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					             Dublin Fire Brigade Paramedics- Insight into
               a Pre-hospital Emergency Care Service

• Brief history of DFB - Oldest uniform body in the state Since 1862
  (Oldest Ambulance service provider in Ireland) Since 1898

• Benefits of combined Fire/Emergency Medical service (EMS) for 
  patients

• Our areas of operations

• Statistics/ type and numbers of calls

• Information on range of pre-hospital treatment protocols using 
  generic case details 

• Some footage with  real on scene experiences with DFB staff.
Dublin Fire Brigade Paramedics-
  Insight into a Pre-hospital
   Emergency Care Service
       D/O Martin O’Reilly
        S/O Paul Lambert
             Dublin Fire and Ambulance Service

• Oldest uniform body in the 
  state Since 1862

• Oldest Ambulance service in 
  Ireland  - 1898
                 DFB-RCSI Training Institute



•   Educational Partnership with
    RCSI
                                     2011


•   PHECC accredited
     – Institution
     – Programmes
     – Tutors

•   2011 Education & Training
    Standards

•   Cardiac First Response to
    Paramedic
            Practitioner Level required for
               Emergency Ambulance

Paramedic
2 year diploma program


Advanced Paramedic
2 year Graduate
Diploma
Population 
served 1.2 
million

464,749 
Households
Provide a fully integrated 
Fire based Ambulance and 
EMS service

In 2011 we responded to 
90,000 Ambulance/EMS 
calls

72,000 Ambulance/EMS 
incidents
    93,000 Ambulance/EMS 
    mobilisations 
    12,000 Paramedic Fire 
    Appliance responses
     Eastern Regional Control Centre

• Receipt of 999/112 calls for assistance
   – Determine the location and nature of the emergency
   – Determine the priority
   – Pre-arrival instructions

• Provide an appropriate Response
   – The  “Right” response for the patient ? 
   – Nearest appropriate resource
      Benefits of combined Fire/Emergency 
       Medical service (EMS) for patients
• Strategically located- rapid response

• 24/7 Availability of ambulance resources

• Resources reduce time on scene

• Equipment available - early Extrication 

• Enhances safety on scene
• Highline Rescues
  from tower cranes

• Immediate Medical
  assessment and 
  treatment
          Swift Water Rescue

• SRT technicians




                    • Hypothermia
                    • Submersion Incidents
              Road Traffic Collisions

Reduce on scene time

• Spinal Immobilisation/
  Patient handling

• Rapid Extrication

• Safety/Fend off

• Fire Risk
                   Medical
• Basic Life support
• Advanced Life support
• Acute coronary 
  syndromes
• Glycaemic 
  Emergencies
• Seizures 
• Inadequate 
  Respirations
• Stroke
                        Medical
•   Septic shock
•   Poisons/ OD
•   Hypothermia
•   Altered Level of 
    consciousness
                   Trauma
•   External Haemorrhage   • Head Injury
•   Shock-Blood loss       • Traumatic Cardiac 
•   Spinal                   Arrest
•   Burns
•   Limb Fractures
•   Crush injury
Intubation
Vascular Access
                      DFB-RCSI Training Institute

Oxygen (INH)              •   Morphine
Nitrous Oxide (INH)       •   Epinephrine 1:10 000
Salbutamol (INH)          •   Amiodarone
Aspirin (PO)              •   Benzopenecillin
GTN (SL)                  •   Lasix
Glucose Gel (BU)
                          •   Atropine
Glucagon (IM)
Epinephrine 1:1000 (IM)
Naloxone (IM)
Paracetamol (PO)
Clopidogrel (PO)
       Obstetric Emergencies
• Neo natal resus
• Haemorrhage in 
  pregnancy
• Breech birth
• Umbilical cord 
  complications
         The Right Response 
• Immediately Life threatening incidents 

• The nature of these incidents require a 
  rapid response and more responders on 
  scene
  – Paramedic Fire Appliance
  – Paramedic Ambulance 
  – Advanced Paramedic
Fire Appliance 
Paramedics 
60%

Ambulance 
Paramedics
36%

Arrive together
4%
Mater Hospital 
Out of hospital 
cardiac Arrest 
study 
2003-2008
                 Mater Study
•   Improvements in the pre hospital care 
    management of cardiac arrests over the period 
    of the study where;

    –   DFB fire appliance Paramedic equipped with 
        Defibrillators and life saving medications
    –   ERCC began providing telephone assisted CPR
    –   Advanced Paramedics provide pre hospital 
        Advanced Life Support on Fire appliances and 
        Ambulances 
              Mater Study
Conclusions:
 
•The improved quality of Emergency Pre 
Hospital Care has impacted on survival from 
Out Of Hospital Cardiac Arrest, particularly 
from Ventricular Fibrillation
Video of Cardiac Arrest
Thank you for your attention !

        Questions ????

				
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posted:4/1/2014
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