2004 Enhanced EMS / Injury Prevention Course Summary

1. 2004 Enhanced EMS / Injury Prevention CourseSummary

2. The Enhanced EMS Injury Prevention Project is the forerunner of an envisioned series of modules looking to examine and support Emergency Medical Services (EMS) in community public health efforts under the area called Emergency Public Health. The Enhanced EMS Injury Prevention Project was developed as one of the key initiatives of the New Hampshire Intersections Project. The inclusion of public safety was based on the recognition that the vast majority of issues that are mutual to EMS and Public Health are also of interest to Public Safety. The name Intersections was chosen because of the realization that highway safety issues are a prime opportunity for mutual interest and action as well as the Intersections Project operating at the intersection of the professions of EMS, Public Health and Public Safety.

3. Injury prevention efforts were identified in 2002 as an important first step. Specifically, the need for trained community based injury prevention resources was recognized as a major need both in New Hampshire as well as nationally. Injuries are a leading cause of preventable death and disability in New Hampshire as well as nationally.Despite the fact that many evidence-based injury prevention interventions exist, there is no systematic means to implement them at the community level. In addition, there is a scarcity of trained injury prevention practitioners at the community level.

4. During 2002-2003 the concept of an Emergency Public Health training program was developed by the Intersections Project. An Emergency Public Health Curriculum group was formed and comprised of representatives from the New Hampshire Safety and Health Council (now the Safety and Health Council of Northern New England), Keene State College Division of Continuing Education and OSHA training institute, New Hampshire Department of Safety Bureau of Emergency Medical Services, New Hampshire Department of Health and Human Services, University of New Hampshire, Emergency Educators Group, Derry NH Fire Department, Emergency Medicine Community Connection and the New Hampshire EMS and Trauma Coordinating Board began meeting to help formulate the structure of an injury prevention training program for EMS/Fire professionals.

5. In New Hampshire in early 2004 a group of EMS and Fire Service providers began attending a course to acquire skills in conducting injury prevention programs in their communities. This course was the effort of a multidisciplinary coalition led by Dr. Joseph Sabato that took on the task of organizing a program to educate field providers in injury prevention. The project attracted the notice of the National Highway Traffic Safety Administration (NHTSA) which then provided financial support to the program. NHTSA had created an injury prevention curriculum years before as part of the PIER program (Public Information, Education and Relations for EMS), but saw the NH effort as a model for delivering the program to a statewide audience.

6. The class attracted eleven participants who met one day a week for six weeks, then each student developed an injury prevention program for their community. The projects were required for successful completion of the course. The graduation ceremony for the members of the class was held on May 17, 2004 during National EMS Week in a ceremony at the NH Fire Academy. Prior to receiving their diplomas, the participants gave oral presentations of their programs, and poster presentations were displayed. The following slides describe the projects the students designed as well as the poster presentations of their projects.

7. Salem New Hampshire Fire Department Buckle Up-Live to Enjoy Your New Freedom Project Directors - Assistant Chief Kevin Breen and Lieutenant Stephane Cattin Salem Fire Departments Enhanced EMS Injury Prevention Program involved defining a specific curriculum to deliver a consistent message to driver education students. Salem Fire routinely participates in the Salem High School Driver Education program through demonstration of emergency crash extrication and reinforcement of driving safety. The program has never been standardized or evaluated for effectiveness. In addition there was no consistency in the demonstration or experience. In the development of the project a Safe Community Profile was compiled that may serve for the development of future injury prevention efforts. The driver education effort included Salem Fire, Salem High School Driver Education and support staff, students, parents, Salem Police Department School Resource Officer and the Salem DPW. Teenage seat belt use was measured, a curriculum for Salem Fire standardized program was developed and Salem Fire personnel trained in program delivery.

9. Trinity Ambulance Haverhill Massachusetts Enhanced Emergency Medical Services Community Injury Prevention through Traffic Safety Project Director Paramedic Roland Courtemanche Trinity Ambulance implemented a PIER training program for their EMS personnel. The Trinity Ambulance PIER Project developed a safety week for Haverhill. The Risk WatchInjury Program training for 1000 2nd and 3rd grade students was provided. In addition the Haverhill Health Fair provided the back ground for a pre and post survey of alcohol use and seat belt use. The Health Fair program was combined with education related to seat belt use, impaired driving and a post intervention survey. The demonstration of the effects of alcohol impairment through the use of the Fatal Vision impaired driving goggles was a key draw for the program. The intention of the Trinity Ambulance is to continue the PIER training in their organization for all deparent members and to implement the Risk Watch throughout the school system and in the summer camps.

11. Derry Fire Department Child Passenger Safety Seat Program Project Coordinator Lieutenant Scott Haggart Derry Fire Department targeted child passenger safety in their Enhanced EMS Project. For several years, Derry Fire has offered Child Passenger Safety Seat inspection. The program has remained popular but has had no dedicated resources. In addition, the CPSS program was underutilized in the preschool population with booster seats and car seats improperly utilized. To address these issues dedicated resources were budgeted. In order to increase public awareness and the effectiveness of outreach a demonstration program with an actual seat as a demonstration prop was developed. The demonstration targets preschools and kindergartens throughout the area to showcase the need for appropriate installation and fitting of child passenger safety seats and booster seats.

13. Milford Ambulance Service Milford New Hampshire Restraining teenage motor vehicle injuries and fatalities through increased use of seat belts. Project Directors Eric Schelberg, Director and Vicki Blanchard, Paramedic- Milford Ambulance Milford NH 03055 The Milford Ambulance project involved the recognition of low seat belt use and high risk of injury by Milford High School students. The intervention encompassed a pre and post observational and attitudinal survey. The program involved an educational program combined with intense marketing and public awareness. The content was peer driven and included the rollover demonstration, tombstones, fact tents, graphics, police enforcement, and a free prom night limousine ride drawn from those pledging seat belt use. The program focused on the teen peer experiences of crash victims. The post observational study demonstrated an overall 11 percent increase in seat belt use over the pre-intervention period.

15. Londonderry Fire Department Senior Safety Seat belt and Airbag Safety Project Coordinator Lieutenant Fred Heinrich The objective of the Londonderry Fire Department Enhanced EMS Injury Prevention project was to increase seat belt use in older drivers and passengers. In a survey at the local senior center only 54% of seniors used seat belts. National statistics demonstrate much higher Seattle usage across the country than New Hampshire. The Londonderry Fire Department researched and conducted a program targeting seat belt use in older rivers and passengers. The project consisted of a pre-survey of seat belt use, an educational program and a post-survey. The intervention took place at the local senior center adjacent to the fire station. The program reviewed the importance of seat belt use I reducing injuries, the potential dangers of air bags if seat belts are not used, reaction times and the dangers to child passengers by unrestrained adults. The senior seat belt and airbag safety program is continuing as a regular program at Londonderry Fire Department.

16. Town of Londonderry Fire Department Senior SafetySeatbelt & Airbag Safety Introduction Seatbelts Airbags Conclusion Used with Seatbelt Without a lap-shoulder belt chances for death or injury increase dramatically for both driver and front seat passenger. • The Plan • The Londonderry Fire Department and the Senior Affairs Coordinator have teamed together to address senior safety. • In June 2004 the topic of the monthly breakfast will be automobile safety. • Subjects covered will be; • The need for seatbelts. • The dangers of airbags without seatbelt use. • The proper use of seatbelts. • The effect of reaction times. • transporting minors (car seat requirements). • Additional topics will include Slips and Falls, Fire Safety, and Environmental Safety. Usage Seventy-one percent of people injured in motor vehicle crashes in 2002, were unrestrained. The national seatbelt usage rate for 2003 was 79%. During a recent survey at the Londonderry Senior Center only 54% of seniors were using seatbelts. National When the elderly are involved in Motor Vehicle Crashes their injuries are more severe. Nationally of the 42,000 deaths from motor vehicle crashes seventeen percent, 7,000, were sixty-five or older. New Hampshire Of the 10,692 elderly patients hospitalized in New Hampshire from 1997 to 2001 more than half, 5,590 were discharged to a Skilled nursing facility/structured/assisted living. Only 14% were discharged directly home. New Hampshire is the only state in the country that does not have a seatbelt law for adults over the age of 18. There is currently 153,000 adults 65+ in New Hampshire. Position The Driver must maintain at least 10 inches from the airbag to be properly positioned. Proper Placement Make sure your safety belt fits right. It should sit low across the hips without riding up onto your stomach. The shoulder part of the belt should be across the collarbone and chest, not against the neck or face. Other Factors Additional Information • Alcohol • 41% of all fatalities were alcohol related. • Medication • Side Effect (drowsness, Blurred vision, ect) • Over medicated • Under medicated • Unsafe medication combination • Age related factors • Decreased vision. • Reaction time. Lieutenant Fred Heinrich Londonderry Fire Department 280 Mammoth Road Londonderry, NH 03053 Phone: (603) 432-1125 E-mail: Medic3160@Hotmail.com Acknowledgements • Londonderry Professional Fire Fighters, IAFF 3160 • Londonderry Fire Department, Deputy Chief Carrier • Londonderry Senior Affairs Coordinator, Sara Landry • Dr. Joe Sabato • Keene State College Used with Airbags The use of manual lap-shoulder belt decreases the risk of fatality by 45%. An Airbag plus lap-shoulder belt decreases the risk of fatality by 51%

17. Pelham New Hampshire Fire Department Pelham High School Intersection Project Project leader Firefighter EMT Richard S. Hanegan The Pelham Fire Department intervention targeted identification and recognition of high risk intersections within the community. The Senior and Junior classes of Pelham High School participated in a program reviewing ideas related to roadway safety, impaired driving and the use of the New Hampshire Police Academy Rollover Convincer. The program was hosted at a local cinema/restaurant. Participants included a State Representative/Selectman, Fire, Police, High School, Driver Education, Community Emergency Response Team, Vince and Larry and a Traffic Engineer. The students were presented an overview of the planned reconstruction of the Pelham town center as an example of roadway intersection science. Students then participated in a contest throughout the town to identify potentially unsafe intersections and make recommendations related to improvements. Recommendations are to be made available to town roadway safety planners. The key prevention aspect for injury control involves the use of engineering techniques to improve road safety.

18. 2004 Enhanced EMS Program Pelham High School Intersection Project Pelham Fire Department Bureau of Public Information and Fire Safety Objective Method Attending Community involvement • 300 juniors and seniors from Pelham High School will participate. • Local residents and public officials will discuss ideas and methods to improve our roads. • New Hampshire Police Academy will demonstrate the rollover simulator. • Class will be conducted at Chunky’s Cinema, 150 Bridge street, Pelham NH. Thursday,May 13, 2004 7:30 am – 11:30 am LEADERS Jean-Guy Bergeron – New Hampshire State Representative. Town of Pelham Selectmen E. David Fisher – Pelham Fire Chief Richard S. Hanegan – Pelham Fire, Prevention Officer Dennis Mannion – Pelham Police, Traffic Enforcement Officer John Costa – Pelham High School, Drivers Education Dr. Joe Sabato – Enhanced EMS Program ACTIVISTS Pelham NH CERT (community emergency response team) Leo A. Thibeault – Plans for new intersection (Pelham Center) Jon T. Bossey – NH Police Academy Vince & Larry Crash Dummies – New Hampshire Traffic & Safety Administration Focus on problem intersections in the Town of Pelham. Engineer improvements on road signage, road construction, lighting, and pedestrian usage. Reduce or eliminate motor vehicle crashes, injuries, and fatalities. • (DUI) We can learn from other people’s mistakes. • Tom Boyle Story (video) – convicted of manslaughter for killing his passenger in MVA For more information Pelham High School Intersection Project Contact: Richard S HaneganPelham Fire Department Ph: 603 635 2703Email: ffhanegan@pelhamfire.com 1 student or a team of students could make the difference with a new insightful idea! TOTAL TRAFFIC FATALITIES Acknowledgements Thank you to Jim Nagel, owner Chunky’s Cinema

19. Hampton Fire Rescue Keeping Kids Safe Child Passenger Safety Program Project Director Deputy Chief Chris Silver The Hampton Fire Rescue Department has provided child passenger safety information and safety seat fitting resources. However, the resources were limited as was staff to provide this service. The goal of the Hampton Fire Rescue program is to develop a robust program for child safety seat inspections through program expansion into local hospitals, local day cares, and the Hampton Recreation Department. Hampton Fire Rescue trained additional firefighters as inspection technicians and sponsored increased fitting stations throughout the town. The expansion of the program is expected to help increase seat belt use in older children and adults.

20. Keeping Kids Safe Chris Silver, Deputy Chief Hampton Fire Rescue Introduction Goal The problem is that motor vehicle injuries are the greatest public health problem facing children today. In fact, they are the leading cause of death among children at every age after their first birthday. One important factor is restraint use. Restraint use among young children varies by driver restraint use. In fact, three-quarters of children ages 1 to 4 who ride with an unrestrained driver are also unrestrained and many children who ride in child safety seats are not properly secured. The goal of Hampton Fire Rescue is to develop a well organized program of Child Safety Seat Inspections by expanding the program to include the local hospitals, day cares, and the Hampton Recreation Department. Hampton Fire Rescue hopes to accomplish this by training additional firefighters as inspection technicians and sponsoring several inspections at various locations in town. Additionally it is hoped that the information provided through this program will carry over to older children and adults by encouraging proper use of restraint systems. Purpose The purpose of this program is to increase the proper use of child passenger restraint systems. A study by the National Highway Traffic Safety Administration found that child safety seats reduce the risk of death in passenger cars by about 70% for infants and by about 55% for toddlers ages 1 to 4. For children ages 9 years and older, car seat belts reduce injury risk by about 50%. • Child Safety Laws and RegulationsNew Hampshire State Child Occupant Protection Law • Effective Date01/01/2004 • Law Mandate • Children ages 5 and under and less than 55 inches in height must be properly restrained in an appropriate child safety seat. • Children ages 17 and under must be restrained in some manner regardless of seating position (primary enforcement).* • When New Hampshire does mandate restraint use, it requires the driver to secure both the child safety seat and the child properly. Acknowledgements New Hampshire Child Passenger Safety Program at the Injury Prevention Center, Buckle-Up New Hampshire, New Hampshire Bureau of Emergency Medical Services, National Highway Traffic Safety Administration

21. Concord New Hampshire Fire Department Senior Seat belt Use Project Project Coordinators Shawn Riley and Timothy Robinson Concord New Hampshire Fire Department targeted Safety and Seat Belt use in older drivers. The program was targeted in concert with the opening of a new senior center. New Hampshire older drivers and passengers have much lower seat belt use than national rates for the same age group. Areas covered during the program include information about air bags, seat belt usage and increased injuries in older occupants in motor vehicle crashes. A pre-intervention observational survey of seat belt use and a post intervention survey are part of the program. A second survey will measure the attitudes and educational impact pre and post intervention.

23. FOR FURTHER INFORMATION • Contact Clay Odell, EMTP, RN, Trauma Coordinator, NH Div. Of FST&EMS: • 603-448-4927 • email: codell@safety.state.nh.us • See the NH Intersections Collaborative website at: www.emergencypublichealth.com Most of the materials for this presentation have been adapted from the Intersections Collaborative report to NHTSA, available on the above website.