January 2004 EMS Wire Service

Waning Interest Shelves Pox Plan

Less than a year after it was launched, the U.S. government's much-ballyhooed smallpox vaccination plan is "dead in the water," according to USA Today.

"The fact is, it's ceased," the Centers for Disease Control and Prevention's Ray Strikas told the newspaper for its October 16 article.

The pace of vaccinations dropped significantly after reports last April of heart problems associated with the vaccine. States had expected to administer 450,000 doses to healthcare workers who would serve on response teams in the event of a smallpox outbreak, but at press time, fewer than 40,000 had been vaccinated.

Walter Orenstein, director of the CDC's National Immunization Program, said the program will be folded into a larger effort to prepare medical personnel to respond to a variety of biological weapons.

-USA Today

Symptoms Key to Detecting Anthrax

Key symptoms can help medical providers distinguish infection with inhaled anthrax from more common respiratory conditions like the flu, according to the Agency for Healthcare Research and Quality.

The AHRQ helped fund a study in which researchers at Cornell's Weill Medical College compared features of 28 inhalation anthrax cases (including 11 from the attacks of 2001) with more than 4,000 cases of common viral respiratory tract infections such as the flu. While symptoms such as fever and cough did not reliably differentiate between anthrax and flu/flulike illnesses, others did, most notably neurologic problems like dizziness and confusion; gastrointestinal symptoms like nausea and vomiting; and shortness of breath. All were more common in patients with inhalation anthrax.

The study's results are being used to create the first evidence-based prehospital screening protocol for anthrax attacks. For more, see the September 2, 2003 Annals of Internal Medicine.

-Agency for Healthcare Research and Quality

Docs Warn of Medicare Fee Fallout

More Medicare patients will seek care in emergency departments unless Congress changes the formula that determines Medicare payments to physicians, the American College of Emergency Physicians warned in a statement released in October.

Under the recently revised Medicare payment rule, payments to physicians will be cut by 4.5% beginning January 1.

In response to these cuts, "Physicians will become increasingly unable and unwilling to see additional Medicare patients," ACEP President Dr. J. Brian Hancock said. "Vital resources are being drained from emergency departments, which are already at the breaking point."

The group urged Congress to increase reimbursements to physicians under the schedule by at least 1.5% a year for the next two years.

-American College of Emergency Physicians

House, Senate Pass PSOB Extension

The public safety officer death benefit (PSOB) should soon be extended to providers who die of strokes or heart attacks while on duty following passage of the Hometown Heroes Survivor Benefits Act by both the Senate and House of Representatives.

Under the program, survivors of police, fire and EMS providers killed on the job receive a one-time financial benefit. The Act, which still must be signed into law by the president, would extend that benefit by presuming that any on-duty stroke or heart attack death is work-related. Previously, survivors had to prove a direct relationship between actions on the job and subsequent medical episodes to receive the benefit.

"Congressman [Bob] Etheridge [the bill's original House sponsor] and Senator [Pat] Leahy [who introduced a companion bill in the Senate] deserve a lot of credit for their tireless efforts to enact this measure," Congressional Fire Services Institute Executive Director Bill Webb said of the passage. "These [and other] members of Congress have demonstrated the bipartisan spirit of the Congressional Fire Services Caucus in working together to ensure passage of this important measure."

-Congressional Fire Services Institute

Action Items to Further EMS Research

EMS professionals at all levels must demand better evidence of effectiveness before implementing new products and procedures, the team of academics behind the EMS Research Agenda said in releasing eight recommendations to advance EMS research in the U.S.

Beyond this, a large cadre of career EMS researchers should be developed and supported, and standardized data collection must be implemented at the local, regional, state and national levels, they say.

The EMS Research Agenda, released in 2002, emphasizes the need for more and better EMS research. An implementation symposium held in June 2002 resulted in the recommendations, which were published in the October 2003 issue of Academic Emergency Medicine.

Other recommendations include the creation of Centers of Excellence to facilitate EMS research; that federal agencies that sponsor EMS research should acknowledge their commitment to it; that states, corporations and charitable foundations should support EMS research; that EMS professionals, systems and policy makers should apply the results of EMS research; and that the FDA and Office of Human Research Protections should work to identify consent barriers to EMS research and strategies to reduce their impact.

-Academic Emergency Medicine

Medtronic Promotes AEDs in Schools

Medtronic Physio-Control, maker of the Lifepak line of AEDs, has announced the launch of a national educational initiative to inform parents, students, educators and community leaders about the importance of having AEDs in schools.

The initiative, known as Lifepak Heart Safe Schools, was kicked off in October at Cardozo High School in Washington, DC, where three people have died from sudden cardiac arrest in the last two years. The school will be equipped with Lifepaks, and staff will receive CPR/AED training.

Central to the initiative is a website, www.aedhelp.com, by which parents and educators can get information on making schools "heart safe." It includes a "how-to" guide for AED implementation; funding ideas; AED site assessment information; special pricing for schools; and access to a training CD-ROM produced for high school students by the National Center for Early Defibrillation.

-Medtronic Physio-Control

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