Medical Oversight for Wilderness EMS Will Smith, MD, EMT-P, FAWM Wilderness and Emergency Medicine Consulting, LLC 2012 NAEMSP Annual Conference Tucson, AZ www.wildernessdoc.com Take Home Points Do what is right for the patient! Medical Directors should practice and know what their field providers do! Avoid applying ‘front country’ EMS protocols to the wilderness – They need special attention! Objectives Discuss EMS medical oversight and issues for Wilderness EMS Provide overview of Wilderness EMS protocols and groups
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Medical Oversight forWilderness EMS
Will Smith, MD, EMT-P, FAWMWilderness and Emergency Medicine Consulting, LLC
2012 NAEMSP Annual ConferenceTucson, AZ
www.wildernessdoc.com
Take Home Points
Do what is right for the patient!
Medical Directors should practice and know what their field providers do!
Avoid applying ‘front country’ EMS protocols to the wilderness – They need special attention!
Objectives
Discuss EMS medical oversight and issues for Wilderness EMS
Provide overview of Wilderness EMS protocols and groups
Experience
NREMT-ParamedicStarted as EMT-Basic in 1990
University of Wyoming – B.S. Molecular Bio/Pre-Med
National Ski Patrol (WEC/OEC Instructor)
University of Washington School of Medicine – M.D.
Medical College of Wisconsin, Milwaukee, WI Emergency Medicine Residency
ExperienceNational Park Service
Medical Advisor, Grand Teton National Park, SEAZ Parks
National Park Service EMS Advisory Council
Medical Director, Teton County, WY Search and Rescue
Medical Director, Jackson Hole Fire/EMS – Jackson, WY
Emergency Department Physician - Jackson, WY
Experience
Member, American Heart Association First Aid Subcommittee - 2010 Guidelines
Member, International First Aid Science Advisory BoardNAEMSP Representative
Military Experience – MAJ, Medical Corps, US Army Reserve
NAEMSP/NASEMSO Operational EMS Position StatementFunction within and not outside of mainstream health care systemHave a qualified medical director (Medical Oversight)Established standards are metProviders should function within defined scope of practice
Wilderness Medicine
Emergency Medical Services
Search and Rescue
www.naemsp.org/position.htmlMarch2010
Medical Oversight
DirectOn-scene
On-line (radio or other communication)
Medical Oversight
IndirectProtocols
QA review
Teaching
Participant Screening
Other Wilderness Specific Items
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Article 4 - Treatment Protocols
Abdominal Pain >
Acute Coronary Syndromes >
Airway Management >
Allergic Reaction >
Altered LOC >
Altitude Illness >
Burns- Chemical >
Burns- Electrical >
Burns- Thermal >
CHF >
Diabetic Emergencies >
Fractures >
Head Injury >
Hypertensive Emergency >
OB Emergencies >
Patient Assessment >
Respiratory Distress >
Seizure >
Severed Body Parts >
Smoke Inhalation- CO Poisoning >
Stoke / CVA >
Syncope >
Toxic Ingestion- Poisoning >
Traumatic Arrest >
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