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

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

3. 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

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

5. 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

6. Briefly cover the Org chart

7. Medical Direction

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

9. 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.

10. 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.

11. Quality Management

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

13. 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.

14. 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.

15. Education & Research

16. 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.

17. 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.

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

19. Disaster Planning & Response

20. 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.

22. 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.

23. 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