Inland Counties Emergency Medical Agency. The Role of Trauma Centers In Disasters

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1 Inland Counties Emergency Medical Agency The Role of Trauma Centers In Disasters

ICEMA Mission Ensure an effective system of quality patient care and coordinated emergency medical response that best serves the public, our most important stakeholder.

2 ICEMA Mission Ensure an effective system of quality patient care and coordinated emergency medical response that best serves the public, our most important stakeholder. This is accomplished by planning, implementing and evaluating an effective EMS system for all participants and stakeholders. ICEMA mission is in line with the County Vision at all levels of organization.

3 California EMS Regulations California Health and Safety Code, Division 2.5 The local EMS agency shall plan, implement, and evaluate an emergency medical services system, in accordance with the provisions of this part, consisting of an organized pattern of readiness and response services based on public and private agreements and operational procedures ( ) California Health and Safety Code, Division 2.5 Requires the LEMSA Medical Director to establish policies and procedures pertaining to medical control including dispatch, patient destination, patient care guidelines, and quality assurance ( ) California Code of Regulations, Title 22 Requires the Medical Director of the LEMSA to maintain medical control by developing written medical policies establishing the requirements for the initiation, completion, review, evaluation and retention of patient care records (Chapter 4. Section )

ICEMA Responsibilities/Services EMS System Organization, Management and Maintenance Paramedic Accreditation, EMT Certification and Continuing Education Prehospital Treatment and Medical Control EMS

4 ICEMA Responsibilities/Services EMS System Organization, Management and Maintenance Paramedic Accreditation, EMT Certification and Continuing Education Prehospital Treatment and Medical Control EMS and Hospital Communications Coordination Ground and Air Ambulance Transportation Public Information and Education Regional Trauma, Stroke and STEMI Specialty Care Center Designation and Oversight Data Collection and Evaluation Continuous Quality Improvement Disaster Medical and Resource Management

5 ICEMA Designated EMS Providers 39 ALS Providers 36 BLS Providers 21 Receiving Hospitals 6 EMS Aircraft Providers 1,300 Paramedics 3,000 EMTs 240 MICNs 80 Flight Nurses

6 ICEMA Designated Hospitals 8 Base Hospitals 6 STEMI Receiving Centers 21 Paramedic Receiving Hospitals 2 Adult/1 Pediatric Trauma Centers 6 Neurovascular Stroke Receiving Centers

Trauma Center Overview All Trauma Centers are licensed acute care hospitals All provide specialized care at one of four levels of designation Level I and

7 Trauma Center Overview All Trauma Centers are licensed acute care hospitals All provide specialized care at one of four levels of designation Level I and II Similar personnel, services and resources Surgeons and OR teams must be available 24/7 Primary difference Level I conducts research and provides training

Trauma Center Overview Level III and IV Generally provide initial stabilization Transfer to Level I or II as needed Greatest difference between Levels I and II Surgical

8 Trauma Center Overview Level III and IV Generally provide initial stabilization Transfer to Level I or II as needed Greatest difference between Levels I and II Surgical capabilities not in house 24/7 Surgeons and OR Teams on call back Level I and II Pediatric Focus specifically on pediatric trauma patients Level I also requires research and training

Center Palm Springs Riverside University Health System Moreno Valley Riverside Community Hospital-Level II Adult and

9 Inland Empire Trauma Centers San Bernardino County Loma Linda University Medical Center-Level I Adult and Pediatric Loma Linda Arrowhead Regional Medical Center-Level II Colton Riverside County-All Level II Desert Regional Medical Center Palm Springs Riverside University Health System Moreno Valley Riverside Community Hospital-Level II Adult and Pediatrics Riverside Inland Valley Medical Center Wildomar Los Angeles County Antelope Valley Hospital-Level II Lancaster

Hospitals in a Disaster In a major disaster all hospitals become trauma centers All have Emergency Medicine physicians experienced in trauma management Patients that

10 Hospitals in a Disaster In a major disaster all hospitals become trauma centers All have Emergency Medicine physicians experienced in trauma management Patients that exceed a community hospital's abilities can be transferred as the incident stabilizes Continuation of care is a normal process Disasters will likely delay or prevent transfers

11 Mutual Aid Coordination California divided into six Governor's Office of Emergency Services Regions Inland Empire in Region VI Trauma Centers routinely receive cross border patients Medical Health Operational Area Coordinators manage in-county resources Regional Disaster Medical Health Coordinators assist during disasters Large numbers of patients are involved Acquisition of personnel needed to support an incident Other resources

Medical Health Mutual Aid California Disaster and Civil Defense Master Mutual Aid Agreement-1950 Established the framework for the use of Mutual Aid assets 11 County OES Regions I and VI M/H Mutual

12 Medical Health Mutual Aid California Disaster and Civil Defense Master Mutual Aid Agreement-1950 Established the framework for the use of Mutual Aid assets 11 County OES Regions I and VI M/H Mutual Aid aggreement-1997 An outcome of the Northridge Earthquake ICEMA/Public Health/Behavioral Health MOU-2013 Identifies the lead roles of the EMS Administrator and the Health Officer who share the Medical Health Operational Area Coordinator (MHOAC) positon Medical incidents-icema Health-Public Health The Riverside County EMS Agency Director is the Region VI Regional Disaster Medical Health Coordinator (RDMHC)

14 EMS Response

16 Northridge Eathquake-1994 Magnitude 6.7 Fatalities - 57 Injuries - > 8,700 Most patients managed within respective affected counties All Medical/Health coordinator levels engaged M/H mutual aid was primarily for personnel No significant patient movements out of OAs

17 Hurricane Katrina-1995 Category 5 Fatalities - Approximately 1,836 Injuries - Unknown Displaced - > 1 million people Impacted area - > 90,000 square miles National Disaster Medical System International Mutual Aid

18 Trauma Centers The use of trauma centers in disaster is scalable All hospitals must be ready to receive major trauma patients Mutual aid levels: County Region State Federal International

19 Questions?

20 ICEMA Contact Information Tom Lynch, EMS Administrator Office: Cell: Fax: ICEMA Duty Officer 24/7 number: ICEMA 1425 South D Street San Bernardino, CA Mail Code 0060

SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 915

SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 915 PURPOSE To establish a mechanism for obtaining authorization/reauthorization to practice as a Mobile Intensive Care Nurse (MICN) within