Alert: New OEMS Requirements for Patient Care Documentation

April 17, 2017

TO: Virginia Emergency Medical Services (EMS) agencies
Regional EMS Councils

From: Michael D. Berg, BS, NRP
Manager, Regulation and Compliance
Cam Crittenden, RN
Manager, Trauma and Critical Care

SUBJECT: Patient Care Documentation

Please find attached a revised agency policy regarding the completion of a patient care report for Virginia EMS agencies. This policy is effective July 1, 2017 and remains in effect until acted on by the Office of Emergency Medical Services.

This policy applies to all categories of Virginia EMS agencies (911, non-emergency, ground, air, etc.). Please direct any questions to the appropriate program manager.

I. Purpose

§32.1-116.1 of the Code of Virginia (Code) mandates that each licensed Emergency Medical Services (EMS) agency submit data to the Office of Emergency Medical Services (OEMS) on a prescribed format as approved by the Board of Health (http://law.lis.virginia.gov/vacode/32.1-116.1/ . The Virginia Emergency Medical Services Regulations (Regulations) 12VAC5-31-560 also identifies the need for Emergency Medical Services (EMS) agencies to report patient care data to OEMS (http://law.lis.virginia.gov/admincode/title12/agency5/chapter31/section560/ . The policy exists to provide a consistent standard for OEMS staff and Emergency Medical Services agencies as to when a patient care report is to be completed and data transmitted to OEMS.

II. Scope

Incident documentation involves the recording of all patient assessment and treatment performed by licensed EMS agencies providing prehospital emergency medical services, inter-facility transport or pre-scheduled patient transport. Data submission involves transmitting the required data set that is collected through incident documentation to the OEMS. This policy applies to all EMS agencies licensed to operate within the
Commonwealth of Virginia.

III. Definitions

Medical care facility – means (as defined by § 32.1-102.1 of the Code and 12VAC5-31-10 of the Regulations) any institution, place, building or agency, whether or not licensed or required to be licensed by the Board of Health or the Department of Behavioral Health and Developmental Services, whether operated for profit or nonprofit and whether privately owned or privately operated or owned or operated by a local governmental unit, (i) by or in which health services are furnished, conducted, operated or offered for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, whether medical or surgical, of two or more nonrelated persons who are injured or physically sick or have mental illness, or for the care of two or more nonrelated persons requiring or receiving medical, surgical or nursing attention or services as acute, chronic, convalescent, aged, physically disabled or crippled or (ii) which is the recipient of reimbursements from third-party health insurance programs or prepaid medical service plans.

IV. Requirements

A. Whenever an EMS agency is requested (scheduled, unscheduled, emergent or nonemergent) to provide patient care for a real or potential patient, a patient care report shall be completed and the data shall be submitted to OEMS as per the Code of Virginia §32.1116.1 (http://law.lis.virginia.gov/vacode/32.1-116.1/ ). All licensed EMS agencies shall document and submit data on all EMS incidents
including but not limited to:

 

  1. Cancelled calls (by Public Safety Answering Point – 911 center)
  2. Standby’s (fire assist, law enforcement assist), public events such as recreational events (football games, large gatherings)
  3. Patient refusals (care and/or transportation – established patient provider relationship)
  4. Patient transfers.

Documentation and data to be submitted includes:

  1. Any transport to or from a physician’s office, clinic or health care facility that is for prescheduled testing, evaluation or treatment.
  2. Discharges from a medical care facility.
  3. Scheduled admissions to a medical care facility whether from a private residence or another medical care facility


B. This applies to all EMS agencies including surface and air agencies.

C. In the event multiple permitted vehicles are involved in the same incident, only one report per patient is required unless a mass casualty event has been declared.

D. In a multi-agency response to an incident, one patient care report documenting the incident and the EMS agency response will suffice providing no patient care has been rendered or a patient is transported to a medical care facility by the responding EMS agency.

1. In the event a mass casualty event has been declared, the use of triage tags will suffice in lieu of individual patient care reports. One main patient care report shall be completed by the primary (lead) EMS agency identifying the event and the number of patients involved in the incident.

E. For EMS agencies who provide large event staffing, scheduled or as part of their “mission”(i.e. Kings Dominion, Busch Gardens, concert venue, etc.): If no patient is transported or transferred to a transport agency as a result of assessment and treatment, then only a patient care report noting “standby only” is required and submitted. Any patient transfer or transport must be documented and the data transmitted to OEMS.

F. Data related to the use of permitted vehicles performing administrative, training or maintenance functions can be documented for agency use; however, it should NOT be submitted to the Office of EMS.

V. Conditions

This policy will remain in effect until revised or terminated by OEMS.

VI. Effective Date: July 1, 2017

(Click here to download document.)

 

 

Alert - CAMTS  Lifeport Clip Decks Urgent Safety Notice

Republished from the CAMTS Blog

Commission on Accreditation of Medical Transport Systems (CAMTS) has received several calls on this safety issue.  We have been made aware of incidents as a result of the LifePort Clip Decks.  We have been told that not all parties have received the following notice from LifePort.  Please heed this urgent warning!

Re: LifePort, Inc.’s Clip Decks – All Models/Part Numbers

It has recently come to our attention that Life port’s Clip Deck may be subject to misues in the field.  Our records show that you purchased, received through an intermediary, or may be in possession of a Life port Clip Deck.  Accordingly, this is to inform you that Life Port’s Clip Deck is designed and to be used for the purposes of non-vehicular ground transfers only.

LifePort’s Clip Deck is not designed, approved and should not be used, under any circumstances, to secure or retain an AeroSled during ground vehicle travel of any kind, including ambulance travel.  LifePort’s Clip Deck is not, and has never been, intended to be used in ambulances or any type of ground vehicles, under any circumstances.  Any such usage will expose all persons using the equipment, including but not limited to patients, passengers and medical professionals, to possible injury or death and therefore should be ceased immediately.

Please immediately contact LifePort’s Customer Service Department at 360 225-1212 or via email at customerservice@lifeport.com to arrange for shipment of warning placards for affixation on all Clip Decks consistent with the above.  LifePort will provide all placards free of cost, including affixation instructions.

Sincerely

Patrick Ogle

Customer Service Manager

LifePort

 

The following was received from a CAMTS accredited program:

On 6-5-17, while traveling in a ground ambulance, the LifePort sled came out of its base when going around a curve.  This is the third occurrence of a sled coming out of the base at our program.   When the second occurred in 2010, we took a harder look at the pins and receptacle holes they go into.  We found two design flaws:  1) the metal where the pin went into was made of a softer metal, aluminum, versus steel like the one in our aircraft base 2) the hole is drilled on the edge of a bevel, facilitating its wear.  When we contacted Lifeport at that time with our findings and looking for help, they offered no solutions nor assistance.  We fixed the problem ourselves with our mechanic replacing the receiving metal receptacles with steel ones in all our stretchers as are in our aircraft base.

The current clip deck involved in the incident 6-5-17 was received six months ago with our new isolette.   We knew we should replace the receiving metal parts and had begun the process but unfortunately it was not high priority as the prior clip decks had been used for ~ 10 years before the incidents occurred.  Apparently, an even inferior metal is being used in current production for the degradation seen in the images to have occurred so rapidly.    The hole is no longer round, but oblong and by its being in the bevel, you can see in image looking top down, this allows for a more rapid loss of integrity.

Our program has yet to receive the attached Lifeport notice.  We know of at least 2 others that have not received this notice; we are all current customers.    We learned of the warning via AAMS Critical Care Ground Special Interest Group who had a member receive this notice. 

Lifeport clipdeck - new from top_edited

Click here for a link to the original article.

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Alert - FDA Approves Extended Use Dates for Some PEMS Medications


Due to the ongoing critical shortages of injectable drugs used in critical care, the FDA has approved extending the expiration dates of certain medications noted in the link below.  These medications include some prefilled syringes containing atropine, D50, sodium bicarbonate and epinephrine.  This list is subject to change and the link should be reviewed occasionally.  PEMS will provide notification when we become aware of any changes.  To help ensure patient safety, these products must continue to be stored as per labeled conditions.  

Please click on the link to access the list of extended medications:  https://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm563360.htm

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Alert - DEA Guidebook for First Responders

Due to the increasing instances of responder exposure to fentanyl and related substances, the DEA, in coordination with CDC and other agencies, has provided guidance to emergency responders who may encounter these substances.  Click on the graphic to download the guidelines.  PEMS recommends that this information be included in in-service training as soon as practical for all responders.

Fentanyl Guide Fire EMS June 2017 Public

  Click here to download document.

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