Since the mid 1950's the North County Fire Protection District has provided high quality ambulance services to its citizens, and in 1990 the District initiated a paramedic program which now serves as a model for much of San Diego County. The challenge emergency medical service ( EMS ) providers face is to make important, sometimes critical decisions with a limited amount of information. Below you will find a summary concerning your EMS system.
The EMS program is integrated into and administered through the Fire Department and as a result, all EMS personnel are also fire fighters experienced in emergency rescue, extrication, and the suppression and confinement of hazardous materials. All fire fighters are specifically trained and bi-annually re-licensed as Emergency Medical Technicians (EMT's). Additionally, since 1990 all new full-time recruits have also been trained as paramedics.
Each full-time fire engine company and each ambulance is staffed with at least one paramedic, providing at least two paramedics on every call for medical service. This ensures rapid arrival of advanced life support (ALS) trained personnel to each medical emergency. This standard of care is largely uniform throughout the metropolitan portions of San Diego County and for this reason, it is common for a fire engine and an ambulance to respond to a medical emergency.
To properly serve the community, paramedic ambulances are located in a manner that best services all the residents of the community. The location of ambulances is based on meeting County mandated response time criteria, which is for a paramedic ambulance to arrive on the scene of all medical aid calls within 10 minutes, 90% of the time.
In an effort to minimize the response time to citizen's emergency calls, we have implemented a "boundary drop" program which allows for sharing of surrounding agencies' fire and paramedic ambulance resources.
The Demand for Emergency Medical Service
The public's demand for emergency medical services has steadily increased over the years and represents approximately 75% of all calls for service (4,303 total calls in 2006). Approximately 70% of all EMS calls result in an ambulance transport to the hospital or transport by a helicopter to a hospital providing specialized services.
The County of San Diego Medical Director is responsible for all medical aspects of pre-hospital patient care. The Medical Director has the authority to approve the level of pre-hospital care which may be rendered by EMTs and Paramedics within the County of San Diego, as well as establish and monitor compliance with field performance guidelines and training standards. Paramedics receive direct medical control from an assigned Base Hospital , which assists in making treatment and transport destination decisions.
A Battalion Chief heads the EMS Division with the direct assistance of the Medical Services Officer (MSO). These two individuals provide direct day-to-day oversight of the EMS delivery system for the North County Fire Protection District and are responsible for the operations and maintenance of EMS , quality assurance, emergency medical training, complaint disposition, fiscal management, and compliance with all polices, orders, and procedures.
Ideal provision of emergency medical services relies upon total community involvement. As such each member of the community represents a link in the "chain of survival." To that end the Fire Department provides CPR instruction and has implemented a Public Access Defibrillation (PAD) program, which encompasses placement of 30 Automatic External Defibrillators (AED's) throughout the community.
In order to maximize customer service, the Fire Department also sends customer satisfaction surveys to persons that utilize our ambulance services. Should you or a member of our family require these services please provide us feedback so that we can continue to improve our quality of service.
The Future of EMS
The scope and complexity of medical services provided by paramedics continues to evolve, with paramedics providing many critical interventions that were once only available in the hospital setting. Currently our County is participating in the Resource Outcome Consortium (ROC) trial study program, which is evaluating new cutting edge treatment for trauma and cardiac arrest victims. Additionally, many hospitals are now providing specialty care, to include trauma centers, stroke or acute myocardial infarction specialty centers, and pediatric or burn specialty care.