EMS Subject Matter Expert Tip During mass medical surge, some initial caller screening may be performed through use of prerecorded messages played while a caller is waiting. Such messages should be developed in coordination with your healthcare coalition (to assure situational awareness) and be approved by the chief medical officer for the event (Public Health) and the EMS medical director. Your coalition can determine when the message should be played. One option is to present a recorded message when the initial call taker forwards nonemergent calls to the dispatcher. This message will support efficient queue management and maximize the availability of EMD trained communicators for urgent patients. Initial Caller Screening Dispatch Initial Caller Screening ("Controller") These individuals are the first to speak with a caller. They authenticate the call and determine if it should be routed to a trained medical dispatcher. During an emergency, these initial screeners can also provide callers with basic information, such as the status of the EMS system (e.g., ambulances may be delayed), locations of outpatient treatment and alternate care centers, or websites containing basic care and treatment information. Initial caller screening can be conducted by substitute personnel with appropriate protocols, training, and supervision. Possible sources of substitute personnel include former dispatchers and retired dispatch personnel. EMS SMEs recommended against using volunteers without prior dispatch experience or without the ability to be trained and practice that training on a routine basis in a dispatch setting. JIT training for medical surge dispatchers is not recommended. Dispatch EMS dispatchers should be emergency medical dispatchers with the necessary training or medical expertise to determine the acuity of the caller's medical condition, dispatch appropriate EMS resources, and provide pre-arrival medical advice. (37) Individuals must be comfortable with day-to-day dispatch operations such that they can more easily adapt to the protocol changes required for an expansion of tiered dispatch. Training EMDs requires time and funding. Training EMDs only to serve during a disaster is likely infeasible for most communities. Communities should instead consider ways to maximize the capacity of existing trained dispatchers by Assuring nonemergent calls are appropriately directed to others who can provide medical advice and referral. Arranging alternate resources outside of the standard EMS response system.
Author or Organization Title and Description Available at Utah Hospitals and Health Systems Association for the Utah Department of Health Utah Pandemic Influenza Hospital and ICU Triage Guidelines Guidelines and algorithms intended to guide the allocation of patient care resources during an influenza pandemic or other public health emergency, when demand for services dramatically exceeds supply. (Prehospital settings, EMS, page 2) Appendices: Committee on Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations; Institute of Medicine Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response Table 6-1. Potential EMS Response Adaptations Under Conventional, Contingency, and Crisis Conditions A Note on Training EMS Personnel to Perform Modified Treatment and Transport Implementing modified treatment and transport strategies represents a change in traditional EMS practice. Providing education and training to perform modified treatment and transport in advance of an actual incident is recommended. This change in traditional practice to incorporate more complex decision making requires more education and training. Education on the actual protocols for where to transport can be just-in-time. Providers must be trained and retrained, and their knowledge/skills must be validated on a regular basis. As many EMS experts have argued, strategies for expanding EMS systems capacity will be most successful if at least some activities are integrated into daily operations.
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Lincoln Professor of Health Law and Ethics Sandra Day O'Conner College of Law Arizona State University, and Network for Public Health Law Kenneth Knipper, FF, EMT Chairman of Emergency Medical Services/Rescue Section National Volunteer Fire Council Kenneth Miller, MD, PhD Medical Director Emergency Medical Services Section Orange County Fire Authority, and Orange County Health Care Agency Mickey Moore, AAS, EMT-P Deputy Director Georgia Office of Emergency Medical Services Paul Patrick Director Bureau of Emergency Medical Services and Preparedness Utah Department of Health, and National Association of State Emergency Medical Services Officials Severo Rodriguez, MS, NREMT-P, LP, AEMCA Executive Director National Registry of Emergency Medical Technicians Gregory Scott, MBA Operations Research Analyst Research and Analytics International Academies of Emergency Dispatch Anthony Sequoyah President Emergency Medical Services National Native American Emergency Medical Services Association Umair Shah, MD, MPH Executive Director Harris County Public Health and Environmental Services Robin Shivley, EMT Director Emergency Medical Services Michigan Department of Community Health John Sinclair Fire Chief Kittitas Valley Fire Rescue, and International Association of Fire Chiefs Jennifer Sinibaldi, MPH Director Public Health Preparedness Association of State and Territorial Health Officials Peter Taillac, MD Medical Director Bureau of Emergency Medical Services and Preparedness Utah Department of Health, and University of Utah Division of Emergency Medicine Ronald Thackery Senior Vice President Professional Services American Ambulance Association David Thomson, MD, MPA, MS, FACEP, CMTE
Federal Government Participants Greg Burel Director Division of Strategic National Stockpile Office of Public Health Preparedness and Response Centers for Disease Control and Prevention Lisa Dillard Lead Public Health Advisor Program Preparedness Branch Division of Strategic National Stockpile Centers for Disease Control and Prevention Christopher Handley, MS Management and Program Analyst Commander Navy Installations Command Operating Forces (N30) U.S. Navy David Hunter, MPH, MSW LCDR, U.S. Public Health Service Public Health Analyst Office of Public Health Preparedness and Response Centers for Disease Control and Prevention Gregg Margolis, PhD, NREMT-P Director Assistant Secretary for Preparedness and Response U.S. Department of Health and Human Services Patrick Nonnenmacher Emergency Coordinator Office of State, Tribal, Local, and Territorial Support Centers for Disease Control and Prevention Georgina Peacock, MD, MPH Medical Officer National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention Scott Sasserƚ, MD Associate Professor Emory University Angela Schwartz, MBA Associate Director Policy, Planning, and Evaluation Office of Public Health Preparedness and Response Centers for Disease Control and Prevention David Sugerman, MD, MPH, FACEP CDR, U.S. Public Health Service Medical Officer Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention Todd Talbert, MA Associate Director Division of State and Local Readiness Office of Public Health Preparedness and Response Centers for Disease Control and Prevention Richard Wild, MD, JD, MBA, FACEP Chief Medical Officer