#GMVEMSC: UVMC Cath Lab is Operational
#GMVEMSC Training: Advisory Re: Functional Needs Patients During Current Disaster Response
GREATER MIAMI VALLEY EMS COUNCIL ADVISORY:
HANDLING of FUNCTIONAL NEEDS PATIENTS and REQUIRED MEDICAL EQUIPMENT
This Advisory is for use by paramedics to help determine appropriate care for patients requiring chronic oxygen, aerosol treatments, and use of other respiratory equipment. At times, patients may call 911 with the only concern being lack of power. American Red Cross (ARC) Shelters for individuals with functional needs have been opened in Montgomery County. Functional Needs refers to individuals who, under usual circumstances, can function on their own or with support systems. However, during an emergency or in the absence of some services (e.g., electrical power), their level of independence is challenged. This Advisory is intended to help EMS providers better educate individuals regarding their options and make informed decisions. At this time, it is NOT recommended that EMS transport directly to a shelter.
ARC shelters are operational at the locations listed below, are handicapped accessible, have individual cots, restroom and shower facilities, and food. Service Animals are permitted. Family groups as well as the young and old may all access the shelter. Goals of Functional Needs Shelter Triage:
- Meet appropriate needs of persons seeking shelter during disasters and other major events.
- To the greatest degree feasible, clients who do not need hospital care should be sheltered to reduce unnecessary overcrowding at hospitals.
Shelter locations:
· Morton Middle School, 8555 Peters Pike, Vandalia
· The Ridge Church, 7555 Brookville-Phillipsburg Road
· Corinthian Church, 700 N. James H. McGee, Trotwood
· First Baptist Church, 3939 Swigart, Kettering
At the option of local department chiefs and medical directors, this Advisory can be used during the current declared disaster to make patients and their families aware of this option. EMS should, if feasible, contact the ARC Lead Nurse at 513-760-2167 before recommending that patients self-transport to a shelter.
Whether being transported to an Emergency Department or self-transporting to a Functional Needs Shelter, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient. This will facilitate discharge of the patient to an appropriate shelter or alternate living situation after Emergency Department evaluation.
- Persons with no functional/medical needs may be referred directly to a standard shelter.
- Functional needs: needs that can be met in a shelter include persons with the following:
· Blind or vision impairments
· Deafness or trouble hearing
· Oxygen dependent
· Previously treated breaks, fractures, or sprains (including those on crutches or in a cast)
· Non-English speaking
· Clients with wheelchairs or other mobility devices
· Service animal
· Dementia
· Immune system disorders
· Diabetes
· MRSA, TB, and other infectious diseases (depending on treatment status)
· Dependence on medication
· Dependent children, including those who enter the shelter without their parent or guardian
· Certain individuals who have medical needs such as those on a ventilator, nebulizer, colostomy/ileostomy, and the like can be evaluated for care within a shelter, especially if the client is accompanied by a family member or care aide.
Individuals with advanced chronic medical requirements may self-transport to the shelter with a care aide or family members. When the caregiver is able to provide the daily medical needs of these clients, they can generally remain in the shelter
An additional Advisory will be issued when the Functional Needs Shelters are no longer operating.
It is highly recommended that every patient encountered by EMS receive a full prehospital evaluation. Patients should be informed of any assessment findings that, in the opinion of the crew, would necessitate transport to the Emergency Department. Refusal of transport must be informed refusal and should be handled according to each agency’s policies.
Once again, REGARDLESS OF DESTINATION, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient.
#GMVEMSC: Advisory Re: Functional Needs Patients During Current Disaster Response
GREATER MIAMI VALLEY EMS COUNCIL ADVISORY:
HANDLING of FUNCTIONAL NEEDS PATIENTS and REQUIRED MEDICAL EQUIPMENT
This Advisory is for use by paramedics to help determine appropriate care for patients requiring chronic oxygen, aerosol treatments, and use of other respiratory equipment. At times, patients may call 911 with the only concern being lack of power. American Red Cross (ARC) Shelters for individuals with functional needs have been opened in Montgomery County. Functional Needs refers to individuals who, under usual circumstances, can function on their own or with support systems. However, during an emergency or in the absence of some services (e.g., electrical power), their level of independence is challenged. This Advisory is intended to help EMS providers better educate individuals regarding their options and make informed decisions. At this time, it is NOT recommended that EMS transport directly to a shelter.
ARC shelters are operational at the locations listed below, are handicapped accessible, have individual cots, restroom and shower facilities, and food. Service Animals are permitted. Family groups as well as the young and old may all access the shelter. Goals of Functional Needs Shelter Triage:
- Meet appropriate needs of persons seeking shelter during disasters and other major events.
- To the greatest degree feasible, clients who do not need hospital care should be sheltered to reduce unnecessary overcrowding at hospitals.
Shelter locations:
· Morton Middle School, 8555 Peters Pike, Vandalia
· The Ridge Church, 7555 Brookville-Phillipsburg Road
· Corinthian Church, 700 N. James H. McGee, Trotwood
· First Baptist Church, 3939 Swigart, Kettering
At the option of local department chiefs and medical directors, this Advisory can be used during the current declared disaster to make patients and their families aware of this option. EMS should, if feasible, contact the ARC Lead Nurse at 513-760-2167 before recommending that patients self-transport to a shelter.
Whether being transported to an Emergency Department or self-transporting to a Functional Needs Shelter, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient. This will facilitate discharge of the patient to an appropriate shelter or alternate living situation after Emergency Department evaluation.
- Persons with no functional/medical needs may be referred directly to a standard shelter.
- Functional needs: needs that can be met in a shelter include persons with the following:
· Blind or vision impairments
· Deafness or trouble hearing
· Oxygen dependent
· Previously treated breaks, fractures, or sprains (including those on crutches or in a cast)
· Non-English speaking
· Clients with wheelchairs or other mobility devices
· Service animal
· Dementia
· Immune system disorders
· Diabetes
· MRSA, TB, and other infectious diseases (depending on treatment status)
· Dependence on medication
· Dependent children, including those who enter the shelter without their parent or guardian
· Certain individuals who have medical needs such as those on a ventilator, nebulizer, colostomy/ileostomy, and the like can be evaluated for care within a shelter, especially if the client is accompanied by a family member or care aide.
Individuals with advanced chronic medical requirements may self-transport to the shelter with a care aide or family members. When the caregiver is able to provide the daily medical needs of these clients, they can generally remain in the shelter
An additional Advisory will be issued when the Functional Needs Shelters are no longer operating.
It is highly recommended that every patient encountered by EMS receive a full prehospital evaluation. Patients should be informed of any assessment findings that, in the opinion of the crew, would necessitate transport to the Emergency Department. Refusal of transport must be informed refusal and should be handled according to each agency’s policies.
Once again, REGARDLESS OF DESTINATION, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient.
#GMVEMSC Protocol: Advisory Re: Functional Needs Patients During Current Disaster Response
GREATER MIAMI VALLEY EMS COUNCIL ADVISORY:
HANDLING of FUNCTIONAL NEEDS PATIENTS and REQUIRED MEDICAL EQUIPMENT
This Advisory is for use by paramedics to help determine appropriate care for patients requiring chronic oxygen, aerosol treatments, and use of other respiratory equipment. At times, patients may call 911 with the only concern being lack of power. American Red Cross (ARC) Shelters for individuals with functional needs have been opened in Montgomery County. Functional Needs refers to individuals who, under usual circumstances, can function on their own or with support systems. However, during an emergency or in the absence of some services (e.g., electrical power), their level of independence is challenged. This Advisory is intended to help EMS providers better educate individuals regarding their options and make informed decisions. At this time, it is NOT recommended that EMS transport directly to a shelter.
ARC shelters are operational at the locations listed below, are handicapped accessible, have individual cots, restroom and shower facilities, and food. Service Animals are permitted. Family groups as well as the young and old may all access the shelter. Goals of Functional Needs Shelter Triage:
- Meet appropriate needs of persons seeking shelter during disasters and other major events.
- To the greatest degree feasible, clients who do not need hospital care should be sheltered to reduce unnecessary overcrowding at hospitals.
Shelter locations:
· Morton Middle School, 8555 Peters Pike, Vandalia
· The Ridge Church, 7555 Brookville-Phillipsburg Road
· Corinthian Church, 700 N. James H. McGee, Trotwood
· First Baptist Church, 3939 Swigart, Kettering
At the option of local department chiefs and medical directors, this Advisory can be used during the current declared disaster to make patients and their families aware of this option. EMS should, if feasible, contact the ARC Lead Nurse at 513-760-2167 before recommending that patients self-transport to a shelter.
Whether being transported to an Emergency Department or self-transporting to a Functional Needs Shelter, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient. This will facilitate discharge of the patient to an appropriate shelter or alternate living situation after Emergency Department evaluation.
- Persons with no functional/medical needs may be referred directly to a standard shelter.
- Functional needs: needs that can be met in a shelter include persons with the following:
· Blind or vision impairments
· Deafness or trouble hearing
· Oxygen dependent
· Previously treated breaks, fractures, or sprains (including those on crutches or in a cast)
· Non-English speaking
· Clients with wheelchairs or other mobility devices
· Service animal
· Dementia
· Immune system disorders
· Diabetes
· MRSA, TB, and other infectious diseases (depending on treatment status)
· Dependence on medication
· Dependent children, including those who enter the shelter without their parent or guardian
· Certain individuals who have medical needs such as those on a ventilator, nebulizer, colostomy/ileostomy, and the like can be evaluated for care within a shelter, especially if the client is accompanied by a family member or care aide.
Individuals with advanced chronic medical requirements may self-transport to the shelter with a care aide or family members. When the caregiver is able to provide the daily medical needs of these clients, they can generally remain in the shelter
An additional Advisory will be issued when the Functional Needs Shelters are no longer operating.
It is highly recommended that every patient encountered by EMS receive a full prehospital evaluation. Patients should be informed of any assessment findings that, in the opinion of the crew, would necessitate transport to the Emergency Department. Refusal of transport must be informed refusal and should be handled according to each agency’s policies.
Once again, REGARDLESS OF DESTINATION, it is CRITICAL that ALL medications (particularly respiratory meds) and medical equipment such as oxygen, oxygen concentrators, CPAP machines, nebulizers, and all required tubing and fittings SHOULD accompany the patient.
#GMVEMSC: UVMC Rerouting Cardiac Patients Until Further Notice
GMVEMSC has been asked to make EMS aware that Upper Valley Medical Center is rerouting all cardiac patients until further notice because their cath lab is down. Contact Mark Senseman, EMS Coordinator, with any questions.
David N. Gerstner, President
Greater Miami Valley EMS Council
#GMVEMSC Protocol: FW: Standing Orders Testing EXTENSION
Greater Miami Valley EMS Council has received concerns regarding the deadline date for Standing Orders testing. Given the devastation experienced by many jurisdictions in our region, we are concerned that there are EMS agencies that may not even have realized that they have personnel who still need to be tested (written or skills).
Therefore, and after consultation with the Education and Standing Orders chairs, EMS Council is extending the deadline for Standing Orders testing. All practical and computer-based testing (CBT) must now be completed by June 28, 2019 at 2359 hours. This extension comes with two important caveats:
· EMS personnel (not agencies) who have not successfully completed all skills testing and passed the CBT MUST CONTINUE TO OPERATE USING 2018 protocols.
· All EMS personnel who have successfully completed skills testing and passed the CBT MUST begin using the 2019 Protocols on June 1st, 2019.
All other requirements in Standing Orders and the Implementation Guidelines remain in effect.
The thoughts and prayers of all us at GMVEMSC are with all of you who have been impacted by or assisted in so many ways with the response to this disaster. Our region and our profession have again stepped up when the need was greatest. Thank you for all that you do.
David N. Gerstner, President
Greater Miami Valley EMS Council
#GMVEMSC: FW: Standing Orders Testing EXTENSION
Greater Miami Valley EMS Council has received concerns regarding the deadline date for Standing Orders testing. Given the devastation experienced by many jurisdictions in our region, we are concerned that there are EMS agencies that may not even have realized that they have personnel who still need to be tested (written or skills).
Therefore, and after consultation with the Education and Standing Orders chairs, EMS Council is extending the deadline for Standing Orders testing. All practical and computer-based testing (CBT) must now be completed by June 28, 2019 at 2359 hours. This extension comes with two important caveats:
· EMS personnel (not agencies) who have not successfully completed all skills testing and passed the CBT MUST CONTINUE TO OPERATE USING 2018 protocols.
· All EMS personnel who have successfully completed skills testing and passed the CBT MUST begin using the 2019 Protocols on June 1st, 2019.
All other requirements in Standing Orders and the Implementation Guidelines remain in effect.
The thoughts and prayers of all us at GMVEMSC are with all of you who have been impacted by or assisted in so many ways with the response to this disaster. Our region and our profession have again stepped up when the need was greatest. Thank you for all that you do.
David N. Gerstner, President
Greater Miami Valley EMS Council
#GMVEMSC Training: FW: Standing Orders Testing EXTENSION
Greater Miami Valley EMS Council has received concerns regarding the deadline date for Standing Orders testing. Given the devastation experienced by many jurisdictions in our region, we are concerned that there are EMS agencies that may not even have realized that they have personnel who still need to be tested (written or skills).
Therefore, and after consultation with the Education and Standing Orders chairs, EMS Council is extending the deadline for Standing Orders testing. All practical and computer-based testing (CBT) must now be completed by June 28, 2019 at 2359 hours. This extension comes with two important caveats:
· EMS personnel (not agencies) who have not successfully completed all skills testing and passed the CBT MUST CONTINUE TO OPERATE USING 2018 protocols.
· All EMS personnel who have successfully completed skills testing and passed the CBT MUST begin using the 2019 Protocols on June 1st, 2019.
All other requirements in Standing Orders and the Implementation Guidelines remain in effect.
The thoughts and prayers of all us at GMVEMSC are with all of you who have been impacted by or assisted in so many ways with the response to this disaster. Our region and our profession have again stepped up when the need was greatest. Thank you for all that you do.
David N. Gerstner, President
Greater Miami Valley EMS Council
#GMVEMSC: UPDATE RE: 75 closure 75 North and South bound
The interstate closure on 75 between Needmore Road and Rt 4. There has been some discrepancies on the start time for the closure. We will continue to share information as we get it.
#GMVEMSC: 75 closure 75 North and South bound
Interstate 75 both North and South bound will be closed starting now for 15-30 Minutes for DP&L infrastructure repairs.
#GMVEMSC: Dayton Airport Exercise Postponed
Per Bruce Bales, Airport Fire Rescue Chief at the Department of Aviation, City of Dayton:
Due to the extreme weather last night and the area wide response, the Dayton International Airport full-scale exercise planned for tomorrow, May 29th, 2019 is being rescheduled. The new date will be June 12th at 0800.
MMRS/RMRS/EP Coordinator
Department of Fire I City of Dayton
300 N. Main St. I Dayton, Ohio 45402
Office 937.333.4551 I Fax 937.333.4561 I www.daytonohio.gov
24/7 Pager: 937-227-8705 or E-mail 9372278705@archwireless.net
Cell 937.776.4410
david.gerstner@daytonohio.gov I http://DaytonMMRS.org
#GMVEMSC Training: Dayton Airport Exercise Postponed
Per Bruce Bales, Airport Fire Rescue Chief at the Department of Aviation, City of Dayton:
Due to the extreme weather last night and the area wide response, the Dayton International Airport full-scale exercise planned for tomorrow, May 29th, 2019 is being rescheduled. The new date will be June 12th at 0800.
MMRS/RMRS/EP Coordinator
Department of Fire I City of Dayton
300 N. Main St. I Dayton, Ohio 45402
Office 937.333.4551 I Fax 937.333.4561 I www.daytonohio.gov
24/7 Pager: 937-227-8705 or E-mail 9372278705@archwireless.net
Cell 937.776.4410
david.gerstner@daytonohio.gov I http://DaytonMMRS.org
#GMVEMSC Training: FW: CALCIUM GLUCONATE JITSO
On behalf of GMVEMSC Standing Orders Chairperson, John Russell and Dr. Marriott, Region 3 RPAB Chair, a Just in Time Standing Order (JITSO) is now in effect. Paramedics are authorized to use either Calcium Chloride or Calcium Gluconate, whichever is available. See below for the full JITSO.
Subject: CALCIUM GLUCONATE JITSO
We are experiencing a critical shortage of CALCIUM CHLORIDE, and therefore CALCIUM GLUCONATE may be in any drug bag. Please refer to page 72 (below) of the Standing Orders.
This email serves as notice that the CALCIUM GLUCONATE "Just In Time Standing Order" is now in effect. If calcium is indicated, and CALCIUM GLUCONATE is in the drug bag, this JITSO is to be followed.
CALCIUM GLUCONATE
(JITSO)
PACKAGED: 1 gram in 10 ml vial, 100 mg/ml
INDICATIONS: Renal dialysis patient in cardiac arrest or ♦ bradycardia. Calcium Channel Blocker OD Hydrofluoric Acid exposure with tetany OR cardiac arrest. Tetany may present as: overactive neurological reflexes, spasms of the hands and feet, cramps, and laryngospasm. Prophylactically, after exposure to Hydrofluoric Acid Crush syndrome
ADULT: Cardiac Arrest, CCB OD and Hydrofluoric Acid exposure with tetany or cardiac arrest: 1 g (10 ml) IV Hydrofluoric Acid Exposure Prophylaxis: 400 mg IV (4 ml) Crush: 1 gm
PEDI: Cardiac Arrest & OD: 20 mg/kg IV (max dose 500 mg in Calcium Channel Blocker OD) ♦ Crush:
THERAPEUTIC ACTION: Antagonizes cardiac toxicity in hyperkalemia associated with dialysis patients. Reverses symptoms of Calcium Channel Blocker
CONTRAINDICATIONS:
PRECAUTIONS AND SIDE EFFECTS: Bradycardia (may cause asystole), hypotension, metallic taste, severe local necrosis and sloughing following IV infiltration; may produce vasospasm in coronary and cerebral arteries. Hypertension and bradycardia may occur with rapid administration. Do not administer with Sodium Bicarbonate because if the two substances are mixed, a precipitate develops. Flush tubing between drugs.
REQUIRES MCP: ADULT: Arrest--No Calcium Channel Blocker OD—Yes Renal dialysis patient in bradycardia - Yes Hydrofluoric Acid Exposure—Yes Prophylaxis—Yes Crush syndrome--Yes PEDI: Arrest—No Calcium Channel Blocker OD—Yes Crush syndrome—Yes
David N. Gerstner, President
Greater Miami Valley EMS Council
#GMVEMSC: FW: CALCIUM GLUCONATE JITSO
On behalf of GMVEMSC Standing Orders Chairperson, John Russell and Dr. Marriott, Region 3 RPAB Chair, a Just in Time Standing Order (JITSO) is now in effect. Paramedics are authorized to use either Calcium Chloride or Calcium Gluconate, whichever is available. See below for the full JITSO.
Subject: CALCIUM GLUCONATE JITSO
We are experiencing a critical shortage of CALCIUM CHLORIDE, and therefore CALCIUM GLUCONATE may be in any drug bag. Please refer to page 72 (below) of the Standing Orders.
This email serves as notice that the CALCIUM GLUCONATE "Just In Time Standing Order" is now in effect. If calcium is indicated, and CALCIUM GLUCONATE is in the drug bag, this JITSO is to be followed.
CALCIUM GLUCONATE
(JITSO)
PACKAGED: 1 gram in 10 ml vial, 100 mg/ml
INDICATIONS: Renal dialysis patient in cardiac arrest or ♦ bradycardia. Calcium Channel Blocker OD Hydrofluoric Acid exposure with tetany OR cardiac arrest. Tetany may present as: overactive neurological reflexes, spasms of the hands and feet, cramps, and laryngospasm. Prophylactically, after exposure to Hydrofluoric Acid Crush syndrome
ADULT: Cardiac Arrest, CCB OD and Hydrofluoric Acid exposure with tetany or cardiac arrest: 1 g (10 ml) IV Hydrofluoric Acid Exposure Prophylaxis: 400 mg IV (4 ml) Crush: 1 gm
PEDI: Cardiac Arrest & OD: 20 mg/kg IV (max dose 500 mg in Calcium Channel Blocker OD) ♦ Crush:
THERAPEUTIC ACTION: Antagonizes cardiac toxicity in hyperkalemia associated with dialysis patients. Reverses symptoms of Calcium Channel Blocker
CONTRAINDICATIONS:
PRECAUTIONS AND SIDE EFFECTS: Bradycardia (may cause asystole), hypotension, metallic taste, severe local necrosis and sloughing following IV infiltration; may produce vasospasm in coronary and cerebral arteries. Hypertension and bradycardia may occur with rapid administration. Do not administer with Sodium Bicarbonate because if the two substances are mixed, a precipitate develops. Flush tubing between drugs.
REQUIRES MCP: ADULT: Arrest--No Calcium Channel Blocker OD—Yes Renal dialysis patient in bradycardia - Yes Hydrofluoric Acid Exposure—Yes Prophylaxis—Yes Crush syndrome--Yes PEDI: Arrest—No Calcium Channel Blocker OD—Yes Crush syndrome—Yes
David N. Gerstner, President
Greater Miami Valley EMS Council