MIEMSS The Maryland Institute for Emergency Medical Services Systems (MIEMSS) oversees and coordinates all components of the statewide EMS system (including planning, operations, evaluation, and research), provides leadership and medical direction, conducts and/or supports EMS educational programs, operates and maintains a statewide com- munications system, designates trauma and specialty centers, licenses and regulates commercial ambulance services, and participates in EMS- related public education and prevention programs. MIEMSS provides the executive support for the EMS Board in review- ing and approving the budgets for agencies receiving funds from the EMS Operations Fund, developing and promulgating regulations and protocols, proposing EMS system legislation, licensing/certifying and disciplining EMS providers, and conducting other EMS Board busi- ness. MIEMSS also provides the administrative and staff support for the Statewide EMS Advisory Council (SEMSAC) and five EMS regional councils. 2012–2013 ANNUAL REPORT CONTENTS MIEMSS insidefrontcover Mission/Vision/KeyGoals iv FromtheEMSBoardChairman 1 MIEMSS FromtheExecutiveDirector 2 Administration 3 AeromedicalOperations 4 AttorneyGeneral’sOffice 4 CommunicationsEngineeringServices 5 ComplianceOffice 7 DoNotResuscitateProgram 8 EducationalSupportServices 8 EmergencyHealthServicesDepartment, UniversityofMarylandatBaltimoreCounty 9 EmergencyMedicalServicesforChildrenDepartment 10 EMRC/SYSCOM 16 GovernmentAffairs 17 HealthCareFacilitiesandSpecialPrograms 18 InformationTechnology 22 LicensureandCertification 26 MarylandCriticalIncidentStressManagementProgram 27 MedicalDirector’sOffice 28 QualityManagement 29 RegionalProgramsandEmergencyOperations 31 StateOfficeofCommercialAmbulanceLicensingandRegulation 37 Maryland Trauma and Specialty Referral Centers Overview 39 TraumaCenterCategorization 40 AdultTraumaCenters PARC:RAdamsCowleyShockTraumaCenter, UniversityofMarylandMedicalSystem 40 Level I: TheJohnsHopkinsHospital,AdultTraumaCenter 46 Level II: JohnsHopkinsBayviewMedicalCenterTraumaCenter 48 PrinceGeorge’sHospitalCenter 49 SinaiHospitalTraumaCenter 50 SuburbanHospital–JohnsHopkinsMedicine 51 Level III: MeritusMedicalCenterTraumaCenter 53 PeninsulaRegionalMedicalCenterTraumaCenter 54 WesternMarylandRegionalMedicalCenter 55 i Specialty Referral Centers Adult Burns JohnsHopkinsBurnCenter,JohnsHopkinsBayviewMedicalCenter 56 TheBurnCenteratMedStarWashingtonHospitalCenter 56 Pediatric Burns JohnsHopkinsChildren’sCenter 57 Children’sNationalMedicalCenter 58 TheCurtisNationalHandCenteratMedStarUnionMemorialHospital 58 CenterforHyperbaricMedicine,RAdamsCowleyShockTraumaCenter 60 MarylandEyeTraumaCenter,TheWilmerEyeInstituteatJohnsHopkins 61 NeurotraumaCenter,RAdamsCowleyShockTraumaCenter 61 Pediatric Trauma PediatricTraumaCenteratJohnsHopkinsChildren’sCenter 62 PediatricTraumaCenter,Children’sNationalMedicalCenter 64 PoisonConsultationCenter,MarylandPoisonCenter 65 Rehabilitation 67 Maryland EMS Statistics (Tables & Graphs) 68 Maryland Trauma Statistics 73 Age Distribution of Patients Treated at Pediatric or Adult Trauma Centers 73 Maryland Adult Trauma Statistics Report (Tables & Graphs) TotalCasesReportedbyTraumaCenters 73 OccurrenceofInjurybyCounty 74 ResidenceofPatientsbyCounty 74 GenderProfile 74 PatientswithProtectiveDevicesatTimeofTraumaIncident 74 ModeofPatientTransporttoTraumaCenters 75 OriginofPatientTransporttoTraumaCenters 75 EmergencyDepartmentArrivalsbyDayofWeek 75 EmergencyDepartmentArrivalsbyTimeofDay 75 NumberofDeathsbyAge 76 NumberofInjuriesbyAge 76 NumberofInjuriesandDeathsbyAge 76 EtiologyofInjuries 76 BloodAlcoholConcentrationofPatientsbyInjuryType 76 EtiologyofInjuriesbyAge 77 EtiologyDistributionforPatientswithBluntInjuries 77 EtiologyDistributionforPatientswithPenetratingInjuries 77 AgeDistributionofPatients 77 InjuryTypeDistributionofPatients 77 FinalDispositionofPatients 78 InjurySeverityScoresbyInjuryType 78 InjurySeverityScoresofPatientswithPenetratingInjuries 78 InjurySeverityScoresofPatientswithBluntInjuries 78 InjurySeverityScoresofPatientswithEitherBluntorPenetratingInjuries 78 ii Maryland Adult Burn Statistics (Tables & Graphs) TotalNumberofAdultBurnCases 79 SeasonofYearDistribution 79 TimeofArrivalDistribution 79 PlaceofInjury 79 OccurrenceofInjurybyCounty 80 ResidenceofPatientsbyCounty 80 ModeofPatientTransport 80 EtiologyofInjurybyAge 81 FinalDispositionofPatients 81 GenderProfile 81 NumberofInjuriesbyAge 81 Maryland Pediatric Trauma Statistics Report (Tables & Graphs) TotalCasesTreatedatPediatricTraumaCenters 82 EmergencyDepartmentArrivalsbyDayofWeek 82 EmergencyDepartmentArrivalsbyTimeofDay 82 GenderProfile 82 OutcomeProfile 82 ModeofPatientTransportbyCenter 83 OriginofPatientTransportbyCenter 83 InjuryType 83 EtiologyofInjuries 83 EtiologyofInjuriesbyAge(PediatricTraumaCenters) 83 NumberofInjuriesandDeathsbyAge 84 NumberofInjuriesbyAge 84 NumberofDeathsbyAge 84 FinalDispositionofPatients 84 EtiologyofInjuriesbyAge(PediatricorAdultTraumaCenters) 84 OccurrenceofInjurybyCounty 85 ResidenceofPatientsbyCounty 85 ChildrenwithProtectiveDevicesatTimeofTraumaIncident 85 Maryland Pediatric Burn Statistics Report (Tables & Graphs) TotalNumberofPediatricBurnCases 86 PlaceofInjury 86 SeasonofYearDistribution 86 TimeofArrivalDistribution 86 OccurrenceofInjurybyCounty 87 ResidenceofPatientsbyCounty 87 ModeofPatientTransportbyBurnCenter 87 OriginofPatientTransportbyBurnCenter 87 EtiologyofInjuriesbyAge 88 FinalDispositionofPatients 88 TotalBodySurfaceAreaBurnedbyLengthofStayinDays 88 GenderProfile 88 NumberofInjuriesbyAge 88 NumberofPatients(PediatricBurnClinics) 89 GenderProfile(PediatricBurnClinics) 89 EtiologyofInjurybyAge(PediatricBurnClinics) 89 National Study Center for Trauma and EMS 90 Current Listing of EMS Board, Statewide EMS Advisory Council and MIEMSS Executive Director insidebackcover iii Mission/Vision/Key Goals MISSION ConsistentwithMarylandlawandguidedbytheEMSPlan,toprovidethe resources(communications,infrastructure,grants,andtraining),leadership(vision, expertise,andcoordination),andoversight(medical,regulatory,andadministrative) necessaryforMaryland’sstatewideemergencymedicalservices(EMS)systemto functionoptimallyandtoprovideeffectivecaretopatientsbyreducingpreventable deaths,disability,anddiscomfort. VISION TobeastateEMSsystemacknowledgedasaleaderforprovidingthehighest qualitypatientcareandthatissoughtouttohelpotherEMSsystemsattainthesame levelofqualitycare. KEY GOALS • Providehighqualitymedicalcaretoindividualsreceivingemergencymedical services. •Maintainawell-functioningemergencymedicalservicessystem. iv FROM THE EMS BOARD CHAIRMAN his2012-2013AnnualReportmarksthe20thanniversaryofthecreationofthesys- temTofgovernance,oversight,andcoordinationforMaryland’sStatewideEMSSystem. In1992theGovernor’sEMSCommission,chargedwithpreparingtheEMSsystem for“entryintothe21stcentury,”recommendedaformalizedstructureforastatewide EMSsystem.TheCommission’srecommendationswereturnedintoastatutoryframe- Donald L. DeVries, Jr., Esq. workin1993,whichhasresultedintheongoingandsuccessfuloperationofMaryland’s Chairman, EMS Board StatewideEMSSystem. SignificantchangesinourEMSsystemhaveoccurredoverthepast20years.Someofthemostnotableinclude: • Ongoinglicensingandcertificationofnearly30,000EMSproviders,manyofwhomarevolunteers,as wellasapeer-reviewedcredentialingprocesseswithappealrightsfordisciplinaryissues;establishment ofweb-basedservicesforEMSproviders,includingimplementationofasuccessfulinternet-based EMSprehospitalpatientcarerecordsystem,trackingoflicensure/certificationstatus,andprovideredu- cation;andonlinecontinuingeducationandprotocolupdateinformation,makingiteasierforproviders tomaintainrequirementsoflicensure/certification. • Statewide applicationofuniformmedicalprotocolsforEMSproviders,alongwithregularprotocol updatessothatEMScanprovidethemostcurrentandeffectivetreatmenttocriticallyillandinjured patientsduringtheprehospitalemergencyphaseofcare. • A comprehensiveandexpandedstructurefordesignationoftraumaandspecialtycentersthatincludes neurotraumaandeyetraumacenters,burncenters,primaryandcomprehensivestrokecenters,cardiac interventionalcenters,andperinatalreferralcenters.Designationstandardsareperiodicallyupdatedto reflectnationalstandards. • Ongoing operationofoneofthelargestmedicalcommunicationssystems,whichlinksallcomponents oftheprehospitalcaresystemandencompassescommunicationstowers,microwaveradios,EMSand helicoptercommunications,andhospitalconsoles. Yetevenatthis20-yearmarkourEMSsystemremainsaworkinprogress.Duringthepastyear,thefirst ofthenewhelicopterfleetwasdeliveredtotheMarylandStatePoliceAviationCommand.Thedeliveryofthe newhelicoptersistheculminatingeventinamulti-yearefforttosecureareplacementfleet;thehardworkof manyindividualsandentitiesledtothisachievement. AlsoinFY2013,thefinancialstabilityofthestatewideEMSsystemwassecuredforthenearfuturebyan increaseinthevehicleregistrationfeesurchargethatfundsmanycomponentsofthesystem.Ensuringtheavail- abilityofthefinancialsupportneededbyourEMSsystemwasasignificantgoal,theattainmentofwhichwill enablecritically-neededupdatestoourcommunicationssystem. Maryland’sEMSSystemremainsuniqueinthenationasacommunityofvolunteerandcareerorganiza- tionsandpersonnel;police,firedepartments,andfire/EMSand“thirdservice”providers;traumaandspecialty centers;healthcareproviders;9-1-1servicesandoperators;andstate,county,andlocalgovernmentsandjuris- dictions.Oursuccessesareduetothehardworkanddedicationofourmanypartners,andthespiritofcoopera-