RESIDENT ROTATION IN EMERGENCY MEDICAL SERVICES
The resident rotation provides the emergency medicine resident with a graduated, longitudinal exposure to out of hospital operations. The bulk of the rotation takes place aboard first line, advanced life support transport units with the Baltimore City Fire Department. Residents ride along with first responding "medic" crews and EMS district officers.
PGY-1 EMS ROTATION
The intern EMS experience consists of "ride along" shifts integrated into the clinical schedule. On the "EMS day," interns will report to a designated fire station and climb aboard one of the city's full time ALS transport units. Interns will gain experience with the assessment, treatment, transport, and triage of undifferentiated patients encountered in the prehospital setting. Interns will perfom clinical skills under the supervision of licensed paramedic personnel. Selected didatic readings which cover the history and scope of emergency medical services will complement the rotation.
-Overview of Maryland Emergency Medical Services (Please email Dr. Lawner for the link to the audio-enabled powerpoint)
-Book chapter: EMS System Design
-Book chapter: EMS Personnel
PGY-2 EMS ROTATION
Residents will continue riding along with ALS transport units. In addition, resident physicians will have the opportunity to shadow an EMS district officer. Residents are encouraged to broaden their exposure to EMS and can take advantage of "fly-along" shifts with the Maryland State Police. Residents are commonly assigned a dispatch observation shift at Maryland Instiute for Emergency Medical Services Systems (MIEMSS). Experiences are also available in other EMS jurisdictions, including Baltimore and Montgomery Counties. Finally, residents complete the MIEMSS-sanctioned "base station course" so that they are formally credentialed to provide on-line medical direction.
PGY-2 residents are encouraged to complete more in-depth readings in Disaster Preparedness and Incident Command. FEMA courses and a basic overview of the existing triage algoithm are found on website's "disaster medicine" tab. The importance of a working knowledge of emergency preparedness and response has been highlighted by recent experience with the SARS-CoV pandemic. Emergency medicine physicians are positioned on the front lines of health care and must be capable of interfacing with aspects of the National Incident Management System.
PGY-2 residents should complete the following items/readings:
1) FEMA Incident Command Courses
2) Overview of Triage and "SALT" Mass Casualty Triage
-The section's webpage contains a basic description of the triage process in addition to MIEMSS specific information.
3) Selected Emergency Management and Disaster Didactics
-Residents are encouraged to complete assigned readings in mass casaulty response and emergency management.
-Book chapters: Disaster Management and Mass Gathering Medical Care
PGY-3 EMS ROTATION
Residents eager for a more immersive experience in emergency medical services can partner with local medical directors. The PGY-3 EMS experience is an optional, mentored elective that exposes resident physicians to the challenges of operational medical direction. Additional experience in on-scene supervision, quality assurance, program management, and EMS education is offered. The rotation is tailored to the indivdual resident's interest. Examples of senior EMS electives include:
1) Operational EMS program management
2) Tactical EMS program supprot
3) Administrative EMS interface
4) Mass gathering EMS and emergency public health
5) Educational EMS program support