Time - ND EMS Association - Home · RN & Paramedic Team Trained in RSI, IABP, 12 Lead EKG, Pressure Monitoring Participates with the major insurance carriers Bismarck Air Medical

Nominate the NextStar of LifeNominate the NextStar of LifeNominate the NextStar of Life

TimeTimeVolume 37 ❒ I s sue 4 ❒ Fa l l 2016“Your Voice for EMS in Nor th Dakota”

Inside:When to call AirMedNDEMT at the Capitol

Sternal Introsseous DeviceDickinson First Responders

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TABLE of Contents

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NDEMSA OfficersJim Restemayer ......................... PresidentPatrick Tracy ...................... Vice-PresidentOPEN .........................Secretary/Treasurer

Curt Halmrast .................... Past President

Board MembersNorthwestDiane Witteman ......................... PresidentTami Petersen ......................Jennifer Reed Jeri Warrenburg

NortheastEdward Bina .............................. PresidentRudi Bloomquist ................... Jan Samson

Eric Toutenhoofd

SouthwestSuzan Hanson ........................... PresidentKelly Dollinger ................ Linda Lindemann

Adam Parker

SoutheastCheryl Flick ................................ PresidentJason Eblen ............................ Loretta Haas

Tim Meyer

Education AppointeeRon Lawler

Fire/Rescue AppointeePhilip Anderson

Past PresidentsMark Weber ........................Derek Hanson

Mark Haugen ............................Char Skaff

Medical DirectorBen Roller, MD

Division of EMS and TraumaTom Nehring ..............................Director

Advertising Contact InformationJoe Sitter - [email protected] Printing Service, Inc. ... 701.255.3900

NDEMSA Membership ..................1,463

Response Time Circulation ...........1,950

Response Time is published quarterly by Quality Printing Service, Inc.

All rights reserved. Information contained within may not be reprinted wholly or in part without the written consent of the publisher.

THE ND EMS ASSOCIATION1622 E. Interstate Ave.Bismarck, ND 58503

701-221-0567

877-221-EMSA

Fax: 701-221-0693

www.ndemsa.org

[email protected]

www.facebook.com/ndemsa

Presidents Message .............................. 2-3

Education Coordinator ................................4

Education Representative ...........................5

Strategic Planning ................................. 6-7

When to call AirMed .................................8

Call for Candidates ...................................9

Conference Reports ................................10

Call for Award Applications .......................11

NDEMS at the Capitol .............................13

Sternal Introsseous Device ................... 16-17

Dickinson First Responders ................... 18-19

Up Coming Events ..................................20

January 11th, 2017The deadline for the Winter issue is

The ND EMS Association is pleased to accept submissions for Response Time.

Submissions should be reasonable in length due to space considerations. In order to

ensure the quality of our publication, editing for grammar, spelling, punctuation, and content may occur. Articles, photos, and

advertising should be submitted in electronic form.

To submit, please email NDEMSA at :

Follow us on Twitter

RESPONSE TIME Fall 2016 1

From the President...As we transition into that time of year where the Halloween decorations are coming down and we start thinking about putting up Christmas lights we can celebrate the fact that (so far) we have had very nice weather. Hopefully this will allow us more time to get outside and finish those last minute projects. Inevitably, it will get colder and the snow will fall but

so far mother nature is giving us a brief reprieve before we begin to enjoy our North Dakota winter. This fall we hope that you take a moment to check out everything going on in the North Dakota EMS Association on our ND EMS Association website at http://ndemsa.org and at one of the regional events.

Currently, we are seeking nominations for Regional Directors and a Vice-President. To give more members the opportunity to participate and receive nominations from a larger audience we are seeking nominations from throughout the four regions. The deadline to submit nominations is 12/31/16. Following the last regional conference in February NDEMSA members will vote on-line for the nominated candidates. Additional information on the nominations and voting process can be found in the Response Times and on the NDEMSA website. NDEMSA is looking for individuals to help continue the good work being done on behalf of North Dakota’s emergency medical services and its providers. Grant funding, legislation, advocacy and education are just a few of the tremendous benefits provided here in North

Dakota through the effort of your EMS Association. Please consider being part of process and running for a position on your NDEMSA board.

The legislative session will also begin soon here in North Dakota. While the 65th legislative assembly will organize in December and convene in regular session in January there is a great deal that we need to start working on much earlier. It is vitally important that you and your agency are involved in the process. Contact your local Senators and Representatives to share with them the importance of local EMS. ND EMS Association staff also needs your help crafting our message for the Governor and the legislature. To do that we need your input. E-mail, call, or talk with one of the North Dakota EMS Association Officers, Directors, Regional Advisers, or staff and let them know what we might do to help address issues affecting emergency medical services.

On January 31st the North Dakota EMS Association will hold it’s annual EMS Day at the Capital. This is an excellent opportunity to share information with your state legislators and answer their questions on the needs of ND EMS across the state. We hope that you’ll take part in this excellent event in Bismarck.

Also part of the EMS Day at the Capital we celebrate our 2017 ND Stars of Life. This program recognizes and rewards those individuals who epitomize the dedicated mission of EMS. All too often we fail to promote the exceptional work being done within our organization. This is a great way to share some of the efforts by our dedicated providers with the public and with our states legislators. Take a few moments to nominate members from within your agency for their outstanding service in your community and beyond.

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2016 NDEMSA Board

Jim RestemayerNDEMSA [email protected]

I wanted to extend my appreciation to everyone that came out to one of the eight Future of EMS meetings held across the state. We were very fortunate to have a number of individuals, services and representatives share their thoughts on the problems facing our emergency medical systems. This is not a unique problem to North Dakota. Nationally every state is facing a similar dilemma, but the difficulties we are facing may take a local approach to fix. It is also a problem that cannot be fixed by the state office or by the legislature. We need to look inward at ourselves and examine whether those things that we have been doing forever are indeed the best practices. We need to begin talking with our neighbors and considering how we may better collaborate together to help ensure a vital system of EMS remains. Sharing ideas, resources, and manpower to develop a reliable system of EMS across the state. If there was an aspect missing from those meetings it was the lack of interaction with our city and county leaders. In all of our meetings they were largely absent. It will be vitally important to engage the leaders in your community as well as the public in those discussions and planning. They need to hear your story. This series of meetings was the beginning of what should be an ongoing discussion taking place in big cities and small towns. I hope that you’ll continue working on the Future of EMS in your community and across the state.

There are also a number of changes taking place at the NDEMSA. Longtime members Jim DeMell and Ken Reed are stepping down from their positions on the Board. Both of these men have been tremendous asset to EMS

in North Dakota. Giving their time, talents, and energy to help better emergency medical services as part of the North Dakota EMS Association, we want to extend our sincere appreciation for their tireless efforts. They have exemplified the philosophy of IN SERVICE TO OTHERS. On behalf of the NDEMSA Board of Directors and the members of our association I want to say Thank You for all that each one has done.

Lastly, there are a number of conferences coming up here in North Dakota. Please take advantage of the excellent educational training being offered. Regional and national speakers will bring outstanding EMS education to the regional conferences, Phase II educational programs, and at the management conference. We invite you to attend some or all of these sessions. If you have any questions on what’s being offered or have a suggestion for other types of training please don’t hesitate to go to our website or call the NDEMSA office at 701-221-0567. We look forward to hearing from you.

On behalf of your patients and the people we serve THANK YOU for the work that you do every day! We look forward to seeing you at an upcoming NDEMSA event.


From the Education Coordinator...

Greetings fellow EMS providers.October was a busy month for NDEMSA Board members and a number of NDEMSA members. On the weekend of October 1 & 2 board members met in Bismarck for 2 days of Strategic planning. Discussion topics included: The Future of EMS, grants, legislative priorities, education, budget, NDEMSA membership and recruitment and the regional and state conferences.

From October 5th -7th I was fortunate to be able to attend the Resuscitation Academy in King County Seattle, Washington. The Resuscitation Academy is designed to help EMS managers and directors improve witnessed V-Fib cardiac arrest in their communities. King County and Seattle have over 60% save rate in witnessed V-Fib cardiac arrest.

The course included, lectures and discussions on data, QI program development, training and leadership. All of which were monitored by national leaders in cardiac resuscitation. Attendees were also given information on reporting, dispatcher assisted CPR instructions and data resources. This attendee learned firsthand that correctly applying chest compressions for more the two minutes is not possible. Of the 2 dozen or so attendees who chose to participate in the day long High Quality CPR class, zero % could do more than 2 minutes of chest compression adequately.

Attendees were from, Washington, California, Illinois, Michigan, Maine, Vermont, New Hampshire, England, New Zealand and North Dakota.

On Saturday October15th approximately 60 ALS and BLS EMS students took their Psychomotor exam sponsored by the ND Division of EMS Services, the NDEMSA and hosted by Bismarck Community College.

The NDEMSA Board of Directors met on Monday October 24th in Bismarck for their quarterly meeting. The meeting was held at the Ramada Hotel.

Phase II education planning is in the process of being completed. This education will be brought to your service at no cost to you. Subject matter this year will be Sepsis, High Quality CPR and documentation. The class will consist of a short lecture and hands-on assessment and treatment followed by documentation.

Service leaders and training officers, a Phase II instructor will be contacting you in the near future to set up a time to offer this class at your facility.

The State Conference planning committee will be meeting in November to schedule presenters and topics for the upcoming EMS Rendezvous in April. If you know someone who you think would be a good presenter, please contact me and I will relay the information to the other committee members. All requests will be considered.

Dates to put on your calendar:

January 14-15, SW Regional Conference in Jamestown.

January 28-29, NW Regional conference in Minot.

February 18-19, NE Regional Conference in Grand Forks.

April 6-8, EMS Rendezvous in Bismarck.

June 5-6. Management Conference in Bismarck.

Until next time, have a great and safe Thanksgiving.

Randal SeversonNDEMSA Education [email protected]


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From the Education Representative...

The Association is working on the next round of training sessions with the Foundation grant. This Phase II will focus on Sepsis, teamwork in CPR (with some LUCAS refresher thrown in), and documentation. Watch for more information coming out in the next couple months. Remember that these sessions are free to you.

I want to remind everyone that the NREMT will now accept recertification hours you take immediately after you receive your new card to meet your hours requirement for the next cycle. So, if you are on the ball and get your stuff sent in to NREMT in November, December or January, you can now count conferences you attend between then and March 31!

Speaking of conferences, planning is well underway for this season’s 3 remaining regional conferences and the annual state Rendezvous. Check out the website for details and to register. There will be a lot of great speakers and more NCCR topics than ever.

If you are teaching any initial EMS courses, remember to coordinate with the training centers early to ensure that your initial students can test at their test sites. This will be a new process for some of them and they need to plan ahead for space and staff. Please make sure that all of your students are registered with the NREMT prior to the test site.

For AEMT and paramedic programs - the NREMT has announced that they will begin requiring a PATT (Psychomotor Authorization To Test) number for ALS level students prior to taking a practical test. No details have come out yet on how this will work. But it appears that they are simply ensuring people have an NREMT account prior to any testing. This will help to eliminate any paperwork issues that some of our students run into when they haven’t registered. You should be getting information about this in the next month or so.

If you have any initial education or recertification questions, or input about EMS education in North Dakota, please let me know at [email protected].

Ron Lawler, NREMT-PEducation [email protected]

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the knowledge to provide quality pre-hospital patient care.


NDEMSAStrategic PlanningOctober 01, 2016

NDEMSA STRATEGIC PLANNING October 01, 2016

2016 Strategic Planning Report On October 1st and 2nd 2016, members of the Board of Directors of the North Dakota EMS Association met in Bismarck to conduct a strategic planning session. The purpose of the planning session was to develop a course of action for the Association to follow and implement over the next 2 to 5 years. Prior to the Strategic Planning Session board members were asked to complete a survey. The survey was to see what the board members felt are priorities of NDEMSA. After reviewing the survey, areas identified for discussion were

1. Foundation Organization

2. Legislative Efforts

3. Member Services

4. Education and Conferences

5. Regional Advisor Positions and Transition

6. Social Media and Advertising

1. OverviewThis report discusses the most important topics and the action plan put in place for the upcoming year for the ND EMS Association. 2. Foundation-The North Dakota EMS Foundation is a 501(c)(3) organization that began in 2004. The establishing vision of the Foundation was to promote and support prehospital emergency medical services across the great state of North Dakota. The Foundation is dedicated to the state's EMS providers, ambulance services and quick response units; and it places a major emphasis on the continued viability of individual rural providers and response groups. Most people are not sure what the foundation does. A priority of the ND EMS Association is getting the Foundation visible and thriving. A. Define what the foundation does. B. Develop a board consisting of membership primarily not on the NDEMSA Board. C. Develop a brochure for the Foundation D. Increase awareness of the Foundation's mission through social media, NDEMSA Response Times articles, fund-raising events, and conference booths. 3. Legislation The North Dakota EMS Association strongly believes in being "the advocate" for EMS providers and EMS agencies alike in North Dakota. The Association has been a voice for ND EMS since 1976 and has had significant advocacy efforts since the 2005 legislative session. Even though our citizen legislature meets only every two years, our advocacy committee is active year-round identifying rule changes, and other impacts to EMS. At the planning, there was discussion of what the legislative efforts of NDEMSA should be for the 2017 Legislative Session. A. Promote the NDEMSA legislative efforts. B. The Future of EMS Meetings identified the difficulty reaching legislators and local leaders. A legislative luncheon at the regional conferences will be looked into to see if plausible. C. New policies enacted through the legislative process versus to enact new rules / regulations. D. Involve the membership in picking legislative priorities. RESPONSE TIME Fall 20166

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5. EDUCATION OneofNDEMSA’sprimarygoalsiseducationforemergencypersonal.Someofthemaingoalsdiscussedattheplanningforeducationincluded:

A. The regional conferences will be coordinated to assure NCCR topics are offered. B. NDEMSA will focus on in-person education. Exploring on-line education. C. NDEMSA will explore other educational opportunities for its members. D. NDEMSA will increase EMR educational opportunities. 6. MEMBERSHIP A. The goal is to increase membership by 50%

7. REGIONAL ADVISORSWithJimDeMellretiring,LynnHartmanistheonlyregionaladvisoremployed.TheNDEMSAssociationhasbegunthediscussiononwhethertokeeptheprogram,howmanyadvisorstoemploy,andwhattheirresponsibilitiesshouldbe.Furtherdiscussionwillensueonthistopic. A. Regional Advisors will promote the NDEMSA, as well as address issues affecting EMS agencies.

B. Regional Advisors will share promotional materials with squad leaders and members and discuss the work done by the NDEMSA and the benefits of belonging to the NDEMSA.

C. Regional Advisors will discuss that their consulting services are for members only D. The NDEMSA Board of Directors will discuss what the best way to continue the Regional Advisors program. This discussion will include how many Regional Advisors should be hired, how many hours, and potential recruitment of advisors.

8. SOCIAL MEDIA and ADVERTISING Theteamwantedtogetimportantnewsanddatestomembersonsocialmediaandourwebsite;togetNDEMSA’snameouttheretoletnonmembersknowwhattheassociation’smissionis.

A. Establish a Snapchat and Instagram account for the NDEMSA. B. Coordinate all social media with Hoot Suite. C. Set up Facebook event for every NDEMSA conference. D. Send out advertisement letters to members about events that are occurring. E. Look into what we need to do to legally send out mass messaging. F. Look into an on-line Response Times option.

9. CONFERENCES Ateachconference,evaluationsarecollectedfromtheattendees.Thedirectorsreviewedtheevaluationstoseewheretheycanimprove.Changesthatwillbeimplementedthisyear:

A. At the 2017 Rendezvous there will be a social, instead of a Saturday night dance. B. At the regional conferences a vendor can purchase a booth for $100 or donate an item of equal or greater value. C. Consider reducing the number of concurrent sessions at the Rendezvous and increasing focus on providing NCCR topics / sessions.

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When to Call for AirMed?Ashley Kann FP-C NRP

It is 2:30 a.m. and the pager goes off. You roll over and listen as the dispatcher tells you that you need to respond to what sounds like a critical patient. Your town is 20 minutes from the closest critical access hospital and another hour from the closest tertiary center. Your ambulance is staffed tonight with 2 EMTs with another EMT crew on call. You stand up and get dressed and you are on your way to the ambulance bay. As you are driving what thoughts cross your mind? Are you thinking about the kind of care the patient will need? When is the other truck going to be enroute? Are you wishing you could get the patient to definitive care quicker? One resource that is sometime overlooked is the use of air-medical services. Air-medical helicopters are positioned throughout the state to help you efficiently treat and transport your patients to the tertiary centers. One of the benefits of air-medical transport is that they can fly up to 160 mph directly to you - no road signs, no turns, and no ice/snow on the roads to slow them down.

Some of the questions that have been asked regarding the use of air medical resources are:

Q: What if we get there and we do not need you? Does the ambulance get billed?

A: Typically, air-ambulance operators do not charge if they are dispatched and then cancelled when not needed. Check with your local air-ambulance operator for their specific practices.

Q: How long does it take for a helicopter to get into the air?

A: Services typically can lift-off within 10 minutes; this is circumstantial depending on extended weather checks and safety concerns.

Q: Where does the patient go after we send them with you?

A: Patients are transported to the closest most appropriate hospital. If the patient is able, or family is present they can help make the decision depending on condition of the patient.

Q: What qualifies a patient to go by a helicopter versus a ground ambulance?

A: Any patient with a time-sensitive injury or illness or when the treatments needed is above your scope of practice. Below is a list of common criteria that is often used.

• Cardiac arrest or post arrest

• STEMI

• Stroke like symptoms

• Unstable vital signs

• Any patient needing quick access to specialized critical care and immediate transport. Burns

• Amputations

• Changes in LOC

• Falls >3x pts height

• MCC >20 MPH

• Unstable airway

• Potential unstable airway

• Car vs. Pedestrian

• High speed

• Ejection

• Rollovers

• Extended extrication

• Multiple patients (MCI)

• Death in vehicle

• Trauma center >20 minutes away

Q: What type of equipment or skills can they provide?

A: Each service is different in what they carry or are capable of providing this list fits some or all providers in the state:

• Chest Tubes & Needle Decompression• TXA • Blood• RSI (Rapid Sequence Intubation)• Video laryngoscope

• Lucas Device• Cardiac Drugs and Stroke medications• Cold Saline• Ventilators• CPAP/BiPAP

The most important part of activating an aircraft is time, the time to get the helicopter enroute, the time to get them to the patient, and the time to get the patient to the hospital. Getting an aircraft enroute as soon as possible can greatly decrease the time it takes for a patient to get to definitive care. Air-medical resources are best utilized when activated early, if you wait until you are absolutely sure you need an Air Medical helicopter, you have waited too long. It is better to activate early and cancel them if you determine they are not needed.

Air-medical Services are a valuable resource to all ambulance services in North Dakota. It is important that every responder feels comfortable activating them when the situation arises. Please contact me, or the air medical services in your region, if you have any further questions.


Call for Candidatesfor the 2017 NDEMSA Executive and Regional

Directors PositionsNominations Due December 31, 2016

How to Become a CandidateInterested candidates are required to submit a nomination statement and photo to be published in the winter Response Time and on social media websites. Nominations are due on or before December 31, 2016. This deadline allows for adequate time for candidates’ biographies to be shared on NDEMSA news outlets, prior to voting. Please review the new Nomination and Election Rules effective this year. As per election policy, nominations are NOT accepted from the floor during the annual meeting.

Positions up for Election in 2017 include;• Vice President

• Two (2) Directors in Each Region

All officers and director terms are for two (2) years.

To be eligible for the Vice President position, candidates must be a current NDEMSA member and have previously served a full term on the NDEMSA board. The Vice President’s term will begin at the ND EMS Rendezvous after the annual meeting.

To be an eligible candidate for the regional director positions, he or she must be a current NDEMSA member and will run in his or her respective region. The officer terms commence after the voting results have been counted and verified (on or around March 1st).

If you would like to be, or know someone who should be included on the 2017 ballot for the Vice President or regional director position, please complete the nomination form, which can be found at www.ndemsa.org/Nominations-&-Elections.

To submit a nomination statement and picture, please email it to [email protected].

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SOpening for NDEMSA Secretary/Treasurer

Ken Reed resigned as NDEMSA Secretary / Treasurer on 10/28/16. We want to thank Ken for his service to the EMS Association. We appreciate his time, talents, and dedication to North Dakota EMS!

The NDEMSA will be seeking an individual to fill the open term as Secretary-Treasurer. To be eligible for the Secretary-Treasurer position, candidates must be a current NDEMSA member and is currently on the NDEMSA Board and has served a full 2-year term. The vacancy shall be filled for the unexpired portion of the term by the remaining board of directors, elected by the board of directors. Nomination forms for the position may be found on the NDEMSA website. The nomination deadline is January 24, 2017 at 5:00 pm. A vote will be held by the NDEMSA board of directors meeting on January 31, 2017.

For additional information please contact Corrie at 701-221-0567.


NE Region

SE Region

NW Region

SW Region

NDEMSA Regional Conference Dates and Hotel Information

Southeast Conference- January 13-15, 2017 Quality Suites Jamestown ND (507 - 25th Street Southwest, Jamestown, ND 701-252-3611)

Rooms are $89.00/night plus tax and the block rate will be ending 12/12/2017. Brochures for the SE Conference should be out in late November.

Northwest Conference- January 28-29, 2017 Grand Hotel Minot ND (1505 N Broadway, Minot, ND, 701-852-3161) The rooms are $85.00 plus tax and the block rate will be ending 1/19/2017.Brochures for the NW Conference should be out in late November.

Northeast Conference-February 18-19, 2017 Red Roof Inn Townhouse, (710 1st Ave N, Grand Forks, ND 701-746-5411). Rooms are $85.00/night plus tax and the block rate will be ending 2/17/2017. Brochures will be out in December.


The Southwest Region EMS Conference was held September 24 and 25th, 2016 at the Medora Community Center. NDEMSA again partnered up with North Dakota Safety Council to offer Oil and Gas Training to Emergency First Responders.

The weekend kicked off with a preconference Friday, September 23rd. SIM-ND and Regions Hospital presented adult cardiac arrest, pediatric cardiac arrest, post resc. care, and chest pain from cardiovascular disease.

Saturday had a variety of breakout sessions featuring both LCCR and NCCR hours. Topics included stroke; Incident Command for First Responders: EMS, Firefighters, and Law Enforcement; Drilling Rig Safety 101; pediatric cardiac rate disturbance; First Responder protocols for workplace violence and active shooter situations; field triage; responding to pipeline emergencies; landing zone safety and communications; ventilation vs. oxygenation; assisted ventilation; LVAD and tourniquets; toxic gases: The Unseen Danger; endocrine; and wave, lines and fakers-12 Lead Tools.

Sunday sessions included pain management, special health care, crew management-teamwork, oxygenation, medication delivery, immunological, PTSD, quality improvement, concussions/head injuries, and alcoholism. Thank you Karen Manor, Jenny Rech, Ken Reed, Ben Badon, Kelli Sears, Art Wanner, Don Moseman, Marcy Dawson, Ashley Kann, Tyler Kien Topf, Ryan Nelson, Dustin Austin, Ron Lawler, and Tom Dobryzinski for speaking at the SW Regional Conference.

Next year’s conference will be September 29th through October 1st, 2017.The SW Board of directors who are up for reelection are Adam Parker and Kelly Dollinger. With the nomination changes, their terms will be up after the last regional conference.

Thank you to the SW Directors Suzan Hanson, Linda Lindeman, Adam Parker, and Kelly Dollinger for all your hard work. Thank you to all the sponsors. With their donations, each attendee was able to get a door prize.

Thanks again to SIM-ND, Regions Hospital, Hess, Sanford Health, and the North Dakota Safety Council and the Medora Community Center.

SW Conference September 23-25, 2016

The North Dakota EMS Association is proud to sponsor an awards program that highlights the accomplishments of so many dedicated EMS providers in North Dakota. Each year we are in awe of the hard work and passion that our award winners have shown throughout their careers in EMS. We hope you or your agency will consider recognizing the very best of North Dakota’s EMS providers.

The deadline for all awards, both regional and statewide, is March 1, 2017. All nominations must be submitted online at www.ndemsa.org/Awards.

The awards committee reviews the submissions, and notifies the nominator whether or not their submission was chosen. This will allow those who did win an award to make plans to attend the 2017 EMS Rendezvous Awards Banquet and Table of Honor Ceremony on Saturday evening, April 8, 2017 in Bismarck. Some nominators choose to keep the award a “secret” while others are told ahead of time. The awards committee will only notify the nominator, not the nominee.

The 2017 regional awards include Siren Award, Rising Star Award, Telecommunications Award, and the Service of the Year Award. One regional service of the year nominee is chosen for the state EMS Service of the Year.

The statewide awards for 2017 include Media Award, Medical Director of the Year, Grace Knapp Award, Distinguished Service Award, and EMS Provider of the Year Award.

The Table of Honor Ceremony pays tribute to those volunteers and career EMS/Fire personnel who are no longer with us. You can help us honor such a person by nominating them for the Table of Honor Ceremony. The first twelve Table of Honor nominations will be chosen.

The simple online form listing the criteria and nomination information for both the regional and statewide awards and the Table of Honor Ceremony can be found on our website at www.ndemsa.org under the “Awards Programs” tab.

NDEMSA is now Accepting Award Applications

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2017Stars of LifeOn January 31, 2017, NDEMSA will be hosting the biennial celebration of the Stars of EMS. Stars of Life is an opportunity to educate the public and our legislators of the role EMS plays in providing first-class healthcare.

The event EMS and Hospital Day at the Capitol begins with lunch and a medal ceremony held in the early afternoon. This is also an opportunity to speak with your local legislators. The Day at the Capitol allows healthcare professionals to share the struggles and rewards of serving in North Dakota.

The evening has a social gathering with government leaders, other Stars of EMS, Association board members, and other EMS personnel. It is followed by dinner and the presentation of the Stars.

Good candidates for the Stars of Life are individuals who show a strong commitment and enthusiasm for EMS in North Dakota. If you have a person on your squad with these qualities, show your appreciation by making them a Star! Nomination forms have been sent out to all of the squads and the nomination form can also be found online www.ndemsa.org under Awards Programs.


Notice of Non-DeductiblityDear Members,

For income tax purposes, membership dues paid to the North Dakota EMS Association (NDEMSA) are deductible as a business or trade expense. However, pursuant to Internal Revenue Code (IRC) Section 162 (e) and Section 6033 (e) certain lobbying and political expenses are NOT deductible and information concerning their non-deductibility must be communicated by tax-exempt organizations to their members. In compliance with these requirements, you are hereby notified that NDEMSA estimates it has or will spend 50% of your dues on these activities and that amount is therefore not tax deductible.

We advise all members to consult their tax advisor if they have any questions.

American Income Life In October members were mailed a letter and yellow card from American Income Life with details of the no-cost $3,500 Accidental Death and Dismemberment Benefit and Health Services Discount. If you fill out and return this yellow card to American Income Life, you will receive a certificate of coverage and name your beneficiary. Returning the card will also get a health services discount card for you and your family. A representative may also contact you to see if you are interested in other insurance American Income Life can offer to you. As a member of the North Dakota EMS Association you will still receive the $3,500 Death and Dismemberment benefit even if you do not return the card. If you are contacted by American Income Life regarding other insurance options you can say no and your benefits will not be affected. If you have any questions or concerns regarding this benefit, please call the office at 701-221-0567 or email [email protected]

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by Tim Meyer

The North Dakota EMS Association is the primary organization to promote legislative initiatives in our state. That means that we represent the interests of individual EMS providers, quick response units, and ground and air-ambulance services in the legislative process. In that pursuit we also represent the general public since our goals of having a strong EMS system benefits public safety.

The Association has a plan to accomplish our legislative goals which I’ll outline later in this article. Our Board of Directors has a standing Advocacy Committee that works to develop the Association’s legislative agenda prior to each legislative session. The Association also has a lobbyist to coordinate our approach to the legislature. We contract with Bill Kalanek and APT Solutions to do this work for us.

The 65th Legislative Assembly will convene in regular session on Tuesday, January 3rd, 2017 in Bismarck. By statute the session cannot be longer than 80 legislative days and is scheduled to be completed by Wednesday, April 26th. Prior to January 9th, legislators can file an unlimited number of bills and after that date each legislator may not introduce more than 5 additional bills. Representatives cannot introduce new bills after January 16th and Senators cannot introduce bills after January 23rd.

If you’ve been paying attention to state government issues you’ll know that this session will be unlike those in the recent past. North Dakota no longer has the major budget surpluses from oil tax revenue and high farm commodity prices. For those reasons alone we will have a budget struggle in our state. In addition, by the time you read this North Dakota will have elected a new Governor. That will also add uncertainty to the process. Our strategy will be to try to protect the programs and funding that we currently have. We have been assured by the current administration that EMS programs will not suffer cuts in the Governor’s budget but we have to be ready to provide strong testimony in support of our initiatives.

• The Association primary legislative initiative is protecting the funding for the EMS Funding Area Grants. This will appear in the Health Department’s Bill. In the last session, the Legislature appropriated $7.5 million for this grant. During the mandatory budget reductions made last year the total was reduced to about $7.35 million. We want this to stay at that level. In addition, we’d like the local match requirement loophole to be eliminated. This would require an actual hard match of $10 per capita instead of a soft match of the same amount that could have been from ambulance billings. Finally, in

last session there was a separation of the oil impact EMS agencies that only allowed them to access 15% of the Funding Area Grant if they received any oil impact grant money. As you can imagine this will not be equitable since the oil tax revenues have fallen sharply. However, since that was a Session Law from last Session, the Health Department’s budget bill should resolve this issue. We will monitor this bill’s progress to ensure those initiatives are included.

• There’s a national effort to develop an interstate licensure compact for EMS providers. It’s called Replica; Recognition of EMS Personnel Licensure Interstate Compact. This would make it easier for EMS providers to work in multiple states without having to get licensed in each state. The Association supports this initiative and will seek legislative sponsors for this bill.

• We would also like to amend the current law that speaks to EMS personnel working in a hospital setting. The Association will work with the North Dakota Medical Association, the North Dakota Hospital Association, and other stakeholder groups to draft clarifying language for a bill. We anticipate one of the other associations leading this initiative and we will provide supporting testimony.

• We’d like to change the law to allow non-ambulance vehicles that are operated by a licensed ambulance service or QRU to be considered Class A Emergency Vehicles. Currently the only EMS vehicles that have that designation are ambulances. The Association supports this and will seek legislative sponsors for this bill.

There are also several things that we would support if they were legislative bills but we are not actively pursuing sponsors for:

• Restricting drone use near an accident or EMS helicopter operations.

• EMS themed vanity license plates.• Expanded WSI coverage for volunteers. Line of

Duty Death and Post Traumatic Stress Disorder benefits for EMS providers.

• Enabling legislation for 9-1-1 call centers to use Pulse Point dispatching. This would dispatch lay persons that were near the scene of an emergency through a smart-phone app.

We look forward to working with the North Dakota Legislature and the many stakeholders in the lawmaking process. If you’d like more information go to our website www.ndemsa.org and click on Advocacy 2017 or call the NDEMSA office at 701-221-0567.

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The Sternal Introsseous DeviceWritten 2015-2016 BSC EMS/Paramedic Program Graduate Krystal Thorndike

Over the years EMS tools have changes and improved making them more efficient, easier to use and sometimes more cost effective. The intraosseous devices are not exempt from the evolution of EMS tools. Intraosseous use as an alternative to intravenous access gained popularity because it delivered medications and fluids to vital organs when the intravenous route was unavailable. The use of these devices dates back to the 1920s when it was first discovered, however when the intravenous catheters were developed, the IO went away.

Over the years, developers have created several types of intraosseous devices including the EZ IO, FASTResponder, FAST-1, Bone Injector Gun, Jamshidi and Cook. These devices can be inserted in the sternum, the medial side under the tibial tuberosity, the humerus, and the iliac crest. The most commonly use intraosseous devices used are the manual Jamshidi or Cook and the EZ IO.

The sternal options over the years have fallen out of favor due to their barbaric looking device, but a recent study is changing all that. In this study, experts looked at the infusion rates of the intraosseous devices in three areas: humerus, tibia and sternum. The results were astounding. They infused a cadaver simultaneously with normal saline under 300 mmHg pressure for five minutes with the following mean rates: Sternum 93.7ml/min, Humerus 57.1ml/min and Tibia 30.7ml/min. They also infused a dyed form of saline in the cadaver and looked at how quickly each site could circulate through the body, simulating a possible dose of epinephrine during cardiac arrest. The sternal route circulated faster and more equally than the other two and provided higher serum levels when it was used in comparison to the tibial route. The fluids being administered into the marrow space are much more reliable because they are like an un-collapsible vein and they have proven to have a higher absorption rate compared to the intravenous route. Also, by immediately accessing the sternal interosseous route over an intravenous route for cardiac medications, provided the opportunity for greater patient outcomes. This is a very important consideration as studies have shown the earlier epinephrine is delivered to the patient in cardiac arrest, the greater the outcome for return of spontaneous circulation.

Researchers have also discovered the use of a sternal intraosseous device to be much less painful than the humoral or tibial route when it’s inserted correctly. Providers have a less successful placement rate with the tibia and humerus than the sternal due to the possibility they may slide the needle off the side of the bone. The sternal intraosseous is placed just below the sternal notch and before the xyphoid process, reducing the risk of failing at insertion. Unlike intravenous routes, intraosseous routes can be felt instead of visualized adding to the ease of insertion. No more trying to look for a vein in poor lighting on night crashes or dark bathrooms. Another benefit of the sternal option is that is can be placed during CPR without interrupting or getting in the way of compressions. Minimizing interruptions during CPR has been shown to increase favorable outcomes.

All of these new facts considered, the FASTResponder Sternal IO has an improved model which hit the market recently and is gaining popularity. The device is small, lightweight and compactible. The FASTResponder has a one-time use making it easy to minimize infection and reduce cross contamination. Its competitor, the EZ IO has the gun which needs to be properly disinfected after each use, but how many providers actually take the time to do it? There is no batteries or power source required for the device making it easy and portable. No more bulky black case to shove in your kit with all the other intravenous access equipment like the EZ IO. The device has


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automatic depth control which means no drilling or guessing about if the device is inserted deep enough or if you have gone too far into the mediastinum. It also has one size needle built in and is safe for all patients 12 and older, eliminating the need for different needle sizes for each patient. Once inserted, it also has a low-profile extension tubing system for delivering medications, with a clear protector cap to provide extra security while still allowing the provider to see the site.

Compared to the popular EZ IO for extremity access, the FASTResponder is much more cost effective as well. The EZ IO costs around $600 to purchase just the gun, with each single-use needle costing approximately $160 each, not to mention the cost of keeping fresh batteries in the gun. Plus when you purchase the EZ IO, you will need to purchase multiples of the different sized needles. In comparison, the FASTResponder is a one-time, one-size-fits-all (age 12 and older) use device costing $160 each. That’s it, providers can skip the gun and save $600!

In conclusion, the sternal intraosseous route for fluid and medication administration is becoming popular again after a hiatus. New technology is making it easier to use, easier to secure and maintain access

and sleek. The one-time use device is cost effective and reduces cross-contamination. It’s a pretty slick tool!

Works Cited

Moloff, Alan, Dr. “All Intraosseous Sites Are Not Equal.” (2016): n. page. www.pyng.com. Web.

“Intraosseous Access.” : Overview, Indications, Contraindications. N.p., n.d. Web. 07 July 2016.

“Discovery of the Intraosseous Route for Fluid Administration.” -- Foëx 17 (2): 136. N.p., n.d. Web. 07 July 2016.

“An Idea Whose Time Has Come.” Science News 100.6 (1971): 92. Web.

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Dickinson area first responders encourage students to focus on the road ahead while drivingBy Sydney Mook , Dickinson Press

It’s not uncommon to see people texting while driving, whether they are stopped at a stoplight or driving down the highway.

According to distraction.gov, in 2014, 3,179 people were killed and an estimated 431,000 people were injured in motor vehicle crashes involving a distracted driver. Dickinson area first responders are trying to show high schoolers in and around Stark County that just one text message or changing one song can change someone’s life forever.

The Dickinson Ambulance Service has joined the “One Text or Call Could Wreck It All” campaign to stop distracted driving.

“We all know that talking on our cellphones while driving is distracting, but that doesn’t stop most people from continuing to do it,” Riley Howard, an emergency medical technician with the Dickinson Ambulance Service said. “... We hope that once people see the statistics and realize the danger involved, they will change their driving habits to help protect themselves, their families, and others on the road.”

The Dickinson Ambulance Service and Dickinson High School, have an entire month’s worth of events planned during September to help students understand the importance of focusing on the road, rather than on their phones.

Howard, who graduated from DHS in 2015, has planned a full-scale emergency demonstration for local high school students to show possible consequences for those who choose to drive while distracted, which will be the first of its kind in Dickinson in more than 10 years. Following the demonstration, the family of Janae Moore will speak to students.

Moore was a Dickinson State University student and standout women’s basketball player who was killed in 2013 in a single-car accident near her hometown of Sidney, Mont., because it was believed she was texting and driving.

Members of the Dickinson Ambulance Service, the North Dakota Highway Patrol, members of the Dickinson police and fire departments and CHI St. Alexius will all be involved in the demonstration on Sept. 14.

“We are just trying to make this campaign as impactful as we can,” Howard said.

Howard said they are also planning another guest speaker later in the month and said he will be going to schools around the county to talk about the dangers of distracted driving.

Bobbie Johnson, a health careers teacher at DHS, challenged 54 of her students to come up with different ways to help out with the campaign.

The classes have been working to come up with posters to hang around the school building, created a Twitter account to share videos about the impact of drunk driving and have decided to hold a bake sale some time in September with the money raised from the bake sale going to a family that has been affected by distracted driving.

Johnson said having the students involved has been beneficial and hopes that by them being directly involved in the campaign, it will start a serious conversation about texting and driving.

“Even driving to work, you see how many people are looking down or looking at their phones,” Johnson said. “So, I would love if my students would start a conversation with each other or even with their parents about it.”

Addyson Rose, a senior at DHS and one of the students in Johnson’s class, put herself in charge of talking to area law enforcement about the effects of distracted driving and has been researching statistics about distracted driving and coming up with the best way to present all of that to students.

Rose said working on the project has been an eye-opening experience for her and it has made her think twice about checking her phone or even changing a song while she’s driving.

“I feel so guilty,” Rose said. “It hits home because just one stupid text message that I send could affect someone’s life forever or even mine.”

Rose said she knows many of her friends text and drive at least occasionally. She added that since she started working on the campaign, she hasn’t been texting and driving because she understands that results of one text message can be “scary.”

She added that while they can talk to other students about texting and driving, it often doesn’t really hit home for them until they hear or watch people’s stories who have directly been affected by distracted driving.


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“It’s real, it’s such a real thing,” Rose said. “We can reach out to them, but I think the campaign will really get to them.”

She said while she knows it won’t stop everyone from texting and driving, she hopes that they think about what they are doing before they decide to send a text while in control of a vehicle.

“I hope that they think about what that text could do,” Rose said, “or that Snapchat, or whatever it is. Just to focus on the road and think about whose life they could affect.”

Involving the communityBesides bringing their message to high schoolers, Howard said they are also trying to encourage all members of the community to stop texting and driving.

The Dickinson Ambulance Service, in conjunction with local police and firefighting personnel,

will also be partnering with local businesses and organizations to set distracted driving policies.

Howard said they have already had many local businesses present their distracted driving policies to them and are working with many others to help them build their own distracted driving policy to encourage their employees not to text and drive.

“Every driver in Dickinson has a role in this effort,” Howard said. “A lot of them (businesses) are really excited about it and more than willing to help out with any additional things we might need.”


NDEMSANDEMSA

Upcoming NDEMSA Events

December 31, 2016 All NDEMSA Board

Nominations Due

January 13-15, 2017 SE Conference,

Jamestown, ND

January 28-29, 2017 NW Conference,

Minot ND

January 31, 2017 EMS Day at the Capitol -

Stars of Life CelebrationNDESMA Board Meeting

February 18-19, 2017 NW Conference,

Grand Forks ND

March 1, 2017 All Award Nominations Due

April 6-8, 2017 42nd EMS Rendezvous Conference, Bismarck ND

June 5 & 6, 2017 3rd Annual Management Conference

Bismarck, ND

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