EMS Week 2012

This week, Jeff Sternlicht, M.D., Chairman of Emergency Medicine at GBMC since November 2007 and a GBMC emergency physician for the past 14 years, is guest blogging.  GBMC’s Emergency Department experiences about 60,000 patient visits annually.

On average, more than 20 ambulances a day back into the bays at the Greater Baltimore Medical Center Emergency Department, each time with someone in the unit who has called 911 and needs medical care.

Sometimes, it’s a victim injured in a vehicle crash.  Or it may be someone having trouble breathing, someone who has fallen, or someone who just isn’t feeling very well.  That’s more than 650 times a month, and nearly 8,000 times a year that our clinicians will interact with an Emergency Medical Services (EMS) provider from the community, who has provided pre-hospital care and is relying on the expertise of GBMC doctors, nurses, techs and other staff to care for their patient.

This week in recognition of National EMS Week (May 20 – 26) I had the chance to ride along with Baltimore County Fire Department EMS 1 Captain Steve Adelsberger, a district supervisor  whose territory includes the Towson area.  It was a quiet few hours as far as call volume, but we had lots of good discussions about pre-hospital EMS care, emergency room care, and how their folks and our staff work together to provide the best possible experience for each patient.

We stopped by Fire Station 11 in Hillendale, and I had the chance to meet with the engine and ambulance crew, including a new paramedic and another who was completing his two-year practical exam. Sitting and talking with the crew about issues such as electronic medical records and utilization / waste of the 911 system, such as when patients call for an ambulance when they have a relatively minor “non emergent” situation, was a good experience and well worth taking a few hours away from the office.  It was reassuring to hear that EMS providers agree that too often, the emergency room is the path of least resistance for many in the community.

(Although this year it wasn’t as exciting as my EMS Week ridealong a few years ago when, as we were leaving the county’s 911 Center, we were dispatched to respond back to the center for a 911 operator having a headache and who had passed out).

One of the more interesting conversations I had with Captain Adelsberger and the Station 11 crew was around EMS calls to the many nursing homes, assisted living and other long-term care facilities, where the protocols for when to summon emergency assistance unfortunately vary greatly.  I was impressed that the county EMS personnel have a guidebook specific to responses for these facilities, but it would be great if the system were standardized.  For example, if each facility had the same cover sheet where the patients’ medications, allergies, vital statistics and chief complaint could be listed, that would make it much easier for the transition from facility to EMS pre-hospital care to hospital staff.

For the most part, the EMS pre-hospital care system works very well in Baltimore County. Operations are standardized, and it is very similar to the LEAN processes we are using at GBMC.

One example of the system working well with a successful outcome happened this past February. Seventy-year-old Ann Thiessen of Bel Air was working at the animal shelter in northern Baltimore County when she suddenly collapsed.  A co-worker who was a former volunteer EMS provider thankfully was nearby and performed CPR until an ambulance arrived and care was turned over to the paramedics.  The medic crew transported the patient to GBMC, where my colleague John Wogan. M .D. led a team who was able to save Thiessen.  She was discharged after a few days in the hospital. This is one of several “chain of survival” stories that will be shared at a very special event next Friday at Fire Station #10 in Parkville, where EMS providers will also encourage citizens to take a CPR class.

I also want to congratulate the county’s new EMS Director, Christian Griffin, who was promoted from the field recently.  Many of us working in the ED became familiar with “Griff” when he was working as an EMS 1 district officer.  I was able to spend some time at headquarters during the ridealong talking with Director Griffin and look forward to an excellent working relationship.

Even after the past 14 years as an emergency medicine doctor in the community, being able to experience stories like that remind me why I come to work every day.

Have you had a positive experience with the pre-hospital EMS system and GBMC that you want to share?