County of Simcoe Paramedic Services Deployment and Response … · 2016-02-03 · Deployment and Response Time Performance Plan for the County of Simcoe Paramedic Services – September

Deployment and Response Time

Performance Plan for the County of Simcoe

Paramedic Services – September 2015 V1.0

County of Simcoe Paramedic Services

1110 Highway 26

Midhurst, ON L0L 1X0 Phone 1-866-893-9300

Fax 705-722-6601

Table of Contents

Introduction ............................................................................................................................ 6

Mandate............................................................................................................................... 6

Challenge ............................................................................................................................ 6

Definitions .............................................................................................................................. 8

Authorized Officials – County of Simcoe Paramedic Services ............................................ 10

Response Time Targets – County Of Simcoe Paramedic Services ...................................... 10

Dimensional Dispatching System ......................................................................................... 11

a) Organization Assignment and Responsibilities............................................................ 11

Simcoe Deployer – Tactical Channel 4 Responsibilities .................................................. 11

Simcoe Assigner– Tactical Channel 4 Responsibilities.................................................... 11

Simcoe Follower– Tactical Channel 5 Responsibilities ................................................... 11

b) Performance Expectations............................................................................................ 11

Expectation of Georgian CACC ....................................................................................... 11

Expectations of County of Simcoe Paramedic Units ........................................................ 12

c) Post-Call Expectations ................................................................................................. 12

Scheduled Resources (Effective April 6, 2015) ................................................................... 13

Emergency Coverage (System Status Management Plan) .................................................. 14

a) Priority Posting Plan ..................................................................................................... 14

b) Severe Workload Management Guidelines .................................................................. 14

c) Mutual Aid – Assistance to other Municipalities .......................................................... 15

d) Administrative Assignment .......................................................................................... 15

Rapid Response Units ........................................................................................................... 16

a) Focus ............................................................................................................................ 16

b) Attending with Transporting Paramedic Units: ............................................................ 16

Providing Advanced Care Paramedic Support –DPCI-II ...................................................... 16

a) Within the County of Simcoe ....................................................................................... 16

b) Out-Of-County ACP Response .................................................................................... 17

c) Simcoe County ACP Deployment Criteria ................................................................... 17

Medically Necessary Transfers (All Priorities) .................................................................... 17

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County of Simcoe Paramedic Services Deployment and Response Time

Peformance Plan 2015

a) Deferral of Non-Emergent Transfers ......................................................................... 17

b) Non-Emergency (Priority 1 or 2) Transfers ............................................................... 18

c) Priority 3 or 4 Transfers............................................................................................. 18

d) Return Patient Wait Times ........................................................................................ 19

e) Long Distance Transfers ............................................................................................ 19

f) Multi-Patient Transfers .............................................................................................. 19

g) Facilities Requesting Advanced Care Paramedics .................................................... 19

h) Transport for Transplantation .................................................................................... 19

i) Teams and Medical Equipment ................................................................................. 19

j) Out-of-Province Transfers ........................................................................................ 19

k) Transports to the United States of America ............................................................... 20

l) Mitigation of Off-load Delays ................................................................................... 20

Priority 3 Call Assignment Delays ........................................................................................ 20

Patient Destination and Distribution ..................................................................................... 21

Start-of-Shift Issues .............................................................................................................. 21

End-of-Shift Issues................................................................................................................ 21

Break Periods for Paramedics ............................................................................................... 22

County of Simcoe Paramedic Break Periods .................................................................... 23

Request for Police in 10-2000 situations .............................................................................. 23

a) Actions on a “10-2000” Request ............................................................................... 23

County of Simcoe Paramedic Services Management Notification ....................................... 24

a) Platoon Supervisor Notification ................................................................................ 24

b) CSPS Notifications .................................................................................................... 24

Bariatric Equipment and Transport ...................................................................................... 24

Multi-Casualty, Major Incident, Multi Patient Unit (MPU) and Specialized Response Units

.............................................................................................................................................. 25

a) Multi Patient Unit (MPU) .......................................................................................... 25

b) Multi-Casualty Incidents (MCI) ................................................................................ 25

c) Emergency Support Units (ESU 3301 & 3302) ........................................................ 25

d) Mobile Command Unit (MCU 3310) ........................................................................ 25

MCI Incident Levels ......................................................................................................... 26

a) MCI Channel ............................................................................................................. 27

b) Request for Resources ............................................................................................... 27

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c) Incident Response Unit Paramedics (IRU) ................................................................ 27

d) IRU Call Assignments (Mandatory) .......................................................................... 27

e) Accessing Transit for Emergency Shelter ................................................................. 28

IRU Deployment Process Map ......................................................................................... 29

Severe Weather Protocol ...................................................................................................... 30

Labour Disruption/Strike Protocol ....................................................................................... 31

Public Access Defibrillation Sites ........................................................................................ 31

Priority Posting Plan 0700-0859 MORNING ...................................................................... 32

Priority Posting Plan 0900-1759 PEAK ............................................................................... 33

Priority Posting Plan 1800-0659 NIGHTS ........................................................................... 34

APPENDIX A – Platoon Supervisor Notification List ........................................................ 35

APPENDIX B – CSPS Break Management Tool ................................................................ 36

APPENDIX C – Response Times Targets ........................................................................... 37

APPENDIX D – Tiered Response Agreement ..................................................................... 38

APPENDIX E – Patient Priority System Agreement ........................................................... 39

APPENDIX F – Ornge Designated Landing Zones ............................................................. 40

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Introduction

The County of Simcoe through its Paramedic Services Department is responsible for ensuring

the proper provision of land ambulance services within the 16 municipalities of Simcoe County,

the separated cities of Orillia and Barrie and Canadian Forces Base Borden.

This deployment and response time performance plan provides the Ministry of Health and Long

Term Care (MOHLTC) Central Ambulance Communications Centre (CACC) and Field Office

the strategy used to deploy County Of Simcoe resources to meet response time performance and

business objectives.

The provisions in this plan are made in accordance with:

The Ambulance Act of Ontario,

The Employment Standards Act of Ontario,

The Occupational Health and Safety Act of Ontario,

The Highway Traffic Act of Ontario,

The Coroners Act of Ontario,

The County Of Simcoe & OPSEU 303 Collective Agreement, and

The MOH Manual of Practice for Ambulance Communications Officers and Central

Ambulance Communications Centres

Paramedic Services will be reviewing this plan on a regular basis. Any revisions to this plan

must be approved by the County Of Simcoe Paramedic Services prior to implementation.

Mandate

To establish an efficient and effective organizational deployment model that is consistent as well

as responsive to the evolving emergency services needs of the community and operation.

Historical data and identified trends are used to determine the quantity and placement of

Paramedic resources.

Challenge

The County is a composite of diverse segments including high population density in the Cities of

Barrie and Orillia, smaller relative population density areas in the many towns, including

industrial, large commercial/retail enterprises, rural farming operations as well as large area of

wilderness, outdoor recreation areas and tourist attractions drawing many campers, hikers and

tourists during all seasons.

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This plan is approved by:

________________________________ Andrew Robert, Director & Chief

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Definitions

ACO Ambulance Communications Officer.

ACP Advanced Care Paramedic.

Available A fully staffed Ambulance or Rapid Response Unit, available to respond

Resource to a request for service.

CACC Central Ambulance Communication Centre.

CBRNE Chemical, Biological, Radiological, Nuclear, Explosive Incident

CODE 0 Administrative/Other: Movement of a vehicle for any non-patient reason

other than covered by Codes 7, 8 or 9

CODE 1 Deferrable Call: A non-emergency call which may be delayed without

being physically detrimental to the patient

CODE 2 Scheduled Call: A non-emergency call which must be done at a specific

time due to the limited availability of special treatment or

diagnostic/receiving facilities. Such scheduling is not done because of

patient preference or convenience

CODE 3 Prompt Call: A call for service which may be responded to with moderate

delay. The patient is stable or under professional care and not in

immediate danger

CODE 4 Urgent Call: An emergency call requiring immediate response.

CODE 5 Obviously dead as defined in the Ontario Basic Life Support Standards

under the Ambulance Act

CODE 6 Legally Dead Patient: The patient has been pronounced dead by an

attending physician

CODE 7 Down Staffed Vehicle: A regularly scheduled vehicle is available for a

call, but one or more staff is unavailable such as due to illness or delayed

arriving for work

CODE 9 Maintenance Call: A vehicle is out of service for mechanical failure or for

maintenance at base or is sent to a garage for servicing

CTAS Canadian Triage Acuity Scale, a rating scale assigned to each emergency

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patient used to establish the severity of illness and priority of care

CSPS County of Simcoe Paramedic Services

ED Emergency Department

EHSB Emergency Health Services Branch of the

Ministry of Health and Long Term Care.

IRU Incident Response Unit

MCI Multiple Casualty Incident

MPU Multi Patient Unit

OLD Off Load Delay - Related to hospital wait time for patients to be accepted

from the paramedic by the receiving facility. Any time greater than 30

minutes is considered a delay in transfer of care

ORNGE Ontario Air and Land Transport Ambulance Service as per the Ambulance

Act

PAD Public Access Defibrillator

PCI Percutaneous Coronary Intervention

PCP Primary Care Paramedic

POST Designated point or area to which a resource may be assigned for

emergency response coverage

PPS Patient Priority System

PRIORITY Code designating the urgency of the call (see Code 1 to Code 4)

PU (Paramedic Unit) – Ambulance, normally staffed with two Paramedics

Preceptor A Paramedic crew with a Student Paramedic on board

RRU Rapid Response Unit, normally staffed by a single Paramedic with limited

transport capability (no stretcher)

SCA Sudden Cardiac Arrest

SSM System Status Management

STEMI S – T segment Elevation Myocardial Infarction

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Authorized Officials – County of Simcoe Paramedic Services

The following County of Simcoe Paramedic Services positions:

Director and Chief

Deputy Chief Operations

Deputy Chief Logistics

Deputy Chief Performance, Quality and Development

CSPS Supervisor

Platoon Supervisors

Acting Platoon Supervisors (in the capacity of performing such duties)

Hold the authority to:

a) Remove a vehicle that is not currently assigned to a Priority 3 or 4 calls from

operations.

b) Change the location of a vehicle that is not currently assigned to a Priority 3 or 4 call to

facilitate operational requirements in consultation with CACC.

c) Request the deferral / reassignment of Priority 1, 2, 3, or emergency coverage

assignments to facilitate break periods and mitigate end-of-shift overtime.

d) In consultation with the CACC Supervisor, approve the completion of a code 1 or 2 originating at hospital to mitigate the effects of off-load delay.

e) Approve the assignment of an additional vehicle to attend a scene to mitigate end- of-

shift overtime, provided the resources are available and there is no delay in patient care

and the transport of a patient.

f) Initiate a specialized Paramedic Services response outside the scope of this plan.

g) Temporarily amend the Deployment Plan as required to meet specific operational

requirements

Response Time Targets – County Of Simcoe Paramedic Services Appendix C outlines the approved Response Time Standard for the County of Simcoe

Paramedic Services in accordance with the Ontario Land Ambulance Certification Standard, Part

III Operation Certification Criteria; B.3.

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Dimensional Dispatching System

a) Organization Assignment and Responsibilities

Simcoe Deployer – Tactical Channel 4 Responsibilities

1. Emergency coverage assignments

2. Rostering of resources

3. Break management

4. Code 9 and administrative assignments

5. End of shift management

Simcoe Assigner– Tactical Channel 4 Responsibilities

1. Identifies closest vehicle and assigns all emergency calls.

Simcoe Follower– Tactical Channel 5 Responsibilities

1. Follows all ongoing calls

2. Monitors ongoing incidents

County of Simcoe Paramedic Resources– Channel Assignment

1. All available resources will remain on Tactical Channel 4

2. All resources assigned to a call will remain on Tactical Channel 5 until departing

the hospital or cleared from the scene.

3. All Platoon Supervisors will remain on Tactical Channel 5 and can be assigned by

the Simcoe Follower or may request attachment to a call.

b) Performance Expectations

Expectation of Georgian CACC

1. When assigning an emergency call, the ACO will only provide a priority code,

major cross-street, address, and UTM on Tactical Channel 4 before advising crew

to switch to Tactical Channel 5. Once booking on air Tactical Channel 4, the

crew will be marked as mobile at this time.

2. After the crew has booked onto Tactical Channel 5, the ACO will provide all

additional call details.

3. The Simcoe Follower ACO will provide all call details within 2 minutes of the

receipt of call/T0 (unless details are delayed by the call taker).

4. The Simcoe Follower ACO will respond immediately all 10-2000 radio requests.

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Expectations of County of Simcoe Paramedic Units

1. All units will book onto Tactical Channel 4 when booking on air for an

emergency call. Once initial details are received, units will begin responding and

will turn to Tactical Channel 5 for further details.

2. All units will respond to all radio requests by dispatch with the full vehicle

number and current location (i.e. “3210, Tiffin & Anne”).

3. All units will utilize the cell phone or landline for any non-urgent

communications in order to keep the air traffic minimal.

c) Post-Call Expectations

1. All units will notify dispatch as soon as their stretcher is cleared and their

equipment is clean and available for service.

2. Depending on the nature of the previous call, enhanced cleaning and disinfection

may be required. All resources will advise dispatch of any delay or Code 9 status

due to cleaning or disinfecting.

3. A Paramedic unit is not available for calls until cleaning and disinfection is

complete. If cleaning and disinfection requirements are expected to take longer

than 20 minutes from transfer of care or necessitates returning to a Paramedic

station, the crew is responsible for notifying their Platoon Supervisor.

4. Documentation must never delay a unit from returning to service.

5. All units transporting one way outside of Simcoe County will immediately depart

the hospital once transfer of care is complete and the vehicle is cleaned and

returned to a serviceable state. All documentation will be completed upon

returning to Simcoe County. See section Medically Necessary Transfers re:

return transports

6. Available resources will notify CACC and switch to Tactical Channel 4 at their

earliest opportunity or once clearing the hospital.

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Scheduled Resources (Effective April 6, 2015) Station Start

Times

24 Hour

Amb.

PCP

24 Hour

Amb.

ACP

12 Hour

Amb.

PCP

12 Hour

Amb.

ACP

24 Hour

RRU

ACP

12 Hour

RRU

ACP

Alliston 0600 ●

0700 ●

0800 ●

Angus 0700 ●

Bradford 0700 ●

0830 ●

Barrie

(Tiffin)

0600 ●

0700 ●

0800 ●

1300 ●

Barrie

(Bayfield)

0630 ●

0700 ● (IRU)

0700 ● (IRU)

1600 ●*

Stroud 0700 ●

0800 ●

0900 ●

Orillia 0530 ●

0700 ● (IRU)

0700 ●

0730 ●

1300 ●

Washago 0800 ●

Collingwood 0600 ●

0700 ●

1500 ●

Stayner 0730 ● Wasaga Beach 0630 ●

Coldwater 0700 ●

Craighurst 1000 ●

Elmvale 0900 ●

Midland 0630 ●

0800 ●

*(Saturdays 52 weeks, Friday June to Sept (19 weeks))

PEAK 30 + 2 RRU (includes units starting before 1900 some extending to 0400)

NIGHTS 18 + 1 RRU

(Not including Special events or Gator patrols)

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Emergency Coverage (System Status Management Plan)

a) Priority Posting Plan

1. Emergency coverage will be maintained in accordance with the priority posting

locations (see Priority Posting Plans). As the number of available resources changes,

the ACO will assign/re-assign available resources in accordance with the appropriate

Priority Posting Plan.

2. All posts within the County of Simcoe are community based (i.e. a unit must be

located within the community boundaries). This includes any available unit at a

hospital within that community.

3. The nearest, most appropriate Paramedic Unit to an emergency coverage post will

normally be assigned to that post.

4. A single remaining resource available in Midland must not be moved for

emergency coverage assignments. Barrie Coverage – Tiffin is Primary. Second

unit can be mobile in Barrie or a cleared unit at RVH.

5. When above level thirteen (13) in the Priority Posting Plans, all units will be

repatriated back to their assigned communities for coverage whenever possible in

consultation with on-duty Platoon Supervisor. All stations listed at or above

resource level thirteen (13) must be covered with the minimal amounts indicated.

6. Stations not listed in the Priority Plans will only be covered by their assigned

resource.

b) Severe Workload Management Guidelines

1. YELLOW COVERAGE: The ACO will defer Priority 1 and 2 patient transfers as

required to avoid dropping to level Orange coverage.

2. ORANGE COVERAGE: The ACO will continue to defer Priority 1 and 2 patient

transfers. Priority 3 calls will be held up to 30 minutes to avoid dropping into level

Red coverage. At level 11 (8 at night), Supervisors shall assess area hospitals to

determine resource availability.

3. RED COVERAGE: The ACO will continue to defer Priority 1 and 2 patient

transfers. CACC will advise and confirm acknowledgement from the on-duty

Platoon Supervisors on the Follower channel when in Level Red. Priority 3 calls will

be held until level Orange or higher level coverage is restored.

4. When resources reach or drop below 4, the posts at this level will not be dropped to

cover the other remaining communities.

5. Priority 3 calls in severe workload management are exempt from delays or holding if

the nature of the call meets criteria outlined in the Priority 3 Call Assignment Delays

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section.

c) Mutual Aid – Assistance to other Municipalities

1. County of Simcoe Paramedic Services will only respond to Priority 3 - prompt non-

life threatening calls in other municipalities when:

The call has been in the originating CACC’s ‘waiting incidents’ queue for at

least sixty (60) minutes, and

The County of Simcoe Paramedic Services System Status Level is above the

“Orange” level coverage defined in the posting plan.

The other municipality is still unable to respond faster based on geographical

response time and the delay is strictly due to high resource demand in the

municipality and not to facilitate a meal or rest period.

ACP resources will only be dispatched to a call outside of the County of Simcoe

if it is the closest unit in time to a Priority 4 or if responding as the closest

available ACP back-up.

The above criteria also applies for County of Simcoe Paramedic units

travelling within other UTMs.

Rama and Beausoleil First Nation Communities are considered “in-county”

and the above language does not apply.

2. County of Simcoe Paramedic Services will provide emergency coverage for

municipalities other than the County of Simcoe when:

The System Status Level is above “Red” level coverage defined in the Priority

Posting Plan); the other municipality’s EMS resources must be utilized first

before resources from Simcoe County; and the on-duty Platoon Supervisor has

authorized the emergency coverage assignment.

Simcoe County will support Rama and Beausoleil with ACP back-up when

requested as defined in the ACP response and SSM guidelines.

d) Administrative Assignment

1. As required, a Paramedic unit may be placed on administrative assignment (Code 0)

when staff are required to attend meetings, administrative duties or on-duty training

however are not deemed as “out-of-service”. The Platoon Supervisor will advise

CACC of any unit on Administrative Duty. When on Administrative Duty, the

following criteria apply:

The unit will not be assigned Priority Level 1, 2 or 3 calls.

The unit will not be assigned emergency coverage posts unless resources

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drop into the Red level according to the Priority Posting Plan.

The unit will be sent to any Priority Level 4 calls when it is the closest

vehicle. A transport unit may be concurrently sent.

Rapid Response Units

a) Focus

1. The primary role of the Rapid Response Unit (RRU) is to provide Paramedic level

response. While the RRU would not normally transport a patient to hospital, the

single Paramedic may transport a stable, ambulatory patient, as per CSPS policy.

An RRU will not be considered for emergency coverage.

2. The RRU will be assigned first to all Code 4 calls in which they are the closest

unit.

3. The RRU will support transport unit on calls where additional assistance is

required, however may be reassigned to a first response call if required.

4. The RRU may be staffed by an Incident Response Unit Paramedic.

b) Attending with Transporting Paramedic Units:

The RRU medic will attend with the transporting Paramedic unit should further care or

additional assistance is required.

Providing Advanced Care Paramedic Support –DPCI-II

a) Within the County of Simcoe

1. The ACO will assess the location of the closest available ACP resource and dispatch

the unit as an additional resource when:

The call type indicates an ACP response or based on a request from an on-scene

unit, and

The ACP unit has an estimated response time that is not longer than twenty (20)

minutes unless circumstances at the scene will delay patient transport (i.e.

patient trapped).

On Scene resources are not permitted to delay departure waiting for the ACP

resource to arrive

2. ACP Intercepts for PCP Resources

An ACP intercept means an ACP resource will meet a PCP resource while en-

route to the hospital at the request of the attending PCP Paramedic. Intercepts

with ACP resources will only be permitted when the following conditions exist:

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The patient is not VSA.

Basic Life Support procedures (such as airway and ventilation techniques) have

not resolved the need for ACP support.

The most direct route to the hospital is followed.

b) Out-Of-County ACP Response

ACP resources will only be dispatched to a call outside of the County of Simcoe if it is the

closest resource in time to a Priority 4 or if responding as ACP back-up.

ACP resources will not be assigned out-of-county emergency transfers unless it is a Priority 3

or 4 and a PCP resource is not readily available to transport the patient. Southlake Regional

Health Centre is to be considered an “in-County receiving facility”.

c) Simcoe County ACP Deployment Criteria

ACP resources will be dispatched to the following call types based on the DPCI 2 Card:

1. Absence of breathing

2. Cardiac arrest

3. Airway obstruction

4. Unconsciousness

5. Entrapment

6. Penetrating trauma to the head, thoracic or abdominal area

7. Uncontrolled bleeding (not including vaginal, rectal or catheter site bleeding)

8. Motor vehicle collision (with confirmed or suspected life threatening injuries)

9. Pedestrian struck or occupant ejected

10. Drowning/near drowning

11. Active or multiple seizures

Medically Necessary Transfers (All Priorities)

a) Deferral of Non-Emergent Transfers

The County of Simcoe Paramedic Services management, and/or the CACC management,

have the authority to defer all non-emergency transfers once a determination is made that the

current need, or anticipated need, of emergency calls may overwhelm existing ambulance

resources or in the event of emergency road closures (i.e., inclement weather Multiple

Casualty Incidents, [MCIs]). Non-emergency transfers out of the County will be deferred

until a PCP resource is available. The CACC Supervisor or designate and CSPS Platoon

Supervisor will ensure each other are notified and document accordingly. ACP resources

may be utilized for emergency response to a hospital if they are the closest unit, however

should not normally be assigned to nonemergency transfers. The sending hospital will

continue to be required to provide appropriately trained patient transport escorts and should

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be reminded of this requirement if the CACC call taker is not advised that an escort is being

provided.

b) Non-Emergency (Priority 1 or 2) Transfers

Priority 1 and 2 non-emergency transfers shall be booked and assigned within the following

parameters:

1. County of Simcoe Paramedic units will not be assigned to pick up patient

outside the County of Simcoe with exception of point #3 below.

2. Priority 1 or 2 calls will not incur overtime.

3. County of Simcoe Paramedic units returning from out-of-county may be assigned

a return transfer back to Simcoe County as the following criteria:

Platoon Supervisor approval is required.

The patient is at a hospital within 10 minutes of the current location of the

ambulance or within 10 minutes of their most direct route of return.

The patient is ready for immediate pick up.

The assignment will keep the resource within the vehicle’s service area.

The priority Posting Plan is above yellow level coverage.

The assignment will not result in the generation of overtime or during the

Paramedic’s designated break period.

4. Priority 1 or 2 calls will be deferred between 1100hrs-1500hrs and 2300-0300hrs

or until all Paramedics have completed their break period, or unless approved by a

Platoon Supervisor.

5. Priority 1 or 2 calls out of county will be deferred between 0200hrs – 0500hrs.

6. A maximum of 2 non-emergency transfers will be permitted out of the County of

Simcoe at a given time.

c) Priority 3 or 4 Transfers

Priority 4 emergency transfers should be treated as per the community response to the same

priority calls. The initial responding transport unit may assess on arrival at the hospital if the

patient can wait for a more appropriate unit to transfer the patient based on shift time and

crew type. Priority 3 transfers will be immediately deferred and the ACO, in conjunction

with the on-duty Platoon Supervisor will assign the most appropriate Paramedic Unit to

service the transfer.

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d) Return Patient Wait Times

Simcoe County Paramedic units will wait the time required to complete vehicle/equipment

and preparation plus a maximum of 10 minutes (maximum 30 minutes total). The crew is

responsible to ensure the patient, accompanying staff and receiving facility staff is aware of

this time constraint on initial contact. When this time has elapsed the crew shall confirm in

person whether the patient is ready for immediate return. If the patient is not ready for

immediate return the crew will advise the facility they are leaving, clear the scene and advise

CACC.

e) Long Distance Transfers

County of Simcoe Paramedic Service resources shall not be assigned to calls with a travel

distance in excess of two hundred and forty kilometers (240 km = West - Sarnia, East -

Belleville, North – Sudbury) unless:

1. The call cannot be completed by Ornge, and

2. County of Simcoe Paramedic Services management has been notified and

approved the transfer.

f) Multi-Patient Transfers

Completion of multi- patient transfers are at the discretion of the Paramedic crew in

consultation with the on-duty Platoon Supervisor.

g) Facilities Requesting Advanced Care Paramedics

Facilities requesting ACPs to provide ACP treatment during transfer should be referred to

CritiCall Ontario.

ACP treatment is limited to emergency response to a scene except under the express

authorization of a Base Hospital delegating physician.

h) Transport for Transplantation

County of Simcoe Paramedic Service resources will not be assigned to transport body parts

for transplantation unless approved by a Platoon Supervisor. County of Simcoe Paramedic

Services may be assigned to transport a body once pronounced, for the purpose of tissue

transplantation on the order of a physician.

i) Teams and Medical Equipment

County of Simcoe Paramedic Services shall make every attempt to facilitate however

should not be relied upon or be responsible to return medical teams or medical equipment.

j) Out-of-Province Transfers

County of Simcoe Paramedic Service resources shall not be assigned to calls outside of the

Province unless a Platoon Supervisor has been notified and approved the transfer.

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k) Transports to the United States of America

For all calls that require a transport out of Canada to the United States of America, the CACC

must confirm that the Paramedics hold an unrestricted drivers license under the Canada/US

Medical Reciprocity Agreement for Commercial Drivers and are able to successfully

negotiate the customs/border requirements of the United State. There is no guarantee that

Paramedics will have appropriate documentation or permissions to cross international

borders.

CACC must notify the Platoon Supervisor so that he/she can facilitate assist with assessment

and facilitating the necessary documentation for the border crossing. CACC will provide the

following information to the intended U.S. Customs border crossing (for each occupant):

Citizenship

Age and DOB

Name

MOH OASIS number (for Paramedics)

CACC will provide specific direction to the assigned resources as required and notify the

receiving facility of approximate ETA and any patient updates. Units will establish and

maintain radio communication with Niagara CACC when passing into Niagara Region and

while in the U.S. Paramedics will communicate via cell phone with CACC as required.

l) Mitigation of Off-load Delays

The Platoon Supervisor, in consultation with Georgian CACC management or CACC

Supervisor may approve the completion of any code 1 or 2 assignment originating from a

hospital that will facilitate the off-loading of patients in County of Simcoe Paramedic

Services’ care. Such assignments will be completed when approved regardless of system

status level and that any Priority 3 or 4 calls waiting in queue must be serviced before the

code 1 or 2 assignment.

Note: The purpose of this action is to improve the overall emergency coverage by making an

ambulance available sooner, on completion of the transfer, than if it were to remain on off-

load delay.

Priority 3 Call Assignment Delays The following criteria applies to calls dispatched as Priority 3 or downgraded to Priority 3 before

the first Paramedic or Allied Agency (e.g.: Police or Fire Services) unit arrives on scene.

1. Patients who are in a suspected unprotected environment (e.g.: outside in extreme

temperatures) based on caller information are exempt from any call delays.

2. Requests for Paramedics from on-scene Allied Agencies (e.g:. police and fire

services) are exempt from any call delays.

3. Patients who self-present (e.g: at EMS Stations) or who are encountered by on-

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duty Paramedics (e.g.: are flagged down) are exempt from any call delays.

4. Priority 3 calls shall be delayed to a maximum of thirty (30) minutes when the

system level identified in the Posting Plan has Priority 3 delay criteria.

5. Rapid Response Units will only be assigned to Priority 3 calls after the call has

been delayed thirty (30) minutes and no Paramedic Unit is available to respond.

6. CACC is to advise callers of the delays and updated ETA’s as circumstances

change.

Patient Destination and Distribution Patient Destination and Distribution will occur in accordance with the County of Simcoe Patient

Priority System (PPS) (under development)

Start-of-Shift Issues

1. Paramedics are provided up to twenty (20) minutes at the start of their shift to ensure

that their vehicle is properly equipped and the electronic equipment (defibrillator,

radio, cell phones, etc.) is fully functional.

2. Non-emergency calls (Priority 1, 2) will not be assigned within the first 20 minutes

of a shift start or vehicle/crew transition.

3. In the event that a vehicle/equipment check at the start of the shift is interrupted by a

request for emergency response, the paramedic crew is to respond immediately and

provide the best level of care the physical resources at hand allow. If the crew

identifies that they are missing equipment or supplies that are necessary to provide

essential care and/or transport of the patient, they will request a back-up crew. The

ACO shall assign the back-up resource immediately.

4. Resources shall be allowed to return to the nearest station to complete their

vehicle/equipment check (20 minutes total) as required.

End-of-Shift Issues 1. ACO’s will commence the return of resources to their originating station during the

last sixty (60) minutes of assigned shift.

2. Resources in the last sixty (60) minutes of their shift will not be assigned Priority 1

and 2 calls.

3. Resources in the last thirty (30) minutes of their shift will not be assigned Priority

Code 3 calls unless the call is exempt from call delay (see Priority 3 Call

Assignment Delays).

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4. Resources in the last thirty (30) minutes of their shift will only be assigned

Emergency Coverage posts to maintain level Red, otherwise will be cleared back to

their reporting station for end-of-shift.

5. When a resource has exceeded their designated end-of-shift time they will only be

considered available for Priority 4 calls when they are the closest appropriate

resource. A transport unit will be concurrently dispatched. It is expected that

Paramedics coming on shift will utilize equipped spare vehicles available to relieve

the demand on Paramedics that are on shift overrun.

6. Resources assigned to a call or on off-load delay will require a transport/relief

crew within thirty (30) minutes prior to their end-of-shift (if available).

Break Periods for Paramedics 1. Simcoe County Paramedics are entitled to one (1) break period of thirty (30)

minutes per shift.

2. Break periods will be monitored by CACC after the fourth hour of an 8-10 hour

shift or the fifth hour of the 12-hour shift. These time periods are known as break

‘windows’. Break periods will automatically begin if the crew is at base. Mobile

crews need to advise CACC if they are within their break period. Breaks will be

accommodated at the earliest opportunity once the window has started, up to the

end of the shift, until an uninterrupted 30 minute break is obtained.

3. A tracking sheet for the ACO is provided in Appendix B to assist the ACO in

identifying resources that are on or have completed their break. CACC will fax the

completed Appendix B once per day.

4. Paramedics due for their break period shall be assigned to the closest most

appropriate station (preferably their reporting station).

5. Once at the assigned break period location, vehicles shall be marked conditionally

available for Priority 4 assignments only. If a break period is interrupted, the break

period shall be reassigned when possible.

6. Paramedics who have reached the start of their break window shall not be assigned

Priority 1, 2, or 3 calls (unless the Priority 3 is exempt from delays) until their break

has been completed.

7. Breaks will only be interrupted for Emergency Coverage assignments to maintain

level Orange coverage in the Priority Posting Plan.

8. Break periods cannot be deferred or ‘saved’ at the request of Paramedics.

9. Resources with a 15 minute or longer travel time back to their reporting station

should be assigned to the closest station for their break period.

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County of Simcoe Paramedic Break Periods

Request for Police in 10-2000 situations In the event that a Paramedic crew reports a ‘10-2000’ or requires immediate police assistance,

the ACO must communicate all information available immediately to the police Communications

officer using plain language including requesting that the call be upgrade to the highest priority.

a) Actions on a “10-2000” Request

1. The ACO will immediately respond to the crew and confirm the request.

2. The crew must answer with “Alpha Charlie” in the event of a false alarm. Any

other response will be treated as an emergency with an urgent police response.

3. The nearest available Paramedic resource and Platoon Supervisor will be

immediately dispatched to the location of the crew requesting the 10-2000. All

additional resources will stage in a safe location until Police have secured the

scene.

4. Once the emergency has been dealt with, the Platoon Supervisor will clear the 10-

2000.

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The Platoon Supervisor must be notified on all 10-2000 requests except verified false

alarms.

County of Simcoe Paramedic Services Management Notification

a) Platoon Supervisor Notification

The County of Simcoe Paramedic Services will normally maintain three Platoon Supervisors

on-duty. The Supervisor contact number is 705-719-9398. The Platoon Supervisors are

responsible for the following geographic area:

1. Northwest Platoon Supervisor (Option 1) – Collingwood, Wasaga, Clearview,

Springwater, Tiny, Tay, Midland, Penetanguishene, Borden-Essa.

2. South Platoon Supervisor (Option 2) – Barrie, Adjala-Tosorontio, New- Tecumseth,

Bradford West Gwillimbury, Innisfil.

3. Northeast Platoon Supervisor (Option 3) – Severn, Oro-Medonte, Orillia, Ramara,

Barrie North.

b) CSPS Notifications

The CACC Supervisor or ACO is responsible for notifying the appropriate Platoon

Supervisor as per the notification matrix (See Appendix A).

The CSPS Duty Officer may be contacted through a Platoon Supervisor as necessary. The

CSPS Duty Officer is responsible for notifying the Chief of CSPS. A CSPS Duty Officer will

be on-duty at all times.

Bariatric Equipment and Transport

The CACC Supervisor will notify the CSPS Platoon Supervisor as soon as possible of a bariatric

call, when made aware through call taking, or as advised by Paramedics on-scene.

A minimum of two Paramedic Units will be assigned to bariatric calls. The on-scene crew may

request additional resources as required. All Paramedic Units can carry an empty bariatric

stretcher. CACC will dispatch the closest available Paramedic Unit to the closest station with

bariatric equipment to transport the equipment to the scene. Each station with bariatric

equipment is designated on the Simcoe County Fleet Status sheet with a “B” after each

number.

If not already assigned to the call, CACC will deploy a Bariatric Designated Paramedic Unit

capable of transporting a bariatric patient. Each bariatric capable vehicle is designated on the

Simcoe County Fleet Status sheet with a “B” after each number. These vehicles have special

securing hooks for the bariatric stretcher that are required when the bariatric stretcher is loaded

with a patient.

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Multi-Casualty, Major Incident, Multi Patient Unit (MPU) and

Specialized Response Units

a) Multi Patient Unit (MPU)

County of Simcoe Paramedic Services do not currently operate a Multi-Patient Unit

(MPU). York Region Paramedic Services and Toronto Paramedic Services have the two

nearest MPUs to the County of Simcoe.

1. Criteria for deployment of the MPU by CACC are:

Incidents involving the actual or potential of twenty (20) or more

patients,

Any incident (evacuation, fire, etc.) involving a hospital or long-term

(nursing) home.

An event or multi-casualty incident (MCI) and a request is made by the

Platoon Supervisor for an MPU.

At the request of on-scene Paramedic Command

Note. All MPU deployments are to be confirmed with on-scene Paramedic

Command.

b) Multi-Casualty Incidents (MCI)

The first arriving Paramedic Unit is responsible for establishing Paramedic Command and

initiating triage protocols. The Platoon Supervisor on arrival will assume Command and

coordinate the MCI response. The response to an MCI should be initiated based on the

minimum resource requirements according to the level of MCI (reference MCI Incident

Levels)

c) Emergency Support Units (ESU 3301 & 3302)

The Emergency Support Units (ESU) are 3301 and 3302. Both units are trailers that will

be towed to the site either by an IRU Paramedic or a Platoon Supervisor. The ESU may be

deployed to potential MCI and emergency incidents such as CBRNE/Hazmat as well as

multi-vehicle collisions on regional highways such as Hwy 400.

d) Mobile Command Unit (MCU 3310)

The deployment of the Mobile Command Unit (MCU) will be concurrent with the

deployment of the IRU or at the direction of the CSPS Platoon Supervisor. This unit may

be utilized on scene at any time a large scale or long duration event is in progress. An IRU

Paramedic or Platoon Supervisor is responsible for deploying the Mobile Command.

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MCI Incident Levels

MCI

Level

Criteria Initial Response

Level 1 Any incident involving 2-4 patients

and at least 1 patient is CTAS 1 or

2.

Any incident involving 2-4 patients

and one or more is trapped.


and air is requested or responding.

Two or Paramedic Units are

required.

Two or more Paramedic Units

Paramedic Supervisor

Air ambulance if required

Allied agencies

Level 2 Any incident involving 5-9 patients

and the incident is localized.*


and air is requested or responding.

Multiple Paramedic Units required.

Adequate County of Simcoe

Paramedic Resources is available.

*Localized defined as all patients are at

one scene.

Multiple Paramedic Units


ESU and MCU as required

Duty Officer notification (based on the

Paramedic Supervisor’s judgment)

Dedicated CACC MCI Channel as

required

Air ambulance as required

Level 3

Any incident involving 10 or more

patients and the incident is

localized.*

Incident is not expected to exceed 4-

6 hours.

Other EMS support/involvement

may be required.

*Localized defined as all patients are at

one scene.



Duty Officer notification

ESU, MCU, MPU

Dedicated CACC MCI Channel


Other EMS Service

support/involvement if required

Level 4

Any incident involving 20 or more

patients or any Level 2 or higher

MCI that is widespread or with

patients in multiple locations.

Incident duration is more than 4

hours.

Situations where the Duty Officer

has assessed the need for

neighboring UTM/EMS support

and/or up-staffing Paramedic Units

is required.



Duty Officer notification

ESU, MCU and MPU

Dedicated CACC MCI Channel


Base Hospital Notification (24hr

Emergency Number)

Other EMS Service

support/involvement if required

Up-staffing of Paramedic Units as

determined by Duty Officer

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a) MCI Channel

An MCI specific radio channel will be assigned by CACC to manage a specific incident

based on the MCI Incident Level. The on-scene Paramedic Command may request a

separate radio channel if not already assigned by CACC. CACC is responsible for managing

demands for air-time on each talk group in use by the County of Simcoe Paramedic Services.

b) Request for Resources

All requests for additional resources by the on-scene Paramedic Command will be facilitated

by CACC. Any challenges with respect to availability of resources will be communicated to

the on-scene Paramedic Commander.

c) Incident Response Unit Paramedics (IRU)

The County of Simcoe Paramedic Services will at times, deploy an IRU resource. The IRU

is normally staffed on the RRUs in Barrie and Orillia and one Paramedic Unit in Barrie. The

Platoon Supervisor has access to a 24hr on-call IRU Supervisor. The Incident Response

Unit Paramedics are trained and equipped to provide specialized response to the following

incident types:

1. Multi-Casualty Incidents (MCI),

2. Hazardous Materials (HAZMAT) and Chemical, Biological, Radiological, Nuclear,

Explosive (CBRNE) incidents.

3. Police tactical response (Barricaded/Hostage/High risk warrant situations)

IRU Paramedics will identify themselves as IRU when booking on at the start of their shift.

d) IRU Call Assignments (Mandatory)

The Incident Response Unit resources should be assigned as primary resources as early into

the call as possible. Units on off-load delay or non-emergency assignments should be

relieved as soon as possible. Incident Response Unit resources are to be dispatched (based

on call information or on request) to calls involving;

1. Potential or confirmed Hazardous Materials (HAZMAT) or Chemical, Biological,

Radiological, Nuclear, or Explosive (CBRNE) incidents.

2. Any unknown or possible exposure to an unknown substance.

3. Any incident with multiple unexplained complaints or symptoms.

4. Major fire or a fire with known or suspected casualties (closest IRU unit within 20

minute response time)

5. Overdoses or suicides suspected of using hazardous materials or suspected smoke

inhalation.

6. Multiple Casualties Incidents (MCIs), including large MVCs, or on Highway 400

or Highway 11, causing road closures.

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7. Any incident involving a tractor trailer carrying a mixed load, gas, chemical, or

radiological substances.

8. Tactical Police incidents or a request from Police for IRU/Tactical Paramedics.

9. Any request by allied agency for IRU Paramedics.

In the event of a response request with the Police, for a planned deployment, the Police will

provide a time and rendezvous location for an operational briefing.

Incident Response Unit Paramedics shall update/notify CACC and their Platoon Supervisor

of their status and estimated time to return to available status.

Once on scene, Incident Response Unit Paramedics will normally communicate though the

police network. Communications to CACC may be facilitated via cell phone or via the

police communications centres.

When available, an IRU-RRU will be deployed to whenever a CSPS unit is placed on a

staging/standby request by the police or allied agency.

Run numbers will be given for all IRU call assignments.

e) Accessing Transit for Emergency Shelter

1. Transit bus requests will be facilitated through the Police or municipal/county EOC

if activated. All transit services are managed by the lower tier municipalities. The

need for transit buses to temporarily shelter in place or transport evacuees should be

coordinated through a Unified Incident Command.

Version 1.0 Page 29



IRU Deployment Process Map

Is the IRU Request

Urgent or Scheduled?

Urgent

1. Communications to go directly through

agency Communication Centres.

2. CACC will dispatch IRU directly.

3. CACC will notify Platoon Supervisor

Scheduled

Police Warrant or Planned

Operation

1. CACC will send the closest available Paramedic Crew.

2. Once the initial crew is dispatched, CACC will send the

closest IRU Rapid Response Unit (RRU).

3. If available, the Barrie North IRU Transport Unit will be sent to

support the IRU-RRU.

4. If additional IRU Paramedics are required, CACC will

coordinate the deployment of any available IRU Paramedic in

conjunction with the Platoon Supervisor.

1. Call IRU Supervisor (S. Trafford) @

705-818-0749).

2. If no answer, call the On-Call IRU

Supervisor @ 705-719-9398, Option 9.

1. IRU Supervisor to coordinate deployment with CACC and

Platoon Supervisor.

2. If there is no IRU on-duty, the IRU Supervisor in

conjunction with the Platoon Supervisor and Duty Officer

will assess the need to up-staff an IRU Paramedic.

3. The Duty Officer may authorize an IRU up-staff as

required.

Incident Response Unit Contact List:

Platoon Supervisor Number:

705-719-9398, On-Call IRU Supervisor Option 9

Stephen Trafford 705-818-0749

Greg VanRooyen 705-818-0735

Craig Hassberger 705-818-0750

IRU Available?

Yes No

IRU Supervisor to push SWN

message for up-staff

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Severe Weather Protocol The following is the protocol for severe weather and may be implemented for the County of

Simcoe as a whole or part.

The Severe Weather Protocol will be activated when:

a. An Environment Canada Storm WARNING is declared for the County of Simcoe

or any one of the municipalities within.

b. Feedback from the on-duty Platoon Supervisor confirming that the road

conditions are degraded such that travel is significantly impeded.

c. The Platoon Supervisor requests CACC implements the Severe Weather Protocol.

The Severe Weather Protocol will be discontinued when:

a. An Environment Canada Storm WARNING is cancelled for the County of Simcoe

or any of the municipalities within.

b. Feedback from the on-duty Platoon Supervisor confirming that road conditions

have improved such that travel is no longer impeded.

c. The Platoon Supervisor request CACC cancel the Severe Weather protocol.

When a severe weather protocol has been declared, CACC will ensure all available resources

are deployed from stations or hospitals only - mobile posts will not be assigned.

a. Resources should be assigned to the closest station in the posting plan that is not

directly affected or in the path of the severe weather (e.g.: Tornado).

b. Priority 1 & 2, non-emergent transfers will be deferred until the severe weather

protocol is ended.

c. In extreme cases the Chief Paramedic Services, or designate, may authorize an “all

stop” for the affected areas of the County when severe weather is threatening the

health and safety of workers (e.g.: during an active tornado or blinding road

conditions with closures). During an ‘all stop’ no Ambulance calls will be

dispatched. All calls will remain in the ARIS call queue. Once the all stop is

lifted, call will be assigned in accordance with CACC LOP’s.

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Labour Disruption/Strike Protocol In the event of a labour disruption or strike, the County of Simcoe Paramedic will maintain all

operations pertaining to the response of Priority 3 and 4 emergency calls.

The following conditions will apply during a labour disruption or strike in accordance with the

Essential Services Agreement between the County of Simcoe and Ontario Public Service

Employees Union (OPSEU) Local 303:

a. All Priority 1 and 2 non-emergency transfers will not normally be serviced.

b. All administrative duties will be booked through the Platoon Supervisor (or other

means as designated at that time) and will not be directly assigned to any on-duty

resources.

Public Access Defibrillation Sites The County of Simcoe Paramedic Services maintains a list of all known Public Access

Defibrillators (PAD) in the County. Bi-annually, in March and September, a spreadsheet of all

known locations is emailed to CACC for entry into premise notes. Any new sites that become

known in between the bi-annual dates are emailed to CACC separately. CACC will

communicate the location of a known PAD to the caller when receiving a call where a potential

PAD would be required.

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Priority Posting Plan

0700-0859 MORNING

# Barrie Alliston Midland Collingwood Wasaga

Beach Orillia Stroud Bradford Coldwater Angus Stayner

YELLOW COVERAGE: The ACO will defer Priority 1 and 2 patient transfers as required to avoid dropping to level Orange coverage.

13 2 1 1 1 1 2 1 1 1 1 1

ORANGE COVERAGE: The ACO will continue to defer Priority 1 and 2 patient transfers. Priority 3 calls will be held up to 30 minutes to avoid dropping into level Red coverage.

At level 11, Supervisors shall assess area hospitals to determine resource availability.

12 2 1 1 1 1 2 1 1 1 1

11 2 1 1 1 1 1 1 1 1 1

10 1 1 1 1 1 1 1 1 1 1

9 1 1 1 1 1 1 1 1 1

RED COVERAGE: The ACO will continue to defer Priority 1 and 2 patient transfers. CACC will advise and confirm acknowledgement from the on-duty Platoon Supervisors on

the Follower channel when in Level Red. Priority 3 calls will be held until level Orange or higher level coverage is restored.

8 1 1 1 Carpool lot 1 1 1 1

7 1 1 1 Carpool lot 1 1 1

6 1 1 1 Carpool lot 1 1

5 1 1 1 Carpool lot 1

4 1 Cookstown 1 Carpool lot

Midland post does not move for emergency coverage assignments Barrie Coverage – Tiffin is Primary. Second unit can be mobile in Barrie or a cleared unit at RVH.

Version 1.0 Page 33




0900-1759 PEAK


Beach Orillia Stroud Bradford Coldwater Angus Elmvale


13 2 1 1 1 1 2 1 1 1 1 1



12 2 1 1 1 1 2 1 1 1 1

11 2 1 1 1 1 1 1 1 1 1

10 1 1 1 1 1 1 1 1 1 1

9 1 1 1 1 1 1 1 1 1



8 1 1 1 Carpool lot 1 1 1 1






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1800-0659 NIGHTS


Beach Orillia Stroud Bradford Coldwater Angus Stayner


13 2 1 1 1 1 2 1 1 1 1 1



12 2 1 1 1 1 2 1 1 1 1

11 2 1 1 1 1 1 1 1 1 1

10 1 1 1 1 1 1 1 1 1 1

9 1 1 1 1 1 1 1 1 1



8 1 1 1 Carpool lot 1 1 1 1






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APPENDIX A – Platoon Supervisor Notification List

Incident

10-2000 calls

Any incident involving known public figures

Emergency call to a Simcoe County facility/admin centre

Any incident requiring three (3) or more Ambulances

Fire standbys

Bariatric calls

Hazmat/CBRNE incident

Out of province transfers

Code 4 waiting >5 min

Code 3 waiting >30 min

Any vehicle collision involving a Paramedic, Fire, Police or County Of Simcoe vehicle

Paramedic critical injury/illness/assault while on-duty

Any incident where foul play in suspected

Any Paramedic Unit being staged/delay in patient contact

Any armed stand-off or hostage taking

Stabbing/shooting/shots fired

Evacuation (apt building/hosp/school/nursing home/public building)

Public transit/school bus incident

Industrial accident with life threats

MVC/trapped patients

Ornge air ambulance response

Critical equipment/vehicle failure

Scene delay >30 min

Off load delay > 60 min

End of shift OT > 30 min

VSA with unusual circumstances

Service complaint

Previously unreported outbreaks

Paramedic resources in Red Level as outlined in the Posting plan

Emergency coverage request from other UTMs

Request for transport of a body or body part for the purpose of tissue transplantation

Any down-staffing at CACC that impacts the normal operation of CACC

Incident Response Unit up-staffing

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APPENDIX B – CSPS Break Management Tool SHIFT 1100 1200 1300 1400 1500 1600 1700 1800 1900 2000 2100 2200 2300 Break

Complete

ALLISTON

0600

0700

0800

ANGUS

0700

BARRIE BAYFIELD

0630 1130-1330

0700

0700

1600

BARRIE TIFFIN

0600

0700

0800

1300

BRADFORD

0700

0830 1330-1530

COLD WATER

0700

COLLINGWOOD

0600

0700

1500

CRAIGHURST

1000

ELMVALE

0900

MIDLAND

0630 1130-1330

0800

ORILLIA

0530 1030-1230

0600

0700

0730 1230-1430

1300

STAYNER

0730 1230-1430

STROUD

0700

0800

0900

WASHAGO

0600

WASAGA BEACH

0630 1130-1330

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APPENDIX C – Response Times Targets

Patient Acuity

on Paramedic

1st

Contact

Type of Provider and Response Time

Target (From paramedic notified of call

to arrive site)

Percentage

of Time

Target

Achieved

Sudden Cardiac Arrest (SCA)

Defibrillator Response by any responder Six (6) minutes or less

50%

CTAS 1 Including SCA

Paramedic Response (Ambulance or RRU) Eight (8) minutes or less

50%

CTAS 2 Paramedic Response (Ambulance or RRU) Ten (10) minutes or less

70%

CTAS 3 Paramedic Response (Ambulance or RRU) Fifteen (15) minutes or less

85%

CTAS 4 Paramedic Response (Ambulance or RRU)

Twenty (20) minutes or less

90%

CTAS 5 Paramedic Response (Ambulance or RRU)

Twenty five (25) minutes or less

90%

Passed by Council October 14, 2014

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APPENDIX D – Tiered Response Agreement

See attached

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APPENDIX E – Patient Priority System Agreement

See attached

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APPENDIX F – Ornge Designated Landing Zones

Under development

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County of Simcoe Paramedic Services

1110 Hwy 26, Midhurst, ON

L0L 1 X0

www.simcoe.ca

705-726-9300

http://www.simcoe.ca/

Documents

County of Simcoe Paramedic Services Deployment and Response … · 2016-02-03 · Deployment and Response Time Performance Plan for the County of Simcoe Paramedic Services – September