Upcoming Events
- February 6, 2025, 10:00-11:00 am: Cardiac Ready Community Advisory Committee Meeting
- February 25-26, 2025: NDEMSA Management Conference
- March 6, 2025, 10:00 am-2:00 pm: Stroke Task Force Meeting
- March 11, 2025, 1:00-2:00 pm: EMSC Advisory Committee Meeting
- March 19, 2025, 12:00-1:00 pm: State Trauma Committee
- April 3-5, 2025: NDEMSA EMS Conference
- April 10, 2025, 10:00 am- 4:00 pm: EMSAC Meeting
- May 1, 2025, 10:00 -11:00 am: Cardiac Ready Community Advisory Committee Meeting
- May 11-17, 2025: EMS Week
- May 21 , 2025: EMSC Day
- June 5, 2025, 10:00 am-2:00 pm: Stroke Task Force Meeting
- June 10, 2025, 1:00-2:00 pm: EMSC Advisory Committee Meeting
- June 18, 2025, 12:00-1:00 pm: State Trauma Committee
- July 17, 2025, 10:00 am- 4:00 pm: EMSAC Meeting
- August 7, 2025, 10:00-11:00 am: Cardiac Ready Community Advisory Committee Meeting
- September 4, 2025, 10:00 am-2:00 pm: Stroke Task Force Meeting
- September 9, 2025, 1:00-2:00 pm: EMSC Advisory Committee Meeting
- September 17, 2025, 12:00-1:00 pm: State Trauma Committee
- October 16, 2025, 10:00 am- 4:00 pm: EMSAC Meeting
- November 6, 2025, 10:00-11:00 am: Cardiac Ready Community Advisory Committee Meeting
- December 4, 2025, 10:00-2:00 pm: Stroke Task Force Meeting
- December 9, 2025, 1:00-2:00 pm: EMSC Advisory Committee Meeting
- December 17, 2025, 12:00-1:00 pm: State Trauma Committee
Emergency Medical Services (EMS) Update
Required Formation of Rural Ambulance Service District
Emergency medical service operations licensed under NDCC Chapter 23-27 as a basic life support or advanced life support ambulance service for which a territory has been assigned pursuant to this chapter does not include a city with a population greater than six thousand five hundred according to the 2020 census data published by the United States census bureau, and is not otherwise exempted, must:
- Conduct a rural ambulance service district organizational meeting pursuant to the procedure in section 11-28.3-06 prior to June 30, 2025. After such organizational meeting the district shall be deemed organized and operating under the provisions of chapter 11-28.3.
The following licensed ambulance services are exempt from section 23-27-07:
- Licensed ambulance services that are county owned.
- Licensed ambulance services that are city owned.
- Licensed ambulance services that are part of a joint powers agreement with a city or county-owned ambulance.
- Licensed ambulance services owned by tribal or federal government.
- Existing rural ambulance service districts organized pursuant to chapter 11-28.3.
Ambulance services not in compliance with this section may not be eligible for relicensure under NDCC chapter 23-27.
For additional information, contact Chris Price at cprice@nd.gov or (701) 328-4728.
NREMT Website
Visit the NREMT website here to access areas relevant to your role, including Educator, Training Officer, Medical Director, etc. At the bottom of the dashboard page, you will find frequently asked questions and video tutorials to assist with your queries.
Upcoming NREMT Renewal Guidelines
For Those Renewing by March 2025: We have been following this education breakdown for many years. You can access the guidelines here.
For Those Renewing After March 31, 2025: The new NREMT renewal guidelines offer a broader and more user-friendly structure. An important update includes adding 10% more NCCR hours for Pediatric Education. Access the renewal guidelines here.
Required NCCP Hours
Next Steps After Renewal:
- Once you receive verification of your renewal from NREMT, a new 2025 EMS registration must be completed.
- Advanced-level providers require a Medical Director's signature on a new form for each service.
- CPR/Drivers: Must renew with the EMS Unit each time CPR certification is updated.
- Nurses: Must renew with the EMS Unit each time they renew their nursing license.
Important EMS Forms and Resources
Access the latest forms and updates from the EMS Unit:
- Emergency Medical Systems website here.
- 2025 EMS Registration Form here.
- 2025 ALS Provider License Renewal Application here.
- Non-Nationally Registered EMR Continuing Education Report here.
- Access the updated North Dakota EMS Treatment Guidelines here.
- When submitting for EMS grants, utilize the PRS system. Instructions are here.
Big Picture Update
- We continue working closely with Albertsons to optimize the EMS Personnel/Agency Registry, "Big Picture." We appreciate your patience as we refine this system.
- Instructions on how to log in to the Big Picture System are here.
- Access the EMS Big Picture EMS System here.
EMSAC
- Next EMSAC meeting: April 10, 2025, 10:00 am- 4:00 pm.
Educational Opportunities
- February 25-26, 2025: ND EMS Association EMS Management Conference-register here.
- April 3-5, 2025: ND EMS Association Annual Conference-Come visit the EMSU booth at the NDEMSA Conference!
EMS Week: May 11-17, 2025
Your commitment to providing exceptional emergency care to the people of North Dakota is deeply valued. EMS is a vital service that thrives because of dedicated professionals like you. Happy EMS Week!
If you have any questions regarding the EMS System, please contact Kerry Krikava at klkrikava@nd.gov.
Emergency Medical Services for Children (EMSC) Update
Pediatric Emergency Care Coordinator (PECC) for Prehospital Providers
- PECC for Prehospital Providers is an EMS provider designated within your organization who ensures that providers are prepared to care for ill and injured children. Having a PECC is the single most important step for enhancing pediatric care in your service. A PECC is an essential part to having your service be considered Pediatric Ready. Ideally every agency will have one or more PECCs but multiple agencies may share the same PECC.
- Ensure your service has a PECC signed up with ND EMSC so you aren't missing out on symposiums, equipment, and other opportunities!
- If you have a PECC but haven't gotten the emails please send an updated email address to cgreer@nd.gov
- To learn more and apply: Complete the application to register as a Pediatric Emergency Care Coordinator (PECC) here.
Pediatric Emergency Care Coordinator (PECC) Program for Hospital Emergency Departments
- In the hospital setting, a PECC is an RN and a physician (in smaller facilities an APP may fill this role) team within the emergency department who ensure that its providers are prepared to deliver the best care for ill and injured children.
- Learn more and apply here.
PECC Initiatives:
- In an initiative to reduce pediatric medication errors, hospitals that sign up for PECC are eligible to receive a free pediatric scale that weighs in kilograms only. Hospitals must provide their ED policy specifying that weight must be completed in kilograms.
- The RN of the PECC team also receives a Pediatric Care After Resuscitation (PCAR) course worth 18 credits for free. Only ten spots are remaining.
- Upcoming initiative for PECC teams is vein finders with pediatric attachment. This involves a certain percentage of staff completing education on TXA, blood products, and IV fluids. More to come on that from EMSC.
- ND EMSC worked to help EMS agencies get more comfortable with triaging pediatrics in a disaster by sending agencies that completed a national survey, pediatric triage disaster kits.
- An initiative to help reduce medication errors in the prehospital setting by equipping ambulances with epinephrine anaphylaxis kits was sent to EMS agencies with a PECC.
- EMSC is happy to provide resources for all sorts of pediatrics topics. This includes attending squad meetings. Get in touch with ND EMSC to see how they can help your squad be more comfortable with pediatric patients!
Early Bird Award
Don't forget to fill out the Early Bird Award form after you have assisted with a delivery. Make sure to get your stork pin! Apply here.
Educational Opportunities
- EMSC virtual symposiums are currently being scheduled. Make sure your service has a PECC registered with EMSC so that you don’t miss out on these FREE education opportunities! Continuing education credits available.
Be sure to stop by and visit with ND EMSC at the state EMS Conference, April 3-5th!
For questions regarding the EMSC Program, please contact Chettie Greer at cgreer@nd.gov.
Trauma System of Care Update
26th Annual North Dakota Statewide Trauma Conference
October 8-9, 2025 in Minot, ND
Pre-registration required. Agenda and registration information will be available late summer.
Trauma Designation Standards
Updated 2025 Level IV and V Trauma Designation Standards. Available here.
Educational Opportunities
Comprehensive Advanced Life Support (CALS) Bismarck: June 11-12th Early registration and special pricing opening the end of February to hospitals participating in the EMSC PECC program. For more information on CALS: https://www.calsprogram.org/
Visit the North Dakota Trauma System website here.
For questions regarding the Trauma System, please contact Mary Waldo at mwaldo@nd.gov.
Cardiac System of Care Update
Coordinator Spotlight
Lindsey Gellner
I’m Lindsey Gellner, Emergency Department Manager at Unity Medical Center in Grafton, ND. I live in Grafton with my three children. I have been employed as an RN with Unity Medical Center since August of 2019 and became the Emergency Department Manager in February of 2022. Prior to that, I worked as a paramedic and ambulance director for 10 years before going back to school to become an RN. In my current role, I serve in many different capacities, including Cardiac Coordinator.
When asked why her facility is applying for the Acute Cardiac Ready Hospital Designation, replied, "Unity Medical Center, a Level V Trauma Center and certified Acute Stroke Ready Hospital, is dedicated to providing exceptional care to our patients. Pursuing Acute Cardiac Ready Hospital designation reflects our ongoing commitment to advancing the quality of care we deliver. We are dedicated to providing the best in cardiac care and we feel that the pursuit of an Acute Cardiac Ready Hospital designation is an essential step toward further improving the health and well-being of our community.."
Become an Acute Cardiac Ready Hospital (ACRH)
- Enroll and contribute STEMI patient data to the state cardiac registry, GWTG-Coronary Artery Disease (CAD).
- Meet established ACRH designation criteria. View the designation criteria here.
- Apply to be designated as a STEMI referring center by the state.
Statewide Cardiac Registry FAQ
- What registry did Emergency Medical Systems choose as the North Dakota statewide cardiac registry? The American Heart Association's Get with the Guidelines-Coronary Artery Disease (GWTG-CAD) was selected.
- Is participation in the statewide registry mandatory? No. However, if your facility would like to be designated by the state as a STEMI referring or receiving center, contribution to the statewide registry is required.
- How is the registry paid for? The facility will pay for the registry and chart entry time, and the state will subsidize the cost as the legislature allows. Currently, the state pays for 100% of GWTG-CAD.
- What is the Rural Health Care Outcomes Accelerator Program? Enroll now and get GWTG-CAD registry for free for three years! A new AHA three-year initiative that aims to eliminate rural health care disparities by providing new enroller hospitals free access to GWTG programs, including GWTG-CAD. All ND critical access hospitals are eligible. More information here.
- What is required by the state to be designated a STEMI referring or STEMI receiving center? 1. The facility must be certified by the state or one of the ND approved Cardiac Certification Programs for STEMI Receiving Center Designation. View the approved STEMI Receiving certification programs here. 2. The facility must participate in the statewide cardiac registry.
GWTG-CAD for free for the next three years!
Enroll by June 20, 2025 to qualify.
Cardiac System of Care Advisory Committee Reorganization
What is the purpose? The Cardiac System of Care Advisory Committee is designed to be committed to supporting the state’s efforts in the development of a robust system of care.
What is the goal? The primary focus revolves around the development of a comprehensive system plan, as well as the maintenance and enhancement of hospital designation standards, state treatment guidelines, and continuous quality improvement initiatives.
Who should apply? Individuals who are interested in contributing to the advancement of the Cardiac System of Care in North Dakota.
What representation is needed? Seeking representation from the following areas: critical access hospitals, tertiary hospitals, physicians or advanced practice providers, EMS agency serving rural area, and EMS agency serving urban area.
What are the expectations? Participants must demonstrate positive intent, foster collegiality, and engage in the necessary activities to ensure the successful establishment of a fully functional cardiovascular care system.
What are the benefits of participation? Joining the Cardiac System of Care Advisory Committee provides a unique opportunity to play a pivotal role in advancing cardiac care across the state. This collaborative group unites cardiac experts dedicated to improving patient outcomes through evidence-based practice guideline development, performance improvement initiatives, education, and outreach efforts.
Key Benefits Include:
- Continuous Performance Improvement: Analyze quality metric data to identify opportunities for improvement and use your expertise to create and implement performance improvement initiatives aimed at enhancing efficiency, effectiveness, and outcomes of cardiac care.
- Development of Evidence-Based Practice Guidelines: The committee ensures that clinical practices align with evidence-based standards. By collaborating on the refinement of the State guidelines, members help establish consistency and excellence in cardiac care delivery.
- Opportunities for Education and Outreach: Members contribute to the education of healthcare providers and the public, increasing awareness of cardiac care best practices and promoting the importance of timely and effective treatment. This work extends the committee’s impact, and you may see improved patient outcomes in your care setting.
- Guiding Development of a Comprehensive Cardiac Care System: From hospital designation criteria to treatment protocols, members influence the framework of the care system.
- Engagement with Experts: Participation fosters connections with leading cardiac professionals, enabling members to exchange ideas, share insights, and collaborate on innovative solutions.
- Professional Growth and Recognition: Serving on the committee highlights your leadership and dedication to improving cardiac care at a statewide level. It also offers opportunities for professional development by keeping you engaged.
- Together, we can improve outcomes and save lives!
Cardiac Advisory Committee Application deadline: March 31, 2025.
Apply here.
Visit the Cardiac System of Care website here.
For questions regarding the Cardiac System of Care, please contact Christine Greff at cgreff@nd.gov.
Stroke System of Care Update
Coordinator Spotlight
Holly Nissen
I have been a Sanford Health employee for 22 years, with a background in ICU, PICU, and education. I have been a stroke coordinator (SC) for 5 years. I do Acute Stroke Ready Hospital (ASRH) site visits for both ND and MN. I am a past chair of the ND Stroke Task Force and an ASLS instructor. Stroke care is my passion, and I love being in the SC role!
I enjoy getting to know the stroke teams at the ASRHs. I appreciate learning about their programs and the patients they care for. Being an ASRH site surveyor challenges me to stay current with clinical practice guidelines and the care of stroke patients.
I have witnessed the care of stroke patients improve across the state. I know the stroke coordinator role can be challenging, and I am happy to have contributed to the ND state guidelines and ASRH designation reference guide.
Meet Dr. Bajgur
Introduction: Hello, everyone. It’s an honor to serve on the North Dakota State Stroke Task Force team. I am deeply committed to improving stroke care and outcomes in our state. As a double board-certified neurologist in Adult and Vascular Neurology with additional training in Neuroendovascular surgery, I look forward to working collaboratively with all of you to make a meaningful difference in the lives of our patients and their families.
Message from Dr. Bajgur: “When running a code stroke, always see the bigger picture. The NIHSS is a useful tool, but it has limitations—it tends to favor Left MCA strokes over Right MCA strokes and anterior circulation strokes over posterior circulation strokes. That’s why it’s crucial to go beyond the numbers and ask: Are the symptoms truly disabling compared to the patient’s baseline?
This is where a ‘Neuro stress test’ becomes invaluable. It’s not about whether the patient scores a 0 or 2 on the NIHSS—it’s about functional disability. For instance, if a patient with NIHSS 0 cannot sit at the edge of the bed due to truncal ataxia, that’s disabling. If they can sit but can’t stand without support, that’s disabling. If they can stand but can’t walk independently, that’s disabling. Each step tests their functional integrity, revealing deficits the NIHSS might miss.
When learning, it’s okay to overcall a code stroke rather than under calling it. Early intervention can be life-changing, and it’s always better to err on the side of action than regret a missed opportunity to improve a patient’s quality of life.”
2024 Acute Stroke Ready Hospital (ASRH) Reference Guide with Appendices
- The Acute Stroke Ready Hospital Reference Guide with Appendices has been distributed.
- Designed to assist the ASRH in preparing for stroke center designation and to enhance stroke programs.
- Includes step-by-step instructions on utilizing the GWTG-Stroke registry, example policies/protocols, and performance improvement tools.
- Resources include a comprehensive stroke log template, EMS/staff feedback forms, post IV-thrombolytic complication management guidelines, example stroke orders sets, and a comprehensive stroke case review form.
Stroke Task Force Performance Improvement
- The Stroke Task Force chose three quality measures to work toward improving in 2024. These measures are critical access hospital quality measures and include door to CT interpretation less than 45 minutes, door to IV thrombolytic less than 60 minutes, and stroke consultation.
- Please review the 2024 Stroke Performance Improvement Tip Sheet for tips and tricks on improving compliance with these measures.
Stroke Task Force
- Next Stroke Task Force Meeting: March 6, 2025, 10:00 am-2:00 pm.
- The Stroke Task Force is looking for critical access hospital stroke coordinators from the Southwest region of the state and a representative from the North Dakota Emergency Medical Services Association (NDEMSA) to join the Stroke Task Force. If interested, please Contact Christine Greff at cgreff@nd.gov.
Stroke Educational Opportunities & Events
2025 North Dakota Stroke Conference
Advanced Stroke Life Support (ASLS)
Sanford Fargo is offering the new blended ASLS course with two separate focuses: pre-hospital and in-hospital. The primary audience is nurses, mid-level providers, and paramedics.
This AHA course has two components: on-line modules and in-person skills check-off.
1) The on-line modules are deployed by the Sanford Ambulance EMS Education Department.
2) The in-person skills check-offs can be done in Fargo or at your local hospital.
The AHA course fee per person is $162 for in-hospital, $142 for pre-hospital, and $182 for both. The in-hospital course is 5.25 CEUs/CMEs.
For more information on registering for ASLS and arranging skills check-off, reach out to Holly at Holly.nissen@sanfordhealth.org.
Stroke Care Bootcamp
If your facility is looking for stroke education hours, Essentia Health offers a Stroke Care Bootcamp! This includes a presentation and case review on stroke at your facility and offers 2 hours of continuing education credits. It is geared toward nursing but any staff on your acute stroke team are welcome to attend. If interested, email WestStrokeProgram@EssentiaHealth.org to learn more.
Other Stroke Education
Tailored Stroke Education:
- Sanford Fargo provides stroke education to providers, nurses and other team members in the hospital and to pre-hospital EMS staff and first responders. Lectures or stroke code simulations are tailored to meet individual hospital needs.
- Topics can range from a general overview, stroke recognition, neuro/stroke assessment, NIHSS tips, stroke syndromes, anatomy/physiology related to stroke, diagnostics/treatment for stroke, risk factors, stroke work-up, stroke prevention-medications/lifestyle changes, and/or your stroke code process. For pre-hospital groups, the lecture focus would be on recognizing stroke and beginning the stroke code process.
- Contact Holly at Holly.Nissen@sanfordhealth.org to arrange an education offering that meets your hospital’s needs.
Stroke Support Groups
2025 Meeting Dates
Bismarck
Fargo
Survivors of Stroke (SOS) Support Group
February 20, 2025: Neuroplasticity with Lynn from Vivistim.
March 20, 2025: Heart Healthy Cooking- You don’t need to be a chef to create heart healthy meals with Jess Barnick, Stroke Program Educator.
- Stroke survivors and family/caregivers invited.
- Occurs the third Thursday of every month from 3:00-4:30 pm.
- Sanford South University Hospital, 1720 South University Drive (hospital main entrance is on 11th Street). Room 1A-1 (near guest services desk).
- Survivors of Stroke Newsletter available. For more information or to receive the newsletter, email StrokeFargo@sanfordhealth.org
Visit the Stroke System of Care website here.
For questions regarding the Stroke System of Care, please contact Christine Greff at cgreff@nd.gov.
Cardiac Ready Community Program (CRC) Update
Cardiac Ready Community Guidelines
Community Blood Pressure Screening
As a part of the Cardiac Ready Community (CRC) Program, your community must provide community blood pressure screening. Your CRC program should follow a standard blood pressure guideline, have a blood pressure screening protocol, and provide education on blood pressure and hypertension.
You may utilize the American Heart Association blood pressure guidelines and education to help support your community screening efforts.
- Find the Cardiac Ready Community Guidelines here.
PulsePoint AED Application
- Your community's public access AEDs should be entered into the free PulsePoint AED application.
- It is free, easy to use, and enables you to build an AED registry for your community. Making it easier to find an AED when a cardiac emergency strikes.
- AEDs entered into PulsePoint are accessible to emergency dispatchers and disclosed to emergency responders, including nearby citizens trained in CPR and off-duty professionals.
- Once AEDs are entered they are visible to anyone using the application. This increases awareness of community AED locations.
It is quick and easy to add your AEDs to the registry. Watch the how to video below:
Cardiac Ready Community Advisory Committee
- Next Cardiac Ready Community Advisory Committee Meeting: February 6, 2025, 10:00-11:00 am
- Interested in becoming a Cardiac Ready Community Advisory Committee member? We are looking for new members that represent Cardiac Ready Communities. Contact Christine Greff at cgreff@nd.gov.
Visit the Cardiac Ready Community Program website here.
For questions regarding the Cardiac Ready Community Program, contact Christine Greff at cgreff@nd.gov
Helmsley ND Law Enforcement AED Project Update
Helmsley Project Evaluation
- There have been a total of 449 incidents of out-of-hospital cardiac arrest where an AED from this grant project was used.
- Return of spontaneous circulation (ROSC) was achieved 11.8% of the time.
- 80.8% of the cases presented with a non- shockable initial rhythm.
Hearts on Duty Program
When a LIEFPAK CR2 AED funded by the Helmsley Charitable Trust is used to save a life during a sudden cardiac arrest, the Hearts on Duty Program gives an AED to the officer involved in the save to donate to a community organization of their choice on the survivor’s behalf.
The Hearts on Duty Program recognizes officer, John Grossbauer of the Grafton Police Department for his involvement in saving a life with the AED supplied by the Helmsley ND Law Enforcement AED Project. Officer Grossbauer donated his Hearts on Duty AED to the Grafton Armory, which will be used as a community center.
The Hearts on Duty Program recognizes officer, Cory Beckman of the Jamestown Police Department for his involvement in saving a life with the AED supplied by the Helmsley ND Law Enforcement AED Project. Officer Beckman donated his Hearts on Duty AED to the James Valley Youth for Christ organization.
For questions regarding the Helmsley ND Law Enforcement AED project, contact Christine Greff at cgreff@nd.gov
Emergency Medical Systems
Phone: (701) 328-2388
Website: www.hhs.nd.gov/health/EMS
Email: dems@nd.gov
Credits:
Created with images by Zak Zeinert - "Looking out over the badlands of North Dakota" • Tyler Olson - "EMS with Oxygen" • hedgehog94 - "Scared mother standing with doctors and her injured daughter." • Chalabala - "Emergency medical service" • Chalabala - "Emergency medical service" • amazing studio - "Doctor holding red heart in his hand in nursing hospital ward : healthy strong medical concept ." • airdone - "Committee" • Deemerwha studio - "business man working on laptop computer and application Form Information for the searching job or fill out personal data for online web job the application form. Employment Concept." • Svitlana - "Doctors, man and a woman, are looking through MRI images" • auremar - "first-aid cardiopulmonary resuscitation course using automated external defibrillator device aed" • pongsakorn - "Fire alarm system on a brick an emergency during fire.Automated External Defibrillator AED emergency life saving equipment mounted on wall of rowing club." • kenchiro168 - "Professional doctor reporting measuring blood pressure results to young male patient at clinic. Diagnostic and prevention of men diseases concept" • Andrey Popov - "Various Contact Us Methods. White Phone, Email"