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INTRODUCTION

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Although physicians are not the primary providers of prehospital care in the United States, field response capability is still considered an essential component of a modern EMS system. As discussed in Chapter 29, the EMS physician must be prepared to go to the scene to ensure the quality of the care in the system through direct observation, provide emergency response for mass casualty situations, and provide advanced level care in some infrequent circumstances. In order to perform these various field activities, the EMS physician must first be able to respond to the field. Several methods of transporting the EMS physician to a scene are available. The EMS physician could drive their private vehicle to a scene, or a field supervisor vehicle or law enforcement vehicle could be used to pick up and deliver the EMS physician to a scene. Unfortunately these solutions achieve the task of delivering the EMS physician but do not simultaneously deliver the equipment needed by the EMS physician to perform their mission. A more efficient and effective deployment of the EMS physician can be accomplished by providing the EMS physician with a specially designed, equipped, and dedicated EMS physician response vehicle (PRV). Various EMS systems have implemented such vehicles into their fleet and include the EMS PRV as a deployable asset in many circumstances. The ideal EMS PRV will allow for the safe, rapid, and efficient delivery of the EMS physician and associated specialty equipment to the scene. The development of such an asset must be a careful and thoughtful undertaking, as there are many factors that must be considered as the vehicle is designed, built, and equipped in order to create an end product that meets the needs of the EMS physician and the EMS system.

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OBJECTIVES

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  • Describe the types of physician field response (primary, secondary, and tertiary).

  • Describe different types of physician teams and task forces.

  • Describe minimum training standards for safe and effective physician field response.

  • Give examples of physician field response dispatch criteria.

  • Discuss types of advanced interventions provided by EMS physicians in the field.

  • Describe the ideal design qualities of an EMS physician response vehicle.

  • Discuss specific design details, costs, and benefits.

  • Discuss interoperability concerns for EMS physicians relating to ­communications and radio equipment.

  • Describe EMS equipment appropriate for EMS physician response, and discuss when it is appropriate to exclude items known to be ­carried by local EMS/fire agency vehicles.

  • Describe equipment that may be needed to perform EMS physician level interventions.

  • Describe the proper storage of controlled substances and other drugs in the vehicle.

  • Discuss mobility concerns and limitations to standard EMS bags.

  • Describe appropriate PPE levels for various types of operations.

  • Discuss the design and deployment of special operations trailers for prolonged events.

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PHYSICIAN FIELD RESPONSE

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When considering field response it is appropriate to categorize the types of responses and to use this organizational scheme when ...

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