EMS
Pre-hospital medicine is constantly changing and evolving. At Maricopa Medical Center, we believe that as emergency physicians we are in the best position to assist and direct the future of pre-hospital care.
MMC is a Base Hospital responsible for the off line medical control of four different agencies: two air services (LifeNet, Eagle Air Med) and four ground-based programs: (Buckeye Valley Rescue and Sacred Mountain Ambulance Service). Online medical direction is provided to the programs that base at MMC and numerous other agencies, including Phoenix Fire Department. Currently residents and attendings are responsible for over 4500 radio communications a year. MMC receives approximately 7000 patients a year by ground EMS and 2000 patients a year by air medical helicopters.
Education of our providers is an important aspect of our program. The residents and attending physicians help present over 20 formal chart reviews and 20 CME lectures per year. In addition, our program provides instruction in multiple procedure, airway, and cadaver labs a year. All residents are required to present at least one formal pre-hospital lecture during their residency tenure.
Research in the Pre-hospital arena is growing at Maricopa Medical Center. Recent and current projects include: F.A.S.T. 1 a sternal intraosseus device; ILMA (intubating laryngeal mask airway) as a rescue airway; Pre-hospital arrival as a predictor for hospital admission; and decision rules for CHF in the Pre-hospital setting. The relationship we have developed with LifeNet, Phoenix Fire and Rural Metro provide us with many opportunities for future research
To fully appreciate patient care in the Pre-hospital setting our philosophy is that residents should spend time in the field gaining practical experience. Residents are required to ride along with our crews a minimum of 48 hours during the Residency. Residents have the opportunity to fly with aeromedical services; however, it has always been our policy that no one is required to fly.
We now have a month long elective which has been designed to give the participating resident a framework that can be used to create an EMS experience that covers the core areas of EMS and yet allows for personalizing the elective to cover in more depth areas of one’s own interest.
Residents that would like to gain additional training and experiences in pre-hospital care are limited only by their own creativity and ingenuity. Residents have been involved in many different electives and EMS activities, such as being Medical Director for a volunteer ambulance service, participating in State EMS committees, event (race) medicine, urban and mountain search and rescue, EMS administrative elective, paramedic education in many venues, and flight physician for a fixed winged program.
We believe that the exposure our residents receive in pre-hospital care at MMC will provide a solid foundation in EMS. The numerous and varied experiences available will allow each resident to be prepared for future involvement in EMS at whatever level they choose.
Bruce Horwood, MD FACEP