Richmond Area Emergency Medical Services (EMS) in the greater Richmond area is internationally acclaimed and uses the latest, state-of-the-art technology to provide high-quality, rapid, cost-effective, advanced life support emergency medical care.
Richmond Ambulance Authority (http://www.raaems.org/), which serves the city of Richmond, is an all advanced life support service. RAA’s dispatch center is staffed with nationally registered paramedics who have special training as dispatchers. They provide scripted pre-arrival emergency instructions to callers. Paramedic units are not based at fixed locations (such as firehouses); rather, sophisticated computer programs are used in real time to calculate the probability of a life or death emergency in various areas of the city at a given moment. Paramedic units are thus constantly on the move being directed to “high risk” sectors of the city based on the computer predictions. The result is 95% of all life-threatening emergency calls have a paramedic unit on scene in 8 minutes or less (average response time interval of 5 minutes with a fire department 1st response unit on scene typically in 3 minutes or less). This makes our EMS response time interval characteristics among the fastest in the world at a cost to our citizens that approximates the median per capita cost in the United States. The Richmond Ambulance Authority is under the Medical Direction of Dr. Joseph P. Ornato. Therefore, there is seamless integration of pre-hospital emergency care and subsequent hospital based care.
Chesterfield County Fire and Emergency Medical Services(http://www.chesterfield.gov/fire/), a metropolitan size fire and EMS department as recognized by the International Association of Fire Chiefs, is a combination department, comprised of 442 uniformed fire and EMS personnel, 45 non-uniformed employees and an estimated 130 volunteer firefighters and 150 volunteer emergency medical providers. The county provides emergency fire and EMS services from 21 fire and EMS facilities and eight volunteer rescue facilities. In fiscal year 2014, CFEMS answered 36,881 calls for service. The percentile for the call load shows 77% EMS, 19% miscellaneous alarms, 3% other fires, and 1% structure fires.
Besides providing the citizens of Chesterfield County the traditional fire and emergency medical services, Chesterfield strives to incorporate an all-hazards approach to emergency response. The department has developed three specialty teams; the hazardous materials incident response team; the technical rescue team; and the dive team.
Henrico County Division of Fire (http://henrico.us/fire/) serves a population of more than 325,000 residents in Henrico County, Virginia in the United States, across a diverse community of 244 square miles. Ranging from metropolitan development and commercial districts to rural farms and forested areas, Henrico Fire maintains a comprehensive, all-hazards capability. The Division is responsible for fire suppression, emergency medical services, hazardous materials response, technical rescue, water rescue, fire prevention, fire investigation, public education, disaster preparedness and emergency management. The department operates 15 ALS transport units, around the clock providing life-saving care. Each of the twenty fire stations across the county are equipped with an engine company, staffed with a minimum of three personnel. Additionally, there are three heavy rescue squads and five ladder towers, also staffed with a minimum of three personnel. In addition, the department operates a Water Rescue Team, Technical Rescue Team, Hazardous Incident Team and special events resources. These specialized teams are supported by three heavy rescue squads and accompanying apparatus.
In 1998, Henrico Fire was one of the first departments in the world to achieve international accreditation from the Commission on Fire Accreditation International (CFAI). In 2014, the Division of Fire responded to 46,310 emergency incidents. In 2015, Henrico County received a Class 1 designation from the Insurance Services Office (ISO) which is the highest rating available to any community. Henrico Fire has been continuously accredited by the Commission on Fire Accreditation International (CFAI) since 1998. In 2015, Henrico County became the first county in America to receive accredited status and an ISO rating of Class 1 at the same time.
VCU Department of Emergency Medicine (http://emergencymedicine.vcu.edu/) is a newly-renovated, state-of-the-art facility with approximately 100 beds and is staffed with 62 attending faculty physicians, 40 emergency medicine residents, PharmD staff, mid-level providers (PAs and NPs) and >300 nurses. At any given time, there are 6-9 board certified attending faculty physicians and 8-16 residents on duty. It includes a 15-bay, high-tech resuscitation area that is one of the largest and best-equipped in the nation.
VCU Department of Emergency Medicine faculty provide operational medical direction for emergency medical services (EMS) units in the city of Richmond and its surrounding counties as well as for the Virginia State police and LifeEvac helicopter services. Together, our rescue helicopters transport approximately 1,500 critical patients to VCU each year. Our facility also serves as the region's Level 1 adult and pediatric trauma center, comprehensive post-resuscitation center, burn center, comprehensive stroke center, comprehensive cardiovascular and cardiac surgical center, and neurosurgical trauma center. The Department of Emergency Medicine Chairman is VCU Site Principal Investigator for NIH’s Neurologic Emergency Treatment Trials Network (NETT) and serves as Cardiac Co-Chair for NIH’s Resuscitation Outcomes Consortium (ROC).
ED Imaging - There are 4 digital plain film xray machines plus two dual-head, latest generation CT scanners capable of high-resolution coronary, cerebral, and peripheral angiography. Radiologists staff an ED “reading area” 24/7. All attending and resident emergency physicians are trained and certified to perform “point of care” emergency ultrasound in the department. We currently have 10 ultrasound machines and perform >800 studies per month in the department. There is an extensive quality assurance program with over-read of all “point of care studies” by our ultrasound director. Emergency MRI is available 24/7 in the same building just 3 floors above the ED.
The department contains the following specialized areas: Adult and Pediatric Registration/Waiting; Triage; Trauma/Resuscitation Unit; Adult Acute Unit; Pediatric Unit, Fast-Track, and Clinical Decision (Observation) Unit. There are 2 HAZMAT decontamination rooms in the department and a 100 foot corridor adjacent to the ED drive equipped with overhead, temperature-controlled, high volume decontamination showerheads for mass decontamination. All effluent water is captured in special drains and does not enter the city sewer system. The ED has its own Stat Lab staffed and operated by the Department of Pathology 24/7. Two of our adult acute treatment rooms are bariatric-equipped units with hoists that can safely lift a >800 lb patient. We also have 5 acute rooms, including an additional 3 rooms in our Trauma/Resuscitation Unit that are capable of providing emergency dialysis. We are the only hospital in the region that has ED Extracorporeal Membrane Oxygenation (ECMO) capability 24/7. In the last 5 years, our institution has placed >600 adult and pediatric patients on ECMO emergently, including 1-2/month in the ED. The ED Clinical Decision Unit (CDU) has 18 beds and is staffed by separate EM/IM board certified faculty, mid-levels (PAs and NPs), and nurses. The unit is operational 24/7 and admits 3,500-4,000 patients per year. All beds are monitored. Observation unit protocols for admission, clinical care, and discharge are followed for all patients. The average length of stay is 16 hours. Four of the patient rooms are “geriatric equipped” to provide the safest possible environment for such patients.