Skip to main content

Tag: Global Medical Response (GMR)

In Memory of the Crew of Air Evac Lifeteam N295AE

Statement from Global Medical Response

Air Evac Lifeteam is heartbroken to report that three crew members have perished in an incident that occurred on Saturday, January 20. At 11:23 pm local time AEL’s Operations Control Center (OCC) lost contact with the aircraft, a Bell 206L3 with call sign N295AE. The crew is based out of Weatherford, OK, and was returning to base after completing a patient care transport in Oklahoma City when the OCC lost contact with them. Nearby AEL teams assisted local law enforcement with the search.

Our primary focus is on supporting the families and our team members. CISM teams have been sent to assist our team members during this time.

It is with a heavy heart that we share the names of our three colleagues. Pilot Russell Haslam, Flight Nurse Adam Tebben and Flight Paramedic Steven Fitzgerald. We continue to hold their families in our hearts.

AEL has turned over the scene and investigation to the NTSB

All Clear Foundation Names Mike Taigman Chairman of the Board

This appointment demonstrates its commitment to serving those in emergency services with the wellness resources they need, when they need them, free of charge

Denver, Colorado, USA – All Clear Foundation (ACF), a national 501c3 nonprofit dedicated to improving the wellbeing and longevity of Emergency Responders, including Healthcare Workers, and their families, has appointed Mike Taigman Chairman of the Board.

“My life’s purpose–for my entire life–has been to recognize suffering in all its forms and do something about it. All Clear Foundation’s mission is in complete alignment with that passion,” says Taigman. “I am humbled and excited by this opportunity.”

A Proven Track Record

Taigman brings a wealth of experience to this role. He spent decades on the streets of Denver as a paramedic, honing his “people first” approach. The author of more than 600 articles in professional journals, Taigman is a recognized expert in the areas of quality improvement, data science, leadership, and EMS. He serves as adjunct faculty at University of Maryland, Baltimore County and UCSF, and he is the Improvement Guide at FirstWatch, a data analytics firm dedicated to quality improvement in public safety.

“We are thrilled to have Mike on board,” says Rhonda Kelly, the foundation’s Executive Director. “His passion for improving quality of life among Emergency Responders is sincere and his track record is unparalleled. We appreciate his focus on the full spectrum of wellness supports from proactive education to crisis intervention.  And we are very excited about his commitment to utilizing evidence-based practices to drive improvement.”

ACF relies upon the power of strategic partnerships to affect change and appreciates Taigman’s extensive experience building and growing partnerships in the Responder wellness world. In addition to facilitating development of EMS Agenda 2050, a vision EMS 20 years into the future, he is the author of Super-Charge Your Stress Management in the Age of COVID and is regular faculty at the Institute for Healthcare Improvement.

 

A Vision Forward

Among his top priorities, Taigman looks forward to ensuring the sustainability of All Clear’s mission. “My hope is to support the ongoing mission and build sustainable support and funding for the foundation so we can continue this important work,” says Taigman. “There’s so much evidence that being involved in emergency services and healthcare takes a toll on the folks doing the job.”

“All Clear Foundation has pulled together an ecosystem of resources that is unmatched and provides them free of charge to Emergency Responders, their agencies, and their families. Securing reliable support for these efforts is essential and ongoing.”

A Clear Need

The need is there. One study found Emergency Responders suffer from depression and PTSD at five times the rate of the general population. Among the many challenges inherent in the work are frequent trauma exposure, rotating shift schedules, limited agency support, amplified stress on the family and other relationships, and physical injury.

“Too many Emergency Responders have paid for their service with their lives, either in quality or longevity,” says Director Kelly. “The barriers of shame, stigma, lack of local resources, and lack of finances have kept many from accessing the supports they deserve and need. This is where All Clear Foundation steps in. Built by Responders, for Responders, we are here to help across the domains of wellness: mental, emotional, physical, social, and spiritual.”

Supporting First Responders

All Clear Foundation provides an array of easily accessible and navigable wellness solutions at no cost to agencies or participants. ResponderStrong, its mental health initiative, has had a significant impact nationally and continues to grow with hybrid-format educational content and digital tools. Partners organizations include Global Medical Response, FirstNet-Built with AT&T, Abbott Nutrition, The Center for Relationship Education, IndyCar, IPSDI, Sigma Tactical Wellness, and NERPSC.

“The work All Clear and its partner organizations provide is saving lives,” says Taigman. “But, beyond that, it’s making Emergency Responders happier, healthier, and more resilient. This is good news for all of us.”

 

###

ABOUT FIRSTWATCH

Since 1998, FirstWatch has been helping EMS agencies monitor real-time situational awareness, operational performance, clinical quality and performance improvement measures, as well as health surveillance, bioterrorism or other potentially concerning incidents. FirstWatch is designed to aggregate data from your agency’s CAD, ePCR, ProQA, RMS, Hospital ED, Billing and Phone system into a single, automated real-time view. For more information, visit www.firstwatch.net.

ABOUT ALL CLEAR FOUNDATION

Through assessing community wellness needs, priorities, and barriers, All Clear Foundation, a 501c3 public charity, leverages the power of strategic partnerships to create easily accessible and navigable systems of wellness solutions, improving the wellbeing and longevity of those who serve our communities. In 2019, ACF was founded by Global Medical Response as an autonomous public charity designed to serve and benefit the national Emergency Responder community. As one of the largest employers of Public Safety personnel in the U.S., GMR believes it has a duty to support the overall wellness of all Responders nationally. All Clear Foundation’s mission is to improve the overall wellbeing and longevity of those who serve our communities in times of need. We believe that healthy emergency responders contribute to healthier communities. For more information, visit www.allclearfoundation.org.

For more information, please contact Crawford Coates at ccoates@firstwatch.net.

Letter to VA Reimbursement of Ambulance Services

The AAA has sent a letter to VA Secretary Denis McDonough asking him to delay the implementation of a final rule that would allow the Department of Veterans Affairs (VA) to reimburse at the lower of billable charges or Medicare rates for certain non-contracted ambulance services. The proposed rule was issued back in 2020 but we understand that the VA could now issue the final rule in January 2023. GMR has been advocating on Capitol Hill for a delay in air and ground ambulance services. The AAA will be issuing later today a request for AAA members to reach out to the VA to also request the delay.

 

December 12, 2022

The Honorable Denis McDonough
Secretary of Veterans Affairs
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420

Dear Secretary McDonough,

The American Ambulance Association (AAA) respectfully requests that the Department delay release and implementation of the final rule on the “Change in Rates VA Pays for Special Modes of Transportation (RIN 2900-AP89).” Reimbursing for services to veterans at Medicare rates would have dire consequences for the ability of ground ambulance service organizations to provide lifesaving 9-1-1 emergency and also interfacility ambulance services not only to veterans but entire communities. We ask that the Department delay the rule until after Congress has had an opportunity to act on the results from the Medicare ambulance data collection system which is currently underway.

As documented by the Government Accountability Office (GAO) in 2007 and 2012, the Medicare program reimburses ground ambulance service organizations below the cost of providing their services when temporary add-ons are not considered. Since 2012, the disparity between the cost of providing ambulance services and reimbursement by Medicare has only increased through sequestration cuts, a reduction in inflation updates, and other Medicare payment policy changes. Ground ambulance service organizations are already facing difficult financial straits and cannot
sustain a reduction in reimbursement from another federal payor.

Ground ambulance service organizations serve as the foundation for emergency medical response for veterans and communities throughout the country. Our members are a vital component of our local and national health care and 9-1-1 emergency response systems and serve as lifelines of medical care for many rural and underserved communities. However, our ability to continue to serve communities is already at risk due to inadequate reimbursement and access to care for veterans would be further jeopardized if the Department were to reimburse at lower levels for ground ambulance services.

The AAA is the primary association for ground ambulance service organizations, including governmental entities, volunteer services, private for-profit, private not-for-profit, and hospital-based ambulance services. Our members provide emergency and non-emergency medical transportation services to more than 75 percent of the U.S. population. AAA members serve
patients in all 50 states and provide services in urban, rural, and super-rural areas.

Again, we request that you delay the release and implementation of the final rule on the “Change in Rates VA Pays for Special Modes of Transportation”.

If you have any questions regarding our request, please do not hesitate to have a member of your staff contact AAA Senior Vice President of Government Affairs Tristan North. Tristan can be reached by phone at (202) 802-9025 or email at tnorth@ambulance.org.

Thank you in advance for your consideration.

Sincerely,

/AAA - AmerAmbAssoc Team Folder/Signatures/Baird, Shawn Signature.png
Shawn Baird
President

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

Rest in Peace, Jacob Dindinger

From Global Medical Response

It is with a heavy heart that we inform you that Jacob’s family made the decision to remove him from life support. This decision did not come easy; it came after many tests and conversations and much consideration to his condition. Jacob fought hard, but unfortunately the injuries he sustained were so damaging, he was not able to survive them.

Jacob made such a big impact in our community with each interaction he had. He was dedicated and driven to succeed and continually looking for his next accomplishment. To Jacob, failure was a setback, but it didn’t stop him from working harder to succeed. His family meant everything to him, and the smiles we have seen in recent photos show the love he had for his family and friends. He made an even bigger impact on our family here at AMR and we feel like we are all better people after being touched by Jacob and his family.

These past two weeks have been difficult for the entire GMR family. We appreciate all the support you have given to our local teams as well as the family. CISM teams have been working in Arizona to help our teams there, and GMR Life teams have been offering support across all our operations. I encourage you to reach out to them and to our HR teams, and to use EAP resources.

When final arrangements have been made, we will notify our local teams.

If you would like to help the family, a Go Fund Me account has been established.

Thank you,

Glenn Kasprzyk, Southwest Region President
Jackie Evans, Regional Director
Global Medical Response

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

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

Stay In Touch!

By signing up, you agree to the AAA Privacy Policy & Terms of Use