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CASE REVIEW LEARNING POINT Influenza patient with severe symptoms. In the setting of widespread outbreaks, EMS providers should be familiar and confident in the management of potentially contagious patients, and have the available protection of immunizations, protective equipment and safe practices. EMS care and decision-making priorities need to be matched with the local public health agency. All hospitals have the potential for diversion. In urban areas where hospitals are closer to each other, it is typically felt that diversion carries less of a penalty for community patient care. However, in areas where a single hospital stands geographically isolated, there will be signifcant transportation issues for patients and their families if care needs to be diverted. These isolated hospitals must be extraordi- narily well prepared for patient fuxes and utilize diversion rarely. As in this case, the EMS system can have a diffcult job in understanding and conveying the diversion message. Dispatch centers may need signifcant clarifcation of what form of diversion is taking place, how long it will last and how to effectively communicate the message to EMS units in the feld. Many 9-1-1 dispatchers are police or civilian personnel and must be given explicitly worded diversion messages to deliver. Some areas have established policies that eliminate diversion, rerouting or patient offoad delays. In these communities regional planning leads to development of improved system status management, with tools that are utilized by the EMS system, hospitals, the major payers and the general medical community. These systems provide a comprehensive toolbox for identifying key community resources and communicating their status to providers. These allow the regional health system to operate more effciently while still enabling the community to access excellent care at peak demand times. Over time, Internet-based status management programs and a hospital bed "spot market" system will tie together large regions for healthcare delivery and make bed availability brutally effcient. There will, however, always be a concern about the management of unplanned needs and disasters. James J. Augustine, MD, FACEP, is medical advisor for Washington Township Fire Department in the Dayton, OH, area. He is director of clinical operations at EMP Management in Canton, OH, a clinical associate professor in the Department of Emergency Medicine at Wright State University in Dayton, and an editorial advisory board member for EMS World. Contact him at jaugustine@emp.com. EMERGENCY RESPONSE TEXAS A&M; ENGINEERING EXTENSION SERVICE/EMERGENCY SERVICES TRAINING Specialized training can be tailored to meet your needs in: • Emergency Medical Services • Operations • NIMS / ICS • Exercise / Drills • Human Patient Simulator • Rescue • HazMat • Fire • WMD • US&R; • Ambulance Strike Team • Emergency Operations Training Center Schedule these or any of our 130+ courses today! www.teex.org/¿re • 1.866.878.8900 For More Information Circle 13 on Reader Service Card 22 MARCH 2013 | EMSWORLD.com