Community medicine’s “front line”

It’s just past midnight. You awaken with pain and pressure in your chest. Your breath is short. The pain intensifies, and you think “heart attack.” You call 911. Within minutes, paramedics are assessing your symptoms, providing initial life-saving measures and transporting you safely to your local hospital. 

Every single day, emergency situations arise in the community, and Emergency Medical Services (EMS) providers are the real-life heroes. Thanks to their life-saving actions, members of the community are able to receive the necessary treatment as quickly as possible. As medicine’s “front line,” Advocate Sherman Hospital in Elgin, Illinois considers EMS partners in the community as truly an extension of the hospital’s quality care in the field.

Currently, Sherman’s Emergency Department sees an average of about 900 to 1,000 ambulance patients a month. That’s why Sherman and its EMS partners work closely together to ensure streamlined care and communication.

“Our partnership with the Greater Elgin EMS system enables our high quality medical care to be delivered before the patient comes through the Emergency Department’s doors,” says Dr. Steve Zahn, medical director of the emergency department at Advocate Sherman Hospital. 

An educational resource
Sherman has been a resource hospital for local paramedics and EMTs since 1975. As a resource hospital, Sherman provides training for new paramedics and EMTs as well as continuing education on a monthly basis. The continuing education topics change each month to ensure EMTs stay up-to-date on specific protocols for a variety of medical conditions. Sherman also holds quarterly meetings with the area’s fire chiefs to inform them of any changes and have open conversations on the best way to lead health in the community. 

“Continuing education offered through Sherman to all EMS providers in the area helps us to stay on the cutting-edge of the emergency medical services field,” says Steve Schmitendorf, Chief of the East Dundee Fire District. “Communication and ongoing training is key to ensure both the hospital and EMS are on the same page. We have a strong working relationship with Sherman in order to provide a high level of care to citizens in our community.” 

Streamlined care and communication
When paramedics are called to duty, they follow standing medical orders (SMOs), which are mutually agreed upon protocols for different medical situations determined by Sherman. These SMOs ensure both care and communication is streamlined between EMS and Sherman. “SMOs are a list of per diagnosis techniques, treatments and medicines that paramedics are able to start immediately to ensure everyone in an emergency situation is able to receive high quality care as quickly as possible,” Dr. Zahn says. 

Communication between Sherman and its EMS partners in the field is also key for the ED to prepare for the patient’s arrival. For example, if paramedics determine that someone is experiencing a heart attack, they will call a Code Cardiac to inform the hospital of the patient’s condition and estimated time of arrival. “Even before a patient arrives at the hospital, the Emergency Department is preparing for his or her treatment,” Dr. Zahn explains. “A cardiologist has been paged, the cardiac catheterization lab and cardiac angiography suite has been notified, etc. Paramedics call Sherman ahead of time to activate this cascade of events so the patient is treated immediately upon arrival.” 

This strong relationship with EMS has been instrumental in helping Sherman to achieve important accreditations and awards. For example, Sherman was recently re-accredited as a Certified Chest Pain Center by the Society of Cardiovascular Patient Care. One of the key elements required to achieve this accreditation is “Emergency Department integration with Emergency Medical Services in order to collaborate and share metrics on care” of a cardiac patient. 

Leading health in the community
In addition to providing emergency care, Sherman’s partnership with EMS is evolving to focus on preventative medicine to better serve the health needs of the community. According to John Fahy, Chief of the Elgin Fire Department, a pilot program in the planning stages will focus on wellness checks for Sherman patients within the community. For example, a program piloted last year had paramedic visiting the homes of congestive heart failure patients to check their vital signs and ask a set list of questions to assess their condition. 

“Community paramedicine is a buzz word in emergency medical services, and I see this as the future of medicine,” Chief Fahy says. ‘The focus is on preventative medicine where paramedics check up on patients at their homes instead of having them come to the hospital for non-emergency situations. Our partnership with Sherman is continually focused on building a model to better serve the medical needs of our community.”