1. Orange County EMS Office of the Medical Director George A. Ralls MD Medical Director Orange County EMS System

2. Objectives • Describe roles within the office • Explain the primary scope of activities • Provide an update on OCEMS System operations

3. Orange County Fire Rescue • Orlando Fire Department • Reedy Creek Emergency Services • Rural-Metro Ambulance • Health Central Ambulance • Apopka Fire Department • Winter Garden Fire Department • Ocoee Fire Department • GOAA

4. The Orange County EMS System • Approximately 2000 EMT’s and Paramedics • 200,000 EMS calls yearly • 95,000 transports

5. Office of the Medical Director • A division of the Orange County Health & Family Services Department • Primary mission • Provide Medical Direction (per FAC 64-E) for all agencies participating in the OC EMS System • Create a high level standard of care throughout Orange County

7. Medical Direction

8. Direct Medical Oversight

9. On-Line Medical Control

10. Orange County EMS System Medical Treatment Protocols Indirect Medical Oversight • Evidence Based • Updated version in effect Sept. 1, 2008

11. Quality Management

13. 06-07 Cardiac Arrest Summary

14. April 2008 average offload time 8 minutes in focused study at four busiest ER’s

15. Education & Research

16. Continuing Education for EMTs and Paramedics • On-line, classroom, and face-to-face teaching • Teaching environment for physicians in training • ORMC and Florida Hospital resident physician rotation in EMS • FSU Medical student electives in EMS and EMS research

17. Lead to statewide requirement for use of a monitoring device to improve patient safety

19. Disaster Planning & Response

20. Orange County Health & Medical disaster coordination (ESF-8) • Maintain PSN registry • Over 3400 OC citizens registered • Disaster Management Assistance Team • Urban Area Security Initiative-Medical Lead • Region 5 Domestic Security Taskforce

22. Other Activities • EMS related COPCN review and submissions • EMS System enhancements through grant opportunities • Over $300,000 for EMS enhancements annually • Public health initiatives • Orange County Medical Clinic • AHA Certified Training Center • Approximately 5000 certifications processed in ’07-’08 • Liaison with clinical and administrative hospital personnel

23. Summary • The office provides Medical Direction and support to OCEMS System agencies • Roles and responsibilities are diverse • Positive trends in key clinical indicators • Offload delays significantly improved • EMS protocols updated Sept. 2008