# Delaware 2012 EMS report



## NomadicMedic (Apr 25, 2013)

http://dhss.delaware.gov/dph/ems/files/demsocreport2012.pdf

If you're interested.


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## chaz90 (Apr 25, 2013)

Interesting read. That was the first time I heard mention of prospective pre-hospital antibiotic therapy.


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## NomadicMedic (Apr 25, 2013)

Also nice to know that medic 104 is the next station on the "going to build a new one" list. 

There's also a lot of information that's not normally shared, like the BLS scratch list.


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## EMDispatch (Apr 26, 2013)

I wish there would've been more statistics relating to the effectiveness of EMD. I did manageo learn plenty about my neighboring PSAPS though... I wish we could  get incentive pay for high QA.


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## NomadicMedic (Apr 26, 2013)

By effectiveness of the EMD, what do you mean? This is what the caller said verses of this is what the call actually was? As in the call codes as a 10 Delta 4 and actually IS cardiac chest pain?


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## EMDispatch (Apr 26, 2013)

DEmedic said:


> By effectiveness of the EMD, what do you mean? This is what the caller said verses of this is what the call actually was? As in the call codes as a 10 Delta 4 and actually IS cardiac chest pain?



Accuracy of coding would be fascinating, but I'll automatically assume it's gotta be somewhere around 40-60%. They could've given data on time to CPR instructions and then compare it to ROSC rates, witnessed/unwitnessed, AED use  prior to EMS arrival. it would also nice to see their average call reception to dispatch time, time for full interrogation. I'd also love to see evidence of increased coding accuracy with the use of some of the newer "diagnostic" tools added to the system.

The detail provided just seemed a little weak. Having ACE certification means they must calls within certain acceptable ranges, but nothing more. If you don't know NAED, then you'd have little to no chance really know what the hell the ACE certification really means. I was hoping to see some actual numbers and evidence that what we do on the phone makes a difference in the outcome. They had a great chance in the report to do that, and help solidify the importance of having EMDs in the system. Unfortunately they didn't come close, I did at least appreciate the fact it did recognize EMDs in the report.


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## NomadicMedic (Apr 26, 2013)

Good stuff. I'll admit I don't know an awful lot about PMD. I do know that they do have detailed reports on that have been shared with our agency, but don't believe there're out for public consumption. 

The early CPR/defibrillator and ROSC data points are tracked in both DEMERS (formerly EDIN) and in the CARES database.


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## chaz90 (Apr 26, 2013)

We can look up the time from phone pick up to dispatch on each call as well as the average time on a statistics page.


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## EMDispatch (Apr 26, 2013)

chaz90 said:


> We can look up the time from phone pick up to dispatch on each call as well as the average time on a statistics page.



Our units are now getting the call origination time with our integrated system. By chance do either of you know if SUSCOM is using OMEGA (no dispatch) level protocols?


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## chaz90 (Apr 26, 2013)

Yep. I've heard it a few times, but they do dispatch a BLS unit to it, and I've hear about an ALS unit being added on to an Omega call by dispatch request. My old service in CO dispatched Omegas with the same non emergent response of a BLS engine and ALS ambulance that an Alpha or Bravo call received. What is the criteria for Omega? It's supposed to be poison control with no priority symptoms right?


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## NomadicMedic (Apr 26, 2013)

An omega call is usually a prearranged call, for example, if 93 is picking up a patient at Nanticoke for a return trip, That's put out as an omega. 

Also, FYI, Susscom is Sussex DSP, not fire/EMS.


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## EMDispatch (Apr 26, 2013)

chaz90 said:


> What is the criteria for Omega? It's supposed to be poison control with no priority symptoms right?





DEmedic said:


> An omega call is usually a prearranged call, for example, if 93 is picking up a patient at Nanticoke for a return trip, That's put out as an omega.
> 
> Also, FYI, Susscom is Sussex DSP, not fire/EMS.



Thanks for the info, never knew that was the delineation between dispatchers.

OMEGAs are referrals, prearranged transports, and can be used for pts with absolutely no remotely priority symptoms ( 3 week old toe pains, and transport to the ER for a prescription). Very few centers fully utilize them, we don't even use them at all. By contrast MedStar in Fort Worth, TX and Louisville EMS in KY have added EMD-RN's (ECN is the official title) who further triage omega calls and refer them to clinics, etc.


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## NomadicMedic (Apr 26, 2013)

Right. Here, an omega is almost always a prearranged call, unless the Pro Q/A codes it omega. (Which I've heard once, and the dispatcher sounded very confused...) Even three week old toe pain will get coded as an alpha. 

And our response criteria is: Alpha and Bravo, BLS only. Charlie, Delta and Echo are ALS/BLS. They also allow "dispatcher discretion" for ALS on alpha and bravo dispatches. I was sent on a 29alpha this morning that was clearly ALS, but coded BLS. We frequently get added on to Bravo seizures. 

Also, if the name of the comm center has a "com" at the end, it's DSP.


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## medicsb (May 2, 2013)

Thought it a bit weird that they didn't provide more cardiac arrest data, especially considering that at least 2 counties are part of CARES.  

Interesting to see the amount of money spent by the different counties on ALS.


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## NomadicMedic (May 2, 2013)

I just saw most of the CARES database data for Sussex County. It actually hasn't fully trended for a full year when the DEMSOC report was published.


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