Huntington Memorial Hospital is one of 20 hospitals in Los Angeles County that is a paramedic base hospital. When medical 9-1-1 is accessed, emergency medical technicians (EMTs) and paramedics from our local fire departments arrive on scene. The paramedics perform a detailed assessment of the patient and if their findings meet base hospital contact criteria (as outlined by the LA County Emergency Medical Services), the paramedic then contacts their assigned base hospital (fire departments assigned to Huntington Hospital are Pasadena Fire, South Pasadena Fire, San Marino Fire, San Gabriel Fire, City Fire Station 12, County Fire Station 11 and 19). The paramedics give a report of their assessment findings over the radio to a registered nurse who is certified by Los Angeles County as a Mobile Intensive Care Nurse (MICN). The MICN then evaluates the assessment and provides the paramedic with orders for medication and/or medical interventions as well as provide the paramedic with a hospital destination. Huntington Hospital manages approximately 1,000 base hospital paramedic assessments and contacts per year.
Hospital destination is determined by transporting the patients to the Most Accessible Receiving hospital (MAR) unless:
- The MAR is on emergency department saturation (ED Sat). This means this hospital is so full that they do not have any available beds and have multiple people (either from 9-1-1 traffic or in the waiting room) waiting for extended periods.
- The patient meets specialty center criteria/guidelines and is to be transported to the closest designated specialty center.
Hospitals are evaluated by the Los Angeles County Emergency Medical Services Agency (LACO EMS Agency) for specialty center designation.
Huntington Hospital has earned the following specialty center designations (all of which are available 24-hours a day and 365 days of the year):
- Trauma Center: Huntington Hospital is the only TC in the San Gabriel Valley. There are specific criteria/guidelines outlined by the LACO EMS Agency for patients to be transported to a TC. Huntington Hospital has a catchment area which extends (approximately) to the 2 and 10 freeways to the edge of Monrovia and the local mountains. As a TC we must have critical surgical intervention available immediately at any hour of the day as well as specialized equipment and specially trained Emergency Department, Surgical and Intensive Care (ICU) Registered Nurses (RN).
- Pediatric Medical Care Center: Huntington Hospital is also the only PMC in the San Gabriel Valley. There is specialized criteria for pediatric patients to be transported to a PMC, but basically the pediatric patient is in a critical medical state. As a PMC we must have RNs specially trained in critical pediatric care in the ED and Pediatric ICU.
- ST Elevation Myocardial Infarct (STEMI) Receiving Center or aka “heart attack”: Paramedics are capable of performing a 12 lead EKG in the field which can diagnose a patient having a serious heart attack (aka “STEMI”) for which the patient needs immediate intervention in a cardiac catheterization laboratory (cath lab). Most times the paramedics actually electronically transmit the EKG to Huntington Hospital our ED physician to diagnose. Upon diagnosis, the ED physician or staff will immediately call an interventional cardiologist and our cath lab team of nurses and technicians. In January of 2011, all such hospitals also became hospitals for which cardiac arrest patients that obtained return of spontaneous circulation (ROSC – also known as a return of pulses) in the field were to be transported. This is because many cardiac arrest patients with ROSC are having a heart attack and need cath lab intervention as well therapeutic hypothermia to help preserve brain function post cardiac arrest.
See the video below for a more detailed explanation:
- Comprehensive Stroke Center: Paramedics perform a neurological assessment on patients appearing to have signs and symptoms of a stroke. Taking into account the paramedic assessment and the onset of symptoms, the determination can be made to send a patient to an approved Stroke Center. In our Stroke Center, Huntington Hospital physicians can perform neurological interventions by removing the clot in the brain and providing medications to prevent further brain damage and promote recovery for the stroke patients.
- Perinatal Center: Huntington Hospital provides complete care for the obstetrics including high risk patients and their newborn by having a comprehensive labor and delivery department as well as a neonatal intensive care unit.