HomeMy WebLinkAboutworksheetCITY OF MIAMI, FLORIDA
INTER -OFFICE MEMORANDUM
TO: The Honorable Mayor
Memb of the City
FROM :
Joe Arroa
Chief A inistrator/City Manager
NOV '1 5 -' 04
i2.11 g
DATE : FILE : FM-07/.doc
SUBJECT : Worksheet for Agenda Item
REFERENCES:
ENCLOSURES:
Department Requesting Agenda Item: Fire -Rescue
1. Subject: Establish a Special Revenue Fund Entitled: "CPAP/State of Florida EMS Matching
Grant M4066 Award (FY 2004)."
2. Purpose of item:
Adopt a Resolution establishing a special revenue fund entitled: "CPAP/State of Florida EMS
Matching Grant M4066 Award (FY 2004)," to support the pre -hospital activities and other
emergency medical services items. and appropriating funds for the operation of same, in the
amount of $44,600, consisting of a grant, in the amount of $33,450, from the State of Florida
Department of Health, Bureau of Emergency Medical Services ("EMS"), with matching funds,
in the amount of $11,150. allocated from the Department of Fire -Rescue's Operating Budget,
Account Code No. 001000.280601.6.714. The funds will be used as stipulated by the grant. for
the acquisition of continuous positive airway pressure devices (CPAPs) and accessories.
3. History of item:
One of the top priorities of the City of Miami Department of Fire -Rescue is to "save lives." In
2002, the Department of Fire -Rescue received 63,041 emergency medical services ("EMS")
calls. Of those calls 1,611 were calls to assist patients having, difficulty breathing due to
suffering from asthma, near -downing, edema, bronchitis, emphysema and/or pneumonia.
Treating patients with these conditions is very challenging to EMS responders because of the
life -threatening potential for many pre -hospital patients. Field treatments have been limited to
initially supplying oxygen and administering vasodilators, diuretics. and morphine, but these
are ineffective in a significant number of victims. Forced to resort to the aggressive therapy of
endothracheal intubation and positive pressure bag -value -mask ventilation (BVM), EMS
personnel must conduct a major team effort to intubate the patient which is inherently
physically difficult, has a high degree of risk, is invasive, expensive, and distressing to the
patient. Risks associated with the intubation process itself are hypoxia, failed or esophageal
intubation, sedation, barotraumas, and nosocomial infection,
In randomized controlled trials, CPAPs have been shown to deliver efficient treatment that
avoids almost all need for performing endotracheal incubation with invasive ventilation.
Records of CPAP use by EMS personnel in Delaware showed that of 800 CPAP uses in the
field, only 10-15 (2%) patients required intubation. In addition, CPAP use reduced the need
The Honorable Mayor and
Members of the City Commission
Page 2 of 2
for medication, stabilized acute pulmonary edema. improved oxygenation and hypercapnio,
decreased respiratory laboring, and cut emergency department and hospital stay times. In May
2002, Hatlestad states that paramedics reported significant improvement in patient condition
from use of CPAP, going from initially being in so much distress they could barely speak, to
arriving at the hospital feeling like they were ready to go home.
The City of Miami has been awarded a grant, in the amount of $33,450, from the State of
Florida, Department of Health, in accordance with Section 401.113 (21 (b), Florida Statutes. to
provide grants to Emergency Medical Services ("EMS") organizations for the improvement,
expansion and continuation of pre -hospital activities and other eme gency item as specified in
the Grant Applications. Specifically, the City of Miami will use these funds along with the
matching funds allocated by the City of Miami for $11,150 as stipulated by the grant, for the
purchase of CPAP units and accessories.
It is now appropriate to accept said grant award, establish a special revenue fund, and
appropriate the said grant award therein for this fiscal year.
4. Does this item correlate with the CIP plan or Strategic Plan? If so, how?
Yes. It contributes with public safety.
5. Does this item have any effect on residents within the City of Miami? If so, how?
Yes. Accepting this grant will allow the City to use these funds as stipulated by said grant to
purchase CPAP units and accessories to equip all the Department of Fire -Rescue's ALS
vehicles. CPAPs quickly improve oxygenation and ventilation in acute edema or COPD
patients.
b. Will this item impact any specific District? If so, which one?
No.
7. Does this item have any fiscal impact? (Please provide dollar amount)
No. The Department of Fire -Rescue anticipates less medications and intubation accessories
will have to be used .
Approved by: Director /Chief/Manage
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FM.077,doc