MINUTES OF THE FEDERAL INTERAGENCY COMMITTEE ON EMERGENCY MEDICAL SERVICES (FICEMS) Ambulance Safety Subcommittee DATE & TIME:June 3, 2004 9:00 a.m. LOCATION: National Emergency Training Center (NETC) Building J, Room 101 16825 South Seton Avenue Emmitsburg, Maryland 21727 MEMBER AGENCY REPRESENTATION:Department of Homeland Security Federal Emergency Management Agency (FEMA) Mr. Bill Troup United States Fire Administration Mr. Steve Dyer – Intern working for United States Fire Administration Department of Agriculture No Representation Department of Commerce (DOC) No Representation Department of Defense (DOD) Department of the Navy CDR. Duane C. Caneva Bureau of Medicine and Surgery Department of Health and Human Services (DHHS) Ms. Nancy Romano AS Subcommittee Chair National Institute for Occupational Safety and Health (NIOSH) Indian Health Service Cathy Stueckemann Office of Clinical and Preventative Services Leah Hess Office of Clinical and Preventative Services Department of Interior No Representation Department of Justice (DOJ) No Representation Department of Labor No Representation Department of Transportation (DOT) Mr. Dave Bryson National Highway Traffic Safety Administration (NHTSA) Mr. Drew Dawson National Highway Traffic Safety Administration Department of Veteran Affairs No Representation Federal Bureau of Investigation (FBI) No Representation Federal Communications Commission No Representation General Services Administration (GSA) No Representation OTHER ATTENDEES PRIVATE SECTOR:American Ambulance Association Mr. Kurt Krumperman American Integrated Training Systems (AITS) Mr. Billy Rutherford American Society Testing & Materials (ASTM) Mr. Pete Chambers Council of Governments Ms. Christine Woodard Maryland Institute for Emergency Medical Services System Ms. Rene Fechter National Volunteer Fire Council (NVFC) Mr. Joe Robison VFIS Mr. Richard Patrick DIAL-IN PARTICIPANTS:Centronia Ambulance Corps Mr. Larry Wiersch Commission on Accreditation of Medical Transport Systems Ms. Eileen Frazier Department of Health and Human Services (DHHS) Ms. Nancy Romano AS Subcommittee Chair National Institute for Occupational Safety and Health (NIOSH) Estero Fire & Rescue Department & IAOFC Dr. Jeff Lindsey Harlem Hospital Ms. Nadine Levick International Association of Fire Fighters Mr. Jonathan Moore Little Rock, AR, Metropolitan Emergency Medical Systems (MEMS) Mr. Jon Swanson The Insurance Professionals Mr. Bill Leonard I. WELCOME Ms. Nancy Romano called the meeting to order at 9:00 a.m. and proceeded with introductions. II. INTRODUCTIONS and REVIEW OF ATTENDEESS' INVOLVEMENT IN AMBULANCE SAFETY PROJECTS Attendees introduced themselves and Ms. Romano made a motion to approve the meeting minutes from March. Minutes were approved. Dial-in participants continued to express their difficulty hearing people in the room, and though efforts were made to improve this condition, those on the phone reiterated experience difficulty hearing. Ms. Romano, NIOSH, mentioned that the subcommittee continues to grow and let take this opportunity to go around the room and talk about the projects each of you are working on and share those with the group. Mr. David Bryson, NHTSA, discussed the proposed purpose/agenda for a 1-day event similar to this subcommittee, however, plans to invite other participates as well. NHTSA welcomes feedback on the agenda and topics listed on the draft handout, see attachment. The anticipated location is at NHTSA sometime in November. Mr. Pete Chambers, ASTM, suggested doing a track at one of the annual conferences such as the EMS Expo or a similar event. Mr. Drew Dawson, NHTSA, mentioned that combined meetings have not been received well. The federal participates seem to have very limited ability to send multiple people on travel at the same time, therefore reducing the federal participation if combined at a national/annual conference. Mr. Bill Troup, USFA, also noted that funding availability is sensitive to the timing of the event. Mr. Bill Leonard, The Insurance Professionals, asked if there is a list of the EMS industry related conferences available. Ms. Romano will provide a list of Federal agency meetings/conferences to Mr. Leonard. (ACTION ITEM) Mr. Kurt Krumperman, AAA, provided a comment for David Bryson regarding the presentation on the black box; he suggested putting out a broad invite to various vendors of driving safety providers. Mr. Pete Chambers, ASTM, commented that this approach might open up pandora's box since Mr. Bryson is looking at specific data collected by NHTSA vs. a technology driven data. Mr. David Bryson, NHTSA, agreed with both Mr. Krumperman and Mr. Chambers that it is important to key in on the data vs. technology so that we keep Pandora's Box closed. Ms. Cathy Stueckemann, IHS, currently has been working on Emergency Vehicle Operation Courses, three which have been completed thus far at our national training center. CDR. Duane Caneva, U.S. Navy, mentioned they are trying to figure out who will be riding on their ambulances. Traditionally it has been our corpsman but over the past several years, it has been switching between personnel and other staffing. We are trying to figure out what is the best approach, who will be the project manager etc… Other areas of interest may be; DREAMS, a Research & Development program, which provides a telemedicine capability on an ambulance meant for the field core in conjunction with a large civilian piece (may be related to the black box). We have also been receiving a lot of information back from Operation Iraqi Freedom on the gold standards used on the battle field. It is probably more related to helo safety protocol but that could indeed apply to the civilian world. Ms. Nancy Romano recommended he talk more about this at the September FICEMS Meeting. Commander Caneva said he would confirm a volunteer to talk more about these issues for the main FICEMS meeting in September. (ACTION ITEM for Main FICEMS) Mr. Billy Rutherford, reported that there is a lot of information & work available in these areas that Commander Caneva mentioned. If interested in this work, contact Mr. Rutherford and he will be glad to share that information. Ms. Nancy Romano, NIOSH, mentioned that they are still analyzing crash testing and pretty soon will be able to present this data. They are moving into the next phase of the Occupant Safety project which relates to the human factors. Mr. Bill Troup, USFA, addressed that the USFA has just finished up the Emergency Vehicle Safety Initiative. They hope to have the report printed and on the website sometime this summer. Mr. Troup expressed thanks to those who helped on this initiative. Now entering phase two, they are taking the recommendation from the Emergency Vehicle Safety Initiative and partnering with the three major national fire trade groups to take the recommendations and develop targeted strategies for implementation with their constituent groups. USFA is working with the Society of Automotive Engineers – received funding from the federal community, addressing science & technology issues to prevent the blinding of oncoming drivers (loss of night vision). Another project on the horizon is the Traffic Incident Management Systems, USFA is partnering with International Fire Service Training Association to look at layouts of vehicles on the highway to prevent fire fighters & vehicles from being struck. Reports: Other Interested Parties Ms. Renee Fechter, MIMS, reported that the commercial ambulance division has been focused on ambulance safety for sometime. Currently we are trying to create a database to focus our efforts and where we can go to increase the safety issues and improve ambulances. Mr. Bill Troup suggested contacting Paul Moore; the interest is similar to the study that Paul Moore is conducting on crash testing. Dr. Nadine Levick, Harlem Hospital, expressed that there is a lot of reproduction in regards to data collection and research that we are all doing. We need to optimize what has already been done in the States and throughout the world. She will be happy to share data & to ensure we are not duplicating research that has already been done. The real concern is this is reinventing the wheel. Ms. Fechter commented that she would be interested in the data. Mr. Bill Troup will forward Dr. Levick's contact information to Ms. Fechter (ACTION ITEM) Mr. Rick Patrick,VFIS, commented about Operation Safe Arrival, an initiative which began 2-years ago to address the issues of emergency vehicle collisions. The internal research showed that the majority of the issues appeared to be lack of management driven for safe driving. Operation Safe Arrival is an incentive based program, now in 5 focused states, asking them to participate in this campaign to make a cultural change from the top down. Phase I deals with intersections since it is the primary area of concern. Eventually, we will hopefully roll-out to the rest of the states (Hawaii is not an issue based on the data collected). The future phases are Phase II – planned to deal with roll overs, & Phase III – addressing highway safety. Our programs have nothing to do with tangible risk control products; it's based on 100% prevention on the human component. Ms. Romano asked that he provide a short presentation on this program at the September meeting. (AGENDA ITEM) Mr. Patrick will let Ms. Romano know how much time to a lot for the presentation. (ACTION ITEM) Mr. Vic DeSantis, SafetyTech International Inc., nothing to report at this time. Ms. Christine Woodard, Council of Governments, nothing to report at this time. Mr. Billy Rutherford, American Integrated Training Systems, reported AITS continues to be involved in train-the trainer course for the EVOC course. He also mentioned they are doing a lot of work in emergency response/responder work, but the Air Force is doing a better job developing training documentation. Dr. Jeff Lindsey, Estero Fire & Rescue Department, reported and discussed simulation and effects/benefits. When in a simulation environment, you are looking at two learning transfer environments 1) near and 2) far. In Lafayette, we looked at a near learning transfer environment study. Far learning transfer is not exactly the same as what they learn when they get into a different/multiple vehicles. He mentioned that he does not advocate that simulation is a replacement for true emergency vehicle driving training but it has shown in multiple disciplines a true effect on teaching individuals how to operate different types of vehicles has shown a number of great effects. This is the first research that has dealt with EMS drivers using a simulator to test the effects of the study and if there are significant effects, I am happy to report that the effects were indeed significant. Ms. Romano also suggested adding a short presentation at the September meeting. (AGENDA ITEM) Mr. Joe Robison, National Volunteer Fire Council, reported he was looking forward to your report (USFA) coming out in September. Mr. Robison recently visited the Mediterranean and is interested in why European emergency vehicles run with their lights on all the time. This question was posed for Ms. Levick who was not on the conference call at this time. Mr. Pete Chambers, ASTM, noted that ASTM deals more in terms of the specifications and the science behind the vehicles themselves. When we begin talking about Dr. Levick data as cross over data, he doesn't understand how the data can be cross-over data since Europe do not have ambulances that are similar to those used in the states. With the important information coming out of the testing, the industry improvements, testing methods are getting better but right know we keep discussing and reiterating the safety issues. Mr. Chambers expressed that he is not sure what the subcommittees focus is right now. His understanding was that discussing the human factor was the next step. He expressed that he would like a more focused approach from the group on whatever we choose to deal with. The outcomes would become more valuable if we become more focused. Each meeting we continue to hear introductions on new efforts which indefinite extend the effort the group can put forth. ASTM has used Mel's KKK standard as the basis and moving forward and trying to put science behind them. ASTM & Mr. Chambers are looking for the science behind them vs. the anecdotal variances. Mr. Chambers expressed he would like more leadership on the focus of this subcommittee. Mr. Kurt Krumperman, AAA, defers to Larry Wiersch to report on the AAA activities. Mr. Larry Weirsch, AAA, mentioned that they have accomplished the ability to make sure science is recognized as a significant issue. He noted that overall they have had a relatively poor response from the states in relation to data collection. When they get the data, they are going to attempt to put science behind the data. We have seen a huge change from the human factor perspective. Essentially, we are addressing the human factor with additional training. Participating in the VFIS program and we are seeing behavioral changes with positive impact on the human factor. Progress is slow but we are getting all on the same page. Dr. Jeff Lindsey, IAOFC & Estero Fire & Rescue Department, reported that he is working with Operation Safe arrival with Mr. Patrick, working on a research study using simulation of emergency response drivers. Mr. Bill Leonard, The Insurance Professionals, reported an increase in stretcher issues which seem to be a center of gravity issue, and the other is the lack of use of shoulder restraints inside the vehicles. Dr. Jack Lindsey mentioned that since the institution of their program, Operation Safe Arrival, they have seen a dramatic change in that mentality just by additional recognition and monitoring. Ms. Eileen Frazier, Commission on Accreditation of Medical Transport Systems, wanted to add to Larry Wiersch's comment about data. Ms. Frazier attended the National Association of State EMS Directors Meeting last year and one of their projects is to collect ambulance accident data on a nationwide basis. We should be able to get collective data shortly. III. SUBCOMMITTEE OBJECTIVE The section was not discussed at length other than Mr. Chambers mentioning his interest in the subcommittee becoming more focused and requesting additional leadership from this aspect. IV. ACTION ITEM REVIEW Mr. Bill Troup investigated the possibility of developing web links from the FICEMS Page of the USFA website that could include Federal agencies that participate in FICEMS as members, and potentially non-member organizations. Update: At this point, since FICEMS is not an advisory committee, the web links should pertain to Federal participants. Ms. Nancy Romano sent members the database that she and Mr. John Russell are putting together with good information on crash data and information on organized training programs. Mr. Jeff Lindsey was scheduled to do a presentation on his paper on using simulators to train emergency drivers at the June meeting. Update: This presentation has been moved to the September meeting. Ms. Nancy Romano will forward information to the group from Mr. Brian Walker regarding dealing with bio-terrorism events. Update: Ms. Romano will forward the information once she receives the information from Mr. Walker. NEW ACTION ITEMS from this meeting: 1. Ms. Romano will provide a list of Federal agency meetings/conferences to Mr. Leonard. 2. Ms. Nancy Romano recommended he talk more about this in the September FICEMS Meeting. Commander Caneva said he would confirm if a volunteer could talk more about these issues for the main FICEMS meeting in September. (ACTION ITEM for Main FICEMS Meeting) 3. Mr. Bill Troup will forward Dr. Levick's contact information to Ms. Fechter. 4. Ms. Romano asked that Mr. Rick Patrick provide a short presentation Operation Safe Arrival at the September meeting. Mr. Patrick will let Ms. Romano know how much time to a lot for the presentation. 5. It was suggested and agreed upon that the AS would have frequent teleconferences due to time issues and difficulty hearing when calling into FICEMS. Ms. Romano agreed to have the teleconferences and use the quarterly meetings for more subcommittee updates. V. NEXT MEETING AGENDA Presentation by Mr. Rick Patrick on Operation Safe Arrival Presentation by Dr. Jeff Lindsey on Simulation Effects and Benefits VI. NEXT MEETING September 2, 2004, 9:00 a.m. Building J, Room 107 NETC, Emmitsburg, MD VII. ADJOURNMENT Meeting adjourned at 10:30 a.m. 8 FICEMS Ambulance Safety Subcommittee DRAFT Minutes – June 2004 FICEMS Ambulance Safety Subcommittee DRAFT Minutes – June 2004