Industry News

The EMS and emergency industries are constantly changing -- new technologies, changes in protocols, and other updates need to be shared in a timely manner so all of our EMS workers can be their most effective. Read below for information and links to important content. Check in often to be sure you are up-to-date.

HeartStart MRx Monitor Defibrillator Recall

Phillips is recalling the HeartStart MRx Monitor/Defibrillator due to electrical and battery connection issues that may prevent the device from powering up, charging, and delivering an electrical shock therapy. The device may also unexpectedly stop pacing.  The FDA has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death. Find complete details onlineOff Site Icon

LIFEPAK 1000 Defibrillator Recall

Physio-Control Inc. has recalled the LIFEPAK 1000 Defibrillator due to an electrical issue which may cause the device to shut down unexpectedly. The FDA has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death. Visit the US Food and Drug Administration website for complete detailsOff Site Icon

Personally Furnishing Naloxone by Emergency Medical Service Personnel

The State Board of Pharmacy has received several inquiries from EMS organizations asking if it is possible to provide naloxone to individuals who refuse transport after an overdose emergency, or to that person's family or friends. In response, they have developed a document to guide EMS through the steps needed to provide naloxone in such a situation. 

Update: Greater Miami Valley EMS Council and the Regional Physicians Advisory Board, working with Public Health, law enforcement, ADAMHS, and others, are investigating the development of an Optional Standing Order on this that agencies could use at their discretion. In the meantime, it is very important that every EMS provider remember the following: 

  • EMS can only furnish naloxone to be used by others with the express permission of their agency and their agency medical director, and then only when complying with ALL Board requirements, including training, labeling, record-keeping, etc.
  • UNDER NO CIRCUMSTANCES may naloxone from the Greater Miami Valley EMS Council Drug Bags be given to others for use at a future date. 

Learn more 

SFY 2017-2018 EMS Priority One & Supplemental Grants Available

Applications are due April 1 by 5 p.m. and must be submitted through the EMS Grants Management System (link to  https://services.dps.ohio.gov/EMSAgencies). If you have not created an account with the new system, you will need to register for a new account.

NOTE: EMS Priority One and Supplemental Grants will no longer be funded in one 12-month grant cycle. EMS Priority One and Supplemental Grants will now occur in two shortened funding cycles over a 12-month period. Learn moreOff Site Icon

Cyanide in Sight

A new resource, Cyanide in Sight, has been launched to help raise awareness among first responders and medical personnel about the potential threat of cyanide poisoning from closed space fire smoke.

This website was developed to provide EMS with additional information and resources to help raise awareness about the signs and symptoms of cyanide poisoning from closed space fire smoke. Cyanide poisoning may be difficult to detect, so, when assessing a suspected patient, it is important to look for the three main signs: 

  • Exposure to Fire or Smoke (in an enclosed area)
  • Altered Mental Status (such as confusion and disorientation)
  • Soot (in nose or mouth)

Visit CyanideInSight.comOff Site Iconfor more information, tools, and resources to keep you informed and prepared. If you have more questions, please contact the Meridian Medical Technologies team at (800) 638-8093.

Lifepak 1000 Defibrillators by Physio-Control: Voluntary Field Action - Immediately Remove and Reinstall Battery

Physio-Control announced that the company is launching a voluntary field action for the LIFEPAK 1000 defibrillator due to reported instances where the device has shut down unexpectedly during patient treatment. The company has received 34 reports where customers have attempted to use their LIFEPAK 1000 defibrillator and the device has shut down unexpectedly due to an intermittent connection between the battery and device electrical contacts. A defibrillator in this scenario may not be able to deliver therapy during a resuscitation attempt, which may expose patients to the risk of serious harm or death. The company is aware of eight adverse events related to this issue. 

The company is contacting customers and advising them to immediately remove and reinstall the battery from their device(s). Customers are also being advised to implement a weekly schedule of battery removal and reinstallation for all LIFEPAK 1000 devices. The removal and reinstallation of the battery will clean the contacts of oxidation and will reduce the likelihood of this issue from occurring. Physio-Control will be initiating a hardware device correction for all affected LIFEPAK 1000 devices and the company will contact customers to schedule device corrections once the hardware correction is ready for implementation.   

Information about this notice is available onlineOff Site Icon

Recall of MAD Nasal™ Intranasal Mucosal Atomization Devices

Greater Miami Valley EMS Council (GMVEMSC) has been doing its best to keep all agencies in the region (including EMS, LE, EMA, public health, hospitals, and others) fully informed about the rapidly changing status of the emergency recall of MAD Nasal™ Intranasal Mucosal Atomization Devices. Please recognize that this is a national situation. Council has no ability to provide expedited replacement of MADs. Their best recommendation is to follow the recall procedures carefully. As new information becomes available, they will release it via the EMS Council listserv.

In the meantime, the GMVEMSC Medical Director and Region 3 RPAB Chair Dr. Marriott has authorized the Just in Time Standing Order (JITSO) below to enable Paramedics and Advanced EMTs to provide initial doses of naloxone via the IV or IM routes, especially when a MAD is not available.  

Unfortunately, EMRs and EMTs are only permitted to administer naloxone by the nasal route or by auto-injector.  At the present time, Council is not aware of any agencies that use naloxone auto-injectors. If your agency does and is in need of a JITSO to permit EMRs or EMTs to use the auto-injectors, please notify council at gmvemsc@gdaha.org, or send an email to David Gerstner at david.gerstner@daytonohio.gov

Paramedic/Advanced EMT Narcotic Overdose JITSO

  • If patient has a pulse, Naloxone should be administered before inserting an ETT.
  • Consider patient restraint before administration of Naloxone:
    • If respirations are impaired or there is suspicion of narcotic overdose, administer Naloxone, up to 2 mg IN, 2 mg IV or 4 mg IM. Titrate to adequate respirations.  
    • May repeat Naloxone doses.
    • Naloxone:
      • = 20 kg 0.1 mg/kg  IN, IV, IM  (max dose 2 mg), may repeat x one
      • > 20 kg 2 mg,  IN, IV, IM,  may repeat x one      
      • Naloxone slow IV is preferred, but it may be given IN or IM before IV is established.
      • Titrate to adequate respirations.
      • If using IN route and respirations don't improve after 3 minutes, establish IV and administer IV dose.
         
     
  • After administration of Naloxone, patient transport by EMS is encouraged.

Safety Alerts on Fentanyl Analogues

Ohio Emergency Medical Services issued two notices regarding analogues of fentanyl - carfentanil and furanylfentanyl.
Please pay close attention to the picture at the bottom of the Officer Safety Alert from the DEA which shows the size of a lethal dose of fentanyl, and remember, carfentanil is many, many times stronger. It's extremely important to wear PPE on overdose calls.  
EMS Bulletin
Officer Safety Alert

Opioids and the Use of Personal Protective Equipment (PPE)

The Ohio Department of Public Safety issued this memo regarding the evolution of heroin abuse within the opioid crisis and the importance of PPE. Learn more.

Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities

Due to an influx of fentanyl-laced counterfeit pills and toxic fentanyl-related compounds, there has been a further increased risk of fentanyl-related overdoses and fatalities. Please refer to the official CDC Health Alert Network providing background and recommendations.

Synthetic Drug Carfentanil More Powerful Than Fentanyl Reported Within the United States 

Although Carfentanil has not yet been documented in post mortem blood samples in Montgomery County, it has been seen in other samples submitted to the Miami Valley Regional Crime Lab, as well as other locations here in Ohio, including Summit County, Columbus, and Cleveland. The following reports came from the MESH Coalition in Indianapolis:

  • According to several reports, one of the strongest opioids in the world is showing up across the United States. Carfentanil, which is typically used to sedate elephants, is said to be 10,000 times more powerful than morphine and 100 times more powerful than fentanyl. So far, the drug is believed to have appeared in western Pennsylvania, Ohio, Kentucky and Florida. (Sources: Emergency Management, KGW)
  • Carfentanil, which was formerly known under the commercial name Wildnil, is an analog of the synthetic opioid analgesic fentanyl. Given this, it will induce similar effects of analgesia as other opioids, however, due to its potency, it will also induce strong side effects such as sedation. Carfentanil, in liquid form, is odorless and colorless, making it virtually impossible for recreational drug users to know what they're taking, or how much. (Sources: PubChem, Business Insider)
  • Carfentanil is just one part of the far bigger issue of opioid abuse in the United States. According to the American Society of Addiction Medicine (ASAM) drug overdose is the leading cause of accidental death in the US, with 47,055 lethal drug overdoses in 2014. Close to 19,000 of these deaths were related to prescription pain relievers and  approximately 10,574 overdose deaths were related to heroin in 2014. (Source: ASAM)

Safety Bulletin Regarding the Handling of Fentanyl

The Bureau of Criminal Investigation in the Ohio Attorney General's Office issued a safety bulletin on June 27, 2016, regarding the dangers involved with handling the drug, fentanyl. This safety message applies to all public safety personnel. Learn more.

National Terrorism Advisory System Bulletin 

In response to the tragic events in Orlando, The Department of Homeland Security issued a National Terrorism System Bulletin on June 16, 2016. Learn more.

Updated Active Shooter and Complex Coordinated Attack Resorces

As the recent attacks in Brussels, Belgium so tragically demonstrate, we continue to face ongoing threats in an uncertain world. Active shooter events, the use of improvised explosive devices (IEDs), and the threat of complex coordinated attacks must be considered as at least plausible, if not probable. Below are some of the many resources that already exist that will guide you.

Training for Complex Coordinated Attacks:

Integrated response (culture change):

Hemorrhage Control (Early care saves lives):

Prevailing Response Models and Concepts:

Bystander Preparedness and Response:

Grant opportunities:

Other Resources:

US Department of Homeland Security Highlights Best Practices to Prevent First Responder Impersonation

First responders provide the first line of defense for nearly all critical infrastructure sectors and the general public during natural disasters and other physical emergencies. However, malicious actors, both international and domestic, seeking to exploit the public trust first responders have earned, have sought to impersonate first responders in order to do harm to the American people, exploit site vulnerabilities, or destroy critical infrastructure. Malicious actions include the acquisition of authentic or fraudulent uniforms, equipment, vehicles, and other items that may be associated with law enforcement, fire, and emergency services personnel. Therefore, it is imperative emergency services organizations maintain an awareness of the current threat environment and continue to remain vigilant. Learn more by reading The Department of Homeland Security (DHS) fact sheet.

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