Agenda - 08-30-2012 - 2 - Laserfiche WebLink

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Comprehensive Assessment of Emergency Medical Services 7 DRAFT REPORT and 911/Communications Center Operations Study The actual operation of local services is financed entirely at the local level. If the County operates an ambulance service as a line department, it may establish rates, fees, and charges to be collected by the service and it may appropriate County funds to the service (G.S. 153A-250). By statute, all ambulance service providers in North Carolina must be licensed by the State (G.S. 131E- 151.1), each vehicle that is operated as an ambulance must be permitted by the State (G.S. 131E-156), and all assigned ambulance personnel must be certified by the State (G.S. 151E-158). Medical Direction "Medical Oversight" refers to the responsibility for the management and accountability of the medical care aspects of an EMS System. Medical Oversight includes physician direction of the initial education and continuing education of EMS personnel or medical (responder) crew members; development and monitoring of both operational and treatment protocols; evaluation of the medical care rendered by EMS personnel or medical (responder) crew members; participation in system or program evaluation; and directing, by two-way voice communications, the medical care rendered by the EMS personnel or medical (responder) crew members. Subsequently, the County's "Medical Director" is the physician responsible for the medical aspects of the management of an EMS System, or Trauma Center. Subsequently, the Medical Director in Orange County is a licensed, practicing physician whose responsibilities with regards to the County's EMS operation ultimately include certification, medical control, and the continuing education of its employees. Level of Care "Level of Care" refers to the level of training and legal certification held by the caregiver or responder. Individuals are certified based on their highest completed level of training. 10 NCAC 3D and 21 NCAC 32H are quite specific with regards to the type of care, procedures, and medications that can be administered by individuals at each level of certification. In North Carolina there are four (4) levels of certification assigned to EMS providers. The brief descriptions provided below are those defined by the North Carolina Office of Emergency Medical Services (NCOEMS). The Medical Responder (MR) and Emergency Medical Technician-Basic (EMT-B) levels are referred to as "Basic Life Support", or BLS. The remaining levels of care;EMT-I, and EMT-P, are referred to as "Advanced Life Support", or ALS. Medical Responder (MR): Assists pre-hospital technicians in providing basic life support (BLS) care; follows training guidelines of first responders per USDOT. Emergency Medical Technician-Basic (EMT-B): Second level of BLS; individuals trained in advanced first aid, measuring vital signs, CPR, oxygen therapy, etc. intended to take advantage of automatic and semi-automatic external cardiac defibrillators for on-scene defibrillation of patients risking sudden death from ventricular defibrillation; additional training includes advanced airway and administration of epinephrine. Emergency Medical Technician-Intermediate (EMT-I): Allowed to use advanced airway devices, provide intravenous fluid replacement, administer various medications used to correct diabetic, narcotic overdose, respiratory emergency, allergic reactions, and use of automatic and semi- automatic defibrillators. Emergency Medical Technician-Paramedic (EMT-P): In addition to all previous skills, trained in techniques of cricothyrotomy, needle chest decompression, urinary catheter insertion and nasal intubations; in addition to administration of a broad range of medications. Solutions for Local Government,Inc. 5