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Published by steven.constantine, 2018-08-27 14:03:37

EMS NEWSLETTER 1_2018

EMS NEWSLETTER 1_2018

EMS NEWSLETTER

May 2018

STEMI CORNER STROKE FAST LANE TRAUMA WORLD

STEMI Strong Time is Brain WHAT’S NEW IN TRAUMA

See who set the record for FMC to Find out where CyFair Stroke program What is a considered a Level 2 Alert?
Balloon time. currently stands with Door to Needle Find out the inside and see our volume.
rates in 1st Quarter 2018.

SEPSIS SURVIVAL

Recognition and Bundle Compliance is crucial
when it comes to treatment of Sepsis.

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CyFair Medical Center May 2018 CyFair Medical Center May 2018

STEMI Strong Recipients

Jacinto City Sets Record for FMC to Balloon LEVEL 2 ALERTS:
MODERATE INJURIES

STEMI CORNER STEM  (Non-GSW) Isolated pen-
etrating injuries to the
head, neck, chest or abdo-
men with stable vital signs

 Isolated open or de-
pressed skull fractures
from blunt trauma

 Falls greater than 2 ½
times the height of the pa-
tient

 Fall from any height w/ an-
ticoagulation therapy
(excludes aspirin)

46 Minutes!  Ejection from an enclosed

vehicle The initial assessment and evaluation of severely injured trauma

 High speed auto crash patients should begin with EMS and then seamlessly transition
with initial speed > 40 mph through the emergency department and hospital phases of care.
with one or more the fol- EMS should have the authority to call for a trauma team activation
most often involving physiologic and anatomic findings in the field.
lowing:
A Level 2 Alert involves the ED physician, ED Charge Nurse, Pri-
Abnormal V/S
Any abnormalities mary Trauma Nurse, Secondary Nurse, ED Technician, and Radi-
(deformities)
ology. If the ED physician requires the consult of the Trauma Sur-
Seat belt marks or steering geon it can be ordered as Urgent (60 minute arrival time) or Stat
wheel marks (30 minute arrival time).

 Auto/Pedestrian/Bicycle Bayshore Medical Center had 1,604 Level 2 Alerts for 2017
injury with > 20 mph im- and 326 Level 2 Alerts for 2018 YTD.

pact

EMS STRONG, BAYSHORE PROUD  MCC > 30 mph or with GOT QUESTIONS
separation of rider from
bike Contact Mark Kelton
[email protected]
 Rollover MVC or death of
an occupant

2 32

CyFair Medical Center May 2018 CyFair Medical Center May 2018

STROKE FAST LANE

Stroke is the 3rd leading causes of death in the United States and the leading cause of serious, long-
term disability in the United States. Each year nearly 795,000 people have a stroke and nearly three-quarters
of all strokes occur in people over the age of 65. One-fourth of strokes occur in people under the age of 65 and
the risk of a stroke more than doubles each decade after the age of 55. Here at Cy Fair Medical Center our
Stroke Program provides high quality evidence based care to all patients presenting with stroke symptoms.
We work with an interdisciplinary team to make sure we are giving the highest quality of care for all stroke pa-
tients to meet and exceed goals/standards that we practice to improve patient outcomes. At CyFair Medical
Center, we are exceeding our goals! Currently for 1st Quarter 2018 we are at 100% for our Door to Needle in
under 60 minutes . We are currently at 57% for our Door to Needle of 45 minutes.

Cy Fair Y2D TPA times Hemorrhagic
Conversion rate

0/7
0%

100 94 From ED 3 94 min was delay
90 67 in pt decision for treatment.
80 43 67 min starting medication in
70 37 time
60 30
50 51
40
30 34
20
Cypress Fairbanks Medical 10
Center is certified as a Primary 0
Stroke Center
by The Joint Commission Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

5/5 4/7
100 % 57%

% <60 minute % <45 minute
Goal > 90% Goal > 50%

4 33

CyFair Medical Center May 2018 CyFair Medical Center May 2018

Sepsis was the sixth most common principle diagnosis for hospitalization in the United States in 2009, accord- 34
ing to the national discharge data reported by the Agency for Healthcare Research and Quality (AHRQ). The AHRQ da-
ta, reports that the sepsis mortality rate is more than eight times higher than mortality rates among patients admitted for
other conditions, and is responsible for more deaths annually than breast, lung, and prostate cancer combined. Sepsis
is the number one cause of death in non-coronary ICU’s and is the single most expensive condition treated (20.3 Billion
in 2011). The HCA Gulf Coast Division had 4,254 Severe Sepsis and Septic Shock patients in 2015, of which 1006 did
not survive. Sepsis is a medical emergency and minutes matter. Statistics indicate that for every hour delay in antibiotic
administration for a septic shock patient, the risk of death increases by 7.6% for each hour. At Bayshore Medical Cen-
ter, we have implemented processes consistent with the guidelines of the Surviving Sepsis Campaign and the Center
for Medicare & Medicare Services (CMS) in order to provide high-quality care for patients with severe sepsis or septic
shock. Most sepsis patients present in the ED and this is where we have seen the most improvement with sepsis bun-
dle compliance. We are working toward completing all bundle elements within one hour vs. the three-hour time frame
allowed per CMS protocol. We strive to administer the appropriate antibiotics within one hour of suspected sepsis in
order to provide our patients with the most optimal outcome. By increasing our bundle compliance, we expect a de-
crease in the mortality rates for these patients. In 2017, Bayshore Medical Center has demonstrated a consistent de-
crease in mortality rate for Septic Shock and Severe Sepsis (Maroon line in the graph below). In the 1st Quarter of 2018,
the mortality rates continue to be below the goal of <30% for Septic Shock and <8% for Severe Sepsis. Our overall bun-
dle compliance has improved from 66% to 71% with a goal of >70% (Blue line in the graph below). Antibiotic admin-
istration within one hour has also improved for 1st Quarter 2018 with an increase from 51% to 60% with a goal of >65%
(Orange line in the graph below). We strive daily to provide the highest quality care in a timely manner to all of our pa-

Severe Sepsis and Septic Shock Combined (POA)

Severe Sepsis (POA) Septic Shock (POA)

4

CyFair Medical Center February 2018 CyFair Medical Center February 2018

National EMS Week May 20 – 26
Quarterly EMS Meeting August 15 @ 12:30pm

Improved ED staffing EMS AGENCY 2017 Transports Admit ESI 1 ESI 2 ESI 3 ESI 4 ESI
Rate 5
We have made significant strides in improving the ED staffing to Acadian 6,552 37% 3% 38% 53% 6% 0%
better meet the needs of our community during this time of un- Deer Park 866 47% 5% 46% 46% 3% 0%
precedented volume. At our times of highest volume, Monday Houston FD 553 2% 41% 52% 5%
and Tuesday afternoons and evenings, we have 19 ED staff mem- La Porte EMS 442 48% 7% 38% 49% 6% 0%
bers - including RN’s, LVN’s, EMT’s and PCT’s – on the floor as- South Houston EMS 350 42% 3% 36% 56% 4% 0%
sisting and caring for our patients. At the same time, we have 5 Channelview FD 287 5% 41% 51% 3%
Practitioners in the ED (MD’s and NP’s) to rapidly greet and as- North Channel EMS 255 41% 4% 45% 49% 2% 0%
sess our patients. This improvement in staffing has allowed us to Galena Park 122 50% 0% 53% 45% 2% 0%
consistently greet our patients in less than 10 minutes, on aver- 56% 6% 3% 0%
age, leading to overall improved patient safety and outcomes. South Lake Houston EMS 100 3% 36% 55% 5%
SUMMARY 11,097 54% 40% 52% 0%
Patient follow up
51% 0%
CFMC employs staff members to “follow-up” with our discharge patients. Our goal is to
attempt to reach every patient who gets discharged home within 24 hours of their dis- 42% 0%
charge. We reach out to answer questions that may not have been addressed during
their ED visit, to verify the patient or their family member understand their diagnosis and
at-home treatment plan, and to seek out information that may help us improve the care we
deliver within the ED. We have been able to assist many patients with finding an afforda-
ble medication option, clarifying medications they have been prescribed, once even figur-
ing out a patient had lost one of the antibiotic prescriptions she had been given!

GOT QUESTIONS Patient Privacy EMS volume –

Contact Tara Zarco Planning has begun to add permanent ceiling-hung curtains For the month of February, we have received 831 patients via EMS, an 18% volume
Manager Emergency Department to our hall bed locations. Permanent signage and work- increase for the month. Overall, our general ED volume is up ~ 22% from last
[email protected] stations will be added as well. This will improve the privacy year. Our door to bed time is currently 9 minutes for EMS patients, on average.
Javier Deloza for our patients, and improve the workflow for all staff. Cur-
Director – Emergency Department rently, materials have been ordered, and work is expected to
[email protected] begin within the next month.

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CyFair Medical Center May 2018 CyFair Medical Center May 2018

2018 SETRAC First Responders and Hospital Awards

EMS WEEK 2018

Monday, May 21st Monday Munchies 11:00 AM to 3:00 PM
Foreign Policy Food Truck
Tuesday, May 22nd Free for those in uniform or
Wednesday, May 23rd can show credentials

Taco Tuesday 7:30 AM to 10:30 AM
Breakfast Tacos in the
Trauma System of Care Award HCA Gulf Coast Division is recognized with the
Multi-Agency/Major Emergency Team award EMS Lounge
Bayshore Medical Center was awarded
the SETRAC Trauma System of Care for at the SETRAC Banquet: Warrior Wednesday Bags 3:00 PM to 6:00 PM
the Southeast Region. We want to thank Grab a treat bag fit for a
our EMS partners for being an important In advance of Harvey’s landfall and throughout warrior on the go filled with
part of our Trauma service. the storm, the HCA Gulf Coast Division activat- sweet treats
ed an HCA Command Center that worked in
tandem with SETRAC. EMS Quarterly Meeting 12:00 PM to 1:00 PM

Thursday, May 24th Thank You Thursday 11:00 AM to 3:00 PM
Friday, May 25th A thank you from our Sen-

ior Leaders Grilling Hot
Dogs & Burgers in the bay

Bayshore celebrates Mr. Doug Tanner Floating Friday 3:00 PM to 6:00 PM
Citizen Hero of the Year Award Soda Floats in the EMS

Mr. Tanner was instrumental in the acquisition of Lounge
an AED at his church and taking a community
CPR class. He would later use his skills and 56
knowledge to save a life. He was recognized for
these very actions at the biannual 2018 SETRAC
awards.

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CyFair Medical Center May 2018 CyFair Medical Center May 2018

HAVE YOU MET OUR EMERGENCY DEPARTMENT PHYSICIANS?

Dr. Nicolas Spampinato Dr. Jameson Dr. Jose Medina, MD Dr. Minh Pham, DO Dr. William O’Malley, Dr. Thomas Lindsay,
MD Bowles, DO MD MD

Medical Director

Karen Robinson, NP Dr. Syed, Hasan, DO Lori Wisdom, NP Dr. David Wang, MD

Melanie StLaurent, NP Joan Ganguzza, PA-C Lorraine Hall, PA-C Eric Rasch, PA-C
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