H1N1 Staffing Issues

[x635 4,066]

This applies to all agencies, fire, PD, EMS, Communications, etc, career or volunteer.

Does your agency have a staffing plan in place in case we do get hit by a pandemic flu?

I'm not talking about responding to calls, I'm talking about the ability to respond. How would your department be impacted if several members got the swine flu? Additionally, how would your department be affected if members had to take time off or couldn't respond because they had to take care of sick family?

Do any agencies have plans in place to deal with these issues?

[FFFORD 27]

Great question. I never thought about that. As far as I know, my Fire department and VAC do not have anything set. Unless I have not been advised due to my absence from being at college, we do not have anything. I am certainly going to bring this up however!

[EJS1810 7]

Putnam County 911 is putting together a staffing plan. Other counties that i know of include Dutchess & Ononadaga (Where Dutchess & Putnam got the original plan from). It will give an idea on how to remain operational if a certain percentqage of the work force is out sick. Now is the time to be getting this in place. You will not be able to play catch up. i feel too many people have a "stick their head in the sand" attitude to H1N1 and feel it is just hype.

[Goose 188]

Once the vaccine hits the streets, its projected to be 95% effective in 95% of the population. Get it and you should be protected. It's produced the same way the seasonal flu vaccine is, and is generally safe as long as you have no hx of guion barre syndrome or are allergic to eggs.

We should really be talking about prevention, if you ask me.

In my opinion the top priority should be to vaccinate all employees. Mandate and have PPE protocols in place (ie: if you're going to use nebulized medications or have to intubate on goes gloves, N95, Gown, and eye protection, no exceptions). If things get pandemic bad at the local level (i don't foresee this) i think the REMAC should look to temporarily eliminate nebulized medications and intubation (they did it in Toronto during the SARS outbreak and it helped to limit the risk to providers and prevent further spread of the infection). Prevent sick employees from working and have them stay home for a minimum of 24 hours after symptoms break.

There is a lot more to talk about but i would really urge people to look at how Toronto EMS handled the SARS outbreak, its a model for us all.

Edited September 29, 2009 by Goose

[x635 4,066]

We should really be talking about prevention, if you ask me.

Flus can mutate quickly, and not everybody can get vaccinated.Flu can spread easily across emergency servicves personel, with the shared facilities and equipment we all use. Not just EMS, but PD, Fire, Communications, ER's, etc. Even with as much prevention as there may be, people can get sick. Cops are married to nurses who work in the ER, who could bring home the disease. Firefighters are married to teachers, the possibilites are endless despite as much prevention as there could be. My question was worst case scenario there was an outbreak of the flu in your region, how would your agency deal with staffing challenges?

You mentioned having sick employees out for 24 hours after symptoms appear. Well, when those providers call in sick, who will fill the gaps? If someone has a family member to attend to, how are those absences going to be handled?

While I also don't see this flu getting to a pandemic level, even though statistically we are due for one, we must be prepared staffing-wise. Many agencies are shortstaffed as it is, and during a normal flu season things can get hectic enough with scheduling. My question was not about what to do to prevent the flu or to prevent it from spreading, my question was in regards to how agencies would handle normal, everyday calls if they are down a significant amount of staff? Many agencies mandate overtime when people call in sick on a normal day- are the healthy people going to be required to work an outrageous amount of hours to fill in the gaps? Will call responses be handled differently? How will the overtime affect the budget? What is the return to work policy going to be? All these are issues that need to be thought out and planned for in advance.

[Goose 188]

My question was worst case scenario there was an outbreak of the flu in your region, how would your agency deal with staffing challenges?

Relax. I never said there shouldn't be plans in place for the possibility of large portions of the workforce being sick. I'm offering my opinion on the matter. Additionally, i speak from my perspective which is EMS but that doesn't mean that lessons learned elsewhere can't in some way be applied to other sectors of public safety. We don't have to re-invent the wheel - like i said look at what Toronto did during their SARS outbreak and i'm sure you will be able to find a host of things that can be applied. I'll even break it down for anyone who is interested (can't find anything about the Toronto fire service though):

Toronto PD response to SARS outbreak, a retrospective:

http://policechiefmagazine.org/magazine/in...;issue_id=42005

Toronto EMS and SARS (article from the CDC, tells part of the story but some of the good stuff is left out)

http://www.cdc.gov/ncidod/EID/vol10no9/pdfs/04-0170.pdf

[NWFDMedic 58]

I know Dutchess is quite a ways along in their pandemic planning and information distribution. I attended a pretty informative CME at St. Luke's-Cornwall on pandemic preparedness as well. It's really staggering when you consider that we may have to respond to a 30-40% greater call volume with 30-40% of our staffing calling in sick at any particular time. On an agency level, our effort thus far has been on information regarding precautions and treatment of flu-like symptoms but there are pandemic plans in place should the need arise.

If H1N1 starts heading toward pandemic levels, I think the state and federal governments will have to become involved too. They have to inform people that the best place for a flu patient without comorbid factors is to stay home. Also, I'm guessing they might allow EMS providers to suggest and possibly even refuse transport to patients with flu-like symptoms that are otherwise uncomplicated, possibly delivering medications or prescriptions to patients in the field.

[SRS131EMTFF 471]

Having spoke to the Director of the VT Department of Health (EMS), I know that the State of Vermont and all of its individual districts have been working on contingency plans in-case agencies are severely taxed due to a pandemic flu (H1N1 being todays main player). These plans include multiple additional mutual aid agreements regarding man power (most crews up here are volunteer but still have crews and shifts and man the rig 24/7), facilities and equipment. This would mean sharing EMTs, Medics, officers and drivers as well as quarters and ambulances if crews can not be organized or sustained. As well as specifically or centrally locating resources so that they may be utilized quickly, efficiently and with good judgement.

In addition, if it does reach epidemic or pandemic level, then the EMS response system will be integrated into a triage system that could entail EMTs not transporting flu patients or not transporting to certain hospitals or entrances of hospitals. Furthermore it could entail EMTs and medics actually treating patients in ERs and other treatment and triage centers so that more important, valuable and scarce resources are not over burdened. This is all of course is under the medical direction of the local Trauma Center emergency medicine director.

Edited September 29, 2009 by bvfdjc316

[x635 4,066]

Relax. I never said there shouldn't be plans in place for the possibility of large portions of the workforce being sick. I'm offering my opinion on the matter. Additionally, i speak from my perspective which is EMS but that doesn't mean that lessons learned elsewhere can't in some way be applied to other sectors of public safety. We don't have to re-invent the wheel - like i said look at what Toronto did during their SARS outbreak and i'm sure you will be able to find a host of things that can be applied. I'll even break it down for anyone who is interested

Where am I not relaxed? I am simply replying to your post.

Although Toronoto handled the SARS outbreak well, there are vast differences between the way healthcare and emergency services are delivered there then in the Hudson Valley.

You have a mish-mosh of all different types of agencies, with different types of staffing here. Additionally, healthcare in Canada is socialized and available to all citizens, in the US, it can have a significant economic effect, especially with the state of our economy.

There are lessons we can learn from that, but we are so fragmented as an emergency services community, that many of their lessons learned wouldn't be applicable to many of the HV's communities.

Also, you have to look at other factors, even if you are just looking at it from an EMS perspective. Who maintains your ambulance? Where do you get your supplies? Is the agency that dispatches you properly prepared, and what happens if they're not? Who keeps up with all your paperwork and payroll (can they work from home)?

We can look and learn from other agencies lessons, but I think that strong emphasis needs to be placed on each individual agency having a multi-faceted plan to address staffing that goes beyond just the first response side.

[ny10570 745]

This whole thing is good practice for a real pandemic. Since the outbreak we're talking about a few hundred deaths nation wide. While sad, this is a drop in the bucket for regular flu. People need to take a deep breath and worry about how this is going to affect themselves. Any time you get a patient with a fever or productive cough you should be wearing a face mask and eye protection prior to administering nebulized meds. Same goes for intubation. We should always be washing our hands after each patient. We need to stop coming to work when we're sick. If you're at risk or are taking care of young children you need to get this vaccine. If you've ever really had the flu then I'm sure you'll be right behind me getting the vaccine.