Medical Control

BIMDC is responsible for answering medical control for multiple area EMS agencies including Fallon and Cataldo ambulance services. Any ambulance transporting a vented patient to BIDMC, has a clinical question regarding a patient, or is treating a patient who refuses transport will also call medical control. The EM2 resident is responsible for answering the "red phone" immediately when it rings.

Typically, the resident will take the call without the need to involve the attending. However, they have been instructed to get the EM3 and/or attending involved if they have further questions or feel uncomfortable with the phone call. These can be high risk, complicated situations and we have had issues before where an attending was not involved when they should have been. Never make the resident feel bad about escalating the phone call to the attending.

Of note, for ventilated patients (from IFT protocol Part 5.1):

  • All artificially ventilated patients must be transferred on a ventilator.
  • Unless the transfer is time sensitive in nature (e.g., STEMI, aortic dissection, acute CVA, unstable trauma, etc.), the following requirements apply to ventilator use and / or adjustment:
    • Patients must be observed, by the sending facility, for a minimum of 20 minutes after any adjustment in ventilator settings.
    • Patients should be on the transport ventilator for 20 minutes prior to departure.
  • All ventilators must be able to meet the demands of the patient’s condition, taking into consideration all settings and features described or stipulated by the sending facility and / or physician.
  • Ventilators may not be full control mode only and must be capable of meeting the patient’s ventilatory needs.
  • On-line MEDICAL CONTROL is required for any instance when adjustment of the ventilator settings is needed.

We view our relationships with EMS providers as key to our success, and treat them with the highest respect and collegiality at all times. Any deficiencies in pre-hospital care should be brought to the attention of David Schoenfeld, our EMS director, to be addressed though the established quality assurance process.

Note that there is no such thing as ambulance “diversion” as of 2010 throughout Massachusetts.

All calls are recorded and QA'd by the EMS division.

Please contact David Schoenfeld, our EMS director, for a current document of EMS protocols, and if you have any further questions or concerns.