MSC recently deployed a medical team to provide medical support for an oil exploration company in West Africa.
Our specialists were able to reach the remote location and set up a field clinic in a very short time.

Having experienced medical professionals on-site, especially when operating in a high-risk environment,  is a valuable asset contributing to the employees well being and peace of mind.

Cleveland EMS ambulances called a 'catastrophic failure'


The union representing dispatchers, EMTs and paramedics describes the fleet of Cleveland EMS ambulances as a "catastrophic failure."

"They're breaking down. Our fleet is done. They're crippled," said Daniel Nemeth, president of the Cleveland Association Rescue Employees.

Nemeth says all too often the city has fewer than the desired 18 functioning ambulances on the streets.

Nemeth said one day last week, six units -- or one-third of the city's fleet -- was in the shop for repairs and unable to transport critically injured patients.

"That is totally unacceptable for a city this size," said Cleveland City Councilman Mike Polensek. "You have to have a minimum of 18 units working the city."

Channel 3 News Investigator Tom Meyer obtained a number of computer- aided dispatch messages showing the city was forced to use city SUVs because ambulances were broken down and out of service.

The SUVs are used as first responders and do not transport injured victims to the hospital. They must wait in hope that an ambulance will arrive.

"This is not drama. These are lives. They [the city] are putting a price on the citizens of Cleveland," Nemeth said.

Nemeth said the same rubber gloves that paramedics wear to treat patients have also been used to hold a hydraulic hose together on one of the city's ambulances.

In addition, he discovered one patient was transported in the back of one ambulance that had a cracked body frame.

"They're putting Band-Aids on these amputated items and that's not a fix. It's getting to the point that they are sending vehicles out that are unsafe," said Nemeth.

The union had a study performed to determine how Cleveland EMS ambulances stack up against other ambulances in eight cities of similar or larger size.

The study found that the average ambulance spends 4.8 years or 163,833 miles in front-line 911 service. In Cleveland, two front-line ambulances are 9 years old. At least five front-line ambulances have more than 240,000 miles, which is about the equivalent of circling the world 10 times.

Channel 3 news reached out to acting EMS commissioner Nicole Carlton for comment, but she said she was unavailable.

The assistant director of Public Safety, Ed Eckart, agreed to talk. He acknowledged that the city has, on recent occasions, had fewer than a full fleet of EMS ambulances available due to break downs of several aging units.

As a result, SUVs have been used to carry EMTs to scenes.

Eckart said he was unaware of the union's complaints, but he said citizens are being treated properly.

"We're satisfied that the current condition of the fleet can meet the needs and expectations of the community," he said. "In a perfect world, absolutely, you'd like to have all brand new stuff."

He said the city received two new ambulances in June and, over the Fourth of July holiday weekend, 19 EMS ambulances were in service. Normally, the city has 18 ambulances in service.

In addition, four new ambulances are scheduled to hit city streets by year's end, Eckart said.

Watch WKYC investigative report on the following link:

http://www.wkyc.com/story/news/investigations/2015/07/06/ems-ambulances-catastrophic-unsafe-cleveland/29779585/

The routine practice of giving oxygen to patients having heart attacks has been linked to increased heart damage and a greater risk of repeat attacks in a landmark study by Melbourne researchers.

Researchers say the findings, presented at the annual American Heart Association conference in Chicago on Wednesday night, are likely to change guidelines for emergency treatment around the world.

Their study followed 441 patients who were treated by Ambulance Victoria paramedics for the most serious type of heart attack, called an ST-segment elevation myocardial infarction (STEMI), in which the coronary artery is completely blocked.

Half of the group were given oxygen through a mask in accordance with routine practice, even though their oxygen levels were normal. The other half did not receive oxygen and simply breathed normal air.

Researchers found patients given oxygen were five times more likely to have a repeat heart attack during their stay in hospital compared with those who did not receive oxygen.

Patients given oxygen were also found to have 20 per cent more damage to heart tissue as shown on an MRI scan six months later.

Researchers did not find any statistically significant difference in survival between the two groups. However, studies are under way overseas to assess this.

Principal investigator Stephen Bernard, a senior intensive care specialist at The Alfred hospital, said giving oxygen to patients with chest pain had been standard practice for decades.

"A heart attack is when an artery to the heart muscle is blocked and you suddenly get chest pain because that part of the heart is not getting any oxygen," he said.

"For 30 or 40 years we've given oxygen, the theory being that part of the heart isn't getting any so we should give it."

Professor Bernard said it was only in recent years that doctors had began to question the practice, and worry about causing damage by flooding the injured heart with oxygen once the blockage was cleared.

Co-researcher and paramedic Ziad Nehme said oxygen could actually narrow coronary arteries and reduce blood flow to the heart, and may increase inflammation and stress on the heart tissue during a heart attack.

He said Ambulance Victoria had already modified its approach and gave oxygen to patients having a heart attack only if oxygen levels in their blood were below normal.

Professor Bernard said he expected patients undergoing emergency treatment for heart attacks would no longer routinely receive oxygen as a result of the study, which is due to be published in a journal, although it would take time for guidelines to be reviewed.

"People like to see a thorough review by experts, but we think the results are pretty compelling, and if I get chest pain tonight, I am not letting anyone give me oxygen," he said.



http://www.theage.com.au/victoria/oxygen-damaging-for-heart-attack-patients-study-says-20141120-11qgzl.html

MSC will provide PLB's to all its employees. Personal Locator Beacons can be rapidly activated in emergencies to activate the satellite-based COSPASS-SARSAT dedicated rescue system.

Once switched on, the beacon will provide an exact location and a personal code, allowing for a fast and precise response.

When lost or injured in a remote location, the PLB is a proven life-saver and can make a huge difference on the case outcome.

MSC recently won a contract to supply 14 Advanced Life Support ( ALS) ambulances to a newly founded private emergency medical service in West Africa.
The units will be fully equipped according to the latest standards and will be delivered in three separate batches over the course of the next 14 months.
MSC will also provide specialized training to the ambulance crews and will supervise the operation until it achieves full operational status.

January 7, 2015 -- Grey County, in partnership with the Owen Sound Family Health Team and St. Michael’s Hospital (Rescu), has officially launched an “EPIC” new community paramedicine program. The one-year clinical trial will study the value of in‑home healthcare by paramedics in reducing emergency room visits and hospital admissions.

Expanding Paramedicine in the Community (EPIC) utilizes highly skilled community paramedics to monitor and treat patients in the comfort of their own home. In-home treatment can help prevent a condition from progressing to a point where a hospital visit is necessary.

“Too often patients with a chronic condition end up in the hospital or worse from symptoms that could be identified and treated by a community paramedic,” says Mike Muir, Director of Paramedic Services with Grey County. “Our community paramedics can save patients unnecessary suffering and trips to the emergency room by checking in regularly and catching symptoms early.”

Currently Grey County’s primary care paramedics act as first responders and are limited in what medications and treatments they are able to administer. Through the EPIC program, two paramedics have been reassigned and trained as community paramedics, a designation which greatly increases the treatments a paramedic can administer through consultation with a patient’s doctor.

EPIC focuses on patients diagnosed with the chronic conditions diabetes mellitus (DM), congestive heart failure (CHF), and chronic obstructive pulmonary disorder (COPD). These are three of the most common chronic conditions in the world. The trial will run for one year and is paid through one-time funding of $300,000 approved by the province this past September. Grey County Council supported the funding application in 2014.

“We were very pleased to learn our funding application had been approved and we could participate in this important study,” says Grey County Warden Kevin Eccles. “Healthcare is imperative to all residents in our community and it’s important to find innovative new ways to improve access to medical professionals and to reduce emergency room wait times.”

Leading the EPIC study in Ontario is St. Michael’s Hospital.

“There’s no high-quality evidence showing that, beyond the current system of care, community paramedicine provides an additional cost-effective care to elderly or chronic patients,” said Dr. Laurie Morrison, a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and the Director of the Rescu – a group studying out‑of‑hospital emergency healthcare. “EPIC will address this gap in science.”

Patients Needed for the Trial

The Owen Sound Family Health Team will work locally with Grey County paramedics to administer the trial. In total 200 voluntary patients are required. To qualify, individuals must be existing patients with the Owen Sound Family Health Team and be diagnosed with at least one of the chronic conditions mentioned above.

Qualifying patients have been sent a letter from the Family Health Team requesting participation in the study. Patients must complete and return the response card within two weeks to be eligible for the program.

“We encourage all qualifying patients to get their response cards in quickly as space in the trial is limited,” says Dr. Shiv Grewal of the Owen Sound Family Health Team. “Those participating in the trial will benefit from convenient in-home treatment by community paramedics working closely with their family doctor.”
The program also benefits patients without access to transportation finding it difficult or impossible to attend regular appointments.



Data will be collected confidentially throughout the study and analyzed by a third party. Results will be used to help determine the effectiveness of community paramedicine.

Training Our Community Paramedics

Grey County Paramedic Services is drawing on the experience and expertise of two long-time paramedics to fulfil the community paramedic roles for the year. Veteran primary care paramedics Rick Trombley and Scott Luce have been reassigned to the position from an elite group of applicants.

“A primary care paramedic shows up when a disease has progressed to a point where a patient needs immediate medical attention and ends up in the hospital,” explains Trombley about the difference in paramedic roles. “On the other hand, a community paramedic enters the picture much earlier and acts as an intervener by reporting the patient’s conditions to their family doctor early on and providing the recommended treatments.” Trombley points out community paramedics have the training needed to administer some of the same medications a patient would traditionally only receive at the hospital by a doctor.

Community paramedics also have the unique opportunity to observe patients in their home setting to learn more about their lifestyle and habits and to help educate them in ways to better manage their disease.

To prepare for their new role Trombley and Luce completed an intense training course through Centennial College. The course involved online, classroom and in‑field learning as the pair was able to ride along with York Region community paramedics on the job. York has been conducting a paramedicine trial since 2013 with positive results.

“I’m really looking forward to building relationships with patients and providing better care to prevent avoidable pain and trips to the emergency room,” said Luce when asked what he’s looking forward to in his new role. “This trial is taking the paramedic role in a new direction and it’s very exciting to be involved.”


http://www.emsworld.com/news/12032798/community-paramedicine-clinical-trial-launches-in-canada

Goal of paramedic house calls, chronic disease monitoring is to reduce 911 calls from frequent users and minimize hospital readmissions

HOUSTON, Texas — William Jones sat on a brown sofa in his small, cluttered living room, as a paramedic rolled up his jean leg and pulled down his sock, revealing a limb swollen with fluid.

The 77-year-old's faulty kidneys concerned paramedic Nivea Wheat.

"We might need to get you in to your doctor," Wheat told Jones.

Several feet away, Morgan Clark, another paramedic, sat at a wooden kitchen table, methodically sorting some 10 different types of medication for Jones' heart problems, kidney disease, diabetes and other health problems into a color-coded pill box.

It's an unusual role for paramedics who are used to seeing a patient for 15 minutes in the back of an ambulance. For about two months now, Wheat and Clark have visited Jones' house every week, checking his blood sugar, taking his blood pressure readings, setting up appointments with his doctor and helping Jones find a home health nurse.

These relationships are becoming increasingly common as health care organizations push to reduce reliance on the costly emergency response system.

Wheat and Clark are part of a new six-member group in the Montgomery County Hospital District, an adaptable team of paramedics that helps patients who repeatedly find themselves in the emergency room navigate a dauntingly complex health care system and identify more proactive approaches to their health.

They're calling the program "community paramedicine."

"Obviously for much of the population, 911 is a great service. For the heart attacks, the strokes, the trauma, it's a great system, and we do that very well here at MCHD," said Andrew Karrer, who is running the district's community paramedicine program. "But for a lot of individuals, that's not necessarily what they need. They need other options."

'Back and forth'

While still new and untested in many areas of the country, emergency response providers are increasingly creating similar programs. Harris County Emergency Corps, an emergency response provider for north Harris County, started a community paramedicine program in the summer, which it calls "mobile integrated health care."

A few months ago, Fort Bend County announced a similar program.

Matt Zavadsky, a spokesman for MedStar in Fort Worth, one of the earliest adopters of the community paramedicine program that consults with others throughout the country, said according to his organization's research, there are about 230 different community paramedicine programs in the country. When Fort Worth started its program in 2009, there were only three, he said.

"People are seeing that these programs can have a really big impact," said Richard Bradley, chief of the EMS and disaster medicine division at University of Texas Health Science Center at Houston.

Partly driving the proliferation is a desire to improve patient outcomes. Patients in these programs receive more intimate instruction and care, rather than being treated by multiple doctors in an ER.

But Zavadsky said a bigger impetus is likely the passage of the Affordable Care Act, also known as Obamacare, which penalizes hospitals for readmissions and creates a financial incentive for proactive programs like community paramedicine.

A goal for the MCHD is to reduce 911 calls from frequent users, Karrer said.

While he said that in its first year, almost two-thirds of the patients who worked with community paramedics reduced their 911 usage, there's not enough data to say whether the program is working.

"We just want to see we're moving in the right direction for these individuals," he said.

That goal has meant paramedics playing a variety of new and unique roles - from health care adviser to social worker to therapist - for a segment of the population that has been "falling through those cracks" in the health care system, he said.

Some patients they visit have only an elementary school education and can't understand the pages of verbose medical instructions they receive after being discharged from the hospital. Some are uninsured and don't have primary-care physicians. Some have severe anxiety or other behavioral health problems.

They all see 911 as their only option to access the care they need, Karrer and his team said.

Jones would repeatedly end up in the emergency room after fainting due to low blood sugar because he didn't take his insulin shots or medication properly. "I've been back and forth in the hospital forever," Jones said.

Managing 42 patients

To pinpoint whom to contact, Karrer looks at who has called 911 between 10 and 35 times in the past six months. Then paramedics contact those individuals and ask if they'd like help, an offer they've found has been overwhelmingly appreciated.

"The single most common thing people tell me is, 'I've never had someone explain this in common terms before,'?" said Cathy Kraus, the case manager for the program.

So far, paramedics in Montgomery County are managing 42 patients, up from 26 last year when the program started. After hiring four paramedics this October, the goal is to reach 120 patients and 145 the year after that, Karrer said.

That number pales in comparison to the need in the county. Based on the 911 data he looks at, Karrer estimates there are likely thousands of people overusing the system.

At Jones' house, when Clark swings open the door of the fridge, it's filled with gallon jugs of milk, regular and chocolate, orange juice and a bottle of Dr Pepper, which, upon some light interrogation, Jones coyly admits drinking from time to time.

But the beverages risk dangerously elevating Jones' blood sugar, so Wheat volunteers to bring him some Crystal Light or another, healthier drink. With other patients, paramedics in these programs might do groceries, help them with their electric or water bills, or simply show up and provide a regular social presence in patients' lives.

"We're kind of doing a reboot on our thinking of what is this role of the ambulance, what is the role of the heath care providers that are on it," said Chivas Guillotte, vice president of clinical services for the Harris County Emergency Corps.

At least for Wheat and Clark, the ultimate goal isn't to be waiting on Jones indefinitely. Their job is to connect him with the right resources and, eventually, get him off the high-frequency 911 user list.

But for Jones, the paramedics are a mainstay in his life. There are tight embraces and kisses on the cheek when Wheat and Clark enter and leave his house.

"I hope I can stay in contact with y'all," Jones said.

"I don't have nothing else."



McClatchy-Tribune News Service©2014 the Houston Chronicle



http://www.ems1.com/ems-products/financial-services/articles/2040772-Community-paramedic-programs-expanding-in-Texas/?utm_source=newsletter&utm_medium=email&utm_campaign=featuredNews&nlid=2040995

The bill would help bolster staffing by allowing them to claim a portion of the value of the services they donate each year as a charitable donation

WASHINGTON — Congressman Dave Loebsack is pushing to help rural fire departments.

The Democrat joined Republican Congressman David B. McKinley out of West Virginia in introducing legislation to create a tax deduction for volunteer first responders in the hopes that it will help volunteer fire departments and other public safety organizations recruit and retain volunteers.

"I’d like to thank Representatives McKinley and Loebsack for introducing this important legislation," Chief Philip C. Stittleburg, Chairman of the National Volunteer Fire Council, said in a release. "The services donated by volunteer emergency response personnel are valued at more than $140 billion annually and the average responder donates services worth more than $18,000 each year. At the same time, local agencies are increasingly struggling to recruit and retain volunteer firefighters and EMTs. This common sense bill would help bolster staffing in volunteer public safety agencies by allowing responders to claim a portion of the value of the services they donate each year as a charitable donation."


EMS1 : http://www.ems1.com/legislation-funding/articles/2043516-Congress-looks-at-tax-break-for-volunteer-responders/

Read more: 
http://www.connecttristates.com/news/story.aspx?id=1134387#.VI71-CvF-Sp

WASHINGTON -The District of Columbia is losing paramedics at an alarming rate and they are not being replaced.

53 have resigned or retired since Kenneth Ellerbe became fire chief in 2011.

It is an exodus that has led to a critical staffing shortage with advanced life support units going unfilled every day.

The firefighters’ union has been sounding the alarm for months, telling D.C. councilmembers and anyone who will listen, the net loss of paramedics has created a “crisis” situation with first responders forced to work 36-hour shifts and advanced life support units left off the streets every single day.

Normal protocol has 14 medic units staffed during every shift. It is a number designed to make sure advanced life support is available within minutes of a 911 call in every ward in the city.

But as paramedics leave without being replaced, those 14 medic units have dwindled.

According to the firefighters union in 2011, two to three Advanced Life Support units were downgraded to Basic Life Support every day.

In 2012, the numbers went from four to five, and so far this year, it is averaging five to six downgrades every day.

"Pretty simply, the basic difference between a paramedic and an EMT is that the paramedic brings the ER to you in the first 20 minutes, so everything the ER can do in those first critical minutes, a paramedic can do for you in the field," said Paramedic Joe Papariello in an interview Thursday.

"Take for example the month of April. According to the union in April 2011, more than 23 percent of the scheduled Advanced Life Support units were taken off the streets."

In April of last year, it was more than 34 percent, and so far this year, it has risen to more than 42 percent.

"And when we don't have enough units on the street, units have to respond out of their areas that they are supposed to protect, and it puts a stress on the system and on the individual, and that's why a lot of our medics are leaving,” said Papariello.

The staffing shortage has also lead to forced overtime. In 2012, according to the union, 185 times paramedics were held over for a 36-hour shift. So far this year, it’s happened 136 times.

On Friday morning, Chief Ellerbe will go before the D.C. Council’s Judiciary Committee where he is expected to testify about his ambulance deployment plan.

He declined our request for an on-camera interview.

In recent testimony, the chief told the council he plans to train current EMTs to become paramedics. But as the union points out, that could take up to two years.



Read more: http://www.myfoxdc.com/story/22275588/dc-paramedic-departures-causing-major-concerns-over-staffing#ixzz2TgAtmp86 
Follow us: @myfoxdc on Twitter | myfoxdc on Facebook

The NTSB will gather Tuesday to give a cause for the accident in August 2011 that killed four people


WASHINGTON — A medevac pilot was sending and receiving text messages before a crash that killed all four people on board, it emerged Monday.


Bloomberg.com reported that it's the first time such distractions have been implicated in a fatal commercial aviation accident.

The NTSB will gather Tuesday to give a cause for the accident in August 2011 that killed four people – patient Terry Tacoronte, Pilot James Freudenbert, Randy Bever, a flight nurse, and Chris Frakes, a paramedic – and to discuss the documented seven texts sent and received by the pilot prior to the crash, according to the article.

Freudenbert, 34, disclosed to a coworker before the crash that he hadn’t slept well the night before his flight and he failed to refuel the helicopter before flying to a hospital in Bethany, Missouri, according to NTSB records.

He recognized the mistake after landing at the hospital and spoke to a company dispatcher about where he could get more fuel and was headed to Midwest National Air Center Airport before the helicopter crashed, according to Bloomberg.

The Air Methods Corp. (AIRM) helicopter crashed in a field after running out of fuel. Electronic devices used by pilots during flight are prohibited by company rules, according to the reports. 

“This is a classic example of dividing attention in a way that compromises safety,” David Strayer, a psychology professor at the University of Utah in Salt Lake City who has studied how personal electronic devices cause distraction, told Bloomberg.

Full article: http://www.ems1.com/air-medical-transport/articles/1429050-Texting-while-flying-linked-to-fatal-medevac-crash/