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CDC PSAP Ebola Guidance
Interim Guidance for Monitoring and Movement of Persons with Ebola Virus Disease Exposure Guidance: Air Medical Transport for Patients with Ebola Interim Guidance: EMS Systems & 9-1-1 PSAPs: Management of Patients in the U.S. Clinician Information - U.S. Healthcare Settings Safe Management of Patients in U.S. Hospitals Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals Guidance: Safe Handling of Human Remains in U.S. Hospitals and Mortuaries Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus Iterimm Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Known or Suspected Ebola Virus Disease in the United States August 26, 2014 Who this is for: Managers of 9-1-1 Public Safety Answering Points (PSAPs), EMS Agencies, EMS systems, law enforcement agencies and fire service agencies as well as individual emergency medical services providers (including emergency medical technicians (EMTs), paramedics, and medical first responders, such as law enforcement and fire service personnel). What this is for: Guidance for handling inquiries and responding to patients with suspected Ebola symptoms, and for keeping workers safe. How to use: Managers should use this information to understand and explain to staff how to respond and stay safe. Individual providers can use this information to respond to suspected Ebola patients and to stay safe. Key Points: •The likelihood of contracting Ebola is extremely low unless a person has direct unprotected contact with the blood or body fluids (like urine, saliva, feces, vomit, sweat, and semen) of a person who is sick with Ebola or direct handling of bats, rodents, or nonhuman primates from areas with Ebola outbreaks. •When risk of Ebola is elevated in their community, it is important for PSAPs to question callers about: ◦Residence in, or travel to, a country where an Ebola outbreak is occurring; ◦Signs and symptoms of Ebola (such as fever, vomiting, diarrhea); and ◦Other risk factors, like having touched someone who is sick with Ebola. •PSAPS should tell EMS personnel this information before they get to the location so they can put on the correct personal protective equipment (PPE) (described below). •EMS staff should check for symptoms and risk factors for Ebola. Staff should notify the receiving healthcare facility in advance when they are bringing a patient with suspected Ebola, so that proper infection control precautions can be taken. The guidance provided in this document is based on current knowledge of Ebola. Updates will be posted as needed on the CDC Ebola webpage. The information contained in this document is intended to complement existing guidance for healthcare personnel, Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals Background The current Ebola outbreak in West Africa has increased the possibility of patients with Ebola traveling from the affected countries to the United States.1 The likelihood of contracting Ebola is extremely low unless a person has direct unprotected contact with the body fluids of a person (like urine, saliva, feces, vomit, sweat, and semen) or direct handling of bats, rodents, or nonhuman primates from areas with Ebola outbreaks.2 Initial signs and symptoms of Ebola include sudden fever, chills, and muscle aches, with diarrhea, nausea, vomiting, and abdominal pain occurring after about 5 days. Other symptoms such as chest pain, shortness of breath, headache, or confusion, may also develop. Symptoms may become increasingly severe and may include jaundice (yellow skin), severe weight loss, mental confusion, bleeding inside and outside the body, shock, and multi-organ failure.3 Ebola is an often-fatal disease and care is needed when coming in direct contact with a recent traveler from a country with an Ebola outbreak who has symptoms of Ebola. The initial signs and symptoms of Ebola are similar to many other more common diseases found in West Africa (such as malaria and typhoid). Ebola should be considered in anyone with fever who has traveled to, or lived in, an area where Ebola is present. 2 The incubation period for Ebola, from exposure to when signs or symptoms appear, ranges from 2 to 21 days (most commonly 8-10 days). Any Ebola patient with signs or symptoms should be considered infectious. Ebola patients without symptoms are not contagious. The prevention of Ebola includes actions to avoid exposure to blood or body fluids of infected patients through contact with skin, mucous membranes of the eyes, nose, or mouth, or injuries with contaminated needles or other sharp objects. Emergency medical services (EMS) personnel, along with other emergency services staff, have a vital role in responding to requests for help, triaging patients, and providing emergency treatment to patients. Unlike patient care in the controlled environment of a hospital or other fixed medical facility, EMS patient care before getting to a hospital is provided in an uncontrolled environment. This setting is often confined to a very small space and frequently requires rapid medical decision-making and interventions with limited information. EMS personnel are frequently unable to determine the patient history before having to administer emergency care. Coordination among 9-1-1 Public Safety Answering Points (PSAPs), the EMS system, healthcare facilities, and the public health system is important when responding to patients with suspected Ebola. Each 9-1-1 and EMS system should include an EMS medical director to provide appropriate medical supervision. Case Definition for Ebola Virus Disease (EVD) The CDC’s most current case definition for EVD may be accessed here:http://www.cdc.gov/vhf/ebola/hcp/case-definition.html. Recommendations for 9-1-1 Public Safety Answering Points (PSAPs) State and local EMS authorities may authorize PSAPs and other emergency call centers to use modified caller queries about Ebola when they consider the risk of Ebola to be elevated in their community (e.g., in the event that patients with confirmed Ebola are identified in the area). This will be decided from information provided by local, state, and federal public health authorities, including the city or county health department(s), state health department(s), and CDC. For modified caller queries: It will be important for PSAPs to question callers and determine if anyone at the incident possibly has Ebola. This should be communicated immediately to EMS personnel before arrival and to assign the appropriate EMS resources. PSAPs should review existing medical dispatch procedures and coordinate any changes with their EMS medical director and with their local public health department. •PSAP call takers should consider screening callers for symptoms and risk factors of Ebola. Callers should be asked if they, or someone at the incident, have fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and if they have additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained bleeding. ◦If PSAP call takers suspect a caller is reporting symptoms of Ebola, they should screen callers for risk factors within the past 3 weeks before onset of symptoms. Risk factors include: ◾Contact with blood or body fluids of a patient known to have or suspected to have Ebola; ◾Residence in–or travel to–a country where an Ebola outbreak is occurring (a list of impacted countries can be accessed at the following link: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html); or ◾Direct handling of bats, rodents, or non-human primates from disease-endemic areas. ◦If PSAP call takers have information alerting them to a person with possible Ebola, they should make sure any first responders and EMS personnel are made confidentially aware of the potential for Ebola before the responders arrive on scene. ◦If responding at an airport or other port of entry to the United States, the PSAP should notify the CDC Quarantine Station for the port of entry. Contact information for CDC Quarantine Stations can be accessed at the following link: http://www.cdc.gov/quarantine/quarantinestationcontactlistfull.html Recommendations for EMS and Medical First Responders, Including Firefighters and Law Enforcement Personnel For the purposes of this section, “EMS personnel” means pre-hospital EMS, law enforcement and fire service first responders. These EMS personnel practices should be based on the most up-to-date Ebola clinical recommendations and information from appropriate public health authorities and EMS medical direction. When state and local EMS authorities consider the threat to be elevated (based on information provided by local, state, and federal public health authorities, including the city or county health department(s), state health department(s), and the CDC), they may direct EMS personnel to modify their practices as described below. Patient assessment Interim recommendations: 1.Address scene safety: ◦If PSAP call takers advise that the patient is suspected of having Ebola, EMS personnel should put on the PPE appropriate for suspected cases of Ebola (described below) before entering the scene. ◦Keep the patient separated from other persons as much as possible. ◦Use caution when approaching a patient with Ebola. Illness can cause delirium, with erratic behavior that can place EMS personnel at risk of infection, e.g., flailing or staggering. 2.During patient assessment and management, EMS personnel should consider the symptoms and risk factors of Ebola: ◦All patients should be assessed for symptoms of Ebola (fever of greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage). If the patient has symptoms of Ebola, then ask the patient about risk factors within the past 3 weeks before the onset of symptoms, including: ◾Contact with blood or body fluids of a patient known to have or suspected to have Ebola; ◾Residence in—or travel to— a country where an Ebola outbreak is occurring (a list of impacted countries can be accessed at the following link: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html); or ◾Direct handling of bats, rodents, or non-human primates from disease-endemic areas. ◦Based on the presence of symptoms and risk factors, put on or continue to wear appropriate PPE and follow the scene safety guidelines for suspected case of Ebola. ◦If there are no risk factors, proceed with normal EMS care. EMS Transfer of Patient Care to a Healthcare Facility EMS personnel should notify the receiving healthcare facility when transporting a suspected Ebola patient, so that appropriate infection control precautions may be prepared prior to patient arrival. Any U.S. hospital that is following CDC's infection control recommendations and can isolate a patient in a private room‎ is capable of safely managing a patient with Ebola. Interfacility Transport EMS personnel involved in the air or ground interfacility transfer of patients with suspected or confirmed Ebola should wear recommended PPE (described below). Infection Control EMS personnel can safely manage a patient with suspected or confirmed Ebola by following recommended isolation and infection control procedures, including standard, contact, and droplet precautions. Particular attention should be paid to protecting mucous membranes of the eyes, nose, and mouth from splashes of infectious material, or self-inoculation from soiled gloves. Early recognition and identification of patients with potential Ebola is critical. An EMS agency managing a suspected Ebola patient should follow these CDC recommendations: •Limit activities, especially during transport, that can increase the risk of exposure to infectious material (e.g., airway management, cardiopulmonary resuscitation, use of needles). •Limit the use of needles and other sharps as much as possible. All needles and sharps should be handled with extreme care and disposed in puncture-proof, sealed containers. •Phlebotomy, procedures, and laboratory testing should be limited to the minimum necessary for essential diagnostic evaluation and medical care. Use of Personal protective equipment (PPE) Use of standard, contact, and droplet precautions is sufficient for most situations when treating a patient with a suspected case of Ebola as defined above. EMS personnel should wear: •Gloves •Gown (fluid resistant or impermeable) •Eye protection (goggles or face shield that fully covers the front and sides of the face) •Facemask •Additional PPE might be required in certain situations (e.g., large amounts of blood and body fluids present in the environment), including but not limited to double gloving, disposable shoe covers, and leg coverings. Pre-hospital resuscitation procedures such as endotracheal intubation, open suctioning of airways, and cardiopulmonary resuscitation frequently result in a large amount of body fluids, such as saliva and vomit. Performing these procedures in a less controlled environment (e.g., moving vehicle) increases risk of exposure for EMS personnel. If conducted, perform these procedures under safer circumstances (e.g., stopped vehicle, hospital destination). During pre-hospital resuscitation procedures (intubation, open suctioning of airways, cardiopulmonary resuscitation): •In addition to recommended PPE, respiratory protection that is at least as protective as a NIOSH-certified fit-tested N95 filtering facepiece respirator or higher should be worn (instead of a facemask). •Additional PPE must be considered for these situations due to the potential increased risk for contact with blood and body fluids including, but not limited to, double gloving, disposable shoe covers, and leg coverings. If blood, body fluids, secretions, or excretions from a patient with suspected Ebola come into direct contact with the EMS provider’s skin or mucous membranes, then the EMS provider should immediately stop working. They should wash the affected skin surfaces with soap and water and report exposure to an occupational health provider or supervisor for follow-up. Recommended PPE should be used by EMS personnel as follows: •PPE should be worn upon entry into the scene and continued to be worn until personnel are no longer in contact with the patient. •PPE should be carefully removed without contaminating one’s eyes, mucous membranes, or clothing with potentially infectious materials. •PPE should be placed into a medical waste container at the hospital or double bagged and held in a secure location. •Re-useable PPE should be cleaned and disinfected according to the manufacturer's reprocessing instructions and EMS agency policies. •Instructions for putting on and removing PPE have been published online at http://www.cdc.gov/HAI/prevent/ppe.html and http://www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf[PDF - 2 pages]. •Hand hygiene should be performed immediately after removal of PPE. Environmental infection control Environmental cleaning and disinfection, and safe handling of potentially contaminated materials is essential to reduce the risk of contact with blood, saliva, feces, and other body fluids that can soil the patient care environment. EMS personnel should always practice standard environmental infection control procedures, including vehicle/equipment decontamination, hand hygiene, cough and respiratory hygiene, and proper use of U.S. Food and Drug Administration (FDA) cleared or authorized medical PPE. For additional information, see CDC’s Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus. EMS personnel performing environmental cleaning and disinfection should: •Wear recommended PPE (described above) and consider use of additional barriers (e.g., shoe and leg coverings) if needed. •Wear face protection (facemask with goggles or face shield) when performing tasks such as liquid waste disposal that can generate splashes. •Use an EPA-registered hospital disinfectant with a label claim for one of the non-enveloped viruses (e.g., norovirus, rotavirus, adenovirus, poliovirus) to disinfect environmental surfaces. Alternatively, use a freshly prepared (i.e., within 12 hours) 1:50 dilution of household bleach (final working concentration of 100 parts per million or 0.1% hypochlorite solution) that is prepared fresh daily. Disinfectant should be available in spray bottles or as commercially prepared wipes for use during transport. •Spray and wipe clean any surface that becomes potentially contaminated during transport. These surfaces should be immediately sprayed and wiped clean (if using a commercially prepared disinfectant wipe) and the process repeated to limit environmental contamination. Cleaning EMS Transport Vehicles after Transporting a Patient with Suspected or Confirmed Ebola The following are general guidelines for cleaning or maintaining EMS transport vehicles and equipment after transporting a patient with suspected or confirmed Ebola: •EMS personnel performing cleaning and disinfection should wear recommended PPE (described above) and consider use of additional barriers (e.g., rubber boots or shoe and leg coverings) if needed. Face protection (facemask with goggles or face shield) should be worn since tasks such as liquid waste disposal can generate splashes. •Patient-care surfaces (including stretchers, railings, medical equipment control panels, and adjacent flooring, walls and work surfaces) are likely to become contaminated and should be cleaned and disinfected after transport. •A blood spill or spill of other body fluid or substance (e.g., feces or vomit) should be managed through removal of bulk spill matter, cleaning the site, and then disinfecting the site. For large spills, a chemical disinfectant with sufficient potency is needed to overcome the tendency of proteins in blood and other body substances to neutralize the disinfectant’s active ingredient. •An EPA-registered hospital disinfectant with label claims for viruses that share some technical similarities to Ebola (such as, norovirus, rotavirus, adenovirus, poliovirus) and instructions for cleaning and decontaminating surfaces or objects soiled with blood or body fluids should be used according to those instructions. Alternatively, a 1:10 dilution of household bleach (final working concentration of 500 parts per million or 0. 5% hypochlorite solution) that is prepared fresh daily (i.e., within 12 hours) can be used to treat the spill before covering with absorbent material and wiping up. After the bulk waste is wiped up, the surface should be disinfected as described in the bullet above. •Contaminated reusable patient care equipment should be placed in biohazard bags and labeled for cleaning and disinfection according to agency policies. Reusable equipment should be cleaned and disinfected according to manufacturer's instructions by trained personnel wearing correct PPE. Avoid contamination of reusable porous surfaces that cannot be made single use. •Use only a mattress and pillow with plastic or other covering that fluids cannot get through. To reduce exposure among staff to potentially contaminated textiles (cloth products) while laundering, discard all linens, non-fluid-impermeable pillows or mattresses as a regulated medical waste. Follow-up and/or reporting measures by EMS personnel after caring for a suspected or confirmed Ebola patient •EMS personnel should be aware of the follow-up and/or reporting measures they should take after caring for a suspected or confirmed Ebola patient. •EMS agencies should develop policies for monitoring and management of EMS personnel potentially exposed to Ebola. •EMS agencies should develop sick leave policies for EMS personnel that are non-punitive, flexible and consistent with public health guidance •Ensure that all EMS personnel, including staff who are not directly employed by the healthcare facility but provide essential daily services, are aware of the sick leave policies. •EMS personnel with exposure to blood, bodily fluids, secretions, or excretions from a patient with suspected or confirmed Ebola should immediately: ◦Stop working and wash the affected skin surfaces with soap and water. Mucous membranes (e.g., conjunctiva) should be irrigated with a large amount of water or eyewash solution; ◦Contact occupational health/supervisor for assessment and access to post-exposure management services; and ◦Receive medical evaluation and follow-up care, including fever monitoring twice daily for 21 days, after the last known exposure. They may continue to work while receiving twice daily fever checks, based upon EMS agency policy and discussion with local, state, and federal public health authorities. •EMS personnel who develop sudden onset of fever, intense weakness or muscle pains, vomiting, diarrhea, or any signs of hemorrhage after an unprotected exposure (i.e., not wearing recommended PPE at the time of patient contact or through direct contact to blood or body fluids) to a patient with suspected or confirmed Ebola should: ◦Not report to work or immediately stop working and isolate themselves; ◦Notify their supervisor, who should notify local and state health departments; ◦Contact occupational health/supervisor for assessment and access to post-exposure management services; and ◦Comply with work exclusions until they are deemed no longer infectious to others. 1 http://www.cdc.gov/vhf/ebola/hcp/patient-management-us-hospitals.html 2 http://www.cdc.gov/vhf/ebola/hcp/case-definition.html 3 http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html...


Dangers of "Dialing Direct"
Some people believe that driving to a fire station is the quickest way to obtain service in a medical emergency. The danger with this thinking is that apparatus in a station does not necessarily mean that personnel are at the station. Let’s take Station 1 in Chester for instance; if the engine and ambulance are gone, there may still be a brush truck and a spare engine or ambulance in the house. The previous statement would be a situation where there are no personnel in the station. Dialing 9-1-1, for a medical emergency, gets an immediate response of the most appropriate and closest units available. A citizen could not know that units at fire stations are tied up on calls, training or some other function. Even if you are out, you should dial 9-1-1, giving the dispatcher the best address possible. If, for whatever reason, you drive to a fire station and no one comes to the door, do not leave! Call 9-1-1 from the parking lot of the station and tell the dispatcher what station you are at. The dispatcher will then dispatch the closest and most appropriate units to your location. Driving from fire station to fire station could prove fatal, especially if a full assignment has just been dispatched to a structure fire. The greatest chance of survival in a medical emergency is to get basic life support (BLS) on scene within six minutes and advanced life support (ALS) on scene within 10 minutes. I know that attempts have been made to trim these times even more, but the chain of survival has multiple parts, with everyone having a role. The citizen must recognize a medical emergency and call 9-1-1, as quickly as possible. Citizen care, for example CPR, is a necessary piece of a person’s potential survival. Once a dispatcher receives the call, the dispatcher must dispatch the closest and most appropriate response, as quickly as possible. Once the station(s) receive the call, they must get on the street as quickly as possible, as well as drive the most direct route to get to the address of the emergency. Proper house numbering also allows units to find your home or business quicker. Time is truly of the essence in a medical or fire emergency. The quicker you make the call, the quicker units will arrive. Delays translate into lost time. The system is designed for units to come to you, not you to go to them. You might think that you are saving time, but in all honesty you may drastically increase the time it takes to get personnel to your location. Call 9-1-1; state your emergency, name, address and phone number. Take instructions from the dispatcher, and do everything possible to let responding units know where you are....


NFPA Looks at CA Call Times
The National Fire Protection Association says the total response time for the Oceano house fire last week is within its standards, though call handling for the initial 911 call does not fall within its recommended time frame. KSBY News spoke with Ken Willette, public fire protection division manager, and he says the agency sets a series of benchmarks for call handling so emergency crews have enough time to respond. The NFPA recommends from the time the very first 911 call is answered, that it take 1 minute 45 seconds to notify the appropriate fire agency. The standard allows for some room, up to 2 mins 40 secs, to allot for situations that call for multiple transfers and alarms coming in via cell phone, email, text and other methods. Willette reviewedthe call timelines supplied to KSBY News by the San Luis Obispo County Sheriff's Office, California Highway Patrol, CAL FIRE, Grover Beach Police Dept. and Five Cities Fire authority. A land line call that came into the San Luis Obispo County Sheriff's Office, transferred to Grover Beach dispatch, who then notified Five Cities Fire took 2 mins 19 seconds. This is within the standard, according to Willette. However, the cell phone call that came in more than a minute before the landline call went first to CHP, whose dispatchers transferred the call to CAL FIRE in 44 seconds; CAL FIRE sent the information to Grover Beach via their computer-aided dispatch system in 1 minute 16 seconds; and Grover Beach alerted Five Cities Fire in 1 min 49 secs. "It's that continuum. Now the more you transfer the calls and the more time that's added to it...if it goes beyond the amount of time for our recommended standards, it widdles down the amount of time responders have to intervene," Willette said. The agencies say they indepedently met the time standards, but Willette says it's supposed to be a collective effort. "The intent of the standard is that is one block of call, from the first call to the responders going... Is that 1 minute and 45 seconds to two minutes 40 seconds. It doesn't accumulate over each independent agency. For the alarm handling part, if you look at that in isolation, they did not meet the recommended standards," Willette said. Agencies say their dispatchers acted swiftly. "We transfered it right away. This one was under 40 seconds," CHP Capt. Matt Olson said. "We had part of that and our response was fast, as fast as any dispatch center could do," CAL FIRE Chief Robert Lewin said. "Would we like to see it lower? Sure. There's going to be adjustments, and our review of this material is allowing us to make those necessary adjustments," Grover Beach Police Commander John Peters said. Peters says his department has come up with ways to shave about 1 minute off some dispatch times, by reducing the number of transfers. He says they are meeting again on Tuesday to discuss future emergency call handling. ******** The San Luis Obispo County Sheriff's Office, Cal Fire and California Highway Patrol invited KSBY News to the Sheriff's Office Thursday afternoon to clarify their call timelines. "All three dispatch centers really exceed all protocols and all procedures and the timelines for response," San Luis Obispo County Undersheriff Tim Olivas said. Here is the timeline for 911 calls. The numbers have been supplied by the three aforementioned agencies, as well as Grover Beach Police Department and Five Cities Fire Authority. 12:09:11 CHP received first 911 cell phone call 12:09:55 Cal Fire receives transfer of cell phone call from CHP 12:11:11 Cal Fire transfers info from 911 call to Grover Beach dispatch via CAD system 12:11:22 Cal Fire dispatched first mutual aid engine from Mesa department 12:11:27 Grover Beach dispatch receives information 12:12:12 Cal Fire transfers info from 911 call to Grover Beach via phone 12:13:16 Grover Beach dispatch sends tones to Five Cities Fire 12:17:52 Five Cities Fire first engine arrives on scene 12:18:33 Cal Fire mutual aid engine arrives on scene 12:10:57 San Luis Obispo County Sheriff's Office receives first 911 call from landline in Oceano 12:11:35 Sheriff's Office transfers call to Grover Beach dispatch 12:13:16 Grover Beach dispatch sends tones to Five Cities Fire 12:14:23 Sheriff's Office transfers calls to Cal Fire when can't get through to Grover Beach 12:17:52 Five Cities Fire first engine arrives on scene The National Fire Protection Association says their standard for "alarm handling" response, including answering, transferring and processing is 1 minute and 45 seconds for 90 percent of calls and up to 2 minutes and 40 seconds for 99 percent of calls. The call handling from the time the first 911 call came into CHP and transferred it to Cal Fire to when Grover Beach got the call to when Five Cities Fire was notified: 4 minutes and 5 seconds total. From the first 911 call to when Cal Fire dispatched an engine: 2 minutes and 11 seconds. From the Sheriff's Office's first 911 call to when Grover Beach got the call to when Five Cities Fire was notified was 2 minutes and 19 seconds. All agencies say they completed their segments within the NFPA standard. "The time between CHP receiving the first call and Cal Fire transferring to Grover Beach Police Department is 1 minute and 16 seconds," Olivas said. "We are confident all our actions were done appropriately and within the proper time frames," Cal Fire Chief Robert Lewin said. An NFPA representative says, however, the time is counted from when the very first 911 call comes in to the time the appropriate fire agency is notified. That is no matter how many agencies are involved and how many times the call is transferred. ******** From the time the first 911 call was made to when fire crews arrived on scene at a fire in Oceano Thursday, it took 8 minutes and 32 seconds, according to Grover Beach Police Commander John Peters. At press time, various agencies involved in the emergency call and response are still investigating why it took dispatchers close to five minutes to notify Five Cities Fire Authority of a house fire in their area on Thursday around noon. This is more than twice the 1 minute 45 seconds the American Fire Protection Association recommends it should take to handle an alarm, including answering, transferring and processing an emergency call. Five Cities Fire's Interim Battalion Chief Randy Steffan says 911 calls went first the California Highway Patrol, to the San Luis Obispo County Sheriff's Office, to Cal Fire, back to the Sheriff's Office, then to Grover Beach Police Dept. dispatch, before ending up where the call needed to be, with Five Cities Fire. "We're experiencing some initial dispatch delays. Not only on fires, but on traffic accidents and medical aids as well," Steffan said, explaining the transfers are due to recent dispatch consolidations. "If we don't know about the call, we can't respond until we're dispatched." CHP says their first 911 call came in at 12:09 p.m. Five Cities Fire says they heard from dispatchers at 12:14 p.m., then their first engine arrived on scene at Beach Street in Oceano at 12:17. Neighbors say they started calling 911 starting at noon, and as flames rose 15 to 20 feet in the air, wondered why they weren't hearing sirens. "Still no fire trucks, so i called 911. I couldn't get through and I called three times," next door neighbor Curt Bevington said. Neighbor Allan Mackenzie says he was lucky his house came away with little damage; however, he believes the fire could have remained in the backyard shed rather than spreading to the house had fire crews been dispatched earlier. "It became very clear just how fortunate I was," Mackenzie said. "It does make me wonder who's minding the store. Because obviously the oversight on this...they took their eyes off the ball." KSBY News is consolidating call records from the various agencies, and will continue to follow the story. Peters says Grover Beach Police are also investigating, as is the Sheriff's Office, to find out why there was a lag during that incident. He says some of the times may be off, as some of the agencies use a world clock to record times, while others manually enter them...


FIREFIGHTER HANDCUFFED AFTER NOT MOVING APPARATUS "It's Déjà Vu All Over Again"
 A dispute occurred between emergency responders at the scene of an accident in Winn Parish Saturday morning, resulting in a firefighter in handcuffs.Winnfield (Louisiana) firefighter Jonathan Johnson was taken from the scene of a two-vehicle accident for continuing to block traffic with a fire engine. Johnson was one of two members of the city fire department to respond to the call — which is standard operating procedure for the department, Fire Chief James Keith said — arriving at 7:12 a.m. with the engine and a rescue unit.He blocked traffic with the engine around the wreck that had occurred in a turning lane of a four-lane road. Keith said Johnson parked the vehicle for scene safety and turned his attention to the driver to check for injuries with the paramedic.Winn Parish Sheriff Cranford Jordan said the accident was minor and did not warrant a fire engine. There were no injuries."I was parish fire chief before I was sheriff," he said. "We need a close working relationship with everybody. There are times to block the road. An officer or fireman has to use his judgment."As a parish and a city entity, the WPSO and Winnfield Fire Department do not work together often. The wreck occurred in what Keith called a "gray area" near the city limits, but the city department was paged."We're going to go, we're going to respond irregardless of where it's at," Keith said. "We're all emergency responders."Responding officer Dep. Ralph Henson asked Johnson to move the engine as he had asked the ambulance and fire department rescue unit, both of which complied.Johnson did not move the vehicle because, according to Keith, he was assisting the paramedic. Jordan said Henson then called for back-up and Dep. Kelly Fannin arrived.Neither Keith nor Jordan were on scene. They received reports of the incident from their employees.Keith said Johnson was backing up the engine when Fannin arrived and told him to get out of the fire truck.Jordan said Fannin gave the command three times and, when he did not comply, removed him. Keith said Johnson did not comply immediately because the fire truck was in gear. He said the removal was physical and heated.Johnson was handcuffed and brought to the Winn Parish Sheriff's Office where he was restrained by leg to a bench until Henson, the officer working the scene of the accident, arrived. Jordan said that is standard procedure when the arresting officer is not the one working the case."He was treated just like anybody else," Jordan said.Johnson was held about two hours and given a citation for disobeying a police officer."This is very unfortunate that it happened like this," Jordan said. "We appreciate them responding. It (the wreck) could have been bad. But they have an obligation to listen to the officer."He said the incident between the two departments is not major. He said it could have been avoided had Johnson complied like the other two responders asked to move their vehicles."Order had to be maintained," Jordan said. "Everyone has to obey the law. ... He (the deputy) didn't ask him to do anything the other two didn't do."...


Remembering 2 Firefighters Killed in The Line of Duty (The Secret List)
All, 2 Los Angeles County Firefighters gave their lives in the Line of Duty 5 years ago today when they were driven off the side of a road in heavy smoke and into heavy fire conditions in the Mt. Gleason area, south of Acton. Killed in the Line of Duty were FF Specialist Arnaldo "Arnie" Quinones, 35 and Captain Tedmund "Ted" Hall, 47. Captain Hall had been with the LA County FD for 26 years and Arnie Quinones had been with the department 8 years. RIP. HERE is related video: http://youtu.be/ngOTx4Yb5ks Take Care. Be Careful. Pass It On. BillyG The Secret List 8-30-2014/1600 hrs www.FireFighterCloseCalls.com ...


5 IA FFs INJURED AT HIGH-RISE FIRE
Five firefighters were treated for injuries received fighting a fire in a downtown Des Moines building Saturday morning. The blaze was reported shortly after midnight at the 19-story Equitable Building. Fire Chief John TeKippe said two firefighters were hurt by falling debris, one fell off an eight-foot ladder and two others were treated for heat-related issues. The fire was contained in a crawl space with electrical wiring and ductwork on the second floor where most of the damage occurred. Some upper floors had smoke damage....


4 FFs INJURED AT COW BARN FIRE IN NY
About 30 cows perished and four firefighters were injured in a fire that leveled a large barn at 98 Alburg Road. The cause was found to be electrical and the fire to have started near hot water heater or exhaust fan, said Moira Volunteer Fire Department Chief Timothy Trimm.Farm owner Craig Tucker's property was struck by lightning last week, Trimm said, and some appliances in his home were affected."Whether that did some damage (to the barn) at that time who knows," he said.Four firefighters sustained injuries, Trimm said.Three were treated at the fire site and one went to the hospital via private vehicle.One firefighter's injury was heat-related, one sustained a cut to his hand, one was hit with a deck gun which resulted in a minor head injury and Trimm suspected he may have broken a rib when he fell.'GLOWING RED'The call was dispatched at about 1:15 p.m."He (Tucker) was at the other end of the barn and one of the workers hollered at him that the milk house was on fire."Trimm said he could see the smoke from a mile and a half away as he was approaching the property."A portion of the roof on the front side was already glowing red when we pulled in."While around 30 cows died, Tucker was able to get some of his other cows out of the burning structure to safety, Trimm said."They were working on getting the cows out when we got there and they gave up on it."The number of cows saved was unknown Friday.Some of the cows that died were dairy cows and others were heifers, Trimm said.THIRTEEN DEPARTMENTSThe barn was approximately 150-foot long by 30-foot wide, Trimm said.It was at least half-full of hay, which helped fuel the flames, Trimm said.Crews were able to keep the fire contained to the barn and it didn't spread to the equipment repair shed about 20 feet from the barn or Tucker's house, which is about 200 feet from the barn, he said.Tucker has insurance and told Trimm he plans to rebuild, the chief said.Thirteen departments from two counties responded as mutual aid: Dickinson, Brushton, Bombay, Bangor, St. Regis Falls, Duane, Fort Covington, Westville, Malone, Hogansburg/Akwesasne from Franklin County and Nicholville, North Lawrence and Lawrenceville from St. Lawrence County.The Moira Volunteer Fire Department was back in service at around 10 p.m....


FIREFIGHTER BEATEN BY CROWDS AFTER APPARATUS RUNS INTO CIVILIANS, KILLING 1 CIVILIAN AND SERIOUSLY INJURING OTHERS-THE PHILIPPINES
A man was killed and 13 others were injured today after a fire truck hit pedestrians in Manila, Philippines. The fire truck reportedly lost its brakes and rammed through pedestrians along Angel Linao Street in Paco, Manila, this afternoon. The fire apparatus driver immediately fled the area after the accident. The injured pedestrians were rushed to the Philippine General Hospital (PGH) in Manila. It is further reported that the rig belonged to the Manila Southern Volunteer Brigade. Reports are that the fire truck driver John Mark Calica, 35, of Southern Manila volunteer fire, did not survive the beatings when the people found him. ...


COLLAPSE CLOSE CALL AT HOUSE FIRE WITH ENTRAPMENT
On June 14th 2014 at 0400 Rock Hall Volunteer Fire Company was alerted for a working house fire with entrapment. chief 7 went on location confirming entrapment. Engine 72 followed in with orders to pull a line and make entrance into residence. crews hit out side delta wall and some of the heavier fire loads while one crew attempted excess as the nozzle man made his way into residence porch his air pack got caught on the door handle of a refrigerator. as he pulled away the second floor of the rescue room came down and closed the Bourkes of the nozzle mans helmet. All crews where ordered out. also at this time the whole house was energized crews where getting shocked on wood. Look at structures of houses better. watch for signs of collapse better. No matter how soon you call for power shut off keep an eye out for electrical hazards...


PARAMEDIC STUDENT ATTACKED OUTSIDE JAX FIREHOUSE
The Jacksonville Sheriff's Office is investigating an attack on a female paramedic student at a fire station on the Westside.According to the incident report obtained by Action News, a woman told police she left Fire Station No. 52 on Collins Road at 12:45 a.m. when someone attacked her.JFRD spokesman Tom Francis and Chief Marty Senterfitt told Action News the victim is a paramedic student.Police said the woman suffered a puncture wound below her rib cage and multiple lacerations on her upper thighs."Upon learning the details of this incredibly reprehensible and despicable crime we were saddened and above all else angered," said JFRD Public Information Officer Tom Francis.  The woman told police the attacker ran off in an undetermined direction, according to the report.  The woman said she went to the fire station and banged on the door for help before passing out.According to police, she came to and called 911 and firefighters found her quickly after the station went on alert."As we learn more information perhaps in the aftermath of this incident, take a look at some of the measures that take place as it relates to this particular program involving the training of paramedics," said Francis.   - See more at: http://www.actionnewsjax.com/news/news/local/jfrd-jso-investigating-incident-involving-female-p/nhBMJ/#sthash.PFmgfKZp.dpuf...






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