Webinar 7/7 | Lights & Sirens Responses


Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!

Free Webinar July 7 | 14:00–15:15 ET

HOT (red light and siren) responses put EMS providers and the public at significant risk. Studies have demonstrated that the time saved during this mode of vehicle operation and that reducing HOT responses enhances safety of personnel, with little to no impact on patient outcomes. Some agencies have ‘dabbled’ with responding COLD (without lights and sirens) to some calls, but perhaps none as dramatic as Niagara Region EMS in Ontario, Canada – who successfully flipped their HOT responses to a mere 10% of their 911 calls! Why did they do it? How did they do it? What has been the community response? What has been the response from their workforce? Has there been any difference in patient outcomes? Join Niagara Region EMS to learn the answers to these questions and more. Panelists from co-hosting associations will participate to share their perspectives on this important EMS safety issue!

Speakers

Kevin Smith, BAppB:ES, CMM III, ACP, CEMC
Chief
Niagara Emergency Medical Services

Jon R. Krohmer, MD, FACEP, FAEMS
Team Lead, COVID-19 EMS/Prehospital Team
Director, Office of EMS
National Highway Traffic Safety Administration

Douglas F. Kupas, MD, EMT-P, FAEMS, FACEP
Medical Director, NAEMT
Medical Director, Geisinger EMS

Matt Zavadsky, MS-HSA, NREMT
Chief Strategic Integration Officer
MedStar Mobile Integrated Healthcare

Bryan R. Wilson, MD, NRP, FAAEM
Assistant Professor of Emergency Medicine
St. Luke’s University Health Network
Medical Director, City of Bethlehem EMS

Robert McClintock
Director of Fire & EMS Operations
Technical Assistance and Information Resources
International Association of Fire Fighters

Mike McEvoy, PhD, NRP, RN, CCRN
Chair – EMS Section Board – International Association of Fire Chiefs
EMS Coordinator – Saratoga County, New York
Chief Medical Officer – West Crescent Fire Department
Professional Development Coordinator – Clifton Park & Halfmoon EMS
Cardiovascular ICU Nurse Clinician – Albany Medical Center

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Study | EMS Super-Utilizers

The Penn State College of Medicine is conducting a national study of social needs in EMS patients, particularly in regards to potential interventions for EMS super-utilizers (frequent flyers). The study consists of an approximately 7 minute online survey with questions about provider (911-EMT, Paramedic, EMS Physician) knowledge of social needs, recognition of patient needs, perceptions of possible interventions, and background information. Those who participate will have the option to enter into a drawing for a $50 gift card.

With the implementation of programs such as ET3, we are hoping to hear from as many EMS providers as possible to give them a voice in how to best to address social needs and EMS super-utilizers. As such, we are hoping you consider sharing our study flyerstudy overview from JEMS, or the study link with your employees and/or social media.

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

CAAS | Standards v4.0 First Draft Available for Public Comment

The Commission on Accreditation of Ambulance Services (CAAS) is pleased to announce the first public comment period on the first draft of the CAAS Accreditation Standards document version 4.0. All materially affected parties including members of the EMS community, EMS groups and associations, affiliated healthcare groups and associations, members of other public health and safety communities, and the general public are encouraged to review and comment on these proposed standards.

The revision of the CAAS Accreditation Standards was an extensive process conducted by the Standards Review Committee, a diverse and comprehensive team of EMS, Fire, and healthcare professionals that has dedicated over 250 work hours and engaged with subject matter experts and materially impacted stakeholders across EMS and healthcare to create this first draft of the v4.0 CAAS Accreditation Standards.

These standards were developed in accordance with the standard establishing policies set forth by the American National Standards Institute (ANSI.) CAAS is an ANSI Standards Developing Organization (SDO) committed to the development of Ambulance Accreditation Standards in a fair, balanced, accessible, and responsive manner.

This is the first public comment period, and we encourage you to review and provide your feedback to the CAAS Standards Review Committee using this online form. This public comment period will be open from March 26, 2021 until May 25, 2021.

CAAS v4.0 Accreditation Standards – First Draft and Public Comment Form

We ask that you submit one form for each standard comment you have – please do not comment on multiple standards in one form. We want to be able to review the feedback in an organized manner.

If you have any questions on the proposed standards or the standard-setting process, please contact us at caas-staff@tcag.com. We look forward to your feedback.

EMS.gov | Response to Incidents w Electric / Hybrid Vehicles

From NHTSA’s EMS.gov on February 11

New Report Highlights Potential Risks While Responding to Incidents Involving Electric or Hybrid Vehicles

Responders urged to review NHTSA guidance for vehicles equipped with high-voltage batteries

A new National Transportation Safety Board report offers safety recommendations for emergency response involving electric vehicles (EV) and hybrid-electric vehicles (HEV) equipped with high-voltage batteries.

NTSB investigations into four electric vehicle fires identified two major safety issues:

  • The inadequacy of vehicle manufacturers’ emergency response guides.
  • The gaps in safety standards and research related to high-voltage lithium-ion batteries involved in high-speed, high-severity crashes.

EMS, fire and law enforcement personnel are encouraged to review the report to stay up to date on the latest safety advisories for responding to vehicle crashes of this nature. In addition, NHTSA’s guidance for responding to emergency incidents involving these types of vehicles provides important information for all first responders and can be accessed on NHTSA.gov.

To access the full report, read the official NTSB announcement.

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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National Academies | Vaccine Confidence Information Gathering Session

Friday. December 18, 2020
11:30–16:00 ET

Register Free

To inform a forthcoming rapid expert consultation on building public confidence in SARS-CoV-2 vaccines, the Societal Experts Action Network (SEAN) of the National Academies will hold an information gathering session on vaccine confidence. The session will cover the current state of vaccine confidence, reasons for hesitancy, and best practices for messaging. Facilitated discussions will incorporate special attention to communities at higher risk of contracting and dying from COVID-19, including underserved and vulnerable communities. Drawing from what is known about reaching and engaging diverse audiences to change beliefs and attitudes, this session will illustrate strategies that are likely to promote uptake of FDA-approved vaccines to prevent COVID-19.

This project is being done in collaboration with the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats.

Register Free

COVID-19 Vaccine Update from Gundersen Tri-State Ambulance

COVID-19 has significantly affected our community and communities around the country and the world. Through the beginning of December, there have been over 14 million confirmed COVID cases in the United States. This represents only about 4% of the US population. Vaccination against this novel coronavirus seems necessary to achieve a level of immunity that will prevent significant burden on all aspects of American life.

In a small survey of EMS Providers by EMS1, 41% of respondents indicated they would not be willing to receive a COVID-19 vaccine if approved for use. An additional 19% indicated they were not sure and 12% only if mandated by their employer. This leaves only 24% who indicated they would be willing to receive the vaccine.

Based on these and other survey results, Gundersen Tri-State Ambulance sought to provide information to its team members and to all regional EMS providers. The goal of this podcast style video is to allow our team members and others who may view it to make a more informed decision about receiving a COVID-19 vaccine.

If you are viewing this from outside our regional EMS system, be sure to discuss this topic further with your EMS Medical Director, service leadership, personal physician, etc.

https://www.tristateambulance.org/ems-covid-vaccine/

ACEP | EMS Priority Access to the COVID-19 Vaccine

Thank you to ACEP for the following statement.

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Webinar | EMS Performance: NEMSQA Quality Measures

EMS Performance: NEMSQA Quality Measures Webinar
December 3, 2020 | 15:00 ET | Register Now►

Performance measures drive practice, protocols, spending, and behaviors across healthcare. The National EMS Quality Alliance (NEMSQA) is leading the charge in development, refinement and dissemination of quality and performance measures for EMS. Working with EMS organizations, stakeholders, partners from government and industry, NEMSQA updated the EMS Compass measures to ensure their evidence-basis and make them readily deployable across the EMS community to drive quality and improvement in patient care. This program will inform you about the work of NEMSQA, how the NEMSQA measures are being implemented already, and how you can employ NEMSQA measures to improve performance in your EMS service or region.

Register Now

NEMSQA Mission Statement
NEMSQA will develop and endorse evidence-based quality measures for EMS and healthcare partners that improve the experience and outcomes of patients and care providers.

NEMSQA Vision Statement
Improving patient outcomes through the collaborative development of quality measures for EMS and health systems of care.

CARES Act Reporting Requirements Released

All recipients of payments from the Department of Health and Human Services’ Provider Relief Fund (PRF) are required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.

Providers that received more than $10,000 in grants will have to report on how they spent funds on coronavirus-related expenses and lost revenue in 2020 by Feb. 15, 2021. If providers do not spend all their grant funds by the end of 2020, they will be required to submit a final report on the remaining funds by July 31, 2021.

Any recipient of PRF payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment.  Any recipients identified as having provided inaccurate information to HHS will be subject to payment recoupment and other legal action.

For more details, please refer to the Terms and Conditions associated with each payment distribution and the Reporting Requirements and Auditing FAQs.

Read more from HHS

CO | Anesthesiologists want paramedics to stop injecting people with ketamine during arrests

From the Colorado Sun

A group of Colorado anesthesiologists wants paramedics to stop injecting people with a powerful sedative when police believe suspects are out of control until officials finish a review launched nearly a year after the death of Elijah McClain, a Black man put in a stranglehold by officers and injected with ketamine.

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NHTSA: EMS Accessing PPE

The National Highway Traffic Safety Administration has released a memo reinforcing the best methods for EMS agencies to request PPE supplies:

  • The preferred method of EMS agencies to obtain PPE is via ordering through the normal supply distribution chains from which they normally order EMS supplies and equipment. The supply chain distributors are becoming more stable in their access to PPE components. In addition, in the near future, Boundtree will have available a larger supply of N95 NIOSH Tested/Approved respirators for purchase, which EMS can tap into
    purchasing;
  • PPE push at the national level is not possible without a Resource Request from the States. Local EMS agencies should work with their local emergency management agency with requests pushed up to the state emergency management agency or for EMS PPE Resource Requests where there are still elevated (albeit decreasing or stabilizing) COVID-19 cases. Once those formal Resouce Requests are received at the federal level,
    they will be reviewed and acted upon.

Download Memo