William Torres Jr.
EMS Department Head
Marcus Daly Memorial Hospital
1200 Westwood Drive
Hamilton, MT 59840
Our EMS Department
During our last two submissions, we outlined calling 911 and what to expect
when visiting our Emergency Department. I would like to expand on our
EMS Department and some of the important roles our emergency care providers
The primary role of emergency medical services is to respond to requests
for medical assistance from the community. They provide medical assessment
and treatment to the sick and injured. The level of service and scope
of practice is dependent on the emergency care provider's training.
It ranges from the emergency medical responder to paramedic with the critical
care transport endorsement. Our department employs emergency medical technicians,
advanced emergency medical technicians, paramedics, and paramedics with
critical care transport endorsements.
Our emergency care providers are dispatched by our Ravalli County Sheriff's
Office 911 Center. When the pager alerts, our emergency care providers
stop what they are doing and respond. This is true for all emergency responders
and most thrive on this zero to sixty unpredictability. Regardless of
the emergency agency, paid or volunteer, we share this trait.
Our EMS Department is made up of dedicated employees. They come from different
backgrounds, different states, and different experience levels. They often
are volunteers at your local fire departments, stand with you at the school
bus stops, and attend the same religious services. Like you, they are
dedicated to their community and want to do their part.
Another important role of our emergency care providers is to assist in
the inter-facility transfer of a patient requiring a higher level of service
or a service not provided at our facility. Our emergency department physician
will work with the patient to provide a diagnosis and recommendation for
a treatment plan. When the emergency department physician and patient
agree that the treatment plan includes transfer, our emergency care providers
will be contacted. The emergency department physician will determine the
level of service and the mode of transportation.
The physician responsible for sending the patient processes many layers
of information when deciding the best mode and time for a transfer. Medical
necessity is one of the first decision. Insurance companies, including
government programs, require that there is a medical necessity for use
of an ambulance when transferring a patient. Also considered is the urgency
of the transport. Does the patient need to be transferred immediately,
urgently or non-emergency. Non-emergency transfers are usually scheduled
during daytime hours for the safety of the patient and crews.
The decision regarding the urgency of the transfer resides with the physician.
They are the provider who has evaluated the patient and are well informed
of the results and diagnosis. The physician will consult a specialty physician
at the facility best suited for care of the patient. After the consultation
the physician will discuss the options with the patient. This discussion
is important and allows the patient to be involved with their care.
When the discussions have been completed and agreed to by the patient
our Paramedic Crew Chief is contacted to facilitate the inter-facility
transfer by assigning the appropriate level of provider. The emergency
care provider performs care under the authority of a medical director.
Our medical director is responsible for the treatment protocols which
are considered standing orders. He has also delegated immediate medical
direction to our on duty emergency physician. This direction is called
on-line medical control.
Our EMS Department is also involved with community outreach. We visit
and are visited by school groups and community groups interested in learning
and seeing an ambulance in person. There is always excitement and very
good questions asked by our visitors. We discuss calling 911, knowing
their address, and what to do if they have to request EMS. The children
have the opportunity to touch the equipment and sit in the driver's seat.
We also schedule job shadows with high school students interested in learning
about EMS. These students are always engaged and ask great questions.
We spend time discussing the similarities and differences of urban and
rural EMS, as well as fire-based, hospital-based, and private EMS.
Another part of outreach is blood pressure clinics at local facilities.
This is becoming an important outreach program as it identifies elevated
blood pressure which has been either untreated or more importantly unknown
to the person.
Our EMS Department is very involved in EMS education and life support
training at our hospital. They facilitate CPR courses as well as Advanced
Cardiac Life Support and Pediatric Advanced Life Support.
I am very blessed to be associated with a team of dedicated emergency
care providers. We work together to achieve our mission of quality, accessible,
and personalized health care. They are often the first MDMH face you see
as you access our emergency department either by calling EMS or walking
through our doors.
The health column is a brought to you by collaboration amongst the Ravalli
Republic and Marcus Daly Memorial Hospital. For questions and or comments
about this week's health column, please contact Willie Torres, Jr.,
EMS Department Head,
at Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton MT 59840.
Working together to build a healthier community!