COVID-19 Town Halls

Upcoming Town Halls

COVID-19 and Public Health Intersection in EMS 

Monday, November 9, 2020
1:00 pm ET/12:00 pm CT/11:00 am MT/10:00 am PT


register nowRegister now to join NAEMSP and our host Dr. Lekshmi Kumar, for the next installment of our COVID-19 Town Hall Series as we discuss how COVID-19 has impacted Public Health EMS. 

Host:

  • Lekshmi Kumar, MD, MPH - Dr. Kumar completed her ER residency at Mayo Clinic Rochester MN, EMS fellowship at Emory and MPH at Rollins school of Public Health. ER attending at Emory University Hospital and has been medical director for both ambulance and fire based systems for the past 8 years. Currently Medical director for Grady EMS that is a hospital-based EMS system, a component of Grady Health System and provides 911 services to the City of Atlanta in addition to 16 counties across Georgia with an approximate annual call volume of 130,000 within the City of Atlanta.H

Presenters include:

  • Chelsea White, MD, NRP, FAEMS, FACEP - Dr. White is an emergency physician in the Department of Emergency Medicine at University of New Mexico, USA.  He is the Director of the UNM Center for Rural and Tribal EMS as well as the soon-to-be immediate past Director of the UNM EMS Fellowship.  He currently serves as EMS Medical Director for Cibola (sih-BOW-la) County Fire and Emergency Medical Services, Pueblo of Acoma (AAH-co-mah) EMS/Fire Department, Pueblo of Isleta EMS, Pueblo of Laguna Fire Rescue, Pine Hill Emergency Medical Services, and the TóHajiilee (to-HA-juh-lay) Field Office of Navajo Nation EMS.  He is the President of the New Mexico Chapter of the NAEMSP.  
  • Ray Barishansky, MPH, MS - Mr. Barishansky is the Deputy Secretary for Health Preparedness and Community Protection at the Pennsylvania Department of Health. From 2012 to 2015, he served as the Director of the Office of Emergency Medical Services for the Connecticut Department of Public Health. Prior to that, he served as the Chief of Public Health Emergency Preparedness and Response for the Prince George's County (MD) Health Department from 2008 to 2012. Mr. Barishansky is currently enrolled in a Doctoral Program in Public Health (DrPH) at the Fairbanks School of Public Health at Indiana University. He holds a Bachelor of Arts degree from Touro College, a Master of Public Health degree from New York Medical College and a Master of Science in Homeland Security Studies from Long Island University. He is a graduate of the Senior Executives in State and Local Government program held at the John F. Kennedy School of Government at Harvard University (2006) and has also earned a Certified Public Manager (CPM) certification through Arizona State University. Mr. Barishansky has authored articles in such publications as EMS Magazine, the Journal of Emergency Medical Services (JEMS), EMS Insider, Domestic Preparedness Journal, the Journal of Homeland Security and Emergency Management, Emergency Management Magazine, and the Crisis Response Journal (UK). He is a nationally recognized speaker and has made presentations at various EMS and Public Health conferences.
  • Justin Stewart, AAS Paramedic, ME - Justin Stewart is the Training Officer for Rockingham County EMS.  Justin has taken Rockingham County EMS to the tip of the spear in prehospital patient care in the country. He has accomplished this with revolutionary partnerships with Social Services and Health Departments. One example of this is integrating paramedics with the Department of Health and Social Services, working hand in hand with social workers, mental health providers, and substance abuse peer support specialists. Justin is inspired by his wife of twenty-six years, Sarah, and their six daughters, one of which he lost to cancer in 2011. Justin likes to spend time with his family in his free time and is active in his church.  

Town Hall Recordings

Economic Impact of COVID-19 
9/8/2020

Click here to download a recording of the session - Access password: S*9q!FKs

Moderator: NAEMSP Secretary/Treasurer José  G. Cabañas, MD, MPH, FAEMS
Participants:

  • J. Stephen Lee. Steve manages the PPG office in downtown Pittsburgh and works with clients to develop, implement and monitor tailored financial solutions. He also serves as the firm's Chief Investment Officer, overseeing the firm's investment research, portfolio construction and portfolio management. Steve joined the team in 2012 when Pittsburgh-based H.L. Zeve Associates merged with JFS. Before the merger, Steve worked as a Lead Advisor for H.L. Zeve since 1994. Prior to this, Steve lived in New Orleans, LA, where he owned and operated an oil and gas exploration and production company, managing funds from private and corporate investors. He received a Bachelor's Degree in Geological Sciences from Brown University and earned his Master's Degree in Business Administration (MBA) from the University of Pittsburgh Katz School of Business.
  • Ronald W. Yost. Ron works with clients to develop, implement and monitor tailored financial solutions at our PPG office in downtown Pittsburgh. He is also a member of the firm's Business Development team. Ron joined the team in 2012 when Pittsburgh-based H.L. Zeve Associates merged with JFS. Before the merger, Ron worked as Vice President for H.L. Zeve since 2004. Prior to this, Ron was Vice President and Manager of Charles Schwab's Monroeville office where he oversaw a staff of six and was responsible for firm assets of approximately $700 million.

Join the discussion forum.

Urban EMS Considerations in the COVID-19 Era
8/12/2020

Click here to download a recording of the session - Access password: V3oNdLn$

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Marianne Gausche-Hill, FACEP, FFAP, FAEMS. Dr. Gausche-Hill is the Medical Director for Los Angeles County Emergency Medical Services (EMS) Agency, Professor of Clinical Emergency Medicine and Pediatrics at the David Geffen School of Medicine at UCLA and serves as Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. The LA County EMS Agency receives over 700,000 911 calls a year, has over 70 receiving centers with multiple specialty centers including stroke, STEMI, Trauma, and pediatric. She is nationally and internationally known for her work as an EMS researcher and educator, and for her leadership in the field of EMS and pediatric emergency medicine. She is best known for her study of pre-hospital airway management for children published in JAMA 2000 and her work on the National Pediatric Readiness Project published in JAMA- Pediatrics in 2015. She has won numerous national awards for her leadership in emergency medicine, pediatric emergency medicine and EMS. Dr. Gausche-Hill currently serves as a senior editor for the textbook, Rosen's Emergency Medicine: Concepts and Clinical Practice, and serves on the American Board of Emergency Medicine Board of Directors.
  • Drew Harrell, MD, FAEMS, Dr. Harrell is an Associate Professor of Emergency Medicine and EMS in the Division of EMS, Disaster, and Austere Medicine, Department of Emergency Medicine at the University of New Mexico School of Medicine. He is board-certified in both Emergency Medicine and Emergency Medical Services practice and has been a practicing EMS physician in New Mexico for over 10 years. He started in EMS in 1991 when he first took a Wilderness EMT class and, in a prior career, worked as both a nationally registered paramedic and wildland firefighter throughout the western US. He currently provides EMS Physician field response and medical direction through the UNM EMS Medical Direction Consortium program in Albuquerque for the multiple EMS partner agencies of the EMS Consortium. Drew currently serves as the operational EMS Medical Director for the following agencies: Grand Canyon National Park Emergency Services, Bernalillo County Sheriff's Department,  the New Mexico State Police and State Search and Rescue, and the Albuquerque Police Dept. Special Operations Division TEMS team. Additionally, he provides operational TEMS medical support as a Reserve Deputy with the Bernalillo County Sheriff's Department Special Weapons and Tactics Team and is also the educational program Medical Director for the US Air Force Pararescue paramedic training program through the UNM EMS Academy. His areas of interest include pre-hospital EMS practice and education, tactical and austere medical care, and EMS medical direction.
  • Lekshmi Kumar, MD, MPG, Dr. Kumar completed ER residency at Mayo Clinic Rochester MN, EMS fellowship at Emory and MPH at Rollins school of Public Health. She was an ER attending at Emory University Hospital and has been medical director for both ambulance and fire based systems for the past eight years. She is currently Medical Director for Grady EMS that is a hospital-based EMS system, a component of Grady Health System and provides 911 services to the City of Atlanta in addition to 16 counties across Georgia with an approximate annual call volume of 130,000 within the City of Atlanta.
Key take-aways:
  • As emergency care of the COVID-19 patient matured, death rates fell in spite of an increase in overall cases.  This underscores the importance of continually building upon lessons learned.
  • The idea that PPE usage is effective if used properly and consistently is supported by the ongoing data. Therefore, many EMS systems have begun to relax restrictions on “aerosol generating procedures” as long as clinicians don and doff their PPE appropriately.
  • Urban EMS services cannot be expected to know, let alone follow, dozens of different “protocols” for facility entry during this pandemic.  Coordination, at a system level, of EMS resources and response is essential.
  • While the overwhelming “tsunami” of anticipated EMS calls thankfully did not materialize, the preparatory steps—including treat-in-place protocols, alternative destination sites, and dispatch screening and triage modifications—should be examined for implementation in a post-COVID world in the context of quality medical oversight and increased CMS flexibilities for payment. 

Join the discussion forum.

EMS Education Considerations in the COVID-19 Era
7/28/20

Click here to download a recording of the session - Access password: ^Hs3G68T

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Maia Dorsett, MD, PhD, FAEMS, medical director of EMS Education Programs for Monroe Community College in Rochester, New York and the Monroe-Livingston Associate Regional Medical Director for Education and Quality
  • Joshua Stilley, MD, medical director for University of Missouri Ambulance, University of Missouri EMS Education and the National EMS Education Standards Update Committee
  • Anthony Liu, BS, AEMT, student at Austin Community College's Paramedic program and Advanced EMT for the Hays County EMS in Texas 
  • Ginger Locke, BA, NRP, Associate Professor of EMS Professions at Austin Community College and creator of the Medic Mindset podcast
Key take-aways:
  • Boxes “checked” does not equal material learned. In light of reduced clinical time and patient contacts, medical directors must find innovative ways to determine student competency such as replacing mere number of hours or patient contacts with individual learner demonstration of competencies in managing key chief complaints and skills.
  • Seeking other clinical facilities in more rural areas eager to have students has been a solution for many programs, and letting clinical sites know the school will provide student PPE assuages many initial concerns for PPE shortages.  
  • Program weaknesses have been uncovered because of the COVID-19 crisis. Use this time to specifically address those weaknesses not only for the current pandemic but for the next one surely on the horizon.
  • Simulation is here to stay, and schools must be willing to accept that it is time-intensive and needs dedicated support in order to be done correctly. 
  • Physician medical directors must be ardent advocates of their students and not only develop but maintain and cultivate relationships with key hospitals, agencies and other clinical partners to support the learner’s educational experience.

Join the discussion forum.

Air Ambulance Transport during COVID-19 (originally named HEMS Considerations in the COVID-19 Era) 7/7/20

Click here to download a recording of the session - Access password: 0J&[email protected]?=

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Leslie Osborn, MD
  • Angela Cornelius, MD, FACEP
  • Ray Bennett, BSN, RN
Key take-aways:
  • Using dedicated aircraft for known COVID-positive patients may help reduce down time for decontamination keeping more aircraft in service. 
  • Temporary use of scrubs instead of flight suits may be appropriate in some circumstances when considerations include crew fatigue, turnaround time for decontamination, and laundering logistics. 
  • HEPA filtration in aircraft may filter circulated air, but it does not always filter the air between you and the person in front of you. Continued use of appropriate PPE is essential, and crews cannot depend solely on HEPA filters within certain aircraft. 
  • There continues to be a paucity of data regarding aerosol-generating procedures and their use within rotor-wing or fixed-wing airframes, but current practice is to limit AGPs similar to ground ambulance services. 
  • Certain PPE configurations can make headset communication almost impossible.  Services must find the right PPE to fit with their night vision equipment, helmets, and/or microphones as applicable and fit-test with these unique configurations at altitude when possible. 
Join the discussion forum.

Quality Improvement in EMS in the COVID-19 Era 6/26/20

Click here to download a recording of the session - Access password: [email protected]^

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Remle Crowe, PhD, NREMT, research scientist, ESO; faculty member, NAEMSP Quality and Safety Course
  • Tim Burns, NRP, Montgomery County
  • Scott Dorsey, MS, Chief of Strategic Analysis and Improvement 
  • Stephanie Ashford, Ed.S., NRP, paramedic training officer, St. Charles County, Missouri; faculty, NAEMSP Quality and Safety Course
Key take-aways
  • Data is meaningless until one can turn it into useful information and put it into context, and that context is often provided in the form of control charts.  (See the links in our Follow-up Forum for online resources to make your own control charts!)
  • One doesn’t necessarily need a Ph.D. to turn data into information, but educating oneself to the fundamentals of Information Science will be important to avoid early frustration.  Great resource books and courses are on our Follow-up Forum. 
  • Data points must be defined. These definitions don’t have to be perfect, but they must be consistent in order to make meaningful comparisons.  
  • Avoid the urge to make sweeping changes in your system. Enact and examine small tests of change first.
  • COVID-19 surveillance has demonstrated that QA and CQI principles can help drive clinical protocols, but can also sustain Human Resources priorities by illustrating PPE utilization and effectiveness.
  • A QA program needs more than just “buy-in” from administrators. It needs support. Win that support by finding out what is important to your leadership and demonstrate your value by being the source of actionable intelligence that would help them with their responsibilities.
Join the discussion forum.

NAEMSP Town Hall: Rural and Tribal EMS Considerations in the COVID-19 Era 6/11/20

Click here to download a recording of the session - Access password: 2w^#t9W2
 
Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Jenna White, MD, EMS physician; associate professor of Emergency Medicine, University of New Mexico in Albuquerque, NM. 
  • Julie Houle, MD, MHA, emergency physician in northern Minnesota. 
  • Joy Crook, MD, associate professor and vice chair, clinical affairs, Department of Emergency Medicine, University of New Mexico; New Mexico State EMS Medical Director; Medical Director for AMR in Central New Mexico; member of the Secretary of Health's Medical Advisory Team during the Covid pandemic.
  • Allen Lewis, MPA, CEMSO, Paramedic: Fire Chief, Virginia Fire Department,  Virginia, Minnesota; adjunct professor, College of Safety and Emergency Services, Columbia Southern University 
Key take-aways:
  • Workforce protection is even more critical in rural/tribal agencies, as there is little to no redundancies in staffing with limited mutual aid options.
  • Public health messaging in rural and tribal areas is challenging not only due to geographic expanse but often a lack of electricity, much less Wi-Fi or technology.
  • Rural and tribal EMS providers are a valuable avenue for public health messaging, as they are known and trusted by the patients and also speak their language, know their customs, and engender their confidence.
  • Cultural norms of multi-generational housing among tribal nations necessitated development of isolation facilities when family members became ill.
  • Isolation facilities may be staffed with medical personnel furloughed from other institutions.
  • Rural EMS must move to a system where services are rendered to those who need it as opposed only to whoever is paying for it.
Join the discussion forum.

NAEMSP Town Hall: Mental Wellbeing in the COVID-19 Era 5/28/20

Click here to download the recording of the session - Access password: 8D$%.N2U

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Ann Marie Farina, AAS, BA
  • Elizabeth Donnelly, PhD, MSW, MPH, NREMT, Associate Professor, School of Social Work, University of Windsor
  • Lauren Maloney, MD, NRP, FP-C, NCEE, EMS, Fellow, Stony Brook University Hospital; Adjunct Assistant Professor of Biomedical Engineering, Stony Brook University; Associate Medical Director, SBU Paramedic Program;  faculty, SBU Institute for Engineering-Driven Medicine
  • Chief Randy Mellow, Chief, Peterborough County/City Paramedics; President, The Paramedic Chiefs of Canada; member, Canadian Institute for Public Safety Research and Treatment - Public Safety Steering Committee. 
Key take-aways:
  • It is just as okay to be okay as it is to be “not okay” during a crisis.
  • Coping with stressors can range from a simple “buddy check” to formal counseling and everything in between but everyone must recognize the need for assistance in themselves, as well as others, and seek or provide the necessary support.
  • Setting up a local support and response program for “routine” incidents will garner trust and get personnel accustomed to reaping the benefits of such a system, which will truly reveal its worth when a major catastrophe hits; involve key administrators and stakeholders early in the inception phase.
  • Communication styles and strategies during a major event must be adjusted to avoid secondary traumas from ineffective or harmful attempts at conveying information.
  • See the NAEMSP COVID-19 Resource Page and discussion forum for a printout of helpful resources.
Join the discussion forum

NAEMSP Town Hall: Emerging Critical Care Concepts in the Management of COVID-19 5/14/20

Click here to download the recording of the the session - Access Password: 9k$66D=0

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Jacob B. Keeperman, M.D., EMT, FAEMS, Department of Anesthesiology, Division of Critical Care Medicine; Department of Emergency Medicine, Division of EMS, Washington University School of Medicine, St. Louis, MO
  • Amjad Musleh, M.D., Department of Anesthesiology, Division of Critical Care Medicine; Department of Emergency Medicine, Division of EMS, Washington University School of Medicine, St. Louis, MO
  • Christopher Palmer, M.D., EMT, Department of Anesthesiology, Division of Critical Care Medicine; Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO

NAEMSP Town Hall: Chapter Insights Surrounding COVID-19 4/30/20

Click here to download the recording of the the session - Access Password: 2l#0Do82

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:

  • Josef Schenker, MD, FAEMS: NAEMSP New York Chapter President
  • Joslyn Joseph, DO, EMT: NAEMSP New Jersey Chapter President
  • Jeff Williams, MD, FAEMS: NAEMSP North Carolina Chapter President
  • Joseph Zalkin: NAEMSP North Carolina Chapter Executive Director
  • Jeff Jarvis, MD, EMT-P, FAEMS: NAEMSP Texas Chapter President
Key take-aways
  • Crisis Standards of Care should be crafted before a crisis occurs.
  • State chapters should be a resource to government officials when it comes to addressing clinical aspects of public policy.
  • Including non-NAEMSP members in chapter-sponsored advocacy activities and educational efforts can demonstrate value to stakeholders and provide an avenue to recruit new members.
  • The COVID crisis has revealed the utility of telehealth in medical control applications in addition to mobile integrated healthcare. 
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NAEMSP Town Hall: EMS Legal Issues Regarding COVID-19 4/16/20

Click here to download recording of session -  Access Password: H0#84+48

NAEMSP President, Dr. David K. Tan, spoke with our guests, attorneys Matthew Streger and Margaret Keavney.

Key take-aways:

  • Be sure to consider local or state waivers of existing law when crafting Crisis Standards of Care
  • If allowing crews to not transport suspected COVID patients who are well-appearing with acceptable vital signs, perhaps in a shared decision-making model, consider crafting an “acknowledgement form” that includes patient education rather than a “refusal form” since the patient is not really “refusing” your care or transport
  • CMS has issued temporary regulatory waivers to include expanding the list of allowable destinations for ambulance transport during the Public Health Emergency (PHE) for the COVID-19 pandemic
  • Police departments and dispatch agencies are generally not considered a “covered entity” and, therefore, are not required to comply with the HIPAA Privacy Rule
  • COVID status may be reported to a law enforcement official to prevent or lessen a serious and/or imminent threat to the health or safety of an individual or to the public
  • The Ryan White Act was expanded to include COVID-19 reporting

Join the discussion forum

NAEMSP Town Hall Meeting - Protecting Your Providers: Seattle’s COVID-19 Experience 

Watch now. (Access Password: 4lG38G)

Moderator: NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS
Participants:
  • Thomas Rea, MD, MPH, is the Medical Program Director for King County EMS and a Professor of Medicine at the University of Washington. 
  • Michael Sayre, MD, is the Medical Director for Seattle Fire Department and a Professor of Emergency Medicine at the University of Washington. 
Key take-aways:
  • PPE works!  Greater risk to EMS may actually be off-duty or if not practicing social distancing and basic infection control procedures while at work. 
  • At this time, PPE is a limited resource, so agencies must risk stratify its use to conserve appropriately until supplies become stable.
  • The “Scout” procedure is an added layer of screening to augment the EMD/Dispatch pre-screen as well as another avenue to conserve PPE
Join the discussion forum.

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