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Emergency Medical Services Rotation For Residents

This rotation is designed to give the resident a basic familiarity of the pre-hospital environment in Albuquerque and Bernalillo County.
Time will be spent in the following activities:

  1. Learning about EMS through formal lectures and assigned reading
  2. Teaching emergency medicine to paramedic and EMT students
  3. Understanding EMS through in-the-field ride-alongs with local EMS services.
  4. Participating in EMS Fellow activities as scheduled during the rotation month

The rotation is coordinated by Paul Cheney, MD (clinical) and Marc-David Munk, MD (didactics) and is based out of the EMS Academy (EMSA), 2700 Yale Blvd SE. (505) 272-5757

During, or before the 1-month EMS rotation, each resident must complete the following requirements:

  • 1) Complete Field Experience/Ride-Alongs. Rideouts may be done prior to the rotation, but must be completed by the end of the rotation month.
  • 2) Complete a Dispatch Experience
  • 3) Attend 2 EMS Resident/ Fellow Didactic Sessions, held alternating Tuesdays at EMSA
  • 4) Complete assigned readings
  • 5)Supervise one paramedic student educational activity within the UNMH system.
  • 6)Assist with one skills competency lab rotation at EMSA, held most Wednesdays.
  • 7) Review one EMS case or one QA project
  • 8) Meet with Dr. Cheney and/or Dr. Harrell during the first week of the rotation.
  • 9) Complete the MCEP course by the completion of the rotation, at the latest.
  • 10) Attendance at required EMS meetings as listed.

Required Textbook: (May be signed out and borrowed for the month) Emergency Medical Services: Clinical Practice and Systems Oversight series published by NAEMSP.

We will use three volumes from this series:

  • 1- Clinical Aspects of Prehospital Medicine (CAPM)
  • 2- Evaluating and Improving Quality on EMS (EIQ)
  • 3- Medical Oversight of EMS (MOE)

Other resources can be found at the EMS Resident Rotation website: http://hsc.unm.edu/SOM/emsacad/EMSrotation.shtml

Field Experience/Ride-Alongs:

Required Reading:

  1. Bernalillo County EMS Protocols. Up to date protocols are on the rotation website.
  2. MOE Chapters 11, 12, 13, 14, 15, 16, 22

Each Resident must complete a minimum of 32 hours of field ride along experience. A certain proportion of that time is required with certain local services. The remainder may be fulfilled with additional time, either with the required services, or in combination with the optional services listed below. You should set up your ride along time well in advance, before the start of the rotation.

  1. Required Field Experience:
    NOTE: 12 hours of ride-alongs must be completed during the first 15 months of residency. After the 3rd month of 2nd year, the residents will be eligible for the MCEP class and examination—and 12 hours of ride-alongs are required.
    1. AFD: 8 hours. 8 hours with EMS Field Supervisor and/or medical director; or 4 hours with EMS Field Supervisor (QA Captain) and 4 hours at an AFD Station with an AFD rescue and/or pumper.
    2. AAS: 8 hours. As 3rd rider on the ambulance
    3. BCFD: 4 hours. Preferably with the EMS commander; alternatively, spend 4 hours with station #2 in the South Valley.
  2. Optional Field Experience:
    1. Rio Rancho Fire and Rescue
    2. Lifeguard Air (Requires completion of special training)
    3. PHI Air (Requires completion of special training)
    4. Selected Medicine Bow Events/State Fair Clinic
    5. Selected Urban Search and Rescue Drills/Exercises
    6. Selected DMAT Drills/Exercises

Contact information to make arrangements for ride-alongs:
Albuquerque Fire Department (AFD)
EMS Commander Jon Sigurdson jsigurdson@cabq.gov Contact him for ride-alongs and dispatch experience. Please contact him early in your rotation to assure scheduling. Commander Sigurdson will also coordinate your ride along with the QA captain, dispatch center, and fire station.

Albuquerque Ambulance Service (AAS)
Contact Drue Bralove: e-mail her at dbralove@phs.org . You will need to bring third rider application form (completed and approved), picture ID, and proof of medical insurance.

Bernalillo County Fire Department (BCFD)
EMS Deputy Chief Chris Petroff, cpetroff@bernco.gov

Rio Rancho Fire and Rescue
EMS Chief Paul Bearce, pbearce@ci.rio-rancho.nm.us
Darren Braude MD. dbraude@salud.unm.edu

Lifeguard Air Ambulance
George Kennedy, MD gkennedy@salud.unm.edu

PHI
Darryl Macias, MD dmacias@salud.unm.edu

Medicine Bow
Chris Wade EMT-P. cwade@salud.unm.edu

New Mexico Task Force One Urban Search and Rescue (NMTF-1 USAR)
Drew Harrell, MD. ajharrell@salud.unm.edu



Dispatch Experience:

Required Reading:

  1. Chapters 47, 48, 49, 50 MOE

EM residents are required to spend a minimum of 4 hours at the AFD Dispatch Center. This does not include the visit during intern orientation month. A certain portion of that time (approximately 1 hour) will be spent observing the dispatch quality assurance officer while he reviews dispatch tapes. Approximately 3 hours will be spent listening on headsets to dispatchers at work speaking with 911 callers, and interacting with dispatchers and dispatch supervisors.

Learning Objectives:

  • Understand how 911 system works in Albuquerque.
  • Understand how EMS dispatch is integrated into the 911 system.
  • Understand medical priority dispatch and how it is employed in Albuquerque. Understand how the dispatch center coordinates activities of the fire rescue response, the ambulance transport service, law enforcement, and with other surrounding EMS agencies.
  • Familiarize yourself with dispatch center quality assurance process.
  • Understand how dispatchers give emergency care instructions (e.g., CPR, childbirth, bleeding control, etc), over the phone to the lay public.

  1. Contact person is Commander Jon Sigurdson (See above). He will arrange your dispatch experience.
  2. Residents are encouraged (but not required) to visit the AAS dispatch center and Bernalillo County dispatch center. Brief visits may be incorporated into your ride along with those services.

EMS Education

Required Reading:

  1. MOE Chapters 1, 2, 3, 27, 28, 29

    • EM residents are required to give at least one paramedic student educational activity within the UNMH system. Contact Paramedic Program Manager Robert McDaniels at the EMS Academy to arrange your lecture well in advance.RMcDaniels@salud.unm.edu
    • EM residents are required to assist with ne paramedic skills competency lab, held most Wednesdays at the EMS Academy. Arrange this with Robert McDaniels at the EMS Academy. You may also choose to proctor one EMS400 (Advanced Assessment) class, held afternoons in the Spring semester.

Learning Objectives:

  1. To understand the initial training requirements and continuing educational requirements for the different levels of EMT.
  2. To have an appreciation of the breadth and depth of EMS training and how to teach at the appropriate level.
  3. To develop experience with classroom instruction and lecture delivery to an EMT audience.

Case Review or QA project:

Required Reading:

  1. EIQ Chapters 1 and 3

Each resident is required to participate in at least one case review or QA project.

QA Project:

This will occur in an individual or small group format with Dr. Cheney. Participation in several is encouraged, but not required. Sources for the cases may be literature, ride-alongs, MCEP recording, or other sources as available. You may then research the issue and re-assemble the EMS personnel for a de-briefing and educational session. During this month, one case will be researched and presented at resident conference or noon conference. This case should be discussed and approved by Dr. Cheney.

Or

EMS Quality Assurance Project:


EM residents nay choose to complete an EMS QA project. Should the scope of the project be sufficient, and after approval by Dr. Cheney and Dr. McLaughlin, this project may also provide sufficient credit for a research, community, or the Emergency Medicine quality improvement project. The project can take many forms, but in general, it should arise from an area of interest or question generated during your EMS activities. Examples of past projects include:

  1. Identifying a specific training need and developing a training module to address that need.
  2. Chart review to address specific questions; e.g., presenting rhythms in out of hospital cardiac arrest; Whether protocol was followed for certain interventions/interactions, e.g., refusal of treatment and transport; Whether spinal immobilization criteria were met in trauma patients not back-boarded.
  3. Chart review to identify adequate vs. inadequate documentation for specific problems.
  4. Policy and protocol review and active participation in developing new protocols or procedural policies.
  5. Etc.

Once you have identified an area of interest or have formulated an avenue of inquiry, you should approach one of the EMS faculty to oversee the project. Identification of the project should be made before the third year.

Meeting with Dr. Cheney:

During the first week of the rotation, you need to schedule a meeting with Paul Cheney to:

  1. Ensure that clinical and administrative rotations have been properly scheduled.
  2. Discuss general concepts regarding the role of a service medical director.

MCEP Course:

All residents are expected to complete their MCEP (medical control emergency physician) training and become authorized to act as an MCEP prior to January 1st of their second year. This will include attendance of the MCEP course, successful completion of the MCEP protocol test, and a final meeting to review the test and go over any unanswered questions. You must have completed at least 12 hours of your ride-along experience prior to taking the test. You will achieve competency with appropriate radio procedure and etiquette (UHF and 800 megahertz), as well as appropriate documentation of each call.

Required Reading:

  1. Albuquerque and Bernalillo County Protocols
  2. New Mexico State EMS Scope of Practice
  3. CAPM Chapters 42, 43, 45.

EMS Meetings:

Your attendance at certain EMS meetings is required. You are encouraged to participate in additional optional meetings.

Required:

  1. One service QA meeting
  2. One PAC (providers advisory committee) Mtg
  3. One MCB (medical control board) Mtg
  4. One EMS Authority Mtg

The EMS Calender of events can be found here

Optional Activities:

Many optional activities can be arranged for residents with a particular interest in EMS:

  1. Assistant medical director for an EMS service or agency
  2. Completion of the aero-medical course and performing flight medicine
  3. Membership on the DMAT team and participation in DMAT drills
  4. Membership on the USAR team. Contact Diane Rimple, MD
  5. EMS Research Project
  6. Tactical EMS (Special Operations Medical Support volume of the NAEMSP series). Contact the tactical EMS Medical Directors George Kennedy, MD or Justin Hazen, MD.
  7. Wilderness EMS and membership on search and rescue teams (MOE Chapter 19). Contact Jason Williams, EMSA.
  8. Special Event EMS. Contact Chris Wade.

EMS Rotation Sign Off Sheet