Health Resuscitation Outcomes Consortium - paramedis
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MEMORANDUM
April 26, 2005
TO:
The Honorable Mayor and City Council Members
FROM:
Michael C. Van Milligen, City Manager
SUBJECT: National Institutes of Health Resuscitation Outcomes Consortium
The City of Dubuque paramedic service has been invited to participate in a research
project of the National Institutes of Health on out-of-hospital resuscitation. The
University of Iowa Hospitals and Clinics has created the Iowa Resuscitation Outcomes
Consortium that consists of eleven paramedic ambulance -services and the University.
The study's grant period officially began September 1 of last year, and will run nearly
five years. Under the tightest of medical control and oversight by physicians and
scientists, the City's paramedic teams will be utilizing and testing several new protocols
involving drugs, devices and strategies in the area of medical and trauma resuscitation.
The grant will cover all needed training, equipment and disposable supplies to carry out
the protocols, and the reporting of the results.
Emergency Medical Services Supervisor Ric Jones has researched the legalities and
liabilities of this undertaking. He advises that the City's Physician Medical Directors,
Corporation Counsel, the City's general liability carrier and their underwriters believe
that the City assumes no more risk than that which is ordinary in the provision of
ambulance service. The City's insurance company and its underwriters advise that the
City's professional liability insurance covers the City's participation in this study.
In addition, local Institutional Review Boards at Mercy and Finley Hospitals must
investigate and sign off on any and all protocols or procedures in the study before they
can be used in the field.
City staff believes that none of the proposed protocols have potential to harm the
patients involved in the study. The focus of this study is to bring to the forefront the very
best practices in resuscitative skills, strategies, tools and pharmaceutical agents. Most
cardiac arrest patients die despite aggressive efforts to resuscitate them. This study
expects to improve the likelihood of surviving cardiac arrest.
The City of Dubuque will benefit from its participation in several ways. The top three
cardiac monitor/defibrillator manufactures are advancing proposals to provide their
latest equipment free of charge to study participants. All needed equipment and training
will be provided by the University of Iowa clinical staff. The City will be reimbursed for
data collection costs.
..
Fire Chief Dan Brown is recommending City Council approval for the City of Dubuque to
participate in the Iowa Resuscitation Outcomes Consortium.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
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Michael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, Corporation Counsel
Cindy Steinhauser, Assistant City Manager
E. Daniel Brown, Fire Chief
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CITY OF DUBUQUE, IOWA
MEMORANDUM
April 14, 2005
TO: Michael C. Van Milligen, City Manager
FROM: E. Daniel Brown, Fire Chief f DE
SUBJECT: National Institutes of Health Resuscitation Outcomes Consortium
Our paramedic service has been invited to participate in a research project
of the National Institutes of Health on out-of-hospital resuscitation. The National
Institutes of Health is the steward of medical and behavioral research for the
nation. It is an agency under the U.S. Department of Health and Human
Services. Ten centers in North America were selected to participate in this
Resuscitation Outcomes Network. University of Iowa Hospitals and Clinics
(UIH&C) is one of the centers and at their invitation our paramedic service will be
one of the groups in this study. Eleven of Iowa's larger paramedic ambulance
services will be participating. We will be among the smallest emergency medical
services providers in the nation to participate in this project.
University of Iowa Hospitals and Clinics has created the Iowa
Resuscitation Outcomes Consortium that consists of the eleven paramedic
ambulance services and the University. The base requirement of the study was
that a group be able to enroll 500 cardiac arrest cases per year. No system in
Iowa is that busy. In our Fire Department we respond to about 40 cardiac arrest
calls annually. The consortium of the eleven services exceeds the required
number of cases. Our colleagues in Iowa who we hope to join in this undertaking
are: Johnson County EMS, Iowa City; Area Ambulance Service, Cedar Rapids;
Medic EMS, Davenport; Waterloo Fire Dept. EMS, Waterloo; Covenant/Sartori
EMS, Waterloo-Cedar Falls; Des Moines Fire Dept. EMS, Des Moines; West Des
Moines Fire EMS, West Des Moines; Dallas Co. EMS, West Des Moines;
Siouxland Paramedics, Sioux City; and Henry Co. Health Center EMS, Mt.
Pleasant.
The study's grant period officially began September 1 of last year, and will
run nearly five years. Under the tightest of medical control and oversight by the
world's most pre-eminent physicians and scientists in their field, our paramedic
teams will be utilizing and testing several new protocols involving drugs, devices
and strategies in the area of medical and trauma resuscitation. The grant will
cover all needed training, equipment and disposable supplies to carry out the
protocols, and the reporting of the results.
Emergency Medical Services Supervisor Ric Jones has researched the
legalities and liabilities of this undertaking and in meetings with our Physician
Medical Directors, Corporation Counsel, the City's general liability carrier and
their underwriters we are of the unanimous conclusion' that the City assumes no
more risk than that which is ordinary in the provision of ambulance service. Our
insurance company and its underwriters assure us that the City's professional
liability insurance covers our participation in this study.
In addition, local Institutional Review Boards at Mercy and Finley Hospitals
must investigate and sign off on any and all protocols or procedures in the study
before they can be used in the field.
We are confident that none of the proposed protocols have potential to
harm the patients involved in the study. Emergency Medical Services agencies
utilize their most resources on cardiac arrest and severe trauma patients. In spite
of this, survival rates are very low. The focus of this study is to bring to the
forefront the very best practices in resuscitative skills, strategies, tools and
pharmaceutical agents. Simply put, most cardiac arrest patients die despite
aggressive efforts to resuscitate them. This study expects to improve the
likelihood of surviving cardiac arrest.
One early focus of the study will simply be reinforcement of the basics of
providing CPR. Research has changed the way CPR is taught and is quite likely
to change it some more. It is now known that the upstroke in the CPR
compression cycle is as important as the downstroke in creating a pressure
differential within the chest cavity. This pressure differential is what moves blood.
Our cardiac monitors will be equipped with devices to help the rescuer evaluate
their CPR efforts. This immediate feedback will assure that this important basic
skill is consistently accurate and adequate.
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The Dubuque Fire Department is honored to be helping to create the
science that will save many lives now and in the future. There will be a total of
twenty paramedic services in the nation that are invited to be in this study.
Eleven of these services are in Iowa, where the first out of hospital defibrillation
programs for basic providers were created in the 1970's. Iowa has continued to
be a worldwide leader in EMS innovation. The other nine EMS systems are
large urban systems in Seattle, Washington; Portland, Oregon; San Diego,
California; Dallas, Texas; Pittsburg, Pennsylvania; Birmingham, Alabama;
Toronto, Ontario, Canada; Ottawa, Ontario, Canada; and Vancouver, British
Columbia, Canada.
The City of Dubuque will benefit from its participation in several ways.
Right now the top three cardiac monitor/defibrillator manufacturers are advancing
proposals to provide their latest equipment free of charge to study participants.
All needed equipment and training will be provided by the University of Iowa
clinical staff on our premises and accommodating our schedules. The City will
be reimbursed for data collection costs.
I respectfully request that the City of Dubuque accept the invitation to
participate in the Iowa Resuscitation Outcomes Consortium.