Delivery of EMS Services
EMS services are typically provided in response to a medical emergency reported through the 9-1-1 emergency telephone system. A 9-1-1 call placed from any telephone is automatically routed to the appropriate designated primary Public Safety Answering Point (PSAP) usually located at the dispatch center for the law enforcement agency in whose jurisdiction the 9-1-1 call is placed. At the PSAP, whether local or CHP, a telecommunicator determines the nature of the emergency and, transfers medical emergencies to the appropriate fire/medical dispatch center for Emergency Medical Dispatch (EMD) triage. In some cases, such as in Richmond and areas served by the San Ramon Valley Fire Protection District, the primary PSAP and fire/medical dispatch center are part of the same facility. During the EMD process, a certified EMD dispatcher obtains details of the medical emergency and dispatches appropriate EMS resources. When indicated, the EMD dispatcher provides pre-arrival medical instructions to the caller.
The three locally authorized and Internationally Accredited Emergency Dispatch (IAED) EMD centers in Contra Costa County include the San Ramon Valley Fire Communications Center, the Richmond Police Communications Center, and the Contra Costa Regional Fire Communications Centers (CCRFCC), All local EMD centers utilize the Medical Priority Dispatch System (MPDS) which provides standardized triage for all medical emergencies across the county.
The initial response to a medical aid request generally includes both a non-transporting fire first responder unit and an emergency ambulance. Most firefighters are trained and certified as Emergency Medical Technicians to provide Basic Life Support (BLS). Regardless of EMT certification, all firefighters in Contra Costa County are trained to provide first aid, CPR and defibrillation. Most fire resources in the County are staffed with at least one paramedic, able to initiate Advanced Life Support (ALS). Crockett-Carquinez Fire and Richmond Fire provide first responder service at the BLS level.
Emergency ambulance response throughout the County is provided by private or fire district ambulance service. San Ramon Valley Fire and Moraga-Orinda Fire provide emergency ambulance services within their respective districts. Contra Costa County Fire is the County's contracted emergency ambulance provider covering all other areas of the County through a sub-contract with AMR, referred to as the Alliance. Emergency ambulances are staffed with one paramedic and one EMT. BLS ambulances are staffed with two EMTs and may be used to respond to calls when indicated by local policy.
Patient treatment and transport are delivered according to State regulations and County EMS policies and treatment guidelines. Patients are transported to General Acute Care Hospitals (GACH). Hospital destination is determined based upon patient preference and County EMS policy. Critical patients may be directed to the nearest, most appropriate emergency department (e.g., STEMI Receiving Center, trauma center, stroke center, etc.) Non-critical patients may be transported to hospitals of choice within reasonable travel time. Air ambulance service is available 24 hours a day to transport critical patients when ground ambulance transport time would be excessive.