What mechanisms does EMS put into action when calls for EMS assistance exceed the EMS resources available to respond? Are agreements already in place to reduce healthcare system stress? What are the mechanisms that are successfully used to decrease healthcare system stress? A healthcare coalition or planning team will need to understand and review available EMS resources (i.e., supplies and equipment, staff, and space) and how these resources can be adapted to address medical surge (see Worksheet 2.5 – Resource Review by Disaster Scenario on page 25). Trigger discussions also should include who defines triggers and who makes the decision to initiate action based on the trigger. EMS roles and capabilities vary significantly across local communities. Analyzing the information about the mechanisms and parties responsible for initiating triggers is important information that can guide community surge planning. (See Worksheet 2.6 – Trigger Identification Discussion Questions on the previous page for suggested discussion topics for identifying triggers for EMS systems.) The NAS report, Crisis Standards of Care: A Toolkit for Indicators and Triggers (available at is one resource to generate discussion and thought in recognizing triggers. An example of triggers for expanding EMS system capacity is the catastrophic plan triggers for initiating resource requests and federal interventions at the onset of an event of specific severity. These plans are developed as a collaboration between FEMA, HHS, and state/local response agencies and can be obtained from local or state emergency management, as appropriate. The following are examples of surveillance data that could trigger the implementation of emergency plans (recommended by experts attending the EMS Stakeholder Meeting) Time required for a PSAP to answer an emergency call ("answer time") exceeds established standards. Number of calls to a PSAP exceed EMS resources. Hospitals are diverting patients. Hospital beds are at or exceeding capacity. Observed severity/lethality of the disease.
What mechanisms does EMS put into action when calls for EMS assistance exceed the EMS resources available to respond? Are agreements already in place to reduce healthcare system stress? What are the mechanisms that are successfully used to decrease healthcare system stress? A healthcare coalition or planning team will need to understand and review available EMS resources (i.e., supplies and equipment, staff, and space) and how these resources can be adapted to address medical surge (see Worksheet 2.5 – Resource Review by Disaster Scenario on page 25). Trigger discussions also should include who defines triggers and who makes the decision to initiate action based on the trigger. EMS roles and capabilities vary significantly across local communities. Analyzing the information about the mechanisms and parties responsible for initiating triggers is important information that can guide community surge planning. (See Worksheet 2.6 – Trigger Identification Discussion Questions on the previous page for suggested discussion topics for identifying triggers for EMS systems.) The NAS report, Crisis Standards of Care: A Toolkit for Indicators and Triggers (available at is one resource to generate discussion and thought in recognizing triggers. An example of triggers for expanding EMS system capacity is the catastrophic plan triggers for initiating resource requests and federal interventions at the onset of an event of specific severity. These plans are developed as a collaboration between FEMA, HHS, and state/local response agencies and can be obtained from local or state emergency management, as appropriate. The following are examples of surveillance data that could trigger the implementation of emergency plans (recommended by experts attending the EMS Stakeholder Meeting) Time required for a PSAP to answer an emergency call ("answer time") exceeds established standards. Number of calls to a PSAP exceed EMS resources. Hospitals are diverting patients. Hospital beds are at or exceeding capacity. Observed severity/lethality of the disease.