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San Francisco debriefs New Year—s Eve EMS surge; officials say medical surge must be a top priority
Summary
City officials said a surge of emergency medical calls on New Year—s Eve strained dispatch and ambulance resources, prompting mutual aid and new field-hospital trials; officials urged planning for medical surge capacity because hospitals operate near capacity on ordinary days.
San Francisco officials said an unexpectedly large surge of emergency medical calls on New Year—s Eve stretched dispatch and ambulance capacity and highlighted the need to prioritize medical surge planning.
"We took 350 calls that night on just EMS," said Steve O'Plante, emergency operations manager, describing sample CAD and prehospital-care-review data that showed a heavy, alcohol-related spike during the 1:30 a.m. to 5:30 a.m. surge. O'Plante said the city increased ambulances from a surge baseline (27) by calling on BLS inter-facility providers and accepted mutual aid from San Mateo County (a strike team of three ambulances and a supervisor) when code-3 calls hanging peaked at about 33.
Rob Dudgeon of the Department of Emergency Management said exercises and incidents show the next major gap to address is medical surge. "Our health care system operates at 85, 90% capacity on a good day," he said, arguing that mass casualty or prolonged-care events will overwhelm usual resources.
Officials also described an operational trial to reduce hospital transports during concentrated events. Ahead of St. Patrick's Day the city deployed a 20-by-80-foot field hospital adjacent to a sobriety center, staffed with generator power, heat and nurses trained in sobriety medicine. "We saw 11 patients come in ... none of whom would have gone to 1171 Mission," O'Plante said, noting the trial prevented hospital admissions and reduced turnaround time for emergency crews.
Dudgeon and O'Plante said the response relied on coordination across agencies, surge staffing in dispatch and pre-existing mutual-aid agreements. They recommended formalizing the field-hospital capability and continuing partnerships with nonprofit providers such as the Delancey Street Foundation, which helped deploy and take down tents during the exercise and is being included in a memorandum of understanding.
Officials said the city will convene additional planning, training and after-action work to translate the lessons into durable systems for events and disasters. The Department of Emergency Management emphasized communications redundancies (whiteboards and pencil-and-paper fallbacks in the EOC) after a temporary city-network outage delayed electronic access during the incident.
The city plans further work with the health system and partner agencies to expand pragmatic surge options and to incorporate field-hospital and sobriety-center adjacencies into event planning.
