EMS Excellence

CARES Symposium

In 2012, HCDFRS and the Resuscitation Academy offered the first Cardiac Arrest Resuscitation Experience Symposium (CARES) conference on the East Coast.The CARES conference is a two-day workshop aimed at improving survival of sudden cardiac arrest.This marked the first time the highly respected Resuscitation Academy faculty took their expertise “on the road” – bringing their time-tested strategies to others who are interested in improving survivability in their communities.

Maryland Resuscitation Academy

Expanding upon our initial work with the Resuscitation Academy, HCDFRS began hosting the Maryland Resuscitation Academy in 2013 as a means of sharing our experience and encouraging other communities to adopt international best practices to improve survivability in out-of-hospital cardiac arrests.Since 2013, HCDFRS has hosted the Maryland Resuscitation Academy at the PSTC a total of nine times.

Through our efforts to improve out-of-hospital cardiac arrest survivability, HCDFRS has been recognized by a number of different organizations, including:

• International Association of Fire Chiefs (IAFC) and Physio-Control – Heart Safe Community Award (2012)
• Journal of Emergency Medical Services (JEMS) - Captain Dale Becker honored as EMS 10 Innovator (2012)
• Congressional Fire Services Institute – EMS Award (2013)
• Journal of Emergency Medical Services (JEMS) – Dr. Kevin Seaman honored as EMS 10 Innovator (2013)

Citizen CPR

Since the middle 1990s, HCDFRS has offered one of the region’s most expansive and comprehensive Citizen CPR programs.We remain committed to training all Howard County residents and employees how to respond in the event of Sudden Cardiac Arrest (SCA).With the recent adoption by the American Heart Association (AHA) of Hands-Only CPR, HCDFRS has expanded our program to teach CPR throughout the county.

In partnership with the Howard County Public School System, Howard County General Hospital, the Howard County Public Library System, and Howard Community College, HCDFRS purchased 50 manikins for the school system and provided “train-the-trainer” instruction for teachers who will then train students in Hands-Only CPR.This program has been incorporated into the curriculum, and all students receive Hands-Only CPR training in the 6th and 9th grades as a requirement for graduation.

Total Quality Management (TQM)

In an effort to improve patient outcomes and system performance, HCDFRS embraced Total Quality Management (TQM), a holistic approach of continuous improvement throughout the organization.The TQM program is designed to radically transform the organization through progressive changes in the attitudes, practices, structures, and systems.

Among several TQM projects, HCDFRS evaluated trauma scene times in 2000 in an attempt to reduce the time for trauma patients to receive definitive care.Additionally, HCDFRS used the principles of TQM to revise and refine the ALS precepting process in 2001.

Driving Change Throughout Maryland – and the United States

As our EMS program evolved over time, HCDFRS began seen throughout Maryland and, in some cases, the United States as a well-run system with a robust quality assurance program and exceptionally skilled providers.These factors allowed HCDFRS to drive change through the implementation of new programs.

As one example, HCDFRS was one of two EMS systems in Maryland (after the Maryland State Police) to pilot the Rapid Sequence Intubation (RSI) program.RSI is an advanced airway management procedure used to intubate patients under general anesthesia who are at high risk of pulmonary aspiration.The State EMS Medical Director chose HCDFRS for this pilot as a result of our exceptional quality assurance program and the highly effective oversight of our system by our medical director.

In 2011, HCDFRS was the first EMS jurisdiction in Maryland to implement video laryngoscopy using the GlideScope Ranger video laryngoscope.The device has dramatically improved intubation success by displaying a clear, real-time view of the airway during endotracheal tube placement.Prior to the implementation of the program, intubation success with traditional laryngoscopy was 64% in the County.After GlideScope training and deployment, intubation success improved dramatically to 98% - a difference that is both statistically and clinically significant.Since the implementation of this program, HCDFRS has published a number of abstracts detailing our success with this device.

Over the years, HCDFRS has worked with MIEMSS to improve the Maryland Medical Protocols for EMS Providers.The following statewide protocol changes were instituted as a result of our direct involvement:

• Pulmonary Edema/CHF (2006)
• Patient-Initiated Refusal of Care Program (2008)
• High Performance CPR (2014 as Optional Supplemental Protocol – 2015 as required part of protocol)
• GlideScope video laryngoscopy

None of these innovations would be possible without the highly talented EMS providers who provide exceptional emergency medical services throughout the county.Several HCDFRS EMS providers were featured in the textbook, Avoiding Common Prehospital Errors, in 2013.Contributors included:

• Dale E. Becker, NREMT-P
• Robert Dice, MS, RN, NREMT-P
• Theresa M. Gallo, BS, NREMT-P
• P. Marc Fischer, MBA, NREMT-P
• Richard Leonard, AS, NREMT-P
• Kevin G. Seaman, MD, FACEP
• Cerisa Speight, NREMT-P
• Gregory R. Valcourt, AAS, NREMT-P, CCP-C

STEMI Program

HCDFRS has a long history of excellence in the treatment of Acute Coronary Syndromes (ACS) and Sudden Cardiac Arrest (SCA).Our progress with these programs has greatly improved our community’s access to emergent cardiac care.

American Heart Association's Mission: Lifeline

A significant number of STEMI patients don't receive prompt reperfusion therapy, which is critical in restoring blood flow. Mission: Lifeline seeks to save lives by closing the gaps that separate these patients from timely access to appropriate treatments. Mission: Lifeline’s EMS recognition program recognizes emergency medical services for their efforts in improving systems of care and improving the quality of life for these patients. We are proud to achieve recognition by the American Heart Association for following the latest research-based standards for acute coronary syndrome with a Mission: Lifeline Silver award. Learn more here.

Public Access Bleeding Control Kits

The Howard County Comprehensive Public Safety Hemorrhage Control Initiative aims to reduce the impact of hemorrhage in victims of traumatic injury and to improve mass casualty response by increasing knowledge of hemorrhage control techniques and improving access to hemorrhage control supplies.

The program includes the following key components:

• Public Access Bleeding Control kit placement co-located with select AEDs throughout Howard County.
• Bleeding control training for members of the public safety community and the general public.
• Working to ensuring that public safety personnel have access to the bleeding control equipment.