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• 4Pyrn r, <br /> w L <br /> LIR0.1A <br /> ♦ s 1`L n <br /> THE UNIVERSITY OF NORTH CAROLINA <br /> AT <br /> CHAPEL HILL <br /> The School of Medicine The University of North Carolina at Chapel Hill <br /> Department of Emergency Medicine CB#7594 <br /> Greg Mears,MD,FACEP Chapel Hill, NC 27599-7594 <br /> Head,Division of EMS Phone:(919)966-6440 <br /> Medical Director,Orange County FAX: (919)966-3049 <br /> e-mail: gdm @med.unc.edu <br /> March 21, 1996 <br /> Jeanette Smith <br /> Orange County EMS <br /> 1914 New Hope Church Road <br /> Chapel Hill, NC 27514 <br /> Re: EMS Training Quality, Management and Performance <br /> Dear Jeanette: <br /> Looking back over my involvement the past three years with Orange County EMS, <br /> there is one issue that continues to be a problem. It is very nice to have a system <br /> that has such a large number of volunteers; but the problem is the large number of <br /> participants who are active within the OCEMS System and maintaining continuing <br /> education and quality of performance. <br /> Most of the problem involves very limited patient contact. With Orange County being <br /> a relatively rural type county, the number of patients each volunteer EMS personnel <br /> is in contact with is very limited. Unfortunately, this makes it very difficult to stay <br /> proficient in advanced life support skills, such as IV administration, intubation, and <br /> acute care management. It is also very difficult to create a continuing education <br /> program that allows paramedics and those with advanced skills to continue <br /> expanding their fund of knowledge while maintaining the large number of lower level <br /> advanced life support providers who are needing to learn and maintain the very basic <br /> topics and issues. <br /> My recommendation to the County is to continue forward with the plan to create an <br /> initial response paramedic to be present at every patient evaluation. With the current <br /> census and call volume under Orange County operations, this would significantly <br /> reduce the number of highly trained personnel who would be required to have <br /> advanced skills training and procedural confidence. This, therefore, would allow for <br /> more one-on-one or small group training sessions for these more advanced <br /> providers. <br />