Fentanyl Increasingly Dangerous to First Responders

Fentanyl is a powerful drug that can be 50 times more potent than heroin. First responders are being warned to take precautions to avoid being exposed to the drug. Photo courtesy of the Drug Enforcement Administration.

The explosion of the opioid epidemic that is responsible for thousands of overdoses and deaths is a consistent problem that EMS and law enforcement encounter on an almost daily basis. Usually, the victims of these powerful drugs, such as heroin and fentanyl, are opioid users, who EMS personnel and law enforcement are regularly called to assist. However, first responders are also being warned about the increased risks they face of being exposed to these deadly drugs, specifically fentanyl—a popular synthetic opioid that is 40 to 50 times more powerful than heroin. To respond to these dangers, the Drug Enforcement Administration (DEA) released a field guide called “Fentanyl: A Brief Guide for First Responders” for EMS and police who find themselves responding to opioid-related calls.

“We need everybody in the United States to understand how dangerous this is,” Acting DEA Administrator Chuck Rosenberg warned. “Exposure to an amount equivalent to a few grains of sand can kill you.”

The warnings have become more urgent in recent months due to numerous cases of accidental overdoses and exposures involving EMS and police.

In May, Chris Green, a police officer with the East Liverpool Police Department, was accidentally exposed to fentanyl during a routine traffic stop after he inadvertently ingested the drug through his skin. Green needed four shots of Narcan, an emergency overdose medication, to be revived after collapsing from the effects of the drug. In another case, two Paramedics and a sheriff’s deputy in Hardford County, Maryland, were treated after showing signs of opioid exposure while treating an overdose victim.

“It is important to get the word out to everyone because it may be the first responder who needs to have Narcan administered,” said Baltimore City Health Commissioner Leana Wen.

The risks of accidental exposure are so high, in fact, that some emergency personnel have even begun carrying Narcan kits for drug-sniffing K-9s, just in case the dogs ingest the deadly drugs.

The DEA guide, along with a National Institute for Occupational Safety and Health manual on preventing fentanyl exposure, suggests certain precautions be taken to lower the risk of coming in direct contact with the substance. Personnel should be able to recognize the signs and symptoms of an overdose, be aware of the ways fentanyl can be ingested, and only allow trained professionals to handle substances that are suspect.

“Assume the worst,” Rosenberg said. “Don’t touch this stuff or the wrappings that it comes in without the proper personal protective equipment.”

The DEA video “Fentanyl: A Real Threat to Law Enforcement” offers advice on how police and EMS can protect themselves from the dangers of fentanyl.

Read more about fentanyl.


Medevac Ambulance Founder Passes Away

It is with great sadness that the American Ambulance Association has learned of the passing of Joe Dolphin, founder of Medevac Ambulance. We will be keeping Joe and his family in our thoughts during this time. A Celebration of Life service will be held on Friday, June 23 at St. Michael’s Church in Poway, Ca., at 10:30 a.m.


In 1971, Joe Dolphin founded Medevac Ambulance, which would become the first US Ambulance company to go national.

Joseph’s parents, Carl and Mary Ellen founded the original Dolphin’s Ambulance Service in 1941. In the late 1960s, the founders were retiring, and their two sons were interested in different parts of the business. Joseph chose the ambulance business, and Patrick continued the Medical Equipment Rentals.

In the 1980s, Medevac operated in Central and Southern California including: San Diego County, Santa Clara County, San Mateo County, and Los Angeles County.

Medevac Mid-America was formed in 1981, when the company was awarded the Kansas City MO MAST contract. It was then purchased by Tom Little in 1988 after they lost the Kansas City MAST Contract. After the purchase by Little, the operation was renamed Medevac Medical Services, which was acquired by AMR in 1994.

San Mateo County: Medevac’s first 911 Contract was signed with San Mateo County in 1976. This operation closed in 1991 when they lost the 911 contract.

Santa Clara County: First Contracted with Medevac in 1978 for emergency ambulance service. The San Clara County Operations of Medevac were acquired by Paul Shirley of Pac Med Ambulance in 1989. (Vanguard was one of the 4 companies initially acquired in 1992 to form AMR) Vanguard had a long history, starting in 1963, as Santa Cruz Ambulance, then Pac Med in 1989, finally becoming Vanguard before the sale to AMR.

San Diego County: Medevac held the San Diego EMS Contract from 1978 to 1983.

Los Angeles County: The Medevac LA County Operations were purchased by Crippin Ambulance on October 1, 1992. This was the last remaining operation of Medevac.

About the Founder: Joe Dolphin was president and CEO of the San Diego-headquartered Medevac, Inc. He was appointed by Ronald Reagan to the California Emergency Medical Advisory Committee in 1974. He started the City of San Diego Paramedic Program in 1978. In 1981, Medevac was named as one of the nation’s 100 fastest growing private companies by INC. magazine. Medevac provided service in the following counties and cities: San Diego, San Francisco, San Mateo, Santa Clara, San Bernardino, Los Angeles, Kansas City, Missouri and Topeka, Kansas.

As the Republican nominee for California State Senate, 39th District, in 1996, Joe received more votes in his district (126,653) than Bob Dole did. In 1995, Dolphin was President of the Board of Governors of the California Community Colleges. In 1993, he served as the Foreman of San Diego County’s Grand Jury.



In Memory of Lahiri Garcia & Paul Besaw (AMR Palm Beach/Broward)

The American Ambulance Association was deeply saddened to learn that Lahiri Garcia (51) and Paul Besaw (36) were killed on June 1 in the line of duty. Both were longstanding and respected team members at AMR Palm Beach/Broward County in Florida.

In an interview with WPTV, AMR Regional Director Bill Hall said, “The AMR family has lost two amazing people. They were dedicated husbands, fathers, friends and teammates. Our thoughts are with both families during this difficult time. Lahiri and Paul will be greatly missed. Garcia and Besaw were committed to caring for others, and together they had nearly 40 years of service for AMR and the community.”

“Thank you all for your kind thoughts and sentiments during the past few days. This week, we celebrate the lives of our fallen colleagues, Paul Besaw and Lahiri Garcia, who tragically lost their lives in an unfortunate ambulance accident last Thursday morning,” said Terance Ramotar, regional director of AMR. “These two gentleman have dedicated their lives to the EMS profession and we are preparing a tribute on Thursday to honor their service.”

A processional, followed by funeral services, is scheduled for Thursday, June 8, 2017, at Courtyard Gardens of Jupiter, FL, located at 1790 Indian Creek Drive West, Jupiter, FL. The staging will be on Indian Creek Drive West, and the processional will begin at approximately 9 a.m. The processional ends at Christ Fellowship Church (5343 Northlake Blvd, Palm Beach Gardens, FL), where formal funeral services for Besaw and Garcia are to be held.

The AAA extends its deepest condolences to the Garcia and Besaw families, as well as their friends and colleagues.

Lifetime Achievement of Susan McHenry

Congratulations to Susan McHenry of the National Highway Traffic Safety Administration’s Office of EMS! The National Association of State EMS Officials passes Resolution 2017-01 honoring the lifetime achievement of Susan McHenry. Her 40 year career began at the Virginia Department of Health in 1976 and has continued at the on at the National Highway Traffic Safety Administration’s Office of EMS since 1996. View the resolution here.

Happy Holidays!

Happy holidays to you and your family from the American Ambulance Association. We so deeply appreciate your selfless service to your communities.

AAA will reopen to serve you at 9:00 a.m. ET on Tuesday, January 3.


In Memory of Joe Paolella, Sr

The American Ambulance Association was deeply saddened to learn of the recent passing of Joseph “Joe” Paolella, Sr.

Joe, along with his brother Phil Paolella, was the co-owner of New Haven Ambulance Service, one of the four companies that founded American Medical Response (AMR).

Joe was an innovator and pioneer in the field of pre-hospital care, and he will be deeply missed by the American Ambulance Association and it’s members throughout the United States. Joe devoted much of his career to advocating for legislation and regulations that paved the way in ensuring that the highest levels of patient care are delivered by ambulance providers in Connecticut and across our nation. Joe also selflessly mentored many ambulance leaders throughout their careers, giving many hours of his time to developing the talents of others.

Joe’s wife, Lorraine Paolella, and their entire family are in our thoughts.

Visiting Hours

Wednesday, December 21, 2016
4:00 PM – 7:00 PM
Iovanne Funeral Home, Inc.
11 Wooster Place
New Haven, CT US 06511


A Mass of Christian Burial will be celebrated Thursday morning at 11:30 in St. George Church, Guilford. Please go directly to Church Thursday morning. Burial will follow in All Saints Cemetery, North Haven.

St. George Church
33 Whitfield Street
Guilford, CT 06437

Donations in Lieu of Flowers

In lieu of flowers contributions in Joe’s memory may be made to The MSA Coalition 9935-D Rea Road, #212 Charlotte, NC 28277 or Masonicare Home Health & Hospice 22 Masonic Ave. Wallingford, CT 06492.

Obituary & Additional Details

Read Joe’s obituary at the Iovanne Funeral Home website►

2016 AMBY Innovation in EMS: Tri-State Ambulance, Patient Transport Project

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Tri-State Ambulance Awarded a 2016 AMBY for Innovation in EMS

amby-congrats-tri-state-ambulanceAmbulance services which provide 911 coverage frequently have patients who request service but ultimately fail to accept transportation to a hospital for further care. Depending on the service area, non-transports can be 30% or more of all requests for service. These ambulance responses can range from falls or diabetic issues, to motor vehicle crashes and anything in between. It is known that transporting a patient to an emergency department is not always the most appropriate choice for their medical care. Often, a visit or a conversation with their primary care or specialty provider may be a better option.

Due to HIPAA regulations and continuity of care rules, the patient response information, when they are not transported, does not proceed further than a typical quality assurance or billing department review. This ultimately leaves the patient’s primary care provider or other specialty care provider completely unaware that their patient was cared for by another medical professional in an urgent setting. Upon investigation we found that the general public was unaware that their information from the contact with an ambulance service was not being sent to their current providers. In an electronic world, the general assumption by most patients was that all medical situations would be collected in one comprehensive medical record and not separated by service providers. This situation was noticed by a new billing manager who was often the last person to look at a patient’s medical record. It was quickly realized that other health care professionals should be aware of patients who are cared for by an ambulance crew and not transported.

Although there have been tremendous strides made in the Community Paramedic (CP) or Mobile Integrated Health (MIH) programs, the industry is still far from global reimbursement and universal standards. The hope for this project was to establish essential communication that was missing between a patient’s medical provider and the documented ambulance visit. Through this communication, providers may proactively set an appointment with the patient which could help prevent an emergency room visit or ultimate admission and therefore reduce the potential patients that would be subject to a CP or MIH program. As with most aspects of healthcare, it is proven that early intervention has the best long term results and often at a significant cost savings to the system and patient. The best systems would utilize a multifaceted approach that uses early intervention and post care follow up.

The goal of the project was to make available the patient care report from an encounter with an ambulance crew, when not transported, to their permanent medical record of their primary and/or specialty care provider. Secondly, it was intended for a provider to deliver proper follow up care and ultimately improve patient outcomes or experiences. It was thought that patients who receive the proper follow up care are less likely to call for an ambulance again for the same issue, thus reducing repetitive patients. It was also considered that improved follow-up would reduce the potential for the patient to develop more serious medical situations in the future.

<h5>Planning and Implementation</h5>

  • All stakeholders were identified and made aware of the current plight
  • Legal and compliance departments were consulted on all legalities with release of a patient medical records to a third party
  • Analyzed current electronic patient care reporting (ePCR) system for viability
  • Ensured process required minimal resources and would be cost effective
  • Created electronic release of information to third party form that met all legal requirements
  • Educated and trained employees on proper utilization of form • Built paperless IT structure to support secure sharing of information
  • Created procedure for hospital follow-up of patients • Monitored and adjusted processes to ensure goals were being met

The project was first implemented in Q4 of 2013 with some major changes since inception. The basic practice of sending patient medical records to the medical provider of the patient’s choice was implemented and worked smoothly from the start. The process involves an ambulance crew obtaining two signatures from a patient when transport was refused. The first signature is the acknowledgement of the refusal of transport and the second is the voluntary request to disclose their medical record to the provider of their choice. The release of information disclosure is strictly voluntary and complies with HIPAA regulations. After implementation, it was noticed that the process didn’t seem to have a quantifiable way to track improvement in patient results or outcomes. On January 1st of 2015, the new process was executed with two local health systems that routes the patient record directly to a quality assurance nurse for review. Both of these local health systems incorporate large medical clinics which provide medical services to the vast majority of the local population. The nurse would then contact the patient to see how they are doing since the encounter with the ambulance crew and to schedule appointments with their providers if needed. The nurse was also able to see if the patient had come in to urgent care or the emergency department after they refused transport or to see if they have any pending appointments. Dependent on the nurse findings from the telephone call, they had the ability to contact a patient to change an appointment to an earlier date or to see if there are any other services that they can refer to the patient.

The initial impact has proven to be very successful. The first positive impact was with our paramedics and EMTs and their response to the new process. Sending the ePCR to the patient’s medical provider allowed the employees to know that the patient was going to get further care or follow up that they needed. This has enabled the field EMS provider to still feel a sense of completion and satisfaction because they are providing the catalyst for further care. Also, when these patients receive a follow up call or physician visit they are less likely to become a high utilizer, as shown by preliminary data. Reducing unnecessary calls for repetitive patients has also improved employee morale. Further research is being conducted to evaluate the percentage of improvement from the reduction of repetitive patients.

Another positive impact was discovered when patients would ultimately go by other means to an urgent care or emergency department and in turn notify the emergency provider that they were evaluated by EMS. At the request of the emergency department provider, we are then able to send them the patient response information from our interaction. This information provides assessments and other key factors that the attending provider may need to offer effective care. This can all happen in real time because the patient has already provided written authorization for the release of their medical record to the provider.

An unexpected result that has also created a positive impact is the utilization of the hospital’s immense resources. When a patient has authorized us to send their medical records to their healthcare provider it creates a bond that allows us to share information for the benefit of the patient. This makes it possible for us to reach out to social workers or other healthcare resources such as patient advocates to help patients with things that we are not equipped or staffed to handle. A person will utilize the 911 system for an unmet need, even if not medical in nature. We now have an expanded use of resources to meet the needs of patients in our community.

Improvements have been made to our quality assurance program for patients who requested service but refused transportation. With the addition of the follow-up calls by nurses, we were able to track and review patient outcomes when they refused transportation. Being able to ascertain a patient’s final diagnosis by another medical professional versus what was determined in the field has given us valuable information to use for training and education. Before the use of this new method the quality assurance process could only make a determination based on the narrative written by the crew. Now, we are able to have a full circle review of the care and outcome of the patient. As health care continues to evolve with trends towards CP and MIH and possible changes to Medicare reimbursement, reviews like this are becoming ever more important. Additional research is being proposed by a local hospital to do a retrospective analysis to determine the impact of the process on patient outcomes. The study is focused on patients who called 911 related to a fall and are over the age of 55. The purpose of the study is to determine if interventions performed by their provider reduced the likelihood of future falls or injuries related to falls. This is being done in conjunction with data from the hospital and any interactions a patient has had with the ambulance service.

Congratulations to Tri-State Ambulance for their selection as a 2016 AMBY Winner.


2016 AMBY Best Use of Technology: Trinity EMS & Firstwatch, Opioid Epidemic Project

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Trinity EMS & FirstWatch Opioid Epidemic Project Awarded a 2016 AMBY for Best Use of Technology

Trinity EMS & FirstWatch | Massachusetts

amby-congrats-trinity-ems-with-firstwatchMassachusetts has seen a massive increase in opiate overdoses and deaths. In 2013 there were 918 opiate related deaths in Massachusetts. Massachusetts had 1531 deaths in the first six months of 2016. Many of the communities Trinity EMS serves are on the front lines of this issue. Their EMT’s and paramedics are helping to revive patients every day from an opiate overdose. Understanding the scope of an issue is a critical first step to solving an issue. They started using their PCR data to help frame the issue for their communities. They began tracking the demographics such as age and gender of the patients, time of day and day of the week, and location within the communities. They also monitor the volume to identify spikes in volume in individual communities and system wide. Trinity reported data monthly, one month behind to the health department, public safety partners, methadone clinics, hospitals and city governments. This data was well received. Other services contacted them for help in developing their tracking and reporting. They added FirstWatch to their program to speed up the notifications. Monthly reporting is still valuable. Instant reporting is even better. FirstWatch allows their communities to be notified within an hour of an opiate overdose. Public health and public safety now have this intelligence right away.

The goal was to gather and present data in a cross discipline format for aid with better understanding on the situation. First responders, law enforcement, public health, EMS, and district attorneys, and the press have received and used their data. Trinity wanted to show:

  • The profile of the patients we are seeing
  • The frequency of the patients
  • The location and time of the overdoses
  • The severity of the patients. (Our volume of overdoses have leveled off, the acuity of the patents is still increasing)
  • Our monthly report is a key performance indicator as to the opiate issue at the street level in our communities
  • Our needle pick up data indicated where outdoor intravenous drug use is happening
  • Many of the overdose calls to the 911 centers are not communicated as being overdoses; “fall”, “respiratory”, “unconscious” are common chief complaints at dispatch. This data would not have been collected and reported using chief complaint as a filter

When it became clear the opiate issue was becoming a wide spread crisis Trinity started working the issue. They knew their best area to provide data from was PCRs. They came up with a set of data points they thought would help. They attended many meetings and public events. During those forums dozens of additional questions and theories came forward. Trinity took and implemented all that they had data for. (Example. There was question about social benefits and opiate use. They are able to show on an ongoing basis that there is no correlation between opiate overdoses and the 1st and 15th of the month.)

Before 2015, Trinity reported opiate overdoses usually annually only when requested. Starting in 2015 they reported monthly. They wanted to provide data even quicker. Trinity had seen FirstWatch a few years before. They felt the speed and automation FirstWatch could provide was a critical improvement. The intelligence gathered with knowing in live time of opiate overdoses can’t be overstated. The automation allows that intelligence to be gathered no matter the day or time.

Trinity started working with FirstWatch in December 2015. In May 2016, Trinity put FirstWatch directly into the hands of public health, public safety and public schools. Each discipline has a HIPAA compliant login with access to data specific to their mission. They worked very closely with FirstWatch so they could understand the capabilities within the system. They brought the idea and FirstWatch brought the execution and focus. The FirstWatch platform is amazingly powerful for Trinity, to provide live access is amazing. In June 2016, Trinity participated in a Middlesex County District Attorney opiate task force meeting. Trinity had earlier in the meeting done a 20 minute presentation on the opiate crisis in our city. This provided the 70 people in attendance a fresh look at the data. Towards the end of the meeting conference to alert families and friends of addicts to watch their loved ones, and scheduled “emergency” Narcan administration training for the community. During DA Ryan’s presentation, Trinity received a FirstWatch alert for a 39 year old female opiate overdose from 30 minutes before. Three minutes later they received another alert for a 41 year old female that suffered a fatal opiate overdose. They were able to share that with the group and drive home the DA’s message.

The City Governments, Public Health, Police and Fire Departments in Trinity’s communities were eager to learn about the data they were able to collect, and their data began to become focal points at press conferences and city council meetings. News agencies began contacting Trinity to help paint the picture of the epidemic in feature stories. In sharing the mapping aspect of Firstwatch they hope that these agencies can further understand the epidemic and develop plans to combat it. Trinity has become the de facto subject matter experts of the opiate crisis.

Congratulations to Trinity EMS and FirstWatch for their selection as 2016 AMBY Winners.


2016 AMBY Best Quality Improvement Program: Gold Cross Ambulance, Documentation Program

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Gold Cross Ambulance’s Documentation Project Project Awarded a 2016 AMBY for Best Quality Improvement Program

Gold Cross Ambulance | Utah

amby-congrats-gold-crossThe documentation review process at Gold Cross Ambulance had not changed much since the day of paper trip tickets. Retrospective documentation feedback was being given to crews, but they were not fully utilizing the capabilities of their technology to analyze the feedback and make significant improvements. Gold Cross Ambulance hypothesized that improved documentation goals would lead to better patient care and increased reimbursements. They knew they needed to make improvements in the review process and to better utilize the technology that was already in place. In addition to the documentation goals, they identified the opportunity to work some small, but significant, clinical improvements into a documentation project. One initial focus of clinical improvement was making sure the field crews were obtaining at least two sets of vital signs on every patient, and properly documenting these vital signs in the electronic patient care report (ePCR). Of all the performance indicators we measure, trending of vital signs touches every patient contacted. Educators from Utah EMS for Children shared research citing “inadequate recognition of and response to hypotension and hypoxia was associated with higher odds of disability and death” (Hewes H., 2016). This was such a basic thing to measure, but it had potential to impact every contacted patient. Gold Cross know that vital signs were an area in which they could improve, while also meeting their documentation goals. To do so, they implemented the following:

  1. Create a way to measure overall documentation quality.
  2. Establish a formal standard for documentation and educate crews about the documentation expectations.
  3. Improve the overall documentation of the ePCR.
  4. Improve the number of patients with properly collected and documented vital signs.
  5. Improve amount of reimbursement and decrease collection cycle time.

Gold Cross formed a work group to tackle these issues, which consisted of members of the Quality Department, Training Department, Billing Department, and Operations Department. The group meets every other week to evaluate progress and assess the need for adjustments to the system. Mid-year of 2014, the group worked to revise the program for documentation evaluation. A new standard was created based on the ePCR fields. A point system was established for documentation which gave each ePCR field a weighted number of points, equaling 100%. Incomplete or missing fields result in a loss of points for that field, which provided a way to measure documentation performance. The scoring data is tracked in our ePCR quality module, allowing us to analyze and report on the data easily. The feedback on any areas of missed points is sent to the crew via the ePCR messaging system, so it is easily accessible to the crews during regular daily tasks. Feedback is focused on improvement comments instead of punitive comments. Positive feedback is included in each evaluation. The group released an initial version of the General Instructions for the ePCR, which was an internal manual detailing expectations for every field in our ePCR. The focus was to provide clear expectations to all field crews regarding how to properly fill out the ePCR and what content should be included. The training department created an educational program on the online educational software program, detailing the documentation guidelines and testing the crews on the material. The General Instructions for the ePCR were also posted on the company training site, so crews would have easy access at any time. The Quality Department developed a class for the newly hired providers. The class emphasizes the need for quality documentation, outlines the program, and includes actual documentation examples for evaluation and discussion. Patient advocacy through documentation is instilled in the participants of this class. The Billing Department developed a class which is taught at six months after hire. In the class, documentation is reviewed from class participants. The billing department shows how the bill is processed from the documentation, and they discuss common challenges to the billing process. The program has been monitored with continuous PDSA cycles and has been adjusted as needed for continued improvement.

An initial company goal for documentation was set at 90%. From project start to current date, the company-wide documentation averages have increase from 74% at the beginning of the project to 96% currently. Field crews have expressed greater clarity in the company expectations for documentation. The overall average documentation scores by division are posted regularly for the company to view, and this has had the additional benefit of sparking a competitive streak between some of our divisions, further improving the scores. The improvement in collection of vital signs not only improved overall patient care, but resulted in a Performance Improvement Award from the Utah State Bureau of EMS in 2016. The bureau looked at pediatric vital signs and recognized two rural and two urban EMS agencies in the state for their improvements. Gold Cross Eastern Division won the award for a rural agency, and Gold Cross Salt Lake Division won for the urban agency. Their study found our agency improved the collection of pediatric vital signs by 53% in our urban area and 66% in our rural area.

The most important impact of this project is improvement in patient care, which is our primary mission. The goals for complete documentation have encouraged field crews to make sure they complete proper assessments, since they know those areas of the ePCR are evaluated and must be complete. Improvements in assessment result in better differential diagnoses and improved treatment plans and outcomes. The documentation project has positively impacted Gold Cross financially as expected. Reimbursement rates have increased and the time to complete the collection cycle has improved. Due to the documentation improvements, the billing staff spends less time researching information, following up on incomplete documentation, and fighting in appeals.

Congratulations to Gold Cross Ambulance for the Reduced Readmissions Project’s selection as a 2016 AMBY Winner for Best Community Impact Program.


2016 AMBY Best Community Impact Program: Medic Ambulance, Reduced Readmissions Project

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Medic Ambulance Reduced Readmissions Project Awarded a 2016 AMBY for Best Community Impact Program

Medic Ambulance | California

amby-congrats-medic-ambulanceMedic Ambulance Service is the exclusive ALS service provider in Solano County, a HRSA-designated medically underserved area with a physician-provider to population ratio of 81.1 per 100,000. In 2014 Medic Ambulance became aware of an opportunity to participate in a Community Paramedicine Pilot initiated through California Ste EMSA. After collaborating with LEMSA and the community hospitals, Medic Ambulance unanimously concluded that the 23% average readmission rates for each CHF and COPD patients was taking a crippling toll on the hospitals’ reimbursement and increasing Emergency Department wait times. Starting in January of 2015, Medic Ambulance Service enrolled six paramedics into approximately 300 hours of additional training focused on the biopsychosocial needs of patients with CHF or COPD. The education has continued through monthly case reviews and peer-to-peer lessons-learned where the entire team brainstorms innovative solutions to the patients’ challenges. From the beginning, Medic Ambulance Service was poised on creating a sustainable model that would persevere past the period of being a pilot or grant funding. They made this goal of preservation well-known to all stakeholders, and after quickly proving the value through low readmission rates they had established a sustainable funding source, happy to pay for Community Paramedicine Services.

Project Goals

  1. Reduce the readmission rates of patients with CHF or COPD.
  2. To create a sustainably funded model to ensure the project remains available to our community and is replicable in other areas.
  3. Provide superior customer service.
  4. Teach patients how to improve their health by appealing to the patient’s values.
  5. To provide these services at a lower cost than was otherwise available.

Project Phases

  • Planning Phase: The project was planned based upon the results of the community needs assessment. The findings indicated that there is a substantial difficulty within the community to access restorative medical aid. Each Community Paramedic underwent over 300 hours of focused training on the management of CHF and COPD, cultural sensitivity, and rehabilitative services.
  • Implementation Phase: To ensure compliance with the strictest regard for patient outcomes and program oversight Medic’s Community Paramedicine Program is IRB approved, reports at least monthly to a Steering Committee with diverse medical and nonmedical expertise, 100% charting review by a Registered Nurse, and utilization of, EMS Survey Team, a third-party patient surveyor. These highly trained Community Paramedics began seeing patients in September of 2015 and the most common question we are asked by the local hospitals is when can we help them lower their readmission rates for patients that don’t have CHF or COPD. With a sustainable and reproducible model we intend to keep filling healthcare gaps and mold healthcare delivery to suit the needs of every community we serve!

Our goals with this project are built upon the IHI Triple AIM to improve the patient experience of care, improve the health of populations, and reduce the per capita cost of health care. We are absolutely meeting these foundational goals!

  • 85 patients have been referred to the program (59 enrolled)
  • 118 visits have been completed

Medic Ambulance measures and objectives reveal that the enrolled population has only a 8.5% unplanned readmission rate; as opposed to a 23% rate of those not enrolled. During home visits it was discovered that:

  • 50.8% of patients had medication errors
  • 48.7% of the patients that thought they were taking all their medications correctly weren’t
  • 72.9% of patients needed help understanding their discharge instructions.

These enrolled patients also self identify an average overall health rating improvement of 22.8% between their pre-enrollment and post -enrollment health. During this same interval the patients’ understanding of their hospital discharge instructions has risen by 16.8%, understanding of when to take medications improved 8.3%, and understanding of their medication side effects improved by 14.1%.

EMS Survey Team, a third party patient surveyor, attempts phone contact with all enrolled patients. These scores are recorded and measured against the 128 different EMS services they contract with. This program is the #1 rated provider with a total score of 96.48/100 and 100% of all responses have been positive.

Patient Feedback

“It’s been a very good experience. She (the Community Paramedic) explained everything so I could understand.” – Patient

“There’s a lot of people out there who need this, especially those without insurance.” – Patient

“My blood pressure started going up and it wouldn’t come down. I had medication but it wasn’t helping.” – Patient who was not taking her medication at the correct frequency.

“She (a patient) feels more comfortable.” – Patient’s daughter “This is a pilot program but everyone so far is very pleased with how it is working.” – Director of case management at a referring hospital. “If I get sick I know they’re gonna be there for me and that I’m not alone.” – Patient

As a third generational, family-owned EMS provider, nothing is more important to us than the community we serve as the exclusive ALS provider. The creation of this program wasn’t created as merely a proof of concept, we continue to grow and adapt this program to meet the needs of the populations through changing the landscape of health care. The impact of this program’s success has been marked with already saving the health care system $137,000 with a projected savings of $685,000 by the end of 2017, improved health literacy in vulnerable populations, reducing overuse on the 9-1-1 and Emergency Department systems, and catalyzing positive health changes through empowerment. It is projected that over 25% of the patients enrolled into this program have a functional health literacy defined as “below basic”, the lowest possible category per the National Assessment of Adult Literacy, compared to 14% of American adults that fall into this category. At this level of health literacy the dates of appointments and clearly defined times to take medications are often understood, but the understanding of how negative lifestyle choices, such as smoking, poor diet, and recreational drug use affect their management of diseases is not universally comprehended.

Congratulations to Medic Ambulance for the Reduced Readmissions Project’s selection as a 2016 AMBY Winner for Best Community Impact Program.


2016 AMBY Best Public Relations Campaign: EMSA, CPR Education Program

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

EMSA CPR Education Program Awarded a 2016 AMBY for Best Public Relations Campaign

Emergency Medical Services Authority (EMSA) | Tulsa, Oklahoma

amby-congrats-emsaEMSA, the Emergency Medical Services Authority, is Oklahoma’s largest provider of pre-hospital emergency medical care. We provide ambulance service to more than 1.1 million residents in central and northeast Oklahoma. EMSA was established in Tulsa in 1977 and later expanded to include Bixby, Jenks and Sand Springs. EMSA began providing service to Oklahoma City in 1990. EMSA is the ambulance provider in 16 cities across the state. As a public trust authority of the City of Tulsa and City of Oklahoma City governments, EMSA is charged with ensuring the highest quality of emergency medical service at the best possible price. There are several entities that work together in the EMSA system, including the Cities of Oklahoma City and Tulsa, the medical director, and the contracted ambulance provider. EMSA oversees all business aspects including ambulances and other capital equipment, maintaining patient records, billing and more. The medical director conducts routine audits and testing of all medics practicing in the system, writes seamless protocols to ensure the continuity of care between first responders and transport medics, researches new treatment modalities and evaluates complaints. EMSA is committed to training and building awareness about CPR in EMSA’s 16 service areas. The program includes a variety of year-round opportunities to learn Hands-Only CPR(TM), as well as leveraging various opportunities to promote CPR education through traditional earned media, digital advertising, and social media. Also, EMSA medics were part of a national challenge to train as many local citizens as possible in Hands-Only CPR, called World CPR Day.

The CPR Education Program had one ultimate goal which was to increase the number of Oklahoma citizens who can effectively do CPR statewide (mostly Hands-Only CPR). The secondary goal was to connect the message of health care expertise and community involvement with EMSA, as an organization, by providing non-emergency interactions with EMSA medics and promoting CPR-related stories in earned media and digital platforms. Two measurable objectives were identified for the CPR Education Program.

Primary Objective

The first objective was to train more than 2,000 Oklahomans on how to conduct Hands-Only CPR on World CPR Day and 10,000 at the Tulsa State Fair and Oklahoma City State Fair. The second specific objective was to utilize earned media, social media, events and public figures to educate the community that EMSA is their CPR resource for training.

For many years EMSA, along with its 16 partnering first-responder agencies, achieved a heart attack survival rate six times higher than the national average. Recognizing that bystander response times were integrated into this health outcome, EMSA noted an opportunity to magnify and improve these successful numbers. The heart attack survival rate results are based on patients in cardiac arrest who received some form of bystander CPR and were found in a shockable rhythm (an ECG rhythm that is treatable using defibrillation) on first EMS contact.

Secondary Objective

The American Heart Association Research The American Heart Association conducts numerous studies on the impact of bystander CPR. These studies prove that during cardiac arrest a person’s survival chance increases significantly with immediate CPR, that CPR can be taught in a very short amount of time, and that compression-only CPR is effective for saving lives. When paramedics arrive on-scene, a patient who is in cardiac arrest and is found in a shockable rhythm (an ECG rhythm that is treatable using defibrillation) is more likely to survive if they receive some form of bystander CPR. The impact of bystander CPR has improved significantly in the past decade. In 2010, the AMR bystander CPR rate was 21.4 percent and in 2014 it increased to 40.8 percent.

Every five years, EMSA conducts a citizen survey to review the perception of services. The most recent report (2012) shows 80 percent of people who use EMSA have a positive impression. Additionally, the public responds extremely favorably to medics and paramedics; however, most people don’t meet a medic until they’re experiencing a medical emergency. Utilizing this information EMSA expanded its public events to put medics in front of potential patients more regularly — before they experience an emergency. Although the CPR Campaign primarily focuses on health-outcomes related to cardiac arrest, a secondary benefit is providing one-on-one opportunities for the general public to spend with EMSA medics, allowing those without ambulance-experience to see first-hand the caring and compassionate men and women who work at EMSA.

In order to build community awareness around the health impact of knowing CPR, EMSA focused on two general audiences: the first included citizens of EMSA’s service area without Hands-Only CPR training, the second group was the opinion leaders. The opinion leaders with the highest stakes for improving health outcomes on a statewide basis were determined to be elected officials.

EMSA has conducted CPR training throughout the community for decades. EMSA also partners with other CPR-certification agencies to increase access to CPR education. For the past three years, EMSA has organized an annual special event to train a large number of citizens in Hands-Only CPR and also communicate the importance of learning CPR. In addition, EMSA provides stand-by ambulances at the Oklahoma State Tulsa State fair annually; during the fair EMSA utilizes an informational booth space to provide citizens with an opportunity to learn CPR.

The CPR Education Program consisted of three key areas. The first was participation in large-scale events that provide an opportunity for training a large number of people (World CPR Day and the two State Fairs). These larger events would be used as a catalyst. The second area was building awareness that EMSA offers CPR training, both Hands-Only and traditional CPR, to the general public within their service area. The final area was recruiting a prominent Oklahoman to participate in a CPR training in order to maximize attention to the importance of CPR training for all individuals. All of the focus areas, and the message that CPR saves lives, were promoted through traditional earned media, advertising, and social engagement.

Large-Scale Training Events

World CPR Day is organized on a national level by AMR and on a local level by EMSA. Each year the EMSA communications team strategically identifies partnership events and organizations to bring Hands-Only CPR in front of Tulsa and Oklahoma City-area citizens. There are many options annually because the wide audience-base includes all individuals in EMSA’s service area without Hands-Only CPR training. EMSA hosted CPR trainings throughout coverage areas utilizing ongoing events at businesses and organizations, such as the business board meetings. Some trainings were private and others were public events. Utilizing earned media and social media, World CPR Day was heavily promoted and resulted in strong participation. Reviewing the World CPR date and community events we noticed the two largest events that could incorporate CPR training were the Big 12 Baseball tournament and the Dallas Cowboys Mobile Museum. These two events were slated to attract large crowds of active Tulsans ideal for learning Hands-Only CPR. EMSA worked alongside the Tulsa Regional Chamber to coordinate a training site at Fan Fest, the fair-like celebration that runs concurrently during the Big 12 Baseball Tournaments. EMSA also had the Dallas Cowboys mobile museum for their evening sessions at LaFortune Park. In addition to the large public trainings, EMSA hosted smaller CPR trainings throughout our coverage areas utilizing ongoing events at area businesses and organizations, such as the Jenks Chamber of Commerce Board Meeting. The largest private training was at Roosevelt Middle School in Oklahoma City where EMSA trained more than 600 students. The Tulsa and Oklahoma City State Fairs provide easy-access to large groups of Oklahoma residents who are eager to learn CPR in order to save a life. Although the location and interaction opportunities are optimal, medics do use key message points, such as “It’s most likely a loved one’s life you’ll save,” to encourage passers-by to participate in the training. Thousands of individuals learned Hands-Only CPR at the state fairs last year. CPR Training Requests EMSA generally receives 30 requests per year to train small groups on how to perform CPR. These are businesses and organizations, as well as teams and non-profits. During the CPR Education Program, EMSA promoted CPR training through all owned mediums including its website and social channels. After promoting World CPR Day and the importance of learning Hands-Only CPR, EMSA inquiries for trainings increased by almost 25 percent. Most of the new requests came from government officials or civic-related organizations, which are targeted groups because their circle of influence is generally larger than other groups.

Training High-Profile Oklahoman in Hands-Only CPR

EMSA individuals researched prominent Oklahomans to find who fit with EMSA’s mission and goals. We needed individuals that would create a buzz online and in traditional media. After considering various famous individuals we determined that elected officials were the most inclined to be concerned with the overall health and well-being of Oklahomans. We set our goals high, and invited the Governor to learn Hands-Only CPR. Additionally, we sent requests to various local elected officials to offer a CPR class during a City Council meeting. We were pleased that Oklahoma’s Governor Mary Fallin, the Tulsa City Council and Oklahoma City Council accepted our invitations, and in three separate events, they learned the steps to save a life through CPR. The events created a stir in local newspapers and TV while also creating engagement online through our EMSA social channels and other digital news sources. Promotion EMSA promoted World CPR Day, CPR trainings, and the elected-officials training events throughout the year. Additionally, EMSA hosted several in-studio CPR demonstrations at Oklahoma City and Tulsa media stations. Another media component was promoting feature stories on patients that survive because of CPR. The final promotional component was a digital ad campaign that are PSAs about the three C’s of CPR: check, call, and compress.

See measurable outcomes below; additionally review work samples to view social media samples, earned media samples and more.

  • Measurable Objective: train 2,000 attendees how to do Hands-Only CPR on World CPR Day. Result: Trained 2,585 people 1,201 in Tulsa and 1,384 in OKC Measureable Objective: train 10,000 attendees how to do Hands-only CPR at the two Oklahoma State Fairs. Result: Trained more than 10,000 people at the Tulsa State and Oklahoma State Fairs.
  • Measurable Objective: Utilize social media to increase awareness of World CPR Day Result: More than 20,000 unique social media impressions for various social media posts promoting and celebrating World CPR Day.
  • Measurable Objective: Utilize earned media, social media and World CPR Day to educate the community that EMSA is their CPR resource for training.
  • Result: Following World CPR Day EMSA was contacted by several community groups wanting EMSA medics to teach Hands-Only CPR at their monthly meetings. Additionally, EMSA gained a lot of media coverage and social media activity due to the high-visibility leadership participating in Hands-Only CPR.

The overall impact of the ongoing EMSA CPR program continues to increase the number of Oklahoma residents who can perform CPR. This ultimately affects improved health outcomes. Additionally, this campaign provides one-on-one time with medics which produces a familiarity with the ambulance authority that will provide long-term mutually beneficial outcomes.

Congratulations to EMSA for the CPR Education Program’s selection as a 2016 AMBY Winner for Best Public Relations Campaign.


2016 AMBY Best Community Impact Program: AMR, River Rescue Program

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

American Medical Response River Rescue Program Awarded a 2016 AMBY for Best Community Impact Program

amby-2016-congrats-amrAMR | Oregon

The Oregon River Safety Program (aka AMR River Rescue Program) is provided by American Medical Response (AMR) as a community service for two communities it serves in Oregon. The program is the only one of its kind exclusively operated by a private EMS provider, supported by strong community partnerships, and was developed after a series of thirteen drowning deaths over five years in the 1990s at two popular river parks. Ten years earlier, AMR developed its Reach and Treat (RAT) Wilderness Medicine Program to provide medical care for people ill or injured on Mount Hood and the surrounding national forest. Since Swift Water Rescue was part of the existing Reach and Treat Teams training and competency, AMR worked with the Troutdale City Council and a group of dedicated civic leaders to launch the River Rescue Program in July, 1999. For the remainder of the summer, AMR used its RAT Team members as Swift Water Rescue Specialists to staff the new River Rescue program.

The program was developed to meet the certification standards of the United States Lifesaving Association (USLA) for open water lifeguarding, and is staffed by Oregon licensed Emergency Medical Technicians and Paramedics. To meet USLA requirements, AMR developed an 80-hour training program with core USLA curriculum as well as additional site-specific training. River Rescue Technicians are not the same as pool lifeguards, but instead are highly trained and certified professionals with expertise in lifeguarding, swift water rescue, and medical care. The AMR River Rescue program received USLA Advanced Lifeguard Agency Certification in April 2012. The United States Lifesaving Association is America’s nonprofit professional association of lifeguards and open water rescuers. The USLA works to reduce the incidence of death and injury in the aquatic environment through public education, national lifeguard standards, training programs, promotion of high levels of lifeguard readiness, and other means.

This year marked the 18th season for the program. From 1999 through 2016, the AMR team performed 97 rescues, more than 1,400 assists of people in distress, and dedicated thousands of hours to prevention activity. Based on pre-program statistics, 66 drownings would have occurred over those years without the program. Each year, the team consists of approximately 20 River Rescue Technicians trained in Swift Water Rescue who provide life guard services seven days a week, ten hours a day at Glenn Otto Park in Troutdale, and at High Rocks Park in Gladstone, Oregon from Memorial Day weekend through Labor Day.

AMR’s Oregon River Safety Program has been highly successful in relegating some of the State’s highest drowning sites for recreational waterways to a footnote in history. The Program has increased swimmer safety through public awareness campaigns; prevention interventions, such as life jacket loaner programs; and community and media partnerships. It has also amassed a wealth of data to guide program enhancement which has documented a significant increase in the use of life jackets for all age groups. Lastly, the Program has prevented drowning through direct and often dramatic rescue interventions by AMR technicians.

From its inception, the goal of AMR’s River Rescue Program has been to prevent loss of life due to drowning and to make the locations AMR guards safer. Primary responsibilities of River Rescue Technicians are to provide public education on water safety, raise awareness of the potential hazards of rivers and open bodies of water, promote life jacket use, deter risky behaviors (such as drug/alcohol use and unsafe ways of floating downriver on makeshift “rafts”), and rapidly respond to swimmers in distress. AMR River Rescue has released a new mission statement for 2016: Drowning prevention through education, vigilance and rescue.

AMR River Rescue utilizes a public health model “Spectrum of Prevention” approach to support the goal of drowning prevention by focusing efforts on: individuals, groups, providers, networks, organizations, and public policy makers. Injury prevention efforts are targeted by utilizing the significant amount of data captured by the program each year to help identify trends. AMR River Rescue has also developed strong partnerships with traditional media to further educational goals, allowing them to reach large television/radio audiences with important water safety messages for visitors to Oregon’s rivers, as well as tips and advice to prevent drowning elsewhere, such as in pools and spas, and in and around the home. In addition to onsite, rivers-edge, education and prevention, River Rescue Team members participate in social media and community events to share information on water and pool safety for children and parents.

Planning and implementation of the program has developed over the course of the last eighteen years. In 1999, after 13 people drowned over a five-year period at Glenn Otto Park on the Sandy River in Troutdale, Oregon, AMR worked with local officials and civic leaders to pioneer an on-site river rescue program using EMS personnel trained as lifeguards specializing in swift water rescue. The program was modeled after ten years of success with the Reach and Treat Team developed by AMR in the late 1980s. AMR’s River Rescue program is distinctly different than the Sheriff’s office and fire departments’ water rescue programs. While they cover long stretches of waterways and can only respond after an incident is reported, AMR’s program focuses on the most dangerous river sections that have the highest drowning mortality sites. To protect these areas, public education and risk mitigation were made priorities and coupled with the River Rescue Technicians’ training in Swift Water Rescue to spot trouble and act immediately.

The window to intervene in a developing drowning and save a life is often less than 30 seconds. After several years of program development, the River Rescue Program received certification from the United States Lifesaving Association (USLA), which is recognized internationally as the “gold standard” for accreditation.* To meet USLA standards, AMR developed a unique 80 hour training program with a core USLA curriculum with additional swift water and medical training. The program is unique in the U.S. and is the only certified agency that provides lifeguards solely in a swift water environment (versus beaches or lakes).

Because prevention is an important component of the program, a life jacket loaner program was developed, offering free daily use of hundreds of personal flotation devices (sizes from infant to adult) to visitors of the parks. In the summer of 2002, after three people drowned in less than a month at High Rocks Park along the Clackamas River, AMR expanded the program to cover the popular river site. Responsibility for the Clackamas River is vested with the Clackamas County Sheriff’s Office, but the shore is governed by two cities, one on each side of the river. The lack of clear jurisdictional responsibility had caused a stalemate over how to improve safety at High Rocks Park for many years until AMR proposed expanding its River Rescue Program to that site and agreed to accept responsibility. (AMR knows the county well – as they have been the 9-1-1 ambulance provider in Clackamas County for decades). High Rocks Park presents much different challenges than Glenn Otto, with 20-25 foot rock cliffs and formations from which adventurers jump into the cold, fast moving water. Both the Sandy and Clackamas River share origin from Mount Hood glaciers and have swift current, cold water and underwater hazards.

The program also serves as a regional resource for water safety public education, water hazard mitigation, deployable rescue swimmers, as an in-water search resource for recovery of drowning fatalities in other areas of local rivers (upon request from law enforcement) and provide services and support to the Regional Clackamas County Water Safety Consortium.

Clackamas County Water Rescue Consortium members include:

  • AMR River Rescue Program
  • Canby Fire District
  • Clackamas County Sheriff’s Office Marine Patrol
  • Clackamas County Fire District 1
  • Estacada Fire District
  • Gladstone Fire Department
  • Lake Oswego Fire Department
  • Tualatin Valley Fire & Rescue
  • Sandy Fire District Recruitment and Training

To prepare for staffing the river parks by Memorial Day weekend, AMR begins each season by recruiting candidates in February. They must pass a rigorous swim test (covering 500 meters in less than 10 minutes without the assistance of any propulsion devices) in order to continue through the selection and training process. New candidates join returning members in a challenging, eighty-hour course led by veteran River Rescue Technicians and other experts. Training topics include:

  • Swift water Hydrology and Hazards
  • Swift water Rescue Tactics
  • Lifeguarding Tactics
  • Observation and scanning
  • Rescue Scene Management
  • Community Education
  • Rescue kayaks
  • Rescue paddleboards
  • Media Relations
  • Staffing River Parks

Teams of 2-3 River Rescue Technicians are on duty at each site, and are in constant radio communications with each other, AMR’s Communications Center, the 9-1-1 Center and local law enforcement officers. An alert is transmitted any time a River Rescue Specialist enters the water to conduct an assist or rescue, and if not canceled within five minutes, a full EMS response is dispatched. According to the USLA, the most challenging assignment for a lifeguard is safeguarding natural bodies of water, referred to as open water. Unlike pools and waterparks, crowd conditions, swift currents, cold water, underwater hazards, weather, and related conditions of open water can change quickly and pose unique obstacles to maintaining water safety. A primary responsibility is to provide constant outreach to warn visitors of the hazards, both new inherent, at each site. AMR technicians monitor water temperature, current speed, underwater hazards and public census at regular intervals every day, including in-water assessments. Even the most seasoned swimmer can be taken by surprise in swift moving water, but are generally less inclined to exercise risky behavior after an on-site expert has informed them of the hazards and possible consequences. Over the years, AMR’s River Rescue Team has become the region’s water safety subject-matter experts whom media outlets and others frequently turn to for water safety messages. Due to the focus on prevention and media interactions, the River Rescue Team receives annual training in prevention messaging and media interaction, including mock on-camera interviews and speaking points which undergo annual revisions based on previous years data.

Over the last 18 years the program has successfully reduced the drowning rate at Glenn Otto and High Rocks parks from approximately 1 in 15,000 to 1 in 256,500. The very first achievement however, was relieving community tension. At the first City Council meeting after the program began, then Councilor and now Mayor Doug Daoust, asked AMR leaders “how it feels to deliver a miracle?” Having received one of the highest compliments it could imagine, and with intense media attention, AMR set about re-instilling the philosophy of extensive selection and training, hypervigilance, and a primary focus on prevention. The official title, Oregon River Safety Program, was so named because water safety and prevention is the core focus of the program. Not only has community awareness and use of lifejackets increased, but families frequently state that they come to one of the parks for the add safety of lifeguards. The drowning rate at Glenn Otto and High Rocks parks has been reduced from approximately 1 in 15,000 to 1 in 256,500, and AMR hopes to continue to improve every year. In 2016 alone two people (a sixteen year old and a six year old) were pulled up from underwater, and an additional 147 adults and children were assisted before submerging. Over 18 years the program has directly intervened in 1,650 lives who were either beginning to or actively drowning, and have made direct prevention contacts to 23,330 people and families. The program:

  • Has saved lives, which has in return, propelled the continuance of the program.
  • Stopped the long history of fatal drownings in young people at the two parks.
  • Success created relief among the communities and community good will towards AMR’s River Rescue Team.
  • Has enhanced strong community partnerships.
  • Raised overall awareness in communities and the region about hazards of rivers in Oregon.
  • Has helped to normalized life jacket use.
  • Developed an avenue for EMTs to transition from River Rescue to AMR Ambulance Operations.
  • Has changed city parks from former “party” hangouts (with alcohol, drug use and risky behavior) to more family-friendly environments, decreasing law enforcement issues.
  • Has seen the number of visitors to the parks increase.
  • Has seen life jacket use improve across all age groups and the implemented life jacket loaner program has seen yearly increasing demand.

Today, AMR funds most of the $160,000 annual program as a community service, assisted by the City of Troutdale with a $10,000 grant most years. An additional $10,000 per year is needed for new/refreshed equipment and is a relatively small portion of the Multnomah and Clackamas County budgets. Seed funding to purchase equipment in the early years was provided by the Troutdale Booster Club and Providence Milwaukie Hospital. The program has also received grants from Safe Kids Portland Metro, Safe Kids Worldwide and the Consumer Product Safety Commission to purchase PFDs for the life jacket loaner program, develop water safety banners, support for water safety educational programs and awareness materials to distribute at events throughout the season.

Congratulations to AMR for the River Rescue Program’s selection as a 2016 AMBY Winner for Best Community Impact Program.


MetroWest Takes Highest Honors at Oregon EMS Awards

Hearty congratulations to AAA member MetroWest, whose employees took top honors at the September 23 Oregon EMS Awards.

Oregon Emergency Medical Services has many outstanding providers, extraordinary acts and meritorious service that are recognized every year.  On Friday evening, September 23rd, at the Oregon EMS Awards Banquet in Bend, Metro West Ambulance Crewmembers, Larry Hornaday, Paramedic and Trish Smith, EMT, were be recognized as the Paramedic and EMT providers of the year for the State of Oregon.

Read the full story on the MetroWest site.





Louisiana Floods: JEMS-AAA Adopt-A-Family Program

AAA is teaming up with JEMS to help our member organizations adopt the families of fellow EMS providers. If your company is interested in helping one or more families with clothing, household necessities, and more, please complete the short form below. Thank you for your time and generosity.




Acadian Sets Up Employee Flood Relief Fund

August 18, 2016–In the wake of historic flooding across South Louisiana, Acadian has established an Employee Assistance Fund for those employees who suffered damage and losses.

During the storm response, Acadian activated more than 60 additional ambulances and crews, and assisted in the evacuation of hospitals, nursing facilities and prisons across their affected service area. Additional crews from Acadian’s Texas operations came in to assist with the load.

Although Acadian’s operations never ceased during rising floodwaters, many of Acadian’s medics and employees experienced flooded homes and vehicles. It is a testament to their dedication that many employees still reported for work, helping to rescue residents and treat the injured, while facing their own tragedies.

“Our company has more than 100 employees whose homes flooded and suffered substantial damage. We are working with those employees to help them meet their families’ immediate needs and are working to develop other methods of support to help them through what will be a long and tedious recovery and rebuilding process,” said Acadian Chairman & CEO Richard Zuschlag.

The Employee Assistance Fund is administered through the Community Foundation of Acadiana, a Lafayette, Louisiana-based 501(c)(3) philanthropic organization. Donations will be facilitated through the secure link below, and funds will be distributed to employees throughout Louisiana who have been affected.

Acadian Ambulance is one of the largest ambulance services in the nation, offering emergency and non-emergency transportation to areas in Louisiana, Texas, and Mississippi.

Acadian Employee Assistance Fund donation form: www.AcadianGiving.com

Fundraiser for AMR Medic Hit By Drunk Driver

Sad News from Michigan—Critical Care Paramedic With Severe Head Injuries

At approximately 4:30 am on August 7th, AMR unit 201 was moving post locations in Allegan County, MI when the unit was struck head on by an alleged drunk driver. Critical Care Paramedic crew members Kevin Jongekryg and Tim Hoffman were both injured in the collision, and were transported by their coworkers to a local hospital. Jongekryg, a 23 year veteran with AMR, suffered moderate orthopedic injuries and was ultimately discharged home a day later.

Hoffman, an 11 years provider with AMR, suffered multiple, significant head injuries requiring transfer into Grand Rapids, MI for emergency surgery. He is currently listed in critical condition and remains intubated. At this time Tim does have some spontaneous movement and has not been having seizures but is showing weakness on one side of his body. His doctors say he is improving, but slowly. He still has multiple surgeries upcoming and does not yet have a long-term prognosis for recovery.

Hoffman, his wife Kristen and his 13 month old daughter Anna have support from both family and community but they have a very long road ahead. A fundraiser site has been set up to collect money to aid in his recovery and to help provide for daily living expenses while he is unable to work. Please consider donating to help support Tim and his family. Anything helps. If you aren’t able to donate, please consider sharing this information on social media and throughout your organization. Thank you for your assistance.

Donate for Tim's Care

Spotlight: SSM Health Cardinal Glennon Children’s Hospital STARS Program

The Special Needs Tracking & Awareness Response System (STARS), was founded just over two years ago at SSM Health Cardinal Glennon’s Children’s Hospital in St. Louis, Missouri. The team at Cardinal Glennon realized that they needed to do something to address the growing number of children in the U.S. with special health care needs, many of whom are at a higher risk for repeated ambulance transports.

As an EMT for over 18 years, Patricia Casey, the Missouri Coordinator of the STARS Program, knows how intimidating it can be for a first responder to walk into a home that in many ways may look like a hospital room. Children with special health care needs can require many different types of in home medical equipment that first responders are often not familiar with. The STARS Program aims to make the job of the first responders easier while making children with medical needs and their parents more comfortable with ambulances in case they need to be transported in one.

Cardinal Glennon works with local ambulance districts to enroll children with special medical needs in that district’s STAR Program. Once a child is registered in STARS, they are given a unique patient identification number and a home visit is scheduled with the patient and their family to compile pertinent medical history. Participating ambulance companies then create a book with all of the stars in their area so that their first responders have access to the medical information on the go. If a STAR needs to be transported, their caregiver can relay their STAR number to the dispatcher who will then let the first responders know. First responders can then look up crucial medical information about the STARS patient, so they can be better prepared when they arrive on scene.

Knowing that many medical devices in the homes of the STARS may be foreign to first responders, Cardinal Glennon’s staff provides free necessary trainings all around Missouri and now Illinois. Shelby Cox works as the Team Lead for EMS outreach, and Josh Dugal, RN, is the EMT-P STARS Coordinator for Illinois. Together with Casey, they help keep the program running smoothly. Each participating ambulance company appoints a STARS coordinator on their staff who will make biannual home visits and make sure the STARS medical information is up to date. Cardinal Glennon also sets up regular opportunities for STARS to visit their local first responders. Giving STARS the chance to get familiar with an ambulance and their local first responders prior to a medical emergency has been proven to help out both parties when an emergency occurs.

A paramedic who has responded to STARS calls explains that “the STARS system permitted me to have advanced medical knowledge before I walked through the door. There was no time lost backtracking to learn the patient’s history or baseline in the midst of a chaotic scene”. In addition to helping the first responders, the STARS program has been a huge reassurance to the parents of STARS whose children may often need medical assistance.

To learn more about Cardinal Glennon’s STARS program, visit their website or check them out on Facebook. Also check out Patricia Casey’s Article on the STARS Program which includes testimonials from both parents and first responders who have participated in the program.
Thanks to the entire team at Cardinal Glennon for your great work!

Do you know of other innovative programs being run by ambulance services? Share with the AAA so that we might feature those programs on the AAA Blog as well.

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