NREMT Statement to National Governors Association

COVID-19 Impact on Essential Critical Infrastructure Workers and Requested URGENT Action of Governors to Ensure Continuity of the Supply of Certified Emergency Medical Services Professionals (EMTs & Paramedics) and other Essential Critical Infrastructure Workers. Statement by the National Registry of Emergency Medical Technicians. Download PDF Problem: The national COVID-19 pandemic containment efforts inadvertently impact a vital component of the licensure pathway for Essential Critical Infrastructure Workers like emergency medical services (EMS) responders (EMTs and paramedics) and many other health professions. Without immediate intervention, thousands of professionals – prepared and scheduled to take their final certification exams – could be prohibited from responding to the national public health crisis. Facts bearing on the problem: • Essential Critical Infrastructure Workers like EMTs, Paramedics, and other health professionals – in the interest of public safety – are required to take certification or licensure examinations prior to state licensure. For over 70 health professions, these examinations are administered by Pearson VUE in either a Pearson VUE owned facility (PPC) or its network of independent third-party test centers (PVTCs). • During the week of March 9th, most colleges and universities in the United States closed; consequently, this closed many PVTCs co-located on these campuses where...

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CMS NEWS: Trump Administration Launches New Healthcare Toolkit

Trump Administration Launches New Toolkit to Help States Navigate COVID-19 Pre-Hospital/Emergency Medical Services (EMS) Resources At President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision-makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities. This toolkit includes a full suite of available resources to maximize responsiveness based on state and local needs, building on President Trump’s commitment to a COVID-19 response that is locally executed, state-managed, and federally supported. This work was developed by the Healthcare Resilience Task Force as part of the unified government’s response to COVID-19. This Topic Collection focuses on plans, tools, templates, and other immediately implementable resources to help with COVID-19 preparedness, response, recovery, and mitigation efforts, focusing on pre-hospital and emergency medical services (EMS) settings, including public safety answering points (PSAPs). Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID19 outbreak management. If you have COVID-19 promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant...

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Supplemental Funding for Emergency Medical Services

COVID-19: Supplemental Funding for Emergency Medical Services Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team. Download PDF 1. Purpose: This paper outlines two supplemental funding options for Emergency Medical Services (EMS) agencies affected by the COVID-19 pandemic. 2. Scope: This information applies to private non-profit organizations as well as for-profit EMS agencies. This guidance does not apply to government-owned and operated EMS agencies. 3. Overview of Existing Supplemental Funding Opportunities: a. Stafford Act Emergency and/or Major Disaster Declaration (Stafford Act): Emergency protective measures to save lives and protect public health (including emergency medical care and transport) are eligible for reimbursement under the Federal Emergency Management Agency’s (FEMA) Public Assistance program. State, territorial, tribal, and local government entities and certain private non-profit organizations are eligible to apply for Public Assistance. FEMA assistance will be provided at a 75 percent federal cost-share and may not duplicate assistance provided by the U.S. Department of Health and Human Services or other federal agencies. b. Coronavirus Aid, Relief, and Economic Security Act (CARES Act): The Paycheck Protection Program is a loan program administered by the U.S. Small Business Administration (SBA) to incentivize small businesses to keep workers on the payroll....

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CISA Releases Version 3.0 of the Essential Critical Infrastructure Workers List

Private Sector Update Created and distributed by the U.S. Department of Homeland Security Private Sector Office private.sector@dhs.gov April 17, 2020 The Cybersecurity and Infrastructure Security Agency (CISA) has released Version 3.0 of the Essential Critical Infrastructure Workers list. Version 3.0 provides clarity around a range of positions needed to support the critical infrastructure functions laid out in the original guidance and Version 2.0. This iteration includes a reorganization of the section around Healthcare and Public Health and more detail to clarify essential workers; emphasis for Emergency Medical Services workers; and adds lawyers and legal aid workers. Also included is language focused on sustained access and freedom of movement; a reference to the CDC guidance on safety for critical infrastructure workers; and a statement saying sick employees should avoid the workplace and the workforce. In worker categories, all references to “employees” or “contractors” have been changed to “workers.” Other additions include a reference to the USCG Marine Safety Information Bulletin on essential maritime workers; clarified language including vehicle manufacture; and many other small changes to clarify language. CISA issued initial guidance on Essential Critical Infrastructure Workers on March 19, which was developed to help state, local, tribal, and territorial authorities as...

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911 and Emergency Medical Services (EMS) Algorithms

911 and Emergency Medical Services (EMS) Algorithms Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team. Download PDF Attached, please find the latest document released by the Health Systems Resiliency Task Force.  Please use the communication mechanisms at your disposal to share this information with your members, constituents and clients.  All Task Force documents will also be posted on EMS.gov and/or 911.gov (as appropriate).  The NHTSA created these two portals for COVID Resources and will continue to update them three times a week, with new links and documents containing information on a variety of COVID-related topics.  You will find COVID resources here on EMS.gov, and here on 911.gov....

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Personal Protective Equipment Supply for Emergency Medical Services (EMS)

Personal Protective Equipment Supply for Emergency Medical Services (EMS) Document Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team.  Download PDF Current Situation Personal Protective Equipment (PPE) supplies, including N-95 respirators and gowns, are in short supply due to the COVID-19 pandemic. These shortages are anticipated to resolve over time as additional sources are identified and manufacturing capacity is expanded. In the interim, Emergency Medical Services (EMS) agencies that are unable to meet their PPE requirements through regular distribution channels are advised to submit requests for PPE supplies through their local and/or state emergency management officials, which are then submitted to Federal Emergency Management Agency (FEMA) for sourcing and allocation. Background Due to the COVID-19 pandemic, health care providers are exhausting PPE supplies faster than they can be sourced. EMS agencies are part of the critical infrastructure sector and are strongly considered in the decision-making process to allocate supplies. Actions Taken to Address Supply Issues The Strategic National Stockpile (SNS) has been activated to provide PPE supplies to states for distribution to healthcare agencies. Supplies are being allocated to states on a pro-rata basis for distribution by the state. Initial distributions from the SNS were limited....

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Considerations for State Emergency Medical Service Offices in Response to COVID-19

Considerations for State Emergency Medical Service Offices in Response to COVID-19 Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team. Download PDF Integration of Emergency Medical Services (EMS) into the state emergency management structure Ensure that the state EMS Office, including the state EMS medical director, is represented in, or has direct input into, the state Emergency Operations Center (EOC) and its public health equivalent. Define the chain of command within the EOC to ensure EMS input to leadership. Clarify the roles and responsibilities of EMS medical directors (local/state/regional) to the state emergency management office. Potential need for waiver/suspension of EMS laws and regulations relating to: Public Safety Answering Points (PSAP) operations. Personnel licensure (and re-licensure). Out-of-state reciprocity. Medical oversight. Ambulance staffing. Patient treatment/scope of practice. Patient transport. Training and education. Protocol adherence. EMS licenses and certifications Develop guidance re: temporary extensions of state EMS licenses that are expiring. Develop guidance re: provisional licensing of EMS clinicians in certain circumstances (e.g., licensed out-of-state, completed course requirements but not testing, recently expired license). Identify which EMS certifications (e.g., CPR, PALS, ITLS, PHTLS, ACLS) have been automatically extended by a certification organization. Provide guidance on potential strategies for...

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Public Service Answering Points (PSAPs)/Emergency Communications Centers (ECCs) Call Screening

Public Service Answering Points (PSAPs)/Emergency Communications Centers (ECCs) Call Screening Document Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team. Download PDF This document is intended to provide procedural guidance to Public Safety Answering Points (PSAPs) and Emergency Medical Service (EMS) agencies on practices that could result in improved call screening and EMS care with the potential to decrease unnecessary COVID-19 transports to hospitals. If adopted these could alleviate a significant load on the currently strained healthcare system, and decrease additional infectious disease exposures among the community and healthcare providers. NOTE: protocols would have to be approved by state or local medical oversight This guidance applies to all PSAP and EMS delivery models including but not limited to; free standing, third-service; fire-based, hospital-based, independent volunteer, private and related emergency medical service providers.  For all requests for emergency care (including interfacility transports) the dispatcher/call taker should ask the following questions: Has the Patient had a positive COVID-19 test? Is the Patient A COVID-19 Person Under Investigation (PUI)? – (PUI is defined as: A patient who has been tested for COVID-19 but has not received their result). Does the patient have Flu-like symptoms (fever, chills, tiredness, cough, muscle aches,...

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EMS Week 2020

FOR IMMEDIATE RELEASE March 16, 2020 EMS STRONG LAUNCHES “READY TODAY. PREPARING FOR TOMORROW.” CAMPAIGN TO HONOR EMS PROFESSIONALS Campaign unifies the profession and brings awareness to National EMS Week, May 17-23, 2020  WASHINGTON March 16, 2020– The American College of Emergency Physicians (ACEP), in partnership with the National Association of Emergency Medical Technicians (NAEMT), is proud to announce this year’s EMS STRONG campaign theme: READY TODAY. PREPARING FOR TOMORROW. The annual EMS STRONG campaign provides opportunities to recognize the Emergency Medical Services (EMS) community, enhance and strengthen the profession on a national level and celebrate National EMS Week, May 17-23, 2020. The campaign brings together key organizations, media partners and corporate sponsors that are committed to recognizing and fortifying the EMS community, commending recent groundbreaking accomplishments and increasing awareness of National EMS Week. “As we enter a new decade, we look ahead to the future of prehospital care. This future will include dramatic improvements in patient care, thanks to advances in research, information sharing and life- changing technology,” says William P. Jaquis, MD, FACEP, President of ACEP. “During National EMS Week, and throughout the year, we are proud to recognize EMS and fire professionals who tirelessly serve their communities (more…)

COVID-19 Update II for EMS

First Case of 2019 Novel Coronavirus in the United States The New England Journal of Medicine has rapidly published a peer-reviewed paper on the Snohomish County WA ‘Patient 1’. This was the first reported case of COVID 19 in the US. This seminal document, which given the magnitude of the case and its initial findings is released in full here The work by Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, et al for the Washington State 2019-nCoV Case Investigation Team was turned round in just over 5 weeks and below is an ‘Executive summary’ ( as extracted from the paper) but the full paper and range of results should be read in full. Patient Presentation On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever. On checking into the clinic, the patient put on a mask in the waiting room. After waiting approximately 20 minutes, he was taken into an examination room and underwent evaluation by a provider. He disclosed that he had returned to Washington State on January 15 after traveling to visit family in Wuhan, China. (more…)

4 Tips: Add Empathy to EMS Care

Empathy is about trying to understand, as best we can, someone else’s situation or experience. The question is, do we in EMS truly understand the word? Are we empathetical to ourselves and to the people we work with? While some say that empathy comes from proper upbringing, today’s decline in civility means we see less and less of it displayed. A major contributing factor is the “tough” exterior we favor in each other: how often have you heard comments like “come on, just suck it up buttercup,” “you need to be tougher than that to be a medic,” or “we’re EMS, we eat our young.” Why are we like this, and why can’t we reinforce the empathy that naturally resides in all of us? Empathy is a big part of our jobs, and we need to teach it to our students, our employees and each other. People need to feel that it’s OK to be empathetic and that it’s a natural part of the whole EMS picture. One of the best techniques to foster empathy is active listening — not only to our patients but also to staff and co-workers. When you actively listen, you H.E.A.R. …  Halt: Stop whatever (more…)

Your EMS Reputation Depends on Three Cs

Your EMS Reputation Depends on Three Cs—Credentials, Courtesy, Community In EMS, your reputation is critical. Your character moves with you from provider to provider and from squad to squad; EMS is a small world where people know about you before you even step foot in the door. People react to you based on judgments from not only real life, but also your digital life. With Facebook, Snapchat, Instagram and other social media networks so prevalent today, your social media profile serves as the basis of your reputation both professionally and privately. Unfortunately, social media blunders abound among EMS providers, affecting their reputations and their future hiring ability. You can find hundreds of examples doing a quick online search; here are just two. Three South Carolina responders fired for making statements like “idiots shutting down I-126. Better not be there when I get off work …” (Kaplan, 2016, para. 3) A Brockton, Mass. dispatcher who said of a pregnant overdose patient, “She needs to be left to rot …” (Shephard, 2018, para. 5) A better way to think of your reputation is the “Three Cs” — Credentials, Courtesy and Community. Credentials may also be called Continuing Education, as it’s vital to...

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Make a Difference: EMS and Human Trafficking

When we think of trafficking, we generally think of drugs or weapons, not human beings. Yet the problem exists in numerous communities where EMS responders deliver care. Human trafficking is defined by the United Nations as “the recruitment, transportation, transfer, harboring, or receipt of persons by improper means for an improper purpose.” (End Slavery Now, 2018, para. 1) A more succinct definition comes from Kathryn Brinsfield, MD, MPH, Assistant Secretary for Health Affairs and Chief Medical Officer for the Department of Homeland Security: “Human trafficking is modern-day slavery.” (DHS, 2017, para. 3) Why is this so important in today’s EMS field? We are the first on scene, we are the ones invited inside where others are not and we are the ones who see an injured person’s environment.  Our interactions with others can help us spot some of the tell-tale indicators. Unfortunately, there are many reasons people are trafficked: Domestic Slavery: People are brought into private homes to work as slave labor, with no options to leave. Sex Trafficking: Children, men and women are forced into the commercial sex industry Forced and Bonded Labor: People are forced to work under the threat of violence for no pay — often to repay (more…)

Changing the Face of EMS for the New Century

EMS has always been the forefront of medicine, delivering care to the sick and injured in various roles dating as far back as the Civil War. It has come a long way from the days of horse and buggy. Yet, where are we going now? One look at the trajectory of Nursing indicates where we are headed. When Nursing first started, the profession was comprised of caring women who were viewed and treated as indentured servants, subservient to the male dominated physicians. Nursing evolved when the “servant” became educated. What followed were thousands of women beginning to diagnose, conduct research and improve outcomes in the healthcare field. Soon thereafter, they broke free of the care assistant model they were in. I see EMS following the same path. The ambulance industry started out as transporters, with a curriculum that was adopted and funded by the Department of Transportation (DOT). The industry has roots in DOT, Police Departments, Fire Departments and the military, but are truly physician extenders that should be firmly rooted in Health Departments. EMS is now developing a language, doing research, obtaining national accreditation for our schools, even supporting continuing education with CAPCE. But we need to do more. (more…)