2019 National EMS Scope of Practice Model, Change Notices

Download Change Notice

Date:               March 29, 2021

To:                  State EMS Directors

From:              Jon R. Krohmer, M.D., FACEP, Director, Office of Emergency Medical Services

RE:                  2019 National EMS Scope of Practice Model, Change Notices

The National EMS Scope of Practice Model (model) was first published in February 2007 by the National Highway Traffic Safety Administration’s (NHTSA’s) Office of Emergency Medical Services (EMS). The most recent version of the model was published by NHTSA in February 2019. The model was developed by the National Association of State EMS Officials (NASEMSO) with funding provided by NHTSA and the Health Resources and Services Administration (HRSA). Over the past 14 years, the model has provided guidance for States in developing their EMS Scope of Practice legislation, rules, and regulation. While the model provides national guidance, each State maintains the authority to regulate EMS within its border, and determine the scope of practice of State-licensed EMS clinicians.

Recognizing that the model may impact States’ ability to urgently update their Scope of Practice rules, in 2016 the National EMS Advisory Council (NEMSAC) recommended that NHTSA develop a standardized urgent update process for the model. The Rapid Process for Emergent Changes to the National EMS Scope of Practice Model (rapid process) was developed by NASEMSO and published by NHTSA in September 2018.

Using the rapid process, in March 2021 NHTSA convened a subject matter expert panel (panel) to respond to the following questions: 1) Should immunizations via the intramuscular (IM) route be added to the emergency medical responder (EMR) and emergency medical technician (EMT) scope of practice levels?; 2) Should monoclonal antibody (MCA) infusion be added to the advanced EMT (AEMT) and paramedic scope of practice levels?; and 3) Should specimen collection via nasal swabbing be added to the EMR, EMT, AEMT, and paramedic scope of practice levels?

The panel considered the ability of EMRs and EMTs to perform the psychomotor skill of medication administration via the IM route and recommended that IM medication administration be added only to the EMT scope of practice as part of their common daily practice.

The panel considered the ability of EMRs and EMTs to administer medical director approved immunizations and recommended that immunizations during a public health emergency be added only to the EMT scope of practice.

The panel considered the ability of EMRs, EMTs, AEMTs, and Paramedics to perform the psychomotor skill of specimen collection via nasal swab and recommended that specimen collection via nasal swab be added only to the EMT, AEMT, and Paramedic scopes of practice as part of their common daily practice.

The panel did not issue a recommendation on MCA infusion.

Based on the panel’s recommendations NHTSA used the rapid process to develop the two attached change notices on IM medication administration, vaccinations during a public health emergency, and specimen collection via nasal swab.

It should be noted that, although the recommendations address the psychomotor skills associated with these specific activities, the assumption of the panel in making the recommendations was that all associated educational activities, knowledge of indications and potential contraindications, other potential skills (e.g.: drawing the appropriate dose of medication up from an ampule or vial [single or multi-dose], supervised assessment of skill competency, and quality improvement activities) would be components of the entire program.

I hope you find these change notices useful to you in meeting the urgent needs of your patients and the practitioners you regulate. In the very near future we will publish a revised version of the model which incorporates these change notices. Please feel free to contact me should you have any questions.

Download Change Notice

CMS COVID-19 Snapshot March 24

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 2.7 million COVID-19 cases among the Medicare population and nearly 700,000 COVID-19 hospitalizations.  This update includes new data on COVID-19 case and hospitalization rates by race/ethnicity.

The updated snapshot covers the period from January 1 to December 26, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by January 22, 2021.

View the Updated Snapshot

Texas A&M Study | Anonymous Survey for EMS

Dr. Joyce Hnatek, Timothy Fan, and Logan DuBose from the Texas A&M College of Medicine are conducting a research study to assess the awareness of an often overlooked patients’ right – the right to not be hospitalized/transported against one’s will. You were selected to receive this invitation because you may provide healthcare to patients with decreased ability to communicate.
We respectfully request that you complete this brief anonymous survey. It should take < 5 minutes to complete. Thank you in advance for your time and support. The informed consent is included in the survey link (https://tamu.qualtrics.com/jfe/form/SV_6LvpSzXslKzRz1z)
Sincerely,

Timothy (fan@tamu.edu) and Logan (logandubose960@tamu.edu)

JAMA | Ontario | Economic Analysis of MIH Delivered by EMS

From JAMA on February 24, 2021

Economic Analysis of Mobile Integrated Health Care Delivered by Emergency Medical Services Paramedic Teams

Question  Is mobile integrated health care (MIH) delivered by emergency medical services more efficient than regular ambulance responses in addressing the needs of urgent care in the community?

Findings  This economic evaluation compared 1740 calls serviced by MIH in 2018 to 2019 with propensity score–matched ambulance calls for the same period and 2 years prior and found that MIH was associated with a decrease in the proportion of patients transported to the emergency department and saved health care costs compared with regular ambulance responses.

Meaning  These findings suggest that MIH is a promising and viable solution to meeting urgent health care needs while improving the efficiency in using emergency care resources.

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EMS.gov | Training Resources for Vaccination Programs Using EMTs

From EMS.gov on February 10

These resources can serve as just in time training for vaccination programs utilizing emergency medical technicians:

Training video on COVID-19 intramuscular vaccine administration
This video created by the Maryland Institute of Emergency Medical Services Systems (MIEMSS) can be used to provide EMTs with didactic knowledge to administer IM injections. With the exception of the MIEMSS link referenced in the video, it can be used by EMTs in any state or territory. It should be accompanied by a skills assessment, which is discussed below.

Intramuscular Injection Skill Checklist
A clinical skills assessment checklist for EMTs preparing to administer IM injections.

SARS-CoV-2 Vaccine Training for EMTs
A written description of the skills required of EMTs to administer the vaccine.

Moderna and Pfizer Vaccine Comparison
A simple side-by-side comparison of the Pfizer and Moderna SARS-CoV-2 vaccines

Vaccine Update Video
In this presentation from late January 2021, Florida State EMS Medical Director Kenneth Scheppke, MD, provides an overview of the latest science related to COVID vaccines.

COVID-19 Vaccination Training Programs and Reference Materials for Healthcare Professionals
CDC recommended resources to prepare healthcare workers to administer COVID-19 vaccines.

EMS Vaccine Administration Program Manual
This guide from the State of Indiana can serve as a resource to help state and local officials and EMS organizations with the creation and implementation of EMS vaccination programs.

CDC | National Forum on COVID-19 Vaccine

Download CDC Fact Sheet

In support of the Biden-Harris administration’s National Strategy for the COVID-19 Response and Pandemic Preparedness, the Centers for Disease Control and Prevention is organizing a virtual National Forum on COVID-19 Vaccine that will bring together practitioners from national, state, tribal, local, and territorial levels who are engaged in vaccinating communities across the nation.

The Forum will facilitate information exchange on the most effective strategies to:

  • Build trust and confidence in COVID-19 vaccines
  • Use data to drive vaccine implementation
  • Provide practical information for optimizing and maximizing equitable vaccine access

Practitioners include representatives of organizations focused on vaccine implementation in communities from:

  • State, tribal, local, and territorial public health departments
  • Healthcare system providers and administrators and their national affiliate organizations
  • Pharmacies
  • Medical and public health academic institutions
  • Community-based health service organizations

Dates and Deadlines:

  • February 9: Registration opens: www.cdc.gov/covidvaccineforum
  • February 16: Last day to register
  • February 22: Building Trust and Vaccine Confidence
  • February 23: Data to Drive Vaccine Implementation
  • February 24: Optimize and Maximize Equitable Access

Download CDC Fact Sheet

AHA Pre-Hospital News & Resources

From the American Heart Association on February 10

Dear Pre-hospital Emergency Colleagues,

The American Heart Association®’s Quality, Outcomes Research and Analytics team is excited to launch the Pre-hospital News and Resources newsletter for prehospital emergency care providers. In this issue you will find information on 2021 Mission: Lifeline Recognition information, conferences and webinars, prehospital resources, American Heart Association guidelines and statement, prehospital articles, and 2020 Mission: Lifeline recognized agencies.

2021 MISSION: LIFELINE® EMS RECOGNITION

The 2021 Mission: Lifeline EMS recognition updates are now available. The Mission: Lifeline EMS recognition is a program designed to showcase emergency prehospital care organizations across the nation for excellent care based on American Heart Association guidelines.

Process

For agencies that applied for 2020 recognition. An email fromAHASurveys@surveys.heart.org was sent on December 17, 2020 to the primary contacts from last year that will include a recognition application link, unique to the applicant agency. ACTION: If you applied last year and have not received your application link, please let your regional quality director know immediately.

For new applicants or agencies that did not apply in 2020.  ACTION: Please complete the 2021 New Mission: Lifeline EMS Application Request form. Upon completion of this form an application link will be sent via email within 2-business days.

Recognition Measures

For the 2021 recognition year (based on 2020 calendar year data) the required achievement measures will remain the same as those required for 2020 recognition, below.

Due to COVID-19, updates to the required achievement measures to include the two new stroke measures is being delayed until 2022.  On a related note, the National EMS Quality Alliance approved 11 measures in August 2019 including  “Stroke-01 Suspected Stroke Receiving Prehospital Stroke Assessment” which is one of the Mission: Lifeline EMS stroke recognition measures planned for 2022.

Data Submission

The data submission portal is open and will remain open and accessible through the application deadline, April 30, 2021.

Recognition Resources

To assist agencies, there are resources on the website including; Application Overview VideoRecognition CriteriaRecognition FAQApplication Category, and Webinars

Recognition Questions or Assistances

If you have questions or need assistance, please reach out to your regional Mission: Lifeline EMS contact below.

Eastern region (CT, DC, DE, MA, MD, ME, NH, NJ, NY, PA, RI, VA, VT, WV)
Rob Horton – rob.horton@heart.org
Midwest region (IA, IN, IL, KS, KY, MI, MN, MO, ND, NE, OH, SD, WI)
Alex Kuhn – alexander.kuhn@heart.org
Southeast region (AL, FL, GA, LA, MS, NC, PR, SC, TN)
Lori Hollowell – lori.hollowell@heart.org
Southwest region (AR, CO, NM, OK, TX, WY)
Loni Denne – loni.denne@heart.org
Western region (AK, AZ, CA, HI, ID, MT, NV, OR, UT, WA)
Paula Hudson – paula.hudson@heart.org

CONFERENCES AND WEBINARS

February 11, 2021 from 11am – 12pm CST
Resuscitation Education in the Real World: How the Columbus Fire Department transformed the way they practice High-Quality CPRFebruary 18, 2021 from 9am – 12pm CST
Innov8te NRP:  Introduction to the Neonatal Resuscitation Program, 8th Education

February 23, 2021 from 12pm-1pm CST
Getting to the Heart of the Issue: Rural Stroke and Cardiac System of Care Trends, Inequities and Opportunities

March 11, 2021 from 1pm-2pm CST 
Pre-Hospital Quality Roundtable Webinar

March 17-19, 2021
International Stroke ConferenceMarch 31, 2021 9am-4pm CST 
Strive to Revive Resuscitation Virtual Conference 
Agenda and registration coming soon. 

Recorded Webinars 

Outcomes of Targeted Temperature Management Webinar

RQI Pre-hospital and Public Safety Programs – RQI Telecommunicator Webinar

PREHOSPITAL RESOURCES 

Mission: Lifeline Stroke  is excited to announce the release of the Severity-based Stroke Triage Algorithm for EMS and a one-page document explaining the algorithm.

The AHA Lifelong Learning Pre-Hospital Stroke Rapid Response(on demand) course is designed to assist pre-hospital and hospital personnel in the education of EMS providers in their communities. Approved for 0.75 CAPCE Advanced CEHs.

Nominate a Heartsaver Hero.  The award is our way of saying thank you for performing the heroic act of CPR, a critical link in our chain of survival.

Check out the American Heart Association’s Don’t Die of Doubt campaign for useful information and tools to educate your community on the importance of calling 911 during an emergency.

The American Heart Association has teamed up with RapidSOS to create the world’s first emergency response data platform that securely links life-saving data from connected devices or profiles to 911 and first responders in an emergency.

AMERICAN HEART ASSOCIATION GUIDELINES AND STATEMENTS

Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association

2020 American Heart Association Guidelines for CPR and ECC (GuidelinesInstructor UpdatesDigital Content Highlights)

Telecommunicator Cardiopulmonary Resuscitation: A Policy Statement from the American Heart Association

PREHOSPITAL ARTICLES OF INTEREST

STEMI
Catheterization Laboratory Activation Time in Patients Transferred With ST-Segment-Elevation Myocardial Infarction: Insights From the Mission: Lifeline STEMI Accelerator-2 Project

Prehospital Activation of Hospital Resources (PreAct) ST‐Segment–Elevation Myocardial Infarction (STEMI): A Standardized Approach to Prehospital Activation and Direct to the Catheterization Laboratory for STEMI Recommendations From the American Heart Association’s Mission: Lifeline Program

Stroke
A Community-Engaged Stroke Preparedness Intervention in Chicago

Emergency Medical Services Utilization for Acute Stroke Care: Analysis of the Paul Coverdell National Acute Stroke Program, 2014-2019

Cardiac Arrest
Detailed post-resuscitation debrief reports: A novel example from a large EMS system

Delay to Initiation of Out-of-Hospital Cardiac Arrest EMS Treatments

Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest

Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic

Other articles of interests
Firefighting as an Independent Risk Factor for Atrial Fibrillation

PREHOSPITAL AGENCY MISSION: LIFELINE RECOGNITION

In 2020, more than 600 prehospital agencies were recognized for the quality of care provided for STEMI patients.

A special recognition goes out to the following 33 agencies that have been recognized every year.
Agency City State
Los Angeles County EMS Agency Santa Fe Springs CA
Oceanside Fire Department Oceanside CA
Ventura County EMS Oxnard CA
Western Connecticut Health Network Affiliates – EMS Danbury CT
Okaloosa County Department of Public Safety – EMS Division Niceville FL
MetroAtlanta Ambulance Service Marietta GA
Ada County Paramedics Boise ID
MidMichigan Health EMS Midland MI
Warren Fire Department Warren MI
Cabarrus EMS Concord NC
Rowan County Emergency Services – EMS Division Salisbury NC
NHRMC AirLink/VitaLink Critical Care Transport Wilmington NC
Mecklenburg EMS Agency Charlotte NC
Pender EMS & Fire Rocky Point NC
New Hanover Regional EMS Wilmington NC
Cumberland County EMS Fayetteville NC
F-M Ambulance Service Fargo ND
University Hospital EMS Newark NJ
Empress EMS Yonkers NY
Strongsville Fire Department Strongsville OH
EMSTAT Norman OK
Macungie Ambulance Corps Macungie PA
Riddle EMS Media PA
Western Berks Ambulance Association West Lawn PA
Lexington County EMS Lexington SC
Greenville County EMS Greenville SC
Charleston County EMS North Charleston SC
Grand Prairie Fire Department Grand Prairie TX
Williamson County EMS Georgetown TX
San Antonio Fire Department San Antonio TX
Garland Fire Department Garland TX
Austin Travis County EMS Austin TX
Alexandria Fire Department Alexandria VA

Rural Policy Research Institute EMS Study

From RUPRI in January 2021

Characteristics and Challenges of Rural Ambulance Agencies – A Brief Review and Policy Considerations

Rural ambulance agencies, a fundamental component of the rural emergency medical services (EMS) system, are challenged by the following issues:

  • long distances and challenging terrain that prolong emergency response and transport times,
  • insufficient payment by insurers to cover standby and fixed costs,
  • a changing workforce that has historically relied on volunteers but increasingly must include paid personnel,
  • a lack of regional EMS plans to coordinate services, and
  • insufficient State and Federal policy coordination across oversight agencies.

Specific public policies to address rural ambulance agency challenges could include the following:

  • Increase ambulance payment to adequately cover reasonable standby and fixed costs.
  • Consider EMS an essential service, the same as firefighting and law enforcement.
  • Collect rural ambulance agency workforce data to better understand workforce needs.
  • Expand the scope and authority of the Federal Interagency Committee on EMS to address rural ambulance agency payment and workforce challenges.

Download PDF Report

CMS | COVID-19 Vaccine Resources

As COVID-19 vaccines begin rolling out across the country CMS is taking action to protect the health and safety of our nation’s patients and providers and keeping you updated on the latest COVID-19 resources from HHS, CDC and CMS.

With information coming from many different sources, CMS has compiled resources and materials to help you share important and relevant information on the COVID- 19 vaccine with the people that you serve. You can find these and more resources on the COVID-19 Partner Resources Page and the HHS COVID Education Campaign page. We look forward to partnering with you to promote vaccine safety and encourage our beneficiaries to get vaccinated when they have the opportunity.

If you are a healthcare provider:

Both the CDC and CMS have useful resources for your practice. Look to CDC for the latest science, vaccine administration information and patient-focused resources.

You can find additional resources on the CDC Resources for Health Care Providers Page.

CMS released aCOVID-19 Provider Toolkit to ensure health care providers have the necessary tools to respond to the COVID-19 public health emergency. The toolkit includes information on:

You can also review the set of COVID-19 FAQs, which has information specific to health care providers who bill Medicare for administering COVID-19 vaccines.

Here’s what else you should know:

  • Medicare covers the COVID-19 vaccine, so there will be no cost to your patients with Medicare.  Medicare will reimburse you for administering the vaccine.
  • State governments are handling the distribution of COVID-19 vaccines. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
  • People without health insurance or whose insurance does not provide coverage of the vaccine can also get COVID-19 vaccine at no cost.  Providers administering the vaccine to people without health insurance or whose insurance does not provide coverage of the vaccine can request reimbursement for the administration of the COVID-19 vaccine through the Provider Relief Fund.
  • Most professional associations have pages devoted to COVID-19 vaccination.  Your association may have advice tailored to your discipline, specialty and/or location.

How can you help educate your patients?

  • You are a trusted source…encourage your patients to get the vaccine when it is available to them.
  • Let them know the vaccine is no cost and will help keep them from getting COVID-19. Learn more about the benefits of the vaccine.
  • Let them know the vaccine is safe and that safety is a top priority for COVID-19 vaccines.
  • Remind them to continue practicing the 3Ws (Wear a Mask, Watch your distance, Wash your hands).

Questions? Please e-mail us: Partnership@cms.hhs.gov

CMS | Updated Medicare COVID-19 Snapshot

From CMS on January 15

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 1.9 million COVID-19 cases among the Medicare population and over 493,000 COVID-19 hospitalizations.

The updated snapshot covers the period from January 1 to November 21, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by December 18, 2020.

Read on CMS.gov

BMJ | Pfizer Second Dose Efficacy 95%

Covid-19: Pfizer vaccine efficacy was 52% after first dose and 95% after second dose, paper shows
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4826 (Published 11 December 2020)
Cite this as: BMJ 2020;371:m4826

The Pfizer and BioNTech covid-19 vaccine may provide some early protection, starting 12 days after the first dose, the peer reviewed results of a phase III trial have found.

The study, published in the New England Journal of Medicine,1 found that vaccine efficacy between the first and second doses was 52% (95% credible interval 29.5% to 68.4%), with 39 cases of covid-19 in the vaccine group and 82 cases in the placebo group.

Seven or more days after the second dose, vaccine efficacy then rose to 95% (90.3% to 97.6%), with eight covid-19 cases reported in the vaccine group and 162 cases in the placebo group.

The vaccine has so far been approved in Canada and in the UK, where it is already being rolled out to people over 80 and healthcare workers. In the US the Food and Drug Administration’s independent panel has voted in favour of emergency use authorisation for the vaccine, and the agency is expected to approve it within days.2

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CMS | Report Highlights Four Years of Accomplishments In Healthcare

From CMS on January 13

Today, the Centers for Medicare and Medicaid Services (CMS) released “Putting Patients First: The Centers for Medicare & Medicaid Services’ Record of Accomplishment from 2017-2020,” a report highlighting the agency’s transformation in ensuring all Americans have access to quality and affordable healthcare.

The report examines CMS’ accomplishments over the last four years, highlighting agency actions that responded to the coronavirus disease 2019 (COVID-19) pandemic and furthered CMS’s Four Core Goals identified in 2017: empowering patients and doctors, ushering in a new era of state flexibility and local leadership, developing innovative approaches, and improving the CMS customer service experience.

Accomplishments covered in the report include the response to the COVID-19 pandemic and efforts through 16 strategic initiatives that resulted in major regulatory actions, changes in guidance, and streamlined processes and procedures – including the reorganization of CMS. It also allows agency staff and leadership to better understand the impacts of policy decisions, while providing a resource to inform future CMS decisions. The report also covers how progress with respect to the Four Core Goals significantly contributed to the agency’s ability to respond to the unprecedented COVID-19 public health event.

Access “Putting Patients First: The Centers for Medicare & Medicaid Services’ Record of Accomplishment from 2017-2020.” 

KHN | One Ambulance Ride Leads to Another When Packed Hospitals Cannot Handle Non-Covid Patients

From Kaiser Health News on January 11

One Ambulance Ride Leads to Another When Packed Hospitals Cannot Handle Non-Covid Patients

Keely Connolly thought she would be safe once the ambulance arrived at Hutchinson Regional Medical Center in Kansas.

She was having difficulty breathing because she’d had to miss a kidney dialysis treatment a few days earlier for lack of child care. Her potassium was dangerously high, putting her at risk of a heart attack. But she trusted she would be fine once she was admitted and dialysis was begun.

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On-Demand | EMS Physician Virtual Town Hall: COVID Vaccines

Cohosted by NAEMT, NAEMSP, and NASEMSO
Recorded Thursday, January 7, 2021
2:00–3:00 pm EST

EMS practitioners have been serving as the “tip of the spear” in responding to and managing the COVID-19 pandemic. Paramedics and EMTs across the country have contracted COVID-19, and too many have succumbed to the virus. The launch of the vaccination program has included a great deal of information about the vaccines, not all of which has been accurate. Confusing or misleading information about COVID-19 vaccinations may cause some EMS practitioners to choose not to receive the vaccine.

To help cut through the noise, NAEMT has assembled some of our nation’s most notable EMS physician leaders for a virtual town hall to answer your questions and concerns regarding the COVID vaccines. This will be a spirited discussion, led primarily by the questions YOU ask. Questions can be asked live, or submitted in advance to Matt Zavadsky.

Moderator: Matt Zavadsky, MS-HSA, NREMT – Chief Strategic Integration Officer, Medstar Mobile Healthcare, Ft. Worth, TX; 2019-2020 President, NAEMT

Panelists:

  • Doug Kupas, MD, FAEMS, FACEP – EMS Medical Director, Commonwealth of Pennsylvania; NAEMSP Board Member; NASEMSO Medical Director’s Council
  • Kenneth A. Scheppke, MD, FAEMS – EMS Medical Director, State of Florida; Medical Director, Palm Beach County Fire Rescue
  • Veer D. Vithalani, MD, FACEP, FAEMS – System Medical Director, Office of the Medical Director, Metropolitan Area EMS Authority; Chief Medical Officer, MedStar Mobile Healthcare
  • Jon R. Krohmer, MD, FACEP, FAEMS – Director, Office of EMS, National Highway Traffic Safety Administration; Team Lead, HHS Healthcare Resiliency Working Group EMS/Prehospital Team

de Beaumont | COVID-19 Vaccine Acceptance Language

From the de Beaumont Foundation

The findings of a new national poll, “The Language of Vaccine Acceptance,” reveal the urgent need for political and health leaders to adjust their messaging to improve confidence in COVID-19 vaccines. The poll identifies the language that will be most effective in reaching all Americans, especially those who are currently less likely to take a vaccine, including rural Americans, Republicans age 18-49, Black Americans 18-49, and women 18-49.

The nationwide poll was conducted by the de Beaumont Foundation and pollster Frank Luntz in partnership with the American Public Health Association, the National Collaborative for Health Equity, and Resolve to Save Lives, an Initiative of Vital Strategies.

Highlights

  • Sixty percent of Americans said they were either “absolutely certain” or would “probably” get the vaccine if they could now.
  • The groups least likely to say they were “absolutely certain” were Americans in rural/farm communities (26%), Republicans age 18-49 (27%), Black Americans 18-49 (28%), and women 18-49 (29%). This compares with 41% of all respondents who said they were “absolutely certain” they would get the vaccine.
  • When asked about the biggest concern about taking the COVID-19 vaccine, one-third of all respondents (33%) said either long-term side effects or short-term side effects. The top three statements about side effects that respondents found most reassuring were “the likelihood of experiencing a severe side effect is less than 0.5%,” mild side effects “are normal signs that their body is building protection,” and “most side effects should go away in a few days.”
  • When asked what they want most from a vaccine, respondents said “a return to normal,” followed by “safety” and “immunity.”
  • When asked which statement was the most convincing, 62% of respondents chose “getting vaccinated will help keep you, your family, your community, the economy, and your country safe and healthy” over “taking the vaccine is the right thing to do for yourself, for your family, your community, the economy, and the country” (38%). This highlights the need to avoid moralizing and lecturing Americans when it comes to the importance of vaccine acceptance.
  • Family is by far the most powerful motivator for vaccine acceptance. Significantly more Americans said they’d be most willing to take the vaccine for their family as opposed to “your country,” “the economy,” “your community,” or “your friends.”
  • The most convincing reasons to take the vaccine were “at 95 percent efficacy, this vaccine is extraordinarily effective at protecting you from the virus” and “vaccines will help bring this pandemic to an end,” and “getting vaccinated will help keep you, your family, your community, and your country healthy and safe.”

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JEMS | Approaches in Prehospital Sepsis Screening

From JEMS on January 5, 2021

by Katherine J. Coulter, Mary F. Hintzsche

Sepsis is a life-threatening emergency. According to the U.S. Centers for Disease Control and Prevention (CDC) (2019), at least 1.7 million American adults develop sepsis each year, of which 270,000 die from sepsis-related complications. Sepsis is an underlying infection that occurs in an individual’s body when he/she responds to a severe infection.1 An infection that may result in sepsis is not limited to one system of a person’s body,2 but often, sepsis is linked to infections in the lungs, kidneys, skin or bowels.1

Emergency medical service providers transfer approximately 50% of septic patients.3 Septic patients are very ill. These patients are at increased risk of death if sepsis progresses to septic shock.3 Without timely identification of sepsis, and prompt intervention methods to decrease the infection’s severity, an individual’s likelihood of mortality increases.

The CDC has several sepsis-related projects underway. Projects developed by the CDC to reduce sepsis mortality rates include community and consumer education, developing tools for tracking and surveilling sepsis, and further preventing infections contracted in healthcare settings.1 In 2016, the CDC created an early recognition and timely sepsis treatment effort entitled “Get Ahead of Sepsis.”2 The purpose of this effort is to emphasize the critical nature of early recognition of sepsis, prevention of infection through education to the layperson, emergency medical services (EMS), and healthcare professionals.

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CHART Model Community Transformation Track App Deadline Extended

From CMS on December 29, 2020

CHART Model Community Transformation Track Application Deadline Extension

The Centers for Medicare & Medicaid Services (CMS) will extend the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track application deadline by one month to March 16, 2021.

This extension is in response to feedback received from stakeholders, including comments about the challenges of preparing an application during the coronavirus disease 2019 (COVID-19) public health emergency. Extending the application deadline will allow interested applicants additional time to prepare their applications.

The Community Transformation Track will provide up-front funding to up to 15 rural communities across the country. The rural communities will be awarded seed money to work with health care providers and payers across the community to design systems of care that improve access to high quality care that is sustainable and value-based.

Due 1/15 | EMS for Children Scholar & Fellow Applications

From CMS on December 14, 2020

EMSC Scholars & Fellows Program

In an effort to grow future leaders who will continue to support and improve efforts to provide high-quality EMS care to children, the EMS for Children Innovation and Improvement Center (EIIC) is offering two opportunities for early career clinicians and health systems trainees: the EMSC Scholars Program and the EMSC Fellows Program. All clinicians (i.e., EMTs, paramedics, nurses, advanced practice providers, physicians, etc.) and graduate students or early career faculty within related fields (e.g. health policy, healthcare administration, and public health) are encouraged to apply now. Applications will be accepted until January 15, 2021.

The EMSC Scholars Program is a 1- to 2-year program during which early career clinicians will work alongside EIIC leaders to develop and implement a unique project focused on a key area of interest. EMSC scholars’ projects cross two or more domains of interest including advocacy, knowledge translation, knowledge dissemination, marketing and communications, prehospital pediatric readiness, pediatric readiness of emergency departments, quality improvement methodology, analytics, workforce development, health policy, healthcare administration, research, and value-based care. Scholars are expected to commit 2 to 4 hours per week.

The EMSC Fellows Program is designed to support trainees and early career professionals with an opportunity to engage in EIIC-led efforts to better understand systems-based strategies for improvement. Fellows are invited to serve on national steering committees to better understand the work of EMSC stakeholders. Fellows will be assigned to a single domain of focus and one or more EIIC mentors who will provide ongoing support and opportunities for participation. Appointments are for 1 to 2 years, with an expected time commitment of 2 to 4 hours per month.

Learn More