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August 28, 2014

This document outlines current facts and IAED recommendations regarding the recent Ebola Virus Disease outbreak in West Africa for AMPDS users

Background on the current Ebola Virus outbreak

The Center for Disease Control (CDC) is currently working with the World Health Organization (WHO), the ministries of health of Guinea, Liberia, and Sierra Leone, and other international organizations in response to an outbreak of Ebola virus disease (EVD) in West Africa. No EVD cases have been documented outside of West Africa to date.

As of August 28, 2014, according to WHO, the total of suspected and confirmed cases were 3,069 and 1,552 deaths (case fatality 55–60%) had been reported across the four affected countries.

This is the largest outbreak of EVD ever documented and the first recorded in West Africa. Although the disease is rare, it can spread from person to person, especially among health care staff and other people who have close contact with an infected person. EVD is spread through direct contact with blood or body fluids such as, but not limited to, the sweat, semen, breast milk, saliva, feces or urine of an infected person or animal, or through contact with objects that have been contaminated by these body fluids (e.g., syringes) of an infected person.

Symptoms

The incubation period for EVD (from exposure to when signs or symptoms appear), ranges from 2 to 21 days (most commonly 8–10 days).

  • Early symptoms include sudden fever, chills, and muscle aches.
  • Around the fifth day, a skin rash can occur. Nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea may follow.
  • Symptoms become increasingly severe and may include jaundice (yellow skin), severe weight loss, mental confusion, bleeding inside and outside the body, shock, multi-organ failure and death. The fatality rate can vary from 40 to 90%.

A fever in a person who has traveled to or lived in an area where EVD is present is likely to be caused by a more common infectious disease. However, it is strongly recommended that such a person should be evaluated by a health care provider to rule out an EVD infection.

Prevention

The prevention of EVD infection includes measures to avoid contact with blood and body fluids of infected individuals.

IMPORTANT: Alert the crew of any vehicle dispatched to a patient who is symptomatic of EVD to ensure that necessary infection control precautions and policies are followed.

All receiving health care facilities should be notified, in advance, when a suspected case of EVD is to be transported to the facility.

It should be noted that patients can transmit the virus while febrile and through later stages of disease, as well as postmortem, when persons touch the body during funeral preparations.

Healthcare providers should be alert for and evaluate suspected patients for EVD infection who have both consistent symptoms and risk factors as follows: Clinical criteria, which includes fever and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage;

AND

Epidemiologic risk factors within the past 3 weeks (21 days) before the onset of symptoms like contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active (West Africa); or direct handling of bats, rodents, or primates from disease-endemic areas.

The CDC recommends testing for all persons with onset of fever within 21 days of having a high-risk exposure. A high-risk exposure includes any of the following:

  • Percutaneous or mucous membrane exposure, or direct skin contact with body fluids of a person with a confirmed or suspected case of EVD without appropriate personal protective equipment (PPE),
  • Laboratory processing of body fluids of suspected or confirmed EVD cases without appropriate PPE or standard biosafety precautions, or
  • Participation in funeral rites or other direct exposure to human remains in the geographic area where the outbreak is occurring without appropriate PPE.

The Emerging Infectious Disease Surveillance Tool (SRI/MERS/Ebola)

On August 25th, 2014, the latest update of the MPDS infectious diseases surveillance tool, previously known as the Severe Respiratory Infection (SRI) tool was released for use in the ProQA software.

All ProQA users have access to the Emerging Infectious Disease Surveillance Tool (EID Tool)—developed and approved by the International Academies of Emergency Dispatch (IAED) Chemical, Biological, Radiological, & Nuclear (CBRN) Committee—which has had an update applied to version 12.1 and 12.2 of the MPDS Protocol. This tool covers recent travel and all likely symptoms of Ebola (the last update was in May when the Middle East Respiratory Syndrome "camel flu" scare was active and travel was a concern for that illness). The EID tool can be accessed at any time, in any active ProQA case.

As with our past position, the EID Tool can be utilized by any agency that has approval from their Medical Director. Typically, we recommend the call be processed through Case Entry and Key Questions and a Final Code be generated as per standard practice. At that point, if the patient has symptoms consistent with EVD (as approved by local medical control), and the caller has mentioned epidemiologic/travel risk factors (as approved by local medical control), the EMD should select the EID Tool to complete the interrogation. For EVD, the Chief Complaints we recommend for use of the EID tool are those that represent typical flu-like symptoms and unexplained bleeding: Protocol 26 Sick Person, Protocol 6 Breathing Problems, Protocol 18 Headache, Protocol 10 Chest Pain, and Protocol 21 Hemorrhage (MEDICAL)

This additional interrogation may extend the total calltaking time for those patients presenting initially with related symptoms and risk factors, but will not impact the time it takes to post a call for dispatch, or notify responders, as long as the EID Tool is launched after Final Coding is complete. This additional questioning may identify potential EVD patients and allow for appropriate notification to responders and receiving hospitals etc., and for the modification of local response assignment and/or referral policies and procedures. The use of the EID Tool also enables the notification of governmental healthcare organizations on a local, national, and/or international level.

References:

  1. Center for Disease Control (CDC). "Ebola Hemorrhagic Fever." 2014; Aug 12. http://www.cdc.gov/vhf/ebola/ (accessed August 12, 2014).
  2.  European Centre for Disease Prevention and Control. "Epidemiological update: outbreak of Ebola virus disease in West Africa." 2014; Aug 8. http://www.ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-9133-18ff4cb1b568&ID=1042 (accessed August 12, 2014).
  3.  HSC Public Health Agency. "Ebola virus disease." Health Protection United Kingdom. 2014; Aug 8. http://www.publichealth.hscni.net/news/ebola-virus-disease (accessed August 12, 2014).
  4.  World Health Organization. "WHO Director-General, west African presidents to launch intensified Ebola outbreak response plan." 2014; July 31. http://www.who.int/mediacentre/news/releases/2014/ebola-outbreak-response-plan/en/ (accessed August 12, 2014).

Click to download PDF

August 9, 2014

This document outlines current facts and IAED recommendations regarding the recent Ebola Virus Disease outbreak in West Africa for AMPDS users

Background on the current Ebola Virus outbreak

The Center for Disease Control (CDC) is currently working with the World Health Organization (WHO), the ministries of health of Guinea, Liberia, and Sierra Leone, and other international organizations in response to an outbreak of Ebola virus disease (EVD) in West Africa. No EVD cases have been documented outside of West Africa to date.

As of August 12, 2014, according to WHO, a total of 1,848 cases and 1,013 deaths (case fatality 55–60%) had been reported across the four affected countries. This is the largest outbreak of EVD ever documented and the first recorded in West Africa.

Although the disease is rare, it can spread from person to person, especially among health care staff and other people who have close contact with an infected person. EVD is spread through direct contact with blood or body fluids such as, but not limited to, the sweat, semen, breast milk, saliva, feces or urine of an infected person or animal, or through contact with objects that have been contaminated by these body fluids (e.g., syringes) of an infected person.

Symptoms

The incubation period for EVD (from exposure to when signs or symptoms appear), ranges from 2 to 21 days (most commonly 8–10 days).

  • Early symptoms include sudden fever, chills, and muscle aches.
  • Around the fifth day, a skin rash can occur. Nausea, vomiting, chest pain, sore throat, abdominal pain, and diarrhea may follow.
  • Symptoms become increasingly severe and may include jaundice (yellow skin), severe weight loss, mental confusion, bleeding inside and outside the body, shock, multi-organ failure and death. The fatality rate can vary from 40 to 90%.

A fever in a person who has traveled to or lived in an area where EVD is present is likely to be caused by a more common infectious disease. However, it is strongly recommended that such a person should be evaluated by a health care provider to rule out an EVD infection.

Prevention

The prevention of EVD infection includes measures to avoid contact with blood and body fluids of infected individuals.

IMPORTANT: Alert the crew of any vehicle dispatched to a patient who is symptomatic of EVD to ensure that necessary infection control precautions and policies are followed.

All receiving health care facilities should be notified, in advance, when a suspected case of EVD is to be transported to the facility.

It should be noted that patients can transmit the virus while febrile and through later stages of disease, as well as postmortem, when persons touch the body during funeral preparations.

Healthcare providers should be alert for and evaluate suspected patients for EVD infection who have both consistent symptoms and risk factors as follows:

Clinical criteria, which includes fever and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage;

AND

Epidemiologic risk factors within the past 3 weeks (21 days) before the onset of symptoms like contact with blood or other body fluids of a patient known to have or suspected to have EVD; residence in—or travel to—an area where EVD transmission is active (West Africa); or direct handling of bats, rodents, or primates from disease-endemic areas.

The CDC recommends testing for all persons with onset of fever within 21 days of having a high-risk exposure. A high-risk exposure includes any of the following:

  • Percutaneous or mucous membrane exposure, or direct skin contact with body fluids of a person with a confirmed or suspected case of EVD without appropriate personal protective equipment (PPE),
  • Laboratory processing of body fluids of suspected or confirmed EVD cases without appropriate PPE or standard biosafety precautions, or
  • Participation in funeral rites or other direct exposure to human remains in the geographic area where the outbreak is occurring without appropriate PPE.

The Severe Respiratory Infection (SRI) Tool

All ProQA users have access to the Severe Respiratory Infection tool—developed and approved by the International Academies of Emergency Dispatch (IAED) Chemical, Biological, Radiological, & Nuclear (CBRN) Committee—which has had an update applied to version 12.1 and 12.2 of the MPDS Protocol. This tool covers recent travel and all likely symptoms of Ebola (the last update was in May when the Middle East Respiratory Syndrome "camel flu" scare was active and travel was a concern for that illness). The SRI tool can be accessed at any time, in any active ProQA case.

As with our past position, the SRI Tool can be utilized by any agency that has approval from their Medical Director. Typically, we recommend the call be processed through Case Entry and Key Questions and a Final Code be generated as per standard practice. At that point, if the patient has symptoms consistent with EVD (as approved by local medical control), and the caller has mentioned epidemiologic/travel risk factors (as approved by local medical control), the EMD should select the SRI Tool to complete the interrogation. For EVD, the Chief Complaints we recommend for use of the SRI tool are those that represent typical flu-like symptoms and unexplained bleeding: Protocol 26 Sick Person, Protocol 6 Breathing Problems, Protocol 18 Headache, Protocol 10 Chest Pain, and Protocol 21 Hemorrhage (MEDICAL).

This additional interrogation may extend the total calltaking time for those patients presenting initially with related symptoms and risk factors, but will not impact the time it takes to post a call for dispatch, or notify responders, as long as the SRI Tool is launched after Final Coding is complete. This additional questioning may identify potential EVD patients and allow for appropriate notification to responders and receiving hospitals etc., and for the modification of local response assignment and/or referral policies and procedures. The use of the SRI Tool also enables the notification of governmental healthcare organizations on a local, national, and/or international level.


References:

  1. Center for Disease Control (CDC). "Ebola Hemorrhagic Fever." 2014; Aug 12. http://www.cdc.gov/vhf/ebola/ (accessed August 12, 2014).
  2.  European Centre for Disease Prevention and Control. "Epidemiological update: outbreak of Ebola virus disease in West Africa." 2014; Aug 8. http://www.ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-9133-18ff4cb1b568&ID=1042 (accessed August 12, 2014).
  3.  HSC Public Health Agency. "Ebola virus disease." Health Protection United Kingdom. 2014; Aug 8. http://www.publichealth.hscni.net/news/ebola-virus-disease (accessed August 12, 2014).
  4.  World Health Organization. "WHO Director-General, west African presidents to launch intensified Ebola outbreak response plan." 2014; July 31. http://www.who.int/mediacentre/news/releases/2014/ebola-outbreak-response-plan/en/ (accessed August 12, 2014).

Click to download PDF

October 8, 2012

Technology leads to local man’s rescue

By Jessica Heffner
Posted: Friday, Oct. 5, 2012

SPRINGFIELD — 

Cell phone technology and ingenuity are being credited with helping paramedics and dispatchers locate a diabetic man who got lost in the woods.

The middle-aged man called 911 Sunday after wandering off of Berger Avenue, across the railroad tracks and into a wooded area. He told dispatchers he was disoriented, was afraid his blood sugar was dropping and had no idea where he was. He could not identify any landmarks, and at one point possibly passed out, said Springfield dispatcher Kerrie Kimpel.

“We just had an open line with his cell phone, so we didn’t know if he had passed out or dropped his phone or what had happened to him,” she said.

Paramedics and police officers who arrived near where dispatchers had used GPS to locate the man were unable to get him to respond to calls. Since they were unable to see him in the thick brush, Jason Simons said he got the idea to call 911 from his own cell phone and have dispatchers triangulate his signal with that of the ailing man.

“They (the dispatchers) were telling me the general area he was located in and told me to go north or south,” Simons said.

It took about 45 minutes to play what the medics called a complicated “game of hide and seek,” but eventually they located the man, who was on the ground not far from his phone. Medics and officers were able to walk him out of the woods and to a waiting ambulance.

A search like this isn’t common, and Lt. John Hainey said it’s the first time they’ve used their own cell phones and GPS to locate someone.

“If he was not using his cell phone, if he wasn’t carrying one with an open line for 911, it could have been a nightmare,” Hainey said.

“GPS is definitely a modernization we’d eventually like to have in our vehicles and be able to use with hand-held,” Simons said.

The man, whose name was not released due to privacy issues, was OK. Emergency crews advice if you’re going out alone, make sure you tell someone where you’re going, carry your cell phone and never hesitate to call 911 if you get lost.

http://www.springfieldnewssun.com/news/news/local/technology-leads-to-local-mans-rescue/nSWMw/

October 8, 2012

Western Colorado Community College developing degree for 911 work

Tuesday, September 18, 2012

A two-year associate degree program for 911 dispatchers could make its way into Western Colorado Community College’s list of degree offerings within the next few years.

The community college is “in the process” of creating an associate of applied science degree program for 911 dispatching, according to Brigitte Sundermann, the school’s vice president of community college affairs. Sundermann said she’s not sure how long it will take for the program to gain approval from a curriculum committee and Colorado Mesa University’s board of trustees.

If the program clears those hurdles, she has a precursory idea of how the program will work: with a blend of existing general education, criminal justice and other courses paired with hands-on experience in the local 911 communications center or a simulation lab.

Grand Junction Police Chief John Camper said he and a few of his colleagues suggested a 911 dispatching program at a Colorado Mesa brainstorming session that invited local leaders to share concepts for degrees that would benefit the business community. Only a high school diploma or its equivalent are required to become a 911 dispatcher in Grand Junction and emergency medical dispatch certification courses are available on the Front Range. Even with an associate degree, Camper said it’s unlikely 911 dispatcher candidates will be able to cut back on the months of training required to work at the local 911 communications center. But he wants to see a higher-level associate degree program so potential employees will see dispatching as more of a career goal than a temporary job.

“You just don’t talk to too many people who say, ‘When I grow up, I want to be a dispatcher.’ I think it’s because we haven’t made it a career path. It’s more of an afterthought for some people,” he said.

An associate degree in dispatching is a rare find in the U.S. Hutchinson Community College in Hutchinson, Kan., offers an associate degree in emergency medical services,  emergency dispatch. Grossmont College in El Cajon, Calif., offered the same degree, but suspended classes in the program this fall due to budget cuts.

Camper said he envisions coursework in the WCCC program including psychology, public speaking, negotiation and Emergency Medical Technician-related courses to help dispatchers learn communication skills, understand ambulance operations, and better handle speaking to people in distress. Camper said he doesn’t see deficiencies in these areas among his current personnel, but he does see a high turnover rate due to the stress of the job.

“I have to believe if someone went into the occupation with the intention of becoming a dispatcher and went to school for it, it enhances the likelihood of success” and longevity, he said.

Police, fire and ambulance dispatch jobs are expected to grow by 12 percent between 2010 and 2020, according to the U.S. Bureau of Labor Statistics. Sundermann said she is OK with being one of the few schools to offer an associate degree in emergency dispatch if it meets a need in the Grand Junction 911 center.

“It is a growing field,” she said. “I think that’s what community colleges do, provide unique programs because we’re constantly trying to meet community needs.”

http://www.gjsentinel.com/news/articles/western-colorado-community-college-developing-degr/

October 8, 2012

With Halloween only weeks away, people's thoughts turn to witches, vampires, and zombies. But zombies aren't just a Halloween time of year thing anymore. Their rise in popularity has organizations like the Utah Division of Emergency Management and the Centers for Disease Control and Prevention capitalizing on their popularity. Read below to find out more or visithttp://www.ksl.com/?sid=22399161&nid=148&title=preparedness-officials-want-utahns-ready-for-zombie-apocalypse&s_cid=queue-12 

Preparedness officials want Utahns ready for zombie apocalypse

By Andrew Wittenberg

SALT LAKE CITY — When it comes to preparing for disaster, you have to be ready for just about anything — natural and unnatural. While it may sound a bit strange, local emergency preparedness experts say your preparation should account for a zombie apocalypse.

Officials at the Utah Division of Emergency Management and the Centers for Disease Control and Prevention are capitalizing on the recent rise in popularity of all things zombie.

"Because zombies are just so popular in culture these days, the CDC thought it was really fitting to build a campaign around everyone's new favorite monster," explained Joe Dougherty, with the Utah Division of Emergency Management.

The CDC started its zombie campaign a couple of years ago, releasing a fictional comic book-style preparedness guide based entirely on the idea.

As funny and weird as it may seem, there actually are some truths to being prepared for the Zombie Apocalypse. For instance, we found two local groups that offer survival training with the zombie theme: ZAPS, short for Zombie Apocalypse Preparedness; and Survival and STG, or Strategic Tactical Group.

"We kind of use the popularity of it to say not only could (zombies) be used as products to get people to come to a course, but now we can have a lot of fun with it," said Sean Stephens, ZAPs.

"We started out offering just a disaster preparedness course, and we didn't get a lot of people wanting to come to it," Chris Willden from the SGT told KSL News. "So, we thought we'll just throw a different spin on it."

Both groups are aware this whole zombie idea may sound crazy to some, but they say if you're prepared for the zombie apocalypse, you're prepared for just about anything.

"Those that are prepared, they're going to sustain themselves and their family and have a better outcome in the end," Wilden said.

The old saying is still true. Better to be safe, than sorry.

August 21, 2012

911 Medical Emergencies Getting Faster Service, Officials Say

Now when a 911 call comes in, pre-paramedic-arrival instructions begin over the phone, as soon as the medical emergency is identified.

A new computer system being phased into the county’s Perris-based dispatch hub is giving trained 911 dispatchers medically supported tools that cut response times to zero, according to Cal Fire spokeswoman Jody Hagemann.

"It’s giving residents a higher level of service,” added Cal Fire Battalion Chief Phil Rawlings.

Dispatchers are currently training on the new computer system known as the Medical Priority Dispatch System. Now when a 911 call comes in, pre-paramedic-arrival instructions begin over the phone, as soon as the medical emergency is identified. The dispatcher types the nature of the medical emergency into the MPDS, which in turn spells out medical instructions for the dispatcher to relay to the victim and/or caller while waiting for paramedics to arrive.

“The dispatchers buy us time,” Rawlings explained.

Paramedics in route to the emergency are patched into the system via computer hardware installed in all field equipment, so they know what’s transpiring during 911 calls. The connectivity between first responders and dispatchers allows for more seamless care, Rawlings said.

Hagemann, who has worked as a 911 dispatcher, said the system helps take pressure off those taking emergency calls.

“Even though dispatchers are trained, there is liability,” Hagemann said. Without a system like MPDS, pre-paramedic-arrival instructions can vary slightly. Using the MPDS, the dispatcher relays “medically approved” information, Hagemann explained.

Supervisor Bob Buster, who represents District 1 -- which includes Lake Elsinore and Widlomar -- pushed for the upgrade. He said it will help save lives and allow first responders to better prioritize resource allocation so life-or-death situations get attention first.

In a two-page brief drafted last year by Buster, he noted that about 80 percent of the county's 911 calls are medical-related, but "many of those calls stem from non-emergency and non-life-threatening incidents.''

The supervisor argued that the protocol for answering a request for medical aid is to deploy a fire engine with two firefighters and a paramedic -- responding with lights and siren -- along with an ambulance staffed by two emergency medical technicians, rolling code three.

"Responding with a full array of assets with red lights and siren to every medical aid call -- many of which first-responders call 'band-aid calls' -- takes emergency response units out of service unnecessarily and contributes to increased response times in [true] life-threatening emergencies when units farther away must be dispatched,'' Buster wrote.

"An integrated CAD system utilizing Medical Priority Dispatch System protocols would allow emergency medical service providers to immediately identify the nature of the emergency and share automated data concerning the location of the caller, thus decreasing ambulance dispatch and response times,'' the supervisor argued.

Rawlings said resource allocation and protocols have not changed – yet.

“This is an evolution,” he said, noting that the MPDS is being rolled out in phases.

The system cost the county approximately $185,000 up front and just over $29,000 annually.

American Medical Response (AMR), the ambulance service provider under contract with the county, is also upgrading to connect with the system.

According to Buster, the AMR is spending approximately $90,000 on the upgrade.

This article can be found at http://lakeelsinore-wildomar.patch.com/articles/911-medical-emergencies-getting-faster-service-officials-say

May 18, 2010

Dispatcher provided CPR saves drowning infant

The Rockland 911 Dispatchers Association will honor dispatcher Peter Medina, EMD, of the Ramapo (NY) Police Department, at its June 6, 2010, meeting for his efforts to help save a drowning infant. According to a press release announcing the award, Medina CPR provided Pre-Arrival Instructions to the mother of an infant found face down and not breathing in a five gallon bucket of water. The child was breathing when EMS arrived and was reported well on his way to recovery.

May 17, 2010

Two Lives Saved

Beaver Dam Dailly Citizen

JUNEAU - A disabled man who was stuck inside a burning house and man who wasn't breathing after suddenly seizing are both alive today thanks to harrowing police work on Sunday.
Dodge County Central Dispatch received a frantic 911 call from Barbara Riese, 48, who reported that her boyfriend George Hanson, 59, was stuck inside a burning house at N2189 Highway EE in the town of Ashippun just before 10 p.m. Sunday.
Responding officers and emergency officials found smoke and flames billowing from the house.
Dodge County Sheriff's Patrol Captain Molly Soblewski said Riese told officers that Hanson, who is paralyzed, was on the floor of the hallway inside the smoke-filled house.
Deputies Eric Krueger and Jermey Wolfe quickly jumped into action.

Click here

May 16, 2010

Dispatcher Stays On Line with Fire Victim

Free-lance Star, Virginia

At about 1 a.m. on Feb. 5, Spotsylvania County 911 dispatcher Domonique Curry answered a call that would change her life.

Sandy Hill, a 43-year-old local actress and singer, called 911 to report that her Spotswood Furnace Road house was on fire. Hill was trapped in her second-floor bedroom with smoke funneling in.

Curry remembers hearing sirens in the background, which gave her confidence that Hill would be rescued.

So in the meantime, Curry tried to get Hill to safety.

In a calm voice, Curry told Hill to open one of her bedroom windows or try to break it. When Hill was unable to do either task, Curry told her to drop to the ground and cover her face.

Curry told Hill, who stayed on her cell phone, to use clothing to block smoke from coming into the room.

"I didn't feel panicked at that moment because I knew units were there," Curry said during an interview Wednesday in Spotsylvania County Sheriff Howard Smith's office.

Click here

April 13, 2010

Public Safety Telecommunicators Week

Sheridan, Wyoming

With phones ringing and papers rustling, the Dispatch Center on Monday morning was bustling in typical fashion at the Sheridan Police Department.

In between taking calls and sending officers to various locations, Dispatcher Kat Hersman took some time to chat about her job. She alternates between focusing her calls for the Sheriff's Office and the Police Department. Hersman has been with Dispatch for 2 1/2 years, and she tells us what she likes about the position.

Click here