Summary of EMR pilot at Prince George

1. Prince George Fire Rescue
EMR Trial
Prince George City Council
Presentation
June 11, 2012

2. Why EMR in Prince George?
• Broader scope of care
• Esp. analgesia, preparation for transport
• Unified “piece-meal” skills in one license
• Established practice – many EMRs
• Economical & long licensing & renewal
• Enabled and supported by leg’n & reg’n
• Achieved goals of Cameron Report &
Community Charter

3. Purpose of Trial
1. Can FFs accurately & safely deliver EMR-level
care?
2. Does FF EMR provide potential benefit to
patients without significant events?
3. Does FF EMR enhance teamwork among Fire
and BCAS Paramedics?

4. Results
Raw Data (entire trial period = 22 months)
• Medical Calls = 5870 (60%)
• Arrive >3 min before BCAS = 1413 (24%)
• Remain >5 min after BCAS = 3149 (54%)
• Cancel = 2110 (36%)

5. Results
Raw Data (cont’d)
• Glucometry = 309 Glucose = 23
• ASA = 17 Nitroglycerin = 6
• Entonox = 22 IV Maint. = 238
• Obst. Del. = 2 Transp. Prep = 20 +
• Complaints = 0 Adv. Events = 0

6. Discussion - Outcomes
1. Accurate delivery of protocols by FF EMRs?
• YES!
• Several hundred interventions with no adverse
events or “official” complaints
• No misapplication of Nitroglycerin, Aspirin,
Entonox
• Improved diabetic care

7. Discussion - Outcomes
2. “Potential” benefit to pts without adverse events?
• YES!
• Pain Relief / Aspirin / Nitroglycerin / Glucose
• Childbirths
• Transport Preparation
– Protect patients from elements
– “Zero scene time” for delayed ambulance response
– Only available conveyance to “cold zone”

8. Discussion - Outcomes
3. Enhanced teamwork?
• YES!
• 238 incidents of IV maintenance
• Avg. 13.6 min on scene with BCAS 56% of calls
• Anecdotal increase of interventions under BCAS
supervision, especially Advanced Paramedics
• Verbal testimonials from Paramedics

9. Discussion - Outcomes
4. Cost-effective?
• YES!
• Training & capital equipment needs addressed
within existing budget over 4 years; no ongoing
capital costs
• Incremental increase in consumables
• No additional cost for license maintenance
• $10/year/person for renewal

10. Moving Forward
Recommendations to EHSC
• Embrace and utilize available local Fire resources in
a coordinated & synergistic fashion, instead of
current “competitive” system
– Single ambulance unit response where local EMR
resources available
– Shared training and mentorship
– Consider integrated EMS/Fire dispatching
– Move to integrated electronic documentation

11. Conclusions
• With medical oversight, FFs can practice at
their license level safely & effectively
• Patients experience improved care
• Teamwork is enhanced
• Cost-effective
• Only treatment/evac/transport option for
challenging environments
• Could greatly ameliorate EMS system with
improved integration
• Time to move forward