Orange County NC Website
Comprehensive Assessment of Emergency Medical Services 50 <br />and 911 /Communications Center Operations Study <br />The actual operation of local services is financed entirely at the local level. If the County operates an <br />ambulance service as a line department, it may establish rates, fees, and charges to be collected by the <br />service and it may appropriate County funds to the service (G.S. 153A -250). <br />By statute, all ambulance service providers in North Carolina must be licensed by the State (G.S. 131E - <br />151.1), each vehicle that is operated as an ambulance must be permitted by the State (G.S. 131E -156), <br />and all assigned ambulance personnel must be certified by the State (G.S. 151E -158). <br />Medical Direction <br />"Medical Oversight" refers to the responsibility for the management and accountability of the medical <br />care aspects of an EMS System. Medical Oversight includes physician direction of the initial education <br />and continuing education of EMS personnel or medical (responder) crew members; development and <br />monitoring of both operational and treatment protocols; evaluation of the medical care rendered by <br />EMS personnel or medical (responder) crew members; participation in system or program evaluation; <br />and directing, by two -way voice communications, the medical care rendered by the EMS personnel or <br />medical (responder) crew members. Subsequently, the County's "Medical Director" is the physician <br />responsible for the medical aspects of the management of an EMS System, or Trauma Center. <br />Subsequently, the Medical Director in Orange County is a licensed, practicing physician whose <br />responsibilities with regards to the County's EMS operation ultimately include certification, medical <br />control, and the continuing education of its employees. <br />Level of Care <br />"Level of Care" refers to the level of training and legal certification held by the caregiver or responder. <br />Individuals are certified based on their highest completed level of training. 10 NCAC 3D and 21 NCAC <br />32H are quite specific with regards to the type of care, procedures, and medications that can be <br />administered by individuals at each level of certification. In North Carolina there are four (4) levels of <br />certification assigned to EMS providers. The brief descriptions provided below are those defined by the <br />North Carolina Office of Emergency Medical Services (NCOEMS). The Medical Responder (MR) and <br />Emergency Medical Technician -Basic (EMT -B) levels are referred to as "Basic Life Support' or BLS. The <br />remaining levels of care, EMT -1, and EMT -P, are referred to as "Advanced Life Support' orALS. <br />Medical Responder (MR): Assists pre - hospital technicians in providing basic life support (BLS) <br />care; follows training guidelines of first responders per USDOT. <br />Emergency Medical Technician -Basic (EMT -B): Second level of BLS; individuals trained in <br />advanced first aid, measuring vital signs, CPR, oxygen therapy, etc. intended to take advantage <br />of automatic and semi - automatic external cardiac defibrillators for on -scene defibrillation of <br />patients risking sudden death from ventricular defibrillation; additional training includes <br />advanced airway and administration of epinephrine. <br />Emergency Medical Technician - Intermediate (EMT -1): Allowed to use advanced airway devices, <br />provide intravenous fluid replacement, administer various medications used to correct diabetic, <br />narcotic overdose, respiratory emergency, allergic reactions, and use of automatic and semi- <br />automatic defibrillators. <br />Emergency Medical Technician - Paramedic (EMT -P): In addition to all previous skills, trained in <br />techniques of cricothyrotomy, needle chest decompression, urinary catheter insertion and nasal <br />intubations; in addition to administration of a broad range of medications. <br />Solutions for Local Government, Inc. 6 <br />