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System Redesign – EMS Update #2

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Alameda County EMS is a high performance EMS system located in the Bay Area of Northern California.There are over 140,000 9-1-1 call each year in the system.
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Hello everyone.

This latest update comes to you after a significant event in the process of gaining stability in our EMS system so that we can continue to advance the EMS system redesign and RFP process we began several months ago.

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Ambulance System Redesign Project – Citygate UPDATE #2

Stewart Gary

Stewart Gary

Principal, Public Safety (Law Enforcement; Fire & Emergency Services) at Citygate Associates, LLC
Mr. Gary leads Citygate’s public safety practice areas of Law Enforcement and Fire & Emergency Services. He has recently directed the Rancho Cucamonga police services analysis, the Hesperia partners JPA feasibility study, a police and dispatch consolidation study for Brea and partners, and has been working on public safety studies of all types for over a decade. Chief Gary is the retired Fire Chief of the Livermore-Pleasanton Fire Department in Alameda County, California. Over the last fourteen years, he has performed over 200 organizational, staffing, and deployment studies and has worked with a variety of communities on staffing, master plan, and deployment studies. He has worked with The Omega Group, Citygate’s public safety data specialist, for over a decade and understands how to draw staffing and deployment conclusions from data.
Stewart Gary

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It has been a busy summer and early Fall on the project! We appreciate all of the interest shown in the stakeholder listening meetings. We have met with representatives of city leadership, receiving hospitals, public safety providers, Paramedics Plus management and their employee representatives. We have received and are modeling field deployment incident and current system revenue data sets.

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Ambulance System Redesign Project – Citygate UPDATE #1

Stewart Gary

Stewart Gary

Principal, Public Safety (Law Enforcement; Fire & Emergency Services) at Citygate Associates, LLC
Mr. Gary leads Citygate’s public safety practice areas of Law Enforcement and Fire & Emergency Services. He has recently directed the Rancho Cucamonga police services analysis, the Hesperia partners JPA feasibility study, a police and dispatch consolidation study for Brea and partners, and has been working on public safety studies of all types for over a decade. Chief Gary is the retired Fire Chief of the Livermore-Pleasanton Fire Department in Alameda County, California. Over the last fourteen years, he has performed over 200 organizational, staffing, and deployment studies and has worked with a variety of communities on staffing, master plan, and deployment studies. He has worked with The Omega Group, Citygate’s public safety data specialist, for over a decade and understands how to draw staffing and deployment conclusions from data.
Stewart Gary

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In June 2015, the Alameda County Board of Supervisors awarded the ambulance system re-bid and research project to Citygate Associates, LLC of Folsom, California. The project will result in a Request for Proposal (RFP) to re-bid the ambulance Exclusive Operating Area (EOA) contract currently held by Paramedics Plus due to changing health care economics. The intent is to award a new contract at the end of the current agreement in November 2016. The project has three macro phases:

  1. Investigate the current system situation and identify opportunities for patient care improvements and cost-effective changes
  2. Develop the RFP and bidder evaluation tools
  3. Assist the County with reviewing bidder submittals and finalizing contract language with a preferred vendor

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Does Magnesium Lead to Better Outcomes in Stroke?

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Alameda County EMS is a high performance EMS system located in the Bay Area of Northern California.There are over 140,000 9-1-1 call each year in the system.
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Previous studies have shown that magnesium sulfate can act as a possible neuroprotective agent in stroke [1]. Magnesium seemed to be potentially beneficial if given in the first 3 hours, but lacked benefit when given after 7 hours [1]. “Prehospital Use of Magnesium Sulfate as Neuroprotection in Acute Stroke” is a study released in the New England Journal of Medicine this year that attempted to look at both the efficacy of magnesium sulfate as a neuroprotective agent as well as the feasibility of early administration of potential neuroprotective agents in the prehospital setting. The study found no difference in neurologic outcomes or mortality in stroke patients who received magnesium vs. those who received placebo. The study did demonstrate that it was possible to deliver magnesium within 2 hours of symptom onset in the prehospital setting [2]. Continue Reading…

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Benefit of Epinephrine in Cardiac Arrest

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Alameda County EMS is a high performance EMS system located in the Bay Area of Northern California.There are over 140,000 9-1-1 call each year in the system.
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Epinephrine_1-10000A recent study in the Journal of American College of Cardiology [1] has shown worse neurologic outcomes for patients receiving epinephrine during cardiac arrest. The study, “Is Epinephrine During Cardiac Arrest Associated With Worse Outcomes in Resuscitated Patients,” looked at resuscitated patients who received epinephrine and those who did not during cardiac arrest.  Good neurologic outcome was defined as a Cerebral Performance Category (CPC) score of one or two.
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SMR Update

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Alameda County EMS is a high performance EMS system located in the Bay Area of Northern California.There are over 140,000 9-1-1 call each year in the system.
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Spine Injury assessment and Spinal Motion Restriction (SMR) update and message from the Alameda County EMS Agency.

There has been an additional 28% decrease from the date of publication through 2014.

There has been an additional 28% decrease in the use of rigid backboards from the date of publication through 2014.

We have seen a tremendous reduction in the use of the hard backboard in Alameda County. As published in our Prehospital Emergency Care (PEC) peer reviewed journal, within four months of implementing our new spine injury assessment guidelines, we reduced the use of hard backboard immobilizations by 58%.  We want that trend to continue.

It all starts with a proper assessment. In emergency medicine it is important to figure out what is wrong with a patient. It is equally important to figure out what is NOT wrong with the patient and not subject them to unnecessary and potentially harmful treatments, including spine immobilization. It is clear that traditional spine immobilization causes more harm than good in subset of trauma patients. There has never been any study, or research that shows any benefit of spine immobilization. Continue Reading…

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Community Paramedicine in Alameda County

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Alameda County EMS is a high performance EMS system located in the Bay Area of Northern California.There are over 140,000 9-1-1 call each year in the system.
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HFDalameda-city-fireAlameda County is set to launch its two year Community Paramedicine Pilot Project in Alameda County in summer of 2014.  Along with Alameda County EMS, Hayward and Alameda City Fire Continue Reading…

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Ambulance Lag Time Study

Karl Sporer, M.D.

Karl Sporer, M.D.

EMS Medical Director at Alameda County EMS
Dr. Karl Sporer is an emergency physician with over 20 years experience at San Francisco General Hospital.Previously he served as the medical director for San Mateo County and more recently San Francisco Fire Department.He received the California ACEPEMS Achievement Award in 2005 and was recently selected as the EMS Medical Director of the year by California EMSA.
Karl Sporer, M.D.

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This is the result of a study requested by the Alameda County Fire Chiefs. It was conducted by ACRECC and included all EMS calls (excluding Hayward and Oakland) that occurred during 2013.

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