County of Brant Ambulance

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1 CCTU New Business I received a copy of the Ministry Press release on the implementation of the Critical Care Paramedic Initiative proposed for the province and the Hamilton Region. The HHS has not been formally contacted regarding this proposal by either the ministry or ORNGE. At this time, we are not planning on making any changes to our program. I am wondering if any of the service providers have any additional information such as: Implementation date? Will this team assist outlying community hospitals with Critical Care patient transfers or will it just be for Inter facility transports? How will the team be staffed? CCTU Summary Report The CCTU has been extremely busy in December and January due to high patient acuity and the bed management issues the HHS has been experiencing. As per the last PQoCC meeting, I have advised the CCTU staff to request the dispatcher dispatch the EMS vehicle code 3 and not code 4. Code 4 is to be reserved for a direct physician request. County of Brant Ambulance Date: January 29, 2007 To: PQCC From: Russell King Duty Manager Q&A /Training Re: County of Brant Updates

2 1. Dave Dungey has completed all components of the TEMS ALS program and has graduated from they program. On Wednesday January 24, 2007 Dave wrote the provincial ALS exam. We wish him well. 2. Spoke to Adam Dawson from Zoll medical. The software for the ZOLL M Series defibrillators has not been released. Adam hopes to have answers from his IT department this week. 3. We completed the PM s on our suction units. We replaced all rechargeable batteries and all components. Hamilton CACC Report to Hamilton Health Sciences Base Hospital Program Pre-Hospital Quality of Care Committee January 30, 2007 Hamilton CACC Staffing ACO 2 Supervisory Staffing 5 Out of 6 2 ACO 1 Employees have been temporarily seconded to the position. One (1) permanent vacancy will be filled by competition in February 2007 ACO1 Unclassified Staffing Two (2) Unclassified Ambulance Communications Officers (ACO 1) hired April 18, 2006 have completed the ACO Core Education Course, local training including call taking and dispatching skills is ongoing. One (1) Unclassified ACO 1 hired January 8, 2007 is currently enrolled in the EHSB Core Education Program. Hamilton CACC has requested two (2) ACO 1 seats in the next EHS ACO Core Education session scheduled to begin May Education 2007 Continuing Medical Education (CME) EHSB Level C CPR First Aid Recertification will be provide to those ACO employees requiring same. ARIS II Distance Calculator tool education has been completed, providing ACO s with the capability to estimate travel in km assisting in seamless, call-share and double dispatch incidents. Version 1.0 of the EHSB Manual of Practice has been introduced and implemented within all Ministry CACC and Ambulance Communication Services across the province. The Manual of Practice replaces the CACC Manual of Operational Policy

3 and Procedures. Written in plain language with updated terminology and practices as well as the separation of definitions, policies and practices, the Manual of Practice has less content repetition, is shorter, easier to use and amend than its predecessor. Quality Assurance Hamilton CACC has implemented the Provincial CACC / ACC Quality Assurance Initiative or Key Performance Standards Quality Assurance Program (KPSQAP). The program includes auditing of both call taking and dispatching functions for Ambulance Communication Officers (ACO). The installation of the program has been completed. Hamilton CACC Service Review July 2006 I would like to extend sincere thanks to the area ambulance services and stakeholders for completing the service review questionnaires. Although a final report is pending the preliminary findings of the review were positive. Hamilton Emergency Services EMS Service Report Currently Training Winter Con Ed: Subjects include CPR, New BLS Standards, some new equipment, orientation to the retractable IV catheters. Service Review: The MOH undertakes reviews of EMS services on a 3 year cycle. HES is scheduled to be reviewed in 2007, and we learned recently that the review will be in April. We are scrambling to prepare, but we believe we will be ready. Consultants Report: The City of Hamilton has contracted a consultant firm to give us some guidance and suggestions for the future of Hamilton EMS, and to provide us with some feedback on the directions that we have recently taken. Among the specific issues that the consultant should report on include: The number of vehicles required servicing our calls. The appropriate deployment of those vehicles. The appropriate ratio of ACPs and PCPs. The use of prehospital 12 Lead ECGs. Our handling of resource narrowing incidents.

4 The complete report is expected within the next several weeks. Monitors and 12 Leads: We are scheduled to replace our inventory of cardiac monitors early in the New Year (2008), and will be undertaking the purchasing process over the course of this year. We are considering the addition of the ability to acquire a 12 Lead ECG, subject to the direction in the consultant s report. E.M.S. Division 95 Culver Street, Simcoe, Ontario N3Y 2V Fax: Administration Headquarters Date: January 18, To: Base Hospital From: Norfolk County E.M.S. Norfolk County E.M.S. received the 2 nd of two new vehicles in November with a new radio of On January 10, 2007 Norfolk County E.M.S. moved into a new base at the Delhi location, 789 James street. The base houses two vehicles and is operational 24 hrs. Norfolk County Hired a new Fire Chief, Mr Terry Dicks, in December, and he is fitting in to our system very well. We moved over to the new protocols in late January with all the defibrillators as of that date on the new protocol. Norfolk County E.M.S. will be starting another I.V. course with the initial testing on Feb 1 st 2007 and the course starting sometime in mid March. Norfolk County E.M.S. now has MRX Defibrillators in all stations and Heart start 4000s as back up monitors.

5 2007 has already started with yet another power outage due to weather, with some areas of Norfolk without power for hours during the week of Jan 15. We anticipate a busier than normal 2007 due to increased population/building in the area and two Friday the 13ths in April and July. Prehospital Quality of Care Committee Meeting Report January 30, 2007 Primary Care Paramedics Happy New Year to all! I have just a few quick things to report to PQoCC at this time. First of all, Norfolk County has implemented the new Phillips MRX monitors onto the trucks with the new protocols coming into effect January 29 th, The monitors have been well received by staff and once the familiarization period has passed, the paramedics will enjoy the added features and ease-of-use this monitor provides. We are not foreseeing any issues with the upcoming new protocols, but there is always an adjustment period when getting used to new things. I will be able to report better on this at our next meeting. The TORIT study continues without any issues save minor ones concerning public places and determination of police vs. paramedic responsibility in these situations. The problems seem to be ironing themselves out. One major issue I would like to see discussed is the position I am in with PQoCC. I am the representative for primary care paramedics but I feel that it is difficult to accurately and effectively represent all PCP s from all the services. I am quite prepared to report on any issues or concerns from a Norfolk County EMS standpoint, but have to date never received any information, concerns or questions from any other services. This has led me to believe that there are communication difficulties, rather than the lack of issues. I am wondering if anyone has any suggestions to facilitate communications amongst all PCP s in all the services so that every voice can be heard and not just mine coming from one service. I would appreciate any discussion on this matter. Thanks, Sarah Townsend Primary Care Paramedic Representative Norfolk County EMS SIX NATIONS AMBULANCE

6 January 19, 2007 Summary of Activities: We put our new double stretcher unit into service on November 1, We have hired an additional two medics one is still undergoing orientation. Our other newer medic has completed her Base Hospital probation and has been an asset to our service. We have had three TORIT calls, which fell under the protocol guidelines. Things went relatively well from the medics perspective. All of our medics completed the re-certification process on December 04, 2006 and I m sure any and all remedial projects were completed and turned in. I haven t been notified of any outstanding. We completed our in-service training and refresher course over two months. September 20 and October 18 were our training dates. This training has been implemented as part of the orientation package for new hires. We have yet to implement the new Cardiac arrest protocols, we are waiting to have our monitors converted and are hoping to coordinate something with Brant, but vacations and time off over Christmas have been a hold up. Hopefully things will be back to normal now and something can be arranged in the very near future. We are going to have to investigate the possibility of upgrading our computer hardware in the very near future. We continue to be plagued with hardware and software problems and with so much information being transferred electronically; we need to have reliable computers, especially with year-end fast approaching.

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