Heart Attack Counter Attack

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Emergency Medical Service (EMS)
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EMS delivers frontline 911 pre hospital care to
our community for

• sudden illness (heart attack, stroke, diabetic
  reactions, asthma etc.)
• traumatic injuries (motor vehicle collisions,
  burns, falls, sporting injuries etc.)

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EMS Staff includes

• 34 full time Paramedics 9 are Advanced Care
• (ACP) and 25 are Primary Care Paramedics
  (PCP)
• 37 part time Paramedics (8 ACP and 29 PCP)
• 3 Paramedic Supervisors
• (two operational and one for quality
  assurance and
• education)
• 1 Administration Assistant
• EMS Manager / Deputy Chief (Keith Kirkpatrick)
• EMS Director / Chief (David Guilbault)

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EMS Vehicles

• The vehicles we use are known as Emergency
  Response Units (ERU) and Ambulances. Those
  vehicles respond to medical emergencies in the
  community bringing Primary or Advanced Care
  Paramedics.

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EMS Stats

• CKL EMS responds to approximately 12,000 calls
  per year
• 4,200 life threatening emergencies (lights and
  siren response)
• 3,500 urgent requests for help
• 500 emergency transfers (moving patients from
  Ross Memorial hospital to specialized medical
  facilities out side of CKL)
• 300 non urgent transfers EMS rarely provides
  this service as it is now done by the Community
  Care non Urgent Transfer Service
• 120 emergency trips from the community airport to
  Ross Memorial Hospital and back to move
  critically ill patients for the air ambulances

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CKL EMS Stats (cont)

• 4000 standbys (moving ambulances and or
  emergency response units into geographical
  positions to cover areas of concern)
• The majority of the standbys are to cover
  our own communities in CKL. Other standbys are to
  provide Paramedics at incidents that support
  Police or Fire Services at scenes with a
  potential for people to be injured. We also
  provide EMS standbys for neighboring communities
  as requested and they cover for us in reciprocal
  agreements.
• When you see an EMS ambulance or response vehicle
  sitting on the side of the road, you will now
  know that they are providing standby coverage to
  ensure a quick EMS response for the specific area
  they are in.

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Modern EMSmore than a fast ride to the hospital
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• Kawartha Lakes EMS provides both Primary and
  Advance Care Paramedics
• The Primary Care Paramedics have medical
  delegation to perform,
• Basic Life Support (professional responder
  CPR, airway management, oxygen therapy, basic
  trauma life support), semi automatic
  defibrillation (for the management of sudden
  cardiac arrest), symptom relief medications (i.e.
  nitroglycerin, aspirin, glucagon, ventolin, and
  adrenalin) these medications are used for the
  management of heart attack, diabetic reactions,
  asthma and allergic reaction.
• Advance Care Paramedics are delegated to
  perform all of the procedures outlined for the
  primary level as well as, Advanced Life Support
  (advanced cardiac life support, advanced
  assessment and critical interventions) ,
  Intubation (placing a special tube directly into
  a persons windpipe), chest decompression
  (inserting a needle into a persons chest to re
  inflate a collapsed lung), intravenous (insertion
  of a needle into a vien), medications and fluids
  are put through the intravenous for numerous
  situations (cardiac arrest, heart attack,
  respiratory conditions, diabetes, seizure
  conditions, shock care for trauma and burns),
  electrical therapy (manual defibrillation,
  cardioversion and cardiac pacing).

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ornge (spelled correctly)

• Is the delivery of Critical Care Paramedics
  to our community through the ornge patient care
  system (ambulances, helicopters and planes). Most
  citizens understand ornge through the air
  ambulance they see landing at large motor vehicle
  collisions. These paramedics are very
  sophisticated and perform all the skill set of
  both the primary and advanced care providers as
  well as
• Critical surgical procedures, administration
  of intensive care medications, use of infusion
  pumps and intravenous drips, and administration
  of blood and blood products

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Todays Paramedic
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Today's Paramedic (cont)

• Today's Paramedic is a well trained
  emergency health care provider.
• Primary Care Paramedic certificate program is
  two years at community college (2000 hours)
  local colleges that offer this program are Sir
  Sandford Fleming, Durham, Centennial and Humber
  Colleges.
• Advanced Care Paramedic program is one
  additional year at a post
• certificate approved College (1000 hours)
  local colleges that offer
• this program are - Durham and Humber
  College.
• Critical Care Paramedic program is one more
  additional year by the
• medical director that oversees the ornge
  program in intensive care
• and flight medicine (1000 hours).

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Paramedics are a Community Life Line
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Paramedics are a community Life Line (cont)

• Paramedics provide
• Life saving care
• Compassion and empathy to those in need
• Comfort and pain management
• Public education in preparedness (safety, first
  aid, CPR and Public Access Defibrillation)

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Primary Zones
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Primary Zones (cont)

• We have paramedics stationed in three primary
  zones
• Lindsay - 89 St. David Street three 12
  hour day time ambulances (6 paramedics) and two
  12 hour night shift ambulances (4 paramedics).
• The third ambulance in Lindsay is moved to
  other areas of the community when the 911 call
  volume can be predicted to increase (i.e. Fenelon
  Falls area on summer weekends).
• Bobcaygeon 1 Duke Street - one ambulance
  24 hours per day (4 paramedics 2 for day shift
  and 2 for night shift).
• Fenelon Falls 1 Industrial Drive - one
  ambulance 24 hours per day (4 paramedics 2 for
  day shift and 2 for night shift).

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Secondary Zones

• Are areas in the community where we
  position EMS resources (response vehicles or
  ambulances) when we can predict response times
  may increase due to
• 911 call volume (i.e. summer weekends)
• Community events (i.e. parades, fairs and
  festivals)
• Severe weather or road closures
• The most common secondary zones are Oakwood,
  Manvers area, Omemee and Coboconk

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Community Involvement
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• EMS is a vital part of the community and our
  paramedics are involved in championing many
  important causes including
• Paramedics in The Park (annual event fundraising
  for various community charities)
• Heart and Stroke Foundation endeavors
  (fundraising, CPR education and safe
  defibrillation deployment)
• Community Care (providing ongoing support and
  patient transport expertise)
• Supporting the troops (pilgrimages to
  repatriation ceremonies, wearing red on Fridays)
• Participating in CKL Police initiatives (cops for
  cancer and the polar plunge)
• St. John ambulance (donation of ambulance and
  equipment)
• Support of the Food Source and A Place Called
  Home

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Community Education and Preparedness
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Start A Heart

• EMS is managing and working with community
  partners (i.e. Heart and Stroke, Ross Memorial
  Hospital, and the Fire Department) on an
  aggressive Public Access Defibrillation (PAD)
  program. This program is called Start a Heart.
  Today we have 60 PAD sites in the community and
  our paramedics have taught about 5,000 citizens
  over the past three years in CPR and the use of a
  public access defibrillator (PAD). We encourage
  groups who are hosting large public events to
  contact us so we can help make sure the event is
  safe by planning for medical emergencies before
  they happen. EMS has several loaner PAD machines
  for citizens to borrow for a nominal donation
  back into the maintenance of the Start-A-Heart
  Program.

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Heart Hero

• EMS Paramedics have developed a Heart Hero
  program designed to empower children to teach
  adults the live saving skill of CPR. This is
  another initiative where community donations are
  welcomed to empower our youth to truly be
  leaders!

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Teaching the Next Generation
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Cardiac Arrest Saves

• Pictured are cardiac arrest saves from 2008 and
  2009 in which Paramedics played a crucial role.
• Obviously Paramedics do a lot more than cardiac
  arrest management, however, these saves are the
  most dramatic of EMS calls.

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EMSs Recent Past
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EMSs Recent Past (cont)

• EMS became organized in Ontario about 40
  years ago and standardization of vehicles and
  equipment as well as basic life support education
  became important. The first Advanced Care
  Paramedic programs started with
• Toronto air ambulance (1977), land ambulances in
  Oshawa (1979), and then Toronto / Hamilton
  (1984)
• The first Primary Paramedic program was in
  Windsor in 1989 (defibrillation and symptom
  relief medications)
• CKL had its first EMS defibrillator program in
  1989 and Primary Care Paramedics by 1993. The
  first Advanced Care Paramedics hit the streets of
  Lindsay in 1997

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EMS and the Future

• EMS is now being revaluated as to its
  future and questions are being such as
• Can paramedics provide more care for patients in
  the home?
• Does more paramedic care result in shorter
  hospital stays?
• Can some patients be treated by a Paramedic and
  left in their home?
• Can we move patients directly from their homes or
  scenes to specialized hospitals (this is already
  occurring for stroke patients)?

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Historical EMS Data

• Historical data directs EMS in community
  preparedness and locating paramedics in areas
  where medical emergencies can be predicated. One
  example of this is placing Paramedics on bikes so
  they can reach people in congested areas (i.e.
  parades, fairs, festivals etc.).
• Research statistics predict an increased need
  for Paramedics when 1,000 or more people, with an
  average age of 50, gather. Our bike paramedics
  have treated minor and serious patients at every
  event that have been deployed to in 2009.

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The End