1. Emergency Medical Services (EMS) System
S-SV EMS MICN Course
Module 1
Emergency Medical Services (EMS) System
S-SV EMS Agency MICN Training (Updated )

2. S-SV EMS Agency MICN Training (Updated 12-2017)
What Is EMS?
Dispatch
Medical Priority Dispatch Systems (MPDS)
EMS call determinants and response priority using approved protocols (based on caller reported pt. condition)
Emergency Medical Dispatch (EMD)
Pre-arrival instructions (first aid, hands only CPR, etc.)
First responders (law enforcement, fire dept.)
Ambulance transport (ground and air)
S-SV EMS Agency MICN Training (Updated )

3. S-SV EMS Agency MICN Training (Updated 12-2017)
What Is EMS?
Acute Care Hospitals
Receiving hospitals
Base hospitals (utilize MICNs)
Modified base hospitals (no MICNs)
Specialty receiving centers (stroke, STEMI, trauma)
S-SV EMS Agency MICN Training (Updated )

4. California EMS Laws & Regulations
Health and Safety Code, Division 2.5
Establishes the EMS Authority (statewide EMS oversight)
Requires each county to designate a local EMS agency (LEMSA)
Contains all California EMS laws
Code of Regulations, Title 22
Contains all California EMS regulations
S-SV EMS Agency MICN Training (Updated )

5. California EMS Authority (EMSA)
State EMS oversight entity
Director of EMS
Physician, appointed by the Governor
Chief Deputy Director
Administrative staff position
Additional administrative and staff support positions
Approximately 80 personnel
S-SV EMS Agency MICN Training (Updated )

6. California EMS Authority (EMSA)
Responsibilities
Develop EMS regulations
EMS training program standards
EMS personnel scope of practice
EMS personnel certification/licensure and enforcement requirements
EMS system requirements (local EMS agencies, EMS providers, trauma, disaster, etc.)
Review and approve local EMS plans
S-SV EMS Agency MICN Training (Updated )

7. California EMS Authority (EMSA)
Responsibilities (continued)
Trauma system planning
Develop standards for trauma care
Review and approve local trauma system plans
Stroke & STEMI system planning
Development of stoke and STEMI regulations currently in progress
S-SV EMS Agency MICN Training (Updated )

8. California EMS Authority (EMSA)
Responsibilities (continued)
EMS for children
Ensure critically ill/injured children have access to appropriate emergency care
Poison Control system
Develop standards, monitor and evaluate
S-SV EMS Agency MICN Training (Updated )

9. California EMS Authority (EMSA)
Responsibilities (continued)
Disaster medical management
Statewide disaster planning and response coordination
Disaster Medical Assistance Teams (DMAT)
Ambulance Strike Teams (AST)
Disaster Healthcare Volunteers/Medical Reserve Corps
S-SV EMS Agency MICN Training (Updated )

10. California EMS Authority (EMSA)
Responsibilities (continued)
Public education
Statewide EMS data collection
Injury prevention
First Aid and CPR training requirements for bus drivers and day care providers
S-SV EMS Agency MICN Training (Updated )

11. Local EMS Agencies (LEMSAs)
33 California LEMSAs
26 single county
Primarily urban and suburban counties
7 regional
Primarily suburban and rural counties
At least 3 counties required to qualify for state matching funding
S-SV EMS Agency MICN Training (Updated )

12. Local EMS Agencies (LEMSAs)
Responsibilities
Provide local regulatory oversight and ensure public heath and safety as it relates to prehospital EMS care
Lay rescuer AED program monitoring
EMS dispatch entities (MPDS, EMD)
EMS aspects of law enforcement and fire agencies
Ambulance transport providers (ground, air)
Specialty EMS programs (tactical, fireline, etc.)
EMS aspects of acute care hospitals
S-SV EMS Agency MICN Training (Updated )

13. Local EMS Agencies (LEMSAs)
Responsibilities (continued)
Develop EMS policies and treatment protocols (including specialty care center designation and EMS patient destinations)
Receiving hospitals, base/modified base hospitals
Specialty care centers (stroke, STEMI, trauma)
S-SV EMS Agency MICN Training (Updated )

14. Local EMS Agencies (LEMSAs)
Responsibilities (continued)
Approval and oversight of prehospital personnel
EMR – certification and enforcement
EMT/AEMT – certification and enforcement
Paramedic – accreditation (enforcement referred to EMSA)
MICN – authorize (enforcement referred to BRN)
S-SV EMS Agency MICN Training (Updated )

15. Local EMS Agencies (LEMSAs)
Responsibilities (continued)
Authorize and monitor EMS training programs
Develop and implement county/regional EMS plans (EMS system, stroke, STEMI, trauma, etc.)
Medical and heath disaster planning and response (in collaboration with local public health)
Multiple other EMS system oversight activities
S-SV EMS Agency MICN Training (Updated )

16. S-SV EMS Agency MICN Training (Updated 12-2017)
Regional LEMSA established through a joint powers agreement (10 counties)
Butte, Colusa, Glenn, Nevada, Placer, Shasta, Siskiyou, Sutter, Tehama, and Yuba counties
1.3 million population
21,000+ square miles
150,000+ annual EMS calls
S-SV EMS Agency MICN Training (Updated )

17. S-SV EMS Agency MICN Training (Updated 07-2017)
96 BLS first responder agencies
9 ALS/LALS first responder agencies
30 BLS and ALS ground ambulance providers
8 EMS aircraft providers
3000+ EMS prehospital personnel
18 acute care hospitals (located in the S-SV EMS region)
S-SV EMS Agency MICN Training (Updated )

18. S-SV EMS Agency Org. Chart
S-SV EMS Agency MICN Training (Updated )

19. S-SV EMS System Committees
Individual county EMCCs/EMAGs
Regional Medical Control Advisory Committee (EMS policy & treatment protocol development)
Regional Continuous Quality Improvement Committee
Regional EMS Aircraft Committee
Regional STEMI Quality Improvement Committee
Regional Trauma Quality Improvement Committee
S-SV EMS Agency MICN Training (Updated )

20. S-SV EMS Base Hospitals
Enloe Medical Center
Fairchild Medical Center
Feather River Hospital
Mercy Medical Center Mount Shasta
Mercy Medical Center Redding
Oroville Hospital
Rideout Regional Medical Center
Shasta Regional Medical Center
Sutter Roseville Medical Center
St. Elizabeth Community Hospital
UCDMC (trauma only)
S-SV EMS Agency MICN Training (Updated )

21. S-SV EMS Modified Base and Receiving Hospitals
Modified base (EMS medical direction by physicians only)
Kaiser Roseville Medical Center
Mayers Memorial Hospital
Sutter Auburn Faith Hospital
Sierra Nevada Memorial Hospital
Tahoe Forest Hospital
Receiving hospital (no EMS medical direction)
Orchard Hospital
Glenn Medical Center
S-SV EMS Agency MICN Training (Updated )

22. S-SV EMS Trauma Centers
UCDMC (Level 1 & Pedi)
Enloe Medical Center (Level 2)
Sutter Roseville Medical Center (Level 2)
Mercy Medical Center Redding (Level 2)
Mercy Medical Center Mt. Shasta (Level 3)
Rideout Regional Medical Center (Level 3)
St. Elizabeth Community Hospital (Level 3)
Fairchild Medical Center (Level 4)
S-SV EMS Agency MICN Training (Updated )

23. S-SV EMS Stroke Receiving Centers
Enloe Medical Center
Feather River Hospital
Kaiser Roseville Medical Center
Mercy Medical Center Redding
Oroville Hospital
Rideout Regional Medical Center
Sierra Nevada Memorial Hospital
Sutter Auburn Faith Hospital
Sutter Roseville Medical Center
Shasta Regional Medical Center
S-SV EMS Agency MICN Training (Updated )

24. S-SV EMS STEMI Receiving Centers
Enloe Medical Center
Kaiser Roseville Medical Center
Mercy Medical Center Redding
Rideout Regional Medical Center
Shasta Regional Medical Center
Sutter Roseville Medical Center
S-SV EMS Agency MICN Training (Updated )

25. S-SV EMS Agency MICN Training (Updated 12-2017)
Base Hospitals
MICN requirements
RN with ED experience (recommended by base hosp.)
Trained and authorized as an MICN by S-SV EMS
MICN roles and responsibilities
Provide medical direction to EMS prehospital personnel according to S-SV EMS policies/protocols
Liaison with base hospital physicians for EMS consultation and orders when necessary
S-SV EMS Agency MICN Training (Updated )

26. S-SV EMS Agency MICN Training (Updated 12-2017)
Base Hospitals
Prehospital Coordinator requirements
RN with ED experience
Employed/appointed by the base hospital
Prehospital Coordinator responsibilities
Resource for MICNs
Educate MICNs on new/revised S-SV EMS policies/protocols
Prehospital CQI
Liaison with base hospital medical director, EMS prehospital providers and S-SV EMS
S-SV EMS Agency MICN Training (Updated )

27. S-SV EMS Agency MICN Training (Updated 12-2017)
Base Hospitals
Base Hospital Medical Director requirements
Physician licensed in California (MD/DO)
Regularly works in ED of base hospital (hospital appointed)
Experience and knowledge in base hospital radio operations and S-SV EMS policies/protocols
Base Hospital Medical Director responsibilities
Resource for Prehospital Coordinator, MICNs and EMS prehospital providers/personnel
S-SV EMS Agency MICN Training (Updated )

28. EMS QI Program (EMSQIP)
All EMS system participants required to develop and maintain an S-SV EMS approved EMSQIP, including:
Description of EMS QI processes
Monitoring and reporting of EMS QI indicators
Involves EMS process/personnel improvement, education, remediation, and recognition
S-SV EMS Agency MICN Training (Updated )

29. EMS QI Program (EMSQIP)
EMS issues/questions should be referred to the Prehospital Coordinator
Protocol deviation (without base physician order)
Patient presentation does not match report given
Radio report not effective
Critical/unusual cases with good learning components
Questionable destination decisions
Conflict that could not be resolved at time of event
Noting a job well done that deserves recognition
S-SV EMS Agency MICN Training (Updated )

30. EMS QI Program (EMSQIP)
Cases are reviewed and education information is shared with involved entities
Cases that require further investigation, involve multiple providers, or may require S-SV EMS policy/protocol revision are referred to the appropriate regional QI committee(s)
S-SV EMS Agency MICN Training (Updated )