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Report regarding a resolution approving a purchase agreement for ten cardiac monitors/defibrillators in the amount of $444,148.89, and authorizing the City Manager to enter into a purchase agreement with Zoll Medical Corporation (Richard Walls, Emergency Medical Services Chief)
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RECOMMENDATION
Recommendation
It is recommended Council adopt a resolution approving the purchase of ten cardiac monitor/defibrillators in the amount of $444,148.89 and authorizing the City Manager to enter into a purchase agreement with Zoll Medical Corporation for the purchase and shipping of ten Zoll X-series Advanced cardiac monitor/defibrillators, necessary accessories and five-year all-inclusive service and maintenance plan in an amount not to exceed $444,148.89.
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BACKGROUND/DISCUSSION
The South San Francisco Fire Department (SSFFD) is tasked with providing advanced life support (ALS) services. This is accomplished through paramedic/firefighters responding to emergencies on multiple vehicle types. These vehicles include engine companies, quint companies, and rescue ambulances strategically placed throughout the City in five fire stations. While the paramedic/firefighters perform patient assessments, additional personnel assist in gathering key vital sign information. A cardiac monitor (monitor) is crucial piece of diagnostic equipment used to assess patient life status. Monitors are portable medical devices that capture several components of a patient’s vital signs: blood pressure, heart rate, carbon dioxide levels, blood oxygenation, and reading of electrical heart rhythms. The monitor can deliver lifesaving defibrillations from a paramedic/firefighter when the heart requires ALS intervention. The following staff report and resolution address replacing the City’s existing fire apparatus monitors.
The SSFFD has a long tradition of providing emergency medical services (EMS) to the residents of South San Francisco and surrounding communities. The SSFFD responded to 5,915 EMS/Rescue responses in 2021. Each one of these responses requires an ALS provider to assess and treat patients based on their signs or symptoms. The monitor is the most frequently utilized medical diagnostic tool in an ALS provider's cache. The information gathered guides the ALS provider in making critical life-saving decisions for prehospital care.
While it is important to note that the SSFFD is providing a high level of medical care now, technology has improved, and the lifespan of the existing monitors has surpassed their five-year replacement plan. Our current monitors were purchased in 2015. Maintenance and replacement part purchases have become more frequent and costly. In order to continue to provide the highest quality of service and maintain reliable diagnostic equipment, staff feels it is vital to replace the current inventory of monitors within the SSFFD.
Fire administration staff prepared a request for proposal using the following criteria as selection guidelines:
• Ability to provide real-time feedback of paramedic treatment performance and patient response.
• Ability for the paramedic to evaluate the underlying cardiac rhythm during cardio-pulmonary resuscitation without stopping chest compressions.
• Capability to monitor multiple patient vital signs.
• Performs instant and continuous cardiac monitoring of at least four leads.
• Performs cardiac monitoring through 12-lead ECGs on demand.
• Performs instant and constant monitoring of saturation percentage of oxygen (SPO2) and level of exhaled carbon dioxide (CO2).
• Ability to deliver synchronized cardioversion and defibrillation.
• Ability to transmit cardiac rhythms directly to a remote emergency physician in order to activate specialized treatment resources.
• Ability to print on the scene.
• Data reporting capability and integration with patient care reports, quality assurance processes, ambulance billing systems.
• Low carrying weight of the monitor and
• The primary functional unit is one piece.
Selection Process
Fire staff followed current procedures to distribute a Request for Proposal (RFP) for replacing the cardiac monitors. The proposal was open for submittals from August 31, 2022 through September 16, 2022. Two proposals were received during the process.
Zoll Medical Corporation $354,071.90
Stryker $415,549.05
These two proposals fit the requirements listed during the RFP and moved forward for field testing. Several factors were set to measure the current operational compatibility of the new cardiac monitors. After placing each trial unit into service with paramedic/firefighters, surveys were conducted to gather data points on each unit for comparison. Each unit was evaluated during emergency medical responses. The unit selected by SSFFD field personnel was the Zoll X-series Advanced cardiac monitor (Zoll cardiac monitor).
The Zoll cardiac monitor provides paramedic/firefighters with crucial vital sign information and uses state-of-the-art technology for data integration. Another benefit is the unit’s ability to measure depth and rate of chest compressions to ensure adequate circulatory movement during a cardiac arrest. The monitor can transmit 12-lead information directly to a cardiac physician in the emergency room. This capability to identify patients having specific cardiac events is critical in determining patient transportation destination as only recognized hospitals have the capabilities to deal with certain cardiac related emergencies. These specialty hospitals perform timely interventions during a cardiac emergency.
Additionally, Zoll cardiac monitors provide detailed information about emergency response that can be used for education and quality assurance. The data is compatible with our current records management systems. Our own City of South San Francisco Information Technology staff maintain these management systems. The new model selected is lightweight and mobile, providing our firefighters with the most flexible tool for adapting to the various environments found in field emergency patient care. The ergonomics of the Zoll cardiac monitor help reduce the probability of injury to our personnel who carry various amounts of equipment on every emergency response. The new cardiac monitor weighs only 12 pounds, less than half the weight of other model tested.
As a final enhancement, Fire Department staff has selected a five-year all-inclusive warranty and preventative maintenance plan for the new monitors. This is the longest available plan. Annual preventative maintenance is required for cardiac monitors to be used on the public. This plan will include all unintentional damage and repair, in addition to annual preventative maintenance. The cost of this plan is an additional $83,520. Bringing the final cost for monitors and all-inclusive maintenance and service plan to $444,148.89, slightly less than what was approved in the budget.
FISCAL IMPACT
A total of $450,888 was approved in the City of South San Francisco FY 22-23 adopted budget for the purchase of cardiac monitors.
The initial request for funding was constructed in the following manner.
FY 22-23 General Fund $347,184
Public Safety Impact Fee fund (PSIF) $103,704
TOTAL $450,888
The quoted price for the selected monitors is less than the approved budget at $444,148.89. The Fire Department currently has ten older model cardiac monitors that this purchase will replace. The department wants to retain some of these monitors that are in the best condition for use as reserve units. The manufacturer has offered a trade-in reimbursement for the remaining monitors which will help offset total costs. Keeping reserve monitors will allow the department flexibility for special events, disasters, or deployment model updates. Due to the cost of annual preventative maintenance, the department has determined that retaining a five-monitor surplus is the appropriate balance of cost and utility to best serve department needs.
The purchase of the monitors with the all-inclusive warranty and preventative maintenance plan will now be funded constructed in the following manner.
FY 22-23 General Fund $341,994.65
Public Safety Impact Fee fund (PSIF) $102,154.25
TOTAL $444,148.89
This new composition accounts for the maximum allowable PSIF portion of 23%.
RELATIONSHIP TO STRATEGIC PLAN
This action is in line with Strategic Plan Priority 5, in that it promotes financial stability.
CONCLUSION
It is recommended Council adopt a resolution approving a purchase agreement for the purchase of ten cardiac monitor/defibrillators in the amount of $444,148.89 and authorizing the City Manager to enter into a purchase agreement with Zoll Medical Corporation for the purchase and shipping of Zoll X-series Advanced cardiac monitor/ defibrillators, necessary accessories and five-year all-inclusive service and maintenance plan in an amount not to exceed $444,148.89.