Western Mass Emergency
Medical Services Committee, Inc.
Meeting:
Physicians Council
Date: March 14, 2002
Place: East Wing 2 Conference Room, CDH,
Northampton
Presiding: Dr. Dinneen, Chairperson
Called
to Order: 9:03 am
Adjourned: 9:56 am
Attendance:
Present
– Dr.
Conway, Dr. Dinneen, Dr. Fay, Dr. Hayden, Dr. Mausel and Ms. Maxwell PA-C
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.
Diversion
Report:
Discussion –
A
diversion report for Region 1 Hospitals during the month of February was handed
out. More hospitals are going on diversion (CDH, FMC and HH). The state
diversion website is operational and Mr. Cote from WMEMS is updating it when
hospitals go on diversion in Region One. DPH issued a document called Uniform
Definitions/Rules Governing Ambulance Diversion to all hospitals and ambulance
services in the Commonwealth. In our region we will still continue with 2-hour
time limits on diversion with an option for the following 2 hours if no other
contiguous hospital is waiting to go on diversion. Our regional policy limits a
hospital to 4 continuous hours of diversion, and then they have to be off
diversion for at least 4 hours before they can go on diversion again.
Action- None
Medical
Services:
Discussion-
Dr.
Dinneen reported that the State Medical Control task force has completed the
‘Standards for Providing Medical Direction and Oversight’ document. The final draft
will go to the Medical Services and the various stakeholder groups (e.g., fire
services, private services, hospital-based services) for comments. Mr. Brad
Prenney from DPH then brought up the issue of Paramedic/Basic waivers and a
lengthy discussion followed. It was very apparent that different regions have
varying opinions. All agreed that the current regulation of Paramedic/Paramedic
is the ideal staffing configuration but there still needs to be some
flexibility for regions such as western Massachusetts and the Cape/Islands. It
was suggested that there be guidelines created to help regions when making P/B
waiver decisions. Nothing definitive was decided. The next State Medical
Services meeting will be Friday April 12, 2002 at 10 a.m. in Framingham.
Action- None
At
the last regional Council meeting there was a request from an ALS service for
the Physicians Council to look at creating a regional policy with guidelines
for ALS to BLS triage. Copies of three policies (Holyoke Hospital EMS, BHS and
Region 5) were passed out for members to review. Several points were mentioned;
some services cannot triage to BLS based on contracts and some services use
emergency medical dispatching (EMD) to send appropriate resources. Based on the
discussion, the council decided to NOT recommend a regional ALS to BLS triage
protocol. They decided to have the office send out the three copies and have
the ALS services, in conjunction with their medical director, to develop
service specific policies.
Action- The office to
send ALS services copies of ALS to BLS triage policies with a cover letter.
FYI:
Dr. Mausel
shared with the council a problem he had recently when trying to transfer out
patients needing a higher level of care than Wing could offer. There was
discussion among those present how one could best facilitate the process. Dr.
Fay suggested that UMASS LifeFlight should be able to make the calls and find a
facility able to accept the patient once the local resources are exhausted. Dr.
Mausel stated that on one occasion UMASS was very helpful but on another they
told him to figure it out. He also stated that in the smaller hospitals it is
very time consuming to try to make all the calls while continuing to treat the
patients still coming in. It is also difficult not knowing all the hospitals in
the Boston area and what their specialties are. A suggestion was made to have
the office call Dr. Restuccia from UMASS and request their written policy for
when hospitals need to transport patients out.
Action- The office to
contact Dr. Restuccia and request policy.
FYI:
Ms.
Josefski reported that the office had been contacted by the Noble Hospital
pharmacy in regards to a possible shortage of Valium. No one present had heard
anything.
FYI:
Dr.
Hayden had a question about ALS Interfacility transfers and medical control.
Ms. Moriarty explained that medical control may be designated to a doctor from
the floor (i.e., ICU, CCU) on a case-by-case basis or in general. If this is
done then there must be a hospital policy in place stating that medical control
has been designated to…. and whom the crew must contact if a problem arises
during transport and the designated doctor is not available.
Next
Meeting:
The
next meeting will be held on April 11, 2002 at 9:00 am. This meeting will be held in East Wing 2
Conference Room.
Adjourn: A motion was made to adjourn at 9:56 am. This motion was seconded
and approved unanimously.
Dawn
Josefski, Recorder