FLORIDA AMBULANCE DEPLOYMENT STANDARD OPERATING PROCEDURE Versin 1.7 7/2/2018 1. PURPOSE: The purpse f this Ambulance Deplyment Standard Operating Prcedure (ADSOP) is t establish a mechanism fr State ESF-8 t marshal and deply grund and air emergency medical services (EMS) assets during disaster respnse. 2. SITUATION: EMS assets are a critical cmpnent f the public health and medical respnse system. Cunty Emergency Operatins Centers (EOC) may request additinal EMS resurces during a disaster t supplement grund and air ambulances and EMS persnnel in cunties when their resurces are verwhelmed by a majr emergency r catastrphic disaster. The State EOC may request EMS resurces t fulfill missins frm ther states under EMAC. Specific missins fr EMS assets may include: Patient and medical facility evacuatin supprt. Augmentatin f day t day EMS services. Patient triage, treatment, and transprt. Appendix VIII, Public Health, and Medical Services, f the State Cmprehensive Emergency Management Plan, establishes that deplyment f EMS resurces will be crdinated by State ESF-8, with ESF 4 and 9, the Flrida Fire Chief s Assciatin, (FFCA), the Flrida Ambulance Assciatin (FAA), and as necessary, the Flrida Aermedical Assciatin (FAMA). 3. ASSUMPTIONS: The Department f Health ESF-8 Public Health and Medical, des nt pssess the capabilities f prviding EMS transprt. Resurces are prvided by nn-impacted lcal EMS prviders. As f February 2017, Flrida has 5107 permitted EMS vehicles and 140 permitted EMS aircraft. The EMS vehicles cnsist f 2640 ALS transprt, 1777 ALS nn-transprt, and 550 BLS transprt. The air medical aircraft cnsists f 56 helicpters and 84 airplanes. In additin, Flrida has 23 Mass Casualty Supprt Units strategically lcated thrughut the state. State-level deplyments f EMS assets will be authrized by State ESF-8 and crdinated with State ESF 4 and 9, FAA, and FAMA. Deplyments f EMS assets will strictly adhere t the principles f Flrida s Incident Cmmand System. Resurces can mst efficiently be identified and marshaled wrking thrugh established rganizatinal structures and pints f cntact. EMS resurces will deply under an authrized missin request and will nt self-dispatch t the incident scene. Availability f EMS assets may be limited during disasters due t cmpeting peratinal cmmitments. All ambulance deplyments are subject t weather cnditins and safety cnsideratins. Page 1 f 18
When requested, the prcesses established in this SOP can be implemented t supprt interstate mutual aid requests fr EMS assets thrugh the Emergency Management Assistance Cmpact (EMAC). 4. AUTHORITIES: Flrida Statutes Chapter 252.36 (5) (b), authrizes the use f all available resurces f the state gvernment and f each plitical subdivisin f the state, as reasnably necessary t cpe with the emergency. 5. CONCEPT OF OPERATIONS Flrida s cncept f peratins is t deply EMS assets as typed Ambulance Strike Teams (AST), Ambulance Task Frces (ATF) r single EMS resurces. The preferred methd f deplyment is as an AST/ATF; hwever single EMS resurces may be deplyed based n specific missin requirements. Flrida has adpted the Natinal Incident Management System (NIMS) typing fr EMS resurces. EMS assets that may be deplyed pursuant t this SOP include: Air ambulances (Fixed-Wing). Air ambulances (Rtary-Wing). Ambulance (Grund). Ambulance Strike Teams. Ambulance Strike Team Leaders. Air Ambulance Strike Teams. Air Ambulance Strike Team Leaders. Ambulance Task Frces. Ambulance Task Frce Leaders. Ambulance Task Frce Grup r Divisin Supervisr. EMS Branch Directr Medical Directrs Registered Nurses. Paramedics. Emergency Medical Technicians (EMTs). A. Pre-event Actins fr Incidents with Ntice: 120 Hurs Pre-Event- Planning: 1. Disseminate pre-event messaging t lcal, state, and federal EMS resurces that estimates pssible needs and prjected preparedness activities fr the next 5 day. 96 72 Hurs Pre-Event: 1. ESF-8 Patient Mvement t cnduct pre-event utreach with ESF 4 and 9, FFCA, FAA, FAMA. 2. Verify with rganizatinal representatives the availability f reginal liaisns 3. Identify rganizatinal representatives that may deply t the State EOC (SEOC) t embed with ESF-8 Patient Mvement. 48 24 Hurs Pre-Event: 1. Cnduct AST/ATF inventry f each regin that culd ptentially respnd t the estimated area f peratin. 2. Cmplete a Health and Safety Risk Assessment fr EMS resurces that may be deplyed t the area f peratin. 3. Identify Frward Operating Base (FOB) as needed fr rapid entry pst event Page 2 f 18
24 0 Hurs Pre-Event 1. Upn the request f ESF-8 Patient Mvement, deply rganizatinal representatives t SEOC t embed with ESF-8 Patient Mvement 2. Stage EMS resurces if needed. B. Request Prcess fr Incidents with Ntice: Requests t the state fr EMS assets must be crdinated thrugh Cunty EOCs, and requested thrugh and dcumented in the State request system. Resurces shuld be requested by asset typed descriptins. A request will include a capability-based descriptin f hw the resurces will be used as a part f the peratin. Missins fr EMS assets will initially be assigned t State ESF-8 in the SEOC. State ESF-8 will validate the missin based n current situatinal awareness and resurce availability. ESF-8 will then determine the type f missin request and the crrect type f deplyment assistance needed. Once validated, the State ESF-8 will request EMS resurce deplyment assistance frm State ESF 4 and 9, FAA, and/r FAMA, depending n the type f missin and resurce requested. State ESF-8 will assign missin numbers t deplyed EMS resurces. ESF-8 Patient Mvement Respnsibilities: Missin requests fr the evacuatin f a health care facilities, standbys, and nnemergent special needs shelter assistance will initially be crdinated thrugh the FAA and reginal EMS liaisns. Grund ambulances, EMTs, and paramedics will be identified, mbilized, deplyed, tracked, and dembilized thrugh the FAA in partnership with ESF-8. The FAA will wrk with State ESF-8 and the Flrida Department f Health t designate ne EMS reginal liaisn fr each f the seven dmestic security regins in Flrida. ESF-4/9 Respnsibilities: Missin requests fr grund ambulances, EMTs, and paramedics fr Urban Search and Rescue (US&R), r requests fr AST Type I r Type III will be crdinated thrugh ESF 4/9. Other nn-health care facility missins will initially be crdinated thrugh ESF 4/9 and the reginal fire-based EMS liaisns. ESF 4/9 ambulance resurces will be identified, mbilized, deplyed, tracked, and dembilized thrugh the Flrida Fire Chiefs Assciatin (FFCA), as stated in the Statewide Emergency Respnse Plan (SERP). ESF-8 and ESF4/9 Cllabratins: Missin requests that cannt be cmpletely filled by FAA r FFCA will be crdinated between state ESF-8 and state ESF 4/9. This cllabratin will be needed when units frm different rganizatinal types are required t cmplete ASTs/ATFs. Flrida Air Medical Assciatin Respnsibilities: Missin requests fr air ambulance resurces will be identified, mbilized, deplyed, tracked, and dembilized thrugh FAMA, as per the Flrida Air Medical Services, Disaster Respnse Plan. T include Flrida Nenatal Transprt Netwrk Assciatin (FNPTNA), disaster plan. Page 3 f 18
The reginal fire-based, nn-fire -based, and/r FAMA liaisns will wrk directly with EMS prviders t identify assets available fr deplyment, deply thse assets and wrk with the AST/ATF Leaders/Grup - Divisin Supervisrs t track deplyed EMS resurces. When pssible, EMS resurces will be acquired frm ne r mre un-impacted gegraphical regins in rder prevent the further burden n the impacted regin. State ESF-8, State ESF 4 and 9, FAA, and/r FAMA will cllectively assign the duty f AST/ATF Leader, and/r Grup/Divisin Supervisr t trained and qualified persnnel (see Attachment B: Flrida Standards fr an Ambulance Strike Frce and Ambulance Task Frce). State ESF-8, in cncert with the AST/ATF Leaders/Grup - Divisin Supervisrs, will manage, as necessary, lgistical supprt fr the grund/air ambulance deplyment (htels, fuel, fd, re-supply, cmmand vehicles, Mass Casualty Supprt Units). State ESF-8 will attempt t acquire and deply an EMS mbile cmmand pst when three r mre AST/ATF are deplyed t each area f peratins. State ESF-8, wrking with State ESF-1, will attempt t acquire and crdinate the deplyment f nn-ambulance transprtatin resurces (Para-transit vehicles, buses). State ESF-8 as necessary, will deply a liaisn t the incident t crdinate activities with the AST/ATF Leaders/Grup - Divisin Supervisrs. Once deplyed, ambulance resurce activities will be managed by the assigned AST/ATF Leaders/Grup - Divisin Supervisrs and State ESF-8 Liaisn (if deplyed). C. Request Prcess fr N-Ntice Incident Deplyments: N-ntice incidents may nt allw fr pre-event crdinatin amng State ESF-8, ESF 4 and 9, FAA, and FAMA as nted in 5. A & B abve. The prcedures belw describe request prcess ptins fr n-ntice incidents: State ESF-8, ESF 4 and 9, FAA, and FAMA will cllabrate t maintain the n-ntice deplyment plan fr grund/air ambulance resurces. Grund Ambulance Primary Deplyment Optin: State ESF-8 and State ESF 4 and 9 will fllw the deplyment prcess as nted abve in 5. A & B. Grund Ambulance Secndary Deplyment Optin: The State ESF-8 may wrk directly with EMS prviders t deply additinal grund ambulance resurces. State ESF-8 will keep State ESF 4 and 9 and FAA aware f the status f the deplyment. Nn-fire based grund ambulance prviders that participate in a n-ntice deplyment will, at the request f State ESF 8: Deply a department supervisr t serve as an AST/ATF Leaders/Grup - Divisin Supervisr. Deply ambulance resurces that are lgistically capable f sustaining themselves fr 3 days (staff, unifrms, medical equipment, and supplies, etc.). Page 4 f 18
Ntify their EMS and/r Fire liaisn f any need t dembilize the deplyed assets at any time during the deplyment. Air Ambulance Deplyment: State ESF-8, thrugh FAMA, will acquire the necessary air ambulances t meet the needs f the incident. State ESF-8, thrugh FAMA, will deply additinal air ambulance resurces t replace the n-ntice deplyed resurces within 12 24 hurs f the initial deplyment. This assures EMS assets rapidly deplyed can return t hme base if necessary and lng-term supprt fr the missin remains available. FAMA will assure that air ambulance prviders that participate in a n-ntice deplyment will: Deply an air ambulance department supervisr fr each grup f five air ambulances that FAMA sends t the deplyment t assist the designated AST/ATF Leaders/Grup Strike Team Leader. Deply air ambulance resurces that are lgistically capable f sustaining themselves fr 72 hurs (staff, unifrms, medical equipment, and supplies, fuel, maintenance, etc). Ntify the FAMA Liaisn f any need t dembilize the deplyed assets at any time during the deplyment. D. Cmmunicatins: Deplyed EMS persnnel will utilize the current Vlume f the Emergency Medical Services Cmmunicatins Plan (EMSCP) as a reference guide in rder t determine lcal radi frequencies t be used during a deplyment. The Emergency Medical Services Cmmunicatins Plan (EMSCP) is the peratinal field manual t be carried n all transprt permitted EMS vehicles within Flrida. It cntains infrmatin fr day-t-day peratins, as well as prviding the data necessary t enable radi cmmunicatins during transprt peratins in unfamiliar areas, including neighbring cunties in Gergia and Alabama. E. Activatin Prcess Guidelines fr EMS Prviders Upn Request fr Deplyment: The fllwing guidelines are prvided nce a grund/air ambulance prvider is ntified f a deplyment: Grund/air ambulances/medical persnnel shuld reprt as quickly as pssible t the assigned rally pint. Persnnel are t take their prepared three-day G Packs with them t the assignment (see Attachment C: Equipment Recmmendatins fr Deplyed Grund/Air Ambulance Persnnel). State ESF-8, State ESF 4 and 9, FAA, and FAMA will prvide agency representatives t wrk with the fire and nn-fire service- based grund/air AST/ATF Leaders/Grup - Divisin Supervisr in crdinating teams and getting them t the incident. ESF 4 and 9 r FFCA, FAA, and FAMA representatives, if requested and assigned, will liaise with the ESF-8. F. Resurce Management All grund/air ambulances will reprt t their designated rally pint(s) t meet with AST/ATF Leaders/Grup - Divisin Supervisrs as applicable. At the rally pint(s), the AST/ATF Leaders/Grup - Divisin Supervisrs will be respnsible fr the fllwing: Intrducing team members. Briefing team members n current incident cnditins, safety issues and the Ambulance Deplyment Standard Operating Prcedure (ADSOP) Cde f Cnduct. Page 5 f 18
Issuing ptential assignments. Determining respnse rute(s), cnsidering the time f day, traffic, fd, and fuel stps. Making and cmmunicating travel plans (cnvy rder). Identifying radi frequencies fr en rute cmmunicatins (typically a Talk-A-Rund channel). Cnducting a checklist assessment f the ADSOP readiness and equipment availability. Ntifying the jurisdictinal cmmunicatin center f status and ETA t the incident site/staging area. Review the ABCs f Staging: A-assignment B-bss C-cmmunicatins D-destinatin E-equipment If a grund/air ambulance unit is unable t cntinue t respnd fr any reasn, the AST/ATF Leaders/Grup - Divisin Supervisr will cntact the State ESF-8 t request replacement f the unit. State ESF-8 will in turn, ntify State ESF 4 and 9 and/r representatives frm the FAA r FAMA f the situatin. The AST/ATF Leaders/Grup - Divisin Supervisr shall reprt any deplyment-related incidents/accidents t the State ESF-8. The State ESF-8 will in turn ntify the State ESF 4 and 9 representatives and/r, the FAA, r FAMA f the situatin. Each grund/air ambulance crew shall maintain respnsibility fr their persnal equipment, their grund/air ambulance, and their medical equipment /supplies. Any prblems shuld be reprted t the AST/ATF Leaders/Grup - Divisin Supervisr. At the incident scene, the deplyed ambulance team shall reprt t the AST/ATF Leaders/Grup - Divisin Supervisr and check in at the incident staging area r assigned area. The AST/ATF Leaders/Grup - Divisin Supervisr will be respnsible fr the fllwing: Initiating and using ICS Frm 214 (Unit Lg) fr the entire deplyment. Obtaining rientatin t hspital lcatins (lcal infrmatin and ICS 206 EMS Cmmunicatins Plan is a resurce fr this infrmatin). Determining preferred travel rutes and brief team members. Receiving incident briefing (IAP, ICS 205 - Cmmunicatins Plan and ICS 206 - Medical Plan). Briefing team members n Incident and their assignments. Prviding infrmatin, including resurce rder and missin number, fr check-in (ICS Frm 211). Reprting fr line assignment(s) r t a staging area as directed. AST/ATF Leaders/Grup - Divisin Supervisr will, at least n a daily basis, prvide Situatin Reprts (see Attachment D: Daily Situatin Reprt Template) t State ESF-8 at the SEOC. State ESF-8 will assure that the Situatin Reprts are placed in State Resurce System. Medical Prtcls: Whenever deplyed, each AST/ATF Leaders/Grup - Divisin Supervisr, EMT, Paramedic r Registered Nurse wh prvides any medical care during the Page 6 f 18
incident, may utilize the scpe f practice fr which she/he is trained, licensed, and accredited accrding t the plicies and prcedures established by his/her Lcal Emergency Medical Services Agency. Grund/air ambulance persnnel may nt exceed their medical scpe f practice regardless f directin r instructins they may receive frm any authrity while participating n an ambulance deplyment. G. Lgistical Supprt: The deplyment team reprting t the scene f an incident shuld nt expect lgistical supprt services t be in place in the early stages f the incident. Fr this reasn, all deplyed ambulance teams are expected t be self-sufficient fr up t 3 days r have a plan t be supprted in the respnse area. The lcatin and magnitude f the incident will determine the level f supprt services available. State ESF-8 will wrk t prvide lgistical supprt beynd the 24-hur mark fr the deplyed EMS resurces. Hwever: The AST/ATF Leaders/Grup - Divisin Supervisr may have t utilize cmmercial services fr fd, fuel, and supplies until these lgistical services are established. Obtaining replacement medical supplies during the first days f a disaster may als be difficult. The AST/ATF Leaders/Grup - Divisin Supervisr may have t wrk within the lcal EMS structure t replenish medical supplies fr the deplyed ambulance team. (The Cunty Emergency Manager, with the assistance f lcal ESF-8, may be able t prvide medical resupply services.) The AST/ATF Leaders/Grup - Divisin Supervisr r designee is expected t attend all peratinal shift briefings and keep all persnnel n the team infrmed f existing and predicted cnditins. If the individual units f the ambulance deplyment are assigned t single resurce functins (e.g., patient transprtatin, triage, r treatment) the AST/ATF Leaders/Grup - Divisin Supervisr will make cntact with the persnnel at least nce during each Operatinal Perid. If pssible, all units in an ambulance deplyment will stay tgether when ff-shift unless therwise directed by the AST/ATF Leaders/Grup - Divisin Supervisr. At a minimum, all team members will remain in cnstant cmmunicatins. Until incident facilities are established, each AST/ATF Leaders/Grup - Divisin Supervisr will crdinate with their respective supprt services t prvide facilities supprt t the ambulance deplyment team. H. Dembilizatin: State ESF-8 in crdinatin with State ESF 4 & 9, FAA, and/r FAMA are respnsible fr the preparatin and implementatin f the grund/air ambulance Dembilizatin Plan t ensure that an rderly, safe, and cst-effective mvement f persnnel and equipment is accmplished frm the incident site(s). FAMA in crdinatin with State ESF-8 is respnsible fr the preparatin and implementatin f the air ambulance Dembilizatin Plan t ensure that an rderly, safe, and cst-effective mvement f persnnel and equipment is accmplished frm the incident site(s). At n time shuld a deplyed grund/air ambulance team r individual crewmember leave withut receiving departure instructins frm their AST/ATF Leaders/Grup - Divisin Supervisr. State ESF-8 will crdinate dembilizatin f EMS resurces with State ESF 4 and 9, FAA, and FAMA. State ESF-8 will crdinate with State ESF 4 and 9 t implement any required decntaminatin prcesses f equipment and persnnel. Page 7 f 18
AST/ATF Leaders/Grup - Divisin Supervisrs shuld btain necessary supplies t assure that the grund/air ambulances leave in a state f readiness whenever pssible. If unable t replace lst, used r damaged equipment, the AST/ATF Leaders/Grup - Divisin Supervisr will ntify State ESF-8 representatives at the SEOC prir t leaving the incident/staging lcatin. State ESF-8 will ntify FAMA f the dembilizatin. The AST/ATF Leaders/Grup - Divisin Supervisr will cllect and return all radis and equipment n lan fr the incident. The AST/ATF Leaders/Grup - Divisin Supervisr will recrd timekeeping recrds and submit them t State ESF-8 prir t departure. All deplyed ambulance persnnel will receive a debriefing frm the AST/ATF Leaders/Grup - Divisin Supervisr prir t departure frm the incident site(s). Vehicles safety checks will be cnducted by AST/ATF Leader/Grup - Divisin Leader prir t the EMS unit s departure frm the incident site. Any prblems will be cmmunicated t the AST/ATF Leaders/Grup - Divisin Supervisr. The AST/ATF Leaders/Grup - Divisin Supervisr will review return travel prcedures with departing EMS persnnel. State ESF- 8 will ntify State ESF 4 & 9 and/r the FAA f grund ambulance release time, travel rute, estimated time f arrival back at hme base, and actual arrival time back at hme base. FAMA will ntify State ESF-8 f air ambulance release time, travel rute, estimated time f arrival back at hme base, and actual arrival time back at hme base. I. Cde f Cnduct: The cnduct f deplyed resurces under the ADSOP is f paramunt imprtance t State ESF-8, ESF 4 and 9, the EMS Advisry Cuncil, FAA, American Medical Assciatin (AMA), the Spnsring Agency, and the lcal Authrity Having Jurisdictin (AHJ). This Cde f Cnduct cnsists f the rules and standards gverning the expected demeanr f members f agencies respnding as part f the ADSOP. Each system member is bth a representative f their respnse team and their Spnsring Agency. Any vilatin f principles r adverse behavir demnstrated will be lked upn as unprfessinal. Such behavir may discredit the gd wrk that the resurce cmpletes and will reflect prly n the entire team's perfrmance and Spnsring Agency. The deplying EMS resurces are representatives f a well-rganized, highly trained, and disciplined grup f respnders wh have been assembled t help cmmunities in need f their assistance. At the cnclusin f a missin, team members must ensure that their perfrmance has been psitive and that they will be remembered fr the prfessinal manner in which they cnducted themselves bth scially and in the wrk envirnment. General Respnsibilities It is the respnsibility f the Spnsring Agency t prepare its members regarding cnduct befre deplyment. Each deplyed member is bund by their Spnsring Agency s rules, regulatins, plicies, and prcedures. It is the respnsibility f the AST/ATF Leaders/Grup - Divisin Supervisr r designee(s) t reinfrce the ADSOP Cde f Cnduct during all planning sessins, team meetings, and briefings, and t mnitr cmpliance. Any vilatins must be dcumented, with apprpriate fllw-up actin taken, by State ESF-8, ESF 4 and 9, FAA, FAMA and the Spnsring Agency. Page 8 f 18
At n time during a missin will deplyed members take persnal advantage f any situatin and/r pprtunity that arises. It is the respnsibility f each deplyed member t abide by this Cde f Cnduct. As a basic guide, deplyed members will base all their actins and decisins n the ethical, mral, and legal cnsequences f thse actins. It is in this manner that psitive and beneficial utcmes will prevail in all events. Accrdingly, members will: Keep the value f life and the welfare f the patient cnstantly in mind. Remain cgnizant f cultural issues including race, religin, gender and natinality, and peple with disabilities. Abide by all lcal law enfrcement practices, including lcal plicies regarding weapns. Deplyed members will nt carry firearms. Abide by all regulatins regarding the handling f sensitive infrmatin, including HIPAA. Fllw lcal regulatins regarding medical care and handling f patients and/r human remains. Fllw lcal jurisdictin and federal regulatins r restrictins regarding taking and shwing pictures f patients r structures. Fllw prescribed directin regarding dress cde and persnal prtective equipment. Nt be in pssessin f nn-prescribed r illegal substances, nr cnsume alchlic beverages while n duty r subject t call. Only prcure equipment thrugh apprpriate channels. Nt accept gratuities t prmte cperatin. Nt deface any prperty (unless apprved structure marking) nr remve prperty frm an peratinal wrk site as a suvenir. Transit nly via apprved radways and nt enter int restricted areas unless apprved. Demnstrate prper cnsideratin fr ther teams capabilities and perating practices. J. Reimbursement: It is the respnsibility f the respnding agency t track their emplyee s time n assignment, vehicle miles/hurs and expenses incurred as a direct result f the deplyment. Pst deplyment, the respnding agency will send claim dcumentatin reimbursement package t the ESF-8 Finance-Administratin email at StateESF8.Fin-Adm@flhealth.gv. N reimbursement will ccur fr activity that was NOT requested by the State ESF-8. Page 9 f 18
Damaged r lst equipment shall be dcumented n the ICS 214 frm and a detailed explanatin prvided t State ESF- 8 during the data cllectin phase pst-deplyment. At n time shall submitted csts exceed the nrmal custmary rates and csts. 6. RECORD OF CHANGES & APPROVAL This Ambulance Deplyment Standard Operating Prcedure replaces and supersedes the previusly apprved Plan dated March 14, 2012. A cpy f this Ambulance Deplyment Standard Operating Plan will be made available t all licensed EMS prviders in the state f Flrida. 7. ATTACHMENTS A. Minimum Requirements fr EMS Participatin B. Flrida Standards fr an Ambulance Strike Frce and Ambulance Task Frce C. Equipment Recmmendatins fr Deplyed Grund/Air Ambulance Persnnel D. Daily Situatin Reprt Template E. Self Deplyment Ntice Page 10 f 18
Attachment A: Minimum Requirements fr EMS Participatin EMS rganizatins that will deply will be cmpliant with this SOP: ADSOP grund/air ambulance prvider will hld current licenses and be cnsidered t be in gd standing by the Flrida Department f Health, Bureau f Emergency Medical Services. ADSOP grund/air ambulance prviders will be respnsible fr the deplyment nly f qualified persnnel as described in this dcument. Standards fr Ambulance Individual Persnnel: Be a member r emplyee in gd standing f the EMS prvider rganizatin. Be currently certified/licensed and in gd standing as an EMT, Paramedic r Registered Nurse with the state f Flrida. Have a minimum f ne year f EMS experience as an EMT, Paramedic r Registered Nurse. Cmpleted ICS 100. Cmpleted ICS 700. Have current immunizatins as identified in Natinal Incident Management System (NIMS) typing fr EMS resurces. Cmpleted Hazardus Materials Awareness level training. Preferred Standards: Be trained and able t wrk in Level C persnal prtective equipment (in accrdance with CFR 1910.120 APP B) Cmpleted WMD Awareness Level Training. Standards fr an Air/Ambulance Strike Team (AST) Leader/Ambulance Task Frce Leader (ATL): Minimum Training Requirements fr the AST/ATL Leader: Must be currently certified and in gd standing as an EMT, Paramedic r Registered Nurse with the state f Flrida. All training requirements fr the individual persnnel abve plus: ICS 200. ICS 800. Tw years EMS experience in an EMS leadership psitin. Optinal: Flrida Ambulance Strike Team/Task Frce Leader Curse. Duties and Respnsibilities f the AST/ATL Leader: The AST/ATL Leader is respnsible fr: Assuring the safety and readiness f the assigned AST/ATL persnnel and equipment. Maintain accuntability f all deplyed persnnel assigned Crdinating the mvement f the persnnel and equipment traveling t and returning frm an incident site. Supervising the peratins f the AST/ATL team at the incident site, as directed by the Ambulance Grup r Divisin Supervisr, r Incident Cmmander. Maintaining familiarity with persnnel and equipment peratins, including assembly, respnse, and direct actins f the assigned persnnel, keeping team accuntability at all times. Page 11 f 18
Cntacting apprpriate incident persnnel with prblems encuntered during the deplyment, including administrative, mechanical, peratinal, r lgistical issues. Prir t deplyment, determining missin duratin, special circumstances, reprting lcatin and cntact infrmatin. Ensuring cmpletin and submissin f ICS dcuments fr timekeeping, dembilizatin (ICS Frm 214), and lessns learned. Prviding Situatin Reprt and Incident Actin Plan (IAP) t State ESF-8, State ESF 4 and 9, and/r FAA (as apprpriate), pursuant t the schedule prescribed by the receiving entity(s). Participate in After Actin Reprt (AAR) Prcess. In summary, the AST/ATL Leader must have the capability and experience t manage, crdinate, and direct the actins f the ambulance persnnel at a wide variety f emergency situatins. This includes maintaining all required recrds and ensuring the lgistical needs f persnnel are met during the entire activatin. Recmmended Standards fr an Ambulance Grup - Divisin Supervisr/EMS Branch Directr/Medical Directr: All training requirements fr the AST/ATF Leader requirements abve, plus: Minimum five years experience in an EMS leadership rle. ICS 300. ICS 400. Successful Cmpletin f the Flrida Ambulance Strike Team/Task Frce Leader Curse. Duties and Respnsibilities f the Grup - Divisin Supervisr/EMS Branch Directr Ensure that administrative supprt persnnel, deply with necessary ffice supplies, deply with the Grup/Divisin Supervisr/Directr. Ensure the safety and readiness f the deplying persnnel and equipment. Crdinate the mvement f the persnnel and equipment traveling t and returning frm an incident. Supervise the peratinal deplyment f the ambulance strike teams/task frces at the incident, as directed by the Operatins Sectin Chief, r Incident Cmmander. Maintain familiarity with persnnel and equipment, including assembly, respnse, and direct actins f the assigned units, keeping the team accuntability at all times. Cntact apprpriate State Incident Cmmand (ESF-8, 4 and r 9) persnnel with prblems encuntered by deplying teams, including administrative, mechanical, peratinal, r lgistical issues. Ensure vehicles have adequate cmmunicatins capability (see cmmunicatins sectin). Maintain psitive public relatins during the incident. Prir t deplyment, determine missin duratin, special circumstances, reprting lcatin and cntact infrmatin. Ensure cmpletin and submissin f ICS dcuments fr timekeeping and dembilizatin (ICS Frm 214). Participate in the After Actin Reprt (AAR) Prcess. In summary, the AST/ATF Leaders/Grup - Divisin Supervisrs/Directrs must have the capability and experience t manage, crdinate, and direct the actins f the grund/air ambulance teams at a wide variety f emergency situatins. This includes maintaining all required Page 12 f 18
recrds and ensuring the administrative and lgistical needs f the teams are met during the deplyments. Page 13 f 18
Attachment B: Flrida Standards fr an Ambulance Strike Frce and Ambulance Task Frce Air/Ambulance Strike Team A Flrida Ambulance Strike Team will cnsist f the fllwing NIMS typed assets: Three t five grund/air ambulances f the same type. Tw Ambulance Strike Team Leaders with separate vehicles (fr 24-hur peratins). Ambulance Task Frce A Flrida Ambulance Task Frce will cntain the fllwing assets: Three t five related grund/air ambulances f different types. Tw Ambulance Task Frce Team Leaders with separate vehicles (fr 24-hur peratins). Optinal Deplyment Resurces: Additinal resurce may be required t supprt EMS activities during the respnse. Deplyment f the fllwing resurces will be determined at the time f missin tasking by State ESF-8 in cncert with ESF 4 and 9, the FAA, and FAMA: State ESF-8 Disaster Preparedness Cnsultants Cmmunicatins trailer(s). Cmmand vehicle that has radi cmmunicatins capabilities, satellite phnes, wireless internet capabilities, generatr pwer and enugh reserve fuel t last three days. Ambulance Task Frce Incident Management Team (IMT) representatives. Mass Casualty Incident (MCI) Supprt Units(s) with generatr and fuel fr three days. Type 2 Field Mbile Mechanics with service vehicles and equipment/supplies. Grund vehicle fuel tender Type I that is capable f carrying enugh diesel fuel and gasline t supprt the deplyment fr three days. Helicpter fuel tender with grund crew. Helicpter mechanic with equipment and supplies. Fd and water adequate enugh t sustain the AST/ATF fr three days. Tents and cts with air cnditining, generatr, and fuel in adequate quantities/size t supprt the AST/ATF fr three days. Page 14 f 18
Attachment C: Equipment Recmmendatins fr Deplyed Grund/Air Ambulance Persnnel Persnal GO Pack fr deplying persnnel shuld cntain the fllwing: Clthing (shirts, pants, shrts, etc) in sufficient quantities and apprpriate fr climate. Jacket. Safety bts. Sunglasses. Hat Ptable water fr three days. Rain gear. Fd supplies r Meals Ready t Eat (MREs) fr three days. Tilet paper. Persnal meds (enugh t last furteen days) and medical histry dcumentatin. Vaccinatin and inculatin recrds. Tiletries & ther persnal items as needed. Sunscreen. Bug spray. Sleeping bag & pillw. Hearing prtectin (ear plugs). Pht I.D. and petty cash. Official agency ID. EMT and BLS certificatin cards and/r Paramedic and ACLS certificatin cards. Handheld flashlight(s) with extra batteries. Grund/Air Ambulance: Sufficient quantities f equipment and supplies t meet expected 3 day deplyment that meets minimum scpe f practice (ALS r BLS) as determined by applicable statute and rules. Maps f incident area and surrunding areas. Cmmunicatins equipment (TBD). Capability t purchase fuel lcally (credit cards [department, crprate r persnal], and r cash). 20 Patient Care Reprts (PCRs). 20 Disaster Triage Tags. 2 Pair wrk glves. 2 Safety helmets with dust-prf safety gggles. 4 HEPA N95 masks and 4 dust filters. 2 Handheld flashlights with batteries. Supplies and equipment fr AST/ATF Leaders/Grup - Divisin Supervisrs that is in additin t persnal G Packs: ICS psitin specific vests. Maps f impacted area and surrunding areas. Laptp cmputer with wireless capability, vehicle-based charger, wall charger, printer, paper, ffice supplies. Cmpass and/r prtable GPS. Capability t purchase fuel (credit cards [department, crprate r persnal], and r cash). Cmmunicatins equipment capable f cmmunicating with the teams en rute and at the incident: Cell phne, radis, extra batteries, satellite phne and chargers. Page 15 f 18
State f Flrida Field Operatins Guide (FOG) Manual. Fd supplies r MREs (quantities sufficient enugh t supprt the team fr length f deplyment). Ptable Water (Quantities sufficient t supprt the team fr length f deplyment). 50 Disaster Triage Tags. 2 Safety helmets with dust-prf safety gggles. 2 Pairs wrk glves. 2 Flashlights r headlamp. ICS Frms & Ambulance Strike Team/Task Frce/Grup/Divisin Leader(s) Kit. 100 Patient Care Reprts (PCRs). Extra bulbs etc. as needed fr all equipment. Page 16 f 18
Attachment D: Daily Situatin Reprt Template Date f Operatins: Reprting Perid: Current Situatin Summary f day s events. Area f Operatins (gegraphic descriptin). List f assets deplyments by area f peratins. Operatins undertaken. Operatins t be undertaken in current perid (Wrk Perid Objectives). Lgistical issues and recmmendatins. Cmmunicatins issues and recmmendatins. Administrative issues and recmmendatins. Prpsed Dembilizatin Plan (when applicable) Submit t: StateESF8.Planning@flhealth.gv Page 17 f 18
Attachment E: Self Deplyment Ntice DO NOT RESPOND TO THE IMPACTED AREA UNLESS AUTHORIZED In rder t help minimize self-deplyments prir t a frmal, authrized ambulance deplyment, State ESF-8 will distribute the fllwing ntice t all EMS Prviders. State ESF-8 is crdinating the deplyment f EMS resurces t the <incident name> impacted area with State ESF 4 and 9, the Flrida Ambulance Assciatin, and the Flrida Aermedical Assciatin. State ESF 4 and 9 will be wrking with the Flrida Fire Chiefs Assciatin, State Emergency Respnse Plan (SERP) Reginal Crdinatrs as the pints f cntact. State ESF 8 will be wrking with the Flrida Ambulance Assciatin, and the Reginal EMS Crdinatrs as the pints f cntact. The Flrida Aermedical Assciatin will wrk with Flrida licensed air ambulance prviders as the pint f cntact. Yu are being deplyed t assist the lcal EMS in their respnse t the incident. Yur assistance is greatly appreciated. While n the deplyment yu will wrk under the Incident Cmmander r designee (Medical Branch, Transprt Officer, etc.). Yu must wrk within the ICS system, and fllw the directins f the Incident Cmmand staff r the Ambulance Strike Team/Task Frce/Grup Divisin Supervisr. Prir t Deplyment Please cnsider the fllwing: Perid f service may be fr seven t ten days. Have a credit card fr the purchase f fuel, fd and r ther persnal supplies. Each vehicle must be permitted, staffed, and equipped at the level permitted (BLS, ALS). Vehicles/aircraft available fr the respnse are t be mechanically sund and capable f sustained peratin during the deplyment perid in additin t travel t and frm the area f peratins. Deplying teams and persnnel will have with them the items in Attachments C. While n Assignment: Fllw the Ambulance Deplyment Standard Operating Prcedure, Cde f Cnduct at all times. Freelancing is nt allwed. Any freelancing will cause the service and the persnnel n the vehicle t be relieved f assignment and ntificatin f the hme rganizatin. All persnnel are t stay with their assigned unit until assigned a task by the Strike Team/Task Frce/Grup Divisin Supervisr. Keep radi traffic t a minimum. Use plain English. Yu are directed t fllw yur rganizatin s apprved patient care prtcls. Yu may nly perfrm prcedures and prvide medicatins cvered r described in yur rganizatin s clinical prtcls. If yu are advised t prvide care with which yu are nt familiar, yu must advise the medical cntrl physician that what was requested is beynd the scpe f practice r calls fr a medicatin that is nt a part f the rganizatin s clinical prtcl. At all times yu must prvide nly the care allwed under yur Flrida certificatin. Page 18 f 18