About Medicine: Our EMS Department

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 perform daily.

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, wtorres@mdmh.org at Marcus Daly Memorial Hospital, 1200 Westwood Drive, Hamilton MT 59840. Working together to build a healthier community!


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