Orange County EMS Office of the Medical Director George A. Ralls MD Medical Director Orange County EMS System

Objectives Describe roles within the office Explain the primary scope of activities Provide an update on OCEMS System operations

Orange County Fire Rescue Orlando Fire Department Reedy Creek Emergency Services Rural-Metro Ambulance Health Central Ambulance Apopka Fire Department Winter Garden Fire Department Ocoee Fire Department GOAA Describe the EMS System

The Orange County EMS System Approximately 2000 EMT’s and Paramedics 200,000 EMS calls yearly 95,000 transports

Office of the Medical Director A division of the Orange County Health & Family Services Department Primary mission Provide Medical Direction (per FAC 64-E) for all agencies participating in the OC EMS System Create a high level standard of care throughout Orange County

Briefly cover the Org chart

Medical Direction

Direct Medical Oversight Discuss the Direct Medical Oversight provided by OMD physicians in the field, and by radio.

On-Line Medical Control Discuss the success of the Medical Control Base Station, which provides 24/7 access to a Board Certified Emergency Physician for paramedic questions and additional orders.

Orange County EMS System Medical Treatment Protocols Indirect Medical Oversight Evidence Based Updated version in effect Sept. 1, 2008 Discuss the role of Protocols in our EMS System.

Quality Management

Brief description of how data is analyzed and interpreted for EMS QM.

06-07 Cardiac Arrest Summary Give an example of our system Return of Spontaneous Circulation (ROSC) numbers; other key clinical indicators can be quickly discussed.

April 2008 average offload time 8 minutes in focused study at four busiest ER’s Brief description of offload delay as a recent challenge for EMS nationwide. Discuss our local success in dealing with this issue.

Education & Research

Continuing Education for EMTs and Paramedics On-line, classroom, and face-to-face teaching Teaching environment for physicians in training ORMC and Florida Hospital resident physician rotation in EMS FSU Medical student electives in EMS and EMS research Discuss the office’s role in education of EMS personnel and other healthcare providers.

Lead to statewide requirement for use of a monitoring device to improve patient safety Give an example of a project that recently led to a positive patient safety measure statewide.

Give an example of a project that is addressing future disaster prepardness needs.

Disaster Planning & Response

Orange County Health & Medical disaster coordination (ESF-8) Maintain PSN registry Over 3400 OC citizens registered Disaster Management Assistance Team Urban Area Security Initiative-Medical Lead Region 5 Domestic Security Taskforce Briefly outline the office’s role in disaster planning and response.

Other Activities EMS related COPCN review and submissions EMS System enhancements through grant opportunities Over $300,000 for EMS enhancements annually Public health initiatives Orange County Medical Clinic AHA Certified Training Center Approximately 5000 certifications processed in ’07-’08 Liaison with clinical and administrative hospital personnel Describe other current activities in addition to EMS System oversight.

Summary The office provides Medical Direction and support to OCEMS System agencies Roles and responsibilities are diverse Positive trends in key clinical indicators Offload delays significantly improved EMS protocols updated Sept. 2008