summer educational conference renaissance hotel asheville, nc july 7-10, 2012

Summer Educational

Conference

Renaissance Hotel Asheville , NC

July 7-10, 2012

Regina Godette-CrawfordChief, OEMS

Regina Godette-CrawfordChief, OEMS

EMS UPDATE

OEMS ADMINISTRATION

Staff Changes/Retirements/Promot

ions at the OEMS

• Elva Barnhardt Contracts Manager retired in March 2012

• Heather Majernik Education & Credentialing Manager accepted a

position with Wake Health & Hospitals in May 2012.

• Shelley Carraway Hospital Preparedness Program Manager accepted a position

with the Division office in June 2012.

OEMS ADMINISTRATION

Staff Promotions at the OEMS

•Chuck Lewis, EMT-P, RN Western Regional Manager

•Allen Johnson, EMT-P Eastern Regional Manager

OEMS ADMINISTRATION

• Data Review Committee organized to review and define data points.

• Completed review and update of 13P 21 NCAC rules as required by Session Law 2011-398 (formerly SB 781). This rule Required annually.

• NFPA 1917 Ambulance Standards is forthcoming, which will change the standards for Ambulance Construction in NC. NCOEMS is participating on a committee within NAEMSO to address this issue at the national level. We will work with NCAEMSA to address any standards needed for North Carolina.

OEMS ADMINISTRATION

EMS White Paper• H.R. 3144 - introduced in October 2011• Currently in two (2) Committees

House Committee on Energy and Commerce House Committee on Ways and Means

Nothing has changed 

Blood & Urine Sampling for DWI Suspects

Blood & Urine Sampling

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

Statewide Survey Response

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

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

Statewide Response to Survey

AlamanceAlexander

Alleghany

Anson

Ashe

Avery

Beaufort

Bertie

Bladen

Brunswick

Buncombe

Burke

Cabarrus

Caldwell

Camden

Carteret

Caswell

Catawba Chatham

Cherokee

Chowan

Clay

Cleveland

Columbus

Craven

Cumberland

Currituck

DareDavidson

Davie

Duplin

DurhamEdgecombe

Forsyth Franklin

Gaston

Gates

Graham

Granville

Greene

Guilford

Halifax

Harnett

Haywood

Henderson

Hertford

Hoke

Hyde

Iredell

Jackson

Johnston

Jones

Lee

Lenoir

Lincoln

McDowell

Macon

MadisonMartin

Mecklenburg

Mitchell

MontgomeryMoore

Nash

New Hanover

Northampton

Onslow

Orange

Pamlico

Pasquotank

Pender

Perquimans

Person

Pitt

Polk

Randolph

Richmond

Robeson

Rockingham

Rowan

Rutherford

Sampson

Scotland

Stanly

StokesSurr

y

Swain

Transylvania

Tyrrell

Union

VanceWarren

Washington

Watauga

Wayne

Wilkes

Wilson

Yadkin

Yancey

Wake

Response to Survey 70 Counties

No Response 31 Counties

Specialty Care Responses 4 Agencies

Total Agencies Responding to Survey 93Total Counties Responding to Survey 70

Blood & Urine Sampling

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

No29

31%Yes64

69%

Blood & Urine Sampling

• How often does this occur?

47

102 5

05

101520253035404550

1 to 5times/mo.

6 to 10times/mo.

11 to 15times/mo.

Over 16times/mo.

Blood & Urine Sampling

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

Hwy.Patrol 45

Local Police Dept.,

14

County Sheriff

5

Blood & Urine Sampling

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

Yes28

30%No65

70%

Sample Sampling Policies

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

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

Blood & Urine Sampling

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

Yes21

23%

No72

77%

Blood & Urine Sampling

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

27 29

37

0

5

10

15

20

25

30

35

40

No RemainUnchanged

Yes Repealed

Needs to beRewritten

Medication Shortage

Medication Shortage

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

Medication Shortage

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

No16

17%

Yes77

83%

Medication Shortage

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

13

64

9

55

10

67

33

44

10

67

0

10

20

30

40

50

60

70

Atropine CalciumChloride

Dextrose Valium Diltiazem

YesNo

Medication Shortage

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

9

68

14

63

33

44

33

44

0

10

20

30

40

50

60

70

Benadryl Epinephrine 1:1,000

Epinephrine1:10,000

Etomidate

YesNo

Medication Shortage

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

23

54

23

54

19

58

13

64

0

10

20

30

40

50

60

70

Fentanyl Toradol Mag. Sul. Ativan

YesNo

Medication Shortage

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

26

51

23

54

16

61

24

53

0

10

20

30

40

50

60

70

Versed Morphine Narcan Zofran

Yes

No

Medication Shortage

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

2

75

1

76

22

55

7

70

0

10

20

30

40

50

60

70

80

Phenergan Propofol Sodium Bicarb. Vercuronium

Yes

No

Medication Shortage

Summary• It appears that EMS Agencies are

dealing with current medication shortages.

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

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

RULES UPDATE

RULES UPDATE

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

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

Healthcare Preparedness Response and Recovery

Healthcare Preparedness Response and Recovery

Operations–Statewide Exercise May 2012

•State Medical Support Shelters

•Pitt County/Cumberland County

•SMRS

•Local Support

–Mission Packages•Working with NC Emergency Management

•Capability focused (no longer team)

• Healthcare Preparedness Capabilities – Released January 2012– 8 Capabilities– Aligned with the 15 PH

Capabilities

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

Healthcare Preparedness Response and Recovery

•FY12 ASPR Grant $10,319,477

•State Projects of Interest–Patient Tracking

–Resource Tracking

– Inventory Management

•Regional Applications–Capabilities based

–Risk Assessment

–Gap analysis

–Due August 1, 2012

Healthcare Preparedness Response and Recovery

Democratic National Convention (DNC)– DNC Health and Medical Planning

– SMRS Response•SMAT II

•SMAT III

•AST

•Mobile Disaster Hospital– Rapid Response Unit

•Medical Coordination Team

•NC Baptist Men Logistical Support

Healthcare Preparedness Response and Recovery

EMS Assessment Project

• Assessment by UNC-School of Public Health

• Goal to conduct a program assessment to include;DisasterTraumaEMS

• Currently completing a survey and interviews with OEMS staff and management

• EMS Systems will receive survey link within the next month

• SMAT Teams will receive survey link within the next 2 months and possibility of on site interviews

 • Assessment with recommendations to be completed by

January 2013

Healthcare Preparedness Response and Recovery

Program Changes•New Staff

•HPR&R Operations - Jeff Peterson

Vacancies:• Hospital Preparedness Program Coordinator

•Shelley Carraway•June 1 moved to DHSR Planning Section•Position Posted

• Communications •Danny Allen •Position under review

System Update

EMS SYSTEMS UPDATE

2012 NCCEP Protocols are now released

Posted at www.ncems.org

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

– Please direct any questions to your Regional EMS Office.

– We will be making available the Protocol Implementation Form.

HEALTH SYSTEMS & TRAUMA

UPCOMING TRAUMA SITE VISITS

• Moses H. Cone Memorial Hospital/Cone Health– August 2012

• Duke University Medical Center– October 2012

• Wake Forest Baptist Medical Center– November 2012

• High Point Regional Health System– November 2012

• New Hanover Regional Medical Center– December 2012

• WakeMed/Raleigh Campus– March 2013

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

• New Validation Tool to ensure trauma registry data quality.

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

TRAUMA REGISTRY

EDUCATION

EDUCATION

Agenda for the Future– OEMS is working with the NC Association of EMS

Educators and the NC Community College System to develop the new curricula.

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

– One NREMT transition course was conducted as a pilot. Two courses are pending to after January 1, 2013 as NREMT will not accept transition courses conducted prior to that date.

– A floating timeline for implementation has been developed. This is dependent on NCOEMS Education Rules revision.

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

EDUCATION

Credentials

NCOEMS is receiving an influx of Expired Emergency Medical Dispatch (EMD) Credentials.

Please remind your EMD communication center that personnel must maintain an up-to-date North Carolina EMD Credential or they are not allowed to process EMD calls.

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

Emergency Medicine Today

October 6-10, 2012Koury Convention Center, Greensboro NC

Registration InformationConference registration will be available in late

July or early August.

COMPLIANCE UPDATE

COMPLIANCE UPDATE

OEMS Enforcement StatisticsJanuary 1, 2012 – June 30, 2012

77 - Total Complaints Received.

23 - Complaints closed with no substantiated rule violations.

44 - Complaints became formal investigations with substantiated rule violations.

10 - Complaints are presently been addressed.

COMPLIANCE UPDATE

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

• The NC EMS Disciplinary Committee interviewed 25 individuals.

COMPLIANCE UPDATE

•Enforcement actions taken resulted in:

6 Individuals credentials revoked. 2 Credentialing Applications denied. 3 Credentials Summarily Suspended.

COMPLIANCE UPDATE

Enforcement actions were necessary due to:Potential Substance abuse issues.Criminal histories including felonies.Providing medical care and treatment

outside the credentialed scope of practice.

Falsification of credentialing application.

COMMUNICATIONS

COMMUNICATIONS

FCC MANDATORY NARROWBANDING

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

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

EMS FOR CHILDREN

EMSC Site Visit in Chapel Hill– NCOEMS attended the site visit to support the EMSPIC

and Dr. Jane Brice on their “EMS and Pediatric Trauma: A North Carolina Population Based Performance Improvement Intervention and Evaluation Using Multiple Linked Healthcare Databases” conducted by HRSA

EMS FOR CHILDREN

The EMS for Children contact is: McKenzie L. Cook

EMS FOR CHILDREN

CIS DATA SYSTEMS

FREQUENTLY ASKED QUESTION LINKS

• Credentialing Information System (CIS) video tutorials http://www.emspic.org/applications/cis

• Credential Information System (CIS)http://www.emspic.org/faqs/cis

• PreMIS video tutorials http://www.emspic.org/applications/premis

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

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

CIS DATA SYSTEMS

Questions?