How's the System?

Per Milwaukee County's antisecrecy policy (MCO 56.24),

A representative of government of the American type is dependent upon an informed electorate and recognizes that secrecy in government is the antithesis of America's loftiest and noblest ideals. It's the policy of the County that the public is entitled to the fullest and most complete information regarding the affairs of county government as is compatible with the conduct of county governmental affairs and of the transaction of governmental business. To that end, all boards, commissions and department heads must do everything reasonably possible to comply with the spirit of such laws.

In short, Milwaukee County is wholeheartedly committed to transparency. In compliance with — and in full support of — the spirit of the law, OEM shares below the status of a series of metrics, broken down by OEM division, updated regularly. For additional information on any of these metrics, or to request consideration of additional metrics, email us at oemcomms@milwaukeecountywi.gov. 

 Radio Services

OASIS Intergovernmental Agreement

OASIS is a P25 digital, simulcast, trunked, 800MHz public safety radio system covering both Waukesha and Milwaukee Counties. Each county has deployed radio towers and infrastructure equipment (e.g., transmitters, dispatch consoles) within their boundaries. Within Milwaukee County, the OASIS Intergovernmental Agreement (IGA) defines responsibilities of the County (through OEM) as a system operator and those responsibilities of the user agencies as subscribers.

Learn more about OASIS in the OASIS 2018 Annual Report.

OASIS System Users

OASIS’s Milwaukee County subsystem serves 70 agencies, shown below. Mutual aid use continues to be extended to select non-governmental organizations that provide support to emergency-response efforts, and it is also extended to public safety agencies in neighboring counties to enable them to communicate when necessary with agencies in Milwaukee County.

OASIS System Encryption

Encryption of public safety radios can significantly decrease the possibility that sensitive information can be used to impede effective emergency response or jeopardize the safety of life and property. In a radio communications system, the Advanced Encryption Standard (AES) is a means of encoding radio transmissions to such a degree that it becomes extremely difficult to listen without authorization, the proper decoding equipment and the correct key.

911 Communications

Public Safety Answering Points (PSAPs)

OEM’s 911 Communications Division is responsible for the prompt response and delivery of emergency services to 911 callers, serving as the Public Safety Answering Point (PSAP) for Milwaukee County.

Text-to-911

Text-to-911 is the ability to send a text message to reach 911 emergency call takers from your mobile phone or device. However, because text-to-911 is currently only available in certain locations, you should always contact 911 by making a voice call, if you can. If you are deaf, hard of hearing or speech disabled, and text-to-911 is not available, use a TTY or a telecommunications relay service, if possible.

Dispatch-Assisted CPR

If dispatchers are trained and able to talk bystanders through how to perform CPR on a cardiac arrest victim, they can turn an untrained bystander into a lifesaver. A cardiac arrest victim’s chance of survival decreases 10% with every minute that passes between collapse and start of CPR, and immediate CPR can double, even triple chances of survival. Milwaukee County Office of Emergency Management and the Medical College of Wisconsin developed and implemented a system for 911 dispatchers to give bystander CPR pre-arrival instructions to all callers in the County, thanks to funding from a Healthier Wisconsin Partnership Program grant. Now a state law, dispatchers across the rest of Wisconsin will be able to give CPR instructions over the phone or easily transfer a caller to a 911 center like ours that can give CPR instructions.

Emergency Medical Dispatch (EMD)

Emergency Medical Dispatch is a systematic program of handling medical calls. Trained telecommunicators, using locally approved EMD Guidecards, quickly and properly determine the nature and priority of the call, dispatch the appropriate response, then give the caller instructions to help treat the patient until the responding EMS unit arrives.

Emergency Medical Services

OEM’s Emergency Medical Services Division is responsible for the protocols and standards of care of over 500 paramedics. OEM assures quality improvement by conducting non-punitive randomized checks and ensuring a clean and quality data repository that contains HIPAA-compliant patient care records which are used nationally in research and analytics for improvements in patient outcomes. Among a number of variables that are measured and tracked, the following metrics provide a brief representation of our system.

Advanced Life Support (ALS)

Advanced Life Support (ALS) means use, by appropriately trained and licensed personnel, in pre-hospital and interfacility emergency care and transportation of patients, of the medical knowledge, skills and techniques included in the department-approved training required for licensure of Emergency Medical Technicians-Paramedic (EMT-P), under Wis. Admin. Code ch. DHS 112, and which are not included in Basic Life Support (BLS).

Transport to Hospitals

If any one member of the EMS team, regardless of their team assignment, feels it is in the best interest of a patient to be evaluated and/or transported, the EMS unit will evaluate and/or transport the patient. The level of transport will be determined by patient assessment needs and treatment provided. Transport shall be to the closest, most appropriate open receiving hospital, taking into consideration the patient’s medical condition, patient's request, location of regular care, primary medical doctor and/or medical records and insurance.

Primary Impressions

The primary impression is a concise statement describing the symptom, problem or condition that is the reason for a medical encounter. Milwaukee County uses more than 250 specific descriptors, from Abdominal Pain to Weakness, which fall into 10 broad categories.

Reason for Choosing Destination

OEM, EMS agencies and health care systems work in partnership to ensure access to safe and high-quality care. Per OEM’s operational policy, patients have the right to make informed health choices including hospital destination within the Milwaukee County EMS System; care outside of an informed patient care choice may impact safety, quality and economic risks. Some hospitals are considered a specialty resource center designed and prepared to handle certain types of patients (eg, Level 1 Trauma Centers, Comprehensive Stroke Centers, cardiac intervention). While one hospital may be closer, it may not be the most appropriate facility depending on the resource needs of the patient.

OEM-EMS App

Launched in 2017, OEM’s free app is designed to allow EMS providers in the field easy and searchable access to the protocols and practical skills guiding medical care provided within the Milwaukee County EMS system. The Standards of Care manual is broken down into the following sections: Universal Care/Operations, Cardiovascular, General Medicine, GI-GU-GYN, Pediatric Specific, Respiratory/Airway, Research, Resuscitation, Special Operations/TEMS, Toxins/Environmental, Trauma and Practical Skills.

Overdose Detection Mapping Application Program (ODMAP)

As data shows a continuing increase in overdose deaths, a consistent methodology to track overdoses, both fatal and non-fatal, in real time across jurisdictions, is necessary to mobilize a public health response capable of addressing these issues within our communities. Overdose Detection Mapping Application Program (ODMAP) links first responders on scene to a mapping tool to track overdoses to stimulate real-time response and strategic analysis across jurisdictions. It is a mobile tool, capable of being used in the field on any mobile device or data terminal connected to an agency’s computer-aided dispatch (CAD) system.

Law Enforcement Officers Trained and Equipped with Naloxone

EMS providers may or may not be the first responder to an opioid-related drug overdose victim. Law enforcement officers may encounter an overdose patient before medical help arrives and in such case, a properly trained officer can take simple measures in safely administering naloxone, potentially saving a life. The agencies below have been properly trained to administer naloxone by OEM-EMS. Standard operating procedures have been developed that capture methods to properly identify a person undergoing an opioid-related exposure, subsequent victim distress and how to safely dispense naloxone.

Emergency Management

Emergency Operations Plans (EOPs)

In the federal system of emergency management, local government must act first to attend to the public’s emergency needs. A municipality's emergency operations plan (EOP) is a document that:

• Describes how people and property will be protected in emergencies and disasters
• Identifies personnel, equipment, facilities, supplies and other resources available — within the jurisdiction or by agreement with other jurisdictions — for use during response and recovery operations
• Identifies steps to address mitigation concerns during response and recovery activities

Depending on the nature and size of the emergency, county, state and federal assistance may be provided to the local jurisdiction.

Hazard Mitigation Plan

Local hazard mitigation planning forms the foundation for a community’s long-term strategy to reduce disaster losses and break the cycle of disaster damage, reconstruction and repeated damage in the next disaster. The plan creates a framework for risk-based decision making to reduce damages to lives, property and the economy from future disasters. As County emergency management, OEM is required to develop a hazard mitigation plan. Adoption of the county plan makes the local municipality eligible to apply for FEMA hazard mitigation grants.

Ban on Tar-Based Sealants

In late 2016, the US Geological Survey (USGS) issued findings that as many as 78% of Milwaukee streams have toxic levels of polycyclic aromatic hydrocarbons (PAHs). PAHs are organic contaminants that in high amounts can harm aquatic animals, cause cancer, genetic mutations and reproductive issues. Commonly used as the “blacktop” on asphalt roads and parking lots, coal-tar pavement sealant was found to contribute up to 77% of the PAHs found in streambeds. The City of Milwaukee issued an ordinance banning use of coal-tar sealants in February 2017, and environmental groups are advocating for all municipalities to follow suit.