Rural EMS Issues for Medical Directors

Rural EMS	 Issues for Medical Directors Rural EMS	 Issues for Medical Directors - Start

Added : 2019-03-20 Views :3K

Download Presentation

Rural EMS Issues for Medical Directors

Download Presentation - The PPT/PDF document "Rural EMS Issues for Medical Directors" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.

Presentations text content in Rural EMS Issues for Medical Directors


Rural EMS

Issues for Medical Directors

Brian Barhorst, MD





Discuss several differences between Rural and Non-rural EMS

Discuss some difficulties and benefits that may arise for the Medical Director


Case Study #1

Your Volunteer EMS Service is paged to a home at the edge of the county for a 65 year old diabetic who is “not acting right.” An additional page 5 minutes later is needed to get a full 2 man crew at the station to begin response. On arrival, 22 minutes after the first page, the BLS crew radios dispatch for a paramedic for the full arrest. They also call the local ED, and ask the locums ED Physician if they should wait for the paramedic or transport immediately… or should they even start CPR?


Case Study #2

Tones drop for multiple squads in response to a call for school shooting with 12 victims at a village school. The local squad has one ambulance, and all ten members respond, 2 leaving their tractors in the fields, as the county seat sends two city crews, and five surrounding districts start the 1 ambulance they each have available, leaving half of the county uncovered. The village’s single police officer on duty has never drawn his duty weapon on a live scene before, the local ED 30 minutes away has four beds, and the two helicopter services in the region are unable to fly due to fog this morning.


Case study #3

The community is holding it’s Fall Festival Bake Sale to hopefully enable the local EMS service to replace its aging LifePak 10


, since the tax levy failed and the grant fell through. The MAST trousers sit proudly out as part of the display, as the Chief feels they are life-saving devices, and wonder why you, as the volunteer Medical Director, want to remove them from the Protocols…



Strong call to serve – Dedicated

Roster vs Active Members

“Chute” times – from page to en-route

Physical Fitness


Paramedic Paradox

ALS intercept plan



Experience / Skills maintenance

Rural Squad Volumes as low as 100/year

How many are kids?

Rural Medics may only get 1-2 intubations/year

Simulation time?

OR time?


Using your friendly neighborhood HEMS outreach…


Quality assurance

Rural Medical Directors rarely have help

Single Rural EMS coordinator in a county

Hospital Based, focused on Education

Volunteer squad run review

How many is enough? Benchmarks?

Corrective Actions


Social Media? E-mail?


Continuing Education sources



Dispatch / PSAP experience

Over-the-Phone care

Call volume vs staffing


(Controlled) Drug tracking/SECURITY


Austere environments / Special ops


Being an engaged Med Director…

Medical Director Experience/Expectations

Community Involvement

On Scene Response?

Ride Along Time?

Advocate for self-care/preparedness



Full Time Jobs / Stipend vs Volunteering

Being heard by the State / Nation

Regional Physician Advisory Boards

Rural EMS Committee at NAEMSP


Suggestions for progress

The Key is Teamwork and Collaboration

Research focused on rural EMS.

Regionalization of High Price items (education, communication)



Educational website / Sim set-ups.

Emergency Medical Dispatch?

Be involved with local Emergency Planning Committees.


Realistic Case resolutions

Case #1 – ALS intercept is arranged half way to the ED. Unfortunately, this unwitnessed arrest with no bystander CPR dies.

Case #2 - The community pulls together to help, and the ten volunteers triage the 12 victims, keeping the ambulance on scene for supplies. The incoming squads transport all of the patients to the local hospital, overloading the single coverage physician, but the school has no mass shooting kits, and tourniquet supplies are short. Out of the 6 dead, five would have survived in an urban school district.

Case #3 – The community pulls through, thanks to the awesome brownies the Medical Director made, and a refurbished LifePak 12


is bought. The local hospital’s biomed department agrees to do periodic maintenance free of charge as a charitable contribution with no strings attached.


About DocSlides
DocSlides allows users to easily upload and share presentations, PDF documents, and images.Share your documents with the world , watch,share and upload any time you want. How can you benefit from using DocSlides? DocSlides consists documents from individuals and organizations on topics ranging from technology and business to travel, health, and education. Find and search for what interests you, and learn from people and more. You can also download DocSlides to read or reference later.