2. This training module is designed to provide an overview of the Altered Standard of Care protocol for local first responders, ambulance providers, and our other emergency response partners. This module will take approximately 2 hour to complete. At the end of this module there will be a 20 question quiz. You must complete the quiz with an 80% success rate to pass. The questions will be based on the information learned during the training module. NOTE: Completion of the quiz is required to receive CE credit.

3. The purpose of the Altered Standard of Care Training is to provide information regarding the alteration of the EMS system in response to an increased demand for medical aid services, beyond the capacity of the current system providers.

4. This training provides an example of how the current 911 system may be altered during a major disaster or pandemic outbreak. The scenario and changes shown in this module are hypothetical only and should not be assumed to reflect actual changes that will be made to the system. Changes to the system during an actual event could look very different than changes proposed in this training module.

6. A pandemic outbreak has affected a large portion of the population. It is a severe variation of the annual flu virus. The EMS system has increasingly become overwhelmed, and there is no estimated time when this impact will end. We simply do not have the resources and personnel to handle the demand for more ambulances. Ahead we will discover what changes can be made to the system to handle this type of overload.

7. We know that things have to change in order to respond to the increased demand. But prior to being able to discuss system changes we must first go over some and a few

8. ASSUMPTIONS

9. Altered Standard of Care simply refers to a level of medical care delivered to individuals under conditions of distress, such as after a disaster or when supplies are insufficient for the demand for emergency care.

10. The "Medical/Health Operational Area Coordinator (MHOAC)" is the Public Health Officer and local EMS Agency Administrator or designee who is responsible, in the event of a disaster or major incident where mutual aid is requested, for obtaining and coordinating services and allocation of resources within the Operational Area (county) border.

11. Within the S-SV EMS Agency's member counties, the "Medical/Health Operational Area Coordinator (MHOAC)" is often a role filled just by the Health Officer, but in a few counties, it is a joint role of the Health Officer and EMS Agency Administrator.

13. A Quick Response Vehicle or QRV is a vehicle that is staffed with at least one paramedic, and equipped with Advanced Life Support (ALS) equipment/supplies per local EMS Agency protocol. Such vehicles may include: ALS supervisor vehicles, shared resources from other emergency response agencies, company cars, rental cars, private cars, etc.

14. As the EOC, we provide a central location from which government at any level can provide interagency coordination and executive decision making in support of the incident response. We carry out the coordination function through: Information collection and evaluation; Priority setting; and Resource management.

15. Decisions we make at the EOC affect the incident response as well as the public response. In an isolated incident the decisions made are not tactical decisions, however, during an incident such as this pandemic flu we would make tactical decisions. The EOC will be in charge of collaborating with all response agencies so they will be on the same page during this incident. The EOC will be the facility from which these agencies are coordinated.

18. The EOC provides a central location from which government at any level can provide:

20. So far we have looked at some definitions as well as the overall role of the EOC. Now we will explore the role Emergency Operations Centers play in multiagency coordination.

21. EOCs coordinate with on-scene incident managers and other agencies and organizations to: Acquire, allocate, and track resources. Manage and share information. Establish response priorities among incidents. Provide legal and financial support. Liaison with other jurisdictions and other levels of government.

22. EOCs are part of a larger system of multiagency coordination that is integral to domestic response as required by the National Incident Management System (NIMS).

23. NIMS—a nationwide, systematic approach to domestic incident management—consists of five components: Preparedness. Communications and Information Management. Resource Management. Command and Management. Ongoing Management and Maintenance.

24. EOCs serve several main functions within a Multiagency Coordination System: Information collection and evaluation—collecting, analyzing, and interpreting information from various sources. Coordination—coordinating the information flow and resources for complex incidents or multiple incidents occurring simultaneously. Priority setting—ensuring that response systems are interconnected and reinforcing interoperability among the various system components, making response more efficient and effective by coordinating available resources, and making decisions based on agreed-upon policies and procedures.

25. EOCs also are critical to: Resource coordination—identifying and acquiring needed resources and allocating existing or known resources. Communications facilitation—establishing interoperable communications among all partners in the MACS and others, as necessary for the response.

32. Don’t forget public information! Some members of the media will go to great lengths for a story. It just makes good sense to provide the media with the information they— and the public—need. NIMS requires public information be organized around a Joint Information System (JIS) that is overseen by a Public Information Officer (PIO).

33. Public Information should consider: Who is the public? What does the public need to know? Who will provide that information? Who will manage the information flow? How will the information be transmitted? When? How often? The answers to these questions will determine how the JIS is established and how it will operate.

34. Public Information also provides critical information to elected officials, agency administrators, and responders. For example, elected officials and others can tell a lot about whether their message is effective by monitoring: Whether the public is responding appropriately to warnings and emergency messages. Rumors that are circulating. The JIS should be designed to monitor incoming information as well as outgoing information.

35. The JIS is an organized, integrated, and coordinated mechanism for delivery of understandable, timely, accurate, and consistent information to the public during an emergency. The JIS includes the plans, protocols, and structures used to provide information to the public during incident operations.

36. The JIS encompasses all public information operations related to the incident: Federal State Local Tribal Private organization PIOs Staff JICs established to support the incident

37. The Public Information Officer (PIO) represents and advises the Incident Command. Through the JIS, the PIO coordinates: Media and public inquiries. Emergency public information and warnings. Rumor monitoring and response. Media monitoring. Through the EOC, the PIO ensures that the media and, therefore, the public receive a consistent message in a timely manner.