Information from Steve Powles...DHS State EMS Council April Meeting Minutes

Here is the highlight of the April Minutes

        4.  Rule Writing Update – Terry Mullins reports revision and rule creation dealing with the
                following over the next 18 months:
§        EMS data collection;
§        Medical director certification;

§        Emergency medical dispatcher training;

§        Alternate destination transport options for ambulance providers;
§        Treatment and triage protocols; Sarah Harpring will be responsible for this process and needs input from stakeholders;
§        Mark Venuti states Rules Committee needs more members.  Current vacancies:  ALS Training Program Representative; Base Hospital Coordinator/Medical Director and Air Ambulance Provider.


Mark Venuti works for the  Flagstaff Fire Department and Guardian Medical Transport
Here is the chairman of the Rules committee

They have not determine when they will tackle EMD

Terry is the Bureau Chief of the EMS Bureau
 

 

EMERGENCY MEDICAL SERVICES COUNCIL

MINUTES

April 20, 2007

150 North 18th Avenue, Suite 540

Phoenix, AZ

 

Members’ Present                                                                             Members’ Absent

Bentley Bobrow, M.D., Chairman         Stewart Hamilton                      Michael Hegarty

Barbara Schaffer                                  David Ridings                           Harold Nystedt

Paul Coe                                              Roy Ryals                                 Kurt Krumperman

Taylor Payson                                      Charlie Smith.                           Marcia Barry

Janine Anderson, R.N.                         Coy Amerson                           Kevin Riley

John Gallagher, M.D.                            Scott Petersen, M.D.                Misty Cisneros

Jeff Daniel, M.D.                                  B. Gene McDaniels                 

Mark Venuti                                         Mike Evans

Bob Ramsey                                         Jerry Stein                                ADHS Staff

Ronalee Quarles                                   Daniel Spaite, M.D.                  Terry Mullins

Sarah Harpring

Traci Alexander

Teleconference

Thelma Brandon-Davis            

Charlie Smith

Michael Ward

                                                                                                           

I.          CALL TO ORDER

Ben Bobrow, Chairman, called the regular meeting of the Emergency Medical Services Council to order at 10:34 a.m.  A quorum was present.  A moment of silence was called for the Virginia Tech shootings.  Memorial service will be at the Capitol today.

           

II.        DISCUSSION and ACTION ON JANUARY 19, 2007 MINUTES

Dr. Bobrow asked for motion to approve minutes.  Motion made by Roy Ryals and seconded by Mike Evans for approval of  January 19, 2007 minutes with two corrections: 1) Move Coy Amerson from Teleconference to Members Present; 2) Top of page 6 under Northern Region, last bullet, remove Steve Faulk and insert Gitti Silven as Treasurer.  Motion Carried.

 

III.       REPORTS:

A.  REPORT FROM THE BUREAU CHIEF:

   1.   Terry Mullins, Bureau Chief, gave a current progress report in regards to computer-      based testing for EMTs: 

§         Basic pass rate at national level 73%;

§         State of Arizona EMT-B 72.8% pass rate;

§         EMT paramedic national pass rate 68%;

§         State of Arizona EMT paramedic 77.1% pass rate.

§         State of Arizona  EMT-I have 100% pass rate

§         Flagstaff testing site operational.

§         There will be three additional sites within 30 days:  Bullhead City, Lake Havasu and Kingman.   John Gallagher states cannot send check for all students at one time for testing.  Students have to pay individually.  Terry Mullins will follow up.

 

2.     Draft Substantive Policy Statement for EMTs Working in a Hospital Environment:

§         Bob Ramsey reports Bureau taking active role in implementing a policy of rights and jurisdictions in regards to EMTs practicing as an EMT in the hospital.  Mark Venuti states previous draft gave EMTs more ability to work for two departments even though nursing and physician licensing boards didn’t want this.

§         Sarah Harpring, Joel Bunis and Terry Mullins met with the Deputy Director  and received approval to move forward and solicit public comment for the draft by placing on website and sending out email.  Draft already approved by the Executive Directors of the Boards of Nursing, Osteopathic and Medical Board.

§         Coy Amerson wanted to make a motion for the EMS Committee to also vote in regards to this issue but Sarah Harpring states it wasn’t on agenda.

§         Terry Mullins states Department of Corrections is also looking into employing EMTs.

 

   3.  Vicki Conditt reported the American College of Surgeons Committee on Trauma is                                       conducting statewide trauma system consultation and evaluation from June 26-29 at                                   Phoenix Wyndham Hotel. June 27 will be a question and answer session.  All                       invited to attend.  The last day will be Summary Report of findings.  The final report is

         expected approximately 60 days after the visit.

 

   4.  Rule Writing Update – Terry Mullins reports revision and rule creation dealing with the                   following over the next 18 months:

§         EMS data collection;

§         Medical director certification;

§         Emergency medical dispatcher training;

§         Alternate destination transport options for ambulance providers;

§         Treatment and triage protocols; Sarah Harpring will be responsible for this process and needs input from stakeholders;

§         Mark Venuti states Rules Committee needs more members.  Current vacancies:  ALS Training Program Representative; Base Hospital Coordinator/Medical Director and Air Ambulance Provider.

 

            B.  CHAIRMAN’S REPORT:

EMS Council Membership Update – Dr. Bobrow:

·        Harry Nystedt and Carol Hobbs resigned. Dr. Dale Wooldridge, who represents EMS for Children at University, will be recommended for appointment as a Lay Member on the EMS Committee.  Lay Member position for Central Region is still open.

 

IV.       DISCUSSION AND ACTION ITEMS:

A.  Discussion on Proposed Rulemaking and Guidance Documents for EMT-B Use of An Esophageal Tracheal Double Lumen Airway Device (Combitube)

Sarah Harpring reported on the Curriculum for EMT-B use of ETDLAD apparatus is intended by Education Subcommittee to replace current guidance document, R925-511.  MDC recommended move forward with proposal; Education Committee recommended to move forward with proposal and to include provision that would require 80% competency on national skills evaluation.  Harpring states if they want this to be enforceable, it needs to be in rule; asking for recommendation as to Guidance Document.  Motion made by Janine Anderson to accept curriculum.  Mark Venuti seconded.

Motion carried. 

 

B.  Laryngeal Mask Airway

§         Terry Mullins reports Education Committee is developing a Guidance Document for the use of LMAs.  The Bureau confirmed with DOT that the use of LMAs is outside of the current curriculum, but that efforts are underway to revise the national curriculum, and LMAs will be included. 

§         The Bureau confirmed with DOT that the use of LMAs is outside of the current curriculum, but that efforts are underway to revise the national curriculum, and LMAs will be included.

§         Janine Anderson states Education Subcommittee is attempting to clean up things that have been approved as training curriculum or had been lost in the process.

§         LMA Curriculum had been written and approved by the Council but not distributed throughout the State of Arizona; will be resubmitted at Education Committee meeting and added to Medical Direction Commission agenda to approve the device and to Emergency Medical Services Council as an information item. 

§         Terry Mullins, Brian Smith and Janine Anderson will devise a draft that will survey evaluating the use of the LMA and other tools/techniques.  Survey will be distributed to ambulance (ground and air) and providers to compile results and share with MDC.

C.  Cardiac Arrest Center Model

     Dr. Bobrow presented an analysis of statewide cardiac arrest data.  Main     

     idea:  to improve survival using in-hospital therapies for cardiac arrest including:

§         Therapeutic hypothermia;

§         Early percutaneous intervention;

§         Standardized pressure support;

§         Standardized ventilation support;

§         Glucose support;

§         Standardized outcome measurement;

§         CQI program. 

 

Proposal:  Form workgroup consisting of: 1) Community ED and hospital stakeholders; 2) Scientific experts; 3) EMS stakeholders.  Goal:  Design the criteria/data collection for Cardiac Arrest Centers; 4) Report back to EMS.  Mark Venuti made a motion to accept; seconded by Dr. Gallagher. 

Motion carried.

 

V.        STATE TRAUMA ADVISORY BOARD

            A.  Discussion/Action on Report from STAB                      

                        1.  Dr. Petersen and Sarah Harpring reports draft Trauma Registry rules have been

                                     approved by STAB; Harpring states the rules specify all data elements that need

                              to be submitted. 

2.  Two definitions of Trauma Centers – Designated and non-designated - how to

 submit data to trauma registry and what needs to be submitted.  Rules will be sent

 out for public comments. 

3.  STAB approved the pre-review questionnaire for the American College of

     Surgeons Trauma System site visit scheduled in June. 

 

VI.       PROTOCOLS, MEDICATIONS AND DEVICES COMMITTE

            No meeting due to lack of agenda items.  Next meeting agenda will be posted for

            May 17, 2007.

 

VII.     EDUCATION SUBCOMMITTEE:

Janine Anderson, Chair of the Education Subcommittee, states the subcommittee is trying to target efforts into the development of curricula for treatments and procedures that are performed in the field.  Among these are the – LMA, Easy IO, Auto Vent and CPAP Curricula that will be reviewed at next meeting.  This will be followed up to make sure all procedures fall into scope of practice according to DOT Curriculum.  Several open agenda items: 

A.  Discussion and Action on Education Committee Recommendations:

     1Draft Rule pertaining to training programs securing written final exams at all

          levels of EMT Training – discussion and action taken to oppose the rule as written.

                  2. Establishment of a Chair for the work group to recommend requirements for on-line                     EMT education and definition of a “contact hour” – chair Jerry Stein.  Please forward                         any other agenda items to Janine Anderson or the Bureau.

          

VIII.         EMERGENCY MEDICAL SERVICES COORDINATING SYSTEMS REPORTS

A.     Central Region – Barbara Schaffer reports AEMS had their board meeting yesterday, April 19, 2007 and will also meet on June 20, 2007; AEMS is currently involved with coordination of three special events:

§         2007 EMS Conference, May 21 at the Marriott Hotel in Mesa; all EMS providers eligible - entitled to attend conference free for 1 night.  Contact Barbara Schaffer or Peggy Baker for questions

§         2007 EMS Recognition Awards - process implemented and nominations accepted for EMS professionals for 11 categories

§         2007-2008 provider assistance and application process implemented –process will be complete by mid June; AEMS continuing to work diversion issues on pilot project – still collecting data. 

 

B.       Southeastern Region – Taylor Payson reports for SAEMS:

§         1st Annual Charles Kramer Memorial Scholarship Fund;

§         Standing committees are continuing to meet on regular basis;

§         90% provider grant process;

§         University Medical Center starting new ED project which will double space for trauma patients;

§         Rural Project continuing – will have more agencies joining later;

§         27 new AEDs;

§         Working with Rural Health Office at the University of Virginia Training Opportunities for Agencies and Critical Access Hospitals;

§         Pediatric conferences will be held in Sierra Vista on July 19 in Flagstaff & July 24 for Graham/ Greenlee County Council sponsored committee. CPR training in February with 110 attendees;

§         4th Annual Golden Hour Golf Tournament raising funds for the trauma program will be held May 11;

§         I-10 widening project underway schedule for June 1; Westbound Speedway access to freeway will be closed first part of next week;

§         Southwest Regional Trauma Conference will be held on August 9 and 10 in Tucson;

§         Met April 9 with DEA and Board of Pharmacy - physician at a base hospital refused to sign an order to allow refill of morphine - almost resulted in a shut down; Board of Pharmacy, pharmacists, hospital and DEA are willing to accept copies of  first care form or replacements of Class 3, 4, 5 narcotics instead of using a written prescription for general patients; solution may be stamped on a copy that certifies signature;

§         Dr. Porter, Director of Trauma has submitted his resignation effective July.

 

C.      Western Region – Jerry Stein reports:      

§         There will be elections on May 10 for substitutions and nominations of members;

§         Provider grant meeting will be held and grants awarded;

§         AED process ongoing;

§         Protocols being reviewed—will be looked at in the next couple of months; data collection will be for one or two departments that will be coming online.

 

D.       Northern Region – Paul Coe reported last meeting March 2, 2007:

§         Approved 06-07 budget;

§         Received training mannequins for Regional Medical Center for Educational programs;

§         Attended teleconference April 7 in regards to contracts for Regional Board of Directors who have various concerns about items in contracts;

§         Conducted Provider Grant Screening for Provider Grant Cycle on the 17th with recommendation from all councils for their approval;

§         State will put out RFP for AED for other groups who are eligible to apply and get group discount purchase – opportunity to purchase AEDs from this year’s contract will be available through the state as well.

 

IX.       CALL TO THE PUBLIC 

§         Mark Venuti reports per DPS that State of Arizona radio system being increased to 26 sites because of a need for a system that will talk to each other; there are 400 eligible agencies who have registered for a free MOU on DPS website www.azdps.gov, under Public Safety Communications and SIEC for Statewide Interoperability Executive Committee; overall usage – allows individuals to speak using either or both VHF and UHF without switching channels; Terry Mullins states will coordinate activity with Mark Venuti to develop information to share.

§         Bob Ramsey reports there is a Lifepak Medtronic situation of which FDA issued a Stop Shipment; Dr. Bobrow reports not a device issue but an accounting issue.

§         Terry Mullins will set up methodology with Bob Ramsey and Dr. Gallagher for a one page notice for placement on the website dealing with the Lifepack Recall.

§         Next meeting add a legislative update to the agenda.

 

X.        SUMMARY OF CURRENT EVENTS

§         Joel Bunis reports proclamation approved for EMS Week.

§         Provider participation for EMS Week is requested.

§         EMS Staff will be visiting different hospitals.

 

XI.       ANNOUNCEMENT OF NEXT MEETING

The next meeting is scheduled for September 21, 2007.

 

XII.     ADJOURNMENT

                This meeting was adjourned at 11:34 a.m.