EMS System Models and Status Management

EMS Delivery Models

• In the United States, most First Response Emergency Medical Services (EMS) are delivered by the fire department, with personnel cross-trained in EMS.
• Other models include public agencies, public-private partnerships, private for-profit agencies, and non-profit corporations.
• Staffing varies between and within these EMS systems.

System Status Management

• System Status Management is used to maximize efficiency and reduce response time.
• It compiles data to determine demand within response areas, taking into account peak loads and increased demand during certain hours.
• Strategic deployment is used to minimize response times during peak demand, but it can take a toll on personnel who have less downtime between calls.
• Ambulances may be posted at strategic locations, such as intersections, to maximize response time based on historical data.

Factors Considered in EMS Stationing

• Distance versus call volume
• Special facilities that create increased emergency medical demands
• Need for maintenance of vehicles and equipment
• Storage, disinfection facilities, classrooms for training and meetings, and sleeping quarters for personnel

Mitigating Hazards During Calls

• In route to the call:
  • Fasten seatbelts
  • Inform dispatch of response
  • Confirm call details and ask for additional information
  • Prepare to assess and care for the patient
  • Review information from dispatch and assign duties to crew
• Securing equipment:
  • Ensure all equipment is secure before placing the vehicle in motion
  • Avoid objects shifting or falling during transport
  • Secure diagnostic equipment and portable oxygen cylinders to prevent them from becoming lethal

Scene Size-Up and Patient Care

• Perform scene size-up and report to dispatch
• Look for hazards and evaluate the need for additional help or specialized equipment
• Evaluate the mechanism of injury or nature of illness
• Take standard precautions when approaching patients
• In multi-patient scenes, provide an estimation of the number of patients and assign roles such as triage or treatment

Traffic Control and Safety

• Ensure orderly traffic flow and prevent additional crashes
• Use reflective vests and warning devices to increase visibility
• Shut down roads if necessary to ensure a safe working environment
• Avoid excessive speed during transport and consider the siren's effective range

Patient Transport and Safety

• Secure patients with shoulder straps and body straps
• Deceleration straps prevent forward movement of the patient in case of sudden stops
• Avoid injuries to patients and providers during transport

Post-Call Procedures

• Clean and disinfect the emergency vehicle and equipment
• Restock supplies and inspect equipment for damage
• Decontaminate the vehicle and remove microbial contamination
• Sterilize equipment using heat or autoclave
• Dispose of medical waste and clean up spills and contaminants

EMS Delivery Models

• Most First Response EMS in the US are delivered by fire departments with cross-trained personnel.
• Other EMS models include public agencies, public-private partnerships, private for-profit agencies, and non-profit corporations.
• Staffing varies between and within these EMS systems.

System Status Management

• System Status Management aims to maximize efficiency and reduce response time.
• It compiles data to determine demand within response areas, considering peak loads and increased demand during certain hours.
• Strategic deployment is used to minimize response times during peak demand.
• Ambulances may be posted at strategic locations to maximize response time based on historical data.

Factors Considered in EMS Stationing

• Distance versus call volume is considered when determining EMS stationing.
• Special facilities that create increased emergency medical demands are taken into account.
• Need for maintenance of vehicles and equipment is considered.
• Storage, disinfection facilities, classrooms, and sleeping quarters for personnel are essential.

Mitigating Hazards During Calls

• Crews should fasten seatbelts, inform dispatch, and confirm call details before responding to a call.
• Equipment should be secured before the vehicle is in motion to prevent shifting or falling during transport.
• Diagnostic equipment and portable oxygen cylinders should be secured to prevent them from becoming lethal.

Scene Size-Up and Patient Care

• Perform scene size-up and report to dispatch to ensure safety.
• Look for hazards and evaluate the need for additional help or specialized equipment.
• Evaluate the mechanism of injury or nature of illness to provide proper care.
• Take standard precautions when approaching patients to prevent infection.

Traffic Control and Safety

• Ensure orderly traffic flow and prevent additional crashes.
• Use reflective vests and warning devices to increase visibility.
• Shut down roads if necessary to ensure a safe working environment.
• Avoid excessive speed during transport and consider the siren's effective range.

Patient Transport and Safety

• Secure patients with shoulder straps and body straps during transport.
• Deceleration straps prevent forward movement of the patient in case of sudden stops.
• Avoid injuries to patients and providers during transport.

Post-Call Procedures

• Clean and disinfect the emergency vehicle and equipment after each call.
• Restock supplies and inspect equipment for damage.
• Decontaminate the vehicle and remove microbial contamination.
• Sterilize equipment using heat or autoclave.
• Dispose of medical waste and clean up spills and contaminants.