Doctors riding ambulances isn't common in the U.S., but some in EMS believe they can be an asset in the field, bringing capabilities and education beyond paramedics', to the benefit of patients. The New Jersey EMS Task Force's Physician Response Team, MD-1, is a specialty resource that can be called to assist with triage and treatment and provide medical consultation to providers at disaster and major emergency scenes.

     The team began in 2005 as a small-scale 24-hour physician response program at a community hospital. It was based on models in New York City and Pittsburgh, and while it initially covered only a small geographic area, its architects hoped to grow it into a statewide program.

     An initial vehicle was donated by a car dealership. A six-month process ensued to obtain blood licensure and equipment, including monitors, surgical equipment, point-of-care testing products and intubation devices. Local donors provided significant help. The vehicle—a Ford Expedition labeled EMS Physician and decaled with New Jersey EMS Task Force emblems—was designed, arranged and made operative. The local hospital was unwilling to cover residents under the program due to insurance reasons, so the emergency department insurance policy was rewritten to include prehospital coverage for attending physicians. We anticipated that several physicians and an EMS Fellow would train on the vehicle, and eventually cover all of New Jersey. The criteria to call the unit would be either delayed on-scene time (greater than one hour or as judged by EMS) or at the request of any local ALS agency.

     One key capability docs would bring to the field would be the ability to give blood. A prehospital blood transfusion license was obtained from the state Department of Health and Senior Services, and a protocol was written to cover transfusion indications, reactions and refrigeration techniques. A portable refrigerator was mounted in the vehicle, with a temperature probe to assure the temperature was maintained at 2°–8°C 24 hours a day. A secondary battery powered the refrigerator, and a shore line was built into the vehicle to plug in when a physician took the vehicle home.