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Patrick Ryan, PAAW President
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Current News and Information from PAAW

October 25, 2016

EMS Live Podcast
PSAP pre arrival cards developed by state EMS board

>> Click for on-demand playback.

This  EMS Live in Wisconsin podcast was recorded on Tuesday, October 25 and lasted 30 minutes.

Our guest was Josh Finke with the State of Wisconsin EMS Advisory Board subcommittee for EMS System Management.

The EMS Advisory Board recently developed a set of guidelines for local dispatch centers to use during certain high acuity calls.  These simple flow charts can make a major difference in the outcomes of patients.  This process has been used in other parts of the State with great success. 

The cards give dispatchers flow charts for pre arrival instructions for on hands only CPR, choking, AED and bleeding control.  If your ambulance service's dispatch center is not using pre arrival instructions the EMS Advisory Board recommends these instructions be utilized.  The three types of patients involved in these guidelines are low frequency and high acuity.  The pre arrival instructions given by dispatchers truly can be lifesaving.

>> Click to download pre arrival cards.

>> Click for on-demand playback. October 20, 2016

EMS Live Podcast

Legislative Study Committee on Volunteer Firefighter and EMT Shortages

Guests included committee members Dana Sechler and John Eich

>> Click for on-demand playback.

On Tuesday, October 11 EMS Live in Wisconsin podcast guests included Legislative Study Committee members Dana Sechler and John Eich.

The Legislative Study Committee on Volunteer Firefighter and EMT Shortages has been meeting every month since July, listening to testimony and receiving correspondence from industry experts, fire and EMS leaders and elected officials on the subject.  According to committee member Dana Sechler, "Eighty percent of the time legislative action comes out of a Study Committee". 

Wisconsin has been riding along as firefighter and EMT staffing shortages have grown year-over-year, and were foretold back when two state legislative study committees were convened in the 1990s to address the topic twenty years ago.  Nothing was done either time - and actually the State's EMS Office shelved the Wisconsin EMS Advisory Board's recommendations.  Just a couple years ago, Wisconsin had over 22,000 licensed First Responders, EMTs and Paramedics.  As of July 2016, that number decreased to 16,500.

Committee member John Eich mentioned during the podcast, "We don't have volunteer police officers in Wisconsin, and fire and EMS are part of the public safety net too."

Door County Emergency Services Director Dan Williams, who also served as chairman of the Wisconsin EMS Advisory Board in the 1990s and 2000s, the same board that offered recommendations to the two Legislative Study Committees in the 1990s, testified before the current Study Committee in August.  "We have to watch this very carefully.  We have to be very, very careful it is the right legislation.  This is a crucial problem - we have to get it right.", according to Williams.  >> Click to review William's presentation and recommendations.

The committee recently met on Tuesday, October 18.  Most of the discussion regarded testimony by a representative with the National Registry of EMTs, and reviewing in detail a memo authored by staff attorney Margit Kelly.  The memo provided a highlight of ideas from previous committee discussions.  >> Click to review Kelly's memo.

It seems the group is headed toward narrowing in on their recommendations based on what they've heard in testimony and various ideas or suggestions that have been offered.  Four different sets of legislation have already been proposed by legislators.

>> Click for on-demand playback.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

Legislative Study Committee listserv email created

Signup today to stay informed!

The Professional Ambulance Association of Wisconsin, in cooperation with the Wisconsin Office of Rural Health, has created a listserv email group dedicated to the firefighter and EMT volunteer shortage discussions currently taking place.  Signup to receive Legislative Study Committee updates, share your ideas and weigh in on the topic.

According to PAAW Executive Director Joe Covelli, "The listserv offers an immediate email communications link for those who would like to participate and stay on top of the latest information being discussed, recommended and decided.  We are coming to a point very soon when legislation is going to be introduced and debated".  Covelli added, "This is a pivotal time for the EMS and fire industry and communities they serve - ambulance services and fire departments need to pay attention to what is happening".

To subscribe to the listserv, click on the link below and enter your name and email address.  Link:  https://lists.wisc.edu/read/all_forums/subscribe?name=volunteer.  You may unsubscribe at anytime.
September 27, 2016

EMS Live Podcast
DNR Scene Calls, MTM Concerns, PSOW Highlights

>> Click for on-demand playback.

This podcast was recorded on Tuesday, September 27.

Have you ever been on a scene call where a patient's family states they have a DNR order for do-not-resuscitate, but they can't produce paperwork or the DNR bracelet isn't on the patient?  How about family wants to change the DNR order and states you must start CPR? What if a DNR order is on a patient from a different state - is it valid in Wisconsin?  DNR authority by EMS practitioners and potential misunderstanding, wrongful application and confusion on scene calls involving DNR paperwork happen.  Listen to this podcast as Helen Pullen with the State of Wisconsin EMS Office discusses DNR and POA.

MTM is Wisconsin's Medicaid broker to arrange medical patient transportation for beneficiaries, to include ambulances.  For the past many months, PAAW has been working diligently behind the scenes to resolve a longstanding problem in ambulance services being denied payment by MTM for approved services, or suffering the consequences of lengthy delays in payment that totals hundreds of thousands of dollars. During the podcast PAAW President Patrick Ryan offered an update.

Finally, the Paramedic Systems of Wisconsin conference was held in Green Bay in mid-September.  What were some of the hot topics and highlights?  Conference director Dan Williams shares a list of items that were important to ambulance service leaders.

>> Click for on-demand playback.

Don't miss a beat of Wisconsin EMS action - listen to EMS Live!

September 22, 2016

PAAW Holds Board of Director and Officer Elections

All incumbent board members with positions up for re-election ran unopposed at the Association's recent Annual Meeting.  Re-elected for another three-year term included, for profit ambulance seat Chris Anderson, Bell Ambulance, Milwaukee; government/municipal ambulance seat Mark Fredrickson, Gold Cross Ambulance, Brillion; and nonprofit ambulance seat Tom Tornstrom, Tri-State Ambulance, La Crosse.  Anderson and Tornstrom were also voted in as executive officers during their term as secretary and treasurer, respectively.

According to PAAW President Patrick Ryan, "The Board has shown stability and strength in several important areas, and Tom, Mark and Chris renewed their commitment through continuing in their board responsibilities.  We are grateful for their on-going service to PAAW and its members."

An example of this is Tom Tornstrom testified before the state Committee on TRIP, and Mark Fredrickson met with Gov. Scott Walker on TRIP days before the Governor signed the bill into law that directly benefited ambulance billing.  Chris Anderson was part of a contingent earlier in the year that met with Congressional House Speaker Paul Ryan.

September 12, 2016

Emergency Medical Responder
Draw up EPI now an option at EMR level

Recently, the EMS Board and the Physicians Advisory Committee (PAC) discussed and recommended the use of draw up EPI (Epinephrine) at the Emergency Medical Responder (EMR) level.

Department of Health Services has reviewed the EMS Board and PAC recommendations and approves the use of draw up EPI at the EMR level.

Any EMR Service wanting to use draw up EPI will need to first complete an Advanced Skills form (F- 00987C) prior to starting deliver of this new option.  >> Click for the Advanced Skills form (F-00987C).

September 12, 2016

Health Care System Research
Wisconsin scores well in health system rankings

PAAW ambulance service members part of these high-performing systems

This 2016 edition of The Commonwealth Fund’s Scorecard on Local Health System Performance assesses the state of health care in more than 300 U.S. communities from 2011 through 2014, a period when the Affordable Care Act was being implemented across the country. In comparing health care access, quality, avoidable hospital use, costs of care, and health outcomes, the Scorecard shows that many U.S. communities experienced improvements: fewer uninsured residents, better quality of care in doctors’ offices and hospitals, more efficient use of hospitals, and fewer deaths from treatable cancers, among other gains. Still, the persistence of widespread differences between areas is a reminder that many local health systems have yet to reach the potential attained elsewhere in the country.

Using the most recent data available, the Scorecard ranks 306 regional health care markets known as “hospital referral regions” on four main dimensions of performance encompassing 36 measures. Top-ranked regions in Hawaii, the Upper Midwest, New England, and the San Francisco Bay area have been performance leaders over time, and they offer achievable improvement benchmarks for policymakers, health system leaders, and community stakeholders.  >> Click for article.

National Ranking - Wisconsin Health Care Market Ranking (overall performance):

Rank 5 - Appleton

Rank 13 - Madison

Rank 15 - La Crosse

Rank 19 - Green Bay

Source:  Commonwealth Fund, 2016 Edition

August 29, 2016

EMS Live in Wisconsin Podcast
Advanced Certification for Critical Care Paramedics

>> Click for on-demand playback.

This EMS Live in Wisconsin podcast was streamed live on Tuesday, August 23 and lasted 30 minutes.  Our guests were Tyler Christifulli and Sam Ireland with LifeStar EMS in West Bend, Wisconsin.  We discussed critical care paramedic advanced training and certification options.

Recently, LifeStar EMS created an advanced internal critical care level that requires an advanced board certification (FP-C, CCP-C) . Their goal is to have their critical care paramedics meet all the same requirements as helicopter EMS services like Flight For Life and Med Flight. These are advanced certifications through the Board of Critical Care Transport Paramedic Certification (BCCTPC); exams are extremely tough and have a 20% pass rate.

The goal at LifeStar EMS is to encourage their critical care paramedics to keep taking steps forward to improve their knowledge.
For more information on certification and testing, refer to the BCCTPC website at https://www.ibscertifications.org/roles/critical-care-paramedic.

>> Click for on-demand playback.
August 27, 2016

Wisconsin Government
Legislative Study Committee on Firefighter and EMT Volunteer Shortages to meet August 30

The second meeting of the Legislative Study Committee on Firefighter and EMT Volunteer Shortages is scheduled for Tuesday, August 30 starting at 9:30 a.m. in Room 412 East at the State Capitol, Madison.  >> Click for meeting agenda.  The first meeting was held on July 26, and additional meetings are scheduled monthly until the end of the year.

>> Click for information regarding the Legislative Study Committee, to include member names, meeting minutes and information, PowerPoint presentations, audio recordings and more.

The Study Committee is directed to examine issues related to the shortage of volunteer firefighters and emergency medical technicians (EMTs) in the state, particularly in rural areas, and propose measures to address the shortage. Specifically, the Study Committee shall study all of the following: (a) the magnitude of volunteer shortages, the areas of the state most affected, and the potential impact of shortages on public health and safety and economic development; (b) whether current training and continuing education requirements contribute to the shortage; (c) relationships between full-time and volunteer emergency response departments and the impact that the shortage of volunteers has on nonvolunteer departments in neighboring communities; and (d) whether the creation of organizations, particularly in rural areas, may help address the shortage. The committee shall develop legislative options to meet needs identified.

August 27, 2016

EMS Product Savings
Naloxone (Narcan) purchases eligible for rebate

Wisconsin Attorney General Brad Schimel announced on March 23, 2016 details of a rebate program for the heroin and prescription opioid antidote naloxone, also known as Narcan.  State, county, and local government agencies, as well as law enforcement and other public and government entities that distribute naloxone are eligible for the Amphastar naloxone rebate.  The Professional Ambulance Association of Wisconsin was instrumental in bringing the rebate to Wisconsin, which is valued at approximately $6.00 per syringe, or a 25% savings.

Rebate forms must be submitted within 60-days of each quarter's end date. Please see Naloxone Rebate Instructions below for submission information.

  • Quarter ended July 30, 2016 (deadline to submit rebate September 30, 2016)
  • Quarter ends October 30, 2016 (deadline to submit rebate December 30, 2016)
  • Quarter ends January 30, 2017 (deadline to submit rebate March 30, 2017)
>> Amphastar Pharmaceuticals, Inc. Contract
>> Naloxone Rebate - Press Release
>> Naloxone Rebate Instructions
>> Naloxone Rebate Account Form
>> Naloxone Purchase Summary Rebate Form

August 27, 2016

National EMS News
Dr. Jon Krohmer named as next director of NHTSA's Office of EMS

The National Highway Traffic Safety Administration (NHTSA) is pleased to announce the appointment of Dr. Jon Krohmer as the Director of the Office of Emergency Medical Services (OEMS). Chosen from a field of more than 30 candidates, Dr. Krohmer comes to this position with a wealth of EMS experience and expertise and will lead NHTSA's collaborative efforts to improve emergency care across the nation.

Board certified as an emergency physician, Dr. Krohmer has been actively involved in EMS for over 30 years, first in his home state of Michigan, and then at the national level, as an active member of the American College of Emergency Physicians (ACEP) and president of the National Association of EMS Physicians (NAEMSP). Dr. Krohmer's federal service began as the Deputy Assistant Secretary for Health Affairs and Deputy Chief Medical Officer for the Department of Homeland Security (DHS). He went on to become the Director of the Health Services Corps for Immigration and Customs Enforcement at DHS and for the past year has provided medical expertise to the U.S. Coast Guard.

"Jon Krohmer's extensive expertise in EMS and experience in federal service will be great assets to the NHTSA EMS program," said Jeff Michael, NHTSA Associate Administrator for Research and Program Development. "His collaborative and patient-centered approach is very important for the EMS Program, which depends on partnerships to achieve its goals. We're very excited to have Jon as part of our NHTSA family."

Dr. Krohmer's first day at NHTSA will be on Tuesday, September 6th. You can learn more about NHTSA's Office of EMS and contact the office at www.ems.gov.

Upcoming Events

Current PAAW Priorities
Community Paramedicine Legislation
MABAS/WI Liability Protection Statute 893.80
State Medicaid Reimbursement & MTM
>> Legislative Study Committee on Firefighter and EMT Volunteer Shortages
Recognize Do-Not-Resuscitate Pendant

Next EMS Live Podcast

Tuesday, November 8

starting at 9:00 a.m. central time


To be determined

Dial in number to listen to the live show or speak with the co-hosts and guests:  


Or listen on any internet connected device - even email in a question.

Treating CHF patients with better results (Tyler Christifulli, Training Coordinator, Lifestar EMS, West Bend, WI)

Most recent EMS Live in Wisconsin Podcast - Listen Now!

Emergency calls or patient contacts to PAAW members last year

Over 272,000

>> See who's a PAAW member.  Not a PAAW member? That's okay. Subscribe to receive free email updates and alerts from PAAW.  >> Click to get started.


Crystal Wallin

Feature writer and La Crosse Paramedic

Recent blog posts by Crystal: Standby for Tones

Weekly IV Fluids and EMS Pharmaceutical Backorder Report

PAAW continues to monitor the ongoing EMS pharmaceutical drug and IV fluids backorder situation by posting weekly updates, courtesy of Bound Tree Medical.

Through a special arrangement with EMS World magazine, PAAW members and their employees or volunteers receive a free 12-month subscription, a $40 value. 

Stay on top of national EMS news, tips, a variety of topics and special reports - delivered right to your home or work address or e-mail account the beginning of every month!  >> Click to receive this benefit.

Monitor Police, Fire and EMS Radio Traffic Around the U.S.!

Browse over 2,000 police, fire and EMS scanner monitoring stations around the U.S. with a simple click of your computer mouse.  It's sure to make any scanner junkie go wild!

>> Click here to find out more about selecting your own monitoring station or click the scanner below to open the audio player for Milwaukee County Fire radio traffic.

Milwaukee County Fire
(click scanner below to activate feed)

Winamp Aplha Display

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