Thursday, May 9, 2013

How EMS works in Downe Township

When you call for an ambulance in Downe Township, you may get more than you bargained for.  Along with an ambulance, you may be greeted by first responders from the local fire department, police, and, depending on the type of emergency, paramedics.  This may sound like overkill, but the above mentioned responders provide different, yet essential medical attention.  Below, I will attempt to explain what each responder does and how crucial their response is to your emergency.

First, I will explain the process in which the responders are notified and the chain of events that follow.  When you call 911, you are immediately asked, "911, where is your emergency?"  The answer to this question will set into motion the events leading up to your local volunteers being notified of your emergency.  Once the 911 operator verifies your address and type of emergency, your call for service is entered into the computer.  Another operator takes this information and dispatches the required emergency responders to your location.  This is known as the initial dispatch.  During the initial dispatch, you (the caller) may still be on the phone with the 911 operator.  The operator is gather additional pertinent information, as well as providing pre-arrival instructions.  If the dispatched responders do not respond 5 minutes after the initial dispatch, another dispatch takes place (second dispatch).  If still, after 7 minutes a responder has not responded, a third dispatch is sent, along with an initial dispatch for mutual aid.  All volunteer agencies, fire or EMS, have mutual aid agreements with neighboring agencies.  A mutual aid agreement is basically a back-up plan in case the primary provider can not/did not respond.  In Downe, our EMS mutual aid agreement is with Lawrence Township.  If after 7 minutes from the initial dispatch the ambulance from Downe has  not responded (due to lack of manpower), an ambulance from Lawrence Township is dispatched.  If the ambulance from Downe is out of service for mechanical reasons or already on an emergency call, Lawrence Township is dispatched on the initial dispatch.

The role of the first responder is critical.  A first responder is CPR certified, and trained in automated external defibrillator usage, spinal and bone fracture immobilization, oxygen administration and, in some cases, emergency childbirth as well as advanced first aid.  A first responder is second link (the 911 dispatcher being the first) in the emergency services chain.  Some first responders are certified EMTs, paramedics, RNs, or even doctors.  The first responder initiates hands on care and prepares the patient for the arrival of the ambulance and transport to the hospital.  If the ambulance takes 5 minutes to respond and then 8 additional minutes to drive to your house, the first responders are capable of providing care until the ambulance arrives.

When the ambulance arrives, so has the third link in the emergency services chain.  The ambulance is staffed with a minimum of one certified EMT, and of course a driver.  An EMT is trained in the same skills as first responders, with more hours of training to obtain their certification.  In addition to those skills, an EMT may assist a patient in taking nitroglycerin (for chest pain), assist a patient in utilizing their inhaler (for asthma and other respiratory diseases) and administering an EPI-pen (for severe allergic reactions).  The public needs to know that the EMTs in Downe are volunteer.  Meaning, that unless a crew is, coincidentally, at the building, the ambulance doesn't respond immediately, if it responds at all.  The volunteers must respond from their homes to the squad building to get the ambulance.  This takes time, as all responding volunteers and even ambulances transporting patients to the ER are subject to the same motor vehicle laws as every other vehicle on the road.  Just because an ambulance has flashing lights and whaling sirens doesn't mean driving 80 mph to the ER.

After calling 911, you may or may not see the fourth link of the chain, depending on the situation.  The paramedics are dispatched to emergencies that may require advanced interventions.  These interventions include inserting an IV, securing an airway with a breathing tube, administering medication and monitioring our heart rate with a heart monitior.  Chances are if your being transported to the hospital from Downe Township, the paramedics will be met on the side of the road during transport.

Rest assured, there is an ambulance coming to your house if you call 911.  Time seems to stand still when waiting for the ambulance.  5 minutes can feel like 50 minutes!!!  The ambulance may not say Downe Township EMS on the side of it, but an ambulance will be there.  There are plans in place to account for instances when DTEMS is unable to respond an ambulance.  There are plans in place to account for instances when LTEMS is unable to provide an ambulance due to thier own emergencies.

The bottom line is mutual aid agreements are in place to make sure an ambulance will be there to pick you or a loved one up.  And in the mean time while waiting for an ambulance, the first responders are more than capable to bridge to gap between the 911 call and the arrival of the ambulance.

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