The JEMS Report

On this episode of The EMS TODAY Show, A.J. Heightman talks with Dr. James Augustine about what we are learning on a daily basis about COVID-19. They also discuss the impact it is having on EMS and emergency departments nationwide, particularly how it is decreasing EMS call volume and ED visits. They also talk about what we should plan for, and who we should be working with in the coming months - particularly when we move through flu season.

In the inaugural podcast of Sacred Cows & Data Cubes, host Jonathon Feit has a conversation with Abby Dotson, PhD, the director of the Oregon POLST Registry and research assistant professor of emergency medicine at Oregon Health & Science University.

Seasoned Haz-Tech Paramedics Joe Hudak and Randy Li speak up close and personal with JEMS Editor Emeritus A.J. Heightman about their experiences during the peak periods of the COVID-19 pandemic in New York City Ground Zero again for a historic American tragedy.

Hudak, a 32-year street medic who responded to the World Trade Center and the crash of an American Airlines plane in Queens in 2001, is featured in the May issue of People magazine because he has the amazing perspective of a paramedic involved in three tragic “one-in-a-lifetime” incidents.

He though he saw it all in his 32 years on the street. He was wrong and is now having to fight and guard against an invisible killer.

Randy Li is a nine-year veteran medic and supervisor who responds to dozens of “jobs” each shift. He has witnessed the best and worst during the pandemic. He’s seen multiple DOAs found in their homes, patients who succumb to other medical issues weeks experienced after their “recovery” from COVID-19 and the recognition and respect EMS and other healthcare workers are receiving daily.

Hudak and Li have been members of a highly trained EMS Competition team that has participated in the JEMS Games for years and explain why COVID-19 is a challenge like no other for EMS personnel. 

The COVID-19 pandemic “wave” is over the top of us and having a major impact on EMS. But that wave will be followed by many other waves well after the pandemic.

Join JEMS Editor Emeritus A.J. Heightman for an in-depth discussion with financial and legislative expert Asbel Montes on the present and future state of EMS. Other topics discussed include:

1. How telehealth has/will change the EMS landscape.

Prehospital systems often implement procedures, practices and equipment that change medicine and encourage hospitals to adopt and continue them throughout the patient care treatment cycle.

 In this treatment-impact episode of The EMS Today Show, JEMS Editor Emeritus A.J. Heightman moderates an outstanding panel of experts who point out that “prone positioning” of patients is now shown to be one of those procedures.  Proning is easy to do, requires no special equipment and can dramatically improve a patient’s oxygen saturation levels.

David A. Farcy MD, FAAEM, FACEP, FCCM, president of the American Academy of Emergency Medicine and chairman, Department of Emergency Medicine and Director, Emergency Medicine Critical Care at Mount Sinai Medical Center and Hildebrandt Emergency Center in Miami Beach, Florida. Dr. Farcy explains patient proning, its history in the treatment of ARDS and the finding that it is extremely effective in the care of patients suffering from COVID-19 infection.

 He stresses that proning has been found to take awake, alert patients presenting as “Happy Hypoxic”. This is defined as being awake but presenting with low pulse oximetry levels that, would cause providers to intubate the patient in the past. With nasal or face mask oxygen, their O2 saturation levels were raised up from 88 to 94 (for example), keeping them from being intubated and, in some cases, being placed on ventilators.

With so many changes and challenges occurring in EMS during the COVID-19 pandemic, JEMS Editor Emeritus A.J. Heightman held a special episode of the EMS TODAY Show with EMS legal expert Steve Wirth, Esq., EMT-P, from the EMS legal firm Page, Wolfberg and Wirth (PWW).

During this special episode, A.J. and Steve discuss:

-- CARES Act funding for EMS services and the terms and conditions of acceptance;

-- HIPAA issues under the Pandemic and the requirement for hospitals to inform EMS agencies if a patient they transported to their facilities tested positive for COVID-19;

-- Documentation issues; and

-- Loosened requirements for EMS to obtain patient signatures.

In this episode, JEMS Editor Emeritus A.J. Heightman interviews Dr. Jeff Clawson, Jerry Overton, Greg Scott, Brian Dale and Christopher Olola, PhD, from the International Academies of Emergency Dispatch (IAED) and the IAED Research, Standards, and Academics Division. They discuss emergency medical dispatch centers playing a crucial role during the COVID-19 pandemic, “Protocol 36,” and what the future might hold for EMS Systems, dispatch and deployment of resources.

Join JEMS Editor-Emeritus A.J. Heightman for an interview with innovative frontline personnel from five Sacramento, California-area fire agencies and hospital facilities that mobilized volunteers in a week to staff four special assignment Community Care Response Units.

Skilled Nursing Facilities in many areas are surfacing as “hot spots” and clusters of COVID-19 outbreaks. On this episode of the EMS TODAY Show, Randy Katz, DO, and JEMS Editor Emeritus A.J. Heightman discuss special considerations for EMS Systems relative to the in their service area and the importance of educating and coordinating with these facilities.

The need for advanced patient ventilation has been at the forefront of patient care during the coronavirus pandemic. The shortage of mechanical ventilators has also surfaced as an overall shortfall in many systems.

Many have raised the issue of why few prehospital response ALS Units are equipped with mechanical ventilators. JEMS Editor Emeritus A.J. Heightman reached out to EMSA, the ALS System serving Tulsa and Oklahoma City, a system that has mechanical ventilators in service for years, to discuss the topic.

Joining A.J. are Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS, and Tyler Wedman, NRP.

Jeffrey M. Goodloe is professor and chief of the EMS Section of the Department of Emergency Medicine at The University of Oklahoma School of Community Medicine in Tulsa. He has the privilege of serving as medical director for the Medical Control Board in the EMS System for Metropolitan Oklahoma City and Tulsa, working with a multitude of agencies, including the Emergency Medical Services Authority (EMSA), the Oklahoma City Fire Department and the Tulsa Fire Department. He started in EMS in 1988 as an EMT-B and has never quit learning.

Tyler Wedman works for Global Medical Response in its operations at EMSA in Oklahoma City. He serves as Director of Clinical Services for EMSA in the “Western Division” which is metropolitan Oklahoma City. He oversees new hire clinical onboarding, CQI, CME, and other clinical and educational duties.