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University of California San Francisco

University of California San Francisco. SFFD EMS SYSTEM . 40 dynamically deployed ambulances Shifts starting time from 0500 until 2130 from 1 central station Only SFFD ambulances are participating in RAMPART 8 receiving hospitals participating in study

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University of California San Francisco

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  1. University of California San Francisco

  2. SFFD EMS SYSTEM 40 dynamically deployed ambulances Shifts starting time from 0500 until 2130 from 1 central station Only SFFD ambulances are participating in RAMPART 8 receiving hospitals participating in study RAMPART implemented 6/19/09 on 10 rigs initially First enrollment 6/27/09 45 enrollments 7 enrollments in 1 week in November Prior PHTSE experience

  3. Study Challenges • Continued Paramedic training • Informed Consent • RAMPART boxes/Megabundle management

  4. Keeping the medics involved/informed and happy!!And locating them!

  5. RAMPART bulletin board w/FAQs, opt out bracelets, auto injector instructions, recent enrollment info, enrollment #s, coordinator contact info, etc. • Flyers with unit #/medics names for each enrollment • RAMPART FAQs • Contact every crew that enrolls a subject • Flyers with protocol clarifications posted or placed in medic’s mailbox. • Practice with expired auto injectors. • In person review to start in January • Mandatory on line CE for medics with RAMPART included in sz/neuro/AMS module.

  6. Protocol Clarifications • If patient stops seizing after IM and before IV study drug, they don’t receive IV study drug. • No focal seizures. • Getting medics to wait 5 min prior to enrollment. • Patient must be actively convulsing.

  7. Informed Consent Challenges

  8. Homeless without any contact info, or marginally housed. • With psych/substance abuse issues other seizure threshold lowering lifestyles. • Subjects discharged from ED prior to investigator arrival or leave AMA prior to investigator arrival. • Addresses not valid with notification letters returned • In SF approximately 30% of subjects • Language issues • Cultural differences/Educational Issues

  9. Notification letters left in patient chart and/or mailed out to patient. • Call ED prior to investigator arrival • Attempt to locate case manager, LAR, psychiatrist, emergency contact or PMD. • Make extra hospital visits • ED info form given by medics to ED staff

  10. Thank you! Jeany Duncan RAMPART EMS Coordinator UCSF duncanj@sfgh.ucsf.edu 415-206-4106

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