The mission of the Emergency Medical Services Division is to provide emergency medical coverage to people residing in or passing through the consolidated municipality of Carson City, and to respond to all requests for emergency medical service within the jurisdictional boundaries of Carson and those other areas covered by contract or mutual aid agreements.
The Emergency Medical Services Division provides advanced life support services 24 hours a day to the citizens of this community and to those people who are just passing through. This is accomplished by staffing two advanced life support ambulances around the clock with one firefighter/paramedic and one EMT, as well as three engine companies in town with a firefighter/paramedic giving them advanced life support capabilities. In addition, two reserve ALS ambulances are fully equipped and are placed into service when needed during high demand periods.
This division does all of the billing, payment collection, and posting for all services rendered. In addition, this division does the billing for the Central Lyon County Fire District. These additional duties were taken on as a means of generating additional revenues. The division continues to search for additional revenues and has implemented an ambulance subscription program. We are currently researching the possibility of a joint effort from the quad-county area and have already reached reciprocal agreement with Central Lyon County and Storey County.Carson City’s new 911 Dispatch Center dispatches emergency medical calls and inter-facility transfers
The City of Carson City Emergency Medical Services (EMS) Division is solely responsible by ordinance for all emergency medical calls and ambulance inter-facility transfers received within the city limits. In addition, mutual aid agreements with surrounding counties extend the area of coverage in times of need. Access to EMS is facilitated by an enhanced 9-1-1 system which dispatches medical calls from a central public safety answering point operated by the Carson City Sheriff’s Department. The dispatch center is staffed with personnel who are also trained in emergency medical dispatching (EMD). A new computerized dispatching system which includes the EMD module now permits a more rapid and accurate prioritization of calls and delivery of pre-arrival medical instructions to callers while the medical units are responding.
The EMS Division employs fifteen career firefighter/paramedics. Five fire suppression personnel are also certified paramedics, and in addition, all other line personnel, which number thirty employees and twenty-five volunteers, are state-certified emergency medical technicians (EMT) at the basic or intermediate level. They respond to emergencies in four fully equipped advanced life support (ALS) ambulances and three paramedic engine companies which serve as both firefighting engines and ALS response vehicles. These engines are equipped with semi-automatic defibrillators which allow life saving rapid defibrillation by EMT personnel as well as paramedics. This increased level of service provides early defibrillation from any fire engine or ambulance unit responding to medical emergencies.
For special events, we continue to use two golf carts which have been converted to mini EMS response vehicles. These are equipped with medical supplies and equipment and are manned with EMS personnel as needed. They can navigate confined areas and gain access to patients where conventional vehicles cannot. They have proven their worth in such events as the Nevada Day celebration.
All 9-1-1 EMS calls, including routine transfers, are answered with at least one ALS ambulance, and, in potentially severe calls, one fire engine company is dispatched for additional support. The 9-1-1 EMD dispatchers, using a new computerized medical priority system and information gathered from the caller, determine the level of response for each call. This combination can provide at least two paramedics and four EMT personnel to handle patient care. While in some cases this much personnel might not actually be needed, the rural environment of the Carson City area and potentially long driving distances dictate this type of response for optimum patient care in critical situations.
EMS division personnel operate under a physician medical director, and are authorized to perform state-of-the-art advanced medical procedures in the field through a comprehensive medical protocol system. The system was developed through cooperation with three surrounding counties and the local hospital staff. This allows quick and effective intervention when only minutes can mean the difference between life and death.
To further enhance the system, a comprehensive EMS computer reporting program is utilized. This program has eliminated the need for a paper report and allows accurate statistical analysis of the overall EMS system performance. EMS reporting data which is required by the State EMS Authority is transmitted electronically using custom-designed software developed locally. This eliminates the paper scanning form, which saves time and money, and guarantees 100% accuracy in the data produced. All of the data represented in this annual report is generated by the program. Monthly reports are also analyzed to pinpoint any potential areas that may need improvement, in conjunction with the reporting system. A quality assurance program is utilized whereby incidents, field-to -hospital radio transmissions, and 911 dispatch tapes are routinely scrutinized to maintain the highest level of patient care possible. Quarterly meetings between physician medical directors, hospital staff, and EMS personnel are held to facilitate a smooth and efficient working relationship within the EMS system.
We are constantly striving to advance with technology and improve efficiency. A computer network linking the outlying stations with all of the headquarters' computers has further enhanced the system. Data can be input from any station, directly into the main database at headquarters. We then use the data for hard copy reports, quality assurance surveys, statistical analysis, ambulance billing, and many other departmental functions. In early 2002 the links between this database and both the CAD system and the billing software, will facilitate the transfer of data electronically and eliminate the duplication of data entry in the billing office and in the stations.
In September of 1996, CC-CARE, an ambulance subscription program, was implemented. Any citizen within the response area of the Carson City Fire Department, as well as dependents living in the household, are eligible to join. For an annual membership fee of $75 per family and $50 per single, they receive unlimited legitimate ambulance trips with virtually no out-of-pocket expense, regardless of the existence or the amount of medical insurance coverage. Membership is renewable on an annual basis. We currently have over 3,000 members. While providing a great benefit to the members, the program also generates a substantial amount of revenue for the ambulance enterprise fund, which further benefits all citizens by helping to keep ambulance user rates as low as possible. In 1997 we introduced CC-CARE+ which added a medical database to the 9-1-1 center. Over 2,000 members provide us with vital medical information which can be transmitted to responding paramedics prior to arrival. This can save additional lives in those cases where patients cannot communicate in emergencies. We have reciprocal agreements with Central Lyon County and Storey County, where our members are covered while in those counties and their members are covered in Carson City. We are also looking to further expand with other surrounding areas that have similar programs.