Emergency Medical Response Services EMRS Project
Emergency medical services are an integration of hospital-based emergency service and pre-hospital emergency care. Emergency medical response services (EMRS) primarily comprise pre-hospital emergency care. The integration of these two systems delivers quality and timely medical care that is known to save lives and decrease mortality and morbidity.
As of now, there is no robust or quality care EMRS available in the war-torn valley of Kashmir. Ambulances available largely function as transportation vehicles mostly without any necessary medical equipment or trained paramedical staff available. This has a huge healthcare impact in Kashmir.
Most of the time there is a significant delay in receiving emergency medical care as the pre-hospital care is non-existent. As a result, mortality and morbidity goes up drastically.
KASHMER is desirous of changing the “transport vehicle concept of ambulances” to “lifesaving emergency medical transportation,” and keen on having an evidence-based EMS driven by technology and trained personnel with universal access. A state of the art EMRS (ambulance service) is being developed and tentative launch date is summer of 2019 as a pilot project.
KASHMER plans to execute an EMRS model that will deliver high-quality ambulance service in Kashmir. These services will be extended to the entire Srinagar district in different phases.
HELP and Save Heart Kashmir are our main ground partners. SAVE HEART is a group of young and passionate physicians who want to make a change in healthcare delivery in Kashmir. They have already made their footprints by helping deliver affordable, quick and quality cardiac care to the poorest sections in Kashmir.
Backbone of the EMRS is a well trained medical and paramedical staff. They will be BLS (Basic Life Support), ACLS (Advanced Life Support), and possibly ATLS (Advanced Trauma Life Support) and PALS (Pediatric Advanced Life Support) certified.
An EMRS Control Room will be established and Two Ambulances (Advance Life and Basic Life Support) will be procured initially with 2 Two paramedics and/or EMT’s
The patient is signed out to the receiving hospital by the ambulance crew. There will be face to face sign out between EMTs/Paramedics and Control room physicians at the end of each shift.
EMRS phone number will be established. This will preferably be a toll-free number for access to the general public. People need to be educated about using this number for emergencies only and not regular healthcare advice.
Clinical Quality Assessment:
This will be done by Save heart Kashmir, our operational partners along with the operations manager.
Bench marks for quality improvement:
Cardiac: Time to 12 lead EKG acquisition, Cardiac scene times and aspirin administration.
Stroke: Stroke scene times, accuracy of neurological assessment, last seen normal
Spinal immobilization assessment and rule out
Sepsis: Temperature measurement, last seen normal.
Feedback from all the patients and their families who used EMRS will be obtained.
Feedback from public will be used to improve the quality and customer service
Each provider receives quarterly QI report outlining their benchmark inclusions and % of meets quality markers. Those providers who fall below an established percentage are identified and Performance Improvement plans are put in place.
How is EMRS funded and sustained?
KASHMER envisions that EMRS service will be provided for free for the first 1-2 years based on the donations from our members and public.
As our program evolves, credibility and trust are established, we can ask for local public support to further expand the program.