Prince George Fire Rescue

EMR Trial

Prince George City Council

Presentation

June 11, 2012

Why EMR in Prince George?

• Broader scope of care • Esp. analgesia, preparation for transport

• Unified “piece-meal” skills in one license

• Established practice – many EMRs

• Economical & long licensing & renewal

• Enabled and supported by leg’n & reg’n

• Achieved goals of Cameron Report &

Community Charter

Purpose of Trial

1. Can FFs accurately & safely deliver EMR-level

care?

2. Does FF EMR provide potential benefit to

patients without significant events?

3. Does FF EMR enhance teamwork among Fire

and BCAS Paramedics?

Results

Raw Data (entire trial period = 22 months)

• Medical Calls = 5870 (60%)

• Arrive >3 min before BCAS = 1413 (24%)

• Remain >5 min after BCAS = 3149 (54%)

• Cancel = 2110 (36%)

Results

Raw Data (cont’d)

• Glucometry = 309 Glucose = 23

• ASA = 17 Nitroglycerin = 6

• Entonox = 22 IV Maint. = 238

• Obst. Del. = 2 Transp. Prep = 20 +

• Complaints = 0 Adv. Events = 0

Discussion - Outcomes

1. Accurate delivery of protocols by FF EMRs?

• YES!

• Several hundred interventions with no adverse

events or “official” complaints

• No misapplication of Nitroglycerin, Aspirin,

Entonox

• Improved diabetic care

Discussion - Outcomes

2. “Potential” benefit to pts without adverse events?

• YES!

• Pain Relief / Aspirin / Nitroglycerin / Glucose

• Childbirths

• Transport Preparation

– Protect patients from elements

– “Zero scene time” for delayed ambulance response

– Only available conveyance to “cold zone”

Discussion - Outcomes

3. Enhanced teamwork?

• YES!

• 238 incidents of IV maintenance

• Avg. 13.6 min on scene with BCAS 56% of calls

• Anecdotal increase of interventions under BCAS

supervision, especially Advanced Paramedics

• Verbal testimonials from Paramedics

Discussion - Outcomes

4. Cost-effective?

• YES!

• Training & capital equipment needs addressed

within existing budget over 4 years; no ongoing

capital costs

• Incremental increase in consumables

• No additional cost for license maintenance

• $10/year/person for renewal

Moving Forward

Recommendations to EHSC • Embrace and utilize available local Fire resources in

a coordinated & synergistic fashion, instead of

current “competitive” system

– Single ambulance unit response where local EMR

resources available

– Shared training and mentorship

– Consider integrated EMS/Fire dispatching

– Move to integrated electronic documentation

Conclusions • With medical oversight, FFs can practice at

their license level safely & effectively

• Patients experience improved care

• Teamwork is enhanced

• Cost-effective

• Only treatment/evac/transport option for

challenging environments

• Could greatly ameliorate EMS system with

improved integration

• Time to move forward