Report Claims EMS “Forgotten” in Planning, Funding; Leads to Senate Bill
Sparked by a report documenting deficiencies in EMS funding, training and equipment, Sen. Susan Collins (R-ME) introduced a bill in March intended to improve EMS preparedness by more effectively coordinating a number of federal programs.
Collins’ bill, the Emergency Medical Services Support Act, came on the heels of a report from New York University’s Center for Catastrophe Preparedness & Response entitled Emergency Medical Services: The Forgotten First Responder. According to that report, EMS received just 4% of total Department of Homeland Security preparedness funding in 2002–3. Among its other findings:
Fewer than a third of the country’s EMTs and paramedics participated in a chem/bio/radiological drill in the last year.
More than half have received less than an hour of training in chem/bio agents and explosives since 9/11, and 20% have received none.
60% of ambulance services have received no federal funds to buy equipment.
In half of all states, fewer than half of EMTs and medics have adequate equipment for a chem/bio response.
The report contains several recommendations, including creating legislation to establish a federal interagency EMS committee; developing EMS-specific terrorism-preparedness guidelines and standards; and increasing homeland security funding for EMS. For a summary, see www.nyu.edu/ccpr/events/20050311-000124.html. For the full report, see www.nyu.edu/ccpr/pdf/NYUEMSreport.pdf.
—USA Today, Center for Catastrophe Preparedness & Response
National Moment of Silence on May 28
The Sixth Annual National Moment of Silence in honor of fallen EMS providers will be held at 7 p.m. on May 28, coinciding with the yearly National EMS Memorial Service in Roanoke, VA.
The National Moment of Silence affords EMS personnel around the country the opportunity to join with those physically attending the Memorial Service in honoring and remembering fellow providers killed in the line of duty. All providers, agencies and emergency communications centers are invited to share 60 seconds of radio silence timed to coincide with the observation in Roanoke. In past years, more than 700 agencies and dispatch centers have participated.
The National EMS Memorial Service, now in its 14th year, will be held at the First Baptist Church of Roanoke. The Memorial Service and Moment of Silence are part of EMS Week, which will be celebrated May 19–25. For more, see page 22.
Those wishing to observe the Moment of Silence can receive instructions for doing so and a suggested script to precede it by visiting http://nmos.nemsms.org or e-mailing nmos@ nemsms.org. To get an idea of how many are participating, organizers ask that participating agency names, cities and states be submitted to the above e-mail.
For more on the National EMS Memorial Service, visit http://nemsms. org. For more on EMS Week, visit www.acep.org/emsweek.
—National EMS Memorial Service
AED Makers Agree: Training Is Important
One of the most important—and possibly the most important—aspects of AED deployment is educating people in how and when to use them, a panel of manufacturers agreed in February.
Representatives from five top AED makers—ZOLL, Cardiac Science, Philips, Medtronic and WelchAllyn—participated in a panel discussion about the role of AEDs in public health and safety at the American Safety and Health Institute’s (ASHI’s) third annual member conference. In a wide-ranging, brand-neutral exchange, they agreed that training is of paramount importance to AEDs’ effectiveness, be they in a corporate environment or a public-access setting.
Participants also agreed that the importance of AEDs is understated, but that it’s a positive sign that the devices are becoming more widely available. All agreed that they’d rather have an AED available—of any brand—than no AED at all.
City Council Mandates AEDs in NYC Locations
New York City’s gyms, parks, stadiums, golf courses, ferry terminals, senior centers, nursing homes and city buildings will be required to have defibrillators on premises under a law passed unanimously by the city council in February.
The mandate, passed by a 47–0 vote, will affect thousands of establishments. It follows a recently passed state law requiring AEDs in state buildings and health clubs with more than 500 members. The city will pay an estimated $1 million to equip its properties; private businesses will be forced to buy their own.
Supporters of the legislation say it will save many lives, given that the likelihood of surviving nonhospital sudden cardiac arrest in NYC is only about 1%. The American Heart Association estimates that up to 50,000 lives could be saved in the U.S. each year if defibrillators were more widely available in public places.
The legislation will take effect June 16.
Chiefs Voice Support for Hazmat Placards
Hazmat placards are essential to emergency responses involving trucks and trains carrying dangerous substances, a survey of fire chiefs has shown.
Ninety-eight percent of chiefs responding to a survey by the International Association of Fire Chiefs (IAFC) reported utilizing the placards in their responses, and the same percentage ranked having those placards as “critical” or “very important.” Removing them, many chiefs said, would make responses longer and more expensive, as any hazmat incident would have to be treated as a worst-case scenario.
The possibility of removing such placards has been broached as a homeland security measure. The IAFC opposes such a step unless an effective replacement system can be devised and implemented, and service members trained in it.
The survey was sent to 7,340 chiefs and officers, of whom 988 responded.
CDC Head Warns of Bird Flu Pandemic; Symptoms May Vary
Scientists believe it’s highly likely that the virus that causes “bird flu” will mutate into a form that infects humans, and warn that such a development could lead to a global pandemic as deadly as the influenza pandemics of years past.
“Our assessment is that this is a very high threat,” Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention (CDC), told members of the American Association for the Advance-ment of Science at their national meeting in February.
Human deaths in Asia have already been attributed to flu contracted from chickens or ducks; the mortality rate of such infections seems high: about 72% of identified patients. Cases of human-to-human transmission have thus far been rare, though several have been documented. Perhaps more ominous is that the virus has spread to cats and can apparently be passed between them.
The strain currently plaguing Asia is part of the H1 family of flu viruses. “Each time we see a new H1 antigen emerge,” Gerber-ding said, “we experience a pandemic.”
Researchers have also learned that the symptoms of bird flu can be more varied than previously thought. A four-year-old Vietnamese boy who died last year did not display the severe respiratory symptoms thought to be characteristic of the disease.
Since the boy’s death wasn’t linked to bird flu until after the fact, investigators are now concerned that other nonrespiratory cases have not been detected, and hence the total number of human cases has been underreported.
“All the surveillance…has been on respiratory infections,” Dr. Menno de Jong of Oxford University’s Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City told reporters. “This reported case shows bird flu can present in a different way. At this point, we don’t know whether this is a rare case or not, but we need to know the whole clinical spectrum of avian flu so we can know how many cases we really have.” For more, see www.cdc.gov/flu/avian/index.htm.
Incident Debriefing “Ineffective,” Says WHO
Single-session psychological debrief-ings—such as the CISD sessions many EMS providers routinely receive after stressful incidents—are not a desirable strategy to help people cope after emergencies, according to a report from the World Health Organization.
The WHO’s Department of Mental Health and Substance Abuse did not recommend such debriefing among several mental-health strategies it endorsed to help those affected by disasters. While it did not directly address emergency responders, WHO concluded that among civilians, at least, such debriefing is “likely ineffective” or even “counterproductive,” because it slows natural recovery.
“[We believe] single-session debriefing to be an unsafe technique when applied outside the setting for which debriefing was originally developed,” the organization’s Dr. Mark van Ommeren told www.MERGI NET.com.
The WHO notes that such debriefing still has many strong proponents, and that much of the evidence surrounding the issue is recent. It cites several recent studies in supporting its conclusion.
The relevant publication is Mental Health in Emergencies: Mental and Social Aspects of Health of Populations Exposed to Extreme Stressors. It’s available at www.who.int/mental_health/ media/en/640.pdf.
—World Health Organization
IAFF Will Work Toward CBRN-Protective PPE
Through funding from the Department of Homeland Security and a contract with the federal government’s Technical Sup-port Working Group, the International Association of Fire Fighters (IAFF) will work to develop structural-firefighting personal protective equipment with enhanced protection against chemical, biological, radiological and nuclear (CBRN) threats.
A project team already assembled will examine possible materials and the design of ensemble interfaces to meet current protective-clothing standards. Prototype de-signs will be laboratory-tested and evaluated in major fire departments.
The IAFF is conducting the project as part of its Project HEROES (Homeland Emergency Response Operational and Equipment Systems) initiative.
Canadian Medics Get Public-Safety Status
After three years of lobbying, paramedics in Canada were poised to succeed in having their profession added to the official list of public-safety occupations (PSOs) that qualify members for early, unreduced retirement benefits.
Under the country’s new federal budget, those in PSOs can also have a higher pension-accrual rate than they were previously allowed. Medics now join police and firefighters in eligibility for this benefit.
Unions representing Canadian medics will now have to negotiate specific benefits with employers.
At press time, the budget had not yet been passed by Parliament; however, support for it there seemed broad enough to ensure passage.
For more: www.paramedic.ca.
—Paramedic Association of Canada
Texas Hospitals Speed Cardiac Treatments
Heart attack patients will receive faster treatment under new procedures implemented by St. David’s hospitals in the Austin (TX) area.
Instead of recalling cardiac teams to the hospitals when patients arrive at night or on weekends, ED staff will call them upon notification by medics in the field, thus getting them there faster and allowing speedier treatment. Having the cardiac teams at the hospitals when the patients arrive will allow quicker catheterization and angioplasty to reopen blocked arteries.
According to data cited by cardiologist Paul Tucker, patients who get balloon angioplasty within three hours are 1.6 times more likely to die than those who get it in one hour.
The hospitals—three in Austin and one in Round Rock—will also place blood-testing machines in their EDs to test cardiac enzymes immediately.