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EMSA Dispatch February 2013



Director's Message: Howard Backer, MD, MPH, FACEP

Our California statute that created the EMS system requires data collection at the local and state level to be used to evaluate system operation and patient outcomes. The data systems required for these analyses have been slow to develop, but are finally mature at many LEMSAs. EMSA has been developing a system to collect EMS data from local EMS agencies, known as the California EMS Information System (CEMSIS), which is funded by a grant from the National Highway Transportation Safety Administration (NHTSA) through the California Office of Traffic Safety.

This year, EMSA received a grant from the California Health Care Foundation (CHCF) to begin using EMS data to develop measures that help to evaluate our EMS system and EMS patient care. The grant is also helping to evaluate the EMS data in CEMSIS with the goal of using this system to increase the accessibility and accuracy of prehospital data for public, policy, academic and research purposes, as well as to facilitate EMS system evaluation and improvement.

Core measures are standardized performance measures or quality indicators that examine elements of the EMS system or treatment provided for specific patient conditions. The measures are based on scientific evidence on procedures and treatments that have demonstrated benefit in the management of a medical condition or illness. Core measures help emergency medical services systems improve the quality of patient care by focusing on the actual results of care.

The medical community has been focused on measuring and comparing results for several decades. Hospitals, managed care organizations, and physician groups must regularly report key measures of treatment, complications, health outcomes, and system processes to various regulatory organizations or evaluation agencies. Most of these measures are publicly available to allow providers to compare their performance to their peers and to allow purchasers and consumers to make informed choices. EMS has lagged far behind the rest of the health care system in measuring performance and patient outcomes and to compare these measures between provider agencies and administrative agencies. EMS performance is currently measured by most local agencies and performance measures are written into the quality evaluation of regional systems of care such as trauma, STEMI, and stroke, which all have time limited protocols that begin in the field and extend into the emergency department and hospital. While several national organizations have proposed measures, none have yet advocated them as national level recommendations or requirements.

The California EMS Core Measures were derived largely from a set of quality indicators developed through a project by the National Quality Forum. Additionally, our core measures were influenced by the NHTSA Performance Measures for emergency medical services. These California core measures will begin to benchmark the performance of EMS systems and the performance of recommended treatments that have been demonstrated to achieve the best results for patients with specific medical conditions. Data to determine these measures will be taken from the prehospital patient care records and results converted into a percentage. The aggregate measures will allow comparison of LEMSAs and provider agencies, but not comparison of individual EMS personnel.

The core measures will evaluate performance in different areas, including:

  • EMS Response and Transport
  • Trauma Care
  • Heart Attack/Acute Myocardial Infarction Care
  • Cardiac Arrest
  • Stroke Care
  • Respiratory Care
  • Pediatric EMS
  • Skill Performance by EMS Providers

Some of the process measures of interest in many of the measures are:

  • Arrival at the scene in a timely manner
  • Timely, focused patient assessment
  • Delivery of time-sensitive prehospital therapy
  • Transport to a hospital capable of providing necessary care

The California core measures were developed by a task force consisting of key data and quality leaders from local EMS agencies, medical directors, hospitals, and prehospital EMS providers. This task force will continue work to refine and improve the measures as initial results are obtained, and they may add measures or drop measures on an annual basis. Members of the data and quality task force are:

  • Daniel Smiley, Chief Deputy Director, EMSA
  • Tom McGinnis, EMS Division Chief, EMSA
  • Teri Harness, EMS Assistant Division Chief, EMSA
  • Adam Davis, Staff Analyst, EMSA
  • Joe Barger, MD, Medical Director, Contra Costa County EMS
  • David Chang, MD, Surgeon, UC San Diego Medical Center
  • Cathy Chidester, RN, Director, Los Angeles County EMS
  • Craig Stroup, Quality Improvement Coordinator, Contra Costa County EMS
  • Karl Sporer, MD, Medical Director, Alameda County EMS
  • Jan Ogar, RN, Assistant Director, San Mateo County EMS
  • Laura Wallin, RN, Quality Improvement Coordinator, Riverside County EMS
  • Dana Solomon, Program Director, California Ambulance Association
  • Dennis Carter, Clinical Education Services Coordinator, American Medical Response
  • Ric Maloney, RN, Quality Improvement Coordinator, Sacramento Metro Fire
  • Jason Vega, Santa Clara County EMS
  • Susan Mori, RN, Quality Improvement Coordinator, Los Angeles County EMS

The next step is to conduct three workshops for local EMS agencies across the state to implement improved data collection and reporting practices. The sessions are two-day workshops that will provide local EMS agencies, providers, hospitals and EMS technology vendors with information about the Core Quality Measures project. The workshops will cover how to interpret, implement, and report each individual core measure. Attendance by local EMS agency administrators, medical directors, data and quality improvement staff is highly recommended.

The dates for the workshops are:

  • February 27 & 28, 2013: Sacramento - EMS Authority.
  • March 6th & 7th, 2013: Santa Fe Springs - LA County EMS Agency.
  • March 11th & 12th, 2013: Concord – Contra Costa County Schools Insurance Group offices.

Any questions about the workshops should be directed to Teri Harness, Assistant EMS
Systems Division Chief, at, or (916) 322-4336, Ext. 462.

These core measures establish an initial baseline for performance that can be evenly compared across all parts of the EMS system. Ultimately, the project will highlight opportunities to improve the quality of patient care delivered within our California EMS system.

Changes to California Commission on Emergency Medical Services

Governor Jerry Brown made the following three appointments on December 19, 2012.

Mark Hartwig, 49, of Rancho Cucamonga, has been appointed to the California Commission on Emergency Medical Services. Hartwig has been fire chief at the San Bernardino County Fire District since 2011. He served as battalion chief and deputy fire chief at the Rancho Cucamonga Fire District from 2005 to 2011 and served in various positions at the San Bernardino County Fire Department from 1992 to 2005, including fire captain. Hartwig is a member of the California Fire Chiefs Association and serves as president of the Emergency Medical Services Section. This position does not require Senate confirmation and there is no compensation. Hartwig is a Republican.

Joy Stovell, 46, of Stockton, has been appointed to the California Commission on Emergency Medical Services. Stovell has been a fire engineer and paramedic for the Contra Costa County Fire Protection District since 1997. She was an office administrator at Cambridge Systematics Inc. from 1989 to 1997. This position does not require Senate confirmation and there is no compensation. Stovell is a Democrat.

Dave Teter, 46, of Cameron Park, has been re-appointed to the Commission, where he has served since 2010 representing the California Department of Forestry and Fire Protection (CAL FIRE).

The Commission on EMS supports the role of EMS agencies to ensure that patients have adequate access to quality emergency medical services, and to ensure the long term stability of these services. The Commission meets quarterly at locations around the state to provide advice to the Director of the California Emergency Medical Services Authority and to approve regulations, standards and guidelines developed by the EMS Authority.

Seats on the Commission on EMS are allocated to specific interest groups via state law in Health & Safety Code Section 1799.2 (a-q). Appointments are made on a staggered schedule established in statute in 1980 and each term is for three years. A commissioner may only serve two consecutive full terms. A commissioner may continue to serve in an expired appointment until a new appointment is made.

Would you like to know who's representing you? Click here for a current roster and more information on the EMS Commission.

EMSA Welcomes New Employees

Shelly Reyes is the new Office Technician in the Personnel Standards Division. Shelly comes to EMSA from a private preschool where she was an infant teacher for the last two years, and a co-preschool teacher for three years at Oahu Headstart. Previous to working with children, Shelly was a Staff Services Analyst at the California State Summer School for the Arts and was a Graduate Student Assistant for the California Department of Education.

Shelly will be working in the Child Care Unit, which approves and monitors first aid, CPR, and preventive health training programs for licensed childcare providers and will also act as support staff for the Enforcement Unit.

In her free time, Shelly enjoys spending time with family, reading and traveling.

Kristi McMahon is the new Administrative Manager in the Fiscal, Administration, and IT Division. She has a background in Finance and comes to EMSA from the Budget Office at Cal EMA. At Cal EMA, Kristi was trained in the standardized Incident Command System (ICS) and has participated in activation exercises at the State Operations Center. Her career in state service includes accounting and procurement functions and she prides herself in excellent customer service. If you have an administrative departmental need go see Kristi and her team.

Kristi loves spending her time with her husband and two sons, ages 6 and 9. They enjoy camping, sporting events, trips to their family home in Tahoe, and going to Disneyland.

Annie Luyen is the new Contract Analyst in the Fiscal, Administration & IT Division. Annie comes to EMSA from the CA Department of Corrections & Rehabilitation with five years of experience specific to contracts and procurement. Annie has held positions at the Office of Statewide Health Planning & Development and the Secretary of State where she worked her way up to an Associate Governmental Program Analyst from a Student Assistant.

Annie was born and raised in Oakland and enjoys spending time with her family in the Bay Area very much. Annie studied Forensic Science in New York and returned to California to obtain a B.S. in Criminal Justice. Annie is very excited to plan her upcoming wedding this Fall on September 1st.

EMSA Launches Permanent Photo Library

Do you have a great EMS-related photograph? Want to share it? Send it to us and we will add it to our new high resolution EMS Photo Gallery!

We have reserved space on our network and website that will be solely dedicated to cataloging and displaying EMS-related photographs. Send us your picture(s) and we will display it, along with others, on our Facebook page and our new website.

The publicly available, organically created library will clearly cite ownership and contact information for each image. For this to be successful, we need your help! Please, send us your pictures of heroism in action. Send us your pictures of compassion, of professionalism, of diversity, team work and education! In doing so, you will be helping to foster and encourage the best, most laudable and desirable qualities of those who serve as emergency response and prehospital personnel.

Send your pictures to Questions? Call (916) 431-3715.

Advanced Emergency Medical Technician with Introduction to Tactical EMS Training Classes Announced

Bill Campbell, Disaster Medical Services Division

The EMS Authority is excited to announce three AEMT with Introduction to Tactical EMS Training pilot courses. The first class was held at the Roseville National College of Technical Instruction (NCTI) campus on January 2nd. Classes will begin at the San Diego and Riverside NCTI campuses on January 14th. The three complimentary pilot courses are funded by Disaster Medical Services Division Homeland Security Funds in partnership with the California Emergency Management Agency. The AEMT with Introduction to Tactical EMS Training pilot courses include 96 hours of classroom instruction, 40 hours of hospital clinical training and 40 hours of field internship.

The AEMT with Introduction to Tactical EMS Training is being offered to advance the capabilities of the certified EMT to provide limited advanced life support in the tactical field setting. This would allow tactical EMTs to add limited advanced life support skills, including IV fluid therapy, advanced airway, and about eight common prehospital medications to their scope of practice. The AEMT student will become an important part of a tactical team and provide improved security and survivability for the entire team. Recent events such as the Colorado theater shootings and the Newtown, Connecticut shootings have served to reemphasize the need for this added security. Pilot course students are EMTs from the law enforcement community, EMTs affiliated with tactical teams and EMTs recommended by programs with tactical teams.

The standards for prehospital emergency care and the people who provide it are governed by the laws in each state. The people who provide emergency care in the field are trained and, except for licensed physicians, must be state licensed or certified EMS personnel. Providers are categorized into three training and licensure/certificate levels in California: Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT) and Paramedic levels. Effective September 12, 2012, AEMTs in California are certified using National Registry examinations. The National Registry of Emergency Medical Technicians Advanced EMT written and skills examinations are now the certifying examinations for the AEMT. Additionally, the course will introduce the student to the basic medical principles and procedures found in the Tactical Casualty Assessment and Treatment Model as detailed in the Peace Officer Standards and Training/EMS Authority Tactical Medicine Guidelines.

The EMS Authority would like to thank the Sierra-Sacramento Valley EMS Agency, San Diego County EMS Agency and Riverside County EMS Agency for their support of this project and granting approval of the training programs in their jurisdictions.

The EMS Authority believes AEMTs and AEMTs with Tactical Training will greatly improve the emergency medical response in California and will provide safer and more secure tactical and emergency medical responders.

2013 EMS Law Books Now Available

This year's law books are now available. Click here to complete a request form. Limit 5 per person.

New Mobile App Aims to Prevent Elder and Dependent Adult Abuse

One in 10 older Americans experiences abuse or neglect each year, and the number of reported cases is growing at a time when resources necessary to properly respond are shrinking.

To assist California law enforcement and EMS personnel in dealing with this problem, the UC Irvine Center of Excellence on Elder Abuse & Neglect has partnered with the Bay Area’s nonprofit Institute on Aging to develop a mobile app called 368+ Elder & Dependent Adult Abuse Guide for CA Law Enforcement.

“We want to provide law enforcement agencies and emergency first responders with a ‘cheat sheet’ about the signs of elder abuse and neglect, the penal code and other resources,” said Dr. Laura Mosqueda, Chair of UC Irvine’s Department of Family Medicine and Director of the university’s geriatrics program and Center of Excellence on Elder Abuse & Neglect.

Some of the app’s features include:

  • Warning signs of abuse, neglect and financial exploitation – what to look for in the home environment, caretaker behavior, senior or dependent adult with a disability;
  • An easy-to-reference summary of California Penal Code 368 (concerning the abuse of elder and dependent adults) and other common crimes/charges that may accompany a PC 368 arrest;
  • Quick tips on memory loss, people with dementia as witnesses, documenting the caretaker’s role, and assessing such injuries as bruises and pressure sores;
  • Agency contacts for cross-reporting and victim assistance;
  • Short training videos; and
  • A way to sign up for bimonthly elder abuse news.

The app is available for download at no cost and it is designed to run on iPhone, iPad and Android operating systems. It is also viewable on mobile HTML5 web browsers at this link. Visit The Center of Excellence on Elder Abuse & Neglect’s website for additional information about the center and app details.

California Trauma and Resuscitation Conference

The fourth Trauma Summit was sponsored by the UC San Diego Center for Resuscitation Science and the UC San Diego Division of Trauma as part of the 3rd Annual California Trauma and Resuscitation Conference. The Summit was presented as an afternoon session on the first day of the conference and was very well attended. Dr. Robert Mackersie, Professor of Surgery at San Francisco General and Chair of the State Trauma Advisory Committee, began the Summit with a “State of the State Trauma System” for California. The goals of the state system were presented and how all system participants will work towards meeting these goals:

  • Providing timely access to trauma care throughout the ‘system’
  • Promoting the delivery of optimal trauma care throughout the continuum
  • Improving community health & wellness

Some key activities to be explored include:

  • ‘Buddy’ system of acute care facilities with ‘send’ & ‘keep’ protocols
  • Focused Performance Improvement with TQIP – like process
  • Development of guidelines / best practices within local and regional programs
  • Mapping & monitoring access to care for the development of an inclusive system
  • Stable funding the system
  • Data management for research & development
  • Discharge destination & long term outcomes

Other Trauma System presentations included:
Access to Care-A Study of California by Dr. Renee Hsia, Department of Emergency Medicine at San Francisco General Hospital. This presentation brought to light thought-provoking data (from OSHPD 2005-2009 data reflecting serious trauma with ISS>15) illustrating initial triage and re-triage to Trauma Centers as well as data showing the percent of patients who were admitted to a Non-Trauma Center.

Field Triage and Re-triage – Obstacles and Solutions by Dr. James Davis, Clinical Professor of Surgery, UCSF and Steven N Parks, Endowed Chair-Surgery UCSF/Fresno. Dr. Davis’ talk called for the development of a regional inclusive system with established primary and secondary (re-triage) guidelines to improve access and system efficiency.

Trauma Center Assessment – Does one size fit all? By Cathy Chidester, Director LA County EMS Agency and Lynn Benninck, Trauma Coordinator Community Regional Medical Center-Fresno. This presentation focused on the need for a standardized process for Trauma Center designation/redesignation based on a specific set of standards and outcome measurements.

CEMSIS and Trauma System PI “How does California develop a TQIP-Like Program” by Dr. Gill Cryer, Trauma Director UCLA Medical Center. The development of a statewide program encourages implementation of best practices, creates a competitive edge in an era of public reporting, and demonstrates commitment to performance improvement.

Regional Trauma Coordinating Committee Showcase was an opportunity for each of the RTCCs to report on current regional projects that have statewide implications.

The Summit closed with an address from Dr. Howard Backer, Director EMS Authority. Dr. Backer confirmed EMSA’s support of a State Trauma System and challenged our trauma partners to go forward in creating such a system with support for regionalization, data, and performance improvement activities. An Open Forum – "Where do we go from here?" provided all the participants to provide input on where they believe we should go from here. All comments are being compiled and will be placed on the EMSA website including all the PowerPoint presentation.

Stay tuned for Summit V!

Hospital Incident Command System (HICS) Revision Update

The revision of the Hospital Incident Command System is now underway, with an estimated release of new materials in early spring of 2013. A series of Frequently Asked Questions (FAQs) continue to be released to provide insight into the process and the proposed revisions.

HICS is an incident management system based on principles of the Incident Command System (ICS), 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) principles.

The 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 Emergency Medical Services Authority (EMSA) 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, the Joint Commission, the United States Department of Homeland Security, the United States Department of Health and Human Services, and United States Department of Veteran Affairs are also participating in the review process. A Secondary Review Group comprised of nearly 60 healthcare professionals from across the country have reviewed and made recommendations on the draft materials developed by the Center. EMSA expects to begin review of the new materials by February 1, 2013.

Some of the changes or additions to the HICS 2013 Revision include development of an Incident Planning Guide and Incident Response Guide for Active Shooter and Tornadoes, the re-naming of the Incident Management Team to Hospital Incident Management Team (to avoid confusion with Federal Incident Management Teams), a new appendix on Small/Rural/Off Hours Healthcare Facilities, and a new HICS 201-S Incident Briefing (Short) Form that consolidates key information into one form.

Drinking and Driving is an EMS Career Killer

By Jerry Allison, MD, MS, NR-P

The EMS Authority has statutory authority and an obligation to protect the health and safety of the public. More importantly, we care about our workforce. We care about retaining you as a licensed EMS professional for the duration of your qualification and desire to practice. Getting arrested and convicted of driving under the influence of alcohol or other drugs puts your future at risk.

But why should something I did while off duty on my own time affect my ability to work, you ask? The courts have clearly affirmed the relationship between EMS off-duty actions and on-duty responsibilities. Driving under the influence is believed to demonstrate lack of sound professional and personal judgment relevant to an individual’s fitness to perform duties of a paramedic or EMT. According to California Health and Safety Code, division 2.5, section 1798.200, the following acts shall be considered evidence of a threat to the public health and safety and may result in the denial, suspension, or revocation of a certificate or license issued under this division...and includes, but is not limited to:

  • Conviction of any crime which is substantially related to the qualifications, functions, and duties of prehospital personnel;
  • Addiction to, the excessive use of, or the misuse of, alcoholic beverages, narcotics, dangerous drugs, or controlled substances.

Here are some facts:

  • More than 50% of all the enforcement actions taken by the EMS Authority against paramedic licenses are for alcohol-related arrests;
  • Driving under the influence can result in revocation of your paramedic license or EMT certification. At minimum, you will be required to undergo substance abuse assessment by a licensed addiction specialist and face licensure probation and/or other penalties;
  • If a paramedic is arrested, the EMS Authority is automatically notified. If an EMT is arrested, the certifying entity and the EMS Authority are both notified.

The usual sequence of events after a paramedic is arrested goes like this:

  1. A DUI arrest is reported to the EMS Authority and an investigation is initiated;
  2. If conviction is reached by the prosecuting court of jurisdiction, the EMS Authority makes a disciplinary decision;
  3. An evaluation and assessment by a licensed addiction specialist (CSAM) is often made a part of the decision. After a CSAM the licensee may be cleared back to work or the expert may determine that a problem exists and further evaluation and/or treatment is necessary. If a licensee fails to obtain a CSAM then further disciplinary action may be taken which could include suspension and/or revocation of one’s license;
  4. The licensee will be placed on probation and may also be ordered to abstain from alcohol and/or undergo periodic random drug and alcohol testing. Incidentally, there is a new test available that can detect alcohol use greater than 72 hours (EtG-Ethylglucuronide), so immediate testing is not required;
  5. If a licensee does not agree with the disciplinary action, he or she may request a hearing with an Administrative Law Judge (ALJ). After the hearing the ALJ issues a proposed decision to uphold, dismiss, or modify the EMS Authority’s decision. The Authority may adopt or modify the proposed decision, or decide the case itself upon the record.

A DUI affects more than just your career. When you are the subject of a DUI arrest and conviction you will be subjected to days lost from work and to loss of income. You may face fees to tow your vehicle, fines from the courts, attorney's fees, and an increase in your automobile insurance premiums or even risk losing your insurance. You may experience a loss of trust from your family or your employer. You may lose your driver's license and ability to travel to work. Many employers will not allow you to work without a valid driver's license. You may also face the devastating emotional and financial consequences of having injured or killed another human (or animal).

EMS professionals are given a tremendous responsibility in caring for the public in the unique environment of the patient’s home, public and private locations, and in the back of an ambulance where the public expects a safe transport to their destination with competent, sober professionals. We are expected to maintain a higher standard than the public and even other health professionals when it comes to operating vehicles under the influence of drugs and/or alcohol.

At the same time, DUI occurs far too commonly among EMS personnel. For one thing, EMS providers tend to skew younger, corresponding with the fact that as many as 65% of DUI arrests involve people under age 30. EMS graduation parties prematurely end the careers of many prospective EMS professionals. An added factor is the pressure of the job; EMS is a demanding profession with a high potential for psychological and physical stressors, which some people manage by self-medicating with alcohol or other drugs.

It should be no secret to most that the first DUI arrest is often not the individual’s first incident of driving while intoxicated. It has been estimated that by the time a person is arrested for DUI they have had multiple episodes of DUI. Don’t wait for an arrest to be your wake-up call. If you find that your drinking is affecting your life at all, or you are unable to control your alcohol use or refrain from abusing legal or illegal drugs you should seek help immediately through your Employee Assistance Plan or contact your primary physician for a referral. Denying that a problem exists or trying unsuccessfully to solve it in private leads to further abuse, costly legal battles, and harsher penalties. It is much better to self-report a problem than to face the consequences of an accident or arrest.

If you have a colleague who may have a substance abuse problem, take care of your own – not by covering, but by helping them see and address the problem before they get into trouble. Offer help, refer them to someone that can help them, or report them to someone that can offer help. We should pay attention to each other and identify patterns that may suggest a problem before there are consequences. Look for:

  • More frequent absences and tardiness
  • Performance or conduct problems
  • Behavioral changes/reactions
  • Difficulty getting along with people
  • Sloppy or incomplete work
  • Forgetfulness, excuses for everything, and incessant apologies
  • Frequent accidents or near misses
  • Less concerned about the safety of themselves & others

As EMS Administrators, medical directors, leaders and supervisors, we have an obligation to our patients and to our workforce to be proactive in addressing this problem. We must create a culture that both educates providers about substance abuse and poor decision-making and makes it easy for an individual to come forward for help.

We cannot believe that having EAP available is enough. We must be observant and identify potential risks, educate our workforce about this problem, and provide an environment that makes it ok to seek help. This will keep our employees, our workforce and our organizations safer.

2012 EMS Awards Ceremony Wrap-up

By Adam Willoughby
Photos by Art Hsieh

Thirty nine medical services providers, associates and civilians were recognized by the Emergency Medical Services Authority for exceptional acts of bravery and service to their communities and the state over the past year.

This year’s Awards Ceremony was the largest yet, with over 200 registered attendees from across the state. The EMS Awards honor noteworthy or exceptional acts and service while working as EMS certified or licensed personnel, administrators, trainers, or volunteers within the EMS system.

This year’s awards were presented to recipients by Dr. Howard Backer, Director of the EMS Authority and Mr. Matt Powers, Interim Chairman of the Commission on EMS. EMS Authority Chief Deputy Director, Dan Smiley served as the event’s emcee.

A complete list of award recipients is available here and photos of the event and award recipients are available here. We thank our partner, San Francisco Paramedic Association for their valuable assistance in planning the event. We also thank event sponsors American Medical Response and BoundTree Medical for their generous support.

Nominations for the 2013 Awards Ceremony are now being accepted. Click here for nomination forms and upcoming details regarding the 2013 ceremony.

Operation Escape
By David Smith, EMT-P

On November 15th, 2012, 48 members of the Sacramento based CALMAT team participated in Operation ESCAPE that was conducted at Mather Airfield in Sacramento County. This exercise was a training and readiness assessment evaluation of a CALMAT team to prepare multiple patients for medical air evacuation. 100 local high school students volunteered to be victims and were made up in full moulage. Injuries ranged from walking wounded to critical. All patients were given triage tags listing the full extent of injuries and this gave the rescuers the ability to update or change status of patients during the exercise. Western Shelter tents were erected at the airfield the day prior and CALMAT staff met with the air crew to establish operational guidelines and safety considerations. This event was also a training experience for the air crew members who staff the C-130 cargo aircraft. The aircraft and crew are part of the U.S. Air Force 94th Flying Samaritans based in Marietta, Georgia. The C-130 turboprop aircraft is specifically designed for medical evacuation. The aircraft is capable of
transporting 26 walking wounded in seats on both sides of the plane and 30 litter patients. 20 members of the 94th Flying Samaritans, some new to the unit, flew seven hours one way from their base just for this training.

On the day of the exercise, the moulaged patients were brought to the CALMAT tents and divided by the severity of their injuries into the appropriate tents. The aircraft was moved into position near the tents and all patients had their triage tag scanned using the JPATS system. This created a manifest of all patients to be given to the aircraft load master. Walking wounded are loaded first, followed by non-critical litter patients and critical patients are loaded last. This is done so that critical patients remain in the hospital environment as long as possible and are first off upon the aircraft reaching its final destination. Once the aircraft was fully loaded, the doors were secured and the aircraft taxied to another portion of the airfield where the patients were unloaded and sent to local hospitals based on injuries and hospital bed availability.

In post debriefing, all agencies involved agreed that the operation was a complete success. Only minor issues that needed to be addressed were found. The exercise provided excellent training and team bonding.

Farewell to June Iljana

We are sad to say farewell to a valued team member, June Iljana, Deputy Director Legislation, Policy & External Affairs, who has left EMSA to take on the new challenge of Executive Director of the California Ambulance Association, effective February 4, 2013.

While at EMSA, June was instrumental and passionate in her quest to drive EMS-related policy and legislation through the process. She spearheaded the creation, maintenance and distribution of EMSA’s e-newsletter, oversaw the production and distribution of the annual EMS Law Book, and she was the driving force that gave life to the EMS Awards Luncheons in 2011 and 2012. June was a admired member of the EMSA executive staff and her energy, expertise, and efficiency will be sorely missed. We at EMSA are grateful we had the opportunity to work with her for almost four years and wish her continued success in her new post.

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

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