Intro to EMS Rotation

POINTS OF CONTACTS

Courtney Greene


Administrative Assistant

1675 Leahy Street

Suite 308B

Muskegon, MI 49442

(231) 728-1967

cploeg@wmrmc.org

Chad Lawton


EMS Administrator

1675 Leahy Street

Suite 308B

Muskegon, MI 49442

(231) 728-1967 (ext. 1040)

clawton@wmrmc.org


Jerry Evans, MD


Medical Director

1675 Leahy Street

Suite 308B

Muskegon, MI 49442

(231) 728-1967 (ext. 1030)

medicaldir@wmrmc.org

Nick McManus, DO


Assistant Medical Director

1675 Leahy Street

Suite 308B

Muskegon, MI 49442

(231) 728-1967 (ext. 1090)

nmcmanus@wmrmc.org

ROTATION OVERVIEW

You will be expected to complete 18 "shifts" during your month. A portion of this time will be spent rotating with various fire departments, EMS and first response support services around our community. This is an incredible opportunity to gain first hand experience and insight into what the entire echelon of prehospital care goes through before a patient presents to your Emergency Department. Further, you will spend time in the regional medical control office located in suite 308B in the administrative building at Hackley Hospital. Here you will gain some insight into how a Medical Control Authority (MCA) operates both in aspects of daily medical and logistical support, as well as in regards to regional disaster preparedness. As future emergency physicians and leaders, you may serve as an MCA director at some point in your career, especially if you plan to practice rural medicine.

It is important to note that 3 of these "shifts" will be spent as asynchronous learning modules for independent study as well as time to complete specialty projects with the Medical Control Authority (MCA). You cannot expect to obtain sufficient EMS knowledge from a few required EMS ride-alongs. This EMS curriculum is designed to give you some insight into federal and state specific medical control, an overview of what it takes to be an EMS medical director as well as some aspects in emergency preparedness/disaster medicine.

VIRTUAL CLASSROOM

You will have a number of online modular assignments for this rotation. These can be accessed through the google classroom that you have been assigned. Please make sure that any assignment is submitted after you read it. You are expected to complete all of the assigned coursework prior to completion of your rotation. Some modules will require you to turn in evidence of course completion. You may turn this in to any of the EMS faculty members or Courtney Ploeg prior to the end of your rotation.

ORIENTATION MODULES

Resident duties in the emergency department and in the prehospital setting are very different. To EMS providers, residents are doctors and outsiders. These two qualities can create a substantial barrier during EMS shifts or ride-alongs. Accept and express that you know very little about how to be an EMT or paramedic (even if you were an EMT in a previous life). Even though you may have more years of formal medical training, your ability to recite Rosen’s does not trump real-world experience. Just accept it.

The orientation module seres will need to be completed prior to your first ride along. These briefly discuss the approach to patient evaluation in the field as well as scene and equipment safety. In each module, answer the content knowledge questions and submit the module upon completion for credit. These modules are required to be completed prior to your first ride-along shift with an ambulance or fire agency. The orientation module can be accessed through the google classroom.

SHIFT BREAKDOWN

# 1 - Orientation modules/central dispatch shift


# 6 - Ambulance shifts


# 2 - Fire department shifts


# 4 - MCA EMS Faculty Shifts (wednesday afternoons)


# 2 - MCA Office/Administrative shifts


# 3 - Asynchronous learning shifts

RIDE-ALONG SHIFTS

EMS is a niche within EM that draws considerable interest from residents, but finding time for EMS experience in residency can be difficult. Many EM residents acquire some EMS experience prior to residency, but for those without prior experience, residency is a great time to get to know EMS providers and better understand what they experience. EM residencies are required to provide a basic EMS education, which offers only a glimpse into the world of EMS. We want residents to be more involved in prehospital care, develop a better understanding of the system, and learn from our EMS colleagues.

Dress Code



While in the field, you will likely get dirty. Please dress respectfully, as you represent not only your fellow residents, but also the EMS organization that you are embedded with that day. Acceptable dress includes EMT pants or Khakis with a polo shirt while in the field. Keep in mind that anything you do wear, could potentially be damaged. If you need pants for your rotation, and with not to purchase them, please ask your Chiefs, and attempts to borrow them from other residents will be made. Please do not wear scrubs while in the field. A high-visibility reflective vest is also required when on an ambulance.

REFLECTIVE VESTS



While in the field, you will likely get dirty. Please dress respectfully, as you represent not only your fellow residents, but also the EMS organization that you are embedded with that day. Acceptable dress includes EMT pants or Khakis with a polo shirt while in the field. Keep in mind that anything you do wear, could potentially be damaged. Please do not wear scrubs while in the field. A high-visibility reflective vest is also required to be worn on roadways, by state law. One will be provided to you at the start of your rotation and will need to be returned uopn completion of the month.

tips for success

TIP # 1: KNOW YOUR ROLE

Know the role of the on-scene physician within the EMS command structure – prehospital care is a delicate balancing act of politics and medicine. During your month, you will spend time completing the introductory NIMS online courses (100, 700). For now, understand that you are not the boss. All positions carry very different responsibilities, and if you really want to understand and be accepted within EMS, you need to understand this culture. Residents lack EMS skills and experience, and there’s no substitution for time on the job. The fact is spending time with EMS crews enhances your understanding, builds stronger relationships, and improves your skills

TIP # 2: KNOW HOW TO READ A PROTOCOL

It is unlikely that you will know the protocols in just a month, but you should at least where to find them and reference them frequently. Each EMS agency had a set of protocols that guide patient care and you should know them cold. Chances are, they aren’t much different that what you would do in the ED. A quick way to lose respect and trust from an EMS provider is to suggest patient care that drastically deviates from established protocols. If you don’t know the protocol, just ask and be open to some teaching!


Muskegon County EMS protocols can be found at www.wmrmcc.org --> Protocols --> Muskegon

TIP # 3: Appreciate those willing to teach you


  1. Be humble, courteous, and leave your ego at home.

  2. Ask to be treated like a new paramedic or FTO student, and dress the part.

  3. Remember you are there primarily to learn.

  4. Ask questions and look for opportunities to improve your skills, but never steal procedures.

  5. Offer to help by carrying equipment, pushing the stretcher, taking vitas, starting an IV, or cleaning up after a run.

  6. If you are spending the day in a firehouse station, pitch in money for lunch or dinner

  7. Take time to get to know your colleagues.

  8. Ask about the frustrations and rewards of the job and see how you can work to reduce those frustrations.

  9. Ask what EMS providers like physicians to do when they bring a patient to the ED (it might surprise you).

SPECIALTY PROJECTS

You will have 2 full days scheduled with an EMS faculty member in the MCA office. During this time, you will be assigned to work on 1 of 2 specialty projects pertinent to medical direction and the medical control authority. These projects are a small taste of tasks expected of an EMS medical director. The EMS track residents may have ongoing projects that need assistance. Don't forget to document these activities for residency based scholarly activity...it counts!

Develop a CME lecture for the state database

One of the primary roles of an EMS medical director is involvement in education and training activities. TRAIN is a national learning network that provides thousands of quality training opportunities to more than 2 million professionals who protect and improve the public's health. Powered by the Public Health Foundation (PHF), the TRAIN Learning Network brings together agencies and organizations in the public health, healthcare, and preparedness sectors to disseminate, track, and share trainings for the health workforce on a centralized training platform. MI-TRAIN is the affiliate branch of TRAIN for the state of Michigan, managed by the Michigan Department of Health and Human Services; Bureau of EMS, Trauma, and Preparedness; and Michigan State Police.


The Bureau of EMS, Trauma, and Preparedness has agreed to use lectures resorded by our residents as potential CME opportunities for EMS personnel across the state. Please design and organize a 30 minute lecture on a topic of your choosing pertinent to pre-hospital medicine. You may look through the catelog of lectures on MI-TRAIN for examples of the types of lectures they are looking for. After you design your lecture, you will give your lecture at one of the EMS track didactics sessions and this will be recorded and submitted to MI-TRAIN by the EMS faculty. If you are not comfortable recording your voice for this project, please let the EMS faculty know.

Protocol test bank questions

One of the primary duties of a Medical Control Authority is to establish written protocols for the practice of life support agencies and EMS personnel and uphold accountability for adherence to these protocols. That means, we need to have adequate education and confirmation of knowledge before these protocols are adopted in the field.

For this project, watch this 30 minute NREMT Test Writing and Validation video from MI-Train. If you have not already done so, you will need to create an account to watch this video. This is a state platform for CME used by the state of Michigan for EMS providers and if you have any interest in pursuing a career as an EMS medical director in the state, you should be familiar with this platform. This video covers the information necessary for validation and writing of test items at an NREMT level. Print your certificate of completion and turn it into the EMS Faculty drop box in the EMS office for credit.

After watching the video, please write 10 well designed NREMT level test questions for EMS provider continuing education. Please email Chad Lawton or Dr. McManus to determine the protocols of interest for these test questions.

ASYNCHRONOUS LEARNING MODULES

You will have 3 days blocked off on your schedule for Asynchronous learning exercises. Each day will have a series of online/independent learning modules or readings to complete. You do not have to complete them on the scheduled day, although these days are specifically set aside to allow you ample time to accomplish these modules during your rotation.

A.L. Module Set # 1

Introduction to the EMS System

The purpose of this module is to lay a foundation for the general overview of the EMS System

A.L. Module Set # 2

Emergency/Disaster Preparedness

The purpose of this module is to introduce the resident to the incident command structure through the FEMA modules and an introduction to the emergency preparedness in the state of Michigan.

A.L. Module Set # 3

Virtual Ride-Along

In this module, you will watch 15 short videos, each ranging 2 to 10 minutes in length. These videos are of various EMS providers interacting in patient contact scenarios. Following each video, you will see a number of open ended prompts to deepen your knowledge and understanding of prehospital protocols and medical direction. Please answer the prompts and submit your answers. These answers will be discussed at your faculty meeting on the 4th Wednesday session.

EMS DIDACTICS

You will be expected to attend the EMS didactics that occur immediately following the regularly scheduled EM didactics on Wednesdays and will last roughly 1 hour.

ADMINISTRATIVE DAYS

There will be a total of 6 administrative shifts during your rotation where you will learn more about medical control and what being an EMS medical director is all about.

FOUR of these administrative shifts will occur immediately after the scheduled EM conference on Wednesday. You will spend the afternoon with Dr. Evans or Dr. McManus in the MCA office located in suite 308B in the administrative building at Hackley Hospital. At each shift, you will get a lecture pertinent to medical control and oversight and have time for open ended discussion. You can expect to be done around 4-5 pm each day.


TOPICS FOR FACULTY DIRECTED LECTURES:

WEEK 1: Role of an EMS Medical Director

WEEK 2: Agency Oversight and the PRSO Process

WEEK 3: Emergency Preparedness and Response

WEEK 4: Faculty small group discussion of virtual ride along experience


The remianing TWO shifts will be full day administrative shifts. You are expected to meet one of the faculty members at the MCA office at the time dictated on your schedule (this time may vary). If the EMS faculty member has any scheduled administrative meetings these days, you will attend those as well. If there are meetings that you are expected to attend, these will be listed on your course schedule that you will receive prior to the start of your rotation. When meetings are not occuring, your administrative time should be spent working on your specialty project for the month.

ROTATION ADDRESSES

WMRMC Office

1675 Leahy St Suite 308B

Muskegon, MI 49442

Professional Med Team, Station 1

2445 Park st

Muskegon Heights, MI 49444

Professional Med Team, Station 2

965 Fork St

Muskegon, MI 49442

Fruitport Township Fire, Station 1

5815 Airline Rd

Fruitport, MI 49415

Muskegon Central Dispatch

770 Terrace St

Muskegon, MI 49442

Muskegon Township Fire, Station 1

1117 S Walker Rd

Muskegon, MI 49442

Muskegon Fire Dept, Station 3

770 Terrace St

Muskegon, MI 49442

Dalton Fire Department

1650 E Riley-Thompson Rd

Muskegon, MI 49445

White Lake Ambulance Authority

8220 Whitehall Rd

Whitehall, MI 49461

Norton Shores Fire Dept, Station 3

1100 E Pontaluna Rd

Muskegon, MI 49444

Egelston Township Fire Dept.

5380 E Apple Ave

Muskegon, MI 49442

AMR

517 S Division

Grand Rapids, MI 49503