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National Association of State Emergency Medical Services Officials (NASEMSO)

National Association of State Emergency Medical Services Officials (NASEMSO). SCOHTS Annual Meeting April 28-30, 2010 Dia Gainor, Chief, Idaho EMS Bureau Chair of HITS Committee. NASEMSO – Who are we?. National organization representing all state and territorial EMS offices.

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National Association of State Emergency Medical Services Officials (NASEMSO)

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  1. National Association of State Emergency Medical Services Officials (NASEMSO) SCOHTS Annual Meeting April 28-30, 2010 Dia Gainor, Chief, Idaho EMS Bureau Chair of HITS Committee

  2. NASEMSO – Who are we? • National organization representing all state and territorial EMS offices. • All states have lead EMS agency, most often housed within the Department of Health or Department of Public Safety - In some states an independent agency/board. • State EMS agencies are generally responsible for oversight of ambulances and EMS personnel (paramedics, EMTs, first responders) and a variety of other regulatory and grant programs.

  3. NASEMSO Highway Incident and Traffic Systems (HITS) Committee HITS Committee purpose: • Engage NASEMSO on highway safety issues relevant to EMS. • Collaborate with highway safety partners (nationally and at state level) to promote their understanding of EMS and to identify opportunities for cooperative efforts to reduce injuries and save lives.

  4. Why are we here? • Foster relationships with highway safety colleagues in SCOHTS. • Explore ways to join efforts to pursue common priorities. • Describe our new Highway Mass Casualty Readiness Project, a joint effort between EMS and highway safety representatives.

  5. NASEMSO Highway Mass Casualty Readiness Project • Two-part project conceptualized in response to Mexican Hat, Utah, motor coach crash. • Funded by NHTSA, Office of EMS. • Multi-disciplinary work group designing two new tools to assess EMS capabilities by region and segments of highways. • Kick-off meeting held April 27-28, preceding SCOHTS meeting.

  6. NASEMSO Hwy Mass Casualty Readiness Project: Work Group • Dia Gainor, CHAIR Chief, Idaho EMS Bureau • Mary Hedges, Prog Advsr, NASEMSO • Jolene Whitney, Deputy Dir Utah Bureau of EMS • Richard “ Chip” Cooper EMS Bureau, NH Dept of Safety • Kelly Hardy, Hwy Safety Prog Mgr AASHTO • Bob Pollack, Safety Data Mgr Ofc of Safety, FHWA, Wash., DC • Susan McHenry Ofc of EMS, NHTSA • Katherine Burke Moore, Ex Dir MN EMS Regulatory Board • Dennis Blair , Director Alabama EMS Office • Loren Hill, Consultant, OTC MN Dept. of Public Safety • Mark Bush, Operations Prog Mgr AASHTO • George Kennedy , MD NM EMS Medical Director • Tom Martin, Op. Prog Coord I-95 Corridor Coalition • Dan Mack, Asst Fire Chief Miami, OH • Robert Oenning WA State 9-1-1 Director • John Saunders, Dir, Hwy Sfty Srvcs, VA Dept Motor Vehicles • Bill Castagno, EMS Chief, UMDNJ University Hospital, Newark NJ • Tom Judge, Executive Director LifeFlight of Maine, Bangor, ME • Cynthia Wright-Johnson MD Institute for EMS Systems • Jeff Salomone, MD Emory Univ, Atlanta, GA

  7. Mexican Hat Motor Coach Crash • Charter bus with 53 passengers overturned on rural highway near Mexican Hat, Utah, in January 2008. • Crash not reported for 36 minutes. • 1st EMS Unit reached scene 1 hour after crash. • Victims still being transported more than 4 hours after crash. • 9 killed and 43 seriously injured. • No “Golden Hour” advantage.

  8. Motor coach , post-crash 50 of 53 occupants were ejected

  9. Mass casualty incidents on rural stretches of highway pose challenges • Mexican Hat crash demonstrated importance of ready access to features taken for granted in emergency response situations, e.g., • Communications access (ability to call 9-1-1) • Quick EMS response • Advanced Life Support (ALS) level of care • Access to trauma centers • None were available in this sparsely populated area. • Given the limitations, emergency response performed exceedingly well.

  10. EMS Response & Transport • San Juan County’s 8 ambulances - all volunteer, Basic Life Support (BLS) • Kayenta Navajo Nation- 4 BLS ambulances • Moab-Grand County EMS- 3 ALS ambulances • Mesa County Colorado – 2 ambulances • Durango, Colorado – 2 ambulances • Air ambulances grounded due to weather • Closest hospital - 75 miles • Closest Level 1 Trauma Center- 190 miles

  11. NTSB recommendations to AASHTO & NASEMSO In letter dated 5/29/2009: Work with the Federal Highway Administration (FHWA) to develop and implement criteria based on traffic patterns, passenger volumes and bus types that can be used to assess the risks of rural travel by large bus types. (NTSB Safety Recommendation H-09-08)

  12. NTSB Recommendation to NHTSA/OEMS for FICEMS(Federal Interagency Committee on EMS) “Develop a plan that can be used by the States and public safety answering points to pursue funding for enhancements of wireless communications coverage that can facilitate prompt accident notification and emergency response along high risk rural roads, as identified under SAFETEA-LU criteria, and along rural roads having substantial large bus traffic. (H-09-04)”

  13. NTSB Recommendation to NHTSA/OEMS for FICEMS(Federal Interagency Committee on EMS) “Evaluate the system of emergency care response to large-scale transportation-related rural accidents and, once that evaluation is completed, develop guidelines for emergency medical service response and provide those guidelines to the States. (H-09-5)”

  14. Part 1: Event Response & Readiness Assessment (ERRA) • Evaluation tool to assess degree of optimum preparedness for responding to mass casualty events. • To be used by local, regional or state EMS agencies for self-evaluating readiness to respond. • Assessment results can influence EMS and highway safety programmatic decisions. • Can be used as scorecard, establishing benchmarks and progress made.

  15. ERRA Example for State • Benchmark: The location of persons calling into 9-1-1can always be identified. • Indicator: The entire state is covered by Enhanced (“E”) 9-1-1(location of caller displayed). • Scoring: 0 = Not known 1 = No E 9-1-1 2 = Partial E 9-1-1 coverage 3 = Half of state covered by E 9-1-1 4 = Most of state covered by E 9-1-1 5 = Entire state covered by E 9-1-1

  16. Part 2: Model Inventory of Emergency Care Elements (MIECE) • MIECE (pronounced “mice”) • Emergency Care Inventory, modeled after MIRE • Working Matrix of Data Elements • Use of defined characteristics of emergency care system • To display resource availability and system capacity by segments of highway

  17. MIECE Example • Data Element: Ground Ambulance • Definition: EMS vehicle that travels by ground, capable of transporting patient on cot, staffed by one or more persons trained to a minimum of EMT level • Priority: 1 • Ease of Data Collection: E (Easy)

  18. Highway Mass Casualty Readiness Project: Deliverables in 2011 • 1st Edition of Integration and Response Capability Assessment – ERRA • 1st scorecard of state level assessment findings • Draft Matrix of Emergency Care Inventory – MIECE • A Proof of Concept for MIECE

  19. Questions? Where do we go from here?

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