Emergency Medical Services

Thanks to the generous support of the public, the Central Jackson County Fire Protection District will purchase several pieces of medical equipment which will dramatically improve the level of care we provide for our citizens. Last April, a bond was passed for CJC which will fund many much needed projects within the district including the purchase of new cardiac monitor defibrillators, auto pulse CPR devices, and video laryngoscopes.

CJC currently utilizes MRL monitor defibrillators which are over six years old. Although reliable, the current monitor defibrillators operate on “old platform” technology which severely limits their use. Additionally, our current monitor defibrillators are out of warranty and CJC has realized high costs in the upkeep of these units. CJC is currently completing a field evaluation of two monitor defibrillators. Both of these monitor defibrillators have proven to be superior to our current equipment and no doubt will provide us with state of the art technology. Some of the features of the new monitor defibrillators include 12 lead acquisition and transmission, and oxygen and carbon dioxide monitoring.

If you have taken a CPR course recently you are familiar with the expression “push hard and fast.” When a person experiences sudden cardiac arrest, CPR should be initiated immediately with cardiac compressions being delivered at one hundred compressions a minute. Evidence based medicine shows us that continuous compressions without interruptions give a person the best chance of being resuscitated. CJC has also completed a field trial of the AutoPulse Cardiac Support Pump manufactured by Zoll Medical. The AutoPulse is a device that provides continuous cardiac compressions eliminating the need to stop compressions while moving the patient from the home to the ambulance.

Think back to a basic first aid or CPR course that you have taken. Do you remember the “ABC’s”? “A” represents airway, “B” breathing, and “C” circulation. Airway control in the sick or injured patient is paramount. Depending on the severity of the patient, airway management could be as simple as positioning of the head, but yet others require more advanced methods. Indotracheal intubation is the most direct and best method to control an airway. In this advanced technique, a paramedic will place a tube in the trachea which will allow for direct control.

This procedure requires a device called a laryngoscope. In most patients, the procedure of intubation is relatively easy, but for others, it can be very challenging. To assist our paramedics with the procedure of intubation, CJC will purchase the McGrath Video Laryngoscope. This device has received great acclaim from many anesthesiologists around the country. Essentially it allows the paramedic to view the airway with little manipulation of the head, thus increasing the first time success of intubation.

We at CJC are very thankful for the support we receive from our constituents, and we take great pride in being good stewards with tax payer monies. Because of your support, CJC will be able to continue to provide the best care possible with state of the art equipment.

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The Central Jackson County Fire Protection District provides Advanced Life Support services to the constituents of the district. This fire service based EMS system is supplemented by paramedics who are assigned to fire apparatus. By using additional paramedics in the field, advanced life support services can be provided more rapidly.

Capabilities:
Three fully staffed ALS units
Additional paramedics on fire apparatus for fast ALS service
Automated External Defibrillators (AED's) on fire apparatus

If you have questions pertaining to EMS, contact Paul Lininger, Assistant Chief of E.M.S. at 816-229-2522

TIPS FOR BEFORE THE AMBULANCE ARRIVES:

After you have called 911, there are several things you can do until Emergency
Responders arrive. These simple procedures will greatly aid the Emergency Responders and the patient they will treat.

If you determine that the patient is pulse-less and non-breathing, begin cardiopulmonary resuscitation (CPR), but only if you have been trained in this life saving technique.

Stay calm; do not get excited. This will reassure the patient that help is on the way.

Make the patient as comfortable as possible.

Gather all the medication that the patient may be taking. This will help Emergency Responders better determine the medical history of the patient.

Move all furniture or obstacles out of the way so Emergency Responders have easy access to the patient.

Make sure all pets are secure in another part of the house.

Remember the time, this is very important. When was the last time you talked to the patient? How long has this medical condition existed? How long has the person been unconscious?
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Care of Wounds

In general, to care for wounds you should:

Expose the wound. Clothing over and around the open wound must be cut away. Avoid aggravating the patent's injuries. Do not try to remove clothing by pulling the items over the patients head or limbs. Simply lift aside or cut the clothing away from the site of the injury.

Clear the wound surface. Remove foreign matter from the surface of the wound with a sterile gauze pad or clean towel. This method will reduce the chance of contamination from your fingers. Do not try to clean the wound or pick out any particles or debris. If bleeding from the wound is controlled, take care not to restart or increase the flow of blood.

Control the bleeding. Start with direct pressure at the point of bleeding or with direct pressure and elevation. If the bleeding continues, try pressure point control. A tourniquet should be used as a last resort for life-threatening bleeding from a limb.

Prevent Further contamination. Use a sterile dressing, clean cloth, or clean handkerchief to cover the wound. After the bleeding has been controlled, bandage the dressing in place.

Keep the patient lying still. Any patient activity increases circulation. Keep the patient lying down, using a blanket or other form of covering to provide protection from the elements.

Burns
What can cause a burn?

Thermal Agents
    *    Flames
    *    Hot Liquids
    *    The Sun
    *    Steam
    *    Radiation

Chemical
    *    Acids
    *    Fluids
    *    Other Corrosives

Electricity
    *    Becoming part of a electrical circuit (while grounded)
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What can you do?
Affect a Rescue

Remove the person from the source of the potential injury. If the injury involves electricity, insure that the electricity is turned off or that the victim is not in contact with the electrical current. When dealing with chemical or thermal agents, remove the person carefully from the source of the injury and move you and them to a safe environment.

Stop the burning process

Remove the injury causing substance. If the clothing catches fire, STOP DROP AND ROLL to smother the flames. DO NOT RUN! It will only increase the flames and extent of injury. Remove burned clothing and jewelry which can retain heat and intensify the injury. (SPECIAL NOTE: If the clothing adhere to the skin, leave it in place and cut or tear around it to remove the source of heat.)

Pour cool, clean water over the burned area for 10-15 Minutes
Longer periods are recommended for chemical burns. DO NOT put ice on injured area. This may cause greater injury. DO NOT USE OINTMENTS OR BUTTER, LARD, ETC. These products may cause deeper burning by containing heat and are a potential source of infection.

Very minor burn injuries Can be treated with commercial antiseptic sprays and covered with a clean, dry dressing. In the event that an infection occurs...seek medical attention immediately.

More severe burn injuries and those involving chemical and electricity should prompt an immediate response from your local emergency medical service system or fire department.

More sophisticated medical care is mandatory for any type of severe burn injury.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
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Purpose of this Notice: CJCFPD is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information or PHI, and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. This Notice describes your legal rights, advises you of our privacy practices, and lets you know how CJCFPD is permitted to use and disclose PHI about you.

CJCFPD is also required to abide by the terms of the version of this Notice currently in effect. In most situations we may use this information as described in this Notice without your permission, but there are some situations where we may use it only after we obtain your written authorization, if we are required by law to do so.

Uses and Disclosures of PHI: CJCFPD may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission. Examples of our use of your PHI:

For treatment. This includes such things as verbal and written information that we obtain about you and use pertaining to your medical condition and treatment provided to you by us and other medical personnel (including doctors and nurses who give orders to allow us to provide treatment to you). It also includes information we give to other health care personnel to whom we transfer your care and treatment, and includes transfer of PHI via radio or telephone to the hospital or dispatch center as well as providing the hospital with a copy of the written record we create in the course of providing you with treatment and transport.

For payment. This includes any activities we must undertake in order to get reimbursed for the services we provide to you, including such things as organizing your PHI and submitting bills to insurance companies (either directly or through a third party billing company), management of billed claims for services rendered, medical necessity determinations and reviews, utilization review, and collection of outstanding accounts.

For health care operations. This includes quality assurance activities, licensing, and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures, obtaining legal and financial services, conducting business planning, processing grievances and complaints, creating reports that do not individually identify you for data collection purposes, fundraising, and certain marketing activities.

Fundraising. We may contact you when we are in the process of raising funds for CJCFPD, or to provide you with information about our annual subscription program.
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Reminders for Scheduled Transports and Information on Other Services. We may also contact you to provide you with a reminder of any scheduled appointments for non-emergency ambulance and medical transportation, or for other information about alternative services we provide or other health-related benefits and services that may be of interest to you.

Use and Disclosure of PHI Without Your Authorization. CJCFPD is permitted to use PHI without your written authorization, or opportunity to object in certain situations, including:

·          For CJCFPD’s use in treating you or in obtaining payment for services provided to you or in other health care operations;

·          For the treatment activities of another health care provider;

·          To another health care provider or entity for the payment activities of the provider or entity that receives the information (such as your hospital or insurance company);

·          To another health care provider (such as the hospital to which you are transported) for the health care operations activities of the entity that receives the information as long as the entity receiving the information has or has had a relationship with you and the PHI pertains to that relationship;

·          For health care fraud and abuse detection or for activities related to compliance with the law;

·          To a family member, other relative, or close personal friend or other individual involved in your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your family, relatives, or friends if we infer from the circumstances that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when your spouse has called the ambulance for you.   In situations where you are not capable of objecting (because you are not present or due to your incapacity or medical emergency), we may, in our professional judgment, determine that a disclosure to your family member, relative, or friend is in your best interest. In that situation, we will disclose only health information relevant to that person's involvement in your care. For example, we may inform the person who accompanied you in the ambulance that you have certain symptoms and we may give that person an update on your vital signs and treatment that is being administered by our ambulance crew;
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·          To a public health authority in certain situations (such as reporting a birth, death or disease as required by law, as part of a public health investigation, to report child or adult abuse or neglect or domestic violence, to report adverse events such as product defects, or to notify a person about exposure to a possible communicable disease as required by law;

·          For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the health care system;

·          For judicial and administrative proceedings as required by a court or administrative order, or in some cases in response to a subpoena or other legal process;

·          For law enforcement activities in limited situations, such as when there is a warrant for the request, or when the information is needed to locate a suspect or stop a crime;

·          For military, national defense and security and other special government functions;

·          To avert a serious threat to the health and safety of a person or the public at large;

·          For workers’ compensation purposes, and in compliance with workers’ compensation laws;

·          To coroners, medical examiners, and funeral directors for identifying a deceased person, determining cause of death, or carrying on their duties as authorized by law;

·          If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ donation and transplantation

·          For research projects, but this will be subject to strict oversight and approvals and health information will be released only when there is a minimal risk to your privacy and adequate safeguards are in place in accordance with the law

·          We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
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Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization, (the authorization must specifically identify the information we seek to use or disclose, as well as when and how we seek to use or disclose it). You may revoke your authorization at any time, in writing, except to the extent that we have already used or disclosed medical information in reliance on that authorization.

Patient Rights: As a patient, you have a number of rights with respect to the protection of your PHI, including:

The right to access, copy or inspect your PHI. This means you may come to our offices and inspect and copy most of the medical information about you that we maintain. We will normally provide you with access to this information within 30 days of your request. We may also charge you a reasonable fee for you to copy any medical information that you have the right to access. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials.

We have available forms to request access to your PHI and we will provide a written response if we deny you access and let you know your appeal rights. If you wish to inspect and copy your medical information, you should contact the privacy officer listed at the end of this Notice.

The right to amend your PHI. You have the right to ask us to amend written medical information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your medical information only in certain circumstances, like when we believe the information you have asked us to amend is correct. If you wish to request that we amend the medical information that we have about you, you should contact the privacy officer listed at the end of this Notice.

The right to request an accounting of our use and disclosure of your PHI. You may request an accounting from us of certain disclosures of your medical information that we have made in the last six years prior to the date of your request. We are not required to give you an accounting of information we have used or disclosed for purposes of treatment, payment or health care operations, or when we share your health information with our business associates, like our billing company or a medical facility from/to which we have transported you.

We are also not required to give you an accounting of our uses of protected health information for which you have already given us written authorization. If you wish to request an accounting of the medical information about you that we have used or disclosed that is not exempted from the accounting requirement, you should contact the privacy officer listed at the end of this Notice.
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The right to request that we restrict the uses and disclosures of your PHI. You have the right to request that we restrict how we use and disclose your medical information that we have about you for treatment, payment or health care operations, or to restrict the information that is provided to family, friends and other individuals involved in your health care. But if you request a restriction and the information you asked us to restrict is needed to provide you with emergency treatment, then we may use the PHI or disclose the PHI to a health care provider to provide you with emergency treatment. CJCFPD is not required to agree to any restrictions you request, but any restrictions agreed to by CJCFPD are binding on CJCFPD.

Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request. If we maintain a web site, we will prominently post a copy of this Notice on our web site and make the Notice available electronically through the web site. If you allow us, we will forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the Notice.

Revisions to the Notice: CJCFPD reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all protected health information that we maintain. Any material changes to the Notice will be promptly posted in our facilities and posted to our web site, if we maintain one. You can get a copy of the latest version of this Notice by contacting the Privacy Officer identified below.

Your Legal Rights and Complaints: You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the government. Should you have any questions, comments or complaints you may direct all inquiries to the privacy officer listed at the end of this Notice. Individuals will not be retaliated against for filing a complaint.

If you have any questions or if you wish to file a complaint or exercise any rights listed in this Notice, please contact:
Paul Lininger, Assistant Chief of EMS
CJCFPD
805 NE Jefferson
Blue Springs, MO 64014
(816)229-2522