SPRINGFIELD — Mercy Medical Center is committed to innovation in the delivery of emergency medical services (EMS), and the most recent example of that commitment is the launch of the new Mercy CERT program that brings a hospital Emergency Department physician directly to the patient in the field.
A CERT (Community Emergency Response Team) physician responds to 911 medical emergencies together with an ambulance. The CERT vehicle is equipped with resources to provide additional advanced care not traditionally available to patients by paramedics.
The CERT vehicle is currently staffed three to four days a week by a board-certified emergency medicine physician. Dr. Matthew Cauchon is the medical director of the program. The vehicle is equipped with radios that allow the responding physician to communicate with Mercy-affiliated EMS, fire, and police services in Western Mass.
CERT physicians on scene of a patient in need of emergency care support EMS with patient-management decisions in the field and en route to the hospital. In addition to being able to provide advanced care, they also have access to equipment and procedures not typically available in the EMS system. These include:
• Rapid-sequence intubation medications to sedate and paralyze patients, which is the standard of care in a hospital and provides safer intubation;
• IV medications to increase blood pressure and heart function in a very sick patient in shock;
• Advanced airway management, including indirect laryngoscopy, supraglottic devices, and surgical cricothryroidotomy, a last-resort, life-saving airway procedure;
• Point-of-care ISTAT to check vital labs prior to arrival at the ED;
• Mass-casualty equipment including tourniquets, special clotting bandages, and other life-saving equipment; and
• Field amputation, or the ability to amputate an entrapped extremity.
The ability to provide a blood transfusion to patients in shock from acute blood loss will soon be available as well.
According to Cauchon, patients and their family members are surprised and relieved when he arrives on the scene. What they may not realize is that this program promotes real-time quality improvement as the EMS physician works directly with the paramedics providing live feedback on patient care during and after a specific call. In this way, education is more meaningful as it associated with an actual patient and their immediate clinical needs.
“Dr. Cauchon and his CERT physicians bring an asset to the field that has long been missing,” said Johnathon Hall, a paramedic with Alert Ambulance, Chicopee Division. “A key part of being an EMS medical director is field supervision. His direct clinical oversight and real-time feedback is invaluable. He makes EMS feel like part of the whole emergency-medicine system. He ensures standards are held by all providers, and providing real-time medical control is helpful to me and my patients.”