Western Mass Emergency
Medical Services Committee, Inc.
Meeting:
Physicians Council
Date: June 14, 2001
Place: East Wing 2 Conference Room, CDH,
Northampton
Presiding: Dr. Dinneen, Chairperson
Called
to Order: 9:06 am
Adjourned: 10:10 am
Attendance:
Present
– Dr.
Conway, Dr. Dinneen, Dr. Durkin, Dr. Mausel, and Dr. Noonan
Minutes: A motion was made to accept minutes as written. This was seconded and approved unanimously.
Note: As members were present from Ware Fire Department and Adams Ambulance, their Waiver Requests were moved to the beginning of the meeting.
Ware
Fire Department Initial P/B Waiver
Discussion –
Dr. Conway mentioned to the committee that he
is concerned about the lack of attendance by Dr. LaFleur. He feels that
decisions made by the Physicians Council directly affect his area. Mr. Coulombe stated that he and the other
two Ware Fire members were discussing this issue and they are not sure if Dr.
LaFleur is responsible for attending these meetings or perhaps Dr.
Gerstein. Mr. Gagnon told the committee
that both Dr. LaFleur and Dr. Gerstein have been instrumental giving EMS
guidance to the Ware Fire Department. They have a CQI system and both doctors
look over all of their runs. Mr.
Coulombe reported that they have two paramedics on each shift and they plan to
continue this. If the new hires are not
paramedics, they have to sign a contract stating that they will advance in
level. They have only 3 basics, 1 of
which is close to retirement. The rest
of their members are Intermediates and Paramedics.
Dr.
Dinneen would like to see more involvement from physicians, and asked that the
WMEMS office continue to send a copy of minutes and meeting notices to Dr.
Gerstein, but also send them to Dr. LaFleur.
A
motion was made to recommend the Ware P/B Waiver to Regional Council. This
motion was seconded and approved unanimously with 0 abstentions.
Action – WMEMS office to send copy of minutes and
meeting notices to Dr. LaFleur
Physicians Council to recommend this waiver
to Regional Council
Adams
Ambulance Initial P/I Waiver:
Discussion –
Mr.
LaPlante and Mr. Martin presented the Adams Ambulance P/I waiver application
which included an employee roster showing adequate coverage. They also have per diem personnel who are
on-call if needed. Adams Ambulance has
a mutual aid agreement with North Adams Ambulance and Village Ambulance. Their Medical Director is Paul Donovan, DO. Mr. LaPlante and Mr. Martin also informed
the committee that they plan to conduct an ALS/BLS Interface course biannually.
A
motion was made to recommend the Adams Ambulance P/I Waiver to Regional
Council. This motion was seconded and approved unanimously with 0 abstentions.
Action – Physicians Council to recommend this waiver to Regional Council
Amiodarone
Dosing:
Discussion –
Ms.
Josefski reports there have been some concerns relayed to her from West
Springfield Fire regarding the dosing of amiodarone. They are wondering where the figure 10cc. came from that is in
our protocols. Dr. Dinneen asked this
question at Medical Services and it was a figure that was established after
discussion with the manufacturer and according to the AHA guidelines. Ms. Moriarty stated that medical services
felt the proper administration over a 10-minute time period is the crucial
element.
After
some discussion it was agreed that no action be taken and the protocols are to
be followed as written.
Action – None
Dr. Conway attended the May 5 EMCAB meeting. There was discussion about the state wanting a universal Affiliation Agreement with all hospitals, emergency services, and PAD programs. There was lengthy discussion about what signatures the state would like on the last page of this agreement. It was expressed that they want the hospitals’ president to sign, along with the pharmacist, nursing director, and medical director, etc.
Action – None
Action – WMEMS office to
send out updated list to all ALS services stating they can use whatever form
the pharmacy supplies the medication.
Discussion –
Dr. Conway reported that many agencies and businesses are now purchasing defibrillators through the PAD program (public access to defibrillation). Currently, Pyramid Malls in Holyoke, Lanesboro, and Hadley are also in the process of initiating this program. Their Medical Director is out of New York and Dr. Conway has told Pyramid that they need a Medical Director in Massachusetts, therefore, he has designed a packet that is being given to these groups. Ms. Moriarty reports that a meeting is going to be set up soon surrounding Pyramid Malls. Dr. Conway passed around a copy of a sample agreement he has created and is using for PAD programs.
Action – None
Infusion
Pump Letter:
Discussion –
Dr.
Durkin drafted a letter to all EMS services in Region 1. Ms. Josefski mentioned to Dr. Dinneen at the
beginning of this meeting that she had spoken with someone at OEMS and isn’t
sure that the infusion pumps can be used in our Region. As Ms. Josefski had left to attend another
meeting, this issue was tabled until September to give Ms. Moriarty time to
research that discussion. Dr. Dinneen
thought the letter was good, and the WMEMS office would put in on their
letterhead. A motion was made to
approve the letter, pending Ms. Moriartys’ discussion with Ms. Josefski. This motion was approved unanimously with 0
abstentions.
Action – Ms. Moriarty to speak with
Ms. Josefski and send out letter if approved.
Ms. Moriarty to give update on this issue at
Septembers meeting.
Letter
to Non Represented Hospitals:
Discussion –
Ms.
Josefski is in the process of drafting a letter to the hospitals that do not
have regular attendance at Physicians Council meetings.
Action – WMEMS office to send out
letters to non-represented hospitals.
There
are proposed protocol changes pertaining to Prehospital Beta Blockers. OEMS mailed out the recommended changes
approximately two months ago. They were
discussed at the state medical services meeting and then had to go to the state
Executive Committee for final approval.
There is a proposal for adding Metoprolol, which will only be used by 12
lead services as a med-con order. As of now, Dr. Dinneen isn’t sure what was
the outcome at the Executive Meeting.
Action – Further update at the September meeting.
LAPSS
Screen:
Discussion –
Dr. Conway asked the committee what ever happened with putting the LAPSS screen on the back of the thrombolytic scale. The committee believes that it was voted on that this would be done. {Review of previous minutes shows that it was voted on but then later decided that there is some controversy
among
neurologists and this is a screen for information gathering purposes only. Dr.
Lukovitz from BSMC is willing to go to any services in the BSMC area and
present a program on the appropriate use and procedure for filling out the
screen.}
Action – WMEMS to contact Dr.
Lukovitz.
Question
Regarding Nitroglycerin:
Discussion –
Dr.
Conway has an issue with the wording in the protocols surrounding nitroglycerin
use in which it states that the emergency responder will administer this to the
patient, as opposed to assisting the patient with their nitro. Ms. Moriarty says that she will check into
the wording and feels that OEMS wouldn’t have a problem changing it.
Action – Ms. Moriarty to check
with OEMS regarding wording about Nitroglycerin.
Diversion
Report:
Discussion –
Ms.
Moriarty reports that she hasn’t heard about any recent problems with
diversion. In addition, there have not
been any meetings lately. The state has
developed emergency regulations that have been established to assist with
diversion problems, such as the web-based diversion site. All ambulance services will have to be able
to access this site 24 hours a day, possibly through the dispatch centers.
Action – WMEMS to set up a regional diversion
meeting.
Next
Meeting:
Discussion –
The
next meeting will be held on September 13, 2001 at 9:00 am. This meeting will be held in East Wing 2
Conference Room.
Adjourn: A motion was made to adjourn at 10:10 am. This motion was
seconded and approved unanimously.
Lisa
Herringshaw, Secretary, Recorder