emergency medical services CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT

Size: px
Start display at page:

Download "emergency medical services CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT"

Transcription

1 emergency medical services 2014 CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT

2 message from the director Contra Costa County s Emergency Medical Services (EMS) system withstood several tests in 2014, from a community hospital forced by finances to stop its emergency ambulance traffic to the appearance of the Ebola virus in the United States, which prompted rapid, large-scale preparations locally and at all levels of government. I am pleased to report that the system and all of its stakeholders performed as expected, working as a team to adapt and deliver on their promise of safe, highquality care for the community. While 2015 has brought new challenges, we are confident in the system s ability to adapt and persevere. EMS is a highly coordinated network of first responders and other emergency professionals, who work together through a system of public-private partnerships to provide Contra Costa with round-the-clock access to acute medical care and transport, every day of the year. This report is a snapshot of the system s performance in 2014, during which our dedicated professionals handled 87,974 emergency responses, and this report reflects their invaluable efforts. It is a privilege to present this report on behalf of all participants in the Contra Costa EMS system. A healthy system also strives to improve, and we worked hard to help the county navigate the changing EMS landscape. The EMS Modernization Project Report, released in June 2014, is a great example. Find it under Documents & Reports at cchealth.org/ems. The project amounted to a comprehensive review of the entire system that included stakeholders and the public, with a goal of analyzing current performance and finding ways to improve before issuing a request for proposals for a new emergency ambulance contract, which we did this year. The key message of that study was that we must all prepare not just for emergencies or disasters, but for change. Contra Costa s EMS system met all expectations in 2014, is well positioned to continue providing timely, high-quality service, now and in the future. Patricia Frost RN, MS, PNP Director, Contra Costa EMS

3 table of contents Message From The Director... 1 Emergency Medical Services Mission Statement & Core Values... 3 Contra Costa EMS System... 4 EMS Timeline: Recent Accomplishments and Significant Events Contra Costa EMS Modernization Project... 8 EMS System Response Requirements... 9 Ambulance Emergency Response Zone (ERZ) Chart... 9 Population Centers...10 Population Use of EMS Services...11 Contra Costa County EMS Service Utilization by Population Chart...11 Contra Costa County Quick Population Facts...12 County Service Area EM-1 (Measure H) Funding...13 Contra Costa EMS System Funding 2014 Chart Special Project Funding Supported By Measure H Funds...14 Emergency System Resources EMS Resources In Contra Costa County Specialty Care Receiving Centers...19 EMS System Utilization EMS and Hospitals Working Together...24 Cardiac Arrest Program...25 Incidence of Cardiac Events in Contra Costa County, Chart...25 Cardiac Arrest Survival...26 Survival to Hospital Discharge (Utstein) Chart...26 Bystander Save Lives Chart...26 STEMI System: Time is Muscle Mission: Lifeline Bronze Award...29 Performance Standards...29 STEMI System Performance Indicators Chart...29 Mean Time Intervals in Minutes Chart...30 Prehospital Performance Measures, Patients Receiving Care by Task Chart...30 Stroke System: Time is Brain Trauma System All Trauma Patients vs Trauma Activations by Year Chart...33 Trauma Patients in Contra Costa County Chart...34 Disaster, Medical Surge and Response Activities...36 Contra Costa County Declared Multi-Casualty Incidents Chart...37 Contra Costa Medical Reserve Corps (MRC)...38 Public Access Defibrillation Program Quality Improvement & Patient Safety Emergency Medical Services for Children Contra Costa EMS Staff Directory...46 Contra Costa County EMS The System of Emergency Medical Services

4 medical services Contra Costa s coordinated EMS system began in 1968, when the Board of Supervisors appointed the Contra Costa Emergency Medical Care Committee to oversee EMS within the county. The first EMS System Plan was established in mission statement The mission of Contra Costa County EMS is to ensure that quality emergency medical services are available for all people in Contra Costa County, and that emergency medical care is provided in a coordinated, professional, and timely manner. Core Values Monitor and ensure patient safety at all times Inspire and emulate professionalism Provide services with high level of integrity Assure a reliable and high-quality emergency response Support and facilitate emergency and disaster preparedness Integrate with healthcare systems to improve outcomes Promote and support community resiliency 3

5 contra costa ems system ccc board of supervisors Emergency Medical Care Committee (EMCC) Health Services Director ccc ems agency Ambulance Provider Committee Pre-Trauma Audit Committee (PRE-TAC) Trauma Audit Committee (TAC) Facilities & Critical Care Committee Medical Health Disaster Forum Medical Advisory Committee (MAC) STEMI Oversight Committee Stroke Oversight Committee Quality Improvement Committee ems system participants Dispatch Centers First Responders Trauma Centers Air Ambulance Rescue Aircraft Ambulance Services EMS Training Programs & Continuing Education Providers Hospitals 4

6 ems timeline: recent accomplishments and significant events Launched a STEMI system, including a 12-lead ECG program, in ambulances and five receiving hospitals: Doctors Medical Center in San Pablo, John Muir Health Walnut Creek and Concord campuses, San Ramon Regional Medical Center and Kaiser Permanente Medical Center in Walnut Creek. (STEMI is an acronym meaning "ST segment elevation myocardial infarction," a type of heart attack.) Developed online portal for access to prehospital training curriculum. Sutter Delta Medical Center became the sixth receiving hospital for Contra Costa s STEMI system. Implemented Contra Costa County Medical Reserve Corps. Chest Pain Centers at John Muir Health s Concord and Walnut Creek campuses received accreditation in percutaneous coronary intervention (PCI). Stroke System Stakeholder Advisory Group formed. East Contra Costa Fire Protection District formed. Implemented EMS Twitter feed. Developed 911 inter-facility emergency response dispatch and prehospital protocols. Drafted first countywide pediatric and neonatal disaster and medical surge toolkit. Awarded a $30,000 CEMSIS trauma grant to support statewide data sharing. Initiated a paramedic fire agency contract compliance process. Implemented the American Heart Association s HeartSafe Community program locally. New EMS website launched. Implemented state-mandated EMT regulation and oversight. El Cerrito and all cities in the San Ramon Valley became HeartSafe Communities. The Board of Supervisors approves the Stroke System Program. John Muir Health s Concord and Walnut Creek campuses, Kaiser Permanente Medical Centers in Antioch, Richmond and Walnut Creek, Doctors Medical Center in San Pablo and San Ramon Regional Medical Center are designated Primary Stroke Receiving Centers. Acquired a Disaster Mobile Support Unit for county and regional response. Implemented a 12-lead transmission program with six STEMI Centers. Adopted Institute of Healthcare Improvement (IHI) Certificate of Quality, Patient Safety and Leadership core curriculum for EMS personnel. Implemented Continuous Quality Improvement Initiatives on Pediatric Medication Safety and Bariatric Resource Awareness. 5

7 ems timeline: recent accomplishments and significant events Launched a comprehensive primary stroke system. Kensington was designated as a HeartSafe Community. Participated in the medical and public health response to a fire at the Chevron Richmond Oil Refinery that affected 15,213 patients. Published a white paper, The Importance of Fire-EMS First Medical Response. Implemented prehospital high performance resuscitation protocols. Sponsored a Data Sanity conference. Provided matching funds for a FEMA Assistance to Firefighters Grant (AFG) to acquire new cardiac monitors. Co-sponsored the first California Neonatal/Pediatric Disaster Coalition Conference. Established ambulance provider quarterly training and meetings. All county Advanced Life Support (ALS) ambulance providers began transmitting real-time 12-lead information to hospitals. Began EMS System Modernization Study engaging more than 130 stakeholders. Emergency radio communication became accessible to all county ambulance providers, community clinics and long-term care facilities. Received an Urban Areas Security Initiative grant allowing the East Bay Regional Communications System to purchase disaster communication equipment for hospitals. Presented at an Institute of Medicine conference in Washington DC about supporting local, regional and statewide disaster preparedness for children. Provided mutual aid in response to Asiana Airlines crash at San Francisco International Airport on July 6. California extended the sunset of the Maddy Emergency Medical Services Fund, providing Contra Costa with $2.2 million annually to help cover uncompensated emergency care, pediatric trauma and EMS programs. Contra Costa Regional Medical Center s Health Information Exchange began using Electronic Patient Information Charts (EPIC) to track EMS patient care outcomes. The Cardiac Arrest Registry to Enhance Survival (CARES) showed Contra Costa s Utstein survival rate was 25.6%, and Utstein survival when a bystander performs CPR was 35.5%. 6

8 ems timeline: recent accomplishments and significant events 2014 Instituted a new Spinal Motion Restriction protocol and policy. Annual trauma and EMS System plan updates sent to the state EMS Authority. Presented on EMS stroke systems of care at the annual American Association of Neuroscience Nurses conference. Issued the final report for the Contra Costa EMS System Modernization Study. Contra Costa EMS receives the American Heart Association s Mission Lifeline EMS Bronze Award for STEMI System performance. Submitted a report to the California Department of Health Services and state Emergency Services Authority about the community impacts associated with the pending downgrade of services at Doctors Medical Center in San Pablo. EMS medical director approved Fireline Paramedic function for Fire Paramedics serving outside Contra Costa County. Contra Costa EMS s response to the 2009 H1N1 epidemic was featured in a Department of Homeland Security/FEMA national course about pediatric disaster response and emergency preparedness. Provided mutual ambulance and medical aid to Napa County following the August 24 earthquake. Received a state EMS Authority Health Information Exchange Grant to support quality improvement and EMS System performance reporting. The Contra Costa EMS Never Event Initiative to maintain patient safety during transfer of patients is recognized as a best practice by the California EMS Authority. Never events are patient transfer-of-care delays between EMS and hospitals that take longer than 60 minutes. Awarded a Homeland Security grant to provide AEDs to law enforcement. In partnership with American Medical Response, implemented an Infectious Disease Ambulance Response Team in response to Ebola. Dr. David Goldstein appointed new EMS Medical Director effective November Participated in regional medical health disaster exercises focusing on anthrax. Issued a public report about Contra Costa s community hospital transfer of care. Issued a final report for the Doctors Medical Center Regional Planning Group. 7

9 contra costa ems modernization project During 2014, hundreds of stakeholders and members of the public participated in the EMS Modernization Project. The purpose of this independent, comprehensive review of Contra Costa s entire EMS system was to optimize operations to benefit patients and the community. emergency calls in contra costa The number of emergency calls in Contra Costa grew by 10.5% from 2009 to % Increase The report made numerous recommendations regarding local implementation of healthcare reform, financial issues, community health and clinical care, including: Explore development of alternative destinations and transport models to better serve patients. Integrate prehospital data between EMS providers and hospitals to support cost-effective health initiatives. A single, robust medical dispatch center that efficiently matches patients with the most appropriate EMS transportation resources. Cardiac arrest outcomes can be greatly improved by expanding the capabilities of bystanders through aggressive community CPR training, public access to defibrillators, community education and engaging public first responders. Future modifications of the EMS system should be based on quality and patient outcome data, and evidence from research supporting national standards of prehospital care. The 2014 EMS System Modernization Project, facilitated by Fitch and Associates, can be found at 8

10 ems system response requirements ensuring quality ems delivery The County awards exclusive ambulance operating contracts through a competitive process for all Emergency Response Zones (ERZs), with the exception of that served by the Moraga Orinda Fire Protection District, which has a non-competitive ERZ. Emergency ambulance service delivery contracts require compliance with standards for response time, staffing, training and equipment. Providers must offer reliable programs to ensure the delivery of safe and competent patient care. The quality of EMS delivery is frequently measured by response time, although it has been well established that factors such as early recognition of a serious condition, calling 911 early, dispatch-aided medical instruction, public access to defibrillation devices, bystander CPR capability, and rapid transport to the appropriate hospital are also important. Patients with critical conditions make up 7% to 13% of Contra Costa s total 911 calls. Response time requirements are established by the county for all emergency ambulance providers. American Medical Response (AMR) was awarded the current contract in 2005 and delivers approximately 90% of the emergency ambulance service in the county. The EMS agency is the Board of Supervisors designated contract manager and reviews AMR s performance monthly. Monthly performance reports are posted at cchealth.org/ems/amr.php. Performance monitoring for independent fire districts providing EMS ambulance services is a responsibility shared by those fire districts and the EMS Agency.. ambulance emergency response zone (erz) response time requirements by minutes and response percent 1 ERZ Provider Geographic Area Urban Rural Response % ERZ A (AMR) City of Richmond 10:00 20:00 95% ERZ B (AMR) West County (non- 11:45 20:00 90% Richmond) ERZ C (AMR) Central County 11:45 20:00 90% ERZ D (AMR) Antioch, Bay Point, Pittsburg 11:45 20:00 90% area ERZ E (AMR) East Contra Costa County 11:45 16:45 2 Suburban 90% 20:00 Rural ERZ Moraga Orinda Moraga Orinda Fire 11:59 20:00 90% Protection District 3 ERZ San Ramon San Ramon Valley Fire Protection District 3 10:00 20:00 95% Source: Contra Costa EMS Agency Verified Provider Dispatch Data 1 Current ambulance response performance requirements for the contracted ambulance provider 2 Includes Bethel Island and Discovery Bay 3 A fire protection district provides emergency ambulance service in this zone. A fire district board is the local authority for establishing response requirements in this service area. 9

11 population centers contra costa county ambulance zones geogr aphy Contra Costa County is located in the San Francisco Bay Area of Northern California, northeast of San Francisco and southwest of Sacramento. The county covers roughly 716 square miles, including 19 cities and numerous unincorporated communities. The county has The industry standard for 911 ambulance response is 12 minutes. seven emergency response zones for ambulance-based paramedic service. Each response zone is geographically and demographically diverse, and average response times reported include urban, suburban and rural responses. ambulance response performance by zone and service provider ERA ZONE/PROVIDER AREA SERVED 2014 AVERAGE CODE 3 (LIGHTS AND SIRENS) RESPONSE TIME IN MINUTES ERZ A/AMR City of Richmond 4:58 ERZ B/AMR West County 4:46 ERZ C/AMR Central County 5:23 ERZ D/AMR Antioch/Bay Point/Pittsburg 5:06 ERZ E/AMR East County 6:24 Moraga-Orinda ERZ Moraga Orinda Fire Protection District 5:33 San Ramon ERZ San Ramon Valley Fire Protection District 4:15 10

12 POPULATION USE OF EMS SERVICES In 2014, Contra Costa County had an estimated population of 1,111,339, making it the ninth most populous county in California. Concord, Richmond and Antioch were the three largest cities in the county, each home to more than 100,000 residents. Between 2010 and 2014, the county gained more than 62,000 residents. EMS utilization over the last three years is displayed below. contra costa county ems service utilization by population Population 4 1,078,257* 1,094,205* 1,111,339 EMS Responses 5 86,134 85,033 87,974 EMS Responses/1000 population Average EMS Responses/day Square Miles EMS Serves Population Density 1,438 1,465* 1,465 Responses per square mile Response per square mile Response per person ratio County Median Household Income County Population below poverty $79,135 $78,187* $78, % 10.2%* 10.5% * All populations are estimated 4 Source: US Census Bureau. 5 Total includes all responses, including those that did not result in patient transport. 11

13 contra costa county quick population facts Population, ,049,197 Population, 2014 estimate 1,111,339 Population change as a percentage, April 1, 2010 to July 1, % People younger than 5 as a percentage, % People younger than 18 as a percentage, % People 65 and older as a percentage, % FFemales as a percentage, % White people as a percentage, % African-American people as a percentage, % Native American & Alaskan people as a percentage, % Asian people as a percentage, % Native Hawaiian or Pacific Islander people as a percentage, % People reporting two or more races, percentage, % People of Hispanic or Latino origin, percentage, % Non-Hispanic white people, percentage, % governance The County of Contra Costa was incorporated in 1850 as one of the original 27 counties of California, with Martinez as the county seat. Contra Costa County is governed by a board of five elected supervisors, each representing a geographical district. Under the board s guidance, county government manages 35 divisions of service for the community. The division responsible for the statutory coordination, oversight and delivery of emergency medical services is the Contra Costa EMS Agency. 12

14 county service area em-1 (measure h) funding County Service Area EM-1 (Measure H) parcel levies provide limited but important support for the provision and quality of emergency medical services for the residents of Contra Costa County since In 2014, Measure H assessments generated approximately $4.7 million. Currently, fire districts receive 60% of that revenue for first-responder EMS programs. The remaining funds support EMS system programs (17%) and multi-casualty and medical mutual aid dispatch from the Contra Costa Sheriff s Office (5%), with the remainder allocated for other services. Priorities for Measure H funding include: Paramedic first responder and ambulance services Countywide firstresponder and publicaccess defibrillation programs Fire equipment and training for multi-casualty and disaster response Emergency and disaster radio and communication systems Fire and ambulance dispatch technology enhancements Electronic patient care record system support for fire first responders Medical and quality oversight of paramedic personnel EMS "systems of care" programs (Trauma, STEMI, Stroke and Cardiac Arrest) Pre-hospital equipment and training to support safe and competent care Measure H 75 % ($4,724,405) contra costa ems system funding 2014 Permits, certifications & other revenue 9 %. ($558,454). Maddy EMS Fund (SB 12) 9 % ($542,771) Hospital Preparedness Grant 7 % ($423,941) 13

15 2014 special project funding supported by measure h funds 1 2 First Watch data system enhancement $5,490 3 EMS System Modernization Project $116,000 4 ATRUS AED Link and National AED Registry $38,800 Institute of Health Care Improvement scholarships $1,800 EMS system dispatch technology enhancement Technology enhancement for EMS system performance reporting 50+ IHI scholarships to support EMS provider quality improvement training EMS system redesign to prepare for emergency ambulance procurement 2014 total = $162,090 14

16 emergency system resources Contra Costa EMS System is composed of several partners working together to bring the highest level of patient care to our constituents. A PSAP answers emergency calls for police, firefighting and ambulance services public safety answering POINTS and Dispatch Centers public safety answering points (psaps) Antioch Police Department California Highway Patrol Concord Police Department Contra Costa Sheriff s Office East Bay Regional Park District Police Martinez Police Department Pinole Police Department Pleasant Hill Police Department Richmond Police Department Walnut Creek Police Department fire/medical dispatch centers Contra Costa County Fire Protection District Contra Costa Sheriff s Office (multi-casualty coordination) Richmond Police Department San Ramon Valley Fire Protection District ambulance dispatch centers American Medical Response Contra Costa County Fire Protection District (Moraga-Orinda only) San Ramon Valley Fire Protection District 15

17 emergency system resources county fire protection districts Contra Costa County Fire Protection District Crockett-Carquinez Fire Protection District municipal fire departments El Cerrito Fire Department Pinole Fire Department Richmond Fire Department independent fire protection districts East Contra Costa Fire Protection District Kensington Fire Protection District (served by El Cerrito Fire Department) Moraga-Orinda Fire Protection District Rodeo-Hercules Fire Protection District San Ramon Valley Fire Protection District ems paramedic s ervice providers American Medical Response California Highway Patrol (helicopter unit) Concord Police Department (tactical paramedic program) Contra Costa County Fire Protection District El Cerrito Fire Department Moraga-Orinda Fire Protection District Pinole Fire Department Rodeo-Hercules Fire Protection District San Ramon Valley Fire Protection District public safety defibrillation programs Antioch Police Department Brentwood Police Department California State Parks (Mt. Diablo) Concord Police Department Contra Costa Sheriff s Office Clayton Police Department Crockett-Carquinez Fire Protection District Danville Police Department East Contra Costa Fire Protection District El Cerrito Police Department Hercules Police Department Kensington Police Department Lafayette Police Department Moraga Police Department Orinda Police Department Pittsburg Police Department Richmond Fire Department Richmond Police Department San Ramon Police Department Non-emergency ambulance providers 16

18 ems resources in contra costa county EMS TYPE OF PERSONNEL Emergency Medical Dispatchers Emergency Medical Technicians Paramedics Mobile Intensive Care Nurses Public safety dispatch centers (PSAPs) Fire and EMS dispatch centers Available emergency ambulance units per day Non-emergency ambulance units HOSPITALS Base Hospital Receiving Hospitals* *Doctors Medical Center stopped receiving emergency ambulance transports in August

19 ems resources in contra costa county certification & professional standards The EMS Agency is designated by state law as the county s regulatory agency for emergency medical technicians (EMTs) and paramedics. The agency certifies EMTs and accredits paramedics to ensure they meet professional and clinical standards for safety and service. The EMS Agency is also responsible under the County s ambulance ordinance for the management of the county s 911 ambulance contract with American Medical Response and for the permitting of ambulance providers who originate patient transports from within the county. EMS Certification & Professional Standards, 2014 EMS EMT Certifications 684 Paramedic Accreditations 233 Ambulance Permits 11 18

20 911 specialty care receiving centers EMS Facility STEMI Helipad Labor & Delivery Stroke Contra Costa Regional Medical Center &Health Centers Doctors Medical Center San Pablo* Sutter Delta Medical Center Antioch San Ramon Regional Medical Center John Muir Health Concord Kaiser Medical Center Walnut Creek Kaiser Medical Center Richmond Kaiser Medical Center Antioch John Muir Health Walnut Creek Trauma Behavioral *Doctors Medical Center stopped receiving emergency ambulance transports in August

21 ems system utilization total ems responses Responses By Year 2012 American Medical Response 78,589 San Ramon Valley Fire Protection District 5,447 Moraga Orinda Fire Protection District 2,098 Total 86,134 Responses By Year 2013 American Medical Response 77,327 San Ramon Valley Fire Protection District 5,704 Moraga Orinda Fire Protection District 2,003 Total 85,034 Responses By Year 2014 American Medical Response 79,707 San Ramon Valley Fire Protection District 6,166 Moraga Orinda Fire Protection District 2,101 Total 87,974 *An EMS Response typically occurs after a 911 request for emergency medical services. 20

22 ems system utilization 2014 Emergency Medical Dispatch (EMD) Activity EMS EMD Agency EMD Responses Total 911 Calls Contra Costa County Fire Protection District 45,262 56,677 Richmond Fire Department 11,641 16,358 San Ramon Valley Fire Protection District 4,208 6,166 Emergency Medical Dispatch (EMD) agencies receive 911 calls and, in cases of medical emergency, have specially trained dispatchers available to provide medical instructions to callers and direct appropriate resources to address the emergency. 21

23 ems system utilization total ems transports Transports By Year 2012 American Medical Response 59,997 San Ramon Valley Fire Protection 3,825 District Moraga Orinda Fire Protection 1,314 District Total 64,527 Transports By Year 2013 American Medical Response 58,911 San Ramon Valley Fire Protection 3,926 District Moraga Orinda Fire Protection 1,296 District Total 64,133 Transports By Year 2014 American Medical Response 59,533 San Ramon Valley Fire Protection District 3,969 Moraga Orinda Fire Protection District 1,368 Total 64,870 EMS transport totals include transports for both life-threatening and non-threatening conditions. In Contra Costa County, emergency transport for non-life threatening conditions makes up 87% to 93% of all calls for transport. 22

24 ems system utilization ems transports to hospital within contra costa county Transports By Year 2014 Contra Costa Regional Medical Center 10,538 Doctors Medical Center 4,224* John Muir Medical Center Concord 9,345 John Muir Medical Center Walnut Creek 8,008 Kaiser Permanente Medical Center Antioch Kaiser Permanente Medical Center Richmond Kaiser Permanente Medical Center Walnut Creek 5,259 6,289 6,907 San Ramon Regional Medical Center 2,021 Sutter Delta Medical Center 8,433 *Doctors Medical Center stopped receiving emergency ambulance transports in August

25 ems and hospitals working together Trauma Medical Total 550 2,643 3, ,227 2, base hospital calls by type Base Hospitals provide medical consultation to EMS personnel in the field when they encounter patients with conditions outside of standardized EMS protocols, or in situations that require realtime medical consultation. John Muir Medical Center in Walnut Creek serves as the base hospital for Contra Costa County ,075 2,

26 cardiac arrest program Incidence of Cardiac Events in Contra Costa County, EMS Events Population Incidence Events Population Incidence per per 100, ,000 East County , , Central County , , West County , , Total 521 1,063, ,071, Contra Costa County participates in a national cardiac arrest survival registry program, which allows for comparative benchmarking and improvement in cardiac arrest emergency care. Through our partnership with the Cardiac Arrest Registry to Enhance Survival (CARES), we collect uniform and reliable outcome information, and have made significant changes to enhance the delivery of CPR by bystanders and improve pre-hospital cardiac arrest care in our communities. We track our progress using the Utstein survival measure, a standardized cardiac arrest reporting tool introduced in The measure is used nationally by EMS systems to set benchmarks and compare results. 25

27 cardiac arrest survival Survival to Hospital Discharge (Utstein) EMS % 36% 30% Source: Data obtained by the cardiac arrest registry to enhance survival (CARES). Inclusion criteria: A witnessed, out-of-hospital cardiac arrest where the patient is found in a shockable rhythm and resuscitation is attempted by an emergency responder. national benchmark 29% Cardiac patients who received care that met or exceeded benchmarks found in CARES and the Utstein Uniform Reporting Guidelines were more likely to survive to hospital discharge than patients who did not. Bystanders Save Lives EMS % 37% 38% Source: Data obtained by the cardiac arrest registry to enhance survival (CARES). national benchmark 38% Data show an increase in bystanders initiating CPR on someone entering cardiac arrest before emergency medical responders arrive. The CARES national benchmark for this kind of bystander interaction is 38% of all cardiac arrest cases. For more information about this program, visit cchealth.org/ems/cardiac-arrest.php. 26

28 stemi system time is muscle Cardiovascular disease is the leading cause of death in the United States. Each year, approximately 250,000 people experience the most deadly type of heart attack, ST Elevation Myocardial Infarction (STEMI). Patients suffering from STEMIs have the best chance for survival when they receive rapid assessment and transport to a hospital that is a designated STEMI Receiving Center. These hospitals have specialized equipment and personnel to treat these deadly heart attacks. Planning of the Contra Costa County STEMI System began in The first STEMI centers began receiving patients in January The system supports rapid field identification and prehospital management by paramedics, early notification of cardiac intervention teams and rapid transport to designated STEMI Receiving Centers. Paramedics use field transmission of 12-Lead ECGs and STEMI Alerts to provide the hospital with advance notification of patient arrival. This early notification allows the hospital to assemble the necessary resources to immediately treat the patient upon arrival. There are currently five STEMI Receiving Centers in Contra Costa County: San Ramon Regional Medical Center, John Muir Medical Centers in Concord and Walnut Creek, Sutter Delta Medical Center in Antioch, Kaiser Permanente Medical Center in Walnut Creek. Contra Costa community hospitals that do not provide STEMI services work closely with Receiving Centers to facilitate rapid treatment and transfer of any STEMI patients who arrive at their emergency departments. The goal for the patient who is having a STEMI is to receive a procedure called Percutaneous Cardiac Intervention that quickly restores blood flow to the heart. The STEMI system evaluates emergency responses based on how quickly specific steps of care are followed, including important clinical interventions, such as 12-lead ECG acquisition and aspirin administered by prehospital providers. STEMI system performance is based on standards developed by the American College of Cardiology, the American Heart Association and the California Department of Public Health. 27

29 stemi system time is muscle 28

30 stemi system time is muscle mission: lifeline bronze award The Contra Costa County STEMI System has consistently met or exceeded national and local benchmarks and performance measures for the last five years. In 2013 and 2014, Contra Costa s system received Bronze Level recognition from the American Heart Association s Mission Lifeline Program. The Mission Lifeline Program recognizes systems of care that meet the following performance measures: First medical contact to intervention in less than 90 minutes 75% of the time, and 12-lead ECGs obtained on patients having chest pain 75% of the time. performance standards Scene time The time from arrival at the scene to the departure from the scene should be 15 minutes or less. First medical contact to intervention The time the patient is first seen by medical (or prehospital) personnel to the time they receive intervention should be 90 minutes or less. 911 call to intervention The total time from the first 911 call to intervention should be 120 minutes or less. STEMI System Performance Indicators EMS Number of EMS STEMI Alerts

31 stemi system time is muscle Mean Time Intervals in Minutes EMS to Hospital ED Arrival Mean Scene Time Interval to Hospital Intervention ECG to Hospital Intervention First Medical Contact to Intervention Door to Hospital Intervention Prehospital Performance Measures, Patients Receiving Care by Task EMS Patient Care Task Aspirin administered or noted as not indicated 92% 90% 92% 12-Lead ECG acquired on STEMI patients 97% 98% 99% Patient identified as having a STEMI and transported to a STEMI Receiving Center 100% 100% 100% Intervention in less than 90 minutes of 12-lead ECG 85% 81% 76% For more information about this program, visit cchealth.org/ems/stemi.php. 30

32 stroke system time is brain Stroke is the third-leading cause of death nationally, and the leading cause of disability. The Contra Costa County Stroke System of Care facilitates rapid assessment and transport of patients by paramedics to a designated Primary Stroke Center, enabling patients to receive lifesaving treatment and prevent permanent impairment. All participating hospitals are required to be certified as Primary Stroke Receiving Centers. This certification recognizes that a hospital has achieved a high level of compliance with national standards in stroke care, and is able to meet the specialized needs of stroke patients. Contra Costa County had approximately 757 stroke system activations in 2014 The primary objective of a stroke system is to coordinate care between the emergency medical system and hospitals so that patients possibly suffering from stroke receive care within 3 to 4 1/2 hours of their first symptoms Contra Costa County has designated six Primary Stroke Receiving Centers: San Ramon Regional Medical Center, John Muir Medical Centers in Walnut Creek and Concord, Kaiser Permanente Medical Centers in Antioch, Richmond and Walnut Creek. Contra Costa s Primary Stroke Receiving Centers participate in the California Stroke Registry (CSR), a statewide stroke database designed to promote improvement in acute stroke treatment. Through the CSR, participants can evaluate specific measurements of quality of care. Contra Costa EMS participates in the development and refinement of state EMS stroke system performance measures, including national EMS benchmarks such as on-scene time and documentation of prearrival notification. These data are compiled using pre-hospital EMS transport provider documentation that has been stripped of patient identifiers. For example, one goal is to track how often the clot-busting medication TPA (Tissue Plasminogen Activator) is administered within 4 1/2 hours of symptom onset. 31

33 stroke system time is brain Act in Time call HeartSafe Community Contra Costa Health Services know the signs Stroke If someone experiences sudden: Trouble walking Weakness on one side if someone Trouble seeing Trouble speaking experiences know the signs Heart Attack sudden: If someone experiences: Chest discomfort Arm, back, neck or jaw pain Shortness of breath Sweating, nausea, lightheadedness Trouble walking know the signs Weakness on one side Cardiac Arrest If someone collapses and is: Trouble seeing Not responding Not breathing Begin Hands Only CPR; Trouble Use an AED as soon speaking as one arrives. Call

34 trauma system The Board of Supervisors approved a comprehensive trauma system plan for the county in 1986, and the EMS Agency designated John Muir Medical Center in Walnut Creek as the county's trauma receiving center. John Muir also provides and receives aid as needed from a regional network of trauma centers that includes hospitals serving Alameda, Marin, Solano and Sonoma counties. The goal of a trauma system is to ensure that coordinated emergency services are available to critical trauma patients. This is accomplished through EMS and hospital protocols that facilitate rapid identification, management, and transport of critical trauma patients to a designated trauma center within the "golden hour" the first hour after injury, considered the most crucial time for successful treatment. Ambulance and Base Hospital personnel use EMS-approved triage protocols to identify critical trauma patients. Ambulance crews provide the trauma center with an "early alert" so that the trauma team can be mobilized to manage the critical trauma patient upon arrival. All Trauma Patients vs Trauma Activations by Year EMS All Trauma Patients 1,636 1,588 1,526 All Trauma Center Activations 1, ,123 Source: Trauma One Data Base 33

35 trauma system Traumatic injury can cause significant disability or death and affects all age groups and communities. When emergency first responders arrive at a scene where trauma is involved, they quickly evaluate the patients to determine the appropriate destination for treatment. Patients with severe, life-threatening injuries are considered Major Trauma Victims (MTV), and they are primary candidates to visit one of the region s designated trauma centers. A field activation of the trauma system happens when a first responder triages an MTV directly to a trauma center. John Muir Medical Center in Walnut Creek is the primary trauma center in Contra Costa County, while UCSF Benioff Children s Hospital Oakland is the primary trauma center for pediatric cases. Not all of the patients necessarily have traumatic injuries at a trauma scene. EMS providers quickly triage patients according to the severity of their injuries, their likely treatment needs and the hospital emergency department best suited to meet those needs. Trauma Patients in Contra Costa County EMS Patients transported to John Muir Medical Center in Walnut Creek from an emergency trauma scene Patients transported to UCSF Benioff Children s Hospital Oakland from an emergency trauma scene Patients transported to another trauma center from an emergency trauma scene Patients transported to a non-trauma center hospital from an emergency trauma scene 1,030 1,251 1, ,347 1, John Muir Health changed its data collection methodology in Source: EMS Agency based on data from the John Muir Health, Walnut Creek Trauma Registry and Emergency Department Log. 34

36 disaster, medical surge and response 35

37 disaster, medical surge and response Healthcare systems are vulnerable to disruptions due to disasters and emergencies. Mass casualty events can rapidly overwhelm local and regional healthcare systems with large numbers of patients (known as medical surge"). Healthcare systems, public and private entities, and the community, acting in concert, all play a role in managing these crises. The mission of the Disaster Preparedness/Medical Surge Program is to promote and support the emergency preparedness, response, recovery, and resiliency activities of Contra Costa Health Services, the local medical health system, and other external partners and stakeholders. The Disaster/Medical Surge Program team: Collaborates with EMS and medical health system participants in disaster/medical surge preparedness, response, and recovery activities Performs grant management functions in support of disaster/medical surge preparedness, response, and recovery activities Oversees the Contra Costa County Medical Reserve Corps (MRC) operations and administration The goal is to ensure that Contra Costa County s medical health system is prepared to quickly respond, manage and recover from disasters, emergencies and medical surges. APRIL 5 APRIL 23 JUNE 2013 to MAY, 2014 JUNE 16 JUNE to DECEMBER JUNE to DECEMBER JUNE 24 & 25, 2014 OCTOBER 23, 2014 OCTOBER to NOVEMBER NOVEMBER 20 DECEMBER 2014 ACTIVITIES The MRC was activated and deployed to Alameda County The MRC participated in a regional exercise to establish a point-of-dispensing site (POD) Conducted medical surge training and drills at long-term care and health centers Conducted burn care training for hospitals and first responders Conducted pediatric triage and evacuation training for hospitals Conducted bimonthly patient triage and tracking drills with American Medical Response and hospital emergency departments Conducted hazardous materials training for hospitals Participated in a state tabletop exercise for a simulated aerosolized anthrax event Provided Ebola training to Doctors Medical Center in San Pablo The MRC participated in a regional exercise to establish a point-of-dispensing site (POD) Conducted multiple suspect Ebola patient transportation drills with ambulance providers and hospitals 36

38 disaster, medical surge and response multi-casualty incidents Multi-casualty incidents (MCI) are evaluated based on the number of patients involved. A Tier 0 MCI declaration has zero to five patients, and all EMS stakeholders are notified because the incident has potential to grow larger. A Tier 1 MCI involves six to 10 patients, a Tier 2 MCI has 11 to 50, and a Tier 3 MCI has more than 50 patients. Notifications and resource ordering happen at all levels commensurate with the Incident Command System (ICS), National Incident Management System (NIMS), and Standardized Emergency Management System (SEMS). Contra Costa County Declared Multi-Casualty Incidents EMS Tier Tier Tier Tier

39 contra costa medical reserve corps (mrc) The Medical Reserve Corps (MRC) includes both medical and non-medical volunteers and is configured for three levels of response. This provides a scalable approach to incidents MRC Membership Doctors Emergency Medical Technicians (EMTs) Nurses Public Health Professionals Physician Assistants/ Nurse Practitioners Non-medical Personnel individual volunteers provide immediate, basic support to the community, often integrated with other community response partners. teams provide up to eight personnel and their equipment for immediate or planned support for first aid stations, points of dispensing and shelter support. unit activations combine multiple teams to support prolonged operations deploying staff, equipment, and a pharmaceutical cache to treat as many as 1,000 people. Training and exercising the MRC ensures that volunteers are versed in county policies and procedures. In addition, collaborative training with community partners, such as Community Emergency Response Teams and the American Red Cross, prepares the Corps for a more robust public health response to meet the needs of local residents. Activities conducted in 2014 included: Providing medical screenings for clients at Contra Costa s Project Homeless Connect Teaching hands-only CPR for the HeartSafe Community Program Administering measles and flu vaccines at county clinics Conducting training and drills for first receivers at points of dispensing Providing disaster preparedness education at community health fairs Supporting community events with first aid stations 38

40 public access defibrillation program supporting citizen heroes The EMS system s public outreach efforts increase awareness and educate residents about the actions they should take in the event of a medical emergency. This includes knowing the signs of heart attack, stroke, or sudden cardiac arrest, calling 911 and acting in time to save lives. Contra Costa EMS encourages our community members to learn CPR and how to use an automated external defibrillator (AED). Learning hands-only CPR is easy and takes only a few minutes for adults. The EMS Agency, HeartSafe communities, and numerous EMS system stakeholders partner to provide this training at community events, promoted at cccems.org. Brochures and instructional packets are available that contain all the information necessary to implement a public-access defibrillation program and to register an AED. EMS also provides speakers for community organizations such as Rotary Clubs and schools. In a heartsafe community, all elements of the Chain of Survival are in place immediate recognition and access, early CPR, rapid defibrillation, effective advanced care and integrated post-cardiac arrest care. The EMS Agency and the American Heart Association are partnering with communities in Contra Costa County to improve cardiovascular health and increase the chances that anyone suffering a cardiovascular emergency heart attack, stroke, or cardiac arrest will have the best possible chance for survival. Contra Costa s HeartSafe Communities are Alamo, Brentwood, Clayton, Concord, Danville, El Cerrito, Kensington and San Ramon. For more information about the program visit: 39

41 public access defibrillation program The goal of the Public Access Defibrillation Program is to ensure access to automated external defibrillators (AED) to anyone who needs them in Contra Costa County, and to train members of the public in their use. The program began in 2005 when Contra Costa EMS distributed 42 automated external defibrillators (AEDs) to public agencies throughout the county, trained 121 county employees and provided AED orientations and trainings for other staff. EMS continues to work with American Medical Response to assist with the distribution of 25 AEDS annually in the community. Contra Costa participates in a national AED registry that allows emergency dispatch centers to rapidly link registered public-access AEDs and trained responders with sudden cardiac arrest victims. public safety aed progr am The first-responder defibrillation program, established countywide in 1992, provides rapid access to life-saving care for patients with cardiac arrest. Initially the program was implemented in the fire service, but many police departments have since equipped patrol cars with defibrillators. AEDs are currently carried on police cars in Antioch, Blackhawk, Brentwood, Clayton, Concord, Danville, El Cerrito, Hercules, Kensington, Lafayette, Martinez, Moraga, Orinda, Pinole, Pittsburg, Pleasant Hill, Richmond, San Pablo, San Ramon, Walnut Creek and Contra Costa Sheriff s Office. Many police agencies have already played critical roles in saving lives using AEDs. AEDs are also carried by fire apparatus in Crockett-Carquinez, Richmond and East Contra Costa County. For more information about this program, visit cchealth.org/ems/aed.php 40

42 quality improvement & patient safety 2014 Quality Improvement is an integral part of all aspects of EMS services in Contra Costa County. EMS activity and patient care outcomes are routinely measured to assure the system is performing as designed. These measures focus on patient and provider safety, quality of care and competency in the delivery of EMS services. During 2014, all EMS system performance levels were within normal statistical control limits, and they continued to meet or exceed established national benchmarks. patient safety events The EMS Agency is committed to supporting a culture of safety. As part of that effort we continue to expand and monitor our performance with a Patient Safety Events Program. Part of a comprehensive, continuous quality improvement program includes review and evaluation of all aspects of clinical and operational care for patient safety. In 2014, the Quality Improvement Division created Quality Review Team (QRT) to address EMS safety events. EMS safety events are reported by the community or any member of the EMS team. Our team reviews each event report and acts upon it as part of a quality improvement process. quality leadership council The performance of our systems of care is monitored and evaluated by the EMS Quality Leadership Council (QLC), which meets every six months. All representatives who provide EMS services in Contra Costa County are members of the QLC, including hospitals, fire departments, ambulance companies and others. In addition to evaluating and contributing to decisions about performance and performance standards, the QLC is also integral to implementing new quality initiatives and improving the system as a whole. quality improvement initatives high performance cardiac arrest & cpr GOAL: To increase the quality of CPR provided to patients in cardiac arrest. Phase I: Staff Research & Review Indicators to measure quality such as compression, ratios, depth and pauses for shock were developed and data pulled. Phase II: Task Team QLC Review A training program was developed with staff and an implementation plan was completed. 41

43 quality improvement & patient safety 2014 Phase III: Approval & Planning Initial indicators were presented to the QLC. Phase IV: Implement & Monitoring The same initial quality indicators will be reviewed by staff and the QLC in Phase V: Outcome To be determined. Preliminary reports show improvement. Phase VI: Sustaining To be determined ems patient off-load time reduction GOAL: To monitor and reduce the handoff times between ambulances and hospital emergency departments. Phase I: Staff Research & Review Current measures reflect that during high-volume periods, patients arriving at emergency departments by ambulance are often waiting longer than 30 minutes for offloading. Phase II: Task Team QLC Review The measures and other pertinent information were reviewed by internal staff and the QLC. Phase III: Approval & Planning A letter was sent to all hospitals and ambulance providers to announce more intense monitoring and solicit feedback on this issue. Phase IV: Implement & Monitoring Reports will be updated monthly and hospital leadership received an linking to the report when it is posted. Phase V: Outcome EMS staff and QLC will measure in six months to evaluate reduction in off-load times. Phase VI: Sustaining To be determined 42

44 quality improvement & patient safety 2014 pediatric medication safety GOAL: To check sustainability of our documented reduction in pediatric medication inaccuracies and to measure and sustain improvements. Phase I: Staff Research & Review Data was gathered and reviewed by EMS Staff and published in the EMS Best Practices newsletter. Phase II: Task Team QLC Review The information will be reviewed by internal staff and former task team leads. Phase III: Approval & Planning The information was reviewed by theqlc. Phase IV: Implement & Monitoring Staff and QLC will evaluate data and indicators for progress. Phase V: Outcome To be determined Phase VI: Sustaining To be determined Phase IV: Implement & Monitoring Reports will be updated monthly and hospital leadership received an linking to the report when it is posted. Phase V: Outcome EMS staff and QLC will measure in six months to evaluate reduction in off-load times. Phase VI: Sustaining To be determined 43

45 EMERGENCY MEDICAL SERVICES FOR CHILDREN The Emergency Medical Services for Children Program (EMSC) monitors and maintains a coordinated and comprehensive system that delivers high-quality emergency care for the children of Contra Costa County. background In 2014, Contra Costa emergency departments saw 81,961 children. Fortunately, 94% of them did not require hospitalization. Contra Costa County s designated pediatric critical care and trauma center is UCSF Benioff Children s Hospital & Research Center Oakland. Inpatient pediatric services are provided at John Muir Medical Center in Walnut Creek, Kaiser Permanente Medical Center in Walnut Creek and San Ramon Regional Medical Center. In addition, all Contra Costa community hospitals and emergency departments are expected to be ready for emergencies involving children Pediatric Emergency Department Visits < 1 year 1 9 years years Total Contra Costa Regional Medical Center 857 2,923 4,167 7,947 Doctors Medical Center in San Pablo* 514 3,554 3,244 7,312 John Muir Medical Center in Concord 874 5,901 4,867 11,642 John Muir Medical Center in Walnut Creek 786 3,665 3,463 7,914 Kaiser Permanente Medical Center in Richmond 720 3,948 3,955 8,623 Kaiser Permanente Medical Center in Antioch 994 5,032 5,136 11,162 Kaiser Permanente Medical Center in Walnut Creek 711 4,431 4,306 9,448 Sutter Delta Medical Center in Antioch 1,518 6,875 6,037 14,430 San Ramon Regional Medical Center 185 1,509 1,789 3,483 Total 7,159 37,838 36,964 81,961 EMS *Doctors Medical Center stopped receiving emergency ambulances in August 2014 and closed in April

46 EMERGENCY MEDICAL SERVICES FOR CHILDREN history In 1999, Contra Costa Emergency Medical Services began local implementation of the California EMS for Children Program. The program ensures that each EMS first responder, ambulance provider and emergency department has the equipment and training needed to effectively treat children. Since most pediatric emergencies are preventable, the program not only focuses on the coordination of pediatric emergency and critical care services but also focuses on injury prevention. In 2009, Contra Costa partnered with Alameda County on EMSC to support regional injury prevention, promote pediatric prehospital and emergency care capability, and promote statewide neonatal and pediatric disaster and medical surge planning. accomplishments and significant events Contra Costa community hospitals all participated in the 2013 California Pediatric Readiness Project, benchmarking hospitals on pediatric capability based on the most current national guidelines for care of children in the emergency department. Median Pediatric Readiness for all Contra Costa hospitals was over 82%, compared to the California statewide median of 70%. Contra Costa EMS is home to the California Neonatal/Pediatric and Perinatal Disaster Preparedness Coalition, which works to implement recommendations supported by the National Advisory Committee for Children and Disasters. neonatal and perinatal disaster preparedness project The Neonatal and Perinatal Disaster Preparedness Project helps in planning to support newborns and mothers in the event of disaster, and prepares the system for medical surges from this population. Staff education has been successful, 25 bedside go bags were distributed at four of Contra Costa s five neonatal intensive care units. Over the next two years, Contra Costa EMS will update its EMSC Program Plan. To learn more, visit 45

47 contra costa ems staff directory Patricia Frost EMS Director Joe Barger EMS Medical Director David Goldstein Assistant EMS Medical Director Jesse Allured EMS Program Coordinator Bruce Kenagy Prehospital Care Coordinator Aaron Doyle Prehospital Care Coordinator Craig Stroup Prehospital Care Coordinator Chad Henry Prehospital Care Coordinator Maria Fairbanks Prehospital Care Coordinator Marshall Bennett Prehospital Care Coordinator Steve Huck Emergency Preparedness Manager Lisa Vajgrt-Smith Medical Reserve Corps Coordinator Mateika Martin Emergency Preparedness Trainer Leticia Andreas Secretary Jeanne Kerr Administrative Analyst Patti Weisinger Account Clerk Carol Gray Senior Clerk contact information 1340 Arnold Drive, Suite 126 Martinez, CA (phone) (fax) Follow us on Facebook/Twitter 46

EMERGENCY MEDICAL SERVICES CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT

EMERGENCY MEDICAL SERVICES CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT EMERGENCY MEDICAL SERVICES 2017 CONTRA COSTA EMS SYSTEM PERFORMANCE REPORT For more information visit ccchealth.org/ems MESSAGE FROM THE DIRECTOR 2017 An EMS System Striving for Optimization Contra Costa

More information

Contra Costa County Emergency Medical Services. STEMI System Performance Report

Contra Costa County Emergency Medical Services. STEMI System Performance Report Contra Costa County Emergency Medical Services STEMI System Performance Report Quarter 4, 2009 & Year to Date 2009 Contra Costa Emergency Medical Services STEMI System Performance Executive Report: Quarter

More information

Contra Costa County Emergency Medical Services. STEMI System Performance Report

Contra Costa County Emergency Medical Services. STEMI System Performance Report Contra Costa County Emergency Medical Services STEMI System Performance Report Quarter III 2009 Contra Costa Emergency Medical Services STEMI System Performance Executive Report: Quarter III, 2009 Advisory

More information

Emergency Medical Services Agency

Emergency Medical Services Agency 2006/2007 Annual Program Report November 2007 1340 Arnold Drive, Suite 126 Martinez, CA 94553 (925) 646-4690 fax (925) 646-4379 www.cccems.org TABLE OF CONTENTS I. INTRODUCTION...1 A. OVERVIEW OF EMS...3

More information

Contra Costa County Local Hazard Mitigation Plan Update. Information on the process

Contra Costa County Local Hazard Mitigation Plan Update. Information on the process Contra Costa County Local Hazard Mitigation Plan Update Information on the process What is Mitigation? Preparedness Mitigation Response Recovery Sustained action taken to reduce or eliminate long-term

More information

Contra Costa Emergency Medical Services Agency

Contra Costa Emergency Medical Services Agency Contra Costa Emergency Medical Services Agency EMS System Plan Update 2016 1340 ARNOLD DRIVE, SUTIE 126 MARTINEZ, CA 94553 (925) 646 4690 FA (925) 646 4379 WWW.CCCEMS.ORG September 30, 2017 1 EECUTIVE

More information

South Central Region EMS & Trauma Care Council Patient Care Procedures

South Central Region EMS & Trauma Care Council Patient Care Procedures South Central Region EMS & Trauma Care Council Patient Care s Table of Contents PCP #1 Dispatch PCP #2 Response Times PCP #3 Triage and Transport PCP #4 Inter-Facility Transfer PCP #5 Medical Command at

More information

John Brown, MD, FACEP Medical Director Emergency Medical Services Agency Department of Emergency Management. February 16, 2010

John Brown, MD, FACEP Medical Director Emergency Medical Services Agency Department of Emergency Management. February 16, 2010 Status of Emergency Medical Services and Medical Oversight in San Francisco John Brown, MD, FACEP Medical Director Emergency Medical Services Agency Department of Emergency Management February 16, 2010

More information

Countywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report

Countywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report Countywide Emergency Department 9-1-1 Ambulance Patient Transfer of Care Report Performance Report Prepared by: Contra Costa Emergency Medical Services Visit us at www.cccems.org 2/11/2016 Contra Costa

More information

Countywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report

Countywide Emergency Department Ambulance Patient Transfer of Care Report Performance Report Countywide Emergency Department 9-1-1 Ambulance Patient Transfer of Care Report Performance Report Prepared by: Contra Costa Emergency Medical Services Visit us at www.cccems.org 2/28/2017 Patient Transfer

More information

Emergency Medical Services Agency

Emergency Medical Services Agency 2005/2006 Annual Program Report - September 2006-1340 Arnold Drive, Suite 126 Martinez, CA 94553 (925) 646-4690 fax (925) 646-4379 www.cccems.org TABLE OF CONTENTS I. INTRODUCTION...1 A. OVERVIEW OF EMS...3

More information

2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures

2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures 2018 Mission: Lifeline EMS Detailed Recognition Criteria, Achievement Measures and Reporting Measures Table of Contents Mission: Lifeline EMS Recognition Award Levels Page 2 Mission: Lifeline EMS Recognition

More information

San Luis Obispo Emergency Medical Services Agency. Continuous Quality Improvement Plan

San Luis Obispo Emergency Medical Services Agency. Continuous Quality Improvement Plan San Luis Obispo Emergency Medical Services Agency Continuous Quality Improvement Plan February 2016 1 Table of Contents 1. Introduction. 3 Vision Statement Philosophical Statement of Professional Ethics

More information

Standard Policies Policy 4002

Standard Policies Policy 4002 I. PURPOSE This policy identifies the procedure for determining the appropriate receiving facility for patients transported by ground ambulance to the Emergency Department (ED) of an acute care hospital.

More information

URBAN SHIELD OVERVIEW

URBAN SHIELD OVERVIEW URBAN SHIELD OVERVIEW September 7-11, 2017 Over 200 partners and 6,000 volunteers Scenario sites in Alameda, San Francisco, San Mateo, and Contra Costa Counties Regional Care and Shelter Tabletop Exercise

More information

Multiple Patient Management Plan

Multiple Patient Management Plan 2018 [NAME OF PLAN] Multiple Patient Management Plan Marin County Health & Human Services Emergency Medical Services Agency Supports the Marin County Operational Area Emergency Operations Plan and Medical

More information

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health Manual: Subject: Emergency Medical Services Administrative Policies and Procedures Multi-Casualty

More information

Marin County EMS Agency

Marin County EMS Agency Marin County EMS Agency Multiple Patient Management Plan Excellent Care Every Patient, Every Time July 2013 899 Northgate Drive #104, San Rafael, CA 94903 ph. 415-473-6871 fax 415-473-3747 www.marinems.org

More information

TILLAMOOK COUNTY, OREGON EMERGENCY OPERATIONS PLAN ANNEX R EARTHQUAKE & TSUNAMI

TILLAMOOK COUNTY, OREGON EMERGENCY OPERATIONS PLAN ANNEX R EARTHQUAKE & TSUNAMI TILLAMOOK COUNTY, OREGON EMERGENCY OPERATIONS PLAN ANNEX R EARTHQUAKE & TSUNAMI I. PURPOSE A. Tillamook coastal communities are at risk to both earthquakes and tsunamis. Tsunamis are sea waves produced

More information

Chapter 1. Learning Objectives. Learning Objectives 9/11/2012. Introduction to EMS Systems

Chapter 1. Learning Objectives. Learning Objectives 9/11/2012. Introduction to EMS Systems Chapter 1 Introduction to EMS Systems Learning Objectives Define the attributes of emergency medical services (EMS) systems List 14 attributes of a functioning EMS system Differentiate the roles and responsibilities

More information

NATIONAL AMBULANCE SERVICE ONE LIFE PROJECT

NATIONAL AMBULANCE SERVICE ONE LIFE PROJECT February 2015 NATIONAL AMBULANCE SERVICE ONE LIFE PROJECT Improving patient outcomes from Out Of Hospital Cardiac Arrest David Hennelly AP MSc Jan 2015 THE ONE LIFE PROJECT IS BEING LED BY THE NATIONAL

More information

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual Policy Memorandum 2006-02 Clearing of Patients in Custody 4/27/2006 2009-01 Billing for services to non-transported patients 1/5/2009 2010-04 Bariatric Patient Transports 12/17/2010 2012-01 DNR and POLST

More information

COUNTY OF SAN LUIS OBISPO HEALTH AGENCY. Pu b l i c H e a l t h D ep a r t m en t. Penny Borenstein, M.D., M.P.H.

COUNTY OF SAN LUIS OBISPO HEALTH AGENCY. Pu b l i c H e a l t h D ep a r t m en t. Penny Borenstein, M.D., M.P.H. COUNTY OF SAN LUIS OBISPO HEALTH AGENCY Pu b l i c H e a l t h D ep a r t m en t Emergency Medical Services Division Jeff Hamm Health Agency Director Penny Borenstein, M.D., M.P.H. Health Officer Executive

More information

Toolkit. Minnesota Department of Health and American Heart Association

Toolkit. Minnesota Department of Health and American Heart Association Toolkit Minnesota Department of Health and American Heart Association In partnership with Minnesota Department of Health American Heart Association - Minnesota Minnesota Ambulance Association MN Resuscitation

More information

EMS Subspecialty Certification Review Course. Learning Objectives

EMS Subspecialty Certification Review Course. Learning Objectives EMS Subspecialty Certification Review Course Mass Gatherings: 4.3 Disaster Planning and Operations: 4.3.1 Human Resource Needs in Disaster Response 4.3.2 Care Teams 4.3.2.1 Physician Placement 4.3.2.2

More information

This Annex describes the emergency medical service protocol to guide and coordinate actions during initial mass casualty medical response activities.

This Annex describes the emergency medical service protocol to guide and coordinate actions during initial mass casualty medical response activities. A N N E X C : M A S S C A S U A L T Y E M S P R O T O C O L This Annex describes the emergency medical service protocol to guide and coordinate actions during initial mass casualty medical response activities.

More information

San Joaquin County Emergency Medical Services Agency

San Joaquin County Emergency Medical Services Agency San Joaquin County Emergency Medical Services Agency http://www.sjgov.org/ems DATE: Mailing Address PO Box 220 French Camp, CA 95231 TO: FROM: SUBJ.: All Prehospital Personnel and Providers Emergency Department

More information

Contra Costa County. Emergency Medical Services Multi-Casualty Incident Plan

Contra Costa County. Emergency Medical Services Multi-Casualty Incident Plan Contra Costa County Emergency Medical Services Plan July 1, 2007 Contra Costa County Health Services Department Emergency Medical Services Agency Plan Table of Contents Plan Scope 2 Plan Objectives

More information

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual Policy Memorandum 2006-02 Clearing of Patients in Custody 4/27/2006 2009-01 Billing for services to non-transported patients 1/5/2009 2009-02 Emergency and Non-Emergency Patient Definitions 1/5/2009 2010-02

More information

Region III STEMI Plan

Region III STEMI Plan Region III STEMI Plan I. Plan Goals A. To develop a Region III STEMI System that when implemented, will result in decreased mortality and morbidity in the MIEMSS Region III. In order to accomplish this,

More information

National Assessment of Clinical Quality Programs. Introduction. National Assessment of Clinical Quality Programs. Demographics

National Assessment of Clinical Quality Programs. Introduction. National Assessment of Clinical Quality Programs. Demographics National Assessment of Clinical Quality Programs Introduction With the support of the NAEMSP Quality Improvement Committee, this study group is interested in understanding the national picture of clinical

More information

Nassau Regional Medical Advisory Committee

Nassau Regional Medical Advisory Committee Nassau Regional Medical Advisory Committee Advisories Advisory# Subject Issued Effective 07-02.1 BLS Assisted Medications 2/7/07 2/7/07 07-06.1 BLS Use of Pulse Oximeters 6/6/07 6/6/07 08-12.1 Incident

More information

EMS Quality Improvement Program ( ) I. Authority II. Mission Statement III. Vision Statement... 2

EMS Quality Improvement Program ( ) I. Authority II. Mission Statement III. Vision Statement... 2 Contents Emergency Medical Services Division Policies Procedures Protocols EMS Quality Improvement Program (1002.00) I. Authority... 2 II. Mission Statement... 2 III. Vision Statement... 2 IV. Kern County

More information

9 ESF 9 Search and Rescue

9 ESF 9 Search and Rescue 9 ESF 9 Search and Rescue THIS PAGE LEFT BLANK INTENTIONALLY Table of Contents 1 Introduction... 1 1.1 Purpose and Scope... 1 1.2 Relationship to Other ESF Annexes... 1 1.3 Policies and Agreements... 2

More information

Urban Shield is a continuous, 48-hour Full Scale Multi-Disciplinary Homeland Security/Disaster Preparedness Exercise hosted by the Alameda County

Urban Shield is a continuous, 48-hour Full Scale Multi-Disciplinary Homeland Security/Disaster Preparedness Exercise hosted by the Alameda County Urban Shield is a continuous, 48-hour Full Scale Multi-Disciplinary Homeland Security/Disaster Preparedness Exercise hosted by the Alameda County Sheriff s Office, with the support of the Bay Area Urban

More information

Monterey County Emergency Medical Services Agency: Annual Report FY 13/14

Monterey County Emergency Medical Services Agency: Annual Report FY 13/14 Monterey County Emergency Medical Services Agency: Annual Report FY 13/14 Prepared by Monterey County Emergency Medical Services Agency September 2014 1 Executive Summary Thank you to all Monterey County

More information

EMS Subspecialty Certification Review Course. Mass Casualty Management (4.1.3) Question 8/14/ Mass Casualty Management

EMS Subspecialty Certification Review Course. Mass Casualty Management (4.1.3) Question 8/14/ Mass Casualty Management EMS Subspecialty Certification Review Course 4.1.3 Mass Casualty Management Version: 2017 Mass Casualty Management (4.1.3) Overview of Emergency Management Overview of National Response Framework Local,

More information

STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION

STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION POLICY NO: FAC - 9 DATE ISSUED: 11/2016 DATE TO BE REVIEWED: 11/2019 STEMI SYSTEM RECEIVING CENTER STANDARDS AND DESIGNATION Purpose: To define the criteria for designation as a STEMI Receiving Center

More information

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES STRATEGIC PLAN

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES STRATEGIC PLAN CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES STRATEGIC PLAN 2015-2020-2030 Published: 10/27/14 Last update: 10/27/14 CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES STRATEGIC

More information

Chapter 1, Part 2 EMS SYSTEMS EMS System A comprehensive network of personnel, equipment, and established to deliver aid and emergency medical care

Chapter 1, Part 2 EMS SYSTEMS EMS System A comprehensive network of personnel, equipment, and established to deliver aid and emergency medical care 1 3 4 5 6 7 8 9 10 11 1 Chapter 1, Part EMS SYSTEMS EMS System A comprehensive network of personnel, equipment, and established to deliver aid and emergency medical care to the community. IN-HOSPITAL COMPONENTS

More information

Pensacola Fire Department. FY 2016 Budget Workshop

Pensacola Fire Department. FY 2016 Budget Workshop Pensacola Fire Department FY 2016 Budget Workshop 1 Mission The primary mission of the Pensacola Fire Department is to provide a wide range of services and programs designed to protect lives and property

More information

Oswego County EMS. Multiple-Casualty Incident Plan

Oswego County EMS. Multiple-Casualty Incident Plan Oswego County EMS Multiple-Casualty Incident Plan Revised December 2013 IF this is an actual MCI THEN go directly to the checklist section on page 14. 2 Index 1. Purpose 4 2. Objectives 4 3. Responsibilities

More information

Oklahoma Public Health and Medical Response System Overview

Oklahoma Public Health and Medical Response System Overview Oklahoma Public Health and Medical Response System Overview Introduction Oklahoma is a large and diverse state located on the Southern Great Plains of the United States. The State covers an area of 69,903

More information

Alameda County Disaster Preparedness Health Coalition. Medical and Health Tabletop Exercise - January 22, 2015

Alameda County Disaster Preparedness Health Coalition. Medical and Health Tabletop Exercise - January 22, 2015 1 Alameda County Disaster Preparedness Health Coalition Medical and Health Tabletop Exercise - January 22, 2015 2 Scope This tabletop exercise was planned for Alameda County Disaster Preparedness Health

More information

EMS Modernization Project Report

EMS Modernization Project Report March 2014 EMS Modernization Project Report Contra Costa County Prepared by: FITCH & ASSOCIATES, LLC 2901 Williamsburg Terrace #G Platte City Missouri 64079 816.431.2600 www.fitchassoc.com Contra Costa

More information

JOINT COMMITTEE TO CREATE A NATIONAL POLICY TO ENHANCE SURVIVABILITY FROM MASS CASUALTY SHOOTING EVENTS HARTFORD CONSENSUS II

JOINT COMMITTEE TO CREATE A NATIONAL POLICY TO ENHANCE SURVIVABILITY FROM MASS CASUALTY SHOOTING EVENTS HARTFORD CONSENSUS II July 11, 2013 JOINT COMMITTEE TO CREATE A NATIONAL POLICY TO ENHANCE SURVIVABILITY FROM MASS CASUALTY SHOOTING EVENTS HARTFORD CONSENSUS II Concept to Action On April 2, 2013, representatives from a select

More information

EMS S Y S T EM REPOR T

EMS S Y S T EM REPOR T LOS ANGELES COUNTY EMS AGENCY INSIDE THIS ISSUE: EMERGENCY 2 DEPARTMENTS PATIENTS PER 2 TREATMENT BAY EMERGENCY 3 DEPARTMENT SATURATION EMS VOLUME 4 MOST PREVALENT 5 CHIEF COM- PLAINTS EMS PROVIDER 6 AGENCIES

More information

Town of Brookfield, Connecticut Mass Casualty Incident Plan

Town of Brookfield, Connecticut Mass Casualty Incident Plan Town of Brookfield, Connecticut Mass Casualty Incident Plan 1.0 Definition Of Mass Casualty Incident: A Mass Casualty Incident is an incident having multiple patients that would exceed the amount Brookfield

More information

communication, and resource sharing for effective medical surge management during a disaster.

communication, and resource sharing for effective medical surge management during a disaster. STRATEGIC PLAN FOR 2015-2016 NORTHERN UTAH HEALTHCARE COALITION Approved by the N. UT. Healthcare Coalition, -/-/15 following approval by the Executive Committee on -/-/15 OUR MISSION: To serve our communities

More information

Template 6.2. Core Functions of EMS Systems and EMS Personnel in the Implementation of CSC Plans

Template 6.2. Core Functions of EMS Systems and EMS Personnel in the Implementation of CSC Plans Template 6.2. Core Functions of EMS Systems and EMS Personnel in the Implementation of CSC Plans Function 1. Assessment and Activation State State EMS office, in collaboration with the state public health

More information

TIME CRITICAL DIAGNOSIS SYSTEM

TIME CRITICAL DIAGNOSIS SYSTEM TIME CRITICAL DIAGNOSIS SYSTEM Recommendations to Advance Emergency Medical Care for Stroke and STEMI in Missouri Time Critical Diagnosis System Task Force for Stroke and STEMI August 2008 online version

More information

Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies

Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies Southwest Texas Regional Advisory Council Regional Percutaneous Coronary Intervention Facility & EMS Heart Alert Agencies LETTER OF ATTESTATION August, 2015 BACKGROUND The Southwest Regional Advisory Council

More information

DUFFERIN COUNTY PARAMEDIC SERVICE

DUFFERIN COUNTY PARAMEDIC SERVICE DUFFERIN COUNTY PARAMEDIC SERVICE 2015-2016 ANNUAL REPORT Table of Contents Patient Stories... 2 Vision, Mission, Values... 3 Our Service... 4 Our People... 5 System Performance... 6 Program Development...

More information

Administrative Procedure

Administrative Procedure Administrative Procedure Number: 408 Effective: Interim Supersedes: 07/28/1998 Page: 1 of 7 Subject: EMERGENCY ACTION PLAN 1.0. PURPOSE: To establish procedures for the evacuation of University buildings

More information

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual

San Joaquin County Emergency Medical Services Agency Policy and Procedure Manual Policy Memorandum 2006-02 Clearing of Patients in Custody 4/27/2006 2009-01 Billing for services to non-transported patients 1/5/2009 2009-02 Emergency and Non-Emergency Patient Definitions 1/5/2009 2010-02

More information

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES DEPARTMENT OF EMERGENCY MEDICAL SERVICES (757)-385-1999 FAX (757) 431-3019 477 VIKING DRIVE, SUITE 130 VIRGINIA BEACH, VA 23452 CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES OPERATIONAL

More information

Emergency Medical Services Agency. Emergency Medical Services for Children Plan Program Evaluation and Update

Emergency Medical Services Agency. Emergency Medical Services for Children Plan Program Evaluation and Update Emergency Medical Services Agency Emergency Medical Services for Children Plan Program Evaluation and Update January 1, 2009 TABLE OF CONTENTS Introduction... 1 I. Authority and Purpose... 2 II. Summary

More information

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health

CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health CENTRAL CALIFORNIA EMERGENCY MEDICAL SERVICES A Division of the Fresno County Department of Public Health Manual: Subject: Emergency Medical Services Administrative Policies and Procedures Multi-Casualty

More information

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DESTINATION POLICY

SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY DESTINATION POLICY SAN FRANCISCO EMERGENCY MEDICAL SERVICES AGENCY I. PURPOSE DESTINATION POLICY Policy Reference No.: 5000 Supersedes: February 1, 2015 A. To identify the approved ambulance-transport destinations for the

More information

Paramedic First Responder Policies and Procedures December 1, 2015

Paramedic First Responder Policies and Procedures December 1, 2015 Emergency Medical Services Division Paramedic First Responder Policies and Procedures December 1, 2015 Kern County Fire Department Station 58 Pine Mountain Club Edward D. Hill EMS Director Kristopher Lyon,

More information

TACOMA FIRE DEPARTMENT STANDARDS OF COVER EXECUTIVE SUMMARY

TACOMA FIRE DEPARTMENT STANDARDS OF COVER EXECUTIVE SUMMARY TACOMA FIRE DEPARTMENT STANDARDS OF COVER EXECUTIVE SUMMARY The Tacoma Fire Department (TFD) has a long history and proud tradition of service to the greater Tacoma community. From volunteer bucket brigades

More information

2016 Community Health Improvement Plan

2016 Community Health Improvement Plan 2016 Community Health Improvement Plan Table of Contents 1. EXECUTIVE SUMMARY... 2. ABOUT OUR JOHN MUIR HEALTH... Mission, Vision, Values... Community Commitment... About Community Benefit... Communities

More information

Program Planning and Implementation Guide EMS

Program Planning and Implementation Guide EMS LIFEPAK 500 automated external defibrillator Program Planning and Implementation Guide EMS Timely defibrillation is the only effective therapy currently available for cardiac arrest caused by ventricular

More information

Medical Reserve Corps Contra Costa County

Medical Reserve Corps Contra Costa County MRC Members Fe Montesclaros-Fumar and Duncan Seibert College Park High School Medical Reserve Corps Contra Costa County CCCMRC helps to train over 3,000 Mt. Diablo School District students in CPR This

More information

National Association of EMS Educators Pre-EMS Education and Instructor Development Accepted by the NAEMSE Board of Directors September 10, 2003

National Association of EMS Educators Pre-EMS Education and Instructor Development Accepted by the NAEMSE Board of Directors September 10, 2003 POSITION PAPER National Association of EMS Educators Pre-EMS Education and Instructor Development Accepted by the NAEMSE Board of Directors September 10, 2003 Introduction The National Association of EMS

More information

Fire Control - Ambulance Rescue

Fire Control - Ambulance Rescue 69 Fire Control - Ambulance Rescue Mission Dedicated to the preservation of life, property, and the environment. Our goal is to provide quality, costeffective professional services predicated upon the

More information

Annual Report. DUFFERIN COUNTY PARAMEDIC SERVICE 325 Blind Line Orangeville, ON L9W 5J8

Annual Report. DUFFERIN COUNTY PARAMEDIC SERVICE 325 Blind Line Orangeville, ON L9W 5J8 2014 Annual Report DUFFERIN COUNTY PARAMEDIC SERVICE 325 Blind Line Orangeville, ON L9W 5J8 Table of Contents Human Resources... 2 Vehicles... 2 Stations... 3 Responses... 4 Public Access Defibrillator

More information

University of San Francisco EMERGENCY OPERATIONS PLAN

University of San Francisco EMERGENCY OPERATIONS PLAN University of San Francisco EMERGENCY OPERATIONS PLAN University of San Francisco Emergency Operations Plan Plan Contact Eric Giardini Director of Campus Resilience 415-422-4222 This plan complies with

More information

WESTCHESTER REGIONAL

WESTCHESTER REGIONAL WESTCHESTER REGIONAL EMERGENCY MEDICAL SERVICES COUNCIL POLICY STATEMENT Supersedes/Updates: New Policy No. 11-02 Date: February 8, 2011 Re: EMS System Resource Utilization Pg(s): 5 INTRODUCTION The Westchester

More information

Resuscitation Council (UK) Guidelines for the use of Automated External Defibrillators SUPERSEDED

Resuscitation Council (UK) Guidelines for the use of Automated External Defibrillators SUPERSEDED Page 1 of 7 Resuscitation Council (UK) Guidelines for the use of Automated External Defibrillators Resuscitation Guidelines 2000 Contents 1. Introduction 2. The 'chain of survival' concept 3. Recommendations

More information

OKALOOSA COUNTY EMERGENCY MEDICAL SERVICES STANDARD OPERATING PROCEDURE Medical Incident Command Policy:

OKALOOSA COUNTY EMERGENCY MEDICAL SERVICES STANDARD OPERATING PROCEDURE Medical Incident Command Policy: Title: Medical Incident Command Policy: 429.00 Purpose: Policy: This standard operating procedure (SOP) identifies the procedure to be employed when establishing EMS Command. It also designates responsibility

More information

On Improving Response

On Improving Response On Improving Response Robert B Dunne MD FACEP The main focus of hospitals in a disaster is to preserve life and health. Disaster preparedness often focuses on technical details and misses the big picture

More information

Urban Area Security Initiative (UASI) Super-Urban Area Security Initiative (SUASI)

Urban Area Security Initiative (UASI) Super-Urban Area Security Initiative (SUASI) Urban Area Security Initiative (UASI) Super-Urban Area Security Initiative (SUASI) Super-Urban Area Security Initiative (SUASI) The Bay Area Super-Urban Area Security Initiative (SUASI) is a federal Department

More information

If you have any questions or comments regarding the following Public Health Emergency Response Plan, please contact:

If you have any questions or comments regarding the following Public Health Emergency Response Plan, please contact: If you have any questions or comments regarding the following Public Health Emergency Response Plan, please contact: Amy Ascani, RS Emergency Planning Coordinator 330-493-9904 ext.267 ascania@starkhealth.org

More information

THE CODE 1000 PLAN. for ST. LOUIS COUNTY AND MUNICIPAL LAW ENFORCEMENT AGENCIES. January 2013

THE CODE 1000 PLAN. for ST. LOUIS COUNTY AND MUNICIPAL LAW ENFORCEMENT AGENCIES. January 2013 THE CODE 1000 PLAN for ST. LOUIS COUNTY AND MUNICIPAL LAW ENFORCEMENT AGENCIES January 2013 1 of 12 Table of Contents SECTION 1.0 GENERAL... 1 1.1 Definition - Purpose - Applicability...1 1.2 Authority...1

More information

STEMI System of Care Policy

STEMI System of Care Policy County of Kern Emergency Medical Services STEMI System of Care Policy Ross Elliott EMS Director Robert Barnes, M.D. Medical Director 1 TABLE OF CONTENTS PURPOSE... 2 AUTHORITY... 2 DEFINITIONS... 2 DESIGNATION...

More information

ALZHEIMER S/DEMENTIA RESOURCES FOR FAMILIES

ALZHEIMER S/DEMENTIA RESOURCES FOR FAMILIES ALZHEIMER S/DEMENTIA RESOURCES FOR FAMILIES There are many community services and resources to help families caring for persons with Alzheimer s disease. To help families find the services they need, Information

More information

The Future of Emergency Care in the United States Health System. Regional Dissemination Workshop New Orleans, LA November 2, 2006

The Future of Emergency Care in the United States Health System. Regional Dissemination Workshop New Orleans, LA November 2, 2006 The Future of Emergency Care in the United States Health System Regional Dissemination Workshop New Orleans, LA November 2, 2006 Sponsors Josiah Macy, Jr. Foundation Agency for Healthcare Research and

More information

City of Piedmont, California Invites Applications For Fire Lieutenant and Fire Captain

City of Piedmont, California Invites Applications For Fire Lieutenant and Fire Captain City of Piedmont, California Invites Applications For Fire Lieutenant and Fire Captain Annual Salary: Lieutenant $100,008; Captain: $95,148 to $115,596 Plus incentives and a generous benefits package Apply

More information

Model Policy. Active Shooter. Updated: April 2018 PURPOSE

Model Policy. Active Shooter. Updated: April 2018 PURPOSE Model Policy Active Shooter Updated: April 2018 I. PURPOSE Hot Zone: A geographic area, consisting of the immediate incident location, with a direct and immediate threat to personal safety or health. All

More information

Response & Transportation

Response & Transportation Contra Costa County EMS Agency Response & Transportation Table of Contents 4000 Administrative Policy Number Formally Public Safety / EMT AED Programs 4001 18 Patient Destination Determination 4002 9 Approved

More information

Position Description

Position Description Position Description Job Title: Ambulance or Emergency Medical Task Force Leader Date: April 2013 Department: Operations & Office of Emergency Management Status: Non-exempt or Exempt Reports To: Ambulance

More information

MONTGOMERY COUNTY, KANSAS EMERGENCY OPERATIONS PLAN. ESF4-Fire Fighting

MONTGOMERY COUNTY, KANSAS EMERGENCY OPERATIONS PLAN. ESF4-Fire Fighting MONTGOMERY COUNTY, KANSAS EMERGENCY OPERATIONS PLAN ESF4-Fire Fighting Planning Team ESF Coordinator Support Agency Non-governmental Organizations State Agency Montgomery County Rural Fire Caney Fire Department

More information

Emergency Mass Care and Shelter

Emergency Mass Care and Shelter Contact: Jim Mellander Foreperson 925-608-2621 Contra Costa County Grand Jury Report 1702 Emergency Mass Care and Shelter Are We Ready? TO: Board of Supervisors, Office of the Sheriff SUMMARY The Contra

More information

Emergency Medical Services Program

Emergency Medical Services Program County of Santa Cruz HEALTH SERVICES AGENCY 1080 EMELINE AVENUE, SANTA CRUZ, CA 95060 (831) 454-4120 FAX: (831) 454-4272 TDD: (831) 454-4123 EMERGENCY MEDICAL SERVICES PROGRAM Policy No. 7000 Reviewed

More information

SAN LUIS OBISPO COUNTY HEALTH AGENCY

SAN LUIS OBISPO COUNTY HEALTH AGENCY SAN LUIS OBISPO COUNTY HEALTH AGENCY Public Health Department Emergency Medical Services Division 2156 Sierra Way, San Luis Obispo, CA 93401 805-788-2511 FAX 805-788-2517 www.sloemsa.org Operations MEETING

More information

PREPAREDNESS MATTERS. District Preparedness Update. In This Issue: We re ready! Are you? Charles C. Gibson, Chief of Police

PREPAREDNESS MATTERS. District Preparedness Update. In This Issue: We re ready! Are you? Charles C. Gibson, Chief of Police Charles C. Gibson, Chief of Police PREPAREDNESS MATTERS Be a partner in preparedness be ready! Issue 5, Volume 1 April 2010 Contra Costa Community College District 500 Court Street Martinez, CA 94553 (925)229-1000

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Hansen CM, Kragholm K, Pearson DA, et al. Association of bystander and first-responder intervention with survival after out-of-hospital cardiac arrest in North Carolina, 2010-2013.

More information

Monterey County Emergency Medical Services Agency Strategic Plan

Monterey County Emergency Medical Services Agency Strategic Plan Monterey County Emergency Medical Services Agency Strategic Plan December 2017 1 Mission, Vision, and Values Statements Mission Statement: The mission of the is to enhance, protect, and improve the health

More information

Medical & Health Communications and Information Sharing Plan

Medical & Health Communications and Information Sharing Plan Medical & Health Communications and Information Sharing Plan **DRAFT** Revised: 09/22/14 (leave blank) MEDICAL HEALTH COMMUNICATIONS PLAN (revised: 09/22/14) - Page 2 of 26 Table of Contents 1. Introduction...

More information

The Kootenai County Emergency Operations Center. EOC 101 E-Learning Version 1.2

The Kootenai County Emergency Operations Center. EOC 101 E-Learning Version 1.2 The Kootenai County Emergency Operations Center EOC 101 E-Learning Version 1.2 Before we begin... You can proceed at your own speed through this course. The slides are numbered in the lower left hand corner

More information

Organization and Administration

Organization and Administration rganization and Administration Supersedes: 08-14-06 Effective: 02-23-11 Boston EMS is structured into a series of organizational components that represent functional groupings of employees performing similar

More information

Emergency Medical Services Regulation. Adopted October 1, 2009

Emergency Medical Services Regulation. Adopted October 1, 2009 Emergency Medical Services Regulation Adopted October 1, 2009 WHEREAS, the Boston Public Health Act established the Boston Public Health Commission ("Commission") as the board of health for the City of

More information

Chapter 190 Emergency Medical Service: Overview and Ground Transport

Chapter 190 Emergency Medical Service: Overview and Ground Transport Chapter 190 Emergency Medical Service: Overview and Ground Transport Episode Overview There are multiple designs for EMS systems, including public and private services, those operating at basic and advanced

More information

EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement.

EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement. 1 EP15: Describe and demonstrate interdisciplinary collaboration using continuous quality and process improvement. Interdisciplinary collaboration is an essential component of Riverside Medical Center

More information

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES

CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES DEPART MENT OF EMERGENCY MEDICAL SERVICES (757)-426-5005 FAX (757) 425-7864 1917 ARCTIC AVENUE VIRGINIA BEACH, VA 23451 CITY OF VIRGINIA BEACH DEPARTMENT OF EMERGENCY MEDICAL SERVICES OPERATIONAL RESPONSE

More information

Active Shooter Guideline

Active Shooter Guideline 1. Purpose: This procedure establishes guidelines for Monterey County Public Safety Personnel who respond to Active Shooter Incidents (ASI). The goal is to provide effective rescue and treatment procedures,

More information

The Trauma System. Prevention Pre-hospital care and transport Acute hospital care Rehab Research

The Trauma System. Prevention Pre-hospital care and transport Acute hospital care Rehab Research An Overview The Trauma System The Office of Emergency Medical Services & Trauma System (OEMSTS) is responsible for oversight of the trauma system. The ideal trauma system includes; Prevention Pre-hospital

More information

EMERGENCY MEDICAL CARE COMMITTEE CONTRA COSTA COUNTY

EMERGENCY MEDICAL CARE COMMITTEE CONTRA COSTA COUNTY EMERGENCY MEDICAL CARE COMMITTEE CONTRA COSTA COUNTY Agenda 4:00 p.m. 1. Introduction of Members and Guests 4:03 2. Approval of Minutes from September 13, 2017 4:05 3. Chair s Report Kacey Hansen, EMCC

More information

SACRAMENTO COUNTY 2016 EMS Plan Update: TABLE 1 Page 1 of 8 A. SYSTEM ORGANIZATION AND MANAGEMENT Does not currently meet standard Meets minimum standard Meets recommended guidelines Shortrange plan Long-range

More information