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EMSA DISPATCH - August 2012

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EMSA Participates in Community Paramedicine Roundtable Discussion

By Howard Backer, MD, MPH, FACEP
Director, EMS Authority

1Community Paramedicine (CP) is a relatively new concept that is generally understood as increased options for patient evaluation, management and transport. CP programs have been implemented in much of Canada, the State of Minnesota, and communities across the United States. Many of these programs aim to use EMS roles to effectively address community health needs.

In June EMSA had an opportunity to participate in a Community Paramedicine roundtable discussion, hosted by the California Health Care Foundation (CHCF). Participants included representatives from California Nurses Association, Emergency Nurses Association, local EMS agencies, public and private payers.

CHCF will work with the U.C. Davis Institute for Population Health Improvement to develop a policy analysis of CP in California EMS. EMS stakeholders will have an opportunity to comment on this report.

Minnesota Governor Mark Dayton signed the first statewide CP law in the nation this past April, creating a new certification for EMS personnel. In their expanded role, Minnesota Community Paramedics will perform community outreach, health screening assessments and instruction, disease management, wound care and mental health recognition.

Moving forward, we hope to support CHCF and U.C. Davis to assure understanding and input of all points of view. I’m confident this partnership will result in highly useful information which will help to frame the potential and options of CP in California.


Nominations are now being accepted for the California EMS Awards

By Robin R Robinson, EMS Authority Executive Division

AwardsBrave. Dedicated. Willing. Reliable. These words describe the 78,000 licensed or certified EMS providers in California. They demonstrate these qualities every day by coming to the aid of others when they are most in need and ensuring that the EMS system works well. But each year, due to circumstance or extraordinary effort, certain individuals among us shine. The EMS Authority seeks to recognize those individuals through California Emergency Medical Services Awards.

Nominations are now being accepted for praiseworthy acts or accomplishments that occurred between October 1, 2011 and September 7, 2012. The awards program honors special accomplishments, meritorious and heroic acts, innovations or fresh ideas to improve EMS in the state, or other unique and/or significant contributions by EMS personnel, physicians, nurses, EMTs, other medical providers, local officials, members of the law enforcement community, citizens, and first responders.

The nomination deadline for this year is September 7th. EMS providers, supervisors, and managers are encouraged to nominate any deserving individual for recognition. For additional information regarding award categories and to download nomination forms, please visit www.emsa.ca.gov/about/awards/default.asp or call Robin R Robinson at 916-322-4336, ext. 447. The luncheon ceremony will be held December 5, 2012 at Marines Memorial Hotel in San Francisco and will be conducted at no cost to the state.

Medal of Valor
Recognizes an EMT for acts of personal valor or heroism in the delivery of emergency medical care, which results in the saving of a life under extreme conditions and/or in extraordinary circumstances.

EMS Cross
Recognizes a uniformed EMT who by act and deed represents the most outstanding achievement or accomplishment in EMS over an extended period of time. This is the highest award that can be conferred in the absence of extreme conditions and extraordinary circumstances.

Distinguished Service Medal
Recognizes an individual for distinguished service or achievement affecting statewide EMS over an extended period of time. A maximum of ten Distinguished Service Medals will be awarded in any one year.

Meritorious Service Medal
Recognizes an individual for a meritorious act or service within EMS. This award also recognizes an EMT for an act that is above and beyond the call of duty in the course of a particular EMS emergency or event.

Lifesaving Medal
Recognizes an EMS provider who, while in an off-duty or volunteer capacity, makes an extremely noteworthy contribution to efforts which result in the saving of a life.

Community Service Award
Recognizes an EMT who has made an outstanding commitment to non-patient care aspects of a community's EMS system. Special emphasis is on EMS Public Information, Education, and Relations. A maximum of ten Community Service Awards will be conferred in any one year.

Inter-service EMS Recognition Medal
Recognizes outstanding heroism, extraordinary service, or achievement of non-EMTs (police officers, firefighters, lifeguards, dispatchers, and other public or private safety officers) for outstanding or exceptional support of a particular EMS emergency, event or operation.

Civilian Award for EMS
Recognizes a civilian (non-certified, non-health care provider) who provides extraordinary service during the course of an EMS emergency. Awards are relatively based upon the degree of patient outcome, extreme conditions, or extraordinary circumstances.

EMT of the Year Award (3)
Honors an EMT-I, AEMT and EMT-Paramedic, each of whom is exemplary in his/her quality of patient care and/or dedication to their community. Any statewide certified EMT-I or EMT-II, and any licensed EMT-Paramedic is eligible. Nominations may be made by anyone. Describe the nominee's qualities and contributions to the local EMS service or system. Letters of support from fellow EMTs, local EMS directors, and local officials will be weighed heavily.

EMS Educator of the Year Award
Honors an EMS educator who excels as a teacher or who has made a significant contribution to the EMS education program in the state.

EMS Medical Director of the Year Award
Honors a physician who serves or has served the EMS system by providing medical direction, on-line or off-line, and who has made a special contribution through systems development, continuing education, quality assurance, medical community liaison, etc.

EMS Administrator of the Year Award
Honors an EMS system administrator who has distinguished him or her self through noteworthy contribution to a local, regional, or to the statewide EMS system.


NREMT Bridge Training Guidelines

By Adam Morrill and Laura Little, EMS Personnel Standards Division

NREMT

In 2007, the National Highway Transportation Safety Administration (NHTSA) released updates to the National EMS Scope of Practice Model relating to certification standards. The updated standards reflect a national effort to establish uniform scope of practice criteria for paramedics and emergency medical technicians nationwide. Beginning this year, the National Registry of EMTs is transitioning its educational requirements to reflect the new standards.

Newly certified or licensed EMTs and paramedics will not be affected by this change because they will already have been trained to the new standard before taking the exam; however any current EMT or paramedic who wishes to maintain National Registry certification must take a transition course to learn the new material. Completion of a transition course is not necessary to maintain California EMT certification or paramedic licensure.

EMSA has developed a transition course curriculum to assist local EMS agencies in developing policies to approve transitional training and certification programs that are in compliance with the new national scope of practice models. EMTs must complete the transition course by March 31, 2016 and paramedics by March 31, 2017. Previously, California EMT-IIs were not nationally registered so they are not impacted by the change.

The suggested transition course curriculum was developed in coordination with various stakeholders, including EMS educators, local EMS agencies and other interested parties. Additionally, the suggested curriculum relies heavily on the work produced by the National Association of State EMS Officials (NASEMSO) in their gap analysis of the differences between the prior National Standard Curricula and the new National Education Standards.


Neonatal Pediatric Disaster Coalition

By Pat Frost, RN, MS, PNP, Director Contra Costa Emergency Medical Services and Cynthia Frankel, RN, MN, Co-Chair, CA Neonatal / Pediatric Disaster Coalition

On June 7th, Alameda and Contra Costa County EMS, in collaboration with EMSA, sponsored a successful conference with representatives from throughout the state working on the next steps for supporting neonatal and pediatric disaster preparedness throughout our medical health system. Read about it in this press article.

The coalition would like to thank the strong partnerships that helped make this such a success including Dr. Howard Backer and Dr. Farid Nasr from EMSA, Dr. Marianne Gausche-Hill and Dr. Ramon Johnson from California EMSC, California Hospital Association Disaster Leadership, Community and Mental Health Coalition Experts, Oakland Children's, Lucile Salter Packard Children's Hospital, U.C. Davis, Loma Linda University Medical Center, physician and nurse leadership.

Outstanding presentations and discussions filled the entire day. Our deepest thanks go to Alameda County EMS who again took the lead in coordinating the conference. The California Neonatal Pediatric Disaster Coalition would also like to acknowledge our other outstanding speakers and engaged participants!

If you missed the conference, the materials are available here or on our Coalition googlesite here.

The California Neonatal Pediatric Disaster Coalition is a grass roots network committed to supporting local medical/health system preparedness for children by putting disaster resources for infants and children "within your reach." Please share this information with interested parties.


Hospital Incident Command System (HICS)

The revision of the Hospital Incident Command System is now underway, with an estimated release of new materials in late fall or early winter of 2012. A series of Frequently Asked Questions (FAQs) will be released to provide insight into the process and the proposed revisions.

HICS is an incident management system based on Incident Command System (ICS) principles, which assists hospitals in improving their emergency management planning, response, and recovery capabilities for unplanned and planned events. HICS is consistent with ICS and the National Incident Management System (NIMS).

HICSThe current version of HICS has not been revised since 2006; the updated version will include new terminology, updated incident action planning forms and provide better interoperability for multi-agency coordination.

The HICS Center for Training and Education has been contracted by the California EMS Authority to coordinate the revision process. The HICS Center Board is comprised of members from the 2006 National Work Group who crafted the HICS version being updated. Personnel from the American Hospital Association, Joint Commission, Department of Homeland Security, Department of Health and Human Services, and Department of Veteran Affairs are also participating in the review process. A secondary review group comprised of nearly 80 health care professionals from across the country will review and make recommendations on the draft materials devised by the Center.

Some of the changes or additions to the HICS revision include development of an incident planning guide and incident response guide for active shooter, a revised Hospital Incident Management Team/HICS Organization Chart to consolidate some positions such as having only one Food Unit Leader, a new Job Action Sheet for Ham Radio Operators, and a new HICS 201-S Incident Briefing (Short) Form that consolidates key information into one form.


Regulation Revision Update

By Sean Trask, EMS Personnel Standards Division

EMT Regulation Revisions:
The proposed revisions to the EMT regulations were approved by the Commission on EMS on March 21, 2012 and submitted to the Office of Administrative Law on July 11, 2012. The EMS Authority anticipates that the EMT regulations will become effective in mid-September. The proposed changes include the following:

  • Incorporate the National EMS Education Standards for EMT basic training;
  • Increase the required EMT basic course hours from a minimum of 120 to 160 hours (136 hours of didactic training and 24 hours of clinical experience) and the minimum number of patient contacts from 5 to 10;
  • Amend the scope of practice to mirror the National EMS Scope of Practice Model;
  • Clean-up sections of the regulations to provide more clarity.

Advanced EMT Regulation Revisions:
The proposed revisions to the AEMT regulations were approved by the Commission on EMS on March 21, 2012 and submitted to the Office of Administrative Law on July 11, 2012. The EMS Authority anticipates that the AEMT regulations will become effective in mid-September. The proposed changes include the following:

  • Incorporate the National EMS Education Standards for AEMT basic training;
  • Increase the required minimum AEMT basic course hours from 88 to 160 hours (80 hours of didactic instruction, 40 hours of clinical experience, and 40 hours of field internship);
  • Amend the Scope of Practice to mirror the National EMS Scope of Practice Model;
  • Clean-up sections of the regulations to provide more clarity;
  • Update sections pertaining to Base Hospital accreditation and base coordinator requirements.

Paramedic Regulation Revisions:
The proposed revisions to the Paramedic regulations were approved by the Commission on EMS on June 20, 2012 and submitted to the Office of Administrative Law on August 1, 2012. The EMS Authority (EMSA) anticipates that the Paramedic Regulations may become effective in mid-February 2013. The proposed changes include the following:

  • Addition of the Critical Care Paramedic: scope of practice, training requirements, and certification requirements.
  • Amend the basic scope of practice for consistency with the National EMS Scope of Practice Model and to move a number of commonly approved local optional scope of practice items into the basic scope.
  • Update sections pertaining to Base Hospital accreditation and base coordinator requirements.
  • Clean-up sections of the regulations to provide more clarity.

Licensure Renewal Videos Help Prevent Common Mistakes

By Priscilla Rivera, EMS Personnel Standards Division

Video

The Paramedic Licensure Unit has created three useful informational videos that will help paramedics avoid common application errors and licensure delays. Using a combination of volunteer staff, PowerPoint and some ingenuity, these videos have been made available to the general public through the EMS Authorities’ YouTube channel. The videos identify commonly made mistakes and offer tips for avoiding them.

“We do our best to help the medic’s get their licenses back as soon as possible,” Paramedic Licensure Unit Manager June Leicht said. “This is just one of the newest tools we offer.”

Recently the Unit had a chance to see just how helpful the videos are when Medic Gerardo Martinez stopped by the office. Medic Martinez was on a trip from LA to Oregon when he decided to watch our videos. As he watched he realized there was an error on his application. His quick response saved him what could have been weeks of delays on his application due to a very common mistake. We hope all medics who watch this video get as much useful information as Medic Martinez did.

“The video is very helpful because I knew right away what I did wrong. It was easy to follow and really helped me out,” Medic Martinez said.

The three new informational videos include:

  • Initial In-State Informational Video (Covers questions regarding applications for medics applying for the first time and trained in the state of California)
  • Initial Out-of-State Informational Video (Covers questions regarding applications for medics applying for the first time and trained in outside the state of California)
  • Renewal Informational Video (Covers questions regarding issues found with renewal applications)

Recent statistics show the number of applications being sent back averaged 13-14% a month, at an estimated cost to the department of $3,500. Through the videos and other steps taken by the Licensure Unit the department will be able to save money and reduce the number of applications returned. The videos can be found at the EMS Authority YouTube channel: http://www.youtube.com/user/EMSAuthority.


EMS on the Fireline

FIRESCOPEFire season is fully underway in California and across the U.S. It goes without saying that wildland firefighting is dangerous work, so it’s critical that medical care be immediately available on the fireline. This requires specially trained personnel who can provide temporizing medical care in an austere environment under extreme conditions.

Since 2000, the duty position of Fireline Emergency Medical Technician (FEMT) has been a part of the Incident Command System (ICS) available to be ordered as a resource at the direction of the incident commander. In 2009, FIRESCOPE approved the position manual for Fireline Emergency Medical Technician-Paramedic (FEMP).

“FIRESCOPE has been working on the fireline medic position for several years to formalize the delivery of advanced life support prehospital care in a wildland fire setting,” explained Mike Giannini, EMS Battalion Chief for Marin County Fire Department. He is also a member of the FIRESCOPE EMS Specialist Group which wrote the FEMP position manual.

The FEMP position manual provides the qualifications and requirements. Once an individual meets the requirements outlined in the position manual and they are approved by their fire chief, they can be assigned to an incident anywhere in the state.

Sharing resources among jurisdictions makes it possible to multiply available resources many times over when needed, but it also introduces complexity when licensing or certification, accreditation and local control are involved. Although paramedics are licensed by the EMS Authority at the state level, they must have authorization to practice from the local EMS medical director within the county where they are working.

For this reason, each LEMSA should have a written policy which provides a process for sending paramedics out of county expressly for FEMP assignments. Cathy Chidester, Los Angeles County EMS Administrator, represents the Emergency Medical Services Administrator’s Association of California (EMSAAC) on the FIRESCOPE EMS Specialist Group. “It’s critical for counties to understand this program and develop their policies to ensure that there is good medical director coordination when a medic is deployed in a mutual aid capacity,” she explained.

The Los Angeles County policy was used to develop a sample LEMSA Fireline Medic Policy. That document, along with the ICS position descriptions, training requirements and a sample LEMSA Fireline Medic policy, visit the FIRESCOPE EMS Specialist Group webpage at http://firescope.org/specialist-groups/ems/specialist-ems.htm


Bill Hartley Appointed to Health Program Manager II

HartleyEMSA congratulates Bill Hartley on his appointment to the position of Health Program Manager II in the Disaster Medical Services (DMS) Division. Bill will serve as the Assistant Chief of Operations for the division and his duties will include the oversight of the Response Resources Unit and the Response Personnel Unit as well as the management of the DMS budget and grants. Bill has done an excellent job as the Response Resources Unit Manager for the past three and a half years and, in addition, has taken on an increasing role in the grants management process.

Bill is a licensed vocational nurse and joined EMSA five years ago as a health program specialist in the plans and training unit. Prior to joining EMSA, Bill worked as a medical technical assistant with the Department of Corrections where he coordinated medical logistics, which proved valuable as EMSA began developing logistics for the state’s Mobile Medical Assets Program.

Bill’s professional history also includes 24 years as a volunteer firefighter for the cities of Rocklin and Lincoln, working as an emergency medical technician for a private ambulance provider in Placer County, and working as a dispatcher for the Lincoln Police Department.


Bryan Hanley Receives NDMS Outstanding Achievement Award

HANLEY

Bryan Hanley, who serves as a member of EMSA's Regional Disaster Medical Health Specialist Program from Region I, was recognized for his outstanding achievement from the newly appointed Director of the National Disaster Medical System (NDMS), Dr. Andrew Garret, during the awards ceremony at thi s year’s United States Department of Health and Human Services Integrated Training Summit held in Nashville, TN in May.

Bryan is a member of the EMSA’s Regional Disaster Medical Health Specialist Program serving California’s Mutual Aid Region I. Bryan received the NDMS team award for his service as the Administrative Officer and Paramedic for the California-1 Disaster Medical Assistance Team (DMAT CA-1). Bryan has worked in EMS for over twenty years, eight of those years he has served on the disaster response team. As a member of DMAT CA-1, Bryan has deployed to Hurricane Katrina, the 2007 Florida Hurricanes, and various Gulf Coast Hurricanes and has supported deployment to numerous National Security Events.

EMSA is proud to have team members like Bryan serving on the NDMS and other response teams.


Priscilla Rivera Named EMSA Employee of the Quarter

By June Leicht, EMS Personnel Standards Division

Priscilla(Priscilla at left)

EMSA is proud to announce that Priscilla Rivera has been selected by her peers as the Employee of the Quarter. Priscilla is a management services technician in the Paramedic Licensure Unit and has worked for EMSA for a year and a half. Priscilla processes paramedic renewal applications, writes policies and procedures, maintains workload statistics, creates flow charts for various work processes, and works on special projects for EMSA's Licensure Unit.

Priscilla has a can-do attitude and provides excellent customer service to medics, her co-workers, and to representatives from other government agencies. After seeing the high number of deficiency letters being sent out, Priscilla suggested the creation of informational videos to help the medics. With the help of other EMSA staff, Priscilla created three different videos to assist medics in completing their applications. The videos identify common mistakes made on licensure applications and give tips to avoid them. Watch the videos here www.youtube.com/user/EMSAuthority.

In her effort to expand her knowledge and skills, Priscilla participated in EMSA's Golden Guardian Exercise in June and worked with emergency response representatives from throughout California. She holds a bachelor of arts degree in journalism from Chico State University and a master’s of science degree in public relations from Syracuse University.

Outside of work, Priscilla has earned her diving certificate and has discovered a love for white water rafting. She enjoys reading, figuring out puzzles and is always willing to help a friend. Recently, she participated in the Race for the Cure in Sacramento with her Manager, June Leicht. She is also joining her niece’s team “Chloe’s Army of Elves” to raise money for the Arthritis Foundation’s Jingle Bell Run in Seattle. Priscilla’s niece was diagnosed with Juvenile Arthritis when she was just 18 months old. Since then Priscilla and her family have been active in advocating Arthritis research. Her pleasant and supportive attitude has made her an excellent Employee of the Quarter. Thanks Priscilla for all your hard work!


EMSA Partners with U.S. Dept. of Veterans Affairs To Tackle Homelessness

By Adam Willoughby, EMS Authority Executive Division

Transitioning from military service to civilian life can be a very difficult process, resulting in homelessness for some service members. Numbers show that veteran homelessness is a national concern, with nearly 68,000 veterans going homeless on any given night in 2011.

Emergency medical personnel are uniquely positioned to help connect veterans with resources they may need because we interact with people in desperate situations every day. Therefore, EMSA is pleased to partner with the US Department of Veteran’s Affairs (VA) to help spread the word about a VA initiative designed to connect veterans with resources they need.

Through the Homeless Veterans Initiative, the VA has committed $800 million in FY 2011 to strengthen programs that prevent and end homelessness among Veterans.

In the course of rendering patient care, ask the patient if he or she is a veteran. If so, and if it appears that they may need more than medical help, simply give them an item containing the VA’s phone number.Vets

You can request cards, brochures, hats, bags, bandanas and many other give-away items for free from the VA and they all carry the message that the VA has resources to help veterans who are homeless or who are at risk of being homeless. Order at www.va.gov/homeless/materials_center.asp#giveaway

EMSA encourages local EMS providers to recognize their unique position to help veterans in need. Take advantage of the free resources provided through the VA and keep a supply of materials on-hand to distribute at every opportunity. If you have any questions about the program, email VAHomeless_Veteran_Outreach@va.gov.


Rattlesnake Bites at 12 Year High in California

By Adam Willoughby, EMS Authority Executive Division


As an EMS professional in California, it is important to be aware of the fact that rattlesnake bites are on the rise. According to the California Poison Control System Executive Director, Dr. Stuart E. Heard, the number of calls into the California Poison Control System regarding rattlesnake bites is at a 12 year high, with a 48% increase over last year.

Snake Chart
Should you respond to a rattlesnake bite victim, follow these best treatment practices: (1) Calm and reassure the patient that they will be OK. While often painful, rattlesnake bites are rarely fatal in adults; (2) Wash bite area with soap and water; (3) Apply a cold, wet cloth over the bite; (4) Immediately transport patient to the nearest emergency facility for treatment.

Equally important for treating a rattlesnake bite victim is what NOT to do. Do NOT: (1) Apply a tourniquet; (2) Pack the bite area in ice; (3) Cut the wound with a knife or razor; (4) Use your mouth to suck out the venom; (5) Let the victim drink alcohol; (6) Apply electric shock.

If dispatched on a rattlesnake bite call, remember your emergency plan and best treatment practices. Calm the victim and transport to the nearest emergency facility. There is treatment available once the patient arrives.

As you speak with people throughout your communities, take the opportunity whenever possible to educate people about the increase in rattlesnake bites and inform them of these simple prevention techniques.

• Remind them hands, feet and ankles are the most common sites for rattlesnake bites.
• Never go barefoot or wear sandals when walking in the rough. Always wear hiking boots.
• Always stay on paths. Avoid tall grass, weeds and heavy underbrush where there may be snakes.
• Use a walking stick when hiking. If you come across a snake, it can strike the stick instead of you.
• Always look for concealed snakes before picking up rocks, sticks or firewood.
• Always check carefully around stumps or logs before sitting.
• When climbing, always look before putting your hands in a new location. Snakes can climb walls, trees and rocks and are frequently found at high altitudes.
• Never grab "sticks" or "branches" while swimming. Rattlesnakes are excellent swimmers.
• Baby rattlesnakes are venomous! They can and do bite. Leave them alone.
• Never hike alone. Always have a buddy to help in case of an emergency. Learn basic life-saving methods.
• Don't handle freshly killed snakes. You may still be bitten.
• Never tease a snake to see how far it can strike. You can be several feet from the snake and still be within striking distance.
• Don't keep rattlesnakes as pets. The majority of rattlesnake bites occur when people (usually intoxicated young men in their 20s) tease or play with their "pet" rattlesnake.
• Teach children to respect snakes and to leave snakes alone. Curious children who pick up snakes are frequently bitten.
• Always give snakes the right of way!

Emergency Medical Services Authority | 10901 Gold Center Drive | Rancho Cordova, CA 95670

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