Summer Educational Conference

Renaissance Hotel Asheville , NC July 7-10, 2012

EMS UPDATE

Regina Godette-Crawford

Chief, OEMS

OEMS ADMINISTRATION

Staff Changes/Retirements/Promotions at the OEMS

• Elva Barnhardt

Contracts Manager retired in March 2012

• Heather Majernik

Education & Credentialing Manager accepted a position with Wake Health & Hospitals in May 2012.

• Shelley Carraway

Hospital Preparedness Program Manager accepted a position with the Division office in June 2012.

OEMS ADMINISTRATION

Staff Promotions at the OEMS

• Chuck Lewis, EMT-P, RN

Western Regional Manager

• Allen Johnson, EMT-P

Eastern Regional Manager

OEMS ADMINISTRATION

• Data Review Committee organized to review and

define data points.

• Completed review and update of 13P 21 NCAC rules

as required by Session Law 2011-398 (formerly SB 781). This rule Required annually.

• NFPA 1917 Ambulance Standards is forthcoming,

which will change the standards for Ambulance Construction in NC. NCOEMS is participating on a committee within NAEMSO to address this issue at the national level. We will work with NCAEMSA to address any standards needed for North Carolina.

OEMS ADMINISTRATION

EMS White Paper

• H.R. 3144 - introduced in October 2011 • Currently in two (2) Committees House Committee on Energy and Commerce House Committee on Ways and Means

Nothing has changed

Blood & Urine Sampling for DWI Suspects

Blood & Urine Sampling

• Memo forwarded out statewide on July 2, 2012 stating OEMS position on current G.S. § 20 139.1(d2)

Statewide Survey Response

• Survey was forwarded out to assess impact of issues on EMS Systems across the state.

• This survey addressed two topics that has affected most agencies; – Blood & Urine Sampling for DWI Suspects – Medication Shortages

Statewide Response to Survey

Ashe Alleghany Surry Stokes Rockingham Caswell Person Granville Vance Warren Watauga Wilkes Yadkin Mitchell Yancey Avery Caldwell Alexander Davie Forsyth Guilford Orange Alamance Durham Franklin Madison Graham Cherokee Clay Swain Macon Burke McDowell Catawba Haywood Buncombe Jackson Henderson Polk Lincoln Rutherford Cleveland Gaston Transylvania Iredell Rowan Davidson Cabarrus Mecklenburg Union Montgomery Stanly Randolph Anson Moore Richmond Chatham Lee Hoke Harnett Wake Cumberland Johnston Sampson Nash Wilson Wayne Duplin Northampton Halifax Edgecombe Greene Lenoir Pitt Jones Hertford Bertie Martin Craven Gates Washington Beaufort Pamlico Currituck Camden Pasquotank Perquimans Chowan Tyrrell Hyde Dare Carteret Scotland Robeson Bladen Onslow Pender

Response to Survey No Response 70 Counties 31 Counties

Columbus Brunswick New Hanover

Specialty Care Responses 4 Agencies Total Agencies Responding to Survey Total Counties Responding to Survey 93 70

Blood & Urine Sampling

• Are you currently being requested by Law Enforcement in your area to obtain blood and/or urine specimens for alcohol and controlled substance testing?

No 29 31% Yes 64 69%

Blood & Urine Sampling

• How often does this occur?

50 45 40 35 30 25 20 15 10 5 0 47 1 to 5 times/mo.

10 6 to 10 times/mo.

2 11 to 15 times/mo.

5 Over 16 times/mo.

Blood & Urine Sampling

• Which branch of Law Enforcement has been requesting you to obtain blood specimens for alcohol and controlled substance testing?

County Sheriff 5 Local Police Dept., 14 Hwy.

Patrol 45

Blood & Urine Sampling

• Does your EMS Agency/System have a current policy to provide guidance to staff in securing blood and/or urine specimens for Law Enforcement?

No 65 70% Yes 28 30%

Sample Sampling Policies

• • Several Policies adopted by Agencies were submitted in the Survey, and available to assist any Agency interested in creating a Policy or Guideline for use.

Feel free to contact your Regional EMS Office to obtain copies of these Samples

Blood & Urine Sampling

• Has the requirement for obtaining blood and/or urine samples for Law Enforcement been a burden to your EMS Agency/System?

No 72 77% Yes 21 23%

Blood & Urine Sampling

• Do you think the requirement as defined in G.S. 20-139.1(d2) for EMS personnel to obtain blood and/or urine samples when directed by law enforcement should be repealed?

40 35 30 25 20 15 10 5 0 27 29 37 No Remain Unchanged Yes Repealed Needs to be Rewritten

Medication Shortage

Medication Shortage

• Memo forwarded out statewide on July 2, 2012 stating OEMS position.

Medication Shortage

• Has your EMS Agency/System been affected by the current medication shortages?

No 16 17% Yes 77 83%

Medication Shortage

• Is your EMS Agency/System currently experiencing a shortage of:

70 60 50 40 30 20 10 0 64 55 13 9 Atropine Calcium Chloride 10 67 Dextrose 33 44 67 Valium 10 Diltiazem Yes No

Medication Shortage

• Is your EMS Agency/System currently experiencing a shortage of:

30 20 10 0 70 60 50 40 68 63 33 44 33 44 9 Benadryl 14 Epinephrine 1:1,000 Epinephrine 1:10,000 Etomidate Yes No

Medication Shortage

• Is your EMS Agency/System currently experiencing a shortage of:

70 60 50 40 30 20 10 0 23 54 Fentanyl 23 54 19 58 Toradol Mag. Sul.

13 64 Ativan Yes No

Medication Shortage

• Is your EMS Agency/System currently experiencing a shortage of:

70 60 50 40 30 20 10 0 26 51 23 54 16 61 24 53 Versed Morphine Narcan Zofran Yes No

Medication Shortage

• Is your EMS Agency/System currently experiencing a shortage of:

40 30 20 10 0 80 70 60 50 75 2 Phenergan 76 55 70 22 7 1 Propofol Sodium Bicarb. Vercuronium Yes No

Medication Shortage

Summary

• It appears that EMS Agencies are dealing with current medication shortages.

• It is apparent by the survey that EMS agencies will be substantially impacted if the medication shortage continues.

• OEMS has been involved in some meetings with Federal partners to determine potential solutions.

RULES UPDATE

RULES UPDATE

Rule .0221 “Transportation of Patients Between Hospitals” became effective July 1, 2012.

• This rule allows traditional and Specialty Care programs to transport non-specialty care patients between hospitals using an RN or other allied health professional attending the patient.

Healthcare Preparedness Response and Recovery

Healthcare Preparedness Response and Recovery

Operations

– Statewide Exercise May 2012 • State Medical Support Shelters • Pitt County/Cumberland County • SMRS • Local Support – Mission Packages • Working with NC Emergency Management • Capability focused (no longer team)

• Healthcare

Preparedness Capabilities

– Released January 2012 – 8 Capabilities – Aligned with the 15 PH Capabilities

http://www.phe.gov/Preparedness/planning/hpp/reports/Documents/capabilities.pdf

Healthcare Preparedness Response and Recovery

•

FY12 ASPR Grant

$10,319,477 • State Projects of Interest – Patient Tracking – Resource Tracking – Inventory Management • Regional Applications – Capabilities based – Risk Assessment – Gap analysis – Due August 1, 2012

Healthcare Preparedness Response and Recovery

Democratic National Convention (DNC)

– DNC Health and Medical Planning – SMRS Response • SMAT II • SMAT III • AST • Mobile Disaster Hospital – Rapid Response Unit • Medical Coordination Team • NC Baptist Men Logistical Support

Healthcare Preparedness Response and Recovery

EMS Assessment Project

• Assessment by UNC-School of Public Health • Goal to conduct a program assessment to include;

Disaster Trauma EMS

• Currently completing a survey and interviews with OEMS staff and

management

• EMS Systems will receive survey link within the next month • SMAT Teams will receive survey link within the next 2 months and

possibility of on site interviews

• Assessment with recommendations to be completed by January 2013

Healthcare Preparedness Response and Recovery

Program Changes

• • New Staff • • HPR&R Operations - Jeff Peterson

Vacancies:

Hospital Preparedness Program Coordinator Shelley Carraway • June 1 moved to DHSR Planning Section • Position Posted • Communications • Danny Allen • Position under review

System Update

EMS SYSTEMS UPDATE

2012 NCCEP Protocols are now released Posted at

www.ncems.org

– You may begin your implementation of these protocols, and submitting your applications for approval.

– Please direct any questions to your Regional EMS Office. – We will be making available the Protocol Implementation Form.

HEALTH SYSTEMS & TRAUMA

UPCOMING TRAUMA SITE VISITS

• • • • • • Moses H. Cone Memorial Hospital/Cone Health – August 2012 Duke University Medical Center – October 2012 Wake Forest Baptist Medical Center – November 2012 High Point Regional Health System – November 2012 New Hanover Regional Medical Center – December 2012 WakeMed/Raleigh Campus – March 2013

TRAUMA REGISTRY

• • • Updating software to enable capture of data in compliance with NTDB standards and ACS Guidelines.

New Validation Tool to ensure trauma registry data quality.

New process implemented for data completion. Record completion reduced from 365 days post patient discharge, down to 80 days post patient discharge.

EDUCATION

EDUCATION

Agenda for the Future

– – OEMS is working with the NC Association of EMS Educators and the NC Community College System to develop the new curricula.

The NC Association of EMS Educators is applying for a grant for curriculum development.

– – – One NREMT transition course was conducted as a pilot. Two courses are pending to after January 1, 2013 as NREMT will not accept transition courses conducted prior to that date. A floating timeline for implementation has been developed. This is dependent on NCOEMS Education Rules revision.

OEMS would like to implement all levels by January 1, 2014.

EDUCATION

Credentials

 NCOEMS is receiving an influx of Expired Emergency Medical Dispatch (EMD) Credentials.  Please remind your EMD communication center that personnel must maintain an up-to-date North Carolina EMD Credential or they are not allowed to process EMD calls.

 NCOEMS, with the help of the EMS PIC, initiated a system to notify providers of pending credential expiration. The system has been in operation for the past two months.

Emergency Medicine Today

October 6-10, 2012

Koury Convention Center, Greensboro NC

Registration Information

Conference registration will be available in late July or early August.

COMPLIANCE UPDATE

COMPLIANCE UPDATE

OEMS Enforcement Statistics

January 1, 2012 – June 30, 2012

77 - Total Complaints Received.

23 - Complaints closed with no substantiated rule violations.

44 - Complaints became formal investigations with substantiated rule violations.

10 - Complaints are presently been addressed.

COMPLIANCE UPDATE

• The agency’s Case Review Panel reviewed 60 cases involving investigations and individuals with criminal histories.

• The NC EMS Disciplinary Committee interviewed 25 individuals.

COMPLIANCE UPDATE

• Enforcement actions taken resulted in:    6 Individuals credentials revoked.

2 Credentialing Applications denied.

3 Credentials Summarily Suspended.

COMPLIANCE UPDATE

Enforcement actions were necessary due to:  Potential Substance abuse issues.

  Criminal histories including felonies.

Providing medical care and treatment outside the credentialed scope of practice.

 Falsification of credentialing application.

COMMUNICATIONS

COMMUNICATIONS

FCC MANDATORY NARROWBANDING

• FCC VHF / UHF “narrow banding” must be complete by January 1, 2013 — all VHF and UHF radios must operate on channel bandwidths of 12.5 kHz or less.

• The FCC expects that licensees will ultimately implement equipment designed to operate on channel bandwidths of 6.25 kHz or less. This affects 155.280; 155.340; and all VHF and UHF radio systems.

EMS FOR CHILDREN

EMS FOR CHILDREN

EMSC Site Visit in Chapel Hill

– NCOEMS attended the site visit to support the EMSPIC and Dr. Jane Brice on their “EMS and Pediatric Trauma: A North Carolina Population Based Performance Improvement Intervention and Evaluation Using Multiple Linked Healthcare Databases” conducted by HRSA

EMS FOR CHILDREN

The EMS for Children contact is: McKenzie L. Cook

CIS DATA SYSTEMS

CIS DATA SYSTEMS

FREQUENTLY ASKED QUESTION LINKS

• Credentialing Information System (CIS) video tutorials

http://www.emspic.org/applications/cis

• Credential Information System (CIS)

http://www.emspic.org/faqs/cis

• PreMIS video tutorials

http://www.emspic.org/applications/premis

• State Medical Asset Resource Tracking Tool (SMARTT) video tutorials

http://www.emspic.org/applications/smartt

Questions?