Management of the EMS Authority's Emergency Operations Center

Upon learning that a major disaster has occurred, the EMS Authority follows an established set of procedures to determine the status of the EMS system, the number of casualties, and the need for medical supplies and personnel (EMSA, 1992a, 1992b, 1992c). Instructions are also included for starting a graded response depending on the size of the event. In this case, as noted, it was felt that the Emergency Medical State Operations Center (EMSOC) should be opened and staffed. A modified version of the Incident Command System is used to manage the EMSOC. The Incident Commander, Chief of Staff, Chief of Operations, Chief of Planning, and Public Information Officer sections were staffed from both the Disaster Division, and the EMS Division of the Agency. At the time, the Agency had 30 staff members. Seven analysts (including one sent to the OES State Operations Center) and two clerical staff were necessary to staff each shift. The shifts were divided into eight hour segments. After reviewing the pattern of violence and determining that it tended to drop off by 11:00 PM, and that the EMS system was responding adequately with no anticipated problems, the EMSOC was shut down each evening. This conserved staff and kept them fresh for a major response if needed. However, even with these arrangements, staff could have become exhausted if the event had continued for more than three days. The EMSOC does not manage the local medical response to an event; it supports the local response. Two activities are key to this role. First, an accurate, rapid assessment of the situation must be made within the first few hours to determine if a major supply and health care personnel recruitment effort are necessary. This is accomplished by reaching the County EMS Agency in the affected area, observing media reports, obtaining OES assessments, monitoring amateur radio broadcasts, telephone contacts with responders in the area, and other means. Second, a link must be established with the local medical EOC to keep abreast of events, and to consult on response strategy and anticipated developments. This information is gathered together to create a situation report and response plan at least three times during a twenty-four hour period. Such plans were developed for Thursday and Friday. Several problem areas were identified with the State EMSA EOC. If was difficult to turn off the automated telephone answering system so that calls could be immediately answered and handled by staff. Individual notes were kept by each ICS position but no overall log was kept. Staff members from other divisions within the department found it difficult to understand newly assigned roles and to interpret how they applied to the current situation.

Medical Care for the Injured

Continue to Emergency Medical Services Operations Center Working Environment

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