Western Mass Emergency Medical Services Committee, Inc.

Meeting: Physicians Council

Date: February 14, 2002

Place: East Wing 2 Conference Room, CDH, Northampton

Presiding: Dr. Dinneen, Chairperson

Called to Order: 9:06 am

Adjourned: 9:55 am

Attendance:

Present – Dr. Conway, Dr. Dinneen, Dr. Durkin, Dr. Fay, Dr. Gutterman, Dr. Hayden, Dr. Mausel, Ms. Maxwell PA-C, Dr. Noonan and Dr. Sutton

Absent – Dr. Sabatelli

Guests – Annie Chou, Dawn Josefski and Linda Moriarty

Conflict of Interest Statement: The chairperson opened the meeting with a conflict of interest statement. No one present had any conflicts to divulge for any items on the agenda.

Minutes: A motion was made to accept minutes as written. This was seconded and approved unanimously.

Old Business

Diversion Report:

Discussion –

A diversion report for Region 1 Hospitals during the month of January as well as a graph comparing the past 2 years was handed out. A note was made that the statistics representing Mary Lane and Mercy need to be corrected. Each member present reviewed that diversion notification call sheet for the individual hospital’s, several additions and corrected phone numbers were noted. Dr. Sutton made a request to have the Statewide Diversion Website linked from the WMEMS website.

Action – Ms. Josefski to relay the changes to Mr. Cote.

Ms. Josefski to add the diversion website as a link on the WMEMS website.

Medical Services:

Discussion-

Dr. Durkin reported on the State Medical Services meeting. Dr. Gabor has resigned as the pediatric physician representative and the replacement is someone from the Boston area. The committed voted to allow volume infusion pumps on emergency (‘911’) calls, as well as ALS Interfacility Transfers, by services already trained in their use, effective immediately. The was also a discussion and vote to change the medication list in the Statewide Protocols:

- Delete from optional list: Dobutamine (Dobutrex); Flumazenil (Romazicon); Solu-Medrol (Methylprednisolone); Norepinephrine (Levophed); Oxytocin (Pitocin); and Nifedipine (Procardia, Adalat).

- Move from optional to required list: Neosynephrine Nasal Spray (Phenylephrine HCL); 2% Lidocaine Jelly; Atrovent® (Ipratropium); Midazolam (Versed); Saline Flush and cetacaine Spray.

- Move from required to optional list: Lactated Ringers

There was also a discussion at the state meeting about the possible shortage of Lasix. There was a suggestion to make Bumex (bumetanide) an option if Lasix becomes unavailable. The state will monitor this situation.

Dr. Durkin reported on the discussion and clarification that a rescue airway is an option in any difficult intubation (when initial attempts have failed), to be utilized by properly trained and authorized EMS personnel, with or without Versed. There had been some confusion based on the wording in the State protocols.

Finally, the State Medical Control task force has almost completed the ‘Standards for Providing Medical Direction and Oversight’ document. Once a final draft is completed it will go to the Medical Services and the various stakeholder groups (e.g., fire services, private services, hospital-based services) for comments.

Action – The office to send a letter to ALS services in Region One informing them of the decision to allow volume infusion pumps in emergency settings by individuals trained via the ALS Interfacility course.

New Business

Lactated Ringers:

Discussion-

The members present discussed the pros/cons of LR for the pre-hospital use and decided that the transport times in our region are not overly significant therefore burns can be treated using NS while enroute to a trauma center. Motion to delete LR from the Region One required list. Motion passed with one abstention, Dr. Sutton.

Action- The office to update the Region medication list and send out to ALS services.

Westfield Fire P/B Waiver Renewal Request:

Discussion-

Copies of the P/B renewal packet were sent around for review by members. Dr. Sutton spoke in support of the Westfield Fire Department; he is involved with their QA and continuing education programs. They currently have 19 Paramedics who work out of 1 main station and 2 substations. Westfield is also able to provide intercepts to the surrounding towns. Motion was made to recommend approval of Westfield Fire P/B renewal waiver. Motion passed with one abstention, Dr. Sutton.

Action- Dr. Dinneen to bring forward the recommendation to Regional Council.

Tracheostomy:

Discussion-

The updated Statewide Treatment Protocols call for the removal of a plugged tracheostomy tube in pediatric patients. It was decided that the office would develop a one-hour continuing education outline, based on the PEPP information, and make it available to all services in the region.

Action- The office to develop a tracheostomy removal outline

Review if Adams Ambulance P/B run reports:

The council members present divided the run reports and reviewed. There were many reports without medical control signatures and one report where treatment for an asthma attack occurred without transport or documentation that medical control had been notified. Ms. Maxwell will bring these matters to the attention of the Adams Ambulance management.

Next Meeting:

The next meeting will be held on March 14, 2002 at 9:00 am. This meeting will be held in East Wing 2 Conference Room.

Adjourn: A motion was made to adjourn at 9:55 am. This motion was seconded and approved unanimously.

Dawn Josefski, Recorder