EMS
Elective Name: EMS
Elective Mentor: Dr. Brian Savino and Dr. Seth Dukes
Elective Duration: 2 or 4 weeks
Elective Description: The EMS elective is designed to provide the resident EM physician with expanded exposure to the California emergency medical system. The resident physician will work closely with the Loma Linda EMS faculty and local EMS agencies to accomplish the goals and objective listed below.
Educational Goals:
1. Develop understanding of the activation and response process of EMS
2. Develop understanding of the infrastructure of the EMS system and common models (e.g. Third Service vs Public Utility Model vs etc.)
3. Develop understanding of the capability of different EMS units
4. Develop understanding of the different training/education levels of EMS providers
5. Develop understanding of how police, fire, and costal service integrate their response with medical systems for emergency events
6. Develop understanding of issues of jurisdiction pertaining to the command of an emergency scene
7. Develop understanding of NIMS Command and Management and the Incident Command System
8. Appreciate the complexity of multiple agency response to emergency events
9. Develop understanding of different triage methods (e.g. START, JumpSTART, SALT, CDC Triage, etc)
10. Increase awareness of professional working relationships between EMS and Emergency Departments
Success of the goals will be demonstrated by the objectives listed below.
Objectives:
Core Competency – Interpersonal and Communication Skills:
1. Verbalize to the EMS elective mentor the common frustrations voiced by EMS personnel as it pertains to Emergency Department/EMS interaction.
2. Discuss with the EMS elective mentor potential ideas that could address the frustrations listed by EMS personnel.
Core Competency – System Based Practice:
1. Attend at least one ICEMA or REMSA meeting (ideally PMAC, Physician Medical Advisory Council).
2. Complete online ICS courses (100 and 200) for an overview of NIMS and ICS.
a. https://training.fema.gov/is/courseoverview.aspx?code=IS-‐100.b
b. https://training.fema.gov/is/courseoverview.aspx?code=IS-‐200.b
3. Perform a minimum of five “ride alongs” with variable EMS agencies for each 2 week elective block. (2 week elective minimum of 5 ride alongs, 4 week elective minimum of 10 ride alongs)
4. Present a lecture to an EMS agency (topic and agency to be determined during rotation, meet with EMS elective mentor to determine)
5. Demonstrate competency in goals 1 through 9 listed above by submitting a one-‐page summary of an EMS/Police response to one of the scenarios below:
a. An explosion during a little league baseball game with 2 pediatric and 2 adult victims that are not breathing and unresponsive, 10 victims with spontaneous breathing but unresponsive, 20 victims who are breathing/alert/tachypneic, 20 victims who are breathing/altered/not tachypneic, and 100 victims who walk away from ground zero. First: define active shooter. Second: describe EMS and Police response to an active shooter pre-‐Columbine High School shooting and current response strategies for an active shooter. Third management of victims: there are 3 pediatric and 2 adult victims that are not breathing and unresponsive, there are 3 victims with arterial bleeding from a leg and tachypneic, and there are 10 victims that are walking/following commands/no respiratory distress/no obvious uncontrolled bleeding.
b. Specific attention should be given to how the activation of EMS would occur, what portions of the infrastructure would respond, which units would be needed, how police/fire/ems would coordinate, and who would have jurisdiction over the scene.
The summary should be submitted to the elective mentor for review and residency coordinator for filing.
Core Competency – Practice Based Learning and Improvement:
1. Submit to the residency coordinator and elective mentor a list of primary literature, texts, and resources used to prepare presentation and answer the EMS scenario.
2. Submit presentation to the residency coordinator and elective mentor.
Failure to demonstrate competency in the above objectives will result in remediation. Remediation will consist of continuing to work on the above listed objectives during non-‐elective months until they have been successfully completed.