How is the System Designed?

Like most other EMS systems in the country, Medic relies on EMT first responders and a Paramedic ambulance to safely and appropriately treat patients suffering from medical emergencies. First responders assess the patient and perform the basic life support (BLS) skills known to make a difference in clinical outcome. After conducting a patient evaluation, they can defibrillate a heart, perform CPR, help control bleeding, and administer oxygen.

Here in Mecklenburg County, they're also permitted to perform more advanced treatments, including assisting patients in taking prescribed medications (such as nitroglycerine) and administering a specific drug to treat a life-threatening allergic reaction.

When the Medic ambulance arrives, often before or with first responders, it is staffed with a team of at least one paramedic who can deliver advanced life support (ALS) care including inserting a breathing tube into a person's lungs, starting IV's and administering sophisticated drugs intravenously. All patients benefit from BLS care while far fewer require ALS interventions.

Because Paramedics perform invasive procedures and have a broader scope of clinical practice than EMT's, certification requires a much higher level of training (more than 1,300 hours to meet the national standard), rigorous continuing education and frequent demonstration of skills to ensure competency. By contrast, EMT certification requires approximately 120 hours of instruction.

 It's Healthcare

Mecklenburg EMS Agency, Medic, was created in 1996 as a unique partnership between the County and both hospital systems, Carolinas Healthcare and Presbyterian Health to provide prehospital healthcare to this community.

The EMS system was created after an open, public and extensive debate among all local governments, and representatives of the healthcare and public safety communities.

At the system's foundation is the requirement that any changes in clinical care be guided by medical evidence and demonstrated improvements in patient outcome.

In the next 12 months, paramedic teams will respond to more than 90,000 calls for emergency medical help in Mecklenburg County. Each time they are equipped and trained to deliver advanced life support (ALS) care if needed. The system is supported by more than 1500 EMS first responders who have the tools and skills necessary to be expert in delivering basic life support (BLS) care.

Medical Expertise, Responsibility and Accountability

The County defines operating standards in a performance-based contract, while the hospital systems provide strong healthcare management and clinical oversight. No EMS system in the nation is held to a higher level of accountability than Medic.

Medic includes a physician based Medical Control Board (MCB) and a physician based Quality Management oversight committee. By design, the system relies on their clinical expertise to guide patient care decisions.

On the Medical Control Board, eight voting physicians (four from each hospital) and a number of non-voting members including the Medical Director and the Charlotte Fire Chief, routinely evaluate ways to further improve the system.

The MCB uses the same standards employed in-hospital to judge possible improvements in the pre-hospital environment. Any idea must be supported by clinical evidence and must demonstrate an improvement in patient care and patient outcome. Like the rest of healthcare, ideas that do not demonstrate an improvement over current "best practices" are not adopted.

System Endorsed

On a number of occasions, the design of the Medic system has been reviewed, evaluated and endorsed by medical experts and lawmakers alike. These community leaders feel Medic's performance is very strong. In addition, they cite the design itself as being the best structure to ensure ongoing improvement in the face of future challenges.