Emergency Medical Services
Emergency medical services provide prehospital medical care to out-of-hospital cardiac arrest patients on scene and while transporting to the hospital. In rural areas, the responding emergency medical services’ scope of practice varies from basic life support capabilities, which may be limited to effective chest compressions and use of a bag-mask device, to advanced life support capabilities encompassing a set of interventions and medication treatments intended to support airway, breathing, and circulation.
The evaluation of the emergency medical services cardiac subsystem of care includes:
- Mapping of the emergency medical services’ agencies’ response processes to out-of-hospital cardiac arrest calls. The resulting process flow maps in conjunction with time stamp data may assist the emergency medical services’ continuous quality improvement (CQI) efforts. System wide mapping allows the medical director to follow patient care from start to finish on any case.
- System-wide exercises to test and improve emergency medical services’ documentation procedures and communication protocols with other subsystems.
- Evaluation of a North Dakota emergency medical services pilot project designed to advance emergency medical services’ documentation and quality improvement practices.
- Evaluation of a South Dakota pilot project designed to demonstrate the possibilities of real-time flow of patient care data between emergency dispatch centers, emergency medical services, hospitals, and the state’ health information exchange network.
Barriers to Efficiency
- Rural emergency medical services’ agencies’ dependency on a volunteer workforce presents challenges including recruitment and retention of volunteers.
- Long hospital transportation times coupled with limited resources are common challenges in rural emergency medical services face that can affect patient care (i.e. high performance cardiopulmonary resuscitation (CPR)).
- Maintaining adequate medical direction can be difficult for rural emergency medical services.
- Limited cell phone and radio network coverage can cause issues when communicating with other subsystems.
- Development and Fundraising Toolkit, Minnesota Resuscitation Academy
- EMS Toolkit, Minnesota Department of Health
- Rural Emergency Medical Services, Rural Health Information Hub
- Rural EMS Resources, National Association of State EMS Officials
- State EMS Offices Listing, National Association of State EMS Officials
- Cardiac Ready Communities Initiative, Montana Department of Public Health and Human Services
- HEARTSafe Communities
- Heart Safe Communities, Minnesota Department of Health
- Survive Cardiac Arrest, University of Washington
- Ten Steps for Improving Survival from Sudden Cardiac Arrest, The Resuscitation Academy
- The Heart Rescue Project, The Medtronic Foundation
High Performance CPR
- 2015 CPR & Emergency Cardiac Care Guidelines, American Heart Association
- High-Quality CPR, American Heart Association
- High Performance CPR Toolkit, The Resuscitation Academy
- High Performance CPR Videos, Resources, The Resuscitation Academy
- CARES – Cardiac Arrest Registry to Enhance Survival
- EMS COMPASS, National Association of State EMS Officials
- EMS Data, Wyoming Department of Health
- Minnesota CARES, Minnesota Resuscitation Consortium
- CODE-STAT – CPR Data Review Software
- Early Defibrillation, Rochester Police Department, Minnesota
- Police Defibrillation Toolkit, The Resuscitation Academy
- EMS Protocols Toolkit, Minnesota Resuscitation Academy