Inland Counties Emergency Medical Agency The Role of Trauma Centers In Disasters
ICEMA Mission Ensure an effective system of quality patient care and coordinated emergency medical response that best serves the public, our most important stakeholder. This is accomplished by planning, implementing and evaluating an effective EMS system for all participants and stakeholders. ICEMA mission is in line with the County Vision at all levels of organization.
California EMS Regulations California Health and Safety Code, Division 2.5 The local EMS agency shall plan, implement, and evaluate an emergency medical services system, in accordance with the provisions of this part, consisting of an organized pattern of readiness and response services based on public and private agreements and operational procedures (1797.204) California Health and Safety Code, Division 2.5 Requires the LEMSA Medical Director to establish policies and procedures pertaining to medical control including dispatch, patient destination, patient care guidelines, and quality assurance (1797.220) California Code of Regulations, Title 22 Requires the Medical Director of the LEMSA to maintain medical control by developing written medical policies establishing the requirements for the initiation, completion, review, evaluation and retention of patient care records (Chapter 4. Section 100169)
ICEMA Responsibilities/Services EMS System Organization, Management and Maintenance Paramedic Accreditation, EMT Certification and Continuing Education Prehospital Treatment and Medical Control EMS and Hospital Communications Coordination Ground and Air Ambulance Transportation Public Information and Education Regional Trauma, Stroke and STEMI Specialty Care Center Designation and Oversight Data Collection and Evaluation Continuous Quality Improvement Disaster Medical and Resource Management
ICEMA Designated EMS Providers 39 ALS Providers 36 BLS Providers 21 Receiving Hospitals 6 EMS Aircraft Providers 1,300 Paramedics 3,000 EMTs 240 MICNs 80 Flight Nurses
ICEMA Designated Hospitals 8 Base Hospitals 6 STEMI Receiving Centers 21 Paramedic Receiving Hospitals 2 Adult/1 Pediatric Trauma Centers 6 Neurovascular Stroke Receiving Centers
Trauma Center Overview All Trauma Centers are licensed acute care hospitals All provide specialized care at one of four levels of designation Level I and II Similar personnel, services and resources Surgeons and OR teams must be available 24/7 Primary difference Level I conducts research and provides training
Trauma Center Overview Level III and IV Generally provide initial stabilization Transfer to Level I or II as needed Greatest difference between Levels I and II Surgical capabilities not in house 24/7 Surgeons and OR Teams on call back Level I and II Pediatric Focus specifically on pediatric trauma patients Level I also requires research and training
Inland Empire Trauma Centers San Bernardino County Loma Linda University Medical Center-Level I Adult and Pediatric Loma Linda Arrowhead Regional Medical Center-Level II Colton Riverside County-All Level II Desert Regional Medical Center Palm Springs Riverside University Health System Moreno Valley Riverside Community Hospital-Level II Adult and Pediatrics Riverside Inland Valley Medical Center Wildomar Los Angeles County Antelope Valley Hospital-Level II Lancaster
Hospitals in a Disaster In a major disaster all hospitals become trauma centers All have Emergency Medicine physicians experienced in trauma management Patients that exceed a community hospital's abilities can be transferred as the incident stabilizes Continuation of care is a normal process Disasters will likely delay or prevent transfers
Mutual Aid Coordination California divided into six Governor's Office of Emergency Services Regions Inland Empire in Region VI Trauma Centers routinely receive cross border patients Medical Health Operational Area Coordinators manage in-county resources Regional Disaster Medical Health Coordinators assist during disasters Large numbers of patients are involved Acquisition of personnel needed to support an incident Other resources
Medical Health Mutual Aid California Disaster and Civil Defense Master Mutual Aid Agreement-1950 Established the framework for the use of Mutual Aid assets 11 County OES Regions I and VI M/H Mutual Aid aggreement-1997 An outcome of the Northridge Earthquake ICEMA/Public Health/Behavioral Health MOU-2013 Identifies the lead roles of the EMS Administrator and the Health Officer who share the Medical Health Operational Area Coordinator (MHOAC) positon Medical incidents-icema Health-Public Health The Riverside County EMS Agency Director is the Region VI Regional Disaster Medical Health Coordinator (RDMHC)
EMS Response
Northridge Eathquake-1994 Magnitude 6.7 Fatalities - 57 Injuries - > 8,700 Most patients managed within respective affected counties All Medical/Health coordinator levels engaged M/H mutual aid was primarily for personnel No significant patient movements out of OAs
Hurricane Katrina-1995 Category 5 Fatalities - Approximately 1,836 Injuries - Unknown Displaced - > 1 million people Impacted area - > 90,000 square miles National Disaster Medical System International Mutual Aid
Trauma Centers The use of trauma centers in disaster is scalable All hospitals must be ready to receive major trauma patients Mutual aid levels: County Region State Federal International
Questions?
ICEMA Contact Information Tom Lynch, EMS Administrator Office: 909.388.5830 Cell: 909.841.6876 Fax: 909.388.5825 tom.lynch@cao.sbcounty.gov ICEMA Duty Officer 24/7 number: 909.208.8618 ICEMA 1425 South D Street San Bernardino, CA 92415-0060 Mail Code 0060