It is the mission of Dallas County Emergency Medical Services to provide advanced lifesaving pre-hospital care to the citizens and visitors of Dallas County. Through seamless teamwork and interoperability of all emergency services, DCEMS will treat all its’ patients with quality, professional, and timely care for which our patients deserve. DCEMS will always strive to lead the way in pre-hospital care and improve the health and safety of Dallas County.
Placing a call for help may be done on any type of phone, by dialing 911. A 911 call is received by a dispatcher trained in receiving emergency calls and an ambulance is sent out immediately.
Ambulance crews are alerted to the call by a message sent out over a special radio frequency. Every medic on duty carries a pager that is able to receive the message. Information is given about the location of the call, and what has happened to the patient. A First Responder department within the vicinity of the call, receives the page simultaneously and responds to the call.
The medic safety and regard for the safety of the public is a priority at Dallas County Emergency Medical Services. When the public sees an ambulance responding with its’ lights and siren in use, it is going to a call. Because of state of the art care and the ability to stabilize the patient while en route, it is no longer necessary to drive the patient to the hospital using lights and sirens. Only the worst patient conditions warrant such a response to the hospital. This reduces risk to the patient, paramedics, and the public.
Assessment of the patient is an important step of EMS in the care of a patient of an illness or injury. Gone are the days where a patient is thrown in the back of an ambulance and sped to the hospital. After arriving at the patient's side, the emergency medical technicians (EMTs) begin a rapid assessment of the patient's physical condition. Although taking the history of the patient's illness and assessing the physical conditon adds some time for the pateint to get to the hospital, the medic is able to radio ahead to the hospital so the emergency room may prepare to treat the patient as soon as the ambulance arrives. This shortens the patient’s wait to be treated by the hospital, because the emergency room is already informed of the patients condition. The assessment and history of the illness is an overall benefit to the care of the patient.
The EMTs are able to perform many emergency interventions at the patients side or on the way to the hospital. Treatment of injuries or illnesses that are performed before a patient is taken to the hospital
has proven effective to improve the outcome of the illness or injury. Many of the skills performed by the medics are identical to the skills that doctors and nurses do in the emergency room. The ambulance carries high-tech equipment that is portable and durable enough to be used in any type of environment, whether a patient is in their bed or at the bottom of a mountain bike trail.
The emergency medical technician is able to perform skills such as cardiac monitoring, pulse oximetry, oxygen administration, intubation, and defibrillation. The medics are also able to start IVs, and administer emergency medications which may be vital to correcting illnesses or injuries such as heart problems. The EMTs are trained to recognize situations that call for intervention and act quickly to improve the patient’s condition. There are a variety of situations that the medics are prepared to handle, and frequent training makes them even more proficient with these lifesaving skills. The lifesaving care provided by the medics insures the patient’s condition is given attention from the moment the paramedics arrive at the patient’s side.
Packaging and Transport
Transportation or moving the patient to the hospital is a major part of Dallas County Emergency Medical Services. Patients are packaged to provide the best treatment and most comfortable ride to the hospital. Packaging of the patient is performed differently for various injuries and illnesses. Usually, patients with medical problems are placed on a stretcher and moved to the ambulance. This is done to reduce the stress of the patient and the workload placed on the patients heart. Increased stress to the heart may cause a patient’s condition to worsen.
Patients who are injured traumatically are handled differently according to their injuries. Severe injures that may cause damage to a persons spinal column are handled with special care. This special care includes placing an immobilization collar around the patient’s neck, and securing the victim flat to a backboard. This minimizes the movement of the patient and prevents any further damage to the spine. Individual injuries are assessed by the emergency medical technicians to determine the best course of transportation for the patient, whether it would be transportation by ground or air ambulance. Expedient transport to the closest appropriate hospital is then initiated, keeping the safety of all in mind.
There are a variety of pre-hospital certification levels for communities to choose from. In 1983, because of variations in state and regional EMS terminology, there were as many as 30 levels of prehospital care providers. Since then, the National Registry of EMTs has recognized. Along with the Department of Transportation has developed curriculum for three levels. They are as follows:
The EMT-B should be competent at CPR, airway management, hemorrhage control, stabilization of fractures, emergency childbirth, basic extrication, communications, and patient assisted medications. In some cases the EMT may undergo additional training in cardiac defibrillation (EMT-D). This certification level requires a minimum of 100 hours of classroom lecture/practical skills lab, 24 hours of hospital clinical experience, and 24 hours of supervised field internship.
The EMT-I should possess all the EMT-B skills. In addition, he or she should be competent at advanced airway management and intravenous fluid therapy. This certification level requires a minimum of 100 hours of classroom lecture/practical skills lab, 48 hours of hospital clinical experience, and 48 hours of supervised field internship.
The EMT-P should possess all the skills required of an EMT-B and EMT-I. In addition he or she should be trained in advanced patient assessment, trauma management, pharmacology, cardiology, and other medical emergencies. Paramedics should successfully complete Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support(PALS) courses offered by the American Heart Association. Basic Trauma Life Support (BTLS) or Prehospital Trauma Life Support (PHTLS) course completion is also desirable.
This certification level requires a minimum of 500 hours of classroom lecture/practical skills lab, 250 hours of hospital clinical experience, and 150 hours of supervised field internship.
This level is the latest addition by the State Bureau of EMS. The EMT-PS will also possess all of the above skills along with a broader knowledge base of critical care incidents obtained either through education or work experience. The EMT-PS will also possess the ability to interpret the 12-Lead ECG, medication assisted intubations, and initiation of thrombolytic therapy. The curriculum for these primary education programs include classroom lectures, practical skills lab work, hospital clinical experience, and field supervised field internship.
The training of prehospital personnel is a critical phase of the EMS system. This only marks the beginning of the learning process. The EMS field is an ever-changing profession with discovery of new theories and innovations. There is a mandatory minimum of continuing education hours that must be met as required by the state. EMT-B's must have at least 24 hours of CEHs every 2 years, EMT-I's at least 36 hours, EMT-P's at least 48 hours, and EMT-PS's at least 60 hours.