Notices and Events
Table of Contents
State Emergency Medical Control Committee Meeting (SEMCC)
The next SEMCC meeting will be held March 6, 2018 at the Alabama Fire College at 1:00 p.m. (map) There will also be an EMS Providers Town Hall Meeting at 10:00 a.m. prior to the SEMCC meeting.
The Alabama Administrative Monthly is published by the Legislative Reference Service pursuant to subsection (f) of Section 41-22-7 of the Code of Alabama 1975. The Monthly contains notices by state agencies of the intent to adopt, amend, or repeal rules.
The Open Meetings Act guarantees that Alabama's citizens have open access to agencies, boards, commissions, and other governmental bodies which conduct the people's business. Meeting notices can be found online.
Advanced Trauma Life Support (ATLS)
Erlanger is offering 2-day ATLS courses. The student courses will be held March 15-16, June 21-22, August 16-17, and October 18-19, 2018. The refresher courses will be held March 16 and October 19, 2018. The student course fee is $875 and the refresher course fee is $525. Online registration and credit card payments may be made through the Erlanger Trauma Services PRovider Education webpage. For more information or to register, please contact Regena J. Young.
All Hazards Disaster Response
Floods, tornadoes, earthquakes, bus wrecks, active shooters, terror attacks. When you look around your city or region, are you truly ready for the many types of disaster scenarios that could come your way?
Get prepared to respond with All Hazards Disaster Response (AHDR), NAEMT’s new course that teaches participants how to analyze potential threats in their area, assess available resources, and create a response plan that will save lives.
Features of a response plan covered in the course include: Communicating effectively during disasters; mutual aid and interoperability; managing resources such as supplies, medications, and equipment; triage and transportation strategies and challenges; and patient tracking and evacuation.
At the start of the course, participants conduct a “hazards vulnerability analysis” to assess features of their environment, both natural and manmade, that pose risk, along with assessing the needs of vulnerable populations, such as assisted living homes or hospitals, that need special consideration during such an event.
Instructors can customize the course to fit the specific needs of participants, including geographic area and availability of resources. Content is presented in the context of realistic scenarios, culminating with a large-scale mass casualty activity.
Alabama Serious Infectious Disease Network Webcast
With the ever evolving world of infectious diseases, being prepared to identify and respond to potentially highly infectious patients is critical. Through the Serious Infectious Disease Network (SIDN) Alabama’s tiered response will be a coordinated effort. A tiered response requires that each healthcare provider understands their role and responsibility. This program will provide an overview of Alabama’s SIDN, to include descriptions of front line and assessment hospitals, emergency medical services and notification processes.
IV Fluid Shortages
The OEMS is aware of IV fluid shortages. Please review Dr. Crawford's memo from 2014. It is still effective today.
Alabama Department of Public Health (ADPH) announces stroke system expansion in Alabama
The ADPH and OEMS are activating a Statewide Stroke System beginnning October 30, 2017.
National Registry of EMTs Update
The National Registry has provided updated information about certification and recertification. There is also information about their website and other issues you may encounter.
Newly Released Guidance on Fentanyl Exposure
Over the weekend, the American College of Medical Toxicologists released an authoritative, well-researched position paper on “preventing occupational fentanyl and fentanyl analog exposure to emergency responders.”
One key feature of this document is that it clarifies the role of dermal exposure to illicitly-manufactured fentanyl and fentanyl analogs as a health hazard for first responders, noting that dermal toxicity is, in fact, very low for the powdered fentanyl products, and that standard universal precautions, and in some cases an N95 mask for respiratory protection, are sufficient protection for law enforcement and other first responders. It should be noted that NIOSH has recently updated their guidance on this topic, and this guidance can be found online.
Extended Use Dates Provided by Pfizer to Assist with Emergency Syringe Shortages
Due to the ongoing critical shortages of injectable drugs, the Food and Drug Administration (FDA) is alerting health care professionals and emergency responders of updated dates through which some of these injectable drugs, manufactured by Hospira Inc, a Pfizer company, may be used beyond the manufacturer’s labeled expiration date. To help ensure patient safety, these products should have been — and should continue to be — stored as per labeled conditions. The information is available on the FDA website.
Drug Shortage Information
American Society of Health-System Pharmacists and its partners works to keep the public informed of the most current drug shortages. Shortages can adversely affect drug therapy, compromise or delay medical procedures, and result in medication errors.
Improving EMS Worker Safety Through Ambulance Design and Testing
The National Institute for Occupational Safety and Health in partnership with the Department of Homeland Security's Science and Technology Directorate released a 7-part video series. This series is focused on keeping EMS workers and their patients safe in the ambulance patient compartment during a crash event.
Key points about the video series:
- Addresses research efforts to make design improvements in seating, patient cots, equipment mounts, storage cabinets, and the overall patient compartment body.
- Covers 10 new crash test methods published by the Society of Automotive Engineers (SAE) to improve ambulance design.
You may also find this infographic useful in highlighting the 10 new SAE crash test methods.
Why Alabama Needs ALFirstComm
ALFirstComm has posted educational videos about the importance of ALFirstNet and the need for Alabama to be a part of the network.
EMS Standing Orders Threatened by Pending DEA Rule
Pending federal regulations threaten a longstanding practice allowing EMS personnel to administer controlled substances to patients.
This practice will soon be prohibited unless the Controlled Substance Act is amended.
Urge your U.S. Legislator to Co-Sponsor H.R. 4365, the “Protecting Patient Access to Emergency Medications Act."
H.R. 4365, bi-partisan legislation recently introduced by Rep. Richard Hudson (R-NC), would amend the Controlled Substance Act to allow EMS Agencies to continue using standing orders from their medical director for the delivery and administration of a controlled substance (Schedule II -V).
Please visit the NAEMSP Advocacy website and view the toolkit for H.R. 4365.
When Ambulances Crash
NHTSA has put together an infographic with crash data collected between 1992 and 2011.
Association of State and Territory Health Officials Information Update: Public Health Response to Ebola Outbreak
CDC reported on the ASTHO All State and Territorial Health Officials call on August 8 that there have been 1700 confirmed cases of Ebola Virus and 900 deaths in West Africa. Those are conservative numbers and expectations are that the situation may get worse before it gets better in West Africa. The primary CDC strategy at this point is to contain the spread of the disease in West Africa. CDC has deployed 33 people, have 19 deployments pending and are ramping up for additional deployments. CDC has elevated the status of its Emergency Operations Center to Level 1 which enables them to have more flexibility with resources and makes all CDC staff available as needed in the response. The key messages Dr. Frieden conveyed during the call were:
- This outbreak is unprecedented in Africa- may surpass all other Ebola outbreaks combined; will be a long hard fight, but we have the right tools- "traditional public health"
- Ebola doesn't spread through casual contact and is only contagious from individuals who are sick
- 1st line of defense: To protect Americans, we must stop this at the source in Africa; seeing some progress - Guinea is doing better; deeply concerned about Lagos; out of control in Liberia
- 2nd line of defense is exit screening: Improving airport screening procedures
- 3rd line of defense: Educating physicians to think Ebola if the patient has been in West Africa and the patient has a fever and symptoms consistent with Ebola
- Control is straightforward: meticulous attention and adherence to standard infection control procedures (gown, gloves, eye protection and mask)
On August 8, the World Health Organization declared the outbreak to be an international public health emergency. CDC's staff is working in partnership with affected countries on exit border screening procedures to control the spread of the outbreak.
Ebola Guidance for EMS Systems
- Interim Guidance for EMS Systems and 9-1-1 Public Safety Answering Points for Management of Patients with Known or Suspected Ebola Virus Disease in the United States (CDC)
CDC Ebola Response Update
Ebola Fast Facts Flyer
The ADPH Epidemiology Division has developed a fast facts flyer for those who might have to deal with an ebola situation.
American Academy of Pediatrics (AAP) Ebola Outbreak information
The Children and Disasters section of the AAP website also has resources available.
Federal Drug Administration (FDA) Warning: Powdered Pure Caffeine
The FDA is warning about powdered pure caffeine being marketed directly to consumers, and recommends avoiding these products. In particular, FDA is concerned about powdered pure caffeine sold in bulk bags over the internet. The FDA is aware of at least one death of a teenager who used these products.
These products are essentially 100 percent caffeine. A single teaspoon of pure caffeine is roughly equivalent to the amount in 25 cups of coffee.
Pure caffeine is a powerful stimulant and very small amounts may cause accidental overdose. Parents should be aware that these products may be attractive to young people.
Symptoms of caffeine overdose can include rapid or dangerously erratic heartbeat, seizures and death. Vomiting, diarrhea, stupor and disorientation are also symptoms of caffeine toxicity. These symptoms are likely to be much more severe than those resulting from drinking too much coffee, tea or other caffeinated beverages.
All consumers seeking caffeinated products should be aware of the potentially high potency of these powdered pure caffeine products. Parent should recognize that teenagers and young adults may be drawn to these products for their perceived benefits.
What to do:
- The FDA advises consumers to avoid powdered pure caffeine.
- It is nearly impossible to accurately measure powdered pure caffeine with common kitchen measuring tools and you can easily consume a lethal amount.
- If you believe that you are having an adverse event related to caffeine, stop using it and seek immediate medical care or advice.
- The FDA wants to know about adverse events associated with powdered pure caffeine and other highly caffeinated products. You or your health care provider can help by reporting these adverse events to FDA in the following ways: by phone at 240-402-2405 or by email at CAERS@cfsan.fda.gov
Why this advice is important: Pure caffeine products are potentially dangerous, and serious adverse events can result, including death. People with pre-existing heart conditions should not use them.
Inter-Facility Transfer issues
Dr. William Crawford, State EMS Medical Director, has responded to several questions posted to our office about inter-facility patient transfers.
Influenza A (H7N9) Updates
The Centers for Disease Control and Prevention (CDC) released updated information related to human infections with influenza A (H7N9) in China.
- CDC issued a Health Update via the Health Alert Network that summarizes the H7N9 situation and new testing and reporting recommendations for H7N9 in the United States.
- The following guidance documents for health professionals are also available on the CDC website:
- Interim Guidance on Case Definitions to be Used for Avian Influenza A (H7N9) Case Investigations in the United States. The guidance is available online.
- Interim Guidance for Specimen Collection, Processing, and Testing for Patients Who May Be Infected with Avian Influenza A (H7N9) Virus. The guidance is available online.
- Interim Risk Assessment and Biosafety Level Recommendations for Working with Influenza A (H7N9) Viruses. The guidance is available online.
Guide to Infection Prevention in EMS
The purpose of this guide is to provide EMS system responders and their organizations with a practical resource to infection recognition and prevention in the EMS environment. This guide contains current information, recommendations, regulations, resources, program examples, and forms to utilize in the EMS system responder setting. Please distribute freely.
Alabama Law for Volunteer First-Responder Vehicle Operators
Many communities rely on volunteer fire departments for their fire protection and EMS response. A brochure is provided to educate volunteer fire and EMS personnel as to their responsibilities and legal considerations while responding to calls for service in an effort to keep them - and the community they serve - safe.
EMS Community News and Updates
There are things happening in local communities that you may not be aware of. Please check out our EMS Community News and Updates page for more information.
Intelligence Guide for First Responders
The Interagency Threat Assessment and Coordination Group (ITACG) has released the Intelligence Guide for First Responders. It is designed to assist first responders in accessing and understanding Federal intelligence reporting and to encourage the sharing of information. The ITACG consists of state, local, and tribal first responders from around the United States and federal intelligence analysts from the Department of Homeland Security, Federal Bureau of Investigation, and National Counterterrorism Center working to enhance the sharing of federal information on counterterrorism, homeland security, and weapons of mass destruction with state, local, and tribal consumers of intelligence.
Nerve Agent Antidote Kits
The Alabama Department of Public Health received notice from the Food and Drug Administration (FDA) that the expiration dates for certain Duodote (nerve agent antidote kits) lot numbers have been extended up to one year due to a manufacturer's backorder. First responders who received the antidote kits should verify if the expiration date has been extended before discarding kits. More lot numbers may received extended expiration dating in the future. View lot numbers that received extended dating.
The Alabama Department of Public Health (ADPH) began providing nerve agent antidote kits to emergency medical services personnel several years ago. As funding allows, ADPH will continue to provide the devices to emergency medical service agencies that meet the required criteria. Agencies requesting nerve agent antidote kits must develop a program and train their staff on the program and antidote kits including indications, dosage, storage etc. Training documentation and a request form must be submitted to ADPH.
Intravenous Fluid and Other Advanced Life Support Procedures
Please remember that intravenous (IV) fluids and Advanced Life Support (ALS) procedures are to be performed only when done by protocol, an on-line medical direction physician gives a verbal order, or under the physician's direct supervision. The August 2, 2010 Memo from Director Dennis Blair offers more information as well as a position statement from the Alabama High School Athletic Association.
Page last updated: February 13, 2018