Meeting was called to order at 1300 hours by Chair Bill Dousa. He thanked Kensington Volunteer Fire Company for hosting the meeting and lunch. Chair report – The safety subcommittee (no red lights and siren) has met several times and is moving forward. There is a presentation that is being worked on for the Ambulance Safety Committee later this month. A draft standard is being worked on for dispatch and transport to a facility. This will be a guideline and the plan will be for each jurisdiction to have a county protocol/standard in place. There was a question of responding to a scene non emergency and on arrival there is a priority patient. Most incidents occur during lights and siren while transporting (several are catastrophic). It will be a re-education for providers and the community alike. Recording Secretary – Linda Dousa sent around an attendance roster for input and corrections. She will keep this updated for each meeting. If anyone has a change in email or phone number, please let her know. Association Officers – Vice President Dave Lewis thanked everyone for their continued work. There are several goals that we will be working on; the new EMT-B curriculum; EMS safety task force along with MIEMSS. MSFA has been working with all the partners in looking at the MEMSOF funds. There is a meeting in the next couple weeks to set a plan before talking to the Governor. According to the news, the state is on the verge of signing the contract for the new helicopters. This should go to the board of public works next week for approval. There will be a formal press release afterward. ALS Sub Committee – Marianne Warehime has been in touch with MFRI to talk about the MICRB certification. Cross jurisdiction training is still being worked on. At this time, the volunteer entities are in favor; the large career jurisdictions are going to do their own thing. The plan is to get the plan and send it to the Medical Directors and the senior EMS officers for their approval. It has been a slow process but is moving forward. BLS Sub committee –
Joan Williams stated they had nothing to report. MIEMSS– Dr. Alcorta gave an update on protocol changes for 2011:
• New medication will be Dexamethzone (Decadron) for moderate to severe
asthmatics. The route of administration will be IV for adults, oral for pediatric patients.
• Protocol for Go Team activation. There will be indications for activation.
• Bucking protocol (intubated patients who are trying to pull the tube) will be
moved into standard ALS care. Versed will be the drug of choice.
• All transport units by 2012 must have pulse oximetry onboard. • Capnography (waveform) – must be available on all ALS transport units by 2015
• Pain management – MIEMSS has been working with NHTSA and National
Children’s Center is looking at helicopter and pain protocols. Based on national standards, pain management in Maryland has been under treated. The new protocol for morphine will be .1mg/kg. There will be strong education and this will be looked at closely over the next year. Documentation will be crucial prior to and after medication use.
• EMS DNR – the current protocol is EMS DNR-A/DNI. There were many
physicians who questioned if the old DNR-A form (intubation allowed) would be accepted. After discussion with the End of Life committee, the old form will be reinstated. They will now have 3 options available.
• Other protocol changes are verbiage changes.
Cardiac intervention centers – 17 out of 23 centers have sent in applications for approval. The standards have been approved. The other facilities should be sending applications in by next spring for approval. Each region has a STEMI committee that will be setting up guidelines for transport to a center. Medication shortages are being addressed. Pre loaded syringes should be up to normal supply. Hospira is back up to supply and are presently filling back orders. Succinocholine is in short supply; there is a reasonable supply in the field right now. Cardizem is also in short supply. Please let Dr. Alcorta know if your jurisdiction is having an issue with shortages. Learning management system – the program is moving forward with minimal issues. MIEMSS will soon be shooting the new protocol updates which will be placed online in January. Providers will be required to complete them by June 1 so that jurisdictions can be notified of those not compliant prior to the July 1 new protocol implementation. A question was raised if MIEMSS can do something about providers who still have not taken a protocol update. Dr. Alcorta stated MIEMSS licenses the provider but has no say in whether the provider can ride the company unit. Another question was raised about providers who do a re-cert after the fact, can their cards be held until after they complete a protocol update? Motion by Charlie Simpson, second by Susan Mott to have MIEMSS hold recertification cards for those providers who have not completed protocol reviews. Discussion – Charlie Wills stated the computer/cookie issues need to be addressed so providers who have completed the update receive credit. Charlie Simpson stated doing this as a motion will lend credibility to the committee and this will also work on cleaning up the process of credentialing and making sure the providers are up to date. Motion carried. A formal letter will be sent to Dr. Alcorta. Several online training programs have been linked to the management system. Summerset County SWOT has been completed; St. Mary County’s SWOT will begin soon. BDLS course on November 30 will be held at North West. It is posted on the MFRI website. ePCR – Image Trend software is being worked on. They are making sure the data set will work with minimal issues. The protocols will be available for review while doing the report. Medication dosages will be available for pop up if needed. This should improve documentation and will be a learning experience. The new ePCR will be tested in Harford, Cecil and Queen Anne Counties beginning in November. The testing will last 30 days. MIEMSS will be doing train the trainer sessions to make training easier for each jurisdiction. Joe Davis will be the lead trainer. There will be a sub committee to look at the short form to be left at the hospitals; they will also be looking at “cheat sheets” for units. Wayne Tome is interested in participating in this sub committee. HUD – every helicopter request is looked at by the Medical Director and QA officer from each jurisdiction. There are 3 questions that are answered also. Right now the helicopter requests are 90% compliant with protocol; 79% saving time; 78% benefit for the patient. Vigilant Guard is an exercise that will be happening in the Baltimore area in November. Charlie Simpson questioned if a study has been done on the effectiveness of succinocholine. Dr. Alcorta receives quarterly reports from the jurisdictions who do RSI to see if things need to be adjusted. MFRI – ALS - Steve Frye stated September and October are busy due to many classes. Only one class has been canceled due to low enrollment. BLS –Les Hawthorne stated the new guidelines for AHA are coming out: Jan – Mar Healthcare and Friends and Family; April – June Heartsaver classes; July – Sept ACLS; Oct – Dec PALS. The new Emergency Care 12th edition from Brady is scheduled to come out in April. This may delay the pilot programs until the fall sessions. Instructor roll out will be 6 hours and should happen in April or May. There was a question of the new students getting full protocol books while in class vs the pocket protocols. Brady is working on a bridge book.
MSP Aviation – not present. RAC Shock Trauma – not present. New Business – Chris St. John stated Kensington has been working on a tool kit with a vendor in Colorado. He handed out documentation for review and feedback. Old Business – Marcine Goodloe, President of the Montgomery Volunteer Fire Rescue Association, gave an update on the ambulance fee proposal. In the county, they have a fire tax which is supposed to cover fire companies. If they do EMS billing, those funds will not be placed in the fire companies; it will go in the general coffers. They have won the battle and have gotten the question on the ballot for November. Good of the committee – Wayne has 3 XL large shirts left at $19.00 each if interested. Next meeting – Saturday January 15, 2011 at Hurlock. Lunch at 12 noon, meeting at 1pm. Adjournment – 1440. Respectfully submitted Linda Dousa
Technician Training Tutorial Dispensing Pediatric Antibiotic Suspensions Improper mixing of antibiotic suspensions is a source of medication errors in pediatric patients. In some cases, the problem has been caused by suspensions that weren’t reconstituted. The parents administered the drug as powder, which resulted in an overdose. It’s important that pharmacy technicians take
Androgen receptor locked nucleic acid antisense oligos potently knocks down target gene expression both in vitro and in vivo Baisong Liao, Yixian Zhang, Jolanta Kosek, Wenzhe Liu, Stephen Castaneda, Lee M. Greenberger, Ivan D. Horak Abstract #4631 Enzon Pharmaceuticals, Inc., Piscataway, NJ INTRODUCTION In vitro results with LNCaP cells In vitro results with 22Rv