EMS Providers: An Extension of the ED in the Field

Posted on Mon, May 16, 2016
EMS Providers: An Extension of the ED in the Field

By Albert Ritter, MD, FACEP
It’s National EMS Week and we are reminded of the contribution our partners provide in the pre-hospital setting.
Twenty-four hours a day, seven days a week, whether it’s steamy hot or freezing cold, on the side of the highway with tractor trailers rushing by or in the third floor walk-up apartment. Some are volunteers serving their communities on their time off from a day job.
EMS providers in our communities, both paramedics and basic EMTs, should be viewed as an extension of our care into the field. The care they provide in the first few minutes of a medical emergency or traumatic injury can make the difference between a good outcome and a bad outcome. Good communication and a congenial, respectful, relationship between pre-hospital providers and emergency department staff is essential for patients to receive the best possible treatment. This kind of relationship encourages a dialog that directly benefits ED staff, the healthcare facilities we work in, and ultimately our patients.
Pre-hospital medicine is evolving and becoming increasingly more complex. EMS providers are being tasked with more responsibility in the care of patients experiencing sepsis, STEMI, CVA and trauma. The appropriate use of therapies such as TXA and CPAP and changing standards for pre-hospital activation of cath labs, stroke teams and spinal motion restriction are critical to good care. By maintaining an open and friendly dialog and providing education, we can influence how this care is provided to our patients and ensure that standards are met and maintained. I’m always impressed by the curiosity and interest EMS providers show regarding educational opportunities, whether provided in didactic settings or as informal anecdotal feedback regarding a patient. It’s crucial to provide this teaching in a supportive and educational manner that’s appropriate to their level of training.
Another aspect of maintaining good relationships with our EMS partners is that they are the best advocates for our facilities within the communities we serve and with local government. This can be extremely helpful for community outreach and with public health initiatives such as stroke and heart attack recognition and CPR programs. The providers also instill confidence in our patients that they will receive the best of care on arrival, relieving a lot of anxiety and improving patient cooperation.
Finally, this is a group of committed individuals who often work in really difficult conditions to treat and transport our patients. In many communities, they are volunteers who train and care for patients on time off from work and away from their families. They deserve our thanks and our appreciation.
Albert Ritter, MD

Albert Ritter, MD, FACEP, is an attending emergency physician at Morristown Medical Center, Morristown, N.J., and is medical director of Atlantic Ambulance Corporation, operated by Atlantic Health System.

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