Farmacia italiana online: acquisto cialis in Italia e Roma senza ricetta.
Microsoft word - 09septmin.doc
THE September, 2007 BOARD MEETING FOR THE JOINT COMMITTEE OF EMERGENCY
MEDICAL SERVICES IN TRUMBULL COUNTY WAS HELD at 11:30 am on 9/26, 2007 at
Abruzzi’s 422 restaurant.
Voting Members present were as follows: 1) Chairman – none
2) Co Chairman – none
3) TMH REPRESETATIVE – George Snyder 4) Education REPRESENTATIVE – George Brown
1) FIRE CHIEF – Roger French 2) PRIVATE SERVICE – none
3) FIRE BASIC – Dale Briggs
4) FIRE INTERMEDIATE – Ken Laughlin
5) FIRE MEDIC – Fred Stosik
6) PRIVATE BASIC – none
7) PRIVATE INTERMEDIATE – none
8) PRIVATE MEDIC – Randy Pugh
9) First Responder – none
Ken Schick, Tim Thomas, Rudy Harsany, John Hickey
Motion to accept minutes by John Hickey; second by George Brown.
Motion approved with no opposition. 2. TREASURERS REPORT
Golf outing expenditures were 2066.21. We took in $2468 all together leaving us with $402.21 profit
and another $200 that is supposed to be coming in.
TOTAL in our account is .$3587.57. 3. COMMITTEE REPORTS
i. Planning, Development & Fund Raising –
Golf outing at Avalon South, 9/14/07 – Rudy Harsany Everyone there had a great time. We ended up with 6 teams of 4 golfers and had sponsorships for every hole. Stat Medi-vac had their outing on the same day. Everyone agreed that it went very well for our first time out. The question was raised about next year’s outing date. Howland is having their’s on the 2nd Friday of September. We decided to plan ours for 9/5. Rudy will advise Stat of our date so there won’t be any conflict this time. Rudy also agreed to chair next year’s event since everything is pretty much in place after this year’s planning. .
b. 6.03 Code of Regulations – Ken Laughlin –
i. Letter was sent to Woodrow Sams concerning last month’s
ii. Elections – The secretary will send out letters about the positions
of fire intermediate, private basic and private medic that will be up for election in December. He will remind all that the Code of Regulations states that anyone interested needs to show previous interest by attending 2 board meetings during the previous year.
1. There are four elected board members that have not made
their 5 meetings thus far. Two of those do not have the ability to make 5 meetings at this time. George Brown made a motion to send a letter to each reminding them of the 5 meeting rule. Those who fail to do so will be removed from the board effective 1/1/08. Randy Pugh seconded the motion. There was no further discussion. Motion passed with no opposition.
2. The question was raised concerning the difference between
the elected board positions requiring a 5 meeting per year attendance and the appointed positions without the same requirement. There are items that are discussed that make it hard to vote with the informational background that occurs at board meetings when one has not been in attendance. George Brown made a motion to send a letter to all persons who are in the appointed positions on the board stating that all those in elected positions are required to attend 5 meetings per year. We would ask that they make every effort to do the same. Fred Stosik seconded the motion. Motion passed with no opposition.
a. The next training scheduled is on the first
Wednesday of November. There will be a two day training on 12 lead EKG reading probably taking place on 11/14 & 15. It will be the same lecture both days offering 6 – 8 CEU’s. It will be held at
either Leo’s or Avalon. There is also the possibility that that training will take place of the normal first Wednesday CE. TMH will send out “save the date” postcards prior to that meeting.
b. On October 15 training on the EZ I/O will be held
at Warren twp. TMH will get someone there to authorize CE. Chief Schick will send out a fax to all departments with the information.
c. Anyone who attends a medic school through TMH
will have fees for future EMS symposiums sponsored by TMH waived.
1. Cardiac symposium. – It was held on Wednesday,
September 12, 2007 from 8 am to 3:30 pm at Leo’s Ristorante on E. Market in Warren. Dr. Berg was a great speaker. He offered some good information that very well may affect and be included in our protocol
a. There are more than a few arrests that come into
TMH ER having had the improper sequence of shocks according to the current ACLS guidelines. 200 / 300 / 360 is no longer appropriate. All medics are asked to review current ACLS guidelines.
b. There are also many “trauma” patients being
brought in who have not been in full c-spine immobilization. If someone is not backboarded for a good reason, please DOCUMENT, DOCUMENT, DOCUMENT.
c. On your run reports please include the time ER was
notified. Too many run reports are coming in without that information.
d. If you know of an incident that is questionable
whether it is in the field or concerning care in ER please write it up and make sure it gets to George Snyder. Unless an incident is reported, it is doubtful that George will get it and can do something about it (i.e. ALS squad cancelled enroute by a basic unit for chest pain.)
d. 6.06 Protocol Committee – George Snyder
i. On September 10 there was a county wide protocol meeting at
Abruzzi’s 422, time – 6 pm. All departments were requested to send at least one representative to the meeting with ideas for upcoming revisions / additions with supporting documentation for any requested updates. Taser Barb removal, CPAP for basics and intermediates, Nitro and beta blockers, RSI and the addition of Fentanyl, Atavan, Cardizem and Lopressor were discussed by those present and Dr. Spirtos. George Snyder has researched protocols nation-wide for how others handle RSI. If RSI were to be adopted it would need to include annual requirements for
medics. The secretary was asked to request the state add the drugs Fentanyl, Atavan, Cardizem and Lopressor to the drug license for 2008 for possible inclusion in the protocol subject to the board’s future discussions.
ii. There was a large discussion concerning the protocol committee
and Dr. Spirtos making decisions about adding drugs to the drug license for possible inclusion without discussing it with the board first. Procedural point: the board needs to vote to add drugs to the drug license prior to the addition of said drugs. Dr. Spirtos needs to get possible changes in writing ahead of time in order for him to research and review them ahead of time. The protocol committee apologizes and in future years this discussion will need to come earlier in the year so it will not happen again.
iii. Protocol completions – Fred Stosik –
Tom Dempsey – Paramedic / Bristol - Champion. Eric Fenstermaker – basic / Bristol; Ken Mauch – Basic / Vienna; Randy Pugh made a motion to grant protocol to the above named person(s). Ken Laughlin seconded the motion. Motion passed with no opposition.
iv. The Disciplinary policy personnel – At the August board meeting
it was suggested that a private administrator also serve on the committee. Joe Robinson, Randy Pugh and Jack Popodak all agreed to serve. A voice mail was left at Clemente’s offering the position. A suggestion was made to allow all 3 to serve in the position. Anyone who would be free at a particular time could serve. If someone from their department was being questioned, another rep should serve at that time. This was agreed to by the board. Further discussion centered on also having a position of “Fire administrator”. John Hickey, Fire chief at Champion FD was one of the volunteers at the last meeting. The other four chiefs who serve on the board were also present and agreed to serve if needed.
v. The secretary sent the drug license request on behalf of all
departments with protocol under the JCEMS in TC to the state on 9/11 including the four new drugs (Fentanyl, Atavan, Cardizem and Lopressor) discussed at the protocol meeting.
4. Informational reports
a. State EMS Board update – none b. RPAB –none
i. Regional geographical changes. Chief Brown – none
c. Ohio Medical Transportation Board – none
5. Old Business
6. New Business –
a. If any squad uses an EZ-I/O or King airway and needs a replacement, get
a hold of the charge nurse on shift. Those items are locked up at present due to the disappearance of the same.
b. George Brown made a motion to elect Randy Pugh as vice chair of the
board to run the meetings in the absence of Dr. Spirtos. Ken Laughlin seconded the motion. Motion passed with no opposition.
c. George Brown made a motion to have a one day retreat in January to
review all things pertaining to this board including committees which have not been reviewed since 2004. It could be held at Howland with lunch included. Randy Pugh seconded the motion. Dr. Spirtos should set the date according to his schedule. George Snyder will contact him to let him know. The secretary shared that he still has copies of the strategic planning results from 2000 / 2001. He offered to send copies to all board members. The suggestion was accepted. Motion passed with no opposition.
Minutes recorded by
Secretary: Dale Briggs
Chairman: Ted Spirtos
By Charlcie Gill Rabbits produce two types of droppings: fecal pellets and cecotropes. The latter are produced in a region of the rabbit's digestive tract called the cecum. The cecum contains a natural community of bacteria and fungi that provide essential nutrients and possibly even protect the rabbit from harmful pathogens. By consuming the cecotropes as they exit the anus, the
I REQUISITI DI CAPACITA’ ECONOMICA E FINANZIARIA NEGLI APPALTI DI SERVIZI E FORNITURE – FATTURATO GLOBALE E FATTURATO SPECIFICO SOMMARIO: 1. Capacità economica e finanziaria (art. 41 D.lgs. 163/2006) Principi generali; 2. Criteri e principi da seguire per definire i requisiti di partecipazione – 3. Fatturato globale e fat-turato specifico. 4. Entità del fatturato e “soglia di non cen