North Dakota Emergency Medical Services Association

December Monthly Newsletter



The North Dakota EMS Association Has Big Plans in the Works 

COVID-19 Vaccine and Distribution Townhall

December 21, 2020 7:00 pm CST

The North Dakota EMS Association is hosting a Q & A Townhall to address questions about the COVID-19 vaccine and distribution.

The Townhall panelists are Dr. Jeffrey Sather, State Medical Director and Trinity Health Mandan and George Gerhardt,  Health Resources and Response Section,

Click here for the link to register for the townhall. 

Please submit the questions you would like to see answered during the townhall to

Notice to Instructor Coordinators and Certified Education Coordinators

December 29, 2020 at 7:00 PM CST


There is a WebEx meeting scheduled for December 29, 2020 at 7:00 PM CST to provide information regarding the portfolio EMT rollout and 

psychomotor testing. 

This is especially important for those classes beginning after January 1, 2021.

The rollout information is attached here  for your review prior to this meeting.


This meeting will be recorded and presented again at the IC Refresher pre-conference as well as in June of 2021. If you are interested in attending for the live presentation on December 29, 2020, please contact the DEMS or email for more information.

Central Nervous System Injuries Townhall

January 12, 2021 5:00 pm CST

January's Rural EMS Counts will be on central nervous system injuries presented by Howard Walth, Trauma Coordinator for CHI St. Alexius Health.

The objectives of the Townhall-

1.     Identify the signs and symptoms displayed by a patient with a traumatic brain injury.

2.     Discuss pathophysiology of traumatic brain injury.

3.     Describe appropriate treatment of a patient with a traumatic brain injury.

Click here for the link to register for the townhall. 

The Northwest and Southeast Regional Online Conference

January 23-24, 2021  

The Northwest and Southeast directors decided this in 2021 to pool their resources together and put on an amazing online conference! They are currently putting on the finishing touches on the schedule but these NCCR courses will be offered-

Pediatric Cardiac Arrest 1 Hr.

CNS Injury 1 Hr.

Crew Resource Management 1 Hr.

Endocrine/Diabetes 1 Hr.

Ambulance Safety 0.5 Hr.

Hygiene/Vaccinations 0.5 Hr.

Evidence Based Guidelines 0.5 Hr

ACS 1 Hr.

Infectious Disease 0.5 Hr.

Fluid Resuscitation 0.5 Hr.

Pain Management 1 Hr.

Immunological 0.5 Hr.

Field Triage 1 Hr.

Trauma Triage 1 Hr.

OB Emergencies 0.5 Hr.

Visit here for updates and registration

The Northeast Regional Conference

February 13-14, 2021  

Hilton Garden Inn

4301 James Ray Dr.

Grand Forks ND 58201

with the February 12, 2021 Preconference at

Altru Rehab- Basement 

1300 S Columbia Road 

Grand Forks ND, 58203

The Northeast Board of Directors are closely monitoring the COVID-19 situation and will adhere to the North Dakota Smart Restart Guidelines.  If there is a change in risk level or the cases rise considerably, there is a possibility of the Northeast Conference being held virtually. If this is the case, participants will be informed and refunded if they do not plan to attend the virtual conference. The decision will be made on or around January 5th. 

NCCR Classes offered this year at the Northeast Conference 

Post Resuscitation 0.5 Hour

VADS 0.5 Hour

Stroke 1.5 Hours

Trauma Triage 1 Hour

Hemorrhage Control 0.5 Hour

Special Healthcare Needs 2 Hours

Psychiatric  1.0 Hour

Toxicological/ Opioids 0.5 Hour

Neurological/ Seizures 0.5 Hour

At Risk Populations 0.5 Hour

Culture of Safety 0.5 Hour

Pediatric Transport 0.5 Hour

Research 1.0 Hour

Click here to view the full schedule and for information on registration

Online EMR Course

February, 2021

The North Dakota EMS Association's 10 week Online EMR Course has been updated and the first course of 2021 begins in February. Registration will open in the beginning of January. The information regarding this course will be updated in the upcoming weeks. Check ND EMS Association's Facebook page and website for more information.  

NCCR Day Online Course

March 19, 2021

The North Dakota EMS Association and Sanford EMS Education will be hosting a 6- hour NCCR day. This course along with BLS Provider certification and 8 hours of approved LCCR content will fulfill all the EMR Requirements for re-certification.  Registration will open in the beginning of February. The information regarding this course will be updated in the upcoming weeks. Check ND EMS Association's Facebook page and website for more information.  


Online IC Refresher

April 8, 2021 

The Instructor Coordinator recertification course has been modified and will be offered online this year.  Registration will open in the beginning of February. The information regarding the IC Refresher will be updated in the upcoming weeks. Check ND EMS Association's Facebook page and website for more information.

The 45th Annual North Dakota EMS Association's Annual Conference 

April 9-11, 2021

SAVE THE DATE! This year the Annual Conference will be online, but it will still have the great speakers and topics as years' past! Registration will open in February. The information regarding this course will be updated in the upcoming weeks. Check ND EMS Association's Facebook page and our website for more information.  


Red Lights and Sirens – Finally Time to Use Less?

Christopher Dick, BA-Biology, NREMT-P, ND Rural EMS Counts SME

Red lights and sirens (RLS) responses and transports have never been shown through scientific study to improve patient outcomes. However, scientific studies dating back even to the 1950’s, have shown RLS use increases the rate of collisions of ambulances, increases rates of injuries and severity in these collisions, and increases the rate of non-emergency vehicle crashes. These same studies show 4.5-5% of all ambulance calls are true emergencies and result in potentially life saving interventions (PLSI) being performed. Lastly, these studies show we save only 1-4 minutes in improved response or transport time depending on whether an ambulance responds in a rural, suburban, or urban environment. While we have improved and use less RLS during patient transports, our industry has not adopted widespread reduction in our RLS use during 911 responses.1 Why, if we have known for years that RLS have little to no impact on patient outcome, do we continue to use them most of the time in our response to 911 calls? Is it because we have always done it and we were trained to do it? Is it because we believe it saves lives? Is it because we think the public expects it? I argue it is a combination of those things, and we can do better to protect our patients and the public we are entrusted to “first do no harm” to.

Fifteen years ago, during my good fortune of leading a small, rural agency in the mountains of CO, we wrestled with and addressed this sticky topic. At the time, we responded to approximately 1000 EMS 911 calls per year. This is not different from a lot of call volumes across rural services or regions in ND. One of our supervisors, Brian Donaldson (now an EMS agency leader in WI) who was never afraid to ask questions or shake things up, came to me with an observation and a proposal. He said to me, “We are responding to 85-90% of our 911 calls with RLS. What if we reduced that number and our risk to our patients and public by changing what we respond RLS to?” Intrigued, I asked him to tell me more.

Like anyone proposing a major operational change, Brian had done his homework and reviewed and compiled research in support of the proposed change. He showed me, through scientific data, that in a response area like ours we were at most saving 30-45 seconds by using RLS to respond. We determined, after reviewing the data from a lot of the studies I referenced at the intro to this article, it no longer made sense for our agency to put responders and the public at increased risk to make up a little bit of time for so very few “true” emergency calls where PLSI are performed. So, we got to work revising our protocol and operating guidelines for RLS response.

Since we did not have Priority Dispatching available at the time in our dispatch center, we decided we would respond to the following types of dispatches RLS:

· Airway/Respiratory, Cardiac, Stroke/Suspected CVA, Diabetic, Seizure, Imminent childbirth, and penetrating trauma emergencies

· Pt. determined to be in extremis through initial dispatch info

· Responder discretion

We would no longer respond RLS to the following call types:

· Car accidents with no patient in extremis

· Clinic or other licensed health care facilities with 24-hour nursing/physician care

· Extremity trauma, mental health/domestic calls, abdominal pain, nausea/vomiting, generalized sick calls

· Limited dispatch info indicating any true emergency

Did we get pushback initially after this change? Yes, but only from our fellow LE and Fire Department responders. We received no pushback or negative feedback from the lay public. Through education for the public with one newspaper article on the changed protocol, they seemed to embrace the change and we heard nothing but positive from them about less noise through town and less risk to the public. Through continued training and discussion about how we were responding moving forward with our LE and Fire partners they came to understand we were still going en route immediately and were responding timely. We were just doing so quieter and with less risk and chaos. After 3-6 months responding according to the guidelines above, the naysayers quieted completely. After these changes our RLS responses moved from 85-90% of our calls to closer to 50% of our calls. Our staff appreciated the change over time and our increased dedication to their safety.

If you have read this far, you may be asking, “So how are we doing in 2020 nationally and in ND?” A study published in Prehospital Emergency Care in late summer 2020 examined RLS use from national ESO data from 2018 across 1187 EMS agencies. The ESO data examined a sample set of 3.84 million ambulance responses. Of these 3.84 million responses only 6.9% had a PLSI. However, 85.8% of all the 911 responses used RLS to scene. This is not vastly different from an exhaustive NHTSA research paper, by Douglas Kupas, MD in May 2017, into RLS use across the United States showing RLS use in 911 responses of 75%.2 Looking at raw ESO data from 2019 in North Dakota only we fall near these numbers. In almost 63,000 responses, data shows we responded emergent 71% of the time. In 41,000 patient transports we used RLS only 10% of the time.

In a 2017 webinar about the NHTSA study, consensus from experts was that we should develop industry benchmarks of 50% RLS use in 911 responses and 5% or less RLS use in patient

transport. I agree wholeheartedly with these benchmarks. When I look at all the previous research on this topic and couple it with the experience I gained from the “experiment” we did and implemented in rural CO, I think it is crazy if EMS agencies are not reviewing their RLS response and looking at ways they can meet these proposed benchmarks.

Often when responders discuss this topic one question always arises, “Are we at increased liability when we don’t respond RLS?“ In other words, “will patients sue me if I don’t come to their emergency RLS?” I always counter them with this, “Highly unlikely, but I do know they will sue you if you respond RLS to an isolated broken arm and you hit someone’s child riding their bike or T-bone someone’s grandparent driving to church.” While no one protocol or standard operating guideline will fit every response area in ND, every agency should examine their current protocols or SOG and work to reduce unnecessary RLS response and transport. We owe this to our patients, our co-workers and the public!

Be safe and never stop improving!

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1622 East Interstate Avenue, Bismarck, ND 58503


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