Appendix D: A Comprehensive Chronology of the Los Angeles County and State Emergency Medical Services Agency Responses to the South Central Los Angeles Civil Disturbance
|
Wednesday, April 29 5:00 PM - Saint Francis Medical Center begins to plan for anticipated injured coming to emergency department. Detailed supply and staffing needs. Places extra security and Emergency Department Clinical staff on shift. 5:57 PM - LA City Fire receives first call about a civil disturbance related injury. 6:20 PM - LA City Emergency Operations Center operational. Approx. 6:30 PM - Martin Luther King Hospital and Daniel Freeman Hospital begin to receive significant numbers of casualties. 7:30 - Daniel Freeman Hospital implements internal disaster plan. Time Unk. - Martin Luther King establishes EOC in hospital. 10:45 PM - Los Angeles Department of Health Services Emergency Operations staff notified by County EOC to establish EOC. Saint Francis Medical Center begins to see some ambulance traffic that normally would go to Martin Luther King Hospital or Daniel Freeman Hospital. Locally injured persons will not show up at Saint Francis Medical Center until morning. 10:30 PM - After viewing looting and other activities on TV, the EMS Authority Director alerts disaster staff and requests that an evaluation of the situation be developed. The Los Angeles County EMS Administrator, California Ambulance Association,, and OES Warning Center are contacted. Conclusion is reached that, while there is a great deal of looting, and people being injured including responders, that the Los Angeles emergency medical services system is able to absorb it. EMS Authority Director decides to keep disaster staff person on alert and to activate the Emergency Medical Services Operations Center (EMSOC) the following morning. 11:00 PM - Some of Daniel Freeman Hospital's staff have been working 24 hours. 1:00 AM - Los Angeles Department of Health Services Emergency Operations Center (LA DHS EOC) is established and conducts first hospital bed call down, and for casualties. Gathered same information every six hours and then every 12 hours later in the event.
7:30 AM - EMSOC is opened by disaster staff. LA DHS EOC is called for an update on casualties, hospital beds, and other EMS system data. Six hospitals reported on Disaster Alert. Many walk-ins to hospitals. Casualty data collected. 7:45 AM - EMSOC calls OES State Operations Center (SOC) to share casualty and other data. A state response situation update is requested from Office of Emergency Services (OES). 8:00 AM - Saint Francis Medical Center finds that its food and most supply vendors will not make deliveries. 9:00 AM - Disaster staff person to SOC. 9:30 AM - LA DHS EOC places paramedics in disaster area on communications failure protocols. All catchment and service areas for trauma centers and paramedic receiving hospital are lifted. Hospitals are not permitted to divert paramedic traffic. Rescue units instructed to contact the USC Medical Alert Center for patient destination. Five LA DHS Basic Life Support (BLS) ambulances are assigned to LA City Fire Department at their request. 10:00 AM - EMSOC obtains update from LA DHS EOC: six hospitals continue on Disaster Alert status; Martin Luther King Hospital is running out of blood but LA Red Cross supplies are adequate; many walk-ins and ambulances arriving at hospitals that are damaged. Reports that at the present time there is no need for additional staff, supplies, or equipment. 10:30 AM - State Department of Health Services is briefed. 11:00 AM - EMSA action plan is prepared for next 24 hours: track status of EMS system and casualties; track status of blood banks; determine need for mutual aid and if patient staging areas have to be established; determine EMSOC staffing needs; and place Orange County and San Bernardino County EMS Agencies on alert. Health and Welfare Agency is briefed. Goodhew Ambulance is unable to obtain police protection for dispatch center and closes it. Dispatch function is moved to Torrance. 12:00 PM - Saint Francis Medical Center experiences a substantial increase in casualties. 12:30 PM - EMSA faxes a copy of status report to State Department of Health Services, Health and Welfare Agency, and SOC. Time Unk. - Saint Francis establishes an escort service with assistance of individual law enforcement officers and identifies safe routes to hospital. 12:40 PM - Kaiser West Los Angeles contacts EMSOC. Some employees not reporting, in due to child care, transportation, fear of being injured on way in. 1:30 PM - LA DHS EOC reports sudden increase in number of casualties, that Martin Luther King Hospital and Daniel Freeman Hospital are most affected. No additional supplies or personnel are required. LA DHS EOC has establishes an escort service for county hospital personnel at Carson City Hall. Martin Luther King Hospital on ambulance diversion. Long Beach Fire Department begins to receive numerous EMS calls. Civil disturbances increase in number. 2:30 PM - California Blood Bank System put on alert. Indicate that they are in contact with LA Red Cross and that there is sufficient blood available locally. San Bernardino contacts EMSOC to make arrangements for personnel, supplies, ambulances, etc., if needed. 3:00 PM - Los An-eles civil disturbance reported to be "out of control. " Events beginning to take place in San Francisco, San Jose and other locations. New EMSOC action plan developed including: recall all staff and set up staffing schedule for duration of event; place RDMHCs and major counties on alert and requested them to contact ambulance coordinators and major hospitals; establish a medical branch at OES Los Alamitos Staging area; and identification to OES of hospitals and blood banks as critical facilities that need to be protected. Martin Luther King Hospital's transportation protection system for staff is operational. Security staff are identifying safe routes to and from hospital. Saint Francis Medical Center administrators go out of the community area and purchase 500 loaves of bread and other food stuffs. 3:30 PM - EMSOC receives request from State Board of Pharmacy to assist a licensed drug wholesaler to move supplies into area. General Medical requests escort for trucks into area. EMSOC be-ins working on issue of law enforcement security for transporting medical supplies and drugs to hospitals and coordinates with SOC and LA DHS EOC. Telephone communications problems experienced with contacting LA DHS EOC. Request California Amateur Radio Service (CARES) to establish radio contact with LA DHS EOC. 5:00 PM - Martin Luther King Hospital Closed to paramedic deliveries but able to take some critical patients. Saint Francis Medical Center experiencing electrical brown-outs during the day. San Bernardino EMS Agency reports looting and one hospital on diversion. Mutual aid being established for LA County if needed. 5:30 PM - EMSOC contacts Sacramento County EMS Agency and determines that hospitals are on alert. 5:50 PM - EMSA requests OES Region 11 Regional Disaster Medical Health Coordinator to place county EMS Agencies on alert. 6:00 PM - Saint Francis Medical Center establishes food and information area for paramedic, EMT, and law enforcement personnel. 6:15 PM - Orange County EMS Agency is contacted by EMSOC with a request to staff OES Los Alamitos Medical Branch. 6:30 PM - Orange County EMS Agency and San Louis Obispo EMS Agency agree to staff Los Alamitos Medical Branch. Orange County EMS Agency is ready to coordinate patient evacuations into county from LA hospitals. 6:45 PM - CARES establishes a link with LA DHS EOC via Kaiser hospital radio net. Establishes that they feel that they don't need additional help with communications. 20 DB Search and Rescue, Orange County, calls Daniel Freeman Hospital and offers personnel. 6:50 PM - Daniel Freeman Hospital determines that they need additional personnel. Contact 20 DB directly. 20 DB notifies EMSA that Daniel Freeman Hospital needs personnel and that they are ready to respond. EMSOC expresses concern that proper procedure is not being followed. Raises problem with LA DHS EOC. 7:00 PM - EMSOC prepares action plan for evening: staff scheduling, alert Bay area counties, and establish Medical Branch at Los Alamitos. Orange County EMS staff contact OES at Los Alamitos to make arrangement for activating Med.ical Branch. San Luis Obispo EMS Agency staff on way to Los Alamitos. Fresno County EMS Agency staff will serve as backup only if necessary. 7:40 PM - San Bernardino County, Region VI RDMHC, identifies available mutual aid medical resources. 7:45 PM - EMSOC asks LA DHS EOC if they anticipate assistance from EMSOC to obtain medical supplies, establish a dedicated radio link, make arrangements for power or water for hospitals, or to establish staging areas to transport supplies and personnel into area. Time Unk. - Martin Luther Kino, Hospital begins to run short of blood because Red Cross Unknown refused to deliver it without security. Request assistance from LA DHS EOC. LA DHS EOC transports blood to Martin Luther King hospital using a county ambulance. 8:00 PM - Daniel Freeman Hospital Confirms that they will need staff with EMSA. 20 DB calls Los Alamitos before request is approved by LAEMSA and is told that a helicopter can deliver staff if official approval is obtained. Confusion results at Los Alamitos about whether they have been officially authorized to meet 20 DB request. EMSA coordinates Daniel Freeman Hospital/County contacts so that official permission is obtained. 8:30 PM - Red Cross shelter notifies LA DHS EOC that some victims in the shelter need their prescription medications. Arrangements are made through the LA County USC Medical Center Pharmacy to provide them. 8:35 PM - Daniel Freeman Hospital calls EMSOC reports that hospital emergency departments are very busy but not overrun. Some hospital staff have been working 24 hours. EMSOC tells them to contact LA DHS EOC to arrange for transport, etc., of 20 DB. 9:00 PM - EMSOC contacts California National Guard, 175th Medical Brigade and verifies that they are on alert. They will provide medical care to Guard personnel. 9:15 PM - LA DHS EOC makes request to OES at Los Alamitos to transport medical personnel to Daniel Freeman Hospital. Problems experienced with finding someone to administer Loyalty Oath which is required to register as a Los Angeles County volunteer disaster worker (they are Orange County residents) . Also a problem with finding a driver with a class B license to transport volunteers from Los Alamitos to Daniel Freeman. 9:40 PM - EMSOC contacts San Francisco EMS Agency and determines that bed status is adequate. 10:00 PM - EMSOC contacts San Bernardino EMS Agency and determines that there are no reported injuries or EMS system problems. 10:30 PM - Medical Branch established at OES Los Alamitos by Orange County EMS Agency representative. Meanwhile 20 DBs are stopped at gate to Los Alamitos. No one is aware of their needs. 11:30 PM - OES at Los Alamitos Medical Branch receives a call from LA DHS EOC requesting nursing staff assistance of any kind for Daniel Freeman Hospital. 11-2:00 AM - EMS.OC status update provided to OES, Health and Welfare Agency, and Department of Health Services. Numerous telephone contacts are made between EMSOC, LA DHS EOC, and OES Los Alamitos Medical Branch to coordinate efforts to obtain LA County Disaster Service Worker status and send medical volunteers from Orange County to Daniel Freeman Hospital.
1:30 AM - California National Guard platoon arrives at Saint Francis Hospital. 2:00 AM - OES Los Alamitos Medical Branch and LA DHS EOC finalize details for transporting and registering members of the Orange County Search and Rescue. OES Los Alamitos Medical Branch issues a call, through Orange County Communications H.E.A.R., for volunteer nursing staff. 2:30 AM - EMSOC shut down. SOC representative retires at 2:30 AM. Emergency beeper numbers provided to OES, LA DHS EOC, and OES Medical Branch at Los Alamitos. 3:00 AM - LA County Sheriff's bus arrives and transports 3 registered nurses and 6 emergency medical technicians to Daniel Freeman Hospital. 3:30 AM - San Luis Obispo EMS Agency Administrator relieves Orange County EMS Agency representative at Los Alamitos. 6:30 AM - EMSOC opened, staff sent to SOC and to LA DHS EOC. Update requested from LA DHS EOC, and from EMS Agencies in San Francisco and San Bernardino. 7:30 AM - Southern California Earthquake Program staff member relieves San Luis Obispo EMS Agency Staff member at OES Los Alamitos Disaster Branch. 8:30 AM - EMSOC Action plan developed for the day. LA situation seems to be improving 9:00 AM - EMSOC request from SOC to assist with developing a means for distributing drugs to people in the community. Request forwarded to EMSA representative at LA DHS EOC. Decision is made by LA DHS EOC to refer problem to LA Public Health Programs. 10:00 AM - Contact maintained with LA DHS EOC, updates made, and new situation reports prepared. OES Regions 11 and VI have resumed normal emergency medical operations. They will remain on alert for mutual aid over the weekend. 11:00 AM - Orange County Hospital Council representative makes a request to Orange County EMS Agency for nursing personnel on behalf of Daniel Freeman Hospital. Request passed along to OES Los Alamitos Medical Branch. 11:30 AM - OES Los Alamitos Medical Branch receive request to obtain nursing staff for a 7:00 PM to 7:00 AM shift at Daniel Freeman Hospital. Consistent with earlier request. 12:00 PM - OES Los Alamitos Medical Branch requests Orange County EMS Agency to send out a message via H.E.A.R. to recruit volunteer nursing, staff. 1:00 PM - Second group of medical personnel, consisting of 2 EMT-Paramedics and 8 EMTS, leave Los Alamitos for Daniel Freeman Hospital. Time Unk. - Saint Francis Medical Center establishes limited low cost feeding program for community elderly and others. 5:00 PM - Civil Disturbance seems to have reduced intensity to the level to where it is certain that LA EMS system can handle the problem. EMSOC shut down. SOC representative retires at 10 PM. Emergency beeper numbers provided to OES, LA DHS EOC, and OES Los Alamitos. 6:00 PM - Two registered nurses, one LVN, one Physician Assistant, two Medical Assistants, and ten EMTs depart Los Alamitos for Daniel Freeman Hospital. Time Unk. - Military has ambulances in LA. The 7th Infantry Division, US Army is ready to set up a casualty collection point if needed. 11:00-12PM - Orange County EMS Agency and OES Los Alamitos Medical Branch determine that no additional staffing or mutual aid is necessary.
8:00 AM - Staff member sent to SOC. EMSOC staff placed on alert but EMSOC not opened. 8:00 AM - LA DHS EOC reestablishes requirement for base hospital contacts. 3:00 PM - EMSOC receives request from Assembly Speaker Brown's office to set up a California National Guard field hospital. Request forwarded to LA DHS EOC. 5:00 PM - LA DHS EOC shuts down and transfers function to USC County Hospital Medical Alert Center. EMS contact remains at LA Sheriff's EOC. The Medical Branch at Los Alamitos will be shut down at 8:00. An EMS staff person will be available via beeper. All catchment and service areas for trauma centers and paramedic receiving, hospitals are reestablished. 7:00 PM - EMSA representative at SOC receives a request for contact persons for Critical Incident Stress Debriefing Teams from Los Alamitos Medical Branch. Names of contact persons in various counties provided. 11:45 PM - EMSA staff person on alert status provides OES with preliminary evaluation of State EMS response at their request.
7:00 AM - EMSA staff available via beeper to SOC. LA DHS EOC is open from 7:00 AM to 7:00 PM. 5:00 PM - LA DHS EOC deactivated and County EOC EMS representative not longer required. LA DHS EMS Agency staff remain on call.
11:00 PM - Counties contacted for possible response are taken off of alert. |
Return to the Table of Contents
Medical Care for the Injured