HEALTH RESERVE WORKFORCE AND EMERGENCY MEDICAL TEAMS (EMTs)
ATTACHMENT 10 RESERVE HEALTH WORKFORCE CLASSIFICATION UNDER THE HEALTH CLUSTER SYSTEM
3.12.3 EMT Service Standards
EMT has an obligation to ensure the quality of healthcare services for affected communities. EMT is mobilized to the disaster-affected areas within a maximum of 24 hours after the incident (especially EMT Type 1). EMT is stationed or traveling to serve and refer victims of health crises. EMT is under the control and coordination of EMTCC, in this case, under the coordination of the health service sub-cluster. In the absence of an established HEOC, the first EMT to arrive at the disaster site may become the EMTCC and help coordinate other EMTs.
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Table 3.4 Types of EMT
EMT Structure Response Time Duration of
Assignment
Type 1 Mobile Within the first 24
hours
14 effective days Type 1 Fixed
Type 2 Within the first 24-
36 hours
21 effective days
Type 3 Within the first 36-
48 hours
28 effective days
Specialist Care Team Adjustable to needs
The organization or institution establishing EMT must have the scope of service, competency and qualification of human resources, as well as facilities and logistics with the following minimum provisions.
Table 3.5 Minimum Service Standards for Type 1 Mobile EMT
Scope of Service Competencies and Qualifications
Facilities and Logistics
a. Health services:
•
1 doctor a. Ambulance•
Triage•
2 nurse b. Emergency kit•
Initial medicaltreatment
•
1 ambulance driver c. Medications and medical supplies•
Trauma and non- traumaemergency treatment
•
Stabilization and referral of patients requiring inpatient care and higher levels of treatment•
Basic health services84
Scope of Service Competencies and Qualifications
Facilities and Logistics
● Emergency reproductive health, basic midwifery, and newborn care
b. Service duration of 8 hours per day.
c. Minimum of 50 patients served per day.
d. Services can be conducted in ambulances, tents, or other possible facilities.
e. Support or activate health services in affected areas.
Table 3.6 Minimum Standards for Type 1 Fixed EMT Service
Scope of Services Competencies and
Qualifications Facilities and Logistics a. Primary Health
Services:
● Triage
● Initial medical care
● Trauma and non-trauma emergency care
● Stabilization and referral of patients requiring inpatient care and higher levels of treatment
● Basic health services
● Reproductive health services, basic obstetric and newborn care.
b. Service duration of 8 hours per day.
● 1 doctor,
● 2 nurses,
● 1 pharmacist,
● 1 general/
logistics personnel
● 1 administration staff
a. Emergency kit b. Medications c. Medical and general logistics
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Scope of Services Competencies and
Qualifications Facilities and Logistics c. Minimum of 100
patients per day.
d. Services can be carried out at healthcare facilities, tents, or other suitable facilities.
e. Supporting or activating health services in the affected area's health service facilities.
The implementing organization/ institution in the province and district/city may also form Type 2, 3, and Specialist Care Teams that provide advanced/specialist health services such as surgery, obstetrics and gynecology, internal medicine, pediatrics, anesthesia, orthopedics, and others.
Table 3.7 Minimum Standards for Type 2 EMT Service
Scope of Services Competencies and
Qualifications (minimum) Facilities and Logistics In addition to Type 1
services:
● New patient admissions, referrals
● Inpatient care,
● General surgery and
● Midwifery
Trauma and other major conditions that include:
a. Surgical triage and advanced life support, b. Definitive wound and
fracture management, c. Damage control surgery d. General emergency
surgery and obstetrics, e. Inpatient care for non-
trauma emergencies, f. Basic anesthesia, X-
rays, blood transfusions, g. Lab services, and
medical rehabilitation,
Staff:
a.. Including doctors trained in emergency care and general medical care (including maternal and child health services), b. Surgical and anesthesia
staff for the operating room,
c. Medical staff and nurses to handle inpatient care and other services (radiology, laboratory, etc.)
d. Pharmacy staff e. Logistics staff The ratio must meet or exceed:
a. Anesthesia technician/
anesthesiologist ratio, i.e. 1 surgeon for 5 surgical technical staff for each operating table.
● 1 operating table
● 7 major surgeries or 15 minor surgeries per day
● 20 inpatient beds
● 24-hour/7-day service
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Scope of Services Competencies and
Qualifications (minimum) Facilities and Logistics h. Services can be carried
out at definitive health facilities, field hospitals, or other suitable facilities that meet the applicable technical standards/
specifications.
b. The nurse ratio should be at least 1 nurse for 8 beds (24 hours)
c. Expert medical equipment technicians.
The number, types of personnel, and logistics needed to form Type 2 EMT can be seen in the annex.
Table 3.8 Minimum Standards for Type 3 EMT Service
Scope of Services Competencies and Qualifications
(minimum) Facilities and Logistics In addition to Type 2 services:
● Complex surgical care, inpatient referral, including intensive care unit (ICU) capacity.
● In addition to Type 2 services, Type 3 EMT also provides:
● Primary and stabilization care
● Complex wound and orthopedic reconstruction care,
● Advanced X-ray services, blood transfusions, lab and rehabilitation services,
● Advanced pediatric health services and adult anesthesia, equipped with an Intensive Care Unit (ICU) bed with 24-hour service with the availability of respiratory support equipment (ventilator).
The staff must meet the competency standards and ratios of EMT type 2 and orthoplastic reconstructive surgeons. The ratio is 1 nurse to 2 beds in intensive care (24 hours).
● At least 2 operating tables
● > 100 outpatient visits
● > 40 inpatient admissions (20 inpatient postoperative beds)
● 15 major surgeries or 30 minor surgeries per day
● 4 intensive care beds
● 24-hour service/7 days a week
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Table 3.9 Minimum Standards for EMT Specialist Care Teams Scope of Services Competencies and
Qualifications (minimum) Facilities and Logistics
● Specialized care specific to a discipline, supporting the services provided by EMT types 2 + 3 or local hospitals.
● Specialized services may include:
Burn treatment, dialysis and care for edema symptoms, maxillofacial surgery, orthoplastic surgery, intensive rehabilitation, maternal health*, neonatal and child health services.
● Respond to existing needs for specialized services.
● Incorporated into and working from EMT 2 or 3, national hospitals or health systems.
● For some services, it can be independent, such as
community health services.
● Qualification and competency standards are tailored to each professional organization.
Adjusted to the capacity of the service and the standards of each profession.
The type of drugs and EMT logistics are adjusted to the type of service.