Emergency Medical Services (EMS) have come a long way since the early days when those trained in first aid would simply “scoop up” a patient and drive them to the hospital with little to no definitive care. Today, modern medicine has extended from the hospital setting and into the “field”, allowing paramedics and EMTs to treat patients quickly and safely with modern equipment and a host of treatment options and medications.
How EMS Works in Monroe County
Each EMS system varies from area to area, usually within a given county. In Monroe County, each ambulance agency is independently operated and patient care is overseen by a medical director, an M.D. who monitors the care rendered to each patient and assists in training medical providers.
Calling 911 & Dispatch
When you call 911, you are routed to the Monroe County 911 Center in downtown Rochester. A telecommunicator will ask a number of questions of the caller in an attempt to determine if the need is fire, police or EMS related. If medical attention is needed and the call is within the Town of Henrietta, the call data is routed to a dispatcher at 911 who in turn sends the “job” to CHS Healthcare. We receive the call via a secure computer, alphanumeric digital pagers and by voice dispatch over a radio frequency.
CHS Healthcare does not have dispatchers in-house 24/7. We do, from time to time, have a few members that volunteer their time to acknowledge calls from the 911 dispatcher, answer phones and greet people at our base. There is not always someone at our headquarters to answer your telephone call. Given this, it is critical that if you wish for CHS Healthcare to respond to assist you, ALWAYS DIAL 911. If you do call our business line for a medical concern, we will ask you to hang up and call 911 instead.
Once the call is dispatched to us, we respond immediately. Our average time from “time of dispatch” to going en route is just over one minute. Each EMS call is assigned a priority by the 911 telecommunicator. This priority code determines, in most cases, whether or not we respond to the scene with or without lights & sirens. Our total average response time is approximately 9 minutes* depending on the location, priority of the call, time of day and where the ambulance unit is responding from.
*Priority 1 and 2 calls within the Town of Henrietta only
We are extremely proud of our call coverage percentage. Residents of Henrietta will receive a response by CHS Healthcare 98% of the time (as of July 2011). However, there are times when our agency becomes extremely busy and resources are temporarily taxed. The balance of the calls (2%) will be handled by a neighboring EMS or commercial ambulance agency. There is a slight chance that you may be cared for by one of these other agencies, including Brighton Ambulance, Rural/Metro Medical Services, Rush Volunteer Ambulance, RIT Ambulance, Scottsville Rescue Squad, Pittsford Ambulance, Monroe Ambulance, or Honeoye Falls-Mendon Ambulance. Likewise, CHS Healthcare responds to other towns and counties, assisting when they become busy.
Our fleet is comprised of 10 emergency response vehicles – 6 ambulances and 4 “fly cars”, which are SUV’s staffed by one individual who can care for the patient until an ambulance arrives. All vehicles are New York State (NYS) certified, meaning they have been inspected by officials of NYS and carry all the equipment that is specified by the NYS requirement Part 800.
The majority of the time, our ambulances are setup as “ALS” (advanced life support), staffed with at least one paramedic to treat the patient. Occasionally, we will setup “BLS” ambulances (basic life support), staffed with an EMT who respond with a paramedic fly car in the event advanced care is needed.
When you dial 911 and CHS Healthcare responds, the vehicle(s) that come to your aid may vary based on our staffing levels, your location, and the seriousness of the injury/illness.
Your Medical Care – EMT (BLS) & Paramedic (ALS)
The in-charge medic caring for you on an EMS call is certified as either an Emergency Medical Technician (EMT) or Paramedic. There are two levels of care provided by an ambulance in Monroe County:
Basic Life Support (BLS)
BLS is handled by a NYS certified EMT who evaluates and treats the patient at the scene and en route to the hospital. In New York State, EMTs are trained to handle a variety of patient symptoms, illnesses and injury including bleeding, falls/trauma, oxygen administration and more. All medics are certified to use an AED (automated external cardiac defibrillator), units used on patients who are in cardiac arrest to “shock” their hearts into a normal rhythm. Basic EMTs are also all trained in the administration of Epi-Pens, Aspirin, Nitrogylcerin and Albuterol which can help save a patient’s life if they are experiencing certain symptoms.
Advanced Life Support (ALS)
ALS is handled by NYS certified paramedics. The ALS program at HVA began service in 1975. This service requires the greatest amount of medical training for our members. Paramedics are required to attend extensive classroom, hospital-based, and field-based training (usually 1,500+ hours).
Paramedics respond on life threatening (or potentially life threatening) emergencies as well as other serious calls. They assist in caring for the seriously injured or ill patients. Any emergency call that involves a life-threatening situation will have a paramedic respond to it.
Paramedics at CHS Healthcare are trained to:
- Start IV or IO access (intravenous or intraosseous)
- Administer advanced medications – over 25 different drugs
- Provide advanced respiratory care – CPAP, intubation, orogastric tubes, surgical airway, RSI
- Diagnose and treat cardiac rhythm disorders
- Manage & oversee primary care for patients in cardiac and respiratory arrest
- Treat life threatening traumatic injury
- Interpret advanced cardiac ECG’s (12-lead) – identifying life threatening heart attacks
- Diagnose acute stroke symptoms
Several paramedics at CHS Healthcare have also completed the Rapid Sequence Induction (RSI) Program, enabling them to sedate, paralyze, and perform intubation on patients that are in severe need of assisted breathing through the use of an Endotrachael (ET) Tube.
The level of care (BLS or ALS) you receive during transport will depend on your symptoms and the necessary care provided by the ambulance crew. Generally, there will be one primary medic taking care of you who may be assisted by another medic or a trainee who is learning to care for patients. If you’re being treated by a paramedic, he/she may wish to start an IV on you during transport in order to allow for administration of medications by both EMS and the hospital staff. Our medics work to make you as comfortable as possible during transport to the hospital.
We currently are only able to transport patients to a local emergency department. Unfortunately, we cannot transport to urgent care centers at this time. The choice of which hospital we transport to is primarily up to the patient. We can provide basic guidance and information on the various hospitals however the ultimate decision lays with the patient.
At The Hospital
Upon arrival at the hospital, the crew will take the patient to the “triage” area specifically for patients arriving by ambulance. The medic will provide information to the triage nurse who will then assign a place for the patient within the emergency department. The assignment may be to an open bed or to the waiting room. After the patient has been transferred to the hospital, the medic in charge completes an electronic patient chart that becomes part of the patient’s medical record.