Rule Expanding Electronic Submission Requirements for Injury & Illness Data for High Hazard Employers
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Draft Report on Infection Prevention and Control for the EMS/911 Workforce Released: Public Comment Requested
From EMS.gov on April 12, 2022
The draft report for the technical brief on Infection Prevention and Control for the Emergency Medical Services (EMS)/911 workforce has been released by the Evidence-based Practice Center (EPC) Program at the Agency for Healthcare Research and Quality (AHRQ). The draft report is available for review and feedback through April 22, 2022 on Effective Healthcare’s website.
The technical brief summarizes the latest evidence on infectious pathogen exposure among the EMS/911 workforce and offers recommendations for the prevention, recognition, and control of infectious diseases and other related exposures that may be acquired in occupational settings. The AHRQ is requesting feedback from the community to improve the final technical brief. The agency values feedback and will consider all comments received.
AHRQ is a government agency that produces evidence-based guidance to improve the quality of healthcare delivery. It coordinates these efforts with partners in the field to ensure the evidence is understood and put into practice. For more information on the EPC Program, visit here. This project is supported by NHTSA’s Office of EMS, which strives to reduce death and disability by providing leadership and coordination to the EMS community in assessing, planning, developing, and promoting comprehensive, evidence-based emergency medical services and 911 systems. |
The United States Department of Labor (US DOL) has published a notice of intent to partially reopen the rule-making process to permit additional comment and a public hearing on certain aspects of the OSHA Emergency Temporary Standard for Healthcare employers which was originally published in June 2021. OSHA is seeking further input from stakeholders as they develop a final standard. The public hearing will begin on April 27, 2022.
The agency is reopening the rulemaking record to allow for new data and comments on topics, including the following:
OSHA made it clear that it is not proposing mandatory COVID-19 vaccination for healthcare workers. However, they are seeking comments regarding how it could help employers further support healthcare worker employees in their vaccination and boosting efforts. This could include paid leave, including travel time, for those seeking vaccinations or boosters.
The notice in the Federal Register had a slightly more relaxed tone as many areas in the country have seen a significant drop-off in cases. If you are interested in submitting comments, you can do so electronically at www.regulations.gov. If you wish to attend the video-based public hearing, you must file a notice of intention to appear with the US DOL within 14 days of the notice being officially published in the Federal Register.
If you have any questions about your current obligations under the OSHA rules, please email the AAA at hello@ambulance.org.
Please either Join!
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Douglas F. Kupas, Matt Zavadsky, Brooke Burton, Shawn Baird, Jeff J. Clawson, Chip Decker, Peter Dworsky, Bruce Evans, Dave Finger, Jeffrey M. Goodloe, Brian LaCroix, Gary G. Ludwig, Michael McEvoy, David K. Tan, Kyle L. Thornton, Kevin Smith, Bryan R. Wilson
Download PDF Position Statement
The National Association of EMS Physicians and the then National Association of State EMS Directors created a position statement on emergency medical vehicle use of lights and siren in 1994 (1). This document updates and replaces this previous statement and is now a joint position statement with the Academy of International Mobile Healthcare Integration, American Ambulance Association, American College of Emergency Physicians, Center for Patient Safety, International Academies of Emergency Dispatch, International Association of EMS Chiefs, International Association of Fire Chiefs, National Association of EMS Physicians, National Association of Emergency Medical Technicians, National Association of State EMS Officials, National EMS Management Association, National EMS Quality Alliance, National Volunteer Fire Council and Paramedic Chiefs of Canada.
In 2009, there were 1,579 ambulance crash injuries (2), and most EMS vehicle crashes occur when driving with lights and siren (L&S) (3). When compared with other similar-sized vehicles, ambulance crashes are more often at intersections, more often at traffic signals, and more often with multiple injuries, including 84% involving three or more people (4).
From 1996 to 2012, there were 137 civilian fatalities and 228 civilian injuries resulting from fire service vehicle incidents and 64 civilian fatalities and 217 civilian injuries resulting from ambulance incidents. According to the
U.S. Fire Administration (USFA), 179 firefighters died as the result of vehicle crashes from 2004 to 2013 (5). The National EMS Memorial Service reports that approximately 97 EMS practitioners were killed in ambulance collisions from 1993 to 2010 in the United States (6).
Traffic-related fatality rates for law enforcement officers, firefighters, and EMS practitioners are estimated to be 2.5 to 4.8 times higher than the national average among all occupations (7). In a recent survey of 675 EMS practitioners, 7.7% reported being involved in an EMS vehicle crash, with 100% of those occurring in clear weather and while using L&S. 80% reported a broadside strike as the type of MVC (8). Additionally, one survey found estimates of approximately four “wake effect” collisions (defined as collisions caused by, but not involving the L&S operating emergency vehicle) for every crash involving an emergency vehicle (9).
For EMS, the purpose of using L&S is to improve patient outcomes by decreasing the time to care at the scene or to arrival at a hospital for additional care, but only a small percentage of medical emergencies have better outcomes from L&S use. Over a dozen studies show that the average time saved with L&S response or transport ranges from 42 seconds to 3.8 minutes. Alternatively, L&S response increases the chance of an EMS vehicle crash by 50% and almost triples the chance of crash during patient transport (11). Emergency vehicle crashes cause delays to care and injuries to patients, EMS practitioners, and the public. These crashes also increase emergency vehicle resource use through the need for additional vehicle responses, have long-lasting effects on the reputation of an emergency organization, and increases stress and anxiety among emergency services personnel.
Despite these alarming statistics, L&S continue to be used in 74% of EMS responses, and 21.6% of EMS transports, with a wide variation in L&S use among agencies and among census districts in the United States (10).
Although L&S response is currently common to medical calls, few (6.9%) of these result in a potentially lifesaving intervention by emergency practitioners (12). Some agencies have used an evidence-based or quality improvement approach to reduce their use of L&S during responses to medical calls to 20-33%, without any discernable harmful effect on patient outcome. Additionally, many EMS agencies transport very few patients to the hospital with L&S.
Emergency medical dispatch (EMD) protocols have been proven to safely and effectively categorize requests for medical response by types of call and level of medical acuity and urgency. Emergency response agencies have successfully used these EMD categorizations to prioritize the calls that justify a L&S response. Physician medical oversight, formal quality improvement programs, and collaboration with responding emergency services agencies to understand outcomes is essential to effective, safe, consistent, and high-quality EMD.
The sponsoring organizations of this statement believe that the following principles should guide L&S use during emergency vehicle response to medical calls and initiatives to safely decrease the use of L&S when appropriate:
In most settings, L&S response or transport saves less than a few minutes during an emergency medical response, and there are few time-sensitive medical emergencies where an immediate intervention or treatment in those minutes is lifesaving. These time-sensitive emergencies can usually be identified through utilization of high-quality dispatcher call prioritization using approved EMD protocols. For many medical calls, a prompt response by EMS practitioners without L&S provides high-quality patient care without the risk of L&S-related crashes. EMS care is part of the much broader spectrum of acute health care, and efficiencies in the emergency department, operative, and hospital phases of care can compensate for any minutes lost with non-L&S response or transport.
Academy of International Mobile Healthcare Integration
American Ambulance Association
American College of Emergency Physicians
Center for Patient Safety
International Academies of Emergency Dispatch
International Association of EMS Chiefs
International Association of Fire Chiefs
National Association of EMS Physicians
National Association of Emergency Medical Technicians
National Association of State EMS Officials
National EMS Management Association
National EMS Quality Alliance
National Volunteer Fire Council
Prehosp Disaster Med. 2011;26(5): 346-352.
Ann Emerg Med, 2002;40: 625-632.
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This week, the Safer Federal Workforce Task Force released new guidance on COVID-19 workplace safety protocols for Federal contractors and subcontractors. On September 9, President Biden signed Executive Order 14042, Ensuring Adequate COVID Safety Protocols for Federal Contractors, which directed executive departments and agencies to ensure that all federal contractors and subcontractors comply with all guidance published by the Task Force. These workplace safety protocols will apply to all covered contractor and subcontractor employees in covered contractor workplaces even if they are not working on Federal Government contracts.
Pursuant to the guidance issued this week, and in addition to any requirements or workplace safety protocols that are applicable because a contractor or subcontractor employee is present at a Federal workplace, Federal contractors and subcontractors with a covered contract will be required to conform to the following workplace safety protocols:
The guidance provides details regarding who is included under these new rules. Under the latest guidance, a “Covered Contractor Employee” means any full-time or part-time employee of a covered contractor” working on” or “in connection with” a covered contract or working at a covered contractor workplace. This includes employees of covered contractors who are not themselves working on or in connection with a covered contract, except for those employees who only perform work outside the United States or its outlying areas. This means that all ambulance service employees, who perform work related to or in connection with the contract, such as dispatchers, human resource and billing personnel, training staff, etc. are subject to the new requirements. This includes employees working from remotely or from home, who are performing work in connection with the contract.
Under the guidance, a “Covered Contractor Workplaces” are locations controlled by a covered contractor at which any employee of a covered contractor working on or in connection with a covered contract is likely to be present during the period of performance for a covered contract. This includes those workplaces such as ambulance stations, administrative offices, etc.
Covered contractors must ensure that all their covered employees are fully vaccinated for COVID-19 unless the employee is legally entitled to an accommodation. Covered contractor employees must be fully vaccinated no later than December 8, 2021. The guidance detailed that vaccination is required of all employees, even if they have previously been infected with COVID-19.
Under this guidance, the contractor or subcontractor must review the covered employee’s documentation to prove vaccination status. The guidance identifies the list of acceptable documents an employee can furnish to prove vaccination, including:
*Digital copies of these records are acceptable (jpg, scanned PDF, etc.)
The guidance specified that a signed attestation by the employee is not acceptable proof of vaccination. Additionally, the guidance stated that recent COVID-19 antibody tests do not satisfy the requirements under these rules.
Covered contractors must ensure that all individuals, including covered contractor employees and visitors, comply with published CDC guidance for masking and physical distancing at a covered contractor workplace. The guidance provided more details on these masking and physical distancing requirements. These include requiring unvaccinated individuals to mask indoors and in certain outdoor settings regardless of COVID-19 transmission levels. Contractors are required to monitor the community transmission levels on the CDC COVID-19 Data Tracker County View website on a weekly basis.
Covered contractors must designate a person or persons to coordinate implementation of, and compliance with, these workplace safety protocols at covered contractor workplaces. Their responsibilities to coordinate COVID-19 workplace safety protocols may comprise some or all of their regular duties. This individual can be the same person who is designated under other state or local COVID-19 safety requirements.
The guidance makes it clear that the rules applicable to all federal contractors and supersedes any state or local rules or regulations that are contrary to these provisions. That means that any rules that prohibit mask or other COVID-19 related safety mandates, or otherwise contradict the rules under this guidance will not excuse a federal contractor’s obligations under these rules.
The guidance will be finalized by the Office of Management & Budget in the coming days. In the meantime, if you have any questions or need assistance, contact the AAA at hello@ambulance.org.
Flipping OFF the Switch on HOT Emergency Medical Vehicle Responses!
Recorded July 7, 2021 | 14:00–15:15 pm ET | FREE Webinar
Download Slide Deck | Watch on YouTube
HOT (red light and siren) responses put EMS providers and the public at significant risk. Studies have demonstrated that the time saved during this mode of vehicle operation and that reducing HOT responses enhances safety of personnel, with little to no impact on patient outcomes. Some agencies have ‘dabbled’ with responding COLD (without lights and sirens) to some calls, but perhaps none as dramatic as Niagara Region EMS in Ontario, Canada – who successfully flipped their HOT responses to a mere 10% of their 911 calls! Why did they do it? How did they do it? What has been the community response? What has been the response from their workforce? Has there been any difference in patient outcomes? Join Niagara Region EMS to learn the answers to these questions and more. Panelists from co-hosting associations will participate to share their perspectives on this important EMS safety issue!
Kevin Smith, BAppB:ES, CMM III, ACP, CEMC
Chief
Niagara Emergency Medical Services
Jon R. Krohmer, MD, FACEP, FAEMS
Director, Office of EMS
National Highway Traffic Safety Administration
Team Lead, COVID-19 EMS/Prehospital Team
Douglas F. Kupas, MD, EMT-P, FAEMS, FACEP
Medical Director, NAEMT
Medical Director, Geisinger EMS
Matt Zavadsky, MS-HSA, NREMT
Chief Strategic Integration Officer
MedStar Mobile Integrated Healthcare
Bryan R. Wilson, MD, NRP, FAAEM
Assistant Professor of Emergency Medicine
St. Luke’s University Health Network
Medical Director, City of Bethlehem EMS
Robert McClintock
Director of Fire & EMS Operations
Technical Assistance and Information Resources
International Association of Fire Fighters
Mike McEvoy, PhD, NRP, RN, CCRN
Chair – EMS Section Board – International Association of Fire Chiefs
EMS Coordinator – Saratoga County, New York
Chief Medical Officer – West Crescent Fire Department
Professional Development Coordinator – Clifton Park & Halfmoon EMS
Cardiovascular ICU Nurse Clinician – Albany Medical Center
The following quote is attributed to Suzanne Schwartz, M.D., M.B.A., director of the Office of Strategic Partnerships and Technology Innovation in the FDA’s Center for Devices and Radiological Health
“Throughout the pandemic, the FDA has worked closely with our federal partners at the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH), the Occupational Safety and Health Administration (OSHA) and with manufacturers to protect our front-line workers by facilitating access to the medical supplies they require. As a result of these efforts, our country is now better positioned to provide health care workers with access to NIOSH-approved N95s rather than using non-NIOSH-approved respirators or reusing decontaminated disposable respirators.
Early in the public health emergency, there was a need to issue emergency use authorizations (EUAs) for non-NIOSH-approved respirators as well as decontamination and bioburden reduction systems to disinfect disposable respirators. Today, those conditions no longer exist. Our national supply of NIOSH-approved N95s is more accessible to our health care workers every day.
Today, the FDA is taking additional action by announcing the revocation of EUAs for imported, non-NIOSH-approved respirators as well as decontamination and bioburden reduction systems because of an increase in domestically-manufactured NIOSH-approved N95s available throughout the country. As access to domestic supply of disposable respirators continues to significantly improve, health care organizations should transition away from crisis capacity conservation strategies that were implemented at the onset of the pandemic.”
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The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
Free Webinar July 7 | 14:00–15:15 ET
HOT (red light and siren) responses put EMS providers and the public at significant risk. Studies have demonstrated that the time saved during this mode of vehicle operation and that reducing HOT responses enhances safety of personnel, with little to no impact on patient outcomes. Some agencies have ‘dabbled’ with responding COLD (without lights and sirens) to some calls, but perhaps none as dramatic as Niagara Region EMS in Ontario, Canada – who successfully flipped their HOT responses to a mere 10% of their 911 calls! Why did they do it? How did they do it? What has been the community response? What has been the response from their workforce? Has there been any difference in patient outcomes? Join Niagara Region EMS to learn the answers to these questions and more. Panelists from co-hosting associations will participate to share their perspectives on this important EMS safety issue!
Kevin Smith, BAppB:ES, CMM III, ACP, CEMC
Chief
Niagara Emergency Medical Services
Jon R. Krohmer, MD, FACEP, FAEMS
Team Lead, COVID-19 EMS/Prehospital Team
Director, Office of EMS
National Highway Traffic Safety Administration
Douglas F. Kupas, MD, EMT-P, FAEMS, FACEP
Medical Director, NAEMT
Medical Director, Geisinger EMS
Matt Zavadsky, MS-HSA, NREMT
Chief Strategic Integration Officer
MedStar Mobile Integrated Healthcare
Bryan R. Wilson, MD, NRP, FAAEM
Assistant Professor of Emergency Medicine
St. Luke’s University Health Network
Medical Director, City of Bethlehem EMS
Robert McClintock
Director of Fire & EMS Operations
Technical Assistance and Information Resources
International Association of Fire Fighters
Mike McEvoy, PhD, NRP, RN, CCRN
Chair – EMS Section Board – International Association of Fire Chiefs
EMS Coordinator – Saratoga County, New York
Chief Medical Officer – West Crescent Fire Department
Professional Development Coordinator – Clifton Park & Halfmoon EMS
Cardiovascular ICU Nurse Clinician – Albany Medical Center
The Commission on Accreditation of Ambulance Services (CAAS) is pleased to announce the first public comment period on the first draft of the CAAS Accreditation Standards document version 4.0. All materially affected parties including members of the EMS community, EMS groups and associations, affiliated healthcare groups and associations, members of other public health and safety communities, and the general public are encouraged to review and comment on these proposed standards.
The revision of the CAAS Accreditation Standards was an extensive process conducted by the Standards Review Committee, a diverse and comprehensive team of EMS, Fire, and healthcare professionals that has dedicated over 250 work hours and engaged with subject matter experts and materially impacted stakeholders across EMS and healthcare to create this first draft of the v4.0 CAAS Accreditation Standards.
These standards were developed in accordance with the standard establishing policies set forth by the American National Standards Institute (ANSI.) CAAS is an ANSI Standards Developing Organization (SDO) committed to the development of Ambulance Accreditation Standards in a fair, balanced, accessible, and responsive manner.
This is the first public comment period, and we encourage you to review and provide your feedback to the CAAS Standards Review Committee using this online form. This public comment period will be open from March 26, 2021 until May 25, 2021.
CAAS v4.0 Accreditation Standards – First Draft and Public Comment Form
We ask that you submit one form for each standard comment you have – please do not comment on multiple standards in one form. We want to be able to review the feedback in an organized manner.
If you have any questions on the proposed standards or the standard-setting process, please contact us at caas-staff@tcag.com. We look forward to your feedback.
From NHTSA’s EMS.gov on February 11
Responders urged to review NHTSA guidance for vehicles equipped with high-voltage batteries
A new National Transportation Safety Board report offers safety recommendations for emergency response involving electric vehicles (EV) and hybrid-electric vehicles (HEV) equipped with high-voltage batteries.
NTSB investigations into four electric vehicle fires identified two major safety issues:
EMS, fire and law enforcement personnel are encouraged to review the report to stay up to date on the latest safety advisories for responding to vehicle crashes of this nature. In addition, NHTSA’s guidance for responding to emergency incidents involving these types of vehicles provides important information for all first responders and can be accessed on NHTSA.gov.
To access the full report, read the official NTSB announcement.
U.S. Department of Labor | January 29, 2021
US Department of Labor issues stronger workplace guidance on coronavirus
New OSHA guidance seeks to mitigate, prevent viral spread in the workplace
WASHINGTON, DC – The U.S. Department of Labor announced today that its Occupational Safety and Health Administration has issued stronger worker safety guidance to help employers and workers implement a coronavirus protection program and better identify risks which could lead to exposure and contraction. Last week, President Biden directed OSHA to release clear guidance for employers to help keep workers safe from COVID-19 exposure.
“Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace” provides updated guidance and recommendations, and outlines existing safety and health standards. OSHA is providing the recommendations to assist employers in providing a safe and healthful workplace.
“More than 400,000 Americans have died from COVID-19 and millions of people are out of work as a result of this crisis. Employers and workers can help our nation fight and overcome this deadly pandemic by committing themselves to making their workplaces as safe as possible,” said Senior Counselor to the Secretary of Labor M. Patricia Smith. “The recommendations in OSHA’s updated guidance will help us defeat the virus, strengthen our economy and bring an end to the staggering human and economic toll that the coronavirus has taken on our nation.”
Implementing a coronavirus protection program is the most effective way to reduce the spread of the virus. The guidance announced today recommends several essential elements in a prevention program:
“OSHA is updating its guidance to reduce the risk of transmission of the coronavirus and improve worker protections so businesses can operate safely and employees can stay safe and working,” said Principal Deputy Assistant Secretary for Occupational Safety and Health Jim Frederick.
The guidance details key measures for limiting coronavirus’s spread, including ensuring infected or potentially infected people are not in the workplace, implementing and following physical distancing protocols and using surgical masks or cloth face coverings. It also provides guidance on use of personal protective equipment, improving ventilation, good hygiene and routine cleaning.
OSHA will update today’s guidance as developments in science, best practices and standards warrant.
This guidance is not a standard or regulation, and it creates no new legal obligations. It contains recommendations as well as descriptions of existing mandatory safety and health standards. The recommendations are advisory in nature, informational in content and are intended to assist employers in recognizing and abating hazards likely to cause death or serious physical harm as part of their obligation to provide a safe and healthful workplace.
Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance.
Read best practices on the FEMA US Fire Administration Website
Civil unrest may occur as a period of social upheaval during heightened community tension or at mass gatherings such as sporting events, concerts and political conventions. The safety risk for fire and emergency medical services (EMS) personnel responding to these fluid incidents may be elevated.
The U.S. Fire Administration (USFA) and the National Highway Traffic Safety Administration’s Office of Emergency Medical Services worked together to compile these best practices to assist you with your response to civil unrest incidents in your community. Fire and EMS personnel should follow the general guidance in this section to prepare personnel, the station, apparatus and the community for emergency response in a challenging environment.
AAA members have free access to Savvik Buying Group savings!
Safety for your employees today is paramount. Finding the safety products you need, is what we do. With some trying to limit the number of gloves that you can purchase, Savvik has been able to find nitrile gloves for immediate shipment with no limits.
From the US General Accountability Office on December 17
First responders stopped on the side of the road risk being struck by passing vehicles. To protect these workers, all states and D.C. enacted “Move Over” laws that require motorists to move over to another lane or slow down when they pass a roadside incident.
The Department of Transportation helps state officials educate the public about Move Over laws and administers funding that state officials can use for enforcement efforts. It also trains first responders in protecting themselves on the roadside.
The Department is planning to study motorist behaviors that contribute to roadside incidents and technologies that protect first responders.
Sponsored content from affiliate member Distance CME
Wondering which state has the highest incidence of deer accidents in the U.S.?
West Virginia, followed by Montana and Pennsylvania, according to a State Farm Insurance report. Deer collisions increase from October through December, which includes elk and moose.
Car crashes caused by deer accidents account for up to about 200 fatalities per year and 10,000 injuries, according to West Bend Insurance Divisions.