Hamilton County EMS

The fellow’s primary ground EMS experience will be with HCEMS, which is a third-service, municipal EMS service providing pre-hospital care to the Chattanooga area. Hamilton County is a large county and provides a good mixture of EMS styles, mostly urban and suburban, though some areas in the northern most portion of the county are about a 45 minute drive from downtown. HCEMS currently staffs 16 ALS ambulances, generally staffed with one paramedic and one EMT. The service runs about 53,000 calls a year.

Orientation

Orientation to HCEMS will vary a bit from fellow to fellow depending on his/her degree of prior EMS experience. Those who have experience working on an ambulance as an EMT or paramedic won’t need much more than a few rides around the area with a supervisor or EMS physician in order to learn the area and ensure we’re comfortable with your driving habits. Those with minimal EMS experience will need a bit more introduction to the system, including observation rides with on-duty crews. In either case, an Emergency Vehicle Operator Course (EVOC) will be completed as well.

Following Orientation

The fellow will have access to an SUV response vehicle with lights and sirens that he/she may keep at home in order to allow quick response to incidents when available. We ask that the fellow dedicate at least four days a month (self scheduled) to ground EMS response. The fellow has access to the Computer Aided Dispatch (CAD) system and service radios, generally self dispatching to calls that are close enough to arrive in a timely manner and which meet educational goals.

Of note, the role and goals of an EMS physician in the field are generally those more akin to a supervisor or mentor. In most cases, you are not there to take over care from the medics. You are there to get immersive understanding of how the system works, provide feedback/real-time teaching, and yes, assist clinically as needed. On rare occasions, an EMS physician may be needed for truly advanced care needs, but these situations are rare. With that said, the ACGME does require experience with important, core EM procedures in the field, namely airway management and cardiac arrest management, and the fellow should look for opportunities to gain that experience.

Medical Direction

You will also assist Dr. Buchheit with the medical direction of the service, attending regular QA meetings and other administrative opportunities as they arise, as well as helping with education and training of EMS crews.