EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday - PowerPoint PPT Presentation

MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday February 2, 2017

MATTHEW CONSTANTINE DIRECTOR INTRODUCTIONS

TEC January 18 th 2017

Ground on scene time ‐ 90 th percentile ‐ Filtered 25.0 20.0 15.0 10.0 5.0 0.0

Ground Scene Time ‐ Average ‐ Unfiltered Chart Title 50 40 30 20 10 0 NOV OCT AUG JULY JUNE DEC SEPT

Ground Scene Time ‐ Average ‐ Filtered Chart Title 60.0 50.0 40.0 30.0 20.0 10.0 AUG SEPT JUNE OCT JULY DEC NOV 0.0

Core Measures Reported Delay December November October September August None ‐ Under 10 Min 18 14 14 11 9 None ‐ Over 10 Min 6 16 15 8 7 Other ‐ Description 0 0 9 8 4 Other ‐ No Description 3 11 2 0 0 Safety/Crowd/Staff 1 0 0 2 3 Language Barrier 0 0 0 0 0 Extrication >20min 2 3 3 0 0 Distance/Vehicle Crash 1 0 0 0 0 Other Hospital 0 0 0 0 0 Reporting Error 0 0 0 0 0 Extremis 0 0 0 0 0 Calls Over 10 min (44%) (68%) (68%) (62%) (56%) Total Calls 34 44 44 45 23

MGT 439 Seat Availability • MGT 439 Pediatric disaster prep and response training will be held April 13 th ‐ 14 th at Public Health. • Remaining seats are few and are filling quickly. If you would like a spot please contact me as soon as possible to ensure you have a seat. • George Baker. 661 ‐ 868 ‐ 5218. BakerG@co.kern.ca.us

Car Seat Technician • Kern County EMS is sponsoring a car seat inspection class and clinic march 6 ‐ 10 th with a seat inspection and installation clinic on the 11 th . • The class is 8 hours a day for 4 days and the cost is 84.00 per attendee. The class will be held at Olive Drive Training Facility. • We strongly encourage participation from all stakeholders. • Register at cert.safekids.org and click on Become A Tech.

Standardized Pediatric Drug Formulary System Collaborative Meeting February 2 nd , 2017

Drug Errors in the Pediatric Population • Research has shown that medication errors in children occur in 35% of cases primarily due to pediatric resuscitations being high stress, low frequency and high stakes situations. • Errors occur due to many factors including the need for rapid determination of weight, calculations of medications based on the formulation of the drug creates undue stress for prehospital providers. Implementation of a standardized formulary can reduce • pediatric medication errors significantly as well as allow the EMS provider to focus on what is important, life saving management.

Ensuring Pediatric Drug Safety • Ensuring the right medication and the right dose EVERYTIME is the ultimate goal in utilizing a standardized formulary. • By pre ‐ calculating all medication dosing in kg and mLs on a length based resuscitation tape we can ensure safe drug delivery in the prehospital setting. • Current use: 1. High risk in low volume emergent situations. 2. Multiple drug concentrations/formularies. 3. Increased risk of errors.

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

Pros and Cons • Pros: 1. System wide consistency for pediatric drug administration. 2. Reduction in provider stress and medication errors. 3. Streamlines new hire training and information retention. 4. Liability reduction. • Cons: 1. Initial cost of new length based tapes. 2. Drug shortages may cause significant inconsistencies with the formulary.

Length based tape use • In order for a standardized formulary to function all EMS providers must become accustom to using the length based tape every time on any patient less than 15 years old. Mila medical based in Carlsbad Ca. produces a product known as • Dose by Growth. This device is a length based tape very similar to the Broselow device but all drug dosages are pre ‐ calculated using the local jurisdictions formulary and protocols.

Length Based Tape Pre ‐ Calculated Example From Dose by Growth

ReddiNet Bed Availability / MCI Response

MCI Response

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

Year To Date 70 60 50 40 30 Alerts Responses 20 10 0 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 74.60% 48.39% 73.68% 91.94% 83.33% 66.67% 50.82% 41.18% 96.83% 58.82% 47 30 14 57 10 42 31 7 61 10 63 62 19 62 12 63 61 17 63 17

Patient Distribution

Pt Dist I D M Total BHH 1 0 0 1 0.45% BMH 0 0 36 36 16.22% DRMC 0 2 6 8 3.60% KMC 18 16 82 116 52.25% KVH 0 0 0 0 0.00% MER 1 1 10 12 5.41% MSW 0 0 9 9 4.05% RRH 0 4 0 4 1.80% SJCH 0 2 19 21 9.46% Tehach 0 0 15 15 6.76% Total 222

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

Year To Date 8 7 6 5 4 Alerts 3 Responses 2 1 0 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 60.00% 50.00% 75.00% 100.00% 50.00% 83.33% 66.67% 80.00% 100.00% 50.00% 3 3 3 7 2 5 4 4 6 2 5 6 4 7 4 6 6 5 6 4

Patient Distribution

Pt Dist I D M Total BHH 0 0 0 0 0.00% BMH 0 0 0 0 0.00% DRMC 0 0 0 0 0.00% KMC 0 1 0 1 6.25% KVH 0 0 0 0 0.00% MER 0 0 0 0 0.00% MSW 0 0 0 0 0.00% RRH 0 0 2 2 12.50% SJCH 0 0 5 5 31.25% Tehach 0 0 8 8 50.00% Total 16

Bed Availability

Bed Availability Reporting Number of Number of Number of Days Days Days B.A. B.A. B.A. not reported >1 Reported reported December BHH 15 16 0 BMH 31 0 30 DRMC 30 1 19 KMC 31 0 29 KVH 11 20 0 MER 31 0 30 MSW 31 0 25 RRH 30 1 23 SJH 29 2 28 THD 31 0 30

2016 Number of Days B.A. Reported Number of days B.A. reported >1 400 365 365 364 364 364 364 363 352 350 343 343 340 350 319 312 301 300 273 250 219 200 141 150 100 71 50 18 0 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

Bed Availability Reporting Number of Number of Number of Days Days Days B.A. B.A. B.A. not reported >1 Reported reported January BHH 15 16 0 BMH 31 0 28 DRMC 30 1 23 KMC 31 0 28 KVH 10 21 0 MER 30 1 22 MSW 28 3 20 RRH 31 0 17 SJH 31 0 31 THD 31 0 30

2017 Number of Days B.A. Reported Number of days B.A. not Reported 35 31 31 31 31 31 31 30 30 30 30 28 28 28 25 23 22 20 20 17 15 15 10 10 5 0 0 0 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

Rotor ‐ Wing Air Ambulance Performance Standards

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

Proposed Revisions • Deletion of multiple requirements – Requirements of law were re ‐ stated (i.e. employment law) • Deletion of repetitive statements • Revision of multiple sections to comply with ADA • Added direction of Statewide work

Public Comment Period • Posted for public comment – January 26, 2017 through February 26, 2017 • Submit comments to Jana Richardson

Lay Person AED Policy

Lay Person AED Policy • Title 22, Division 9, Chapter 1.8 was repealed • Health and Safety Code Division 2.5, 1797.196 • Public comment period began on January 26 th and will end February 26, 2017.

Ambulance Destination Decision Policies and Procedures

Public Comment • Published for public comment – November 4, 2016 through December 4, 2016 • Received one comment

Next Steps • EMCAB Approval – February 9, 2017

Burn Center Designation

Public Comments • Final public comment period December 1 ‐ 15, 2016 • Received three comments

Next Steps • EMCAB for approval – February 9, 2017

MATTHEW CONSTANTINE DIRECTOR ANNOUNCEMENTS

MATTHEW CONSTANTINE DIRECTOR THANK YOU FOR COMING HAVE A GREAT MONTH