Emergency Medical Services
The Department of Health is the lead agency for emergency medical services (EMS) in the commonwealth. The department’s Bureau of Emergency Medical Services is responsible for the statewide development and coordination of a comprehensive system to prevent and reduce premature death and disability. The bureau also interfaces with the State Health Improvement Plan (SHIP) and Healthy People 2020 objectives for the commonwealth.
Pennsylvania’s EMS system is defined by Act 37 of 2009. The state’s EMS system includes 15 Regional EMS Councils, the Statewide Advisory Council and the Pennsylvania Trauma Systems Foundation. Approximately 60,000 EMS personnel and more than 1,000 licensed ground and air ambulance services respond to over one million patients each year in Pennsylvania’s EMS delivery system.
RESOURCE MANAGEMENT - The Bureau licenses all ambulance services and credentials all prehospital providers in the commonwealth. Currently, almost 1,000 licensed ambulance services operate over 3,500 ambulance vehicles and 32 air ambulances. Personnel are certified as First Responders, Emergency Medical Technicians, EMT-Paramedics, Prehospital Registered Nurses and Health Professional Physicians. The Medical Command Facility Directors and Medical Command Physicians are recognized by the EMS Regional Councils and credentialed by the EMS office. Trauma care is provided by 27 facilities accredited by the Pennsylvania Trauma Systems Foundation (PTSF). The Bureau links with PA’s Poison Control Centers (located in Philadelphia and Pittsburgh) that provide advice and service to EMS personnel.
HUMAN RESOURCES AND EDUCATION - Accredited training institutes and accredited continuing education sponsors deliver training programs at 188 sites. Over 60 accredited training institutes provide educational programs leading to certification. All EMS training programs for certification must meet or exceed the U.S. Department of Transportation National Highway Traffic Safety Administration's National Standard Curriculum, be approved by Pennsylvania and comply with statutory and regulatory requirements.
TRANSPORTATION – Pennsylvania ambulance services operate as basic life support (BLS) or advanced life support (ALS). All licenses are issued for a three-year period. In 1994, the Department adopted a Quick Response Service (QRS) category for license. QRSs do not transport patients, but can arrive in shorter periods of time and begin care in locations that do not have nearby ambulance services available.
FACILITIES - The Department of Health licenses 234 facilities as acute care hospitals. Hospitals must be recognized as Medical Command Facilities (MCF) to provide on-line medical command to prehospital personnel. Over 150 hospitals are recognized as MCF. The Department of Health supports the Pennsylvania Poison Control System accessed by the National Poison Control Number 1-800-222-1222.
COMMUNICATIONS - The Bureau of EMS works with many partners to assure that a communications network exists that links patients, providers, public safety answering points (PSAPs) and receiving facilities. The Bureau approves the emergency medical dispatch protocol training programs used for dispatcher training.
PUBLIC INFORMATION, EDUCATION AND PREVENTION – The Bureau of EMS actively promotes Public Information, Education & Prevention activities. Examples are Trauma and Injury Prevention Seminar (TIPS) for EMS practitioners; Dare to Care Training (bystander care), a collaborative program with Pennsylvania’s Department of Transportation, EMSC Child Care Consultant/Trainer Course to train prehospital personnel to work with day care centers in prevention; EMS Week activities every year the third week in May; collaboration with PA’s Poison Control Centers and the Save A Life Foundation. The Bureau of EMS serves on the champion management team for Pennsylvania's Risk Watch Program.
MEDICAL DIRECTION - EMS is a medical care system that involves medical practice as delegated by physicians to non-physician providers who manage patient care outside the traditional confines of an office or hospital. All prehospital ALS practitioners must receive medical command authorization from their ALS service medical director before they are permitted to practice. All on-line command is provided through medical command facilities and supervised by a medical command facility director. Each Regional EMS Council has a regional medical director and a regional medical advisory committee. The role and responsibilities of the Regional EMS Council medical directors and the Commonwealth EMS medical director are articulated in the EMS regulations.
EVALUATION - A uniform statewide out-of-hospital data collection system captures the minimum data necessary to measure compliance with standards. The Bureau of EMS monitors ambulance services’ response patterns, response time, and staffing patterns compared to the regulatory requirements. Highway crash data from the Pennsylvania Department of Transportation and hospital inpatient discharge data from the Pennsylvania Health Care Cost Containment Council (HC4) is linked with EMS data to produce a comprehensive database. This database supports Pennsylvania’s participation in a national project know as CODES (Crash Outcome Data Evaluation System) that focuses on outcomes of motor vehicle crashes.
SUMMARY – The Bureau of EMS develops policy, assesses program operations and provides quality assurance oversight of the EMS system components. It establishes statewide priorities for funding and distributes EMS funds to Regional Councils for system operation and funding of regional priorities. The Bureau promotes system improvements through special projects and research with academic partners; and partnerships with the Pennsylvania Emergency Health Systems Council, the Pennsylvania Trauma Foundation and the two poison control centers. The Office works closely with the State’s Department of Transportation on data analysis and accident prevention and response projects, and with the Pennsylvania Emergency Management Agency (PEMA) for emergency preparedness, planning, response and training as well as 911 initiatives.