Members Present
Jim Berner
Franz Keilhauer
Suzanne Martens
Mark Mirick
Ron Pirrallo
Keith Wesley
Mark Westfall

Members Not Present
Bill Perloff
Mike Curtis

BEMSIP Staff Present
Rick Barney
Jon Morgan
Nan Turner

1. Introductions
2. Approval of June meeting minutes

   Minutes from the June 28 , 2001 meeting were reviewed. Motion by Ron Pirrallo, second by Jim Berner, to accept the June meeting minutes. All Present – Aye.

3. Follow up agenda item for discussion at December 20 meeting

   Dr. Wesley inquired about the progress of the guidelines document. The goal of the guidelines document is to provide suggested criteria for services to consider in making a decision to move to a higher level of care. Dr. Barney volunteered to work with Section staff to draft some provider guidelines for PAC to react to.

4. Medical Director Course

Other areas of the course that need to be included:

• Missing language on MDs relationship to training center - Rick Barney
• MD contract – Keith Wesley
• Due Process - Keith Wesley
• Insurance coverage – Keith Wesley
• Protocol writing basics - Terry Gonderzik
• Quality assurance & competencies - Mark Westfall

Nan Turner reported that the Medical Director’s Web-based Course will be through UW-Madison as a distance learning course. Text should be fairly complete before it starts to be loaded as a web course. There is an option for narrative and CMEs will be available. The committee agreed that the course should be 8 – 10 hours in length.  Question is whether someone who has taken the 2-day NASEMSP course needs to take the Wisconsin course. The recommendation is that all physicians take the Wisconsin course. It was further recommended that we start by requiring all paramedic and new intermediate medical directors.

Other suggestions for the course:

• Consider short survey as part of sign-on to get background info on MDs.
• Link each question to information in text. If the answer is wrong, you get kicked to the background text.

The draft document was reviewed and comments included:

• Pay for medical director should not be listed as an option – remove "optional"
• Contract could also apply to the MD as training center medical director.

Motion by Franz Keilhauer, second my Mark Westfall to accept the MD contract document with modifications. All Present – Aye.

1. Due Process Policy

   A draft of the due process policy was reviewed. This would be used when the MD takes away authority for an EMT to practice. There was discussion of how this would occur in various scenarios. Motion by Mark Mirick, second by Mark Westfall to accept document with modifications.

   Medical Director update

Rick Barney updated the committee on various activities, including:

• Intermediate protocols templates are being written.
• ALS Paramedic protocols – "Best Practice" – Goal is to be completed by next summer
• Meeting with EMT-Intermediate curriculum committee to finalize content, competencies, and hours
• Overview of the status of HFS 112 – paramedic rule.

Dr. Barney asked for comment by PAC on two items:

1. Inclusion of amiodarone as an accepted drug for new EMT-Intermediates. Motion by Keith Wesley, second by Jim Berner to include amiodarone as an accepted drug for use by the new EMT-Intermediate.
2. Request by a physician to modify the AED protocol for use by EMT-basic DA and First Responder-Defibrillation to shock continuously rather than provide 1 minute CPR after normal protocol is completed. Rationale is long initial response time and time to advanced life support. Committee agreed that this should not be approved.

1. Paramedic and Intermediate Refresher curriculum and competencies

   Dr. Wesley distributed "Paramedic Competencies" and"Paramedic Refresher" documents for discussion. The questioned raised was, should medical directors have a competency list of skills to approve EMTs at all levels to renew licenses? Item will be left for consideration by each medical director and forwarded to the Education Committee of the EMS Board.

2. Other business

Two items were forwarded from the EMS Board:

1. Should PAC recommend that all services have a pain management protocol? It was suggested that this should be included with the NASEMSP statement on this issue. Nan Turner distributed an article from the EMS Insider- Pain Management: An EMS Necessity. Suzanne Martens will develop a template for members to react to.
2. Question from the Board Sub-committee working on the First Responder curriculum on whether the First Responder curriculum covers appropriate scope of practice items? Motion by Mark Westfall, second by Jim Berner to advise the Education Committee that the advanced medical module should be removed.
3. Membership list will be updated and forwarded to PAC members.

1. Next meeting