Peninsulas Emergency Medical Services Council, Inc. Medical Advisors Committee

Regular Session

In accordance with the Americans with Disabilities Act (ADA), the Peninsulas Emergency Medical Services (PEMS) Council, Inc is committed to ensuring that individuals with disabilities are not denied an opportunity to participate in and benefit from any service, program, or activity

offered by the PEMS Council. Persons with disabilities who anticipate needing special accommodations or have questions about physical access may call (804) 693-6234 in advance of the program

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AGENDA Thursday December 13th, 2018 at 1:00 pm

Peninsulas EMS Council Office, 6876 Main Street, Gloucester, VA 23061 Teleconference at https://global.gotomeeting.com/join/140209165

Telephone +1 (872) 240-3412 Access Code: 140-209-165

1. Call to Order – Lisa Dodd, DO 2. Introductions 3. MAC Membership Changes

a. Review Bylaw Membership requirements 4. Approval of Minutes – September 13th, 2018 5. Regional OMD Report – Cheryl Lawson, MD 6. OMD Membership – Michael Player 7. Committee Reports

a. Pharmacy Committee –Chair, Suzanne Hopkins, PharmD from SWRMC • Next Meeting – February 6th, 2019 at 3 pm

b. Performance Improvement Committee – D. Thomas • Next Meeting- March 14th, 2019 at 3 pm

c. PPP Committee – David Justis, MD • Next Meeting – January 10th, 2019 at 10 am

d. Clinical Program Task Forces (Stroke, STEMI, Trauma) – D. Thomas i. Trauma Task Force – Debbie Thomas

• Next Meeting – March 14th, 2019 at 1 pm ii. Stroke Task Force

• Next Meeting – January 10th, 2019 at 1 pm iii. STEMI Task Force

• Next Meeting – February 14th, 2019 at 1 pm iv. Behavioral Health Task Force- A. Ashe

• Next Meeting – TBA e. EMS Operations – J. Bendit

• Next Meeting – January 8th, 2019 at 7:00 pm f. Interfacility and Critical Care Transport Committee – J. Bendit

• Next Meeting – January 17th, 2019 at 3:00 pm 8. PEMS Updates

9. Old Business

a. Protocol Rollout/PowerPoint 2019

10. New Business a. Benadryl Shortage b. Physicians’ signature for meds/HEMS

11. For the Good of the Order a. Important Dates

Peninsulas Emergency Medical Services Council, Inc. Medical Advisors Committee

Regular Session

In accordance with the Americans with Disabilities Act (ADA), the Peninsulas Emergency Medical Services (PEMS) Council, Inc is committed to ensuring that individuals with disabilities are not denied an opportunity to participate in and benefit from any service, program, or activity

offered by the PEMS Council. Persons with disabilities who anticipate needing special accommodations or have questions about physical access may call (804) 693-6234 in advance of the program

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i. December 24-25, 2018 PEMS Office Closed (State Holiday) ii. December 31, 2018 – January 1, 2019 PEMS Office Closed (State

Holiday) iii. January 18th & 21st, 2019 PEMS Office Closed (State Holiday) iv. February 18th, 2019 PEMS Office Closed (State Holiday)

b. 2019 MAC Meetings i. March 14th, 2019 7:00 pm

ii. June 13th, 2019 7:00 pm iii. September 12th, 2019 7:00 pm iv. December, 2019 TBA

c. Verify Attendance

12. Adjournment

Peninsulas Emergency Medical Services Council, Inc. PO Box 1297, 6876 Main Street

Gloucester, VA 23061 Office (804) 693-6234 - Fax (804) 693-6277

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PEMS Medical Advisory Committee Meeting Minutes A PEMS Council Standing Committee

Meeting Date: December 13th, 2018 Meeting Location: PEMS- Classroom Room Chaired By: L. Dodd Begin Time: 1:40 p.m. End Time: 2:40 p.m. Minutes Submitted By: Seth Craig Draft Approved Date: 3-14-19

Members Present: Members Absent: Staff: Others: Baker, MD, Chris Apostoles, MD, Steve Ashe, Amy Doak, Melissa (York County) Dodd, DO, Lisa (Chair) Bass, MD, Gregory Craig, Seth Erwin, MD, Eleanor (Vice-Chair) (TC) Berry, Wayne Hoyle, Paul Fish, Jr, MD, James Clarke, DO, Clarence Thomas, Debbie Justis, MD, David Clifford, MD, Christianne Lawson, MD, Cheryl Dudley, DO, James Sweet, Jason (James City) Dunn, MD, Chad Enzor, Lindsay Garrison, MD, James Gupta, MD, Sudershan Haas, MD, Christopher Harper, Kimberly James, MD, Christopher Jennings, MD, Torino Laing, Jim McCorry, DO, James Ray, MD, Gaylord Skrip, MD, Stephen Sutherland, MD, Paul Veek, Phillip Weber, MD, Brent Williams, Cynthia

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Item Discussion Action Required By Whom/When

Call to Order Meeting Called to Order at 1:40 p.m. by L. Dodd; Those present and on teleconference introduced themselves.

MAC Membership Changes

OMD Membership Report – MAC Committee has a vacancy for Licensed EMS Agency (Middle Peninsula), Licensed EMS Agency (Northern Neck).

Seek new members

MAC

Approval of Minutes Approval of the September 27th, 2018 Minutes. Motion by J. Sweet to approve, Second by M. Doak. Minutes approved unanimously as written.

Regional OMD Report

Dr. Lawson- 2019 Protocol changes have been approved by the MAC.

OMD Membership S. Craig provided information about the OEMS CE dates and locations for OMDs. OMDs expiring in 2019 have been notified.

Committee Reports

Committee Reports – a. Pharmacy Committee –S. Craig for C. Williams

• Diphenhydramine shortage still • Next Meeting February 6th, 2019 at 3:00 p.m.

b. Performance Improvement Committee – D. Thomas

• Investigating temperature and EtCO2 capabilities by PEMS agencies, especially as related to sepsis identification. Recently sent out a survey to agencies regarding thermometer and usage. Results indicated that most agencies who responded to the survey use tympanic thermometers.

• Examining HEMS usage in the region. • Examining the QI process for Strokes and STEMIs • Next Meeting – March 14th, 2019 3:00 pm.

c. PPP Committee – D. Justis

• Will present 2019 Protocol Slides under new business • Next Meeting – January 10th, 2019 at 10:00 am

d. Clinical Programs Task Forces

i. Trauma Task Force – D. Thomas • Prehospital providers in PEMS Region are NOT under-triaging trauma patients • Save the Dates: VCU Trauma 3/22/19 and Hampton Roads Trauma 4/26/19 • Next Meeting December 20th, 2018 at 1 pm

ii. Stroke Task Force – D. Thomas • PEMS has 70% compliance on R.A.C.E. Scores reporting by providers • Next Meeting – January 10th, 2019, at 1:00 pm

iii. STEMI Task Force –D. Thomas • Time between Patient Contact and 12 Lead Acquisition for Chest Pain- Protocols 5

minutes, AHA 10 minutes, PEMS average is 10 minutes • Next Meeting – February 14th, 2019, at 1:00 pm

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Item Discussion Action Required By Whom/When iv. Behavioral Health Task Force- A. Ashe

• Received a Regional Behavioral Health Plan Grant to include training for regional approach to train CISM, etc.

e. EMS Operations Committee – S. Craig for J. Bendit • Please complete MIRs for incidents- agencies and pharmacies- diversions, med box errors, etc • Next Meeting – January 8th, 2019 at 7:00 pm

f. Interfacility and Critical Care Transport Committee – S. Craig for J. Bendit

• Need participants • Next Meeting – January 17th, 2019, at 3:00 PM

PEMS Updates Received CE/AUX MOU for FY19- PEMS Staff will be conducting CE/AUX programs in the region without active ECs. Regional Council re-designation is being processed.

Old Business Still working on Critical Care Paramedic Course within the region.

See if this is feasible

S. Craig

New Business

Physician’s signature for HEMS and Controlled Substance Administration- YCFLS had an incident recently where an ED physician refused to sign the PEMS Medication Usage Form because he had not seen the patient. Dr. Fish made a motion to add Ketamine to the PEMS Regional Protocols for Pain Management and Excited Delirium. Dr. Lawson seconded the motion. The motion was approved unanimously. Some agencies requested a process to receive new protocol files prior to actual rollout to make printed copies.

Revise Pain Mgt and Excited Delirium Protocols with Ketamine Develop Process

PPP/ongoing S. Craig/P. Hoyle

For the Good of the Order

For the Good of the Order a. Important Dates

• December 24th, 2018- January 1, 2019 PEMS Office Closed

b. 2019 MAC Meetings c. Verify attendance

Adjournment Meeting was adjourned at 2:40 p.m.