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This article explores the importance of time in the EMS process, from the initial call to treatment and transportation of patients. It discusses the different levels of care, the role of EMS responders, and the significance of timely intervention for various medical conditions. Additionally, it touches on the factors influencing medical necessity and how EMS services are evaluated.
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EMS Goals Chris Rohrbach Dan Nichols
The EMS Process Injury/Illness Call 911 EMD 911 Dispatch Units Responds 1st Unit on Scene Patient Treatment Right EMS Services on Scene Patient Transported Patient Treated Patient at Hospital Patient at Appropriate Facility Ambulance available
Is the EMS service good? Medical Necessity Priority 1- 1st Response ALS BLS Severity of Condition Priority 2- ALS BLS Priority 3- BLS Priority 4- BLS (Non-Emergency) Patient’s Impression
Known process parameters: • “Golden Hour” • Used for multi-system or severe single system trauma • 60 minutes from injury to treatment • “FAST Door-to-Needle” • Used for strokes • Ranges from 60 minutes to 3 hours • Literature supports recovery ability directly attributed to intervention time • Sudden Cardiac Arrest • Survival without CPR/AED after 3-5 minutes is less than 10%
The EMS Process: What is the “Time” Injury/Illness Call 911 EMD 911 Dispatch Units Responds 1st Unit on Scene Patient 1st Responders Call maker Patient Treatment Right EMS Services on Scene Ambulances Patient Transported Patient at Hospital Patient at Appropriate Facility Ambulance Available
The EMS Process: What is the Time Maker? Injury/Illness Patients / Bystanders Call 911 EMD Patients / Bystanders and Dispatch Centers 911 Dispatch Units Responds Responders 1st Unit on Scene Patient Treatment Right EMS Services on Scene EMS Protocols Patient Transported Patient at Hospital Patient at Appropriate Facility Ambulance Available Distance / Method of Transport
Hospitals H H H H H H H H
Trauma Hospitals H H H H H H H H
Stroke Hospitals H H H H H H H H
Statistical: No EMS System“Drive to Hospital” H H H H H H H H
Injury/Illness Calling 911 • Is 911 accessible? • Why do you call 911? • When do you call 911? • What are my other options? • What is the capability of bystanders?
Next Questions • Look at all the input times • How important is “time” • Medical needs • Customer perception • Determining reliability • Compare current status to national standards