EMS Committee News

NYSAFC EMS Committee

This column will keep you up to date on news affecting EMS providers, educators, chiefs, and administrators. You’ll read about significant developments in EMS policy, regulations, and legislation here. Our current representation in practically every venue affecting EMS in New York allows us to not only know what’s happening, but also have a voice in the process. We welcome submissions to this column addressed to the NYSAFC EMS Committee via email or by mail to the association office. Look for more news from the State EMS Council in SIZE UP magazine Issue 3 • 2014, which will be available in September.

News from the State EMS Council (SEMSCO)

The Legislative Committee recommended that SEMSCO seek legislative support and funding to install additional panels on the New York State EMS Memorial. Sadly, the Tree of Life is filling.

The 2014 EMS Memorial service was well attended on May 20, 2014, at the Empire State Plaza in Albany, N.Y. Sadly, 12 names were added to the wall this year: John McFarland (FDNY EMS – February 6, 2012), Brian Ellicott (FDNY EMS – November 26, 2007), Ruben Berrios (FDNY EMS – December 10, 2012), Carene A. Brown (FDNY EMS – December 22, 2009), Rudy Havelka (FDNY EMS – July 9, 2013), Clyde F. Sealey (FDNY EMS – April 12, 2009), John W. Wyatt (FDNY EMS – September 24, 2013), Francis Charles (FDNY EMS – August 27, 2013), Anthony Ficara (FDNY EMS – June 15, 2012), Freddie Rosario (FDNY EMS – June 15, 2010), Joseph V. Schiumo (FDNY EMS – December 9, 2012), Michael Cavanagh (FDNY EMS – December 2, 2013). All died from illnesses related to their work at the September 11, 2001, attack site.

Email addresses at the Bureau have changed. Rather than the hieroglyphic initials and numbering scheme of the past, the new emails are simply the employee’s name in the format of first.last@health.ny.gov. Of course, you need to know how to spell their names properly, but fear not – the old emails will work for a bit.

The Bureau of EMS (BEMS) is changing its name. It will now be called the Bureau of EMS and Trauma (BEMST). Give it some time – a creative soul will no doubt morph that into a humorous acronym.

The CME recert program is experiencing an increase in paperwork problems with forged signatures being the most common scandal.

Area EMS office reps have been asked to increase visits to classes, practical skills exams, and training sites.

NFPA 1917: Standard for Automotive Ambulances is progressing through its first revision. Click here for more information. An additional meeting was scheduled for August to finalize the second draft of the second edition with an anticipated publication date of December 12, 2014, final publication in August 2015, and implementation beginning in 2016. The federal KKK ambulance purchasing specification will sunset once this revised NFPA 1917 publishes. The GSA did recently issue several updates to the KKK specification (1822-F, change notice #6 – click here to see), the most significant of which changes the requirements for stretcher mounts. Several organizations have asked the GSA to delay implementation of these changes, originally scheduled for summer 2014. It’s unclear if implementation will proceed or be delayed. One other piece of gossip: CAAS, the Commission on Accreditation of Ambulance Services (www.caas.org), organized a series of meetings to develop a consensus based ground ambulance standard, apparently out of its frustration with the NFPA. While CAAS plans additional meetings, most of the major players (like the International Association of Fire Chiefs) suggested that CAAS take a more active role in the NFPA 1917 process rather than trying to reinvent the wheel. As yet, they have not put that in their pipe and smoked it.

The Division of Homeland Security & Emergency Services recently issued a channel naming document to identify commonly used public safety radio channels. Download this, pass it around, and have your radio repair folks plug these names into your radios. "Just where did this come from," you ask? Well, hold onto your hat for this one, it actually mirrors federal recommendations. Holy cow!

There are roughly 80 ALS-FR and ambulance services currently certified at the intermediate level in New York state. These certificates sunset next May unless the services act to upgrade to AEMT level. Those who snooze will be downgraded to EMT (BLS) level.

The Education folks at the Bureau have been cleared to hire some new folks including permanent clerical positions, which promises to hugely boost paperwork processing efficiencies.

Late submission (and sometimes no submission) of end of course paperwork is increasingly throwing a wrench into the Bureau’s ability to process exam scores. A policy will shortly be enacted to mirror the financial penalties imposed for late submission of student apps: any course sponsor not submitting end of course paperwork within five business days will take a hit to their wallet (or pocketbook, not to discriminate). This is really moronically simple: hand the paperwork in to the exam proctor. Done.

Work continues on development of a CLI/CIC exam. The first version may be ready by fall 2016. This would help to resolve the ongoing squabble over requiring instructor scores on the EMS written exam for recertification purposes. What a unique idea – having an exam that tests instructor skills!

Health Commissioner Dr. Nirav Shah resigned at the end of June (in case you weren’t aware) to take an administrative position with the Kaiser Foundation in Southern California. He is being replaced, at least for the time being, by Dr. Howard Zucker, a physician and attorney with quite a bio. Learn more here. Shah left under attack from many directions, most notably with regards to his ongoing and somewhat slow paced review of hydrofracking.

In a prior edition SEMSCO notes, I reported on the "cash ceiling" that seemed likely to further reduce DOH EMS dollars in the next fiscal year. However, this time around, the EMS budget line was set at $19.7 million, with an increase in the cash ceiling from last year’s $15.6 million to $16.3 million in the current fiscal year. While still short some $131,000 in the Bureau personnel line, it appears that both the Bureau and Training & Education budgets will not suffer as grievously as some expected.

State EMS Director Lee Burns got an earful during an Essex County meeting where EMSers blame increased training requirements for declining volunteerism. The somewhat contentious exchange was carried on news media throughout the United States. Read more here.

On the subject of PCRs, roughly two-thirds are now being submitted electronically. Of the 1,800 services in New York state, some 500 are ePCR approved. Unfortunately, not all submitted ePCRs are making it through the Image Trend Data Bridge that allows DOH to capture data needed to generate useful reports.

Some additional therapeutic hypothermia (TH) data from Dr. John Freese at FDNY who previously promised further analyses of their data. From August 2009 through July 2010, FDNY transported post ROSC (return of spontaneous circulation) patients only to hospitals that could provide TH (n=1,487). From August 2010 through July 2011, FDNY added intra-arrest cooling (using chilled IV fluids) to their protocol (n=1,850). From August 2011 through July 2012, FDNY added CPR feedback to their protocol (n=748). Analyses of these data related to prehospital cooling showed no change in survival to discharge with prehospital cooling, no relationship between total volume of chilled fluids infused and onset of pulmonary edema (as diagnosed by paramedic impression), and, when the patients were further grouped into v-fib, asystole, and PEA arrests, still no differences in survival to discharge associated with prehospital cooling. Interesting information and consistent with other studies that have resulted in wholesale elimination of prehospital post arrest cooling protocols.

FEMA recently released an app version of its Field Operations Guide (FOG). Click here for the description. It is available from both the iTunes and Google Play stores. Good luck finding it, though – watch the video to see the icon you need and search accordingly (FOG, USFA, FEMA, etc.).

Stuff blowing up all around you? You probably need the new CDC Blast Injury mobile app, released June 30, 2014. Available only for iPhones/iPads currently, you can get it here. Not sure why no Droid version; maybe the CDC thinks apples are healthier?

Trauma center designations are proceeding via American College of Surgeons (ACS) verification. The process is quite fascinating and probably worthy of a quick read if you live or work near one, as there are some pretty significant requirements for interaction and integration with EMS. Learn more here. Here’s where things will soon get interesting: there are different levels of trauma centers, some of which do not currently exist in New York (click here to learn more). As some of these newbies such as level III trauma centers come online, trauma triage protocols are going to need revisions and, in some cases, interpretation to better direct providers on where to take their banged up patients. Stay tuned...

The Bureau is working on an EMS provider credentialing project to facilitate recognition and operations at major events. More to follow on that...

The North Country Health Systems Redesign Commission released an interesting report last April detailing measures needed to stabilize the delivery of health care in northern New York. EMS is repeatedly mentioned in the report, with some interesting recommendations. Click here to download and see page 43.

Add these dates to your conference calendars:

NYSVARA Pulse Check Conference – September 12-13, 2014, in Suffern, N.Y. – www.nysvara.org
Vital Signs 2014 – October 23-26, 2014, in Rochester, N.Y. – www.vitalsignsconference.com
EMS Today – February 25-28, 2015, returning to Baltimore, Md. – www.emstoday.com

SEMSCO has two additional meetings scheduled: September 9-10, 2014, and January 13-14, 2015, both at the Hilton Garden Inn in Troy, N.Y. It won’t likely happen, but any additional meetings will be posted here.