EMS Domestic Preparedness Improvement Strategy released by NASEMSO


Ebola crisis validated findings and illuminated importance of EMS as an equal and vital component in healthcare system

WASHINGTON — The 2014 Ebola crisis illuminated many of the gaps identified in the Emergency Medical Services (EMS) Domestic Preparedness Improvement Strategy. In an effort to strengthen EMS systems preparedness and response activities, the National Association of State EMS Officials (NASEMSO), with support from the Department of Homeland Security and participation from various response stakeholders, has developed the EMS Domestic Preparedness Improvement Strategy

During the Ebola crisis many EMS systems did not have adequate capabilities to safely respond to a potential Ebola patient. EMS providers did not have adequate personal protective equipment (PPE), were unable to purchase PPE due to shortages, and some EMS providers were financially challenged to purchase adequate PPE. EMS organizations and personnel received conflicting advice from health authorities about PPE to use, PPE techniques, and proper procedures for decontaminating personnel, equipment, and ambulances. Finally concerns were widespread about the availability of EMS-specific training and personnel competency assessments related to PPE.

The 2014 Ebola crisis also validated the findings, and emphasized the urgency of implementing the strategies and goals identified in the Emergency Medical Services Domestic Preparedness Improvement Strategy. Among those findings:

  • EMS systems are critically important every day, and during all types of disasters. These disasters will have an emergency medical component that must be handled by the local EMS system.
  • The planning, education, funding, and other preparedness efforts by similar disciplines, such as public health, hospital-based healthcare, emergency management or other emergency services, are not substitutes for well-planned, adequately-funded, and prepared EMS systems. The lessons learned and best practices from these similar disciplines do not necessarily transfer to the EMS environment.
  • Better coordination with EMS systems is required for successful disaster responses. EMS must be an equal partner in all preparedness activities, as a matter of routine as well as during critical incidents. Related health, healthcare, emergency services and emergency management organizations cannot meaningfully contribute to the dialogue on behalf of EMS.
  • Numerous gaps in EMS education, training, funding, equipment, policies and procedures, and organizational practices remain.

Report documents solutions for EMS domestic preparedness

The purpose of this report is to document identified solutions to published EMS domestic preparedness gaps. The strategy presents a set of actionable and solutions-oriented recommendations for the EMS community at the appropriate Federal, state, local, tribal, or territorial levels and national associations.

These goals, strategies, tasks, and activities were structured to provide specific guidance and align responsibilities with EMS organizations at the Federal, state, local, tribal, or territorial levels and national associations. The EMS Preparedness Improvement Strategy focuses on the ten most significant gaps in EMS preparedness and response as collaboratively identified through a multi-organizational process.

The ten goals in this project are arranged in four general categories and although numbered one to ten that are not listed by priority

Development and Promulgation of an EMS Strategy

  • Goal One: To create an EMS Preparedness Agenda for the Future

Creation of EMS Preparedness and Response Guidelines

  • Goal Two: To establish comprehensive EMS System preparedness capabilities guidelines
  • Goal Three: To develop EMS personnel preparedness core competencies guidelines
  • Goal Four: To establish guidelines, which provide best practices for EMS responses to high risk situations
  • Goal Five: To create model guidelines and model legislation, including legal protections, to facilitate the development of EMS crisis standards of care
  • Goal Six: To evolve EMS systems, organizations, and personnel to provide optimal care to pediatric patients during medical disaster situations

EMS Preparedness and Response Data, Assessments and Analysis

  • Goal Seven: To develop sufficiently-detailed capability standards, metrics, and assessment methodologies to guide EMS system preparedness planning and assessments
  • Goal Eight: To create a national EMS disaster data collection and analytic capability, which can inform EMS preparedness and response initiatives

EMS Preparedness Organizational Relationships, Responsibilities, and Structures

  • Goal Nine: To improve working relationships and interaction between individual state’s emergency management agencies and emergency medical services’ offices
  • Goal Ten: To determine whether the current federal structure for EMS optimally promotes, leads, and funds EMS preparedness  and response in the regions, states, and locally

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