By any number of measures, the Howard County Department of Fire and Rescue Services is recognized throughout Maryland for its exceptional Emergency Medical Services (EMS) system. In addition to highly trained EMS providers, cutting edge equipment, integrated quality control, and highly engaged medical direction, our EMS system has more recently been recognized throughout the state (and, in some cases, throughout the country) as a progressive system that delivers EMS excellence.
In 2012, HCDFRS and the Resuscitation Academy offered the first Cardiac Arrest Resuscitation Experience Symposium (CARES) conference on the East Coast.The CARES conference is a two-day workshop aimed at improving survival of sudden cardiac arrest.This marked the first time the highly respected Resuscitation Academy faculty took their expertise “on the road” – bringing their time-tested strategies to others who are interested in improving survivability in their communities.
Maryland Resuscitation Academy
Expanding upon our initial work with the Resuscitation Academy, HCDFRS began hosting the Maryland Resuscitation Academy in 2013 as a means of sharing our experience and encouraging other communities to adopt international best practices to improve survivability in out-of-hospital cardiac arrests.Since 2013, HCDFRS has hosted the Maryland Resuscitation Academy at the PSTC a total of nine times.
Through our efforts to improve out-of-hospital cardiac arrest survivability, HCDFRS has been recognized by a number of different organizations, including:
Since the middle 1990s, HCDFRS has offered one of the region’s most expansive and comprehensive Citizen CPR programs.We remain committed to training all Howard County residents and employees how to respond in the event of Sudden Cardiac Arrest (SCA).With the recent adoption by the American Heart Association (AHA) of Hands-Only CPR, HCDFRS has expanded our program to teach CPR throughout the county.
In partnership with the Howard County Public School System, Howard County General Hospital, the Howard County Public Library System, and Howard Community College, HCDFRS purchased 50 manikins for the school system and provided “train-the-trainer” instruction for teachers who will then train students in Hands-Only CPR.This program has been incorporated into the curriculum, and all students receive Hands-Only CPR training in the 6th and 9th grades as a requirement for graduation.
Total Quality Management (TQM)
In an effort to improve patient outcomes and system performance, HCDFRS embraced Total Quality Management (TQM), a holistic approach of continuous improvement throughout the organization.The TQM program is designed to radically transform the organization through progressive changes in the attitudes, practices, structures, and systems.
Among several TQM projects, HCDFRS evaluated trauma scene times in 2000 in an attempt to reduce the time for trauma patients to receive definitive care.Additionally, HCDFRS used the principles of TQM to revise and refine the ALS precepting process in 2001.
Driving Change Throughout Maryland – and the United States
As our EMS program evolved over time, HCDFRS began seen throughout Maryland and, in some cases, the United States as a well-run system with a robust quality assurance program and exceptionally skilled providers.These factors allowed HCDFRS to drive change through the implementation of new programs.
As one example, HCDFRS was one of two EMS systems in Maryland (after the Maryland State Police) to pilot the Rapid Sequence Intubation (RSI) program.RSI is an advanced airway management procedure used to intubate patients under general anesthesia who are at high risk of pulmonary aspiration.The State EMS Medical Director chose HCDFRS for this pilot as a result of our exceptional quality assurance program and the highly effective oversight of our system by our medical director.
In 2011, HCDFRS was the first EMS jurisdiction in Maryland to implement video laryngoscopy using the GlideScope Ranger video laryngoscope.The device has dramatically improved intubation success by displaying a clear, real-time view of the airway during endotracheal tube placement.Prior to the implementation of the program, intubation success with traditional laryngoscopy was 64% in the County.After GlideScope training and deployment, intubation success improved dramatically to 98% - a difference that is both statistically and clinically significant.Since the implementation of this program, HCDFRS has published a number of abstracts detailing our success with this device.
Over the years, HCDFRS has worked with MIEMSS to improve the Maryland Medical Protocols for EMS Providers.The following statewide protocol changes were instituted as a result of our direct involvement:
None of these innovations would be possible without the highly talented EMS providers who provide exceptional emergency medical services throughout the county.Several HCDFRS EMS providers were featured in the textbook, Avoiding Common Prehospital Errors, in 2013.Contributors included: