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.

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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.

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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.

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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…

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NHTSA COVID PPE & Resource Reporting Tool

NHTSA asks EMS agencies across the U.S. to take a few minutes each week to report PPE, personnel status within their agency.

EMS and its public safety colleagues continue to serve at the frontlines in the fight against the COVID-19 pandemic. Resource procurement and distribution of personal protective equipment and staffing shortages continue to challenge EMS leaders. It is vital that local, State and Federal officials have the information they need to help address these issues.

The NHTSA Office of EMS, with support from the team at the NEMSIS Technical Assistance Center, has designed a reporting tool to allow for a consistent, real-time method of reporting PPE supply status and personnel shortages. Your participation in the EMS COVID Resource Reporting Tool provides objective evidence to ensure your local agency’s resource status is understood by State and National EMS leadership, and that your resource needs are being prioritized.

While this information will be available to State and Federal Officials, this reporting tool does not supersede coordination with local and state emergency management, public health, or healthcare coalitions. Organizations should still follow local and state procedures for reporting information and requesting supplies or other additional resource needs.

NHTSA is asking agencies to take a few minutes each week, preferably on Monday mornings, to complete the online form. You can find the form, as well as a video and other information explaining how the information is used and how to complete the form, here.

For questions regarding this process, please contact nemsis@hsc.utah.edu.

EMS COVID Resource Reporting Tool

Tracking the reach of COVID-19 kin loss

From the Proceedings of the National Academy of Sciences

“Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States”

Ashton M. Verdery, Emily Smith-Greenaway, Rachel Margolis, and Jonathan Daw
PNAS July 28, 2020 117 (30) 17695-17701; first published July 10, 2020 https://doi.org/10.1073/pnas.2007476117
Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved June 19, 2020 (received for review April 18, 2020)

COVID-19 has created a mortality shock throughout the world, and it may yield a second wave of population health concerns tied to bereavement and social support reductions. We created the COVID-19 bereavement multiplier, an indicator that clarifies one downstream impact of COVID-19 mortality and can be applied to different epidemiological projections of death counts: How many people are at risk for losing a grandparent, parent, sibling, spouse, or child for each COVID-19 death. In the United States, we estimate that on average, under diverse epidemiological circumstances, every death from COVID-19 will leave approximately nine bereaved. Studying how acute mortality crises reverberate through a population in the form of bereavement multipliers expands understandings of the social impacts of health crises.

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Interim Guidance: COVID-19 and Field Trauma Triage Principles.

The Federal Healthcare Resilience Task Force has released interim guidance on COVID-19 and Field Trauma Triage Principles. This document provides a brief overview of how the Coronavirus Disease 2019 (COVID-19) impacts trauma triage for first responders, including Emergency Medical Service (EMS), fire & rescue, and law enforcement. The contents of this guidance document do not…

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COVID-19 employee Travel FAQ

Over the last week, we have received several questions from AAA members about various COVID-19 impacts on EMS organizations.  As the infection numbers around the country are on the rise, many new issues have arisen that are posing issues with many EMS employers. Travel Orders What can I do when our employee voluntarily chooses to…

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CMS Releases CY 2021 Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) has released the Physician Fee Schedule Proposed Rule for Calendar Year (CY) 2021 which has traditionally included proposed changes to the Ambulance Fee Schedule for the same year. The American Ambulance Association (AAA) has confirmed with CMS that the reason there are no references to the Ambulance…

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NEMSIS | HIPAA and Bidirectional Data Exchange White Paper

Prepared by Page, Wolfberg, and Wirth Overview Emergency Medical Service (EMS) agencies nationwide still widely report that hospitals and other healthcare providers refuse to share patient information with them, citing concerns under the Health Insurance Portability and Accountability Act (HIPAA).1 Misconceptions about HIPAA have created an  artificial barrier to legitimate, approved bidirectional data exchange between…

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