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Craig Goodrich, Fire Chief Anchorage Fire Department
Michael Levy, MD, FACEP (above left) being presented the 2004 State of Alaska Medical Director of the Year. Award presenter is Alaska Lt. Governor Loren Leman
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To access the official website of the Anchorage Fire Department, click on the banner above Anchorage Fire Department EMERGENCY MEDICAL SERVICES Spring 2008 AFD Personnel and Patient Safety
Enhancements and Initiatives Continued work is going into identifying
and developing secure methods of restraining loose items in the ambulances.
The toughest item the department has been facing difficulties with is
securing the cabinet in the patient care module with equipment shelves (by
the side door with the jump and code kits, vent kit, cardiac monitor,
portable suction, and other equipment). Securing the cardiac monitors when in
use on patients is another. The four new ambulances out for bid now
include specifications to include roll-up doors for the equipment cabinets,
similar to what the AFD had with the Freightliner ambulances in the past.
Designing and retrofitting a solution is more difficult. The cardiac monitors
will most likely be secured with seatbelts or a tether system, and this
directive should be released in early March by memo. On another note, three safety projects
have been completed. This includes utilizing chest-waist restraints on the
gurneys, receiving the SafeGuard child restraint
seats, and development of Pediatric
Transport Guidelines. FF/PM Dave Wallace has been visiting stations in late
February and into early March providing training in the new child safety
restraint seats for use in the ambulances. With the latter, Dave secured a
donation through Safe Kids of Alaska for child safety restraint seats which
are specifically designed for use in And in an effort to address an ongoing
“epidemic” of AFD personnel receiving injuries resulting from the transfer of
patients to and from the MICU, Fire Chief Craig Goodrich developed the Safe
Patient Transport guidelines, which can be found in the Documents section
of this website. The goal of the guidelines is to eliminate injuries by
instituting the safe and successful extrication and transfer of a patient
from the scene to the MICU while being alert to potential challenges and
hazards. These guidelines also include
the appointment of one individual to serve as “Transfer Safety Officer” (TSO)
whose responsibility, with the assistance of all responders, is for the design
and implementation of a safe patient transfer strategy and for identification
of lifting/transfer hazards and/or their mitigation for the incident. Prior to moving a patient the TSO will
clearly describe the “exit-plan” including hazards and challenges facing the
responders, and then monitor the progress as the transfer evolves. EMS Projects and Initiatives A lot has happened or is in the process
of happening over the winter of 2007 and into spring of 2008. For one, the
MOM 2008 is nearing completion. EMS Battalion Chief Anne Sigsworth
reports finalizing additional information and changes in formatting. Pocket
guides will remain the same for 2008, as much from the department
restructuring in April 2007 as from change of EMS Battalion Chief
oversight/ownership for the manual (three times in the past year). Several recent updates to the MOM
include changes to the Chest
Pain protocol with emphasis on the rapid 12-Lead ECG, and adding Captopril as a medication for use in acute pulmonary
edema and CHF. A new Anaphylaxis
protocol was published that included more aggressive use of subcutaneous
epinephrine. See the Documents section
of the website for a refresher on the protocols as well as other recent
additions. The AFD is moving forward with enrolling
in the IMMEDIATE trial, a nation-wide multi-center research project to test
whether administering an IV solution of Glucose, Insulin, and potassium
improves the outcome of patients with myocardial infarction. Referred to as
“GIK,” this medication cocktail is administered intravenously via pump to
patients at the first signs and symptoms of an infarction. User names and
passwords have been passed out to all AFD MOA-certified paramedics and
training is underway. The EMS Shift Meetings for April are mandatory for all
FF/PMs to attend and this component will be the
practical training conducted by instructors from Tufts University. The Post
Cardiac Arrest Cooling protocol has been released, and will be
incorporated into the MOM 2008. This procedure involves infusing chilled IV
saline solution in cardiac arrest patients to induce therapeutic hypothermia
(the use of the IV paralytic vecuronium
will also be added to this treatment – succinylcholine
will continue to be used as indicated in the MOM, but not in this situation).
The shift EMS Battalion Chief will be brining the chilled saline solution to
the scenes of cardiac arrests. This procedure, used in patients with ROSC, is
thought to reduce inflammation and slow the natural process of cellular
death. Once the supplies are in place, the new protocol will be initiated and
vecuronium will be placed in the ALS vent kits and on the MICUs.
This should occur in mid- to late-April. The AFD is also participating in the
North Central EMS Institute (NCEMSI)/National EMS Management Association
(NEMSMA) Benchmarking Project. The goal of this project is to identify and
publish best practices based on the information collected from Many Ø
MMRS
program update (FF/PM Scott Luna and FF/PM Eric Taylor) Ø
Physio LUCAS CPR Compression Device trial project (FF/PM Rhett Paulson) Ø
Special
Needs Patient program (FF/PM Dave Wallace) Ø
New
pediatric medical standing orders and kits (FF/PM Steve Mendive)
Ø
Biomedical
P&I and Manual updates (ENG/PM Kevin Baker) Ø
PCR
review program (FF/PM Rob Bowler) Ø
MVI
SOG update (CAPT/PM Rod Harris) Ø
Mass
Fatality SOG development (ENG/PM Wayne Fuller) Personnel should contact Assistant Chief
Scheunemann for further information and if interested with assisting staff on
other project work. In further news that affects AFD EMS,
the State of Alaska Department of Health and Social Services is establishing
portable auto ventilator caches in four Alaskan cities for mass
casualty/pandemic uses. EMS Training Thirty-one new firefighters have
graduated from the 2007 AFD Academy and are beginning to come online as of
March 31st to begin their ALS internships, and operational fire
training and testing. EMS BC Garbe, Captain Kevin Keene, and Assistant Chief
Brian Keene have been working together to develop an enhanced internship
process as compared to previous academies and probationary periods for new
employees. New preceptor training is also in development. EMS Field Delivery #1, which will be
completed primarily in March, includes an overview of proper patient lifting
and moving procedures, as well as training in the use of the King LTD airways
which will be replacing the Combitubes within the
AFD, and eventually area-wide as well (Chugiak and Girdwood VFDs will also be migrating to the King LTD at some point
this year). FF/PM Rob Bowler deserves credit for providing the leg work in
developing the training program for the Kings. FTS Pat Vincent is assisting with
redistribution of MOA-credentialed IDs for AFD paramedics; we are restarting
the program and hope to expand to the paramedics from the volunteer fire
departments and private ambulance services within the year. The Resuscitation Conference for June 6,
7, and 8 is progressing well. New topics include USAR response during
earthquakes, pediatric trauma/burn care, and AHA CPR and resuscitation
research. An ALS core paramedic refresher course (16 hours) will be occurring
the two days prior to the Conference with nationally recognized paramedic
instructors (June 5 and 6). Valerie DeFrance, MICP, is assisting on the
conference website (Valerie is also the 2007 Alaska EMS Administrator of the
Year and the 2007 NAEMT Paramedic of the Year) – the Conference website is www.lorenmarshallfoundation.org. And finally, several congratulations are
in order from January and February, and a welcome back in March. The first
congratulation goes to FF/PM Ryan Staten for completing his AFD ALS
Internship and becoming a full-fledged paramedic as of January 31 (Ryan is
working at Station #1 on B Shift). The second congratulation goes out to
FF/PM Brian Reed for successfully completing 25 years working on AFD
ambulances, preferring to work on ambulances rather than engine companies,
and is still going strong towards year number 26. Although determined
unscientifically, it is speculated Brian has responded on more emergencies,
and examined, treated, and transported more patients than any other employee
in the history of the Anchorage Fire Department. Our hats our off to you,
Brian!
June 6th, 7th, and 8th, 2008 in Anchorage, Alaska The Conference Website is now Online For the 2008 Conference Poster, click here The Loren
Marshall Foundation and the Anchorage Fire Department would like to thank the
sponsors
and speakers for making our 2007 Resuscitation Conference a
success! The documents contained within this website require Adobe Acrobat Reader to view. Click on this link below to download the free Reader 8.0 program.
Last Updated April 6, 2008 |
