MIEMSS. Report to Maryland State Firemen s Association. August 16, Robert R. Bass, MD, FACEP

Transcription

1 MIEMSS Report to Maryland State Firemen s Association August 16, 2009 Robert R. Bass, MD, FACEP

2 MIEMSS Executive Director s Update August, 2009 National Firefighter Health Week August The United States Fire Administration (USFA) encourages firefighters and fire departments to focus on health and wellness the week of August through participation in the Third Annual National Firefighter Health Week. The theme for this year is It takes a healthy heart, mind, and body to do what you do - Keep It Strong. National Firefighter Health Week is an initiative to educate the fire and emergency services community about a variety of health and wellness issues that affect first responders. The program encourages first responders to learn their risk factors and commit to making healthy lifestyle changes - not just during Firefighter Health Week - but throughout the year. For more information on USFA s firefighter health and safety initiatives, please visit EMS Links and Information Regarding H1N1 Flu (Swine Flu). The World Health Organization (WHO) announced that it has declared a H1N1 flu pandemic. They stressed that most cases are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities. Ordinary flu kills about 250,000 to 500,000 people each year. MIEMSS continues working with the CDC and other health related agencies to develop Swine- Origin Influenza A (H1N1) guidance specific for EMS and PSAPs. Please see the MIEMSS web site ( for updated information. The CDC has released recommendations for the H1N1 vaccine schedule and EMS providers are named in the first group of individuals that should be vaccinated when the vaccine becomes available. MIEMSS strongly encourages EMS providers to get vaccinated as soon as the vaccine is available. 1

3 Relocation of MSP Trooper 6. The Maryland State Police (MSP) Aviation Command has requested that the Maryland Emergency Medical Services (EMS) Board approve the relocation of Trooper 6 which would move the current MSP Aviation base located in Centreville to the Easton Airport. The potential for base relocation is possible due to fact that the MSP Aviation is assuming the aviation law enforcement responsibilities of the Department of Natural Resources (DNR). DNR is vacating its hangar at Easton which makes that space potentially available for use by the MSP Aviation. MSP believes this relocation could have significant safety advantages since the Easton Airport site has several runways for emergency landing, instrument landing systems, and air traffic controllers during much of the day. The EMS Board has directed MIEMSS to inform the public and to solicit public input regarding this proposed relocation. Two separate community meetings will be held to inform the public of this proposal and to solicit comments. The first meeting was held at 7:00 PM on Tuesday, July 7, 2009, at the Chester River Hospital Conference Room in Chestertown, Maryland. The second meeting was held at 7:00 PM on Thursday, July 9, 2009, at the Easton Volunteer Fire Department in Easton, Maryland. The EMS Board has tentatively approved the move. New Chief of Information Technology and Communications. David H. Balthis has been hired as the new Chief of Information Technology and Communications at MIEMSS. Dave recently retired from the Howard County Fire Department. He brings his many years of experience in IT and communications to MIEMSS. Dave has been a member of SEMSAC since 2005 representing the Emergency Numbers Board and was recently elected as the vice chair of SEMSAC. EMS Provider Medical Protocols 2009 Implementation. MIEMSS has provided one copy of the Maryland Medical Protocols for EMS Providers (Effective July 1, 2009) pocket protocols to all EMT-Bs, CRT-Is, and EMT-Ps currently certified or licensed in the State. The full version of the protocols can be viewed and downloaded from the MIEMSS website under Documents; Maryland Medical Protocols for EMS Providers (Effective July 1, 2009). Education Standards Committee. MIEMSS is forming an EMS education standards committee to review and prepare for implementation of the standards by 2011/2012. The committee will be comprised of representatives from volunteer, career, commercial, and educational programs and will review the standards, strategize how to implement the standards, as well as determine how best to implement the new levels in Maryland. The committee is scheduled to will meet soon and report its progress to SEMSAC and other interested groups. 2

4 Current Maryland EMS Providers. The total number of current Maryland EMS Providers is 26,894 as of August 1, 2009 (current, extended, jeopardy, military and inactive status) and distribution is as follows: EMD 949 FR 5,924 EMT-B 16,620 CRT EMT-P 2,515 SEMSAC BLS Committee. The BLS Committee is in the process of developing the curriculum for the revised EMT-Basic refresher course. The revised curriculum focuses on medical emergencies, the associated patient assessment, as well as interventions. The revised curriculum is expected to be rolled out to instructors and implemented this fall. Learning Management System (LMS) and Instructors' Corner. The Office of Licensure and Certification has successfully implemented an instructors' corner where BLS, ALS, EMD, and EMSC instructors can share educational resources including presentations, outlines, and other materials with other instructors, statewide. MIEMSS has implemented a learning management system (LMS) where protocol updates, continuing education, and other EMS educational content can be attended by EMS providers, statewide. The LMS uses Articulate.com software and allows for the asynchronous viewing of courses with a high degree of authenticity. The LMS currently has the 2009 protocol updates available online at the MIEMSS website ( There are two programs, one for BLS providers and another two-part presentation for ALS providers. Law Enforcement Emergency Medical Care Course. MIEMSS continues to work with the law enforcement community in fine-tuning an emergency medical care course with specificity and applicability to the law enforcement needs. The medical course contains core first responder content including CPR/AED, patient assessment, medical and trauma care, but also contains law enforcement-specific content such as Care Under Fire, with emphasis on self-care and fellowofficer care in a hazardous environment. Policies and procedures for the course have been completed and are being reviewed by the law enforcement community. 3

5 WebTG and Practice Analysis. MIEMSS, in collaboration with the Atlantic EMS Council has completed review of the new, web-based test generator to be used for all certification and licensure examinations in Maryland; as well as other Atlantic EMS States from North Carolina to New Jersey. WebTG allows for a centralized database of questions to develop psychometricallysound, legally defensible, and reliable examinations. MIEMSS is working with the Atlantic Council to conduct a practice analysis. The practice analysis is a methodical process to provide a snap-shot of the practices in the pre-hospital setting. Data from the practice analysis will be used to provide content validity for future certification examinations offered in the Atlantic Council. The practice analysis is due to be completed later this month. National EMS Education Standards and Instructor Guidelines Now Available. The National EMS Education Standards have been approved and posted on The corresponding Instructional Guidelines for Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced EMT (AEMT), and Paramedic are also posted. To download a PDF version of these documents, please go to click "Education" on the top red navigation bar and select "National EMS Education Standards" from the drop-down menu. Maryland is preparing to transition to the new levels and a subcommittee of SEMSAC is being formed to strategize and collaborate on achieving successful transition from the National Standard Curricula to the EMS Education Standards. Zoll AED Plus Defibrillator Recalled. Zoll Medical Corporation is recalling AED Plus Defibrillators that were manufactured between May 2004 and February Some of the batteries in these devices may not work properly, and the original self-test software cannot adequately detect defective batteries. These devices could fail to deliver a shock to a patient during sudden cardiac arrest. The affected devices have serial numbers whose last six digits are below If you have a device with such a serial number, you should upgrade the software to version The company says the new software will allow the defibrillators to monitor the performance of the batteries through periodic self testing. If the software detects defective batteries, the device will prompt users to install fresh batteries. The new software can be ordered or downloaded from the company. Additional Information: FDA MedWatch Safety Alert. Zoll AED Plus Defibrillator. April 9, s/ucm htm Zoll Medical Corporation. Zoll AED Plus Device Corrective Action. 4

6 Bystander Care Program. Work was completed on revising both the final exam and the evaluation form used in the class. Discussions were held with most of the companies that hosted classes during the pilot phase of the program. Several have agreed to host classes again for new employees and update those that attended previously on protocol changes. Meetings were held with two national organizations about becoming long term partners. Discussions were begun with a commercial driving school and if some issues can be resolved, this could lead to a large state-wide expansion of the program. Two classes were conducted for the truck driver training school at Hagerstown Community College and two were held at the State Highway District 6 Headquarters in LaVale. Regional Programs and Emergency Operations. Regional Health and Medical Committees. The Region III Health and Medical Taskforce continues to move closer to the deployment of an electronic patient tracking application that has been developed with FY 08 UASI funding. The purchasing process has also begun for two mass casualty support vehicles and an alternate care site. Announcement of the FY09 award is expected in mid June. The Region V Regional Hospital and Health Care Memorandum of Understanding regarding Mass Casualty and Disaster Situations has been reviewed and is being amended based on comments received from member hospitals. The goal is for this overarching agreement to be accepted Region wide and serve as a statewide template. The Spring Task Force meeting was cancelled due to increased activities surrounding the H1N1 response. Hospital Preparedness funds o The FY 06 projects are completed and are being closed out. o The FY 07 should be cleared for distribution shortly. Some additional justification was requested from the grantees and a 12 month extension was received. The projects were completed in July of o Region IV Hospital Preparedness Funds - Two FY 2007 grants have been updated with additional information and justification o FY 08 guidance was just released from HHS and the State application is being prepared. Planning for the next Annual Miltenberger Emergency Services Seminar has begun. Teamwork between the Region I Office, the local hospitals, and other local agencies and institutions continues to develop a supportive learning environment that encompasses Fire, EMS, EMD, and Nursing topics. Allegany and Garrett counties continue to implement SWOT recommendations, including development of a formal QA/QI program. With the impending combination of the Braddock and the Cumberland Memorial Campus s of the Western Maryland Health System in Allegany County, the regional council continues to assist in an advisory capacity, as well as finding resources necessary for the transition. 5

7 The Region III Office is managing a $1.2 million Public Safety Interoperable Communications Grants through which MIEMSS received funding to connect the remaining hospitals and 911 centers to the PSInet with VoIP phones. Site surveys and installations are underway statewide. The Region III Office, in coordination with the MIEMSS Communications Department, is nearing completion of a project to provide DEMSTel connectivity to all Region III Hospitals with funding provided by an Urban Area Security Initiative (UASI) grant. The Region V Office has coordinated the Centers for Disease Control inspections, restocking, and upgrades of all Chempack sites in the state. These site visits were conducted by CDC and Regional personnel. Ambulance strike teams are being considered by the EMS Focus group. They have a position paper they are circulating to several groups to get input and concerns. HC Standard software will be received in late Spring. This will host FRED and CHATS and add Patient Tracking. Transportation, Mass Casualty Supplies, and Nerve Agent Antidote supplies are being reassessed. A survey was sent to each jurisdiction to determine their capabilities and site visits will follow to discuss other priorities for emergency preparedness. A Federally-run Disaster Medical Assistance Team (DMAT) has been designated for Maryland. We are in the process of selecting leadership for that team. State run teams are also being considered. MEMA and MDE are in the process of reviewing mass decontamination capabilities and the availability of Personal Protective Equipment for adequacy and interoperability. The MIEMSS Regional offices are managing multiple projects throughout the state. For more information about any of the items listed below, contact your appropriate MIEMSS Regional office Regional Offices have received and are in the process of prioritizing FY10 50/50 Matching Grant applications. An electronic vehicle inspection application developed by Region III, SOCALR, and EMSC is in the field testing phase. Tablet PCs have been procured to run the application and will be used to conduct upcoming inspections. The Peninsula Regional Medical Center nineteenth Annual Trauma Conference Topics in Trauma is scheduled for August 28, 2009 at the Clarion Resort and Hotel in Ocean City Planning for the next Annual Winterfest Seminar has begun. The conference will be held January 28 31, The Somerset County SWOT continues to meet with county stakeholders to develop enhancements to EMS in the county. Updates and completion of the MIEMSS COOP plan are underway. The Roadway Incident Safety Program has been presented in four of the five Regions. Region V has begun to work with the Emergency Education Council on the fall Pyramid program to be held October 16-18, 2009 in Solomons, MD. Voluntary Ambulance Inspections are ongoing Statewide The Region IV Council Sub-Committee for Quality Assurance and Quality Improvement meets the first Monday of each quarter. 6

8 Emergency Medical Services for Children Program (EMSC). The EMSC program staff attended the June 2009 Mid Year meeting of the National Association of State EMS Officials and the EMSC Council, presenting a history of EMS & EMSC to the new managers from across the nation. June 2009 also included participation in the AAP Committee on Pediatric Emergency Medicine held in Annapolis and preparation for the NHTSA workgroup meeting in July on Safe Transport of Children in Ambulances. Work continues on the EMSC Partnership Grant focused on the ten Federal EMSC Performance Measures that have 2011 and 2017 target dates for achievement. The state Pediatric Emergency Medical Advisory Committee (PEMAC) 2009 meetings and subcommittee continue to use Go To Meeting web platform with the handouts, minutes and reference materials posted on PEMAC website. Specific activities will include Updating the Emergency response vehicle standards to meet the new recommendations from the American College of Surgeons, American College of Emergency Physicians, American Academy of Pediatrics and the National Association of EMS Physicians released on March 26, 2009; Develop pediatric emergency department criteria and categorization; Develop base station course focused for transport nurses and Interfacility transport environment; Continue pediatric education at regional and state EMS and Trauma conferences; Develop pediatric modules within BLS and ALS continuing education; Pediatric web casts for hospitals and EMS community; Develop pediatric data reports; Support activities of state PEMAC and Pediatric QI activities Development of a Family Advocacy subcommittee of PEMAC Maryland RISK WATCH Champion Teams coordinated Interactive Life Safety Skills Stations at the MSFA Convention in Ocean City in collaboration with the State Fire Marshal, Maryland State Fireman's Association Fire Prevention Committee, and Safe Kids Maryland Coalitions. Family educational display focused on Raising Safe Kids One Stage at Time with handouts and safety materials for parents along with a series of fire & life safety videos. The skills stations for children included: 9-1-1: Make the Right Call Get Out & Stay Out: Fire escape plans Poisons Act Quickly Find the Hazards inside and out (fire & electrical safety) Walk Safe- Cross Safe (School Bus, Pedestrian and Rail Safety) Alarms & Sprinklers Get Ready For Risk Watch developmental workbooks Burn & Scald prevention tools for the home More information on both life safety themes and family disaster preparedness are in the monthly updates that can be found at The Safe Kids Maryland Coalition June meeting included an update on the Railroad Safety program from Safe Kids USA and presentations from Safe Kids Walk This Way and the Maryland Highway Safety Office Safe Routes to School programs. Meetings, agendas and minutes are posted on the expanded website along with state and national resources for injury 7

9 prevention Maryland Safe Kids membership forms are available from the EMSC Office The Child Passenger Safety (CPS) & Occupant Protection Healthcare Project: Poster session from 2009 Life Savers national conference was presented at the June Safe Kids Maryland & Occupant Protection Task Force meetings June 29 th 2009 CPS Conference calls focused on the risk of hyperthermia when children are left in vehicles Next CPS Conference Call is scheduled for August 20 th 2009 at 12 Noon. CPS Conference Call handouts and audio files are posted on the website SECURE Ambulance Safety project was presented in Harford County and at the MSFA convention, posters are now available from the EMSC & SOCALR offices Yellow Alert. MIEMSS continues to closely monitoring yellow and red alert activity, which has decreased significantly in the past year, even with the onset of the H1N1 virus in April. MIEMSS is working closely with DHMH and Maryland Hospital Association (MHA) to plan for the impact H1N1 and seasonal flu may have on hospitals and EMS related to overcrowding and diversions. A half day Summit is being planned for September at MITAGS. MIEMSS will be posting information on the webpage as it becomes available. Public Access AED Program. Currently, there are 1122 approved layperson AED programs in Maryland with a total of 3255 sites. A list of approved programs is updated monthly and available on the MIEMSS website at Cardiac Centers. In response to informal comments received from Draft 2 of the STEMI regulations, MIEMSS is working on a third draft of regulations. MIEMSS will continue to work with the Maryland Health Care Commission (MHCC), hospitals, ED physicians and cardiologists, EMS providers, etc. to move forward with the designation of STEMI centers in Maryland. MIEMSS has also developed a Minimum Standardized 12 Lead Curriculum that includes the minimum course content that should be taught to ALS providers performing and interpreting 12 lead ECGs. This document has been reviewed for comment and will submitted to the EMS Board for final approval at the September meeting. MHCC also recently changed the door to balloon time requirement for Primary PCI hospitals from 120 minutes in 80% of patients to 90 minutes in 75% of patients. The new standard becomes effective January 1, There are currently 23 hospitals in Maryland that perform primary PCI. EMAIS. The enhanced, printable Patient Care Report (PCR) from EMAIS has been tested and deployed. This final version of the report incorporates recommendations from both EMS jurisdictions and hospitals that use EMAIS. An e-commerce style password reset feature has been launched to assist providers with password problems. Currently, eighteen jurisdictions are utilizing EMAIS, along with seven Operational Programs statewide. Targeted Data Exports have been constructed for EMAIS Jurisdictions and Programs to use in local EMS management. Grant funding has been secured for the analysis of the Maryland EMS Data Collection System, and recommendations for the future emais 3.0. Meetings have been 8

10 conducted with all constituents to solicit feedback and input into the creation of an RFP. Functional elements have been identified and the refined Data Dictionary is in process. Primary Stroke Centers. MIEMSS continues to work closely with system stakeholders to improve acute stroke care in Maryland. Prehospital protocols and designated Primary Stroke Centers play pivotal roles in a statewide acute stroke system of care. The number of designated Primary Stroke Centers statewide is currently 32. Additional hospitals have applied and are in the process of being surveyed. MIEMSS continues working with the telemedicine workgroup of the Governor s Advisory Council on Heart Disease and Stroke and DHMH s Office of Chronic Disease Prevention to explore a statewide stroke telemedicine system. This system would potentially extend stroke neurology expertise to underserved regions of the state, mitigating neurology specialist shortages and the risks of PSCs losing critical resources. The group is working to gather support, refine the project s charter and identify funding sources. EMS Base Stations. The Meet the Protocols 2009 Protocol Update for Base Stations has been distributed through the MIEMSS Regional Offices. MIEMSS is scheduling reviews of approximately 20 EMS base stations. The applicant hospitals have submitted supporting materials. EMS Regional Administrators are coordinating feedback from jurisdictional QA officers and Medical Directors. These reviews will ensure continued compliance with requirements to provide quality online medical consultation, quality management, and clinical access for EMS providers. 9

11 EMS Continuing Education Programs Peninsula Regional Medical Center Trauma Conference (August 28, 2009) Clarion Hotel and Conference Center, contact Lynn Foster at Mid-Atlantic Lifesafety Conference (September 22, 2009) Johns Hopkins Applied Physics Lab, Laurel, MD National Disaster Life Support Program BASIC DISASTER LIFE SUPPORT (BDLS) (September 28, 2009) James N. Robey Public Safety Training Center 2200 Scott Wheeler Drive Marriottsville, MD Register at Application is attached. Washington County Hospital Trauma Seminar (October 7, 2009) Hagerstown Community College, Contact: , ext. 236 Pyramid 09 (October 16-18, 2009) Solomons, MD. Contact Region V Office at Winterfest 2010 (January 28 31, 2010) More information will be available shortly Please check with your MIEMSS regional office, the Maryland EMS News, or the MIEMSS web page about additional registration information. 10

12 Sponsored by Maryland Regional NDLS Coalition Johns Hopkins CEPAR, Maryland Fire and Rescue Institute (MFRI), Maryland Institute for Emergency Medical Services Systems (MIEMSS), The RA Cowley Shock Trauma Center and the University of Maryland at Baltimore County (UMBC) Natio n al Disa ster Life Sup p ort Program BASIC DISASTER LIFE SUPPORT (One-day program) (BDLS is a pre-requisite to attending the future two-day hands-on ADLS course) Register on line NOW at as space is limited. Upon completion of this application, a holding confirmation will be ed to you. Lunch will not be provided. There is a $10 registration fee. If you wish physician or PA CME, there is an additional $10 fee. Books will be provided to attendees upon arrival for the course. There are no other fees or costs. Course is open to all interested parties COURSE LOCATION: James N. Robey Public Safety Training Center 2200 Scott Wheeler Dr Marriottsville, MD Directions: BDLS COURSE DATE: Monday September 28, 2009 Starts promptly at 8:00 am to 5 pm BDLS APPLICATION (Print) Name (Last, First): Current Employer /Department affiliation Phone (Home): License /Certification Number: Phone (Work): Position/Title: Mailing Address: City: State: Zip Code: Fax Number: Address (required): Licensure type: (Mark with X ) Physician, Nurse, EMS, Other Health Care Professional Deadline for BDLS (one day) program: September 23, 2009 I certify that the information recorded on this application is correct. Space is limited so early registration is essential to assure participation and you will receive confirmation by which you will need to bring on the day of the program.