8.2 EMS Medical DirectorCITY OF SALINA
REQUEST FOR CITY COMMISSION ACTION DATE TIME
01/11/2010 4:00 P.M.
AGENDA SECTION ORIGINATING DEPARTMENT: APPROVED FOR
NO: 8 AGENDA:
FIRE DEPARTMENT
ITEM
NO. 2
BY:
BY: Larry Mullikin, Fire Chief
Page 1
ITEM:Resolution No. 10-6699
A resolution authorizing the Mayor to execute the renewal of a professional services contract for
physician services as the Fire Department’s Medical Director with an increase in compensation.
BACKGROUND:
The fire department experienced a change in Medical Directors in 2007 with the retirement of Dr.
Schmidt and the appointment of Dr. Sean Herrington to the position.
Since the appointment of Dr. Herrington the delivery of EMS service for Salina and Saline County has
taken several leaps forward in advanced care. The improvements approved and supervised by Dr.
Herrington have helped many residents survive lif e threatening medical emergencies and only
highlights his commitment to providing “cutting edge” emergency medical services. A short listing of
those improvements include:
The deployment of the EZ-IO® Intraosseous Infusion system. Since time is especially critical in
emergency settings, EZ-IO can be used to establish stable and secure vascular access in less than
10 seconds — for both alert and unconscious children and adults. Once established, the EZ-IO line
remains stable during transport and can be used to deliver drugs, fluids, or blood products required
in the patient’s treatment.
RSI training and protocol oversight. Rapid Sequence Induction (RSI) is an advanced medical
procedure, designed for the expeditious intubation of the trachea of a patient. RSI is generally used
for patients who have an increased risk of aspi rating stomach contents into the lungs due to a
current disease process.
The deployment of King Tubes. The KING LT is a reusable supraglottic airway created as an
alternative to tracheal intubation or mask ventilation. As a versatile airway management tool, the
KING LT provides a patent airway for superior patient ventilation.
The review, approval, and implementation of CCR. To date there have been three formal
publications of outcomes using cardiocerebral resuscitation. The first was from Wisconsin, where
survival during the first year of CCR was compared to the previous three years of CPR per the 2000
guidelines. Neurologically normal survival of witnessed arrests with shockable rhythms tripled, from
15% to 45%. The second was from Arizona, including cities in the Phoenix metropolitan area; there
survival of such patients more than tripled, from 5% to 18%. The third was a three-year follow-up of
the Rock and Walworth County results, in which survival increased from 15% to 40%. The Salina
Fire Department was one of the first departments in the State of Kansas to implement CCR
protocols.
The development, review, and approval of medical protocols that allow the Salina Fire Department
paramedics to deliver H1N1 vaccinations to the community. The Salina Fire Department is only one
of a handful of fire based EMS services with such protocols in place that allow paramedics to
administer vaccinations. Recently, fire department paramedics assisted the Saline County Health
Department in administering H1N1 vaccinations to school children. Since these protocols stand in
place for the future the fire departments paramedics can be deployed without delay should a
community vaccination effort be required.
CITY OF SALINA
REQUEST FOR CITY COMMISSION ACTION DATE TIME
01/11/2010 4:00 P.M.
AGENDA SECTION ORIGINATING DEPARTMENT: APPROVED FOR
NO: 8 AGENDA:
FIRE DEPARTMENT
ITEM
NO. 2
BY:
BY: Larry Mullikin, Fire Chief
Page 2
It’s through Dr. Herrington’s commitment to provide the best and most advanced EMS services that all
of these improvements were made.
The fire administration was approached by Dr. He rrington to reopen his contract for a number of
reasons. Not least among these, is the cost of medical liability insurance. Dr. Herrington has to pay for
his own medical insurance and that cost continues to escalate. A dditionally, the extra time and effort
that Dr. Herrington has put forth in the supervision of the fire department’s paramedics and the review
to serious medical events continues to grow and the compensation has no t be adjusted for three
years. As a result, Dr. Herrington is requesting his yearly compensation be adjusted from $20,000 to
$30,000.
Attached is the letter from Dr. Herrington to the fi re chief requesting the compensation adjustment to
$30,000 per year. In the letter Dr. Herrington states that he is willing to remain at $30,000 per year for
the next three years and would like to reopen the issue in the fourth year if conditions change.
From the fire department s standpoint it has been exciting to see the pr ogress in the delivery of
emergency medical services. Th e deployment of new technology and techniques allows the
paramedics to be more successful in the field. However, not to be lost in this background information
is the fact that Dr. Herrington has to continually demonstrate c onsiderable courage and take on
significant risk when new protocols and techniques are deployed – that also escalates the cost of
medical insurance.
The fire administration would highly recommend granting the compensation increase to Dr. Herrington
based on his performance and value to the community.
FISCAL NOTE:
The fire department currently is budgeted for $20,000 in the 2010 fiscal year. If this request is granted
the line item funding would need to be increased to $30,000.
CONFORMANCE WITH STRATEGIC PLAN
Goal #3:
The City will provide the high est quality of services, cons istent with Governing Body
direction, available resources and staff commitment to quality.
CITY COMMISSION ACTION:
Adopt Resolution No. 10-6699 authorizing a renewal of a pr ofessional services contract for physician
services as the Fire Department’s Medical Director with a yearly amount of $30,000.
SALINA FIRE DEPARTMENT
OFFICE OF THE MEDICAL DIRECTOR
CITY / COUNTY EMS SERVICES
January 5, 2010
TO:
Larry Mullikin, Fire Chief
FROM:
Dr. Sean Herrington, Medical Director
SUBJECT:
Contract for Medical Director Services
I would like to renew my contract as the Salina EMS medical director. Since my
appointment in 2007, I have thoroughly enjoyed serving in this capacity, and I see great
things to come!
I feel that as the medical director of the emergency room, I can help our EMS system
attain goals and achieve things that only the best EMS systems attain. I believe in our
paramedics and EMTs and am proud to be a partner with them.
My goals for 2010 are to continue to attend and improve upon the “Doc 100” meetings
we have every Thursday afternoon and continue to make these educational. I also plan to
add a monthly meeting where I meet with the medical officers and Chief VanBlaricon to
have a more focused “leadership” meeting. I also plan to add a monthly or quarterly
advanced cases review where we review all the trauma, life flight, and field intubation
cases to see what we did right and where we can improve. I will work with Sang Bui to
put in place an interface between the ER and the ambulances so we can have video
viewing capabilities, and we will finali ze the EKG interface transmission. Chief
VanBlaricon and Firefighter/Paramedic Matt White are already putting together the
protocol review process, and I will continue to work closely with them to make sure we
get the majority of our protocols updated and put in the new format.
I would like to give the city and the department a five year commitment. In doing so, I
respectfully ask for an increase in the medical director pay as follows: a yearly increase
starting Jan 1, 2010 up to $30,000/yr for the first three years, and then reopen the contract
and consider an increase to $35,000/yr for the last two years if conditions warrant. I do
feel that the time and energy I invest as the EMS medical director goes beyond the norm
and translates into a emergency medical response system that is one of the best in Kansas.
Our citizens and community deserve no less.