EMS System Models and Status Management

Study Notes

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.

Description

Learn about the different models of Emergency Medical Services (EMS) delivery, including fire department-based and private agencies, and understand the concept of System Status Management to maximize efficiency.