Administration and Leadership, Documentation & Patient Care Reporting, EMS Today Conference, News, Training

EMS Today Coverage: Beyond the sessions and exhibit hall…

Issue 6 and Volume 33.

The 4,500 people who attended the 2008 EMS Today Conference and Exposition had a lot more to do than attend some 100 sessions and visit 298 booths in the exhibit hall.

Fun & games
After two days of preconference sessions, the main conference kicked off with an EMS game show and included evenings devoted to a massive party sponsored by Physio-Control at the ESPN Zone in Baltimore_s Inner Harbor and the 5th annual JEMS Games competition.

During the opening session, six paramedics (with eight to 35 years of experience) competed in answering clinical questions posed by game-show host (and improvisational comedian) Baxter Larmon, PhD, MICP, professor at the UCLA School of Medicine and director of the UCLA Center for Prehospital Care. “This is going to be pretty action packed,” Larmon warned contestants.„Rob Howlett, NREMT-P, RN, of New Hanover (N.C.) Regional EMS won first prize: free registration to the 2009 EMS Today Conference and Exposition, plus an iPod donated by Vidacare Corp.

EMS teams from the U.S. and Canada participated in the JEMS Games preliminaries, and the top five competed in the finals before a standing-room-only crowd the last night of the conference. In the final competition, teams responded to a simulated building collapse with numerous injured patients. “It was difficult [and] brought back some memories [from 9/11]. But we always learn; it keeps you sharp,” says„Lt. James„Fallar, who led the Fire Department of New York team.

FDNY took first place (winning $1,000, plus a GlideScope video laryngoscope donated by Verathon Inc.). The team from FirstHealth Regional EMS in North Carolina won second place ($750), and Kanawha County (W.Va.) Emergency Ambulance Authority took third ($500). Each team also received a host of prizes and equipment provided by„EMS manufacturers. But those in the audience also won: They received lots of entertainment, as well as continuing education credits for watching their colleagues compete.

EMS policy summit
A number of EMS leaders spent an afternoon during the EMS Today Conference and Exposition at the 1st Annual EMS Policy Summit, where they exchanged information and concerns with federal officials involved with EMS.„

Jeff Runge, MD, assistant secretary for health affairs and chief medical officer, Department of Homeland Security (DHS), gave a keynote address followed by a briefing by Advocates for EMS (AEMS), the organization that educates federal lawmakers on behalf of four organizations (National Association of EMS Educators, National Association of EMTs, National Association of EMS Physicians and National Association of State EMS Officials). AEMS lobbyist Lisa Meyer also offered tips on influencing public policy.„

Runge, an emergency physician and former EMT, said he wouldn’t be happy until he visited Capitol Hill and saw “a line of EMS providers out the door” lobbying for their rights. “You’re doing this for your patients, and that carries a lot of weight when you have one voice,” he said.„

High-level representatives from the CDC, DHS, NHTSA, Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response, HHS EMS for Children Program and U.S. Fire Administration described EMS activities within their agencies, and then listened to members of the EMS community discuss their concerns.„

David Marcozzi, MD, director of the new HHS Emergency Care Coordination Center, said federal lawmakers are becoming more aware of EMS. When someone fainted during a recent public event, he reported, presidential candidate Sen. Hillary Clinton, D-NY, called out, “Is there a paramedic in the house?” Marcozzi found it noteworthy that she asked for a paramedic, not a doctor or nurse.

A look at Safey Town
The Frisco (Texas) Fire Department (FFD) won the 2008 Nicholas Rosecrans Award for Safety Town, a scaled-down village designed to educate children about safety issues. Safety Town features real buildings similar to those in Frisco, but on a 5/8 scale, including a fire station with a real fire truck, a police station and businesses. Some 25,000 people in the Houston area have visited Safety Town since it opened Jan. 8, 2007.„

The award, which was announced at the closing ceremony of the EMS Today Conference and Exposition, recognizes emergency responders who demonstrate leadership, commitment and innovation in preventing injuries. It was presented by EPIC Medics of San Diego and sponsored by the Center for Disease Control, JEMS, Laerdal Medical Corp., NHTSA, the RedFlash Group and ZOLL Medical Corp. The award is named for Nicholas Rosecrans, who died in a San Diego swimming pool at the age of two.

According to FFD Chief Mack Borchardt, Safety Town was 15 years in the making. “When we do a dedicated effort for prevention, the credibility of our organization rises exponentially,” he says.

FFD offers to share its model with other communities. “Safety Town could be replicated in any community in the nation,” says Paul Maxwell, president and founder of EPIC Medics. “That was a big factor in their winning.” Visit Safety Town at„www.friscotexas.gov/safetytown.

EMS chiefs organize
Because the EMS Today Conference and Exposition brings thousands of EMS people to Baltimore from all over the world, it provides a great opportunity for people to meet both formally and informally. During this year_s conference, 30 high-level EMS chiefs met in person, with another 20 or so top EMS administrators from the U.S., Canada and several other countries participating by teleconference. After the meeting, the group announced the formation of a new organization, the International Association of EMS Chiefs (IAEMSC), the first stand-alone organization designed to provide a forum and voice for the top chiefs and administrators of EMS systems and services.

“There have been a number of efforts by regulators, medical directors, etc. to provide a strong voice for EMS, but visibly missing from those groups are the people who actually deliver EMS as we know it,” says IAEMSC Board Member Skip Kirkwood, chief of Wake County (N.C.) EMS. “This group intends to make sure that voice is at the table.” For more, visit„www.iaemsc.org and see the May EMS Insider at„www.jems.com. ƒStaff

QUICK TAKES
Lobbying Keeps One DMAT Cache Local
Pressure from elected officials apparently convinced the U.S. Department of Health and Human Services (HHS) to keep at least one Disaster Medical Assistance Team (DMAT) cache local. (See “DMATs in Danger?” May 2008 JEMS, p. 26.) On March 28, HHS notified the DMAT in San Diego that, although its warehouse would close in three days, its cache of medical supplies and equipment would remain local at a naval facility. In a letter published in the San Diego Union-Tribune April 2, CA-4 DMAT Commander Jake Jacoby, MD, wrote, “Thanks to our county supervisors and our congressional delegation, which stood with us against the intention of [HHS] to move our cache to„Los Angeles.” No word yet on other DMAT caches or concerns.

NEMSAC Convenes to Council Feds
The new National EMS Advisory Council (NEMSAC) held its first meeting April 24Ï25 in Washington, D.C. The U.S. Department of Transportation (DOT) created the NEMSAC to advise NHTSA, which leads the Federal Interagency Committee on„EMS. “It was an amazing experience, says Idaho EMS Director Dia Gainor, chosen by DOT to chair the council. “It’s evident that NHTSA is taking this advisory council very seriously and is genuinely interested in our viewpoints and success.” She stressed that DOT selected the 25 NEMSAC members “to represent sectors of the EMS system in this country, not to represent specific organizations.” For more information, see the article in the June EMS Insider posted at„www.jems.com.„ƒStaff

COMING SOON:
All Physio-Control Products
Medtronic Physio-Control reached an agreement with the U.S. Food and Drug Administration (FDA) April 25 that should allow the company to begin shipping all products within the next two to three months. Physio-Control voluntarily halted shipments within the U.S. in January 2007 due to FDA concerns. “We’ve been working on our quality system and are down to just a few things we must do before shipping products globally,” says Physio-Control President Brian Webster.

Although the FDA “consent order” prohibits the company from shipping most products (even outside the U.S.) until it satisfies all requirements, the FDA does allow some exceptions. For example, Webster explains, if a large EMS system has outfitted its fleet with LIFEPAK 12s and is putting several more ambulances on the street, Physio-Control can provide new LIFEPAK 12s for those units. The company can also continue to provide service, parts and supplies as it has throughout the past 18 months. For more information, visit„www.jems.com.

Comment on Proposed Federal EMS Safety Agenda
The National Institute of Occupational Safety and Health (NIOSH) is asking the EMS community to comment by June 30 on a draft “Public Safety Sub-Sector Research Agenda.” The document includes five strategic goals for improving the safety and health of EMS responders, plus dozens of sub-goals with timelines.

NIOSH seeks to reduce traumatic injuries to EMS personnel from vehicle crashes by 15% by 2015; reduce traumatic injuries during the movement of patients and equipment by 30% by 2012; reduce hazard exposures to EMS personnel by 25% by 2012 via effective design and use of personal protective equipment; identify and implement effective EMS workplace-organization policies to reduce EMS illnesses and injuries by 2012; and create an integrated EMS occupational health and safety surveillance data system by 2013. Download the document and information on commenting atwww.cdc.gov/niosh/nora/comment/public/
PubSafSubDraftMar2008.
ƒMannie Garza

CONTROVERSY:
Should the PCR be finished before you leave the ED?
A controversy erupted recently in Western Colorado when the local EMS medical director began insisting EMTs complete an electronic patient care report (PCR) before leaving a patient at a local emergency department. ED staff contended they needed full information on patients delivered by EMS, but some area fire chiefs countered they couldn’t afford to have crews spend an extra 20Ï25 minutes in an ED filling out the PCR.„

What do you think?
Do you think„EMS personnel should be required to complete their PCRs before leaving the ED?
„„„„ > Yes, I think this should be standard practice.
„„„„ > Maybe, depending on the shift_s call volume.
„„„„ > No, I don_t think it_s feasible in my system.
„„„„ > No, I think it takes our time away from other potential calls.

Visit ˙News & ArticlesÓ on JEMS.com to weigh in.

JEMS.com Editor’s Note: This poll is located on the right-hand side of this page.

PRO BONO
Who ‘Owns’ Non-profit„EMS Assets?

Non-profit organizations furnish much of the EMS in the U.S. Although the assets (e.g., vehicles, equipment, buildings and cash) used by these non-profits are usually ˙titledÓ in the name of the organization, under most states_ laws these assets are actually held ˙in trustÓ for the communities they serve. Although this isn_t quite the same as saying these are ˙publicÓ assets, holding them in trust means that, generally speaking, non-profit„EMS organizations are not free to do entirely as they wish with their assets.

The first principle under most state non-profit organization laws is that assets must be used only for their intended charitable or civic purposes. This means, for instance, that a non-profit„EMS organization can_t decide to sell its assets and use the proceeds to open a library instead. The second general principle is that a non-profit_s assets must ordinarily stay in the community. For example, a non-profit„EMS organization could sell an ambulance, but the proceeds from that sale would have to stay in that community serving the same purposes. In other words, the organization could use the proceeds to buy a new ambulance or otherwise advance the organization_s purposes.

Because non-profit assets are held in trust for the benefit of the public, the attorney general of the state typically has oversight authority regarding the use, sale or disposition of the assets, and can initiate or intervene in a legal action to prevent the misuse or ˙wasteÓ of those assets. In addition, when a non-profit organization dissolves, the assets must be distributed for similar charitable or civic purposes, typically pursuant to a ˙dissolution clause,Ó which should appear in the organization_s articles of incorporation or bylaws.

Depending on state law, the organization can typically elect to distribute its assets to another non-profit with a similar mission that serves the community. If there_s no plan of dissolution, the assets are usually distributed in accordance with a court order, and often (but not always) end up with one or more municipalities.

The directors and officers of non-profit EMS organizations must understand that they hold fiduciary duties and must protect the assets of the organization for the good of the public they serve.

This update is provided by„Steve Wirth &„Doug Wolfberg„of„Page, Wolfberg & Wirth LLC(www.pwwemslaw.com), a national„EMS, ambulance and medical transportation industry law firm.

IN MEMORIAM
Peter JF Baskett
, MD, CPR pioneer, editor-in-chief of Resuscitation and a European Resuscitation Council (ERC) board member and former board chair, died April 18. According to the ERC, Baskett introduced advanced training for ambulance personnel in the United Kingdom, laying the basis for today_s paramedics.

William T. Campion Sr., president of Campion Ambulance in Waterbury, Conn., for more than 40 years, died March 21 at age 71.

‘SURVIAL WEEK’ JUNE 22Ï28
The U.S. Fire Service will focus on reducing responder illness and injury during “2008 Fire/EMS Safety, Health and Survival Week” (formerly called ˙Stand Down WeekÓ) June 22Ï28. “The reason for the name change makes good sense, reserving the term stand down for when we have a specific [firefighter line-of-duty death], equipment failure or crisis,” says fire and EMS safety leader Chief Billy Goldfeder. “But the intent hasn_t changed.” For ideas on survival week activities and more information, go to„www.iafc.org/safetyweek.

NAMES IN THE NEWS
Garry Briese
, who served as executive director of the International Association of Fire Chiefs for more than 20 years, has become administrator of Federal Emergency Management Agency Region VII, which covers Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming.

Boston EMS„Lt. Tony Fiorino was recognized by the city_s mayor March 21 for 50 years of dedicated service as a city employee. He began his career in 1958 as a medical aide in the emergency room at Boston City Hospital, which ran the city_s ambulance service at that time, and still works as an EMS field provider.

Three fire departments left the International Association of Fire Chiefs’ Fire-Rescue Med Conference in Las Vegas in April with 2008 Heart Safe Community Awards sponsored by Physio-Control.„City of Delray Beach (Fla.) Fire-Rescue Department won the small community award,„Clackamas County (Ore.)Fire District 1 won the large community award and„City of Sunrise (Fla.) Fire-Rescue Department won the STEMI awareness program award. Congratulations to all three!