western massachusetts

emergency medical services

February 1997, Issue 11
Region I EMS Newsletter

Field EMTs Have a Forum!

The Prehospital Advisory Board has been in existence since Sept. 1995. This committee's purpose is to operate as an interface between the field provider and the regional committees, such as the Physicians' Council, Executive and Regional Councils, that govern the policies and procedures within Region I. It provides the unique opportunity for all EMT levels to influence the rules and regulations that are currently followed within western Massachusetts. The committee is currently reviewing its structure and its membership. If you want to get involved and have a voice please contact WMEMS at 586-6065 and we will notify you of upcoming meetings. Don't let apathy get the best of you. Get involved and be heard!

Comfort Care

OEMS has completed work on the Comfort Care program. Comfort Care is a program that will allow MDs to issue DNR bracelets and DNR verification forms for patients with DNR orders. The bracelet and/or form will be acceptable anywhere in Massachusetts as proof that a patient has a valid DNR. OEMS will be working with the Mass Medical Society to educate the physicians who will be distributing the forms and bracelets. OEMS also intends to notify ambulance services, fire departments and police departments, nursing homes and hospice groups of this new program. There will be a phase-in period during which you can honor the Comfort Care bracelet or form, or a valid DNR as defined by Region I protocol. Once that period is over, only Comfort Care will be acceptable. We will pass along the dates as soon as we have them.

Protocol Changes

The Resuscitation protocol was modified in anticipation of the State's Comfort Care program (see article). The regional protocol was amended to allow the State DNR form or the State Comfort Care bracelet to be accepted as a "valid DNR". Definitions, gleaned from Comfort Care, of what DNR does and does not mean and of palliative care were also added. When the Comfort Care program is officially rolled out, there will be a lengthy phase-in period to allow for education of everyone involved. At the end of the phase-in period only the Comfort Care form or bracelet will be acceptable. The Trauma Triage Plan was modified. Pediatric trauma criteria have been added. The adult criteria have been revised so that they mirror the criteria used by the State Trauma Committee. Criteria for consideration of helicopter use have been added in two places. The first is the addition of a helicopter icon in front of those patient criteria describing patients appropriate for air transport. The second is the addition of a section defining other criteria necessary when accessing air transport such as ground transport time exceeds 30 minutes, location, weather or road conditions, multiple casualties which will exceed local hospital and ground agencies. Semi-Automatic Defibrillation protocol was amended to allow for defibrillators without audio voice recording devices.

Regional Meeting Highlights

The DPH attorney submitted a written opinion concerning the audio recordings and semi-automatic defibrillators. The WMEMS protocol required that your SAED be equipped with voice taping system and that you send the tapes to the regional office. The attorney reviewed the statute regarding audio taping or interception of oral communication and concluded that audio taping of SAED calls without warning all individuals that they are being recorded is a violation of the statute. The Regional Council decided to immediately inform all defib services that they should give oral warning each time an SAED is used in the field. In February the defib protocol was changed so that audio recorders are no longer required. However, the region still requires the data from each defib call. Some of the Physio-Control units have dual voice and ECG recordings on the cassette tape. Those tapes are still required for the ECG data. It was suggested that each service contact the manufacturer on how to best disable the audio recorder on your machine if they choose to do so. Paramedic-Basic Staffing waiver requirements were discussed at length. Requirements such as population, emergency medical dispatch, a second ALS EMT for certain calls were all discussed. After months of discussion, the only recommendation added to the OEMS requirements was simply that "Basic EMTs in any system may attend a WMEMS approved Paramedic Assistant Program to increase effectiveness in working with paramedics. Basic EMTs may not attempt skills they have not been trained in." Granby Fire and Agawam Fire received recommendations for their P/B waiver applications to be sent to OEMS. The council reviewed and approved the Paramedic Assistant Training Program for Basic EMTs. An At-Large voting membership slot has been vacated by a resignation. The new member would fill the vacant seat with a term expiration of 1998. Nominations may be called in to the WMEMS office; the position will be voted on at the March 13th Regional Council meeting to be held in Conf. Rm A, Cooley Dickinson Hospital at 10 am. Please consider getting involved and making a difference! Regional Council meets the 2nd Thursday of every month except July, August & December. Annual Meeting/Banquet This year's festivities will be held at the Delaney House in Holyoke on April 10th. Great food, guest speaker and the Eaton Freeman Award presentation are among the highlights. The festivities begin with a brief regional council meeting at 5:30, social hour with hors d'oeuvres at 6 and dinner at 7p. Last year was our best attended yet with almost 90 people. Invitations will be mailed to all services and hospitals. Everyone is welcome but reservations are required. The cost will be $25.

Call WMEMS at 586-6065 anytime to receive an updated con-ed list via snail mail

Don't Forget the Web

Our web site has many useful resources. We now have over 25 con-ed outlines available for your use, updated con-ed class schedule, regional committees' meeting schedule, the EMS 2000 bill may be read or downloaded, and the draft statewide protocols also may be downloaded to your computer and much more. Check it out at http://www.ici.net/cust_pages/jdemtd/wmems

Regional Awards

Eaton E. Freeman Award is given to an individual whose efforts within their field are directly responsible for benefitting the prehospital field. Submit nomination letter to WMEMS by 3/6/97 for presentation at the Annual meeting on April 10th. Save, Recognition, and Meritorious Award nominations must be submitted to WMEMS by 4/3/97 for presentation during EMS Week in May. Forms are available from WMEMS.

EMS 2000

The continuing story... EMS 2000 has been refiled with the changes that were made at the end of the last legislative session. The House Bill # is 2307. An aide to Senator Rosenberg told me that the bills that pass are on the top five priority list of a majority of legislators. So, we need to contact legslators and push the bill. I will be sending out a sample support letter and fact sheet, but personal contact works best! Get those contacts going, and may be we will get this passed this year.

Statewide Protocols

Another continuing story... The state medical protocols have been approved by the State Advisory Board. The Board directed OEMS to meet with the Regional Directors and Regional Medical Directors to discuss implementation. The state office will also issue an RFP to put the protocols into algorhythm form. The big book of protocols should be out in the 1st half of 1997. The little book (algorhythm form) will be out sometime later.

WMEMS along with Agawam Fire, AMR, BHS, Longmeadow Fire, Westfield Fire and W. Springfield Fire are sponsoring Liability Issues Facing EMS in the 90s on Friday, March 21, 1997 from 8:30 am - 12:30 pm at Carr Hall, Bay Path College. This program is free. Simply preregister at 413-567-3358 by March 18th. This program is presented by a firefighter paramedic from Pennsylvania. Topics include patient refusals, patient drops, patient restraints, emergency vehicle crashes, medical malpractice cases, and much more. (4 hours all levels OEMS EMT credits available.) WMEMS is sponsoring another Emergency Response to Hazardous Materials Incidents (operational level) which is scheduled for Saturday, March 22, 1997, 8am-4pm at the Cooley Dickinson Hospital in Northampton. This program is free but you must register with WMEMS. First come, first serve. Call now, this is a great program! We ran this program in January and the course filled up fast. The faculty come from the eastern part of the state and have worked hard to make this an educational and entertaining program. (6 hours all levels OEMS EMT credits available.) The Semi-Automatic Defibrillation Challenge Sessions have been scheduled for the year. 1997 Defib Quarterly Challenge Sessions all located at Cooley Dickinson Hospital, Northampton: Wed, May 14th, 4p; Mon, Aug 18th, 4p; Fri, Nov 21st, 1pm. Preregistration is necessary. Challenge applications must be submitted two weeks prior to challenge date. 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: Wed, May 14th, 4p; Mon, Aug 18th, 4p; Fri, Nov 21st, 1pm. 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 Tuesday, Nov 18, 9a-5p and Friday, Nov 21, 9a-1p. Preregistration is required.

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