BOX 4-2

Suggestions for Overcoming the Challenges

EMS Human Resources

  • Equip and staff to completely meet the daily call volume of emergency calls and patient transports.

  • Maintain a cadre of part-timers as regular staff (provides surge capacity and trained candidates for full-time vacancies).

  • Recruit new EMTs from undergraduate programs and professional schools such as colleges of nursing, medicine, public health, pharmacy, and dentistry.

  • Establish a community paramedic program to fill existing gaps in health care.

Financial, Tangible, and Talent Resources

  • Educate EMS volunteers on how to find and apply for federal and other grant funding.

  • Look for ways to use nontraditional resources, and for new ways to use traditional resources:

    • Develop expanded roles for community members (ham radio operators, civil air patrol and flying clubs).

    • Identify community assets and resources that can be called upon (e.g., extra generators, faith-based or other community groups that can serve as callers for a phone tree).

Planning and Practice

  • Participate in regional preparedness planning.

  • Strive to have equipment and personnel interoperability across jurisdictions that provide mutual aid.

  • Practice and constantly update MCI plans.

  • Adopt best practices from other industries (e.g., vehicle tracking, crash notification, automatic weather reporting, preferred travel corridors).

  • Look for creative approaches to enhancing care, such as telemedicine (discussed in detail in Chapter 7).

  • Optimize air medical capability and safety (e.g., designated landing zones, fuel and support services, automatic weather reporting, night vision goggles).

Suggestions Specifically for States

  • Establish command and control systems that integrate local, state, and federal emergency response using a common operating structure.

  • Develop safe, secure, and redundant communication systems that can function without the commercial power grid or commercial communication networks.

  • Define the authority to quickly alter standards of care and scope of practice.

  • Determine the necessary knowledge skills and abilities needed for large-scale response and provide training when appropriate using just-in-time strategies.

  • Stockpile and provide the necessary surge assets including personnel, communications equipment, durable medical equipment, and medical supplies.

  • Establish a quality improvement process that reviews the system based on actual or exercised response.

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