Category Archives: EMS
Topics pertaining to San Francisco’s EMS system.
San Francisco’s emergency medical service (EMS) professionals rush every day to the scenes of emergencies to assist in what might be someone’s darkest hour. Wednesday May 20 is our opportunity to honor their achievements, which often go unnoticed.
Our City’s EMS honorees represent paramedics, emergency medical technicians, dispatchers, educators, and emergency room providers. Collectively they are shining examples of San Francisco’s emergency medical services community.
EMS Community Service Award
University San Francisco Emergency Medical Response Service
The EMS Community Service Award is presented to community members not employed by EMS system providers who have demonstrated leadership, compassion, and proficiency in providing emergency care for patients. The University of San Francisco’s Emergency Medical Response Service is this year’s honoree. USF developed their first on-campus EMS response service run by students and developed a community outreach plan to provide CPR, first aid, and disaster response training.
EMS Hospital Provider Award
UCSF Medical Center and UCSF Benioff Children’s Hospital Operation Move Team
The EMS Hospital Provider Award is presented to hospital-based providers for their exemplary care of EMS patients and their efforts on behalf of EMS field providers in building the teamwork that patients need to recover from their crises. The UCSF Medical Center and UCSF Benioff Children’s Hospital Operations Move Team planned and executed a safe move for more than 130 patients from UCSF’s Parnassus and Mount Zion campuses to the new Benioff Children’s Hospital campus with minimal impact on EMS services. As result of their advanced planning, disaster preparedness was enhanced at all sites.
EMS Dispatcher Award
Chancellor Mateo, EMD
The EMS Dispatcher Award is presented for service to patients calling in time of need for medical emergencies above and beyond the normal duties of EMS dispatch. Chancellor Mateo was selected by his peers for 12 years of outstanding performance as a dispatcher and dispatch trainer.
EMS Field Provider Award
Anthony Dumont, EMT-P
The EMS Field Provider Award is presented to an active Emergency Medical Technician or Paramedic who provides excellent care to patients in need in a compassionate, professional and exemplary manner. Anthony Dumont, EMT-P receives this honor for outstanding performance as a public safety provider in law enforcement, firefighting, and emergency medical care. Anthony is a leader in the development of medical support to tactical situations.
Raymond Lim Excellence to EMS Award
Megan Corry, San Francisco City College
Raymond Lim Excellence in EMS is presented to an individual to honor a career spent in caring for EMS patients in an exemplary and extraordinary way. True to the spirit of Raymond Lim, a pioneer in establishing quality care in California EMS, Megan Corry has dedicated her 20-year career to emergency medical services in the field and in the classroom. Megan trains future EMS professional as the Program Director of City College of San Francisco’s nationally accredited paramedic training program.
Congratulations to all of our honorees! Thank you for your service to San Francisco.
Inspired? Attend San Francisco’s Emergency Medical Services Open House at City College of San Francisco on May 20, from noon to 4:00 p.m. San Francisco’s EMS providers and professionals will be on hand to answer your questions. For more information about the San Francisco Emergency Medical Services Open House, Job Fair, andAwards visit: http://www.sfdem.org/emsawards
Have you ever wondered who is on the other end of the line when you call 9-1-1? In the advent of an emergency you call 9-1-1 hoping to ultimately reach fire fighters or police officers, but who coordinates with those entities? Who guides them? Who advises them on the situation, and who helps to keep our officers and fire fighters safe in potentially chaotic instances? Dispatchers are the unsung heroes of our emergency response infrastructure. Last week was National Public Safety Dispatcher Week and the San Francisco Department of Emergency Management celebrated all of our fantastic and talented team of dispatchers. DEM also recognized San Francisco Dispatcher of the Year, Kayleigh Hillcoat.
“Teamwork is vital and I’m proud to work with a team of skilled and compassionate individuals who strive to do their best for our public safety partners and the citizens we serve every day. We put our personal emotions aside and pull through intense, difficult situations together.
The incidents mentioned by Supervisor Mar are no different. I may have been a voice in the chaos, but I was backed by my co-workers helping to log and forward critical information, make calls, notify our allied agencies of crucial updates and dispatching fire and medical response along the way.” Kayleigh remarked during her Recognition of Commendation.
Usually Dispatcher of the Year is recognized for one incident however, Kayleigh is being awarded for commanding three high profile incidents this year. Kayleigh assisted the San Francisco Police Department during an incident that involved a potential officer down, throughout spontaneous celebrations the evening that the San Francisco Giant’s won the World Series, and during public demonstrations in Union Square related to the Ferguson, Missouri protests.
When asked what her favorite part of her job was, Kayleigh responded “[It’s] challenging, there is something different every day, I appreciate being able to directly make a difference in someone’s day or life depending on what the call is about.” She also enjoys the fact that she provides a service to the public, in addition to assisting our fire fighters and police officers.
What most people are not immediately aware of are the difficult parts of the job. Kayleigh shared, “the lack of closure after the call ends can be hard. There isn’t a lot of follow-up on how the emergency was handled or what happened to the caller.” Sometimes dispatchers interact with callers facing grave circumstances; this is a burden all dispatchers carry.
However, Kayleigh has found a wonderful way to deal with some of the more difficult parts of her job by volunteering her time at San Francisco’s Animal Care and Control (AC&C) where she volunteers with the Fetch Program. The Fetch Program is dedicated to dogs brought into the custody of AC&C due to the fact that the owner may be in the hospital, jailed, or evicted. These dogs are often emotionally stressed after being separated from their owners and the comfort of their homes, that’s where Kayleigh steps in. Kayleigh finds solace that she can help in some way post-call by being on the receiving end of displaced animals due to emergencies.
This September Kayleigh will mark her 10th year as a DEM Dispatcher. Congratulations Kayleigh for a job consistently well done and DEM is proud to honor you for your vital contributions to public safety.
Occasionally, staff members at San Francisco DEM have an opportunity to travel abroad. They frequently write back with their observations. The following journals a recent trip by DEM Emergency Medical Services Agency staff members, Crystal Wright and John Brown, who went to Haiti to volunteer their personal time and professional expertise to the rural town of Leon.
Crystal Wright, EMT-P, and John Brown MD, recently returned from a week of volunteer work in rural Leon, a town of some 8,000 people in the Grande Anse province of southwestern Haiti. The reason for their visit was to support a local dispensary staffed with a nurse, a pharmacist, a dentist and a tuberculosis program health aide. The medical operation, begun in 2000 by the Seattle King County Disaster Team (a member of the Disaster Medical Assistance Team program of the U.S. Health and Human Services Department) as a training mission for health care providers to learn how to provide quality care in an austere environment, now provides services to the clinic every four months with a multi-disciplinary team of nurses, physicians, paramedics, EMTs, laboratorians and pharmacists.
Dr. Brown has participated in this effort annually since 2004 and finds enjoyment in seeing returning patients and families from treatment given in previous years. He’s noticed a slow but steady improvement in some infrastructure support since the significant earthquake in January 2010, and the improving overall health of the patients with chronic diseases such as hypertension and diabetes. The teams conform to World Health Organization standards for disease treatment and medications, and work with the local health care system, including the Haitian Health Foundation, to deliver preventive medicine teaching and supplies, and refer high risk patients to the nearby city of Jeremie for treatment.
During his free time on the mission, Dr. Brown enjoys visiting the children and staff at a local orphanage that he supports, and hiking the local trails to visit the farther flung villages in the community, and admire the lush flora and fauna of the countryside.
The trip was Crystal Wright’s first opportunity to participate in this mission, which she found rewarding and reinforcing of her commitment to caring for people.
Working with the Seattle King County Disaster Team was excellent; we had meetings every night to discuss our plans and performance at the clinic. And like Dr. Brown, I did enjoy visiting the orphanage and hiking around the community, as well as greeting as many persons as possible when our clinic had closed. My hope is to continue working with this team and seeing progress and improvement in the future, said Crystal.
New this year was the integration of an emergency physician from Canada, who had extensive knowledge of Haitian history and culture, and the improved care of women’s health needs based on a study done by the Seattle King County Disaster Team last fall to evaluate care for breast disease and sexually transmitted infections. The team regularly screens patients for HIV disease and refers high risk patients to a local treatment program.
Next year the team hopes to resume partnering with the Haitian health ministry to work with young Haitian MDs stationed at the clinic. They also hope to provide outreach services to several more remote villages in the Leon region that do not have dispensaries via mobile teams, which convert the community’s schoolhouse into a temporary clinic.
Where were you in the year 2000? It’s been awhile. Bill Clinton was President and Willie Brown was Mayor of San Francisco. “American Beauty” won the best picture Oscar, while the hit by Santana and Rob Thomas, “Smooth”, edged out Ricky Martin’s “Livin’ La Vida Loca” for a Grammy. Facebook and Twitter didn’t exist.
Have you improved and upgraded over the last 14 years? You probably have. But the radios used by San Francisco Police, Fire, and other public safety agencies haven’t. Seriously. In a digital world, the City’s 7,500 public safety radios operate on a 14-year-old analog system, first installed in the year 2000. Who thinks it’s time for an upgrade?
We do. In partnership with the Police and Fire departments and the Department of Technology, DEM is proud to lead the charge to upgrade the City’s 800 MHz Public Safety Land Mobile Radio System. It provides life-safety radio communications for San Francisco’s Police, Fire, Sheriff, Parking and Traffic, Recreation and Park, and Emergency Management (that’s us) departments. This means critical push-to-talk communications that connects instantly with the 9-1-1 dispatch center for dispatch to emergencies, or calling for backup from other officers in the field. The system uses proprietary analog technology that has now reached end of life, with no replacement parts available.
Last month we received the City’s approval – and critical funding – to finally replace this aging system with current technology. The new radios will be interoperable across the Bay Area, so when a San Francisco police officer goes over to Oakland, her radio will still work. The system will also provide better coverage, like underground in BART stations, as well as down to the Airport.
We estimate that a full system replacement should be complete by mid-2018. So just as Y2K babies will finally graduate and leave home, we’ll say goodbye to our Year 2000 radio system, and upgrade to the future. It’s about time.
While SFDEM was visiting the TaRSIER 117 Operations Center an emergency call came in about a shooting in Taglibaran City. A call taker took the information from the caller and a radio dispatcher notified the Philippine National Police.
Startup life… It’s a lifestyle and a popular hashtag on Twitter or Instagram. It’s the hustle and the grind. The marathon hack-a-thons and the late night drinks where ideas are born. It’s developing the next product or service that’ll change all of our lives. In San Francisco, it drives our economy but there have been some unintended consequences as well.
Over here it’s different. In a two room building in the Bohol province of the Philippines they aren’t developing a new social network, e-commerce site, or dating service. The men and women of this startup don’t develop code or design products. Instead the scrappy staff that make up this startup are dispatchers, medics, and emergency managers and they are making TaRSIER 117 work with nothing more than sheer will. TaRSIER is short for Telephone and Radio System Integrated Emergency Response. 1-1-7 is the phone number Boholinos are encouraged to call when they have an emergency.
Alfonso is a proud Boholino and TaRSIER was his idea. Many years ago his father, Alfonso Sr., had a stroke so they jumped in a car and rushed him to the closest clinic. It took an hour and half…the damage was done. Bohol had ambulances, they had firefighters, and they had police officers but they weren’t coordinated. On top of that each had their own phone number and often that number was different from barangay to barangay (neighborhood to neighborhood). What was needed was central place in Bohol where aid and assistance could be coordinated effectively. Years later, Alfonso became the Provincial Administrator and in March 2011 TaRSIER 117 was launched with a staff of 8.
If TaRSIER was Alphonso’s idea, then Darwin and Mark are the key developers. Darwin was trained as a nurse, but had difficulties finding a nursing job in Bohol, so he worked for a customer call center. When he started at TaRSIER, he drew upon his background to develop the protocols and script his dispatchers use when people call. Mark is also a trained nurse and a former Philippine Red Cross volunteer. Mark uses his medical and Red Cross experience to train TaRSIER’s medical response and rescue teams. Together they are taking what they know and developing the lifesaving protocols, procedures and training for TaRSIER. If something isn’t working they learn from the experience and make adjustments. From what DEM could observe they are doing a phenomenal job with scarce resources and without formal training.
TaRSIER has grown to 47 people who staff and operate Bohol’s emergency operations center, emergency dispatch, and provide ambulance and rescue services. While they have grown with the support of Bohol’s governor, like any startup, they have had their challenges. Educating the public to call 1-1-7 has been an enormous task. TaRSIER averages 250 emergency calls per month for population of 1.2 million. By comparison, San Francisco’s 9-1-1 emergency dispatch center averages more than 3,000 calls per day for a similar population. It’s not because San Francisco has more accidents, fires, or crime. It’s because many people in Bohol in still prefer to seek out help on their own or call the police or fire department directly. If they do call, sometimes it’s for non-emergencies. TaRSIER staff cited examples of people calling to ask what the traffic is like. In other instances, the caller gets upset and asks the dispatcher why they are asking so many questions. DEM assured our counterparts that we also get similar calls.
Retention is another challenge for TaRSIER. Most of the team went to school to be nurses and have had a hard time finding a job in that field. As the staff gains experience and training, they often get offers for higher paying jobs as nurses or in more established emergency management departments in the Philippines. According to Alfonso, in the past year, 14 staff members have left TaRSIER for more lucrative or high profile opportunities.
Not all emergency management departments in the Philippines are startups. The National Disaster Risk Reduction and Management Council (NDRRMC) is the Philippine government’s version of our Federal Emergency Management Agency (FEMA). During our visit to NDRRMC headquarters at Camp Aguinaldo, we found highly professional, knowledgeable, and experienced emergency managers. In addition to earthquakes, the Philippines must contend with 15 to 20 typhoons each season. While NDRRMC is nowhere near a startup, their focus has shifted from managing the response to reducing risk through preparedness.
The Philippines has invested time and resources in engaging the public through both digital and traditional social networks. Facebook is the primary method of digital social networking since it is what most Filipinos use. NDRRMC has also formed a public-private partnership with the country’s mobile providers and developed a smartphone app that provides useful emergency information that is set to launch in the summer of 2014.
The staff at the NDRRMC knows that government can’t be the only answer before, during, and after an emergency. They are investing time in local leadership at the barangay level. People everywhere, whether it is in the Philippines or San Francisco, are likely to listen to information if it is from friend, family member, or other trusted source. This is why the NDRRMC is enlisting church leaders, school teachers, and barangay captains to help Filipinos get more prepared.
Manila’s emergency management agency is in a state somewhere between TaRSIER and the NDRRMC. The Manila DDRMC (MDDRMC) has taken steps towards preparing for the hazards that may face the city’s 1.6 million inhabitants. MDDRMC is building a new combined emergency operations center and emergency dispatch center at Manila City Hall. The center will coordinate everyday emergency calls as well as respond during special event or disaster. DEM was impressed by MDDRMC’s due diligence in designing their combined center. Manila officials built a small demonstration facility and then required every hardware and software vendor to provide a proof of concept for their products before asking for bids. As a result, they could test equipment and software before purchasing them.
While TaRSIER, NDRRMC, and City of Manila are different stages of evolution and capability they were all put to the test in some way in the fall of 2013. DEM’s next post will focus on the response and recovery and lessons learned from the deadliest earthquake in the Philippines in 23 years and the strongest typhoon in recorded history.
The Honorees Are…
Awards season is typically in February when the Oscars and the Grammys are handed out. You could debate The Life of Pi was more deserving than Argo or why Taylor Swift didn’t get another Record of the Year but there is no debating the value and contributions of San Francisco’s Emergency Medical Services Agency (EMSA).
During the 15th Annual EMSA Awards Ceremony awards were presented to outstanding individuals for their commitment to emergency medical care. The honorees are:
Jonathan Baxter, EMT-P
EMS Field Provider Award
Jonathan Baxter is recognized for his years of outstanding service, patient advocacy and promotion of new technologies for EMS. As an eleven year emergency services veteran, Jonathan joined the San Francisco Fire Department in 2000 and dedicated his career to taking on tough assignments. At Fire Station 18 he served on the Surf Rescue Unit. Since 2009, Jonathan has volunteered to work out of Fire Station One- one of the busiest in the nation. At each station he was recognized for his work and received Meritorious Conduct Awards from the Fire Commission. In addition to his service, Jonathan contributed to projects to streamline patient care documentation and improve patient assessment.
Tae-Wol Stanley, MSN, RN, FNP
Shannon Smith-Bernardin, MSN, RN
Community Members of the Year Award
Tae-Wol Stanley and Shannon Smith receive this award for for years of meritorious service to the chronically homeless. The Department of Public Health’s Sobering Center is a twelve bed facility that provides thousands of homeless and medically frail clients with sobering, detox and medical respite services. Ninety percent of patient encounters in the Sobering Center result in a discharge to self-care or a shelter, which significantly decreases the impact on EMS, emergency departments and jails.
As the Clinic Director, Tae-Wol manages its programs, budget, and 35 employees. Tae-Wol has also overseen the expansion of the center to field clinics during citywide special events. In her role as Intake and Sobering Coordinator, Shannon transitioned the staff from LVNs to a mix of RNs and MEAs, wrote its clinical practice guidelines, and designed its referral system.
Jonathan D. Garber, MD
EMS System Hospital Provider Award
As the Chief of Emergency at the Veterans Affairs Medical Center since 1997, Dr. Jonathan Garber has grown the department to include more than 40 physicians and 90 residents. He is highly regarded by his colleagues and students and has been awarded the title of Master Clinician.
Dr. Garber has also been instrumental in helping the VA become more prepared. Under his leadership, the VA has hosted disaster exercises, created the only helipad in the city, and stored a pharmaceutical cache for prophylaxis during a pandemic disease outbreak. Other innovations and improvements include specialty center designation, inter-hospital communications, ACLS courses, and co-sponsoring an EMS fellowship.
Stephen La Plante, EMT
Raymond Lim Excellence in EMS Award
Stephen La Plante receives this award for his steadfast presence and decades of labor to improve and advance public health, EMS and medical disaster preparedness in San Francisco. Prior to his retirement in February, Steve was San Francisco’s EMS Administrator. During his term EMSA hired new staff, wrote a five year strategic master plan, created a program for STEMI and cardiac arrest receiving centers, and reinstated the Exclusive Operating Area that defines the quality and nature of 9-1-1 response to EMS calls.
Steve also contributed to San Francisco’s overall resilience by acquiring a tremendous cache of equipment, including disaster trailers, warehoused medical supplies and pharmaceuticals, and a robust communications system for EMS field providers and between hospitals. These items may serve a critical role should the need arise for rapid deployment of field clinics.
The Department of Emergency Management salutes these outstanding men and women and thanks them for their contributions.
Photos of this year’s EMS Awards recipients:
This SFDEM Blog is written by Ben Tanner, Hospital Liaison within the San Francisco Department of Emergency Management Emergency Medical Services Agency (EMS).
Paramedics in San Francisco just gained new tools to help victims of heart attack or cardiac arrest. (Heart attack = someone alive with chest pain and an obstruction in one of the heart’s arteries; cardiac arrest = someone whose heart has stopped and needs CPR.) The San Francisco EMS Agency, which regulates paramedics, introduced a new “STAR” program on January 7th directing paramedics to transport these patients to specialized cardiac receiving centers.
Paramedics already provide life-saving treatment immediately after encountering someone with a heart attack. Previously, a victim might have been taken by ambulance to any of the eleven hospitals with emergency departments. Now these patients will only go to one of five “STAR” centers: California Pacific Medical Center (Pacific Campus), Kaiser Permanente, St. Mary’s, San Francisco General Hospital, or University of California San Francisco. The reason is simple: these five hospitals have cardiac catheterization laboratories where specially trained doctors and staff may feed a very small tube into the heart to relieve an obstruction that causes a heart attack.
For cardiac arrest patients regain their heartbeats but fail to wake up, paramedics will now use a procedure called “therapeutic hypothermia.” This procedure uses ice packs and/or chilled saline to slow the body’s metabolism and prevent brain damage caused by toxins that accumulate in the blood when someone has no pulse. Each of the five STAR hospitals will continue this treatment for up to two days, and may also need to provide survivors with cardiac catheterization if needed.
These changes bring San Francisco into the current standard of care advocated by the American Heart Association and provide better care and a better chance of survival to
For more on the new paramedic protocols, go to the SF DEM website.
More About the Author:
Ben Tanner, MSN, RN, FNP, CNS, is an emergency nurse who designed the STAR program for the EMS Agency. Before nursing, Ben spent ten years in emergency medicine as an EMT and Paramedic, and 15 years as an American Heart Association instructor and regional faculty. He speaks Spanish and some French, and has trained nurses and doctors on four continents.
As we close this year’s National Emergency Medical Services (EMS) week, DEM wants to highlight the recipients of the 14th Annual EMS Agency and SF Paramedic Association Award Program. Aligning with this year’s National EMS Week theme, EMS: more than a job. It’s a calling, the recipients of this year’s EMS Awards were honored for their dedication and commitment to the field of emergency medical services and those they aid. They are SF Heroes and we are happy to recognize them in this DEM Blog.
Who Was Honored and Why
EMS Field Providers Award Firefighter Anthony Valerio, EMT-P and Lt. Vincent Perez, EMT-1 received these awards posthumously for many years of outstanding performance as a paramedic, as an EMT and for extraordinary bravery as firefighters in the San Francisco Fire Department. On June 2, 2012, Anthony and Vincent lost their lives in the line of duty fighting a fire in Diamond Heights.
EMS Hospital Provider Award Terry Dentoni, RN, MSN with San Francisco General Hospital received this award for outstanding performance in providing more than 25 years of emergency and critical care nursing at SF General Hospital, and for creative and energetic support of satellite sobering centers at special events.
EMS Community Services Award was given to Elaine Rodahl, RN for her leadership in promoting and teaching CPR to thousands of people, and for her tireless work with the American Heart Association to improve the survival rate from cardiac arrest in the Bay Area.
EMS Dispatcher Ulysses J. Levy, EMD received this award his 18 years of outstanding performance as a dispatcher, especially for his extraordinary skill in handling stressful medical calls in a calm and professional manner, as he did in November, 2011 when he assisted a father in the delivery of his baby. The family Ulysses helped was in attendance to the surprise of Ulysses, as was the paramedic who arrived on-scene to provide emergency medical care to the mother and newborn.
Paramedic Captain James M. Fazackerley, EMT-P, SFFD received the Raymond Lim Excellence in EMS for exceptional performance as a paramedic instructor, supervisor and manager for 29 years and for leadership and innovation in emergency medical services.
The Special Recognition Award went to Willie Orey, Jr, EMT-1, AMR posthumously for years of outstanding performance as a unit detailer, stocker and EMT, and for several years of service as a CCT-EMT for San Francisco Ambulance.
Congratulations to all of the award recipients. You are the REAL San Francisco Heroes!