Pandemic planning.

Recent trends of hospital ED overcrowding, ambulance diversion and the persistent "dire straits" of emergency medical systems can be expected to be exacerbated under the conditions a pandemic influenza will present. Partners of community healthcare systems must come together to solve these problems as they develop their pandemic influenza response plans. The solution must involve EMS, hospitals, public health and other healthcare partners, as well as local government. Limited surge capacity, overwhelming numbers of citizens requiring and demanding care, and the worried well will simply compound the challenges EMS responders will face. EMS must get proactive and tap the preparedness resources being marshaled at federal, state and local levels. These preparations will not be complete without an exercise that probes for weaknesses in the response plan. EMS agencies are encouraged to join up with other components of the healthcare system, such as hospitals, community health centers and public health, and conduct joint exercises. And we must not forget the coroners, whose plans must include a mass-fatality plan that details the management of what may become an overwhelming number of deceased.