San Mateo County Emergency Medical Services Agency Coordinating Emergency Medical Services & Medical/Health Emergency Preparedness for San Mateo County Photos courtesy Don Cheu, MD unless otherwise cited

Emergency Medical Services A system to provide care and transportation in response to a sudden and unexpected medical event Includes ambulances, first responders, hospitals, trauma centers, and associated stakeholder organizations Medical component of 911

Government & EMS U.S. Department of Transportation, National Highway Traffic Safety Administration, Traffic Safety, Office of EMS (NHTSA) California Health and Human Services Agency, California EMS Authority (EMSA) Local EMS Agency (LEMSA)

Authority California Health & Safety Code, Division 2.5, Sections 1797 – 1799, Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act. California Code of Regulations, Title 22, Division 9, Prehospital Emergency Medical Services

San Mateo County

San Mateo County Health Department

San Mateo County EMS Agency

Responsibilities EMT Certification Approval of EMS courses and providers Oversee 911 contract Accredit paramedics Develop policies & protocols Coordinate disaster preparedness for prehospital and hospitals

Guidance Emergency Medical Care Committee Medical Advisory Committee Quality Leadership Council Operations Committee Nurse Leadership Committee MCI Working Group Hospital Working Group

Exclusive Operating Area (EOA) EMS System Exclusive Operating Area (EOA) South San Francisco (201)

Public – Private Partnership Photo: courtesy AMR

Public Joint Powers Authority for Fire/EMS Public Safety Communications Single Fire & EMS Dispatching Emergency Medical Dispatch

Private American Medical Response Contractor for most Bay Area counties Largest Ambulance Company in US and World

Data-driven, evidence-based patient care

San Mateo County Mental Health Assessment & Referral Team S M A R T San Mateo County Mental Health Assessment & Referral Team

Emergency Preparedness Medical/Health Operational Area Coordinator Medical – Healthcare Delivery Health – Public Health

Emergency Preparedness PREPARATION Evaluation, planning, training and exercises

Emergency Preparedness PREPARATION RESPONSE Providing rescue, medical care, shelter and other services during the incident, emergency or disaster

Emergency Preparedness PREPARATION RESPONSE RECOVERY Restoring infra-structure, services, lives and the economy to pre-disaster conditions

Emergency Preparedness PREPARATION RESPONSE MITIGATION RECOVERY Taking steps to reduce the effects of events that cannot be prevented

Emergency Preparedness PREPARATION RESPONSE MITIGATION RECOVERY Emergency Preparedness is a continuing cycle of improved preparation, response, recovery and mitigation

HSEEP: Homeland Security Exercise & Evaluation Program Preparation EVALUATE PLAN EXERCISE TRAIN HSEEP: Homeland Security Exercise & Evaluation Program

Guidance for Emergency Preparedness Planning comes from many sources

Preparedness Partners San Mateo County EMS Agency San Francisco International Airport Hospitals and Healthcare Systems Ambulance Services Fire Departments and Districts Public Health Environmental Health Office of Emergency Services Clinics Regional Disaster Medical Health Coordinator California EMS Authority California Department of Health Services National Disaster Medical System Blank

Funding Sources General budget Grants HRSA Health Resources & Services Administration CDC Bioterrorism Preparedness in Public Health DHS Department of Homeland Security through County OES UASI Urban Area Security Initiative through County OES and SF OES

Daily Preparedness EMS, Public Health and Public Safety Communications monitor 911 responses for key medical conditions, providing an early alerting system for public health and bioterrorism emergencies.

Multi-Casualty Incidents

ICS / Medical Group

Ambulance Greater Alarm Plan Supervisors Cover-In/Notification   Initial Response ALS Ambulance Follow System Status Plan Level 1 MCI Air Ambulance * AMR Supervisor Notify BCE Poll Hospitals via HART Poll AMR’s BLS Division Consider Medical Mutual Aid Consider notification of CISM Team through the IC

Ambulance Greater Alarm Plan Supervisors Cover-In/Notification   Level 2 MCI ALS Ambulance BLS Ambulance Follow System Status Plan Notify EMS On-Call Administrator Notify AMR On-Call Manager Consider Medical Mutual Aid Poll Bayshore Ambulance Consider use of WOF Rescue 7,SOF R-61 and R-63 for transport purposes Level 3 MCI** Consider Use of AMR MCI Unit

Ambulance Greater Alarm Plan Supervisors Cover-In/Notification   Level 4 MCI BLS Ambulance Follow System Status Plan Consider Medical Mutual Aid Consider IDT Response Level 5 MCI Level 6 MCI Level 7 MCI Level 8 MCI

Triage START JumpSTART RPM Respirations, Pulse, Mental Status Children under 8 years old One attempt to revive before declaring

Triage

Triage Tags

Mutual Aid Six Mutual Aid Regions Three Administrative Regions Coastal: II Inland: III, IV, V Southern: I, VI

Coastal Region Mutual Aid Region II Del Norte Humbolt Mendocino Lake Napa Sonoma Solano Marin Contra Costa San Francisco Alameda San Mateo Santa Clara Santa Cruz San Benito Monterey

Mutual Aid Structure Standardized Emergency Management System State Operations Center Federal Assets Regional EOC Adjacent OA Operational Area EOC Adjacent OA Adjacent City Local EOC Adjacent City Partner Agencies Incident Partner Agencies

Medical/Health Mutual Aid Emergency Support Function 8 (HHS) Federal Region IX Medical Health Branch CDHS & EMSA Regional Disaster Medical Health Coordinator Regional Disaster Medical Health Specialist Medical Health Operational Area Coordinator

Other Resources

San Mateo County Public Health - Bioterrorism Website www.smhealth.org/bt

San Mateo County Sheriff’s Office of Emergency Services & Homeland Security www.co.sanmateo.ca.us/oes

California EMS Authority – Disaster Medical Services www.emsa.ca.gov/dms2/dms2.asp

California Governor’s Office of Emergency Services www.oes.ca.gov

http://dhs.ca.gov/epo/ California Department of Health Services Emergency Preparedness Office http://dhs.ca.gov/epo/

American Red Cross www.redcross.org

Federal Emergency Management Agency www.fema.gov

Questions www.smhealth.org/ems Thank you!