Operational and Operational and EmergencyEmergencyMedical ServicesMedical ServicesDean A. Ross, Deputy ChiefDean A. Ross, Deputy ChiefNational Park ServiceNational Park ServiceEmergency ServicesEmergency Services ““To those devoid of imagination a blank place To those devoid of imagination a blank place

on the map is a useless waste; to others, the on the map is a useless waste; to others, the most valuable part.” most valuable part.”

Aldo LeopoldAldo Leopold

National Park ServiceNational Park ServiceU.S. Department of the InteriorU.S. Department of the Interior

Mission RequirementMission Requirement

16 USC 1-4. Generally 16 USC 1-4. Generally known as the “Organic known as the “Organic Act,” authorizes the NPS Act,” authorizes the NPS and provides the and provides the authorities authorities to provide emergency to provide emergency services to visitors and services to visitors and employees.employees.

Operational SpaceOperational SpaceMission Space:Mission Space:• Manages 9.2% of US LandsManages 9.2% of US Lands• Many ecosystems and biomesMany ecosystems and biomes• Highest 20,328 feetHighest 20,328 feet• Lowest -282 feetLowest -282 feet• Warmest/ColdestWarmest/Coldest

Critical Missions:Critical Missions:• Emergency Medical Services (>15,000 patients/year)Emergency Medical Services (>15,000 patients/year)• Search and Rescue (>5000 search and rescues/year)Search and Rescue (>5000 search and rescues/year)• Homeland Security (icon, border and counter-narcoterrorism)Homeland Security (icon, border and counter-narcoterrorism)• Law Enforcement/Protection Law Enforcement/Protection • Aviation Aviation • Collateral Structure Fire, Wildland Fire, DivingCollateral Structure Fire, Wildland Fire, Diving

NPS EMS SystemNPS EMS System 137 EMS Programs137 EMS Programs 2286 EMS providers2286 EMS providers

544 ALS (AEMT, EMTP)544 ALS (AEMT, EMTP) 52 ALS (RN, PA)52 ALS (RN, PA) 1690 BLS (EMR, EMT)1690 BLS (EMR, EMT)

4 National Medical Directors4 National Medical Directors 148 Local EMS Advisors148 Local EMS Advisors Six Levels of PracticeSix Levels of Practice

EMREMR Remote EMR *Remote EMR * EMTEMT AEMTAEMT Parkmedic *Parkmedic * ParamedicParamedic

** Advanced Scope Advanced Scope

NPS EMS Patient CareNPS EMS Patient Care Encounters >90,000 /YearEncounters >90,000 /Year Patients >15,000/YearPatients >15,000/Year

65% Basic Life Support65% Basic Life Support 28% Advanced Life Support28% Advanced Life Support 7% Cardiac Care7% Cardiac Care 51% Trauma51% Trauma 49% Medical49% Medical

Transports > 10,000/YearTransports > 10,000/Year 89% Ground89% Ground 8% Air8% Air 3% Vessel3% Vessel

Fatalities ~300/YearFatalities ~300/Year 62% Traumatic62% Traumatic 38% Medical38% Medical

NPS Electronic Patient Care NPS Electronic Patient Care RecordRecord Effects of ePCR use (started in FY 2008)Effects of ePCR use (started in FY 2008)

Created a more evidence based practiceCreated a more evidence based practice Used to establish Quality Improvement/AssuranceUsed to establish Quality Improvement/Assurance Refined/New Protocols and ProceduresRefined/New Protocols and Procedures Epidemiological SurveillanceEpidemiological Surveillance Injury PreventionInjury Prevention Risk ManagementRisk Management BLS/ALS FormularyBLS/ALS Formulary NotificationNotification

FutureFuture Android/iOS InterfaceAndroid/iOS Interface IMARS/SMIS IntegrationIMARS/SMIS Integration

EMS Program-AdditionalEMS Program-Additional NPS operates 3 Emergency Care ClinicsNPS operates 3 Emergency Care Clinics

Yosemite (NPS Staffed)Yosemite (NPS Staffed) Grand Canyon (Contract)Grand Canyon (Contract) Yellowstone (Contract)Yellowstone (Contract)

CISM and Clinical PsychologyCISM and Clinical Psychology > 500 CISM Peers> 500 CISM Peers > 40 Psychologists> 40 Psychologists HotlineHotline

Risk ManagementRisk Management Operational LeadershipOperational Leadership Operational Risk Mgmt. Operational Risk Mgmt.