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Summer Educational
Conference
Renaissance Hotel Asheville , NC
July 7-10, 2012
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Regina Godette-CrawfordChief, OEMS
Regina Godette-CrawfordChief, OEMS
EMS UPDATE
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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.
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OEMS ADMINISTRATION
Staff Promotions at the OEMS
•Chuck Lewis, EMT-P, RN Western Regional Manager
•Allen Johnson, EMT-P Eastern Regional Manager
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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.
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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
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Blood & Urine Sampling for DWI Suspects
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Blood & Urine Sampling
• Memo forwarded out statewide on July 2, 2012 stating OEMS position on current G.S. § 20-139.1(d2)
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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
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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
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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%
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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.
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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
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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%
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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
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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%
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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
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Medication Shortage
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Medication Shortage
• Memo forwarded out statewide on July 2, 2012 stating OEMS position.
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Medication Shortage
• Has your EMS Agency/System been affected by the current medication shortages?
No16
17%
Yes77
83%
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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
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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
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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
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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
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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
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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.
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RULES UPDATE
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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.
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Healthcare Preparedness Response and Recovery
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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)
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• 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
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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
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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
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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
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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
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System Update
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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.
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HEALTH SYSTEMS & TRAUMA
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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
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• 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
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EDUCATION
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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.
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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.
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Emergency Medicine Today
October 6-10, 2012Koury Convention Center, Greensboro NC
Registration InformationConference registration will be available in late
July or early August.
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COMPLIANCE UPDATE
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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.
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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.
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COMPLIANCE UPDATE
•Enforcement actions taken resulted in:
6 Individuals credentials revoked. 2 Credentialing Applications denied. 3 Credentials Summarily Suspended.
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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.
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COMMUNICATIONS
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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.
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EMS FOR CHILDREN
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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
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The EMS for Children contact is: McKenzie L. Cook
EMS FOR CHILDREN
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CIS DATA SYSTEMS
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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
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Questions?