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Standard Operating Procedures
NORTHEAST TENNESSEE
Regional Medical Communications Center
Med Com
Standard Operating Procedures
Resource Coordination Center
Routine and Emergency Operations Procedures
Prepared By
Document Owner(s) Project/Organization Role
Procedure Manual Version Control
Version Date Author Change Description
Note The content of a manual does not constitute nor should it be construed as a guide to all situations.
This manual is a guide for most foreseeable situations tasked of the RMCC.
The Northeast Tennessee RMCC Council, at its option, may change, delete, suspend, or discontinue
parts or the procedures in its entirety, at any time without prior notice.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 1
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
TABLE OF CONTENTS
1 INTRODUCTION ................................................................................................................................... 3
2 STANDARDS OF CONDUCT ............................................................................................................... 4
3 COMMUNICATIONS ROUTING ........................................................................................................... 6
4 MULTIPLE CASUALTY INCIDENTS & MUTUAL AID ......................................................................... 8
5 ALERTS ............................................................................................................................................... 10
6 HRTS ................................................................................................................................................... 11
7 CHEMPACK ........................................................................................................................................ 12
8 COMMUNICATIONS MONITORING................................................................................................... 13
9 AMBULANCE STRIKE TEAM ............................................................................................................ 15
10 CRITICAL INCIDENT STRESS MANAGEMENT (CISM) ................................................................... 16
11 ACRONYMS ........................................................................................................................................ 17
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 2
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
1 INTRODUCTION
This document has been developed by Northeast Tennessee Regional Medical Communications
Center Council (RMCC Council) in order to familiarize RMCC Operators with MedCom (RMCC)
and provide information about key policies and procedures at the Northeast RMCC.
1.1 History
The purpose and goal of the Resource Coordination Center (T.C.A. – 68-140-204)
A statewide system of emergency medical service - area telecommunications shall be developed by the
Tennessee Department of Health, which shall be responsible for the introduction and coordination of such
system into the state emergency preparedness plan.
Each EMS region within the State of Tennessee shall have a resource coordination center (RCC), also
known as Regional Communications Center, or more specifically a Regional Medical Communications
Center (RMCC) as the coordination and communications deal with medical facilities and emergency
medical assets in this context.
The RMCC shall be a central coordination point to delineate lines of communication between all stake-
holders in the region’s emergency medical community. These include, but are not limited to: 9-1-1/EMS
Dispatch Centers, ambulance services, hospitals, and emergency management agencies.
Due to the regional focus and scope of operations, it was reasoned that the regional aeromedical services
with flight coordination centers in Tennessee be approached in their willingness to serve as an RMCC for
their respective areas within the State of Tennessee. Emergency Communications Districts had been
utilized initially when the RCC program was implemented and centers were designated. It was further
rationalized that county 9-1-1 centers are the first resource to become overwhelmed due to the influx of
callers when an event develops within it’s jurisdiction, while aeromedical services do not take calls from the
general public and have an operational area encompassing most if not all counties within their EMS region.
The RMCC shall routinely monitor and respond to ambulance traffic within the region to facilitate hospital
communications either by DTMF encoding, Med-Channel assignment, or frequency control of 155.340 MHz
as needed to prevent unintentional harmful interference of simultaneous transmissions by EMS/Hospitals
within the region. The RMCC shall also assist in notification of hospital advisory & diversion status to the
region’s facilities and ambulance services as directed. The RMCC shall serve as a non-partisan information
conduit, but is not responsible or tasked with routing ambulances to certain hospitals unless so-directed by
the State EMS Office, Incident Commander, or Incident Medical Transport Officer in the event of a disaster.
With the potential for system abuse, the RMCC shall have transparent operations within the medical
community and any lack of impartiality, whether actual or perceived, will be investigated as necessary to the
satisfaction of the RMCC Council and/or State EMS Division.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 3
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
1.2 Changes in Procedure
This manual supersedes all previous policies and procedures for RMCC operation.
While every effort is made to keep the contents of this document current, the RMCC Council
reserves the right to modify, suspend, or terminate any of the policies and procedures described
in the manual with or without prior notice.
Policy/Procedure changes will be submitted to the Chairman of the RMCC Executive Committee
for presentation to the RMCC Council. Action may be taken at the next regularly scheduled
RMCC meeting to consider the proposal. A two-thirds majority of voting members present will be
required to effect change in Standard Operating Procedures.
2 STANDARDS OF CONDUCT
2.1 General Guidelines
All RMCC personnel are urged to become familiar with RMCC rules and standards of conduct
and are expected to follow these rules and standards faithfully in doing their own jobs and
conducting the center’s business.
Radio Codes and Signals will not be utilized in any written or verbal communications.
2.2 Confidential Information and Nondisclosure
By continuing employment in the RMCC, RMCC Personnel agree that they will not disclose or
use any of the RMCC’s confidential information, either during or after their employment. The
RMCC sincerely hopes that its relationship with its RMCC Personnel will be long-term and
mutually rewarding. However, employment with the RMCC assumes an obligation to maintain
confidentiality, even after an employee leaves the RMCC’s employ.
2.3 Ethical Standards
The RMCC insists on the highest ethical standards in conducting its business. Doing the right
thing and acting with integrity are the two driving forces behind the RMCC’s great success story.
When faced with ethical issues, RMCC Personnel are expected to make the right professional
decision consistent with non-biased principles and standards.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 4
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
2.4 Use of Equipment
The RMCC will provide RMCC Personnel with the equipment needed to do their job. None of this
equipment should be used for personal use, nor removed from the physical confines of The
RMCC—unless it is approved for a job that specifically requires use of equipment outside the
physical facility.
2.5 Use of Computer, Phone, and Mail
RMCC property, including HRTS computers, toll-free telephone lines and radios should be used
only for conducting official business. The HRTS (Hospital Resource Tracking System) is for
official RMCC use only.
2.6 Complaint Procedure
2.6.1 Personnel (field, dispatch, facility, etc.) who have a RMCC question or
complaint should first discuss it with their immediate supervisor.
1. RMCC Supervisor to be notified of RMCC procedural complaints
2. RMCC Council to be notified if RMCC issue not resolved
2.6.2 Personnel, who observe, learn of, or, suspect a violation of the Standards of Conduct of
the RMCC or the Rules and Regulations of the Tennessee Department of Health –
Division of EMS, should immediately report the violation in accordance with the following
procedures:
1. Notify Immediate Supervisor
2. Notify Regional EMS Consultant
2.7 Corrective Procedure
The RMCC and/or RMCC Council will work to resolve issues in a timely, confidential manner.
2.8 Suggestions
The RMCC Council encourages suggestions and good ideas about making the RMCC a more
efficient operation and enhancing service to RMCC Stakeholders. All stakeholders can help bring
ideas to the attention of the RMCC Council. All suggestions are valued.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 5
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
3 Communications Routing
3.1 Traditional Ambulance Radio Traffic will remain unchanged.
The primary day to day operation of an RMCC has historically been that of ―operator‖, dialing DTMF codes
for ambulances wanting to talk to a specific hospital on the HEAR system (155.340 MHz – Hospital
Emergency Ambulance Radio), and when communications failures disable an ambulance or hospital from
connecting with the other – information is relayed via telephone or other radio frequencies to the receiving
entity for the ambulance crew.
3.1.1 Hospital Encoding
When an EMS provider contacts the RMCC requesting a line to a hospital, RMCC personnel will
have the ambulance switch over to 155.340 MHz, if the frequency is clear, and dial the DTMF
code for the hospital requested. Should the hospital not answer after two attempts, RMCC
personnel will offer to contact the hospital Emergency Department by telephone and relay the
information for the EMS provider.
If a hospital radio is not working, and the RMCC has been apprised of this situation, the RMCC
will make this information known to the ambulance, and offer to either patch the ambulance
through on 155.340 to the hospital on another frequency band (UHF or 800 MHz where possible),
contact the hospital by telephone and relay the information, or give the ambulance a number to
contact the emergency department via cellular telephone.
RMCC personnel will inform ambulances transporting to a facility of any applicable advisory
status –i.e. diversion- but will not re-direct any ambulance to an alternate facility. Should a facility
being contacted for an EMS provider request transport to another facility (i.e.-diversion status,
etc.), RMCC personnel will give the information to the ambulance crew word-for-word.
When hospital diversion or service advisories have been issued, the RMCC relays this
information to all EMS providers on 155.205 via regional radio broadcast. It has been required
that all EMS providers monitor 155.205 MHz in the specifics of the EMS Telecommunications
Plan – though not all EMS providers monitor this frequency as stipulated. Future considerations
allow the establishment of select-call monitoring, as with the hospitals. This will require EMS
Dispatch entities to utilize DTMF coded squelch and require a DTMF encoder/decoder to alert
other dispatch agencies and the RMCC. The codes have been identified as ―0‖ + the county
numeric code (i.e. 090 for Washington County).
3.2 Frequency Patching
Where allowed by the local system owner, the RMCC may cross-patch frequencies to allow an incoming
ambulance to contact a facility or another EMS provider in a temporary console bridge by patching
frequencies together. This may allow the patching of a provider on 155.280 to a hospital talk group on an
800 MHz system – for example.
Console bridging will not be allowed on the main EMS frequencies of 155.205 or 155.340 for more than a
few minutes, due to the number of users on the system and users in adjacent states that would be
impacted.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 6
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
3.3 Channel Assignment
State VHF (Very High Frequency) frequencies have been designated for specific use.
3.3.1 155.205 MHz will be used as the primary routing frequency, for calling the RMCC,
and initial mutual aid contacts. This frequency is utilized by the State of Virginia as an
EMS mutual aid frequency, and is used by other EMS agencies in other bordering
states. The State EMS Telecommunications Committee has recommended all EMS
providers use a DPL of 205 on this frequency in the near future.
3.3.2 155.280 MHz will be used for primary hospital to hospital communications. EMS
agencies may be approved for use of this frequency as a secondary user on a case
by case basis.
3.3.3 155.295 MHz will be utilized for on-scene use for EMS coordination at events. The
Department of Health has also agreed to allow this frequency to be used at mass-
vaccination clinics by Health Services. This frequency is for mobile and portable use
only.
3.3.4 155.340 MHz is identified nationally as the ―HEAR‖ frequency (Hospital Emergency
Ambulance Radio), and is dedicated solely for EMS to hospital communications. This
frequency will also be used by the RMCC to contact hospitals via radio.
3.4 Recordings of Communications
Recordings may be made available to an agency/facility of their transmissions for
ongoing quality assurance. Each request must be submitted in writing to the RMCC
Supervisor from an official of the department or facility involved.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 7
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
4 Multiple Casualty Incidents & Mutual Aid
4.1 In the event of a Multiple Casualty Incident
4.1.1 RMCC will take proactive measures
When learning of a multiple casualty event, which may require mutual aid resources, the
RMCC will Alert surrounding dispatch centers and hospital emergency departments via
155.205 MHz and 155.340 MHz using county-specific DTMF codes, or the all call code
(911). The Regional EMS Consultant and Regional Hospital Coordinator(s) will also be
notified when learning of an event, or potential event. No agencies will be dispatched or
asked to respond. It will be made clear that this is an advisory only, and services will be
contacted individually if their resources are needed.
4.2 RMCC Activation of Mutual Aid
If the RMCC is contacted by an official or dispatch center for mutual aid resources, the number and type of
resources requested will be obtained, along with the caller’s name, telephone number, any additional
information warranted by the situation (i.e. Weather, Haz-Mat, etc..) location of the command post, staging
area, and where responding units and personnel should report and to whom they should check in. The
caller should also identify the local radio frequency being utilized for coordination on scene and have the
transport officer contact the RMCC for estimated casualties so that facilities can be notified for real-time bed
and service data via immediate HRTS update.
4.2.1 EMS Activation
The RMCC will contact the closest EMS agencies and work away from the event until
sufficient resources are located to respond to the incident as requested by the local jurisdiction.
All ambulances are to check in with the RMCC for resource tracking from home location and
check in at the incident. The Regional EMS Consultant will also be contacted. The Regional
EMS Consultant may also ask the RMCC to contact the State EOC (SEOC) to assure they are
notified of the event.
4.2.2 Hospital Activation
The RMCC will alert hospitals via 155.340 MHz call-out, and follow up with phone calls to
facilities who will most likely be receiving patients to determine their immediate
capabilities until they have updated online with the HRTS (Hospital Resource Tracking
System) network.
4.3 Notification of Regional Hospital EOCs and Bordering States
Notification of facilities and jurisdictions bordering the Northeast Tennessee Region should be
accomplished directly by RMCC as needed. The State EOC shall also be notified, and is to be
tasked with additional out-of-state notifications as necessary.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 8
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
4.4 Ambulance Routing
The RMCC will make the information gathered from the hospitals available to the Incident
Commander, Medical Transport Officer, or EMS Consultant as necessary.
The RMCC will not make hospital transport decisions but will route ambulances as directed by the Incident
Commander, Transport Officer, or Regional Consultant.
4.5 Helicopter Operations
When mutual aid aeromedical helicopters are requested, these shall be coordinated and controlled through
the RMCC. Such operation shall instill safe coordinated operation for in-region and out-of-region services
with a local control point.
The air ambulance will be directed to the Landing Zone designated by the Incident Commander or
Medical Transporting Officer.
Air ambulances shall establish contact on VHF helicopter common frequency 123.025 MHz for air to
air communications, which will also be monitored by the RMCC. The medical crew will coordinate
ground communications through the dedicated aeromedical transport frequency identified by the
Incident Commander. This frequency will also be monitored by the RMCC when possible.
In the event an aircraft does not posses UHF or VHF ground radio capability (i.e. military) they may
communicate on the ____________ aircraft Unicom frequency which can be relayed by the RMCC to
the hospitals or Incident Commander.
Alternate frequencies identified for local aeromedical use by the Civil Air Patrol: ______.______
______.______
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 9
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
5 ALERTS
5.1 Alerting System Participants
Each County contact point and hospital facility shall be alerted and notified when the RMCC learns of:
Severe Weather Warnings
Multiple Casualty Incident (alert potentially effected counties/facilities)
Homeland Security Threat Level change
Major highway artery closures or traffic delays
Local Event requiring the closure of a facility
Activation of the Regional Ambulance Strike Team
Need for Immediate HRTS Status update from hospitals.
EMS agencies will be alerted using all-call or county-specific codes of DTMF on 155.205 MHz.
Hospitals will be alerted using all-call or county-specific codes of DTMF on 155.340 MHz.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 10
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
6 HRTS
Hospital Resource Tracking System (“hurts”)
The Tennessee Department of Health’s - Hospital Resource Tracking System (HRTS) is a stand-alone web
based system for the unified reporting of hospital data sets.
Hospitals are required to report available beds, available services, and closed services (of those available)
on a daily basis. In the event of a disaster, facilities would be asked to update their data for real-time use.
Routine status reporting would only list open and closed services of a facility to the RMCC, Regional EMS
Consultant, and Regional Hospital Coordinator, as well as the State EOC. Each facility can only view its
data, but may view the open and closed services of facilities as other stakeholders during normal use.
In the event of a disaster, State Health or the RMCC can create a Disaster Event within a HRTS area to
make the last entered set of real numbers available to the RMCC and other emergency (EMS/Hospital
Coordinator/EMA) officials. The RMCC, and others will utilize this information to inform event transport
officers so they can make decisions as to where patients will be transferred or transported for their
individual needs and to not overload any one facility.
In the event of Pandemic Influenza, the RMCC will monitor Pandemic Influenza data requested by the
Tennessee Department of Health and provided by hospitals on a daily basis.
6.1 HRTS Activation
Upon learning of a disaster event, the RMCC shall initiate a ―disaster‖ event in the HRTS system.
When the event is created, this will allow full data set information to be displayed to those officials
in need within the region and State EOC (Emergency Operations Center).
The RMCC should also Alert facilities affected of the immediate need for an updated data set using
the alert policy.
The RMCC will contact the Regional EMS Consultant and Regional Hospital Coordinator(s)
immediately after establishing an event in the HRTS program.
6.2 HRTS Exercise
When utilizing HRTS for a disaster exercise, the actual HRTS system will NOT be utilized. The
Tennessee Department of Health has established an EXERCISE Function in a separate section to
prevent the unintentional data set corruption which may occur during an exercise. The actual real-
time data last entered into HRTS will not be affected.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 11
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
7 CHEMPACK
CHEMPACK refers to a pre-positioned package of chemical agent antidotes located in caches
throughout the State of Tennessee. The Northeast Tennessee region houses two CHEMPACKS
routinely, with another being brought in to the region during major events (i.e. Bristol Motor
Speedway NASCAR races)
The CHEMPACK units are identified as Hospital and EMS CHEMPACKS. The Hospital
CHEMPACKS house multi-dose vials and some auto-injectors of medications that would be required
for the treatment of adult and pediatric patients exposed to a nerve agent. The EMS CHEMPACK
contains Mark-I kits for the treatment of 1,000 adult patients exposed to nerve agents.
7.1 CHEMPACK Activation
CHEMPACK Activation may be requested from Hospital, EMS, and 9-1-1 Contacts (identified by
the Department of Health CHEMPACK Procedures). Upon request for CHEMPACK Activation, the
requisite information will be obtained (Who’s requesting, What happened – is happening, When did
it occur, Where did it occur, Why is nerve agent suspected, How do we need to get the
CHEMPACK to you –delivery point).
7.1.1 CHEMPACK MOVEMENT
CHEMPACK housing authorities will be contacted regarding the activation of
CHEMPACK, to prepare for immediate pickup of the transporting agency.
CHEMPACK transport agencies will be dispatched for EMS and/or Hospital transport and
instructed where to pick up their unit.
Regional Hospital Coordinator(s) and Regional EMS Consultants will be notified.
Regional EMS Providers and Hospitals will be alerted.
State EOC will be notified, as will the East Tennessee RMCC.
7.2 CHEMPACK Exercise
The list of CHEMPACK contact numbers will be checked biannually (at least before every major
NASCAR race at Bristol Motor Speedway).
CHEMPACK deployment exercises will utilize an exercise package of similar size and packaging,
provided by the Tennessee Department of Health.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 12
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
8 COMMUNICATIONS MONITORING
8.1 Regional
8.1.1 EMS Dispatch Centers
The RMCC shall perform weekly radio checks on 155.205 MHz with all EMS Dispatch
Entities/9-1-1 Centers in the Northeast Tennessee Region. These checks shall be made
using open channel monitoring or DTMF calling on both the All-Call (911) code, and
Individual County (0+county code) codes to assure continued system capability to
contact each county dispatch point in the event of an emergency.
8.1.2 Hospital Emergency Departments
The RMCC shall perform weekly radio checks on 155.340 MHz with each hospital in the
Northeast Tennessee Region. These checks will be made using DTMF calling using the
all-call code (911) and each facility’s code as supplied by the State Division of EMS.
8.1.3 Communications Failure
Where any problems exist with communications or alerting using DTMF within the region,
the agency/facility and Regional EMS Consultant will be notified and will work with the
RMCC to identify and correct the problem in conjunction with the regional resource.
8.2 Script Format
Radio checks shall use a standard script for these communications checks:
“WQFY386, Johnson City Med-Com on the air for Radio Check (Day, Date, Time). All
Stations please stand by: (roll-call each facility)…
…Recalling: (stations that did not answer)
… Radio Check Complete. Johnson City Med-Com Clear, (time)”
* All call and facility/county specific codes may be alternated each week for testing.
8.3 Inter-Regional
The RMCC shall perform testing of inter-regional communications on a weekly basis.
The Northeast Tennessee RMCC shall contact the Knoxville RMCC (―Med-Link 2‖) using 155.205 MHz,
UHF Med-Channels (pre-identified with Knoxville), and 800 MHz systems where pre-identified.
The RMCC shall also contact the State Emergency Operations Center on a monthly basis using the
frequency identified by TEMA (Tennessee Emergency Management Agency).
8.4 Communications checks with other entities
The RMCC shall also conduct monthly communications checks with:
Regional EMS Consultant
Regional Hospital Coordinator(s) – to include Counterparts in VA, NC, KY.
Regional Health Operations Center (RHOC)
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Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
THP District Office (Fall Branch)
County Emergency Operations Centers, when identified
Hospital Amateur Radio Stations (using ―ham‖ equipment)
8.5 Database Management
The RMCC staff shall regularly update all information on contact lists at least twice annually.
8.6 Large/Special Events
During large events or special operations (Bristol NASCAR race, or Mass Gathering Event), the RMCC
will establish daily communications checks with the EMS component at the command post. These shall
be conducted daily for the duration of each event, or at shift changes where warranted to assure
continued communications.
Local officials shall coordinate all EMS Command Post activities and communications plans, to include
communications checks, with the RMCC.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 14
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
9 Ambulance Strike Team
An Ambulance Strike Team (AST) is an EMS mutual aid unit identified by the Federal Emergency
Management Agency for mutual aid response and implemented by the Tennessee State Division of EMS.
An Ambulance Strike Team is defined as a set of five ambulances of common type (ALS or BLS) staffed
appropriately, licensed/permitted appropriately in the home state, along with a supervisor and
supervisor/support vehicle. This is the common unit for mutual aid response in the State of Tennessee.
Where a mixed ALS/BLS team is utilized, it is identified as an Ambulance Task Force. Where a mixed
ambulance/response unit/etc.. team is utilized; it is identified as an EMS Task Force. Task Force being the
identifier of a mixed resource team with the same goal.
9.1 RMCC Responsibility
The RMCC in each region of the state is responsible for the alerting and coordination of the AST
deployment and response to its assigned rally point, or point of disembarking. It shall also be the
contact point for all communications from and to the AST for region 1 to assure a proper flow of
information to personnel.
The AST leaders will be pre-identified as they are trained and vehicles equipped to support a strike team.
In the same manner, services will be pre-identified in their ability to provide ambulances and personnel
for ambulances /crews that are stocked and available for mobilization as part of an AST.
9.2 Strike Team Activation
The RMCC, when notified by the State EOC or another RMCC will locate an available AST Leader and
five ALS ambulances within the region who can participate as part of the AST for deployment. The
Regional EMS consultant will be notified, and a rally point will be identified for reporting in and checking
equipment. The AST leader will be provided all requisite information relative to the mission.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 15
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
10 Critical Incident Stress Management (CISM)
The Northeast Tennessee Critical Incident Stress Management Team is administered by the State Division
of Emergency Medical Services’ Regional Office. The CISM Team provides debriefing and stress
management services to emergency response personnel and the general public upon request after the
critical event involving unusual levels of stress.
10.1 Activation
When notified of a need for Critical Incident Stress Management services in or out of the region, the
Regional EMS Consultant will be contacted. If unable to contact the regional consultant, the Regional
CISM Team Clinical Coordinator will be contacted. In the event neither of the above parties can be
contacted within 20 minutes, Frontier Health will be contacted using their 24 hour contact number, and/or
the Region 2 EMS Consultant will be notified via the Knoxville RMCC.
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 16
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
Standard Operating Procedures
11 ACRONYMS
AST Ambulance Strike Team
ALS Advanced Life Support
BLS Basic Life Support
CHEMPACK Chemical-antidote Package
CISM Critical Incident Stress Management (formerly Critical Incident Stress Debriefing)
DPL Digital Private Line™, Digital Coded Squelch
DTMF Dual Tone Multi Frequency (i.e. Touch-Tone ™)
EMS Emergency Medical Services
EOC Emergency Operations Center
GHz Gigahertz
Haz-Mat Hazardous Materials
HEAR Hospital Emergency Ambulance Radio
HRTS Hospital Resource Tracking System
MHz Megahertz
NASCAR National Association for Stock Car Auto Racing
RHOC Regional Health Operations Center (regional State Health Department EOC)
RMCC Regional Medical Communications Center (formally RCC per T.C.A.)
TCA Tennessee Code Annotated
TEMA Tennessee Emergency Management Agency
THP Tennessee Highway Patrol
VHF Very High Frequency (radio frequencies from 30-300 MHz)
UHF Ultra High Frequency (radio frequencies from 300 MHz to 3 GHz)
Effective 3/14/2007 The RMCC Council, at its option, may change, delete, suspend or Page 17
Version 1.0 discontinue parts or the procedure in its entirety, at any time without prior
notice. In the event of a policy change, employees will be notified. Any such
action shall apply to existing as well as to future employees.
