EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday - - PowerPoint PPT Presentation

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EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday - - PowerPoint PPT Presentation

Jan 28, 2024 31 likes •604 views

MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday February 2, 2017 MATTHEW CONSTANTINE DIRECTOR INTRODUCTIONS TEC January 18 th 2017 Ground on scene time 90 th percentile Filtered 25.0 20.0

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EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING

Thursday February 2, 2017

MATTHEW CONSTANTINE DIRECTOR

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INTRODUCTIONS

MATTHEW CONSTANTINE DIRECTOR

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TEC January 18th 2017

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Ground on scene time‐90th percentile‐ Filtered

0.0 5.0 10.0 15.0 20.0 25.0

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Ground Scene Time‐Average‐ Unfiltered

10 20 30 40 50

Chart Title

DEC NOV OCT SEPT AUG JULY JUNE

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Ground Scene Time‐Average‐Filtered

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Chart Title

DEC NOV OCT SEPT AUG JULY JUNE

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Core Measures

Reported Delay December November October September August

None‐ Under 10 Min

18 14 14 11 9

None‐ Over 10 Min

6 16 15 8 7

Other‐ Description

9 8 4

Other‐ No Description

3 11 2

Safety/Crowd/Staff

1 2 3

Language Barrier Extrication >20min

2 3 3

Distance/Vehicle Crash

1

Other Hospital Reporting Error Extremis

Calls Over 10 min (44%) (68%) (68%) (62%) (56%) Total Calls 34 44 44 45 23

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MGT 439 Seat Availability

  • MGT 439 Pediatric disaster prep and response

training will be held April 13th‐14th at Public Health.

  • Remaining seats are few and are filling quickly.

If you would like a spot please contact me as soon as possible to ensure you have a seat.

  • George Baker. 661‐868‐5218.

BakerG@co.kern.ca.us

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Car Seat Technician

  • Kern County EMS is sponsoring a car seat

inspection class and clinic march 6‐10th with a seat inspection and installation clinic on the 11th.

  • The class is 8 hours a day for 4 days and the

cost is 84.00 per attendee. The class will be held at Olive Drive Training Facility.

  • We strongly encourage participation from all

stakeholders.

  • Register at cert.safekids.org and click on

Become A Tech.

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Standardized Pediatric Drug Formulary

System Collaborative Meeting February 2nd, 2017

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Drug Errors in the Pediatric Population

  • Research has shown that medication errors in children occur in

35% of cases primarily due to pediatric resuscitations being high stress, low frequency and high stakes situations.

  • Errors occur due to many factors including the need for rapid

determination of weight, calculations of medications based on the formulation of the drug creates undue stress for prehospital providers.

  • Implementation of a standardized formulary can reduce

pediatric medication errors significantly as well as allow the EMS provider to focus on what is important, life saving management.

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Ensuring Pediatric Drug Safety

  • Ensuring the right medication and the right dose

EVERYTIME is the ultimate goal in utilizing a standardized formulary.

  • By pre‐calculating all medication dosing in kg and mLs
  • n a length based resuscitation tape we can ensure

safe drug delivery in the prehospital setting.

  • Current use:
  • 1. High risk in low volume emergent situations.
  • 2. Multiple drug concentrations/formularies.
  • 3. Increased risk of errors.
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Standardized Drug Formulary

  • Allows drugs to be given in exact milliliters
  • Eliminates the need for calculations
  • Reduces medication errors
  • Some changes to our current formulary will be

needed

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Pros and Cons

  • Pros:
  • 1. System wide consistency for pediatric drug

administration.

  • 2. Reduction in provider stress and medication errors.
  • 3. Streamlines new hire training and information

retention.

  • 4. Liability reduction.
  • Cons:
  • 1. Initial cost of new length based tapes.
  • 2. Drug shortages may cause significant inconsistencies

with the formulary.

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Length based tape use

  • In order for a standardized formulary to function all EMS

providers must become accustom to using the length based tape every time on any patient less than 15 years old.

  • Mila medical based in Carlsbad Ca. produces a product known as

Dose by Growth. This device is a length based tape very similar to the Broselow device but all drug dosages are pre‐calculated using the local jurisdictions formulary and protocols.

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Length Based Tape Pre‐Calculated Example From Dose by Growth

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ReddiNet

Bed Availability / MCI Response

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MCI Response

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December Alerts Responses BHH 8 5 BMH 7 1 DRMC 3 3 KMC 8 8 KVH 3 2 MER 8 5 MSW 8 5 RRH 7 4 SJCH 8 8 Tehach 6 1

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10 20 30 40 50 60 70 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 74.60% 48.39% 73.68% 91.94% 83.33% 66.67% 50.82% 41.18% 96.83% 58.82% 47 30 14 57 10 42 31 7 61 10 63 62 19 62 12 63 61 17 63 17

Year To Date

Alerts Responses

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Patient Distribution

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I D M Total BHH 1 1 0.45% BMH 36 36 16.22% DRMC 2 6 8 3.60% KMC 18 16 82 116 52.25% KVH 0.00% MER 1 1 10 12 5.41% MSW 9 9 4.05% RRH 4 4 1.80% SJCH 2 19 21 9.46% Tehach 15 15 6.76% Total 222 Pt Dist

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January Alerts Responses BHH 5 3 BMH 6 3 DRMC 4 3 KMC 7 7 KVH 4 2 MER 6 5 MSW 6 4 RRH 5 4 SJCH 6 6 Tehach 4 2

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1 2 3 4 5 6 7 8 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 60.00% 50.00% 75.00% 100.00% 50.00% 83.33% 66.67% 80.00% 100.00% 50.00% 3 3 3 7 2 5 4 4 6 2 5 6 4 7 4 6 6 5 6 4

Year To Date

Alerts Responses

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Patient Distribution

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I D M Total BHH 0.00% BMH 0.00% DRMC 0.00% KMC 1 1 6.25% KVH 0.00% MER 0.00% MSW 0.00% RRH 2 2 12.50% SJCH 5 5 31.25% Tehach 8 8 50.00% Total 16 Pt Dist

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Bed Availability

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December Number of Days B.A. Reported Number of Days B.A. not reported Number of Days B.A. reported >1 BHH 15 16 BMH 31 30 DRMC 30 1 19 KMC 31 29 KVH 11 20 MER 31 30 MSW 31 25 RRH 30 1 23 SJH 29 2 28 THD 31 30 Bed Availability Reporting

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273 365 343 365 141 364 364 364 364 363 71 340 219 352 18 319 312 301 350 343 50 100 150 200 250 300 350 400 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

2016

Number of Days B.A. Reported Number of days B.A. reported >1

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January Number of Days B.A. Reported Number of Days B.A. not reported Number of Days B.A. reported >1 BHH 15 16 BMH 31 28 DRMC 30 1 23 KMC 31 28 KVH 10 21 MER 30 1 22 MSW 28 3 20 RRH 31 17 SJH 31 31 THD 31 30 Bed Availability Reporting

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15 31 30 31 10 30 28 31 31 31 28 23 28 22 20 17 31 30 5 10 15 20 25 30 35 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

2017

Number of Days B.A. Reported Number of days B.A. not Reported

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Rotor‐Wing Air Ambulance Performance Standards

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Issues Faced

  • Previous versions were pre‐empted by a DOT
  • pinion on ADA
  • Made necessary revisions quickly
  • Requirements contained in Title 22
  • Requirements with EMS Plan
  • Striking a balance
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Proposed Revisions

  • Deletion of multiple requirements

– Requirements of law were re‐stated (i.e. employment law)

  • Deletion of repetitive statements
  • Revision of multiple sections to comply with

ADA

  • Added direction of Statewide work
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Public Comment Period

  • Posted for public comment

– January 26, 2017 through February 26, 2017

  • Submit comments to Jana Richardson
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Lay Person AED Policy

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Lay Person AED Policy

  • Title 22, Division 9, Chapter 1.8 was repealed
  • Health and Safety Code Division 2.5, 1797.196
  • Public comment period began on January 26th

and will end February 26, 2017.

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Ambulance Destination Decision Policies and Procedures

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Public Comment

  • Published for public comment

– November 4, 2016 through December 4, 2016

  • Received one comment
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Next Steps

  • EMCAB Approval

– February 9, 2017

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Burn Center Designation

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Public Comments

  • Final public comment period December 1 ‐15,

2016

  • Received three comments
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Next Steps

  • EMCAB for approval

– February 9, 2017

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ANNOUNCEMENTS

MATTHEW CONSTANTINE DIRECTOR

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THANK YOU FOR COMING

HAVE A GREAT MONTH

MATTHEW CONSTANTINE DIRECTOR