At-Large voting membership slot has been filled during the vote held on June 13, 1996. We had a record number of nominations (nine) for one open position. Thanks to all who expressed interest and wanted to get involved. Dr. Anthony Cirillo, the Medical Director of Hillcrest Hospital's Emergency Department received the most votes and will finish out the term which expires in 1998. Welcome Dr. Cirillo. Regional Paramedic/Basic Staffing Waiver requirements were discussed and approved. Briefly, a service must meet the following criteria to be considered for a P/B waiver: 4 paramedics on staff (minimum), ALS intercept agreement, system in place to access 2nd ALS responder, emergency medical dispatch in place, population criteria of service area must be lower than 25,000 or less than 1500 calls per year, paramedics must have some field experience and be approved by Medical Control Physician. For the entire policy please call WMEMS (413) 586-6065. The Regional Council reviewed and the Executive Committee approved a regional guideline for Paramedic to BLS Release. This is not a policy but a guideline and may be used by services as is or modified by services. OEMS requires ambulance services who utilize paramedic intercept to have a policy in place to release the paramedics if not needed. WMEMS office sent the guideline to all ambulance services. The next regional council meeting is Thursday, September 12, 1996 at 10 am in Conference Room A of the Cooley Dickinson Hospital. All are welcome.
At the end of June the office sent out ten modified prehospital protocols. The changes are summarized below. Head Injury and Substance Abuse protocols were modified in that D5W was replaced with Normal Saline. In the Obstetrics protocol D5W was eliminated as an IV choice. Pediatric guidelines were added to the Anaphylaxis protocol. Paramedic standing orders have been added to the Hyperglycemia and Hypoglycemia protocol to allow for drawing of blood and IV start. Cerebrovascular Emergencies has been added as a new protocol. Neurological Emergencies was changed to Altered Mental Status/Coma and the mechanism/etiologies were changed to: neoplastic, infectious, traumatic, metabolic, and psychogenic. Phase I treatment is now paramedic standing orders and Normal Saline replaces D5W. The Seizure Activity protocol was modified as follows. Standing orders were added to both Intermediate and Paramedic treatments. The phrase "or other alternative seizure Meds." was added to the Med Con may order section. The Drug Index was changed to replace D5W with Normal Saline in the following: Bretylium Tosyalte, Epinephrine 1:10,000, and magnesium sulfate. The following four drugs were added to the index: Neosynephrine spray, Lidocaine Jelly, Viscous Lidocaine, and Tetracaine spray. In the Pediatric Drug Index, D5W was replaced by Normal Saline in Aminophylline and Lidocaine Drip.
So - It's August 1, 1996 and the Legislative session ended yesterday. What is the fate of EMS 2000? We go back to October, 1995. The Health Care Committee reported the bill out and it went to Senate Ways & Means. In May of this year Representatives John McDonough of Boston and Dan Bosley of North Adams offered the bill as an amendment to the budget. They withdrew their amendment because, at that point, the Fire Service could not support the bill as written. After six weeks of meetings, language changes were worked out that were acceptable to all of the "stakeholders" (The Department's term). Senator Rosenberg's (Senate Ways & Means Chairman) staff promised to try to get it out to the Legislature for passage by the end of the session. The changes made were things such as: eliminating references to specialty care centers and adding the Mass Council of Community Hospitals to the Emergency Medical Care Advisory Board; defining emergency medical service first responders, and their role; clarifying local responsibility for EMS plans; ensuring that the local planning process considers all relevant services and resources. (A current copy of the legislation can be found at the WMEMS office or from the Metro Boston EMS Home Page at www.tufts.edu/org/mbemsc.)
With all of the above, what happened? The bill was not reported out of Senate Ways & Means, and so did not pass this session. (For those of you who were not around for the passage of 111c, that took 11, yes eleven, years.)
So, now what happens? Representative McDonough is eager to have it refiled so that he can report it out of committee quickly in January. Senator Rosenberg will do the same. They believe it will then pass quickly. In order for that to happen, we have to continue to talk to our Senators and Representatives about the need for the bill.
The Semi-Automatic Defibrillation Challenge Sessions have been scheduled for the year. 1996 Defib Quarterly Challenge Sessions all located at Cooley Dickinson Hospital, Northampton: 8-10a, Thurs, August 29th; 5-7p, Mon, October 21st. Preregistration is necessary. Call WMEMS 413-586-6065. Paramedic Optional Skills WMEMS credentials MA EMT-Ps in optional skills which consist of intraosseous infusion, needle cricothyroidotomy, needle chest decompression. Challenge/Recertification quarterly sessions are scheduled as follows: September 9, 1:30-3:30 pm or November 22, 12:30-2:30 pm. To challenge the WMEMS Paramedic Optional Skills credential call the office to obtain a challenge application which must be submitted two weeks prior to the challenge date. Paramedic Optional Skills Course (11 hours EMT-P con-ed credit): The annual course will be held November 20, 9a-5p and Friday, November 22, 9a-1p. Preregistration is required. The Second Annual Nurse Management Symposium will be held October 25, 1996 at the Delaney House. This program targets ED and CCU nurse managers, charge nurses and supervisors. Micheline Asselin, Clinical Assistant Professor at U. Mass School of Nursing will be speaking on therapeutic communication and facilitating practical leadership scenarios. Daryl Devoto from the Board of Registration will be addressing addiction in the nursing profession. Call or email WMEMS for a brochure.