EMERGENCY MEDICAL SERVICES 
BERTIE COUNTY EMERGENCY OPERATIONS PLAN
Reviewed / Updated: April 07, 2016

Primary Agency: Emergency Medical Service
 
Support Agencies: Emergency Management
  Rescue
   
Attachments:
Attachment 1: Preparedness / Response Checklist
Also see
Annex Direction and Control
  Resource Management
  EMS Mass Casualty Plan
Checklist Aircraft Incident
  Terrorism
   

 
I. PURPOSE

This procedure provides assistance to the general public by administering medical services during a natural, man-made or technological emergency.
 
II.

SITUATION AND ASSUMPTIONS
 
  A. Situation:
 
   
  1. Most emergency situations can lead to physical harm or bring about other internal medical problems.
     
  2. A well-planned medical support network is essential during emergency situations.
     
  3. Depending on the nature of the incident, complications may include traumatic injury or even death.
     
  4. Bertie County has the following medical facility with emergency medical services: Bertie Memorial Hospital.
     
  5. Four volunteer emergency medical squads are located in Bertie County; two squads are associated with fire departments and a number of firefighters in Bertie are trained as Basic EMTs.
     
  6. Bertie County is primarily served by EastCare medical helicopter from Pitt Memorial Hospital in Greenville, and at times by Nightingale Helicopter from Sentara Hospital, Norfolk, Virginia and Life Flight Helicopter from Duke Hospital from Durham.
     
  7. The nearest trauma center is Pitt Memorial Hospital in Greenville, approximately forty five minutes by road and twenty minutes by helicopter. 
     
  8. Roanoke-Chowan Hospital in Ahoskie (Hertford County), Martin General Hospital in Williamston (Martin County) and Chowan Hospital in Edenton (Chowan County) routinely receive some patients transported by EMS units from Bertie County.
     
  9. A mass casualty event has the potential to quickly overwhelm the limited existing emergency medical resources in Bertie County.
     
  10. There are several nursing homes serving the County, housing approximately 350 persons in addition to staff.
     
  11. At present, all EMS units with the exception of one operate at the ALS level. Lewiston-Woodville EMS operates at the EMT Basic level. 
     
  12. All EMS units rely on the County communications system for paging and dispatching.
  B. Assumptions:
 
   
  1. A large-scale emergency may result in increased demands on hospitals, medical, and emergency medical transport services personnel.
     
  2. Many injuries both minor and relatively severe, will be self-treated by the public.
     
  3. People other than medical personnel will transport many injured to medical facilities.
     
  4. EMS is most critical within the first 30 minutes of the emergency. Mutual aid assistance usually arrives after this critical period.
     
  5. Resources available through area and regional medical services mutual aid agreements will be provided.
     
  6. When local resources can no longer meet the demand of the situation, State agencies will be contacted to provide additional resources and/or assume control of the response.
     
  7. Catastrophic disasters may affect large areas of the County and medical resources may be damaged, destroyed or unavailable.
     
  8. Standard operating guidelines will be developed to guide emergency medical responders in the treatment of patients and personnel involved with radiological and hazardous materials incidents.
     
  9. Disruption of the County's communications system will severely impede delivery of emergency medical service.
     
  10. Debris and water on roadways will hamper EMS unit response.
     
  11. Following a disaster occurrence, field emergency medical facilities will be established; this may include a temporary morgue, first aid station or a triage holding or transportation areas.
     
  12. Victims of a hazardous material incident may require unique or special medical care not typically available in Bertie County.
III. CONCEPT OF OPERATIONS:
 
 
  1. Emergency operations for EMS services will be an extension of normal agency operations.
     
  2. Coordination between EMS/Rescue providers is necessary to ensure emergency operational readiness.
     
  3. EMS will provide field medical care as needed during emergency situations and coordinate necessary medical transportation.
     
  4. Volunteer first aid and rescue squads serving the respective response areas will expand EMS capabilities.
     
  5. During mass casualty incidents, EMS will establish patient triage, holding, and treatment and transportation areas.
     
  6. When necessary, an EMS official will be located at an established command post to coordinate responding medical units and establish communication links with hospitals and the Communications Center.
     
  7. Transfer of authority on-scene will be in accordance with established procedures.
     
  8. EMS capabilities will be expanded by volunteer first responders and fire personnel serving the respective response areas.
     
  9. U.S. Marine Search and Rescue helicopters (PEDRO), USCG helicopters, EastCare, Nightingale and Life Flight air ambulances could be utilized for patient evacuation under certain circumstances.
     
  10. When additional EMS resources are needed, the Bertie County Emergency Management Coordinator will request those resources through the Division of Emergency Management or the State EOC.
     
  11. Local industry, including farmers, may be called upon to provide specialized equipment such as refrigerated trucks, backhoes and heavy equipment for extrication of victims, storage of the deceased, etc.
     
  12. Within the National Response Framework, all public health and medical services are considered an emergency support function (ESF 8).
IV. DIRECTION AND CONTROL
 
 
  1. The EMS director and/ or manager will direct and control EMS operations. For on-scene incidents, the senior officer will assume direction and control.
     
  2. The EMS director and /or manager will maintain communications with their field forces and will keep the EOC informed of activities performed along with personnel and equipment needed to maintain adequate response and recovery efforts.
     
  3. The EMS director and/or manager will coordinate efforts between the County EMS and the Rescue Squads in the event of an emergency situation.
V. CONTINUITY OF GOVERNMENT

Line of Succession:
   
  1. Emergency Medical Services Director
  2. Emergency Medical Services On-Duty Supervisor
  3. Emergency Medical Services On-Duty Assistant Shift Supervisor/Senior Paramedic
     

Attachment 1
Emergency Medical Service Preparedness / Response Checklist
 
   
  Emergency Medical Service Director:
 
  Upon notification report to the Emergency Operations Center to serve in the Support group.
 
  Receive a situational briefing from the EOC. Ask questions and address concerns during the briefing.
 
  Brief the EOC and/or the Incident Commander regarding:
   
Number of BLS and ALS units available
Number of personnel available to operate both BLS and ALS units
Status of hospitals and other medical facilities and the number of beds available
Estimated number of persons that may have to be evacuated by EMS
Status of other medical or skilled care facilities that may require EMS
Status and number of medical personnel that may be on call (EMS/Rescue/First Responders, etc.)
 
  Based upon briefing anticipate the number of units that will be necessary to carry out the EMS mission.
 
  Request mutual aid assistance if warranted.
 
  If mutual aid is not available from surrounding jurisdictions, request additional resources through the Emergency Management Coordinator/Incident Commander.
 
  Brief EMS supervisors.
     
  Emergency Medical Service Supervisors:
 
  Receive a situational briefing from the EMS Director and/or Incident Commander. Ask questions and address immediate concerns.
 
  Prepare a briefing for BLS and/or ALS personnel and include:
   
Number of BLS and ALS units available
Number of personnel available to operate both BLS and ALS units
Status of hospitals and number of beds available or total persons that may have to be evacuated by EMS
Status of other medical or care facilities that may require EMS
Safety
Location of replacement medical supplies if different from normal locations
Special instructions, maps, charts or other information (i.e. evacuations are occurring or about to occur)
Current and forecasted weather
 
  Inspect units and ensure they are properly equipped and supplied at the beginning of each shift.
 
  Carry out other duties that are "normal" day-to-day functions of a supervisor.
 
  Ensure accurate mileage records and personnel time records are kept, and during a disaster ensure copies are made and appropriate reports filed regarding overtime.
 
  Prepare and submit required or necessary reports to the Director in a timely manner.
 
  Immediately report any death or injury of personnel to the Director.
 
  Immediately report any unit damaged or in need of repair that may take it out of service.
 
  Establish and maintain communications with all units at all times.
 
  If not already established, prepare a staging area for EMS units that will be coming to assist and appoint a staging officer if one has not already been appointed.
 
  If staging has been established maintain communications with the Staging Officer and dispatch relief or additional units from the staging area as required.
 
  Ensure you or the Staging Officer briefs all units that will be coming to assist, and that they have a clear understanding of their mission assignments and mission radio frequencies.
 
  Do not hesitate to inspect credentials of assisting personnel and/or equipment and supplies. Relieve any personnel that are not properly trained for the assignment or remove any unit from service that does not meet BLS or ALS standards.
 
  If, upon arrival at the scene of any emergency where multiple agencies are involved and Incident Command has not been established, establish Incident Command and assume the command function until relieved or the circumstances no longer require Incident Command.
 
  Carry out other functions as the circumstances dictate or by instruction of the Director and/or Incident Commander.
 
 

Bertie County Emergency Management - PO Box 530 - Windsor, NC 27983-0530