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  • Monday, March 09, 2015 3:35 PM | PAAW Administrator (Administrator)
    The Wisconsin Physicians Advisory Committee (PAC) met on March 4 to offer its recommendations regarding use of nitrous oxide for pain management, and replacing RSI with Medication Assisted Advanced Airway and expanding options for trained personnel, other than Paramedics, to perform the lifesaving procedure. 

    Use of nitrous oxide was recommended by PAC for ambulance services at the EMT-Intermediate Technician level and higher.  Nitrous oxide is a medication inhaled by mask for patient pain management, and a skill already approved in the National Curriculum.  PAC and the EMS office are currently working through a best practices document before any approvals are given to ambulance services.  In its final form the document will detail education and training requirements as well as exposure, safety and diversion procedures.  Dr. Charles Cady, Wisconsin’s EMS medical director, contacted several state medical directors about their experience using nitrous oxide for pain management.

    Rapid Sequence Intubation, or RSI as it is commonly referred, is a medication induced airway management procedure that includes paralytics and currently requires two Paramedics at the patient's side.  PAC recommends RSI be replaced with Medication Assisted Advanced Airway, and that the medically induced paralytic procedure be administered by two airway trained technicians, of which one must be a Paramedic.  In addition, PAC recommended all new intubating ambulance services have wave form ETCO2 capabilities and all existing intubating services must have it by 2021.
  • Friday, February 27, 2015 2:25 PM | PAAW Administrator (Administrator)
    The American Ambulance Association is requesting industry support with sending your members of Congress letters in support of cosponsoring H.R. 745 and S. 377 by accessing the AAA online letter writing tool.  A sample letter is already preloaded and the tool will automatically determine your members of Congress and send them your letters.  It is easy to use and will only take a few minutes.

    The Medicare Ambulance Access, Fraud Prevention and Reform ActH.R. 745 and S. 377 would make the current temporary Medicare increases of 2% urban, 3% rural and the super rural bonus payment permanent.  Participants should also ask their members of Congress to support an extension of the increases, which expire on March 31. 
  • Wednesday, February 25, 2015 8:16 AM | PAAW Administrator (Administrator)
    A Live Internet and Call In Radio Style Show


    The Professional Ambulance Association of Wisconsin is pleased to announce it will debut its newest digital media program, Wisconsin EMS Live, on Tuesday March 10, starting at 9:00 a.m. central time.

    Wisconsin EMS Live is an internet radio program that can be heard live on the internet or by calling in the second Tuesday each month starting at 9:00 a.m. central time, and when important news breaks. 

    The program is dedicated to discussing EMS in Wisconsin that offers information, perspective and clarity.  Persons can listen to the live program on any internet connected device, or by calling into the show to listen only or ask a question of the co-hosts or guests.  Each episode is recorded, so if you miss the live broadcast you can always listen to a previous episode on-demand.

    According to PAAW Executive Director Joe Covelli, “The past four years we’ve produced a recorded webcast, called EMS to the Point.  The program has done well with over 50 episodes and more than 30,000 downloads".  He added, “One element was missing however – interaction with the listener.  Wisconsin EMS Live changes that by involving hosts, guests and listeners with live call in or chat capabilities”.

    Four co-hosts will provide the show’s dialog, to include:  Chris Anderson, Operations Director, Bell Ambulance, Milwaukee; Joe Covelli, Executive Director, Professional Ambulance Association of Wisconsin; Patrick Ryan, President, Ryan Brothers Ambulance, Madison; and Dan Williams, Director, Emergency Services of Door County, Sturgeon Bay.

    The March 10 debut is scheduled to run from 9:00 to 10:00 a.m. central time and is dedicated to discussing Community Paramedine.  CP, or Mobile Integrated Healthcare as it is also referred, is a conversation building attention and momentum, especially with system models suddenly popping up and being tested in Wisconsin by some departments.  In addition, the program will include conversations with EMS Advisory Board Chairman Jerry Biggart and EMS leadership expert John Becknell.

    The dial in number to listen only or speak with the co-hosts is 646-929-1081.  You can also listen or chat in questions via any internet connected device. 

    For more information, go to www.PAAW.us/wisconsinemslive.

    Don’t miss a beat of Wisconsin EMS action!

  • Tuesday, February 24, 2015 8:21 AM | PAAW Administrator (Administrator)
    Fire departments across Milwaukee have started making home visits to patients as part of what is turning out to be a successful community paramedicine program.

    West Allis is one of the five departments in the county involved in the program designed to prevent patients from frequently calling 911 for problems that can be better handled with improved care, CBS 58 reports.

    The department makes home visits to 29 patients. In 2013, those patients accounted for 857 911 calls, 596 ER visits and 571 ambulance unit hours. Since starting the home visit program in January 2015, none of the patients have called 911.

    After 90 days, the department plans to review the results of the program.

    Source: CBS 58 Milwaukee

  • Thursday, February 19, 2015 11:49 AM | PAAW Administrator (Administrator)
    By Jerry Biggart, Chairman, Wisconsin EMS Advisory Board

    The members of the Governor appointed EMS Advisory Board were shocked to learn the Board was slated for elimination due to being inactive for the last year. The record reflected that we met and worked diligently at every meeting that was scheduled. On behalf of the Board I formally communicated with Department of Health Services, Department of Administration, and the Governor’s Office, in addition to the Professional Fire Fighters of Wisconsin, Professional Ambulance Association of Wisconsin, and Wisconsin EMS Association leadership sending a unified message that elimination of the EMS Board would be detrimental to the State, its citizens, and the EMS stakeholders.
     
    I believe that the Governor and the citizens can be proud of the diversity, effectiveness, dedication, unimpeachable integrity, and expert consultation provided by the EMS Board volunteers that he has appointed. The EMS Board applauds the Governor for removing the recommendation to eliminate the Board prior to the initial budget being released. The Board will seek modifications with the Department of Health to ensure that this debate isn’t repeated moving forward.
     
    This coordinated effort is an example, from a growing list of examples, where EMS advocates representing all EMS providers in Wisconsin, worked together with one unified voice. EMS stakeholder representation is stronger than it’s ever been, and with this renewed spirit of cooperation we will continue to achieve great things.
  • Wednesday, February 18, 2015 3:07 PM | PAAW Administrator (Administrator)

    For a lot of EMS providers, it’s difficult to imagine an entire country not having a single ambulance. But until August 2014 that was a reality in the West African nation of Burkina Faso.

    Now, after not having a single ambulance to serve its population of 17 million until a few months ago, Burkina Faso, a country about eh size of Colorado, will soon be receiving a second, thanks to a donation from Ryan Brothers Ambulance Service, based in Madison, WI, in December.

    The windfall for Burkina Faso can be largely traced to two people: Hassimi Traore and Dawn Kiernan.

    Traore, a chemistry professor at the university of Wisconsin-Whitewater, is a native of Burkina Faso. When he just 12 years old, he witnessed his best friend, his “brother,” get hit by a car hit by a car in his home village of Dédougou. There is no 9-1-1 system in Burkina Faso, so the only way to a clinic or hospital was to walk or, at the time, go by a cart pulled by livestock. Because Traore’s friend was unable to reach a clinic, he died.

    Traore told himself that one day he would help his village so people wouldn’t have to die because there was no way to get to a hospital.

    To fulfill this vow, in 2011 Traore purchased a 1990 Ford ambulance. It took him three years to pay it off with his own money. That was the ambulance that was delivered to Burkina Faso in August.

    It was while he was raising funds to get the ambulance and medical supplies over to Africa that Traore was introduced to Kiernan, an EMT in Whitewater. Kiernan helped send out nearly 700 letters asking for assistance with the endeavor, one of which landed in the lap of Ryan Brothers co-owner Patrick Ryan.

    Ryan notes company policy dictates once a vehicle hits 200,000 miles it can longer be used to transport patients. “Normally we’d remount it, but this time I remembered that letter I’d received,” Ryan says. “I thought, let’s just get a new one and donate this ambulance.”

    In addition to the ambulance, Ryan Brothers donated a variety of back-up medical equipment and supplies to stock the rig. And when it starts its new life in Burkina Faso this spring, it will bring a little Wisconsin with it as a reminder of where it came from.

    “All of the Ryan Brothers decals will remain on the ambulance,” says Kiernan. “The one we took over in August even still has its Wisconsin license plate.”

    Sorely Needed

    To say the new ambulance will be a benefit to the people of Burkina Faso is an understatement.

    According to Kiernan, Burkina Faso’s only hospital is staffed by just six doctors—three general practitioners, one OB/GYN, one pediatrician and one surgeon. The first ambulance serves an area with a population of about 1.8 million people. Since August, it’s already transported about 500 patients, people who might never have made it to the hospital previously.

    Kiernan was able to accompany the first ambulance on its trip to Burkina Faso with a group of volunteers, though the group hit a snag when the ambulance got waylaid in Ghana. “We’d hoped to do some training with the staff in Dédougou, but with our supplies unavailable we couldn’t do as much as we wanted.”

    Still, Kiernan, who says she’s found a friend for life in Traore, plans to return to Burkina Faso with another group to continue the work she’s started. There, Kiernan and her colleagues will be able to provide more extensive EMS training and provide some much-needed assistance in an area where medical supplies and manpower are often scarce. “We’ll go back over once the threat of Ebola has truly subsided. Our goal is to bring other EMTs, stay in Dédougou and work in the hospital for a couple weeks.”

    Source: Jason Busch is an associate editor for EMS World.

  • Wednesday, February 18, 2015 7:57 AM | PAAW Administrator (Administrator)
    Guest:  Dr. Steve Stroman, Medical Director at Eagle III, Oshkosh Fire, DePere Fire and Rescue, and Oconto Falls Area Ambulance

    Over the years, I’ve seen local ambulance service medical directors engaged in policy, procedures, trainings, and quality improvement projects.  Unfortunately, we have medical directors at the other end of the spectrum who are never seen and their name not known by the people working under their MD license.

    When Dr. Steve Stroman from the Green Bay area stood up at last September’s Paramedic Systems of Wisconsin Conference and rattled off over six or seven major initiatives they completed for the year, I listened in amazement.  In this webcast Dr. Stroman offers some great ideas from the medical director’s perspective, and projects they’ve recently completed that you can easily pick up on and do the same.

    Topics covered, include:

    • Identifying gaps in protocols, process and delivery
    • Intra nasal medications
    • Use of ketamine
    • Spinal protection procedures (not immobilization), cost savings
    • Airway video laryngoscopy
    • Cyanide toxicity kit
    • Physician oversight at scene calls
    • 15 lead EKGs

    There’s something to be learned in this webcast.  It’s more than what’s being done, but also what you can do with some effort and collaboration.  EMS departments often strive or boast to be the best.  Proof is in your system’s performance and your next great initiative.  The ideas shared in this webcast can be a good conversation starter. 

    >> Click here to listen now!
  • Tuesday, February 03, 2015 8:06 AM | PAAW Administrator (Administrator)
    The goal is to have seven healthcare coalition regions established in Wisconsin by July 1, 2015.  The regions are determined by the Department of Health, and mirror the previous WHEPP regions, which had been established by patient referral patterns.

     

    Wisconsin identified some gaps in widespread healthcare coordination, to include: coordinated plans for large scale disasters, lack of a formal regional medical coordination structure, established indicators for crisis standards when systems are overwhelmed, evacuation plans, and patient tracking capability.

     

    Healthcare coalitions don’t replace day-to-day functions of individual responder agencies or organizations.  Wisconsin is following a federal model that grew out of recent event experiences with the Joplin tornado and Hurricane Sandy.  The goal is to coordinate how public health, healthcare institutions, and first responder agencies will manage their efforts to enact a uniform and unified response to an emergency, specifically the medical surge aspect of an event.

     

    Get the latest information on Wisconsin’s Healthcare Coalition efforts in this webcast from co-medical advisor Dr. Michael Clark. Click here to listen  now!

  • Friday, January 30, 2015 4:51 PM | PAAW Administrator (Administrator)
    MTM recently announced they will be holding three town hall meetings for their transportation partners.  They are inviting comment on the Wisconsin non-emergency medical transportation (NEMT) program.

     

    MTM, the state of Wisconsin’s non-emergency Medicaid and BadgerCare Plus transportation broker who schedules ambulance and other rides for medical appointments was recently criticized in a Journal Sentinel article for long wait times. 

     

    The town hall meetings will be held in the West Milwaukee area on March 31; the Black River Falls/Tomah area on August 4; and the Green Bay/Appleton area on November 3. The West Milwaukee meeting is scheduled for the Pewaukee Holiday Inn from 5 p.m. to 8 p.m. Locations for the Black River Falls/Tomah and Green Bay/Appleton meetings are TBD and will be announced as the dates approach.

     

    To RSVP, click here

  • Wednesday, January 28, 2015 4:53 PM | PAAW Administrator (Administrator)

    The union for Green Bay firefighters has lost a nearly two-year fight against a city initiative requiring firefighters to make house calls on discharged hospital patients.


    A state labor arbitrator has ruled the city was within its rights to initiate a program in which Bellin Hospital paid the city $50 for each house call.

    But whether the so-called Hook and Ladder program will move forward in its original structure remains to be seen.


    City officials suspended the program indefinitely while awaiting a decision on the grievance filed by the Green Bay Professional Fire Fighters Association.


    The union argued that Hook and Ladder was an improper expansion of firefighters duties and that the city could not impose such new assignments unilaterally under the union's contract.


    >> Read more


    Source:  Green Bay Press Gazette

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