March 13, 2001-     (Also enclosed with this mailing was April- July Training calendar)

To: All CSEMS Agencies/ALS providers

From: Matt Painter

Executive Director

Enclosed is our CE calendar for April through July. FYI we anticipate teaching the following courses over the next year. CT- March, 01 to June 01. EMT basic- May 01 to August 01 at Buena Vista. ST basic Sept. 01 to December 01 at Fairfield. EMT basic Sept. 01 to December 01- Location TBA. CT Feb. 02 to May 02 at CSEMS. ST basic Feb. 02 to May 02 Grottoes. CE year round. These are projected and subject to change pending our grant outcome and need. This is what we have come up with after discussions with the area instructors.

ALS AGENCIES. Recently we have had several problems with intubation. The main problem is undetected esophageal placement. Obviously this results in poor patient outcome. The new ACLS guidelines recommend the use of an End Tidal CO2 device to verify ETT placement. You may have heard of these, they are called "easy caps".(see attached picture). MCRC (OMD Committee) has voted to require these to be used on ALL intubations. These are simple, effective and minimal in cost. They are about $10 to $12 each. There is a pediatric and adult version. You may be familiar with these and already have them. These have become the "standard of care" so we must follow suit. We will be discussing and training with these at the April 2001 Skills Drill. The OMD’s have asked that ALL ALS providers be trained in the use of these devices. PLEASE do not confuse these with continuous ETCO2 monitoring that is very expensive, about $2,000. You are certainly able to purchase and use the more expensive version as some agencies are, but NOT required. We are finalizing the protocol changes. As you may be aware the new ACLS and PALS guidelines are rather ambiguous, so we don’t plan on making any major changes. I have posted an area on our website reviewing the proposed changes/additions. The main hurdle to overcome is getting the pharmacies to agree to add medications due to the cost. Also many agencies are not aware of the C-Spine clearing protocol. This was sent out in August 2000. I have enclosed another copy.

Defib/Combitube. Last April due to MANY serious problems with AED’s the MCRC voted to require yearly recertification in regional Defib/Combitube. This was supposed to already be happening within your agency. However from discussions with the providers who made mistakes some indicated the last time they reviewed AED was 3-4 years ago. The course gives Category 1 credit that you would have needed anyway. FYI the public access defib. program requires a six month update! So a yearly update for EMS is reasonable. The OMD’s have directed CSEMS to monitor ALL providers’ attendance yearly to this course. If a provider fails to attend this course they will be suspended from practice until attendance. We will begin monitoring this in 2001. SO PLEASE DON’T WAIT UNTIL THE LAST MINUTE TO DO THIS. CSEMS offered two instructor courses in February and will try to schedule more. The goal is to have an instructor in each agency. This may seems harsh on paper, but we have had several life costing errors with this from all different levels of providers throughout the entire region.

Nurses in EMS. Many of you have nurses who join your agency. Reminder that LPN’s and RN’s are not allowed to practice EMS under their nursing license. This seems to mostly be an issue with nurses who are EMT’s that have ACLS/PALS etc and be asked to provide ALS care. They are not allowed to do this per state regulation. There is a provision for a nurse on scene in our protocols. This pertains to a nurse who incidentally is on the scene NOT responding with an EMS agency they are a member of. Please note the attached documents Dave Cullen forwarded me from the Office of EMS. There are several mechanisms to "challenge" or take abbreviated versions of EMS courses in Virginia to become certified. I realize this entire situation puts everyone in an uncomfortable position. However these are the rules we have been given to follow.

ID badges. CSEMS continues the regional ID badge program. To date we have done 500 badges. This program has proven beneficial for proper ID of providers in the field.

The OMD’s continue to request we have all providers participate in this program. Please contact the office to arrange a time we can visit your agency to make badges.

We are pleased to announce we have hired a new employee. Matt Lawler is a Cardiac Tech. with Staunton Rescue and has been a dispatcher for Harrisonburg for some time. He also has many credentials in VAVRS as an instructor. Matt will start full time with the office on March 26, 2001. His primary roll will be teaching. So you will need to specify which "Matt" you need to talk with when you call. Matt Painter, or Matt Lawler.

I am very excited about his coming on board as I know this will help us provide more classes and support to you!.

CSEMS has moved! Due to the state cutbacks Western State closed the building we were in. We have a new home on West Beverley Street in Staunton. Our new address is: 2312 West Beverley St. Staunton, Va. 24401. I have directions on the website. www.csems.vaems.org

New state rules/regs. Please look at the proposed new state rules and regulations on the OEMS website. I will be attending the public comment hearings, so let me know if you have concerns you wish for me to bring up.

Thank you for your support. The office is here to assist you in any way. Please feel free to contact us.

Sincerely,

Matt Painter

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