Highlights From NCEMSF

Dozens of campus-based EMS organizations from colleges and universities across North America traveled to Pittsburgh, PA for the 29th annual conference of the National Collegiate Emergency Medical Services Foundation (NCEMSF) Feb. 25–27, 2022.

College-based EMS providers attended sessions on prehospital medical, trauma, disaster preparedness, emergency management, and leadership education, including over 110 lectures, roundtable discussions, expert panels, and hands-on skills labs, in addition to site tours, awards presentations and networking events.

Below are a few of the highlights.

River Rescue Tour

NCEMSF attendees were invited to take a 15-minute walk from the Wyndham Pittsburgh Downtown Hotel to the station of the Pittsburgh River Rescue Unit, just steps from PNC Park, home of the Pittsburgh Pirates.

Pittsburgh sits at the confluence of the Allegheny, Monongahela, and Ohio rivers, and is the second-busiest inland port in the nation. The large volume of commercial traffic and recreational vessels on the water in addition to the bridges and activity on the waterfront creates substantial public-safety needs on the water.

Pittsburgh River Rescue, established in 1984 in partnership with the Pennsylvania Fish and Boat Commission and the United States Coast Guard, responds to all emergencies on the water. The unit is staffed 24 hours a day 365 days a year with at least 2 paramedic divers and 1 or more Pittsburgh police officers. It is prepared to respond to any emergency in the area and provide surface and subsurface rescue and recovery as well as ALS medical care and law enforcement. The EMS divers are responsible for all rescue, recovery, and emergency medical operations.

Look for in-depth coverage of this elite unit in the April issue of EMS World.

EMS Ready Campus

The NCEMSF EMS Ready Campus program recognizes excellence in emergency management and disaster preparedness of collegiate EMS organizations. Additionally, the program provides a framework for the enhancement of emergency management education, overall campus preparedness, and response capabilities for the applicant organization.

The EMS Ready Campus program consists of three tiers of achievement. The following collegiate squads received recognition during the conference awards ceremony:

Bronze Level: Emory University, the University of Texas-Dallas, University of Pennsylvania

Silver Level: Drexel University

Gold Level: George Washington University, Virginia Tech University

Heavy Rescue

The Pittsburgh Bureau of Emergency Medical Services created the Rescue Division in 1977 to enhance the delivery of medically directed technical, tactical and heavy rescue. It is one of the few EMS-based rescue units in the country—most are divisions of the fire department.

Pittsburgh’s Buprenorphine Program

A novel EMS initiative is connecting Pittsburgh residents with substance use disorders with resources that can help. Joshua Schneider, BS, NRP, described a novel buprenorphine program launched by Pittsburgh EMS last October to help reduce the alarming levels of opioid overdoses in the city.

In the first of its kind program in Pennsylvania, the city’s paramedics carry and administer buprenorphine to treat opioid withdrawals. The city is reaching a peak in the overdose crisis, with more deaths than ever before, said Schneider, who is overdose prevention coordinator for the City of Pittsburgh’s Office of Community Health and Safety. Around 2010, deaths from heroin and synthetic opioids trended sharply upward. Underlying causes include criminalization of drug use, an unpredictable and unsafe drug supply, poverty and isolation.

In response to alarming levels of overdose data in Allegheny County, officials looked to a program instituted by Cooper University Hospital in Camden, NJ (Bupe First EMS) to explore the potential of providing a similar service.

Buprenorphine was FDA approved for treatment of opioid use disorders in 2002. Dosing is 8–16 mg initial dose for patients in opioid withdrawal; maintenance dosing is typically 16 mg/day. Overdose on buprenorphine is unlikely.

Initial training for EMS personnel includes didactic instruction including OUD treatment and motivational interviewing, use of destigmatizing language and other strategies. Upon Initial patient contact for an overdose call, including naloxone administration if indicated, EMS crews complete a clinical opioid withdrawal scale (COWS) to assess the severity of withdrawal. Patients must meet inclusion criteria such as 18 years old, conscious and alert, not pregnant, not in medical crisis, and others to be considered for the buprenorphine program.

If these criteria are met and the patient agrees, medics then contact Pittsburgh Poison Center, which connects patients with agencies to provide longitudinal, long-term care such as the UPMC Medical Toxicology Bridge Clinic. Patients speak with a physician either in person or over the phone and receive a prescription for medication.

“This is a bridge program,” stressed Schneider, and designed to facilitate connections to long-term treatment. Some patients place non-emergency calls to enter the program as well.

Currently, 12 medics are trained in the program, which is still in its early stage. Seven patients have been encountered who met eligibility criteria. Four patients were enrolled in the program. All patients who received bupe were referred to UPMC’s bridge program, and no adverse events were reported.

While still in the pilot phase, the goal is to expand the program to EMS services across the state.

HIPAA

One of the final sessions of the conference brought attendees up to speed on HIPAA and what it means for college-based EMS services—considered a covered entity under HIPAA regardless of patient billing practices.

“HIPAA is everyone’s responsibility,” said Justin Keller, NRAEMT, EMS-I, lead instructor at I4 Consulting, adding that it’s a moral obligation as well as a legal one.

Takeaways from Keller’s talk included:

• Never discuss protected health information (PHI) with uninvolved parties, on unencrypted radio channels or in locations where it can be overheard
• Log out of workstations when not in use and don’t leave PHI unattended in non-private locations
• Report suspected breaches
• Know your agency’s policies and procedures—everyone in the service must be trained
• Document everything

In the event of a patient data breach, services must notify the individual(s) whose PHI has been accessed. The state secretary of health and human services must be notified within 60 days of the discovery, and if the breach affected more than 500 people, local major media outlets must be notified as well, Keller explained.

Finally, every agency must have a designated privacy officer. The role can be filled by a person holding another position in the agency, but he or she must be documented on file. Penalties of HIPAA violations can be serious and include sanctions, suspension or expulsion from the agency, said Keller. NEMSIS has resources for those looking to learn more and formulate a HIPAA policy for their department.