​Thurston County's Medic One / Emergency Medical Services (EMS) System was established in 1974.  It was the first public, county-wide, tiered response, EMS system in the United States.

• The Medic One/EMS System provides a fire services based basic and advanced life support emergency medical and trauma care and transport to over 303,400 residents within the county's 727 square miles.
   
• The EMS System responded to 40,301 EMS calls during 2023.
   
• The Medic One System’s paramedic units responded with a countywide average response time of 7.12 minutes.
   
• The paramedic units accomplished an overall 93% county-wide response goal achievement for response goals of 10 minutes urban, 20 minutes suburban and 30 minutes rural classified areas.

​The approach is to involve all jurisdictional entities as participants in the system rather than a sole provider approach.

• Twelve fire departments/districts are providers of Basic Life Support (BLS) and are certified at First Responder or Emergency Medical Technician (EMT) levels.
   
• All Fire/EMS agencies function with one or more Aid vehicle (55 BLS units provide countywide coverage), averaging 6.75 minutes countywide.
   
• All BLS agencies have been auto-defibrillation capable since 1986 and carry epinephrine for severe allergic reactions.
   
• Most fire agencies are primarily volunteer with the exception of the larger municipal departments.
   
• Olympia, Tumwater and Lacey Fire District # 3 are integrated as county-wide providers of Advanced Life Support (ALS) staffing seven units.
   
• Paramedic transport units are dual-role (EMS and fire services) personnel and staffed with two paramedics.
   
• Two private ambulance companies, Olympic Ambulance and American Medical Response (AMR), provide basic life support EMS and inter-facility transport.  Falck Ambulance also provides inter-facility transport.
   
• Private ambulance companies provide four full-time BLS transport units and additional for peak load times.
   
• The System is further supported by a private non-profit EMS helicopter service, AirLift Northwest, stationed at the Olympia Airport.

http://tcomm911.org/

• ​Medical communications is over cellular phone and/or HEAR (Hospital Emergency Administrative Radio).
   
• Two hospitals are designated to receive EMS patients, Providence St. Peter Hospital and Capital Medical Center.
   
• Both hospitals and TCOMM have compatible radio equipment to insure greater than 90% communication coverage county-wide.
   
• The Thurston County EMS System participates in a state wide Trauma Center system.
   
• In 2012, Thurston County implemented a program to be included in a statewide Cardiac and Stroke center system.
   
• Cardiac and Stroke patients meeting state criteria may be transported to cardiac and stroke specialty centers.
   
• Implemented in 2005, was an in-vehicle data system linking ALS units with the Dispatch center and county hospitals via digital radio modem.
   
• Private ambulances are capable of hospital and system communication.
   
• Disaster situations are coordinated on a designated VHF (very high frequency) band.

• ​The Medical Program Director (MPD) is staffed and paid by the Medic One office.
   
• The EMPD provides medical direction and authorization for system function.
   
• Prehospital standing orders/protocols, dispatch protocols, certification, training, testing standards, medical quality assurance and medical disciplinary actions are the EMPD's responsibility.
   
• In 2012, EMPD medical support was initiated to Thurston County SWAT. 

• ALS & ​BLS agencies use an Electronic Patient Care Reporting (ePCR) software called ESO to document all EMS patient care.
   
• ePCR's may be internally reviewed at the Medic One office for quality assurance and quality improvement under a state approved QI plan.
• Since 2014 all ALS & BLS agencies have been on electronic reporting.
   
• As of 2018 Medic One has integrated all ALS and BLS ePCR's through ESO, allowing for an improved and more efficient quality assurance and improvement program across the county EMS system.

• ​The policy making body is the Thurston County Board of County Commissioners (BoCC).
   
• Advisory to the BoCC and the Medic One office is the Thurston County EMS Council.
   
• The EMS Council is made up of 16 members:
   
  • a citizen-at-large from each County Commissioner's district
  • one citizen-at-large countywide physician
  • a BoCC representative
  • three Fire Commissioner representatives
  • a City of Olympia representative
  • a City of Lacey representative
  • a City of Tumwater representative
  • a Fire District # 3 representative
  • a south county Mayors representative for suburban/rural cities
  • an emeritus position
  • and non-voting members; the Chair of Operations Committee and the EMPD

​The Medic One office staff is responsible for developing and implementing system policies and procedures, recommended by the EMS Council and authorized by the Board of County Commissioners.

• The Medic One office is responsible for county-wide:
   
  • system coordination
  • county to region system integration
  • equipment/supply purchase
  • staff support to the EMS Council/committees
  • EMS provider initial BLS training
  • EMS continuing medical education
  • system quality management (QM)
  • ambulance licensing
  • system financial administration
     
• The office provides county-wide citizen CPR training and system education.
    
• In 2011, Public Access Defibrillator (PAD) training was added to the citizen CPR classes.
   
• The CPR program was enhanced in 2013 to add High School CPR training.
   
• PAD trains citizens how to use a public automatic external defibrillator (AED) as part of the CPR programs.
   
• In 2007, the Medic One system implemented a county-wide SafeKids (national childhood trauma prevention program) by partnering with Thurston Child Care Action Council.
   
• SafeKids provides child car seat fitting/education, bicycle helmet fitting/education, water safety education and other child trauma prevention programs.

​Medic One Organizational Chart

​The 2024 Medic One/EMS System is funded by:

• $19.5 million county-wide regular EMS levy
• rate @ .33 cents/$1,000 assessed value
• this covers the county-wide EMS program
• $1 million in other funding

The funding is used across the System with emphasis on full-time paid paramedic response and transport coverage.

The current Medic One/EMS program budget is dispersed as follows:

• 67% to Advanced Life Support (ALS) activities
• 12 Basic Life Support (BLS) activities - 6% of the BLS support budget is dedicated to CPR/Public information activities
• 4% to administration
• 4% Data support - supports ALS and BLS components of electronic patient records data system
• 13% ER&R - Equipment Repair & Replacement fund