EMERGENCY MEDICAL SERVICES PHYSICIANS ADVISORY COMMITTEE MEETING

Thursday, May 18, 2006

Members Present:

Michael Curtis

Wade Woelfle

Mark Schultz

Tom Brazelton

Suzanne Martens

Halim Hennes

Jason Liu

Charles Cady

Mark Westfall

Members Excused:

None

1.0.            Introductions & Welcome - Charles Cady

Dr. Cady welcomed the committee and brought the meeting to order at 10:00 AM

EMS Office Staff: Dan Williams, Keith Wesley

Guests: None

2.0.            Approval of January 12, 2006 minutes – All

Motion by Halim Hennes, second by Jason Liu to approve the minutes from the January 12, 2006 meeting. Motion Carried.

2.1.            Note:  March meeting cancelled due to weather

3.0.            New Business

3.1.            Medical Director Evaluation Tool

            REPORT CARD

Questions on whether or not to further review the EMS report card that provides focus on Medical Direction and use it to assist in the development of Medical Director training and evaluation. Pac felt that input from the Systems Management committee and their review and relevance to the EMS Service component of the Report Card should also take place to determine how it could be used by EMS services.

Discussion was held on potential format and delivery methods.

It was decided to bring the report card back and circulate to the group to decide where to go next.

MEDICAL DIRECTOR EVALUATION TOOL

Look at the format from the report card to develop an evaluation tool that is similar in design to EMS Report Card.

It was decided that the evaluation tool needed to be developed from the Medical Director Contract exhibit 1 sections 1.2.3 A-O to establish the basic areas to be evaluated that were identified as performance criteria from the State MD contract.  A scoring criterion that demonstrates a method for evaluation and improvement needs to be created that reflects the performance criteria.

It was discussed that all associated groups that work in support with the EMS office and the State Medical Director be part of the evaluation process. It was noted that the only group that has official responsibilities to evaluate the position is PAC and evaluation should be limited to that committee. The EMS office can solicit other comments as needed to determine overall EMS satisfaction with the position.

Asked everyone to provide 5 sample questions to be used to develop the tool.

            We developed the following list of those that we definitely need feedback from.  It was felt that we would invite feedback from anyone including professional organization and individuals.  There was concern that feedback from individuals may be biased and difficult to quantify, but this would be considered when evaluating all feedback. 

EMS Office Staff

EMSC

EMS Medical Directors

EMS Board

STAC

Develop tool so that everyone that has some sort of interaction is given the opportunity to provide the feedback. 

3.2.            Inter-facility Transport Guidelines.

The committee discussed the Inter-facility Transport Guidelines that are essentially completed. Dan advised the committee that NHTSA had just released their version of an Inter-facility Transport Guideline and he and Dr. Wesley were doing a quick review to determine if anything was substantially different from our document to that one. It should take a couple of weeks and then if needed the Wisconsin document will be revised and sent out in early July.

3.3.            Standardized state protocols

1.      Mandated State protocols will not be an attainable goal.

2.      Current minimal State protocols need to be revised and made available to services.

3.      Basic level scopes of practice should be used as the bases for developing proper protocols.

4.      Develop a list of what should be in a protocol and a list of what protocols you should have.

5.      Develop a standardized format and determine a date in the future for possibly mandating the selected format. This work should be completed by years end and a possible compliance date would be July 1, 2008.

3.4.            Clarify Sept meeting at PSOW. PSOW will be held September 13-14-15, 2006. Pac and medical directors meeting would be on Wednesday 9-13-06. The meeting will be at the Paper Valley in Appleton.

4.0.            Old Business

4.1.            Advanced Airway QA Tool

The revised form was presented and approved by PAC and will go to state EMS office for form number and implementation use and criteria by EMS office.

4.2.            Excited Delirium Pilot/Protocols

Dr. Curtis introduced the thought that Geodon could be considered as a possible medication instead of Ketamine as an approved medication for the paramedic to use as a medication. Because this medication is not in the Paramedic curriculum and all of the standard medications are based on what is taught in the initial EMT-Paramedic program proof of education, protocol for use and Medical Director approval would be needed as well as a revised service operational plan.

Motion by Curtis, second by Westfall to allow paramedic services to use Geodon for agitated and combative patients age 12 years of age and older and to be added to the Paramedic medication list with appropriate training. Motion carried.

4.3.            Inter-facility transport guidelines

This topic was covered previously.

4.4.            CPAP Pilot

Has been approved and all services have been notified and set the training material and protocols.

Dr. Westfall presented preliminary data from the pilot project.

4.5.            Medical Director’s Course

1.      Current power point should be made available on request.

2.      Develop a revised narrated version to be completed by September.

3.      Determine a sponsoring agent such as State Medical Society. Or independent associations.

4.      Explore the possibility of developing an EMS association.

5.0.            Board Meeting Report. Dan updated the committee on recent EMS Advisory Board activities.

6.0.            EMSC Report—Dr. Brazelton

1. Meeting with Dennis Tomczyk on assessing pediatric capabilities in Wisconsin as part of an expert panel on pediatric issues was very productive and is an ongoing effort to better utilized resources and understanding of pediatric needs in EMS.

2. Child alert is being reviewed in parallel with the Minnesota’s program.

7.0.            Medical Director Report –Dr. Wesley

1.      Various issues were discussed as part of the meeting.

2.      Dr. Wesley will have his first quarterly report prior to next meeting.

New Business.

1. Dan presented a request from Chippewa Falls Fire Dept. requesting a waiver request to allow them to transport patients with ventilators. They are a Intermediate service and the scope of practice does not allow for this level of practice. PAC members overwhelmingly agreed that an intermediate service cannot independently transport a patient on a vent as it is beyond their scope of practice, but any service can transport a vented patient as long as the usual vent operator (nurse, family, or caregiver who is normally responsible for the vent at home or facility) accompanies the patient.  Since another service in the area can provide this service within their scope, a waiver was not deemed necessary. 

8.0.            Next Meeting:  Thursday, July 20, 2006 Medical Society

8.1.            Proposed agenda items

Meeting adjourned at 2:30 PM