A digest of EMSC Program News and Activities
Issue #57 | March 31, 2021
EMSC Scholars and Fellows Program
Meet the 2021 EMSC Scholars and Fellows!
In an effort to grow future leaders within the EMSC space, the EIIC has created the EMSC Scholars and Fellows Program to engage early career clinicians and health systems professionals. We were overwhelmed by the quality and quantity of applications we received during this first cycle of the program, which made selecting candidates very difficult. We are excited to announce the 2021 cohort of Scholars and Fellows! In the coming months, we will be highlighting each of the Fellows & Scholars individually.
EMSC Scholars Program
This program is designed to support early career clinicians and health systems professionals to become future leaders in the EMSC space. EMSC Scholars will work alongside EIIC leaders to develop and implement a unique project focused on a key area(s) of interest. Please join us in welcoming the 2021 EMSC Scholars!
Ashley Foster, MD, from Massachusetts General Hospital
Liliana Morales Perez, MD, MPH, from University of Puerto Rico School of Medicine
Cindy Chang, MD, from Harbor-UCLA Medical Center
Natasha Thompson, FNP-C, from IU Health Ball Memorial Hospital
Samantha Collins, NREMT, EMT-B, BS, from University of Vermont Medical Center
Nina Friedman, MS, CCLS, from New York Presbyterian/Weill Cornell
EMSC Fellows Program
This program is designed to support trainees and early career professionals with an opportunity to engage in EIIC-led efforts to better understand systems-based strategies for improvement. Fellows are invited to serve on national steering committees to better understand the work of EMSC stakeholders. Please join us in welcoming the 2021 EMSC Fellows!
Kenshata Watkins, BS Ed, MD, from UCSF Benioff Children’s Hospitals SF-Oakland
Andrei Stefanescu, MS, from Louisiana Dept. of Health, Office of Public Health, Bureau of Family Health
Robert Sanders from South Shore Hospital
Rosemary Thuss, MA, BScN, RN, from London Health Sciences Centre
Steve “Jason” Crellin, DO, from Geisinger Medical Center
Claire Gahm, MD, from Texas Children’s Hospital
Jefferson Barrett, MD, MPH, from Boston Children’s Hospital
Michelle Pintea, MD, from Rainbow Babies and Children’s Hospital
Chris Pecora, NRP, from Chesapeake Fire Department
Jess Boyle, BS, NRP, FP-c, CCP-C, from Commack Ambulance District
Jennifer Maguire, BSN-RN, from Dominican Hospital
Lisa Hill, DNP, RN, TCRN, EMT-P, from Ascension St. John Hospital
NaTasha Hollis, PhD, NREMT, CPH, from the Centers for Disease Control and Prevention
Hersh Mathur, MD, from Geisinger Medical Center/Northeast Georgia Medical Center
Vishal Naik, MD, from Lurie Children’s Hospital/Northwestern University
Caitlin Farrell, MD, from Boston Children’s Hospital
Caroline Wang, MD, MBA, from University of California, Davis
Benjamin Lang, MD, MPH, from Dell Children’s/UT Austin
Scott Ogelsbee, MPH, NRP, CCEMT-P, from University of New Mexico
Nevena Velikova Rose, DO, from Jackson Memorial Hospital
Easton McClanahan, NRP, from Lincoln Memorial University
Lindsay Jaeger, MD, from University of Chicago Medical Center
Anne Runkle, MD, from Cincinnati Children’s Hospital
Tabitha Cheng, MD, from Harbor-UCLA Pediatric Emergency Medicine
Angelica Cercone, MD, from UPMC Children’s Hospital of Pittsburgh
Kathryn Kothari, MD, from Denver Health and Hospital Authority
Hoi See Tsao, MD, from Hasbro Children’s Hospital
Oliver Boryszewski, BS, FP-C, C-NPT, CCEMT-P, PNCCT, EMT-P, from Loyola University Medical Center
Aaron Salinas, MSN, APRN, FNP-BC, PMHNP-BC, NRP, from The University of Texas Rio Grande Valley
Kyle Schmucker, MD, from Children’s Hospital of Pittsburgh, UMPC
Brian Yorkgitis, PA-C, DO, FACS, from UF Health Jacksonville
Caroline Melhado, MD, from UCSF Benioff Children’s Hospital Oakland
To learn more about the EMSC Scholars and Fellows program, visit EMSC Scholars & Fellows Program.
Lastly, a huge thank you to all of the highly qualified applicants who applied!
HEADACHE Study from PECARN to begin enrollment
Authors: Daniel Tsze, Peter Dayan, Nathan Kuppermann. Ed: Jason Woods
More than 400,000 children present annually to emergency departments (EDs) in the U.S. with chief complaints of headaches. A small but meaningful proportion (0.5-1%) of these children will have brain abnormalities requiring emergent identification, such as tumors, bleeding, or strokes. However, a much larger proportion undergo neuroimaging in the ED, with up to one-third of children with headaches being unnecessarily exposed to the risks associated with neuroimaging.
The most prominent of these risks are lethal malignancies due to ionizing radiation from computed tomography (CT) scanning. The primary reason for the overuse of neuroimaging in the ED is the lack of clarity regarding which clinical characteristics, or “red flag” findings, accurately identify children with headaches who are at risk of having emergent intracranial abnormalities. Current red flag findings were derived from studies with limitations such as retrospective study designs, small sample sizes, and biased study populations. In fact, frequently used red flag findings (e.g., headaches waking the patient from sleep) are common and non-specific, with certain findings occurring in as many as 30-40% of children with headaches.
The Headache Assessment in Children for Emergent Intracranial Abnormalities (HEADACHE) study aims to enroll 28,000 children across 18 sites to create a decision-making algorithm that will allow physicians to determine the precise risk of emergent intracranial abnormalities in children with headaches, and accurately identify those who do and do not require emergent neuroimaging. This information may safely reduce unnecessary emergency department neuroimaging in children with headaches, identify the ones who do, and decrease exposure to risks associated with neuroimaging. Study team training is underway, with an anticipated enrollment start in early February 2021.
2021 NPRP Response Rate Plan goes live; assessment begins May 1!
Response Response Rate Plan and Marketing Package have been sent to EMSC program managers and can now be accessed on our NEDARC website. This package contains important information that will help managers plan, prepare for, and promote the NPRP assessment to emergency departments in their state or territory. The assessment will take place from May 1 – July 31, 2021. For more information managers can contact their NEDARC TA Liaison.
NEDARC has been collecting state reports of the 2020 EMS for Children Program results of the pediatric emergency care coordination (EMSC Performance Measure 02) and skills-checking on pediatric equipment (EMSC Performance Measure 03) for its website. The state reports are based on a template presented in the November 2020 virtual workshop (Getting the Word Out with Less Work!). We thank Arizona, Alaska, Colorado, and Texas EMSC SP Managers for recently sharing their state reports, now found on the NEDARC website. If any EMSC SP Manager has created a report for their state, we encourage them to send it to their NEDARC TA liaison. We are also happy to show EMSC SP Managers how to make a state report.
Knowledge Management: Pediatric Education & Advocacy Kit and what’s next!
Knowledge Management has launched its Pediatric Education and Advocacy Kit (PEAK) content for status epilepticus in December 2020. The site has had over 3500 pages views since its launch. Next, we are turning our attention to the next toolkit topic, which is mental health.
Mental health is one of the most important and challenging areas in pediatric emergency care. Given the broad spectrum and depth of the topic, the KM domain steering committee deemed the three most impactful focus areas for PEAK mental health content will be:
- Suicide prevention and screening
- Managing the agitated patient
- Environmental safety
To this end, content from these mental health topics will be posted to the Knowledge Management Early Access Program (KEAP) page beginning in February 2021. KEAP is the pre-publication page, where content is first posted for review, comments, and feedback by potential end users and those who have content expertise in the topic. This feedback guides iterative improvements and/or assists in determining what is the highest quality content for public release as a PEAK.
In addition to the KEAP site, the first meeting of the expert panel core work group from various partner organizations and stakeholders was held on February 5th to begin a needs assessment, gap analysis, and process mapping for content development. This panel included multidisciplinary representatives from Adolescent and Child Psychiatry, Rural Health, Social Work, Indian Health Services, National Institute for Mental Health, Substance Abuse and Mental Health Services Administration, and included Lorah Ludwig from HRSA. With recommendation from this group, the KM domain team will engage in evidence synthesis, content management, and dissemination. For mental health, a separate expert group of reviewers will also be involved with content editing and feedback prior to its posting on the public facing pages of the EIIC website.
We continue to encourage all to sign up on the EIIC website to be a registered user for free resources, as well as opt in to receive early access content.
Trauma Steering Committee to address gaps in pediatric trauma care:
Traumatic injury is the leading cause of death in children in the United States. The critical goal of an inclusive national trauma system is to ensure that EVERY child receives high quality trauma care at the appropriate level trauma center in the shortest amount of time. Because most injured children are taken to adult trauma centers or hospital emergency departments that do not specialize in the care of children, the EMSC Innovation and Improvement Center (EIIC) continues to work diligently to prepare emergency care providers with the knowledge and skill to care for injured kids. The EMS for Children program is represented among lead organizations in the trauma community and those most highly vested in improving systems to support pediatric trauma care delivery.
A priority for the Trauma Domain is to ensure that pediatric trauma care is integrated into all of the EIIC activities. Together, efforts are underway to promote the exchange of knowledge and information, the development of pediatric evidence-based guidelines, and the dissemination of pediatric trauma education. A Trauma Steering Committee has been created and includes representation of individuals from various national organizations and healthcare disciplines. The initial purpose of the Steering Committee is to identify three priorities for addressing gaps in pediatric trauma care specific to emergency systems across the country. The committee has completed the first and the second phase of a Delphi methodology survey to identify those three priorities. The survey will be completed, and priorities will be identified by July 2021.
Family Advisory Network (FAN) Mail!
We’re working on ensuring that we have an up-to-date FAN Roster. If you have not already confirmed your membership in the FAN, please reach out to our new FAN Project Manager, Jennifer Talley, at Jennifer.Talley@uhhosptials.org If you’re a State Partner in need of a FAN, please let us know that, too!
Red River Region FAN Features
This month we’re featuring the work of the Red River Region (Arkansas, Oklahoma, Louisiana, and Texas). If you have work that you would like featured in our FAN Mail, please reach out to Jennifer Talley at email@example.com
Zac and Brenna Reaves – Oklahoma
It’s been a busy few months for Zac Reaves; as an Extracorporeal Membrane Oxygenation (ECMO) RN specialist and paramedic, he has spent many hours during the pandemic providing vital emergency lung support for very sick COVID-19 patients during their hospital stays or as they are transported to a different facility. In addition to his day-job as an ECMO RN specialist, Zac has also been busy, along with his wife Brenna, doing educational work as FAN members on behalf of the EIIC. Zac and Brenna have provided two formal trainings this year for EMS providers who work with children and youth with special health care needs (CYSHCN). In the first few months of 2020, prior to widespread COVID-19 infections, Zac and Brenna were able to give live educational classes to two different EMS provider groups, one for an ambulance company in their area and one for a rural county agency. Both presentations focused on caring for and transporting medically complex children, and one of the key points that was stressed in addition to the technical medical knowledge was listening to the families. Zac and Brenna both know from experience how critical it is to listen to the family when assisting with an emergency, as an experience they had with EMS services drove that point home. Zac and Brenna became involved with EIIC because of this challenging experience with their special needs son who was an infant at the time. They were driving with their son, who has a neuromuscular disease and is respiratory compromised, when he aspirated and went into cardiac arrest. Zac jumped into action, performing CPR on his son while Brenna contacted 911 though their OnStar system. While speaking to the 911 dispatcher, Zac and Brenna could tell that the dispatcher thought that their son was having a seizure instead of a cardiac arrest. Zac and Brenna tried to correct them, but the dispatcher, who had no idea that Zac is an EMT, didn’t properly listen, and informed the EMS providers that were sent out that their son was having a seizure. When the paramedics arrived on site, they treated Zac and Brenna’s son for a seizure, and again, did not listen to Zac and Brenna when they told him it was a cardiac arrest and aspiration. The seizure treatment continued until they arrived at the hospital emergency room, where doctors who knew Zac, and knew that he was a paramedic, finally listened and began the correct tests and treatments for their son.
This experience made Zac and Brenna passionate about educating EMS providers and families/caregivers of CYSHCN. From his experience as a paramedic, Zac knows that CYSHCN are low frequency, high risk patients, and that many paramedics do not receive adequate educational experiences and training to work with CYSHCN who come through their system. Once COVID-19 forced many institutions to shut down in-person trainings, Zac and Brenna continued to educate families of CYSHCN through informal zoom and telephone meetings orchestrated by their local hospital. The hospital social workers know that Zac and Brenna are both very savvy about the insurance, educational, and medical systems in Oklahoma, and when a family presents with issues in caring for or educating their CYSHCN, the hospital refers them to Zac and Brenna who coach and assist them through the various processes of informing 911/EMS providers of their child’s needs and recording it with their address, working with EMS providers, working with insurance companies to obtain coverage for their child’s needs, working with public schools on IEPs, and helping with other social, medical, and educational services. We are very proud of the work that Zac and Brenna have done, and we thank them for their tireless service to CYSHCN in Oklahoma.
Julie Johnston – Louisiana
One of our long-time FAN members, Julie Johnston has been hard at work with her State Partnership Grant Manager, Amanda Perry throughout 2020. Julie is an active participant in all of the grant activities of the Louisiana EMSC and has been providing a family perspective to their state specific PECC Role Description as well as their EMSC Facility Recognition program guidelines. Julie and Amanda have been working on determining the application process for agencies, the hospital facility recognition criteria, permanence and implementation, and other ways to make recognition a permanent priority through legislation, statute, rule, or policy. A unique feature of Louisana’s EMSC Facility Recognition program is that they include EMS agencies among the facilities they recognize. Julie’s input, dedication, and hard work has been extremely valuable towards these efforts.
Julie’s involvement with EMSC also continues into her role as a FAN member, specifically in serving on our FAN Steering Committee and the EIIC Knowledge Management workgroup. Julie would like to remind FANs to please sign up to be an Early Access Program user to give EIIC feedback on educational material and products prior to release. https://emscimprovement.center/accounts/login/?next=%2Feducation-and-resources%2Fearly-access-content%2F
New FAN Members
Please join us in welcoming new FAN members, Jeremy Sonenschein and Justin Severs. Jeremy serves as the FAN representative for Nevada, and he serves on the FAN Steering Committee and the Research Domain steering committee. Justin joined as the Michigan FAN member in December 2020 and is in the midst of getting oriented to all the work that we do.
Jeremy Sonenschien – Nevada
My name is Jeremy Sonenschein, and I have been a paramedic and EMS/fire science instructor for over 20 years. I am originally from New York where I worked as a firefighter/paramedic with the Fire Department of New York (FDNY) for many years before moving to Los Angeles. While in the San Fernando Valley, I created a one-of-a-kind accredited fire/EMS training program at Francis Polytechnic High School in Sun Valley. The program remains the EMS training model for all of the Los Angeles Unified School District. My wife and I eventually moved to North Carolina where I worked as an Adjunct EMT Instructor at Durham Technical Community College. We planned to remain there; however, my mother became very ill and we had to relocate to Las Vegas to take care of her. We have been in Las Vegas for three years; my previous job was the Emergency Preparedness Manager for Valley Hospital Medical Center. I am currently the EMS Experience Coordinator at the University Medical Center of Southern Nevada and I continue teaching EMS/fire science classes at a local EMS Training Center and for the Clark County Fire Department. I hold a Master’s degree in Higher Education Administration and a Bachelor’s degree in Kinesiology with an emphasis in Sports Medicine. I have dedicated my life to helping others through disaster relief efforts as a professional rescuer further serving at national disasters, including the horrific attacks on 9-11 and Hurricane Katrina. I have been the Las Vegas FAN representative for the Nevada Emergency Medical Services for Children Advisory Committee since October 2019. I look forward to serving on the FAN Steering Committee, continuing my mission to enhance the pediatric and overall healthcare system, and disaster preparedness services provided by Southern Nevada.
Justin Severs - Michigan
Detective - Saginaw Township Police Department (MI)
I was born and raised in Birch Run, MI where I graduated high school. From there, I attended Delta College and obtained two Associate’s Degrees. In 2008 I enrolled in the Delta College Police Academy where I spent 17 weeks learning the basics of law enforcement. Then, in September of 2008, I was hired part time by the Birch Run Police Department while working full time as a manager at Candlelite Bowling & Banquet Center.
On devils night (October 30th) of 2009, I started my career with the City of Saginaw Police Department. I worked at SPD for nearly 5 years before being hired by the Saginaw Township Police Department in 2014. Since I’ve been working at the Saginaw Township Police Department, I have been a lead field training officer, traffic stops instructor, crime scene processor, and in 2018, I was voted Officer of the Year. In June of 2018, I was chosen to fill a vacant detective position within our department. Since then, I have investigated nearly every crime, including homicides.
While not working, I spend my time with my wife, Kelley, my three boys, Cameron, Cayden and Carter, and my two dogs, Ace & Addy. I enjoy sports and coach football, bowling & baseball in Frankenmuth. In 2016, my youngest son, Carter, was diagnosed with Autism. Carter spent four years at the Covenant Center for Autism in Bay City, MI, and now attends school in Frankenmuth where he still receives special services for his autism.
While working in law enforcement and seeing the need for additional tools for first responders and people with disabilities, I made mention to two friends, Brandon Hausbeck (Saginaw City Fire Department) and Andrew Keller (JMW Real Estate), the need for a kit to better equip first responders for situations when dealing with children with autism. Between the three of us, we came up with a kit and Andrew paid for the kits to be donated to five local agencies within Saginaw County. The kits were named “Carter Kits” after my son and the idea has spread like wildfire.
To validate our kit, we brought Dr. Ellen Preen (Avon, CT), a neuropsychologist who also has a child with Autism, onto our team. Together with Dr. Preen, we improved the kit to not only focus on children with autism, but focus on all individuals with sensory disabilities. Recently, we started working with Dr. Sam Mishra and the State of Michigan, to put together a training program for first responders when interacting or responding to calls for service with individuals with autism.