Western Mass Emergency Medical Services Committee, Inc.

Meeting: Physicians Council

Date: November 8, 2001

Place: East Wing 2 Conference Room, CDH, Northampton

Presiding: Dr. Dinneen, Chairperson

Called to Order: 9:05 am

Adjourned: 10:00 am

Attendance:

Present – Dr. Conway, Dr. Dinneen, Mr. Donovan, DO, Dr. Fay, Dr. Gutterman, Dr. Hayden

and Dr. Sutton

Present by Proxy –

Excused – Dr. Mausel

Absent – Dr. Durkin, Dr. Emhoff, Dr. Gabor, Dr. Noonan, Dr. Sabatelli

Guests - Dawn Josefski, Dan LaPlante, Ray Martin, Ms. Maxwell, PA-C and Linda Moriarty

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

New Business

Adams Ambulance P/B Waiver Initial Request:

Discussion-

Mr. Martin presented the P/B waiver application and answered questions from the council. The council had granted Adams a P/I waiver in June. Due to a clerical error at the State office Adams was sent a P/B waiver letter in July but appeared here today to get the proper authorization. Adams has completed the Paramedic Assistant course for their Basic and Intermediate EMTs. The Physician’s reviewed the copies of run forms. Motion was made to recommend approval of Adams Ambulance P/B waiver. Motion passed unanimously.

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

Old Business

Follow up on Infusion Pumps:

Discussion –

Dr. Dinneen sent a letter to Mike Erdos (OEMS Medical Director) and has not received a response yet.

Action – Dr. Dinneen update the council when she receives response.

Follow up of Medical Direction and Oversight Document:

Discussion-

Dr. Sutton reported that the document was discussed at the Massachusetts ACEP meeting. Per Dr. Sutton that group decided not to “throw their weight behind the document in its present draft form”. Dr. Dinneen will keep this council updated as the State task force continues to work on the document.

Action – Dr. Dinneen to keep this council updated as to what the State Medical Services committee decides.

New Business:

West Springfield Fire Dept. Ambulance P/B Waiver Renewal Request:

Discussion-

The council reviewed the waiver renewal request. West Springfield Fire has increased the number of paramedics on their department and is continuing to do so as attrition and training allow. It appears that the department is following their initial plan and is on track. Motion was made to recommend approval of the West Springfield Fire Dept. Ambulance P/B renewal waiver. Motion passed unanimously.

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

Protocol Changes:

Discussion –

The state has approved new protocols, which became effective November 1, 2001. Handed out to members present were: Summary of changes letter from OEMS, new Acute Stoke Protocol, new Pediatric Pain Management Protocol, Pediatric Tracheostomy removal and an outline for Aspirin training for Basic and Intermediate EMTs along with the updated chest pain protocol.

Dr. Sutton pointed out that all stroke patients are possible ischemic stroke patients in the field and should have the thrombolytic checklist filled out because the type of stroke is not diagnosed until the CT scan is performed in the hospital. Discussion ensued in regards to the “appropriate facility”. For the Region 1 pre-hospital personnel appropriate facility will be the nearest hospital.

The council reviewed the one-hour Aspirin training outline and decided to use it as the training tool that each hospital medical director will use. ASA is to be used by EMTs working on ambulances, not EMTs working for first responder services. The office will submit to OEMS an application for continuing education credit for EMTs.

The council next reviewed the chest pain protocol in regard to the medical control option use of Metoprolol (Lopressor). They decided that only paramedic services utilizing 12 lead ECG will be allowed to carry and administer the medication per on-line medical control. Motion to add Metoprolol to the Region 1 medication list. Approved unanimously.

Action – Distribute Aspirin training outline to all medical directors. Dr. Dinneen to notify the Regional Council of the addition of Metoprolol to the Region One list of approved medications.

Diversion Report:

Discussion –

Ms. Moriarty handed out a document called “Uniform Definitions/Rules Governing Ambulance Diversion” from Brad Prenney, DPH. This is a product of the State Diversion Task force, which has been tasked with getting a statewide Diversion Policy. Ms. Moriarty asked the council to review these definitions and vote on either accepting or rejecting them. Discussion followed and most agreed that these definitions are very close to the ones Western Mass already has in place. Motion to accept definitions as presented. Approved unanimously. Also handed out was a copy of the checklist used by BSMC when making the decision to go on diversion.

Action – Ms. Moriarty to bring forward to regional Council and then to the DPH Diversion meeting next week.

FYI:

Dr. Fay inquired as to the feeling of the rest of the council regarding the designation of Level 1, 2 3, 4 hospitals. Dr. Conway felt that BSMC as a level 1 and BMC as a level 2 was sufficient for our Region but if certain hospitals want to go to level 3 or 4 then he is sure that will create a trickle effect.

Dr. Fay also brought up the issue of screening and subsequent billing issues for Medicaid patients being seen in the ER. A discussion followed where different members shared what their facilities do.

Next Meeting:

The next meeting will be held on January 10, 2002 at 9:00 am. This meeting will be held in East Wing 2 Conference Room.

Adjourn: A motion was made to adjourn at 10:00 am. This motion was seconded and approved unanimously. Dawn Josefski, Recorder