EMS Update: April EMS Update: April 20112011

Our Current StaffOur Current Staff

40 Members in Moscow Volunteer Emergency 40 Members in Moscow Volunteer Emergency Ambulance Company; a Company of the Ambulance Company; a Company of the Moscow Volunteer Fire DepartmentMoscow Volunteer Fire Department

19 of our members are students19 of our members are students 14 are Advanced EMTs14 are Advanced EMTs 4 Paramedic 4 Paramedic Rendezvous Program Rendezvous Program Latah County Mutual AidLatah County Mutual Aid

Classes in Structural Firefighting, Rescue, Classes in Structural Firefighting, Rescue, Wildland Firefighting, HAZMAT, Incident Wildland Firefighting, HAZMAT, Incident Command, and EMSCommand, and EMS

Approximately 20,000 hours of training each Approximately 20,000 hours of training each yearyear

100+ Members100+ Members 22 Student Resident Firefighters22 Student Resident Firefighters Staff: Fire Chief, Fire Marshal, Training Staff: Fire Chief, Fire Marshal, Training

Officer, EMS Division ChiefOfficer, EMS Division Chief

Moscow Volunteer Fire Department Moscow Volunteer Fire Department Moscow Volunteer Emergency Ambulance Moscow Volunteer Emergency Ambulance

CompanyCompany

Individual members

Crew Coordinators

MVFD Command

Staff

Ambulance Company Officers

1st Lieutenant

2nd Lieutenant

EMS Division Chief

MVFD Fire Chief

Secretary

Treasurer

Board Representative

MVFD Board

MVEAC has 4 MVEAC has 4 Ambulances Ambulances

3 Stations

M-40M-40

Moscow Call StatisticsMoscow Call Statistics

Our volunteers respond Our volunteers respond from home, work, and from home, work, and schoolschool

MVEAC Operates under MVEAC Operates under the direction of our the direction of our Medical Control Medical Control Physician Dr. McKinnon, Physician Dr. McKinnon, according to the according to the standards of Idaho EMS, standards of Idaho EMS, a division of Idaho a division of Idaho Health and Welfare.Health and Welfare.

Bravo, Charlie, Delta, Bravo, Charlie, Delta, Echo calls get an Engine Echo calls get an Engine Company Response in Company Response in addition to an addition to an ambulance.ambulance.

Whitcom Whitcom Dispatch Dispatch

Latah Co Latah Co S.O. S.O. Dispatch Dispatch

Level of ServiceLevel of Service

Basic Emergency Medical Basic Emergency Medical TechnicianTechnician 120 hour class; 40 hours 120 hour class; 40 hours CMECME

Intermediate EMTIntermediate EMT 70 hour class; 30 hours CME70 hour class; 30 hours CME (soon 250 hour class)(soon 250 hour class)

Paramedic Paramedic 1500 hour class; 70 hours CME plus1500 hour class; 70 hours CME plus skills maintenanceskills maintenance

Latah County Emergency Medical Services

Council

Overview of EMS personnel and calls in Latah County:Personnel Calls (from ID EMS 6/09)

Deary 22 79Genesee 9 54Juliaetta/Kendrick 10 87Moscow 46 1321Potlatch 18 241Troy 11 75Total: 116 1857

2009 Council Projects in Process:Safety LED Lights 116@ $43 = $4988Reflective Vests 116@ $50 = $5800EMT Books 30@$100 = $3000Training/ Cont.EdDVD package $5374Protocols Update 116@$10 $1160Vaccinations 15 @ $200 $3000Testing Fees 30 @ $45 $1350Masimo CO Det. $4000

Current officers/ Members:Present: President Dave Reynolds - Moscow, Vice-President N. Cody Anderson - Moscow, Treasurer Bill Krick – Genesee, Secretary Sue Krick – Genesee, Teresa Quimby – Potlatch, Debi Swinney – Potlatch, Brent Carpenter – Potlatch, Donna Opresik – Deary/Troy, Tina Carlstrom – J/K, Marci Williams – LCSO, Keith Scott – Deary, Val Norris – J/K, Rose Norris – J/K, Debra McKinnon – Gritman, Dan Carscallen - Moscow.

EMT Scope of PracticeEMT Scope of Practice

CPR with semi-auto AEDCPR with semi-auto AED Airway with simple adjuncts; BVMAirway with simple adjuncts; BVM Wound care and bandagingWound care and bandaging Splinting and spinal immobilizationSplinting and spinal immobilization OxygenOxygen Extrication and Incident CommandExtrication and Incident Command

Intermediate ScopeIntermediate Scope

Field intubation Field intubation AutoventAutovent Field Intravenous access and fluid Field Intravenous access and fluid

administrationadministration Additional assessment trainingAdditional assessment training

Paramedic ScopeParamedic Scope

Manual Defibrillation, Synchronized Manual Defibrillation, Synchronized Cardioverson, External PacingCardioverson, External Pacing

Rhythm recognition; 12 lead optional Rhythm recognition; 12 lead optional Intubation; CPAP; Alternate airways; PedsIntubation; CPAP; Alternate airways; Peds Thoracotomy; Crycothyrotomy; IOThoracotomy; Crycothyrotomy; IO Optional RSI and PericardiocentesisOptional RSI and Pericardiocentesis Up to 30 medications pre-hospital, Up to 30 medications pre-hospital,

including pain mgmt and drips.including pain mgmt and drips. ACLS and PALSACLS and PALS Critical Care TransportCritical Care Transport

Medications:   Dose   Med Kit InventoryAmbulance Inventory

Cache Gritman Cache St1

PIXUS full/ minimum

AdenocardAdenosine 6mg/12mg   5 @ 6mg   5 @ 6mg 5 @ 6mg  

Albuterol Ventolin 1.25-2.5mg   5 5 10 10  

Aspirin   325mg   1 bottle 1 bottle 1 bottle 1 bottle  

Atropine Sulfate   0.5-1mg   3 @ 1mg 3 @ 1 mg 3 @ 1mg 3 @ 1mg  

Calcium Chloride 10%   0.5-1g SL   1 @ 1 g 1 @ 1g 1 @ 1g 1 @ 1g  

Dextrose 25%   0.5g/k   1 @ 2.5g 1 @ 2.5g   2  

Dextrose 50%   1g/kg   1 @25g 1 @ 25g 1 @ 25g 10 @ 25g  

Diazepam Valium 5-10mg SL   2 @ 10mg       10/2

Diltiazem Cardizem .25mg/k SL   1 @ 1g 1 @ 1g 1 1  

Diphenhydramine Benadryl 25-50mg   2 @ 50mg 2 @50mg      

Dopamine Intropin 2-20ug/k/m   1   1    

Epinephrine 1:10,000   1mg   5 5 5 5  

Epinephrine 1:1000 Adrenolin 0.3-0.5mg   1 multi 1 multi 1 1  

Furosemide Lasix 0.5-1mg SL   100mg 100mg 100mg 100mg  

Glucagon   0.5-1mg   1 1 1 1  

Lidocaine 2%   1-1.5mg   3 @100mg 3@100mg 3 3  

Mag Sulfate   1g;2g;4g   1 @ 5g 1 @ 5g 1 1  

Meperidine Demerol 50-100mg   2 @ 100mg       10/2

Midazolam Versed 2-4mg   2 @ 5mg       5/2

Morphine Sulfate   2-5mg   2 @ 10mg       10/2

Naloxone Narcan 0.4-2mg   1@.4/1@10mg 1 @ 10mg 5 @ 0.4mg 3 @ 10mg  

Nitroglycerin   0.4mg   1 1 1 1  

Sodium Bicarbonate, 8.4%   1mEq/k   0 1 1 1  

Regional Air Transport Regional Air Transport from Spokanefrom Spokane

Life Flight LewistonLife Flight Lewiston

Welcome to Life Flight Network.htm

Latah Latah County County

EMSEMS

Latah CountyLatah County

PopulationPopulation 35,02935,029 Land AreaLand Area 1,077 Sq Miles1,077 Sq Miles Over 65 years old 10%Over 65 years old 10% Housing unitsHousing units 14,97014,970 Mutual Aid Agreement hosted by Mutual Aid Agreement hosted by

local fire departments, expanded local fire departments, expanded to EMSto EMS

Current Latah County Current Latah County EMSEMS

All agencies and personnel are All agencies and personnel are Volunteer*Volunteer*

Potlatch, Troy, Genesee, Deary/Bovil, Potlatch, Troy, Genesee, Deary/Bovil, Juliaetta, Kendrick, and MoscowJuliaetta, Kendrick, and Moscow..

*One paid Paramedic/EMS *One paid Paramedic/EMS Administrator (60% time) in all of Latah Administrator (60% time) in all of Latah County, from Moscow Ambulance.County, from Moscow Ambulance.

Approximately 1800 EMS responses Approximately 1800 EMS responses annually.annually.

MVEAC Paramedic MVEAC Paramedic ProgramProgram

Concept began 10-12 years agoConcept began 10-12 years ago– Operational in 2006 with limited Operational in 2006 with limited

availabilityavailability– Paramedic Rendezvous within one Paramedic Rendezvous within one

weekweek 1 to 5 Paramedics as they join and 1 to 5 Paramedics as they join and

leaveleave M40 Jump Car w/ Zoll E from grantM40 Jump Car w/ Zoll E from grant

– In service Feb. 2008In service Feb. 2008

Recruitment and Recruitment and Retention ChallengesRetention Challenges Heavy load on long term resident Heavy load on long term resident

local volunteerslocal volunteers Moscow EMS relies on students who Moscow EMS relies on students who

graduate and move on.graduate and move on. Turnover forces continuous classes Turnover forces continuous classes

and trainingand training Turnover and retention is a top issue Turnover and retention is a top issue

for all Latah County EMS agenciesfor all Latah County EMS agencies Top issue nationwide for volunteersTop issue nationwide for volunteers

EMS ClassesEMS Classes

A Basic EMT class is needed every fallA Basic EMT class is needed every fall ALS class every spring (until new ALS class every spring (until new

requirements take effect)requirements take effect) Paramedic Classes every two yearsParamedic Classes every two years

Challenges (cont)Challenges (cont)

How does a volunteer program survive?How does a volunteer program survive? Increasing costs across the budgetIncreasing costs across the budget Shrinking pool of volunteersShrinking pool of volunteers Increasing Urban/Rural interfaceIncreasing Urban/Rural interface

– More families in rural areasMore families in rural areas– Longer transport timesLonger transport times– More time on calls for EMS personnelMore time on calls for EMS personnel

Our success……Our success……

Paramedic Rendezvous program Paramedic Rendezvous program Opperates as Mutual AidOpperates as Mutual Aid 1 to 8 calls per month1 to 8 calls per month Immediate life threatImmediate life threat

– Multisystem traumaMultisystem trauma– Cardiac eventCardiac event

Extremely successfulExtremely successful

What are the goals of What are the goals of this community?this community? Public Expectation: Fully staffed Public Expectation: Fully staffed

paramedic ambulances with rapid paramedic ambulances with rapid response times.response times.

Can we maintain Paramedic Level Can we maintain Paramedic Level Service 24/7?Service 24/7?

Will a tiered response be effective?Will a tiered response be effective? Can the local infrastructure support Can the local infrastructure support

Paramedic Level Response?Paramedic Level Response?

Out of Area TransportsOut of Area Transports

Completed March 2011Completed March 2011 Need: critical care transportNeed: critical care transport Changes in other agency Changes in other agency

availability and weatheravailability and weather

EMS LegislationEMS Legislation

EMS Systems AuthorityEMS Systems Authority– Draft legislation regarding EMS system Draft legislation regarding EMS system

Re-organization Re-organization 2009 Housekeeping/Temp. bill from 2009 Housekeeping/Temp. bill from

Idaho EMSIdaho EMS

-Education Rules in process-Education Rules in process

Ski Patrol?Ski Patrol?