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2004 IEMSA Conference 6 | Continuing Education 14 | Member Profile 26

I o w a E m e r g e n c y M e d i c a l S e r v i c e s A s s o c i a t i o n

J u l y – S e p t e m b e r 2 0 0 4

NON-PROFIT ORGU.S. POSTAGE

PAIDDes Moines, IAPermit # 5481

Iowa Emergency Medical Services Association2600 Vine Street, Suite 400West Des Moines, IA 50265

a V O I C E f o r P O S I T I V E c h a n g e i n I O W A E M S

Iowa Emergency Medical Services Association VOICE Newsletter is Published Quarterly by:

Iowa Emergency Medical Services Association2600 Vine Street, Suite 400West Des Moines, IA 50265

Vol. 2004-03, July – September, 2004

www.iemsa.net | 3

News toSHAREAre you working onan exciting programthat needs to beshared with the membership ofIEMSA? Do you knowof an EMS-relatededucational programthat needs to beshowcased? Has yourservice won an awardor done somethingoutstanding? Do youwant to honor a special member ofyour staff or of thecommunity? If so, youcan submit an articleto be published in theIEMSA newsletter! Inorder to do this, justprepare a pressrelease (and pictures,if appropriate) and e-mail it [email protected] November 17 (to be mailed byDecember 10).

The NewsletterCommittee will reviewall articles submittedand reserves the rightto edit the articles, ifnecessary.

That’s the question Dr. Bryan Bledsoe asked in theMarch 2004 cover story for Emergency MedicalServicesmagazine. His answer was a resounding No!Dr. Bledsoe’s article points out that EMS is one ofthe 10 most underpaid jobs in the U.S.

Can you live on anEMS paycheck?

®

MEDICFirst Aid ®

training programs

Do what you do best!Stay in the business of helping peoplesave lives. Become a MEDIC FIRST AID®

Instructor and teach your community firstaid, CPR, AED, and other health andsafety skills.

MEDIC FIRST AID will provide you with anopportunity that allows you to stay in the field

you love, gain valuable community recognition,and most important, supplement your income with

real money that you’ll feel proud to have earned.

In partnership with the Iowa EMS Association, MEDICFIRST AID offers you a special, low-cost opportunity to

get started as an independent instructor. Contact us orvisit our Web site and let us show you how easy it is to

get started and earn additional income.

Call 800-800-7099or visit our Web site atmedicfirstaid.com /IEMSA/

Don’t wait. Give us a call now!Tell us you’re with the Iowa EMS Association and we’ll help you improve yourfinancial security today.

What’s a highly trained, life-savingprofessional like you to do?

BOARD MEETINGS:The IEMSA Board ofDirectors will meet on thefollowing dates in 2004.Each meeting (with theexception of the AnnualMeeting) will be held atRaccoon River NatureLodge, 2500 Grand Avenue,West Des Moines from10:00 a.m. to 1:00 p.m.

n SEPTEMBER 16

n OCTOBER 21< NOVEMBER 11

Annual Meeting

n DECEMBER 16

2004

CALLING FOR EMT’S IN ACTION Please email your EMT actionphotos to www.iemsa.net.

AdditionalIMPORTANT DATES:

Nov. 11 – 13, 2004

Annual Conference & Trade Show

Polk County Convention Complex

www.iemsa.net | 54 | www.iemsa.net

BY RYAN COBURN

Since the birth of the now known MercySchool of EMS in 1979, the school hasbeen committed to providing quality

EMS training to thousands of Iowans, as well asstudents from across the Nation.

Pre-Hospital Advanced Care (PHAC), orwhat the Mercy School of EMS was ini-tially named in 1979, was created tomeet the need for advanced levelcare to EMS services in CentralIowa. As the EMS industry pro-gressed, Mercy recognized theneed to become involved.

Twenty – five years later, Mercyis still committed to providing thehighest level of education to CentralIowans. Today, the Mercy School of EMSemploys 10 full time staff members dedicated tomeeting the needs of all levels of care, as well asproviding continued education opportunities forEMS providers to stay current on ever-chang-ing practices in the EMS field.

Mercy offers a wide spectrum of classes fromFirst Responder to Paramedic Specialist to meetthe needs of all individuals and departments,both volunteer and career. Mercy’s ParamedicSpecialist Program is nationally accredited bythe Commission on Accreditation of AlliedHealth Education Programs. This programprovides education to individuals seeking certifi-cation as Paramedic Specialists in the state ofIowa through both didactic and opportunities towork closely with many of Mercy’s healthcareprofessionals in many different departmentsthroughout the hospital.

Mercy also provides learning opportunities atthe level of First Responder, EMT-Basic, EMT-Intermediate and Iowa Paramedic which allowsstudents to take their EMS education to anylevel desired.

Several programs and courses have been

added to further the education of Pre-hospitalproviders such as Pre-Hospital Trauma LifeSupport (PHTLS) which gives the providersspecific knowledge on assessment and care oftrauma patients; Pediatric Education for Pre-Hospital Professionals (PEPP) specific to keep-

ing providers’ skills and knowledge ofPediatric pre-hospital treatment up to

date; Geriatric Education forEmergency Medical Services(GEMS), one of the latest coursesavailable designed to be specific tothe largest population of patients

encountered by EMS. In 2002, Mercy also began offer-

ing the Critical Care Paramedic (CCP)class for experienced Paramedic Specialists

to focus on the assessment and treatment of theCritical Care patient by offering them bothclassroom instruction as well as hands on oppor-tunities to become familiar with the skillslearned.

Mercy School of EMS also provides anopportunity for medical professionals of all lev-els to get initial training as well as renewal in allAmerican Heart Association Courses, fromCPR to Advanced Cardiac Life Support.

Over the last 25 years, many changes haveevolved in both EMS and healthcare; however,Mercy’s belief in pre-hospital educationremains the same: fostering a positive, motivat-ed learning environment; identifying and striv-ing to achieve each person’s highest level ofcompetence in delivering emergency medicalcare; and recognizing and promoting the deliv-ery of emergency medicine as part of an overallhealthcare team or system.

For more information on The Mercy School ofEMS or to learn more about one of the manyeducational offerings,please call 515-643-7499, orvisit us on the web at www.mercydesmoines.org.

Many years of firsthand EMS

experience – yours and ours – goes intocustomizing the sys-tems and interior ofeach Life Line vehicle.We excel at details that make your job easier and safer.

Let us customize aLife Line EmergencyVehicle to the way youwork…and get vitaladvantages you cansee, feel and hear.lifelineambulance.com

EMERGENCY VEHICLE SALES & SERVICE Gene Draper, owner • (641) 692-3540 • evss.frontiernet.net

(563) 578-3317Sumner, Iowa

Mercy School of EMS Celebrates

25 YEARS


IEMSA CONFERENCE 2004 Even Bigger and Better

At this same time lastyear there was an arti-cle in the IEMSA

newsletter touting how the2003 IEMSA Conference wasgoing to be bigger and betterthan ever before with expand-ed pre-conference workshopsand more national level speak-ers. Would you believe it if wesaid the same thing again thisyear? Well, it’s true — the2004 IEMSA Conference isgoing to be bigger and betterwith expanded pre-conferenceworkshops and more national-level speakers than ever before!Trust us — it’s true. The 2004Conference is stacking up to beeven better than last year.

The conference committeehas strived once again to bringthe best quality conference pos-sible to Iowa. We have pouredover the evaluations and triedto make sure to implement asmany of your suggestions aspossible. There will be fewer“sweets” for the break snacksand, of course, the stuffed pret-zels will be back! Platedlunches will return for Fridayand Saturday. Pepsi and Cokeproducts, as well as bottledwater will be back. You will beseated at tables for all of thepre-conference workshops andthe general sessions on Fridayand Saturday. The vendor hall

will be overflowing with sever-al new vendors and vendorsshould not be leaving until afterlunch on Saturday.

Although we could neverbring in all the session topicsrequested by participants, wehave made arrangements for

several of the most requestedtopics to be presented in 2004.You asked for more “autopsy”related topics and we haveMary Fran Ernst, medicalexaminer from St. Louis com-ing to present two sessions.You asked for Ag Trauma andwe have Iowa’s Dan Neenan

presenting this topic. Severalof you requested sports injuriesand this topic is Dr. CraigJacobus’ specialty. You askedfor more case studies and wehave those. You asked for sev-eral topics related to sceneissues and, because of this, wehave developed a new pre-con-ference workshop: SceneManagement.

You asked for more speakerslike last year’s Mike Helbockand Baxter Larman; this year’sconference will see an array ofEMS presenters that rival thetop EMS conferences in thecountry. This year’s line up ofspeakers, some of whom arecoming to our conference forthe first time, includes MikeGrill, Paul Werfel, PeterLazzara, Twink Dalton,William Krost, Dr. CraigJacobus, Bob Nixon, and WillChapleau.

The conference on Fridaywill begin with Mike Grill’sgeneral session: “Rebar Boy: ACase Study in PenetratingTrauma.” This title should bepretty self-explanatory…Friday afternoon, we end theday with Dr. Craig Jacobuspresenting “How Can You Winif You Don’t Play.” In this ses-sion “Dr. J” will offer choicesto motivate you and redevelopthe passion that you have had

This year, the Thursdaypre-conference work-shops have been

expanded to include not onlyafternoon sessions but morningsessions and two all-day “spe-cialty classes.” If you look atthe sessions in this year’s con-ference brochure and don’t seesomething that interests you,then you’ve missed reading acolumnbecause theday offerssomething foreveryone!

Back due topopulardemand willbe 4-hour pre-conferenceworkshops onEMSManagementand EMSEducation, aswell as both amorning and/or afternoonoffering of Critical CareParamedic (CCP) Refresher.

Our EMS Management ses-sion will feature three speakers:Jim Graham, Mike Grill andBill Raynovich, speaking onseveral topics of special interestto EMS managers or servicedirectors. Bill Raynovich hasrecently been hired as the newdirector of the EMS Bachelor’s

Degree program at CreightonUniversity in Omaha, and willbe coming to IEMSA’s confer-ence for the first time. Bill is aDoctoral Candidate inEducational Administration(Educational Leadership andOrganizational Learning) andhas a Master's Degree inPublic Health (MPH) with aconcentration in Health

ServicesAdministration.Bill’s expertiseshould beunparalleled.Bill will presenttwo sessions,“Real LiveEMSManagement,Session I – TheFundamentalsof PersonnelManagement”and “Real LiveEMS

Management, Session II –Headaches, Pains andStress…and it’s only MondayMorning.” Closing the EMSManagement workshop will beMike Grill. Mike is a national-ly acclaimed, dynamic speakerwho will be coming to Iowa forhis first appearance. Mike willpresent “Creative Destruction:How to Improve the Quality ofYour Organization.”

for EMS. He will review avariety of skills and activitiesthat will assist you to achieveyour very best. We will beginSaturday with Paul Werfel’s“20 Commandments for PatientCare.” Paul assures this sessionwill be a fun and entertainingstart to the morning. We willend the conference withWilliam Krost presenting,“When our Paths Crossed.”This session is a case study of atrauma call involving severalEMS entities and a field per-formed amputation. He prom-ises that the session “won’tleave a dry eye in the house.”A host of Iowa speakers willcompliment this national speak-er line-up with quality educa-tional breakout sessions of justabout every topic and interest.

We have it all this year -expanded pre-conferenceworkshops, an exhibit hallbusting at the seams with EMSvendors and their products, anexhibit hall reception onThursday evening, an outstand-ing line-up of acclaimed nation-al speakers for Friday andSaturday’s general conferencesessions, the awards luncheonon Friday, the dance with mul-tiple door prizes on Fridaynight. The 2004 IEMSA con-ference brochure should be outin just a few weeks. It will bemailed to every currently certi-fied EMS provider in the state,as long as your address withthe EMS Bureau is current.Look for it soon! ■

WE HAVE IT ALL THIS

YEAR — EXPANDEDPRE-CONFERENCEWORKSHOPS, AN

EXHIBIT HALL BUSTINGAT THE SEAMS WITH

EMS VENDORS, AN EXHIBIT HALLRECEPTION, AN

OUTSTANDING LINE-UPOF ACCLAIMED

NATIONAL SPEAKERS,GENERAL CONFERENCE

SESSIONS, THEAWARDS LUNCHEON,

AND THE DANCE WITHMULTIPLE DOOR PRIZES.

Pre-conference Workshops

Something for Everyone!

(Continued to page 8)


special needs of the older popu-lation. The first of its kind,GEMS has many interestingfeatures, is especially learner-friendly and is on the cuttingedge of clinical practice in geri-atric emergency medical servic-es. EMTs of all levels will findthis one-day basic level pro-gram very rewarding.

Due to requests from par-ticipants for more pediatrics,the second specialty classoffered will be NAEMT’sPre-hospital Pediatric Care(PPC) program. MelissaSally-Mueller will lead this 8hour basic program. PPC isan in-depth study of the pre-hospital care of injured and illchildren. This 8 hour basiclevel course emphasizes apragmatic approach and for-mat, based on teachingproviders a problem focused,assessment based approachwhile concentrating on whatthey need to know. The cur-riculum is designed to allow fora minimal amount of lectureand an ample amount of actualhands-on practice using casebased scenarios.

Still in the developmentstages are plans for an eighthour, all day workshop entitled"Medical Direction." Althoughthis session is being designed

for physicians who providemedical control or who aremedical directors for EMSservices, EMS administratorsand other leaders in EMS mayalso find this session particular-ly useful. Everyone is welcometo attend. Speakers lined upfor this workshop include Dr.David Stilley, Dr. Eric

Dickson, Dr. Carlos Falconand select EMS Bureau staff.Dr. Stilley is the current chair-person for the Iowa Chapter ofACEP and has a longstandinghistory as a medical director fornumerous EMS services inIowa. Dr. Eric Dickson is thecurrent director of EMS pro-grams at the University ofIowa and has previously been amedical director for air trans-port services. Dr. CarlosFalcon is the chair of the IowaScope of Practice Committee, a

member of the State AdvisoryCommittee and is currently themedical director for LeeCounty Ambulance Service.All three physicians will bring awealth of knowledge andexpertise to the workshop.Please alert the physicians yourservice works with about thisopportunity! Physician CME's

will be available.Although open throughout

Thursday afternoon, immedi-ately following Thursday’sworkshops, a reception willbe held in the exhibit hall.Refreshments will be servedas participants have anopportunity to spend sometime with the vendors. At1800, the Annual IEMSABoard meeting will be held.We strongly encourage you

to attend this meeting, earnsome extra CEHs and hearwhat IEMSA has accom-plished in a very productiveand busy year.

Without a doubt Thursdayhas something for everyone.Offered at very economicalprices, participants can enjoysmaller classes, table seatingand specialized training byattending one of the pre-confer-ence workshops. The onlyproblem you will have is decid-ing which one(s) to attend! ■

Have we got a treat forEMS Educators this year! Wehave three of the country’s besteducational speakers lined upfor this session. Will Chapleauwill discuss the use of criticalthinking in teaching, TwinkDalton will address the affec-tive domain and Mike Grill willdemonstrate how to get knock-out visuals to use in your com-puter presentations and classes.EMS educators would have ahard time finding a better line-up anywhere!

This year, CCPs may attenda four-hour morning session, afour-hour afternoon session orattend all day for 8 hours ofCCP level con ed. Althoughdesigned for CCPs, these ses-sions are open to everyonewho loves critical care andadvanced level topics. A hostof Iowa’s top clini-cal presenters,including RosieAdam, DanKeough, LukeMortensen, Mike

Hartley, Lee Ridge and BrianHelland, will join TwinkDalton in presenting topicsmeeting the continuing educa-tion requirements for CCPs.

2004’s conference will seetwo new four-hour workshoptopics: the recently released,“Traumatic Brain Injury pro-gram (TBI)” developed by theBrain Trauma Foundation, and“Scene Management.” TBI isan excellent class dealing withthe assessment and treatmentof brain-injured patients. Youwon’t realize how much youdon’t know until you take thisprogram! Jeri Babb, traumanurse specialist and educatorfrom IMMC will be presentingthis topic and will, without adoubt, do an excellent job.The other new pre-conferenceworkshop this year is “Scene

Management.” This sessionshould be well suited for EMSproviders of all levels, especial-ly EMTs. It will be particular-ly interesting to EMSproviders who also have extri-cation, fire or rescue responsi-bilities. Mike Grill will startoff the session with “Scenery,What You Need to Know” fol-lowed by Brain Wright speak-ing on “Extrication/SceneManagement for the MVC”.We will also have a speakerpresenting on Triage and theworkshop will be capped offwith Will Chapleau speakingon Unified Command. Don’tmiss this one!

Also new for 2004 are two,8-hour specialty classes. CheriWright will be the lead instruc-tor coordinating the GeriatricEmergency Medical Course

(GEMS). GEMSis an exciting cur-riculum designedspecifically to helpEMS providersaddress all of the

Pre-conference Workshops

Something for Everyone!

(Continued from page 7)


WelcomeN E W I E M S A M E M B E R S

INDIVIDUALS:May AlduchRon BakerAnn BarnesJohn BaxterMary E. BehrendsGarthlene BellJerry BergdaleMark BolligDianne BolsingerRoger BolsingerKevin BrixJim BruggemanJames CejkaRose H.ChallgrenShane ClarkJoyce CosbyD. W. CrabbTerry L. CrowRon DackenCrystal DonnellyJim DuncanStephanie Eagen

Kim E. FischerJudy FroehlichJoAnna GlandonPamela A. GustinCandy HannaAmy HoffmannDeb HrubesRobb JacobsenDave JohnsonCarolyn JohnsonDennis JohnsonPaul JuilfsDebbie KasikScott KasikBarry KeldermanTom KrollGayle LangbehnWendy ListerBill LittlerJoseph A. MalloyJames D. MehaffeyPatricia Meyer

Ronald MeyerDenise MillerPatti MillerMelissa MonahanWalter MooreJerry L. NeremDavid D. NewbroughPriscilla OlsenWende OsbergMichelle OttoChristopher ParkerJon T. PetersenScott PigsleyBob PlattsKerri PoduskaMichael ReynoldsBetty RobbLuJeanne Robbins-FinkJanet M. RockowDavid RodgerBarbra RuschBecky Sattler

Jamie SauterAnn SchmidtGreg SchusterDuane SeegebarthDavid SeelyeDorene J. SmithJames StanleyDeb StephensonBrian SudbrockSteve SudbrockCory ThompsonDale TownePat WaldorfSabrina WeberChris WebsterDavid WelanderKevin WheatlyBrent WhitlockDuane WieboldTodd WildeboerDaphne WillwerthHarlan WulfScott Young

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IEMSA HAS MOVED!!!

PHONE NUMBERS AND E-MAILADDRESSES STAY THE SAME

THE MAILING ADDRESS HAS BEENCHANGED TO:

2600 VINE STREET, STE. 400,WEST DES MOINES, IA 50265

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Great news forAffiliate membersof Iowa EMS

Association! Three newbenefits are available forevery service that holds acurrent Affiliate member-

ship — Group Purchasing,the Resource CD and theability to purchase an AEDat grant pricing.

IEMSA is exited toannounce the development ofthe Group PurchasingProgram. The MembershipCommittee researched ven-dors of consumable EMSsupplies and selected twovendors through a competi-tive RFP process. Tri-animHealth Services, Inc. andAlliance Medical have beenchosen based on their willing-ness and ability to provideconsiderable discounts ontheir products to IEMSA’sAffiliate members. IEMSA isconfident that the productsand customer service provid-ed by Tri-anim and Alliancewill be extraordinary and will

benefit Affiliates greatly. A“Group Purchasing” page hasbeen added to IEMSA’s website with valuable informationabout Tri-anim and Alliance,along with links to theirrespective web sites.IEMSA is pleased to partnerwith two leaders in the EMSsupply industry and hopesthat all Affiliates will take fulladvantage of this program.

There is no longer a needto “recreate the wheel” whendeveloping policies and pro-cedures, or search for sam-ples of bylaws in an effort todevelop your own, or down-load a template from a simi-lar organization only to haveto format it to fit your needsand word processing pro-grams! These items andmore are available onIEMSA’s new Resource CDthat is now available at nocharge to Affiliate members.Samples of contracts, HIPPAinformation, and MedicalProtocols are included on theCD. Information on

Recruitment and Hiring,Scope of Practice, andWritten Plans of Action areon it, too!

Need an AED, but justdon’t have a lot of funding?Thanks to a special relation-ship with the vendor whosupplied the AED’s for theFederal Rural Access toEmergency Devices GrantProgram, AED’s can be pur-chased by Affiliate membersnow until the end of this yearat an $800 discount.

Medtronic EmergencyResponse Systems (formerlyknown as Medtronic Physio-Control) has offered IEMSAAffiliate members the abilityto purchase the LifePak CR+for a mere $1399 (plus taxes(when applicable), shippingand handling). This AED,which normally sells for$2200, includes a trainer,data collection software anda computer training program.Call John Goos, 1-800-442-1142 to order.

The Membership commit-tee values its relationship withIEMSA’s Affiliate Membersand welcomes the opportunityto serve them through pro-grams that will be valuable ona practical level. Ambulanceservices and related organiza-tions are eligible to becomeAffiliate members. Checkwith the IEMSA office (515-225-8079) or visit theweb site (www.iemsa.net) forinformation about becomingan Affiliate member ofIEMSA. n

NEW BENEFITSFor Affiliate Members

THREE NEW

BENEFITS ARE

AVAILABLE FOR

EVERY SERVICE

THAT HOLDS A

CURRENT

AFFILIATE

MEMBERSHIP —

GROUP

PURCHASING, THE

RESOURCE CD

AND THE ABILITY

TO PURCHASE AN

AED AT GRANT

PRICING

www.iemsa.net | 15

SCENARIO:You are dispatched to a “10-50 P-unknown” at approximately 2300one evening. Apparently, severalcar-loads of high schoolers werejoy riding, playing “cat andmouse”.

The cars were taking turnspassing each other on a countyhighway when one of the vehicleslost control and struck a bridgeabutment. Enroute to the scene,Dispatch advises that law enforce-ment has arrived and is advisingthat this is a one-vehicle, 10-50.They report one victim, a probablefatality. Upon your arrival, lawenforcement has blocked off theroad for several hundred yards ineither direction and has clearedthe scene of the other vehicles andkids that were in the same group.

As you approach the vehicle,you note tremendous vehicle dam-age with the vehicle intertwined inthe bridge railing. Inside thevehicle driver’s seat, you find a16-year-old male. His upperchest and head are easily visible,but there is major intrusion of thedash into the passenger compart-ment and most of his body fromthe abdomen down is trappedbetween the dash and the seat.

You immediately recognize thevictim as a local high school stu-

dent. Your son is on severalsports teams with this boy. Forjust a minute, you feel an uncom-fortable sense of panic as youhope your son is home-where he issupposed to be. You feel angry andscared at the same time, yet youare unsure how to react, especiallyin front of others. You are feel-ing some new emotions-differentthat you have ever felt sincebecoming involved in EMS.

The victim is pulseless, apneic,and has obvious mortal headinjuries in addition to his entrap-ment. You radio medical controland advise them of your decision(per protocol) to not resuscitatedue to traumatic injuries inconsis-tent with life and the physicianconcurs. You are able to locate IDon the victim and confirm yoursuspected identification. Thisidentification information match-es what the kids in the group havetold the officer on the scene. Thecounty medical examiner is sum-moned to the scene and you pre-pare for what you will believe willbe a lengthy extrication.

A few minutes later you note alarge commotion from the groupof bystanders by the barricades.Soon, law enforcement walks backto you and says, “the other kidscalled this kid’s parents and

they’re here now. They insist oncoming down here to see what ishappening.” Law enforcementsays they have only told themthat their son “ is trapped”. Theofficer adds, “you need to comeand tell them something or we arenot going to be able to controlthem much longer.”

What will you do? Are youprepared to handle this difficultsituation? Will you handle itcorrectly? How do you begin tosort through and deal with yourown emotions?

DEATHS IN KIDS VS. ADULTS: OUR REACTIONS

How is a child’s deathviewed differentlythan an adult’s?

With the death of an adult,especially when the person iselderly or has had long stand-ing illness, the death is almostviewed as being welcome-freeing that person from theirpain or the constraints of anaged body. The same is nottrue of a pediatric death. Apediatric death is rarely, ifever, considered a positiveevent. We often view a pedi-atric death as being unfair-robbing this child of theopportunity to experience afull life. Children are alsoseen as being innocent, andas such, they are often per-ceived as being helpless toprevent, intervene or changethe outcome of their death.As adults, we are responsiblefor many of the choices wemake that contribute or leadto our deaths: smoking, obe-

sity, drinking and driving,seat belt usage, etc. As such,we are more responsible forour own demise and shouldaccept some responsibility forthat. The same is not true ofchildren whose sole existenceseems to be at the will of oth-ers. All of these things makedealing with the death of apediatric patient much harderthan accepting the death ofan adult patient.

What feelings do we havewhen we experience thedeath of a pediatric patient?

The feelings we have arenumerous and varied andseem consistent from individ-ual to individual. We mayfeel untrained or unprepared,wondering and second guess-ing if there was something wefailed to do, something wecould have done better, some-thing we should have donedifferently, etc. In experienc-ing these self-doubts, we mayfind ourselves feeling partlyresponsible for the death. Asa care provider, you must be

able to realize the reasons forthese doubts and be ready todeal with them. We may alsofear being wrongly blamedfor the death or injury by thefamily. It is natural for thefamily to lash out and lookfor a reason - any reason forthis uncomfortable event. Intheir efforts to grasp for somereason, they may blame care-givers for the death or forfailing to do enough to keepthe death from occurring.“You didn’t get there quickenough.” “You didn’t trylong enough.” “You didn’t doeverything you could have.”

For many of us who havechildren, the death of a childmakes us see our own chil-dren as being vulnerable, andwe can empathize too easilywith the parent’s of the childand the emotions they arefeeling. As we sort throughour own emotions, we areoften afraid that if we out-wardly show emotion that wewill be viewed as weak by ourco-workers or family.

NOTIFYING THE LOVEDONES: THE TEAMAPPROACH

EMS providers shouldn’tthink that making a deathnotification is something theywill never have to do.Parents and families do showup on the scene. With thecurrent trend to make a pronouncement of death inthe field, we will be facedwith this uncomfortable taskmore and more often. Evenif resuscitation efforts are

CONTINUINGeducation

“I’M SORRY MRS. SMITH, BUT JOHNNY IS DEAD”DEATH NOTIFICATION AND DEALING WITH THE DEATH OF A PEDIATRIC PATIENT

IOWA EMERGENCY MEDICAL SERVICES ASSOCIAT ION IEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION

14 | www.iemsa.net

LORI REEVES, BA, EMT-PS/ CCP,Lori is the EMS Training ProgramCoordinator for Indian HillsCommunity College in Ottumwa, astaff Paramedic Specialist forOttumwa Regional Mobile IntensiveCare Services, and one of theIEMSA Board Members.

OBJECTIVES: Upon completion of the lesson thestudent will be able to:

1) Identify the emotions thatthey (as care-givers) willlikely experience wheninvolved in a pediatricresuscitation or death.

2) Identify the proper stepsand actions to take whendelivering a death notification.

3) Recognize specific words touse when making a deathnotification.

4) Identify expected familyreactions to the death notifi-cation.

5) Distinguish appropriate andinappropriate things to saywhen speaking to adeceased patient’s family.

6) Discuss family interactionduring a resuscitation orwith the deceased.

DEATH NOTIFICATION AND DEALING WITH

THE DEATH OF A PEDIATRIC PATIENT

EMS PROVIDERSSHOULDN’T THINK

THAT MAKING A DEATH

NOTIFICATION IS SOMETHING

THEY WILL NEVER HAVE

TO DO.


describe what was done. Usewords like "died" and "dead"rather than “gone away”,“passed away”, “passed on”,“no longer with us”, “fatallyinjured”, etc. As you con-clude the notification, tellthem the inevitable outcome.Then pause……. and wait fortheir reaction.

“As you already know your sonJohnny was involved in a verybad automobile accident tonight.EMS was immediately sum-moned to the scene and arrivedquickly. Johnny was found in thevehicle and he had sustained veryserious injuries. I’m afraid therewas nothing that we could do tohelp him. I’m very sorry to tellyou this, but Johnny isdead…………

Be prepared for the family’sreaction. Expected familyreactions to the death notifica-tion may include: fight, flight,freezing, or other forms ofregression. Be prepared for aphysical reaction, includingfainting, shortness of breath,and nausea. Be aware of thepotential for a physical attack.Accept expressions of angerfrom the family without fight-ing back. Do not restrain theperson(s) unless there isimminent danger of injury tothemselves or others.

Let the person(s) respondand ask questions. Try to becomfortable with silence.Sometimes doing nothing isactually doing something.

Your presence alone can help.Continue to use the victim’sactual name, not “the body”or “the deceased.” After thenotification, you may findyourself struggling with whatto do or what to say. In youractions and words, rememberthat feeling sorry for the fami-ly is not as effective as feelingwith the person or family.Shared feelings may be themost meaningful.

SOME APPROPRIATETHINGS TO SAY MAYINCLUDE:• “I’m so sorry.” This is sim-

ple, direct, and validating. • “Most people who have

gone through this reactsimilarly to what you areexperiencing.” This validates and normalizeswhat they are feeling.

• If I were in your situation,I’d feel very ______, too.This also validates and normalizes.

• Answer their questions ashonestly as possible.

• Be prepared to provideaddresses and telephonenumbers of resources, support groups.

• Provide information on theautopsy, if applicable.

• Assist with contacting afuneral service.

• Resist the temptation to tryto comfort people by makingpromises you cannot keep orvalidating things you don’treally know for sure.

• Avoid “small talk”.

INAPPROPRIATE STATE-MENTS YOU DO NOTWANT TO SAY INCLUDE:• “I know how you feel.”

You don’t- unless you havealso lost a child in a similarmanner.

• “Time heals all wounds.” Itdoesn’t.

• “He didn’t know what hithim.” Are we sure?

• “You’ll get over this.” Theywill get better, but they willnever “get over it.”

• “You must focus on yourmemories.” Not now.

• “It must have been theirtime.” Is it ever really anyone’s time?

• “Someday you’ll under-stand why this happened.”They may never under-stand.

• “God must have neededthem more than you did.”Not at this moment.

• “You must be strong foryour spouse / other chil-dren.” Not now-let themgrieve.

• “Your loved one is in a bet-ter place" No- the "betterplace" is home with them.

• “It was God’s will.” Callinga tragic loss the “will ofGod” can have a devastat-ing impact on faith.

• “You must go on with yourlife.” They will the best waythey can, and they don’tneed to be told to. A member of the team should

make contact with the familythe next day. A phone call isprobably most appropriate.

terminated in the emergencyroom rather than in a pre-hospital setting, the EMSprovider should play a part inthe death notification processand be prepared to interactwith the family.

A DEATH NOTIFICATIONSHOULD ALWAYS BEMADE IN PERSON: face-to-face. Never give thistype of news over the phone.You may request that thefamily come to your locationor you might physically go towhere the family is. Propersteps and actions to takewhen delivering a pediatricdeath notification begin withselection of a “team” to makethe notification. Ideally, thisteam should consist of 2-3people. The first team member will make the actual notification and should be aperson in charge. If in thehospital, this will likely be thephysician. In the case of apre-hospital death, this willlikely be the senior medic orperson attending the call. Inaddition, the team shouldinclude at least one personwho was present at the eventor resuscitation or whoknows as many of the detailsof the event as possible.Expect that the family willhave questions about the inci-dent and subsequent events.These questions can be bestanswered by this person.The EMS provider is oftenbest suited of all the care-givers to fill this role when a

child has been brought to thehospital from a pre-hospitalevent. Lastly, (and if avail-able), the team may include aclergy member. This may bethe family’s personal clergyperson, hospital or servicechaplain. The team shouldbe prepared and available tostay with the family for awhile. Plan ahead. Whatwill be said and who will sayit? Make sure your clothesor uniforms are clean and arenot spotted with blood or dirtfrom the ambulance call/resuscitation.

When making plans forthe notification, be sure tochoose as private a location aspossible. No two situations inEMS are ever the same andfinding a private location maybe easier to accomplish insome situations than others.Have the family sit down.Because possible physicalreactions to this news mayinclude fainting or loss ofcontrol of the legs, have all

family members sit if possible.Verify that they are the familyof the deceased. Beforemaking a notification, youshould be sure of the identifi-cation of the victim involved.This type of news shouldnever be given in error.

SCENARIO:As the senior medic on the call,you decide you will make theactual notification. You ask yourEMT partner and the lawenforcement officer to accompanyyou (since he was first on scene ashas spoken some with the otherkids involved). You move your rigaway from the accident scene, butstill far enough away from theother bystanders. You have thevictim’s parents brought to the rigby the officer. You ask them to siton the rear bumper. You ask ifthey are Mr. and Mrs. Smith andif Johnny is their son.

WHAT SHOULD WE SAY?HOW WILL THEY REACT?

Use the injured ordeceased person’s name andinclude the facts. Get right tothe point — they alreadyknow something terrible hashappened. Be direct and usedirect language — don’t tryto overprotect througheuphemisms. Begin with a“preparer” statement: “I’msorry to inform you of thisbut….” Or, “I’m afraid I havesome bad news for you.”Identify the individual, usingtheir name, and brieflydescribe what has happened.In the case of a resuscitation,

I EMSA CONTINUING EDUCATION CATASTROPHIC K ID CALLSIEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION IEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION

BEFORE MAKINGA NOTIFICATION,YOU SHOULD BE

SURE OF THEIDENTIFICATIONOF THE VICTIM

INVOLVED. THISTYPE OF NEWS

SHOULD NEVER BEGIVEN IN ERROR.


The family may have addi-tional questions but even ifnot, the contact shows caringand concern. It is appropri-ate and shows compassion forcaregivers to attend thefuneral or visitation. Itshows the family that thatindividual was someone morethan just a “patient” to you.On the anniversary of thedeath, or on the deceased’sbirthday, a call to the familyor sending a card or note canbe a very special touch.

SHOULD THE FAMILYWATCH?

If the family is present dur-ing the resuscitation effort,allow the family members theoption to watch the resuscita-tive efforts if they wish. Thismay allow them the opportu-nity to spend the last minuteswhile their child is still techni-cally alive. Seeing the resusci-tation efforts may also help thefamily to know in their heartsthat everything that couldhave been done was done. Ithas been shown to helpacceptance and help healing.

After a resuscitation hasbeen terminated (or in thecase where resuscitation wasnot attempted), the familyshould be allowed, (but notforced), to see or hold theirchild if they wish. Preparethe family for what they willsee, i.e. injures, resuscitationequipment, etc. Within rea-son, allow them to stay aslong as they wish.Occasionally, offering the

family the opportunity totake a memento with themsuch as a lock of hair, a pieceof jewelry, etc. may help withthe final parting.

In the situation where thedeceased individual hasreceived serious injuries thatmay be visually shocking, it isstill important to make everyeffort to still allow the familysome contact, (especiallyphysical contact). Preparethe body as much as possibleby cleaning it of blood,removing torn or bloodiedclothes, etc. Cover or protectbody parts that have beenseriously traumatized to pre-vent the family from visualiz-ing them. Although the faceof the victim is what the fam-ily will want to see the most,in some cases this may not bepossible. In these situationstry to allow the family at leastsome contact, perhaps withjust a hand.

PERSONAL POSSESSIONSWhen appropriate, ask the

family how and when theywould like personal posses-sions delivered. Do not deliverpersonal items in a plastictrash bag. Use a box, patientbelongings bag, etc. Explainwhat the contents are and thecondition of the items so theywill know what to expectwhen they decide to open it.Avoid giving the family pos-sessions covered in blood,clean them first or ask thefamily for permission to dis-card these items if appropriate.

MY OWN EMOTIONSAND REACTIONS

Is it appropriate for you toshow emotion? Even if infront of the family or “behindthe scenes?” Yes, caregiversshould allow a display of theirown emotions. In front of thefamily this validates the per-son(s) being notified, demon-strates concern, and has beenshown to have a long-lasting,positive effect. Showing emo-tion “behind the scenes”and/or in front of peers is also

very appropriate. Pediatricdeath produces strong emo-tions within us. Showingemotions just shows that weare human; it allows us todefuse and cope. As you dealwith these events, make sureyou are taking care of your-self. Don’t let your emotionsand the stress you will natural-ly experience in empathizingwith the bereaved build into aproblem for you. Debriefyour own personal reactions;don’t try to carry emotional

pain all by yourself. Do nothesitate to seek assistancefrom family, friends, clergy,and other professionals-CISD/CISM. Rememberthat emotional defenses area natural reaction to astressful situation. Donot be embarrassed if apediatric death pro-duces strong feelingswithin you. As care-givers, we must keep inmind that although thegoal of resuscitation is togive the patient the bestopportunity for recov-ery, the outcome isoften beyondour control. ■

I EMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT IONIEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION

REFERENCES:• Iowa Organization for Crime Victim Assistance

Program, (1992). In Person, In Time, RecommendedProcedures for Death Notification.www.nationalcops.org/forms/in_person.pdf.

• State of California, (2003). Placer County LawEnforcement Chaplaincy Training Manual, Ch. 6 Death& Grieving.www.pcchap.org/PCMANUEL/Chp%206/chapter6.htm.

• State California Youth Authority, (2000). OPVS Bulletin- Death Notification Procedures.www.cya.ca.gov/staff/death.html.

• Wolfram, Wayne, MD, MPH, (2004). Coping With theDeath of a Child in the ED.www.emedicine.com/emerg/topic691.htm

PLEASE REMEMBER,WE CANNOT SAVE

THEM ALL………WE’RENOT SUPPOSED TO.

MAKE THE EVENTPOSITIVE BY TAKINGLESSONS FROM ITTHAT WILL BETTER PREPARE YOU FOR

THE NEXT SITUATIONWHEN YOUR

ACTIONS MAY MAKEA DIFFERENCE.

10- QUESTION

POST-ARTICLE

QuizPEDIATRIC DEATH NOTIFICATION

1) A death notification is best made by:

A) a single individual

B) 2-3 individuals as a “team”

C) 4-5 individuals as a “team”

D) telephone contact, not in person

2) You have just told a father that his son hasdied and he unsuccessfully attempts tostrike you, you should:

A) restrain him

B) realize that this is a normal reaction, do notover react

C) have him arrested

D) administer a sedative medication

3) You have bloody clothes and jewelryremoved from a traumatically injured childthat has died. In regards to giving thesebelongings to the family, which of the following would NOT be appropriate:

A) Place them in a biohazard trash bag and givethem to the family

B) When appropriate, explain the condition of theclothes and ask the family if you may throwthem away.

C) Give them to the family in a patient belongingsbag and clearly explain what is in the bag.

D) Clean the jewelry and clothes as much as possible,place them in a box, and give them to the family.

4) Which phrase would be most appropriateto tell someone his or her child has died?

A) Johnnie is gone.

B) Johnnie has passed on.

C) Johnnie is no longer with us.

D) Johnnie has died



5) Which statement would be appropriate tosay to a family after receiving a deathnotification?

A) I know how you feel.

B) You must be strong for your other children.

C) Other families that have gone through whatyour are going through feel exactly the sameway you do.

D) Time heals all wounds.

6) Showing emotion in front of the family:

A) validates, shows concern and has a long-lastingpositive effect.

B) will make you appear weak and ineffective.

C) inappropriately increases their emotional reaction.

D) is appropriate only if you know the family.

7) Scenario: You are assisting in the resusci-tation of a 5 year old in the ER. Thepatient’s family is present at the hospital.During the resuscitation the family requeststo be with the child. You should:

A) refuse this since it protects the medicalproviders from liability for improper care

B) disallow this and protect them from seeing theresuscitation by putting them in another room.

C) discourage this since it will be unsettling for thefamily to see

D) allow a limited number of family to take turnsbeing with the child as long as it does not hinder resuscitation efforts

8) Scenario: A teenager has died from trau-matic injuries and was not successfullyresuscitated. He suffered severe chest andextremity trauma and portions of his bodywould be quite graphic if seen by the fam-ily. The family has requested to spendtime with the deceased child. You should:

A) not allow them to see him due to the visualshock of his injuries.

B) only allow the strongest family member to seehim for identification purposes only

C) prepare the body by cleaning it, cover theinjured areas, and allow the family to see him.

D) allow the family to view the body from a dis-tance so that the extent of his injuries is notclearly visible

9) You have delivered a death notification toa family. The family becomes angry,claiming the death was the fault of anoth-er EMT who was on the call. They areaccusing them of incorrectly performingsome procedures on the patient. Youshould:?

A) realize this may be a normal reaction and listenbut do not overact

B) contact your service’s lawyer or legal represen-tative

C) tell the family they are inappropriately placingblame

D) walk away from the family and not continuecontact with them

10) A caregiver may seek help dealing withthe death of a pediatric patient by

A) talking to other care-givers about the experience

B) attending a CISD debriefing

C) make an appointment with a professional counselor

D) all the above

IEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION IEMSA CONTINUING EDUCATION PEDIATR IC DEATH NOTIF ICAT ION

Name ______________________________________________________________

Address ____________________________________________________________

City ___________________________ State ____ ZIP ___________ – ________

Daytime Phone Number _______ /_______–_________

Iowa EMS Association Member # _____________________ EMS Level ________

E-mail _____________________________________________________________

For those who have access to email, pleaseemail the above information, along with youranswers to: [email protected]

Otherwise, mail this completed test to: Cheryl BlazekSouthwestern Community College1501 Townline RoadCreston, IA 50801

1. A. B. C. D.

2. A. B. C. D.

3. A. B. C. D.

4. A. B. C. D.

5. A. B. C. D.

6. A. B. C. D.

7. A. B. C. D.

8. A. B. C. D.

9. A. B. C. D.

10. A. B. C. D.

CLIP AND RETURN

IEMSA Members completing this informal continuing education activity should complete allquestions, one through ten, and achieve at least an80% score in order to receive the one hour of continuing education through the SouthwesternCommunity College in Creston, Provider #14.

(Please print legibly.)

CONTINUING EDUCATION IEMSA

answer form

10- QUESTION

POST-ARTICLE

QuizCONTINUED


Postma AcceptsPosition in Florida

On Thursday, May 27,2004, Mark Postma,Executive Director of

MEDIC EMS resigned hisposition over the Iowa QuadCities 911 ParamedicAmbulance Service. Markwas a 22-year employee withMEDIC EMS and served asthe Executive Director for hislast 8 years. Mark was also theAt-Large representative to theIowa EMS Association Boardof Directors from 2001through 2002, serving as Chairof the Legislative Committee.

Mark has accepted the posi-tion of Chief Officer forParamedics Plus, L.L.C. aTyler, Texas company.Paramedics Plus was the suc-cessful bidder to begin 911Paramedic AmbulanceService to Pinellas County’sSunstar EMS System in theTampa Bay area beginningOctober 1, 2004. PinellasCounty has approximately900,000 residents and isserved by the Sunstar/Pinellas

County EMS System. MEDIC EMS is the not-

for-profit 911 ParamedicAmbulance Service in ScottCounty providing 911Ambulance and DispatchingServices. As ExecutiveDirector, MEDIC EMS hasgrown to 130 employees andprovides services in the IowaQuad Cities, LeClaire,Eldridge, and Clinton. Inaddition, MEDIC EMS provides dispatch services for Illini Hospital Ambulanceand MED-FORCE AeroMedical Services.

Mark has also served asChairman of the Board for theCommission on Accreditationof Ambulance Services for theUnited States. The QuadCity Times recognized Markas one of the Quad Cities“Movers & Shakers” in 2003.The Iowa Governors SafetyBureau also recognized him forpromoting safety in the Stateof Iowa.

The MEDIC Board ofDirectors has appointed Ms.Linda Frederiksen, as theInterim Executive Director.Linda has been the QualityManager for MEDIC EMSfor the past 8 years. AnExecutive Search will occurover the next few month’s bythe Board of Directors. ■

BY GARY IRELAND, IEMSA EXECUTIVE DIRECTOR

Enlisting new EMSrecruits has certainlytaken on a new mean-

ing in recent years, and to sayit is a challenging task is amajor understatement.Restocking the EMS providerranks is perhaps the sin-gle factor that is jeopard-izing the future of thevolunteer EMS systemway of life. The pool ofpotential recruits hasseverely diminished overthe years due to such fac-tors as rural populationdecline, job demograph-ics and childcare respon-sibilities to name a few.Coupled with theincreased cost of train-ing, daytime coverage inmany rural Iowa communitieshas reached dangerously lowlevels. Many volunteer EMSservice programs are just oneperson away from a disaster.That is, one person on thesquad becomes sick, movesaway or for some reason isunable to respond, and Iowa’sEMS safety net fails.

As the backbone of Iowa’sEMS system, volunteerism isstruggling to keep up with theincreased demands placed onEMS providers and serviceprograms. Higher trainingstandards, changing expecta-

tions by the public and EMScommunity, and the financialburdens of the volunteer serviceprogram have taken their tollon the system. Even thoughthe future of volunteerism looksa little bleak, new initiatives

directed at recruitment andretention of the volunteer EMSprovider is critical if Iowa is tocontinue with a volunteer EMSdelivery system.

So what’s an option? Ibelieve it takes more than justan ad in the local paper askingfor volunteers. It has been saidthat if you want the best tast-ing apple you should pick itjust before it hits the ground.If we want fresh new recruits,maybe we should get into thepublic schools before the stu-dents graduate. There havebeen a few studies made

regarding the use of 16 and 17year olds on first responseteams and as ambulance atten-dants. The results of the stud-ies have been mixed, and eventhough we know these youngadults are capable, I have

reservations about plac-ing these young people inan EMS environmentthat can be very cruel,even to the veteran EMT.There is, however, a mid-dle of the road option -using Iowa’s publicschool system - thatshould be explored.

A student EMS squadcreated to function with-in a school system couldprovide several benefits.High school students

could be recruited to form anEMS response squad thatwould be available at mostschool functions includingsporting events, fine arts per-formances, and social activities.Training could be completedby the local EMS squad andwould be very basic includingCPR, vitals, communications,and use of an AED. The stu-dent squad, properly attired,would only function at schoolevents and act as the initialresponders for the local squadshould an emergency arise. Itwould essential to announce

RECRUITMENT Retention Revisited

the student squad members ateach school event and giveannual recognition to thosewho serve, much the same asearning a sports letter.

By creating an EMS squadof high school students, youwill have, in effect, createdyour own collection or pool ofindividuals who can serve as afeeder program for the localEMS squad. Additional incen-tives could be offered e.g. edu-cation/training scholarshipsetc. to encourage these youngrecruits to stay. This recruit-ment tool is not an immediatefix, but by partnering with thelocal schools, it could pay bigdividends down the road.

There are other ideas (mostare not new) that should beconsidered/reconsidered whentalking about recruitment andretention. Do you rememberwhen you first became a mem-ber of an EMS squad? Yourenthusiasm was high and thenyou got bogged down withtime consuming extra dutiesthat you didn’t count on, e.g.,fund raising, collecting andentering data, equipmentchecks and maintenance, vehi-cle maintenance and publicrelations to name just a few. Itis those “extra duties” thatmany times pushes the volun-teer over the edge and causes areevaluation of priorities.

So what’s an option? Whenbeating the bushes for recruitswhy not seek communityminded individuals who wouldvolunteer to do some of these“extra duties.”


www.iemsa.net | 25

Honoring Our Own...

24 | www.iemsa.net

OVER THE YEARS, MANY EMS PROVIDERSHAVE GIVEN COUNTLESS HOURS OF THEIRDEDICATED SERVICE TO MANY IOWANS.SOME HAVE EVEN GIVEN THEIR LIFE AS ARESULT OF THEIR COMMITMENT TO IOWA EMS.

Please join IEMSA in honoring our own... EMS Providers who are no longer with us.These honorees may be volunteer or career individuals who have died in the last ten years.

Please send a photo along with the following information:

Decedent’s Name

Date of birth/Date of Death

Died in the line of duty YES NO

Years of service/Service name

Also include your name, address, and phone number shouldwe need to contact you.

Please send a stamped, self-addressed envelope if you wouldlike your photo returned.Deadline for entry is: September 24, 2004

Send to:Mr. Thomas SummittIEMSA1718 Timberline DriveMuscatine, Iowa 52761-2502

We hope to see you at the 15th Annual IEMSA Conference.Please join us for a moving memorial presentation,Remembering Our Own...

The Scoop on Scope:What’s Happening With EMS Scope of Practice?

BY ROSEMARY ADAM

This installment of thequarterly update toour EMS providers

will focus on how the sub-committee on Scope ofPractice functions, on whatinformation decisions arebased, and what happens tothe decisions once they aremade. We will include oneof the Scope questions frompast meetings, as well.

The EMS Scope of PracticeCommittee is made up of:• 2 physicians:

Dr. Carlos Falcon, (Chair)and one vacant position

• 1 RN: Rosemary Adam, RN, PS

• 1 EMS Service Director:Jeff Messerole, PS

• 1 Provider: Tina Young, PS

• 1 Training Program Rep:Cheryl Blazek, EMT-I

This is a subcommittee,appointed from the EMSAdvisory Committee inJanuary of 2003. The purpose is to review scope of practice issues and makerecommendations to theIowa EMS AdvisoryCommittee for consideration.

Decisions from the EMSAdvisory Committee regard-ing scope issues will be for-warded to the Bureau of

EMS for consideration forinclusion/exclusion in theIowa EMS Provider Scopeof Practice Policy. For somedecisions, Iowa rules mayneed to be changed.

The rational decision-making guidelines discussedin the Scope of Practiceissues include the following:• Is the skill needed in the

out-of-hospital setting,given prevailing standard of care?

• Can the EMS provider beexpected to enhancepatient care as a result ofusing the skill given theirscope of practice?

• What would be the educa-tional impact if the skillwere adopted?

• Would this skill/procedurebe applied universally to allcurrently certified providersfor the level(s) identified?

• Would this skill/procedurebe limited to specialty indi-viduals (e.g. documentationof additional training/education and protocol)?

Question: Can the EMT-Intermediate place a sternalIntraosseous device for thepurposes of fluid resuscita-tion in the adult patient?

No. There are no knowl-edge or skill objectives in theIntermediate ’85 or ’99

curricula that speak to indi-cations, contraindications,use and troubleshooting of intraosseous devices. This technique for fluid resuscitation is reserved forthe Iowa Paramedic (EMT-Intermediate), ParamedicSpecialist (EMT-Paramedic)and the CCP-endorsedproviders.

Follow-Up Question:If my Medical Directorwants us to do the adult IO,even though we are certifiedas I-’85 or I-’99, how do wechange this?

In order for a service pro-gram to provide a skill out-side a particular EMS level’sknown scope of practice, a“Pilot Project” would need tobe applied for. This beginswith a literature search thatwould document credibleresearch that shows patientcare benefit from this addi-tional skill, an educationallesson plan, supporting docu-mentation from the ServiceMedical Director and somelogistical information aboutthe Service area.

The next meeting of theScope of Practice subcom-mittee will meet October13th at the Altoona FD.Please, contact the Bureau ofEMS for times. ■

There are individuals in thecommunity who may not bethe least bit interested in takingEMS training and doingpatient care, but might beencouraged to be a part of theEMS squad and perform otherduties. These other dutiesmight include childcare,employee replacement, dataentry or maintenance. Thiswill give the EMS providers abit of reprieve and allow themto do what they really volun-teered for…emergencyresponse. The only little differ-ent twist to this strategy is thatit is important that these “otherduty” volunteers are identifiedas a part of the squad, e.g.,attire, pagers, etc. Their con-tribution to the squad needs torecognized as important as thecertified EMS provider.

Recruitment and retentionof EMS providers is a bigchallenge for volunteer squads.If squads around you don’tseem to have a problem gettingand keeping personnel, youneed to find out why. Trysomething new or revisit someof the old standards. ■

(Continued from page 23)

RECRUITMENT Retention Revisited


It is time to consider yourAt-Large and Regionalrepresentation on the

IEMSA Board of Directors.The representatives electedwill serve two-year termsbeginning in January, 2005.These positions are currentlybeing held by Melissa Sally-Mueller — At-Large, KayLucas & Bill Fish — SWRegion, Bruce Thomas &Judy Rurup — NC Region,Roger Heglund — SCRegion, Kirk Dighton — NERegion, Tom Summitt &Brian Jacobsen — SERegion.

The following are guide-lines for this process. Nomination Requirements:• The nominee must be an

active member of IEMSAfor two years or more.

• Nominations can be sub-mitted by using the formatprovided.

• Nominations must bereceived in the IEMSAoffice by September 24,2004 at noon.

Upon receipt at theIEMSA office, the nomina-tions will be checked toensure compliance with thenomination process. The

nominee’s membership statuswithin the association willalso be verified.

Successful nominations willcomprise the final ballotwhich will be mailed onOctober 8, 2004. These bal-lots will be due back in theIEMSA office by November8, 2004. Detailed instructionswill be provided on the ballot.

We urge all members withan interest in becominginvolved with their profes-sional organization to consid-er nomination. Please com-plete and return the At-Large/Regional NominationForm by September 24, 2004.

Y o u r i n v o l v e m e n t t r u l y m a k e s a d i f f e r e n c e !

AT-LARGE/REGIONAL Nominations Requested

AT-LARGE/REGIONAL Nomination Form

Must be returned to the IEMSA office by September 24, 2004

Nominee’s Name:

Company/Service:

Address:

City/State/Zip:

Phone Number:

Brief biography of nominee (50 words or less — usea separate sheet of paper if necessary):

Nominator’s Name:

Phone Number:

MAIL TO:

IEMSA — At-Large/Regional Nomination2600 Vine Street, Suite 400West Des Moines, IA 50265

The IEMSA Annual EmergencyMedical Services recognition banquetwill be held at the 2004 conference on

Friday, November 12 at the Polk CountyConvention Center. This time is dedicated tothe recognition of EMS leaders in the Stateof Iowa. The nomination criterion is listedbelow. Please write a letter ofrecognition/nomination and return it toIEMSA with your completed nominationform. The Award Nominations must be post-marked no later than September 24, 2004.

CRITERIA FOR NOMINATION(You can nominate yourself)

INDIVIDUAL: The nominee must be currently certified bythe State of Iowa, have strong and consistentclinical skills at his/her certification level, andhave made an outstanding contribution to theEMS system either within or outside ofhis/her squad or service. Award recipientsMUST be (or become) an active Iowa EMSAssociation member.

SERVICE: The nominee must be currently certified bythe State of Iowa, have made outstandingcontribution(s) in the last year to public rela-tions, information and education (PI&E),maintained a positive and outstanding rela-tionship with the community it services andtaken visible and meaningful steps to assurethe professionalism of its personnel and thequality of patient care.

FRIEND OF EMS:Any individual who has made outstandingcontribution(s), which enhance the quality ofEMS at the local, regional or state level.

HALL OF FAME: Any individual who has made outstandingcontributions to EMS during longevity in thefield (10+ years). This individual may besomeone to recognize posthumously. Thiswill be an ongoing plaque displayed in theAssociation Office.

INSTRUCTOR: Any individual who instructs and/or coordi-nates on a full-time or part-time basis; hasdedication to EMS through instruction, num-ber of years in EMS and/or number of yearsinstructing EMS.

DON’T MISS THIS

OPPORTUNITY

TO RECOGNIZE

SOMEONE DESERVING

RECOGNITION!

CALL FOR IEMSA Award Nominations


In 1882, the City ofDavenport establishedits first paid fire depart-

ment. Davenport FireDepartment, (DFD)replaced the many volunteerunits located throughout thecity. The first fire chief ofthe paid department wasMarsh Noel. By 1905, theCity of Davenport couldboast of seven engine compa-nies and two truck compa-nies providing protection. In1960, a third truck companywas added and in 1994, aneighth engine company wasadded with the opening ofStation 8 in the city’s north-east corner. With this addi-tion, the capabilities of theDFD rose to its currentcompliment of 11 companiesat 7 strategically located firehouses.

Emergency MedicalServices within the firedepartment dates back to the1940’s. At that time, thedepartment went on “resusci-tator calls.” DFD expandedits services in the early1970’s with some of the first

certified EMT’s in the Stateof Iowa. In 1980, the firedepartment began operatingas a First Response organiza-tion and was first certified bythe Bureau of EMS in 1994.The department equipped itscompanies with Life Pak300, a semi-automatic defib-rillator in 1995. In 1997, thedepartment upgraded its per-sonnel to EMT-Intermediateby holding a number ofEMT-I courses in house andboasted a very high suc-cess rate on both the writ-ten and practical exam.1998 brought the pur-chase of Life Pak 12’swith manual defibrillationand 12 lead capabilitiesand the hiring of Dr.Walter Bradley asMedical Director. Alsoin that year, DFD beganoperating at the “conditionalParamedic Level” as a non-transport agency. Thedepartment’s first full-timeEmergency Medical ServicesCoordinator was hired aftera national job search in 1999to oversee the department’sEMS Program.

The year 2000 broughtsignificant growth to theDavenport Fire Department.All of its 8 engine companieswere capable of operating atthe Paramedic Level andmany days do. At a mini-mum, the fire department

operates at the IntermediateLevel. Quad City SafeCommunities, a community-wide coalition with the goalof reducing senseless injuriesand death, was formed in2000. DFD is a foundingmember of this importantorganization and embracesprevention efforts as animportant part of our mis-sion. DFD is the first firedepartment based, perma-nent fit station for child safe-

ty seats in Eastern Iowa. Seeing a community need,

in 2003, the fire departmentestablished a Tactical EMSProgram, a joint venturebetween the fire departmentand Davenport PoliceDepartment. This programis designed to provideadvanced life support in tac-tical law enforcement situa-tions. In addition, Dr.Walter Bradley was namedEMS Medical Director ofthe Year by the NationalAssociation of EMT’s at itsannual meeting.

Affiliate Profile

Davenport Fire DepartmentIEMSAAWARD

nomination form

INDIVIDUAL: Volunteer Career

SERVICE: Volunteer Career

INSTRUCTOR: Full Time Part Time

FRIEND OF EMS:

HALL OF FAME:

Nominee’s Name:

Address:

City/State/Zip:

Phone:

Certification Level & Number:

Nominator’s Name:

Address:

City/State/Zip:

Day Telephone:

Evening Telephone:

DEADLINE: SEPTEMBER 24, 2004

MAIL NOMINATIONFORM AND LETTER OF RECOGNITION/NOMINATION TO:IEMSA Awards2600 Vine Street, Suite 400West Des Moines, IA 50265

30 | www.iemsa.net

DFD is committed toEMS at both the local andstate levels. Our EMSCoordinator serves as thePresident of the county EMSAssociation and as a SE rep-resentative to the IEMSABoard of Directors. In addi-tion, he serves on the Boardof Directors for TrinityCollege of Health Sciences,EMS Section.

The Davenport FireDepartment, under the com-mand of Chief Mark Frese,responded to over 8,000 calls

for EMS in 2003. All eightengine companies and onetruck company respond asparamedic-capable rigs andthe remaining two truckcompanies respond at theIntermediate Level. Theaverage response time forEMS calls is 3.4 minutesanywhere in the City ofDavenport.

Our units are staffed withfirefighters cross-trained asEMS providers. The followingare the current EMS certifica-tions and the number of per-sonnel at each certification. • First Responder (3)• Emergency Medical

Technician — Basic (42)• Emergency Medical

Technician — Intermediate (65)

• Emergency MedicalTechnician — Paramedic (30)

The Davenport FireDepartment provides a rapid

EMS response, with highlytrained and skilled personnelcapable of handling medicalemergencies professionally.We recognize that successfuloutcomes depend on howwell we do our job.

Chief Frese, Dr. Bradleyand the Davenport FireDepartment are committed toimproving patient care andwill continue to work jointlywith the medical community toprovide the best emergencymedical services possible. TheCity of Davenport can beproud of the emergency med-ical services it provides to thecommunity and its visitors.Our most important goal con-tinues to be the consistent pro-vision of the finest, mostadvanced, pre-hospital care.Working with the dedicatedmen and women of DavenportFire Department, that goal willnot be difficult to achieve. ■

2004 Board of DirectorsPRESIDENTJeff Dumermuth

VICE PRESIDENTJohn Hill

SECRETARYRosemary Adam

TREASURERBruce Thomas

IMMEDIATE PAST PRESIDENTJeff Messerole

NORTHWEST REGIONJeff MesseroleEvan BensleyJohn Hill

SOUTHWEST REGIONRod RobinsonKay LucasBill Fish

NORTH CENTRALREGIONBruce ThomasJohn CopperJudy Rurup

SOUTH CENTRALREGIONJeff DumermuthBrad MadsenRoger Heglund

NORTHEAST REGIONRic JonesLee RidgeKirk Dighton

SOUTHEAST REGIONTom SummittCindy HewittBrian Jacobsen

AT-LARGERosemary AdamMelissa Sally-Mueller

EDUCATIONCheryl BlazekLori Reeves

LOBBYISTCal Hultman

EXECUTIVEDIRECTORGary Ireland

ADMINISTRATIVEASSISTANTKaren Kreider

COMPLETE CONTACT INFORMATION IS AVAILABLE AT WWW.IEMSA.NET

IOWA EMERGENCY MEDICAL SERVICES ASSOCIAT ION

…collection …reporting - iemsa · 2006-06-16 · web-based product in one. emstat 4 allows...

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