Medic One System Description and
Budget
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Thurston County
Medic One / EMS System
2010
Celebrating 35 years
of Public Service
Thurston
County
's
Medic One / Emergency Medical Services
(EMS) System was established in 1974. It
was the first public, county-wide, tiered response, EMS system in the
United States
. The Medic One/EMS System provides
a fire services based basic and advanced life support emergency medical and
trauma care and transport to over 245,300 residents within the county's 727
square miles. The EMS System
responded to 26,605
EMS
calls with paramedics responding to 10,154 calls and transporting over 3,639
life critical patients during 2009. The Medic One System’s paramedic units
responded with a countywide average response time of 11.7 minutes. The paramedic
units accomplished an overall 94% county-wide response goal achievement for
response goals of 10 minutes urban, 20 minutes suburban and 30 minutes rural
classified areas.
The approach is to
involve all jurisdictional entities as participants in the system rather than a
sole provider approach. Sixteen fire
departments/districts are providers of Basic Life Support (BLS) and are
certified at First Responder or Emergency Medical Technician (EMT) levels.
All Fire/EMS agencies function with one or more Aid vehicles (50 BLS
units provide countywide coverage), averaging 7 minutes countywide.
All BLS agencies have been auto-defibrillation capable since 1986 and
EpiPen qualified (epinephrine for severe allergic reactions) since year 2000.
Most fire agencies are primarily volunteer with the exceptions of the
larger municipal departments.
Olympia
, Tumwater and Lacey Fire District # 3 are integrated as county-wide providers of
Advanced Life Support (ALS) staffing seven units.
Paramedic transport units are dual-role (
EMS
and fire services) personnel and staffed with two paramedics.
The System enhanced paramedic services by adding a Single Paramedic Rapid
Intervention Non Transport (SPRINT) Unit to the south western county area on
July 1,1998. A second SPRINT unit
was added July 1, 2000 to address paramedic response times to west
Olympia
and northwest
Thurston
County
. The goal of the SPRINT unit is to improve ALS level response time and
paramedic transport unit availability. SPRINT #14 unit is stationed at Grand
Mound, has simultaneous response with the Tumwater ALS transport unit and both
units are managed by Tumwater Fire Department. SPRINT unit #10 north western
county was upgraded in 2002 to a full paramedic transport unit after the 2001
Nisqually Earthquake due to accessibility issues with northwest county and west
portion of
Olympia
. Medic unit #10 (formerly SPRINT unit #10) is managed by Olympia Fire
Department. Implemented in 2006, was a peak hour, dual medic staffed ALS
transport unit, Medic unit # 6. The Medic 6 unit was stationed in the Hawks
Prairie/northeast county area to respond to grow in the Lacey Urban Growth
Boundary area and is managed by Lacey Fire District #3. Two private ambulance
companies, Olympic and American Medical
Response (AMR), provide basic life support and inter-facility transport.
Private ambulance companies provide four full-time BLS transport units.
The System is further supported by a nearby private EMS helicopter
service, AirLift Northwest, stationed at
the
Olympia
Airport
.
The
System is activated by the public through an enhanced 9-1-1 (E 9-1-1 ) phone
system to a central dispatch center. Capitol
Communications (CAPCOM) receives 9-1-1 calls and dispatches county-wide
police, fire and
EMS
assistance. Dispatchers use predetermined questions to decide the type and
level of unit to dispatch. Dispatchers
are trained to give pre-arrival aid instructions to citizens awaiting arrival of
EMS
units. The System converted to a three level response system of Criteria Based
Dispatch (CBD) on July 1, 1998. The
Dispatch system implemented a “Telephone” subcategory of the non-emergency
response level on June 1, 2001. The dispatch system routes the “Telephone”
category of non-emergency calls to a 24 hour nurse HealthLine. The nurse
HealthLine is to provide a better level of medical care to 9-1-1 callers not
needing an emergency unit response. In 2009, the System implemented a process
for on scene personnel to access the HealthLine. Medic Units respond with BLS
units on any potentially life-threatening situations.
The first BLS units to arrive on the scene communicate with the incoming
Medic Unit. Medic Units may
communicate care instructions or when medically appropriate the Medic Unit may
be canceled. Medic Units handle all
prehospital ALS, life-critical transports. When
Medic Unit response times are extended, BLS agencies may transport and
rendezvous with responding Medic Units. The
paramedics operate from both "standing orders/protocols" and on-line
communication with the Base Station hospital at Providence St. Peter. The
Base Station determines the medical priority needs of the patient.
The Base Station may authorize ALS transport, BLS transport or
cancellation of
EMS
care. Private ambulances transport
most non-life threatened BLS patients.
Medical
communications is over cellular phone and/or HEAR (Hospital Emergency
Administrative Radio). Two hospitals are designated to receive
EMS
patients, St. Peter and Capital
Medical Center. Both hospitals
and CAPCOM have compatible radio equipment to insure > 90 % communication
coverage county-wide. Fire/EMS units
are dispatched on a single frequency with frequency assignment to one of several
response frequencies. Implemented in 2005, was an in-vehicle data systems
linking ALS units with the Dispatch center and county hospitals via digital
radio modem. Private ambulances are capable of hospital and system
communication. Disaster situations
are coordinated on a designated VHF (very high frequency) band.
Disaster
situations are coordinated through pre-plans, fire Incident Command System, CAPCOM,
and Thurston County Department of Emergency Management. The System maintains
pre-positioned disaster resource trailers that can respond to the site with
additional disaster medical supplies and equipment. The System is capable of
placing immediately in-service, additional fully equipped Medic Units by calling
back paramedic staff.
All
initial and specialized county-wide BLS training and over 100 required
EMS
continuing education classes are provided through the Medic One office.
Implemented in 2008, is a BLS on-line, on-going training and evaluation program
being provided through contract with King County Medic One. Monthly ALS
continuing education, run reviews and quality management are provided by the
Medic One system. Paramedics spend
in-service training time at the Base Station for skill maintenance, patient
follow-up and continuing education. Paramedic
employment and county-wide
EMS
personnel certification testing are provided through the Medic One office.
The Emergency Medical
Program Director (EMPD) is staffed and paid by the Medic
One office. The EMPD provides medical guidance and authorization for system
function. Prehospital standing orders/protocols, dispatch protocols,
certification, training, testing standards, medical quality assurance and
medical disciplinary actions are the EMPD's responsibility.
BLS
agencies use a county designed Medical Incident Reporting (MIR) form to document
all
EMS
patient care. MIR’s can be reviewed at the Medic One office for quality
assurance and quality improvement. ALS reports are input on a central,
in-vehicle, electronic data processing system. The Medic One system has plans to
implement an integrated ALS and BLS system to electronically process all
EMS
reports.
The
policy making body is the Thurston
County
Board
of
County
Commissioners
(BoCC). Advisory to the BoCC and the Medic One
office is the Thurston County EMS Council.
The EMS Council is made up of
15 members: three citizens-at-large,
a BoCC representative, three Fire
Commissioner representatives, a City of
Lacey
representative, a City of
Olympia
representative, a City of Tumwater
representative, a Fire District # 1 and
Fire District # 3 representative, a
south
county
Mayors
representative, the Chair of Operations Committee and the EMPD.
The
Medic One office staff are responsible
for developing and implementing system policies and procedures, recommended by
the EMS Council and authorized by the Board
of County Commissioners. The
Medic One office is responsible for county-wide:
system coordination, county to region system integration,
equipment/supply purchase, staff support to the EMS Council/committees, EMS
provider initial BLS training, EMS continuing medical education, system quality
management (QM), ambulance licensing and system financial administration.
The office provides county-wide citizen CPR training and system
education. In 2009, CPR Training was provided to 2,208 citizens in 184 classes.
Also in 2009, an ongoing Public Access Defibrillator program trained 376 persons
in 47 classes how to use an automatic external defibrillator (AED). In 2007, the
Medic One system implemented a county-wide SafeKids (national childhood trauma
prevention program) by partnering with Thurston Child Care Action Council.
The
full-time Medic One staff is composed
of: administrator, administrative
assistant, BLS training/QM supervisor, BLS training coordinator, ALS training/QM
supervisor, purchasing/CPR coordinator, data entry/receptionist. The part-time Medic
One staff includes: Emergency
Medical Program Director and data system support.
CPR and continuing education instructors are part-time or contract
personnel.
The
2010 Medic One/EMS System is funded by
a $8.9 million county-wide regular EMS levy (rate @ 30.5 cents/$1,000 assessed
value) for the county-wide
EMS
program. The funding is used across
the System with emphasis on full-time paid paramedic transport coverage.
The current Medic One/EMS program budget is dispersed as follows: 80% to
ALS activities, 14% BLS activities, 5% to administration, 1% for CPR/public
information activities.
Address:
Thurston
County
Medic One
2703 Pacific Avenue SE
, Suite C
Olympia
WA
98501
- 2036
Phone: 360 - 704 - 2780 (voice)
360
- 704 - 2781 (FAX)
e-mail:
info@medic-one.thurston.wa.us
Home
Page: http://www.co.thurston.wa.us/medic1/m1_home.htm
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