August 24, 2017

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Bunnell, Florida 32110

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EMS EMS - FAQ Operations Special Operations  

Flagler County Fire Rescue is committed in providing citizens with the highest quality of emergency medical service. FCFR operates 6 ambulance/transport units, 3 advanced life support (ALS) fire engines, and 1 ladder truck. All ambulance/transport units are staffed with two firefighter/paramedics and all ALS engines are staffed with at least two firefighter/paramedics. The department is the sole provider of emergency medical transport for Flagler County.

On a national level, the role of fire service and its involvement in emergency medical services continues to grow. Estimates by the federal government were that up to 80% of pre-hospital medical care was provided by fire service. Flagler County Fire Rescue answers approximately 13,000 calls for service per year. Of those 13,000 calls for service, 85% of those calls were for medical services of some type.

Flagler County Fire Rescue Paramedics work off of a medical protocol under the direction of a medical physician. The paramedics utilizing these protocols have the ability to handle any emergency medical problem that arises. Many people will call the fire department before going to the hospital for treatment.

Dr. Kristen McCabe serves as the countywide medical director for Flagler County. Dr. McCabe is currently the medical director for Florida Hospital Flagler and the chief of medicine. Dr. McCabe is board certified and has been contributing to EMS for many years.

Basic Life Support versus Advanced Life Support Basic Life Support (BLS) and Advanced Life Support (ALS) define levels of care that may be provided by Emergency Medical Technicians and Paramedics. The terms BLS and ALS may also be used to refer to the skill associated with the training. In Flagler County Fire Rescue, the fire engine and the rescues are capable of providing both BLS and ALS.

Basic Life Support care consists of what is commonly referred to as "first aid", cardio-pulmonary resuscitation (CPR), and the use of automatic electronic defibrillators (AED). Advanced life support care consists of medical procedures performed in the field by highly trained paramedics. The types of procedures commonly performed in the field are the use of a cardiac monitor/defibrillator, inserting airway tubes, intravenous lines, and injecting medications. The paramedics also communicate with the hospital emergency room via radio for advice and direction by the emergency room physician. In certain situations, the paramedics are authorized by standing orders and medical protocols from the physician advisor to initiate ALS treatment without contacting medical advice.

Studies have repeatedly shown the importance of immediate bystander CPR plus defibrillation within 3 to 5 minutes of collapse to improve survival from sudden cardiac arrest.

Emergency medical calls for service are not just for cardiac arrest. The range of types of calls is wide just like the wide range of fire calls. Emergency medical calls can range from a stubbed toe to a full cardiac arrest in the field. To categorize medical calls received by the fire department we use generic categories because of the myriad of conditions we encounter. Trauma is one category that would contain sub-categories such as gunshot wounds, stabbings, car crash injuries, persons hit by a car, assaults, falls, and any other type of trauma. Cardiac is another category that would contain sub-categories such as chest pain, or a known cardiovascular disease. Respiratory is a category that would contain sub-categories such as trouble breathing, asthma, bronchitis, or any other respiratory problem. Other categories we track are diabetic problems, seizures, overdoses, psychological/behavioral problems, OBGYN and other. Cardiac arrest is a category in itself.

The amount of calls for medical service has increased steadily over the past three years. The growth in population distribution and population density has contributed to the increase in calls for service.

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