Winter 2017/2018 Issue
The Kentucky Emergency Services Peer Support Team (KESPS)
Responders Supporting Responders!
The Kentucky Community Crisis Response Board (KCCRB) would like to introduce you to the Kentucky Emergency Services Peer Support team (KESPS). KESPS provides the entire spectrum of services from pre-incident training, acute crisis response, and post incident support to emergency services personnel across the Commonwealth.

KCCRB is a state agency, consisting of a board of directors (17 members) and an administrative office (5 staff persons), that manages the KESPS. The team consists of fire fighters, emergency medical services, search and rescue, and dispatch personnel who are trained, credentialed, and on-call to respond to critical incidents and provide Psychological First Aid and peer support in Kentucky.

First responders are trained to use tactical strategies and skills in crisis situations to protect lives and property. Through extensive coursework and field experience they develop the skills to perform the required tasks in a traumatic situation, often without long-lasting impacts. However, one particularly “bad” run or the cumulative effect of several traumatic incidents can overwhelm normal coping mechanisms for first responders of all ages and experience. 
At the core of being a first responder is helping others during traumatic situations. As an EMS responder you experience physical and psychological stressors from long shifts, high call volumes, sleep deprivation and low pay associated with your career. Additional stressors, such as runs involving children, mass casualty incidents, or runs involving a personal connection, can exacerbate stress reactions. Support from other EMS providers in addition to critical incident stress management services is critical to mitigate the impacts of traumatic incidents or cumulative stress.

The purpose of the KESPS team is to provide critical incident stress management services during the acute phase following a critical incident. Peer support in providing these services can prevent the destructive effects of emotional trauma, job-related stress, and to accelerate recovery. In the absence of support services, stress reactions can negatively impact an individual’s performance, career, health and personal relationships.

KESPS is a specialized strike team within the Kentucky Community Crisis Response Board. KCCRB recruits, trains, and credentials experienced emergency services personnel to be peer members of the statewide KESPS team. The team receives training in providing multi-component critical incident stress management (CISM) interventions, and suicide awareness and assessment training.

If you would like more information on becoming a member of the KESPS team or training opportunities for your agency, please contact our office at 502-607-5781 or visit our website at

Download a brochure HERE .
New NHTSA Video Explains the Importance of EMS Data Collection and Use
The NHTSA Office of EMS recently released a two-minute video that shows how EMS data is used to improve EMS systems and patient care at the local, state, and national levels.

It's important that every member of the EMSC community understand the vital role that data and information can play in improving the safety and effectiveness of EMS. It's the frontline providers caring for people every day who generate and collect this information - and the better they understand how it benefits their patients and communities, the better the quality of the data.
Your copy should address 3 key questions: Who am I writing for? (Audience) Why should they Creating a culture of science and data in EMS takes a concerted effort by all of us. Please share the video and message about data in order to reach the broader EMS workforce across the nation.

You can find the video on or YouTube .
Articles of Interest
Prehospital Pain Management: Disparity By Age and Race , Hilary A. Hewes, Mengtao Dai, N. Clay Mann, Tanya Baca & Peter Taillac (2017): Prehospital Emergency Care, DOI: 10.1080/10903127.2017.1367444 

IMPORTANCE: Historically, pain management in the prehospital setting, specifically pediatric pain management, has been inadequate despite many EMS (emergency medical services) transports related to traumatic injury with pain noted as a symptom. The National Emergency Services Information System (NEMSIS) database offers the largest national repository of prehospital data, and can be used to assess current patterns of EMS pain management across the country.

CONCLUSIONS: Documentation of pain as a symptom and pain treatment continue to be infrequent in the prehospital setting in all age groups, especially young children. There appears to be a racial disparity with Black patients less often treated with analgesics. The broad incorporation of national NEMSIS data suggests that these inadequacies are a widespread challenge deserving further attention.

Download the full article HERE .
P r ehospital Administration of Epinephrine in Pediatric Anaphylaxis – A Statewide Perspective , Leslie M. Cristiano, Brian Hiestand, Jason W. Caldwell, W. Adam Gower, Antonio R. Fernandez, Katherine Gilbert & James E. Winslow (2018): Prehospital Emergency Care, DOI: 10.1080/10903127.2017.1376137 

Objective: Timely administration of epinephrine is critical in the treatment of anaphylaxis. This study sought to determine the frequency of administration of epinephrine by EMS providers caring for pediatric patients in the prehospital setting.  

Conclusion: There are missed opportunities for prehospital administration of epinephrine in pediatric patients with anaphylaxis. Very young children (age < 10) had increased odds for not receiving epinephrine.

Abstract available HERE .
Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services, P. Daniel Patterson  , PhD, NRP, J. Stephen Higgins  , PhD, Hans P. A. Van Dongen  , PhD, Daniel J. Buysse  , MD, Ronald W. Thackery  , JD, Douglas F. Kupas  , MD, et al., Prehospital Emergency Care, DO I: 10.1080/10903127.2017.1376137

 “Fatigue is widespread in EMS and is not isolated to one type of EMS operation or category of EMS clinician. The administrators of EMS organizations are tasked with creating shift schedules and mitigating threats to safety. Unfortunately, these administrators are not equipped to address fatigue in the workplace, in part because they have no guidance on how to manage fatigue in the workplace,” said Daniel Patterson, Ph.D., lead author, assistant professor of emergency medicine at the Pitt School of Medicine, and active paramedic clinician. “Operating an ambulance is dangerous and fatigue can threaten safe operation of the vehicle,” said Patterson. “Aside from driving, most of the work EMS clinicians do is patient care, and fatigue can have negative consequences for decision-making abilities and overall performance. The outcomes of fatigue can be devastating for EMS personnel and their patients.”

Patterson and his team of two-dozen co-investigators and staff reviewed more than 38,000 pieces of literature, completed seven systematic literature reviews, including three meta-analyses. Investigators synthesized the quality of the evidence for a panel of experts, who used this information to create evidence based guidelines for fatigue risk management.

"Evidence Based Guidelines for Fatigue Risk Management in Emergency Medical Services” are now available at THIS LINK and all companion
materials, including background information, systematic reviews, evidence tables, and expert commentaries can be freely accessed at THIS LINK

Download the NASEMSO Fatigue Infographic HERE .
 Upcoming Conferences, Meetings,
Educational Opportunities
Free Online CEUs
Bound Tree University offers free online CEUs for EMTs and Paramedics. The courses have been accredited by EMS1 Academy, a CAPCE accredited organization.

They offer two pediatric courses: Pediatric Shortness of Breath and Safe Transport of the Pediatric Patient, along with 8 other classes.
Save the date for the third annual meeting of the Kentucky Pediatric Emergency Care Coalition (KPECC), a voluntary and collaborative effort to improve emergency medical care for children. We need everyone, from our children’s hospitals to our community and critical access hospitals, along with other partners, working together so that we can improve the care our children received when it matters most.

Join us as we work together to raise the bar on pediatric readiness in the ED, to include pediatric metrics in our QI programs, to increase capacity and disaster preparedness to address pediatric issues, and ultimately…to decrease morbidity and mortality for ill and injured children.

We would like to see every hospital join the Kentucky Pediatric Emergency Care Coalition at our third annual meeting on February 21, 2018, in Lexington, KY.
February 21, 2018
9 am to 4 pm @
The Hilary J. Boone Center
500 Rose Street
Lexington, KY

No registration fee!
(but pre-registration is required)

Who should attend?
Every hospital is invited to participate. ED Nurse Managers, ED Medical Directors or Physicians, and providers working with QI Programs and/or Trauma Programs would be excellent representatives, but anyone with a special interest in emergency pediatric care is welcome.

More info to come:
We are still finalizing some of the meeting details but we wanted you to know now so you can save the date! An agenda and registration information will be available soon .

Morgan Scaggs
Register Now - Teaching Mass Casualty Triage: Implementing the new MUCC Instructional Guidelines

EMS Focus webinar hosted by NHTSA’s Office of EMS on February 7 at 1pm EST

Mass casualty incidents usually don't obey jurisdictional boundaries, with responses often involving multiple agencies, regions and even states. Several years ago, to help ensure consistency when responding to these incidents, a group of experts created the Model Uniform Core Criteria for Mass Casualty Incident Triage, or MUCC. While not a system of triage itself, MUCC created a standard set of guidelines that all mass casualty systems should follow. Upon the recommendations of the National EMS Advisory Council and the Federal Interagency Committee on EMS, instructional guidelines were then developed
to help EMS educators teach the basics of MUCC during initial and continuing education for all levels of EMS personnel. 

In this webinar, you'll hear from Dr. E. Brooke Learner, a former EMS field provider and researcher at the Medical College of Wisconsin who served as lead investigator for the development of MUCC; Kandra Strauss-Riggs with the National Center for Disaster Medicine and Public Health, which partnered with NHTSA to develop the new instructional guidelines; and Leaugeay Barnes, an EMS educator who piloted the use of the instructional guidelines. EMS educators and training officers, state regulators and anyone interested in the medical response to major incidents won't want to miss this chance to learn more about improving coordination during these incidents. 

Download this infographic and other safety tip sheets at Safe Kids Worldwide .
Contact Info for KY EMS for Children
A federal and state partnership grant held by the KY Board of EMS

Morgan Scaggs
KYEMSC Project Director
118 James Court, Ste. 50, Lexington, KY 40505
(859) 256-3583
Ideas or submissions for future editions are welcome!

Previous issues can be found on our website HERE