Dublin Fire Brigade Paramedics- Insight into a Pre-hospital Emergency Care Service

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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.

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Dublin Fire Brigade Paramedics- Insight into a
Pre-hospital Emergency Care Service

• D/O Martin OReilly
• S/O Paul Lambert

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Dublin Fire and Ambulance Service

• Oldest uniform body in the state Since 1862
• Oldest Ambulance service in Ireland - 1898

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DFB-RCSI Training Institute

• Educational Partnership with RCSI
• PHECC accredited
• Institution
• Programmes
• Tutors
• 2011 Education Training Standards
• Cardiac First Response to Paramedic

2011
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Practitioner Level required for Emergency
Ambulance

• Paramedic
• 2 year diploma program
• Advanced Paramedic
• 2 year Graduate Diploma

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• Population served 1.2 million
• 464,749 Households

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• 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

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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

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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

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• Highline Rescuesfrom tower cranes
• Immediate Medicalassessment and treatment

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Swift Water Rescue

• SRT technicians

• Hypothermia
• Submersion Incidents

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Road Traffic Collisions

• Reduce on scene time

• Spinal Immobilisation/Patient handling
• Rapid Extrication
• Safety/Fend off
• Fire Risk

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Medical

• Basic Life support
• Advanced Life support
• Acute coronary syndromes
• Glycaemic Emergencies
• Seizures
• Inadequate Respirations
• Stroke

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Medical

• Septic shock
• Poisons/ OD
• Hypothermia
• Altered Level of consciousness

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Trauma

• External Haemorrhage
• Shock-Blood loss
• Spinal
• Burns
• Limb Fractures
• Crush injury

• Head Injury
• Traumatic Cardiac Arrest

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Intubation
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Vascular Access
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DFB-RCSI Training Institute

• Morphine
• Epinephrine 110 000
• Amiodarone
• Benzopenecillin
• Lasix
• Atropine

Oxygen (INH) Nitrous Oxide (INH) Salbutamol
(INH) Aspirin (PO) GTN (SL) Glucose Gel (BU)
Glucagon (IM) Epinephrine 11000 (IM) Naloxone
(IM) Paracetamol (PO) Clopidogrel (PO)
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Obstetric Emergencies

• Neo natal resus
• Haemorrhage in pregnancy
• Breech birth
• Umbilical cord complications

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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

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• Fire Appliance Paramedics
• 60
• Ambulance Paramedics
• 36
• Arrive together
• 4

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• Mater Hospital
• Out of hospital cardiac Arrest study
• 2003-2008

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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

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Mater Study

• Conclusions
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• The improved quality of Emergency Pre Hospital
  Care has impacted on survival from Out Of
  Hospital Cardiac Arrest, particularly from
  Ventricular Fibrillation

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• Video of Cardiac Arrest

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Thank you for your attention !

• Questions ????