Comparison of Emergency Medical Coordination in Two Countywide Disasters: Lessons Learned and Applied

Background: Between the massive firestorms to hit San Diego County in 2003 and 2007, a great deal of effort went into countywide disaster planning, with major emphasis placed on early and wide scale evacuations. An integral part of the disaster response system was the Emergency Medical Services Departmental Operations Center (EMS-DOC), which was responsible to ensure the safe evacuation, shelter, and repatriation of patients in residential care facilities and acute care hospitals.

Methods: In the early stages, the EMS-DOC combined information from field observers with data about wind speed and direction in a geographic information system to determine the projected path of the fire and alert medical facilities of the impending danger. As facilities prepared to evacuate, the EMS-DOC maintained the central hub of communication between evacuating facilities, receiving facilities and the county Emergency Operations Center to ensure that every patient was evacuated to a location with an appropriate level of care.

Outcomes: Ten people died as a direct result of the fires and 59 firefighters were injured, down from 17 deaths and 145 firefighter injuries in 2003. The EMS-DOC assisted with the planning and evacuations of two acute care hospitals and 15 residential care facilities, totaling 2,158 patients, to appropriate locations, and followed up to make sure that they all returned to their original facilities when it was safe to do so.

Conclusions: Lessons from the 2003 fires and other disasters around the nation were not only learned from, but acted upon to ensure the safety of our citizens.