N E W S	EMS DISPATCH
LETTER
Winter 2003	Southern Tier Regional EMS Council

ST RESCU High-Tech Certification/Re-certification Program Aims at Helping to Solve R/R Issues in the STREMS Region!

Rural Health Networks Of The Finger Lakes Region

Southern Tier Regional Emergency Medical Services, Southern Tier ALS, and Rural Health Networks have cooperated in a project to bring the region a new and innovative approach to Cardiopulmonary Resuscitation and Advanced Cardiac Life Support recertification. "Southern Tier Regional Emergency Skills Certification and Update" ST-RESCU

Southern Tier Emergency Medical Services

Table of Contents ST-RESCU  Page 1 Calendar events  Page 2> You've Got Mail  Page 2 PCR Requirements  Page 2 PCR Yellow Copies  Page 2 Grace Period?  Page 3 ID Cards  Page 3 New videos  Page 3 EMS Awards  Page 3 EMS Banquet  Page 3 Council Update  Page 4	The purposes of this project are to promote the recruitment, retention and reactivation of volunteer emergency response and paid personnel; and to offer professionals practicing in institutions within the service area of Southern Tier Emergency Medical Services (STREMS) a time and resource saving method of gaining and maintaining certification in Cardiopulmonary Resuscitation (CPR), advanced cardiac life support (ACLS) and Automatic External Defibrillation (AED) use.      STREMS will coordinate the ST-RESCU projects, and working with Chemung Valley Health Network (CVHN), S2AY Rural Health Network, Rural Health Network of Central Steuben and Rural Health Resources (RHR), Rural Health Networks that serve counties in our region, will provide the equipment and proper training for use of the system. When fully operational, the counties that will be served are Chemung, Schuyler and Steuben. Initial implementation of this project will be carried out by representatives of STREMS, CVHN, S2AY, RHNCS, RHR and STALS. All emergency response personnel, ACLS certified personnel, and those certified in CPR in the STREMS region will be eligible to use this system.
EMS DISPATCH Published by STREMS, Inc. 315 West Water Street, Elmira, NY 14901 Robert W. Nowlan, President; Maryann Sweely, Vice President; James J. Cummings, Treasurer; Ronald H. Kintz, Secretary; Robert C. Rajsky, Council Chairperson; Bernadette Josbeno-Oakes, Council Vice-Chairperson Sponsors: Chemung County, Schuyler County, Steuben County, Arnot Ogden Medical Center, Corning Hospital, Ira Davenport Memorial Hospital, Schuyler Hospital, St. James Mercy Hospital, St. Joseph's Hospital.	People who have already used the system say that it is thorough, fun and challenging. When fully functional, the certification process will be in two phases. The written exam and the skills demonstration will both be technology assisted. The review and update portion of the certification process will be completed at times and places convenient for the individual seeking certification and enrollment accessed through an Internet based product that will be password protected, and will reside on the CVHN server. After completion of the review portion of the certification and the computer based exam, an individual may access the mannequin that is equipped to document the demonstration of skills related to the certification that is being sought. Southern Tier ALS will issue the appropriate certification cards.
To cover this large geographic area, two systems will be required: one system to serve Steuben County, and one system of serve Chemung and Schuyler Counties. The ST-RESCU systems will be placed at various locations, including hospitals, local rescue units, local fire stations, and perhaps other locations in the counties.
Each of the two sets of equipment required for this project will consist of: Mannequins to document the demonstration of the skills portion of certifying (adult, infant) and intubation Interface hardware Laptop computer Instruction manual This project is a great example of how, when agencies work together, major strides in solving recruitment and retention issues can be achieved.      Continued funding for the program can be achieved by incorporating the system into the NYS Certifying courses taught by NYS DOH approved EMS Course Sponsors.      People who have already used the system say that it is thorough, fun and challenging. They all say that having the ability to "do it on their time" is awesome!      As the systems become fully functional, directions on how to access the systems and how to register will be on the STREMS web site: www.strems.org

"SPECIAL THANKS" to Joyce Hyatt from CVHN for her intense dedication to getting this program off the ground.

Contact us STREMS, Inc. Community marketplace 315 West Water Street Elmira NY 14901 (607) 732-2354 In New York State only: 1-800-343-1311

E-mail us: STREMS@stny.rr.com

Calendar events  Page 2 You've Got Mail  Page 2 PCR Requirements  Page 2 PCR Yellow Copies  Page 2 Grace Period?  Page 3 ID Cards  Page 3 New videos  Page 3 EMS Awards  Page 3 EMS Banquet  Page 3 Council Update  Page 4

     We all know how important it is to practice good documentation on our PCR's, but did you know it is just as important to check the correct boxes?

     As the program agency for the counties of Chemung, Steuben, and Schuyler, we are required by the state to screen every PCR for certain data points. The PCR's are then sent to the state contractor to be keypunched. That means they enter certain data off the PCR. That data is compiled and sent back to the regions for quality assurance.

     The current information the state is gathering is as follows:

• Date
• Location Code
• Agency Code
• Presenting Problem
• Number of Vitals taken
• Disposition Code

Any time one of these is not completed, we send the PCR back to you for completion. It is important that we get accurate and complete information, or the data we receive later is not helpful.

     A current concern is how the presenting problem area is being used, or not used. Please remember, anytime you transport a patient, regardless of disposition, you must check an appropriate presenting problem. On many PCR's we find the "other" box checked, and the problem written in the space provided, such as:

• SOB (Use Respiratory distress)
• Nausea and Vomiting ( Use Gastro-intestinal Distress)
• Passed out (Use Syncope)
• Overdose (Use Substance Abuse)
• Fever (Use General Illness)

Some of the things that could legitimately go under other are:

• Transfer
• Pt assist
• Non-Ambulatory
• Protocol ( when a patient is transported with out complaint, but Protocols require transport)

     Why are we concerned that you check the right box? The state does not record what you write in that space. So we will get data back showing a lot of "other" presenting problems, not the number of Respiratory distress of Substance abuse cases you actually had.

     One of the results of PCR data is funding for EMS education. If you shortchange the data system with information now, you will be shortchanging yourselves education funding in the future.

     One other thing to note is the recording of vitals. In order to receive credit for a set of vitals, you must have pulse, respiration, and blood pressure documented. Statements like "Normal", "good cap refill", "good radial pulse" does not count as a vital sign.

     We appreciate the effort that routinely goes in to your documentation and completion of the PCR's.

     Last year we received a letter from the Department of Health, informing us that PCRs could no longer be left at the hospital. STREMS staff and Council officers have had several conversations with DOH personnel, and we have resolved the situation, so we can continue to leave PCRs at the hospitals.

     In the Emergency Department at each of the Southern Tier hospitals, you will find a yellow box with the STREMS logo on it. The box should be locked, and there will be a wide slot in the side of the box. This is for your PCRs. The reason for the locked box is confidentiality. PCRs must be kept confidential. For this reason, the hospitals have agreed to a confidentiality policy for PCRs, which states that if PCRs are handled in a public area, they will be in an envelope or closed folder, and that any copies made for QI purposes will have the name blacked out, and will be destroyed when their purposed is completed.

     Please leave your completed yellow copies of the PCR in the yellow box at the ER. They will be sent to STREMS at the end of each month. You may also mail them directly to STREMS, but be sure they are kept confidential at your station.

Mark your calendar... March 20 - Training Committee, 6:15 PM, Hilton Gardens Inn March 20 - Southern Tier Regional EMS Council, 7PM at the Hilton Gardens. April: no Council meeting May 16: EMS Banquet - see flyer included in newsletter. ID photos may be taken at the office on the third Tuesday of every month, or by appointment, or by Vanessa at any Defib inservice.

Contact us: at 607-732-2354 or 1-800-343-1311. Bob - ext. 10 Cathy - ext. 19 Linda - ext. 11 Dr. Huffner - ext. 12 Judy - ext. 13 E-mail: strems@stny.rr.com Linda: linda-johnson@stny.rr.com Judy: judy-blair@stny.rr.com Cathy: cathy-auge@stny.rr.com Bob: BRajsky@aomc.org Office hours are from 8:30AM-4:30PM, M-F.

"You've got mail!" If you have an e-mail address, you can receive this newsletter and other publications from STREMS delivered to your desk! Send an e-mail to: strems@stny.rr.com and ask to be put on our mailing list. You can receive EMS Dispatch, The Volunteer Connection, Council agendas and minutes, course announcements, notices of upcoming events. Tell us what you'd like to receive.

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"Oh, my card runs out at the end of next month, and there are no courses available. Good thing there's a grace period." Wrong - there is no grace period, there never has been. Your CFR/EMT card works just like your driver's license - when it's expired, you are out of business.

So what can you do? Well, if your CPR card is current, you can do CPR. But you cannot practice as a CFR or EMT until you get your certification renewed.

What you can really do is to prevent expiration from happening. Keep an eye on your expiration date; if your certification expires in May or June, sign up for a course in September. Your new certification will give you 37 months plus any time left on your old card, up to nine months! Whenever your card expires, there is no reason to wait until the last minute to recertify. There is no guarantee that there will be a course where and when you need it. Get into a course six to nine months ahead of your expiration date. You won't lose any of the time on your card.

STREMS ID cards are provided for certified personnel who are active in regional EMS agencies. The purpose of the card is identification of EMS-trained personnel at incidents with multiple-agency response.

The expiration date on the ID card is not the same as your EMT card. Due to the variation in expiration dates on EMT cards (see explanation above), we often do not know your expiration date. So STREMS ID cards have their own expiration dates.

The STREMS ID card authorizes you to practice EMS in the Southern Tier, but is in no way a substitute for your State certification, which you must maintain current at all times.

Airway Management - Anatomy & physiology, adult vs. pediatric; Airway compromise issues; Airway equipment and body substance isolation; Limitations of diagnostic airway equipment and body substance isolation

Hazardous Materials: Awareness, general roles & responsibilities, zones; Routes of entry; Treatment of patients; Personal protective equipment, field decontamination, rehabilitation of personnel.

Psychiatric Emergencies - cognitive impairments; affective behavior impairments; schizophrenia; restraint & control of violent patients

Emerging Issues: Needlestick legislation; divert status; EMS as extension clinic; retention of EMS personnel; tiered EMS response

Man vs. Heavy Metal: Environment /Occupational Accidents; Farm and Agricultural Accidents, Industrial Accidents; Field Amputations

Patient Assessment: Head & Neck; Chest & Abdomen; Back, Soft Tissues, Extremities; Systems

To borrow a videotape, contact the STREMS office. Tapes are loaned for up to two weeks, to instructors, students or active EMS personnel in the Southern Tier Region. Ask for a copy of the complete video list, or download it from http://www.strems.org/videos.html

Enclosed in this newsletter is the description of the EMS Award Categories, and the qualifications for each, at http://www.health.state.ny.us/nysdoh/ems/emsawards.htm. Also enclosed is a nomination form for the awards.

All nominations will be considered for the Southern Tier's regional awards, and the winners will be submitted for the State awards. When you nominate someone, please be specific as to what that person has done to deserve the award - and it must be something done during 2002.

Deadline for award nominations is April 15. All nominations must be typed on the form provided by the Department of Health, at http://www.health.state.ny.us/nysdoh/ems/emsawardsapp.pdf and submitted to the STREMS office at 315 West Water Street, Elmira NY 14901.

Please feel free to make as many copies of the nomination form (front and back, please) and the qualifications, or contact the STREMS office for additional copies.

The EMS Banquet will be held on May 16, at the Corning Country Club. Cash bar from 6-7PM, dinner at 7.

The evening will include a buffet dinner, a special surprise speaker, EMS Awards, and will conclude with a DJ and dancing.

Tickets are $10 per person until May 1, then $15. Make checks payable to STREMS, Inc.

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Southern Tier Regional EMS Council

Recent Council activities:

The Training Committee continues to review and assess course evaluations and grades.

STREMAC: Regional Weapons of Mass Destruction training is needed for all EMS providers. All courses beginning in the STREMS region after November 1st, 2002 are to include at least the 4-hour DOD WMD provider course within the curriculum.

Revisions to the AED Policies and Procedures were approved.

Respirator mask for airborne disease for personal protection, N95 is the mask that has been approved for EMS.

The AED applications for a five year renewal were approved for: Cameron Volunteer Fire Department, Golden Glow Volunteer Fire Department, Watkins Glen Fire Department, Canisteo Fire Department, Cohocton Fire Department/Ambulance, Big Flats Fire Department, Savona Fire Department, Toshiba Display Devices Inc., Addison Volunteer Fire Department, Caton Fire Department, Erin Volunteer Fire Department and Schuyler County Volunteer Ambulance Association. ILS renewal applications were approved for Cameron Volunteer Fire Department and Woodhull Volunteer Fire and Ambulance Corps. ALS renewal was approved for Schuyler County Volunteer Ambulance Association.

Election of STREMAC members: Elected to two year terms were Dr. Huffner as Chairperson, Dr. Chipman, Dr. Klick, Dr. Manganaro, Dr. Naber, Dr. Rob-shaw, Dr. Seaman as Vice Chair, and Dr. Bernett.

Public Relations: The EMS Awards Banquet will be held May 16, 2003, at the Corning Country Club.

Gold Stars of Life was devel-oped by the Public Relations committee, it's an instant recog-nition of either a job well done or a pat on the back or an atta-boy type of award of anything that anybody does that you want to recognize them. Gold Star of Life postcards available from STREMS. Gold Stars of Life nominations: Gene Buchanan of Bath Ambulance and Rural Metro; Ron Kintz, executive director of STREMS Incorporated.

Quality Improvement continues to review regional QI reports. The revised QI manual was approved and distributed; addi-tional copies are available on the website or from the STREMS office. Each area hospital now should be using a yellow locked box in their emergency departments for the PCRs. There is a PCR collection and confidentiality policy number 02-1 on file at the STREMS.

From the Executive Committee, acting as the Nominating Commit-tee: Six members, whose terms expire at the end of 2002, were approved for a four-year term: Mary Buth, Dave Crowley, Donny Duvall, Rick Kimball, Kathy Lunney and MaryAnn Sweely.

Election of Officers: Bob Rajsky we re-elected Chairperson, and Bernadette Josbeno-Oakes, Vice Chairperson.

Links to Council minutes - verbatim and summaries - can be found here: http://www.strems.org/council.html#meetings

Council meetings are held at 7PM on the second Thursday of January, February, March, May, June, September, October, and November. The May, June, September and October meetings are held at the Lodge on the Green in Painted Post; the November, January, February and March meetings are at the Hilton Garden Inn in Big Flats. Meetings are open to the public; visitors are welcome.

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Instant recognition for a job well done, by anyone involved in EMS – CFR, EMT, AEMT (EMT-P, EMT-CC, EMT-I), RN, MDs, “Ambulance driver,” EMD, Instructors, etc...

To recognize:
     *Special situations managed with ease
     *Professionalism
     *Some task done that was above and beyond the “call of duty”
     *Someone who deserves a “pat on the back”
     *Any time that you want to recognize a task well done.

It is not intended to be a substitute for the annual awards.

Nomination cards are included in this newsletter, or are available at the STREMS office, the Council meeting, or nominations can be made via the STREMS website at http://www.strems.org/goldstars.html.

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Is there something you would like to see in the Dispatch? Is there a certain subject that you would like explained? Would you be willing to write an article for the Dispatch? Contact the STREMS office at 732-2354 or write to us.

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