Changes to EMD Guidecards 2009 Flu Considerations New

Changes to EMD Guidecards 2009 Flu Considerations New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ The State of New Jersey, Emergency Medical Dispatch Guidecards have been modified by the Department of Health and Senior Services to address the up-coming flu season and the potential impact of the H 1 N 1 virus. New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ Modifications have been made to the “SICK PERSON” card. ¥ The modified card lists the common signs and symptoms and questions that should be asked when appropriate. New Jersey Office of Emergency Telecommunications Services

Flu Considerations SICK PERSON K E Y Q U E S T I O N S State of New Jersey EMD Guidecards Version 7/09 Is patient alert? Is patient breathing normally? Can I talk to the patient? Yes: What is the problem? Are you short of breath or is it hard to breath? Are you feeling pain anywhere? If so where? (Consider appropriate card. Back, chest, abdomen) Do you feel light headed or dizzy? No: Does the patient answer your questions? What is the patient complaining of? Is the patient complaining of pain? Where? How does the patient feel when he/she sits up? Does the patient respond to you and follow simple commands? Have you checked for a medic alert tag? If there is an alert tag, what does it say? Is there insulin in the refrigerator? Was the onset sudden or gradual? Is the patient complaining of: FLU SYMPTOMS Fever (usually high) Headache Tiredness (can be extreme) Cough, Sore throat Runny or stuffy nose Body aches Diarrhea and vomiting (more common among Is the patient acting normally for him or her? If not, what is different? How does the patient look? children than adults) SIMULTANEOUS ALS/BLS D I S P A T C H Decreased level of consciousness. Multiple fainting episodes BLS DISPATCH Generalized weakness. Medic alert from alarm company. Flu symptoms. (Without critical signs, symptoms or other medical options) High blood pressure without critical symptoms. High temperature. Patient assist. New Jersey Office of Emergency Telecommunications Services

Flu Considerations New Jersey Office of Emergency Telecommunications Services

Flu Signs and Symptoms Fever (usually high) ¥ Headache ¥ Extreme tiredness ¥ Dry cough ¥ Sore throat ¥ Runny or stuffy nose ¥ Muscle aches ¥ Stomach symptoms, such as nausea, vomiting and diarrhea, also can occur but are more common in children than adults. ¥ New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ It is possible that a new strain of the flu or other disease may present with additional or different signs and symptoms. ¥ If this happens DHSS will provide appropriate modifications. ¥ A new guidecard for that specific condition may have to be created. New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ The intention, at the PSAP level, is to identify the possibility of the flu and treat the patient and the responders accordingly. New Jersey Office of Emergency Telecommunications Services

Flu Considerations Indications of the flu without other conditions Serious medical condition with indications of the flu Life-threatening conditions with indications of the flu Medical emergency without indications of the flu New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ Initially the only impact this may have is informing the responders and hospital of the indication of flu and to take appropriate precautions. New Jersey Office of Emergency Telecommunications Services

Flu Considerations ¥ If the number of flu cases increases dramatically, it may require a change in the types of resources we dispatch and where the patient is taken for treatment. ¥ Plans are being made to address this and will be implemented by NJDHSS when appropriate. ¥ NJOETS will distribute guidecard changes. New Jersey Office of Emergency Telecommunications Services

New Jersey Office of Emergency Telecommunications Services

Figure 1: Sample Call Flow for Standard EMD Calls versus Pandemic Flu Calls This chart is for illustrative purposes only, to be modified to locally adopted protocols as need. Standard EMD Call Flow Pandemic Flu Call Flow (using local Pan Flu protocols) 25 (1) At different points in the Pandemic Flu Call Flow process, an EMD call taker may transfer a call to an alternative call center (e. g, poison control centers, nurse advice lines, health care call centers) based on pre-determined Pan Flu EMS Dispatch Protocols. PSAPs should also plan to accept incoming calls from alternative call centers. A community’s mitigation strategy may include call takers instructing callers on social distancing, home care or other care options. New Jersey Office of Emergency Telecommunications Services

Possible Modifications ¥ “Pan ¥ For a specific outbreak ¥ “Pan ¥ Flu Post-Dispatch Instructions” For a specific outbreak ¥ “Pan ¥ Flu EMS Dispatch Protocols” Dispatch or refer ¥ “Pan ¥ Flu Specific Protocol Questions” Flu EMS Operating Protocols” Where patient will be transported to New Jersey Office of Emergency Telecommunications Services

New Jersey Office of Emergency Telecommunications Services

Telecommunicator Requirements ¥ Continuity of Operations ¥ Consider the needs of the PSAP beyond the normal planning that exists in the Continuity of Operations Plan. Considerations should include: Identify staffing alternatives (retirees, former employees, staff from other departments to free up trained staff and supervisors to answer critical 9 -1 -1 calls) ¥ ¥ ¥ ¥ Identify infection control procedures specifically for the pandemic influenza virus Identify isolation and quarantine policies and procedures To limit the exposure of 9 -1 -1 staff, identify isolation and lock-down procedures. Identify onsite treatment areas for those who have become infected. Identify policies related to paid and unpaid leave and care of the families of PSAP staff. State and local 9 -1 -1 pandemic influenza plans should define system-wide processes for vaccinating 9 -1 -1 personnel, as an element of the critical infrastructure. State 9 -1 -1 pandemic influenza plans should, in coordination with public health, law enforcement and emergency management agencies, identify mechanisms for freedom of movement of PSAP personnel when faced with restricted travel laws, isolation/quarantine or security measures. New Jersey Office of Emergency Telecommunications Services

9 -1 -1 Emergency Telecommunication System N. J. A. C. 17: 24 ¥ d) Persons who are not certified as provided in (c) above may be utilized to substitute for a certified call-taker or dispatcher under the following circumstances: 1. A certified call-taker or dispatcher is scheduled for duty but unavailable due to illness or an emergency. Substitute call-takers or dispatchers are not to be used for coverage for meal breaks or other routine scheduled breaks, and ¥ ¥ ¥ 2. The person is one who meets the following requirements: i. Has successfully completed the U. S. Department of Transportation’s "First Responders: Emergency Medical Care Training Course, " or "Crash Injury Management for Traffic Law Enforcement Officers" or "EMT Course"; ii. Has a current ARC, NSC, or AHA CPR certification; iii. Has successfully completed an eight-hour introductory course on the New Jersey 9 -1 -1 emergency enhanced telecommunications system which has been prepared by the local PSAP and approved by OETS; and iv. Has successfully completed annual in-service training during each year of service following completion of the introductory course on the New Jersey 9 -1 -1 emergency enhanced telecommunications system, consisting of an eight-hour program developed by the local PSAP and approved by OETS to address technical developments and improve the provision of 9 -1 -1 services. New Jersey Office of Emergency Telecommunications Services

Staffing Options Administrative staff (trained) Recent retirees or former telecommunicators Reconfigure operations with other PSAPs (TEMPORARILY) Telelcommunicator Emergency Response Taskforce (TERT) New Jersey Office of Emergency Telecommunications Services

Staffing Options ¥ Training requirements for administrative staff used to assist during pandemic. Basic Telecommunicator course ¥ EMD if applicable ¥ Annual continuing education ¥ Scheduled performance evaluations ¥ New Jersey Office of Emergency Telecommunications Services

PSAP Reconfiguration ¥ “Pool” uninfected personnel. ¥ Single location for all services ¥ Specialized separate locations, police dispatch, fire dispatch, medical dispatch, calltaking. Linked by radio, phone or computer. ¥ May have to be refined as conditions change. New Jersey Office of Emergency Telecommunications Services

` ¥ Service level/type of PSAP (Fire, EMS, PD, combined or separate) ¥ Levels of personell certifications ¥ Type of equipment used by center (CAD, Phone, Radio, etc. ) ¥ Maximum number of communicators who may be able to respond at one time (estimate only) ¥ Availability of specialized � mobile� resources that could be deployed New Jersey Office of Emergency Telecommunications Services

Additional Information New Jersey Office of Emergency Telecommunications Services

Prepared by State of New Jersey Office of Information Technology Office of Emergency Telecomunication Services P. O. Box 212 Trenton, New Jersey 08625 -0212 609 -777 -3950 609 -777 -3972 (fax) www. nj. gov/911 New Jersey Office of Emergency Telecommunications Services