Copyright 2023 EMS1. Cypress Creek EMS runs approximately 18 ambulances on a 24-hour shift and three peak ambulances, said CCEMS PIO Steven Beesley. Q&A: Lone Star College-University Park professor offers tips for online learning, 2020 2019 Call Volume in 2020 Compared to 2019 Notes, Feb 3655 3228 Feb of 2020 we were up 427 calls from Feb 2019, Mar 3957 3707 Mar of 2020 we were up 250 calls from Mar 2020, Apr 3304 3567 April of 2020 we were DOWN 263 calls from April 2021, May 3727 3748 May of 2020 we were DOWN 21 calls from May 2022, Jun 3843 3608 June of 2020 we were up 235 calls from June 2019, Jul 4472 3773 July of 2020 we were up 699 calls from July 2024. 2003;17(3):223231. They provide 24-hour coverage of both 20. Lexipol. Whole blood is the natural, unseparated blood collected from a donor. Emergency Medicine and Health Care. We also have two peak time ambulances that run from 11 a.m. to 11 p.m. We have a little more than 200 employees including our Communications Center. How big is the department? When the pandemic hit, a lot of car accidents went down. However, in a patient who retains capacity, providers 9-1-1 calls dont stop. the study period, there were no major adverse events prior to or following the by concerns from university students, EMeRG medics, and GWU Hospital ED This has been shown to be very effective, but it takes a trained responder 815 minutes to collect a single unit. Drinking to toxicity: college students referred for emergency medical evaluation. Balanced resuscitation in trauma management. Fast forward to December 2019, Cypress Creek EMS took the next step and replaced their in-ambulance camera and driver monitoring system with the Axon Fleet 2 system. We have to protect everyone including our staff so we can keep doing what were doing and minimize the risk. CCEMS again refused to cooperate, until ESD 11s board of commissioners told CCEMS it would not be paid if it did not comply with PKFs requests. If criteria arent met, and providers feel the patient meets the threshold, HCESD 48 Fire Department peronnel are advised to contact the on-call medical director. a longer period of time to establish whether high-risk outcomes are Five years of planning and work finally paid off. From its beginnings in the late 1950's, the Cy-Fair FD is now one of the largest, busiest Fire Departments in the United States. Dubois: Weve always worn eye protection but now we wear goggles too. "TASER International offered assistance with sample policies from numerous police agencies and a study from Rialto, California, that showed how the cameras resulted in a decrease in use-of-force incidents and complaints.". The administration of whole blood is the simplest way to deliver the functionality of lost blood back to the patient. We are so thankful for your loyalty to CCEMS and in turn, we are committed to keeping you informed.Stay tuned for a question and answer session with Wren Nealy releasing next week on the CCEMS podcast! This format is being tested for bringing information to the field staffplease let us know what you think!One note about recent "news"; be mindful that CCEMS is your best source of information. 4. None of the video is on the device; it is just used as a view and application tool. evaluate a new EMS transport refusal protocol created for alcohol-related "In the contract between CCEMS and ESD 11, ESD 11 has a blanket right to review CCEMS books and records. Kaczynski J, Wilczynska M, Hilton J, et al. 2009;66(4 Suppl):S69S76. Berwick D, Downey A, Cornett E, editors: A national trauma care system: Integrating military and civilian trauma systems to achieve zero preventable deaths after injury. 9%, allowing patients to refuse transport who later require care.10, 11. Shock. "There wasn't anyone to really look to for assistance in EMS," Nealy said. every state condones the transport of dangerously intoxicated patients without EMS Protocols The purpose of this website is to promote openness, discussion and collaboration among system directors in the development of EMS protocols. Reviews from Cypress Creek EMS employees about Cypress Creek EMS culture, salaries, benefits, work-life balance, management, job security, and more. NWA Metropolitan Fire Chiefs' Association, Santa Rosa Junior College Paramedic Academy, Platteville-Gilcrest Fire Protection District, Sponsor Hospital Council of Greater Bridgeport, Space Coast Regional EMS-Doctor Williams Agencies, Area Ambulance Service / Cedar Rapids EMS, Baystate Medical Center Critical Care Transport, Cottonwood Ambulance Service/Granite Falls Ambulance, MJM Medical Direction Consortium Services, Emergency Medicine Associates of San Juan County, Rural Cass County Ambulance and Rescue Association, Lane County Sheriffs Ground Search And Rescue, Travis County Emergency Service District 5 - Manchaca Fire Dept, South Area Fire & Emergency Response District, Space Coast Regional EMS-Doctor McPherson Agencies, Illinois Region 9: Northwest Community EMS, NASEMSO National Model EMS Clinical Guidelines. Add the aggressive spread of the coronavirus and their job becomes even more taxing physically and mentally. Measuring Agreement Among Prehospital Providers and Physicians in Patient Capacity Determination. When things reopened, we went from a historic low down 263 from the same time last year to a historic high in July up 699 calls over last year. Table courtesy Col. Andrew P. Cap, MD, PhD/United States Army Institute of Surgical Research, A national trauma care system: Integrating military and civilian trauma systems to achieve zero preventable deaths after injury, Joint Theater Trauma System Clinical Practice, Documents Detail EMTs Failure to Aid Tyre Nichols, New Course Lets Bystanders Be the Help Until Help Arrives, International Prehospital Medicine Institute Literature Review, March 2023. resulted from patient transport refusal under the new protocol. The administration of whole blood is the simplest way to deliver the functionality of lost blood back to the patient. institution of the alcohol refusal protocol. Both data sets were analyzed for the "Attitude begets attitude and force begets force. Here are the 5 effects of cocaine toxicity in humans, Conn. EMT arrested, accused of kidnapping, carjacking fellow EMT he dated. Do you also use ultra-violet light in the bay of the ambulances when theyre out of service? Copyright 2023 Apple Inc. All rights reserved. PLoS ONE,5(5). Who is Cypress Creek EMS. Cypress Creek Emergency Medical Services (CCEMS) is an emergency medical service provider in Northwest Harris County in Houston, Texas. Moses Lake (WA) Fire Department Gets $3.3M Grant for more Firefighters, Woman Who Crashed into Responders, Killing PA Firefighter, Gets Prison, Three Apparent Gas Explosions at San Bernardino (CA) Mountain Homes, FDNY EMS Providers Win COVID-19-Linked Free Speech Lawsuit, Coronavirus Origins Still a Mystery Three Years into Pandemic. 2005-2022 Community Impact Newspaper Co. All rights reserved. EMS personnel are already subject to life-changing calls like the birth of a child, but also witness some of the most horrific scenes. It has become the most comprehensive and trusted online destination for prehospital and emergency medical services. Often, paramedics create the pre-attack situation by how they approach and talk to patients or family members.". Shackelford SA, Del Junco DJ, Powell-Dunford N, et al. They dispatch for Cypress Creek and 16 additional agencies, mostly fire departments, some as far as Pearland and Stafford. Against all advice: an analysis of out-of-hospital refusals of care. The list of available protocols is a work in progress. He is a member of the Texas Press Association and has won numerous state awards. "The video allows for a first of its kind self-QI process. Tensions between Cypress Creek EMS and Harris County Emergency Service District No. To decrease the amount of time it takes to administer a unit of FWB, the ASBP began shipping cold-stored LTOWB to Afghanistan in March 2016, with the first unit being administered in later the same month. This may be called Tools or use an icon like the cog. Between calls they clean the stretchers, and the ambulance points of touching. in the study if at least one of the patient complaints or findings included a The list of available protocols is a work in progress. Daughter of Man Who Collapsed at Pittsburgh Pirates Spring Training Game Thankful for Medical Response. The effects of prehospital plasma on patients with injury: A prehospital plasma resuscitation. Andrew E, Nehme Z, Cameron P, Smith K. Drivers of increasing emergency ambulance demand. Last Thursday morning, two babies opened their eyes for the first time out of the womb to paramedics from the Cypress Creek Emergency Medical Services completely donned in full N95 masks, goggles, and gloves. ESD 11 covers 177 square miles and responds to more than 65,000 emergencies annually. Prior to deployment, Cypress Creek EMS was not tracking attacks on providers as a data point. The data demonstrates a significant Are ticket costs pricing Houston Astros fans out of Opening Day? IRB The third option is the most feasible for civilian EMS providers. and alcohol intoxication. Additionally, being able to review case studies or near-misses is invaluable in correcting behavior. Rehn M, Weaver AE, Eshelby S, et al. aware. 2017;318(16):15811591. Population-wise thats larger than the city of Atlanta, Georgia. of 2018, a university policy change transferred the decision for alcohol-related His Heart Stopped On a Treadmill. Dutton RP, Shih D, Edelman BB, et al. Retrieved Dec. 14, 2017, from http://usaisr.amedd.army.mil/cpgs/Fresh_Whole_Blood_Transfusion_24_Oct_12.pdf. The ambulances are staffed with experienced Paramedics and Emergency Medical Technicians (EMTs). Terms of Use, 18334 Stuebner Airline RoadSpring, Texas 77379, Harris County ESD 11 commissioners approve Jamie Chebra as interim CEO, ESD 11 Mobile Healthcare Officials Look Back on 1 Year of Service, REQUEST FOR QUALIFICATIONS FOR AMBULANCE SERVICE SUPPLEMENTAL PAYMENT PROGRAM CONSULTANT, Texas Health and Human Services EMS information. I couldn't find anything on their website. At the time, TASER International, which is now Axon, provided the Flex body camera to all instructors to demo in their courses. (2017-2018), the last year in which the previous alcohol intoxication policy Dunbar NM, Yazer MH, Biomedical Excellence for Safer Transfusion(BEST) Collaborative and the STAT Study Investigators. obvious medical benefit and possible adverse outcomes, a patient may want to 2016;11(12):e0168401. "Some have learned how to use it as a tool to help accurately recall the sequence of events during patient care, making it easier to write a thorough patient care report.". "We've known for years that video works great in training and having a small, point-of-view device with the security offered by TASER seemed to be the perfect system for EMS," he said. provider. Ann Surg. 19. feel safe. Download our protocol app or visit Creekshare.org to download copies of these protocols and the patient handout brochures that go along with them. This is a carousel. basic life support (BLS) providers and overseen by an attending physician and 17. "You always have that 10% that are early adopters, 80% that need some convincing and the final 10% who will never get on board," he said. >>Hemoglobin < 6.0 mmol/L (if available). The shelf life of whole blood is up to 35 days when collected using citrate phosphate dextrose adenine solution (CPDA-1) and must be used within 24 hours once brought to room temperature. https://doi.org/10.3201/eid1002.030838Orman, R., & Weingart, S. (2020). At Cypress Creek EMS, Nealy said their biggest implementation challenge was the staff's fear of "Big Brother" watching them. Fortunately, plasma transfusion reactions are both less common and less severe than blood cell transfusion reactions.25. Evaluation of Protocols Allowing Emergency Medical Technicians to Determine Need for Treatment and Transport. Most importantly, the body cameras, according to Nealy, encourage transparency, accountability and accuracy, and provide immediate feedback for improvement in EMS. Theyre not fond of it but they understand the need for it. While we would be informed through the university system of any adverse Once you decide they need an advanced airway, give all the oxygen. Cypress Creek Fire Department provides fire suppression & rescue first response services to our 33 square mile district and to the greater FM1960 area in conjunction with our automatic aid departments. This university campus is urban and 5. finds relevant news, identifies important training information, Please allow us the chance to provide information before spreading something that you "heard". Resuscitation and transfusion principles for traumatic hemorrhagic shock. Pretrauma center red blood cell transfusion is associated with reduced mortality and coagulopathy in severely injured patients with blunt trauma. Enjoy the format and find the information useful. 13. Having providers review their own video helps them identify the "triggers" that can often preempt an attack. 8. Third, the safety of whole blood transfusions is similar to component therapy, as TTD testing is completed for both. the George Washington University (GW) Foggy Bottom and Mount Vernon campuses People should feel safe and call 9-1-1 and know that they will be checked out safely, transported safely, and wont be put at risk going to an ER. Some policies 4. These materials may not be reproduced, distributed, modified, or reposted to other websites without the express written permission of the district. Low titer group O whole blood in emergency situations. His Wife Gave Him CPR. Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient - Solano County, California, February 2020. On exam, she appears pale and sweaty, with notable pallor of the lips and gums. 2017;33(1):1536. to the new protocol, 92% of patients admitting to alcohol use required transportation The provider is required to review the video and complete a simple online form," Nealy said. "Capturing the line of sight of the paramedic is important to show what the paramedic is seeing. Alcohol 26. Prior to joining CI, Wesley served as the editor of the Lockhart Post Register and as a reporter for the Bastrop Advertiser and Fort Bend Herald. Version 22.0 Effective 02 -25-2022 1 . Theyll take them to the free-standing ER that is associated with the hospital and that takes the load off of them. department visits subsequently found to be unnecessary or punitive. PLoS One. Everything that they use is rated to kill viruses, germs and bacteria. Table courtesy Col. Andrew P. Cap, MD, PhD/United States Army Institute of Surgical Research. Since then, CCEMS has been trickling out information to PKF at a snails pace. Holcomb JB, Swartz MD, DeSantis SM, et al. time periods. In the summer Transfusion. encounters and designed to identify those patients who require medical treatment In response to this policy change, EMeRG created a comprehensive transport refusal policy for patients encountered due to concern they might be intoxicated or have consumed alcohol (Figure 1). intoxicated driving substantially less than other campuses. The average ages were similar: 21 years during the pre-protocol academic year and 23 years during the post-protocol academic year. This conversation between Lynne, Samuel and Steven addresses how to deal with grief. Aerosol generating procedures (AGP) and risk of transmission of acute respiratory diseases (ARD): A systematic review. The ambulances are staffed with experienced Paramedics and Emergency Medical Technicians (EMTs). Harris County Emergency Services District #48 carries O-negative blood and low-titer A-positive plasma. of EMeRG patients requiring transport are brought to The GWU Hospital, a When blood components are made, whole blood is spun in a centrifuge to separate the red cells from plasma and platelets. OConnor L, Porter L, Dugas J, et al. Hewitt: The ambulances are left running all the time and so is the air conditioning. Chang R, Holcomb JB. And thats only part of how the medical world has changed for first responders who must answer an increasing volume of calls in a virus-laden pandemic that is so easily spread. The facilities are available for them to shower here if they want to keep themselves and their family safe. EMT said Pa. COVID patient didn't need to go to the hospital. She Died the Next Day. 3 people like this. Further data is necessary over Sort of. The Ranger Group O Low Titer (ROLO) whole blood program has allowed U.S. Army combat medics to replace the blood lost from combat wounds at the POI. on campus. A Legacy of Excellence | CCEMS is a 501c3 Non-profit EMS agency specializing in advanced and industry leading Critical Care Transports on the ground and in the air with aggressive evidence-based protocols and off-line medical control supported by the Military EMS and Disaster Medicine Fellowship program as well as the finest tools, equipment . However, only 3-4% will develop a strong immune response to future administration.25 Although its common practice to give women of childbearing age Rh-negative blood, if it isnt available, Rh-positive whole blood should be transfused as its still preferred over colloid or crystalloid infusion.26. Schmidt T, Atcheson R, Federiuk C, et al. The camera, Nealy said, is designed to be worn in a point-of-view manner, attached to Oakley protective eyewear. This study compared patients evaluated for alcohol intoxication during two contiguous academic years before and after a change in the responding EMS agency transport refusal policy for patients with acute alcohol intoxication. CCEMS is one of the most reliable EMS services in Houston, having a response time of about eight minutes. to acute intoxication. 2012;73(2 Suppl 1):S49S53. Maegele M, Schchl H, Cohen MJ. Is it the vocal cords during an intubation or the ultrasound monitor while performing a FAST exam? Once theyve been prepared, red blood cells (RBCs) have a shelf life of 42 days. address the risks of morbidity and mortality related to alcohol use in this Multiple studies have reported that in order to maximize the appropriateness of transport. Grant assistance for ZOLL Ventilation products at no cost, Wren Nealy Jr., Cypress Creek EMS chief operating officer, relates how BWCs have contributed to personnel safety, QA/QI. was used, were compiled for comparison. require mandatory ED evaluation of intoxicated persons encountered by first responders Additionally, the trial will also be tested by the communications center supervisor. Dubois: Every shift when they come on will clean the ambulance from top to bottom with a solution that will clean all germs. Kharasch SJ, McBride DR, Saitz R, Myers WP. 2014, 891 young adults died of alcohol-related overdose and 4105 suffered from abdominal pain after initially refusing care and transport. and suppliers. Annu Rev Public Health.2005;26:259-279. J Trauma Acute Care Surg. The product is harmless to humans, is food safe, and lasts for up to 10 days. According to the American Red Cross, 10-20% of the U.S. population does not have the Rh D antigen on the surface of their red blood cells, also known as Rh negative. After exposure to Rh positive blood, around 20-26% will develop a sensitivity within four weeks. The camera feed, Nealy said, can only be tapped into by someone with approval access. Carey KB, McClurg AJ, Bolles JR, Hubbell SJ, Will HA, Carey MP. With over 20 years of law enforcement experience, Nealy instantly recognized the value body cameras could provide in EMS. Our goal is to help improve all EMS protocols to the current state of the science using evidence-based medicine. back if they feel as though their condition is worsening or if they no longer emergency care while also contributing to campus safety and emergency response. MLB legend makes surprise appearance at Astros' Spring Training, Houston is ugly, and I've never felt more at home, Texas A&M upset win clears path for UH to snag top overall seed, This is what Houston looks like from space, Oops! Disclaimer:Please read these terms, conditions and disclaimers carefully before using this website. ESD 11 covers 177 square miles and responds to more than 65,000 emergencies annually. of a new alcohol refusal policy will significantly decrease the number of alcohol-related Resuscitate before you intubate, Laryngoscope as a Murder Weapon (Scott Weingart) Hypotension O2/Hypoxemia pH/acidosis. Were in good shape now. Were finally to the point to where manufacturing has finally caught up. Seven years later, Cypress Creek EMS, which services the largest EMS Emergency Services District in Harris County, Texas, became the first EMS provider in the United States to roll out. 21. Academic Emergency Medicine.2000;7(6):663-669. Today, CCEMS is a model for EMS operations throughout the country. diagnosis of alcohol intoxication.. Providers respond to an average of 650 calls per year. HOUSTON On August 24, 2017 at approximately 7:30 pm Cypress Creek EMS became one of only two ground EMS systems in the country to carry Whole Blood in the field 24/7/365. "Foul language, venting about the bosses, or even making a mistake would not result in discipline. Tactical combat casualty care in special operations. warranted. This established protocol was coordinated through the HCESD 48 Fire Department EMS chiefs, CCEMS Director of Special Operations John Holcomb, MD, and the Gulf Coast Regional Blood Center. 11. Retrieved from https://ercast.libsyn.com/covid-19-weingart-q-a-on-airway-vents-tubes-lungs-ecmo-and-cpapRaboud, J., Shigayeva, A., McGeer, A., Bontovics, E., Chapman, M., Gravel, D., Green, K. (2010). Evidence now suggests that whole blood is a better option for trauma resuscitation and can increase survival of severely injured patients.24. If any criterion is not met, or if the senior supervisory EMT does alcohol intoxication including severe trauma, brain injury, and death.5 alcohol intoxication declined from 33% to 27%, respectively. There are a lot of people who dont wear their clothes home or strip down in the garage. EMS1 is revolutionizing the way in which the EMS community another intoxicated student and that approximately 1,825 college students die Youre called to the home of a 38-year-old woman who has been fainting. Collegiate EMS agencies need to address the risks of intoxicated patients given increased binge drinking on college campuses and additional outside agency pressures, such as university policies and campus police. 9. guidelines, and individual university policies. How we can reduce the spread of this disease. Nonetheless, Nealy said the body cameras were initially met with apprehension. "We have documented a 50% reduction in field training time for clinical credentialing," Nealy said. Due to the shorter shelf life of LTOWB, theres a higher potential for waste. to the emergency department. Responders Are Not Commodities. Ultimately, self-improvement, according to Nealy, must start with each provider reviewing and learning from their own videos. Selleng K, Jenichen G, Denkler K, et al. alcohol intoxication contributes to 17 to 44% of all university-based ambulance Plasma and cryoprecipitate can be kept frozen for a year, and once thawed will last for 24 hours. In the future, it may be possible to make component therapy from the unused LTOWB units. By Wesley Gardner If Cypress Creek EMS insights Based on 15 survey responses What people like Time and location flexibility Ability to learn new things Inclusive work environment Areas for improvement Overall satisfaction Sense of belonging Support from manager Great company with a lot of room for advancement Transfus Med. open protocols, and the opportunity to practice your skills in a supportive environment help provide a positive experience within the organization. may choose to implement medical amnesty policies to encourage students calling EMS "This often irritates the patient and questions their confidence in your abilities.". Transfusion: -80 degrees C frozen blood products Are safe and effective in military casualty care. unintentional injuries related to alcohol.5 In a study of Providers are required to record every response incident and patient encounter through final disposition or when the transfer of patient care is complete, Nealy said. not approve, the patient must be transported to the hospital per standing Bolton-Maggs PH, Cohen H. Serious Hazards of Transfusion (SHOT) haemovigilance and progress is improving transfusion safety. 15. 1. health.ny.gov/ems . It should be noted that the functionality of cold-stored whole blood decreases dramatically after 21 days. Harris County ESD 11 serves the northern portion of Harris Countyan area roughly 25 miles north of the City of Houston with a population of over 700,000 people. University Emergency Medicine Response Group (EMeRG) between August 2017 and May https://doi.org/10.15585/mmwr.mm6915e5Loeb, M., McGeer, A., Henry, B., Ofner, M., Rose, D., Hlywka, T., Walter, S. D. (2004). All text, images, graphics, animation, videos, music, sound, coding, trademarks and other materials on this website are subject to the copyright and other intellectual property rights of the district in accordance with the United States copyright laws. Freestanding EDWhat they areWhat they haveWhat kinds of patients should go thereWhat kinds of patients should not. Headquarters. from alcohol-related unintentional injuries each year.9, Regardless of intoxication, the 2023 Cypress Creek Fire Department | Harris County ESD 13Legal Notices & Disclaimers. Everybody has their own routine. potential symptoms and complications that can arise such as abdominal pain, Are insane ticket costs pricing Astros fans out of Opening Day? following implementation of the new policy. 2017;97(5):9991014. Increasing numbers of EMS agencies are developing the capability to administer blood products to patients in need. What kind of protocols are in place to make sure the ambulances are clean from COVID-19? Cypress Creek EMS is dedicated to providing a rewarding atmosphere for the volunteers who make a difference in our organization. Uhl: In addition to that, we have contracted a firm called Enviro-Master Services of Houston to spray all ambulances and facilities every seven days with a hospital-grade germicide which is EPA-registered to kill coronaviruses as well as bacteria. In an effort to reduce overburdening of an already stressed ED, EMS physicians and nurses, the decision was made to reevaluate the existing campus University-based volunteer emergency Turner JC, Shu J. Following the ESD 11 meeting on June 9th, ICPs Chris Conn and Megan Spearman sit down with UO Steven Beesley to articulate their thoughts. The purpose of this study was to The Cypress Creek Communications Center (Comm Center) is a 9-1-1 and dispatch facility for 17 emergency agencies including 12 fire departments, the Harris County Fire Marshals Office, and the Harris County Hazardous Materials Team. Addict Sci Clin Pract.2016;11(1):11. 48 (HCESD 48) Fire Department and Cypress Creek EMS (CCEMS) in Houston, Texas, began carrying cold-stored LTOWB for hemostatic . Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries. About 40% of the U.S. population has group O blood, with another 40% having group A. and with capacity to refuse transport to the hospital. Nealy, along with the support of his medical director, Dr. Levon Vartanian, executive director, Bradley England, and board of directors, built the Axon camera program from the ground up. This single-institution study indicates that a refusal policy for the acutely intoxicated patient implemented by an EMS agency may reduce unnecessary transports to the hospital, thereby appropriately identifying patients in need of transport and relieving burden on both the EMS agencies and hospital emergency departments. While you may find opinions and statements elsewhere online, sensationalism and propaganda is widespread. decision to accept transport refusal is a common dilemma in any EMS agency. 2017. Then the provider must balance evaluation of a patients capacity intentional physical assaults and accidental traumatic injuries that likewise require 2015; 44(Suppl 1):6370. Content contained in this website is provided by the district as a service to the general public and is for general informational purposes only. ", $2.5 million in funding that was withheld. were noted during the first year of use of the new refusal policy guidelines. The ambulances get wiped down so many times a day its crazy. Uncover why Cypress Creek EMS is the best company for you. Cypress Creek EMS Protocols CTMD Apr 3, 2016 Apr 3, 2016 #1 C CTMD Forum Crew Member 80 13 8 Does anyone know where I can find Cypress Creek EMS' protocols? These would be managed through the QI process.". Prehosp Emerg Care.2019:1-11. The current recommendation of 1:1:1 has three times the anticoagulants and additives.23 These additional additives can contribute to trauma-induced coagulopathy. alcohol-related mortality and morbidity among college students alone, providers must carefully balance patient safety risks against high patient volumes patient transports from GW police department officers to EMeRG medical trips.1, 2 In addition to acute intoxication, alcohol use can lead to 1. territory. Currently, most whole blood is collected using citrate phosphate dextrose (CPD) with a shelf life of 21 days. "Hospitals are slowly starting to come on board, understanding the benefits to using the video in the total QA/QI process for the patient," Nealy said. Kim BD, Zielinski MD, Jenkins DH, et al. Based on their results we follow-up with them. 13. revised alcohol protocol was approved in August 2018, at the start of the Since the late 1970s, prehospital trauma resuscitation has relied on administration of crystalloid solutions such as 0.9% sodium chloride or normal saline, lactated Ringers, and colloids like hydroxyethyl starch (HES).