Pharmacy Resident Rotation

 

 

General Rotation Description:

 

Overview of Baltimore City Department Response Structure

The Baltimore City Fire Department currently operates 24 full time advanced life support (ALS) transport units. Rotations with front line BCFD medic units comprise the foundation of the UMMC EMS experience. These ALS ambulances are supplemented by several “peak load” medic units and roving EMS supervisor units. Designated, “critical alert” basic life support transport units further supplement the system  in the event of an unanticipated surge in 911 call volume. BCFD activates their “critical alert” protocol when all ambulances are either actively engaged in responses or otherwise out of service at a local hospitals  An ALS ambulance is staffed, at a minimum, by two crewmembers. Currently, BCFD provides cross-training to each member. In addition to education in basic fire suppression, at least one BCFD member assigned to an ambulance must be trained to the level of a Cardiac Rescue Technician (CRT) / Emergency Medical Technician-Intermediate. The state of Maryland currently recognizes two levels of prehospital ALS provider: the CRT or the paramedic. CRTs/Emergency Medical Technician- Intermediates complete a fire department training program that spans several months. CRTs learn advanced airway management, advanced assessment, and ALS pharmacology. The paramedic usually completes approximately 1000 hours of didactic instruction and a dedicated field internship. Maryland paramedics are all nationally registered. BCFD is a high volume, high acuity urban EMS service that responds to over 150,000 annual requests for service. The police department and the fire department currently answer 911 calls; requests for emergency medical assistance are then triaged to an Emergency Medical Dispatcher for any necessary pre-arrival care instructions.

 

EMS Operations and Safety

• Scrubs and or khakis/cargo pants are accepted attire. Bring an officially issued ID badge and a stethoscope to each EMS rotation. Closed toed shoes are mandatory for the EMS rotation.
• Introduce yourself to the crew (and have fun!)
• Always carry an extra pair of gloves on your person
• Familiarize yourself with the location of personal protective equipment on the ambulance
• Assist with patient assessment and treatment as directed by the ambulance crew
• Do not exit the ambulance until the crew instructs you to do so.
• Avoid exiting the ambulance from the patient compartment side door- exit through the rear.
• Bring some cash along for the ride- dinner at the firehouse is usually a bargain at $6.00/person!

 

Ride Alongs

Emergency medicine pharmacy residents will be assigned to a front line medic unit. You will accompany the BCFD crew members on 911 responses and observe EMS patient assessment and treatment techniques. The expressed goal of the ride along is to familiarize emergency medicine pharmacy residents with the challenges unique to the delivery of care in the prehospital environment.

Quality Assurance duties may also be included. Quality improvement is an integral part of emergency medicine practice and is a requirement under the Code of Maryland Regulations (COMAR). In addition to completing ride alongs, the resident will assist BCFD EMS supervisors with run report review. Types of high priority calls that benefit from audit include:

• Cardiac arrest
• Priority trauma patients
• Patient refusals
• Advanced airway procedure

Residents will review at least 5 provider reports. The on duty EMS officer will provide PGY-2s with a basic overview of the BCFD Quality Assurance process. Tours of the BCFD dispatch center and the BCFD Quality Assurance office are encouraged. 

Rotation Background

The Section of Prehospital and Disaster Medicine hosts a significant amount of information online. Pharmacy residents can review the various EMS operational and educational programs to learn more about the structure, function, and goals of prehospital care. Consult the Section calendar for a snapshot of ongoing activities. Pharmacy residents are welcome to attend any Protocol Review or relevant administrative meetings. 

 

Rotation Specifics

These vary by the rotation schedule created by the responsible EMS officer. Typical ride along shifts are 8 hours in length. A variety of morning, afternoon, and evening shifts will be included. Station locations and other helpful information are provided within the website. 

 

The preferred method of communication with the preceptor is via email

 

 

The resident will encounter many disease states in the prehospital setting and are encouraged to review EMS protocols and discuss these with their assigned EMS unit personel. Potential topics for discussion include asthma, cardiac arrest, trauma, overdose, altered mental status, myocardial infarction, acute ischemic stroke, and respiratory distress.

 

 

 

To familiarize yourself with the particulars of Maryland EMS, consider reviewing the following sites:
 

1. Maryland Institute for Emergency Medical Services (MIEMSS)
MIEMSS is the state agency tasked with administrative oversight of prehospital care. The state EMS office approves protocols, regulates licensure of EMS personnel, and informs the standards of prehospital practice. 

 

The Department's web page contains detailed information about the organization's structure, mission statement, and apparatus location. 

 

3. Baltimore City Fire Department (Unofficial) International Association of Firefighters / Station Location Page
Regularly updated page containing links to department fire station information and addresses