What exactly is E.M.S.?
E.M.S. is an acronym for our area-wide Emergency Medical Services system. This system includes firefighters and paramedics, ambulance personnel, base station hospital doctors and nurses, paramedic receiving hospital and trauma center staffs. The County of Orange Health Care Agency includes the Emergency Medical Services Agency which oversees paramedic training and protocols and emergency medical, mobile intensive care, and emergency medical transportation policies for the entire county.
What many citizens are unaware of, however, is their role in E.M.S. All residents of Orange County are considered vital links in the E.M.S. delivery system because what they do for the victim (or victims) before firefighters arrive can often mean the difference between life and death for that victim. For this reason, fire departments strongly encourage everyone 13 years or older (minimum age for certification) to become C.P.R. - and first-aid-trained.
Why do fire departments place so much importance on citizens becoming trained in first-aid and C.P.R? Isn't that what we have E.M.S. for?
Brain damage due to lack of oxygen can occur after only four minutes. If a trained person does not ensure that the E.M.S. system is accessed and then intervene by providing rescue breathing and/or C.P.R. immediately, the patient may already have suffered irreversible brain damage by the time emergency medical personnel arrive on the scene. There is nothing that can be done either in the field or at the hospital to restore these brain cells once they have died of oxygen deprivation. What this means to you is that, for the victim's sake, no one can afford to stand around waiting for firefighters. Emergency medical service calls have increased in recent years while fire department personnel rosters have been steadily declining. Despite the fact that fire departments have boundary-drop agreements with surrounding agencies, response times can be markedly lengthened when the first-in units to calls are already tied up and other units must be dispatched from greater distances.
In order to be adequately prepared for any medical emergency, at least one person in every household should have valid C.P.R. and first-aid cards. In times of disaster, such as a major earthquake, 9-1-1 lines will be jammed or down and citizens may be on their own for medical (and fire) emergencies for up to 72 hours! Since everyone is a link in the E.M.S. network, how well prepared you are to deal with these life-threatening emergencies will determine your ultimate success or failure in coping with them. Several years ago, the Orange County Emergency Services Agency reported statistics predicting that every Orange County resident can expect to deal with at least two or three life-threatening medical emergencies in his/her lifetime.
Why do we always see fire engines responding to medical emergency scenes? Isn't that a waste of equipment and man-power?
No. During life-threatening medical emergencies, which is what the E.M.S. is for, firefighters, ambulance personnel, base station hospital doctors and nurses, and paramedic-receiving hospital emergency room staffs all function as a lifesaving team. Because all firefighters in our area must be State-certified Emergency Medical Technicians who can provide Basic Life Support, these firefighters augment paramedics in the field by performing primary and secondary patient surveys, giving oxygen, performing C.P.R. and first-aid procedures, directing the ambulance to the patient's location, retrieving emergency medical equipment and supplies, and monitoring vital signs including: pulse, blood pressure, skin signs, respirations, lung sounds, etc.
Meanwhile, the paramedic team itself is divided into two equally important parts: patient support and radio/patient records. Because paramedics have been hospital-trained in the provision of Advanced Life Support, they will be consulting with the hospital base station doctor or nurse, relaying important patient information, and providing such specialized functions as intubation, I.V. support, defibrillation, heart monitoring, etc. If it's necessary for the patient to be monitored en route to the receiving hospital, one firefighter/paramedic will ride in the ambulance with the patient.
In today's fire departments, most engine companies now have one or two firefighter/paramedics as part of their crews along with a Company Officer (Fire Captain) and an Engineer or driver. At the scene of traffic accidents, for example, the two non-paramedic firefighters may be disconnecting vehicle batteries, keeping a hose line trained on the vehicle in case of fire, blocking wheels, positioning flares, inflating airbags, or performing extrication procedures in addition to their emergency medical responsibilities. Ambulance personnel alone of course, would be unable to provide any of these protective safety operations.
We understand that paramedics respond to "life-threatening" emergencies. What determines such emergencies and what if we're still not sure?
When in doubt, call anyway! It's better to be safe now rather than sorry later if you fail to call when you should have. Life-threatening emergencies include any medical problems whereby airway, breathing, and cardiopulmonary functions are compromised in any way. Some examples include: heart attack; stroke; high blood pressure; breathing problems; drowning; choking; smoke inhalation; extensive burns; traumatic injuries resulting from accidents, falls, and various types of violence; uncontrollable bleeding; head injuries; electrocution; unconsciousness; poisoning; overdoses; severe allergic reactions, etc. Paramedics should always be called whenever neck or spine injuries are either known or suspected (Facial injuries often provide clues that these may also be present.)
Some examples of situations that would not constitute life-threatening medical emergencies include: basic cold and flu symptoms; minor cuts, scrapes, bruises, and abrasions; broken or sprained fingers or toes; minor burns; and, in general, any condition where you could easily transport the victim to a doctor or hospital yourself, and the victim's airway, breathing, cardiopulmonary functions and level of consciousness are normal.