Emergency Training Center of Montana
NASEMSO Update:
1. Labor-Health and Human Services-Education Appropriations Bill Marked by Subcommittee
On June 7, 2007, the House Appropriations Committee Subcommittee on Labor, Health and Human Services, and Education considered the chairman’s mark of the Fiscal Year 2008 appropriations bill. The Preventive Health and Health Services Block Grant received a $10 million increase over last year’s level. The House Subcommittee-passed bill contains $109 million. This program was cut and/or level funded over the past three years. Sixteen states use this funding for EMS programs. The EMS for Children (EMSC) Program was level funded at $19.8 million. The Trauma Planning Systems and Development Act received no funding. Rural Health Outreach Grants received a $14 million increase over the FY 2007 level and is funded at $52.96 million. Flex Grants were level funded at $62.5 million. Rural and Community AEDs received a $537,000 increase, with funding at $2 million. HRSA’s Traumatic Brain Injury program was restored to last year’s level at $8.9 million. Poison Control received a $7.1 million increase to be funded at $30.1 million. No funding was provided to re-establish the Trauma-EMS program. This was undoubtedly due, in part, to the fact that the bill reauthorizing the program was only signed into law a few weeks before the mark-up. A chart of the recommended appropriations is available for NASEMSO members. To obtain the chart, visit http://www.nasemso.org and log-in to the NASEMSO Members Only area. Then visit https://www.nasemso.org/Members/Download_Documents/DraftProjectReports/.
2. DHS Appropriations Bill Passed Out of Committee on June 5
On June 5, 2007, the House Appropriations Committee passed out the FY 2008 Department of Homeland Security (DHS) Appropriations bill. Among the first responder and port security programs, funding is set at $4.52 billion, $1.97 billion above the President’s request and $863 million above 2007. These grants were funded at $4.92 billion in 2004 and have been cut every year since. For more information, visit http://apropriations.house.gov/pdf/HomelandFC.pdf.
3. Importance of Trauma Systems Highlighted in Congressional Record
On May 25, 2007, Representative Gene Green made a statement in the Congressional Record about the importance of trauma systems and the recently enacted legislation reauthorizing Title XII of the U.S. Public Health Service Act. The statement includes a recent NY Times article describing how the Camden, N.J., trauma system and Cooper University Hospital responded to save Governor Jon Corzine’s life and prevent serious disability. To see the statement, visit http://thomas.loc.gov and select Congressional Record. On the search page, query by date and representative.
4. CDC Issues Call for Model Communities
The Centers for Disease Control and Prevention (CDC), through its Terrorism Injuries: Information Dissemination and Exchange (TIIDE) Project, is examining the relationship between the emergency care community and public health in relation to preparedness for mass casualty incidents. The CDC TIIDE Project is seeking examples of “model communities” in which the relationship between the emergency care community and public health is well-established and operationally functional in terms of its capacity to respond to events that might produce large numbers of injuries. Selected communities will be invited to participate in a TIIDE Partners conference at which they can present their model systems. This conference will be held in Atlanta, Ga., on Aug. 13-14, 2007. The CDC will fund two representatives to attend the meeting. Responses are due by July 13. For more information, visit http://www.bt.cdc.gov/masscasualties/callmodelcommunities.asp.
5. AHRQ’s Annual State Snapshots Highlight States’ Strengths and Weaknesses in Health Care Quality
On June 11, 2007, the Agency for Healthcare Research and Quality (AHRQ) released the new State Snapshots. The Web tool shows that states have made promising gains in health care quality while identifying needed improvements in areas ranging from cancer screening to treatments of heart attack patients. AHRQ’s State Snapshots Web tool was launched in 2005. It is an application that helps state health leaders, researchers, consumers, and others understand the status of health care quality in individual states, including each state’s strengths and weaknesses. The 51 State Snapshots are based on 129 quality measures, each of which evaluates a different segment of health care performance. The Web tool provides summaries that measure health care quality in three different contexts: by types of care; by settings of care; and by clinical area. For more information, visit http://www.ahrq.gov/news/press/pr2007/snapshotspr.htm. To access this year’s State Snapshots, visit http://statesnapshots.ahrq.gov.
6. NASEMSO Provides Web Page With E-Mail Survey Results
The NASEMSO Web site at www.nasemso.org includes a special Web page in the News & Publications section featuring the results of member e-mail surveys. Recent surveys posted included topics ranging from how ambulance rates are determined to methods of online training to determining which states submit data to the National Practitioner Data Bank. To date, we have posted results of seven e-mail surveys in 2007, but there are additional surveys for which reports are pending. Please send your e-mail survey reports or results directly to NASEMSO Web Site Content Manager Karen Thompson at thompson@nasemso.org. See 2007 NASEMSO e-mail survey reports at http://www.nasemso.org/NewsAndPublications/News/Surveys.asp.
7. NASEMSO Endorses AHA Conference Proceedings
In late March 2006, the American Heart Association (AHA) convened a three-day conference “Development of Systems of Care for ST-segment Elevation Myocardial Infarction (STEMI) Patients” with multidisciplinary groups of physicians, nurses, EMS personnel, community and tertiary hospital administrators, payers, government officials, and quality, outcomes research and policy experts involved in the care of patients with STEMI. The conference attendees were charged with reviewing the current state or system of care, developing the ideal implementation system, addressing the gaps and barriers between the current and ideal system, and formulating recommendations for research, programs, and policy from the perspective of the constituency they were to represent. Members of more than 20 organizations representing key constituents were in attendance. NASEMSO participated in the conference. The full proceedings have been published in the May 29 issue of Circulation. NASEMSO endorsed the proceedings. For more information, visit http://circ.ahajournals.org/.
8. OSHA Issues Pandemic Influenza Guidance
On May 21, 2007, the Occupational Safety and Health Administration (OSHA) released a health and safety guidance intended to help health care employers and workers prepare for a possible influenza pandemic and protect workers who would be on the “frontline” caring for ill patients. Pandemic Influenza Preparedness and Response Guide for Healthcare Workers and Healthcare Employers provides resources and tools to aid in workplace planning efforts, information about risk communication, technical information about industrial hygiene and infection control techniques in healthcare settings, and advice on diagnosis and treatment of staff. For a copy of this health and safety guidance, visit http://www.osha.gov/Publications/OSHA_pandemic_health.pdf.
9. FDA Finalizes Guidance Documents for Pandemic and Seasonal Influenza Vaccines
The Food and Drug Administration (FDA) on May 31 issued final recommendations to increase the supply of safe and effective influenza vaccines for both seasonal and pandemic use. In March 2006, FDA issued two draft guidance documents for public comment – one for seasonal influenza vaccines and another for pandemic influenza vaccines. The draft documents outline specific approaches for manufacturers to develop new vaccines that are safe, pure and potent. The final guidance documents reflect public input, including vaccine companies and public health officials. Both guidance documents recommend using recent technologies such as cell culture and recombinant manufacturing to enhance the development and evaluation of vaccines. They also recommend adding substances that improve the immune response from the vaccine (novel adjuvants). The guidance documents describe conventional and accelerated approval pathways to vaccine licensure. For more information, visit http://www.fda.gov/bbs/topics/NEWS/2007/NEW01645.html.
10. Idaho Seeks Manager of EMS Systems Development
Idaho seeks a manager of EMS systems development to provide leadership for a major section of the Emergency Medical Service Bureau, composed of statewide EMS programs administered through three regional offices in support of the department’s mission to promote and protect the health and safety of all state residents. The job announcement closes June 22, 2007. More information is available at http://dhr.idaho.gov/stateJobs/default.aspx.
11. NENA Expresses Concern over Consequences of ITC Decision
The National Emergency Number Association (NENA) is concerned with the ruling by the International Trade Commission (ITC) in early June concerning a patent dispute between Broadcom and Qualcomm. While NENA has no interest and expressed no opinion in the patent infringement claim, NENA is concerned about consequences of the “downstream” remedy announced by the ITC, which will have a negative impact on the delivery of 9-1-1 service for American consumers and first responder communications. The ITC’s decision bans the importation of a wide range of cellular handsets used by major carriers within the United States, which will directly impact the delivery of E9-1-1 services to millions of individuals in the United States. According NENA, “a major obstacle has been created that will prevent consumers from upgrading their wireless handsets to newer models that will allow for more accurate, GPS-based location capabilities. The ITC’s ban on importation results in the public being denied new handsets that would improve the ability of 9-1-1 public safety answering points to locate with greater precision victims of crime, accidents, fires or other disasters. For more information, visit http://www.usitc.gov/ext_relations/news_release/2007/er0607ee1.htm and http://www.nena.org.
12. E-Newsletter Focuses on Pediatrics
Urgent Matters – an initiative by George Washington University’s School of Public Health and Health Services to improve hospital patient flow and reduce emergency department crowding – released its latest Patient Flow E-Newsletter (Volume 4, Issue 2), which focuses on “Putting Kids First.” The issue includes several articles by many well-known EMSC colleagues. Among others, articles appearing in the issue include: “Preparing the Emergency Department for Pediatric Patients;” “Child-Ready Emergency Departments: Creating Customized Pediatric Facilities, Equipment and Care;” “Educational Toolkit for Pediatric Emergency Preparedness;” “Leadership Needed: Hospitals Must Work Together to Improve Pediatric Emergency Care;” and “ACEP Reports on the Growing Interest in Pediatric Emergency Medicine.” Visit http://www.urgentmatters.org/newsletter/volume4/issue2/enews.asp to access the newsletter.
13. FEMA’s Incident Management Systems Division Releases Updated Public Works Credentialing Job Titles
As part of U.S. efforts to strengthen catastrophic response capabilities in line with the National Incident Management System (NIMS), the Federal Emergency Management Agency’s Incident Management Systems Division on June 1 released updated Public Works Job Titles. These job titles are now part of the National Emergency Responder Credentialing System, which documents minimum professional qualifications, certifications, training and education requirements that define the standards required for specific emergency response functional positions. The national credentialing process is voluntary (i.e. reflecting only the volunteer participation of a/first responder(s) willing to be deployed under interstate mutual aid agreements or compacts). States must establish a program administered by the state director (or other official designated by the governor) to grant authority to agencies, organizations or other entities to issue qualification cards for persons to be deployed for interstate mutual aid. For additional information, see NIMS Guide 0002, March 27, 2007, National Credentialing Definition and Criteria, at http://www.fema.gov/emergency/nims/rm/guide_rm.shtm and the June 1 NIMS Alert at http://www.fema.gov/pdf/emergency/nims/pwcredentialing_18-07.pdf
NASEMSO Update:
1. The Government’s Response to the Nation’s Emergency Room Crisis Examined in a Hearing Conducted by the House Committee on Oversight and Government Reform
On June 22, the House Committee on Oversight and Government Reform conducted a hearing on “The Government’s Response to the Nation’s Emergency Room Crisis.” In the opening statement, Rep. Elijah Cummings (D-MD) noted that the hearing would examine the response of the Department of Health and Human Services (HHS) to the nation’s emergency care crisis.
The hearing featured testimony from leading private sector experts on emergency care, trauma care, and ambulance services. Robert O’Conner, M.D., professor and chairman, Department of Emergency Medicine at the University of Virginia, represented the Advocates of EMS. (NASEMSO is one of the founding members of this organization.) Ramon W. Johnson, MD., associate director, Department of Emergency Medicine, Mission Hospital Regional Medical Center, represented the American College of Emergency Physicians. Other witnesses included C. William Schwab, M.D., professor and chief, Division of Traumatology and Surgical Critical Care, University of Pennsylvania; Kevin Yeskey, M.D., director, Office of Preparedness and Emergency Operations and acting deputy assistant secretary of the Office of Preparedness and Response, Department of Health and Human Services; and Walter Koroshetz, M.D., deputy director, National Institute of Neurological Diseases and Stroke, National Institutes of Health.
Witnesses at the hearing said that U.S. emergency departments are overcrowded, understaffed and unprepared for large natural disasters or terrorist attacks. O’Connor noted “For the past 20 years, federal support for EMS has been both scarce and uncoordinated. In fact, following the September 11th attacks, when the country focused its attention on all terrorism preparedness, first responders were described as police, fire, and ‘other.’” O’Connor reiterated that in conjunction with police and fire, EMS is the primary first responder for medical assistance in the event of a natural or man-made disaster or public health emergency. Johnson, stating the nation’s emergency care system is “teetering on the brink of collapse,” shared examples of emergency departments that “remain woefully underfunded, understaffed, overcrowded and overwhelmed.”
All testimony is available for download at http://oversight.house.gov/investigations.asp?ID=216.
2. WHA Adopts Resolution on Emergency Trauma Care Systems
On May 23, 2007, the World Health Assembly (WHA) adopted a resolution on emergency trauma care systems. This first ever WHA resolution on this topic, initially proposed by Romania and Thailand, draws the attention of governments to the need to strengthen pre-hospital and emergency trauma care systems (including mass casualty management efforts) and describes a number of steps governments could take. In addition, the resolution invites the World Health Organization (WHO) to scale up its efforts to support countries. Although not legally binding, the resolution is an important commitment from senior public health and development officials around the world to increase efforts to strengthen trauma care systems. The resolution is available at http://www.who.int/gb/ebwha/pdf_files/WHA60/A60_R22-en.pdf.
3. NTSB Issues Safety Recommendation I-07-3
On June 27, the National Transportation Safety Board issued Safety Recommendation I-07-3 to the National Association of State EMS Officials (NASEMSO). The recommendation addresses the risk of overpressure failure of partially pressurized aluminum cylinders and the protection of responders and the general public from a vehicle fire when aluminum cylinders are present. The recommendation is derived from the Safety Board’s investigation of the Sept. 23, 2005, motorcoach fire on Interstate 45, near Wilmer, Texas, during the Hurricane Rita evacuation and is consistent with the evidence found and the analysis performed. The bus was carrying patients from an assisted living center and also had a supply of Oxygen cylinders on board for the patients. The Pipeline and Hazardous Materials Safety Administration (PHMSA) recommends limiting the number of cylinders to the extent practicable and limiting the total weight of cylinders to 99 pounds per vehicle; however, these limitations may not be practicable in an emergency evacuation, such as in advance of a hurricane. Should aluminum cylinders be an issue for emergency responders in any mode of transportation, the safety of the vehicle occupants and the responders is of utmost priority. The Safety Board concluded that the possibility of structural failure in partially pressurized aluminum cylinders when exposed to heat and fire, as occurred on the accident motorcoach, poses a danger to the general public and emergency responders. As a result, the Safety Board has recommended that PHMSA develop standards for the safe transportation of partially pressurized aluminum cylinders and issue guidance to NASEMSO and other interested organizations. For more information, contact the NTSB Quality Assurance Division at 202-314-6403 and reference Safety Recommendation I-07-3.
4. “Working with People with Disabilities” Training DVD Now Available
Working with People with Disabilities – A Guide for Responders now is available from The Baltimore County Fire Department. This 26-minute training DVD, produced in cooperation with the Baltimore County Commission on Disabilities, is designed to help personnel from emergency medical services, fire, police, and others work effectively and compassionately with persons with disabilities. This training has been endorsed by the Maryland Department of Disabilities, Maryland Institute for Emergency Medical Services Systems (MIEMSS), Maryland Fire and Rescue Institute, Maryland State Firemen’s Association (MSFA), and the Maryland Police and Correctional Training Commissions, as well as a number of other public agencies and non-governmental disabilities advocacy groups. This DVD features people with disabilities who were gracious enough to appear in the video and share their “first person” accounts. They communicated their views, concerns, needs and expectations effectively. The DVD is available at no charge for training purposes. To obtain a free copy of the DVD, contact Fire Director James M. Korn at jkorn@baltimorecountymd.gov.
5. HHS Awards Two Contracts to Expand Domestic Vaccine Manufacturing Capacity for a Potential Influenza Pandemic
On June 14, Health & Human Services (HHS) Secretary Mike Leavitt announced the award of two contracts to expand the domestic influenza vaccine manufacturing capacity that could be used in the event of a potential influenza pandemic. The department has awarded two cost-reimbursable contracts totaling $132.5 million to sanofi pasteur and MedImmune over five years to retrofit existing domestic vaccine manufacturing facilities on a cost-sharing basis and to provide warm-base operations for pandemic influenza vaccines. In warm-base operations, the contractor does not shut down the facility. For more information, visit http://www.hhs.gov/news/press/2007pres/06/pr20070614a.html.
6. Special EMS Sessions To Be Held at 5th International Bird Flu Summit
Paramedics, firefighters, police officers, and other emergency first responders will have a chance to learn firsthand the best practices and model protocols they need in order to effectively respond to a pandemic, when they attend the 5th International Bird Flu Summit, Sept. 25-26, 2007, in Las Vegas, Nev. Nine breakout sessions specifically designed for these different emergency management service (EMS) providers were recently added to the agenda of the two-day event. The sessions will be held concurrently with the main plenary session, giving EMS providers a chance to hone their specific expertise and tailor their pandemic preparedness plans. For more information about the conference, visit http://www.new-fields.com.
7. Public Health Advisory Board Established to Advise HHS Secretary on Chemical, Biological or Radiological Agents
The Department of Health and Human Services (HHS) on June 19 announced the establishment of a public health advisory panel concerned with chemical, biological, nuclear or radiological agents. The National Biodefense Science Board will give HHS Secretary Mike Leavitt guidance on preventing, preparing for, and responding to release of such agents, whether they are naturally occurring, accidental, or deliberate. The board, which was authorized by the Pandemic and All-Hazards Preparedness Act, will advise the Secretary about trends, challenges and opportunities in the field. At the Secretary’s request, it also will provide recommendations for research and development. Board members are yet to be selected. There will be 13 members from among leading experts in science, public health and medicine. Four will be from the pharmaceutical, biotechnology and device industries. Four will be from academic institutions. Of the remaining five, one must be from an organization representing health care consumers and one must be a practicing health care professional. To submit a resume or curriculum vitae for consideration to be a board member, e-mail nbsbnominations@hhs.gov. For further information, contact Dr. Susan Cibulsky at nbsbquestions@hhs.gov. The board’s charter and additional information is available at http://www.hhs.gov/aspr/omsph/nbsb.
8. National Emergency Number Association Swears in New Executive Board
A new National Emergency Number Association (NENA) Executive Board took office at the Installation Banquet at the 26th NENA Annual 9-1-1 Conference and Trade Show in mid-June. Jason Barbour, ENP is the president while Ronald Bonneau, ENP became the first vice president. Craig Whittington, ENP was tapped as the newly elected second vice president. Six other Executive Board members were sworn in at the conference, including Ron Bloom, ENP, who became the association’s first ever private sector director. Others sworn in to office include: NENA Hall of Fame Member, John Crabill, ENP, as Northeast Region director; Bob Currier, ENP as North Central Region director; Toni Dunne, ENP as Southeast Region director; NENA Hall of Fame Member, Rick Galway, ENP, as Canadian Region director; and Barbara Jaeger, ENP as Western Region director.
Hydration Policy:
The information below is training focused, but has obvious application to incidents as well, and, it is research based.
University of Maryland, Maryland Fire and Rescue Institute
Purpose: The Maryland Fire and Rescue Institute, as a partner in the Center for Firefighter Safety Research and Development, completed a research study entitled “Health and Safety Guidelines for Firefighter Training”. One of the important observations of the study was that participants were dehydrated before starting their training day and hydration status clearly affected their performance in the training evolutions.
Policy: This policy presents the recommended hydration guidelines for participants prior to, during, and after the completion of strenuous practical training evolutions in order to maintain proper hydration and prevent dehydration.
Procedure: The instructor shall encourage the students to follow these hydration guidelines for all strenuous practical evolutions and other situations that may result in dehydration.
While hydration is a personal responsibility, it is the responsibility of the field instructor to monitor participants for the signs and symptoms of dehydration such as muscle weakness, dizziness, disorientation, hypotension, tachycardia and lack of sweating. The presence of these signs and symptoms constitutes a true medical emergency. The instructor should remove any individual exhibiting these signs and symptoms from the training environment and seek emergency medical support immediately.
Additionally, the instructor should be alert to environmental conditions that may exacerbate dehydration and be familiar with the MFRI policy regarding outdoor training in extreme weather conditions.
The goal of prehydrating is to start the training session euhydrated (properly hydrated) and with normal plasma electrolyte levels. Prehydrating should begin at least several hours before the training session to enable fluid absorption and allow urine output to maintain normal levels.
Prior to the training session, students should slowly drink one ounce of water for every ten pounds of body weight at least four hours before the training session. If the student does not produce urine, or if the urine is dark or highly concentrated, the student should slowly drink an additional one ounce of water for every 20 pounds of body weight about two hours before the training session.
Do not substitute beverages with alcohol or caffeine for water. Caffeine and alcohol act as diuretics and can exacerbate dehydration.
Students should not attempt to hyperhydrate prior to a training session as it has been shown to provide no clear physiologic or performance advantage and can increase the risk of hyponatremia, a potentially lethal condition.
The goal of drinking during the training session is to prevent excessive dehydration and excessive changes in electrolyte balance. The specific amount and rate of fluid replacement is highly variable depending on individual sweat rate, session intensity and duration, and environmental conditions.
Ideally, students should create a customized fluid replacement plan based on pre and post training session weight with the goal to prevent loss of more than 2% of baseline body weight during activity.
In the absence of an individualized fluid replacement plan, students should drink water slowly and continuously during the breaks provided during the training session. Electrolyte replacement beverages may be beneficial in the most extreme training conditions, but the primary goal should be volume replacement, which is best accomplished with water.
Students should continue fluid replacement even if they do not feel thirsty. By the time thirst is detected, the student is already dehydrated which results in decreased performance and increased health and safety risk.
The goal of rehydration is to fully replace any fluid and electrolyte deficit.
Individuals should drink 20 ounces of fluid for every pound of body weight lost during the training session. If the total body weight lost during training in unknown, students should drink slowly and continuously until urine is no longer dark or highly concentrated.
Consuming beverages and snacks with sodium will help expedite rapid and complete recovery by stimulating thirst and fluid retention.
Always Use Vehicles to "block" Accident Scenes:
From our "are there any reasons to always BLOCK with large fire apparatus" file...
A deadly crash occurred on I-75 in Florida Monday afternoon, sending 12 people to the hospital, fatally injuring a civilian and critically injuring a FF. An Alachua County Sheriff's Deputy stopped his patrol car - with lights flashing - in the left-hand southbound lane in order to protect the scene where a white Dodge Caravan had pulled over in the inside emergency lane because a passenger was having a seizure.
Firefighters and paramedics were at the scene to treat the seizure patient and two of the six occupants of the white van had exited the vehicle and were standing around it. The deputy was out of his car trying to wave traffic away from where the paramedics were assisting the seizure patient when a civilian, in a black van, who apparently did not see the flashing lights, plowed into the back of the Crown Vic.
The patrol car was propelled toward the paramedics and occupants of the white van, and three of the FF/paramedics and one occupant were able to jump across the guardrail and avoid the patrol car.
One of the white van's occupants was critically injured when she was pinned between the patrol car and the guardrail. A firefighter/paramedic, Lt. Drew Dabney, 41, of Gainesville, was also dragged by the patrol car and suffered serious injuries. After striking the patrol car, the striking van continued down the road, striking the inside guardrail with the left front corner of the vehicle. The driver of the black van was killed. Thanks BillyG
NASEMSO Update:
NASEMSO Adds Pandemic Flu Page to Web Site
A recent addition to the public side of the NASEMSO Web site is a page on Pandemic Influenza with links to useful resources for both the public and EMS professionals. This resource was compiled by Kathy Robinson, NASEMSO program advisor. The page includes an introduction with a definition of “pandemic” and a list of conditions that must be met for a pandemic outbreak to begin. There is a section on what the public should do in case such an event occurs, followed by resource links to federal, state, non-profit and international sources of information on preparedness. In addition, there are links to Centers for Disease Control (CDC), World Health Organization (WHO) and the National Academies of Science (NAS) reports and tools. Visit http://www.nasemso.org/Resources/PandemicInfluenza.asp to view the NASEMSO Pandemic Influenza Resources and Guidelines page.
NASEMSO Provides Comments on Draft Children’s Bill
Draft legislation has been crafted by Senator Christopher Dodd’s office in partnership with Save the Children and the American Academy of Pediatrics (AAP). The bill establishes a Commission on Children and Disasters that would examine the range of federal disaster efforts in light of children’s needs and make recommendations. It also provides for a National Resource Center on Children and Disasters that would serve as a clearinghouse for the growing body of information on children and various aspects of disasters. NASEMSO reviewed the bill and noted concern that only one of the 10 members of the new commission would be required to have a health background in either child health or pediatrics. NASEMSO stated that the commission could benefit by having more members with medical, preparedness and response expertise. In addition, NASEMSO noted that the creation of the new resource center duplicates or ignores resources that already exist. The EMSC National Resource Center already is established with federal funding and has information on children and disasters readily available. For more information on the draft bill, contact Anika Pierce at apierce@aap.org.
NEMSIS Funding Language Included Appropriations Bill
On July 12, the Senate Appropriations Committee passed out the FY 2008 Transportation, Housing and Urban Development and Related Agencies legislation that contained $1 million for the National Emergency Medical Services Information System (NEMSIS). Report language was included that shows the Committee’s support of NEMSIS and its efforts. For more information, contact Lisa Meyer at lmeyer@cgagroup.com.
EMSC Funding Moving in Both Houses
On June 21, the Senate Appropriations Committee recommended an appropriation of $20 million for the EMSC Program for Fiscal Year 2008. On July 11, the House Appropriations Committee considered the Fiscal Year 2008 Labor-Health and Human Services-Education appropriations and recommended an appropriation of $19.8 million for the EMSC Program for FY 2008. With both committees firmly rejecting the Administration’s proposal to eliminate the program, there is a excellent chance to continue EMSC’s important work. The House and Senate are each expected to consider their respective versions of the legislation and will then come to an agreement on a final version of the appropriations bill before it becomes law. For more information, contact Cindy Pellegrini at the American Academy of Pediatrics at CPellegrini@aap.org.
NEMSIS Software Developers Meeting Scheduled
The 2007 NEMSIS Software Developers Meeting will be held in conjunction with the EMS Summit Conference in Clearwater Beach, Fla. The NEMSIS Software Developers Meeting will be held on Saturday afternoon, Sept. 29. Registration for the meeting is done separately from the EMS Summit. Last year, this meeting filled very quickly and a larger space has been reserved for 2007. However, the meeting is limited to the first 100 registrants. To register, e-mail Paige Nielsen at paige.nielsen@hsc.utah.edu. Topics to be discussed at the meeting include: NEMSIS compliance update; NEMSIS 3.0 Dataset revision process; data quality and usability lessons; and open discussion of EMS software-related issues.
Nevada Project Heartbeat Documents Lives Saved
In late April, Nevada began a statewide public-access defibrillation project. The project, Nevada Project Heartbeat, is the first such statewide project in the United States. It aims to make automated external defibillators (AEDs) available and accessible throughout Nevada communities, with the goal of improving an individual’s chances of survival following sudden cardiac arrest. Nevada Project Heartbeat primarily is sponsored by the University of Nevada School of Medicine’s Center for Education and Health Services Outreach and Office of Rural Health, the Regional EMS Authority, and Humboldt County General Hospital. The Regional EMS Authority will provide CPR and AED training and medical oversight for urban communities statewide, while Humboldt County General Hospital will train and oversee participating rural communities. Already there are several documented saves as a result of Nevada Project Heartbeat. For more information, visit http://www.padprograms.com/nevada.
FCC Issues Katrina Panel Final Rule
The Federal Communications Commission (FCC) issued a final rule, Recommendations of the Independent Panel Reviewing the Impact of Hurricane Katrina on Communications Networks. In the document, the FCC directs the Public Safety and Homeland Security Bureau (PSHSB) to implement several of the recommendations made by the Hurricane Katrina Panel. The Commission also adopted rules requiring some communications providers to have emergency/back-up power and to conduct analyses and submit reports on the redundancy and resiliency of their 9-1-1 and E9-1-1 networks. The full rule is available at http://a257.g.akamaitech.net/7/257/2422/01jan20071800/edocket.access.gpo.gov/2007/pdf/E7-13488.pdf.
EMSC Web Site Adds New Grants Management Section
The EMSC National Resource Center has added a news Grants Management section to its EMSC Web site located at http://www.mchb.hrsa.gov/emsc. The section provides information on key pieces of grants management, including: applying for a competitive EMSC program grant, registering at Grants.gov, registering with EHB, applying for a non-competitive EMSC Program grant, and responding to conditions in the Notice of Grants Awards (NGA). Information also is provided on how to submit a carryover request or no-cost extension, as well as how to submit a request for redirection of funds. The Grants Management section also includes a section on who to contact for help, organized by state, and answers to more than 40 frequently asked questions. To access the Grants Management section of the Web site, visit http://www.mchb.hrsa.gov/emsc. Once there, click on “Grants Management” located in the side bar to the left of the homepage.
HHS to Give States $430 Million for Hospital Preparedness
On June 28, 2007, the Department of Health and Human Services (HHS) announced that this year’s federal grants to states to help healthcare facilities prepare for public health emergencies has been reduced by $20 million compared to 2006. The grants, totaling $430 million, are intended to help healthcare facilities, including hospitals, cope with mass casualties related to bioterrorist attacks, infectious disease outbreaks and natural disasters. According to HHS, this year’s funds are to be designated toward improving interoperable communications, systems to track available hospital beds, advanced registration of volunteer health professionals, and planning for fatality management and hospital evacuation. To learn more and to see a list of amounts given to each state, visit http://www.hhs.gov/news/press/2007pres/06/pr20070628a.html.
Pediatric Preparedness Implementation Kit for Hospitals Now Available
The Care of Children in the Emergency Department: Guidelines for Preparedness Implementation Kit is now available as a downloadable file from the American College of Emergency Physicians’ (ACEP) Web site. This kit will help administrators and other hospital personnel implement essential equipment and staffing recommendations so their emergency departments will be ready to provide the best pediatric care possible. The kit includes the American Academy of Pediatrics/ACEP-approved Care of Children in the Emergency Department: Guidelines for Preparedness; the editorial “Guidelines for Preparedness of Emergency Departments that Care for Children: A Call to Action;” sample policies for the care of children in the emergency department; clinical care guidelines; policy statements; referenced journal articles; a pediatric resuscitation and emergency medication calculator; and other related resources. To access the kit, visit http://host.acep.org.tmp3.secure-xp.net/aapacep/.
AAP Disaster Preparedness Presentations Available Via Web
The American Academy of Pediatrics (AAP) sponsored a half-day educational session on disaster preparedness, recovery, and response last fall in conjunction with its Annual National Conference and Exhibition. The presentations from that session can be viewed via Webcast at http://client.blueskybroadcast.com/AAP/AAP_Peds_21/index.html.
NENA Announces Support for FCC’s Proposed Location Accuracy Testing Rules and Its Intention to Host Summit on the Future of 9-1-1 Location Technology
On June 29, the National Emergency Number Association (NENA) announced its support of the Federal Communications Commission’s (FCC) tentative conclusion to require wireless carriers to meet FCC location accuracy standards at a geographical level defined by Public Safety Answering Point (PSAP) coverage areas. NENA stressed the importance of providing the most accurate information possible to 9-1-1 telecommunicators and also the critical need for all parties from industry and the public safety community to work together with a clear understanding of current challenges and needed steps to implement the rules. In the spirit of collaboration, NENA has announced plans, in conjunction with the Association of Public Safety Communications (APCO), to host a summit in the coming months on the future of 9-1-1 location technology as discussed in the second portion of the FCC’s Notice of Proposed Rulemaking (Section III.B). The goal of the summit will be to bring together public safety representatives and technology experts with leaders form the wireless and IP industry, including those working on automatic location standards critical to the future success of 9-1-1. For more information, e-mail phalley@nena.org.
Students’ Pandemic Hotline Plan Interests Health Agency
The Santa Clara County Public Health Department in San Jose, Calif., is helping Stanford University students develop a plan model for a local pandemic influenza hotline. The hotline will be staffed by home-based volunteers with general knowledge and also would offer the ability to route emergency calls directly to experts. Volunteers would use computer programs to obtain local pandemic information, including information about hygiene, school closures, and how to stay healthy during a pandemic. This service would be a source of information for vulnerable populations, including those who do not have a computer and those who prefer person-to-person interaction. Plans call for the pandemic hotline model to be made available to anyone interested at no cost. For more information, visit http://www.cidrap.umn.edu/cidrap/content/influenza/panflu/news/jul0607stanford.html.
National Summit on Primary Care Emergency Preparedness Scheduled for September
As the nation works toward strengthening its domestic emergency response capabilities, it is becoming more and more evident that a massive amount of resources will be needed to respond to a disaster – be it the next Hurricane Katrina or a pandemic flu outbreak. Primary care providers are currently untapped resources to meet the health needs of the community in a crisis. The Primary Care Development Corporation (PCDC), with a grant from the Agency for Healthcare Research and Quality (AHRQ), is convening the first ever one-day national summit specifically dedicated to the primary care community and disaster planning and response. The summit is aimed at primary care providers, administrators and/or clinicians; state primary care associations; regional emergency response planners, including representatives from local and state departments of health; hospital emergency planners and ambulatory care network administrators; school-based emergency planners; and elected and government officials. Visit http://www.pcdcny.org/documents/PCEPNationalSummitBrochure.pdf for more information on the summit.
NASEMSO Learns of NJ Trauma Coordinator Barbara Hall’s Death
NASEMSO has learned that Barbara Hall, the New Jersey trauma coordinator passed away in late May after a long battle with cancer. In an email to NASEMSO’s Trauma Managers List, Clay Odell noted that “Barbara was smart, funny, strongly dedicated to EMS, and a passionate advocate for trauma care.” Barbara had been a paramedic, a nurse and a teacher in the field of EMS. She recently consulted with public health officials in Poland to offer assistance in developing similar models for pre-hospital emergency care. A celebration of her life was held on June 30 in Pennington, NJ. Memorial contributions in her name may be made to the Organ Fund of Asbury United Methodist Church, 1401 Camden Ave., Salisbury, MD 21801; the Building Fund of Camp Pecometh, 136 Bookers Wharf Road, Centreville, MD 21617; or Humane Society of Wicomico County, 5130 Citation Drive, Salisbury, MD 21804.
Leopold Resigns from Nebraska Department of Health and Human Services
On July 3, Bob Leopold announced that he has resigned from the Nebraska Department of Health and Human Services (DHHS) to accept a position with the Oregon Department of Health as EMS and trauma director. Leopold’s last day with the Nebraska DHHS will be August 2. He will start in his new position in Oregon on August 15. Leopold has been employed with the State of Nebraska for more than 27 years. He was the Nebraska EMS administrator from 1984 to 1995.
DHS Sponsors Fourth Annual National Preparedness Month
The Department of Homeland Security (DHS) is sponsoring the fourth annual National Preparedness Month this September to encourage Americans to prepare for emergencies in their homes, businesses and communities. This year’s effort has a growing coalition of more than 625 national, regional, state, and local organizations pledging support. For the first time, the month will focus on different areas of emergency preparedness: Sept. 1-8, back-to-school (Ready Kids); Sept. 9-15, business preparedness (Ready Business); Sept. 16-22, multicultural preparedness (Listo); and Sept. 23-30, home and family preparedness, including pets, older Americans and individuals with disabilities and special needs (Ready America). Groups can register to become National Preparedness Month coalition members or get more information by visiting http://www.ready.gov and clicking on the National Preparedness Month banner.
Novation Survey on Pandemic Flu Preparedness Examines Hospital Supplies
Novation, the healthcare contracting services company of VHA, Inc., and the University HealthSystem Consortium (UHC), surveyed materials managers to determine the status of their pandemic disaster preparations. While more than half of the hospitals surveyed (68%) reported that they have devoted resources to developing comprehensive pandemic-specific disaster plans, 79 percent of those reported that they could continue operations without external resources for less than one week. Fifty-four percent said that operations could continue for one to three days, and 25 percent say they will be able to operate between four to seven days without external resources. The survey probed for items included in pandemic-specific plans. To read about the survey findings further, visit http://www.infectioncontroltoday.com/hotnews/76h148311751046.html.
Revised Pediatric Emergency Medicine Teaching Tools are Available
The revised Fourth Edition of the Advanced Pediatric Life Support (APLS) Instructor’s ToolKit CD-ROM now is available for order. It contains 30 ready-to-use PowerPoint presentations based on the APLS textbook, along with handouts, instructor notes, skill station instructions, and post-tests. The tools may be used to teach pediatric emergency medicine to any physician audience. The content has been revised to reflect the current American Heart Association resuscitation guidelines and algorithms and relates to the revised Fourth Edition of the APLS student textbook. To order a copy, visit http://www2.acep.org/bookstore/indes.cfm?go=product.detail&id=10166.
National Junior Firefighter Program Launched
Join Spartan Motors and the National Volunteer Fire Council (NVFC) at 11:00 a.m. on Saturday, July 28, at Booth 2008 during the Firehouse Expo in Baltimore, Md. Officials from both organizations will be on hand to announce the launch of the National Junior Firefighter Program, a great way to get young people active and involved in volunteer fire departments. The National Junior Firefighter Program gives young people a chance to learn about local fire, rescue, and emergency medical services response organizations in a safe, controlled, educational, and fun program – and it provides departments with an excellent recruitment tool. For more information, visit http://www.nvfc.org/juniors.
2007 National EMSC Heroes Award Winners Announced
The EMSC National Resource Center has announced the winners of the 2007 National Heroes Awards. They include: Marianne Gausche-Hill, MD, recipient of the EMSC Lifetime Achievement Award; Susan Fuchs, MD, recipient of the EMSC Advisory Board Member Award; Marie Renzi, recipient of the EMSC Project Coordinator of Distinction Award; Elizabeth “Betsy” Smith, RN, NREMT-P, recipient of the EMSC Provider Leadership Award; Shauna Hatton-Ward, recipient of the EMSC Family Representative Volunteer of the Year Award; and Howard Corneli, MD, MS, recipient of the Outstanding EMSC Research Project Award. For a copy of the press release with photos, contact the National Resource Center at 202-884-4927.
CAAS Accredits Twelve Agencies in June
The Commission on Accreditation of Ambulance Services (CAAS) Panel of Commissioners met in June to review accreditation applications. Metro Atlanta Ambulance Service of Marietta, Ga., and Elizabeth Township Area EMS, of Elizabeth Township, Penn., were newly accredited by the panel, bringing the total number of accredited agencies to 107. Ten other agencies were reaccredited. For more information, visit http://www.caas.org.
CAAS Accepting Applications for New Executive Director
Meredith Hellestrae, Commission on Accreditation of Ambulance Services (CAAS) executive director, will be retiring this fall after 11 years in her position. The Center for Association Growth (TCAG), CAAS’ association management company, is accepting applications for this position which is headquartered in Glenview, Ill., a suburb of Chicago. The successful candidate will be responsible for the day-to-day administration of the commission’s activities; maintaining the integrity of the commission’s quality standards; coordinating the activities of the board of directors, Panel of Commissioners, site reviewer pool and the special committees; acting as spokesperson for CAAS with allied organizations, government agencies, and the media; representing the interests of CAAS-accredited agencies; overseeing all membership services; and marketing to prospective agencies through various channels, including seminars, advertising, meeting exhibits, Web site, speakers, published articles, and related activities. Interested candidates should send a cover letter and current resume to CAAS Job Opening, 1926 Waukegan Road, Suite 1, Glenview, IL 60025 or e-mail to marciem@tcag.com. For more information, visit http://www.caas.org.
AMA Launches Preparedness Journal
The American Medical Association (AMA) has launched a new journal, Disaster Medicine and Public Health Preparedness. The journal supports the integration of clinical medicine with public health preparedness and provides individual healthcare providers with a resource to support their public health activities. For more information, visit http://www.ama-assn.org/ama1/pub/upload/mm/-1/disaster-medicine.pdf.
National First Responder Appreciation Day to be September 25
In late June, the U.S. Senate unanimously passed S.R. 215, a resolution sponsored by Senator Wayne Allard (R-CO) that designates September 25th as National First Responder Day. The bipartisan resolution was co-sponsored by 30 of Allard’s Senate colleagues. The resolution has received support from a variety of first responder organizations, including the Colorado State Fire Fighters’ Association, National Law Enforcement Officers Memorial Fund, and the National Association of Emergency Medical Technicians.
NEMA-CDC “Incident Command System for Executives” Training Materials Available
The 2007 “Incident Command System (ICS) for Executives” training materials now are available online. The training curriculum and instructional materials were developed by the National Emergency Management Association (NEMA) and IEM through a grant from the Centers for Disease Control (CDC). For the past three years, NEMA and IEM have been delivering ICS training to state interagency teams comprised of executive level state officials representing public health, emergency management, fire, law enforcement, governors’ offices and other state agencies with roles and responsibilities for disaster preparedness and response. The training consists of an overview of ICS and a bioterrorism-focused tabletop exercise. The training is available at http://www.nemaweb.org/?1100.
Immunization Practices Recommendations Issued by ACIP
On June 28, 2007, the Centers for Disease Control (CDC) posted its recommendations of the Advisory Committee on Immunization Practices (ACIP) 2007. This report updates the 2006 recommendations by the committee regarding the use of influenza vaccine and antiviral agents. The 2007 recommendations include new and updated information. To read the report, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/rr56e629a1.htm.
DVBIC’s Documentary on TBI Available on the Internet
The Defense and Veterans Brain Injury Center’s (DVBIC) documentary, Understanding Traumatic Brain Injury, now is available for viewing online. The documentary is a 29-minute program, introduced by General Colin L. Powell, USA (Ret.), which offers an introduction to traumatic brain injury, a health issue affecting at least 1.4 million Americans each year. It features the recovery journeys of several service personnel and their families. The link for the program is http://dvbic.org/cms.php?p=Education. Two related products also are available on the same page: (1) a fact sheet on traumatic brain injury awareness and prevention, and (2) a Documentary User’s Guide for organizations that plan to use the documentary as part of their educational efforts.
Oregon Seeks EMS Planner
The State of Oregon is seeking an EMS planner. The planner coordinates all planning activities related to EMS, trauma and emergency preparedness, including mitigation, disaster response and recovery, as prioritized by the public health emergency preparedness manager. The planning coordinator works with other preparedness staff to integrate plans and procedures with relevant state agencies and ensures that state-level resources are integrated with the planning requirements of local health departments and relevant federal and non-governmental organizations. The position requires a high level of technical knowledge of state and federal emergency preparedness systems and resources, which are essential for emergency planning and response. For more information, visit http://www.oregon.gov/DHS/jobs/LEHS7205A.shtml.
Health First Seeks Trauma Unit Manager
Mission Search has been engaged by one of Florida’s premier healthcare systems, Health First, to identify, attract, and qualify talented professionals for the position of manager, trauma unit, at their flagship hospital, Holmes Regional Medical Center located in Melbourne, Fla. Holmes Regional Medical is a busy 564 Level II Trauma Center seeing more than 70,000 patients annually, with an active flight program and a highly regarded heart institute. The trauma unit manager is delegated the authority and autonomy for assessing, planning and directing patient care in the unit. For information on this position, contact Tami Coderre at tlc@missionsearchusa.com.
FireFighter Uses Helmet RIGHT WAY!
Firefighter OK After Hot Rod Hits Helmet
WELLINGTON, New Zealand (AP) -- A firefighter is counting his luck after a red-hot steel rod was fired into his helmet from an exploding vehicle, local media reported Thursday. The steel rod was traveling at such speed it punched a hole through a steel door before hitting 41-year-old Gary Wright's Kevlar fire helmet, The New Zealand Herald said.
Wright was getting ready to fight a blaze earlier this month that had engulfed a garage full of vehicles in a suburb of Auckland, New Zealand's biggest city, when the steel rod fired out of an exploding van 62 feet away. "I had only just put my BA (breathing apparatus) set on and put my helmet back on," he said. "I had my head forward and was adjusting the headband on the helmet ... the next minute, whack.... It was a pretty hard whack, it knocked my head back," Wright was quoted as telling the paper. "It felt like someone coming up and giving me a really good clip around my head ... but I had a glance around and no one was there. Then this glowing thing (the rod) attracted my attention at my feet," Wright said.
Waitakere City Fire Chief Bill Ellis said the rod went through the outer Kevlar layer of the helmet but had been stopped by a protective inner layer.
Wright was left with a headache and some pain on the left side of his head where his helmet strap was pulled back by the force of the rod's impact. "It wasn't until on the way home that I saw the hole (in the helmet) and told the boss," he said."I think most people think I was pretty lucky," said Wright, an 11-year fire fighting veteran.
Do you really know how to use the Emergency Response Guidebook?
By Steven De Lisi, Fire Engineering
The latest edition of the Emergency Response Guidebook (ERG) was published in 2004 and was "developed jointly by Transport Canada, the U.S. Department of Transportation, and the Secretariat of Transport Communication of Mexico." Referred to as ERG2004, its intent is to serve as a "guide to aid first responders in quickly identifying the specific or generic hazards of the material(s) involved in a [transportation incident involving dangerous goods] and protecting themselves and the general public during the initial response phase of the incident."
The ERG is normally provided free of charge to local and state emergency service officials through individual state emergency management agencies. First responders should check with representatives of these agencies to determine the book's availability.
The latest edition of the ERG should always be readily available in every vehicle operated by first responders. This includes vehicles of individuals from departments that have a protocol allowing them to respond from home directly to incidents.
Without a doubt, new and sophisticated computer software programs provide substantial amounts of information and are worthwhile additions to any first responder's information arsenal, but there is no substitute for a handheld copy of the ERG2004. The fact is that the ERG2004 is a quick and easy-to-use reference source that can provide all first responders with valuable information that can save lives! However, the unfortunate reality is that due to the relative simplicity of the ERG2004 when compared to other reference sources, some may underestimate this value and also ignore the need to fully understand important details when using the ERG2004 to make critical decisions.
Most first responders probably know how to look up a material's 3-Digit Guide (orange-bordered pages) using the ID Number Index (yellow-bordered pages) or the Name of the Material Index (blue-bordered pages), and they probably know that if an index entry is highlighted, then additional information is provided in the Table of Initial Isolation and Protective Action Distances (green-bordered pages). But there is a lot more to know regarding effective use of the ERG2004 BEFORE an incident occurs!
The following test contains 15 questions regarding your knowledge of the ERG2004. If you don't know an answer, LOOK IT UP. Answers to each question are shown at the end of the test and include page number references for the correct response.
Before you begin, remember that you should always avoid removing copies of the ERG2004 from response apparatus for training and testing purposes. Someone will always forget to put it back where it belongs! Instead, purchase spare copies for use during these types of activities. Copies are available for sale from a number of vendors, including those found on the Internet. When using the ERG2004, be smart, be safe, and remember, everyone goes home!
What are the characteristics required of materials listed in the Table of Initial Isolation and Protective Action Distances (green-bordered pages)?
What does the letter "P" following a guide number in either the ID Number Index (yellow-bordered pages) or the Name of the Materials Index (blue-bordered pages) signify?
What 3-Digit Guide (orange-bordered pages) should be used for ALL explosives except Explosives 1.4 (Explosives C)?
When using the Table of Placards to determine the appropriate 3-Digit Guide (orange-bordered pages) to use, which guide should first responders use when multiple placards point to more than one guide, as when a vehicle displays both "Oxidizer" and "Corrosive" placards?
Distances shown in the Table of Initial Isolation and Protective Action Distances (green-bordered pages) are those likely to be affected during the first __________ minutes after materials are spilled.
When using the ERG2004, if a reference to a 3-Digit Guide (orange-bordered pages) cannot be found, and the incident is believed to involve dangerous goods [hazardous materials], which guide should first responders use until additional information becomes available?
According to the ERG2004, "Shelter In-Place means people should seek shelter inside a building and remain inside until the danger passes." However, when might "in-place protection" NOT be the best option to use?
Materials found in the Table of Initial Isolation and Protective Actions Distances (green-bordered pages) are listed in what order?
If an entry in either the ID Number Index (yellow-bordered pages) or the Name of the Materials Index (blue-bordered pages) is highlighted, first responders are instructed to look for the ID Number and Name of the Material in the Table of Initial Isolation and Protective Action Distances (green-bordered pages). However, what actions should first responders take regarding use of this table if there is a fire or if a fire is involved?
In the Table of Initial Isolation and Protective Action Distances (green-bordered pages), why are the protective action distances separated for use during either "Day" or "Night" time periods?
Each 3-Digit Guide (orange-bordered pages) describes "potential hazards" that a material may display in terms of fire/explosion and health effects upon exposure. Why do some 3-Digit Guides list "Fire/ Explosion" first while others list "Health" first?
What statement do the publishers of the ERG2004 make to first responders regarding use of the ERG2004 at fixed facility locations?
Hazard Identification Codes may be found in the top half of an orange panel on some intermodal bulk containers. Each code is a single digit that ranges from 2 ¿ 9. As an example, "7" indicates a "radioactivity" hazard while "8" indicates a "corrosivity" hazard. What is the significance of repeating the display of a digit (e.g. "33" instead of "3") and preceding the code with the letter "X?"
The ERG2004 states that when using the Table of Initial Isolation and Protective Action Distances (green-bordered pages), the distances shown may increase for worst case scenarios involving the instantaneous release of the entire contents of a package, such as a catastrophic accident. How can first responders estimate this increase in distance?
The ERG2004 is a guide to assist first responders during the initial response phase of an incident involving dangerous goods [hazardous materials]. What is meant by the term "initial response phase?"
ANSWERS:
Materials which are considered toxic by inhalation, including certain chemical warfare agents, or which produce toxic gases upon contact with water. (p. 295)
The letter "P" following the 3-Digit Guide number in the yellow-bordered and blue-bordered pages identifies those materials which present a polymerization hazard under certain conditions. (p.2)
Use Guide 112 for all explosives except for Explosives 1.4 (Explosives C). (p. 1)
When using the Table of Placards to determine the appropriate 3-Digit Guide (orange-bordered pages), if multiple placards point to more than one guide, initially use the most conservative guide (i.e., the guide requiring the greatest degree of protective actions). (p. 15)
30 minutes (p. 295)
Guide 111 (p. 1)
In-place protection may not be the best option if (a) the vapors are flammable; (b) if it will take a long time for the gas to clear the area; or (c) if buildings cannot be closed tightly. (p. 298)
Materials found in the Table of Initial Isolation and Protective Actions Distances are listed in numerical order by ID number. (p. 4)
If there is a fire, or if a fire is involved, go directly to the appropriate 3-Digit Guide (orange-bordered pages) and use the evacuation information shown under "public safety." (p. 24 and p. 96)
In the Table of Initial Isolation and Protective Action Distances, the protective action distances are separated for use during "Day" or "Night" time periods since atmospheric mixing is less effective at dispersing vapor plumes during nighttime. (p. 299) Refer to page 4 for additional information on atmospheric conditions when using this table.
Each 3-Digit Guide (orange-bordered pages) describes "potential hazards" that a material may display in terms of fire/explosion and health effects upon exposure. The highest potential is listed first. (p. 3)
"Be mindful that there may be limited value in its [meaning the ERG2004] application at fixed facility locations." (p. 2)
Doubling of a digit indicates an intensification of that particular hazard. A hazard identification code prefixed by the letter "X" indicates that the material will react dangerously with water. (p. 20)
For worst case scenarios involving the instantaneous release of the entire contents of a package, such as a catastrophic accident, the initial isolation and protective action distances may increase. The increase can be estimated by multiplying the distances by a factor of two (2). (p. 296)
The "initial response phase" of an incident involving dangerous goods [hazardous materials] is "that period following arrival at the scene of an incident during which the presence and/or identification of dangerous goods [hazardous materials] is confirmed, protective actions and area securement are initiated, and assistance of qualified personnel is requested,."
ICS Training on the WEB
Preparedness Announces Two New Web-Based Incident Command System (ICS)
Review Courses
Emmitsburg, Maryland - Charlie Dickinson, Acting USFA Administrator, announced today that the Nation's first-responders can now take two new Incident Command System (ICS) review courses online through the National Emergency Training Center (NETC) Virtual Campus. These new scenario-based courses are intended as a review of fundamental ICS concepts and principles for the student prepared to take intermediate or advanced-level ICS training, or for those who need a refresher in ICS.
"The U.S. Fire Administration continues to move forward, in our efforts to ensure the Nation's first responders have available to them, the most current ICS body of knowledge," said Acting USFA Administrator Charlie Dickinson. "Our firefighters and first responders face numerous challenges in their communities and these courses further ensure the effectiveness and safety of our response and recovery responsibilities."
The USFA, the Emergency Management Institute, and the National Wildfire Coordinating Group, in cooperation with the NIMS Integration Center, have jointly developed ICS 100 through ICS 400 courses based on standard learning objectives. ICS 300 and ICS 400 are classroom-based courses.
All of the ICS courses are based on standard learning objectives and are considered equivalent in terms of meeting NIMS requirements; NFA's courses are geared toward ensuring that operational responders can perform ICS functions in an emergency or incident environment.
Information concerning the National Fire Academy (NFA) versions of ICS 300 and ICS 400 is available through State Fire Training agencies.
New ICS courses now available are:
Q-464 - Fundamentals Review for ICS 300. This course can be utilized as a pre-course module or as remedial training for the classroom version of ICS 300; this course alone does not meet the training requirements for ICS 300.
Q-465 - Fundamentals Review for ICS 400. This course can be utilized as a pre-course module or as remedial training for the classroom version of ICS 400; this course alone does not meet the training requirements for ICS 400.
The two new courses follow the precedent set by the popular on-line interactive ICS training offered on the NETC Virtual Campus, specifically designed for operational responders. Two of the courses often used by responders to meet NIMS ICS training requirements:
Q-462 - ICS 100, Introduction to ICS for Operational First Responders.
Q-463 - ICS 200, Basic ICS for Operational First Responders.
These courses can be found on the NETC Virtual Campus at http://training.fema.gov. Select the "Online Training (NETC Virtual Campus)" link found under Quick Links.
Be CAREFUL!
Meth and First Responders at Issue in Utah Study
By NATALIE HALE, Daily Utah Chronicle
Susan Dunn is concerned.
She represents more than 50 Utah police officers who suffer from medical conditions believed to be related to exposure to drugs, specifically methamphetamines. Most of these officers were exposed to the drugs after they were assigned to metro-narcotic drug busts in the '80s and '90s, when protection against the chemicals wasn't used.
A center at the U is now working on a study to determine if these officers were in fact affected through their line of work. The Rocky Mountain Center for Occupation and Environmental Health from the U signed a contract with the Utah Labor Commission on Nov. 8 to begin working on finding answers for these police officers.
Dunn said the officers received little training on how to handle the chemicals found at the busts. Suits and breathing apparatuses to protect the officers and those who cataloged the evidence were also not provided. "They were even told in the early days to smell the chemicals in order to identify them," Dunn said. "Dangerous drugs such as ammonia, ephedrine, iodine, red devil lye and embalming fluids could be found among the ingredients to make the meth."
To provide the crucial link, which would determine that those exposed to drugs in the line of duty should receive medical compensation, a bill was passed by the Utah State Legislature. In order to determine whether those exposed to the drugs during their work were getting sick because of it, $500,000 was given to fund a study.
"We are concerned because the study by law was supposed to begin July of 2006," said Kurt Hegmann, director of the center and principal investigator of the study. "Starting it now, in mid-November, puts us on a very tight schedule to get it back on track, time-wise." "Now," he said, "we have to get approval from the U's Institutional Review Board in order to get started, which could optimistically take two months." Putting together the records and performing the analysis will require at least 15 people to work on it, Hegmann said.
"We have to calculate the risk of death among them," he said. "We are on a very tight time line and no one knows for sure how many professional firefighters and police officers there are in Utah."
To get compensation for their medical bills, these officers must prove that it was the direct exposure to these drugs from their line of work that is making them ill. "It is their burden of proof to prove they have these diseases as a result of their exposure," said Joyce A. Sewell, administrative director at the Utah Labor Commission. "They don't have a doctor who can state there is a higher incident, that their diseases are causally related."
Ten out of the 50 police officers Dunn represents have esophageal cancer, which is rare among middle-age non-smokers. "When you get sick while working, you get workers' compensation, but most of these men didn't get sick until years later. Some after they retired," Dunn said. "No study has been done in the United States about the medical links of exposure of officers."
The study is due to report to the Utah legislature by October 15, 2008. It is designed to look at the incidence of cancers and illnesses in all of Utah's past firefighters and police officers that were exposed to drug-related chemicals.
"I have had three of the men I represent die in the past four months," Dunn said. "It is my job to make sure that this study gets underway and that these officers are taken care of."
Interesting!
Family sues Campbell County emergency workers, sheriff
By JAMES WARDEN, News-Record Writer
Relatives of a 51-year-old Wright woman who died in a fire she is accused of setting are suing emergency workers because they say she didn't get the treatment she needed to stay alive.
Representatives of Mary Terese Green filed the lawsuit Nov. 8 in Campbell County District Court against Campbell County, county commissioners, the Sheriff's Office and sheriff, Campbell County Memorial Hospital, two jail nurses and a hospital emergency medical technician.
Green was found slumped over and covered in soot inside a burned-out mobile home just before 1 a.m. Dec. 31, 2004. Green was living in the mobile home but had been asked to leave. Witnesses earlier heard her threaten to burn the home down if she was forced to leave. She died Jan. 8, 2005, from complications of smoke inhalation.
Deputies arrested Green on first-degree arson charges when they found her at the scene. She was uncooperative, combative and appeared drunk.
EMT Denny Bohne, a defendant in the case, noted soot in her nasal passages and mouth but did not examine her or take her to the hospital for evaluation, according to court documents.
Green was not examined until 1:50 p.m. when jail nurse Julie Centner, who is a defendant in the case, examined her, according to charging documents. Centner noted in her report that Green was hyperventilating and that she had shortness of breath, a reddened throat and a frequent cough. A detective interviewed her that evening and noted that she was talking in a whisper.Later in the evening, nurse Ann Herman, who is also a defendant in the case, noted that Green had trouble breathing and was complaining of an inability to get enough air, according to court documents.
The next morning, jail staff noted that Green was still complaining of shortness of breath and that she was coughing up black-colored mucus. They contacted Herman, who told them that such complaints were normal with smoke inhalation.
At 8:10 p.m. Jan. 1, jail staff again saw her slump over in front of them, and they called emergency workers.
Green was taken to Campbell County Memorial Hospital but never regained consciousness. She was declared brain dead and taken off of life support Jan. 7 and died the next day.
“That had decedent Mary Green been transported to the emergency department ... she would in all probability have survived,” according to court documents.
The issue was originally brought up March 1 with the Wyoming Medical Review Panel under state governmental claims laws. The review panel's director later notified Green's heirs that the case had been dismissed.
The plaintiffs, including Green's brother Brian Patrick Green, are asking for $2,675 in funeral expenses, attorney's fees and any other relief the court thinks is appropriate.
Campbell County Memorial Hospital declined to comment because of the hospital's policy to not talk about litigation.
Charlene Edwards, a deputy county attorney who also advises the Sheriff's Office, said she had not yet received the lawsuit paperwork and could not comment.
Bohne and Herman also declined to comment. Centner could not be reached at press time.
Robert Tiedeken, the Cheyenne lawyer who filed the case, also did not want to comment. Tiedeken said he prefers to let the court documents speak for themselves once a case is filed.
November, 2006
NASEMSO Elects Officers at Annual Meeting
At the Annual Meeting, October 4-6, 2006, in Charleston, W.Va., NASEMSO elected new officers. The 2006-08 president-elect is Steve Blessing of Delaware. The 2006-07 secretary is Shawn Rogers of Oklahoma. Janet Kastl of Washington was elected 2006-07 treasurer. NASEMSO regions elected the following representatives and alternates, respectively: South Central – Evon Smith (La.) and David Taylor (Ark.); North Central – Brian Bishop (Ky.) and Dan Williams (Wis.); East – Gary Brown (Va.) and Joe Schmider (Pa.); and West – Jim DeTienne (Mont.) and Paul Patrick (Utah). NASEMSO’s Councils elected the following officers: Medical Directors – Chair Keith Wesley M.D. (Wis.), Chair-elect Doug Kupas (Pa.), and Secretary Steve Diaz (Maine); Training Coordinators – Chair Tawni Newton (Idaho), Chair-elect Rob Clawson (N.J.), and Secretary Debbie Tesky (Minn.); Trauma Managers – Chair Clay Odell (N.H.), Chair-elect Jolene Whitney (Utah), and Secretary John Fidler (Iowa); and Data Managers – Chair Tim Erskine (Ohio), Chair-elect Bob Norland (Minn.) and Secretary Linda Williams (Okla.). For more information, contact Executive Director Elizabeth Armstrong, MAM, CAE, at Armstrong@nasemso.org.
NASEMSO Members Adopt Six Resolutions at Annual Meeting
At the 2005 NASEMSO Annual Business Meeting, October 6, 2006, the membership passed six resolutions: 1) In Recognition of the Leadership and Contributions of Mark E. King; 2) Federal Agency Interaction with Local and Regional Emergency Medical Services; 3) Support of the Rural Emergency Medical and Trauma Assistance Center; 4) Emergency Medical Services Personnel Job Related Reading Ability; 5) Emergency Medical Services and Public Safety Communications; and 6) Air Medical. The resolutions have been posted on the NASEMSO Web site at http://www.nasemso.org/AboutNASEMSO/2006_Resolutions.asp.
NASEMSO Mourns Death of West Virginia EMS Director Mark King
Mark King, West Virginia state EMS director, passed away on Oct. 4, 2006, at his residence. His death occurred during NASEMSO’s 2006 Annual Meeting, held in Charleston, W.Va. West Virginia Governor Joe Manchin III participated in a memorial service for Mark held at the conference. A funeral service was held for Mark on Oct. 7, 2006, and he was buried in the Milton Cemetery. Mark had been the director of the West Virginia Office of Emergency Medical Services since 1995. He was the president of NASEMSD (NASEMSO’s predecessor) from 2002 to 2004. He was also acting president for several months in 2001-02, and prior to that served as NASEMSD’s treasurer. Mark served on six NHTSA State EMS System Reassessment Teams in Nebraska, Connecticut, South Dakota, Tennessee, Wisconsin, and Pennsylvania. He was a member of the Atlantic EMS Council and the Trauma Information and Exchange Program Board for the American Trauma Society. Mark also served as an officer in the United States Army, where he served as a Battalion Assistant Operations Officer with the 2/64 Armor and 3/64 Armor Battalion in Schweinfurt, Germany. Mark was survived by three children, his mother and one brother. Mark’s family has requested donations in his honor to the Advocates for EMS, P.O. Box 15945-281, Lenexa, KS 66285-5945. More information, including an online condolence book, is available at http://www.heckfuneralhome.com.
West Virginia Names OEMS Interim Director
James Sowards, deputy director of the Office of Emergency Medical Services, has been appointed to the position of interim director for the Office of Emergency Medical Services. Jim has served in various positions with the Office of Emergency Medical Services during the past ten years.
NASEMSO and ACEP Urge Immunity for Volunteer Emergency Healthcare Practioners
NASEMSO and the American College of Emergency Physicians (ACEP), represented by Richard Alcorta, MD, recently provided solid testimony in support of inclusion of immunity for Volunteer Emergency Healthcare Practitioners at the National Conference of Commissioners on Uniform State Laws. A DHS representative, John Krohmer, MD, Deputy Medical Director, provided further support for our initiative for immunity inclusion. Download the current draft version of the proposed Uniform Emergency Volunteer Health Practitioners Act on the NASEMSO Web site at
http://www.nasemso.org/documents/UEVHPAdraft1006.pdf. This currently approved model law has "reserved" clauses for an immunity section and a Workers Compensation section. The commissioners supported the immunity clause (draft text only; final version not yet released) available for download at http://www.nasemso.org/documents/UEVHPAct100606.pdf.
Input Needed on Pre-Hospital Triage Target Capability Draft
Recently, NASEMSO members received a draft document on Pre-Hospital Triage Target Capability. As discussed in the Domestic Preparedness Committee meeting in West Virginia, NASEMSO will be submitting comments on this document. All comments should be submitted to Leslee Stein-Spencer at lesleess@aol.com by Nov. 15, 2006.
NCHS Releases National Estimates of Crowding in Emergency Departments
The National Center for Health Statistics has released national estimates of crowding in U.S. emergency departments (EDs). The data come from the National Hospital Ambulatory Medical Care Survey, which surveys non-federal, general and short stay hospitals representative of the 50 states and the District of Columbia. The report presents estimates of structure and process characteristics of hospital EDs related to their capacity to treat medical and surgical emergencies. Estimates of EDs experiencing crowded conditions also are presented. A copy of the report is available at http://www.cdc.gov/nchs/data/ad/ad376.pdf.
AHRQ Releases Pediatric Terrorism and Disaster Preparedness
The Agency for Healthcare Research and Quality (AHRQ), in partnership with the American Academy of Pediatrics, has released Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians. This resource was developed to assist pediatricians and other clinicians, state and local emergency planners and others involved in planning and response efforts in addressing the unique needs of children during natural disasters and terrorism incidents. The resource provides an overview of the role of national, regional and local emergency response systems before, during and after disasters and terrorism events. Individual chapters provide detailed information on the triage, supportive care and referral of children affected by natural, biological, chemical, radiological, nuclear, and blast events. Children’s emotional and mental health needs also are described. To access the resource, visit http://www.ahrq.gov/research/pedprep/resource.htm.
FCC Announces Launch of the Public Safety and Homeland Security Bureau
The Federal Communications Commission (FCC) has announced the launch of the Public Safety and Homeland Security Bureau. The events of September 11, 2001 and last year’s hurricane season underscored America’s dependence on an effective national communications infrastructure. The new bureau will build on the FCC’s longstanding commitment to meet the needs of public safety by promoting robust, reliable and resilient communications services in times of emergency. The new bureau is divided into three divisions: Policy Division; Public Communications Outreach and Operations Division; and Communications Systems Analysis Division. For more information, visit http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-267599A1.pdf.
FCC Adopts Pilot Program under Rural Health Care Mechanism
The Federal Communications Commission (FCC) adopted an Order that establishes a pilot program to help public and non-profit health care providers build state and region-wide broadband networks dedicated to the provision of health care services, and connect those networks to Internet 2, a dedicated nationwide backbone. The construction of such networks will bring the benefits of innovative telehealth, and particularly, telemedicine services to those areas of the country where the need for those benefits is most acute. For more information on this Order, visit http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-267605A1.pdf.
Pandemic Flu Mask/Respirator Guidance Posted
Since the publication of the HHS Pandemic Influenza Plan in November 2005, the U.S. Department of Heath and Human Services (HHS) has received numerous comments and inquiries regarding infection control recommendations that relate to surgical mask and respirator use. In October, HHS posted “Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Health Care Settings during an Influenza Pandemic.” For a copy of this guidance, visit http://www.pandemicflu.gov/plan/healthcare/maskguidancehc.html.
NHTSA Releases Fall EMS Update
The latest issue of EMS Update has been posted on the NHTSA Web site. To access the publication, go to http://www.nhtsa.dot.gov and select “Emergency Medical Services Program” from the Quick Links. You find the EMS Update near the top of the page, listed as “NEW.” This issue features articles on the National EMS Education Standards Project, the Next Generation 9-1-1 Initiative, and the EMS Workforce for the 21st Century. EMS Update is a quarterly newsletter produced by the Office of Emergency Medical Services at the National Highway Traffic Safety Administration.
Theme Set for EMS Week 2007
The theme and dates for EMS Week 2007 have been set, and the logo is being finalized. EMS Week 2007 will be May 20-26, 2007. The slogan will be “EMS: Ordinary People, Extraordinary Service.” More information is available at http://www.acep.org/emsweek.
Jane Ball Steps Down as the Director of the EMSC National Resource Center
Jane W. Ball, RN, DrPH, has announced that she will step down as director of the EMSC National Resource Center by the end of December. In an announcement to colleagues, she stated, “Leaving this position and a direct association with the EMSC program after 15 years is one of the most difficult decisions I have ever made. It has been so rewarding to see the positive changes in pediatric emergency care and the EMS system of care over the past 20 years, and to know that in some small way I have helped contribute to those changes.” Jane has many plans for the future, including consulting work, writing pediatric nursing textbooks, and hopefully some continuing association with the EMSC program. To contact Jane through December, email jball@emscnrc.com.
EMSC National Resource Center Seeks Director
Children’s National Medical Center (CNMC), the largest non-profit medical and research facility in the mid-Atlantic region dedicated exclusively to the care of infants, children, adolescents, and young adults, currently is seeking a director for the Emergency Medical Services for Children (EMSC) National Resource Center. The director has the opportunity to influence and improve the emergency health care system for the nation’s children. The EMSC National Resource Center, funded through a federal contract, provides support to the federal EMSC program director and technical assistance to all states and U.S. territories who receive EMSC grant funding. The director develops and implements strategies responsive to the center’s contract work plan that includes dissemination and outreach, education and resource development, and health policy analysis. In collaboration with the federal EMSC program director, the Resource Center director is responsible for promoting EMSC program relationships with national professional organizations and key federal agency leaders. Applicants must possess a Master’s degree in a health-related field, knowledge of the emergency and trauma health system, and a commitment to children’s health issues. More information and the online application is available at http://www.dcchildrens.com.
CAEMSA Releases Hospital Incident Command System Guidebook and Educational Materials
The California Emergency Medical Services Authority (CAEMSA) has posted the Hospital Incident Command System (HICS) Guidebook and Educational Materials on their Web site at http://www.emsa.ca.gov/hics/hics.asp. The HICS Guidebook, formerly known as the Implementation Manual, offers an introduction to the revised Hospital Incident Command System and recommendations for using the accompanying HICS materials. Also included in the educational materials are Incident Planning Guides, Incident Response Guides, Job Action Sheets, and HICS Forms. For more information, visit the “Frequently Asked Questions” section of the materials at http://www.emsa.ca.gov/hics/hics.asp.
NEMSIS Web Site Changed for Easier Location of Compliance Material
Due to the large number of people wanting to directly access NEMSIS compliance information, the NEMSIS.org Web site has been modified to include “compliance” on the header bar of the site. The information now under this bar includes: NEMSIS Compliance Policy, Compliant Software, The Compliance Process, Compliance Testing Schedule, and The Compliance Testing Software. No information on the pages was changed. See the new section of the Web site by visiting http://www.NEMSIS.org.
18. NIMS Integration Center Releases Criteria for Credentialing Incident Management Personnel
As part of the U.S. efforts to strengthen catastrophic response capabilities in line with the National Incident Management System (NIMS), FEMA’s NIMS Integration Center has released initial minimum criteria for Incident Management (IM) personnel to be deployed using a national credentialing system. Comments and feedback are welcome via email to NIMS-credentialing@L-3com.com. Learn more at http://www.fema.gov/pdf/emergency/nims/imp-15-06.pdf.
19. EMAC Releases After-Action Report for Hurricanes Katrina and Rita
The Emergency Management Assistance Compact (EMAC) released its after-action report for the 2005 hurricane season response. According to the report, despite demands put on the system by the catastrophic natural disasters of Hurricanes Katrina and Rita, the compact and its leadership worked effectively, delivering unprecedented levels of personnel and resources to the affected areas. The report is the culmination of nearly 10 months of intensive review and focuses on activities related to Hurricanes Katrina and Rita. It identifies the compact’s major accomplishments as well as areas needing improvement. EMAC’s ability to deliver resources, people and equipment to Louisiana and Mississippi in the face of one of the country’s worst natural disasters was cited as EMAC’s primary accomplishment. The complete after-action report is available at http://www.emacweb.org.
America’s Firefighters to Receive $485 Million in Grants
The U.S. Department of Homeland Security (DHS) announced $91.8 million in direct assistance grants to 860 fire departments and first responder organizations through the department’s FY 2006 Assistance to Firefighters Grant (AFG) program. Additional phases will soon be announced that will total $485 million in FY 2006 AFG awards to nearly 5,000 fire-related organizations nationwide. Read the DHS fact sheet at http://www.dhs.gov/dhspublic/interapp/press_release/press_release_1023.xml.
CRS Releases Report on Agroterrorism Threats and Preparedness
The Congressional Research Service (CRS) at the Library of Congress has released an analysis of “Agroterrorism: Threats and Preparedness.” The report discusses agriculture as a target of terrorism, U.S. congressional and executive branch responses, related federal funding, recommendations on countering the threat, proposed legislation, deterrence, judicial issues, border inspections, animal and plant pathogens and national veterinary stockpiles. Download the report at http://www.fas.org/sgp/crs/terror/RL32521.pdf.
FDA Issues Warning about Counterfeit Glucose Test Strips
The FDA has issued an alert about counterfeit test strips for LifeScan One Touch blood glucose monitors, currently being sold across the United States. The fake test strips could give incorrect blood glucose values. So far no injuries have been reported. The counterfeit products are being sold as One Touch Basic/Profile test strips (lots 272894A, 2619932, and 2606340) and One Touch Ultra test strips (lot 2691191). The fakes are limited to 50-count packages whose outer cartons bear text in several different languages. The counterfeits were distributed nationwide, predominantly to Ohio, Florida, New York, Maryland, and Missouri. There may be ambulances using these devices or patients using them who call 9-1-1. Health care providers and patients can direct their questions to LifeScan at 1-800-227-8862.
FDA Approves Treatment of Nerve-Poisoning Agents for Use in Civilians
The U.S. Food and Drug Administration (FDA) approved Duodote (atropine and pralidoxime chloride injection) for use by trained emergency medical services personnel to treat civilians exposed to life-threatening organophosphorus-containing nerve agents, such as sarin and insecticides. FDA previously approved atropine and pralidoxime chloride injection under the name Antidote Treatement—Nerve Agent Auto-Injector (ATNAA) for military use. ATNAA is not available for use in civilians. Duodote is manufactured by Meridian Medical Technologies, Inc., Columbia, Md. King Pharmaceuticals in Bristol, Tenn. also has been approved to manufacture and distribute Duodote. The manufacturers will distribute Duodote directly to emergency medical service organizations or their suppliers. For more information, visit http://www.fda.gov/bbs/topics/NEWS/2006/NEW01473.html.
September 19, 2006
Reminder: NASEMSO Bylaws Amendments to Be Considered at Annual Meeting
Per NASEMSO bylaws requirements, a notice of potential amendments must be circulated 30 days in advance of the annual business meeting, which occurs Oct. 6, 2006. NASEMSO headquarters notified members on Sept. 6, 2006 via email that an amendment will be considered to allow absentee voting to occur for elections. Currently, only votes on bylaws amendments and positions can occur in absencia. NASEMSO members are encouraged to participate in this year’s annual business meeting. More information is available at http://www.nasemso.org.
NASEMSO Provides Input to GSA on Ambulance Services in Disaster Response
On Sept. 19, 2006, NASEMSO provided comments to the General Services Administration on a solicitation regarding “Federal Ambulance and Paratransit Support.” NASEMSO provided a brief explanation of the primary functions of a state EMS agency. Further, NASEMSO noted that it has preliminarily reviewed the draft Request for Proposals for ambulance services in disaster response and plans to discuss the topic in detail at the NASEMSO Annual Meeting. NASEMSO requested a meeting following the annual meeting and indicated its willingness to facilitate a small group meeting that would bring national, state, and local EMS perspectives to this important issue. For more information, contact NASEMSO President Robert R. Bass, M.D. at rbass@miemss.org.
Nineteen Organizations Urge Funding for Trauma Care Programs
On Sept. 11, 2006, nineteen organizations, including NASEMSO, sent a letter to key House and Senate Appropriators that would meet in conference to resolve differences in the House and Senate versions of the FY 2007 Labor-HHS-Educations appropriations bills. The letter urged Congress to provide the highest possible funding for programs that support trauma care, trauma care research, and injury prevention. The Coalition for American Trauma Care organized the letter. For more information, contact Marcia Mabee at mmabee@ix.netcom.com.
NASEMSO Joins AEMS Letter on NEMSIS
On Sept. 13, 2006, AEMS and 15 other organizations, including NASEMSO, sent a letter to all members of the House and Senate Transportation Appropriations Subcommittees. The Senate version of the Transportation Appropriations bill includes $2 million for the continued implementation of the National Emergency Medical Services Information System (NEMSIS), but no money is included in the House version of the bill. The letter urges consideration and support for the full $2 million in the final Conference Report. For more information, contact Lisa Meyer at lmeyer@cgagroup.com.
Twelve Organizations Support House DHS Appropriations Report Language
Twelve organizations, including NASEMSO, joined in an Advocates of EMS letter in support of the House DHS appropriations report language. The House version was stronger than the Senate version in that it requires at least 10 percent of State Homeland Security Grant funds and the HighThreat, High Density Urban Area Grants to go to EMS providers. The letter, sent on Aug. 16, 2006, went to all Senate and House conferees. For more information, contact Lisa Meyer at lmeyer@cgagroup.com.
AAA Urges EMS Community to Contact Congress about 5% Temporary Medicare Ambulance Rate Increase – AEMS and NASEMSO Issue Letters
The American Ambulance Association (AAA) urges the emergency medical services community to contact members of Congress as soon as possible to ask for their support of temporary Medicare relief for ambulance service providers. A draft letter is available at http://capwiz.com/the-aaa/home/ and can be edited online and transmitted to directly to selected members of Congress. The Government Accountability Office (GAO) is not expected to release its report on the cost of providing ambulance services until late this year. As a result, Congress would not have an opportunity to act on the findings this session. Ambulance service providers are hurting now and at the end of this year will lose the one percent urban and two percent rural relief as well as a reduction in regional relief. The AAA proposal would increase Medicare rates in 2007 and 2008 by five percent for all ambulance service providers regardless of region or service area. While a five percent increase will not solve the problem of diminishing and below-cost Medicare reimbursement, providers are in desperate need of relief and the five percent would help until the GAO releases its report on the cost of providing ambulance services and Congress can implement a permanent fix. Questions on this issue and AAA’s proposal should be directed to Tristan North at tnorth@the-aaa.org. Advocates for EMS, along with nine member organizations including NASEMSO, sent letters to the lead sponsors of the bill in the Senate and House, Senator Trent Lott (MS) and Congressman Tom Reynolds (NY), on Sept. 12. 2006.
NIMS Integration Center Releases Information on NIMS Implementation Activities for Hospitals and Healthcare Systems
The NIMS Integration Center (NIC) has released the NIMS Implementation Activities for Hospitals and Healthcare Systems. These activities are designed to assist hospital and healthcare systems with their implementation of NIMS, further enhancing the efficiency and effectiveness of response and recovery roles. The implementation activities detailed in the present NIMS Implementation Activities for Hospitals and Healthcare Systems resemble those requirement activities that local agencies have worked to adopt since October 2004. Ultimately, the implementation of these activities enhances the relationship between hospitals and their respective local government, public health and other emergency response agencies. A detailed description of the NIMS implementation activities for hospital and healthcare systems, which includes “Fact Sheets” for each implementation activity, may be accessed at http://www.fema.gov/emergency/nims/index.shtm. Questions and comments can be directed to the NIMS NIC at NIMS-Integration-Center@dhs.gov.
Senate Votes to Pass IP-Enabled Voice Communications and Public Safety Act
The U.S. Senate voted Sept. 14, 2006, to include the IP-Enabled Voice Communications and Public Safety Act of 2006 as part of a managers’ amendment to the Safe Port Act (H.R. 4954). The Safe Port Act, as amended, passed the Senate that same day and has been referred to Conference Committee to iron out the differences between the House and Senate versions. The IP-Enabled Voice Communications and Public Safety Act addresses several important issues and provides tools to support the national deployment of E9-1-1 for Voice over IP (VoIP). The complete text of the bill and the current bill status are available by searching for the bill number at http://thomas.loc.gov. The National Emergency Number Association endorses the bill and applauds Senate actions.
NEMSIS Web Site Updated
NHTSA Version 2.2.1 Dataset Errors Found
During the annual software developers meeting, the NEMSIS Technical Assistance Center (TAC) staff received information about errors found in the most recent version of the NHTSA 2.2.1 EMS dataset. The TAC currently is correcting the absence of the front section of the document. Anyone who has discovered any additional issues with the data dictionary should contact Michael Schnyder at Michael.schnyder@hsc.utah.edu.
FDA Reconsidering Consent in Emergency Medicine Research
The Food and Drug Administration (FDA) is taking a close look at the implementation of its 1996 regulation (21 CFA 50.24), which allows clinical emergency research when informed consent cannot be obtained. This federal regulation allows the conduct of research studies to test emergency treatments on patients with specific life-threatening medical conditions (head trauma, cardiac arrest, stroke) when patients cannot give informed consent because of their conditions, and family is not available to provide consent either. Such emergency research has been allowed under very restricted circumstances since 1996, when FDA regulations went into effect providing for a narrow exception to the informed consent research requirements. A draft guidance (Guidance for Institutional Review boards, Clinical Investigators, and Sponsors: Exception from Informed Consent Requirements for Emergency Research) is being made available to assist in the development and conduct of research. FDA will review emergency research with an exception from informed consent by holding a public hearing on Oct. 11, 2006, at the University of Maryland Shady Grove Center in Rockville, Md. FDA is seeking public input on emergency research at the public hearing and also is seeking written comment on the guidance. Visit http://www.fda.gov/dockets/ecomments/ to provide written comments. Additional information is available at http://www.fda.gov/bbs/topics/NEWS/2006/NEW01439.html.
New Brochures Released on Preparedness for Older Americans and Those with Disabilities
The Department of Homeland Security announced on Sept. 6, 2006, joint efforts with the American Association of Retired Persons (AARP), the American Red Cross (ARC), the National Organization on Disability (NOD) and the National Fire Protection Association (NFPA) to assist older Americans and individuals with disabilities in preparing for emergencies. The department’s Ready Campaign, AARP, ARC, and NOD have developed two new brochures highlighting the key preparedness steps older and disabled Americans and their families and caretakers should take before emergencies occur. The NFPA also announced its new Emergency Evacuation Planning Guide for People with Disabilities, designed to help individuals with disabilities and businesses prepare for emergency evacuation events. Additionally, NFPA is including evacuation planning for people with disabilities in its series of emergency evacuation workshops across the country this fall. For free copies of the new emergency preparedness brochures for older Americans and people with disabilities, visit http://www.ready.gov. NFPA’s planning guide can be downloaded at http://www.nfpa.org.
NFPA Seeks Feedback on Draft Standard for Incident Management Personnel Professional Requirements
In 2004, the National Fire Protection Association (NFPA) formed a technical committee to develop job performance requirements for the major positions within the Incident Command System (ICS). The committee has developed a draft standard during the past 18 months. NFPA 1026, Standard for Incident Management Personnel Professional Qualifications, is slated to be adopted at the June 2008 Annual Meeting of NFPA. It contains job performance requirements for 29 major ICS positions. The committee is soliciting public comment and proposals on the draft standard until Nov. 22, 2006. The draft is available at http://www.nfpa.org/itemDetail.asp?categoryID=163&itemID=19006&URL=Codes.
Evaluation of MAYDAY/9-1-1 Field Operational Test Report Issued
The Minnesota Department of Transportation (MnDOT) conducted a federally funded Field Operational Test (FOT) to develop and test a MAYDAY/9-1-1 system. The system automatically routes 9-1-1 calls initiated by Telematics Service Providers (TSP) to an appropriate Public Safety Answering Point (PSAP) based on vehicle location information provided by the instrumented vehicles. This FOT voice routing solution is called TSP Emergency Call Routing Service (TSPECRS). In addition, the Automatic Crash Notification (CAN) or Advanced Automatic Crash Notification (AACN) data from the TSP are shared in real-time with MnDOT in support of emergency response and management via the Conditional Acquisition and Reporting System (CARS). The scope of the evaluation was to conduct an acceptance test on the voice routing system, TSPECRS; perform an analysis on CAN/AACN data routing; solicit feedback from users of the voice and data routing systems; and identify potential deployment issues. The study was conducted by Battelle in association with The Melcher Group. The final report is available at http://www.itsdocs.fhwa.dot.gov/JPODOCS/REPTS_TE/14297.htm.
NPSTC, NASEMSO Support Request to Operate a Public Safety Paging System on 900 MHz Narrowband PCS Frequencies
The City of Richmond, Va., petitioned the Federal Communications Commission (FCC) to operate a regional public safety two-way paging system on 900 MHz band Narrowband PCS (NPCS) Channel 16. It proposed to use NPCS Channel 16 on an exclusive basis with an initial deployment of 23 base station sites to cover the City of Richmond and Henrico, Chesterfield, and Hanover counties. The National Public Safety Telecommunications Council (NPSTC) filed comments on Sept. 12, 2006, urging approval of Richmond’s Application and Waiver Request and rejecting USA Mobility’s position that Richmond’s paging system connect to the public switch network. NASEMSO supported these comments as a member of NPSTC. For more information, contact NASEMSO Communications Technology Liaison Kevin McGinnis at mcginnis@nasemso.org.
NHTSA EMS Update Posted on Web Site
The latest issue of EMS Update has been posted on the NHTSA Web site. The issue features information on Next Generation 9-1-1 and the new NHTSA Uniform Dataset. To access EMS Update, go to the NHTSA Web site at http://www.nhtsa.dot.gov and select “Emergency Medical Services Program” from the Quick Links. The EMS Update is near the top of the page, listed as “NEW.” EMS Update is a quarterly newsletter produced by the Office of Emergency Medical Services at NHTSA.
NIJ Releases 9/11 Report: DNA Identification in Mass Fatality Incidents
On the fifth anniversary of the Sept. 11 terrorist attacks, the Office of Justice Programs’ National Institute of Justice (NIJ) is releasing Lessons Learned from 9/11: DNA Identification in Mass Fatality Incidents. The report was prepared by a panel of the nation’s top forensic scientists who advised New York City’s Office of Chief Medical Examiner on the identification of World Trade Center victims using DNA analysis. NIJ’s report reviews the experiences of the scientists who helped develop techniques and processes for identifying remains, and offers guidance to laboratory directors on how to respond to future mass fatality events. The effort was part of the President’s DNA Initiative. A copy of the report is available at http://www.massfatality.dna.gov.
NOAA Public Alert Radios Distributed to U.S. Schools
NOAA Public Alert Radios were distributed to U.S. public schools to help safeguard children by alerting school personnel to severe weather conditions, terrorist threats and other emergencies, even when other communication lines are unavailable. This school distribution program was sponsored by the Department of Homeland Security (DHS) Citizen Corps; the Department of Commerce’s National Oceanic and Atmospheric Administration (NOAA); and the Department of Education Office of Safe and Drug-Free Schools in recognition of September as National Preparedness Month. More information is available at http://public-alert-radio.nws.noaa.gov/proginfo.htm.
NASEMSO Welcomes New Director in Hawaii
Linda M. Rosen, M.D., M.P.H., is the new chief of the Emergency Medical Services and Injury Prevention System Branch of the State of Hawaii Department of Health. NASEMSO welcomes her participation. She may be contacted by email at Linda.rosen@doh.hawaii.gov.
Nancy Bourgeois Retires
Nancy Bourgeois retired on Aug. 31, 2006. She was the Director of Public Health Emergency Preparedness and Response for the State of Louisiana and a former State Director of EMS. Evon Smith will be stepping into the position of EMS Director. Nancy plans to remain active professionally. She writes, “After a much needed vacation, I will be available for short-term projects.” Nancy can be reached at (985) 386-5269 or (985) 507-1797.
NOAA National Hurricane Center Director to Retire
Max Mayfield, long-time director of the National Hurricane Center in Miami, Fla., will retire at the end of the year after 34 years of federal service. Mayfield said he wishes to spend more time with his wife and family, which has been very limited during the last two record-setting hurricane seasons. “The entire nation will miss Max Mayfield’s extraordinary leadership, expertise and service when he takes his well-deserved retirement from the National Hurricane Center,” said Commerce Secretary Carlos Gutierrez. “As a dedicated forecaster and a voice of calm during hurricane storm seasons, he helped save lives and property. We thank him and wish him well.” A press release about Mayfield’s retirement is available at http://www.publicaffairs.noaa.gov/releases2006/aug06/noaa06-069.html.
Kentucky Invites Participation in Pediatric Terrorism Awareness Course
The Kentucky Injury Prevention and Research Center and the Kentucky Emergency Medical Services for Children Program announce the availability of a new continuing education program, “Pediatric Terrorism Awareness Course.” The course has four main objectives: to review potential terrorist weapons, including the most likely agents in each class; to identify the characteristics that make children more susceptible to the various forms of terrorism; to learn how to recognize, evaluate, and manage pediatric victims of terrorist incidents; and to discuss the various agents of terrorism, including the mechanisms of injury or illness, expected signs and symptoms, and evaluation and treatment of victims. For more information on the course, visit http://www.kiprc.uky.edu/trap/peds.html.
Health Department Releases Guidelines to Help Doctors Treat Those Exposed to the World Trade Center Disaster
On Aug. 31, 2006, the New York City Health Department released updated clinical guidelines for health care providers on how to treat adults exposed to the World Trade Center (WTC) disaster. The guidelines also recommend screening approaches to improve detection of illness possibly associated with WTC exposures. The guidelines are available at http://www.nyc.gov/html/doh/downloads/pdf/chi/chi25-7.pdf. The guidelines will be updated periodically based on published scientific data.
Learning from 9/11: New York-Presbyterian/Weill Cornell Study Reviews Hospital’s Disaster Preparedness
With the nation’s busiest burn center and the metropolitan area’s largest hospital Emergency Medical Services (EMS) fleet, New York-Presbyterian Hospital rescued and treated many survivors of the Sept. 11, 2001, attack on the World Trade Center. A new study published by New York-Presbyterian Hospital/Weill Cornell Medical Center in the September issue of the Journal of Burn Care and Research looks at the hospital’s disaster preparations, especially as they address the challenges of communication and patient triage that occurred on that day. A summary of the article is available at http://news.med.cornell.edu/nyp/nyp_2006/09_07_06.shtml.
DHS Releases Fact Sheet on Protecting the Homeland Post-9/11
On Sept. 8, 2006, the Department of Homeland Security (DHS) published a fact sheet on significant actions to improve U.S. security since the terrorist attacks of Sept. 11, 2001. Efforts include improving security measures for the nation’s aviation system, implementing measures designed to protect our critical infrastructure, using biometrics to establish and verify identity, reflecting on the lessons learned from Hurricane Katrina, increasing the nation’s preparedness for a disaster, and enhancing information sharing among federal, state, local and international partners. The fact sheet is available at http://www.dhs.gov/dhspublic/display?content=5821.
Updated National Strategy for Combating Terrorism Released
On Sept. 5, 2006, President George W. Bush released his updated national Strategy for Combating Terrorism (NSCT), which outlines the U.S. government strategy to protect and defend American interests at home and abroad from terrorism. The report also addresses a strategic vision for the war on terror, advancing effective democracy over the long-term, long- and short-term priorities, successes and challenges. Read the report at http://www.whitehouse.gov/nsc/nsct/2006/index.html. A fact sheet is available at http://www.whitehouse.gov/news/releases/2006/09/20060905.html.
GAO Publishes New Reports on Disaster Relief and Strategic Planning
On Sept. 5, 2006, the Government Accountability Office (GAO) released three reports of interest. “Catastrophic Disasters: Enhanced Leadership, Capabilities and Accountability Controls Will Improve Effectiveness of the Nation’s Preparedness, Response and Recovery System” is available at http://www.gao.gov/cgi-bin/getrpt?GAO-06-618. The report highlights are available at http://www.gao.gov/highlights/d06618high.pdf. “Disaster Relief: Government-wide Framework Needed to Collect and Consolidate Information to Report on Billions in Federal Funding for the 2005 Gulf Coast Hurricanes” may be downloaded at http://www.gao.gov/cgi-bin/getrpt?GAO-06-834. The highlights are available at http://www.gao.gov/highlights/d06834high.pdf. “Hurricane Katrina: Strategic Planning Needed to Guide Future Enhancements Beyond Interim Levee Repairs” may be downloaded at http://www.gao.gov/cgi-bin/getrpt?GAO-06-934. The highlights are available at http://www.gao.gov/highlights/d06934high.pdf.
Two Documents Now Available in the NASEMSO Members-Only Area
Two documents have recently been added to the “Document Download” section of the Members-Only Section of the NASEMSO Web site. Members can log in a find the documents under the Domestic Preparedness heading in the download section. The documents now available are: Pennsylvania Emergency Medical Services Strike Team Guidelines and a Sample Ambulance Grant Agreement. Members can log in on NASEMSO’s home page at http://www.nasemso.org.
September 1, 2006
SAFECOM Is Developing a Statewide Interoperability Planning Guide, NASEMSO Participates
SAFECOM is in the process of developing a Statewide Interoperability Strategic Planning Guide. A draft has been developed and is in the review stage. NASEMSO Project Advisor Kevin McGinnis is participating on the SAFECOM committee responsible for the project. Contact Kevin at mcginnis@nasemso.org for the draft guide or to provide comments.
NEMSIS Software Developers Meeting Covered Many Topics
The NEMSIS Technical Assistance Center (TAC) and various members from the software developers and EMS community met in Clearwater, Fla., on Aug. 26, 2006, for the Annual Software Developers Meeting. Many topics were presented and discussed during the session. Topics included: an update on the TAC, software compliance, the national EMS database, status of states, and more. Feedback on the meeting was positive. Therefore, the NEMSIS TAC will make every effort to continue the event. Presentations have been published on the NEMSIS Web site at http://www.nemsis.org/referenceMaterials/presentations.html.
Application Period for FY 2006 Commercial Equipment Direct Assistance Program Closes September 15
The Department of Homeland Security (DHS) is seeking applications for the fiscal year 2006 Commercial Equipment Direct Assistance Program (CEDAP). This program will provide more than $32 million in equipment to first responders in selected rural and smaller communities who are typically not eligible for funding through the department’s Urban Areas Security Initiative (UASI) grant program. The application period for the CEDAP will close on Sept. 15, 2006. For more information, visit http://www.rkb.mipt.org.
AHRQ Releases Issue Brief on Mass Prophylaxis
The Agency for Healthcare Research and Quality (AHRQ) has released Bioterrorism and Health System Preparedness Issue Brief Number 10, titled “Mass Prophylaxis: Building Blocks for Community Preparedness.” The brief examines the health care system’s ability to administer mass prophylaxis and explains elements typically found within local mass prophylaxis plans. It gives local communities the information and capability to respond to public health emergencies in real time. For more information, visit http://www.ahrq.gov/news/ulp/btbriefs/btbrief10.htm.
FEMA Issues New Recovery Strategies for Mass Sheltering and Housing Assistance Program and Debris Removal Operations
To improve the quality, speed and accountability of federal disaster support to state and local partners, the Federal Emergency Management Agency (FEMA) has issued recovery strategies addressing two key areas of disaster operations. The Mass Sheltering and Housing Assistance and Debris Removal Operations strategies reflect important lessons learned from Hurricane Katrina, and outline a clear and manageable framework for guiding federal and state operational responses during the 2006 hurricane season and beyond. Learn more at http://www.fema.gov/news/newsrelease.fema?id=28178.
FEMA Issues Interim Policy on Temporary Housing Donations
On Aug. 15, 2006, the Federal Emergency Management Agency (FEMA) issued an interim policy on temporary housing unit donations. The purpose of the policy is to establish criteria for permanently donating FEMA-purchased temporary housing units to states, local governments and voluntary organizations. A copy of the interim policy may be downloaded at http://www.iaem.com/documents/TemporaryHousingUnitDonations9455.1.pdf.
Model Communities Web Page Has Been Updated
The Model Communities Web site has been updated. The new page is at a new location. If you are linking to this site from your Web site, please change the link to http://www.bt.cdc.gov/masscasualties/modelcommunities.asp.
Anthrax in Children Difficult to Detect and Treat, New Report Finds
Difficulties in diagnosing anthrax may lead to dangerous delays in caring for children infected with this often-deadly disease, according to a new report from the Agency for Healthcare Research and Quality (AHRQ). Treating pediatric anthrax also is a special challenge because most currently recommended therapies have not been widely used to treat children with the disease. Since anthrax exposure occurs rarely in the United States and most of the recent cases have been naturally occurring, clinicians may not have first-hand knowledge about the disease and might have difficulty diagnosing it. Additionally, symptoms of pediatric anthrax can be confused easily with those of more common illnesses. For more information, visit http://www.ahrq.gov/news/press/pr2006/pedanthpr.htm.
AAP Issues Second Edition of the Family Readiness Kit
The American Academy of Pediatrics (AAP) has released the Family Readiness Kit, Second Edition. The kit is for parents to use at home to help their families prepare for most kinds of disasters. The kit includes a booklet that addresses different types of disasters and simple steps for preparing for them. Information on how to help build neighborhood cooperation in times of an impending disaster and a list of community and national resources also are included. In addition, the kit includes a safety readiness guide, a child identification card, and fact sheets on different types of disasters. To download a copy of the kit, visit http://www.aap.org/family/frk/frkit.htm.
NHTSA Releases Bicycle and Pedestrian Safety Resource Guide
The National Highway Traffic Safety Administration (NHTSA) has released the Bicycle and Pedestrian Safety Resource Guide for highway safety professionals and others who are proactive in developing or directing bicycle and pedestrian safety programs at the state or community level. Copies of the guide are available at http://www.nhtsa.dot.gov.
CEPIN Receives Course Approval from DHS
The Community Emergency Preparedness Information Network (CEPIN) has received approval from the Department of Homeland Security’s (DHS) Office of Grants and Training for its “Emergency Responders and the Deaf and Hard-of-Hearing Community: Taking the First Steps to Disaster Preparedness” curriculum. The training is designed to encourage networking, preparation and communication between emergency responders and deaf and hard-of-hearing people prior to disaster situations. CEPIN partnered with four centers to develop this unique training curriculum: NVRC, Deaf, Inc., DCARA and CSD. Visit http://www.bigmedicine.ca/education.htm#CEPIN_receives_course_approval_from_DHS for more information.
DHS Provides Homeland Security Digital Library
The Department of Homeland Security (DHS) is providing the Homeland Security Digital Library (HSDL) to homeland security officials, researchers, educators and students in an effort to further advance national research and policy development. The library is described as the nation’s premier collection of homeland security policy, strategy and organizational documents. Key features include: thousands of key, selected homeland security documents; full-text advanced search in hundreds of subject categories; direct links to important U.S. policy documents; online databases and journals; cutting edge thesis and research reports; and breaking news stories. Homeland security policy planners, strategists, researchers, scholars, managers and first responders are invited to visit the HSDL at https://www.hsdl.org and register for an individual account. The HSDL currently is being offered to federal, state and local government officials, research and academic institutions, and the U.S. military. While the HSDL is not available to the public, it is being made as widely available as possible to those who need access to its contents.
New DOT Rule Requires Automakers to Tell Consumers if New Vehicles Are Equipped with Event Data Recorders
Automakers will be required, for the first time ever, to tell new car buyers if an Event Data Recorder (EDR) has been installed under a new rule issued on Aug. 21, 2006, by the National Highway Traffic Safety Administration (NHTSA). EDRs are electronic devices that capture crash data in the few seconds before, during and after a crash. EDRs do not capture any data unless there is a collision that is severe enough to cause the airbag to deploy. While automakers are not required to install EDRs, approximately 64 percent of the model year 2005 passenger vehicles came equipped with the device. This new rule will not require automakers to install EDRs if they are not already doing so. The rule may be seen at http://nhtsa.gov/staticfiles/DOT/NHTSA/Rulemaking/Rules/Associated%20Files/EDRFinalRule_Aug2006.pdf
August 31, 2006
Michelin Supports First Responders With Driving America’s Safety Initiative
Local fire/EMS departments can win new tires for emergency service vehicle
Michelin launched the Driving America’s Safety program as part of the tire company’s continued commitment to social and corporate responsibility. In addition to supplying drivers with road safety tips, the program provides people the opportunity to thank local firefighters and EMS personnel by nominating them to receive a donation of a full set of new tires for an emergency services vehicle – from ambulances and fire engines to small rescue trucks and sport utility vehicles.
Fire departments and EMS squads across the country continually face financial restraints and maintenance issues. Michelin’s Driving America’s Safety program enables citizens to play a role in ensuring the vehicles for their community’s first responders are outfitted in the safest and most reliable tires. Visit the Michelin website at www.michelinman.com to obtain information on how to nominate a local firefighter or EMT to be chosen as one of 25 who will receive a new set of Michelin tires for their department.
“For many of us, general safety measures like police and fire departments, as well as good tires and seat belts, provide us with peace of mind,” said Parmeet Grover, Michelin brand director, Michelin Americas Small Tires. “We’re encouraging drivers to take a few extra minutes to think about their safety on the roads and at home. Everyone can take simple steps, including supporting the local heroes who protect their families – firefighters and EMTs.”
Communities can nominate their local heroes by developing a minimum 300-word essay describing why a local firefighter or EMT should receive one set of Michelin tires for an emergency response vehicle. Nominations will be evaluated on a 100-point scale using selected criteria, including:
- Financial need of the EMS squad or fire department
- Compelling stories on the impact the firefighter or EMT has on the community
- Type of apparatus the department uses
Completed nominations can be sent to Michelin via email at michelinman@cohnwolfe.com or via the U.S. Postal Service:
Michelin’s Driving America’s Safety Program
c/o Cohn & Wolfe
292 Madison Avenue, 8th Floor
New York, N.Y. 10017
All nominations must be postmarked by Oct. 31, 2006, and received by Nov. 10, 2006. Additional information can be found at www.michelinman.com.
August 17, 2006
NASEMSO EMS Performance Measures Project Draft Available for Review
The EMS Performance Measures Project’s goal is to develop 25 to 30 general EMS performance measures for use by systems nationwide. The project is staffed by NASEMSO and supported by NHTSA, with a steering committee of national association and federal agency representatives. The steering committee will meet at the end of August to consider comments of the draft EMS Performance Measures Project report. To view the report, visit http://www.MeasureEMS.org. Comments are due by Aug. 28, 2006. A teleconference discussion on the draft will be held on Monday, Aug. 21, 2006, at 4:00 p.m. Eastern. Any NASEMSO member is welcome to participate. Contact Program Advisor Kevin McGinnis to participate at mcginnis@nasemso.org.
NASEMSO Provides Input on ASTHO’s State Public Health Service Project
The Association of State and Territorial Health Officials (ASTHO) is currently undertaking a project to explore the feasibility of developing a common definition of the public health services a citizen should be able to expect from his or her state government. The project is funded by The Robert Wood Johnson Foundation, with hopes that a common understanding of the role of governmental public health at the state level will help to demonstrate performance, promote accountability, and strengthen interactions among partners. ASTHO is working with all partners that may have a stake in a shared definition by exploring the feasibility of conducting such a project. Dia Gainor, chief of the Idaho Emergency Medical Services Bureau, was interviewed and provided NASEMSO’s comments. Her responses centered on the role of EMS as the public health safety net, inclusion and integration of EMS into state public health planning, and the importance of using evidence-based approaches to the evaluation and improvement of EMS systems. For more information on the project, contact ASTHO’s Adam Reichardt at areichardt@astho.org.
NASEMSO Responds to FCC Hurricane Katrina Panel Findings on Public Safety Communications
The Federal Communications Commission’s (FCC) Independent Panel on Hurricane Katrina issued its report in June and is available at http://www.fcc.gov/eb/hkip/REPORTS.html. The FCC sought comments on the report, which were due Aug. 7. NASEMSO joined in a broad statement of response on public safety communications with the National Public Safety Telecommunications Council (NPSTC), but also filed separately on a number of EMS issues. The NASEMSO response document is available at http://www.nasemso.org. The panel provided several EMS specific findings, including: “The FCC should work to assist the emergency medical community to facilitate the resiliency and effectiveness of their emergency communications systems. Among other things, the FCC should: a. educate the emergency medical community about emergency communications and help to coordinate this sector’s emergency communications efforts; b. educate the emergency medical community about various priority communications services (i.e., GETS, WPS and TSP) and urge them to subscribe; c. work with Congress and other appropriate federal departments and agencies to ensure that emergency medical personnel are treated as public safety personnel under the Stafford Act; and d. support DHS efforts to make emergency medical providers eligible for funding for emergency communications equipment under the State Homeland Security Grant Program.”
IRCP Creates Forums on Community Paramedicine and Rural Health Care Delivery
Based on feedback received from a survey of this year’s participants of the Second Annual International Roundtable on Community Paramedicine and Rural Health Care Delivery (IRCP), forums have been added to the IRCP Web site. Anyone may view posts, but you must register on the site in order to place posts. Registration is easy and free. Current forums included: The Future of EMS and Healthcare Integration; Research; Research Funding; Curricula; Data; Cost-Benefit Analysis; and Expanded Role Versus Expanded Scope. There are also forums for comments on past meetings and suggestions for future meetings. Additional forums or forum groups will be added as needed. The forum board is only as useful as the posts it gets. To join, visit http://ircp.ncemsi.org.
IRCP Meeting in Rochester Deemed Success – Actions to Follow
The International Roundtable on Community Paramedicine and Rural Healthcare Delivery (IRCP) met at the Mayo Clinic, in Rochester, Minn., July 24-27, 2006. The agenda for the meeting has been posted at http://ircp.ncemsi.org. The meeting was sponsored by the Mayo Clinic, the North Central EMS Institute, ZOLL Data and ImageTrend. Chris Tilden, Mike McKeage and Bobby Brown were invaluable in planning this year’s meeting. Next year’s meeting will be hosted by Neil Kirby and Russell Bowles in Queensland, Australia. Information will be provided at a later date. A series of conference calls will be conducted over the next year in preparation for the 2007 meeting. The topics of the calls are:
October 2006 – Recap of the U.S. IOM’s “The Future of Emergency Care,” England’s “Transforming NHS Ambulance Services,” and the EMS Chiefs of Canada’s “The Future of EMS in Canada.”
November 2006 – “A Catalog of Existing IRCP Research.”
January 2007 – “Options for Funding IRCP Research and Analysis” and “Is There Interest by National Programs, Foundations or Other Sources in Funding IRCP Specific Research?”
February 2007 – “A Catalog of Existing IRCP Curricula” and “Can/Should There Be an Internationally Standardized IRCP Curriculum?’
March 2007 – “Existing or Planned State, Provincial and National Data Sets” and “Can/Should There Be an Internationally Standardized EMS/IRCP Data Set and Data Format?”
April 2007 – “Cost/Benefit Analysis Template of IRCP Programs.”
For more information on these conference calls or the 2007 meeting, contact Gary Wingrove at (612) 366-3532.
New Regulations Facilitate Adoption of Health Information Technology
On Aug. 1, 2006, Health and Human Services (HHS) Secretary Mike Leavitt announced final regulations that will support physician adoption of electronic prescribing and electronic health records technology. Electronic prescribing enables a physician to transmit a prescription electronically to the patient’s choice of pharmacy or ancillary provider. It can improve patient safety by decreasing prescription errors due to hard-to-read physician handwriting and communication errors, automating the process of checking for drug interactions and allergies and eliminating duplicative laboratory and diagnostic tests. Electronic prescribing also enables physicians and pharmacies to obtain from drug plans information about the patient’s eligibility and medication history. Having this information at the point of care makes writing, transmitting, and filing prescriptions quicker and easier, and also makes it possible for physicians to make informed decisions about the availability of lower-cost, therapeutically appropriate alternatives to the prescribed medicine. Electronic health records technology, when interoperable among health care providers in various settings, offers benefits similar to the benefits of electronic prescribing in terms of reducing medical errors, coordinating care and improving efficiency. The implementation of interoperable electronic health records technology is a critical step in achieving secure and seamless information exchange and improving our health care system. The regulations are posted at http://www.oig.hhs.gov/authorities/docs/06/OIG%20E-Prescribing%20Final%20Rule%20080806.pdf.
House Approves New Health IT Legislation
On July 27, 2006, the U.S. House of Representatives passed the Health Information Technology Promotion Act of 2006 (H.R. 4157), a bill that sets out to improve care, reduce medical errors, and ease the exchange of essential health information via health IT adoption and the implementation of standards, among other tactics. The bill empowers the HHS Office of the National Coordinator for Health IT to oversee standards for storing medical-related data and standards development relating to interoperability. Another major part of the legislation includes a section established to create a “Safe Harbor” within Stark and anti-kickback laws to ease the process through which hospitals and other organizations can provide physicians with technology and support services. The bill has been sent to the Senate. The bill may be downloaded and actions tracked by querying for the bill number at http://thomas.loc.gov.
New Test Can Determine Need for Trip to Hospital After Cardiac Arrest
A new test can help paramedics determine whether it would be worthwhile to take cardiac arrest patients to the hospital, according to a study published Aug. 3, 2006, in the New England Journal of Medicine. Few people survive cardiac arrest, which is caused by an abnormal heart rhythm. For the study, led by Laurie Morrison of the University of Toronto, researchers reviewed medical records, developed an assessment test and evaluated the test when applied to cardiac arrest patients in urban and rural areas of Ontario. About 41, or three percent, of the 1,240 cardiac arrest patients involved in the study survived. All of the patients received cardiopulmonary resuscitation at the scene, an electric shock from a defibrillator to return their heart to normal rhythm, and a trip to the hospital. Later, paramedics completed a form and applied the assessment test to each patient. The test recommends that paramedics not take patients to the hospital when they cannot restore a pulse, when the defibrillator indicates patients should not receive an electric shock, and when paramedics did not witness the cardiac arrest. Overall, 776 patients met the three criteria, and all but four of those patients died – a survival rate of 0.5 percent, the study finds. Researchers said that use of the test would reduce by about two-thirds the number of cardiac arrest patients taken to the hospital. An abstract of the article is available at http://content.nejm.org/cgi/content/abstract/355/5/478.
NYCHWS Publishes Report on the Emergency Care Workforce
As part of a broader study on the future of emergency care in the U.S. health system, the Institute of Medicine commissioned the New York Center for Health Workforce Studies (NYCHWS) to develop a report on the emergency care workforce. This paper reviews the composition of the workforce in emergency care in the United States; describes the educational background and relevant experience of the physicians, nurses, physician assistants, emergency medical technicians, and other providers of emergency care; and examines a wide range of workforce issues. Given the projected increases in demand for emergency medical care services in the United States, several professions could potentially face shortages, including registered nurses, board-certified emergency medicine physicians, and emergency medical technicians. The paper is available at http://chws.albany.edu/.
New Colorado Law Will Cause EMT Certification Changes
On July 31, 2006, the Colorado Governor signed a new law into effect regarding immigration issues. The Colorado legislature was called into a special session in July to consider steps addressing immigration problems. Ultimately, H.B. 1023 was passed. It requires state agencies to verify citizenship and/or legal immigration status prior to providing any state benefit. EMT certification is included as a benefit and the state is making appropriate changes in its internal certification process, including addressing EMT certification applications that are already in process. D. Randy Kuykendall, MLS, NREMT-P, chief of the Emergency Medical and Trauma Services Section in the Colorado Department of Public Health & Environment, shared this information with NASEMSO members. Questions should be directed to him at Rkuykend@smtpgate.dphe.state.co.us.
New Law Sets up Workers’ Compensation Registry for 9/11 Responders and Cleanup Workers, Eliminating Normal Two-Year Filing Deadline
On Aug. 14, 2006, New York Governor Pataki signed a bill that sets up a workers’ compensation registry for workers and volunteers who did rescue, recovery or cleanup work after 9/11. For 9/11 workers and volunteers who register during the next year, the law eliminates the two-year cut-off for filing a workers’ compensation claim. By registering, workers and volunteers who are not sick will have the right to obtain workers’ compensation if they become sick in the future. Workers and volunteers who are sick, but missed the 2003 deadline to file a claim, can register and file a claim at the same time. The new law also applies to volunteer workers, making them eligible for workers’ compensation even though their work was unpaid. The deadline to file a claim or to register with the Workers’ Compensation Board under the new law is Aug. 14, 2007. A fact sheet of detailed information about the new law is available at http://www.nycosh.org/environment_wtc/WTC/2006WCFactSheet.pdf. To obtain information about the procedure to file a claim or to register, contact the New York State Workers’ Compensation Board at 877-632-4996.
NVFC Supports New Legislation to Clarify Tax Status of LOSAP
On Aug. 2, legislation was introduced that would clarify the treatment of length of service award programs (LOSAP) in the federal tax code. LOSAPs are pension-like programs for volunteer emergency services personnel. Nearly 20 percent of the volunteer firefighters in the United States participate in some form of a LOSAP. The National Volunteer Fire Council (NVFC) LOSAP Committee worked closely with Congressman King (R-NY) and other fire groups to develop H.R. 6027. The treatment of LOSAPs in the existing tax structure is ambiguous at best, and it hasn’t been updated legislatively since 1996. The point of LOSAP is to provide participants with a financial benefit after they reach a certain age and length of service. As with pension plans, a LOSAPs should be taxed when a beneficiary begins drawing from it, not each year when a payment is made into the LOSAP account. H.R. 6027 would fix this problem. Another major change that H.R. 6027 makes is to increase the limit on how much can be contributed into an individual’s LOSAP account each year from $3,000 to $5,000. The bill also creates a mechanism for adjusting the $5,000 limit based on inflation. For a copy of the bill or to track its progress, visit http://thomas.loc.gov and search by bill number.
EMSC Offers New TI Grant Funding
In fiscal year 2007, the EMSC Program plans to offer a new Targeted Issues (TI) grant competition. Subject to funding and competition approval, an anticipated seven new awards at up to $200,000 a year for three years will be available. The application guidance will be released on Dec. 5, 2006. The application due date will be March 5, 2007, and the award date will be on Sept. 1, 2007. More information will be available later this year.
Citizen Corps Urges Assistance with Pandemic Flu Preparedness Awareness
As part of a Homeland Security Council initiative on Pandemic Flu Action Planning, Citizen Corps has been working with the Department of Homeland Security (DHS) chief medical officer and the Department of Health and Human Services (HHS) to spread the word about pandemic flu preparedness. Citizen Corps has created a pan flu link from its home page and encourages others to help as well by adding links from partner Web sites. In addition to acknowledging Citizen Corps as a partner on your Web site and including a link to the http://www.citizencorps.gov Web site, they would like you also to include a link to the HHS Web site http://www.pandemicflu.gov. This Web site includes extensive information about pandemic influenza, tracks confirmed cases of avian influenza, details global activities, and provides planning guidance for individuals, businesses, schools, and communities. In addition, Citizen Corps would like to highlight what other organizations are doing for pan flu outreach and education, including newsletters, additional Web sites, training, exercises, or community events. Send any information that highlights your organization’s efforts to Leiloni Stainsby at lstainsby@dfi-intl.com and Jackie Snelling at Jacqueline.snelling@dhs.gov.
AARC Provides Guidance on Ventilator Acquisitions
To assist state and local agencies in planning for a pandemic flu or other mass casualty events, the American Association for Respiratory Care (AARC) has issued a guidance document giving recommendations about ventilator acquisitions and other planning issues that should be considered. The purpose of the document is to provide guidance to the agencies that are making decisions about ventilator acquisitions and to help them address the supplemental issues of personnel, training, supplies and other equipment needed in the event of a pandemic flu or other mass casualty event. The guidance is available at http://www.aarc.org/headlines/ventilator_acquisitions/index.cfm.
Federal Departments Are Expanding Wild Bird Monitoring for H5N1 Avian Influenza
On Aug. 9, 2006, Agriculture Secretary Mike Johanns and Interior Secretary Dirk Kempthorne announced that their departments are expanding wild bird monitoring for highly pathogenic H5N1 avian influenza (HPAI H5N1) beyond Alaska through cooperative agreements and projects made with the lower 48 states, Hawaii and other Pacific islands. A robust monitoring effort helps to ensure early detection should migratory birds carry this virus to North America. Interior’s U.s. Fish and Wildlife Service has finalized cooperative agreements with California, Idaho, Montana, Nevada, Oregon, Utah, and Washington, as well as an agreement with Hawaii which will be completed soon. Thus far, these states and other cooperators have received $1.9 million from the Service to implement monitoring strategies in each state’s surveillance plan. The five monitoring strategies were developed cooperatively among USDA, DOI and the states to ensure that priority wild bird species are sampled comprehensively throughout the southern Pacific Flyway and Pacific Islands. Together with Alaska, these are the priority areas identified by the national strategy because birds migrating from Asia intermingle with those that nest or winter primarily in these locations. For more information about USDA’s and DOI’s avian influenza efforts, visit http://www.usda.gov/birdflu and http://www.doi.gov/issues/avianflu.
Collaboration between NHPCO and Promoting Excellence Will Keep Valuable Resources Online
Promoting Excellence, a program initiated by the Robert Wood Johnson Foundation in 1997, was created to examine ways that the healthcare system cares for people during their final days of life. While the Promoting Excellence program office has closed, the work lives on. Promoting Excellence has partnered with the National Hospice and Palliative Care Organization (NHPCO) to ensure that the wide range of reports, monographs, and in-depth information about demonstration projects will continue to be available at the Web site at http://www.promotingexcellence.org.
NHTSA Has Open Position in the Office of Emergency Medical Services
The National Highway Traffic Safety Administration (NHTSA) has posted a job announcement for a highway safety specialist (GS-2125-09) in the Office of Emergency Medical Services, Research and Program Development division. The office has national responsibility for developing, promoting, implementing, and evaluating new programs, providing technical assistance, guidance and support, and coordinating program activities relative to statewide EMS systems, EMS research, and national education standards. The application period ends Aug. 30, 2006. The job announcement is located at http://jobsearch.usajobs.opm.gov/getjob.asp?JobID=46283269&AVSDM=2006%2D08%2D01+00%3A01%3A01&Logo=0&q=nhtsa&FedEmp=Y&sort=rv&vw=d&brd+3876&ss=0&FedPub=Y&SUBMIT1.x=10.
ASTHO Is Recruiting for Three Positions
The Association of State and Territorial Health Officials (ASTHO) is the national non-profit organization representing the state and territorial public health agencies of the United States, the U.S. territories, and the District of Columbia. ASTHO’s members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy, and to assuring excellence in state-based public health practice. The organization currently is recruiting for three positions: senior principal director, public health excellence; policy analyst, public health informatics; and senior analyst, public health systems. Job descriptions and application procedures are posted in the employment section of the ASTHO Web site at http://www.astho.org.
August 14, 2006
A very recent NIOSH firefighter fatality report covers the death of a Polk County (Florida) Firefighter. Polk Firefighter/EMT Ben Lang, 22, died while assisting the local non-fire EMS service with the transport of a patient to the hospital. He was located in the back of the NON-FD ambulance when the ambulance struck a large tree. It is important to note that this firefighter was riding in an ambulance operated by a 3rd service public EMS agency within his County ... not a vehicle under the authority of the fire department. The NIOSH report identifies worn tires, speed and driver training as noteworthy. This got us thinking. While a FD, Chief and members are clearly responsible for the maintenance of the FD's vehicles, shouldn't we be concerned when firefighters are regularly assigned to "ride in" on an ambulance or related vehicle where the Fire Chief and that FD are not responsible for the vehicle-or the person driving it? In other words, the RISK of placing firefighters in vehicles of other agencies (with driver not under their command as well) is one that should strongly be evaluated by all of us. Sure, if the EMS or ambulance service you assist does have a good driver training program, a good screening program, safe vehicles and safe and enforced practices -- the risk is much lower. But what if they don't? What if that EMS or ambulance service firefighters "ride in with" have no driver training program, no personnel screening program and a poor ambulance maintenance program? As tough as it is for Chiefs, Commissioners and Presidents (Unions, Locals and Volunteer Association) to keep their members safe within the FD environment, this may be an area of added risk worth thinking about.
August 11, 2006
CARDIAC ARREST: Test Can Determine Need for Trip to Hospital |
A new test can help paramedics determine whether it would be worthwhile to take cardiac arrest patients to the hospital, according to a study published on Thursday in the New England Journal of Medicine, the AP/Philadelphia Inquirer reports. Few people survive cardiac arrest, which is caused by an abnormal heart rhythm. For the study, led by Laurie Morrison of the University of Toronto, researchers reviewed medical records, developed an assessment test and evaluated the test when applied to cardiac arrest patients in urban and rural areas of Ontario. About 41, or 3%, of the 1,240 cardiac arrest patients involved in the study survived. All of the patients received cardiopulmonary resuscitation at the scene, an electric shock from a defibrillator to return their hearts to normal rhythm and a trip to the hospital. Later, paramedics completed a form and applied the assessment test to each patient. The test recommends that paramedics not take patients to the hospital when they cannot restore a pulse, when the defibrillator indicates patients should not receive an electric shock and when paramedics did not witness the cardiac arrest. Overall, 776 patients met the three criteria, and all but four of those patients died -- a survival rate of 0.5%, the study finds. Researchers said that use of the test would reduce by about two-thirds the number of cardiac arrest patients taken to the hospital (Nano, AP/Philadelphia Inquirer, 8/3). An abstract of the study is available online.
Defibrillator problems examined
By Carla K. Johnson, The Associated Press
CHICAGO — A review of safety data raises questions about the reliability of the defibrillators that hang on the walls of airports, shopping malls and health clubs. Harvard Medical School researchers found that over the past decade, one in five automated external defibrillators was recalled because of the potential for malfunction, and devices that failed were associated with 370 deaths. Nevertheless, study author Dr. William Maisel said the devices have saved tens of thousands of lives and that the benefits outweigh the risk of malfunctions. He said the study — the first comprehensive look at safety data on the devices — underscores the importance of properly maintaining the defibrillators. The American Heart Association estimates that 900 Americans die each day from sudden cardiac arrest. Defibrillators are meant to revive people by delivering a shock that restores a normal heart rhythm. Combined with cardiopulmonary resuscitation, the easy-to-use devices can keep people alive until emergency crews arrive.
In a 2004 study, the devices helped raise the cardiac-arrest survival rate to 23 percent, compared to 14 percent with CPR alone. Some states have passed laws requiring defibrillators in public buildings, and Congress has approved money for rural communities to buy them. The lunchbox-size devices cost around $700 to $1,200; almost 200,000 are distributed a year. Medtronic Physio-Control, which has 634 employees in Redmond, is one of the leading makers of automated external defibrillators, with its Lifepak 500 products. Philips Medical Systems, another leading company, makes its line of HeartStart defibrillators in Seattle.
The study found that most of the recalls were for electrical or software problems. The findings were based on reports to the Food and Drug Administration from 1996 through 2005. The FDA issued 52 advisories about automated external defibrillators or crucial components during that period. Those advisories applied to 385,922 devices. One malfunction report to the FDA read: "While attempting to defibrillate a patient in cardiac arrest, the device made a loud 'bang' sound and displayed an error message. The device was then unable to charge or discharge energy." The study appears in today's Journal of the American Medical Association.
Rob Clark, spokesman for Medtronic, said the company tracks all its devices and sends word of recalls and safety alerts by certified letter, sometimes following up with phone calls and service visits, and reaches well over 90 percent of device owners.
"The thousands of lives these have saved clearly outweigh the small risk in terms of malfunction," Clark said.
August 2, 2006
North Carolina
Paramedic Shot-Serious Condition
In an incredible event, a 68-year-old man was arrested after shooting a Madison County paramedic (North Carolina) while she was helping him out of a car....after they (EMS and Fire) left the scene to help the wife get her drunk husband home.
Paramedic Tami Stephen was shot once in the chest with a .22-caliber pistol late Sunday night and is in serious condition as of this morning at Mission Hospitals in Asheville.
Cops have arrested Joseph Boyer Candler Jr. on a charge of felony assault with a deadly weapon with intent to kill or inflict serious injury. Fire and EMS personnel responded to the call for a reported person losing consciousness at the Wolf Laurel Country Club. They determined the man, Candler, was intoxicated, said Chief Josh Jenkins of the Ebbs Chapel FD.
So...Candler's wife asked the medics and firefighters to help her get Candler to their house, so they followed her as she drove him home....good customer service. But while helping Joseph Candler out of the vehicle, he pulled a pistol out of his pants pocket and fired one shot into Stephen's chest!!
Volunteer firefighter Darrell Ponder, who was standing behind Candler, grabbed the
gun and restrained him before any more shots could be fired. Cops also found a Colt .380-caliber handgun and two clips in Candler's vehicle. Detectives with the Madison County Sheriff's Department said more charges could be filed against Candler.
Once again we are reminded how this could happen to any of us and how we must keep our eyes and ears open for the unexpected. We wish Paramedic Tami Stephen a quick and successful recovery. Take Care-BE CAREFUL, BillyG
NASEMSO Posts Domestic Preparedness Checklist
State/territory EMS offices will now have a checklist to assist them in a governor-declared emergency. Recently posted on the NASEMSO Web site, this checklist includes identification of recommended federal, state and local plans as well as contact information that each state/territory office should have easily available to them during an incident. A CD with links to the federal plans will be available at the annual NASEMSO meeting in Charleston, W.Va., Oct. 3-6, 2006. For a copy of the checklist, visit http://www.nasemso.org.
NASEMSO Develops Response Policy
A response policy has been developed by NASEMSO to assist a state/territory EMS director who is involved in a governor-declared emergency. The affected EMS state director will have EMS state officials available to assist them either off and/or on-site based on identified need. This policy is based on the success of EMAC during Hurricanes Katrina and Rita. For a copy of the policy, visit http://www.nasemso.org.
NASEMSO Issues Performance Measures for State EMS Offices
Evidence-based performance measures provide guidelines for state/territorial EMS offices to use to gauge their progress in meeting functional and national requirements of an integrated preparedness and response team. NASEMSO has posted “Performance Measures for State EMS Offices” on its Web site at http://www.nasemso.org.
AEMS Work Ensures EMS Is Included in the Pandemic and All-Hazard Preparedness Act
Recently, the Senate Health, Education, Labor and Pensions Committee passed out of committee S. 3678, the Pandemic and All-Hazard Preparedness Act. This bill is a reauthorization of the first bioterrorism bill that created the Hospital Bioterrorism program. Advocates for EMS (AEMS) worked closely with the committee to ensure that EMS is included in all planning and coordinating activities. On July 18, 2006, AEMS wrote a letter in support of the bill. For more information, contact Lisa Meyer at lmeyer@cgagroup.com.
Twenty-four National Organizations Comment on Standard Occupational Classification Revision
On July 14, 2006, 24 national public health organizations, including NASEMSO, provided comments to the Standard Occupational Classification Revision Policy Committee at the U.S. Bureau of Labor Statistics (BLS). These comments were in response to the May 16, 2006, notice in the Federal Register soliciting comments on the Standard Occupational Classification – Revision for 2010. According to the comments, in 1998, 14 public health workforce titles were added to the 200 Standard Occupation Classification (SOC), and the additions improved the alignment of current public health workforce structure and activities within the BLS framework. “Additional refinements to the SOC are needed to represent the full range of public health occupations,” stated the comments. The public health organizations provided an appendix to the comments with suggested modifications to the SOC and urged dialogue between the organizations and BLS. For more information, contact Paul E. Jarris, MD, MBA, at pjarris@astho.org.
ESMC Funds Recommended for Fiscal Year 2007
On July 20, 2006, the Senate Committee on Appropriations considered the FY 2007 Labor-Health and Human Services-Education appropriations bill. The committee recommended an appropriation of $20 million for the Emergency Medical Services for Children (EMSC) Program for FY 2007. This action followed the June 13, 2006, recommendation of $19.8 million for the program by the House Committee on Appropriations. The House and Senate are expected to consider their respective versions of the legislation and reconcile differences. For more information, contact Susan Eads Role at serole@emscnrc.com.
AEMS Letter Supports Retaining FEMA in DHS
On July 17, 2006, Advocates for EMS (AEMS) sent a letter to the chairman and ranking member of the House Homeland Security Committee. NASEMSO was among those signing the letter. The letter supported retaining the Federal Emergency Management Agency (FEMA) within the Department of Homeland Security (DHS). “AEMS believes that moving FEMA out of DHS would only continue the instability that FEMA has experienced since its move to DHS,” stated the letter. “Removing FEMA from DHS would only add additional obstacles for EMS providers in terms of their ability to work with the federal government in response to a natural or man-made disaster.” The letter fully supported providing the necessary authority and resources needed to make FEMA a more efficient and effective entity within DHS. For more information on the letter, contact Lisa Meyer at lmeyer@cgagroup.com.
NASEMSO President Robert R. Bass Testifies on Behalf of IOM
On July 26, 2006, NASEMSO President Robert R. Bass, M.D., F.A.C.E.P., testified before the House Committee on Homeland Security’s Subcommittee on Emergency Preparedness, Science and Technology. He represented the Committee on the Future of Emergency Care in the U.S. Health System of the Institute of Medicine (IOM). This first set of hearings aims to illustrate to Congress the capabilities of our nation’s medical system in handling a range of potential disasters. The hearings were set up in response to a series of reports recently released by IOM which depicted a dim future for emergency medical care unless substantial changes are implemented. See Dr. Bass’s testimony at http://hsc.house.gov/files/TestimonyBass.pdf.
NEMSIS TAC Announces First Group of EMS Software Packages to Achieve NEMSIS Compliance
On July 14, the NEMSIS Technical Assistance Center (TAC) released the first list of EMS software packages that have achieved NEMSIS Compliance. A total of eight EMS software packages participated in the initial compliance test. Four software packages achieved Gold Compliance. Two packages achieved Silver Compliance. For a list of NEMSIS compliant software, visit http://www.nemsis.org/technicalSupport/compliantSoftware.html.
U.S. Surgeon General to Resign
On July 31, 2006, U.S. Surgeon General Richard H. Carmona announced that he is stepping down. In a letter Carmona wrote to his fellow officers in the U.S. Public Health Service, he said that he would judge himself successful if he had persuaded one student to make good health choices or one mother to stop smoking. Carmona’s term expired over the weekend. There has been no announcement regarding an appointment of a successor.
VHA Releases Compendium on Emergency Management
The U.S. Department of Veterans Affairs, Veterans Health Administration (VHA), has released a compendium titled, “Emergency Management: Principles and Practices for Healthcare Systems.” The texts were developed by the Institute for Crisis, Disaster and Risk Management at The George Washington University, under contract to the VHA. The contract called for the identification and validation of emergency response and recovery competencies for four job groups within health care organizations and the development of a curriculum that addressed emergency management program concepts and practices, incident management systems and processes, and organization learning strategies. For a copy of the compendium, visit http://www.va.gov/emshg.
NGA Releases Pandemic Primer for Governors and State Officials
The National Governors Association (NGA) has released “Preparing for A Pandemic Influenza: A Primer for Governors and Senior State Officials.” Developed by NGA’s Center for Best Practices, the primer stresses the need to develop strategies to ensure that essential government and private sector services remain available during pandemics. It also calls for comprehensive planning involving government agencies, businesses, and individuals. A copy of the primer is available at http://www.nga.org/Files/pdf/0607PANDEMICPRIMER.PDF.
NACCHO Publishes Local Health Department Guide to Pandemic Influenza Planning
The National Association of County & City Health Officials (NACCHO) has published “Local Health Department Guide to Pandemic Influenza Planning.” At the core of this guide are plans developed by local health departments that host two of NACCHO’s Advanced Practice Centers, cutting-edge learning laboratories that develop and test tools and resources that help local health departments continue to work on all-hazards preparedness. The guide is intended for use by local health departments as part of a multi-sector effort to coordinate planning and response to a pandemic influenza outbreak. Visit http://www.naccho.org/topics/infectious/influenza/LHDPanFluGuide.cfm to download a copy of the guide.
DHS Releases Pandemic Influenza Guide
In July, the Department of Homeland Security (DHS) released “Pandemic Influenza, Preparedness, Response, and Recovery: Guide for Critical Infrastructure and Key Resources.” The guide is one of the tools DHS has developed for business owner-operators and their contingency planners to enhance pandemic planning. The primary purpose of the guide is to stimulate the U.S. private sector business community to act now. For a copy of the guide, visit http://www.pandemicflu.gov.
APHA Launches Flu Blog
The American Public Health Association (APHA) is launching a blog targeted to the general public on preparedness for pandemic flu and emerging infectious disease. The first of several entries have been posted, and several more are written and ready to go. This is a moderated blog and APHA will post relevant comments that move the discussion forward. The blog address is http://getreadyforflu.blogspot.com/. Comments are encouraged. Send them to pandemicflu@apha.org.
Robert Bass Named as NASEMSO Representative to the EMAC Advisory Group
Robert Bass, M.D., F.A.C.E.P., NASEMSO president, has been named as the NASEMSO representative to the multi-discipline EMAC Advisory Group being established by the National Emergency Management Association (NEMA). The first meeting will be held on Aug. 10, 2006, in Washington, D.C. The first meeting will include discussion of Advisory Group mission and goals; identification of multi-discipline issues, and EMAC overview and lessons learned from Hurricane Katrina. For more information on the advisory group, contact NEMA Executive Director Trina Sheets at tsheets@csg.org.
Forum Releases Key National Indicators for Children’s Well-Being
The Federal Interagency Forum on Child and Family Statistics released its latest annual report, “America’s Children in Brief: Key National Indicators of Well-Being 2006.” The report is a compendium of statistics from 21 federal agencies with the latest available data on environment and education, and on nine background measures related to population and family characteristics. For a copy of the report, visit http://childstats.gov.
NEDARC Updates Its Web Site
The National EMSC Data Analysis Resource Center (NEDARC) has launched its new Web site. The revised site features a user-friendly navigation design and all-new content and resources for EMSC, including a section on EMSC performance measures; step-by-step guidance on data collection, analysis, data utilization, grant writing, and EMS data systems; and a resource library. To access the site, visit http://www.nedarc.org.
CAAS Launches New Web Site
The Commission on Accreditation of Ambulance Services (CAAS) on July 17, 2006, launched a completely redesigned and reconceived Web site to better serve the needs of medical transportation service providers. The new site (http://www.caas.org) is organized to help agencies understand the overall benefits of CAAS accreditation as well as to answer specific questions about the accreditation process. There are a variety of new features on the site, including: CAAS Help Center; Frequently Asked Question Section; CAAS-accredited Agencies Map; CAAS Spotlight; and Events Calendar. In addition to the features listed above, the new site is capable of serving up both audio and video content, including a new series of Podcasts planned for the fall. In addition, a Members-Only section will debut in September, providing CAAS-accredited agencies an area to collaborate and share information.
July 24, 2006
President Bush Issues Executive Order Regarding the Public Alert and Warning System
U.S. President George W. Bush recently issued an executive order instructing the Secretary of the U.S. Department of Homeland Security (DHS) to assess and upgrade the nation’s public warning systems, including the Emergency Alert System (EAS), so that the United States has the capability to alert and warn all Americans through an integrated system. The order notes that the EAS should be capable of working through as many communications pathways as practicable; that the U.S. public warning system must have the capability to alert those with disabilities and those without an understanding of English; that DHS must work with owners and operators of communications facilities to maintain, protect and restore capabilities necessary for the EAS; and that the FCC must adopt rules to ensure that communications systems have the capacity to transmit alerts. The press release on the executive order is available at http://www.whitehouse.gov/news/releases/2006/06/20060626.html.
NASEMSO Joins Letter to Leaders on Interoperability
NASEMSO signed on to a letter organized by COMCARE that was sent to Congressional leaders and the Secretaries of the Departments of Justice, Homeland Security and Health and Human Services. The letters asked the Congressional leaders to ensure that in Congressional legislation and policies of the Departments of Homeland Security, Justice, HHS and other relevant agencies, emergency communications systems and “interoperability” are defined to include inter-organizational data communications, and data communications generally, in addition to the traditional (and critical) first responder voice radio communications. Similarly, emergency communications planning and implementation should be done as an integrated whole, including all organizations involved with emergency response and all forms of communications. For more information, contact Charlee Hess of COMCARE at chess@comcare.org.
DHS Completes National Infrastructure Protection Plan
The U.S. Department of Homeland Security (DHS) announced the completion of the National Infrastructure Protection Plan (NIPP), a comprehensive risk management framework that clearly defines critical infrastructure protection roles and responsibilities for all levels of government, private industry, nongovernmental agencies and tribal partners. The NIPP builds on the principles of the President’s National Strategy for Homeland Security and its companion strategies for the physical protection of critical infrastructure and key assets and the securing of cyberspace. It also fulfills requirements in Homeland Security Presidential Directive (HSPD) 7 and the Homeland Security Act of 2002. For more information, visit http://www.dhs.gov/dhspublic/interapp/editorial/editorial_0827.xml.
HHS Announces New HIPAA Privacy Decision Tool for Emergency Preparedness Planning
The U.S. Department of Health and Human Services (HHS) published a new Web-based interactive decision tool designed to assist emergency preparedness and recovery planners in determining how to access and use health information about persons with disabilities consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. The tool will guide emergency preparedness and recovery planners through a series of questions regarding how the HIPAA Privacy Rule applies to a particular disclosure. By helping users focus on the source of the information being disclosed, to whom it is being disclosed, and for what purpose, users will better meet the needs of the elderly or persons with disabilities in the event of an evacuation. While the tool’s initial purpose focused on emergency planning for persons with disabilities, it is applicable to most emergency planning efforts. The intended audiences include covered entities as well as emergency preparedness and recovery planners at the local, state and federal levels. The tool is available at http://www.hhs.gov/ocr/hipaa/decisiontool/.
Model Legislation for Emergency Volunteer Healthcare Practitioners Created
On July 13, 2006, at its 115th Annual Meeting, the National Conference of Commissioners on Uniform State Laws (NCCUSL) approved eight new acts, including the new Uniform Emergency Volunteer Healthcare Practitioners Act. This act will allow state governments to give reciprocity to other states’ licensees on emergency services providers so that covered individuals may provide services without meeting the disaster state’s licensing requirements. This act was drafted in response to the devastation in the Gulf States from Hurricanes Katrina and Rita, specifically the problem of allowing out-of-state medical professionals to practice in the afflicted areas. After receiving NCCUSL’s seal of approval, a uniform act is officially promulgated for consideration by the states, and legislatures are urged to adopt it. Visit http://www.law.upenn.edu/bll/ulc/uiehsa/2006_annualmeetingdraft.htm for the final version of the model legislation.
HRSA Seeks EMS Officials for Conference
The federal Office of Rural Health Policy at HRSA/HHS is seeking rural EMS leaders interested in the intersection between health information technology (HIT) and quality to participate in a conference. The conference is free to the first 300 participants. The conference, “HIT: A Rural Provider’s Roadmap to Quality,” will be held Sept. 21-23, 2006, at the Marriott Downtown Hotel in Kansas City, Mo. For more information, visit http://ruralhealth.hrsa.gov.
EPA Issues Heat Wave Guide
The U.S. Environmental Protection Agency (EPA) has published Excessive Heat Events Guidebook with assistance from state and local, federal and academic partners. Designed to help community officials, emergency managers, meteorologist and others plan for and respond to excessive heat events, the guidebook highlights best practices that have been employed to save lives during excessive heat events in different urban areas. It provides a menu of options that officials can use to respond to these events in their communities. As a quick reference resources, download the Excessive Heat Events Guidebook in Brief at http://www.epa.gov/heatisland/about/pdf/EHEguide-brief_final.pdf. This document offers summary information and useful tips that can be used when preparing for and responding to excessive heat. The complete guide is available at http://www.epa.gov/heatisland/about/pdf/EHEguide_final.pdf. EPA also has a page of general information related to extreme heat events located at http://www.epa.gov/naturalevents/extremeheat.html.
IOM Future of Emergency Care Series Dissemination Workshops Scheduled
IOM has secured public and private funding to hold four one-day regional workshops to discuss the conclusions and recommendations in the three reports that are part of the Future of Emergency Care Series. The purpose of the workshops is to disseminate the findings from the reports; engage stakeholders in discussion of the issues raised in the reports; and consider implementation issues at the federal, state and local level. Each of the workshops will feature a brief presentation of the conclusions and recommendations in the reports, a reaction panel consisting of individuals drawn from the region, and ample opportunity for interested parties and members of the public to offer comments on the reports. The first workshop will be held on Sept. 7, 2006 at the Primary Children’s Medical Center in Salt Lake City, Utah. The second workshop will be held on Oct. 27, 2006, at the Northwestern Memorial Hospital in Chicago, Ill. Details for the other workshops will be forthcoming. To register for these events, visit http://www.iom.edu/emergencycare/workshops beginning in mid-August.
DHS Launches Updated Emergency Preparedness Web Site
On July 17, 2006, the U.S. Department of Homeland Security’s Ready Campaign launched an updated version of its Web site, http://www.ready.gov, to educate Americans about the simple steps they should take to be ready for a variety of emergencies. The redesigned Ready Web site includes updated emergency preparedness resources, including special preparedness information for pet owners, senior citizens, and individuals with disabilities and special needs. It also provides Americans with increased state and local information so they can learn about the types of emergencies that are more likely to happen in their area and the plans that have been established to deal with those emergencies.
County Develops Pan Flu School Action Kit
Contra Costa County Health Services has developed a Pandemic Flu School Action Kit designed to provide school officials with the practical tools they need to prepare for a pandemic flu outbreak. You can download all kit materials at http://www.cchealth.org/topics/pandemic_flu/school_action_kit/.
HHS Announces Additional $225 Million for State and Local Pandemic Influenza Preparedness Efforts
On July 11, 2006, HHS announced an additional $225 million in funding for state and local preparedness for pandemic influenza. Earlier this year, HHS joined the nation’s governors for a series of state pandemic influenza summits. “These funds will build on the work begun at the summits and help local, tribal, territorial and state public health officials as they undertake critical preparedness planning that communities must do themselves,” stated HHS Secretary Leavitt. The funding announcement is part of $350 million included in recent emergency appropriations for upgrading state and local pandemic influenza preparedness passed by Congress in December. In February, the first phase of $100 million was awarded to states for planning and exercising of pandemic response plans and to identify gaps in preparedness. The second phase of funding is being awarded to begin addressing those identified gaps in pandemic influenza preparedness planning. The grants will be awarded to all 50 states, the District of Columbia, three local jurisdictions (New York City, Chicago, and Los Angeles County), five U.S. Territories and three Freely Associated States of the Pacific. A table, outlining what funds will be available for eligible jurisdictions, is available at http://www.pandemicflu.gov/news/allocation.html.
Summary Proceedings Released from International Summit on Public-Private Preparedness
The International Center for Enterprise Preparedness at New York University has released the findings from its recent summit of business and public sector leaders at its campus in Florence, Italy. The report includes recommendations on public-private information sharing and emergency communications; providing business resources to disasters; and advancing high impact incentives for business preparedness. You can download the report at http://www.nyu.edu/intercep/proceedings-summary.pdf.
EIIP Transcript Available on Chat Regarding Nationwide Plan Review
The Emergency Information Infrastructure Partnership (EIIP) Virtual Forum recently hosted a live online chat and interactive question-and-answer session with Eric Holdeman, director of the Office of Emergency Management for King County, Washington. The topic was a discussion of the recently released Nationwide Plan Review Phase 2 report, which provides findings and recommendations concerning local, state, and federal catastrophic planning. You can download the transcript at http://www.emforum.org/vforum/c060628.htm
New NTDB Pediatric Report Available on ACS Web Site
The National Trauma Data Bank (NTDB) Pediatric Report 2005 now is available on the American College of Surgeons (ACS) Web site. The purpose of the report is to inform the pediatric community, the public, and decision makers about a wide variety of issues that characterized the current state of care for injured infants, children, and adolescents in the United States. To access the report, visit http://www.facs.org/trauma/ntdb.html.
United States to Observe National Preparedness Month in September
For the third straight year, the U.S. Department of Homeland Security (DHS) will sponsor National Preparedness Month, along with a coalition of more than 200 national, region, state and local organizations. National Preparedness Month is a nationwide effort held each September to encourage Americans to prepare for emergencies in their homes, business and schools. This year’s goals are to increase public awareness about the importance of family emergency preparedness and to urge individuals to make themselves and their loved ones better prepared. Learn more about the planned events at http://www.ready.gov.
Texas Hazard Mitigation Package Provides Resource for Hazard Analysis
The Texas hazard Mitigation Package (THMP) is a free online resource created by the Texas Geographic Society (TXGS). TXGS received a FEMA Hazard Mitigation Planning Grant in 2003 to develop an Internet-based viewing and distribution tool for digital geographic datasets that can be used by state and local hazard mitigation planners and emergency managers in identifying natural hazards, risk areas and vulnerabilities in Texas. The site identifies: historical hazard occurrences by the event location or summarized by county; hazard risk areas and other detailed geographic data relative to hazards; and vulnerable population and property value areas to particular hazards. On the site you can download any data to perform detailed quantification of impact on other mapping/GIS systems. The content and organization of this site will evolve at least until March 2007, when current funding concludes. Learn more at http://www.thmp.info.
Urban Institute Issues Reports on Katrina
An Urban Institute team headed by Senior Fellow Rudy Penner is analyzing many of the issues raised by Hurricane Katrina. The institute has posted reports related to children and families, cultural vitality, the economy and taxes, education, government and social services, health policy, housing and non-profits. The report is available at http://www.urban.org/afterkatrina/.
NYC Hurricane Guide Released
Ready New York: Hurricanes and New York City has been released and contains general tips on how to prepare for any emergency, instructions on how to develop a hurricane disaster plan and secure home before a storm, and a map of New York City hurricane evacuation zones. The guide is available for download in 11 languages at http://www.nyc.gov/html/oem/html/ready/hurricane_guide.shtml.
CAAS Accredits Ten Agencies in June
At their June 21, 2006, meeting, the Commission on Accreditation of Ambulance Services (CAAS) Panel of Commissioners granted reaccreditation to ten agencies, including: American Medical Response, Gulfport, Mississippi; American Medical Response, Jackson, Mississippi; American Medical Response, Orange County, Garden Grove, California; American Medical Response of Ventura County, Moorpark, California; The Medical Center, Bowling Green, Kentucky; F-M Ambulance of Fargo, North Dakota; Guilford County EMS of Greensboro, North Carolina; Beech Grove Fire Department of Beech Grove, Indiana, Pride Care Ambulance of Kalamazoo, Michigan, and Medix Ambulance of Mission Viejo, California. There are now currently 102 CAAS-accredited agencies in 32 U.S. states and Nova Scotia, Canada, with more than 200 agencies working on new applications. For more information, visit http://www.caas.org.
NAEMSE Calls for Nominations to Recognize Educators – Deadline is July 31
The National Association of EMS Educators (NAEMSE) is inaugurating a special award to recognize educators across the globe for their excellence in EMS education. The purpose of the award is to recognize those unsung men and women who serve the profession everyday. Nominees do not have to be members of NAEMSE. Details may be found at http://www.naemse.org/hero’s_nominations.pdf.
Dave Miller Leaves Colorado Department of Public Health & Environment
Dave Miller has announced his resignation from the Colorado Department of Public Health and Environment. He is a long-time NCSEMSTC and NASEMSO Training Coordinator Council member. NASEMSO wishes Mr. Miller well in his future endeavors. His replacement has not been named.
New State EMS Director Named for Texas
Maxie Bishop has been named the new State EMS Director for Texas. He will start in this position on Aug. 1, 2006. Bishop replaces Terry Bavousett who resigned in June.
Washington State Recruiting for EMS Licensing & Certification Section Manager
The Washington State Department of Health, Office of EMS & Trauma System, is recruiting to fill its vacant EMS Licensing & Certification Section Manager position. The recruitment announcement is available at http://www.doh.wa.gov/job_ann.htm. Interested candidates who would like further information may contact Janet Kastl at janet.kastl@doh.wa.gov or Sandra Dlugosz at Sandra.dlugosz@doh.wa.gov. The application period will close on July 31.
Executive Manager, Emergency Services Needed in Travis County, Texas
Travis County, Texas, has launched a search for an executive manager of emergency services. The executive manager will be responsible for administration, management, and supervision for the functions performed by the Medical Examiner’s Office, Fire Marshal’s Office, Emergency & Wireless Communications, Emergency Management Office, STAR Flight, and Travis County EMS. The detailed job announcement is available at http://www.TravisCountyJobs.org. For more information, contact Harve Franklin at harve.franklin@co.travis.tx.us.
Recall Notice for Welch Allyn PIC 50 AED
MRL, Inc., and FDA notified healthcare professionals of a Class I recall of Welch Allyn PIC 50 Automated External Defibrillators, catalog #97108X manufactured form March 2002 through October 2004. An electrical contact problem may result in the device’s failure to provide a defibrillation shock, that could result in delay or failure to resuscitate the patient. This failure may be accompanied by various error messages on the display panel, including the “Defib Comm” error message. Read the complete MedWatch Safety summary, including links to the FDA Recall Notice and previous MedWatch alert at http://www.fda.gov/medwatch/safety/2006/safety06.htm#PIC50.
Oxygen Regulator Fires Resulting from Incorrect Use of CGA 870 Seals
FDA and NIOSH clarified recommendations on the use of sealing-type washers (reusable, metal-bound rubber seal) and crush-type gaskets (single use, not reusable, usually Nylon) with oxygen regulators. This update also provides additional recommendations on the proper use of both the plastic seals and rubber/metal seals. Read the complete MedWatch 2006 Safety summary, including links to the updated FDA and NIOSH Public Health Notification at http://www.fda.gov/medwatch/safety/2006/safety06.htm#regulator.
EMSC National Resource Center Distributes Weekly Info to Researchers
The EMSC National Resource Center distributes a weekly informational update to researchers in EMSC and other related fields, regardless of whether they are EMSC program grantees. The EMSC Research Listserv summary is distributed via email every Monday and includes information on data and research resources, meetings, conferences, calls for abstracts, funding opportunities, and publications of interest. Information about EMSC-related research accomplishments, publications, and workshops, sent to the listserv by its readers, also is included. To subscribe to the listserv, send an email with your first and last name, institution, telephone number, and email address to emscresearch@emscnrc.com.
July 12, 2006
Info regarding Pandemic Flu: This is pertinent to school resource officers and/or anyone else who works in a campus environment.
http://www.cchealth.org/topics/pandemic_flu/
Emergency Warning Lights & Parking Procedures
Are They Protecting Us And Making The Emergency Scene Safer?
ROBERT J. FAUGH
Special to Firehouse.Com
Since the early 1950s, when the beacon ray replaced the single flashing light, we have seen more and more lights added to our emergency vehicles. It was believed that if 35 watt bulbs were good, then 100 watt must be better. If two lights made it safer, then six must make it really safe. How about a million candlepower strobe system?
We have reached the point where the warning lights are becoming the problem at emergency scenes and actually making the area less safe for our vehicles and personnel. In the last 10 years lighting your vehicles up like a Christmas tree has become the norm. When moving on the highway this may be ok, but when you are stopped or parked it is not! The 1999 U.S. Fire Administration "white paper" on this topic identified the over use of blinding, confusing, and distracting warning lights as a major cause of accidents, injury and death at emergency scenes.
We all know of emergency personnel who have been struck, killed or seriously injured and emergency vehicles that have be hit by drugged, drunk, fatigued, elderly or just confused drivers. Many of these operators stated "they were blinded or confused by all the lights". In New York State alone, an average of 80 emergency vehicles are struck while parked off the highway, on the side of the road, with all the red warning lights in operation each year. This takes place more than we would like to admit. How many close calls have you had?
Too Many Lights Distract Drivers
Every emergency vehicle has more than enough warning lights and is equipped so that if it is the only vehicle parked at a scene, the light laws are complied with. The problem is that when there are six or seven emergency vehicles at a scene, all the warning lights are left on and the area actually becomes unsafe due to all of the blinding and distracting lights. Those driving in the area of the emergency look at the vehicle warning lights and do not see the personnel who are working in the area near these vehicles. What effects do all of these warning lights have on the crowd and your own crews? Under some conditions, these warning lights also blind us! This is a major safety issue that has been ignored for too long. It is a known fact that the warning lights, at a scene will effect the crowd, shut them off and many will walk away. We set up a "carnival" and wonder why people flock to it!
The Illinois State Police and California Highway Patrol studies questioned the use of light bars on their police cars and the safety of the officers while engaged in their duties next to the roadway. The collision rate for emergency vehicles displaying lights while parked next to the highway were two and a half times higher for the same 100,000 miles driven than for non-emergency vehicles. Many highway patrol and state police departments are going to the slick top cars for safety, better mileage and productivity. Many have "arrow sticks" in the back window.
What Color Lights Are The Safest?
What about color? The knowledge of human perception calls into question the use of warning lights when the vehicle is parked off the highway. Red lights send a message: emergency, stop and invoke irrational behavior from motorist. They also tend to draw persons to the scene or area of the emergency. The psychological reaction to red is rage, anger and hostility. The human eye is more sensitive to red light during the daylight than at night. Instead of warning people to stay away, the red emergency light actually draws drivers towards the lights. This so-called moth effect refers to "a state of narrowed attention associated with excessive concentration on some object or task with the resulting loss of voluntary control over response." People drive where they look! Drugged, drunk, fatigued and elderly drivers have driven right off the roadway and into the parked vehicles displaying red warning lights.
In New York State amber lights are not prohibited. Amber filters allow 60-percent of the light from the bulb to pass through, red allows 25-percent. The amber light also sends a very specific message to those who view it: caution - stay away. A driver who is drugged, drunk, elderly or fatigued will usually drive away from the amber light. Amber also travels through fog, rain or snow much farther than red, blue or clear. In California all emergency vehicles may display at least one amber light to the rear. The New York State Police reported 15 to 20 cars were struck while parked on the side of the road annually when only the red lights were displayed. They now have an amber lens on the driver's side rear flashing light position in the bar and report a drastic reduction of cars hit while displaying the amber light. Federal KKK Ambulance specs - to meet federal funding standards - require one amber light on the rear. The National Fire Protection Association (NFPA) allows amber in all four directions from fire vehicles when in the "parked" or "blocking" mode.
The NYS Motor Vehicle Commissioners rules and regulations, Part 44, allows the use of amber lights by any vehicle involved in a "hazardous operation". If you have a blue or green light and an amber light, you can only use one light at a time for the activity that you are involved in. Part 44 allows 100 candlepower at 35 watts for clear lights.
There is no restriction on vehicles that are allowed to display red or red and white lights; they can use amber along with the red or red and white lights. The NFPA does not allow amber to be displayed from the front in the "response or "moving" mode. Blue light is more visible to the eye at night. Blue does not blend in with the many red lights used at night or on vehicles at night. A bill that just passed over the governors desk allows police to use blue to the rear on their cars.
What is the answer? For parking situations we should limit the use of the warning lights. Warn only from the direction that the traffic is coming towards the scene. You will be amazed how the total scene will calm down when the warning light usage is reduced. Equip the rear of your vehicles with at least one amber light to send that message "caution, stay away". Be careful how you use your headlights, spot lights and other flood lamps as you may be blinding oncoming drivers and other personnel on the scene. Equip you vehicles with "arrow sticks". Both New York State Department of Health & NFPA advise shutting down most of these lights. On controlled access roads no warning lights to the front!
On The Scene, Shut Off Some Lights
Many Fire, EMS & Police are using this limited use procedure at all scenes. The Phoenix, AZ, Fire Department recommends reducing the warning lights, displaying amber and using the hazard flashers to make the scene safer. On the controlled access highways, the vehicle closest to on coming traffic stops several hundred feet prior to the scene, activates the four-way flashers and displays only rear-facing lights.
All other vehicles should shut off all the warning lights and park in a safe position at an angle, if possible. The results have been much more control over the traffic that is moving past the accident or situation. The other lane keeps moving without the gaper's block, they slow to 40 MPH or so and keep on going, even though there are several emergency vehicles at the scene in the other lane. This same procedure can be used on other roadways with minor modification. In the blocking mode they only display amber lights!
At all fire and emergency scenes the same procedure can be used. My fire department and ambulance squad (Rush, NY, Fire/EMS District) has used this procedure for 15 years with excellent results! The reduced lighting policy is used with distracting, confusing and blinding warning lights being shut down. Adequate warning is provided with one red and one amber light along with the hazard flashers. Most of our equipment has an amber arrow sticks built in the rear, which are also used.
NFPA 1901 standard address the warning light problem and has taken it out of the operators hands with automatic shut down of blinding warning lights. NFPA also requires a response and blocking mode of operation, amperage load monitoring system and a restriction on how many amps the lighting system can draw. These requirements were way over due! If you have an older vehicle you can obtain the same results by the switches on the dash, use them to shut down most of the lights when parked at the scene.
Precautions Once You Arrive On Scene
Cones and/or Flares - When using flares and/or cones use the examples that the DOT and road construction crews provide. Place them far enough back to give proper warning and spread them out. Set up your scene as a work zone as soon as possible.
Parking Considerations - If possible park you vehicles on one side of the street and at an angle towards the curb. Park back at least 100 feet. If you're going to protect the scene with your vehicle do so in a manner that will provide the desired protection. After reviewing numerous collisions where emergency vehicles have been run into from the rear it has become clear to me that the protection that people think they are providing in front of their emergency vehicle does not exists. Even heavy fire apparatus with the brakes locked and wheels chocked, have been driven up to 100 feet when struck by a vehicle that didn't weigh ONE-THIRD as much! Firefighters, police and EMS personnel have been killed in these collisions. If you stop back 100 feet and angle the vehicle to the right, you are providing the pump operator a safe area and if the vehicle is hit it will go to the right side of the road and not up into the scene. If you have to cross the road to accomplish your mission angle the vehicle to the left. Both of these angle procedures also keep the blinding headlights from making your scene unsafe
June 30, 2006
IOM Releases Three Reports on the Future of Emergency Care
On June 14, the Institutes of Medicine (IOM) released three highly-anticipated reports from its Committee on the Future of Emergency Medicine in the United States Health System. The reports address three key focus areas of the study – prehospital, hospital-based, and pediatric emergency and trauma care. The pediatric report examines the unique challenges associated with the provision of emergency services to children and adolescents, and evaluates progress since the publication of the IOM’s 1993 report Emergency Medical Services for Children. A recording of the press briefing on the release of the reports is available at http://www.nationalacademies.org. More information about each report is available at http://www.iom.edu/. More information on “The Future of Emergency Care in the United States Health System” is available at http://www.iom.edu/CMS/3809/16107.aspx. The documents can be purchased in either PDF downloadable format or in hard copy by visiting the National Academies Press Web site at http://www.nap.edu/catalog/11621.html. Pre-publication versions are available now with the publication versions scheduled to be available in December. NASEMSO members can contact headquarters for a copy of the PDFs at no charge, and state EMS officials should have received them directly.
AEMS Urges Action Regarding NEMSIS Funding
The House version of the FY 07 Committee-passed Transportation Appropriations bill did not include funding for the National Emergency Medical Services Information System (NEMSIS) data collection initiative. A federal priority for Advocates for EMS (AEMS) is to work to establish a national database for EMS data. Such databases exist to support police and fire services; however, until now there has been no similar national repository for EMS data that can be used to improve patient outcomes. EMS systems vary in their ability to collect and use patient and EMS systems data. Currently, there is no method to easily link disparate EMS databases to allow analysis at a local, state and national level. NHTSA, in cooperation with the Health Resources and Services Administration, has initiated development of NEMSIS. AEMS has issued an action alert and encourages interested parties to contact Congress. The action alert is available at http://www.advocatesforems.org.
House Appropriations for EMSC Moves in Committee
On June 13, 2006, the House Committee on Appropriations considered the Fiscal Year 2007 Labor-Health and Human Services-Education appropriations bill. The committee recommended an appropriation of $19.8 million for the EMSC program for FY 2007. This matched the recommendation of the Subcommittee on Labor, Health and Human Services, Education and Related Agencies. The House of Representatives will consider the bill next. For more information, contact Susan Eads Role, JD, MSLS, public policy and partnerships director for the EMSC National Resource Center, at serole@emscnrc.com.
NIMS Compliance Alert for Hospitals Released
In late May, a memo was released from the NIMS Integration Center regarding NIMS compliance requirements placed upon hospitals and other healthcare facilities. The memo notes that there has been growing confusion, and the alert provides clarification. To view the alert, visit http://www.fema.gov/pdf/emergency/nims/nims_alert.pdf.
NASEMSO, AEMS and Others Support Paulison Nomination
In May, NASEMSO and others signed on to a letter of support organized by the Advocates for EMS. The letter was sent to the Senate Homeland Security and Government Affairs Committees in support of Paulison’s nomination as Under Secretary for FEMA. For more information, contact Lisa Meyer at lmeyer@cgagroup.com.
JCAHO Releases Study on Emergency Preparedness
A new study from the Joint Commission on Accreditation Healthcare Organizations (JCAHO) finds that community-based preparation for and response to disasters will require more effective communication and planning than currently exists among hospitals, public health agencies and community first responders – such as fire, police and emergency medical services. The study also found that national benchmarks are needed to measure and promote emergency preparedness planning. The study, “Integrating Hospitals into Community Emergency Preparedness Planning,” appears in the June 6, 2006, issue of Annals of Internal Medicine. The study, supported in part by a grant from the Agency for Healthcare Research and Quality (AHRQ), is the first large-scale national assessment of how closely hospitals and their communities are collaborating and planning together for natural or other disasters. To view the complete study, visit http://www.anals.org/cgi/content/full/144/11/799.
Second of Two-Part EMSC Series Published in CPEM Journal
As reported in the EMSC QuickNews, the June 2006 issue of Clinical Pediatric Emergency Medicine (CPEM) features several articles written by EMSC colleagues, including staff at Children’s National Medical Center, in Washington, D.C. This is the second half of a two-part issue focusing exclusively on EMSC. The first part was published in March 2006. Some of the articles include: “Emergency Medical Services for Children and the Institute of Medicine Revisited, 1993-2006,” “Pediatric Trauma Systems in the United States: Do They Make a Difference?” and “The Pediatric Emergency Care Applied Research Network: Progress and Update.” Publication of this issue was planned to coincide with the release of the Institute of Medicine report on the Future of Emergency Medicine in the United States Health System. To view the entire June issue of CPEM, visit http://www.journals.elsevierhealth.com/periodicals/ycpem/current.
HHS Announces $1.28 Billion in Funding to States for Bioterrorism Preparedness
The Department of Health and Human Services (HHS) announced that it has made available another $1.2 billion to the states, territories and four metropolitan areas to help strengthen their capacity to respond to terrorism and other public health emergencies. The funds will be used to improve infectious disease surveillance and investigation, enhance the preparedness of hospitals and the health care system to deal with large numbers of casualties, expand public health laboratory and communications capacities and improve connectivity between hospitals, and city, local and state health departments to enhance disease reporting. These emergency preparedness and response efforts are intended to support the National Response Plan. For more information, visit http://www.hhs.gov/news/press/2006pres/20060607.html.
FCC to Seek Comments on Katrina Panel Recommendations
The Federal Communications Commission (FCC) will invite public comment in response to recommendations presented this month by the Independent Panel Reviewing the Impact of Hurricane Katrina on Communications Networks. A Notice of Proposed Rulemaking (NPRM) contains wide-ranging proposals and considerations that could involve FCC rule or administrative changes. The notice is available at http://hraunfoss.fcc.gov/edocs_public/attachmatch/FCC-06-83A1.pdf. The Independent Panel’s report points out that Amateur Radio stations were among those segments of the communications infrastructure adversely affected by Hurricane Katrina. Further, it noted that Amateur Radio volunteers provided communication in many locations where no other means of communicating existed and provided other technical aid to communities affected by Hurricane Katrina. In the NPRM, the FCC asked if it should explore amending its rules to permit automatic grants of certain types of waivers or special temporary authority in declared disaster areas.
10. Exploring Accreditation Project Requests Comments
The Exploring Accreditation Project is examining whether or not it is feasible and desirable to implement a voluntary national accreditation program for state and local public health departments. The project Steering Committee has issued a proposed model for a voluntary national accreditation program for state and local public health departments. The model addresses the major aspects of a voluntary national accreditation program including: governance; eligible participants; roles of federal, state and local governmental public health entities; developing standards and determining conformity; financing and incentives; evaluation; and implementation. The proposed model is available for public comment until July 26, 2006. To view and provide feedback, visit http://www.exploringaccreditation.org.
11. DHS Releases Notice of Change to the National Response Plan
The Department of Homeland Security (DHS) has released a Notice of Change to the National Response Plan (NRP). The Notice of Change is effective immediately and identifies locations in the December 2004 version of the NRP where changes have been made. The Notice of Change will be followed later this year by an extensive review of the NRP, at which time the NRP will be reissued. Visit http://www.dhs.gov/dhspublic/interapp/editorial/editorial_0566.xml for the Notice of Change and the NRP Quick Reference Guide.
12. DHS Releases Review of Nationwide Catastrophic Event Preparedness
The Department of Homeland Security (DHS) on June 16 issued findings from a national assessment of the country’s catastrophic planning capabilities. Responding to directives from President Bush and the Congress following Hurricane Katrina, the Nationwide Plan Review (NPR) looked at whether existing emergency operations plans for states and urban areas are sufficient for managing a catastrophic event. The review also presents conclusions on actions needed by the federal government to improve and coordinate planning. Conducted in all 56 states and territories and 75 urban areas over six months, the NPR was the most comprehensive assessment of emergency operations plans to date relative to planning for a catastrophic event. Reviewers examined nearly 2,800 emergency operations plans and related documents with participation from more than 1,000 emergency managers and homeland security officials. While most areas of the country are well prepared to handle standard disaster situations, the NPR findings demonstrate the need for all levels of government across the country to improve emergency operations plans for catastrophic events such as a major terrorist attack or category-five hurricane. Several areas, including evacuation, attention to populations with special needs, command structure and resource management, were areas needing significant attention. A fact sheet on the NPR is available at http://www.dhs.gov/dhspublic/interapp/press_release/press_release_0928.xml. Visit http://www.dhs.gov/dhspublic/interapp/press_release/press_release_0929.xml for a fact sheet on the NPR initial conclusions. The full NPR is available at http://www.dhs.gov/interweb/assetlibrary/Prep_NationwidePlanReview.pdf.
13. HHS Releases the 2005 State of CDC
The Department of Health and Human Services (HHS) recently released the 2005 State of Centers for Disease Control and Prevention (CDC). The report provides a bird’s-eye view of the great strides made in 2005 to ready the agency to meet future goals and challenges. CDC’s organizational structure was streamlined and new agency-wide goals were set to increase the health impact for all people. Four new buildings were opened. These new facilities provide world-class CDC scientists with the most technologically advanced research tools to fight the health threats of today and tomorrow. In the public arena, CDC faced unprecedented events: the tsunamis in Asia in December 2004, the record-breaking number of hurricanes along the Gulf Coast, and, of course, the deadliest hurricane recorded in the United States since 1928, Hurricane Katrina. A copy of the report is available at http://www.cdc.gov/about/stateofcdc/fy05/cd/SOCDC/SOCDC2005.pdf.
NEDARC Releases Performance Measure Survey Templates
The National EMSC Data Analysis Resource Center (NEDARC) has released its Performance Measure Survey Templates. These templates will help EMSC grantees who are planning to conduct surveys to collect data for performance measure #66. The template may need to be adapted to each state’s particular needs. The templates are available at http://www.nedarc.org/tech_assist/pm_templates.htm.
EMS Software That Successfully Completes NEMSIS Testing to Be Posted June 30
Eleven EMS software packages are being tested for NEMSIS compliance. The 11 packages have been created by eight EMS software developers. They were provided test cases and documentation to begin the NEMSIS Compliance Certification process on May 31. The packages work on one of the following platforms: Web-Based, Windows, Palm OS, or Pocket PC. There are five additional EMS software developers representing an additional eight EMS software packages which have requested to be tested for NEMSIS compliance. These companies have not provided all required information to be included in this initial testing cycle. The software testing had to be completed by June 16. The NEMSIS TAC will validate the results. On June 30, all EMS software packages which completed the NEMSIS compliance testing successfully will be posted at http://www.nemsis.org. The August NEMSIS compliance test cycle will begin on July 31.
Mineta to Step Down from Transportation
The White House announced on June 23 that Transportation Secretary Norman Y. Mineta will step down on July 7. Mineta, the longest-serving Transportation secretary ever and the first Asian-American Cabinet member, submitted a formal letter of resignation to President Bush on June 20. Mineta has served as Transportation secretary since 2001.
Nason Sworn In on June 28 as NHTSA Administrator
On June 28, Nicole R. Nason was sworn in as the new administrator for the National Highway Traffic Safety Administration (NHTSA). She began her duties on May 31, 2006. She joins NHTSA from the Department of Transportation, where she was the assistant secretary for governmental affairs since July 2003. In that position, she was responsible for oversight of congressional affairs, coordinating all legislative and non-legislative relationships between the department and Congress, and directing the presentation of the department’s legislative program. She also worked closely with state and local governments, other federal agencies, public and special interest groups, transportation associations and non-profit organizations. Nason has a bachelor’s degree from American University and a law degree from Case Western University Law School. NASEMSO welcomes Nason to her new position.
FEMA Releases Preparedness DVD
“Getting Ready for Disaster: One Family’s Experience,” a citizen preparedness DVD from the Federal Emergency Management Agency (FEMA), has been released to help people get ready for disasters that may impact their families and communities. The DVD guides viewers through important steps of disaster preparedness and addresses critical issues. It was designed to be used with “Are You Ready? An In-Depth Guide to Citizen Preparedness” and the accompanying facilitator manual for teaching preparedness principles in small group or classroom settings. Free copies of the DVD (FEMA 500) and the “Are Your Ready” guides (IS-22 and IS-22FG) are available through the FEMA Distribution Center at (800) 480-2520. Requests are currently limited to one DVD per caller. In the coming months, the DVD will be translated into Spanish and will be available in both languages on a single DVD. Video files, a transcript and the guide may be downloaded from http://www.fema.gov/areyouready.
Transportation Research Board Issues Guide
The Transportation Research Board of the National Academies has published “A Guide to Transportation’s Role in Public Disasters.” The guide examines development of transportation response options to an extreme event involving chemical, biological or radiological agents. It contains technical information on chemical, biological and radiological threats, including vulnerabilities of the transportation system to these agents and consequence-minimization actions that may be taken within the transportation system in response to events that involve these agents. Learn more at http://www.trb.org/news/blurb_detail.asp?id=6266.
U.S. to Host 2006 International Roundtable on Community Paramedicine and Rural Health Care Delivery
Nearly 50 delegates form Australia, Canada, Scotland, and the United States met July 27-28, 2005, in Nova Scotia to share ideas on integrating rural EMS providers into rural health care delivery systems. The meeting was hosted by the National Association of EMS Physicians (NAEMSP) founder Ron Steward, M.D., and the Emergency Health Services (EHS) Division of the Nova Scotia Department of Health at the Medical School of Dalhousie University of Halifax. The delegates are convening a second meeting July 24-27 at the Mayo Clinic to continue the discussion and to hear about lessons learned in the last year. The delegates are encouraging other countries that either have models to share or an interest in hearing the dialogue to participate. More information is available at http://ircp.ncemsi.org.
Funding Issues the Focus of NENA’s First NG E9-1-1 Program Meeting of 2006
The National Emergency Number Association (NENA) released a summary of the recently convened 9-1-1 funding topic area meeting of the 2006 Next Generation (NG) E9-1-1 Program. The meeting was the first of a series designed to address important policy, technical and operational issues related to the migration and sustainability of a fully IP0enabled NG 9-1-1 system. A full summary of the meeting and information on NENA’s NG E9-1-1 Program, including an overview, Program Partner information and the Initial Findings and Recommendations of the 2005 NG E9-1-1 Program, are available at http://www.nena.org/pages/Content.asp?CID=208&CTID=14.
GAO Issues Report Encouraging Improved Coordination between FEMA and the Red Cross
According to a new report by the Government Accountability Office (GAO), the Federal Emergency Management Agency (FEMA) and the Red Cross – working together for the first time as co-primary agencies for emergency support function-6 (ESF-6) under the National Response Plan – disagreed about their roles and responsibilities, and this disagreement strained working relationships and hampered their efforts to coordinate relief services for hurricane victims. The report, “Coordination between FEMA and the Red Cross Should Be Improved for the 2006 Hurricane Season,” includes GAO’s interim findings on the Red Cross and FEMA’s hurricane operations. GAO will continue to analyze federal and charitable hurricane relief efforts. The report is available at http://www.gao.gov/cgi-bin/getrpt?GAO-06-712.
GAO Issues Report on U.S. Tsunami Preparedness
The U.S. Government Accountability Office (GAO) has issued a report on “U.S. Tsunami Preparedness: Federal and State Partners Collaborate to Reduce Potential Impacts, But Challenges Remain.” The GAO did this study because the 2004 Indian Ocean tsunami raised questions about U.S. preparedness for such an event. The National Oceanic and Atmospheric Administration (NOAA) leads U.S. detection and warning efforts and partners with federal and state agencies in the National Tsunami Hazard Mitigation Program (NTHMP) to reduce tsunami risks. In 2005, Congress appropriated $17.24 million in supplemental funding to enhance these efforts. This report (1) identifies U.S. coastal areas facing the greatest tsunami hazard and the extent to which potential impacts have been assessed, (2) discusses the effectiveness of the existing federal tsunami warning system, (3) describes efforts to mitigate the potential impacts of tsunamis on coastal communities, and (4) assesses NOAA’s efforts to develop long-range plans for federal tsunami programs. For a copy of the report, visit http://www.gao.gov/new.items/d06519.pdf.
RAND Releases Report on Emergency Response to Terrorist Attacks
A new report from the RAND Corporation for the first time presents a framework for characterizing what emergency responders must be prepared to do following a terrorist attack. Titled “Emergency Response to Terrorist Attacks: An Analysis of Mission Performance Requirements,” the report provides a way to quantify emergency response performance requirements in terms of the life-saving missions that need to be accomplished, the level at which those missions must be performed, and the time interval over which they must be conducted. The report is available only to qualified emergency responders and homeland security officials through the U.S. Department of Homeland Security’s (DHS) Lessons Learned Information System found on the Internet at https://www.llis.dhs.gov/member/secure/detail.cfm?content_id=17099. The site is operated by the Oklahoma City Memorial Institute for the Prevention of Terrorism, and credentials must first be presented to gain access.
IAFC Board Approves MASTF Report
In May, the International Association of Fire Chiefs (IAFC) board approved a Mutual Aid System Task Force report. The report came out of a collaborative effort of all divisions within IAFC to evaluate current issues concerning interstate movement of fire service resources and assets. The group identified key issues to improve effectiveness: validate the use of a national point of contact for deployments; establish policies and procedures to enable rapid deployments; identify the aspects that make you eligible to participate; determine the best methods to educate participants on the system and provide training; determine the linkages with other services that will connect the systems together; and determine who will be responsible for funding the development, monitoring and support of the system. The group also recommended the formation of a standing committee within the IAFC to be called the Emergency Management Committee, which will be established following a staff review to develop a mission plan and scope of work. Learn more at http://www.iafc.org.
FEMA Launches Debris Contractor Registry Online
The U.S. Department of Homeland Security’s (DHS) Federal Emergency Management Agency (FEMA) is implementing a number of improvements to strengthen its programs for the 2006 hurricane season. As part of this, FEMA is launching a new Debris Contractor Registry online. This database will establish a nationwide list of debris removal contractors that can help communities better plan for and more rapidly respond to debris removal requirements in times of disaster. In order to register their business, contractors simply log on to the Web site at https://65.207.63.84/usp3_nerr/default.aspx and follow the instructions. Those who encounter problems or have questions or concerns regarding use of the Web site should contact the help desk at (703) 674-3003 or email usp3-support@mantech-ist.com.
GAO Issues Report on Improper Hurricane Disaster Relief Payments
The U.S. Government Accountability Office (GAO) has issued a report on “Hurricanes Katrina and Rita Disaster Relief: Improper and Potentially Fraudulent Individual Assistance Payments Estimated to Be between $600 Million and $1.4 Billion.” The report provides an estimate of improper and potentially fraudulent payments through February 2006 related to certain aspects of disaster registrations, identifies whether improper and potentially fraudulent payments were made to registrants who were incarcerated at the time of the disaster, identifies whether FEMA improperly provided registrants with rental assistance payments at the same time it was paying for their lodging at hotels, and reviews FEMA’s accountability over debit cards and controls over proper debit card usage. The report is available at http://www.gao.gov/new.items/d06844t.pdf.
Alabama State EMS Director Retires
June 2, 2006, was the last day on the job for Jim Prince, director of the Office of EMS and Trauma for the State of Alabama. He spent 36 years in healthcare administration. Prince is a past member of the Executive Committee of NASEMSO. Deputy Director Russell Crowley has become the acting director. He will continue to serve until further notice as the NASEMSO Training Coordinators Council chairman.
MN EMSRB Mourns Passing of Chuck Lonien
Chuck Lonien passed away on June 12, 2006 after a courageous battle with cancer. Chuck was the EMSRB specialist in southwest Minnesota. He worked for more than 20 years with the EMSRB and the Department of Health, spending the last 10 years in Marshall, Minn., as the manager. One colleague wrote, “I had ample opportunities to work with Chuck and experience his love of EMS. He will be missed.” NASEMSO sends condolences to Mr. Lonien’s family and friends.
Gary Brown Honored with 2006 EMSC National Heroes Award
The Emergency Medical Services for Children (EMSC) Program annually recognizes and honors members of its community for their accomplishments in EMSC outreach, education, research and service. Gary Brown was presented the State EMSC Policymaker of Distinction Award. This award honors an individual who has been a state public official within the past five years; has advanced state legislation promoting EMSC programs or related measures; and has a statewide, regional or national reputation for safeguarding the health and well-being of children. For more than 25 years, Brown has served the Commonwealth of Virginia as a state health department employee. In 1997, he was named director of the Virginia Office of EMS. In that role, his support, guidance, and political savvy have ensured a place for EMSC at every level within the state. For example, he added an EMSC representative to the EMS Funding Task Force, to the Virginia Emergency Management Committee and to the annual EMS Symposium Planning Committee. During the 2005 Virginia General Assembly session, Brown spearheaded an initiative to get EMSC added as an objective in the State Emergency Medical Services Plan. This opened the door for EMSC to receive state funds for the first time in 2005. NASEMSO congratulates Gary on this award.
Cannon Appointed Director of Response
Glenn Cannon has been appointed director of FEMA’s Response Division where he will be responsible for coordinating the development and execution of interagency plans, policies and procedures and for response operations in Presidential disaster and emergency declarations and other incidents of national significance. Cannon currently serves as the manager of public safety for M/A-COM Wireless, Inc., a subsidiary of TYCO Electronics, a position he has held since 2001. M/A-COM provides Mission Critical Communications Systems to public safety systems, including state-wide radio systems to both Florida and Pennsylvania. Previously, Cannon served as the manager and chief operating officer of Allegheny County, Penn., beginning in 1996.
Two New Grant Initiatives Announced for Institutions
At a May 31 conference sponsored by the National Trust for Historic Preservation and Tulane University in New Orleans, First Lady Laura Bush announced two new grant initiatives that will provide funding to institutions that have suffered a major disaster. The Institute of Museum and Library Services is reserving $1.5 million of the grant money it will award over the next year for projects related to the Gulf Coast and other regions affected by major disasters. Read more about this program at http://www.imls.gov/news/2006/060106.shtm. The National Endowment for the Humanities will award an additional $750,000 in stabilization grants to cultural and historical institutions along the Gulf Coast. Details of the program are at http://www.neh.gov/news/archive/20060602.html.
Information on New High-Tech Training Facility Available
The EIIP Virtual Forum hosted a live chat presentation on May 24 featuring Robert J. Harper, Jr., program manager for Northrup Grumman, and Charles J. Venable, senior program manager for SAIC. Discussion focused on the Emergency Management Training, Analysis & Simulation Center (EMTASC), a state-of-the-art facility under development in Virginia, devoted to the command and operations management side of homeland security training. EMTASC will employ high-tech modeling and simulation tools to conduct training, exercises, analysis and operational support. Download the discussion transcript at http://www.emforum.org/vforum/lc060524.htm.
June 21, 2006
Interesting article concerning training injuries. REMEMBER, when doing hands on scenario based education, YOU the instructor must assure the safety of the students and simulated patients at all time. We attempt to place the student in a NEAR-REAL scenario for the educational benefit, BUT we must do it with safety in our mind and in our actions!! (Ken)
NFPA: Training Too Often Results in Unnecessary Deaths, Injuries
SUSAN NICOL KYLE, Firehouse.com News
In the past decade, 100 firefighters across the country have died while engaged in training, a NFPA study shows.
Sudden cardiac events were cited as the leading cause of deaths during training, the same culprit that is claiming on-duty firefighters.
"Training is a vital part of fire department operations, but it too often results in unnecessary death and injuries," NFPA researchers wrote, adding that in the past 29 years, 239 firefighters have died during drills.
Following their recent study focusing on training deaths from 1996-2005, the NFPA concluded: "Firefighter deaths during training are particularly needless. The purpose of training is to prevent deaths and injuries, and should certainly not be the cause of casualties...Eight of the 100 were recruits..."
Of the 100 victims, 47 were volunteers; 39 career; five state land management; four federal land management; two civilian members of the military; one pilot; one member of the military and one was an industrial firefighter.
The study showed that the majority of deaths (36) occurred during apparatus or equipment drills, while physical fitness exercises claimed 30 firefighters. Other activities included live burns, 14; underwater training, eight; classes or seminars, five; traveling to or from drills, six; and one person was shot during SWAT training.
Neither of the two firefighters killed in crashes while learning to drive tankers was wearing a seat belt. Investigators determined that one of the vehicles also had several defects.
Three died after being struck by vehicles, including one by a backing engine being driven by an operator with a suspended license; one by vehicle operated by a person under the influence of prescription medication and alcohol; and another by a speeding vehicle involved in the drill. Horseplay also was cited as a factor in that crash.
Two firefighters died after falling from open tailgates of pickup trucks, and another was hit while picking up equipment that had fallen off a fire truck returning from a drill.
The NFPA researchers suggested: "Motor vehicle crashes during training sessions and while traveling to or from...represent an area where ordinary precautions and attention to driving rules and road conditions should have an impact. Seat belts should be worn at all times in all vehicles."
They also said departments should review NFPA 1002, standards for fire apparatus operators, and make sure drivers understand the dynamics involved.
Of the 30 deaths during fitness training, 23 died of sudden cardiac arrest, three each to heat stroke and aneurysms and one from a disease associated with sickle cell trait. Thirteen of those firefighters collapsed while working out, and all were found to have significant health problems. However, the surveyors discovered that not all the personnel under 40 would have been required to take tests that may have detected their hidden cardiac issues.
Six of those cardiac arrest deaths occurred while candidates were taking pack tests for wildland firefighting qualifications.
Two recruits died during fitness training. In one case, investigators listed a number of errors, including no rest or water for more than an hour; dark clothing, an untrained instructor, bullying and no acclimatization for conditioning given the high heat and humidity. The other case involved an experienced runner collapsed after failing to drink water or take advantage of shade.
The NFPA study also found that 14 firefighters died during live fire training. Two died in a flashover during a search and rescue drill. One victim had only been in the department a week.
In another incident, an 18-year-old recruit playing a victim in a burning building died of smoke inhalation. The officer in charge was charged with negligent homicide. Investigators found there were no emergency evacuation ladders in place, no safety lines and no one knew about a sofa fire.
It was the first time the victim had used SCBA in fire conditions.
The NFPA also discovered several violations occurred during another exercise that left a recruit dead, and four others suffering heat-related problems. The investigation showed no safety officer or plan; no formal EMS plan, no RIT teams in place, and the fire environment was not monitored. Recruits were threatened with termination of they left the structure prematurely or were hurt.
The NFPA study also shows that the victims ranged from 17 to 74 with a median age of 43.
Prior to conducting a training exercise, commanders are encouraged to review various NFPA standards.
Researchers concluded: "Since training exercises should be conducted in controlled settings, they must be designed so as not to endanger the participants. This requires that recommended safety procedures be followed. That, in combination with competent instruction, should result in the level of safety necessary to protect lives."
June 20, 2006
Chevrolet Silverado Hybrid Information
General Motors has two downloads that discuss emergency operations when dealing with the Chevrolet Silverado Hybrids and GM air bags and seat belts. There is also information on the GM "I" car structures that all you extricators will find extremely useful.
June 1, 2006
The Technology “Cart” and the EMS “Horse” – New Technology & EMS Project Launched
Many new technologies hold great potential for their application in emergency medicine and the improvement of emergency care. To date, however, most technologies are developed first, leaving those who deliver emergency care to figure out how to use the finished product in the prehospital setting. That may be about to change. Through an initiative coordinated by the National Association of Emergency Medical Services Physicians (NAEMSP), NASEMSO is involved in a project designed to evaluate the utility of technology before it is deployed in EMS.
The “Technology and EMS” project (funded by Emergency Medical Services at the National Highway Traffic Safety Administration (NHTSA)) will link individual EMS experts, national professional associations and educational institutions having extensive EMS knowledge with developers of multiple kinds of technology (e.g., technical devices, information technology) to increase national EMS community involvement in evaluating the clinical and practical utility of technology before it is deployed in EMS. A Technical Consulting Committee (TCC), composed of medical, surgical, emergency medical, public safety, public health and other organizations and agencies convened by NAEMSP, has been charged with developing a template and a process for evaluating new technology for its application in EMS. NASEMSO President Bob Bass (Md.) and NASEMSO Program Advisor Kevin McGinnis will represent the organization in this effort. It is a process that is long overdue.
The Emergency Medical Services Agenda for the Future cites the expanding role of technology in its recommendations for the future practice of emergency care. However, the Agenda specifically recommends, that as technology pertains to the direct clinical care of patients, that EMS “employ new care techniques and technology only after shown to be effective.” The goal of the “Technology & EMS” project is to develop a coordinated method for determining the efficacy, effectiveness, and efficiency of new care technologies in EMS.
The practice of emergency medicine and the delivery of emergency care will continue to evolve, as knowledge is expanded and technology is developed. As technology continues to advance, this project will allow us to reposition the EMS “horse” before the technology “cart.” For more information on NASEMSO’s role, contact Bob Bass at rbass@miemss.org or Kevin McGinnis at mcginnis@nasemso.org. For more information on the “Technology & EMS” project or the TCC, contact Principal Investigator Dr. Robert Domeier at rdomeier@aol.com.
Take Action Today to Ensure Communities Receive Funds to Purchase AEDs
The sudden cardiac arrest victim’s chance of survival can more than double if CPR and an automated external defibrillator (AED) are used immediately. Despite this success, funding for the Rural and Community Access to Emergency Devices Program remains in jeopardy. The program was zeroed out in the President’s FY 2007 budget. In 2005, the program received $8.927 million and the Ad Hoc Coalition to Save Lives through Public Access to Defibrillation is asking Members of Congress to restore funding to its FY 2005 level. The Labor, Health and Human Services & Education (Labor-HHS) Subcommittee on Appropriations is scheduled to mark up the bill on Jun. 7, 2006. The Coalition urges interested parties to contact their representatives immediately to urge support of the program.
Advocates for EMS Applauds Homeland Security Appropriations Language Improving Federal Support of Emergency Medical Services
Members of Advocates for EMS (AEMS), including NASEMSO, on May 16, applauded Chairman Hal Rogers (R-KY), Ranking Member Martin Sabo (D-MN), and the members of the House Homeland Security Appropriations Subcommittee for its inclusion of report language that would increase federal support for emergency medical services in their fiscal year 2007 appropriations bill. The Homeland Security Appropriations bill was passed by the Appropriations Committee by voice vote on May 16. The Committee directive requires the Office of Grants and Training at the Department of Homeland Security (DHS) to include in its grant guidance that state and local governments include EMS representatives in planning committees as an equal partner and to facilitate a nationwide EMS needs assessment. In addition, no later than Jan. 16, 2007, DHS is to report to the House Committee on Appropriations and the House Committee on Homeland Security on the use of state and local, urban area security initiative, and firefighter grant funds for EMS. For more information, contact Lisa Meyer at (202) 448-9500.
NASEMSO, Others Urge Funding for Local Public Health Preparedness
On May 19, 18 organizations, including NASEMSO, sent a letter to Senators Spector and Harkin and Representatives Regula and Obey. The letter called for Congress to fully restore funding for state and local public health preparedness in FY 2007 appropriations for the Centers for Disease Control and Prevention (CDC). Last year, funding for state and local bioterrorism and public health preparedness was cut from $919 million to $824 million, more than 10 percent. This will result in a cut of about 12 percent in the cooperative agreement funding that goes directly to states and four large cities. The letter noted that state and local public health agencies are required to do more each year, even as funding levels decrease. Added responsibilities include food and water defense, vital records security, BioWatch, the U.S. Postal Service Biohazard Detection System (BDS), the Strategic National Stockpile distribution system, and National Incident Management System (NIMS) compliance. The letter calls on Congress to reverse the decline in funding essential to help the governmental public health systems in every state continue progress in preparing for public health emergencies. The letter was coordinated by the National Association of County and City Health Officials. For more information, contact Marcia Mabee at mmabee@ix.netcom.com.
National EMS Education Standards Task Force Conducted Stakeholders Summit
In May 2006, the National EMS Education Standards Task Force conducted a Stakeholders Summit in Silver Spring, Md. Stakeholders from 16 national EMS organizations gathered to review and discuss potential formats for the education standards. In addition to the stakeholder representatives, there were many observers from other national EMS organizations, local EMS services and the EMS publishing community. Stakeholders provided input on the proposed format for all levels of the education standards, and, in general, the stakeholders indicated that more detail was necessary. There was not agreement about the level of detail at each level, but the publishers felt they would be able to produce supplemental materials that will be useful to EMS instructors. Once the proposed format and level of detail is drafted by the Task Force, this information will be provided to the stakeholders for review. The Task Force will use the model format as a template for developing the first drafts of the education standards in late 2006. For more information, contact Dianne Warrick of the National Association of EMS Educators at dianne.warrick@naemse.org.
NAEMSP Seeks Case Studies Involving Medical Directors
The NAEMSP National EMS Medical Directors Course is looking for interesting case studies involving medical directors to use for teaching purposes. The cases should present a current controversy in EMS and should be stripped of any identifying information. Examples might include cases involving physicians on the scene, exceeding the scope of practice in a heroic effort to save a patient, refusal of care by patients who are of uncertain mental status, a basic EMT provider on the scene questioning the quality of care being provided by an ALS provider, and an order from a base station that is inconsistent with EMS protocols. Case studies should be sent to Dr. Bob Swor at raswor@aol.com. Questions should be directed to NASEMSO President Bob Bass at rbass@miemss.org.
NHTSA Releases Guide for Interfacility Patient Transfer
The Office of Emergency Medical Services at the National Highway Traffic Safety Administration (NHTSA) has released the “Guide for Interfacility Patient Transfer.” The guide was developed by the Interfacility Transfer (IFT) Work Group, consisting of representatives of national EMS organizations and Federal agencies directly involved in interfacility transfer. NASEMSO was represented in the project by Mark King (W.Va.) and Fergus Laughridge (Nev.). The guidelines contained in this document are based upon a combination of available objective evidence, a review of generally accepted practices, and the consensus of expert opinions in the field of IFT. The intended audience for this guide is the agency providing IFT at the local, regional, or state level, as well as those involved with planning for IFT or dealing with IFT-related issues. To access the “Guide for Interfacility Patient Transfer,” visit the NHTSA Web site at http://www.nhtsa.dot.gov and click on “Emergency Medical Services Program” in the “Quick Links” section. The guide is listed as “NEW” near the top of the Web page.
Exploring Accreditation Project Examines Feasibility of National Public Health Accreditation System
The National Association of County and City Health Officials (NACCHO) and the Association of State and Territorial Health Officials (ASTHO) are coordinating the “Exploring Accreditation” project to examine the implications and feasibility of a voluntary national public health accreditation system. This initiative began in 2005 with funding from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention (CDC). Building on the expertise and experience of professionals at every level of public health, and with opportunities for public comment, the Exploring Accreditation project is examining all aspects of accreditation issues, including: governance studies; roles of federal, state and local governmental public health entities; financing; and research and evaluation components. The project’s steering committee has reached consensus on several aspects of a model system, which can be viewed at http://www.exploringaccreditation.org/27.html.
DHS Secretary Outlines Steps toward Improving Interoperability
At a May 8 speech, Homeland Security Secretary Michael Chertoff outlined the next steps the U.S. Department of Homeland Security (DHS) will take to improve the interoperability of emergency communications systems used by first responders. Secretary Chertoff emphasized that the technology to allow for interoperability exists and called on states and localities to take the leadership actions necessary to implement interoperable communications. A department survey is being conducted of some 23,000 state and local government users that will establish a baseline. Then, DHS will form a task force led by state and local participants to work toward a set of functional requirements that state and local governments can use to guide their equipment purchases. “We must recognize it is not up to industry to define what is needed. It is up to all of us to define these requirements and tell industry what we need,” said Secretary Chertoff. “In the long term, we are continuing with the rigorous process of arriving at technical standards for future generations of communications equipment, working with our partners in government, the private sector and international standards organizations. But, as important as that is, we cannot wait for the arduous technical standards process to play out before we achieve the improved state of interoperability that we need to respond to our citizen’s needs.”
IOM to Release Three Reports on the Future of Emergency Care
Three reports from the Institute of Medicine’s (IOM) The Future of Emergency Care in the U.S. Health Care System project will be released on Jun. 14, 2006, during a press briefing in Washington, D.C. The reports will address three key focus areas of the study – prehospital, hospital-based, and pediatric emergency and trauma care. The pediatric report will examine the unique challenges associated with the provision of emergency services to children and adolescents, and evaluate progress since the publication of the IOM’s 1993 report Emergency Medical Services for Children. The Jun. 14 press briefing will be available as a Web cast. Instructions for logging on to the Web cast are available at http://www.iom.edu/emergencycare. Prepublication versions of the reports will be available at the briefing. The full commissioned reports will be available in mid-July through the National Academies public access file. Directions for accessing the public access file are available at http://www.nationalacademies.org.
NIPP Base Plan Status Update
Following two rounds of public review and comment, the draft base plan of the National Infrastrucure Protection Plan (NIPP) was provided to the Homeland Security Council’s Critical Infrastructure Protection Policy Coordinating Committee. This interagency group reviewed the document and provided concurrence. The plan is in the process of being reviewed by the HSC Deputies Committee. Once that committee gives its concurrence and/or recommendations, the NIPP Base Plan will be readied for the interagency signatory process in anticipation of its final release. For more information, contact NIPP@dhs.gov.
