Future of Vt EMS from Seven Days - Mar 3, 2023

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Communication with CVMC changes

To EMS District Six Responders,

CVMC is working on to improve our interactions with EMS.   We are looking to change the method EMS calls in reports and calls in to the hospital.   We are also changing the method that EMS gives their verbal report upon arrival.  


 Finally, we are strengthening the staff that should be immediately available in the room when certain critical patients arrives and empowering EMS to categorize these severe patients.  This includes calling in alerts as guided by our EMS protocols.


Please take a moment to review this e-mail in its entirety.   All five points are important.  It includes various changes that go in effect in two days.


MARCH 1st:

1)  EMS will no longer notify the hospital when they are responding to an incident, unless there is a suspected critical patient (trauma, stroke, cardiac/respiratory arrest) or a multi-patient incident.

  • a.  CVMC is working to get the charge nurse notification via Active911 when EMS is dispatched.   This will be by SMS text only and hospital personnel will not have access to the Active911 application.  CVMC leadership is still working through there Information Services (IS) department to get this activated.


2)  EMS will use the EMS phone line (371-4999) to call in their pre-arrival reports.  This phone is at the charge desk and has a distinctive ring.   If a second call comes in simultaneously, it rolls over to the ED main line. 

  • a.  If cell phone communication is not practical or operational, or if cell signal cannot be reached, EMS can use the radio to give their prior-arrival report.  This is still being monitored.
  • b.  All pre-arrival reports should not give patient’s initials or DOB, to include both phone and radio.  Age and gender will suffice.
  • c.  Pre-arrival reports should be given as close to ten minutes before arrival as possible.  We recognize that this is sometimes not practically possible, but the goal should be ten minutes notification.
  • d.  Also, ambulances should not call on the radio when they arrive at the hospital.


3)  EMS reports need to be shortened!  They should be no more than 30-60 seconds in length.  Remember, the purpose of the report is to prepare a room/stretcher for the EMS crew’s arrival and ensure staff are prepared at bedside, if needed.  Most patient reports do not require more than minimal information to achieve these goals.


4)  EMS will call ALERTS for critical patients, that are always priority one.   These alerts include the following (along with their association protocol)

  • a.  CODE BLUE {cardiac/respiratory arrest}        Protocols 3.2A/P
  • b.  SEPSIS ALERT {SIRS Criteria w/ ? infection}    Protocols 2.23A/P
  • c.  STEMI ALERT {STEMI on 12-lead}                   Protocol 3.0
  • d.  STROKE ALERT {Evidence of CVA/LVO}           Protocol 2.26
  • e.  TRAUMA ALERT {Critical Injury or VS}            Protocol 4.9


5)  Vital Signs are only given on the pre-arrival report if abnormal.   This is guided by the vital sign parameters in EMS Protocol 8.15, as outlined below. 


  If EMS reports “stable vital signs”, all vitals fall within these parameters.

  • a.  Pulse Rate between 50 and 105
  • b.  Respiratory Rate between 10 and 24
  • c.  Systolic Blood Pressure 90 and 190
  • d.  Diastolic Blood Pressure 50 and 105
  • e.  Oxygen Saturation between 92 and 100
  • f.  Blood Glucose between 60 and 300


APRIL 1st:

There is a part two of our changes that CVMC is deploying.   Part two includes a “Time Out for EMS” for verbal patient transfer of care at the ED.   This will use a “D-M-I-S-T“ format.   All receiving personnel in the room will become silent and still while paying attention to the verbal report.   The crew chief will give a verbal report to the receiving staff.  The patient will remain on the stretcher until report is complete and accepted (unless patient is critically unstable).  


Scott Bagg is going to assign a Vector Training to all EMS personnel and Cornerstone training to all ED personnel.   We will all be on the same page on how this process will be completed.   Videos demonstrating the process will be included.  CVMC personnel is also hoping that the same “EMS Time Out” will happen in reverse when patients are being transferred from our ED by EMS.


We recognize that this is a work in progress.   Some of this is being “trialed” and will be nuanced if its impact is poor on our system.   Please reach out to Scott Bagg or Kristen Schieman if you have any questions.


Scott Bagg, MSN, RN, NR-P, CCRN, CEN, CPEN, CTRN        

Training Coordinator

Vermont EMS District Six

Must read for all EMS providers......

Seven Days article on VT EMS

Vermont's Emergency Medical Services System Is Struggling to Survive. Can It Be Saved?

BY COLIN FLANDERS

Published March 1, 2023 at 10:00 a.m.
Updated March 2, 2023 at 5:07 p.m.

Vt Digger EMS article

recent news flash

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10



Link to VT EMS 2023 Protocols

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10

Protocol link

Vector log in

MAX: 16-24 students (preference to local applicants) APPLY: Interested instructor candidates should e-mail scott.bagg@cvmc.org for an application, due by 3/10

Vector log in

Link to Vector below.   

For protocol update Sign in and follow links to videos corresponding to your license level.  Don't forget to finish and click done at the end of each video for credit.

If not finding updates, go to the RESOURCE KIT and complete 2023 updates for your licensing level. 

Questions:  Contact your service training officer.

Vector Login Link

Recent NEWS and updates

How to generate reports from Siren for re-certification data.

 This is to help Heads of Services and Training Officers obtain a list of procedures that their responders performed in SIREN.  This is to support them in completing their re-certification skill verification process that is required.

1)  Open Report Writer under the Tools Tab in SIREN.

2)  Choose “Create a Report” button in the upper left-hand corner.

3)  Choose to “Create an Analytical Tabular Report” by pressing the “EMS Incidents” in blue

4)  In the “Measurers” section, enter “Count of Incidents”.  Double click to move this rightward to the Selected Side.

5)  In the “Rows” section, enter “Procedure Crew Member Full Name”.   Double click to move this rightward to the Selected Side.

6)  In the “Rows” section as well, enter “Procedure Performed Description”.   Double click to move this rightward to the Selected Side.

7)  In the Columns section, enter “Procedure Successful”.   Double Click to move this rightward to the Selected Side.

8)  No, press the subtab “Filters” at the top under Design.

9)  Under Additional Filters, press the “Add Dimension Filter”

10) Under Dimension, chose “Incident Date”.   Then under operator, choose “between”.   Finally, under Start Value and End Value, enter the dates (MM/DD/YYYY) that you want the report.  Press “OK”.

11) Finally, in the upper right corner, click “Generate Report”.  

You can save your report under the “Actions” subtab re-use it again.  This report can be set up to report mediation administration as well.

Medical help needed for Vermont City Marathon  Sunday, May 28, 2023. 


February 5, 2023
Dear Prospective Medical Team Member,

The 34th edition of the M&T Bank Vermont City Marathon will be held on Sunday, May 28, 2023. Our medical team is hoping that you will consider volunteering with us on race day.


Vermont’s premiere sporting event is expecting approximately 4200 runners and will need lab personnel, EMTs, Paramedics, ATs, PTs, RNs, PA/NPs, and MD/DOs as well as non-credentialed volunteers for our medical team. We provide advanced care for race participants so as to not overwhelm our hospital and EMS systems. We could not do what we do without all of you. The Run Vermont office passes on feedback from runner evaluations each year, and the continuous theme is that our wonderful volunteers are a major reason racers return year after year. Experienced runners tell us our medical team is one of the best they have seen. We see everything from nausea and vomiting to wounds, fractures, GI bleeds, arrhythmias, hyponatremia, exertional heat stroke, and more. We have a critical care tent, and this has proved essential in our treatment of heat illness. We continue to add your suggestions for team improvement.


If you decide to join our team, please sign up to volunteer at the below link: https://runsignup.com/runvcm/volunteer#36469


You will be assigned to either the course or one of three medical tents. If there is another volunteer you’d like to work with, please feel free to note that. Volunteer location assignments are determined based on area of professional expertise, experience level, and most importantly, how to best allocate our resources. This is highly dependent on the composition of our volunteer pool. Location assignments will be tentatively provided the week of the event.

Volunteer duties will start early on Sunday morning, and you can expect to stay through the middle of the afternoon, depending on where you are stationed. If you have time constraints, please let us know when you sign up or ASAP, as that may affect where we place you.

Volunteers will need to attend one of the two medical team orientation meetings via Zoom to review medical protocols and assignments:
Monday 5/22 at 1830: https://uvmcom.zoom.us/j/96401390236?from=addon (Meeting ID: 964 0139 0236)
Thursday 5/25 at 1830: https://uvmcom.zoom.us/j/96270831297?from=addon (Meeting ID: 962 7083 1297)

Course volunteers will need to pick up their volunteer t-shirt and supply packet at the Sport & Fitness Expo at the DoubleTree by Hilton in Burlington on Friday or Saturday before the race. Packets for tent volunteers will be waiting for you when you arrive at your station on race day. You will need to wear your t-shirt at your assigned station on race day. Other details will follow at meetings or via e-mail.

If you know of other interested volunteers, please pass along this information. Thank you for your help, and please let us know if you have questions.

Best,

Katie Dolbec, MD, FACEP, CAQSM Alison O’Connor Sutherland, MS, ATC, AEMT VCM Medical Director VCM Medical Coordinator
(207) 939-4603 (802)343-3379
katie.dolbec@gmail.com Alison.c.oconnor@gmail.com

link to WAITING TO EXHALE (EMS WORLD)

Medical Director: Ellen Stein MD


To the hard working and dedicated members of Vermont EMS District Six,


1) Thanks for being in EMS .. it's not easy at times 

2) If you are willing to share your training requests/ideas please do

3) PLEASE help me make sure you have the support you need when you or others are stressed out. 

Reach out to me at ANY time 


Be well.

Dr. Ellen Stein

District Medical Advisor

Vermont EMS District Six



link to WAITING TO EXHALE (EMS WORLD)

2022protocols released

VTEMS District 6 Board Meeting

Minutes

Interhospital Transfer subcommittee

Completed a unified PCS for interfacility transports.  See  PCS_Orders_D6_2019,  (link below)

New STEMI protocols

Requested - If possible, call from the field to advise ED that you sent an EKG strip from the field and they will look for it.  See protocol: listed below in Recent downloads.



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