During periods of high volume and acuity, there may arise a need for ALS care that cannot be provided by a local agency. They may request ALS through dispatch. Services that are capable of providing such care are those that have a CON to provide care in that area. If services with a CON are not available then Mutual Aid agreements previously set up should be utilized. All efforts will be made to obtain BLS and ALS level care for appropriate patients as soon as possible following accepted procedures.
************
TO: All Agencies and providers
FROM: Jack Davidoff, MD REMAC Chair
RE: Epinephrine 1:10,000 Shortage
DATE: July 19, 2010 REMAC ADVISORY
A shortage exists in the availability of Epinephrine 1:10,000. Hospira Inc. Is the only manufacturer of this medication, and says that the resupplies should be available by early July. At this time the region is beginning to experience a shortage in 1:10,000 Epinephrine available to EMS. Hospital pharmacies are providing additional vial/ampules of Epinephrine 1:1,000 to meet the need for this resuscitation medication. This advisory is being distributed to remind ALS providers of the process of diluting 1:1,000 to achieve a 1:10,000 concentration.
In the absence of Epinephrine 1;10,000 providers are authorized to use a vial/ampule of Epinephrine 1:1,000 after dilution to achieve a 1:10,000.
Please follow these instructions for using Epinephrine 1:1,00 and diluting to 1:10,000:
1.Using a Saline Flush, remove 1ml. of saline leaving 9ml., or draw up 9ml. of sterile saline into an empty 10ml. syringe
2.Attach a needle
3.Draw up 1ml. of Epinephrine 1:1,000 into the 9ml. or saline ensuring you do not inject saline into the vial/ampule. You now have a 1;10,000 concentration of Epinephrine(1mg/10ml).
4. Remove the needle and use as you would the preloaded Epinephrine
************
TO: All Agencies and providers
FROM: Jack Davidoff, MD REMAC Chair
RE: Drawing Blood for Blood Alcohol Testing
DATE: July 19, 2010
REMAC ADVISORY
Despite a recent NYS law signed into effect by Governor Patterson that allows Paramedics to collect blood samples for alcohol when directed to do so by a Law Enforcement Officer, Paramedics in the Finger Lakes Region are to follow Regional protocols which DO NOT PERMIT Paramedics to do so. Paramedics are to provide any care required by the patient, transport the patient as required and have blood collection accomplished in the Emergency Department.
************
TO: All Agencies and Providers in the Finger Lakes Region
FROM: Finger Lakes Regional EMS Council REMAC
RE: Electronic Patient Care Reports and E-PCR Completion
DATE: May 28, 2010
REMAC ADVISORY
It has recently come to the attention of the REMAC that there is a problem with agencies completing their electronic patient care reports in a timely manner. A recent spot check revealed that several agencies had patient care reports that were greater than 48 hours delinquent. This is not acceptable.
As a reminder NYSDOH Part 800 has several sections that address completing patient care reports in a timely manner, see Part 800.15, 800.16 and 800.21. These particular sections relate to provider conduct, and agency requirements related to patient care reports and record keeping. In discussion with NYSDOH we have been informed that a patient care report is supposed to be left at the hospital with the patient, but with the advent of electronic reporting this is not always possible and most areas now have a policy that establishes an acceptable period of time that agencies have to complete an electronic patient care report.
That having been said the Finger Lakes Regional EMS Council REMAC has established the following standard for agencies completing electronic patient care reports:
1. Any agency utilizing an electronic patient care reporting system will have a chart started on a patient no later than four (4) hours after completion of the response.
2.All electronic patient care reports must be completed within twenty-four (24) hours of the response.
REMAC realizes that at times agencies may not meet this standard but it is hoped that these situations will occur infrequently and be easily explainable.
**************
TO: All Agencies and Providers in the Finger Lakes Region
FROM: Robert Stueber BS EMT-P Program Agency Coordinator
Finger Lakes Regional EMS Council REMAC
RE: Walking patients to the ambulance
DATE: March 22, 2010
REMAC ADVISORY
During information gathering for this year’s regional focused study, BLS Protocol Compliance, it has come to the attention of the Program Agency and the REMAC that a sizeable number of patients are being walked to the ambulance. In some instances, such as an MCI or patients that are encountered outside in inclement weather this may be acceptable. In most cases the documentation justifies the reason for walking the patient to the ambulance, but this is not true in all situations.
The individual that has been assaulted and meets you at the curb would obviously be justified in having been walked to the ambulance, but those patients with complaints such as, dyspnea, chest pain, abdominal pain, and females that are pregnant and possibly in labor should be placed on the stretcher and not walked to the ambulance.
Therefore, REMAC strongly discourages providers from walking patients to the ambulance. This topic will be addressed in the new regional protocols which are currently under development and will fall under Section 1.1 and will state “Patients experiencing potential cardiac or respiratory complaints should not be walked to the ambulance”.
While not every situation can be addressed in the advisory, and patient care report reviews are performed after the incident by individuals that were not on the scene doing what is best for your patient and good documentation may be in your best interest and that of your agency if there is any questions in the future.
************
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC DATE: October 22, 2009
REMAC ADVISORY
The use of internet posting mechanisms, such as blogs, personal websites, social networking sites (e.g.: Facebook, Twitter, etc), and others has become common among all age groups. Although EMS providers are cognizant of the need to avoid posting any patient identifiers which would constitute clear HIPAA violations, there are dangers of posting more subtle, de-identified information. Because it is impossible to anticipate who might view a post, such as someone with a connection to a patient, even the most generic or subtle reference to any EMS incident has the possibility of being linked to the actual case, or of being mistakenly linked to a different patient.
Providers are encouraged to refrain from posting any information or photos regarding calls, patients, or situations related to EMS operations, even if posted in a de-identified, generic manner. Items, whether EMS-related or not, that represent unprofessional behavior can reflect poorly on you and the EMS profession, and may become public. These postings could subject you to unintended exposure and consequences, such as if they were used as character references in medical-legal proceedings, job applications, etc.
Lastly, providers should never be engaged in internet posting or blogging while providing patient care.
Patients not only trust EMS Personnel with their lives, but also with their privacy. EMS Personnel who violate this advisory are violating patient rights and are guilty of professional misconduct.
If there are any questions, do not hesitate to contact the FLREMSC Program Agency office.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC DATE: October 23, 2009
REMAC ADVISORY
It has recently been brought to the attention of REMAC that at times the guidelines related to the use of helipads at hospitals is being misinterpreted.
Below is the wording of the EMTALA regulation related to the use of helipads at hospitals.
THE EXACT LANGUAGE IS:
Tag 406 §489.24(a)
(a) Applicability of provisions of this section.
(1) In the case of a hospital that has an emergency department,
if an individual (whether or not eligible for Medicare benefits
and regardless of ability to pay) "comes to the emergency
department", as defined in paragraph (b) of this section, the
hospital must--
(i) Provide an appropriate medical screening examination within the capability of the hospital’s emergency department,
including ancillary services routinely available to the
emergency department, to determine whether or not an emergency medical condition exists. The examination must be conducted by an individual(s) who is determined qualified by hospital bylaws or rules and regulations and who meets the requirements of §482.55 of this chapter concerning emergency services personnel and direction;
"If an individual who is not a hospital patient comes elsewhere on hospital property (that is, the individual comes to the hospital but not to the dedicated emergency department), an EMTALA obligation on the part of the hospital may be triggered if either the individual requests examination or treatment for an emergency medical condition or if a prudent layperson observer would believe that the individual is suffering from an emergency medical condition. The term "hospital property" means the entire main hospital campus as defined in § 413.65(a),including the parking lot, sidewalk and driveway or hospital departments, including any building owned by the hospital that are within 250 yards of the hospital)....
"The following two circumstances will not trigger EMTALA:
"The use of a hospital’s helipad by local ambulance services
or other hospitals for the transport of individuals to
tertiary hospitals located throughout the State does not
trigger an EMTALA obligation for the hospital that has the
helipad on its property when the helipad is being used for
the purpose of transit as long as the sending hospital
conducted the MSE prior to transporting the individual to
the helipad for medical helicopter transport to a
designated recipient hospital. The sending hospital is
responsible for conducting the MSE prior to transfer to
determine if an EMC exists and implementing stabilizing
treatment or conducting an appropriate transfer."
"Therefore, if the helipad serves simply as a point of transit
for individuals who have received a MSE performed prior to
transfer to the helipad, the hospital with the helipad is not
obligated to perform another MSE prior to the individual’s
continued travel to the recipient hospital. If, however,
while at the helipad, the individual’s condition
deteriorates, the hospital at which the helipad is located
must provide another MSE and stabilizing treatment within
its capacity if requested by medical personnel accompanying
the individual."
"If as part of the EMS protocol, EMS activates helicopter
evacuation of an individual with a potential EMC, the
hospital that has the helipad does not have an EMTALA
obligation if they are not the recipient hospital, unless a
request is made by EMS personnel, the individual or a
legally responsible person acting on the individual’s
behalf for the examination or treatment of an EMC."
RESOURCES:
EMTALA Field Guide: www.emtalafieldguide.com -- Quick guide
to EMTALA rules, application, documentation and common risks
associated with the rule. Pocket size for lab coats.
Practical Guide To Risk Management For Clinics And Physician
Offices: www.clinicrm.com
******
TO: All Agencies FROM: Robert Stueber BS EMT-P Program Agency Coordinator RE: Equipment at Hospitals DATE: July 1, 2009
I have recentlyII have recently been contacted by representatives from the regional councils in the both the Monroe Livingston and Central New York EMS regions about equipment at both Strong Memorial Hospital and Upstate Medical Center.
They request that you pick up your equipment by the end of the month or it will be donated to training facilities in their respective areas. The following agencies have equipment at the following hospitals:
Citizens Hose Company Strong
Benton: Strong
Macedon Strong
Wolcott Strong & Upstate
North Seneca Strong & Upstate
Ontario Vol. Emer. Squad Strong
Marion Strong
Newark Arcadia Strong
Honeoye Richmond Strong
Naples Strong
South Seneca Strong & Upstate
Savannah Upstate
Penn Yan Upstate
Finger Lakes Ambulance Upstate
Seneca Falls Upstate
******
TO: All Services and Providers
FROM: Robert Stueber BS EMT-P Program Agency Coordinator
RE: Submitting Paperwork to the Council Office
DATE: February 9, 2009
Over the past several months the Council and Program Agency offices have noticed that mail arriving in the office has increasingly had content for both parts of the office sent in the same envelope (agency information sheets or EMT class registrations are in the same envelope as PCRs). This practice needs to stop because at times information such as course registrations and agency information sheets are “time sensitive” and when sent in the same envelope as PCRS could go unopened for extended periods of time if the coordinator is out of the office for any reason.
While the Program Agency and the Finger Lakes Regional EMS Council realizes that all of us need to save wherever possible effective immediately PCRs need to be mailed to the office separately from other council and program agency paperwork. Doing so will ensure that “time sensitive” paperwork will be handled in an appropriate and timely manner.
Thank you in advance for your attention to this situation.
******
TO: All Ambulance and First Responder Agencies
FROM: Training and Education Committee
RE: Course Registrations
DATE: December 29, 2008
Over the last couple of years we have noticed that many EMS providers that are recertifying quite often do not show up the first session of class to register for the course, complete the necessary required paperwork, and take the written challenge exam. If you miss the first class you are required to come to the council office in Geneva, NY to register for the course. For some this has not been a problem, while for others complaints have been made about the travel required.
Recent notification from NYDSOH Bureau of EMS has been received regarding the revised dates of submission of the student's application to be registered to take the course. Effective with the spring 2009 classes we will be required to submit the students applications no later than sixty days prior to the exam date, or immediately following the second class date. Therefore, it is imperative tha you alert your EMS providers to attend the first session of the course to register for the program.
Should you have any questions please do not hestitate to contact Donna or Joanna at the council office for further explanation.
******
TO: All agencies and providers FROM: Robert Stueber BS EMT-P Program Agency Coordinator
Jack Davidoff MD – REMAC Chair
RE: Reminder DATE: November 21, 2008
Just a reminder of several thing that will take place in the near future that providers in the Finger Lakes region need to be aware of two REMAC advisories issued this past year that are soon to become policy:
The first was in regards to Nalbuphine (Nubain®), and stated:
In an effort to provide the highest quality care to the patients of the Finger Lakes Region, nalbuphine also known as Nubian® will be removed from the FLREMS analgesia protocol effective January 1, 2009. Agencies currently utilizing this drug as well as those considering implementation of the pain management/analgesia protocol should begin the process of applying for a narcotics license as soon as possible in order to meet the deadline noted above.
Also, in the best interest of our patients any patient who needs analgesia should have an ALS intercept from a ground or air agency that can administer morphine sulfate or fentanyl for pain management since patients are treated with nalbuphine are resistant to further treatment with narcotics for their pain and their management becomes much more complicated.
The second was in regards to Capnography, and stated:
Any agency in the Finger Lakes EMS Region that has members who perform Endotracheal Intubation must have a back up or adjunct airway device available should the airway be difficult or failed. Oropharyngeal and Nasopharyngeal airways are NOT sufficient as adjunct airways. Supraglottic airways are the preferred adjunct airways.
It is also mandatory that some form of End Tidal CO2 detection be utilized in intubated patients. While colorimetric devices are acceptable currently, all agencies should be striving towards Continuous Waveform Capnography which is currently the “gold standard” for detection of esophageal intubation and for documenting endotracheal intubation. All agencies are urged to pursue this goal as soon as possible.
Please note that this regional policy may in the near future be superseded by a NYSDOH policy statement which may make the requirements for and implementation of Continuous Waveform Capnography tougher and occur sooner than the regional date. As soon as this office is aware of the policy we will notify all agencies.
Additionally, during the past several months of PCR reviews the office has noticed that at times there is deviation from regional protocol 1.4 – Oxygen Therapy and more often than not the reason is not documented. Something to ponder:
Basing the administration of oxygen on a pulse oximetry reading may not be in the best interest of your patient because as you may know the pulse-ox obtains its reading based on a sampling of hemoglobin wherever the probe is placed . . . the finger could be 100 percent saturated but the patient with a past medical history that is now experiencing chest pain related to angina may need aggressive oxygen therapy.
Again, while the protocol does allow for some discretion, documenting why there has been deviation from the standard of care avoids questioning at a later date by those not directly involved in the care of your patient.
Safety Note:
It is not only the law in NYS but imperative for your safety and therefore your patient’s safety that all persons in your ambulance (crew, passengers and patients) wear their safety belts and straps at ALL times.
Let us all work together to not only wish for, but work towards a SAFE, HEALTHY Holiday Season
******
TO: To All EMS Agencies RE: Newark Wayne Hospital DATE: June 2008
Larry Brown at Newark Wayne Hospital has asked me to notify everyone that room 12 can no longer be used for completing PCRs. It is being converted to an admissions office.
******
TO: All EMS Agencies DATE: June 2008 RE: Delinquent Accounts
EFFECTIVE JUNE 2008:
ALL prior students who have outstanding fund balances to the finger lakes regional ems council, inc. and have not made restitution will not be able to purchase textbooks, workbooks, supplies, etc. without cash, check, money order, credit card or agency purchase order in hand upon registration for class. Past balances and new text, supplies, etc. must be paid in full prior to or at the first class.
Students entering a course with past due balances will not be able to take the practical exam or receive a core recertification completion certificate until past balances are paid in full.
This notice is pertinent for students who have previously attended and dropped a course in the past.
******
FLCC GENEVA CAMPUS INAUGURAL BLOOD DRIVE
FRIDAY, MARCH 28, 2008
12:00 PM - 5:00 PM
63 PULTENEY STREET - GYMNASIUM
PLEASE CALL DONNA SPINK AT (315) 789-0108 TO SCHEDULE YOUR LIFE SAVING APPOINTMENT.
IF YOU DONATED ON OR BEFORE FEBRUARY 1, YOU WILL BE ELIGIBLE TO DONATE.
******
TO: All Agencies and Providers FROM: Robert Stueber BS EMT-P Program Agency Coordinator RE: Preceptor Workshop DATE: December 3, 2007
Due to circumstances beyond the control of the office the Preceptor Workshop scheduled for December 6, 2007 has been cancelled.
The class has been rescheduled for December 18, 2007 at the same location(Newark Arcadia Ambulance) at the same time(6:30pm).
There are still spaces available and if you are interested in attending this course contact the council office at:
1-800-357-3672 or 315-789-0108.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC DATE: October 5, 2007
REMAC ADVISORY
In an effort to provide the highest quality care to the patients of the Finger Lakes Region, nalbuphine also known as Nubian® will be removed from the FLREMS analgesia protocol effective January 1, 2009. Agencies currently utilizing this drug as well as those considering implementation of the pain management/analgesia protocol should begin the process of applying for a narcotics license as soon as possible in order to meet the deadline noted above.
Also, in the best interest of our patients any patient who needs analgesia should have an ALS intercept from a ground or air agency that can administer morphine sulfate or fentanyl for pain management since patients are treated with nalbuphine are resistant to further treatment with narcotics for their pain and their management becomes much more complicated.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC
DATE: October 5, 2007
REMAC ADVISORY
Any agency in the Finger Lakes EMS Region that has members who perform Endotracheal Intubation must have a back up or adjunct airway device available should the airway be difficult or failed. Oropharyngeal and Nasopharyngeal airways are NOT sufficient as adjunct airways. Supraglottic airways are the preferred adjunct airways.
It is also mandatory that some form of End Tidal CO2 detection be utilized in intubated patients. While colorimetric devices are acceptable currently, all agencies should be striving towards continuous waveform capnography which is currently the “gold standard” for detection of esophageal intubation and for documenting endotracheal intubation. All agencies are urged to pursue this goal as soon as possible.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC
REMAC ADVISORY
It is of utmost importance that ALL EMS Personnel maintain professional conduct with regards to patient privacy. Under no circumstances should any member of an EMS or FIRE agency take pictures of patients other than those used to demonstrate mechanism of injury. If pictures are taken they are to become part of the patient’s permanent record and ALL copies are to be left with the receiving hospital. Under no circumstances should EMS Personnel have copies of PCRs or parts of patient records other than those necessary as part of appropriate record keeping for the agency that they work with or for use with a sanctioned EMS class.
It should be common knowledge that possessing and or distributing such medical record materials other than as part of your agencies record keeping is a violation of HIPPA as well as professional misconduct under NYS Public Health Law Article 30, section 800. Anyone who violates this Advisory will be referred to the NYS Bureau of EMS for investigation which may lead to suspension or revocation of EMS Certification as well as possibly leaving the individual(s) and their agency(s) open to liability by patient(s) and/or family members.
Patients not only trust EMS Personnel with their lives, but also with their privacy. EMS Personnel who violate this advisory are violating patient rights and are guilty of professional misconduct.
******
TO: All Members of REMAC FROM: Jack Davidoff MD, REMAC Chairperson RE: REMAC Meeting for July and September DATE: June 25, 2007
The July REMAC Meeting has been cancelled due to scheduling conflicts. Please make a note that the September REMAC meeting has been moved to September 27, 2007 due to scheduling conflicts as well.
I hope this notice provides everyone with enough advanced notice to rearrange their busy schedules in order to make the meeting which as of this date is scheduled to be webcast.
If there are any questions or concerns feel free to contact either Bob Stueber or myself, and have a great summer.
******
TO: All ALS Agencies and Providers FROM: Ray McLean, ALS Committee Chair RE: ALS Committee DATE: May 17, 2007
This committee has the power to stream line training, protocols, and procedures throughout the region. With that stated all "Action Items" must be voted on as a body and then brought in front of the council for approval.
I strongly recommend that every advanced agency represents themselves at the ALS Committee meetings. Your voice counts, however, if you are not there we will not hear you.
As the Committee makes recommendations to the Council the Council might accept these items which in turn might affect procedures your agency abides by.
The ALS Committee will have voting power so we are asking that every agency submit a letter to Bob Stueber through the Council office on agency letterhead with recommendations for an Agency Representative to sit on the ALS Committee. We are also asking that every Agency has an alternate to sit in when applicable.
This does not mean the EMS community cannot attend. We are strongly encouraging all providers to attend and voice their concerns. This will be done in a formal format and then voted on by Committee seats. Once voted on all items will be brought in front of the council for approval.
The next meeting will take place on June 14th at the Regional Office in Geneva at 1900(7:00PM).
Please get your letters in to Mr. Stueber prior to the meeting so we may plan accordingly.
The Executive Committee has come up with the following action items for vote:
·Membership to include ILS and above agencies
·Each County shall have one representative
·Each Agency who represented shall have a vote, (Can one person have more than
one vote if he/she represents more than one agency) this will need to be discussed at
length during the next meeting.
·The Executive Committee shall not have more than one consecutive year in current
office.
·Meetings shall take place one week prior to Council Meetings.
·Adoption of Mission Statement:
"The ALS Committee will support the development of pre-hospital advanced life support in the Finger Lakes region by working together with the Finger Lakes Regional EMS Council and the Finger Lakes Regional Medical Advisory Committee to facilitate the delivery of high-quality, consistent Advanced Life Support care throughout the region." ·Proposal of Bi-Laws
I look forward to seeing all of you there.
******
TO: All Agencies and Providers FROM: ALS Committee RE: Meeting Notice DATE: April 25, 2007
The ALS committee will hold their next meeting on
May 10, 2007
at
at the regional office located at the
Finger Lakes
Community College Geneva Extension 63 Pulteney St.
,
Geneva
,
NY
All ALS services within the region are urged to send a representative to this meeting.
******
TO: All Agencies and Providers FROM: Robert Stueber BS EMT-P Program Agency Coordinator RE: PCRs DATE: April 2, 2007
On
May 1, 2007
the United Sates Postal Service will be raising their rates and this will directly affect the way the council and program agency distributes information and other services.
One of the biggest services affected will be the distribution of PCRs to the providers. At the present time if an organization requests PCRs and no one will be near the office to pick up the PCRs they are mailed to the agency. To this point while it has been expensive at times to do this the new postal rates will make this practice truly impossible to continue.
As an example, at the present time if an agency requests 125 PCRs and they are mailed to the agency it currently costs approximately $5.20 to mail the package. When the new postal rates take affect in May the same package will cost approximately $10.00 to mail. It is council and program agency’s understanding from conversations with the postal service that organizations should anticipate a twenty-five percent increase in their postage budget. Increases of that size are unacceptable since the agency’s budget is fixed and there is no anticipation of an increase in the near future.
Therefore, effective
July 1, 2007
the following policy will take affect.
The program agency will keep a six-month supply of PCRs on stock for each agency based on the records of PCR submitted to the agency for the previous 6 month period. An agency may call and make arrangement to pick up their PCRs during normal business hours (Monday – Friday
). Evening pick-ups will also be possible if an agency calls the office during business hours. Also, if a group of agencies designate an individual to pick up PCRs for their organization and they have called the office the designated person may pick up the PCRs. The council and program agency will explore all available avenues, within reason, to see that the agencies within the region have PCRs and will work with the agencies to insure that PCRs are available. All reasonable requests will be handled in a timely manner.
If there are any questions feel free to the Program Agency Coordinator – Robert Stueber at: 1-800-357-3672 or via email rstueber@flremsc.org.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC
REMAC ADVISORY
Thompson
Hospital
will have their Operating Room closed beginning at 1600hrs(
) on
April 10, 2007
and will re-open at 0005hrs(
) on
April 16, 2007
.
Thompson relates that they will be able to do only C-sections and/or minor
OB
procedures in their OB OR and they will have another room set up for life threatening emergency surgery only. Things such as hip fractures, appendectomies and other such procedures will need to be transferred to other appropriate facilities.
This does not mean that the ER can not accept patients, but anything that would require surgery and is not life threatening will be transferred. Therefore, good judgment might save both you and your patient from having to make a second trip to another facility.
As always when in doubt contact medical control for guidance/assistance.
******
TO: All Agencies and Providers FROM: Robert J Stueber BS EMT-P Program Agency Coordinator Jack Davidoff MD,
Finger Lakes
Regional
EMS
Council REMAC Chair RE: Focused Study DATE: December 7, 2006
Finger
Lakes
Regional
EMS
Council’s focused study for the current year is evaluating the on scene times for BLS crews that may be performing Blood Glucose Testing. The study will look at the amount of time that is spent on scene and try to determine if on scene times are longer for BLS crews that are performing the skill now that they are trained to do so.
A preliminary set of control data was collected earlier in the year utilizing data taken directly from the PCRs that are sent to the regional office for QA/QI purposes. As part of the control group ALS services were also included since Blood Glucose Testing is a routine skill performed by the services.
The second phase of the study which will begin in January will require the cooperation of all of the services within the region and will again evaluate on scene times. The enclosed form needs to be completed for each patient contact where the patient exhibits: Altered Mental Status, Weakness, Syncope, Seizures, Unconscious/Unresponsive with vital signs. These forms should be completed for all patients with these presenting problems for the months of January, February and March and the form should accompany the PCR for the particular response when PCRs are sent to the regional office for QA/QI. Again both BLS and ALS services will need to complete the form.
Thank you in advance for your cooperation in gathering the data for this study and if there are any questions feel free to contact Bob Stueber in the program agency office for assistance or clarification.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC
REMAC ADVISORY
The following policy has been adopted by the REMAC in regards to BLSFR units within the Finger Lakes Regional EMS Council’s region.
All BLSFR units will submit a Patient Care Report (PCR) each time the unit is dispatched. NYSDOH Version 5 PCRs are to be utilized for reporting, and the research copy shall be submitted to the regional office by the tenth day of the following month. Patient Care Reports will be dispersed to each service upon request to the Program Agency, and the required PCR submission forms will be provided by the program agency as well.
Part 800.15 requires all certified providers to complete a PCR for each patient treated. Additionally as part of the
EMS
system BLSFR must participate in the regional quality assurance program and patient documentation is the foundation of quality assurance.
The medical directors of those organizations that elect not to comply with this policy will be notified by REMAC of the compliance problem. These organizations could find their privileges to carry, administer and/or use Albuterol, Epi-pen auto injectors, and AEDs (other than those organizations in PAD programs) restricted or revoked by their medical director.
******
TO: All Agencies and Providers FROM: Finger Lakes Regional EMS Council REMAC
REMAC ADVISORY
It has recently been brought to the attention of the REMAC that gross deviations from the Trauma Protocol are occurring. While REMAC acknowledges that not every situation is the same, gross deviations from the protocol are problematic. The Trauma Protocol was developed with the use of accepted regional, state and national standards, and refined through out the years to insure that individuals that are injured in the region receive optimal patient care in a timely and appropriate manner. Deviations from this protocol violate accepted regional and national standards, and could put patients at risk for less than positive outcome.
Therefore, it is imperative that both service administrators and field providers review Section 2.0 – Adult Trauma Protocol, and Section 3.10 – Pediatric Trauma Protocol of the 2006 edition of the regional protocols. In summary, both of these protocols outline treatment and transport condition, including transport to appropriate trauma centers and the use of flight evacuation when appropriate.
Again, all services and providers are strongly urged to review these protocols and utilize them, when indicated, for the appropriate care of patients injured in the region.
