Disaster Planning in Action for Coastal Valleys EMS in Northern California

In Fall 2017, with more than 36,807 acres burned, Northern California experienced the worst wildland fire in state history, as the Tubbs fire, a rapid and fast growing wildland fire, burned its way through Sonoma County.

By 23:00 on October 8, 2017, the edge of the fire hit the city limits of Santa Rosa, the most populated city in Sonoma County, with more than 175,000 residents. By the end of the natural disaster, more than 5,500 structures were burned and 24 people lost their lives.

The Team

The Sonoma County Healthcare Coalition, an established working group for disaster response, is made up of hospitals, skilled nursing facilities, dialysis centers, dispatch centers, EMS/Fire providers, urgent care centers and specialty disaster systems. This coalition, with its established countywide disaster plans, best practices, policies, procedures and a forum for communication between all levels of medical services, was put in action during the Tubbs fires.

Working alongside the coalition was the Coastal Valleys EMS Agency, a dual-county local EMS agency. Team members Bryan Cleaver, EMS Administrator; Joanne Chapman, EMS Coordinator; Jen Bank, EMS Coordinator; James Salvante, EMS Coordinator; Carly Sullivan, ALS Coordinator; Theresa Lombardi, Administrative Aid; Lucinda Gardner, Epidemiologist; Mark Luoto, Medical Director; and myself; Data System Manager, all worked around the clock in partnership with the coalition. We worked to support the EMS system, shelters and the staffing of the Sonoma County’s Emergency Operations Center and Health Department’s Departmental Operations Center.

The Disaster & Response

The Tubbs fires were an unpredictable, quickly developing, fast-moving catastrophe. Coastal Valleys’ partnership with ImageTrend would prove to be integral to our response to the disaster. The company provides our ePCR software, data repository, system of care registries, and emergency preparedness solution.

We started using our data by gathering the MCI transports logs from the EMS providers, hospital census and discharge logs, along with meeting with receiving facilities and working with transfer centers. At the same time, during the fires, Lucinda Gardner and I started the process of tracking all of the patients who were evacuated. We followed their mode of transport to the healthcare facilities they were transported to and documented their care outcome. The integration between the Patient Tracking module and our ePCR system, ImageTrend Elite, assisted greatly in this process. As records started to be generated after the fires, our systems automatically began associating records in Patient Tracking with their specific EMS ePCR.

The entire EMS community’s response was critical to the survival of our county’s citizens. REDCOM, Sonoma County’s largest secondary Fire/EMS public safety answering point, a 10-terminal accredited dispatch center, had more than 4,200 incoming and outgoing phone calls in the first 24 hours of the disaster.

Meanwhile, shelters saw more than 4,000 people daily utilize their facilities in the first 72 hours of the fire. More than 800 patients were evacuated from two hospitals, one state-operated hospital and five skilled nursing facilities. Two out of three hospitals in the city of Santa Rosa specifically had to be immediately evacuated with the hospitals utilizing their disaster preparedness plans and assistance from local and neighboring ambulances providers.

With a limited amount of ambulances available, due to those resources being reserved for the critically ill, and the immediate need to evacuate many facilities, creative means were needed to evacuate patients. This creativity ranged from private automobiles, wine tour buses, city buses and wheelchair vans. If it wasn’t for the preplanning and disaster plans of these medical facilities, and their participation in the Sonoma County Healthcare Coalition, many more lives would have been lost.

The heroic actions taken by dispatchers, EMS providers, firefighters, hospital and law enforcement personnel during this disaster is indescribable.

Providers came to work knowing that their own homes were on fire and/or their families were being evacuated at the same time they themselves were serving the community. Crews responded to residences, medical facilities and shelters to evacuate and treat people in need. Hospital personnel transported patients via their own private vehicles as the fires rapidly approached the hospitals. Everyone came together and functioned as one service. The notion of “borders” and “service areas” didn’t exist. Everyone had one goal in mind: get people out of danger and provide the best care possible.

The Aftermath

Sonoma County has learned a lot in the aftermath of this disaster. However, if it hadn’t been for the preplanning, the commitment of dedicated healthcare professionals and public safety personnel, the outcome would have been far worse.

I was also personally effected by the fires: my childhood home was destroyed, I was evacuated from my own home, and am grateful for my aunt and cousin, who rescued my dog while I was at work that night.

We have come together and are rebuilding our community. #SonomaStrong