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Dublin Fire Brigade Paramedics- Insight into a Pre-hospital Emergency Care Service. Brief history of DFB - Oldest uniform body in the state Since 1862 (Oldest Ambulance service provider in Ireland) Since 1898 Benefits of combined Fire/Emergency Medical service (EMS) for patients
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Dublin Fire Brigade Paramedics- Insight into a Pre-hospital Emergency Care Service • Brief history of DFB - Oldest uniform body in the state Since 1862(Oldest Ambulance service provider in Ireland) Since 1898 • Benefits of combined Fire/Emergency Medical service (EMS) for patients • Our areas of operations • Statistics/ type and numbers of calls • Information on range of pre-hospital treatment protocols using generic case details • Some footage with real on scene experiences with DFB staff.
Dublin Fire Brigade Paramedics- Insight into a Pre-hospital Emergency Care Service D/O Martin O’Reilly S/O Paul Lambert
Dublin Fire and Ambulance Service • Oldest uniform body in the state Since 1862 • Oldest Ambulance service in Ireland - 1898
DFB-RCSI Training Institute • Educational Partnership with RCSI • PHECC accredited • Institution • Programmes • Tutors • 2011 Education & Training Standards • Cardiac First Response to Paramedic 2011
Practitioner Level required for Emergency Ambulance Paramedic 2 year diploma program Advanced Paramedic 2 year Graduate Diploma
Population served 1.2 million 464,749 Households
Provide a fully integrated Fire based Ambulance and EMS service In 2011 we responded to 90,000 Ambulance/EMS calls 72,000 Ambulance/EMS incidents 93,000 Ambulance/EMS mobilisations 12,000 Paramedic Fire Appliance responses
Eastern Regional Control Centre • Receipt of 999/112 calls for assistance • Determine the location and nature of the emergency • Determine the priority • Pre-arrival instructions • Provide an appropriate Response • The “Right” response for the patient ? • Nearest appropriate resource
Benefits of combined Fire/Emergency Medical service (EMS) for patients • Strategically located- rapid response • 24/7 Availability of ambulance resources • Resources reduce time on scene • Equipment available - early Extrication • Enhances safety on scene
Highline Rescuesfrom tower cranes • Immediate Medicalassessment and treatment
Swift Water Rescue • SRT technicians • Hypothermia • Submersion Incidents
Road Traffic Collisions Reduce on scene time • Spinal Immobilisation/Patient handling • Rapid Extrication • Safety/Fend off • Fire Risk
Medical • Basic Life support • Advanced Life support • Acute coronary syndromes • Glycaemic Emergencies • Seizures • Inadequate Respirations • Stroke
Medical • Septic shock • Poisons/ OD • Hypothermia • Altered Level of consciousness
Trauma • External Haemorrhage • Shock-Blood loss • Spinal • Burns • Limb Fractures • Crush injury • Head Injury • Traumatic Cardiac Arrest
DFB-RCSI Training Institute Morphine Epinephrine 1:10 000 Amiodarone Benzopenecillin Lasix Atropine Oxygen (INH) Nitrous Oxide (INH) Salbutamol (INH) Aspirin (PO) GTN (SL) Glucose Gel (BU) Glucagon (IM) Epinephrine 1:1000 (IM) Naloxone (IM) Paracetamol (PO) Clopidogrel (PO)
Obstetric Emergencies • Neo natal resus • Haemorrhage in pregnancy • Breech birth • Umbilical cord complications
The Right Response • Immediately Life threatening incidents • The nature of these incidents require a rapid response and more responders on scene • Paramedic Fire Appliance • Paramedic Ambulance • Advanced Paramedic
Fire Appliance Paramedics 60% Ambulance Paramedics 36% Arrive together 4%
Mater Hospital Out of hospital cardiac Arrest study 2003-2008
Mater Study • Improvements in the pre hospital care management of cardiac arrests over the period of the study where; • DFB fire appliance Paramedic equipped with Defibrillators and life saving medications • ERCC began providing telephone assisted CPR • Advanced Paramedics provide pre hospital Advanced Life Support on Fire appliances and Ambulances
Mater Study Conclusions: • The improved quality of Emergency Pre Hospital Care has impacted on survival from Out Of Hospital Cardiac Arrest, particularly from Ventricular Fibrillation
Thank you for your attention ! Questions ????