Medical Care for the Injured:

The Emergency Medical Response
to the April 1992
L.A. Civil Disturbance

Table of Contents

Executive Summary Acknowledgements Introduction The Los Angeles County Emergency Medical Services System Definition of an Emergency Medical Services System The Los Angeles Emergency Medical Services Agency Emergency Medical Field Personnel and Transportation Hospital Emergency Departments and Trauma Centers Communications and Dispatching Patient Transportation Disaster Response Emergency Medical Care for the Poor Ethnicity and Income of South Central Los Angeles Emergency Medical Field Personnel and Patient Transportation Hospital Emergency Care The Injured and Their Injuries Injuries and Deaths Injuries Reported by Hospitals Injuries Cared for in the Field EMS, Law Enforcement, and Fire Service Injuries Community Health Problems Related to the Disturbance Civil Disturbance Related Deaths Day and Time of Occurrence of Injuries and Deaths Demographics of the Injured Contributing Factors Leading to Injuries and Death How People Were Injured The 1965 Watts Riots and Mechanisms of Injury Gun Shot Wounds and Assaults Gang Activities Looting and Arson Law Enforcement Caused Injuries and Deaths Media Coverage Factors Affecting Availability of Primary and other Community Care Other Injury Related Contributing Factors The Effect on Injuries of Curfews and Time of Dispatch of Law Enforcement Personnel Law Enforcement Tactics and Occurrence of Injuries The Public Emergency Call Telephone System The Emergency Call System Routing of Emergency Calls Damage to Switching Systems and Telephone Service Civil Disturbance Related Emergency Calls Emergency Call Volume EMS Call Volume Compared to Fire Service Call Volume The Emergency Medical Services Field Response Resources and Responding Agencies EMS Field Resources Fire Department Response Private Ambulance Companies Response Dispatches, Field Care, and Transport of the Injured Profile of EMS Dispatches and Transports Transport of the Injured by non-EMS Personnel Provision of Emergency Medical Care in the Field Field Support of EMTs Dispatch Location and EMS Coordination Coordination with Law Enforcement, and Other Fire Service Agencies Care and Feeding of Emergency Medical Technicians EMS Equipment Damage EMS Field Communications Medical Equipment Resupply Post Critical Incident Stress Debriefings Comparison of EMS Response with that Made During the 1965 Watts Riots and General Discussion Hospital and Emergency Department Response The Hospital Response Sources of Information Distribution of Casualties Among Hospitals Hospital Resources and Patient Load Hospital Alerting and Internal Disaster Management Hospital Communications Pattern of Hospital Assistance Needs Medical Care Staffing Medical and Other Supplies Electrical Power Medical Diagnostic Equipment, Data Centers, and Laboratory Services Security Damage to Facilities Media Relations Coordination with County LAEMSA Emergency Operations Center Casualty Arrival and Care in the Emergency Department Profile of Emergency Department Casualties and Their Injuries Medical Care Provided to Casualties Prior to Arrival Provision of Care in the Emergency Department Patient Discharge from the Emergency Department Post Disaster Patient Load in the Emergency Department Cost of Providing Care The 1965 Watts Riots and Hospital Care Los Angeles County Emergency Medical Services Agency's Response Overview of LA EMSA Response Management of the LA EMSA EOC Coordination with the County EOC Mutual Aid Discussion of Planning and Management of the Los Angeles EMS Disaster Response Emergency Medical Services Authority Response The Emergency Medical Services Authority Disaster Response Responsibilities EMS Authority Response Overview of Authority Activities Management of the EMS Authority's Emergency Operations Center Emergency Medical Services Operations Center Working Environment Coordination with the LA EMSA Coordination with the State Operations Center and the OES Los Alamitos Regional Center EMSA Response Issues Governor's Recognition of EMS Responders and Organizations Findings and Recommendations The Injured and Their Injuries The Public Emergency Call System The Emergency Medical Services Field Response Hospital and Emergency Department Response Los Angeles County Emergency Medical Services Agency's Response Emergency Medical Services Authority Response and Operations Sources Cited Appendix A: Methods Used to Collect Data Appendix B: Causes of Death Appendix C: A Proposed Method for Tracking the Geographical Direction of a Civil Disturbance 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 Appendix E: EMS Responders and Organizations Recognized for Taking Heroic Action to Save or Care for the Injured, and EMS Authority Director's Speech Graphs Maps Tables