• By Albert Depew

Emergency Medical Services Division

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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 three advanced life support ambulances around the clock with dual-trained Firefighter/Paramedics or Firefighter/Advanced EMTs. In addition, we staff three engine companies in town with a firefighter/paramedic, which gives these engines advanced life support capabilities. Two reserve ALS ambulances are also fully equipped and placed into service when needed during high demand periods.

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 dispatchcenter.jpgcoverage 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 computerized dispatching system which includes the EMD module permits a rapid and accurate prioritization of calls and delivery of pre-arrival medical instructions to callers while the medical units are responding.

The EMS Division budget supports fifteen career Firefighter/Paramedics. Additionally, fire suppression personnel are also certified paramedics and Advanced Emergency Medical Technicians, meaning that all of our personnel are trained and state-certified emergency medical technicians (EMTs) at the intermediate or advanced level. These personnel respond to emergencies in our fully equipped advanced life support (ALS) ambulances and paramedic engine companies which serve as both firefighting engines and ALS response vehicles. These engines are equipped with cardiac defibrillators, which allow lifesaving rapid defibrillation by our personnel. 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 specialized vehicles which have the capability to respond in limited access areas as well as off-road areas. These units 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. Firefighters at the scene of a motor vehicle accident, March 22, 2001.The 9-1-1 EMD dispatchers, using the computerized medical priority system and information gathered from the caller, determine the level of response for each call. This combination can provide at least five EMS personnel to handle patient care. While in some cases this many responders may not actually be needed, the nature and unpredictability of Emergency Medicine, our high call-volume system, and our desire to err on the side of improved patient care are all reasons why we will sometimes send more resources than what are eventually needed. In the event we have too many responders, the unnecessary units quickly return to service and are available for additional emergency incidents.

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.

accident2.jpgWe 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 our system. Data can be input from any station directly into the main database at our computer server location. We then use the data for hard copy reports, quality assurance surveys, statistical analysis, ambulance billing, and many other departmental functions. We have the latest technology in cardiac monitoring, which allows us to transmit 12-lead heart monitoring (similar to the monitoring done within the hospital) directly to the Emergency Room from an emergency scene. This technology allows direct admission to a cardiac catheterization process directly from the field while bypassing the emergency room. The protocol leads to improved survivability and positive outcomes in heart attack patients.

Carson City has an ambulance subscription program that eliminates out-of-pocket expenses for medically necessary ambulance transports. Any citizen (or eligible dependent) living within the response area of the Carson City Fire Department is eligible to join. For an annual membership fee of $75 per family and $50 per individual, you receive unlimited medically necessary ambulance trips with no out-of-pocket expense, regardless of the existence or the amount of medical insurance coverage you have. Membership is renewable on an annual basis. We currently have over 3,000 members. The program offers reciprocal agreements with Central Lyon County, Storey County, Douglas County, and North Lyon County, where our members are covered while in those counties and their members are covered in Carson City. We are working with other local governments and districts to expand the coverage for these reciprocal agreements.

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