Members present:

Tom Brazelton

Charles Cady

Mike Curtis

Mark Schultz

Suzanne Martens

Mark Westfall

Bureau Staff:

Dan Williams

Brian Litza

Cathy Etter

Members Absent:

Franz Keilhauer

Eric Voter

Halim Hennes

Others in Attendance:

Fred Hornby, Bell Ambulance

Agenda Item 1 - Introduction

PAC began at 10:00 AM with introductions around the room and a welcome by Chair, Dr. Charles Cady.

Agenda Item 2 - Approval of February meeting minutes

Motion by Curtis, second by Brazelton to approve the minutes from the February 17, 2005 meeting. Motion Carried.

Agenda Item 3 - New Business

A. Attendance Rule for PAC.

Discussion was held on the need to establish meeting attendance guidelines. Motion by Brazelton, second by Curtis to require a 66% mandatory attendance policy and allow for a 33% absence  for a year that runs from July 1 to June 30 of each year. Telephone attendance is acceptable for full participation when available. When two meeting are missed the member will be notified that 100% will be required for the remainder of the year. Motion Carried.

Note: Departure from the agenda.

Dr. Michael Kellum addressed the PAC with his latest statistical information on the “Call and Pump” demonstration project that is being conducted in Walworth and Rock County. Dr. Kellum reported that the statistics were very impressive and favorable after review of the initial cases. Further evaluation will be ongoing to determine the ability to maintain the increased saved population rates. Potential expansion of the program will be considered.

B. Single paramedic system review.

Discussion was held on whether the PAC wants to do an evaluation of the    effectiveness of the one (1) paramedic systems. Several areas were discussed and the committee decided to start the process with the gathering of the following information.

1.      Determine the total number of providers at this level.

2.      Develop a CQI tool for equal and consistent evaluation.

3.      Should be a retrospective study.

4.      Ask system Medical Directors of 1-Paramedic services to submit 10 Paramedic cases that were flagged with potential problems. It should be a mix of cardiac, respiratory, trauma and pediatric cases.

5.      Cathy Etter of the EMS office will contact the services and set-up a process for filtering the information so that the review does not identify any specific service to the PAC members. If a PAC member is a medical director for a 1-Paramedic service that service will not be included in the study.

C. RSI: Can a single paramedic provide RSI with an EMT-Intermediate present?

Discussion on the current practice of only allowing RSI when two (2) paramedics are at the patient side. Should there be consideration to include a combination of one (1) EMT-Intermediate and one (1) paramedic. After a brief discussion the PAC determined that the current two (2) paramedic standard will be maintained as the only crew combination for RSI.

D. State guideline/protocol templates.

Discussion was held regarding State guidelines and protocols and whether PAC should be reviewing current protocols to assure current standards are included. Also discussed was there a need to provide more protocols than the current ones. The question came up on idea of establishing State protocols that would be developed for all levels and be the standard approved protocols for each level of provider for all providers. Several States have gone to a standard State only protocol which has proven to be very beneficial for services, medical directors and the State from a consistency standpoint. The committee felt as though this was a very worthwhile direction to proceed toward.

It was decided that the committee would look a current protocols from a variety of Wisconsin providers as well as a sampling of other State protocols that have already adopted this system. Several were mentioned as being outstanding. EMS office will obtain the various protocols and support information to initiate this project and send it out to the committee.

E. New non-visualized airway demonstration.

The committee viewed a demonstration by Tri-Anim on the King LTD non-visualized airway. PAC appreciated the opportunity to review the product and information and thanked Tri-Anim for the demonstration.

Agenda Item 4 - Old Business

A. Interfacility Transport Guideline Draft

The committee continued the review of the Interfacility Transport Guidelines and worked through several areas. In the interest of time and many further issues on the agenda the committee decided to continue to comment and review the document among the PAC members by using e-mail. The process will continue with an anticipated close to final product for the next full meeting.

B. Medical Director’s Course

1.        Updates and content are on-going.

2.        Hosting: Meg Taylor from the DHFS has the information submitted at the last meeting and is making arrangements with the department on hosting this on the States website.

3.        PAC approved the use of the Medical Director’s Course as a requirement for Service Medical Director’s.

C. Pediatric AED protocol on website?

The most recent revision of the protocol for the emergency medical care of the pulseless non-breathing patient using semi or fully automated external defibrillation (AED). The protocol was reviewed and several minor issues were addressed. Dr. Martens will make the approved changes and send it to the State EMS office for acceptance and distribution.

D. EMS Report Card.

The review of the EMS report card for EMS services will continue to be reviewed by Dr. Curtis with a report forthcoming.

E. CPAP pilot.

The CPAP project was briefly discussed and Dr. Westfall indicated that he needs more Basic EMT service information. He has received a fair amount of reports from Intermediate and Paramedic service but needs more information from the Basic services that are actually in the pilot. Dr. Westfall circulated statistical information to date on the pilot for committee review.  The EMS office will send out a reminder to all pilot project service on the requirement to submit their data to the State office.

F. Dr. Voter’s continuation on committee.

1.        Board’s decision? It was decided that since Dr. Voter has attended only one meeting since his appointment that PAC would be asking the EMS Advisory Board to recruit a new physician member to the committee. It was decided that because of the time of year and the normal recruitment and replacement process will take place at the EMS Boards June and August meetings that the process will solve the issue. There are three (3) member that expire in July of 2005.

Agenda Item 5 - EMS Advisory Board Meeting Report

Dr Martens reported on the recent EMS Advisory Board meeting.  Licensure changes being reviewed include changing from a 2-year license period to a 4-year licensing period. Dan Williams pointed out the need to assure yearly continuing education.

 

Different forms of alternative learning methods are currently being discussed by the Board. Other methods may include web-based learning, web-cast courses and others.  Several committees’ are being developed to work out the details and establish rules for the process as well as understanding the potential educational opportunities.

Agenda Item 6 - EMS-C

Dr. Brazelton gave a brief report on the activities and made the committee aware of an effort being made by the EMS office to bring all of the various advisory groups to a central meeting to establish areas that of common interest.

Agenda Item 7 - Medical Directors Report

Dr. Gordon provided a written report to the committee of has recent activities.

Agenda Item 8 - Next Meeting

The next meeting will be Thursday June 16, 2005 10:00 AM at the Wisconsin Medical Society building, 330 E. Lakeside Street, Madison, WI

1. Proposed agenda items

Review and determine the impact that the National Scope of Practice may have on Wisconsin EMS.