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It's Your Money: Four-for-Life -

The Four-For-Life program, as amended in 2002, stipulates that four dollars be charged and collected at the time of registration of each passenger vehicle, pickup and panel truck. The funds collected, pursuant to Section 46.2-694, Code of Virginia, shall be used only for emergency medical services. The law further states that the Department of Health shall return twenty-six percent (26%) of the registration fees collected to the locality wherein such vehicle is registered to provide funding for:

(1) Training of volunteer or salaried emergency medical service personnel of licensed, nonprofit emergency medical service agencies; or

(2) for the purchase of necessary equipment and supplies for licensed, nonprofit emergency medical service agencies.


Jurisdictions serve ONLY as the recipient of the money which is to be forwarded to the local agencies. In some areas, the agencies themselves decide how much or how the money is disseminated. In some areas it is equally dived buy the number of agencies  in the  county or city.

Be sure you know how this funding is handled in your jurisdiction because IT’S YOUR MONEY.

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New! Protocol Changes Training Notes We have had numerous inquiries regarding the training for the new protocol revisions.

Steve is in the process of putting the Instructor Update together to get the new training resources and policies out to the Optional Skills Instructors so they can begin the EZIO and CPAP training. 

Also,  the Intermediate Providers will need an Optional Skills class on Zofran (Optional Med-60) before they can administer it. 

Since Amiodarone is listed as an Essential medication for Intermediates and Paramedics, there is no optional skills class required, however since we are used to using prefilled syringes during codes we would encourage all Intermediates and Paramedics to review the attached sheet regarding mixing and administering Amiodarone, as a code situation is not a good time to have to figure new drug mixing calculations.  Click Here for the Amiodarone Administration Guide.   

The mixing instructions will be fixed in the top of all BREMS drug boxes but the proper syringes and the D5W will have to be located among your supplies in your units.  We would encourage pre-planning and maybe doing some training on this at your agency training meetings.

If you have any questions regarding these meds or the Optional Skills Training please contact Steve Wade, Training Coordinator, at (434) 947-5934.

Early Notification to ER of Cardiac Patients Dr. Fenton and Dr. Peter O'Brien have asked all BREMS agencies and providers to assist with getting the most information possible on our chest pain patients to the hospital so they can be better prepared to move them into the system.

If you are trained by a BREMS optional skills instructor to obtain a 12-Lead EKG, please send the 12-Lead as early as possible. Also, please call the hospital via cell phone or other phone with the patient's name (MedCom is 434.947.3211. This will assist in obtaining the patient's previous medical records and allow the hospital staff to be better prepared prior to your arrival.


2019 Regional Awards Banquet



It is that time of year again! Please take the time to recognize the great EMS providers we have in this region for all of their hard work and dedication!  Our recent 2019 Advanced Practice Paramedic Program Candidates will be recognized as well.


Our 2019 Regional Awards Program is scheduled for Thursday, June 6th at 6:30 pm.  The location is the City View by the James located in the Bank of the James Building at 828 Main Street #2002 in Lynchburg, VA 24504.

Click here to check out our venue!


The Award nomination deadline is Friday, May 10th. There are twelve (12) Regional Categories that become State Nominees after the Regional Awards Program has completed.  


To help with the task submission of nominations, please click on the following link for a short nomination form  

This comes straight to our office. 


Thank you all for your support and dedication to the Regional EMS System!


icon 2019 Regional Award Guidelines


icon 2019 Contribution to Children Award

icon 2019 Emergency Preparedness Award

icon 2019 EMS Agency Award

icon 2019 Exellence Award

icon 2019 Health & Safety Award

icon 2019 Nurse Award

icon 2019 Outstanding Administrator Award

icon 2019 Outstanding Physician Award

icon 2019 Outstanding Prehospital Provider Award

icon 2019 Prehospital Educator Award

icon 2019 Telecommunicator Award

icon 2019 Scholarship Award

Trauma Cap Pilot Study

BREMS has been presented with an opportunity to do a pilot study with a device called Trauma Cap. This device is geared towards management of head/scalp lacerations, to improve and standardize treatment of head trauma. The Trauma Cap is completely non-invasive and would be for use in EMS scope from a First Responder level and up. It has an application to the head in a similar way that a swimmers cap would. Then, bands are wrapped around the cap to provide that the cap remains secure and that there is pressure on the wound. This device would be used in conjunction with 4x4s or some type of gauze/bandage beneath the cap directly on the wound itself. The device uses the base of the posterior skull as a fulcrum so that the bands can be placed circumferentially around the cap/head. While very simple in its application, we feel that it is something that could greatly contribute to bleeding control for this patient population. Let’s be honest, we’ve been wrapping patients heads like mummies for years! 

Below is information from the CEO of TraumaCap LLC:


Hello. My name is David Waidelich, CEO of TraumaCap, LLC.  We are extremely excited to partner with Blue Ridge EMS Council and I want to personally thank you for your willingness to participate in the TraumaCap Pilot.  Your unit was chosen for this pilot for a number of reasons, one of which is the reputation you have for innovation and leadership in advancing improved care for the citizens of Virginia.  Our belief is that in the very near future, this device will be the new standard of care for treating head trauma in the pre-hospital, hospital, and combat environments and we are excited you all are involved from the very beginning! 

With that, I want to outline a few things to give you a better understanding of the pilot. 


The Device: A few years back, right here in Lynchburg, VA, a flight nurse for Centra One identified a need for a compressive head dressing that applies uniform pressure in the treatment of head and scalp injuries.  In an effort to provide better care for the region, two local physicians worked with a team of biomedical engineers to address this need and today, we are proud to say that the technology now exists in a device known as TraumaCap.  This early stage device provides rapid application of a head, scalp, and ear pressure dressing for the urgent and emergent setting and will allow hands-free treatment of head and scalp trauma.  Our belief is that this simple, yet elegant device will not only save you time on scene but will also provide hands free care enabling you to provide the best treatment and care possible


The Pilot (Goals):  This pilot, under the approval of Centra IRB Exemption Committee and BREMS leadership, will be the first time TraumaCap  will be used in the field.  We believe TraumaCap is much better than what is currently available to treat head trauma but we also know we can make it better.  That’s where you come in!  Our goal is to get feedback from you, the expert provider and ultimate user who will benefit from its development, in two key areas:

  1. The efficacy and time savings of using TraumaCap.
  2. Improvements that could be made to the device.


The Pilot (Launch):  The pilot will launch on March 11, 2019 and  is very straightforward.  It can be summarized in the below steps.  Familiarize yourself with the device.

  1. Complete Training.  Watch the training video, read the protocols, and review the procedures on the packaging. 
  2. Stock your Unit with the device.  If you need more, they can be provided.
  3. Use it when you think it is the best treatment for a situation.
  4. Provide Feedback via online survey.  


Training:  It is essential that all users of TraumaCap view this quick 8 minute video prior to using the device in the field.  (   



Your feedback is critical.  We think that with your help, BREMS could be on the forefront as we look to get this technology in the field, nationwide.  With that, we ask each of you to fill out a quick survey each time you use this device.  It is designed to take no more than a couple of minutes of your time, and again, will help us in our effort to get his to the field!  As a thank you, we will provide you with a small Starbucks gift card as our thank you for each survey you complete!  


Points of Contact:  Ms. Jenn Kersey will be the lead for BREMS.  You may feel free to reach out to myself (  This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) or our Chief Medical Officer, Dr. John Riordan (  This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) with any questions.  


Again, thank you for your willingness to participate in this pilot and for the great work you do on behalf of our community!