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The Role of EMS Systems in Public Health Emergencies

Published online by Cambridge University Press:  28 June 2012

Barbara A. McIntosh ,
Patricia Hinds  and
Lorraine M. Giordano
Barbara A. McIntosh*
Affiliation:
Director Prehospital Services, Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York, USA State University of New York, Health Sciences Center at Brooklyn, Brooklyn, New York, USA
Patricia Hinds
Affiliation:
Clinical Affairs/Infection Control, New York City Health and Hospitals Corporation, New York City, New York, USA
Lorraine M. Giordano
Affiliation:
State University of New York, Health Sciences Center at Brooklyn, Brooklyn, New York, USA Medical Director, New York City Emergency Medical Service New York City, New York, USA
*
Department of Emergency Medicine, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, New York 11219USA Telephone (718) 283-6027 Facsimile (718) 283-6040
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Abstract

Introduction:

Until now, the public health response to the threat of an epidemic has involved coordination of efforts between federal agencies, local health departments, and individual hospitals, with no defined role for prehospital emergency medical services (EMS) providers.

Methods:

Representatives from the local health department, hospital consortium, and prehospital EMS providers developed an interim plan for dealing with an epidemic alert. The plan allowed for the prehospital use of appropriate isolation procedures, prophylaxis of personnel, and predesignation of receiving hospitals for patients suspected of having infection. Additionally, a dual notification system utilizing an EMS physician and a representative from the Office of Infectious Diseases from the hospital group was implemented to ensure that all potential cases were captured. Initially, the plan was employed only for those cases arising from the Centers for Disease Control and Prevention (CDCJ/Public Health Service (PHS) quarantine unit at the airport, but its use later was expanded to include all potential cases within the 9–1–1 system.

Results:

In the two test situations in which it was employed, the plan incorporating the prehospital EMS sector worked well and extended the “surveillance net” further into the community. During the Pneumonic Plague alert, EMS responded to the quarantine facilities at the airport five times and transported two patients to isolation facilities. Two additional patients were identified and transported to isolation facilities from calls within the 9–1–1 system. In all four isolated cases, Pneumonic Plague was ruled out. During the Ebola alert, no potential cases were identified.

Conclusion:

The incorporation of the prehospital sector into an already existing framework for public health emergencies (i.e., epidemics), enhances the reach of the public safety surveillance net and ensure that proper isolation is continued from identification of a possible case to arrival at a definitive treatment facility.

Keywords

airport surveillance netEbola virusemergency medical servicesepidemicisolationplanningpneumonic plagueprehospitalprophylaxispublic healthquarantine
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 1 , March 1997 , pp. 30 - 35
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

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