Winter Storm CO Warning

Occasionally we will share severe weather information consequential to public health, public safety and EMS response. Below is a CT DPH Press Release addressing the dangers of Carbon Monoxide Poisoning.






HARTFORD – With growing confidence that Connecticut will be impacted by a major winter storm on Tuesday, the Connecticut Department of Public Health (DPH) warns residents of the dangers of carbon monoxide (CO) and urges them to take steps to prevent deadly CO poisoning. In anticipation of power outages, DPH is very concerned about improper use of portable generators and other sources of heat, which could lead to CO poisoning. When power goes out many people run portable generators inside or close to the home, or use charcoal grills inside the home. Generators should be placed at least 20 feet from the house and never inside the house, on a porch, basement, garage or shed. Charcoal grills should never be used indoors.
CO is an invisible, odorless gas that can be fatal. Breathing in excessive amounts of CO can cause loss of consciousness and death. The symptoms of CO poisoning can mimic those of the flu, including headache, fatigue, dizziness, weakness, nausea, vomiting, chest pain, confusion, or loss of consciousness. People who are sleeping or unconscious can die from CO poisoning before they exhibit any symptoms. DPH warns that anyone exhibiting these symptoms should leave the house immediately and call 911 and the Connecticut Poison Control Center at 1-800-222-1222 from another location.
Improper use of portable generators have caused more than half of CO poisonings in Connecticut, according to DPH. DPH offers the following safety tips to prevent CO poisoning:

• Never use portable generators or other gasoline-powered equipment (including tools) indoors or in the garage, basement, shed or other enclosed spaces. Even if the garage or shed doors are open, CO gas can still build up to dangerous levels within minutes.
• Place portable generators at least 20-25 feet from your home. There have been instances where exhaust containing CO gas has been blown back into the house and poisoned occupants when outdoor portable generators were close to the house.
• Opening windows and doors, and operating fans is NOT sufficient to prevent buildup of CO in a home.
• Use charcoal and gas grills or camping stoves outdoors only.
• Make sure exhaust vents for your furnace and gas appliances (dyers, stoves) are free of snow. Exhaust vents blocked by snow can cause combustion gases to back up into the home.
• After a snow storm, make sure your car’s exhaust pipe is clear. A clogged exhaust pipe could lead to carbon monoxide buildup in your vehicle. Fatalities have resulted from people trying warm themselves in their car without clearing snow away from exhaust pipe due build-up of CO gas in car.
DPH developed a video, Carbon Monoxide: The Silent Killer, to help raise awareness of the dangers of CO and how to prevent poisoning. It is available online in English and Spanish by clicking on the following link: .


Winter Storm Stella

Occasionally we will share severe weather information consequential to public health, public safety and EMS response. Below is a warning issued by CT DESPP-EMHS.







Tuesday Morning: Snow beginning between 4:00 – 6:00 AM and becoming
heavy by 9:00 AM. Blizzard conditions are expected after 9:00 AM with
extremely heavy snow (3” – 4” per hour), Northeast winds gusting to 60
MPH at times with near zero visibilities. A crippling impact on all travel is
expected. Minor coastal flooding is also possible at noontime.
Tuesday Afternoon: Blizzard conditions continue thru the afternoon with 3”
– 4” per hour snowfall rates and winds gusting to 60 MPH at times.
Conditions are expected to start to improve by 4:00 PM as the snow tapers
down to moderate levels and then to light levels by 7:00 PM.
Tuesday Evening: The light snow may continue for a few hours and end
completely by 11:00 PM. However the strong winds may continue into
Tuesday night gusting to 30 MPH at times causing a lot of blowing and
drifting of snow.
Total snowfall: of 18 – 28 inches is currently expected across Western and
Central CT with lesser amounts near the southeast coast of 10” – 15”. The
Department of Emergency Services and Public Protection Division of
Emergency Services and Public Protection will continue to closely monitor
this dangerous storm. Another update will be sent out this afternoon at 2:00
PM once the new model runs are in.

Winter Storm “Chris” Update

Occasionally we will share severe weather information consequential to public health, public safety and EMS response. Below is a warning issued by CT DESPP-EMHS.


As colder air moves into our area tonight a low pressure system is forecast to form along the cold front in Virginia. This low is forecast to move quickly to the Northeast as the storm intensifies Thursday morning off the Del-Mar-Va Peninsula. The storm is forecast to generate a large area of moderate to heavy snow which will impact southern and central New England on Thursday. The following forecast is based on a blend of the GFS and NAM models and currently has a good confidence level:

Tonight: Becoming cloudy with temperatures dropping into the mid 30’s. Snow is expected to move into the state between 5:00 – 7:00 AM Thursday morning. The snow is expected to become moderate within 2 hours of starting. Temperatures continuing to fall into the low 30’s by daybreak.

Thursday Morning Rush Hour: Moderate snow becoming heavy at times with 2+ inches of snow on roads and snowfall rates of 1″ – 2″ inches per hour by 9:00 AM. The impact on the morning rush hour is expected to start as moderate and become major by the end of the rush hour. Very slick driving conditions are expected with low visibilities down to (1/4) mile at times. The snow is expected to continue heavy at times thru the morning with temperatures continuing to fall into the upper 20’s by noon.

Thursday Afternoon: Snow tapering off during the early afternoon and ending by 4:00 PM. Some blowing and drifting of the snow is expected with north winds increasing to 20 – 30 MPH. The impact on the afternoon rush hour is expected to be moderate with some snow cover remaining on most roads and temperatures in the upper 20’s.

Total accumulations are currently forecast to range from 8″ – 14″ statewide with isolated higher amounts. The snow is expected to be dryer in northern and central CT and somewhat wetter in southern CT. No icing or significant coastal flooding is expected with this storm. The overall impact of this event is expected to be moderate to major.

Updated 2-7-17 at 430PM

Aetna Appears in Local News!


Yesterday evening long time Paramedic and Operations Supervisor Matt Martinelli represented Aetna Ambulance Service Inc. on Fox 61 news. In the interview, Martinelli provides insight on the CT “Move Over” law, and offers a few simple, yet important suggestions to the public. “It seems everyone is in a hurry to get somewhere,” he said. “We just would like to be able to get to the scene in a safe manner so we can provide proper care for a patient.

The article, posted by reporter Jim Altman, and interview can be found in its entirety by clicking the link below!


Emergency responders say drivers aren’t paying enough attention to the “Move Over” Law



Severe Weather Potential for Friday into Friday Night

Occasionally we will share severe weather information consequential to public health, public safety and EMS response.

What we know:

  • Scattered strong to severe thunderstorms may develop after 4 pm Friday afternoon and last to at least 11 pm.
  • Western and Northern Massachusetts as well as Northern CT have the best potential to see strong to severe thunderstorms.
  • Cannot rule out strong storms across RI and Eastern MA during the overnight hours on Friday into early Saturday morning.
  • Main threats within these storms will be damaging winds, hail, and heavy downpours which could lead to localized minor street flooding.
  • An a isolated tornado cannot be ruled out.

What we don’t know:

  • Will Friday morning showers and/or cloud cover limit severe weather potential
  • The coverage of thunderstorms (scattered vs widespread event).
  • If storms will weaken or strengthen as they move eastward into RI and Eastern MA Friday evening into Friday night.

Heat issues Friday & Saturday:

  • Heat and humidity will return beginning Friday and last into the weekend.
  • Temperatures will warm into the low to mid 90s on both Friday and Saturday.
  • Heat Indices could reach the mid 90s on Friday and low 90s on Saturday.
  • Sunday will also be warm with temps in the low 90s.

Potential Life Threatening Wind Chills & Near Record Cold Temps This Weekend

MaxWindGustMphOccasionally we will share severe weather information consequential to public health, public safety and EMS response.

An arctic air mass will overspread the region Saturday afternoon into Sunday with potential life threatening wind chills and near record cold temperatures. Now is the time to take action and review the preparedness tips below.

Timing: The core of the cold air arrives Saturday afternoon and settles over the region Saturday night into Sunday. Impacts … this is a potentially life threatening cold air mass for residents of MA, RI & CT Saturday afternoon into Sunday with wind chills 15 to 25 below zero and potentially 30 below zero across the interior. In addition, actual air temperatures will approach record low values Saturday night.

Hypothermia  FrostbiteMarine Impacts: Heavy Freezing Spray Saturday afternoon into Sunday may result in dangerous conditions for any vessel in the near shore waters of MA & RI. The threat of heavy freezing spray will lessen with increasing distance from the coastline as water temperatures are warmer offshore.

Potential Snowfall Friday Evening & Overnight: ahead of the Arctic front a brief period of moderate to heavy snow is possible across Cape Cod, Nantucket & Marthas Vineyard. Snow accumulations of 1-3″ are possible. Elsewhere, only a period of light snow or flurries are expected.

External Winter Storm Update from DESPP: January 2016

DESPP Facts and Figures Jan 2016 StormOccasionally we will share severe weather information consequential to public health, public safety and EMS response.


Click here for full DESPP Report and Map: DESPP External Winter Storm Update 1-22-16 at 115 PM



The last model runs of the GFS, NAM and EURO model forecasts are in good agreement on the track however they are still not in good agreement on the amount of snowfall for Connecticut.  The NAM has more than twice the snowfall of either the EURO or GFS.  All three models are still showing a very narrow snowfall cutoff across Connecticut meaning that any slight change in the track will result in a very significant change in snowfall. 

The following forecast is based on a blend of all three models:  Light snow is forecast to spread from south to north across the state tomorrow morning between 6:00 – 10:00 AM.  The snow is forecast light to moderate in northern CT and moderate to heavy at times along the coast by late Saturday afternoon.  The snow is forecast to continue Saturday evening and begin tapering down around midnight.  The snow is forecast to end before dawn on Sunday.  The snow is forecast to be fairly dry and powdery.  The snow will be accompanied by strong Northeast winds gusting to 35 – 45 MPH at times.  Cold temperatures in the upper 20’s are also expected. 

Total snowfall predictions at this time range from 2” – 3” in northern CT, 3” – 6” in central CT and 6” – 10” along the coast.  Note: Very heavy snow with blizzard conditions are expected just to our south over Long Island and New York City.

Current Forecasted Impacts:

Travel Impact:   Saturday AM                  Saturday PM                 Sunday AM                   

                                 Minor                              Moderate                       Minor

Coastal Flooding:   Saturday AM                  Saturday PM                 Sunday AM

                                  Minor                              Moderate                       Minor

Overall Impact:   Minor to Moderate

Forecast Confidence:   Good Confidence for Track / Fair Confidence for Snowfall


State is Monitoring Forecast for Hurricane Joaquin


(HARTFORD, CT) – Governor Dannel P. Malloy today said that his office and state emergency management officials are closely monitoring the activity of Hurricane Joaquin, which is currently in the Atlantic Ocean, and is advising Connecticut residents to closely follow weather reports and prepare for the possibility of its arrival in the region over the next five days.

“We are monitoring the storm closely, and our state emergency management officials have been in regular contact with the national weather service.  While there are many variables with this storm, we are paying close attention to its track,” Governor Malloy said.  “Just as the state and its agencies are monitoring the weather and preparing appropriately, residents should do the same and closely watch forecasts over the next few days.”

Officials with the Connecticut Department of Emergency Services and Public Protection are prepared to coordinate any potential state response and are participating in ongoing National Weather Service conference calls to receive the latest information on the storm’s track.

INTERACT Training for Emergency Medical Services – The ‘Red Envelope’

QIO-and-Qualidigm-logosINTERACT stands for Interventions to Reduce Acute Care Transfers. It is a quality improvement program designed to improve the early identification, assessment, documentation, and communication about changes in the status of residents in skilled nursing facilities.

The goal of INTERACT is to improve care and reduce the frequency of potentially avoidable transfers to the acute hospital. Such transfers can result in numerous complications of hospitalization, and billions of dollars in unnecessary health care expenditures. It includes clinical and educational tools and strategies for use in every day practice in long-term care facilities.

Here is the link to the INTERACT Training for Emergency Services:

Then select “INTERACT Training for Emergency Services”

The training is about 12 minutes in length and covers the new acute care transfer process between a participating nursing home and hospital.

  • Not all nursing homes are part of this initiative so EMS will find that some homes will still be using the W-10 and other documents during their acute care transfers
  • The nursing homes that are using the red envelope as part of their new acute care transfer process will seal the red envelope and have a set of transfer documents for the EMS service so they will not have to open the envelope
  • The rollout date to begin using the new acute care transfer process and the red envelope is August 31, 2015.
  • The entire red envelope should be handed to the ED staff either at triage or in the ED room as the patient is being transferred from the stretcher to the bed
  • The red envelope is to be used only for acute care transfers between participating nursing homes and hospital – they should not be used for other types of transfers
  • There will not be a W-10 as part of the transfer documents – the front page of the INTERACT transfer form along with the residents’ face sheet meet the Department of Health Public Health Code requirements

ASM and South Windsor Fire Department Standby at Circus

SOUTH WINDSOR — On July 19, 2015 ASM and South Windsor Fire Department were requested and assigned to ‘Circus Smirkus‘ at South Windsor High School due to the expected crowds and extreme heat. The circus was hosted by the Silk City Chorus. No transports were reported.

Pictures courtesy of the South Windsor Fire Department Facebook page.

Required Forms for Non-Emergency Ambulance Transport in Connecticut – Volume 2

ASM Bariatric 3This post is an update and rehash of a previous post due to renewed interest in the topic.

Below is a comprehensive list of forms needed to complete a basic life support, routine inter-facility ambulance transfer in the State of Connecticut in 2015. More medical and billing information and demographics are necessary but in regards to forms that go to the ambulance crew, this it…

None of the information below should be construed as legal advice. If there are questions always consult the proper authority. If you have basic questions on this material please call us or post your question in the comments and we will answer to help the greatest number of interested parties. 

Medical Necessity Form (aka Physician’s Certification Statement (PCS) or MNF):  An MNF is required on routine, non-emergency ambulance transports where the patient has Medicare as their primary insurance. It is helpful to have on file for beneficiaries of Medicare HMOs as well. The form essentially works as a prescription for ambulance transport. Medicare never pays for wheelchair van transport so this form represents the threshold between wheelchair van (and all other types of transportation) and ambulance. There are some types of transports from skilled nursing facilities (SNF) and hospital where the sending facility is required to pay for the transport and therefore will not issue or sign an MNF.

There is a misnomer that MNFs are not needed on hospital to hospital and STAT transports because they are inter-facility or emergent. They are indeed required regardless of acuity or receiving facility. Although there are some rules around this they are detailed and convoluted. It is best to provide an MNF on every scheduled ambulance transport in which Medicare or Medicare HMOs are the payor.

A Medical Necessity Form alone does not guarantee payment. In fact it does very little in this regard. It must be on file, but the most important factor is the patient’s condition. The patient must be unsafe to travel by any other means. There are more rules regarding repetitive patients in which a new PCS is only needed every 30-60 days.

The rules around the use of an MNF and meeting Medicare’s medical necessity requirements are extensive and cannot be captured adequately here. Aetna and ASM crews are trained, reviewed, remediated and subject to a rigorous quality assurance process in this regard. If you represent a facility in our service area and feel you would benefit from an in-service to learn more about this, please call (860) 647-9798 x 249.

Physician’s Emergency Certificate (PEC): A PEC is required for the ambulance transport of a psychiatric patient going to any destination (typically a locked behavioral health unit) against their will (or by the will of the physician). In other words, they are being committed to the facility and their ability to make self determination is temporarily suspended by law.

A PEC must be an original form, typically demonstrated by being two-sided and often written in blue ink for this purpose. A copy cannot be used and it must be signed by a physician. It must accompany the patient and therefore cannot be faxed or emailed ahead as facilities will not accept a copy. This form is NOT used for voluntarily committed patients or patients who are conserved where the conservator has ordered transport.

This form also authorizes the ambulance crew to hold the patient against their will. In Connecticut, the only forms that allow an ambulance crew to hold a patient against their will are a PEC and an Emergency Examination Report issued by a licensed clinical social worker or a police officer. It is the policy of Aetna and ASM to also accept and enforce hospital and healthcare ‘Voluntary Commitals’ as granting authority to the ambulance crew to hold patients against their will. Ambulance crews must always use the minimum force necessary and most often this means simply confining the patient and does not necessarily mean the use of force or restraint.

Ambulance crews are not trained or equipped to subdue individuals. Chemical and physical restraints used by ambulance crews are intended to be applied with the assistance of law enforcement or healthcare staff. Judicious, prophylactic application of soft restraints should be strongly considered for patients that present a risk of elopement or danger to self and others. The back of an ambulance is not a controlled and static environment and this should be taken into consideration.

Transportation Authorization Certificate (TAC): A TAC compels the State of Connecticut to pay for the transportation of a patient in need of psychiatric care who is being admitted to an inpatient, state-operated facility. The receiving facility representative signs on Line 4 of this form and it is used as a check and balance before issuing payment to a transportation provider.

There are only five state-operated, inpatient psychiatric facilities in the state, Blue Hills, Cedarcrest (closed), Connecticut Valley Hospital (CVH), Greater Bridgeport Mental Health and Capitol Region Mental Health Center. An ambulance crew does NOT need this form if the destination is any other facility. The need for this form is not created by any other factor such as the chief complaint, the payor or the sending location.

W-10 (demographic portion of the discharge summary): Hospitals and skilled nursing facilities (SNFs) are required to provide the ambulance provider with enough information to safely complete the ambulance transport. Aetna and ASM are Covered Entities under HIPAA, have approved policies and procedures in this regard and all employees have been trained in appropriately handling protected health information (PHI). A hospital or SNF can restrict the amount of information they issue as long as the transport can be safely completed and sufficient information has been provided to carry out treatment, payment and healthcare operations.

Hospitals and SNFs are no longer required to provide a State of Connecticut W-10 form or a full discharge summary and quite often they send the summary electronically to the SNF. Although the W-10 format is not mandated, hospitals and SNFs must provide demographics, history, meds, allergies and any other pertinent information even if the patient is returning to a private residence without scheduled services.

No other form is required for routine BLS ambulance transport. Ambulance crews should NOT be looking for a full discharge summary, so-called “No Harm” letters, full medication administration logs (MARS), psychiatric notes, or any other form that is not listed above. EMTALA-type forms may be useful in informing an ambulance crew as to the patient’s condition and though they may be required paperwork, they are not for the ambulance crew.

Questions? Call the billing office at (860) 647-9798.

Winter Storm 2015 — DESPP Update

NWS Map 3UPDATE from the Department of Emergency Services and Public Protection:

At 4:45 AM the radar continues to show bands of Moderate snow sweeping from the south east to the west.

Temperatures are mostly in the teens with some sites along the coast in the low 20’s.

Winds out of the north east are gusting to near 40 MPH.

The most recent snow fall reports of 2 to (almost) 11 inches verifies the presence of the more moderate bands of snowfall in the eastern and central portions of the state.

  • Marlborough – 10.8
  • Manchester – 7.5
  • Coventry – 6.5
  • Thompson – 8.2

Three-quarter to one-quarter mile visibilities also verify the moderate snowfall.

Some drifting has been reported.

The total snowfall forecast may need to be adjusted downward.  One to two foot snowfall totals are still possible with this storm – particularly for the eastern half of the state.  The western side of the state will probably see snowfall totals between 3 and 12 inches.

Gov. Malloy: Take Necessary Precautions for Possible Blizzard Conditions

NWS MapBlizzard Warning Issued for Entire State, Coastal Flood Watch Also in Effect for Entire Shoreline

(HARTFORD, CT) – With the latest forecast calling for blizzard conditions across parts of the state, Governor Dannel P. Malloy is asking residents to be prepared and take the necessary precautions for a significant snowstorm that will impact the state Monday evening through Tuesday.

“Although storms can be unpredictable, this storm has the potential to have a significant impact on the state and we need to be prepared,” Governor Malloy said. “Just as the state is monitoring and preparing, the public should do the same.”

“The Division of Emergency Management and Homeland Security (DEMHS) is monitoring this storm very closely and is prepared to coordinate any potential state response,” Department of Emergency Services and Public Protection Commissioner Dora B. Schriro said.

DEMHS is also participating in National Weather Service conference calls to get the latest information on the storms track and is sending out regular updates to all municipalities and tribal nations.

The Connecticut Department of Transportation will have its entire fleet of snow plows, including 12 loader-mounted snow blowers, prepared to deploy.  The residual road treatment from the previous weekend storm will help in the efforts to pretreat the road

Governor Malloy will be providing the state with additional updates as conditions warrant.

In order to be prepared for any type of emergency situation, the Governor encourages residents to have an emergency supply kit and follow some basic preparedness tips.

   Additional preparedness tips:

  •     In the event emergency travel is necessary, fill up your car with gas, check oil and windshield fluid levels
  •     Sign up for emergency alerts at
  •     And always, check on your neighbor

For additional info on winter weather preparedness go to or

Bolton Volunteer Fire Department Certificate of Recognition – Life Saving

Tim Lachapelle - Ambulance Service of Manchester, LLC.

ASM’s Tim LaChappelle

On October XX, 2014 Firefighter/EMR Tyler Clark, Firefighter Derrek Kroc, Paramedic Tim LaChappelle and EMT Bob Anderson of ASM Ambulance, responded to a call of a XX year-old female who was having chest pains at 0247 HR. The patient stated that she had been working in the yard during the day and woke up with severe chest pains.

On arrival, the patient was anxiously talking with the responders and then collapsed into cardiac arrest. FF Clark and others immediately started CPR and used a defibrillator to attempt resuscitation. The patient was resuscitated after approximately ten minutes. The patient was transported to the hospital and released to go home seven days later.

Today I present you a certificate for your Extraordinary Personal Actions performed in the line of duty which lead to the successful resuscitation and saving of the life of a citizen of Bolton, CT on October XX, 2014. 

(Some information redacted for patient privacy).