Is There a Role for First Responders in EMS Responses to Medical Facilities?

Abstract

Objective: Emergency medical dispatch (EMD) protocols should match response resources with patient needs. We tested a protocol sending only a commercial ambulance, without fire department first responders (FR), to all non-cardiac-arrest EMS calls at a physician-staffed HMO facility. Study objectives were to determine how often FR provided patient care at such facilities andwhether EMD implementation could conserve FR resources without compromising patient care. Methods: All EMS dispatches to this facility in the 4 months before implementation of the EMD protocol and4 months after implementation were identified through dispatch records, andall FR andambulance patient care reports were reviewed. In the “after” phase, all cases needing ALS transport were reviewed to examine whether there would have been benefit to FR dispatch. Results: Of 242 dispatches in the “before” phase, BLS FR responded to 156 (64%), andALS FR to 117 (48%). BLS FR provided patient care in 2 cases, andALS FR in 17. Of 227 dispatches in the “after” phase, BLS FR responded to 10 (4%), andALS FR to 10 (4%); all but one were protocol violations. BLS FR provided care in one case, andALS FR in three. Review of the 93 “after” cases requiring ALS transport found none where FR presence would have been beneficial. Conclusions: First responders rarely provided patient care when responding to EMS calls at a physician-staffed medical facility. Implementation of an EMD protocol can safely reduce the number of FR responses to unscheduled ambulance calls at such a facility. Key words: emergency medical services; dispatch.