May/June 2014 Emergency Medical Services

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Emergency Medical Care Medical Organizations Services Emergency Medical Services (Continued from page 15)

directors. The Medical Director Standing Advisory Committee (MDSAC) is a component of the MN EMS Regulatory Board designed to maintain physician oversight of the medical aspects of EMS. The MDSAC is composed of EMS physicians from both rural and metro regions and includes representatives from family medicine, emergency medicine and pediatrics. Rural EMS medical directors were instrumental in the inception of our state trauma system through their development of trauma triage and interfacility transport guidelines. Our helicopter EMS systems decrease the time for patients with time sensitive conditions to reach definitive care. Myocardial infarction patients in Minnesota benefit from innovative prehospital protocols which allow a paramedic to activate the coronary catheterization lab at Level 1 Heart Hospitals based on the paramedic’s identification of STEMI on

Active physician involvement in prehospital medicine is streamlining medical care and facilitating the transition from prehospital to in-hospital patient care.

a 12 lead EKG. This has led to decreased door to balloon times which have been shown to improve outcomes for patients. Active physician involvement in prehospital medicine is streamlining medical care and facilitating the transition from prehospital to in-hospital patient care. Cardiac arrest is an example of an acute pathology which is primarily encountered outside of a hospital and initially treated by EMS providers. Traditionally cardiac arrest has had a dismal prognosis; however, with advances in prehospital cardiac

arrest management, return of spontaneous circulation is becoming more common. The establishment of the Minnesota Resuscitation Consortium (MRC) at the University of Minnesota brings together EMS medical directors, emergency physicians and cardiologists to connect prehospital and in-hospital initiatives to improve survival from out-of-hospital cardiac arrests. This multidisciplinary approach solidifies the chain of survival at the physician level and has led to several prospective projects and peer reviewed publications. From public access defibrillation and bystander CPR to state of the art prehospital interventions such as active compression-decompression CPR with intrathoracic pressure regulation to hospital-based therapies including early coronary angiography and post resuscitation therapeutic hypothermia, the MRC is demonstrating the benefits of active, engaged and sub-specialized EMS physicians. Aaron Burnett, M.D., Assistant Medical Director, Regions Hospital EMS, Assistant Professor, Department of Emergency Medicine, University of Minnesota. Dr. Burnett can be reached at: Aaron.M.Burnett@ HealthPartners.Com. (Endnotes) 1. Emergency Medical Services: At the Crossroads. Recommendation 4.4. Washington, DC: The National Academies Press, 2007. 2. Mark T. Steele, M.D. President, American Board of Emergency Medicine. https://www.abem. org/public/subspecialty-certification/emergency-medical-services/ems-announcement. Accessed February 19, 2014. 3. Perina, Debra G., et al. “The core content of emergency medical services medicine.” Prehospital Emergency Care 16.3 (2012): 309-322. 4. Res Q Trial.


May/June 2014


The Journal of the Twin Cities Medical Society