Dublin Fire Brigade Paramedics- Insight into
a Pre-hospital Emergency Care Service
• Brief history of DFB - Oldest uniform body in the state Since 1862
(Oldest Ambulance service provider in Ireland) Since 1898
• Benefits of combined Fire/Emergency Medical service (EMS) for
patients
• Our areas of operations
• Statistics/ type and numbers of calls
• Information on range of pre-hospital treatment protocols using
generic case details
• Some footage with real on scene experiences with DFB staff.
Dublin Fire Brigade ParamedicsInsight into a Pre-hospital
Emergency Care Service
D/O Martin O’Reilly
S/O Paul Lambert
Dublin Fire and Ambulance Service
• Oldest uniform body in the
state Since 1862
• Oldest Ambulance service in
Ireland - 1898
DFB-RCSI Training Institute
• Educational Partnership with
RCSI
2011
• PHECC accredited
– Institution
– Programmes
– Tutors
• 2011 Education & Training
Standards
• Cardiac First Response to
Paramedic
Practitioner Level required for
Emergency Ambulance
Paramedic
2 year diploma program
Advanced Paramedic
2 year Graduate
Diploma
Population
served 1.2
million
464,749
Households
Provide a fully integrated
Fire based Ambulance and
EMS service
In 2011 we responded to
90,000 Ambulance/EMS
calls
72,000 Ambulance/EMS
incidents
93,000 Ambulance/EMS
mobilisations
12,000 Paramedic Fire
Appliance responses
Eastern Regional Control Centre
• Receipt of 999/112 calls for assistance
– Determine the location and nature of the emergency
– Determine the priority
– Pre-arrival instructions
• Provide an appropriate Response
– The “Right” response for the patient ?
– Nearest appropriate resource
Benefits of combined Fire/Emergency
Medical service (EMS) for patients
• Strategically located- rapid response
• 24/7 Availability of ambulance resources
• Resources reduce time on scene
• Equipment available - early Extrication
• Enhances safety on scene
• Highline Rescues
from tower cranes
• Immediate Medical
assessment and
treatment
Swift Water Rescue
• SRT technicians
• Hypothermia
• Submersion Incidents
Road Traffic Collisions
Reduce on scene time
• Spinal Immobilisation/
Patient handling
• Rapid Extrication
• Safety/Fend off
• Fire Risk
Medical
• Basic Life support
• Advanced Life support
• Acute coronary
syndromes
• Glycaemic
Emergencies
• Seizures
• Inadequate
Respirations
• Stroke
Medical
•
•
•
•
Septic shock
Poisons/ OD
Hypothermia
Altered Level of
consciousness
Trauma
•
•
•
•
•
•
External Haemorrhage
Shock-Blood loss
Spinal
Burns
Limb Fractures
Crush injury
• Head Injury
• Traumatic Cardiac
Arrest
Intubation
Vascular Access
DFB-RCSI Training Institute
Oxygen (INH)
Nitrous Oxide (INH)
Salbutamol (INH)
Aspirin (PO)
GTN (SL)
Glucose Gel (BU)
Glucagon (IM)
Epinephrine 1:1000 (IM)
Naloxone (IM)
Paracetamol (PO)
Clopidogrel (PO)
•
•
•
•
•
•
Morphine
Epinephrine 1:10 000
Amiodarone
Benzopenecillin
Lasix
Atropine
Obstetric Emergencies
• Neo natal resus
• Haemorrhage in
pregnancy
• Breech birth
• Umbilical cord
complications
The Right Response
• Immediately Life threatening incidents
• The nature of these incidents require a
rapid response and more responders on
scene
– Paramedic Fire Appliance
– Paramedic Ambulance
– Advanced Paramedic
Fire Appliance
Paramedics
60%
Ambulance
Paramedics
36%
Arrive together
4%
Mater Hospital
Out of hospital
cardiac Arrest
study
2003-2008
Mater Study
•
Improvements in the pre hospital care
management of cardiac arrests over the period
of the study where;
–
–
–
DFB fire appliance Paramedic equipped with
Defibrillators and life saving medications
ERCC began providing telephone assisted CPR
Advanced Paramedics provide pre hospital
Advanced Life Support on Fire appliances and
Ambulances
Mater Study
Conclusions:
• The improved quality of Emergency Pre
Hospital Care has impacted on survival
from Out Of Hospital Cardiac Arrest,
particularly from Ventricular Fibrillation
Video of Cardiac Arrest
Thank you for your attention !
Questions ????