Emergency Medical Systems Update Systems of Care Newsletter-Issue 2

Upcoming Events

  • October 3-5, 2023: State Trauma Conference
  • October 4, 2023, 10:00 am-2:00 pm: Cardiac Task Force Meeting
  • October 25-26, 2023: North Dakota Cardiac and Stroke Conference
  • November 2, 2023, 10:00-11:00 am: Cardiac Ready Community Advisory Committee Meeting
  • December 7, 2023, 10:00-2:00 pm: Stroke Task Force Meeting
  • December 20, 2023, 12:00-1:00 pm: State Trauma Committee

Emergency Medical Services (EMS) Update

The Emergency Medical Systems Unit (EMSU) at the 2023 NDEMSA Annual North Dakota EMS Conference
  • Ambulance Districts were mandated in the most recent legislative session. This will compel ambulance services to create ambulance districts which will provide locally elected oversight and the ability to levy taxes. There will be 100 ambulance districts including those that are already districts. The few exceptions are city, county, federal owned services or a city serving greater than 6,500.
  • The legislature also added $7 million in EMS Rural Assistance Grants. These grants are for operations including staffing and equipment. The total available funding is now $13.875 million. Please contact the EMS Grants Coordinator, Deb Dutchuk, at debdutchuk@nd.gov if you have questions about your service's grant award.
  • The Emergency Medical Services Advisory Council (EMSAC) is looking for new members including an individual representing Quick Response Units, an individual representing an Air Medical Service that performs scene runs, and a representative from the North Dakota 911 Association. Please submit a letter of interest identifying your qualifications to Kerry Krikava at klkrikava@nd.gov.

Big Picture Update

  • Emergency Medical Systems Unit is in the process of changing to a new system for the EMS Personnel/Agency Registry (Big Picture). Unfortunately, this has been a much longer process than was initially anticipated. Once this new system is up and running, finding the information you need will be easy. It will also allow you to update your agency roster, change your personal information, renew your agency/personnel license online, and print your certificates.
  • We apologize for any inconvenience you have experienced throughout this process and appreciate your continued patience. Please refer to the website for updated notes on the system change. Once the Big Picture update is complete, an email notice will be sent to all agencies and EMS personnel with access instructions.

Visit the EMS website here.

If you have any questions regarding the EMS System, please contact Kerry Krikava at klkrikava@nd.gov.

Emergency Medical Services for Children (EMSC) Update

This project is supported by the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), Emergency Medical Services for Children (EMSC) State Partnership grant program, Grant No. H33MC06698-18-00 for $190,650. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
Meet Andi the Ambulance. Andi wants you to be on the lookout for the Pediatric Prepared Voluntary Ambulance Recognition Program.

Pediatric Emergency Care Coordinator (PECC)

  • What is a PECC? A Pediatric Emergency Care Coordinator is an EMS provider designated within your organization who ensures that its providers are prepared to care for ill and injured children. Having 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.
  • What is the purpose of a PECC? The intent of designating and developing the role of a PECC is to ensure that there is a dedicated individual(s) identified at the local EMS agency that represents pediatric interest and performs the responsibilities listed below. These responsibilities can be fulfilled by more than one person, such as the medical director, EMS chief, training officer, or other prehospital professional. Additionally, there could be a region wide individual(s) that performs the responsibilities as a PECC for EMS agencies within a region.
  • Responsibilities: Ensuring compliance with pediatric clinical practice guidelines and/or protocols, promoting pediatric continuing education opportunities, overseeing pediatric process improvement initiatives, ensuring the availability of pediatric medications, equipment, and supplies, promoting participation in pediatric prevention programs, coordinating with other agencies and emergency departments in your area to promote pediatric care, promoting family-centered care, promoting agency and hospital participation in pediatric research efforts such as filling out the yearly EMSC survey sent out by the EMSC Data Center (formerly known as NEDARC), conducting case review and feedback on pediatric calls/patients, identifying best practice, evidence-based medicine specific to pediatrics.
  • Benefits of having a PECC as part of your agency: Having a registered PECC ensures that your service is providing the best pediatric care to your patients. A PECC assists your agency in maintaining best practices in pediatric care and helps to make sure your service knows how to use pediatric equipment. All these things together mean that children in North Dakota are getting the best emergency care they can. As an added benefit to bettering outcomes of pediatric patients, agencies with a registered PECC are first in line for educational opportunities, training, and free equipment.
  • Apply: Complete the application to register as a Pediatric Emergency Care Coordinator (PECC) here.

Emergency Medical Services for Children Communication Cards

  • EMSC would like to help you better communicate with your patients who have communication difficulties, reach out to the EMSC Program Coordinator to get Communication Cards for your service! Now in Spanish/English.

Autism Awareness

  • Did you know Autism Spectrum Disorder (ASD) now affects 1 in 36 children in the United States? Do you want tips and tools to help you better help individuals with ASD? Contact the EMSC Program Coordinator and get the information on a free training and materials to do just that!

Educational Opportunities

  • Virtual symposiums will be held in September, November, and December. 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.

Visit the EMSC Program website here.

For questions regarding the EMSC Program, please contact Chettie Greer at cgreer@nd.gov.

Trauma System of Care Update

23rd Annual North Dakota Statewide Trauma Conference

Save the Date October 3-5, 2023: 24th Annual Trauma Conference. Pre-registration required.
  • SW Trauma Meeting: October 11, 2023, 12:00-1:00 pm
  • NW Trauma Meeting: October 12, 2023, 12:00-1:00 pm
  • SE/NE Trauma Meeting: October 17, 2023, 12:00-1:00 pm
  • Reminder: All ATLS/TNCC Grants must be submitted in the PRS

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

Meet the Cardiac Coordinator: Lori Graber is an RN, a graduate of Trinity School of Nursing in Minot, ND, and Medcenter One College of Nursing in Bismarck, ND. She has been an RN for 41 years. Cardiac nursing has always been a favorite of hers. She started her nursing career in a rural hospital in Rugby, then moved to a Level 2 Trauma Center (Medcenter one in Bismarck, now Sanford Health) and worked in ICU followed by ten years of ED/Trauma Center and Flight Nursing. She currently works at SMP-St. Kateri in Rolla, ND (formerly Presentation Medical Center) and has worked there for 28 years. Lori has worked in the ED, OR, Cardiac Rehab, and outreach clinic. She took the role of Stroke Coordinator one and a half years ago and the role of STEMI Coordinator one year ago. She is also an ACLS, BLS, and PALS instructor. She is married to a farmer and lives near Wolford, ND. She has two married children. Her daughter is an RN, her son is an Emergency Medicine MD, and her daughter-in-law is an RN. She likes to spend her free time with her family.

When asked why her facility is working toward the Acute Cardiac Ready Hospital Designation, Lori replied, "I want everyone in our community to receive the best and most up-to-date treatment for heart disease possible even though we live in a rural area that is two hours from the nearest PCI capable center."

2023 North Dakota Cardiac and Stroke Conference

Register here.

Acute Cardiac Ready Hospital (ACRH) Designation

Learn more about ACRH designation here
  • ACRH Designation Criteria here.
  • ACRH Webinar here.

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? 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/accredited/verified by the state or one of the ND approved Cardiac Certification Programs for STEMI Receiving Center Designation. 2. The facility must participate in the statewide cardiac registry.

Cardiac Task Force

  • Next Cardiac Task Force Meeting: October 4, 2023, 10:00 am-2:00 pm
  • What's the purpose of the Acute Cardiovascular Emergency Medical System of Care Advisory Committee aka the Cardiac Task Force? According to N.D.C.C 23-47-03(2), "the purpose of the acute cardiovascular emergency medical system of care advisory committee is to advise the department on the establishment of an effective system of acute cardiovascular emergency care throughout the state and to take steps to ensure and facilitate the implementation of the system of acute cardiovascular emergency care."
  • The Cardiac Task Force is looking for critical access hospital cardiac coordinators and a representative from the North Dakota Emergency Medical Services Association (NDEMSA) to join the Cardiac Task Force. If interested, please Contact Christine Greff at cgreff@nd.gov.

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

Meet the Stroke Coordinator: Haley Gilstad has been with Sanford Health in Bismarck for seven years. Haley started her nursing career in emergency medicine before transitioning into the Stroke Coordinator position. Haley has held this position for 2.5 years. She is passionate about continual learning and has achieved three additional board certifications as an Advanced Stroke Coordinator, Stroke Certified Nurse, and a Certified Emergency Nurse. Haley values the time she gets to spend sharing her stroke knowledge with patients as well as time spend in the classroom sharing education with healthcare providers. During her time off, she enjoys spending time outdoors, gardening, and traveling.

2023 North Dakota Cardiac and Stroke Conference

Register here.
  • Updated ND Acute Stroke Treatment Guidelines here.
  • Tenecteplase Transition Checklist here.
  • Stroke Educational Videos: BEFAST, FAST-ED, and NIHSS.
  • Stroke Screening Tools: BEFAST/FAST-ED Algorithm here.
  • Dysphagia screen webinar here. Password: Stroke2022

Dysphagia Screen Infographic

The Stroke Task Force recommends the use of the Yale Swallow Screen as an evidence based dysphagia screen. Find printable version here.

Stroke Task Force

  • Next Stroke Task Force Meeting: December 7, 2023, 10:00 am-2:00 pm
  • The Stroke Task Force is looking for critical access hospital stroke coordinators 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

  • The American Association of Neuroscience Nurses (AANN) released a white paper entitled, "Neurological Assessment of the Hospitalized Child." Access the white paper here.

Stroke Support Groups




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

As a part of the Cardiac Ready Community Program, public access AEDs should be deployed in target areas throughout the community.
  • Find the revised Cardiac Ready Community Guidelines here.

PulsePoint AED Application

  • In the revised Cardiac Ready Community Guidelines, one of the designation criteria under the Public Access to AEDs section is to enter AEDs in your community into the free PulsePoint AED application.
  • The PulsePoint AED application 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 that are managed using the PulsePoint AED application are accessible to emergency dispatchers and disclosed to emergency responders, including nearby citizens trained in CPR and off-duty professionals.

Cardiac Ready Community Advisory Committee

  • Next Cardiac Ready Community Advisory Committee Meeting: November 2, 2023, 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

In 2023, four officers involved in saves with the Helmsley grant Stryker CR2 AEDs are eligible to receive an AED to give back to their community.
  • Over 1,600 AEDs have been given to law enforcement first responders across the state

For questions regarding the Helmsley ND Law Enforcement AED project, contact Christine Greff at cgreff@nd.gov

News from our Unit

  • Visit our HHS Emergency Medical Systems Unit website here
For more information, please contact:

Emergency Medical Systems

Phone: (701) 328-2388

Website: www.hhs.nd.gov/health/EMS

Email: dems@nd.gov