Delivering a Higher Level of Quality Care
The North Shore-LIJ Health System ambulance service is committed to providing the highest quality of pre-hospital care to our patients, while continuing to raise the EMS standards of excellence for the communities we serve.
Center for Emergency Medical Services (CEMS) vision is to create a standard of care for pre-hospital and interfacility transportation that exceeds current expectations through:
- Competency/credentialing standards
- Promoting excellence within the continuum of care through a team approach
- Providing comprehensive emergency medical services throughout North Shore-LIJ Health System
- Cost efficiencies
Critical Care Transports - Specialized Care
The Center for Emergency Medical Services is the region’s premier out-of-hospital critical care service. Each and every one of our Paramedics has been trained above and beyond the national paramedic curriculum thru critical care training courses. Using state-of-the art mobile intensive care units, the CEMS transports some of the sickest patients to the systems tertiary facilities, keeping patients in a mobile ICU setting, even when they are between hospitals. These include unstable cardiac transfers, intra-aortic balloon pump patients, left ventricular assist patients, trauma patients, neurosurgery candidates, and critically sick or injured neonates and pediatric cases.
Regardless of where a patient is having an acute cardiac-related episode in a doctor’s office or a hospital CCU, an ambulance is dispatched within seconds, ready to respond anywhere in the region. In cooperation with the health’s system catheterization labs at North Shore University Hospital in Manhasset, Long Island Jewish Medical Center and Lennox Hill Hospital, we have established a rigid and closely monitored time frame from the moment these calls are received by CEMS until the patient has arrived at their final destination. This time sensitive window guarantees rapid access to emergent coronary angioplasty for all North shore-LIJ patients. Working in collaboration with the Department of Cardiology and our medical directors we have decreased the mortality rate of acute MI patients requiring primary angioplasty in the region. In 2010 through a collaborative effort we have been able to achieve a nationally recognized average time from phone call to CEMS to delivery of these critical patients to the receiving cardiac catheterization lab in less than 45 minutes. Our axiom is simple: “Time Is Muscle.”
Neonatal and Pediatric Intensive Care
Working with the Neonatal and Pediatric Intensive Care Unit teams from Steven and Alexandra Cohen Children’s Medical Center of New York and Cohen Children’s Medical Center of New York at North Shore University in Manhasset, crews from the CEMS facilitate the transportation of very sick children into the health system’s specialty units. Using specialized vehicles that support the most sophisticated isolette in the industry, our pediatric and neonatal transport units are designed to allow nurses, doctors, respiratory therapists, paramedics, and EMT’s, the room and resources they need to care from these precious patients. Since time is so critical with sick neonates and pediatric cases, our units are ready to respond within a moment’s notice. Within 20 minutes of the sending of a facility’s request for a transfer, our ambulances are leaving those facilities with the specialty teams on board. Our reach extends over a large portion of the eastern seaboard of the United States – we have transferred patients from such facilities as the Children’s Hospital of Philadelphia (CHOP) and Massachusetts General Hospital of Boston.
The Stroke Rescue Program was implemented at the North Shore –LIJ Health System as a way to streamline the transfer of patients from referring hospitals to the stroke center at North Shore University Hospital, which can deliver more advanced diagnostic and treatment procedures, including local intra-arterial thrombolysis, mechanical thrombectomy, and embolectomy. The goal is to reduce the time from the initial phone call to arrival at the stroke center in less than 60 minutes. CEMS has consistently achieved this goal during the last two years even as our service area has more than doubled in size (see graph). CEMS has continually reduced transport times and improved the transfer process through increased efficiencies and process improvement. These improvements have been imperative to the success of our comprehensive stroke network and are inclusive of 20 hospitals that refer patients in need of advanced treatment.
Over the past decade North Shore – LIJ CEMS has been pioneering and field testing new procedures in pre-hospital care. CEMS was the first EMS Agency in our area to demonstrate the appropriateness of using etomidate for medication facilitated intubation in the field, and spearheaded the implementation of CPAP devices in the pre-hospital treatment of Acute Pulmonary Edema (APE). CEMS researched the effectiveness of pre-hospital use of CPAP and etomidate, presented the results to the medical leadership of CEMS, Suffolk County and New York City Regional Emergency Medical Advisory Committees, who ultimately approved these new procedures and they are presently in practice today.
Our programs success and innovative protocol is directly linked to our paramedic’s ability to adapt new technology and treatment modalities in out-of hospital settings. These are fitting examples of our commitment and dedication to providing the highest level in patient care.