DAVID Y. IGE .ELIZABETH A. CHAR, M.D GOVERNOR OF HAWAII DIRECTOR OF HEALTH DEPT. COMM. NO. 409 STATE OF HAWAII DEPARTMENT OF HEALTH In reply, please refer to: P. O. BOX 3378 HONOLULU, HI 96801-3378 February 22, 2021 The Honorable Ronald D. Kouchi, The Honorable Scott K. Saiki, Speaker President and Members of the Senate and Members of the House of Thirty-first State Legislature Representatives State Capitol, Room 409 Thirty-first State Legislature Honolulu, Hawaii 96813 State Capitol, Room 431 Honolulu, Hawaii 96813 Dear President Kouchi, Speaker Saiki, and Members of the Legislature: For your information and consideration, I am transmitting a copy of the National Highway Traffic Safety Administration Technical Assistance Team: “A Reassessment of Emergency Medical Services, October 14-18, 2019.” In accordance with Section 93-16, Hawaii Revised Statutes, I am also informing you that the report may be viewed electronically at: https://health.hawaii.gov/opppd/department-of-health-reports-to-2021-legislature/ Sincerely, Elizabeth A. Char, M.D. Director of Health Enclosures c: Legislative Reference Bureau Hawaii State Library (2) Hamilton Library STATE OF HAWAII A REASSESSMENT OF EMERGENCY MEDICAL SERVICES October 14 -18, 2019 National Highway Traffic Safety Administration Technical Assistance Team: Dan Manz Curtis Sandy, MD, FACEP, FAEMS Leslee Stein-Spencer, R.N., M.S. Peter Taillac, MD, FACEP, FAEMS Kyle Thornton, EMT-P, M.S. Tour Team: Curtis Sandy, MD, FACEP, FAEMS Keith Wages Dave Bryson, NHTSA Facilitator Susan Gillies, Executive Support TABLE OF CONTENTS Subject Page BACKGROUND ............................................................................................................................................4 ACKNOWLEDGMENTS ...............................................................................: ............................................... 7 INTRODUCTION ...........................................................................................................................................8 A. REGULATION AND POLICY ............................................................................................................. 10 Standard ............................................................................................................................................. 1O Status ................................................................................................................................................... 11 Recommendations .............................................................................................................................. 12 B. RESOURCE MANAGEMENT ........................... :................................................................................ 14 Standard ................................................................ ~ ............................................................................ 14 Status .................................................................................................................................................. 14 Recommendations .............................................................................................................................. 17 C. HUMAN RESOURCES AND EDUCATION ........................................................................................ 18 Standard ..... , ....................................................................................................................................... 18 Status .................................................................................................................................................. 19 Recommendations .............................................................................................................................. 20 D. TRANSPORTATION ..........................................................................................................................22 Standard .............................................................................................................................................22 Status ..................................................................................................................................................22 Recommendations.:............................................................................................................................ 24 E. FACILITIES ................................................................ , ....................................................................... 25 Standard ............................................................................................................................................. 25 Status ................................................................................................................................................... 25 Recommendations .............................................................................................................................. 26 F. COMMUNICATIONS ..........................................................................................................................27 Standard ..............................................................................................................................................27 Status ..................................................................................................................................................27 Recommendations ......................................................................................... :: ................................... 28 G. TRAUMA SYSTEMS ..........................................................................................................................29 Standard .............................................................................................................................................29 Status ......................... , ........................................................................................................................ 29 Recommendations .............................................................................................................................. 30 H. PUBLIC INFORMATION, EDUCATION AND PREVENTION ........................................................... :32 Standard .............................................................................................................................................32 Status ...................................................................................................................................................32 Recommendations .............................................................................................................................. 33 I. MEDICAL DIRECTION ............................................................................................. :......................... 34 Standard ..............................................................................................................................................34 Status ...................................................................................................................................................34 Recommendations ...........................................................................•................................................... 35 J. PREPAREDNESS .............................................................................................................................37 Standard ...........................................................................................·.................................................. 37 Status ..................................................................................................................................................37 Recommendations ......................................................................... , .................................................... 39 K. EVALUATION ....................................................................................................................................40 Standard .............................................................................................................................................40 Status ..................................................................................................................................................41 2 Recommendations .............................................................................................................................. 42 L. CURRICULA VITAE ...........................................................................................................................43 3 BACKGROUND Injury is the leading cause of death for persons in the age group one through 44, as well as the most common cause of hospitalizations for persons under the age of 40. The financial costs of injuries are staggering, costing billions of dollars in health care and social support resources. In 2014, the U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) reported the price tag for crashes was at $871 billion in economic loss and societal harm. This includes $277 billion in economic costs - nearly $900 for each person living in the United States - and $594 billion in harm from the loss of life and the pain and decreased quality of life due to· injuries. Each year over 37,000 people lose their lives on the nation's roads. NHTSA is charged with reducing death and injury on the nation's