Louisville Metro EMS
Encyclopedia
Louisville Metro Emergency Medical Services (abbreviated as LMEMS and known locally within as simply Metro) is the primary provider of pre-hospital life support and emergency care within Louisville
-Jefferson County
, Kentucky. LMEMS is a governmental department, separate from, but equal to, the police and fire services. LMEMS averages 100,000 calls for service, both emergency and non-emergency, each year.
The current Chief Executive Officer is Dr. Neal Richmond, MD and the Chief of Service is Colonel Craig Rodgers, EMT-P.
Louisville Metro EMS has its history rooted in the two major EMS providers that served the area since the earliest days of pre-hospital care of the 1970s.
Police officers transferred the severely ill or injured to hospitals in Louisville and Jefferson County until 1972 when the Jefferson County Medical Society created the first EMS service. The first licensed paramedics in Kentucky graduated in 1975 from a pilot program at Louisville General Hospital, now University of Louisville Hospital. Included were fifteen City of Louisville EMS paramedics and one Jefferson County Police officer paramedic.
(LEMS) was created in 1974 The program was operated by the city and was the first EMS service provided in Louisville. In 1995 the city transferred EMS duties to the Louisville Division of Fire
in an effort to streamline emergency services in the city. The EMS bureau of the Louisville Division of Fire utilized firefighter
s cross-trained as EMTs and paramedics as well as non-firefighting personnel.
had is beginnings in the now-defunct Jefferson County Police Department. Beginning with police officer
paramedics in 1975 and eventually evolving into non-law enforcement personnel assigned only to providing emergency medical care, the Emergency Medical Squad of the county police became Jefferson County Emergency Medical Services (JCEMS) in 1987.
JCEMS provided emergency medical services to all areas within Jefferson County outside of the cities of Louisville, Anchorage and Jeffersontown. JCEMS always fielded ambulances containing at least one paramedic. The JCEMS Disaster Response Team (DRT) responded to all hazardous materials and technical rescue incidents within Jefferson County outside of the City of Louisville. After the creation of LMEMS all hazardous materials responsibilities, along with specialized vehicles and equipment, were transferred to the Jefferson County Fire Service
.
to provide EMS coverage to the entire city-county, the subordination of EMS duties to another "parent" organization such as the police or health departments, or the creation of a stand alone department. After much debate the mayor's office chose to create a new department and Louisville Metro EMS was created on February 5, 2005 by the combining the Louisville Fire Department EMS Bureau and Jefferson County Emergency Medical Services.
(BLS) and Advanced Life Support
(ALS) and is accessible through the 911
system. LMEMS employs an almost entirely full-time workforce of Kentucky-licensed Emergency Medical Technician
s (EMTs) and paramedic
s (also known as EMT-Ps). Most employees maintain optional certification by the National Registry of EMTs, a national EMS accreditation association.
According to LMEMS official web page
LMEMS provides transportation to the emergency department of the chosen hospital. LMEMS does not return patients home nor does it offer transportation to immediate care centers or hospitals without emergency departments. All scheduled ambulance service and inter-facility transports are handled by private ambulance companies retained by the patient. Only under exceptional circumstances will LMEMS provide hospital-to-hospital transfers. These types of transfers are at the request of an emergency department physician wishing a very high level of care and rapid transportation of patients with time-sensitive or critical conditions to more capable facilities (i.e. major trauma, imminent child birth). Most of the time the crew is coincidentally at the hospital for other matters when the request is made for the transfer.
(referred to as technicians or EMTs) and EMT-Paramedics
(usually just called paramedics) have drastically different scopes of practice but all exist to provide care and transportation to the sick and injured. A technician specializes in ambulance operation and basic care as well assistance to advanced providers. Most technicians have an initial six months of training. Paramedic
s use complex diagnostics, perform medical procedures, and administer medications and additional advanced care that would otherwise only be provided by an emergency physician
. Paramedic
s in Kentucky
generally have three years of initial training including at least 750 hours of internship and clinical instruction in addition to about 1200 hours of formal, classroom instruction. An increasing number of paramedic
s possess at least an associates degree, many have bachelor's degrees.
Technicians
are trained to operate independent of a paramedic and when such situations arise they are capable of caring for and transporting any medical emergency to the hospital
on their own.
Although the Kentucky Board of Emergency Medical Services allows for the use of EMT-Intermediate providers, LMEMS does not utilize this mid-level of care provider.
(CEO) and the official head of the service (much like a commissioner). Under the CEO is the top uniformed officer holding the title Chief of Operations and is the accepted chief of department. Traditionally, in the area, the chief of the emergency medical services is not addressed as "chief" but as "colonel
" and styled "The Colonel" as the person in this position wears the silver eagle of a US army colonel. Under the Chief of Operations are two Assistant Chiefs of Operations wearing the silver oak leaf of a lieutenant colonel
. A group of operations officers, wearing the gold oak leaf of a major
, oversee day-to-day operations including scheduling and may be drawn upon to provide additional manpower. Other personnel that act in positions of responsibility wear varying grade insignia in addition to that of major, such as lieutenant
and sergeant
. The rank of captain is no longer used, no one having held the rank since 2008. Field training personnel (FTO) exist, to train new paramedics and EMTs. Their authority primarily extends to clinical and operational competence.
The collar insignia of LMEMS is as follows:
" and all employees beneath the rank of lieutenant colonel are required to become members of the International Brotherhood of Teamsters
(IBT) Local lodge #783. Job assignments, shifts, and vacations are filled using a system based on seniority. However, promotions within the service have been based on appointment by command, an employee's tenure may be taken into account to determine suitability. Any employees' first six months of service with LMEMS is considered a probationary period where the new hire is subject to dismissal without union representation.
Several separate bargaining contracts exist within the service. Street operations personnel, including the majority of EMTs and paramedics, are covered by one contract. Operations officers (majors) are covered by another. Ancillary services personnel in supply and billing have their own contract suited to their unique duties.
A chief and assistant chief steward are elected to oversee union matters for the entire service. Additional elected shop stewards are on duty at most times to assist members with concerns on a day-to-day basis.
s and fire protection districts in the metro area in a cooperative effort to further reduce the amount of time from when a person calls for assistance to the time assistance arrives. The American Heart Association
recommends early defibrillation
to be beneficial to an individual suffering cardiac arrest
and as such most fire apparatus carry automated external defibrillator
s (AEDs) with trained EMTs
to begin stabilizing the patient prior to EMS arrival. Each fire department or fire district is independent and as such have varying response guidelines. Some agencies respond to only the most serious calls while others will respond on nearly every call.
EMS. Anchorage EMS is an ambulance taxing district (as well as a fire protection taxing district) that serves the City of Anchorage
as well as eastern Jefferson County with advanced life support services. Other, private ambulance agencies such as Rural/Metro Corporation
and Yellow EMS provide services for parts of areas near by or within Jefferson County. For example the City of Jeffersontown
in southeastern Jefferson County has for years outsourced its EMS needs. Currently a contract exists with Yellow EMS (YEMS) to provide emergency medical services within the Jeffersontown city limits. YEMS also provides additional assistance during extremely high call volume times to LMEMS and responds to many of LMEMS' low-priority calls. Although these jurisdictions maintain their own ambulance providers, Louisville-Jefferson County government is ultimately responsible for ensuring emergency care is available and in the case that any of these providers cannot operate, LMEMS will ensure a response.
LMEMS also provides mutual aid to other agencies as well. LMEMS paramedic
s are often called upon to provide assistance to BLS
ambulance
crews from other services and other counties when their own advanced providers
are unavailable.
(LMPD) Special Weapons and Tactics Team (SWAT
), Dive Medics and Swift-Water Rescue Medics, as well as retaining a highly visible bicycle team. Personnel are also assigned to the federally administered Joint Emergency Service Unit which seeks to combine all aspects of public safety in a large area into one task force to better coordinate activities in the event of a major emergency.
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Ambulances may be staffed by two Emergency Medical Technicians, one Emergency Medical Technician and one paramedic or, rarely, two paramedics. There is also at least one "Chase car" staffed with a paramedic at any given time. Additional Chase-cars are staffed as need dictates. 2010 policy revisions state there must always be one supervisor per operations division but currently no more than two are ever on duty simultaneously. This leaves at least one division without a supervisor on a recurring basis.
, Iowa and Ford Explorer response vehicles called chase-cars. Currently three styles of ambulances are in use. Specimens of the former LFD and JCEMS (slant-sided) ambulance types remain in use until retirement with new paint and striping. The newest (post-merger) ambulances retain the straight-side feature of the former LFD type and are taller, longer, and heavier. The new design includes a more powerful, greater torque-producing engine (Navistar 7.3L turbo-charged diesel
, and a more spacious patient compartment (6 foot ceiling). These Lifeline brand Superliners are built on the Ford E450 Superduty van chassis.
Most LMEMS response vehicles, including all ambulances, are fitted with satellite transponders that constantly track the exact location of the vehicle, map the potential route to a call, and determine which unit is closest to the emergency.
All ambulances are stocked with a full complement of advanced life support equipment including LifePak 15 cardiac monitor–defibrillators, oral and intravenous medications and fluids. Each ambulance can transport up to three fully immobilized patients. All crew members are trained and equipped with protective gear to treat patients potentially contaminated with hazardous materials.
All charting and patient care information is collected and distributed electronically, eliminating paperwork and reducing the possibility of patient privacy compromise. Electrocardiographs (EKG) can be transmitted wirelessly from the cardiac monitor to the receiving hospital in the advance of the patient's arrival.
to 96.5% of the 399 square miles (1,033.4 km²) of Louisville-Jefferson County
. The cities of Anchorage
and Jeffersontown
was reduced to three. The divisions were then subdivided into smaller sectors to help with faster area recognition. Each division is overseen by an operations officer.
and the east end of Jefferson County. Most crews are deployed from the Division One station located at the East Government Center off Shelbyville Road in Middletown
. Downtown crews deploy from the centralized operations center at Brook and Bloom Streets near the University of Louisville
. Division One normally fields seven ALS ambulances, two BLS ambulances, and 1 paramedic chase-car.
, Beechmont, Wyandotte
, Highview
, West Buechel
, and Okolona
. Most crews deploy from the Division Two station at the Central Government Center at 7201 Outer Loop. A few crews deploy out of the centralized operations center at Brook and Bloom Streets. Division Two regularly fields six ALS ambulances and one BLS ambulance. When needed two additional ambulances, one ALS and one BLS, are used.
including the "west end,"
Pleasure Ridge Park
, and Fairdale
. Division Three activity centers around the Dixie Highway corridor that stretches from the Old California
neighborhood downtown to the rural areas of Valley Station
and Kosmosdale near the Ohio River
. Many Division Three crews deploy from the Division Three station located within the Fairdale Fire Departments Station 2, while others deploy from the centralized operations center at Brook and Bloom Streets. Division Three fields seven ALS ambulances and one BLS ambulance.
Radio codes
With the implementation of the National Incident Management System
by the Federal Emergency Management Agency
(FEMA), the use of 10-codes by LMEMS has, at least officially, ceased. According to FEMA using "plain speech" radio traffic can help eliminate misunderstandings and confusion among different agency with dissimilar radio codes, however LMEMS does not share its radio channels with any other organization or department. While the use of 10-codes is discouraged by LMEMS policy, the use of coded radio traffic continues and is widely tolerated.
Online medical control
Many advanced procedures and medication administration require direct orders from a physician before being performed. All on-online medical control is performed by two-way radio with the attending and resident physicians at University of Louisville Hospital for adult patients, and Kosair Children's Hospital for patients under the age of 18.
Two-way radio
The current Louisville Metro public safety radio system is a Motorola
Project 25-compliant trunking system
. Voice encryption
is used for many channels including all those used by LMEMS, thus radio traffic cannot be received using a scanner. By using voice encryption
the chances of protected health information (PHI)
being compromised by unauthorized monitoring is greatly reduced.
Each LMEMS division has an assigned talkgroup, or channel, for operations (MED channels 1, 2, and 3) and a secondary talkgroup for official communication of non-response natures (TAC channels 1, 2 and 3). Car-to-car talkgroups are used for informal communication. Online medical control is conducted with physicians on talkgroups Hospital 1 for University of Louisville
Hospital (adult patients) and Hospital 2 for Kosair Children's Hospital (for pediatrics). Real-time availability of "non-system" conventional frequencies allow communications with agencies and responders outside of Louisville-Jefferson County
using Project 25-compliant radio equipment.
The table below contains the "old system" conventional radio frequencies. This UHF
FM
system is maintained as a backup but is not regularly used. It was originally installed with the advent of emergency medical services
in the mid-1970s and was considered at the time to be state-of-the-art
.
Response
By department procedure, response requests are assigned to LMEMS resources based on their proximity to the incident and the skill level anticipated by using information gathered from the caller. When a BLS unit is closer to an incident believed to require advanced care an additional ambulance (or, if available, a chase-car) containing a paramedic is also dispatched. Using information gathered from the call, assigned resources are also instructed response with red lights and siren (termed Code-3) or without lights and siren (termed Code-1). If the BLS ambulance crew first arrives and determines that advanced care is not needed the ALS resource may be canceled and ready to respond elsewhere. Patients are transported to any of the area hospitals either Code-1 or Code-3. The decision to use, or not to use, lights and siren enroute to the hospital is at the sole discretion of the crew.
Area Hospitals
Current hospitals served by Louisville Metro EMS include:
Patient transports to hospitals outside of Louisville-Jefferson County
are infrequent and some destinations require supervisor notification and assent.
See also
External links
Louisville, Kentucky
Louisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
-Jefferson County
Jefferson County, Kentucky
As of the census of 2000, there were 693,604 people, 287,012 households, and 183,113 families residing in the county. The population density was . There were 305,835 housing units at an average density of...
, Kentucky. LMEMS is a governmental department, separate from, but equal to, the police and fire services. LMEMS averages 100,000 calls for service, both emergency and non-emergency, each year.
The current Chief Executive Officer is Dr. Neal Richmond, MD and the Chief of Service is Colonel Craig Rodgers, EMT-P.
History
Police officers transferred the severely ill or injured to hospitals in Louisville and Jefferson County until 1972 when the Jefferson County Medical Society created the first EMS service. The first licensed paramedics in Kentucky graduated in 1975 from a pilot program at Louisville General Hospital, now University of Louisville Hospital. Included were fifteen City of Louisville EMS paramedics and one Jefferson County Police officer paramedic.
City of Louisville
Louisville police officers transported patients for many years until Louisville EMSLouisville EMS
Louisville Emergency Medical Services was the primary advanced life support provider within the corporate limits of Louisville, Kentucky from 1972 to 1995...
(LEMS) was created in 1974 The program was operated by the city and was the first EMS service provided in Louisville. In 1995 the city transferred EMS duties to the Louisville Division of Fire
Louisville Division of Fire
The Louisville Division of Fire, commonly known as Louisville Fire Department or Louisville Fire & Rescue , is the sole fire suppression agency for the former city of Louisville, Kentucky and comprises one of 19 fire departments within Louisville-Jefferson County, Kentucky.The Louisville Fire...
in an effort to streamline emergency services in the city. The EMS bureau of the Louisville Division of Fire utilized firefighter
Firefighter
Firefighters are rescuers extensively trained primarily to put out hazardous fires that threaten civilian populations and property, to rescue people from car incidents, collapsed and burning buildings and other such situations...
s cross-trained as EMTs and paramedics as well as non-firefighting personnel.
Jefferson County
Jefferson County EMSJefferson County EMS
Jefferson County Emergency Medical Services was the primary advanced life support provider for Jefferson County, Kentucky outside the limits of the City of Louisville. The merger of Jefferson County Government with the City of Louisville brought about the combining of JCEMS with the EMS bureau of...
had is beginnings in the now-defunct Jefferson County Police Department. Beginning with police officer
Police officer
A police officer is a warranted employee of a police force...
paramedics in 1975 and eventually evolving into non-law enforcement personnel assigned only to providing emergency medical care, the Emergency Medical Squad of the county police became Jefferson County Emergency Medical Services (JCEMS) in 1987.
JCEMS provided emergency medical services to all areas within Jefferson County outside of the cities of Louisville, Anchorage and Jeffersontown. JCEMS always fielded ambulances containing at least one paramedic. The JCEMS Disaster Response Team (DRT) responded to all hazardous materials and technical rescue incidents within Jefferson County outside of the City of Louisville. After the creation of LMEMS all hazardous materials responsibilities, along with specialized vehicles and equipment, were transferred to the Jefferson County Fire Service
Jefferson County Fire Service
The Jefferson County Fire Service is a loose confederation of the 17 independent fire protection districts within Louisville-Jefferson County, Kentucky...
.
City-County Merger and Louisville Metro EMS
The merger of the governments of the City Louisville and Jefferson County took place on January 6, 2003. The most visible (and publicized) merger activity of the new government was the integration of the county and city police forces. No pre-merger preparations were made in regards to emergency medical services. Immediately after the merger, the Louisville Fire Department EMS and Jefferson County EMS continued to operate separately as before. The new Metro Mayor, Jerry Abramson, eventually appointed a task force to review the current EMS practices and determine in what manner EMS will be provided in the new consolidated government. The fire services in Louisville-Jefferson County were (and still are) unable to be combined as nineteen of the twenty fire departments are independent of Metro government and were not subject to any merger legislation. The findings of the EMS task force presented several methods of EMS delivery. Included ideas were retaining two separate services, tasking the Louisville Division of FireLouisville Division of Fire
The Louisville Division of Fire, commonly known as Louisville Fire Department or Louisville Fire & Rescue , is the sole fire suppression agency for the former city of Louisville, Kentucky and comprises one of 19 fire departments within Louisville-Jefferson County, Kentucky.The Louisville Fire...
to provide EMS coverage to the entire city-county, the subordination of EMS duties to another "parent" organization such as the police or health departments, or the creation of a stand alone department. After much debate the mayor's office chose to create a new department and Louisville Metro EMS was created on February 5, 2005 by the combining the Louisville Fire Department EMS Bureau and Jefferson County Emergency Medical Services.
Services
LMEMS is a full-time provider of Basic Life SupportBasic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
(BLS) and Advanced Life Support
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
(ALS) and is accessible through the 911
911
Year 911 was a common year starting on Tuesday of the Julian calendar.-Africa:* Rebellion of the Kutama Berbers against the Fatimid Caliphate...
system. LMEMS employs an almost entirely full-time workforce of Kentucky-licensed Emergency Medical Technician
Emergency medical technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
s (EMTs) and paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
s (also known as EMT-Ps). Most employees maintain optional certification by the National Registry of EMTs, a national EMS accreditation association.
According to LMEMS official web page
LMEMS provides transportation to the emergency department of the chosen hospital. LMEMS does not return patients home nor does it offer transportation to immediate care centers or hospitals without emergency departments. All scheduled ambulance service and inter-facility transports are handled by private ambulance companies retained by the patient. Only under exceptional circumstances will LMEMS provide hospital-to-hospital transfers. These types of transfers are at the request of an emergency department physician wishing a very high level of care and rapid transportation of patients with time-sensitive or critical conditions to more capable facilities (i.e. major trauma, imminent child birth). Most of the time the crew is coincidentally at the hospital for other matters when the request is made for the transfer.
Skills
Louisville Metro EMS utilizes two levels of care providers. EMT-BasicsEmergency medical technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
(referred to as technicians or EMTs) and EMT-Paramedics
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
(usually just called paramedics) have drastically different scopes of practice but all exist to provide care and transportation to the sick and injured. A technician specializes in ambulance operation and basic care as well assistance to advanced providers. Most technicians have an initial six months of training. Paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
s use complex diagnostics, perform medical procedures, and administer medications and additional advanced care that would otherwise only be provided by an emergency physician
Emergency physician
An emergency physician is a physician who works at an emergency department to care for acutely ill patients. The emergency physician is a specialist in advanced cardiac life support , trauma care such as fractures and soft tissue injuries, and management of other life-threatening situations.In...
. Paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
s in Kentucky
Kentucky
The Commonwealth of Kentucky is a state located in the East Central United States of America. As classified by the United States Census Bureau, Kentucky is a Southern state, more specifically in the East South Central region. Kentucky is one of four U.S. states constituted as a commonwealth...
generally have three years of initial training including at least 750 hours of internship and clinical instruction in addition to about 1200 hours of formal, classroom instruction. An increasing number of paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
s possess at least an associates degree, many have bachelor's degrees.
Technicians
Emergency medical technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
are trained to operate independent of a paramedic and when such situations arise they are capable of caring for and transporting any medical emergency to the hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
on their own.
Although the Kentucky Board of Emergency Medical Services allows for the use of EMT-Intermediate providers, LMEMS does not utilize this mid-level of care provider.
| Treatment issue | EMT-B skills (technician) | EMT-P skills (paramedic) |
|---|---|---|
| Airway management | Assessment, manual repositioning, oro- and nasopharyngeal airway adjuncts, manual removal of obstructions, suctioning, King LT-D blind insertion airway device (BIAD) | tracheal intubation Tracheal intubation Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic or rubber tube into the trachea to maintain an open airway or to serve as a conduit through which to administer certain drugs... (oral and nasal), advanced airway management for endotracheal tube, tracheostomy. Deep suctioning, use of Magill forceps, surgical airways (including needle cricothyrotomy) |
| Breathing | Assessment (rate, effort, symmetry, skin color), obstructed airway maneuver, passive oxygen Oxygen Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition... administration by nasal canula, rebreathing and non-rebreathing mask, active oxygen administration by Bag-Valve-Mask (BVM BVM BVM may refer to:* Bachelor of Veterinary Medicine* Bag valve mask, a device used in resuscitation procedures to assist patients in breathing... ) device, pulse oximetry Pulse oximetry Pulse oximetry is a non-invasive method allowing the monitoring of the oxygenation of a patient's hemoglobin.A sensor is placed on a thin part of the patient's body, usually a fingertip or earlobe, or in the case of an infant, across a foot.... |
Active oxygen administration by endotracheal tube or other device using BVM, colometric, side stream, or inline end tidal carbon dioxide (EtCO2) capnography Capnography Capnography is the monitoring of the concentration or partial pressure of carbon dioxide in the respiratory gases. Its main development has been as a monitoring tool for use during anaesthesia and intensive care. It is usually presented as a graph of expiratory plotted against time, or, less... . Use of mechanical transport ventilators (rare), active oxygen administration by surgical airway, decompression of chest cavity using needle/valve device (needle thoracostomy) |
| Circulation | Assessment of pulse (rate, rhythm, volume), blood pressure Blood pressure Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies... , skin color, and capillary refill, patient positioning to enhance circulation, recognition and control of hemorrhage of all types using direct and indirect pressure and tourniquets |
Ability to interpret assessment findings in terms of levels of perfusion Perfusion In physiology, perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue. The word is derived from the French verb "perfuser" meaning to "pour over or through."... , obtaining intravenous access (IV), intravenous fluid replacement, vasoconstricting drugs, intraosseous (IO) cannulation (placement of needle into marrow space of a large bone). Access central venous catheters or peripherally inserted central catheters (PICC). |
| Cardiac arrest Cardiac arrest Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively... |
Cardiopulmonary resuscitation Cardiopulmonary resuscitation Cardiopulmonary resuscitation is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive... , airway management, manual ventilation with BVM, automatic external defibrillator, ResQPod thoracic impedance device |
Dynamic resuscitation including intubation, drug administration (includes anti-arrhythmics), 12-lead ECG interpretation, manual defibrillation, synchronized electrical or chemical cardioversion, and external cardiac pacing |
| Cardiac Monitoring | None | 12-lead ECG monitoring and interpretation including modified chest leads, right-sided leads, and posterior adjunctive leads. |
| Drug administration | Oral, nebulized, auto-injector | Intramuscular and subcutaneous injection, intravenous and intraosseous boluses and infusions, endotracheal tube drug administration, rectal tube, and umbilical venous access. |
| Drug types permitted | Low-risk/immediate requirements e.g. oxygen (hypoxia), aspirin Aspirin Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer... (chest pain), oral glucose Glucose Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate... (low blood sugar), epinephrine Epinephrine Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines... auto-injector (allergic reaction), albuterol (asthma) |
Analgesics for pain, antiarrhythmics (irregularities in heartbeat), cardiac resuscitation drugs, bronchodilators (for breathing), vasoconstrictors (to improve circulation, e.g. dopamine Dopamine Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their... , Pitressin Vasopressin Arginine vasopressin , also known as vasopressin, argipressin or antidiuretic hormone , is a neurohypophysial hormone found in most mammals, including humans. Vasopressin is a peptide hormone that controls the reabsorption of molecules in the tubules of the kidneys by affecting the tissue's... , epinephrine Epinephrine Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines... ), atropine Atropine Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects... for slow heart rates, anticonvulsives (for prolonged seizures), antidotes (naloxone Naloxone Naloxone is an opioid antagonist drug developed by Sankyo in the 1960s. Naloxone is a drug used to counter the effects of opiate overdose, for example heroin or morphine overdose. Naloxone is specifically used to counteract life-threatening depression of the central nervous system and respiratory... for opiate overdose), dextrose 50% in water (low blood sugar), sodium bicarbonate Sodium bicarbonate Sodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula Na HCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It has a slightly salty, alkaline taste resembling that of washing soda . The natural mineral form is... (acidosis) |
| Patient assessment | Basic physical assessment, 'vital' signs, history of general and current condition, pulse oximetry Pulse oximetry Pulse oximetry is a non-invasive method allowing the monitoring of the oxygenation of a patient's hemoglobin.A sensor is placed on a thin part of the patient's body, usually a fingertip or earlobe, or in the case of an infant, across a foot.... |
More detailed physical assessment and history, auscultation, interpretation of assessment findings, ECG interpretation, glucometry, capnography Capnography Capnography is the monitoring of the concentration or partial pressure of carbon dioxide in the respiratory gases. Its main development has been as a monitoring tool for use during anaesthesia and intensive care. It is usually presented as a graph of expiratory plotted against time, or, less... |
| Wound management | Assessment, control of bleeding Bleeding Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system... , application of pressure dressings and other types of dressings, splinting and immobilization |
Pain management |
Ranks
LMEMS is headed by a medical doctor who serves as Chief Executive OfficerChief executive officer
A chief executive officer , managing director , Executive Director for non-profit organizations, or chief executive is the highest-ranking corporate officer or administrator in charge of total management of an organization...
(CEO) and the official head of the service (much like a commissioner). Under the CEO is the top uniformed officer holding the title Chief of Operations and is the accepted chief of department. Traditionally, in the area, the chief of the emergency medical services is not addressed as "chief" but as "colonel
Colonel
Colonel , abbreviated Col or COL, is a military rank of a senior commissioned officer. It or a corresponding rank exists in most armies and in many air forces; the naval equivalent rank is generally "Captain". It is also used in some police forces and other paramilitary rank structures...
" and styled "The Colonel" as the person in this position wears the silver eagle of a US army colonel. Under the Chief of Operations are two Assistant Chiefs of Operations wearing the silver oak leaf of a lieutenant colonel
Lieutenant colonel
Lieutenant colonel is a rank of commissioned officer in the armies and most marine forces and some air forces of the world, typically ranking above a major and below a colonel. The rank of lieutenant colonel is often shortened to simply "colonel" in conversation and in unofficial correspondence...
. A group of operations officers, wearing the gold oak leaf of a major
Major
Major is a rank of commissioned officer, with corresponding ranks existing in almost every military in the world.When used unhyphenated, in conjunction with no other indicator of rank, the term refers to the rank just senior to that of an Army captain and just below the rank of lieutenant colonel. ...
, oversee day-to-day operations including scheduling and may be drawn upon to provide additional manpower. Other personnel that act in positions of responsibility wear varying grade insignia in addition to that of major, such as lieutenant
Lieutenant
A lieutenant is a junior commissioned officer in many nations' armed forces. Typically, the rank of lieutenant in naval usage, while still a junior officer rank, is senior to the army rank...
and sergeant
Sergeant
Sergeant is a rank used in some form by most militaries, police forces, and other uniformed organizations around the world. Its origins are the Latin serviens, "one who serves", through the French term Sergent....
. The rank of captain is no longer used, no one having held the rank since 2008. Field training personnel (FTO) exist, to train new paramedics and EMTs. Their authority primarily extends to clinical and operational competence.
The collar insignia of LMEMS is as follows:
| Title | Insignia |
|---|---|
| C.E.O. Commissioner Commissioner is in principle the title given to a member of a commission or to an individual who has been given a commission .... |
 |
| Chief of Operations |  |
| Asst. Chief of Operations |  |
| Paramedic II/Operations Officer |  |
| Paramedic FTO |  |
| EMT FTO/Operations NCO | |
- The C.E.O. does not wear a uniform thus the general's star is a conjecture.
- Regardless of collar rank an employee's skill level is denoted on the bottom edge of the right sleeve patch, either "Technician" or "Paramedic." A patch reading "Supervisor" was envisioned but never produced.
Union
LMEMS is an established "union shopUnion shop
A union shop is a form of a union security clause under which the employer agrees to hire either labor union members or nonmembers but all non-union employees must become union members within a specified period of time or lose their jobs...
" and all employees beneath the rank of lieutenant colonel are required to become members of the International Brotherhood of Teamsters
Teamsters
The International Brotherhood of Teamsters is a labor union in the United States and Canada. Formed in 1903 by the merger of several local and regional locals of teamsters, the union now represents a diverse membership of blue-collar and professional workers in both the public and private sectors....
(IBT) Local lodge #783. Job assignments, shifts, and vacations are filled using a system based on seniority. However, promotions within the service have been based on appointment by command, an employee's tenure may be taken into account to determine suitability. Any employees' first six months of service with LMEMS is considered a probationary period where the new hire is subject to dismissal without union representation.
Several separate bargaining contracts exist within the service. Street operations personnel, including the majority of EMTs and paramedics, are covered by one contract. Operations officers (majors) are covered by another. Ancillary services personnel in supply and billing have their own contract suited to their unique duties.
A chief and assistant chief steward are elected to oversee union matters for the entire service. Additional elected shop stewards are on duty at most times to assist members with concerns on a day-to-day basis.
Mutual aid
Fire service
LMEMS partners with the various fire departmentFire department
A fire department or fire brigade is a public or private organization that provides fire protection for a certain jurisdiction, which typically is a municipality, county, or fire protection district...
s and fire protection districts in the metro area in a cooperative effort to further reduce the amount of time from when a person calls for assistance to the time assistance arrives. The American Heart Association
American Heart Association
The American Heart Association is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. It is headquartered in Dallas, Texas...
recommends early defibrillation
Defibrillation
Defibrillation is a common treatment for life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator...
to be beneficial to an individual suffering cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
and as such most fire apparatus carry automated external defibrillator
Automated external defibrillator
An automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of...
s (AEDs) with trained EMTs
Emergency medical technician
Emergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
to begin stabilizing the patient prior to EMS arrival. Each fire department or fire district is independent and as such have varying response guidelines. Some agencies respond to only the most serious calls while others will respond on nearly every call.
Other ambulance services
Several other ambulance services exist within Louisville-Jefferson County such as AnchorageAnchorage, Kentucky
As of the census of 2000, there were 2,264 people, 729 households, and 643 families residing in the city. The population density was 744.0 people per square mile . There were 750 housing units at an average density of 246.5 per square mile...
EMS. Anchorage EMS is an ambulance taxing district (as well as a fire protection taxing district) that serves the City of Anchorage
Anchorage, Kentucky
As of the census of 2000, there were 2,264 people, 729 households, and 643 families residing in the city. The population density was 744.0 people per square mile . There were 750 housing units at an average density of 246.5 per square mile...
as well as eastern Jefferson County with advanced life support services. Other, private ambulance agencies such as Rural/Metro Corporation
Rural Metro
Rural/Metro Corporation is a for-profit emergency services organization — the second-largest in the country — providing emergency medical transportation, non-emergency general medical transportation to healthcare facilities and health management organizations, fire protection services, including...
and Yellow EMS provide services for parts of areas near by or within Jefferson County. For example the City of Jeffersontown
Jeffersontown, Kentucky
Jeffersontown is a city in Jefferson County, Kentucky, United States. Before Louisville and Jefferson County were consolidated in 2003, it was the county's largest city outside of Louisville. The population was 26,633 at the 2000 census.- History :...
in southeastern Jefferson County has for years outsourced its EMS needs. Currently a contract exists with Yellow EMS (YEMS) to provide emergency medical services within the Jeffersontown city limits. YEMS also provides additional assistance during extremely high call volume times to LMEMS and responds to many of LMEMS' low-priority calls. Although these jurisdictions maintain their own ambulance providers, Louisville-Jefferson County government is ultimately responsible for ensuring emergency care is available and in the case that any of these providers cannot operate, LMEMS will ensure a response.
LMEMS also provides mutual aid to other agencies as well. LMEMS paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
s are often called upon to provide assistance to BLS
Basic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...
crews from other services and other counties when their own advanced providers
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
are unavailable.
Specialized teams
In addition to the primary task of providing emergency care and transportation, LMEMS also maintains employees assigned to provide specialized service such as Tactical Medics to the Louisville Metro Police DepartmentLouisville Metro Police Department
The Louisville Metro Police Department began operations on January 6, 2003, as part of the creation of the consolidated city-county government in Louisville, Kentucky. It was formed by the merger of the Jefferson County Police Department and the Louisville Division of Police. The Louisville Metro...
(LMPD) Special Weapons and Tactics Team (SWAT
SWAT
A SWAT team is an elite tactical unit in various national law enforcement departments. They are trained to perform high-risk operations that fall outside of the abilities of regular officers...
), Dive Medics and Swift-Water Rescue Medics, as well as retaining a highly visible bicycle team. Personnel are also assigned to the federally administered Joint Emergency Service Unit which seeks to combine all aspects of public safety in a large area into one task force to better coordinate activities in the event of a major emergency.
Deployment
Ground transportation
LMEMS utilizes a fleet of Type III modular ambulances manufactured by Lifeline Emergency Vehicles from SumnerSumner, Iowa
Sumner is a city in Bremer County, Iowa, United States. The city is located along the county's eastern border, between Bremer and Fayette counties. The population was 2,106 at the 2000 census. The Bremer County portion of Sumner is part of the Waterloo–Cedar Falls Metropolitan Statistical Area...
, Iowa and Ford Explorer response vehicles called chase-cars. Currently three styles of ambulances are in use. Specimens of the former LFD and JCEMS (slant-sided) ambulance types remain in use until retirement with new paint and striping. The newest (post-merger) ambulances retain the straight-side feature of the former LFD type and are taller, longer, and heavier. The new design includes a more powerful, greater torque-producing engine (Navistar 7.3L turbo-charged diesel
Diesel engine
A diesel engine is an internal combustion engine that uses the heat of compression to initiate ignition to burn the fuel, which is injected into the combustion chamber...
, and a more spacious patient compartment (6 foot ceiling). These Lifeline brand Superliners are built on the Ford E450 Superduty van chassis.
Most LMEMS response vehicles, including all ambulances, are fitted with satellite transponders that constantly track the exact location of the vehicle, map the potential route to a call, and determine which unit is closest to the emergency.
All ambulances are stocked with a full complement of advanced life support equipment including LifePak 15 cardiac monitor–defibrillators, oral and intravenous medications and fluids. Each ambulance can transport up to three fully immobilized patients. All crew members are trained and equipped with protective gear to treat patients potentially contaminated with hazardous materials.
All charting and patient care information is collected and distributed electronically, eliminating paperwork and reducing the possibility of patient privacy compromise. Electrocardiographs (EKG) can be transmitted wirelessly from the cardiac monitor to the receiving hospital in the advance of the patient's arrival.
Aeromedical Services
Due to hospital proximity and the numerous excellent highways within Jefferson County air ambulances are rarely requested by LMEMS as ground transportation can usually be faster and more effective. As such neither Louisville nor Jefferson County governments have ever maintained a helicopter for air ambulance use. However it is worth noting that the medivac concept, proven effective during the Vietnam War, was provided in the 1970s by the United States Army Reserve on an "as available" basis for non-military use in the Louisville and surrounding areas. Later, several enterprises providing aeromedical services emerged since 1982 through either privately-held companies, corporations, or hospital groups. The original civilian air ambulance services, SkyCare (Jewish Hospital) and StatFLIGHT (Humana Hospital University), merged in 1993 to become StatCare. StatCare was the longest serving aeromedical service in the area to maintain the same name and ownership though it has since been superseded. AirMethods now provides most of the aeromedical services in the region.Area of responsibility and divisions
Louisville Metro EMS has the largest area of geographical responsibility of any Louisville Metro public safety agency. It is the sole provider of emergency medical servicesEmergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
to 96.5% of the 399 square miles (1,033.4 km²) of Louisville-Jefferson County
Jefferson County, Kentucky
As of the census of 2000, there were 693,604 people, 287,012 households, and 183,113 families residing in the county. The population density was . There were 305,835 housing units at an average density of...
. The cities of Anchorage
Anchorage, Kentucky
As of the census of 2000, there were 2,264 people, 729 households, and 643 families residing in the city. The population density was 744.0 people per square mile . There were 750 housing units at an average density of 246.5 per square mile...
and Jeffersontown
Jeffersontown, Kentucky
Jeffersontown is a city in Jefferson County, Kentucky, United States. Before Louisville and Jefferson County were consolidated in 2003, it was the county's largest city outside of Louisville. The population was 26,633 at the 2000 census.- History :...
was reduced to three. The divisions were then subdivided into smaller sectors to help with faster area recognition. Each division is overseen by an operations officer.
| Divisions of Louisville Metro EMS | |
|---|---|
| Division One | St. Matthews St. Matthews, Kentucky St. Matthews is the 20th largest city in Kentucky, United States and is a prominent suburb of Louisville. It is located 8 miles east of downtown Louisville in Jefferson County. It is one of the state's major shopping areas, being home to second and fifth largest malls in Kentucky St. Matthews is... (Medic 211), Middletown Middletown, Kentucky The median income for a household in the city was $53,608, and the median income for a family was $61,667. Males had a median income of $45,417 versus $33,135 for females. The per capita income for the city was $26,660... (Medic 112), Lyndon Lyndon, Kentucky There were 4,520 households out of which 21.9% had children under the age of 18 living with them, 37.5% were married couples living together, 8.9% had a female householder with no husband present, and 50.3% were non-families. 40.1% of all households were made up of individuals and 7.4% had someone... and Graymoor-Devondale Graymoor-Devondale, Kentucky Graymoor-Devondale is a city in Jefferson County, Kentucky, United States. It is the result of the merger of the cities of Graymoor and Devondale... (Medic 113), Berrytown-English Station (Medic 119), Downtown Downtown Louisville Downtown Louisville is the largest central business district in the Commonwealth of Kentucky and the urban hub of the Louisville, Kentucky Metropolitan Area. Its boundaries are the Ohio River to the north, Hancock Street to the east, York and Jacob Streets to the south, and 9th Street to the west... (Medic 151), Smoketown Smoketown, Louisville Smoketown is a neighborhood one mile southeast of downtown Louisville, Kentucky. Smoketown has been a historically black neighborhood since the Civil War. It is the only neighborhood in the city that has had such a continuous presence.... (Medic 255), Camp Taylor and Germantown-Schnitzelburg Germantown, Louisville Germantown is a neighborhood three miles southeast of downtown Louisville, Kentucky, USA. Germantown is also a general term for an area of Louisville from the Original Highlands to St Joseph and Bradley neighborhoods that were predominantly settled by Germans... (Medic 161), Clifton-Crescent Hill Clifton, Louisville Clifton, a neighborhood east of downtown Louisville, Kentucky USA. Clifton was named because of its hilly location on the Ohio River valley escarpment.... (Car 962), Buchertown and The Highlands The Highlands (Louisville) The Highlands is an area of Louisville, Kentucky which contains a high density of nightclubs, eclectic businesses, and many upscale and fast food restaurants. It is centered along a three-mile stretch of Bardstown Road and Baxter Avenue and is so named because it sits atop a ridge between the... (Medic 277), and Douglass, western Hikes Point and Bowman Field (Medic 175). |
| Division Two | Okolona Okolona, Kentucky Okolona is a former census-designated place in southern Jefferson County, Kentucky, United States. It is centered around the intersection of Preston Highway and the Outer Loop. The population was 17,807 at the 2000 census. When the government of Jefferson County merged with the city of Louisville,... (Medic 121), Highview and Hollow Creek Hollow Creek, Kentucky Hollow Creek is a city in Jefferson County, Kentucky, United States. The population was 815 at the 2000 census.-Geography:Hollow Creek is located at .... (Medic 123), Newburg, Watterson Park Watterson Park, Kentucky Watterson Park is a city in Jefferson County, Kentucky, United States. The population was 953 at the 2000 census.-Geography:Watterson Park is located at .... and Poplar Hills Poplar Hills, Kentucky Poplar Hills is a city in Jefferson County, Kentucky, United States. The population was 396 at the 2000 census.-Geography:Poplar Hills is located at .... (Medic 225), Buechel (Medic 127), and Fern Creek (Medic 126), Beechmont (Medic 163), Iroquois Iroquois, Louisville Iroquois is a neighborhood on the south side of Louisville, Kentucky, USA. It is split into two parts by Beechmont. The neighborhood is roughly bounded by Hazelwood Avenue, Beechmont, Third Street, Kenwood Drive, and Iroquois Park. The largely residential neighborhood was developed as a suburb... and Auburndale Auburndale, Louisville Auburndale is a neighborhood on the south side of Louisville, Kentucky, USA. Its boundaries are Palatka Road to the north and New Cut Road and Third Street to the East. The area was originally a part of Isaac H. Fenley's farm, called Hickory Grove, which was 1,100 acres in size by... (Medic 167), and University of Louisville University of Louisville The University of Louisville is a public university in Louisville, Kentucky. When founded in 1798, it was the first city-owned public university in the United States and one of the first universities chartered west of the Allegheny Mountains. The university is mandated by the Kentucky General... (Medic 274) |
| Division Three | Pleasure Ridge Park (Medic 131), Valley Station and Kosmosdale Valley Station, Kentucky Valley Station is a former census-designated place in southwest Jefferson County, Kentucky, United States. The population was 23,489 at the 2010 census. When the government of Jefferson County merged with the city of Louisville, Kentucky in 2003, residents of Valley Station also became citizens of... (Medic 132), Fairdale Fairdale, Kentucky Fairdale is a former census-designated place in southern Jefferson County, Kentucky, United States. The population was 7,658 at the 2000 census. In 2003, the area was annexed to the city of Louisville due to a merger between the city and Jefferson County's unincorporated community... (Medic 135), Shively and Rubbertown Shively, Kentucky Shively is a city in Jefferson County, Kentucky, United States. The population was 15,157 at the 2000 census. It is located southwest of Louisville, Kentucky and directly adjoins the larger city. Shively is centered around the junction of US 60 and the Dixie Highway.-History:Shively was first... (Medic 137), Shawnee Shawnee, Louisville Shawnee is a neighborhood in Louisville, Kentucky. Its boundaries are I-264, West Broadway and Northwestern Parkway . Maps sometimes identify the area as Shawneeland.... (Medic 141). Russell Russell, Louisville Russell is a neighborhood immediately west of downtown Louisville, Kentucky, USA. It was named for renowned African American educator and Bloomfield, Kentucky native Harvey Clarence Russell Sr..... (Medic 243), Portland Portland, Louisville Portland is a neighborhood and former independent town two miles northwest of downtown Louisville, Kentucky. In its early days it was the largest of the six major settlements at the Falls of the Ohio River, the others being Shippingport and Louisville in Kentucky and New Albany, Clarksville, and... (Medic 145), and California California, Kentucky California is a city in Campbell County, Kentucky, United States. The population was 86 at the 2000 census.-Geography:California is located at .... (Medic 147). |
Division One
Division One, the geographically largest division, provides service to downtown LouisvilleLouisville, Kentucky
Louisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
and the east end of Jefferson County. Most crews are deployed from the Division One station located at the East Government Center off Shelbyville Road in Middletown
Middletown, Kentucky
The median income for a household in the city was $53,608, and the median income for a family was $61,667. Males had a median income of $45,417 versus $33,135 for females. The per capita income for the city was $26,660...
. Downtown crews deploy from the centralized operations center at Brook and Bloom Streets near the University of Louisville
University of Louisville
The University of Louisville is a public university in Louisville, Kentucky. When founded in 1798, it was the first city-owned public university in the United States and one of the first universities chartered west of the Allegheny Mountains. The university is mandated by the Kentucky General...
. Division One normally fields seven ALS ambulances, two BLS ambulances, and 1 paramedic chase-car.
Division Two
Division Two services the "south-end" and southern portion of Jefferson County including Fern CreekFern Creek, Kentucky
Fern Creek is a historic community in southeastern Jefferson County, Kentucky, United States. The population was 20,009 at the 2008 census. In 2003, The area was annexed to the city of Louisville as part of a merger between the city and Jefferson County's unincorporated communities. Fern Creek was...
, Beechmont, Wyandotte
Wyandotte, Louisville
Wyandotte, also called Oakdale, is a neighborhood on the southside of Louisville, Kentucky, United States. Its modern boundaries are Longfield Avenue to the north, Taylor Boulevard to the west, I-264 to the south, and Southern Parkway to the east. The opening of Iroquois Park in the early 1890s...
, Highview
Highview, Kentucky
Highview is a former census-designated place in Jefferson County, Kentucky, United States. The population was 15,161 at the 2000 census. On January 6, 2003, the area was annexed to the city of Louisville due to a merger between the city and Jefferson County's unincorporated communities...
, West Buechel
West Buechel, Kentucky
West Buechel is a city in Jefferson County, Kentucky, United States. The population was 1,301 at the 2000 census.-Geography:West Buechel is located at .According to the United States Census Bureau, the city has a total area of , all of it land....
, and Okolona
Okolona, Kentucky
Okolona is a former census-designated place in southern Jefferson County, Kentucky, United States. It is centered around the intersection of Preston Highway and the Outer Loop. The population was 17,807 at the 2000 census. When the government of Jefferson County merged with the city of Louisville,...
. Most crews deploy from the Division Two station at the Central Government Center at 7201 Outer Loop. A few crews deploy out of the centralized operations center at Brook and Bloom Streets. Division Two regularly fields six ALS ambulances and one BLS ambulance. When needed two additional ambulances, one ALS and one BLS, are used.
Division Three
Division Three covers the western side of Louisville-Jefferson CountyJefferson County, Kentucky
As of the census of 2000, there were 693,604 people, 287,012 households, and 183,113 families residing in the county. The population density was . There were 305,835 housing units at an average density of...
including the "west end,"
Pleasure Ridge Park
Pleasure Ridge Park, Kentucky
Pleasure Ridge Park is a former census-designated place in southwest Jefferson County, Kentucky, United States. The population was 26,212 at the 2010 census. In 2003, the area was annexed to the city of Louisville due to a merger between the city and Jefferson County's unincorporated communities...
, and Fairdale
Fairdale, Kentucky
Fairdale is a former census-designated place in southern Jefferson County, Kentucky, United States. The population was 7,658 at the 2000 census. In 2003, the area was annexed to the city of Louisville due to a merger between the city and Jefferson County's unincorporated community...
. Division Three activity centers around the Dixie Highway corridor that stretches from the Old California
California, Louisville
California is a neighborhood in Louisville, Kentucky, USA. There are no written records of the beginning of the neighborhood, but the area was settled by German immigrants around 1849...
neighborhood downtown to the rural areas of Valley Station
Valley Station, Kentucky
Valley Station is a former census-designated place in southwest Jefferson County, Kentucky, United States. The population was 23,489 at the 2010 census. When the government of Jefferson County merged with the city of Louisville, Kentucky in 2003, residents of Valley Station also became citizens of...
and Kosmosdale near the Ohio River
Ohio River
The Ohio River is the largest tributary, by volume, of the Mississippi River. At the confluence, the Ohio is even bigger than the Mississippi and, thus, is hydrologically the main stream of the whole river system, including the Allegheny River further upstream...
. Many Division Three crews deploy from the Division Three station located within the Fairdale Fire Departments Station 2, while others deploy from the centralized operations center at Brook and Bloom Streets. Division Three fields seven ALS ambulances and one BLS ambulance.
Continuity of coverage
Not all locations have ambulances on station at all times. Alternatively, response cars may be placed with a single paramedic or technician instead of an ambulance. All response units use a three-digit radio identification number. The first number denotes the type of resource ("1" ALS ambulance, "2" BLS Ambulance, "3" BLS response car, "8" special detail unit, or "9" ALS response car). The second number identifies the unit's assigned division within the computer-aided dispatch (CAD) system and the third digit is the unit's area of responsibility/beat within the division. Ambulances are prefixed as "Medic" and response cars as "Car."Communications
All LMEMS resources are dispatched and tracked by MetroSafe, a unit of Metro Government within the Emergency Management Agency that handles all public safety communications. Previously many separate dispatch centers existed staffed by the individual agencies they served. MetroSafe puts, for the first time in area history, all emergency call-taking and radio dispatching under one roof. In addition to radio telecommunications MetroSafe is the primary answering point for all 911 calls placed inside Louisville-Jefferson County. Since April, 2010 all government agencies are transitioning to the long-awaited MetroSafe phase III radio system. All the major public safety agencies, of which LMEMS was the first to do so, have now implemented full operational use of the new 800 MHz trunked radios.Radio codes
With the implementation of the National Incident Management System
National Incident Management System
The National Incident Management System is emergency management doctrine used nationwide to coordinate emergency preparedness and incident management and response among the public and private sectors.NIMS is a comprehensive, national approach to incident management that is applicable at all...
by the Federal Emergency Management Agency
Federal Emergency Management Agency
The Federal Emergency Management Agency is an agency of the United States Department of Homeland Security, initially created by Presidential Reorganization Plan No. 1 of 1978 and implemented by two Executive Orders...
(FEMA), the use of 10-codes by LMEMS has, at least officially, ceased. According to FEMA using "plain speech" radio traffic can help eliminate misunderstandings and confusion among different agency with dissimilar radio codes, however LMEMS does not share its radio channels with any other organization or department. While the use of 10-codes is discouraged by LMEMS policy, the use of coded radio traffic continues and is widely tolerated.
Online medical control
Many advanced procedures and medication administration require direct orders from a physician before being performed. All on-online medical control is performed by two-way radio with the attending and resident physicians at University of Louisville Hospital for adult patients, and Kosair Children's Hospital for patients under the age of 18.
Two-way radio
The current Louisville Metro public safety radio system is a Motorola
Motorola
Motorola, Inc. was an American multinational telecommunications company based in Schaumburg, Illinois, which was eventually divided into two independent public companies, Motorola Mobility and Motorola Solutions on January 4, 2011, after losing $4.3 billion from 2007 to 2009...
Project 25-compliant trunking system
Trunked radio system
A trunked radio system is a complex type of computer-controlled radio system. Trunked systems use a few channels , and can have virtually unlimited talkgroups. The control channel computer sends packets of data to enable one talkgroup to talk together, regardless of frequency...
. Voice encryption
Cryptographic protocol
A security protocol is an abstract or concrete protocol that performs a security-related function and applies cryptographic methods.A protocol describes how the algorithms should be used...
is used for many channels including all those used by LMEMS, thus radio traffic cannot be received using a scanner. By using voice encryption
Cryptographic protocol
A security protocol is an abstract or concrete protocol that performs a security-related function and applies cryptographic methods.A protocol describes how the algorithms should be used...
the chances of protected health information (PHI)
Protected health information
Protected health information , under the US Health Insurance Portability and Accountability Act , is any information about health status, provision of health care, or payment for health care that can be linked to a specific individual...
being compromised by unauthorized monitoring is greatly reduced.
Each LMEMS division has an assigned talkgroup, or channel, for operations (MED channels 1, 2, and 3) and a secondary talkgroup for official communication of non-response natures (TAC channels 1, 2 and 3). Car-to-car talkgroups are used for informal communication. Online medical control is conducted with physicians on talkgroups Hospital 1 for University of Louisville
University of Louisville
The University of Louisville is a public university in Louisville, Kentucky. When founded in 1798, it was the first city-owned public university in the United States and one of the first universities chartered west of the Allegheny Mountains. The university is mandated by the Kentucky General...
Hospital (adult patients) and Hospital 2 for Kosair Children's Hospital (for pediatrics). Real-time availability of "non-system" conventional frequencies allow communications with agencies and responders outside of Louisville-Jefferson County
Louisville, Kentucky
Louisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
using Project 25-compliant radio equipment.
The table below contains the "old system" conventional radio frequencies. This UHF
Ultra high frequency
Ultra-High Frequency designates the ITU Radio frequency range of electromagnetic waves between 300 MHz and 3 GHz , also known as the decimetre band or decimetre wave as the wavelengths range from one to ten decimetres...
FM
Frequency modulation
In telecommunications and signal processing, frequency modulation conveys information over a carrier wave by varying its instantaneous frequency. This contrasts with amplitude modulation, in which the amplitude of the carrier is varied while its frequency remains constant...
system is maintained as a backup but is not regularly used. It was originally installed with the advent of emergency medical services
Emergency medical services
Emergency medical services are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency...
in the mid-1970s and was considered at the time to be state-of-the-art
State of the art
The state of the art is the highest level of development, as of a device, technique, or scientific field, achieved at a particular time. It also refers to the level of development reached at any particular time as a result of the latest methodologies employed.- Origin :The earliest use of the term...
.
| Backup LMEMS Radio Channels | ||
|---|---|---|
| Med Channel 10 | Dispatch 2 | 462.975 MHz |
| Med Channel 9 | Dispatch 1 | 462.950 MHz |
| Med Channel 8 | Primary Online Medical Control Channel | 463.175 MHz |
| Med Channel 7 | Seconday Online Medical Control Channel, Mostly Unused | 463.150 MHz |
| Med Channel 6 | Primary Service/Detail Channel | 463.125 MHz |
| Med Channel 5 | Secondary Service/Detail Channel | 463.100 MHz |
| Med Channel 4 | Tertiary Service/Detail Channel, Mostly Unused | 463.075 MHz |
| Med Channel 3 | Talk-around Channel, Mostly Unused | 463.050 MHz |
| Med Channel 2 | Talk-around Channel, Mostly Unused | 463.025 MHz |
| Med Channel 1 | Talk-around Channel, Mostly Unused | 463.000 MHz |
Response
By department procedure, response requests are assigned to LMEMS resources based on their proximity to the incident and the skill level anticipated by using information gathered from the caller. When a BLS unit is closer to an incident believed to require advanced care an additional ambulance (or, if available, a chase-car) containing a paramedic is also dispatched. Using information gathered from the call, assigned resources are also instructed response with red lights and siren (termed Code-3) or without lights and siren (termed Code-1). If the BLS ambulance crew first arrives and determines that advanced care is not needed the ALS resource may be canceled and ready to respond elsewhere. Patients are transported to any of the area hospitals either Code-1 or Code-3. The decision to use, or not to use, lights and siren enroute to the hospital is at the sole discretion of the crew.
Area Hospitals
Current hospitals served by Louisville Metro EMS include:
- University of Louisville HospitalUniversity of LouisvilleThe University of Louisville is a public university in Louisville, Kentucky. When founded in 1798, it was the first city-owned public university in the United States and one of the first universities chartered west of the Allegheny Mountains. The university is mandated by the Kentucky General...
, the region's level 1 trauma centerTrauma centerA trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers grew into existence out of the realization that traumatic injury is a disease process unto itself requiring specialized and experienced...
. - the five hospitals owned by Norton HealthcareNorton HealthcareNorton Healthcare is Kentucky's largest healthcare system with more than 40 locations in and around Louisville, Kentucky. Founded in 1886, Norton's current major products include pediatrics; women's services; orthopedics; cardiac care; stroke care; advanced surgical services; cancer diagnosis,...
- Kosair Children's Hospital (downtown LouisvilleLouisville, KentuckyLouisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
) - Norton Hospital (downtown LouisvilleLouisville, KentuckyLouisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
) - Norton Suburban (St Matthews, Louisville)
- Norton Brownsboro (Springhurst, Louisville)
- Norton Audubon (Audubon Park, LouisvilleAudubon Park, KentuckyAudubon Park is a city in central Jefferson County, Kentucky, United States. The population was 1,545 at the 2000 census. It is located about south of Downtown Louisville, and is surrounded on all sides by the city of Louisville...
)
- Kosair Children's Hospital (downtown Louisville
- the hospitals of Jewish Hospital and St Mary's Healthcare
- Saints Mary and Elizabeth Hospital (Beechmont, Louisville)
- Jewish Hospital (downtown LouisvilleLouisville, KentuckyLouisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
) - Jewish Medical Center-East (St Matthews, Louisville)
- Jewish Medical Center-Northeast (Anchorage, LouisvilleAnchorage, KentuckyAs of the census of 2000, there were 2,264 people, 729 households, and 643 families residing in the city. The population density was 744.0 people per square mile . There were 750 housing units at an average density of 246.5 per square mile...
) - Jewish Medical Center-Southwest (Valley Station, LouisvilleValley Station, KentuckyValley Station is a former census-designated place in southwest Jefferson County, Kentucky, United States. The population was 23,489 at the 2010 census. When the government of Jefferson County merged with the city of Louisville, Kentucky in 2003, residents of Valley Station also became citizens of...
) - Jewish Medical Center-South (Brooks, KYBullitt County, KentuckyAs of the census of 2000, there were 61,236 people, 22,171 households, and 17,736 families residing in the county. The population density was . There were 23,160 housing units at an average density of...
) - Jewish Hospital-Shelbyville (Shelbyville, KYShelby County, KentuckyShelby County is a county located in the U.S. state of Kentucky. As of 2010, the population was 42,074. Its name is in honor of Isaac Shelby, the first Governor of Kentucky. Its county seat is Shelbyville...
) seldom used due to distance
- the hospitals of Baptist Heathcare
- Baptist Hospital East (St Matthews, Louisville)
- Baptist Hospital Northeast (LaGrange, KYOldham County, KentuckyAs of the census of 2000, there were 46,178 people, 14,856 households, and 12,196 families residing in the county. The population density was . There were 15,541 housing units at an average density of...
) seldom used due to distance
- The U.S. Department of Veterans Affairs Louisville Medical CenterVeterans Health AdministrationThe Veterans Health Administration is the component of the United States Department of Veterans Affairs led by the Under Secretary of Veterans Affairs for Health that implements the medical assistance program of the VA through the administration and operation of numerous VA outpatient clinics,...
(Clifton, LouisvilleClifton, LouisvilleClifton, a neighborhood east of downtown Louisville, Kentucky USA. Clifton was named because of its hilly location on the Ohio River valley escarpment....
). - Floyd Memorial Hospital (New AlbanyNew Albany, IndianaNew Albany is a city in Floyd County, Indiana, United States, situated along the Ohio River opposite Louisville, Kentucky. In 1900, 20,628 people lived in New Albany; in 1910, 20,629; in 1920, 22,992; and in 1940, 25,414. The population was 36,372 at the 2010 census. The city is the county seat of...
, Indiana) - Clark Memorial Hospital (JeffersonvilleJeffersonville, IndianaJeffersonville is a city in Clark County, Indiana, along the Ohio River. Locally, the city is often referred to by the abbreviated name Jeff. It is directly across the Ohio River to the north of Louisville, Kentucky along I-65. The population was 44,953 at the 2010 census...
, Indiana)
Patient transports to hospitals outside of Louisville-Jefferson County
Jefferson County, Kentucky
As of the census of 2000, there were 693,604 people, 287,012 households, and 183,113 families residing in the county. The population density was . There were 305,835 housing units at an average density of...
are infrequent and some destinations require supervisor notification and assent.
See also
- Jefferson County Fire ServiceJefferson County Fire ServiceThe Jefferson County Fire Service is a loose confederation of the 17 independent fire protection districts within Louisville-Jefferson County, Kentucky...
- Jefferson Co EMS (defunct)Jefferson County EMSJefferson County Emergency Medical Services was the primary advanced life support provider for Jefferson County, Kentucky outside the limits of the City of Louisville. The merger of Jefferson County Government with the City of Louisville brought about the combining of JCEMS with the EMS bureau of...
- City of Louisville EMS (defunct)Louisville EMSLouisville Emergency Medical Services was the primary advanced life support provider within the corporate limits of Louisville, Kentucky from 1972 to 1995...
- Louisville Division of FireLouisville Division of FireThe Louisville Division of Fire, commonly known as Louisville Fire Department or Louisville Fire & Rescue , is the sole fire suppression agency for the former city of Louisville, Kentucky and comprises one of 19 fire departments within Louisville-Jefferson County, Kentucky.The Louisville Fire...
- Louisville Metro Police DepartmentLouisville Metro Police DepartmentThe Louisville Metro Police Department began operations on January 6, 2003, as part of the creation of the consolidated city-county government in Louisville, Kentucky. It was formed by the merger of the Jefferson County Police Department and the Louisville Division of Police. The Louisville Metro...
External links
Jefferson County Fire Service
The Jefferson County Fire Service is a loose confederation of the 17 independent fire protection districts within Louisville-Jefferson County, Kentucky...
Jefferson County EMS
Jefferson County Emergency Medical Services was the primary advanced life support provider for Jefferson County, Kentucky outside the limits of the City of Louisville. The merger of Jefferson County Government with the City of Louisville brought about the combining of JCEMS with the EMS bureau of...
Louisville EMS
Louisville Emergency Medical Services was the primary advanced life support provider within the corporate limits of Louisville, Kentucky from 1972 to 1995...
Louisville Division of Fire
The Louisville Division of Fire, commonly known as Louisville Fire Department or Louisville Fire & Rescue , is the sole fire suppression agency for the former city of Louisville, Kentucky and comprises one of 19 fire departments within Louisville-Jefferson County, Kentucky.The Louisville Fire...
Louisville Metro Police Department
The Louisville Metro Police Department began operations on January 6, 2003, as part of the creation of the consolidated city-county government in Louisville, Kentucky. It was formed by the merger of the Jefferson County Police Department and the Louisville Division of Police. The Louisville Metro...