Summer Educational
Conference
Renaissance Hotel
Asheville , NC
July 7-10, 2012
EMS UPDATE
Regina Godette-Crawford
Chief, OEMS
OEMS ADMINISTRATION
Staff
Changes/Retirements/Promotions
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. § 20139.1(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
Alleghany
Ashe
Watauga
Northampton
Surry
Stokes Rockingham
Vance
Gates
Hertford
Granville
Wilkes
Currituck
Warren
Caswell Person
Halifax
Yadkin
Forsyth
Mitchell Avery
Caldwell
Alexander
Yancey
Guilford
Perquimans
Chowan
Franklin
Orange
Alamance
Durham
Bertie
Nash
Davie
Edgecombe
Madison
Iredell
McDowell
Chatham
Wilson
Rowan
Buncombe
Pitt
Haywood
Swain
Rutherford
Graham
Henderson
Jackson
Cherokee
Clay
Macon
Transylvania
Polk
Lincoln
Johnston
Cabarrus
Cleveland
Gaston
Lee
Montgomery
Mecklenburg
Stanly
Harnett
Hyde
Wayne
Moore
Lenoir
Craven
Pamlico
Cumberland
Union
Anson Richmond
Hoke
Sampson
Duplin
Bladen
Pender
70 Counties
31 Counties
Columbus
New
Hanover
Brunswick
4 Agencies
Total Agencies Responding to Survey
Total Counties Responding to Survey
Jones
Onslow
Robeson
Specialty Care Responses
Beaufort
Greene
Scotland
Response to Survey
No Response
Tyrrell
Washington
Dare
Randolph
Catawba
Martin
Wake
Davidson
Burke
Camden
Pasquotank
93
70
Carteret
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?
No
29
31%
Yes
64
69%
Blood & Urine Sampling
• How often does this occur?
50
45
40
35
30
25
20
15
10
5
0
47
10
1 to 5
times/mo.
6 to 10
times/mo.
2
11 to 15
times/mo.
5
Over 16
times/mo.
Blood & Urine Sampling
• Which branch of
Law Enforcement
has been requesting
you to obtain blood
specimens for
alcohol and
controlled
substance testing?
Local
Police
Dept.,
14
County
Sheriff
5
Hwy.
Patrol
45
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?
Yes
28
No
65
70%
30%
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?
Yes
21
23%
No
72
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?
40
35
30
25
20
37
27
29
No Remain
Unchanged
Yes
Repealed
15
10
5
0
Needs to be
Rewritten
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?
No
16
17%
Yes
77
83%
Medication Shortage
• Is your EMS Agency/System currently
experiencing a shortage of:
70
60
67
67
64
50
55
40
44
30
Yes
No
33
20
10
0
13
Atropine
9
10
10
Calcium Dextrose
Chloride
Valium
Diltiazem
Medication Shortage
• Is your EMS Agency/System currently
experiencing a shortage of:
70
68
60
63
50
40
44
30
33
44
33
20
10
0
9
Benadryl
14
Epinephrine Epinephrine
1:1,000
1:10,000
Etomidate
Yes
No
Medication Shortage
• Is your EMS Agency/System currently
experiencing a shortage of:
70
60
64
50
54
58
54
40
Yes
No
30
20
23
23
10
0
Fentanyl
Toradol
19
Mag. Sul.
13
Ativan
Medication Shortage
• Is your EMS Agency/System currently
experiencing a shortage of:
70
60
61
50
54
51
53
40
Yes
No
30
20
26
16
10
0
24
23
Versed
Morphine
Narcan
Zofran
Medication Shortage
• Is your EMS Agency/System currently
experiencing a shortage of:
80
70
76
75
70
60
50
55
Yes
No
40
30
20
10
0
22
2
Phenergan
1
Propofol
7
Sodium Bicarb. Vercuronium
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;
Disaster
Trauma
EMS
• 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
TRAUMA REGISTRY
• 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.
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, 2012
Koury Convention Center, Greensboro NC
Registration Information
Conference registration will be available in late July
or early August.
COMPLIANCE UPDATE
COMPLIANCE UPDATE
OEMS Enforcement Statistics
January 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
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
CIS DATA SYSTEMS
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
Questions?