Tag: American Medical Response (AMR)

EMS Narratives | Friday Night [Under The] Lights

EMS Narratives Columns

Below is the first in a series of monthly personal narratives from EMS leaders. If you would like to submit a column for consideration, please email hello@ambulance.org.

Written Friday, November 25, 2022 | By Ed Racht, MD

Happy Friday, and happy Thanksgiving weekend. I hope by now your blood sugar is slowly but surely heading back to baseline despite all the leftovers calling you from the fridge. Worth it though, right? My dad taught me long ago, “everything in moderation—even moderation.”

So, I want to tell you something tonight, especially because it is the Thanksgiving season. I’ve been thinking for a while about how to say this without sounding cliché, routine, robotic, or insincere. And then—as so often happens in life—I got a little help from a very unlikely encounter.

This past Saturday, my bestie, Heather, and I went to try a local diner for breakfast. This place has been around since air was invented. Cash only. Same tables and seats since the day they opened. Part Formica, part particle board countertops. None of the coffee cups match. Open only until 2:00PM and always closed on Sundays. The ham & cheese omelet is $7.99. Biscuits, bread, or hashbrowns only. Everyone that comes in knows everyone else. And it is packed all the time.

We chose a booth in the corner by the window because our server told us that was the warmest table she had available. She was right.

As we sat drinking our coffee in mismatched mugs, we both noticed an elderly man sitting by himself at the end of the counter. He had placed his walker against the ATM along the wall (cash only, remember?).

Then he slowly got up from his stool, grabbed that walker, and carefully wobbled his way to the restroom. It was one of those moments where we both watched and quietly prepared to jump up to help prevent what seemed like an inevitable fall. We didn’t want to offend him with an offer to help but didn’t want him taking a trip to ground either.

We looked across the table at each other and did that mutual raised eyebrow thingy. Ugh. “Warmest booth we have,” she said. Great.

A few minutes later, he slowly made his way back to his spot. But he went a few feet too far this time with the walker, making a beeline directly toward the warmest booth in the diner. He stopped for a minute (what the heck?) grabbed the handwritten check off our table and turned around, without saying a word, and made his way back to his seat. His walker made those sequential two inch turns.

Great. How do you tell an older man he has OUR check (and why did we come here again)?

“Excuse me?” We both said, eyebrows up again.

He turned to us and said, “I’ve got it.”

Wait. What?

He said, “I come up here every day for breakfast when they’re open. Twice a month, I like to buy somebody else’s breakfast. I’ve got it.”

Wow. We sat in stunned silence as this gentleman made his way back to the counter and sat down on his stool.

To make a long story short, we thanked him and struck up a small conversation with him. A few minutes in, he asked, “can I get closer?”

Of course.

So once again we went through the diner-walker challenge and he made his way over to the warmest booth in the restaurant and sat with us for the next hour. We talked about all sorts of things. His wife had been a nurse (mental health was her specialty). He told us about where they had lived and their adventures. He talked a little about his opinions of healthcare today (you can fill in those blanks).

At one point, he told me he lived in Texas and he’d always travel into Mexico to get his medications because they were so much cheaper than in the US. I asked him if he was nervous about going.

He laughed, and said, “I always went in the morning. Bad guys don’t get up early.”

Now, I’ve been in EMS for a few years and you know what? He’s right. Holy crud. Funny and spot-on relevant.

So, why am I telling you about Gary (his real name, by the way)? First, I need to cover a few more things to pull the meaning of this story together. Bear with me.

Fair warning. This next part doesn’t feel Thanksgivingy, but I’m going to argue that it’s at the very heart of a meaningful “thanks.”

Take a look at some of the toughest parts of our world right now:

  • How can we ever understand recent senseless acts of violence—and how will we ever comfort our own who responded?
  • What do we do about the fact that a recent survey shows that nine in 10 nurses believe the quality of patient care often suffers due to nursing shortages?
  • And, by the way, the majority added that they feel guilty about taking a break because they think they must always be on call (55%).
  • … resulting in half of the nurses polled admitting they have considered leaving the nursing profession altogether (50%).
  • And how about this one? According to a AAA survey of 258 EMS organizations across the country, nearly a third of the workforce left their ambulance company after less than a year. Eleven percent left within the first three months!
  • Did you know that the number of serious patient safety incidents reported to The Joint Commission jumped in 2021, reaching the highest annual level seen since the accrediting body started tracking them in 2005?
  • And … In Minnesota, nearly 60% of the state’s EMTs and about 15% of Paramedics did not provide patient care in 2021. This suggests that they left the EMS workforce altogether.

I’ll stop there, because I think you get the gist. How (and why) do I go from a Gary story to this?

This is, without a doubt, the most challenging period of EMS and healthcare history that we have faced together. Ever.

It’s really, really hard right now. And it’s hard in a different way than we’ve ever faced. Clinically hard. Operationally hard. Financially hard. Culturally hard.

Which also means that it’s personally hard. Whether you are directly providing care to a patient or supporting all the complexities that make that interaction possible and effective, it’s hard on us. The facts above reflect exactly that.

Now, I’ve been in EMS for a year or two (insert big-eye emoji), and one of the most rewarding feelings on the planet is creating order out of someone else’s chaos. I honestly believe that people like you choose this profession and support this profession in large part to make other people’s lives better.

Our mission is among the purest and most important on the face of the earth. Just think about how many people enjoyed a Thanksgiving with the people they loved because someone years before fixed their distorted anatomy or disrupted physiology.

It’s easy to forget the massive good a profession, an organization, or an individual can do. Gary gave us a little gift. When I first saw him, I was certain we would end up having to help him. But instead, he helped us.

When we work hard to take care of our patients, our communities, each other, our organization and our profession—They. Take. Care. Of. Us.

So. When our workplace is supportive, people want to join us. When our partners are fun, we seek them out. When our medicine is strong and sound, the medical profession embraces us. When our operation is accountable, we grow, evolve, and thrive when the art and science changes. When we come together as a team, we become the model of effective care. And when all that happens, WE, as individuals, can help tackle all the tough stuff in the most effective way possible.

I’d love to have more people choose EMS as a profession. I’d love to see them seek out advancement and growth. I’d love to see the science evolve to support better outcomes in unplanned illness and injury. I’d love to see hospital metrics and EMS metrics get better, not languish. I’d love to help communities become safer. And I would absolutely love for every one of us individually to be a part of that. I promise. That’s the way we make things so much better.

So tonight, on this day after Thanksgiving, I want to tell you that I’m not just thankful for what you do, I’m also extremely grateful. My daughter taught me there’s a difference. The definition of thankful is “pleased and relieved.” The definition of grateful is “feeling or showing an appreciation of kindness and gratitude.” In that spirit, I wanted to share that I’m grateful for you and I’m grateful for EMS.

We need the best in one another right now. There are four legs in our Bench of EMS Strength:

  • Taking care of ourselves
  • Taking care of our partners
  • Taking care of our patients
  • Taking care of our organizations

There is plenty of hard stuff ahead, so let’s do this. We can sit in the warmest booth in the place. I’m so grateful for that.

So, that’s it from my World. Happy Friday, and happy Thanksgiving.

Ed

ResponderStrong | Personalized Wellness for Emergency Responders

Grit Digital Health Introduces World’s First Personalized Wellness Platform for Emergency Responders

Access YOU | ResponderStrong

At a time when emergency responders are under immense stress, innovative health tech organization develops YOU | ResponderStrong wellness tool to support comprehensive well-being for at-risk group

DENVERAug. 27, 2020 /PRNewswire/ — Grit Digital Health LLC, a tech startup at the intersection of behavioral health, well-being and technology, has partnered with The Anschutz Foundation, Global Medical Response (GMR) and All Clear Foundation to create YOU | ResponderStrong — the world’s first personalized wellness platform for emergency responders. Emergency responders face well-being challenges (e.g. shift work, consistent exposure to trauma, and working in high risk environments) that put them at higher risk for mental health issues and suicide, yet barriers make it difficult to seek out available resources and discuss concerns, leaving many to struggle with these challenges alone.

For emergency responders, rescuing others is second nature, but the mental and physical impacts can be debilitating if left unaddressed. Studies show that first responders are more likely to die by suicide than in the line of duty, 20 to 25 percent of all first responders experience post-traumatic stress and the life expectancy of a first responder is 20 years less than average.

“Responders shouldn’t pay for their service with their lives, either in longevity or quality,” said Rhonda Kelly, founder of ResponderStrong and director of health, wellness and resilience for GMR. “Especially now when the stressors are so extreme and prolonged, burnout is on a meteoric rise. The result of our failing to meet our basic human needs, burnout is one of our biggest enemies. This tool is a tremendous aid in supporting our self-care, building our resiliency, and improving our quality of life.”

Using a human-centered research and design process, the founding partners of you.responderstrong.org brought together national leaders across various emergency responder verticals (law enforcement, EMS, fire service, dispatch and healthcare workers, etc.) to uncover the needs, motivations and challenges of these populations with respect to their mental health and well-being. The insights gathered during this process highlighted the increased pressure and new risks currently facing emergency responders across the country.

“One challenge that has been clear for first responders is figuring out the balance between being able to perform their jobs and also act in the other roles they fill as parents and spouses,” said Caleb Demers, LCSW, who works directly with emergency responders as a clinical social worker and member of the LEADER program at McLean Hospital. “Many patients we work with use a lot of energy attempting to not ‘bring the work home,’ but now that is a tangible fear with more immediate consequences. We see first responders work very hard to maintain confidence and competence in their roles, but when their supports are not as accessible, it affects their mental health.”

The solution is a digital platform, available 24/7, with hundreds of evidence-based resources and tools to support emergency responders with their personal and professional well-being. The first platform of its kind, YOU | ResponderStrong uses a tailored profile and proprietary health assessments to personalize the experience for each emergency responder that creates an account. The platform delivers customized online resources and tools across three areas of well-being: Succeed (financial and career success), Thrive (mental and physical health) and Matter (purpose and connections). The foundations of this comprehensive approach lie in Grit Digital Health’s proprietary well-being model.

“High stress work environments invariably lead to stress that carries into one’s personal life,” said Nathaan Demers, Psy.D., VP and director of clinical programs at Grit Digital Health. “It’s essential that we support the comprehensive well-being of emergency responders by decreasing the stigma and providing educational resources regarding how to support peers, as well as oneself. This is especially important in times of heightened stress, as we see now in light of COVID-19.”

The platform is built on a research-backed tool called YOU, a personalized well-being software created for college campuses and later expanded to serve rural veterans, community mental health centers, workplace wellness and now emergency responders. The platform provides an experience aligned with key research insights gathered from emergency responders: maintaining confidentiality, keeping data secure, including crisis information and providing 24/7 access to support any need any time. Data provided to tap into the platform’s personalization algorithm is completely anonymous, an essential aspect in building trust with emergency responders using the platform.

“Emergency Responders sacrifice more than most and shoulder unfathomable burdens to keep us all safe,” said Janell Farr, president of All Clear Foundation. “They are so focused on helping others that they often don’t take time to help themselves. And if they would like to, options have previously been limited. With YOU | ResponderStrong, responders can now easily assess their overall well-being and immediately access content to enhance their health, well-being and everything in-between.”

The platform is currently undergoing further testing and iteration efforts. Grit Digital Health will collaborate with the founding partner organizations to roll out a second version of the ResponderStrong wellness tool in fall 2020. The release will include learnings from testing with emergency responders and analysis of impact/engagement data. See the tool in action by visiting you.responderstrong.org.

About Grit Digital Health

Grit Digital Health develops behavioral health and well-being solutions through design and technology that envision a new way to approach mental health and well-being. The company solves complex health problems through innovation and creativity, including products that address veteran transitions to civilian life, student loneliness and well-being, employee satisfaction and the mental health of working-age men. For more information, visit www.gritdigitalhealth.com.

About All Clear Foundation

All Clear Foundation is a nonpartisan, nonprofit 501(c)3 supporting First Responders by creating, convening, amplifying and funding innovative programs to improve their life expectancy and wellbeing – as well as the wellbeing of their families. In addition to YOU | ResponderStrong, the foundation has curated a First Responder Resource Database with thousands of resources for responders and their families, and recently launched  ResponderRel8, a peer-to-peer chat app that enables First Responders to connect, celebrate and commiserate with peers without fear or stigma getting in the way, and anonymously if they choose. To learn more about All Clear Foundation’s programs or to join the cause, visit AllClearFoundation.org.

About The Anschutz Foundation

Founded in 1984, The Anschutz Foundation was created by Philip F. Anschutz as a private charitable foundation. Over three decades, the foundation has given substantially to hundreds of nonprofit organizations primarily concentrated in Colorado. The Anschutz Foundation currently makes more than 500 grants annually. In 2016, The Anschutz Foundation received the Outstanding Foundation award from National Philanthropy Day in Colorado. This annual event celebrates exceptional philanthropic and volunteer contributions in Colorado. For more information, visit theanschutzfoundation.org.

About Global Medical Response (GMR)

With more than 38,000 employees, Global Medical Response teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services in the United States, the District of Columbia and around the world. GMR was formed by combining the industry leaders in air, ground, managed medical transportation, and community, industrial/specialty and wildland fire services. Each of our companies have long histories of proudly serving the communities where we live: American Medical Response (AMR), Rural Metro Fire, Air Evac Lifeteam, REACH Air Medical Services, Med-Trans Corporation, AirMed International and Guardian Flight. Combined, we completed 4.9 million patient transports last year utilizing 7,000 ground vehicles, 111 fire vehicles, 306 rotor-wing aircraft and 106 fixed-wing aircraft. We are the largest medical transport company in the world, focusing on intimate and high-service solutions at a local level. For more information, visit globalmedicalresponse.com.

SOURCE Grit Digital Health LLC

Global Medical Response in 2020

Global Medical Response
Lewisville, Texas and Greenwood Village, CO, Texas
38,000 Staff | 3,838 Quarantined in 2020

With more than 38,000 employees, Global Medical Response teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services in the United States and around the world. We provide end-to-end medical transportation as well as fire services, integrated healthcare solutions and disaster response. Our mission statement is providing care to the world at a moment’s notice. With our extensive resources and experience, we are able to work with our partners and communities to develop integrated solutions that capitalize on our national strength while providing care at the local level. Each of our companies have long histories of proudly serving the communities where we live. These include: American Medical Response (AMR), Rural Metro Fire, Air Evac Lifeteam, REACH Air Medical Services, Med-Trans Corporation, AirMed International and Guardian Flight. Combined, we completed 4.9 million patient transports last year utilizing 7,000 ground vehicles, 111 fire vehicles, 306 rotor-wing aircraft and 106 fixed-wing aircraft. We are the largest medical transport company in the world, focusing on intimate and high-service solutions at a local level.

In response to the devastating COVID-19 pandemic, GMR activated its National Command Center (NATCOM) in Dallas, Texas on January 28, 2020 to oversee, monitor and manage GMR’s response to the pandemic. GMR leaders also worked with state and federal agencies to deploy teams for screenings, transports and evacuations. On March 30, GMR began deploying AMR crews and ambulances in response to FEMA’s request for ambulances and EMS personnel to the Northeastern United States. In total, GMR sent three large deployments to New York and New Jersey which included 1,600 caregivers and 500 ambulances to supplement local EMS. As the COVID-19 pandemic continued to spread throughout 2020, GMR sent 50 ambulances and more than 110 personnel to southern Texas, and 25 ambulances and 70 personnel to hard-hit communities in Minnesota. In addition to the COVID-19 response, GMR teams also responded at a moment’s notice to communities impacted by the northwest wildfires and hurricanes. As part of AMR’s FEMA contract, GMR deployed more than 1,600 personnel, 600 ground units and 25 aircraft in response to Hurricanes Laura, Delta and Zeta.

Debora Gault & Tom Tornstrom Receive AAA President’s Award

FOR IMMEDIATE RELEASE
DATE: October 29, 2020
Contact: Maria Bianchi, AAA CEO

Arlington, VA—Aarron Reinert, President of the American Ambulance Association (AAA), is proud to award Debora Gault and Tom Tornstrom with the 2020 President’s Award.

Deb Gault, Global Medical Response (GMR) is receiving the award for leading the efforts with the AAA, to address the outstanding billing issues for ground ambulance services with the Veterans Affairs Administration.  Deb has worked tirelessly over the last several years to get ambulance service claims paid promptly, a prudent layperson standard adopted, and for the VA to be considered the primary payor unless another payor is identified.

Tom Tornstrom, Gundersen Tri-State Ambulance, Inc. is receiving the award for leading the efforts of the AAA, to address issues critical to ground ambulance services in their response to the current Public Health Emergency.  Tom has led a group of industry leaders in addressing PPE shortages, access applying for PPP and CARES Act Funding, and many operational and clinical issues.

The President’s Awards will be given at the AAA Virtual Annual Membership Meeting on November 4, 2020 at 11:15 am eastern time.

About the American Ambulance Association

The American Ambulance Association safeguards the future of mobile healthcare through advocacy, thought leadership, and education. AAA advances sustainable EMS policy, empowering our members to serve their communities with high-quality on-demand healthcare. For more than 40 years, we have proudly represented those who care for people first. www.ambulance.org

AJC | Ambulance companies hit hard by COVID costs

From the Atlanta Journal Constitution by Yamil Berard on  July 17, 2020

“We are gravely concerned that various factors related to this pandemic are pushing ambulance services to the breaking point,‘’ Georgia ambulance executive Pete Quinones wrote to a top official at the Georgia Department of Community Health.

One request by the Georgia Ambulance Providers Association has been to urge the Georgia Trauma Commission to release up to $29 million in block grants to support EMS staffing over the next six months.

“Without that, we don’t have the financial ability to keep a state of readiness,‘’ said Terence Ramotar, director of government affairs for the southeast region for American Medical Response, the exclusive 911 ambulance provider for DeKalb County.

Read full article ►

AAA’s Terence Ramotar on Morning Joe

Terence Ramotar, President of the Florida Ambulance Association and AAA Board member, discusses how the coronavirus crisis in Florida is impacting ambulance services on MSNBC’s Morning Joe!

This morning, AAA Alternate Director and Florida Ambulance Association President Terence Ramotar made a compelling case…

Posted by American Ambulance Association on Thursday, July 16, 2020

July 22 | EMS Advocacy Facebook Livestream


July 22, 2020 | 14:00 ET | Register Now for a Reminder!

Join AAA advocacy experts for a fast-paced informal dialogue on Facebook Live! Learn first-hand about EMS advocacy initiatives in the face of COVID-19.

Register to receive a reminder email one hour in advance of the live broadcast on the American Ambulance Association Facebook page!

Panelists

  • Randy Strozyk, Secretary, AAA
  • Jamie Pafford-Gresham, Chair, AAA Government Affairs Committee
  • Asbel Montes, Chair, AAA Payment Reform Committee
  • Rob Lawrence, Chair, AAA Communications Committee
  • Maria Bianchi, AAA Executive Director
  • Tristan North, AAA SVP of Government Affairs
  • Mercury Group Public Affairs

Register Now

Thank You from NYC

Thank you to the dozens of AAA member ambulance services who answered the call to serve in New York City’s time of need. This Facebook video from fellow member FDNY shows the final deployed medics heading home.

Thank you to the many member organizations who answered the call to serve in the New York and New Jersey #COVID19 response. Your service will not be forgotten! #SupportEMS #AlwaysOpen #NotJustaRide

Posted by American Ambulance Association on Thursday, May 28, 2020

Mercury Public Affairs Update

AAA has teamed up with Mercury Public Affairs to run a robust public affairs campaign to complement our already established lobbying efforts. We are making sure our concerns as frontline EMS responders are heard, by targeting 27 key Senators and Representatives to Congress around the nation.  We are asking them to be the champions we need in Congress and to make sure all of our emergency first responders have the resources they need.

The campaign has been a great success. Major media outlets have picked up our stories, our digital campaign is having higher than industry average conversion rates, and our patch through calls, which have had extremely high percentages of people willing to speak Congressional offices, have been able to provide a steady drumbeat for our issues where it matters.

These  metrics, coupled with the positive feedback we have received from Congressional offices show that notonly do we have the right message, but also that our emergency first responders are being recognized for the work they do during this national health crisis.

It is also helping to build legislative momentum.

We will update you on the campaign as we move forward, but wanted to take some time to share some highlights. 

Media

AAA is running an earned media campaign around issues such as allowing for CMS reimbursement waivers. One of the highlights of this effort has been the following story published in the Wall Street Journal and subsequently featured in the Washington Post Healthcare 202 Newsletter:

Digital Campaign

AAA is running a digital advertising campaign targeted in Congressional districts and states. This campaign will continue with the addition of text messaging in the coming days. Thus far, we have accomplished the following:

Patch Through Calls

AAA ran a 10-day patch through call campaign strategically targeted to Congressional district offices and Senate district offices that complemented the digital campaign:

  • 8,050 calls delivered in total over the last two weeks.
  • This is roughly 15-25 calls per office per day and 200-450 calls per legislator in total.
  • 95% of voters contacted supported AAA’s position. 86% of those supporters were willing to patch-through to their elected official’s office.  These rates are much higher than numbers we are used to seeing for this type of effort.

Rest in Peace, David Martin of AMR

Our hearts are broken for AMR Paramedic David Martin’s family, friends, and American Medical Response colleagues. Your service will never be forgotten. Rest In Peace, David. Your EMS brethren will take it from here.

William David Martin, EMT Paramedic, gave the ultimate sacrifice today. It was not his intent to sacrifice his life for…

Posted by AMR Southwest Mississippi on Wednesday, April 22, 2020

Webinar: A Report From the Front Lines of the COVID-19 Response

FREE WEBINAR

A Report From the Front Lines of the COVID-19 Response

View On-Demand Webinar

Register Here▶

A Report from the Front Lines – What the 911 provider for New Rochelle, NY and the largest ambulance service provider in the U.S. have learned and what you should know to protect your staff and serve your communities

Join Dr. Ed Racht, Chief Medical Officer, and Randy Strozyk, Executive Vice President Operations for Global Medical Response and Hanan Cohen, Director of MIH-CP and Jim O’Connor, Vice President for Empress Ambulance Service for a compelling webinar straight from the front lines of the COVID-19 pandemic.  The panelists will discuss workforce safety and wellness, treatment and transport changes, lessons learned, and the challenge of providing services in some of the hardest-hit areas of our country.

View Global Medical Response’s COVID-19 resource site►

Presenters:

Ed Racht, M.D.
Chief Medical Officer, Global Medical Response 

Dr. Ed Racht has been involved in Emergency Medical Services and healthcare systems for more than 30 years. He currently serves as Chair of the Texas EMS, Trauma and Acute Care Foundation, an organization that provides advocacy, strategic planning and healthcare system credentialing in the State of Texas.

Dr. Racht has been Chief Medical Officer for American Medical Response (AMR) since 2010. Prior to this role, he served as the Chief Medical Officer and Vice President of Medical Affairs for Piedmont Newnan Hospital in metro Atlanta. Dr. Racht was the first full-time Medical Director for the Austin/Travis County Emergency Medical Services System, where he spent 13 years. The System was nationally recognized in the Institute of Medicine’s Report on the state of emergency care for its collaborative approach to challenging healthcare integration issues.

Dr. Racht received his undergraduate and medical degree from Emory University in Atlanta and completed his residency at the Medical College of Virginia.

Dr. Racht is the recipient of numerous awards including being named EMS Medical Director of the Year for the State of Texas, the American Heart Association’s Paul Ledbetter MD Physician Volunteer of the Year Award and was named a “Hero of Emergency Medicine” in 2008 by the American College of Emergency Physicians. In 2015, he was the first recipient of the Joseph P. Ornato Excellence in Clinical Leadership Award, and in 2011 received the Slovis Award for Educational Excellence by the U.S. Metropolitan Municipalities Medical Director Consortium. He is also the third Inductee in the Texas EMS, Trauma and Acute Care Foundation Hall of Fame.

Randy Strozyk
Executive Vice President of Operations, Global Medical Response

Randy Strozyk has been a leader in emergency medical services for more than 40 years and is an integral part of the GMR/AMR executive team. As SVP of Executive Operations, he is engaged in our overall operations and specific areas such as internal and external integration and our event Medical Services. He has extensive experience in EMS operations and management.  He is a long time member of the American Ambulance Association and is presently the AAA Secretary. Strozyk began his career as a paramedic. He holds a Bachelor of Science degree in microbiology from Washington State University and an MBA from California State University.

Jim O’Connor
Vice President, Empress Ambulance Service

Jim O’Connor is the Vice President of Empress Ambulance of Yonkers, New York. Empress is part of the PatientCare EMS Solutions organization. He has been involved in the Emergency Medical Service (EMS) for over four decades and was one of the first paramedics in Westchester County, New York.

Empress is the contracted provider of 911 emergency medical services (EMS) for the cities of New Rochelle, Yonkers, White Plains and Mount Vernon. Empress has a staff of over 500 employees and has been operating in Westchester County since 1985. They also provide all levels of inter-facility ambulance transportation services for some of the most prestigious hospital systems in the New York metropolitan area.

Jim has been active with many EMS organizations and has held Board positions locally, regionally and on a national level. He was a founding member and first Chairman of the Westchester County Regional EMS Council and has served on the Hudson Valley Regional EMS Council, the New York State EMS Council and the American Ambulance Association in Washington, D.C.

Hanan Cohen
Director of MIH-CP, Empress Ambulance Service

Hanan Cohen is the Director of Corporate Development and Community Paramedicine at Empress EMS a large progressive regional ambulance service and EMS provider. He is a Paramedic and Community Paramedic with 30 years’ experience in EMS and Hospital Administration. His focus has been on new program design and application. He has been the administrator for multiple hospital clinical departments as well as a Level 1 Trauma Center. His EMS career has included, rural, suburban and urban EMS systems.

He has spent the past several years researching, developing and implementing MIH-CP programs at Empress EMS providing collaborative community health programs with multiple hospitals in Westchester County and New York City. He is a Certified Ambulance Compliance Officer and member of the American Ambulance Association Payment Reform Committee.

 

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. The patient stated that he had seen a health alert from the U.S. Centers for Disease Control and Prevention (CDC) about the novel coronavirus outbreak in China and, because of his symptoms and recent travel, decided to see a health care provider.

On admission, the patient reported persistent dry cough and a 2-day history of nausea and vomiting; he reported that he had no shortness of breath or chest pain. Vital signs were within normal ranges. On physical examination, the patient was found to have dry mucous membranes. The remainder of the examination was generally unremarkable. After admission, the patient received supportive care, including 2 liters of normal saline and ondansetron for nausea.

Viral Presence

Both upper respiratory specimens obtained on illness day 7 remained positive for 2019-nCoV, including persistent high levels in a nasopharyngeal swab specimen (Ct values, 23 to 24).

Stool obtained on illness day 7 was also positive for 2019-nCoV (Ct values, 36 to 38).

Nasopharyngeal and oropharyngeal specimens obtained on illness days 11 and 12 showed a trend toward decreasing levels of virus

Day 8: Condition Improves

On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.

History Taking

This case report highlights the importance of clinicians eliciting a recent history of travel or exposure to sick contacts in any patient presenting for medical care with acute illness symptoms, in order to ensure appropriate identification and prompt isolation of patients who may be at risk for 2019-nCoV infection and to help reduce further transmission. Finally, this report highlights the need to determine the full spectrum and natural history of clinical disease, pathogenesis, and duration of viral shedding associated with 2019-nCoV infection to inform clinical management and public health decision making.

Conclusion

There is little doubt that this paper is about to become a globally sited document as we continue to deal with COVID 19. As far as EMS and our first response to it goes, the paper reinforces the key actions currently being taken

 

Sample COVID-19 Policies for Mobile Healthcare Providers

Thank you to the following organizations for sharing their policies as examples.

Global Medical Response maintains a COVID-19 page to provide information to all members of the GMR community—clinicians and non-clinicians.

Updates from GMR Chief Medical Officer, Dr. Ed Racht

GMR Procedures

General Information for Caregivers

Compliance

HIPAA Reminder

FirstWatch Solutions

The intention of the COVID-19 Process/Policy Template is to provide agencies, medical directors, or others who want to utilize it, an outline/template on which to build an agency-specific policy/protocol to address COVID-19. This includes suggestions for development and/or oversight committees, outside partners and stakeholders, as well as preparation and process for EMS workers who provide best practice care for patients as well as providing for the protection of pre-hospital providers and medical director(s). Its application is totally up to the user.

This document is meant to be a living document that can be revised as circumstances or guidance changes. It can also be a discussion piece for those who choose to develop a different type of policy but may want to use some of the components of the document as a starting point.

Agency Guidance

CDC Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States
NEW March 6, 2020: CMS COVID-19 FAQs for Healthcare Providers (PDF Download)

March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs.  https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus

February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19.  https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test

February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt

February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov

Congrats to CAAS Accreditations & Recerts

Congratulations to the AAA members who received Commission on the Accreditation of Ambulance Services (CAAS) accreditation or reaccreditation in November and December!

New certifications

  • Superior Air-Ground Ambulance (Elmhurst, IL)

Recertifications

  • Ambucare (Bremen, GA)
  • American Medical Response Central Mississippi (Jackson, MS)
  • American Medical Response, Los Angeles (Irwindale, CA)
  • American Medical Response, San Diego (San Diego, CA)
  • American Medical Response of West Michigan (Grand Rapids, MI)
  • American Medical Response South Mississippi (Gulfport, MS)
  • Lifeguard Ambulance Service (Milton, FL)
  • Metro West Ambulance (Hillsboro, OR)
  • Richmond Ambulance Authority (Richmond, VA)

2017 Robert L. Forbuss Lifetime Achievement Award

Contact: Jessica Marvin
Telephone: 703-610-9018
Email: jmarvin@ambulance.org

AMERICAN AMBULANCE ASSOCIATION HONORS FRED DELLA VALLE WITH THE 2017 ROBERT L. FORBUSS LIFETIME ACHIEVEMENT AWARD

Washington, DC– McLean, VA — The American Ambulance Association (AAA) is proud to award Fred Della Valle with the 2017 Robert L. Forbuss Lifetime Achievement Award.

The Robert L. Forbuss Lifetime Achievement Award is named in honor of the first Executive Director of the American Ambulance Association. The award recognizes a volunteer leader who has made a lifetime body of work that has enhanced the programs and services of the AAA and its members. Fred has achieved this through his decades of service, commitment, and dedication to the AAA and its members.

AAA President Mark Postma noted, “Throughout his years of service to the AAA, Fred has worked tirelessly to advance our mission and serve our members. We are proud to celebrate his contributions and achievements to the AAA and our industry by presenting him with the Robert L. Forbuss Lifetime Achievement Award for 2017.”

Mr. Della Valle will be presented with the Robert L. Forbuss Lifetime Achievement Award at the AAA Annual Conference and Tradeshow Awards Reception on Tuesday, November 14, 2017. This event is the premier event for leaders in the ambulance industry, featuring world-class education, networking, and cutting-edge technology.

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About the American Ambulance Association
Founded in 1979, the AAA represents hundreds of ambulance services across the United States that participate in emergency and nonemergency care and medical transportation. The Association serves as a voice and clearinghouse for ambulance services, and views prehospital care not only as a public service, but also as an essential part of the total public health care system.

AAA Mission Statement
The mission of the American Ambulance Association is to promote health care policies that ensure excellence in the ambulance services industry and provide research, education, and communications programs to enable its members to effectively address the needs of the communities they serve.

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