Whole Blood Transfusions In Ambulances Could Save Lives In Two W.Va. Counties

More life-saving methods are available on ambulances in two West Virginia counties.

The state Department of Health announced Tuesday that West Virginia is the first state in the country to provide statewide protocols for the administration of whole blood on ambulances.

According to the Department of Health’s Director of the Office of Emergency Medical Services, Joseph Ratliff, whole blood transfusions help restore a patient’s blood volume and clotting function much faster than traditional blood component therapy.

Ratliff said administering whole blood to trauma patients can significantly improve their chances of survival.

“Bleeding is often an early cause of death when it comes to trauma patients, but it doesn’t have to be,” Ratliff said. “I’m pleased to see these two counties stepping up to answer the call by providing this lifesaving service to residents.”

Cabell County EMS started offering the service in November of 2023, and in March of 2024, Harrison County also began carrying whole blood on ambulances.

Paramedics delivering whole blood on ambulances in these two counties are trained to administer the transfusion.

To expand the program, the state needs more blood donations. To make an appointment, donors may download the Red Cross Blood Donor App and use “Rapid Pass” which speeds up the time it takes to donate by allowing donors to fill out the questionnaire online.

Donors may also make an appointment at RedCrossBlood.org or call 1-800-RED CROSS 1-800-733-2767.

W.VA. Lawmakers Learn of Challenges Facing EMS Squads

The disappearance of federal grants, decreases in volunteerism and the soaring cost of medical equipment have many EMS squads vastly under supported.

Ambulance response times can be 50 minutes or more. That’s what Chris Hall, executive director of the West Virginia EMS Coalition told the Committee on Volunteer Fire Departments and Emergency Medical Services in a Sunday interim meeting.

“There’s maybe a case where the heart attack comes in, and we’re having response times that may take an hour or more to respond because there’s not an ambulance available in that person’s county,” Hall said. 

Hall said the disappearance of federal grants, decreases in volunteerism and the soaring cost of medical equipment have many EMS squads vastly under supported. He said the cost of ambulances for example have gone up 20 percent, and a stretcher now costs $35,000.

“To purchase, equip, and put all the medical required medical supplies on an ambulance is running from $300,000 to $500,000,” Hall said.

Hall made the point to lawmakers that EMS squads only get paid when they transport a patent, not just for going to the call and rendering aid.

“There’s about 30 percent of the transporting EMS agencies in West Virginia that transport one patient or less per day,” Hall said. “When you’re talking about those kinds of fixed capital cost, there’s no way to recover that based solely on the reimbursement of transporting one patient a day.” 

Hall said West Virginia is the only state in our region that doesn’t provide any state support for EMS. 

“You see other streams of funding used in other states, such as vehicle licensing fees going to EMS and driver’s license fees,” Hall said. “Pennsylvania sends a portion of their version of the coal severance tax back down to EMS and fire.” 

Hall suggested the state set up a graduated grant program to fill the need of about 250 new ambulances.    

“We think maybe potentially the state could come in and do 50 a year,” Hall said. “You do that over a five-year period, and every county gets the minimum number of ambulances that they need.”

Hall suggested EMS agencies get access to state purchasing and that cost reforms were needed in EMS licensing and certification. He suggested that the state increase wages and ramp up its first responder mental health initiatives. 

“We need a centralized database of resources available for mental health out there,” Hall said. “There’s a number of virtual programs that would cover all EMS personnel in the state for about $600,000 a year. And we’d like to see funding presented to the Office of EMS to employ a full-time mental health coordinator.”

Committee co-chair Del. Joe Statler, R-Monongalia, said he was a sponsor of three bills now in the drafting stage to address some of the EMS needs. 

High Tech Preventive Road Maintenance Among House Bills Passed Saturday 

Using artificial intelligence to better maintain state roads was just one of several bills passed by the House of Delegates in a Saturday session.

Using artificial intelligence to better maintain state roads was just one of several bills passed by the House of Delegates in a Saturday session, including:

House Bill 3214 creates the “Road Optimization and Assessment Data (ROAD) Pilot Program.” Highway crews will collect data in Monongalia and Preston Counties to best determine how to maintain roads and highways. They will use a combination of artificial intelligence, GPS, laser measurements and more to predict road faults such as potential potholes, buckles and breaks, to provide plans for preventive maintenance.

House Bill 2064 establishes the Tourism and Commercial Opportunity Zone Tax and Tax Credit Act. The intention is to encourage investment in business development and thereby increase employment and economic development.

House Bill 2483 reduces income tax liability for taxpayers who improve building facades in historic districts and provides for a tax credit of the replacement cost of historic facades.

House Bill 2760 permits firefighters to drive ambulances when both attendants are needed to administer patient care. There was debate over insurance liability when a firefighter drive as company’s ambulance, but it was decided that mutual aid agreements covered the issue

These four bills now go to the Senate for consideration.

State EMS Director Addresses Hiring Challenges, Explains Future Goals

Randy Yohe spoke with state Emergency Medical Director Jody Ratliff on all that’s being done now – and planned for the future – to keep local EMT departments fully staffed.

Major challenges remain across West Virginia in recruiting and retaining enough emergency medical service workers to keep ambulances running.

Randy Yohe spoke with state Emergency Medical Director Jody Ratliff on all that’s being done now – and planned for the future – to keep local EMT departments fully staffed.

Yohe: In June, I saw that West Virginia had lost more than 1900 EMTs over the past three years. At that time the workforce was short by nearly a third. Is that still the general case?

Ratliff: It is still the general case. It’s stressful for the EMS directors in the state right now and they’re trying to recruit as best as they can. Everybody’s looking for different ways to recruit people and get them into the EMS workforce.

Yohe: You told a recent legislative interim committee that the future of EMS across West Virginia is trending positively. So, what are the biggest challenges to EMT recruitment and retention? And, what are the key developments helping meet those challenges?

Ratliff: It takes a special kind of person to go into EMS. The directors out there have to target that person. Typically, we like to target them when they’re first coming out of high school and is that kid who’s who’s looking for something more in life, maybe he doesn’t want to go to college, maybe he does want to go to college, maybe she wants to do something different, whatever the case might be. It’s a very specific person who can do the job and stay in the job. So the challenges are first, finding that person and in today’s society, getting the right pay for that person, and then – the right benefits for that person.

Yohe:Talk about the streamlining regarding the online EMT certification website.

Ratliff: When the state went to (Healthcare & Emergency Response software company) ImageTrend, it developed into basically a self service. It allows the EMS folks out there to do what they want to do without having to call us all the time, without having to email us all the time and then wait for us to get around to it. It streamlines the whole process. They can go in and do it all. Within just a few hours they can have someone certified. It was a barrier at one time. It took anywhere from one to four weeks to get someone certified.

Yohe: You now have a command center and have updated education policies, talk about the benefits there.

Ratliff: Education drives everything for EMS. We’ve been stuck in the mud over the last probably 10 or 15 years with the same education. We know if we’re going to push EMS into the future and have it continue to be part of the healthcare system, then we have to educate our folks better. And, we’re going to do that. We can’t really do much with the initial education, that’s set by national standards. What we can do is update state education. We hope to help the EMS providers out there really become part of that system.

Yohe: I believe there’s a partnership with one if not more, universities, or colleges when it comes to leadership training.

Ratliff: It is, leadership training through the University of Charleston. They do a great job. I just went to their graduation and it warms my heart to see all those folks out there and how many people took the opportunity to go to that class. We also have partnerships with a lot of community colleges who teach the paramedic program.

Yohe: It seems that the state’s mid-level management leadership training happening across several state agencies has really started to pay off.

Ratliff: It has, and people love that. I’ve spoken to a few of our people that went out west and when they spoke to the EMS people there, they didn’t know that other state governor’s did that for them. It was great to hear that our governor stepped up and did that.

Yohe: Explain what the normalization of treat-in-place policies means and how it takes pressure off the state’s emergency rooms.

Ratliff: The treatment in place right now will affect three people, the diabetic, the seizure patient, or someone with COPD. It’s common that EMS will go out and run a diabetic patient and when they do this, the patient won’t be responding correctly. They’ll have low blood sugar, they’ll pass out, they’ll start an IV. When the patient comes back around, what we tend to find out is, maybe the patient took their insulin, missed their breakfast, something along those lines. As soon as we treat them, they come back around and don’t want to go to the hospital. We’re very specific on the patients that we’re targeting for that treatment-in-place. It allows us to treat-in-place and it keeps that patient out of the ER. The ER staff knows that all they (the patient) had to do was eat once they got EMT treatment. It clears us up, clears the ER staff up and clears the beds up in the ER and allows us to get back in service sooner.

Yohe: Some of the $10 million that was allocated by the governor to address these challenges went into the “Answer the Call” recruitment and retention campaign. How has that worked?

Ratliff: It takes time to go through the EMT process or paramedic process and get all the education. So we’re not going to see the true effects and true success until 2023. That’s when we’re really going to start to see how many people were able to get in. Some of the people that we lost during that process that maybe didn’t complete class, we’re not done with them. We still want to go back out and target those people and say, Hey, we want you to come back in, let’s try it again. We’re finding different ways to educate people. One of the things that I can say that is great about the directors right now across the state of West Virginia – is they’re working outside their box. They’re looking at everything they can possibly look at to say, how do we educate these people? Educating a 16-year-old kid and educating a 36-year-old person calls for two completely different ways to educate someone. We’re targeting both audiences and changing the way we educate, and it’s working.

Yohe: Is there anything else that you want to tell me about where EMS stands and where it’s going that I didn’t ask?

Ratliff: There’s still a lot of sleepless nights, people working to make sure they get their shifts covered. People trying to find more employees out there to come into EMS. We encourage anybody who’s ever thought about a career in EMS to come out and join us. We’re more than happy to train you, get you educated and create a future for you.

W.Va. Ambulances See Reimbursement Rate Increase

State ambulance services will receive an additional 10 percent in reimbursement from the Department of Health and Human Resources starting immediately and retroactively to July 1.

State ambulance services will receive an additional 10 percent in reimbursement from the Department of Health and Human Resources starting immediately and retroactively to July 1.

The increase is set to give more than 200 ambulance providers nearly $12 million in additional reimbursements each fiscal year.

The increase comes from a request Gov. Jim Justice made to DHHR Cabinet Secretary Bill Crouch last June. Crouch said these funds are important because a large amount of the state’s ambulance services operate in rural areas with limited healthcare options.

“We really support those folks and what they do, they’re some of our local heroes throughout the state,” Crouch said during Justice’s COVID-19 briefing Wednesday.

The new rate matches Medicare, which is the maximum amount allowed by law.

The rate increase is part of a plan to overcome a shortage of EMTs and paramedics. West Virginia lost more than 1,900 responders over three years, or one-third of its workforce.

Justice previously announced $10 million in American Rescue Plan Act funds for EMS agency relief, and part of those funds went towards providing five mobile certification ambulances providing free training to prospective EMTs and paramedics.

Collision with Ambulance Kills 2 Elk in W.Va.

West Virginia’s elk population dropped to 22 after two elk collided with an ambulance.

News outlets report a calf and an elk died after they jumped over the median on U.S. 119 and collided with an ambulance Monday morning. No patients were in the ambulance and the two ambulance personnel were unharmed.

24 elk were reintroduced into the state in December, marking the first time the animal could be seen in the state since 1875.

Randy Kelley with the state Division of Natural Resources urged drivers to be mindful of their speed and be aware of animal crossings, but says accidents are unavoidable.

Up to 60 more elk could be introduced to the state next spring.

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