Register Now for the National EMS Advisory Council Meeting Webcast Aug. 18-19
The National EMS Advisory Council will be holding a virtual meeting on Tuesday and Wednesday, August 18-19. Members of the public can register for the webcast and view the full agenda here.
The agenda for each day includes meetings of NEMSAC committees during the morning sessions, with the webcast beginning when the full council convenes at 1 pm EDT on Tuesday, August 18, 2020, and 12 pm EDT on Wednesday, August 19, 2020. Items on the council’s agenda include:
COVID-19 response and PPE tracking
The Emergency Triage, Treat and Transport Model (ET3)
Workforce mental health
EMS for Children
The National EMS Assessment
EMS and social determinants of health
The FICEMS strategic plan
Individuals registered for the meeting interested in addressing the council during the public comment periods must submit their comments in writing to Eric Chaney at firstname.lastname@example.org by August 13, 2020.
“You are making a tremendous difference for our country,” Secretary Chao says in video message
In recognition of National Emergency Medical Services Week, U.S. Secretary of Transportation Elaine L. Chao recorded a video message honoring the people of EMS and their families for their sacrifice and dedication to their communities, especially during this unprecedented pandemic. As the nation marks the 46th National EMS Week, we also recognize the 50th anniversary of the creation of the National Highway Traffic Safety Administration, which has supported the advancement of EMS systems since its inception.
EMS professionals have long served at the frontlines of our healthcare system, ready for any emergency. For nearly half a century, we have celebrated the dedication of our nation’s emergency medical services professionals during National EMS Week.
This year we mark this occasion during a most extraordinary time. Instead of hosting awards ceremonies and recognition events, EMS organizations in communities across the United States and around the globe are busy tackling a pandemic like nothing we’ve ever seen–one that tests us as individuals, and as a profession.
This year’s National EMS Week 2020 theme is “Ready today. Preparing for tomorrow.” This theme is so appropriate! As the continually evolving threat of COVID-19 has shown us, we don’t always know what tomorrow will bring. Yet you and your colleagues throughout the first responder and healthcare communities have lived by these words, ready for whatever comes your way, and always preparing for what might come next–even when it’s the unexpected.
I want to thank every EMS clinician and everyone who works hard to support them, including the administrative and logistics staffs and the family members whose own sacrifice makes it possible for you to perform your duty. As director of the NHTSA Office of EMS and leader of the EMS/Prehospital Team within the FEMA Health Systems Resiliency Task Force, I can assure you that your commitment and professionalism have not gone unnoticed. The entire Office of EMS staff is inspired by you to help you be even more ready the next time the tones sound, to support the advancement of local and State EMS systems, and to prepare for future challenges.
Jon R. Krohmer, MD, FACEP, FAEMS
Director, Office of EMS
National Highway Traffic Safety Administration
EMS Focus webinar on Tuesday, May 12, at 3 p.m. ET/12 p.m. PT will feature local EMS medical directors and Federal officials discussing COVID-19 testing and implications for EMS organizations and clinicians
As we continue to learn more about the novel coronavirus and COVID-19, we’re also learning more about COVID-19 testing: Who should get tested, and when? How accurate are the tests? In this webinar, hosted be NHTSA’s Office of EMS, you’ll learn:
The local experience of some of the first EMS systems to have personnel quarantined and test positive for COVID-19
The latest guidance on testing of first responders and other healthcare personnel
What the result of a COVID-19 test or antibody test really means for individuals and EMS organizations
Three panelists deeply involved in the EMS and public health response to COVID-19 will share their expertise:
Jonathan Jui, MD, MPH, FACEP, is EMS medical director for Multnomah County, Oregon, including the City of Portland and the county 911 center. He is also a member of the Oregon 2 Disaster Medical Assistance Team and a professor of emergency medicine at Oregon Health & Science University. Dr. Jui is board certified in emergency medicine, internal medicine, EMS, and infectious disease.
Michael Sayre, MD, is medical director for the Seattle Fire Department and the Seattle Medic One program and an emergency physician at Harborview Medical Center. He is a professor of emergency medicine at the University of Washington, where he also serves as the medical director for the Michael K. Copass Paramedic Training Program and leads the EMS Medicine Fellowship program.
S. Michele Owen, PhD, is associate director for laboratory science at the US Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB prevention. She is also currently serving as Co-Lead for the COVID-19 Laboratory Task Force in the CDC Incident Management Structure.
The webinar will be moderated by Jon Krohmer, MD, FACEP, FAEMS, director of the NHTSA Office of EMS and co-chair of the EMS/Pre-hospital Team within the FEMA Healthcare Resilience Task, which is leading the development of a comprehensive strategy for the US healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19.
Note: This live webinar will be limited to the first 3000 people to login using the link provided. Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour. A recording of the webinar will be shared as soon as it is available.
Our partners at HHS Office of the Assistant Secretary for Preparedness and Response are hosting a COVID-19 Clinical Rounds webinar this week. See below for more information and links to register. And be sure to access the latest COVID-19 information for EMS at the updated COVID-19 Resources for EMS.
Emergency Department: Patient Care and Clinical Operations
Thursday, May 7, 2020 12:00 PM EDT / 9:00 AM PDT
Welcome and Introductions Richard C. Hunt, MD, FACEP, HHS/ASPR National Healthcare Preparedness Programs
Patient Care and Operations James E. Black, MD, Medical Director for Emergency Services for Phoebe Putney Health Systems
Document Developed by the Healthcare Resilience Task Force Behavioral Health Work group and Adapted by the Prehospital [911 and Emergency Medical Services (EMS)] Team. This guidance applies to all delivery models including but not limited to; free standing, third-service; fire-based, hospital-based, independent volunteer, and related emergency medical service providers.
Mitigate Absenteeism by Protecting Emergency Medical Service (EMS) Clinicians’ Psychological Health and Well-being during the COVID-19 Pandemic
The resilience of our Nation’s healthcare system depends on our healthcare workforce’s ability to report for duty. Critical supplies, equipment, and surge capacity rely on dedicated, trained health professionals and support staff to enable care. This document contains general concepts to prepare and take action, such as those listed below, to help your EMS/911 agency protect your workers’ psychological health and well- being.
Prepare your workforce for what is to come before the surge takes place:
Organize peer support—staff-to-staff and family-to-family—to provide assistance with tangible needs like childcare, dependent care, pet care, and food and medication
Assist staff to locate resources to establish emergency plans for childcare, dependent care, pet care, and family communication to mitigate absenteeism due to urgent needs at
Encourage staff to pre-arrange their home to accommodate isolation should the staff member become ill (as not to spread infection to other household members).
Develop a plan to provide boarding on or near the work site for staff who are unable to commute, have a long commute, or concerned about infecting family and
Establish workforce housing by setting up dormitories, acquiring hotel space, or converting unused areas of the
Ensure plans account for non-medical staff (e.g., administration, billing, medical supplies, fleet maintenance, ).
Consider setting up shuttle service for employees, or designate drivers for staff working unusual shifts or prolonged
Check with your local and State Emergency Operations Centers to identify available resources and plans that may help with this
Encourage staff to develop a personal stress management plan to address exercise, nutrition, sleep, mindfulness, and
Pre-identify behavioral health resources in your area such as local behavioral health providers, Red Cross chapters, and Medical Reserve Corps units, tele-mental health services, as well as grief and loss resources for staff who may lose patients, colleagues, or loved
Support your workforce effectively during the surge:
EMS Clinicians may not be able to use the coping mechanisms that they typically rely on to manage stress. Teaching and encouraging the use of simple relaxation techniques may help to decrease their physiological arousal levels and focus on something besides the situation at hand.
Maximize opportunities for effective
Relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help clinicians focus on decreasing the intensity of their
Establish bi-directional communication and a mechanism for staff to make recommendations to leadership through use of dedicated email or a physical suggestion
At each shift change provide briefings on the current status of the work environment, safety procedures, and required safety
Work with agency for plan of judicious and strategic days off or
Establish a behavioral health (or resilience or fatigue management) safety officer who will regularly monitor staff stress, coping, and fatigue management and provide guidance, recommendations, and corrective action as needed. This important role needs to be empowered by leadership and leadership should be committed to adjusting course based on feedback and ground
Stress compromises the immune system and affects physical health. Address staff stress and fatigue with organizational strategies.
Establish and adhere to regular breaks throughout the shift to mitigate fatigue. Limit overtime whenever possible
Rotate workers from high-stress to lower-stress functions and monitor and adjust to address fatigue related to diurnal/shift timing
Monitor and evenly redistribute increased workload resulting from staff illness or accidental exposure.
Establish communications capabilities so that staff can communicate with loved ones and connect with their social supports through internet, video, and
Designate a quiet room or area for staff to use to facilitate rest during
Develop a strategy to ensure that healthy food, water, refreshments, hygiene, and comfort items are readily available without the need to leave the
If staff are sheltering in place at the facility, ensure access to:
information such as newsletters, social media, or television;
facilities and supplies needed for hygiene (e.g., showering, teeth brushing, laundry); and
a means to get needed medications and capability to support personal medical equipment (e.g., CPAP).
Assign experienced staff to mentor and support newer staff and develop just in time onboarding materials to orient staff new to work site, including screening and infection control
Ensure staff know how to access psychological support through available mechanisms such as Employee Assistance Programs, Critical Incident Stress Debriefing (CISM) team, members trained in stress first aid, and the Disaster Distress
SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters (1-800-985-5990 or text TalkWithUs to 66746).
Ensure staff know how to access telehealth/telemedicine resources
1,2,3 This is a non-federal website. Linking to a non-federal website does not constitute an endorsement by the U.S. government, or any of its employees, of the information and/or products presented on that site.
The following document was developed by the Healthcare Resilience Task Force Behavioral Health Work group and Adapted by the Prehospital [911 and Emergency Medical Services (EMS)] Team This guidance applies to all delivery models including but not limited to; free standing, third-service; fire-based, hospital-based, independent volunteer, and related emergency medical service providers. Download PDF from FEMA Website
Managing Patient and Family Distress Associatedwith COVID-19 in the Prehospital caresetting
Tips for Emergency Medical Services Personnel
Day to day operations for Emergency Medical Services (EMS) in the prehospital care setting can cause stress and anxiety under normal conditions. During an emerging infectious disease outbreak, such as COVID-19, the number of individuals experiencing distress—and the intensity of that stress and anxiety—may be significantly amplified. This stress and anxiety can contribute to unwanted patient behaviors, increased calls from those who are anxious but not in need of emergency care, and a reluctance to follow guidance from EMS or other healthcare clinicians, which may ultimately contribute to an increase in mortality and morbidity. This document contains strategies that may be helpful in reducing patient and family stress.
The expected surge of healthcare utilization brought on by an infectious disease outbreak may make it necessary for EMS to modify their usual care practices. These modifications may be in direct contrast with the expectations that patients and families have about prehospital care and other health care, and therefore make their experience even more distressing. Listed below are steps that EMS clinicians and their medical directors can take to help patients and their families manage this distress more effectively, EMS clinicians are encouraged to adapt recommended actions based on their agencies’ individual needs and practical considerations (e.g. limited resources and staff) as approved by the medical director.
Communication: Take time to hear patient concerns and worries
Patients may be scared for themselves or others, may feel guilty, stigmatized, or may be worried about not only practical issues (e.g., who will take care of dependents or pets, how will bills get paid, will they lose their job), but also if they may die from the COVID-19.
When talking with patients, speak to them directly and talk calmly and
Acknowledge the challenges to effective communication presented by personal protective use (PPE) (masks, face shields, and other barriers that limit non-verbal expression).
Reassure patients that you want to minimize any discomfort or concerns they may have about the care they are
Although there may not be clear answers or solutions, try and display openness and honesty to the best of your ability
Have difficult conversations with family members and/or patients as needed (we cannot transport you to the hospital -or – to the hospital of your choice, you are not ill enough to go to the hospital).
Reflect back what you have heard the patient say and identify the emotion the patient is communicating.
Patient: “I want my family to go to the hospital with ”
Provider: “It’s normal to feel scared in this situation and it’s important for you to connect with your family but at this time it is safer for them to stay home while we take you to the hospital”. (if local hospitals have policies in place to not permit family or visitors in the hospital, explain that as well)
VitalTalk1provides practical advice about how to have difficult conversations. The site provides tips and scripts specific to COVID-192 and these resources are also all available on an app3.
Make sure to take time to speak with family members about care and
Social Support: Help patients stay connected with their social support system
While in-person visits may not be possible, consider ways that patients can stay in contact with their social support system (e.g., family, friends, spiritual support).
Consider strategies to promote social support for these populations:
If transporting alone to healthcare facility
Allow patients to bring their phone or tablet
Remind patient to bring necessary
If patient assessed and determined not to need transport
Do they have access to a phone or tablet to keep in touch with their social support network?
Do they have access to telehealth/telemedicine resources?
1,2,3,4,5 This is a non-federal website. Linking to a non-federal website does not constitute an endorsement by the U.S. government, or any of its employees, of the information and/or products presented on that site.
A new COVID-19 resource page on EMS.gov provides easy to find links to the most relevant and up-to-date information from the US Centers for Disease Control and Prevention (CDC), NHTSA Office of EMS and other Federal agencies involved in the response to the pandemic. This includes guidance for treating potential COVID-19 patients, information on PPE use and supplies and processes for handling healthcare providers who have been exposed to coronavirus.
In addition, materials such as the ASPR EMS Infectious Disease playbook, the IOM Crisis Standards of Care framework and the NHTSA EMS Pandemic Guidelines are all available for download.
The COVID-19 EMS resource page will be periodically updated to add the latest information and link to the most current guidance from the CDC and other agencies.
PPE Challenges: Important Information for the First Responder Community
We are all aware of the challenges of obtaining personal protective equipment (PPE) during this pandemic. We hope this information will help address concerns and clarify the replenishment request process.
The current shortage applies to all health care disciplines – the challenges you are experiencing are being felt by your peers. As a nation, we are working very hard to address the challenges through ramped up production and distribution as resources become available. First Responders are recognized as a high priority component of the nation’s critical infrastructure. Decisions regarding PPE allocation are based on specific and identified need and are being prioritized based on those needs.
It may be helpful to reinforce to the first responder community the process for submitting your requests for resupply. It is critical that requests are submitted through the proper process.
Continue to submit your request for replenishment of PPE through your normal distribution supply chain. While the supply remains limited, filling those orders will be challenging and you may not receive your entire requested order.
To request supplies from state or federal resources (eg: stockpiles or reserves), you must submit those requests through your established local emergency management structure. Based on that structure in your state, your request may be then processed through the emergency management chain or through the public health chain to state level emergency management. From the state level, it will be transmitted to the federal level. Final decisions for health care material are made by HHS which will then order distribution of the material.
When submitting that request, indicate the following:
Specific material and quantity request
Detailed risk / exposure justification for the request
Current on-hand requested supplies
Burn rate of current supplies
Other information pertinent to the request
Alternatives that are available and risks associated with pending gaps
This information will be critical in helping to determine the reallocation plan. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to challenge the COVID-19 response. Following the appropriate process for requesting supplies will be critical to your success.
Jon R. Krohmer, MD, FACEP, FAEMS
Director, Office of EMS
COVID-19 is challenging healthcare systems across the country, with many communities already seeing an increased demand for EMS, emergency department and critical care services. A systems approach to developing crisis standards of care, defined as a “substantial change in unusual healthcare operations and the level of care it is possible to deliver,” is critical for EMS systems preparing for any public health emergency. In this webinar, hosted by NHTSA’s Office of EMS, you’ll learn: – Why crisis standards of care planning is so critical in the prehospital setting – How one state is preparing for a surge in demand for EMS services – Implications for local EMS leaders who may have to implement crisis standards of care in their communities The three panelists will share their expertise on crisis standards of care from public health, legal, medical and operational perspectives: – James G. Hodge, Jr., JD, LLM, is the director of the Center for Public Health Law and Policy at Arizona State University and a professor at the Sandra Day O’Connor College of Law. A leading expert in public health emergency law, he has helped draft several model public health regulations and advised public health officials across the country. – Aaron Burnett, MD, FACEP, is the EMS medical director for the State of Minnesota and an associate professor of emergency medicine at the University of Minnesota. As a member of Minnesota’s State EMS Regulatory Board, he helped the State put in place recent changes to regulations to help communities and EMS organizations respond to COVID-19. – John L. Hick, MD, serves as deputy chief EMS medical director and medical director for emergency preparedness at Hennepin County Medical Center in Minneapolis. An expert on disaster response, he also advises the U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response as the lead editor for the Technical Resources, Assistance Center, and Information Exchange. The NHTSA Office of EMS will moderate.
About EMS Focus
EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings.
NHTSA’s Office of EMS has partnered with a number of organizations, Federal agencies and U.S. Department of Transportation offices to develop resources that help EMS agencies understand ambulance crashes, transport patients safely, report ambulance and equipment defects and build or buy safer ambulances.
The National Association of State EMS Officials (NASEMSO) and the National Highway Transportation Safety Administration (NHTSA) hosted a series of meetings for subject matter experts to discuss revisions to the National EMS Scope of Practice model. The experts reviewed the model’s practices, examined education and training procedures, and discussed what certification level, if any, is needed for specific treatments that are now widely-used among EMS professionals. The panel focused on five specific procedures that are commonly practiced: hemorrhage control, Naloxone use, CPAP use, therapeutic hypothermia in cardiac arrest, and pharmacological pain management.
Over the next several months, the panel will continue to examine information and recommend changes to the Scope of Practice model, with final recommendations tentatively set to be submitted in August 2018. For more information, please visit NASEMSO’s website.