Louisville Metro Emergency Medical Services (also known as LMEMS and known locally as simply Metro EMS) is the primary provider of pre-hospital emergency medical care within Louisville-Jefferson County, Kentucky. With an authorized strength of 250 Paramedics and Emergency Medical Technicians (EMTs), LMEMS is the amalgamation of Jefferson County EMS (JCEMS) and the EMS Bureau of the Louisville Division of Fire (LFR). LMEMS was created early in 2005 and was the last of the major public services in the area able to be combined under the city-county merger of January 6, 2003. LMEMS is a government-administered, third-service EMS provider meaning the agency is not a division or bureau of either the police or fire department but is its own agency. Since its creation LMEMS has averaged 100,000 calls for service, both emergency and non-emergency, each year. The current Chief Executive Officer is Dr. Neal Richmond, MD and the Director of Operations is Colonel Craig Rodgers, EMT-P.
Louisville Metro EMS has its history rooted in the two major EMS providers that served the area since the earliest days of pre-hospital care of the 1970s.
Police officers transferred the severely ill or injured to hospitals in Louisville until 1972 when the Jefferson County Medical Society created the first EMS service. The first licensed paramedics in Kentucky graduated in 1975 from a pilot program at the University of Louisville Hospital. Included were fifteen City of Louisville EMS paramedics and one Jefferson County Police officer paramedic.
Due to the extensive use of BLS ambulance crews in Louisville-Jefferson County, many additional skills traditionally reserved for paramedics are authorized for trained EMTs. This expansion of the EMT's abilities has led to the unofficial use of the acronym ELS, or Expanded Life Support, to describe care provided by LMEMS EMTs.
According to LMEMS official web page
Louisville Metro Emergency Medical Services (LMEMS) provides 24-hour-a-day, 911 emergency medical care throughout the Louisville Metro area. Medically focused and data-driven, LMEMS is committed to the development of the latest advances in basic and advanced life support patient care. Utilizing a comprehensive approach to education, training, technology and research, the goal of LMEMS is to provide a "Best-Practices" model for EMS to those whose visit, reside and work in Louisville Metro.
LMEMS provides transportation to the emergency department of the chosen hospital. Currently, all scheduled service and inter-facility transports are handled by private ambulance providers retained by the patient. Only under extreme extenuating circumstances, and only with supervisor approval, will LMEMS provide inter-facility transfers.
LMEMS is a "union shop" and all non-command level employees are required to become members of the International Brotherhood of Teamsters (IBT) Local lodge #783. Job assignments, shifts, and vacations are filled using a system based on seniority. However, promotions within the service are entirely merit-based although an employee's tenure may be taken into account to determine suitability. Any employees' first six months of service with LMEMS is considered a probationary period where the new hire is subject to dismissal without union representation.
In an effort to improve patient care, a Medical Steering Committee has been established to help provide input into protocol development and change.. This committee includes EMTs and paramedics in the process of developing new, progressive patient care protocols.
Even with Jefferson County and Louisville with merged a government several government bodies still operate independently within and near Jefferson County. With the different Fire, Police, and EMS services still operating in the area they have mutual aid deals which is a promise to provide support if needed by near by communities. Fire services can act as a first responder if an ambulance is too far away, and a different ambulance service can respond if closer in a critical situation.
LMEMS partners with the various fire departments and fire protection districts in the metro area in a cooperative effort to further reduce the amount of time from when a person calls for assistance to the time assistance arrives. The American Heart Association recommends early defibrillation to be beneficial to an individual suffering cardiac arrest and as such most fire apparatus carry automated external defibrillators (AEDs) with trained EMTs to medically assist prior to ambulance arrival.
In addition to Fire & Rescue mutual aid deals, several other ambulance services exist within Louisville-Jefferson County such as Anchorage EMS. Other ambulance agencies like Rural Metro and Yellow EMS will provide services for parts of areas near by or within Jefferson County. For example Jeffersontown has a contract with Yellow EMS, which also provides mutual aid to LMEMS when needed.
LMEMS also provides mutual aid to other agencies as well. The Louisville paramedics are often called upon to provide assistance to BLS ambulance crews from other services and other counties when their own advanced providers are unavailable.
Neither Louisville nor Jefferson County government has ever maintained a helicopter for air ambulance use. The medi-vac system, proven effective during the Vietnam conflict, was provided in the 1970s by the United States Army Reserve on an "as available" basis for non-military use in the Louisville area. Later, several enterprises providing aeromedical services emerged since 1982 through either privately-held companies, corporations, or hospital groups. The original civilian air ambulance services, SkyCare (Jewish Hospital) and StatFLIGHT (Humana Hospital University), merged in 1996 to become StatCare. StatCare was the longest serving aeromedical service in the area to maintain the same name and ownership though it has since been superseded.
|Divisions of Louisville Metro EMS|
|Division One||Harrods Creek, Eastwood, Middletown, Lyndon, Springhurst, and St. Matthews.|
|Division Two||Okolona, Highview, southern Camp Taylor, Buechel, and Fern Creek.|
|Division Three||Pleasure Ridge Park, Fairdale, Rubbertown, and Shively.|
|Division Four||Portland, Russell, and Shawnee.|
|Division Five||Downtown, Beechmont, Iroquois, and Auburndale.|
|Division Six||Buchertown, Highlands, northern Camp Taylor, Crescent Hill, and Hikes Point.|
|Division Seven||Refers to the City of Jeffersontown, for mutual aid.|
With the implementation of the National Incident Management System by the Federal Emergency Management Agency (FEMA), the use of 10-codes by LMEMS has, at least officially, ceased. According to FEMA using "plain speech" radio traffic can help eliminate misunderstandings and confusion among different agency with dissimilar radio codes. While the use of 10-codes is discouraged by LMEMS policy the use of coded radio traffic continues and is widely tolerated.
By department procedure, response requests are assigned to LMEMS resources based on their proximity to the incident and the skill level anticipated by using information gathered from the caller. When a BLS unit is closer to an incident believed to require advanced care a paramedic "fly-car" response (or, alternatively, another ambulance containing a paramedic) is also dispatched. Using information gathered from the call, assigned resources are also instructed response with red lights and siren (termed Code-3) or without lights and siren (termed Code-1). If the BLS ambulance crew first arrives and determines that advanced care is not needed the ALS resource may be canceled and ready to respond elsewhere. Patients are transported to any of the area hospitals either Code-1 or Code-3.
Current hospitals regularly served by LMEMS include University of Louisville Hospital, the area's level 1 trauma center, the three hospitals owned by Norton Healthcare (Suburban, Downtown, and Audubon), Saint's Mary and Elizabeth Hospital, Baptist Hospital East, and Jewish Hospital downtown, Jewish East, Jewish Southwest, and the U.S. Department of Veterans Affairs Louisville Medical Center. LMEMS will also transport patients to hospitals outside of Jefferson County on occasion including Baptist Hospital Northeast in Lagrange, KY, Jewish Hospital-Shelbyville in Shelbyville, Kentucky, Jewish South in Bullitt County, Kentucky and both Floyd Memorial and Clark Memorial hospitals in southern Indiana.
Louisville and Jefferson County area police, fire, EMS, and other public services still use the pre-merger radio systems, a combination of VHF-Hi band and UHF. Communications are still splintered and vastly segregated. The MetroSafe project had initially been intended to remedy these issues by 2007. However due to budget shortfalls, cost overruns, and delays the new 800MHz trunking radio system has yet to be implemented.