EMS Saturation Disaster Response Levels

Section 1 - ADMINISTRATIVE POLICIES

1.15 EMS SATURATION DISASTER RESPONSE LEVELS

There will be times when the demand for Emergency Medical Services (EMS) taxes or exceeds the capacity of the EMS system thereby, creating a disaster. The Seminole County EMS (SCEMS) system is determined to have reserves available to handle the next emergency and has developed this plan and it’s concepts to define different levels of disaster status.

The following is a simplified view of EMS disaster status and also some specific concepts and actions to take when certain levels of disaster are reached within the SCEMS system.

Green

The system is in condition green when the majority (16-25) of transport units, personnel, and equipment are available for the next emergency call. Green could also be defined loosely as being within a standard response time in any given area in the system. Standard response time is a statistical and historical average.

Yellow

Condition yellow occurs when the availability of transport units drop to 11-15, due to an increase in call volume and/or hospital delays; not including units temporarily out-of-service for training. It is when the medical need begins to tax the system, yet things are not absolutely critical. Response times have increased to 1½ to twice normal response time. In rural areas condition yellow is reached fairly rapidly because of the limited resources available. In urban areas, condition yellow is reached when the number of move-ups increases response times and the “call load” is increasing. During condition yellow, units temporarily out-of-service for training are placed back in service.

Red

Condition red is reached when there are less than 10 available transport units in the county and/or the ability to provide any reasonable response in a timely manner is severely compromised. Red is a condition that would be considered a severe disaster in the SCEMS system.

EMS Saturation Disaster Response Plan

The Seminole County Public Safety E-911 Communications Center continually monitors the SCEMS system and would be the first to recognize any changes in the system status. As part of this plan, SCEMS units need to be aware of what condition exists at any given time. The communications center will keep units notified through the pager system. As conditions change, SCEMS units will have differing responsibilities. It is advised that when a unit takes a patient through the doors of an ED that they take their pager with them so they are aware of any changes while they are inside the walls of the hospital.

SCEMS units should notify the communications center of “DELAYED OFFLOAD” whenever they have been delayed 15 minutes or greater. Crews are required to notify the communication center immediately after patient care is transferred to hospital personnel and again when they are back in-service.

This plan is intended to be an outline of conditions that define EMS disaster response levels and help provide a template for actions to be taken by SCEMS to expedite units back into service. These are subject to change at any given time. The overall most important concept is that this is not a license to "drop off" a patient at a hospital. With each patient we must identify when the patient requires active monitoring by a medical professional.

Non-Transport Criteria

• Minor extremity injuries with no deformities or loss of neurological/vascular function. Educate patient that “delayed treatment” is an acceptable practice, even if a fracture exists.
• Minor lacerations or abrasions with bleeding stopped with good distal function – educate patient on “delayed closure” is an accepted medical practice. NOTE: If the patient has a deep wound, inquire when they had their last tetanus shot and advise them to follow-up with a physician once adverse weather conditions have ended.
• Earache
• Typical headache for patient not in severe pain
• Back pain – typical patient not in severe pain
• Sore throat (that can swallow), have patient drink/swallow water
• Baker-acted patients without any injuries

Treat and Release

In the event we have patients requiring a breathing treatment or treatment for hypoglycemia and the patient feels better, and does not want to go to the hospital; it is appropriate to leave the patient with family or another caregiver. It is imperative that you perform a thorough evaluation and use good judgment before leaving any patient. In the event that you do transport a patient to the hospital and the ED is busy, please be patient and cordial with the ED staff. If we are in “Condition Yellow or Red”, notify the charge nurse, and follow our standing procedures. Remember, teamwork, common sense, and good judgment goes a long way!

Determination to Implement this Policy

ESF 4-9-10 have the authority to activate the implementation of this policy when conditions are warranted.