Altered Standards of Care

 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.

Welcome to the S-SV EMS Agency Altered Standard of

Care Training Module

PurposeThe 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.

DisclaimerThis 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.

Objectives

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.

SCENARIO

What can we do?

Something has to change!

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

assumptionsdefinitions.

ASSUMPTIONS

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.

Altered Standard of Care

Definitions

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.

Medical HealthOperational Area Coordinator

(MHOAC)

Definitions

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.

Medical HealthOperational Area Coordinator

(MHOAC)

Definitions

The Operational Area Emergency Operations Center or OA EOC is the designated emergency services among all the major disciplines (law, fire, health/medical, public works, etc.) and local jurisdictions (cities, county, districts, etc.) within an Operational Area or county.

OA EOC

Definitions

location forcoordinating and supporting

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.

QRV

Definitions

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.

The Role of the EOC

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.

The Role of the EOC

During this event who will be in charge of making sure that there is a multi-agency collaboration with all response agencies?

A. EMS Coordinator.B. The EOC.C. Inc ident Commander.

Knowledge Review

If you answered, B. The EOC, you are

Although tactical decisions during an isolated incident are made by the Incident Commander, the EOC will make tactical decisions during such a large scale incident due to there not being a particular incident location.

CORRECT

Knowledge Review

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

Knowledge Review

A. On-scene command.B. In teragency coordinat ion.C. Legal responsib i l i ty.

If you answered, B. Interagency Coordination, you are

The EOC provides a central location from which government at any level can provide interagency coordination.

Knowledge Review

CORRECT

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.

So Far…

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.

EOCs

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).

EOCs and NIMS

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.

NIMS Components

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.

EOC Functions

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.

EOC Functions

NIMS is a nationwide, systematic approach to:

A. Fire emergencies.B. Catastrophic disasters.C. Domestic incidents of any type.D. Providing international assistance.

Knowledge Review

If you answered, C. Domestic Incidents of Any Type, you are

NIMS is a nationwide, systematic approach to domestic incidents of any type.

CORRECT

Knowledge Review

______________ defines the operating characteristics, interactive management components, and structure of incident management and emergency response organizations.

A. NIMSB. ICSC. MACS

Knowledge Review

If you answered, B. ICS, you are

ICS defines the operating characteristics, interactive management components, and structure of incident management and emergency response organizations.

CORRECT

Knowledge Review

One of the key functions of an EOC within the larger MACS is to:

A. Direct resources at the incident sceneB. Appoint and monitor the Incident

CommanderC. Establish interoperable communications

as necessary for the response.

Knowledge Review

If you answered, C. Interoperable communications as necessary for the response, you are

One of the key functions of an EOC within the larger MACS is to establish interoperable communications as necessary for the response.

CORRECT

Knowledge Review

Communicating with the Media

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).

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.

Communicating with the Media

Using Public Information as Input to Leaders

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.

Benefits of a Well-Developed Joint Information System

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. 

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

The JIS

The Public Information Officer

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.

NIMS requires that public information be organized around a(n):

A. Joint Information System.B. Senior Elected Official.C. Incident Commander

Knowledge Review

If you answered, A. Joint Information Center, you are

NIMS requires that public information be organized around a Joint Information System.

Knowledge Review

CORRECT