Update from the RIACEP EMS – August 2019

Joseph R. Lauro MD, FACEP
Clinical Associate Professor of Emergency Medicine, Brown University-Warren Alpert Medical School
Chair EMS Medical Directors Committee, RIACEP
EMS Medical Director: The Miriam Hospital/Newport Hospital/Cumberland EMS
RIACEP Representative: Ambulance Service Advisory Board, RIDOH

What a productive year so far! Thanks to all the active members of the committee who further our commitment to improve EMS care and EMS Medical Direction.

As an appetizer, members of the EMS Committee have served up strong advocacy for Emergency Medical Dispatch (EMD) at the RI 911 center. To date, Drs Rybasack-Smith, Asselin, Lauro and Pasichow provided testimony at the State House in support of a bill requiring EMD. The bill did not pass BUT our voices were recognized throughout the state. The 911 center has received funding to support implementation of full EMD at the center. This is a huge step in improving out of hospital care whereby bystanders will be instructed by the emergency dispatcher to provide life saving measures such as CPR and bleeding control. No doubt this will save lives in Rhode Island

For our second dish, the Rhode Island Department of Health had awarded our very own Dr. Heather Rybasack-Smith the prestigious, and inaugural, EMS Medical Director of the year award. Kudos to Heather and congratulate her when you see her.

Dr Williams awards Dr Heather Rybasack-Smith the EMS Medical Director of the year award at the Rhode Island State House

Now for the main dish, Drs. Nick Asselin and Kenneth Williams were guest editors of the May edition of the The Rhode Island Medical Journal. This edition was dedicated toward EMS management of cardiac arrest and included data collected in Rhode Island. Perhaps the most notable data pertains to analysis of our ROSC rates after implementation of the 30 minute CPR protocol in 2017. The authors concluded in their pilot study, that this intervention resulted in a doubling of ROSC after the initiation of the protocol. This trend has held true in their most recent unpublished data with ROSC rates more than doubling and neurologically intact survival increasing by nearly 40%! Stay tuned for more data out of RIPCORD (RI Prehopsital Cardiac arrest Outcomes Registry Dataset) in the upcoming year.

A propos, this thrilling edition of the RIMJ includes a history of Telecommunicator CPR provided by Dr. Rybasack-Smith as well as a look at data utilization in Emergency Medical Services. Topics sure to keep you on the edge of your seat.

Noteworthy: the Brown EMS Division welcomes Drs Kelly Meehan-Coussee and Scott Pasichow. Both are EM physicians with backgrounds in EMS and have dedicated their career to EMS medical direction, advocacy, administration and education. They will spend much of their time as assistant medical directors for Cumberland EMS, an all paramedic third service department providing exemplary care to the residents of Cumberland RI. Additionally the fellows will be serving in medical leadership roles both at Jamestown Fire Department as well as Pascoag FD and life pact critical care transport.

Drs Kelly Meehan-Coussee and Scott Pasichow begin their year as assistant Medical Directors for Cumberland Emergency Medical Services

In the short time since formation of the committee we have seen regulatory changes requiring an EMS Medical Director to be a Board Certified/Board Eligible Emergency Physician, inevitable implementation of EMD at 911, increased collaboration amongst EMS Medical Directors and improved relationships amongst the physicians, EMS departments and legislators. We are looking forward to the upcoming year and welcome new physician members interested in Emergency Medical Services. Stand by for dessert and a doodle poll for the next meeting..