The Hawaii Emergency Medicine Foundation was founded in 2004. It is an IRS verified 501(c)(3) foundation.
The mission of the Hawaii Emergency Medicine Foundation is to improve Emergency Medical Care in Hawaii through education, innovation and adoption of new technology.
The educational efforts started with online educational materials, which provide education to healthcare professionals where-ever they have access to the internet. These materials are geared towards First Responders, Emergency Medical Technicians and Nurses, but all healthcare providers may find them interesting and educational.
The foundation has also been instrumental in bringing innovations in healthcare and pushing the adoption of new technology to improve healthcare delivery and disease outcomes throughout the State of Hawaii. These technological innovations often started out as Pilot projects on Oahu at the Honolulu Emergency Medical Services Department. Thereafter data on the effectiveness of these innovations was shared with the Hawaii State Department of Health, which administers Pre-hospital Emergency Medical Services in the State of Hawaii. This collaboration led to these technological innovations being adopted Statewide by Pre-hospital Emergency Care providers on all islands. In addition to partnering with agencies at the City and State level the foundation has partnered with most of the Hospitals on Oahu, the State Department of Health and the State Department of Transportation, to improve healthcare care using education, improve databases, improve data collection and adopt new technologies. The practice of networking, partnering and working together for common goals has provided many advances in healthcare that the foundation could not accomplish alone.
The technological innovations include nasal drug administration using inexpensive devices which allow some emergency medications to be given by nose in the form of a spray. This revolutionized the care of patients with seizures and pain medication overdoses initially on Oahu and subsequently all over the state of Hawaii.
Another technological innovation is the use of a portable device which delivers continuous positive airway pressure to patients suffering life threatening respiratory illnesses, who can no longer breath well for themselves. These devices are called CPAP for short, and they have rescued many patients who were no longer able to breath, in a safe and noninvasive manner. This helped the patients avoid many potential complications of more invasive methods of providing respiratory or breathing support. These devices have helped to save the lives of many patients suffering from severe breathing difficulties like asthma, congestive heart failure, COPD and also victims of near-drowning.
Some of the projects completed by the Foundation are listed on the right side of this page.
The founder is Joseph D. Lewis, M.D.,
Dr. Lewis is an Emergency Room physician, who has been practicing Emergency Medicine in Hawaii for over 25 years. He practiced at St. Francis Medical Center West for 15 years, where he was the Emergency Room Medical Director, President of the Medical Staff and a member of the Board of Directors for the St. Francis Healthcare System.
Dr. Lewis is Board Certified in Emergency Medicine by the American Board of Emergency Medicine. He is also the former President of the Hawaii Chapter of the American College of Emergency Physicians.
Currently Dr. Lewis is the Medical Director of Emergency Medical Services for the City & County of Honolulu.
Additionally Dr. Lewis has over 25 years of experience in the education of EMT's, medical students, Nurses and Physicians in training. Dr. Lewis has been clinical faculty at the University of Hawaii John Burns Medical School providing clinical training to medical students and physicians in training at St. Francis Medical Center and Queens Medical Center. He also was an instructor at Kapiolani Community College for many years teaching advanced cardiac resuscitation, prehospital trauma patient care, hazardous materials management.
Dr. Lewis was also the former Medical Director for the National Registry of Emergency Medical Technicians Examination and Testing for certification in Hawaii, conducted at Kapiolani Community College.
The Hawaii Emergency Medicine Foundation is a IRS verified 501(c)(3) foundation and contributions are deductible under section 170 of the IRS code.
Hawaii Emergency Medicine Foundation Projects to improve Emergency Medical Care in Hawaii
Emergency Medical Services Online medical education This gives Paramedics, Emergency Medical Technicians and other emergency care providers access to education 24 hours a day, 7 days a week, from anywhere they can access the web. The education is based on nationally and/or internationally accepted medical standards.
Honolulu International Airport Public Access to Defibrillation_Program. A partner project between Hawaii Emergency Medicine Foundation and the State Airports DIvision. This program provides CPR and AED education to the hundreds of staff working at the airport. It also provided AEDs thorughout the airport, so those CPR trained staff and other CPR trained visitors can deliver lifesaving shocks to vistims of cardiac arrest. This idea was important because according to the American heart Association two of the most important determinants of survival from cardiac arrest include early CPR and early defibrillation. This program addresses both. This project was the vision of of State Airport Fire Chief Martinez. Dr. Joseph Lewis worked closely with him and the AED Program Coordinator Ms. Pamela Foster, RN to help create the current program. Subsequent data collected in the years since implementation shows a dramatic increase in cardiac arrest survival at the airport. The current survival rate of over 90% is an 80% improvement over the previous survival rates. This program started on Oahu but has been implemented at all State Operated Airports in Hawaii.
CARES Cardiac Arrest Enhancement Database:
A partner project between Hawaii Emergency Medicine Foundation, the State Department of Health Emergency Services Division, the Honolulu Emergency Medical Services Department and multiple hospitals in the State of Hawaii. This is a nationwide database which looks at cardiac arrest care in our nation. The goal is to produce a reliable database to use for improving cardiac arrest care. Additionally it creates a standardized way to measure and compare treatment options and new therapies. This project is over four years old and is producing good outcome data, which is invaluable to assess current treatment and plan strategies for improvement. This project is currently supported financially by the Center for Disease Control in Atlanta, Georgia. But one day we will need to raise local financial support to maintain this database.
City and County of Honolulu Emergency Medical Services Projects:
Honolulu Emergency Medical Services EKG Transmission Program.
In this project Hawaii Emergency Medicine Foundation partnered with the Queen Emma Foundation, the Queens Medical Center and Honolulu Emergency Medical Services: The Transmission of EKG's of heart attack patients from their home or from the ambulance to the hospital, speeds up care for patients having heart attacks in Hawaii. This strategy shaves 20-45 minutes off the amount of time it takes for the hospital to get to take care of a patient. This is critical for a patient who is having one of the most severe types heart attacks, called a ST segment elevation MI or STEMI. This strategy has been proven nationwide to save lives and reduce complications. Specifically, it has been shown to reduce both death rates, and reduce complications like heart failure and stroke. Plus it decreases the cost of care by shortening the time of hospitalization, reduces the need for admissions to the intensive care unit and by eliminating costly medical complications. This project was supported by a grant from the Queen Emma Foundation at Queen's Medical Center.
City and County of Honolulu Public Access to defibrillation Program. This program is a partner project with officials in City, County and State government buildings to establish CPR programs and placement of automatic electrical defibrillators in approximately 400 public places. This idea was important because two of the most important determinants of survival from cardiac arrest include early CPR and early defibrillation. This program addresses both. This program provides lifesaving therapy in many city office buildings, where large numbers of people go daily, greatly improving outcomes from sudden cardiac death.
City and County of Honolulu CPAP Continuous Positive Airway Pressure devices on emergency ambulances project. Otherwise known as CPAP Project. The Hawaii Emergency Medicine Foundation partnered with the State Department of Health Emergency Services Division and the City and County of Honolulu Emergency Medical Services Department to research devices, write treatment protocols, physicians medical orders and then monitor the results of a pilot project on Oahu with the Honolulu Emergency Services Department. The results of the pilot project helped lead to the adoption of these devices by county ambulance services statewide. These devices provide noninvasive ventilation and oxygenation of patients in respiratory distress from conditions like asthma, congestive heart failure, pulmonary edema, drownings and COPD exacerbations. The use of these devices can prevent patients from needing invasive forms of airway management like endotracheal intubation and mechanical ventilation. These mobile machine are use in the ambulance and save lives and prevent medical complications from more invasive methods of treatment.
Other Innovative Devices Used by Honolulu EMS to save lives, improve survival or prevent medical complications and disability which are a result of joint projects with Hawaii Emergency Medicine Foundation include:
Resqpod Device use in Cardiac arrest to augment cardiac return, improve cardiac output, improve heart and brain perfusion during the cardiac arrest and improve both survival and neurologic outcomes.
Intranasal Medication Atomaization Device.
This device allows Honolulu Emergency Services to use the patients nose as an entry point for life saving medications like Narcan, which reverse narcotic overdoses. This device was researched by Hawaii EMF, then the treatment protocols and physicians orders were written by Hawaii EMF. The device was used on Oahu by Honolulu Emergency Medical Services and after it's successful use here, it was adopted Statewide for use by ambulances all over the State of Hawaii.
EZ IO bone drill to start vascular access in a long bone when veins are available. Specialized electric drills for intraosseous venous access in patients with life threatening conditions.This device was researched by Hawaii EMF, then the treatment protocols and physicians orders were written by Hawaii EMF. The use of this device was adopted Statewide for use by ambulances all over the State of Hawaii.
Trauma Center Development-
While no one person can be accredited with such a feat, the founder has spent 3 years working along side others to assisting in the development of regional trauma centers. Scientific literature searches, Hawaii State Department of Health Data collection, Hawaii Legislature law research, Powerpoint creation and sharing, meeting attendence and sometimes just lending a supportive voice to help make these goals a relity in Hawaii. The founder is especially proud of the development of facilities like Tripler Army Medical Center and Kapioani Womaen and CHildrens Medical Center develop into Level 3 Trauma Centers. These key facilities decompress our main trauma center Queens Medical Center and improve the care delivered at all three facilities.
Acute Heart Attack Care Protocols on Oahu.
The founder joined with visionaries at Queens Medical Center to begin EKG transmission from patients homes on Oahu and in the Honolulu EMS ambulances to give the hospitals early notification of patients arriving with a heart attack. The cooperation of State officials assited this innovation. This innovation saves precious time when a patient is having a heart attack.This precious time is often the difference between: a. life and death, plus b. full recovery versus a life changing disability. It took a few years but the result is protocols which deliver heart attack victims to hospitals with specialized equipment and physician specialists to care for them in the golden 90 minutes. Heart disease is still the number one cause of death in our country and is a focus of our efforts.
Stroke screening education and protocols
Hawaii Emergency Mediciane Foundation developed and adopted education materials to create an online education process for the Emergency Medicial Technicians of the City and County of Honolulu. This project goal was education of Emergency Medical Technicians in early recognition of signs of stroke and the early notification of hospitals. This leads to earlier execution of patient evaluation at the hospital, so that specialized xrays, specialized physicians and special drugs to treat stroke can be given as soon as possible, to save as much brain as possible. Stroke is the number one cause of disability in our country and is a focus of our efforts. The second step working with the Oahu hospitals on a stroke alert system, where EMS does a stroke screening exam and radios the hospital where they plan to take the patient to notify them of a stroke patient enroute to there facility. This starts a hospital protocol which brings in specialized technicians and everyone starts working off a treatment protocol designed to give the stroke victim the best care and hopefully better post stroke neurologic recovery.
Hawaii Pulse Point
This project is a joint project between Hawaii Emergency Medicine Foundation, the Honolulu Emergency Services Department and Emergency Medical Services on Kauai, Maui, Molokai, Lanai and the Big Island of Hawaii.
The project goal is to improve the delivery of healthcare to a person when they suffer sudden death caused by heart disease, also known as a “cardiac arrest”.
The project would accomplish this in two ways;
First, the proposal would improve the chance a person gets lifesaving CPR faster, which the American Heart Association says is vital to survival. Second, the proposal would improve the chance that the person’s chance of getting a lifesaving electrical shock from an automatic electrical defibrillator, which the American Heart association also says it vital for survival.
The American Heart Association’s, a national and internationally recognized expert on cardiac resuscitation, has determined that improving survival from cardiac arrest, otherwise known as sudden death associated with heart disease, requires that a community address five things. Those five things are early recognition, early CPR, early defibrillation (the life saving electrical shock described above.), early advanced cardiac life support and good critical care in the hospital.
The American Heart Association calls these five actions the chain of survival. This project’s goals is to improve survival from cardiac arrest, otherwise known as sudden death related to heart disease by increasing the rate of early bystander CPR and increasing the rate of early electrical defibrillation. Further information on this project can be obtained at www.hawaiipulsepoint.org
Falls in the Elderly
This is the number one reason for 911 calls to the homes of the elderly. Honolulu EMS is assisting the State Department of Health in it's data collection. This data aides the state department of health in creating awareness of the problem and assists others in designing Fall prevention programs. Hawaii EMF is currently seeking ways to participate in fall prevention programs in other ways. Falls in the elderly are of great importance because the injuries can be severe enough to cause death or disability. A simple fall may cause a previously independent elderly person to need to live in a nursing home or assisted living facility due to their injuries. Or the injuries may require a long period of physicial therapy in residential rehabilitation facilities for before they can return home. Sadly many elder die or never return to their homes after a fall on a loose rug or carpet, which is preventable. Currently under development is an application for smartphones and tablet devices called Slip and Fall Prevention. This wold bring fall prevention education to the phone or tablet of the elderly and those who care for them.
1. Cardiac screening to prevent sudden death in school age athletes.
2. Take Heart America- an evidence based approach to sudden cardiac death, which implements seven strategies shown to be successful by the American Heart Association in improving outcomes for patients of sudden cardiac death. This includes both community based strategies to increase bystander CPR, early defibrillation like the previously accomplished public access to defibrillation programs, and hospital based strategies to improve outcomes like therapeutic hypothermia.
3. CPR training in our schools, as part of the health education curriculum.
4. First Aide training in our schools, as part of the health education curriculum.