The Magazine for the Caring Services
Who You Gonna Call?

Established in 1996, Dublin based company Emergency Medical Support Services (FMSS) provide a medical transport and patient care service that is quite unique. Operating with a current staff of ten (including drivers and secretarial stall), the founding members, John Kelly, Declan Traynor and Brian Crowley , have aver 40 years combined experience in the medical care and transport field. They decided to set up the business having identified a requirement for a broader range of medical transport service than that being provided by front line ambulances or taxis.

As Traynor explains, the business has already dramatically changed from that which was formed half a decade ago: "back in 1996, the business was set up for the transport of the transplant teams in Ireland . The idea of a private service dedicated to the provision of the service, with a high standard of vehicles and training was presented to the directors of the liver and heart transplant programs. The service started providing the ground transport nation-wide for these teams,   then progressed onto providing a similar service for UK teams and organs traveling within the country. The co-operation of the Gardaí whilst operating within Dublin and around the country and of the airport police at the major airports is of great assistance in the smooth operation of this 'time-critical' service,' maintains Traynor. “other persons and agencies that give great assistance include the airlines themselves as well as aviation handling agents, East and West link toll bridges and various hospital departments around the country” He adds: “the successful completion of an EMSS transplant mission involves a lot of people at co-operating together”.

This co-operation was the catalyst from which the steady development and expansion of the services provided by EMSS began. During 1997, the provision of an 'International Medical Repatriation Service' was entered into with a number of leading UK insurance and assistance companies. This involved both ground transport within Ireland and assisted travel with patients outside of the country, which in turn led to the establishment of a patient transport service from the companies base in Dublin . This service was based on the new concept of a 'medical car, service for non-critically ill patients - mostly from a number of private Dublin hospitals traveling to other facilities for either tests or treatments. The idea of medical cars as distinct from full-sized ambulances was very radical for its time, a practice for which EMSS have become renowned and admired for. It allowed for major cost saving to be made for hospitals and insurers, while providing a major increase in comfort for patients in the process. The following year saw yet another new approach to the medical transport field in Ireland , with the development of an 'Integrated Mobility Support & special Needs unit' *which allowed EMSS to provide a dedicated wheelchair transporters with all the comfort of their medical cars.

Continued demand for the now highly regarded and much sought after service led them to develop a very high-tech mobile intensive therapy ambulance during 1999- As director of medical car services! John Kelly explains, "this unit was developed taking advantage of the ever expanding area of computer technology and digital data communications. It is equipped with the very latest digital communications suite and video communications Systems. Patient monitoring incorporating three or 12 lead ECO, 5P02 and Non-invasive BP can now be transmitted along with video feed to anywhere in the world via the GSM network. Standard cardiac monitoring and monophasic defibrillation with pacing can be also provided'.

According to Chief Ambulance Officer for EMSS, Brian Crowley : "all these units, from medical cars to IT-ambulance, are designed, maintained and crewed to the very highest standards, this is reflected in the level of staff training both initial and ongoing designed to allow crews deal with any situation in a professional controlled manner. Each unit is equipped to deal with specific medical situations, and all are fully equipped with oxygen supply and full medical-trauma kit' EMSS continue to provide the highest standard of service to patients entrusted to travel with them. The company's vehicles include a Rover G2Osi, - which accommodates three passengers and is fitted with full emergency equipment, oxygen storage, patient transfer chair Then there is the Ford Scorpio 2.3i Ghia, which also carries three passengers in executive comfort and includes all equipment needed.

To complement the medical car division, the mobility support and special needs vehicle is based on the Nissan Vanette Combi . this unit is wheelchair accessible and, once in place, wheelchairs are secured by means of a four-point Q-Straint belt system. The patient is also secured by a shoulder and lap seatbelt while in the wheelchair.

The other variant of this unit is an incubator transport vehicle. Again, the incubator is secured to the floor by means of the four- point Q-Straint system for total safety. The mobile intensive therapy ambulance is based on the Toyota Hiace Hi-Roof. All vehicles have an on board fax machine, internet and e-mail capabilities along with GPS navigation. each of the vehicles is white in colour and is equipped with a high-visibility strobe light bar, three-stage siren and high-intensity reflective medical markings.

EMSS believes that the distinct advantage in using medical-ambulance-cars in certain situations, is that they can often help the patient to be put   at ease when going into an uncomfortable or fearful situation, as medical tests and procedures can often be. Traynor contends, 'we provide a service that meets the demands of hospitals1 nursing homes and insurance companies, that to date could only be provided by full-size front line ambulances ‘It is our experience that people such as radiotherapy or cardiac patients or patients who have traveled from abroad on medical repatriation grounds, or any patient who is nervous or anxious, have expressed concerns at having to travel in large front-line ambulances. The medical cars and understanding staff provided by EMSS will put these patients at ease and comfort whilst in our care" EMSS collect their patients from a variety of locations such as hospitals, nursing homes, ferry ports and airports to name but a few. They escort all patients to the relevant department or area they are required to go to, which ensures continuity of care until they are handed over. It also ensures correct patient introduction and enables EMSS to establish a time for collection for the return journey if applicable.

Traynor points out that:"should it be medically necessary, any patient can be upgraded to a full front line ambulance or transported under blue lights and siren to a medical facility." However, despite all this highly impressive equipment and service, it is the staff that provides the real service, and in keeping with this, Traynor says that the company is, 'noted for our professionalism and ability to integrate with patients and medical personnel. Our drivers ability to cope with situations in a discreet but positive manner is a direct result of the high level of training undertaken in all areas ranging from driving procedures, emergency medical technician programs and emergency response management.

"EMSS carry extensive professional insurance,' he adds, 'and all our staff are fully trained in all front line medical services It is also our policy to continue a program of in-service training for all our front-line personnel, thus ensuring their skills are maintained to the highest standards and that they're fully up to date with the latest practices"

It should be noted that all EMSS drivers partake in a variety of ongoing training programmes, the most intensive of these being the 'Advanced Driving Training Program' set to the standard of the advanced police driving system - 'Roadcraw'. Traynor points out that there is always room for improvement and that you need only look abroad to see where new developments are already making a difference in medical care. "In Sweden for example, as someone's being transported to a medical facility, all the patients details will be keyed in and a barcode will be made UP, it's read by the machine and by the time they reach the hospital, all relevant details are recorded and have been transmitted ahead so all the requirements of the case are in place upon arrival. This can be basic PTS to Major Trauma cases. From our point of view, we wouldn't need to go as in- depth as that but were looking at a similar principle".

Considering that EMSS is one of only a few companies currently in their line of work~ I wondered what Traynor feels separates them from their competition? Carefully considering his reply, he states: "we would like to think that were different in the sense that other private ambulance companies would be very ambulance-oriented, whereas we provide four or five different levels of service - from medical car! wheelchair accessible, ambulance1 to pure assist cases, this allows us to be more flexible and we are more geared to handle the unusual cases. We've also opened up a medical courier division, where we deliver urgent blood, urgent and non-urgent medical equipment and unaccompanied transplant organs, again making us a multi- role Medical Transport Service.' In closing Kelly reveals that 2001 will see another major new introduction of vehicle type, design, and markings, once again making EMSS one of the most progressive and adaptable service providers around, adding that in the very near future their vehicles shall boast "on-board video, DVD, PS2, active mapping, as well as the standard fax and e-mail"