Emergency Medical Services - Since 1978, the
mission of this program has been to administer, maintain, and operate a
State comprehensive emergency medical services system throughout Hawaii
that is designed to reduce medical emergency deaths, injuries, and
permanent long-term disability through the implementation of a fully
integrated cohesive network of related components. The state system
provides for the arrangement of personnel, facilities and such
equipment, primarily in the pre-hospital setting, for the effective and
coordinated delivery of health care services under emergency conditions
whether occurring as a result of the patient's condition, natural
disasters, or other causes. [Hawaii Revised Statutes §321-221]
Injury Prevention - In early 2001, the Department of Health's Injury Prevention and Control Program was officially moved to
the Emergency Medical Services System Branch as one of three sections. By incorporating injury prevention into EMS, the Department joins a
national trend and fulfills the vision of an expanded role for EMS as first articulated in the "EMS Agenda for the Future" released in 1996
by the National Highway Traffic Safety Administration. The Agenda makes clear that injury prevention is an "essential" activity for EMS because of
EMS' unique role, which involves individual health care, public safety and public health.
The Injury Prevention and Control Section (IPCS) is the
Department's focus for injury prevention in communities throughout the
state, and provides statewide coordination and collaboration in all areas
of injury prevention for all age groups.
IPCS is responsible for coordinating, planning, conducting and evaluating
injury prevention interventions, policy development and advocacy, collecting,
analyzing and disseminating injury data, and technical support and training.
Since July 1, 1995, emergency ambulance patients who have been
diagnosed as terminally ill can, if they wish, obtain and wear a "COMFORT CARE ONLY" I.D. bracelet or necklace.
Then, should they stop, or are about to stop breathing, they will receive comfort care such as oxygen, medication for
pain, suctioning of oral secretions, and other comfort measures, but they will NOT receive resuscitation efforts
(i.e., rescue breathing, chest compressions, electric shocks, or medications intended to try to restart the heart). This is a
completely voluntary decision that the terminally ill patient can make if he or she wants.
This law allows terminally ill patients a means to pass away,
when their time comes, in as much comfort as possible, with their
dignity intact and without having to endure the pain, distress
and expense of prolonging their death.
Please feel free to download the following two files (you'll
need both) for additional - including contact - information about
On July 16, 2009, POLST became law without the Governor's signature as Act 186, (Gov. Msg. No. 543).
POLST (Physician's Orders for Life-Sustaining Treatment) is a physician's order that gives patients more
control over their end-of-life care. It specifies the types of treatments that a patient wishes to receive towards
the end of life. Completing a POLST form encourages communication between healthcare providers and patients, enabling
patients to make more informed decisions. The POLST form documents those decisions in a clear manner and can
be quickly understood by all providers, including first responders and emergency medical services (EMS) personnel. As
a result, the patient's wishes can be honored across all settings of care.
Kokua Mau is the lead agency for POLST. For more information about POLST, visit www.kokuamau.org or contact them at (808) 585-9977.
The document, "Mobile Intensive Care Technician Biological
Outbreak/Exposure Mass Prophylaxis & Immunization Standing
Orders," is the first edition of a manual that provides the
Department of Health with standing orders for preventive
antibiotic therapy and/or immunizations in the event of a
bioterrorism attack due to anthrax, brucellosis, plague,
smallpox, or tularemia.
The document contains 1) an overview of the bioterrorism
preparedness response plans regarding mass prophylaxis and
immunization; 2) standing order protocols for anthrax,
brucellosis, plague, smallpox, and tularemia; 3) antibiotic
information for practitioners; 4) antibiotic information
brochures for patients; and 5) data management and consent
This document should be considered an annex to the State of
Hawaii EMS MICT Standing Orders and Extended Standing Orders.
The standing orders contained within this document become
activated when the Director of Health declares a state of
emergency due to a specific bioterrorism incident, and issues a
memorandum ordering the EMS prehospital providers to begin mass
prophylaxis. The memorandum would contain information regarding
the nature of the bioterrorism incident, the causative
microorganism, the population at risk, and the mass prophylaxis
protocol to be followed.
This document may be reviewed annually to ensure that the
standing orders are up to date, and reflect the latest available
recommendations from the Centers for Disease Control and
Prevention for Bioterrorism Preparedness and Response.