Orange County EMS Office of the Medical Director

George A. Ralls MD

Medical Director

Orange County EMS System

Objectives

• Describe roles within the office

• Explain the primary scope of activities

• Provide an update on OCEMS System operations

Orange County Fire RescueOrlando Fire DepartmentReedy Creek Emergency ServicesRural-Metro AmbulanceHealth Central AmbulanceApopka Fire DepartmentWinter Garden Fire DepartmentOcoee Fire DepartmentGOAA

The Orange County EMS System

• Approximately 2000 EMT’s and Paramedics

• 200,000 EMS calls yearly

• 95,000 transports

Office of the Medical Director

• A division of the Orange County Health & Family Services Department

• Primary mission– Provide Medical Direction (per FAC 64-E)

for all agencies participating in the OC EMS System

– Create a high level standard of care throughout Orange County

Assistant MD's Admin Asst

EMS Fellow Quality Manager

Admin Asst

Quality Coordinator Compliance Officer

Admin Spec Admin Spec

Project Coordinator

EMS Manager

Medical Director

Medical Direction

Orange County EMS System Medical Treatment Protocols

• Evidence Based

• Updated version in effect Sept. 1, 2008

Quality Management

06-07 Cardiac Arrest Summary

April 2008 average offload time 8 minutes in focused study at four busiest ER’s

Education & Research

• Continuing Education for EMTs and Paramedics– On-line, classroom, and face-to-face

teaching

• Teaching environment for physicians in training– ORMC and Florida Hospital resident

physician rotation in EMS– FSU Medical student electives in EMS and

EMS research

Lead to statewide requirement for use of a monitoring device to improve patient safety

Disaster Planning & Response

• Orange County Health & Medical disaster coordination (ESF-8)

• Maintain PSN registry• Over 3400 OC citizens registered

• Disaster Management Assistance Team

• Urban Area Security Initiative-Medical Lead

• Region 5 Domestic Security Taskforce

Other Activities

• EMS related COPCN review and submissions• EMS System enhancements through grant

opportunities– Over $300,000 for EMS enhancements annually

• Public health initiatives– Orange County Medical Clinic– AHA Certified Training Center

• Approximately 5000 certifications processed in ’07-’08

• Liaison with clinical and administrative hospital personnel

Summary

• The office provides Medical Direction and support to OCEMS System agencies

• Roles and responsibilities are diverse

• Positive trends in key clinical indicators

• Offload delays significantly improved

• EMS protocols updated Sept. 2008