available. The only Standard Dispatch Order that is initiated by County Communications is SDO 26- Chempack Request. This is to ensure that EMS command staff and the Health Officer are alerted of the request. Public safety answering points and private ambulance dispatch centers should have procedural bulletins in place for when Standard Dispatch Orders are implemented.

Purpose

The purpose of this annex is to delineate each SDO, who is involved in the execution of each, and how and to whom the information is distributed. Each Standard Dispatch Order (SDO) and the flow of information once the decision to execute the order has occurred may be found on the following pages. Please remember Standard Dispatch Orders are temporary modifications made to increase resource availability and functionality of the EMS System.


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Sample Standard Dispatch Orders Execution Form (page 1)


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Standard Dispatch

Order Checklists


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Standard Dispatch Order – 1

Description Enact EOA contractor’s low ambulance levels and high system volume management actions. Overview The EMS System will experience times of high system volume which places an increase demand on ambulance resources. In efforts to maintain adequate ambulance resources within the 911 system the EOA Ambulance provider will enact specific actions in efforts to increase the availability of ambulances. Executed By SDO 1 may be enacted by the County Ambulance EFS, EMS Duty Chief or the EMS Section Chief. Field Crew Response County Ambulance personnel shall follow company provided instructions. Checklist

Action# Actions Time Initial

1 Suspend the following activities

Meal breaks

Hospital extensions

Off duty status

2 Take any needed additional actions to increase 911 ambulance resources within existing policy

3 Notify the EMS Duty Chief


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Standard Dispatch Order – 2 Description Alert Command Staff based on requested group and provide desired communication method (Command Channel or EMS Mednet). Overview Incidents may arise within the EMS System in which the EMS Agency needs to communicate with Command Staff and/or Hospitals. In such events the EMS Duty Chief or EMS Section Chief will enact SDO 2 and notify County Communications of the specific group needing to be alerted and the communications method for each to respond. This alert will notify the respected group to either monitor Command 92 or call in to a conference call line to receive further information and/or instructions. Executed By SDO 2 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response No action required. May monitor if available. Checklist


1 Select desired group

All on duty command staff

All EMS Agency command staff

All on duty and EMS Agency command staff

2 Select desired alerting method (advise how to make contact):

Alert SCC

UHF Radio Paging System

Device capable of receiving CAD email

3 Select desired communication method

Command Channel

Conference Call

4 Conduct roll call

5 Provide Sit Stat and Instructions

6 Advise if communications will continue or if SDO is being cancelled


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Standard Dispatch Order – 3 Description Suspend all Hospital Ring-downs on Command 92 - Allocate for Countywide EMS Command and Control Communications. Overview During normal operations, Command 92 is the command channel utilized by field personnel to inform a hospital of pending arrival and when communicating with the Base Hospital. When events arise in which the EMS Agency requires the use of Command 92 for command or tactical EMS operations, hospital communication over Command 92 can be suspended. When this occurs Standard Dispatch Order 3 will be enacted and communicated to field providers via County Communications as well as EMResource. Field personnel should reference the EMS Prehospital Care Manual Policy #501 for further instructions on communicating with hospitals while SDO 3 is in effect. Executed By SDO 3 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Hospital notifications on Command 92 are discontinued, advise hospital of pending arrival via cell phone, or have County EMS advise the hospital of impending arrival (basic information only). Example: “Medic 43 – advise VMC we are enroute with one adult patient with chest pain, eta 10 minutes.” Checklist


1 Advise County Communications

2 Notify the EMS Section Chief

3 Ensure hospitals and ambulance providers have been noticed by COC

4 Cancel SDO once the channel is no longer needed


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Description Alert all EMS System units Overview Situations may arise within the EMS System in which it may become necessary to provide a priority message to all EMS System units. These messages may include “All Points Broadcast” (APB), “Be on the Look Out” (BOLO), EMS System Roll Call, shelter in place orders or other critical messages. When SDO 4 is enacted, the EMS Duty Chief or the EMS Section Chief will request County Communications to broadcast the appropriate audible tone on County EMS followed by the prepared message. This message will also be sent through the UHF Radio Paging System, EMResource and Alert SCC. Executed By SDO 4 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response All non-emergency traffic must stop until broadcast is complete. Checklist


1 Prepare Text for alert, if not life hazard information, seek approval from the EMS Section Chief

2 Advise COC and ensure they have text for alert

3 Ensure that Alert is transmitted over the Radio, UHF Radio Paging System, EMResource, and Alert SCC

4 If needed, provided updates and follow up information


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Description Alert all private ambulance dispatch centers Overview Situations may arise within the EMS System in which it may become necessary to provide a priority message to all private ambulance dispatch centers. When SDO 5 is enacted the EMS Duty Chief or the EMS Section Chief will prepare the message to be distributed through EMResource, Alert SCC and by telephone through County Communications (if emergent). Executed By SDO 5 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response No action required Checklist




3 Ensure that Alert is transmitted over EMResource, Alert SCC, and if emergent, by phone.

4 Confirm receipt by all recipients

If needed, provided updates and follow up information


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Description Alert all Hospitals Overview Situations may arise within the EMS System in which it may become necessary to provide a priority message to all Hospitals. When SDO 6 is enacted the EMS Duty Chief or the EMS Section Chief will prepare the message to be distributed through EMResource, Alert SCC and by telephone through County Communications (if emergent). Executed By SDO 6 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response No action required Checklist






If needed, provided updates and follow up information


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Description All hospitals ordered open, hospital diversion, and specialty bypass status is suspended. Overview Facility diversion is a management tool that may be used temporarily by local hospitals when the patient load exceeds emergency department or specialty center resources. However, situations may arise when the EMS System is being negatively affected by ambulance diversion, the EMS Agency may require all hospitals to open as necessary. When SDO 7 in enacted the EMS Duty Chief or the EMS Section Chief will prepare the message to be distributed through EMResource, Alert SCC and by telephone through County Communications (if emergent). When the hospital is notified of SDO 7 the hospital shall open immediately. If facility staff considers the direction inappropriate, they may discuss the situation with the Agency during regular business hours. Executed By SDO 7 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Hospitals emergency department diversion and specialty bypass statuses are suspended. Checklist


1 Request approval from the EMS Section Chief, if available

2 Advise COC



5 Terminate SDO as soon as situation allows


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Description Discontinue all Patient Care Reports (PCRs) and replace with triage tags. Overview Patient Care Reports are completed for all patients during normal system operations. When unusual events occur the EMS Duty Chief or the EMS Section Chief may enact SDO 8. These events may include Multiple Casualty Incidents (MCIs) when the EMS System’s Multiple Patient Management Plan is in effect, or when authorized by the County Health Officer, such as in the case of local, state, or federally declared disaster or public health emergency. When this occurs all EMS providers will complete a triage tag for each patient in lieu of a Patient Care Report. Executed By SDO 8 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Discontinue all Patient Care Reports (PCRs) and replace with Triage Tags. Only basic patient information and criticality are collected. Checklist


1 Request approval from the EMS Section Chief, if available

2 Advise COC

3 Ensure that Alert is transmitted over the Radio, UHF Radio Paging System, EMResource, and Alert SCC to the following:

All PSAPS and fire agencies

All ambulance providers

All hospitals



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Standard Dispatch Order - 9 Description Conduct an EMS System Resource Roll Call – determine status and welfare. Overview An EMS System Roll Call is conducted in cases where County Communications or EMS Management needs to verify the availability of units within the EMS System. A roll call may be implemented following a failure of a communications system, immediately following an earthquake or other potential disaster event, or when it is necessary to check the response readiness of EMS units. Executed By SDO 9 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response If EMS System roll call is conducted, standby and respond to County Communications when requested providing Unit ID, status (available / not available), and location, and then standby for assignment. Checklist


1 Notify COC of SDO

2 Ensure that Alert is transmitted over the Radio, Pager, UHF Radio Paging System, EMResource, and Alert SCC

3 Request update on unit status




All hospitals



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Standard Dispatch Order – 10 Description Place all available 911 and Non-911 ambulances in service. Overview Notify each private ambulance dispatch center and PSAP to place all available units into service and immediately make them available for 9-1-1 system responses. Dispatchers shall attach BLS ambulances to any appropriate event. Once attached to an event, the BLS ambulance shall not be cancelled because of ALS ambulance availability. Executed By SDO 10 may be enacted by the EMS Section Chief. Field Crew Response Ambulance providers not currently logged on with County Communications are to contact County Communications and provide the required log in information. Ambulances will communicate with County Communications as outlined in the EMS Communications System Guide. Checklist


1 If available, notify EMS Section Chief

2 Notify COC of SDO

3 Ensure that Alert is transmitted over the phone, Radio, UHF Radio Paging System, EMResource, and Alert SCC to the following:



4 Request update on unit status from COC



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Standard Dispatch Order – 11 Description Notify San Jose, Santa Clara City, and Gilroy Fire Departments that unrestricted use fire based ambulances has been authorized within their jurisdiction (Non system-wide use). Overview Each fire service jurisdiction may use their units in the most effective method as determined by the jurisdiction. This shall include responding to events that require ambulance transportation within their local jurisdiction. Response to and transport of all levels of MPDS triaged and non-triaged (Code 2 and Code 3) events occurring within their jurisdiction is authorized. Upon receiving notification from a PSAP that a fire based ambulance unit has been dispatched to an event, County Communications will inform the PSAP that an ambulance will not be dispatched to the event, unless a need for multiple ambulances exist. If an ambulance has already been attached to the event, it will be canceled. Executed By SDO 11 may be enacted by the EMS Section Chief. Field Crew Response Patients may be transported by fire department emergency ambulances per EMS Policy #614. Checklist


1 If available, request approval and/or notify the EMS Section Chief

2 Notify COC of SDO






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Description Notify San Jose, Santa Clara City, and Gilroy Fire Departments that unrestricted use of their ambulances has been authorized and units may be used system-wide. Overview Same utilization guidelines as Order # 11. When used system-wide, units will be dispatched and tracked by County Communications. Executed By SDO 12 may be enacted by the EMS Section Chief. Field Crew Response Patients may be transported by fire department emergency ambulances per EMS Policy #614. Checklist


1 If available, notify the EMS Section Chief

2 Notify COC of SDO






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Description Dispatch BLS ambulances to “Alpha”, “Bravo” and/or “Code 2” EMS events. Overview Situations may occur when an increase demand is placed upon the EMS System such as immediately following an earthquake or other potential disaster. SDO 13 provides the System with the ability to have BLS ambulances respond to “Alpha”, “Bravo” and/or “Code 2” EMS events. This allows the system to utilize the ALS ambulances for higher acuity calls. Executed By SDO 13 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Once attached to an event, the BLS ambulance shall remain on the event even if the call is upgraded. If ALS is required, the first responder agency shall provide this service (if available) and follow up to the hospital if needed. Checklist


1 Request approval from the EMS Section Chief, if available.

2 Notify COC of SDO

3 Ensure that Alert is transmitted over the Radio, Pager, Frequency 9, EMResource, and Alert SCC





All hospitals



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Description All ambulance responses are handled “Code 3.” Overview To increase ambulance availability, all ambulance responses are handled “Code 3”, regardless of patient severity. This message will be provided through EMResource and County Communications will advise all units in service. Executed By SDO 14 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response All ambulance responses are handled “Code 3”, regardless of patient severity. Checklist



2 Notify COC of SDO






All hospitals



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Description All ambulance transports to the hospital to be handled “Code 3” Overview To increase ambulance availability, all ambulance transports to the hospital are handled “Code 3”, regardless of patient severity. This message will be provided through EMResource and County Communications will advise all units in service. Executed By SDO 15 may be enacted by the EMS Section Chief. Field Crew Response All ambulance transports to the hospital are handled Code 3, regardless of patient severity. Checklist



2 Notify COC of SDO




All PSAPS

All fire agencies



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Standard Dispatch Order – 16 Description Ambulances shall transport to the closest open emergency department regardless of specialty status. Overview To increase ambulance availability, all ambulances shall transport to the closest open emergency department. This message will be provided through EMResource and County Communications will advise all units in service. Executed By SDO 16 may be enacted by the EMS Section Chief. Field Crew Response All ambulances shall transport to the closest open emergency department regardless of specialty. Checklist



2 Notify COC of SDO






All hospitals



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Standard Dispatch Order - 17 Description Automatic ambulance dispatches are suspended until a first response unit arrives on-the-scene and verifies that a patient needing emergency transport exists. Overview To increase ambulance availability and ensure ambulances are sent to calls which truly require an ambulance transport, ambulance dispatches are suspended until a first response unit arrives on-the-scene and verifies that a patient needing emergency transport exists. Ambulances shall only be sent to calls for services when a patient has been identified and is in need of transportation by ambulance. This message will be provided through radio, pager, EMResource, Frequency 9, Alert SCC, and County Communications will advise all PSAPS, fire agencies, ambulance providers and hospitals. Executed By SDO 17 may be enacted by the EMS Section Chief. Field Crew Response Ambulances shall only be sent to calls for services when a patient has been identified and is in need of EMERGENCY transportation by ambulance. Patients not in immediate need will not be transported. Checklist



2 Notify COC of SDO






All hospitals



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Description Ambulance dispatches to “alpha”, “bravo” and/or “code 2” EMS calls are suspended. Overview To increase ambulance availability and ensure ambulances are sent to calls which truly require an ambulance transport, ambulance dispatches to “alpha”, “bravo” and/or “code 2” EMS calls are suspended. This may follow Order # 14 and/or Order # 16, if adequate ambulance resources are not available. This message will be provided through radio, UHF Radio Paging System, EMResource, Alert SCC, and County Communications will advise all PSAPS, fire agencies, ambulance providers and hospitals. Executed By SDO 18 may be enacted by the EMS Section Chief. Field Crew Response Respond to events as directed by County Communications Checklist



2 Notify COC of SDO






All hospitals



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Description PSAPs may discontinue use of Pre-Arrival Instructions (PAI). Overview PSAPS may discontinue the use of Pre-Arrival Instructions (PAI). This message will be provided through radio, UHF Radio Paging System, EMResource, Alert SCC, and County Communications will advise all PSAPS, fire agencies, ambulance providers and hospitals. Executed By SDO 19 may be enacted by the EMS Section Chief. Field Crew Response No action required Checklist



2 Notify COC of SDO

3 Ensure that Alert is transmitted over the Radio, UHF Radio Paging System, EMResource, Rednet and Alert SCC





All hospitals



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Description PSAPs may discontinue use of Emergency Medical Dispatching (EMD) Procedures. Overview To increase call processing availability, only basic event information will be collected. This message will be provided through radio, UHF Radio Paging System, EMResource, Alert SCC, and County Communications will advise all PSAPS, fire agencies, ambulance providers and hospitals. Executed By SDO 20 may be enacted by the EMS Section Chief. Field Crew Response No action required Checklist



2 Notify COC of SDO

3 Ensure that Alert is transmitted over the Radio, UHF Radio Paging System, EMResource, Rednet, and Alert SCC





All hospitals



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Description Patient routing directed by County Overview When central patient routing is in effect, all patient destination assignments will be directed by the County through County Communications as identified in the Critical Actions Guides. This message will be provided through radio, UHF Radio Paging System, EMResource, Alert SCC, and County Communications will advise all PSAPS, fire agencies, ambulance providers and hospitals. Executed By SDO 21 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Follow the Centralized Patient Routing guidelines found in the Critical Actions Guide. Checklist



2 Notify COC of SDO and request a Command Channel


4 Assign EMS command staff member to serve as “County Routing”




All hospitals



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Description Move all ambulances to Mobilization Centers Overview All available ambulances (ALS and BLS) shall be staged at the following mobilization centers:

- North County Mobilization Center De Anza College, Stevens Creek Blvd. @ Stelling Road, Cupertino Advise ambulances currently located in the cities of Palo Alto, Los Altos, Mountain View, Sunnyvale and Cupertino to respond Code 2 to the north County muster station.

- Central County Mobilization Center

Santa Clara County Fairgrounds, Tully Road @ 7th Street, San Jose Advise ambulances currently located in the cities of San Jose, Santa Clara, Milpitas, Saratoga, Campbell and Los Gatos to respond Code 2 to the central County muster station. Advise units to report in on County EMS upon arrival.

- South County Mobilization Center

South Santa Clara County Fire District Station 2, No Name Uno @ Masten, San Martin Advise ambulances located in or near the cities of Morgan Hill, San Martin and Gilroy to respond Code 2 to the south County muster station. Advise units to report in on County EMS upon arrival.

Dispatchers shall determine the number of units to be staged at each location based on the needs of the EMS System. Upon ambulance check in, EMS Duty Chief may determine the redeployment of ambulances based on needs of the system Executed By SDO 22 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response In-service ambulances shall report to one of the Mobilization Centers listed above based upon their current location in the county. Upon arrival at the Mobilization Center ambulances shall check in and provide a t-card to the mobilization center manager and standby for assignment.


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(Standard Dispatch Order – 22 cont.) Checklist











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Description Level 3 activation of the Multiple Patient Management Plan (MPMP) Overview SDO 23 is enacted when an activation of the Multiple Patient Management Plan takes place at a level 3. For operations guidelines refer to the MPMP Level 3-5 Activation Checklist. Executed By SDO 23 may be enacted by the EMS Duty Chief or the EMS Section Chief. Field Crew Response Adhere to the MPMP level 3 activation guidelines. Checklist









All Hospitals



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Description Level 4 activation of the Multiple Patient Management Plan (MPMP) Overview SDO 24 is enacted when an activation of the Multiple Patient Management Plan takes place at a level 4. For operations guidelines refer to the MPMP Level 3-5 Activation Checklist. Executed By SDO 24 may be enacted by the EMS Section Chief. Field Crew Response Adhere to the MPMP level 4 activation guidelines. Checklist









All Hospitals



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Standard Dispatch Order - 25 Description Level 5 activation of the Multiple Patient Management Plan (MPMP) Overview SDO 25 is enacted when an activation of the Multiple Patient Management Plan takes place at a level 5. For operations guidelines refer to the MPMP Level 3-5 Activation Checklist. Executed By SDO 25 may be enacted by the EMS Section Chief. Field Crew Response Adhere to the MPMP level 5 activation guidelines. Checklist




3 Ensure that Alert is transmitted over the Radio, UHF Radio Paging System, EMResource, Redent, and Alert SCC





All Hospitals



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Description CHEMPACK request notification Overview A CHEMPACK request has been received. Executed By SDO 26 may be enacted by the EMS Duty Chief and the EMS Section Chief. Field Crew Response No action required Checklist



2 Obtain situation status with number of patients from requester

3 Request SDO from COC, and command channel

4 Notify Health Officer on call via COC ring down

5 Locate closest chempack to incident and request Law Enforcement pick up

6 If chempack is housed at hospital – ring down ED to advise Pharmacy

If chempack is housed at fire department – request the Agency Duty Officer be notified


.


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Description CHEMPACK Deployment Notification Overview The deployment of a CHEMPACK has been issued. Executed By SDO 26 may be enacted by the EMS Duty Chief and the EMS Section Chief. Field Crew Response No action required Checklist



2 Obtain situation status with number of patients from requester


4 Notify Health Officer on call via COC ring down

5 Locate closest chempack to incident and request Law Enforcement pick up

6 If chempack is housed at hospital – ring down ED to advise Pharmacy

If chempack is housed at fire department – request the Agency Duty Officer be notified



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Standard Dispatch Order – 28 Description Shelter in Place Overview A shelter in place order has been given to either on-scene personnel or to the community at large. This message will be provided through radio, UHF Radio Paging System, EMResource, and Alert SCC. Executed By SDO 28 may be enacted by the EMS Duty Chief and the EMS Section Chief. Field Crew Response Follow directions provided within the Critical Actions Guide Checklist




3 When making announcement ensure that warbler tone is transmitted prior to announcement

4 Request COC or EFS conduct unit roll call and PAR

5 Notify the EMS Section Chief


EMS SUPERVISOR FIELD OPERATIONS GUIDEEMS Supervisor Field Operations Guide Page 8 of 69 (Operational...

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