A Look Back at the NEMSAC Meeting

The agenda was full for the National EMS Advisory Council (NEMSAC) hybrid (in-person and online) meeting on August 9-1011, 2023. The in-person meeting was held at the Yours Truly Hotel DC in Washington, DC.

“The NEMSAC consists of 25 members of the EMS community who represent different aspects of the profession,” says EMS.gov. “The members are appointed by the Secretary of the Department of Transportation for two-year terms, and each may serve up to two terms.”

Here are some highlights from the August 9-10 meeting. Some of the quotations have been edited for clarity and flow.

DOT Seeks Collaboration between EMS, 911, and NHTSA to Improve Post-Crash Care

Gam Wijetunge, Director of the Office of EMS for the U.S. Department of Transportation's

National Highway Traffic Safety Administration (NHTSA) and NEMSAC's Designated Federal Officer (DFO), spoke about EMS responses to vehicle crashes.

"We know through the National EMS Information System or NEMSIS that in 2022 911 dispatched EMS to approximately 1.5 million crashes. Of the fatal crashes that occurred, 40% of those fatalities were still alive when EMS arrived on the scene but then died within 30 days post-crash," Wiejtunge said. "We also know, based on our national estimates, that actually, less than 50% of the PSAPs in the United States use some form of EMD (Emergency Medical Dispatch)."

Increasing the number of PSAPs using EMD is one way to improve these post-crash survival rates, along with stronger partnerships between first responder agencies. "We think there's enormous potential involving EMSes and 911 in collaborative relationships with highway safety," said Wiejtunge. "The data is very powerful: The ability to provide expedient care to patients can really make a significant difference."

Improving Paramedic Professional Recognition Moves to Draft Phase

The Adaptability & Innovation Subcommittee won NEMSAC approval to move its proposed designation of graduate-prepared paramedics as federally recognized practitioners from the research to the draft stage.

“The purpose of this is severalfold,” said Subcommittee Chair David Fifer, Assistant Professor and Online Degrees Coordinator at Eastern Kentucky University. “One of them is recruitment and retention. We'd like to provide a clinical ladder for paramedics to be able to progress beyond the technician level if they choose. The second thing we're hoping to achieve is better patient-centered care. Every paramedic knows that a large proportion of patients probably don't really need emergency care and their needs can be met in other ways. But the legal framework for doing that does not exist right now for paramedics. And then the third big piece is diversified and more sustainable revenue streams for EMS agencies. Practitioners with NPI numbers who could bill for basically CPT codes for all the things that we do for our patients would provide a different kind of revenue stream for agencies that struggle with sustainability and insufficient reimbursements.”

Optimal Medical Response Achieves Final Status

NEMSAC's Preparedness & Education Subcommittee won approval to move its proposal to ensure optimal emergency response to a fully integrated 911 and emergency medical dispatch system from interim to final status. As well, "we have two advisories currently in research status," said Subcommittee Chair Lisa Basgall, Director of Rice University EMS in Houston, Texas. "One is establishing best practices for EMSes to prepare for planned and unplanned large-scale events," she said. "The other advisory that the committee has started to research is EMS' response to active threats. This is definitely a topic that is timely."

Progress Continues on Ambulance Crash Advisory

NEMSAC's Ad Hoc Ambulance MVC Subcommittee is continuing to develop a Comprehensive National Ambulance Crash Data Collection platform to "better understand current crashes and guide future preventative strategies," said Subcommittee Chair Dr. Mark Gestring, Medical Director of the Kessler Trauma Center and Chief of Acute Care Surgery at the University of Rochester in Rochester, New York. "This has been in the works for a little while, but I think it really has some direction now," he told the NEMSAC meeting. "It's currently in draft form. The advisory has been crafted. It's a direction that has now been pretty much agreed to. Definitions are clarified, and now we're in the process of aligning strategic goals with recommendations."

"The main goals of this advisory are Number One, to better understand the full scope of the ambulance crash problem nationally," Dr. Gestring added. "Number Two is to develop infrastructure for better and more complete national data collection related to ambulance crashes. And Number Three, to inform preventative actions and perhaps design modifications and improvements based on what this information platform will provide in terms of new information."

Improving Helicopter Landing Zone Safety

The Professional Safety Subcommittee reported on two advisories that are currently in the research phase.

"The first one is crash scene safety for EMS responders and others on scene," said Subcommittee Chair Carol Jorgensen, EMS Program Manager for the Nebraska Department of Public Health's Office of Emergency Health Systems. "We are specifically looking at ‘struck by' fatalities."

The second advisory being researched is helicopter landing zone best practices. "It was felt that this was a topic that we could suggest to the Sustainability and Efficiency Subcommittee and a proposed title change would be Sustainable Practices for Appropriate Helicopter EMS Utilization for Emergency Medical Transport," Jorgensen said. This change was subsequently approved by NEMSAC at this meeting.

To learn more about NEMSAC and its activities, go to https://www.ems.gov/resources/national-ems-advisory-council-nemsac/.