GREATER MIAMI VALLEY EMS COUNCIL ADVISORY:

HANDLING of FUNCTIONAL NEEDS PATIENTS and REQUIRED MEDICAL EQUIPMENT

 

This Advisory is for use by paramedics to help determine appropriate care for patients requiring chronic oxygen, aerosol treatments, and use of other respiratory equipment. At times, patients may call 911 with the only concern being lack of power. American Red Cross (ARC) Shelters for individuals with functional needs have been opened in Montgomery County. Functional Needs refers to individuals who, under usual circumstances, can function on their own or with support systems. However, during an emergency or in the absence of some services (e.g., electrical power), their level of independence is challenged. This Advisory is intended to help EMS providers better educate individuals regarding their options and make informed decisions. At this time, it is NOT recommended that EMS transport directly to a shelter.

 

ARC shelters are operational at the locations listed below, are handicapped accessible, have individual cots, restroom and shower facilities, and food. Service Animals are permitted. Family groups as well as the young and old may all access the shelter.  Goals of Functional Needs Shelter Triage:

1. Meet appropriate needs of persons seeking shelter during disasters and other major events.
2. To the greatest degree feasible, clients who do not need hospital care should be sheltered to reduce unnecessary overcrowding at hospitals.

 

Shelter locations:

·         Morton Middle School, 8555 Peters Pike, Vandalia

·         The Ridge Church, 7555 Brookville-Phillipsburg Road

·         Corinthian Church, 700 N. James H. McGee, Trotwood

·         First Baptist Church, 3939 Swigart, Kettering

 

At the option of local department chiefs and medical directors, this Advisory can be used during the current declared disaster to make patients and their families aware of this option. EMS should, if feasible, contact the ARC Lead Nurse at 513-760-2167 before recommending that patients self-transport to a shelter. 

 

Whether being transported to an Emergency Department or self-transporting to a Functional Needs Shelter, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient. This will facilitate discharge of the patient to an appropriate shelter or alternate living situation after Emergency Department evaluation.

 

1. Persons with no functional/medical needs may be referred directly to a standard shelter.
2. Functional needs: needs that can be met in a shelter include persons with the following:

·       Blind or vision impairments

·       Deafness or trouble hearing

·       Oxygen dependent

·       Previously treated breaks, fractures, or sprains (including those on crutches or in a cast)

·       Non-English speaking

·       Clients with wheelchairs or other mobility devices

·       Service animal

·       Dementia

·       Immune system disorders

·       Diabetes

·       MRSA, TB, and other infectious diseases (depending on treatment status)

·       Dependence on medication

·       Dependent children, including those who enter the shelter without their parent or guardian

·       Certain individuals who have medical needs such as those on a ventilator, nebulizer, colostomy/ileostomy, and the like can be evaluated for care within a shelter, especially if the client is accompanied by a family member or care aide.

 

Individuals with advanced chronic medical requirements may self-transport to the shelter with a care aide or family members. When the caregiver is able to provide the daily medical needs of these clients, they can generally remain in the shelter

 

An additional Advisory will be issued when the Functional Needs Shelters are no longer operating.

 

It is highly recommended that every patient encountered by EMS receive a full prehospital evaluation. Patients should be informed of any assessment findings that, in the opinion of the crew, would necessitate transport to the Emergency Department. Refusal of transport must be informed refusal and should be handled according to each agency’s policies.

 

Once again, REGARDLESS OF DESTINATION, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient.