Members Present
Jim Berner
Mike Curtis
Franz Keilhauer
Mark Mirick
Bill Perloff
Ron Pirrallo
Jon Robinson
Keith Wesley
Mark Westfall

BEMSIP Staff Present
Jon Morgan

Members Not Present
None

Others Present
Steve Andrews
Pat Kilbane
Suzanne Martens

1.0 Approval of April 2001 Minutes

Minutes from the April 15 meeting were reviewed. Motion to approve the April 2001 minutes by Mark Mirick, second by Jim Berner. All present – Aye.

2.0 State Medical Director Update

Dr. Barney was unable to attend the meeting. Jon Morgan gave an update on HFS 112 - paramedic rule and the trauma plan and related legislation.

• Update on HFS 112 - HFS 112 has passed committees in both houses and can be filed as a rule. There was an objection by the Senate Health Committee to language for one of the staffing options for existing paramedic services. That language has been sent to the Joint Committee on Administrative Rules for their review and action. They have 30 days to act on the objection. DHFS is determining whether the rest of the rule should be filed and made effective without this piece or whether some of the original language needs to be included for the entire rule to proceed.
• Update on Trauma Plan and legislation - A proposal for trauma system funding has been passed and included in the Assembly version of the budget bill. The proposal includes funds for 2 project positions, a contract for analysis of how to develop a trauma registry (database) and monies to support regional trauma advisory council activities. This proposal has to be agreed to by committees from the Assembly and the Senate before it's included in the budget sent to the Governor.

3. Due Process Guidelines

The question of the EMS medical director's role in disciplinary action against an EMT was discussed. The committee would like to develop a template to summarize how the MD ensures quality care is maintained without violating an individual EMT's rights. Two samples of due process mechanisms were reviewed. There are distinct roles that need to be understood for any disciplinary action: the MD's medical role, the employer's administrative role and the State's regulatory role for any action on the EMT license.

Keith Wesley will take the 2 samples and develop a draft template for discussion at the October meeting. It was suggested that a sample MD contract should be included as a guide to services and physicians.

4. EMS Board - Education Committee questions

The Education Committee of the EMS Board asked the PAC to respond to several questions regarding the EMT-basic standards & procedures (S & P) manual and whether the following skills should be included:

• Magill Forceps & Laryngoscope - There was a question on whether this was in or out of the national curriculum. Motion by Mike Curtis, second by Keith Wesley to include the Magill Forceps & Laryngoscope in the S & P manual. All Present - Aye
• Peak Flow meter - Motion by Mark Westfall, second by Franz Keilhauer to not include peak flow meter in the S & P manual. All Present - Aye.
• Pulse Oximetry - Motion by Mike Curtis, second by Franz Keilhauer to include pulse oximetry the S & P manual. All Present - Aye.
• CO2 detectors - Motion by Mark Westfall, second by Franz Keilhauer to not include CO2 detectors in the S & P manual. All Present - Aye.

Bill Perloff gave an update of EMSC activities. Highlights included an update on the upcoming Injury/EMSC conference in October and the BELS (Basic Emergency Life Support) training offered to school staff at several sites this summer. Keith Wesley asked that EMSC be listed as a standing agenda item for future PAC meetings.

• Ron Pirrallo shared a Maryland sample guideline for "extraordinary care not covered by protocol" and asked if this was worth pursuing in WI. The consensus was that this should not be further "defined" by a protocol and was better left unwritten.
• There were several questions about paramedic licenses and paramedic training permits and how they were issued. Jon Morgan responded to the specific questions.
• Keith Wesley summarized potential EMS issues with 2001 Act 2 relating to giving up a baby in the first 72 hours with no questions asked of the mother or father. The general recommendation was that information on this new law should be shared with EMS providers and that following the local hospital protocol is probably the best avenue to pursue. The EMS Section will include information in its next newsletter.
• Several PAC member terms expire in July. Drs. Robinson, Wesley & Westfall are reapplying and new applications have been received from Suzanne Martens and Ronald Meyer. These will be voted on at the July 11 EMS Board meeting.

7. EMS reports - WEMSIS

Jon Morgan distributed EMS reports based on WEMSIS data submitted by providers. The general discussion was that the information was interesting, but the small sample size made interpretation too difficult to project. It was agreed that a more comprehensive data collection and analysis program needs to occur. The EMS Board has just created a special ad-hoc committee to address this issue and they will start work in September. Keith Wesley volunteered to be a PAC representative on that committee.

8. Medical Director's Course

This agenda item was shifted to last to allow for a presentation by Larry Hanrahan on posting the medical director course on the Health Alert Network (HAN). Larry was unavailable so the time was used to further discuss the course.

It was agreed that there should be a PowerPoint slide version of the course available for presentation and a more interactive CD & web-based version for the actual course. Follow-up: (1) Mike Curtis will check with an EMS internet vendor about developing the interactive option and will also check with the Medical College of Wisconsin about CME credit; (2) the Bureau will check on interactive and posting options to the internet within DHFS or through the HAN; (3) PAC members will reformat their sections of the course for consistency and also add evaluation questions to each section.

9. Ambulance provider guidelines

The question was whether PAC could help develop some basic guidelines to assist ambulance services in decision-making as to what scope and level of care is most appropriate for them. The bureau will do an initial draft for PAC to react to at the next meeting.

Next Meeting: October 4 in Green Bay at PSOW