Chris Rohrbach Dan Nichols 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 Treated Patient Transported Patient at Hospital Patient at Appropriate Facility Ambulance available

Severity of Condition Is the EMS service good? Medical Necessity Patient’s Impression Medical Necessity Priority 1- 1st Response ALS BLS Priority 2- Priority 3- Priority 4- BLS (Non-Emergency)

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 Treatment Right EMS Services on Scene Patient Transported Patient at Hospital Patient at Appropriate Facility Ambulance Available Patient 1st Responders Call maker Ambulances

The EMS Process: What is the Time Maker? Injury/Illness Call 911 EMD 911 Dispatch Units Responds 1st Unit on Scene Patient Treatment Right EMS Services on Scene Patient Transported Patient at Hospital Patient at Appropriate Facility Ambulance Available Patients / Bystanders Patients / Bystanders and Dispatch Centers Responders EMS Protocols 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”

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