by Paul Johnson, Division Chief of EMS, Mountain View Fire Rescue
Emergency Medical Services, or EMS, is the general term for ambulance response. However, EMS is really a complicated system and so much more than a simple ambulance operation. At Mountain View Fire we operate a system known as Fire-Based EMS, which means that EMS is provided by the fire department. We have our own ambulances, EMTs, and paramedics and EMS is part of our larger concept of operations known as all-hazards response. Really all this means is that we respond to every kind of emergency you can imagine, and the EMS component is integral to the service we provide. In fact, EMS accounts for the largest majority of the calls for service we run; somewhere between 65%- 70% of our calls are for emergency medical situations.
Every Firefighter is medically trained to the EMT- Basic level and can work on the ambulance. Additionally, every ambulance and many fire engines are staffed with paramedics. Paramedics are the highest level of EMS practitioners in our system. Paramedics are highly trained and skilled healthcare providers. Paramedics do many of the same skills that a doctor will do in the emergency department, but our job is to perform those skills in the field, often in austere conditions. The job of EMS is to be the first touchpoint in the healthcare continuum and set the rest of the patient care, and hospital, up for success in treating the patient.
A brief example would be a person having a heart attack. Our paramedics can identify and diagnose a heart attack and pinpoint the location in the patient’s heart where the heart attack is occurring. The paramedics begin treatment to support the vitals, manage the chest pain, administer medications that will help perfuse the coronary arteries, and declare a cardiac alert to the hospital. Based on the information the paramedics provide, the hospital will clear out an operating room called a ‘cath lab’ and prepare their team for our arrival. When EMS arrives with the patient, having completed as much prep work as possible such as starting IVs, giving medications, trending the heart rhythms with consecutive 12 lead EKGs, etc., the emergency room doctor will briefly confirm our findings and the patient will be taken to the ‘cath lab’ where the cardiologist will catheterize the patient and open the blocked vessel, restoring normal heart function. The entire goal of this process is to reduce the ‘D2B’ or Door-To-Balloon time, which is how we describe making sure the patient gets catheterized as quickly as possible. A reduced ‘D2B’ time is directly correlated to better heart function and better outcomes. EMS exists as one very essential component in the overall care of patients.
Our EMS response covers every type of emergency you can imagine, firefighters and paramedics arrive at work never knowing what they might be called to. They can find themselves helping a patient trapped in a car after a car accident, fighting a structure fire, and helping a person having a heart attack all in the same day. It takes incredible diligence and education to operate at this level. Training and continuing education are very important and ceaseless components of our daily lives. We strive for excellence to deliver the best possible service and patient care. EMS is a very challenging vocation, but that’s part of the reason we love what we do. There is nothing better than knowing you helped somebody during their time of need. Thank you for letting us serve you!