Speaking at an annual meeting of EMS medical directors—the 2014 Gathering of Eagles in Dallas, Texas—Louisville (Ky.) Medical Director Neil Richmond moderated a very transparent discussion on issues that need attention today.
One of the key areas that the medical directors felt needed to be looked at is the practice of crews hurrying to get crashing patients to their ambulance and off to the hospital instead of working the patient as a team at the scene. It was noted that airway issues or treatment errors, such as interruptions in cardiac compressions or failed intubations, can be undetected if a single medic is working a crashing patient in the back of an ambulance, and those issues might be detected if other team members were present to offer assistance and serve as a “second opinion” or back-up.
End-tidal carbon dioxide (EtCO2) monitoring was also discussed, as some EMS systems are suspending the operational privileges of paramedics who failt to monitor EtCO2 on intubated patients.
Sabina Braithwaite. MD, MPH, medical director of the Wichita-Sedgwick County (Kan.) EMS system, spoke about leveraging technology and data integration in today’s modern, busy EMS systems. She told the Eagles her system has been one of the early adopters of the FirstWatch FirstPass assurance database system and has fully integrated her system’s data allowing her to efficiently and effectively “mechanize quality assurance."
FirstPass works by sending EMS call and patient care data into a “cloud” and, rather than just looking at a few parameters, uses multiple databases, key metrics and treatment indicators to effectively determine protocol and procedure compliance in their high call volume system. The same type of “dashboard” system used in the FirstWatch data system, where key performance indicator deviations are presenting on screen, is used in the FirstPass to alert medical directors and supervisors—in real time—as incidents occur or define parameters are not being met.