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From the April 2009 Issue | Tuesday, April 14, 2009


Parmedic Researchers Rewarded
Paramedics not physicians went home from the National Association of EMS Physicians meeting in January with two of the five NAEMSP research awards. (And one of the other three was reserved for a medical student or fellow.)

Nicholas Eschmann, MS, a firefighter/paramedic with the Kenosha (Wisc.) Fire Department, was lead author on the study that won the award for Best Scientific Abstract. That study (Eschmann N, Pirrallo RG, Aufderheide TP, et al: "The effect of [EMS] personnel staffing patterns on patient survival from out-of-hospital cardiac arrest." Prehospital Emergency Care. 13(1):92, 2009), found patient outcomes declined when three or more paramedics were on scene, generating a lot of interest among NAEMSP conference participants.

"This was a difficult study for me, because I don't want to see a difference in staffing," Eschmann says, adding that only 4% of EMS calls are for a cardiac arrest. "I don't want to go to these calls and not have the extra help."

Antonio R. Fernandez, MS, NREMT-P, a research fellow with the National Registry of EMTs, and Jonathon R. Studnek, PhD, NREMT-P, a former NREMT research fellow who recently became director of prehospital research at Carolinas Medical Center, Charlotte, N.C., took the prize for Best Poster Presentation ("The relationship between EMT-basic examination score and success on the national paramedic certification exam." Prehospital Emergency Care. 13(1):100Ï101, 2009).

"As a paramedic myself, I think it_s great to see EMS professionals becoming more interested in EMS research and starting to put forth quality research," says Studnek, who became chair of the NAEMSP Research Committee at the January meeting. (He and Fernandez also co-author the JEMS EMS Mythbusters column.)

We agree. Who better than EMTs and paramedics to research important questions that will shape the future of EMS? And what a great career path!

Shake Up in Tulsa Over Documentation Failure
After an Oklahoma State Department of Health and EMS Division investigation of training procedure documentation at the Tulsa Fire Department (TFD), two top-level officers retired and three other officers were reassigned.

Captain Michael Baker, EMT-P, TFD public information officer, says the recertification review had become an EMS officer saying, "Here's the training we offered over the last two years. We know you attended these, but we can't say what days."

In October, the state showed up after a TFD member filed a complaint of poor and inaccurate recordkeeping. Baker's explanation is that as the EMS burden increased in Tulsa, training increased, but the paperwork didn't. He says, "We grew in EMS, but we didn't support it administratively."

Investigation results were released in mid-January. The department tested 127 firefighters who were "furthest out" from their last EMS protocol testing because they were considered "most at risk" of having missed required training, according to Baker.

The idea was to assure the department, the medical director and Tulsa's citizens that the problem was only with documentation. The firefighters had one week's notice of the test; the result was a 100% pass rate.

It appears the training was effective, even though the paper trail was missing.

Procedures have changed at TFD. There are now seven people who review recertification folders. Baker says, "Now, we look at everything we do in a whole new light. Now, we have the right people in the right places."

Although TFD insists the problem was only a failure to document, documentation is a big deal in EMS.

A lack of proper documentation can result in lapses in patient care or a denied insurance claim for a transport. In this case, besides harming some officers' careers, it may have shaken public confidence in TFD EMTs and in EMS in general. How are your documentation procedures?

Big Macs, Big Help
An EMS crew found more than just two patientsƒone with cardiac difficultiesƒwhen they responded to an Aeromexico flight diverted from Seattle's SEA-TAC airport to Portland International Airport (PDX) Jan. 20. According to a Jan. 23 USA Today article, because PDX didn't have any customs officials on hand to process the unexpected passenger load, airport police kept the plane on the tarmac for several hours and denied those on board egress from the plane. When they realized the passengers had been on the plane for six hours and had run out of food, the crew from Engine 890, including Lieutenant Chris Bryant and Paramedic Dan Weber, went to the nearest McDonald's and bought Big Macs for everyone. The passengers were eventually sent back to Mexico City. Thumbs Up to the Portland EMS/Fire crew for being the only bright spot in this ordeal advocating on behalf of the patientƒand making sure non-patients stay that way. JEMS

To see how one system improved outcomes by collecting and analyzing data, watch"EMS System CEO Talks Data" at  ems.com/extras




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