Vermont Emergency Medical Services

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VTEMSD#3 Board meeting minutes for October 12, 2006.  Meeting held at

St. Michael's College, Tarrant Center, Hall of Fame room and called to order at 1835 by Chair O’Neil.  In attendance were:

 INTRODUCTIONS (O’Neil)

• None

APPROVAL OF MINUTES (O’Neil) 

• Motion to accept the September 2006 minutes as published (Brent/Jones).  Motion approved.

CORRESPONDENCE (O’Neil) 

• None

TREASURY (Lindquist for Danaher) 

• Current balances:
  • Checking        $10,996.75
  • Merrill Lynch   $3,269.11
• Outstanding dues:  BFD, UVM, Milton, VTANGFD, Lamoille
• Motion to accept the October 2006 treasury report as presented (Lindquist/Goss).  Motion approved.
• From Karen Danaher – recommendation to move checking account from Bank North, where our monies do not earn any interest and we are assessed a monthly fee of $6 to the Merchant’s Bank, where we will earn about 4% interest with no fees if < 200 checks per year are processed.  Merchant’s Bank also has a money market account that we can link to the new checking account that will pay 4% interest with a balance of >/= $500.  Having the two accounts linked will keep more funds in the money market account.
  • Motion to accept Treasurer’s recommendation for account relocation (Barron/Brent).  Motion approved.

 MEDICAL DIRECTION (James) 

• 12-Lead EKG project (HeART Foundation) - ongoing
• Code 3 Committee – Still awaiting surveys from services.  Please submit.
• QA/QI – ED Attendings surveyed to determine if they had any training on removing helmets.  None did, with the exception of one who is a former EMT.  Will solicit local athletic trainers for a date in October or November to plan a training session that would bring together 1-2 reps from each VTEMSD#3 service.  Likely outcome is that helmets will be removed in the field, instead of waiting until arrival in the ED.  More to follow from Medical Direction on this.
• Patient Medication Lists – This information needs to get to the ED providers for verification as soon as possible upon arrival in the ED.
• Questions/Issues for Medical Direction – none

FAHC (Helmken) 

• Sharps containers:  (Helmken) FAHC will exchange sharps containers.  Appropriately full sharps containers can be brought to the ED Comm Center in exchange for a new, empty container.  Please ensure that the container if filled to the line designated on the front of the container; and that members are placing only contaminated sharps inside.  Trash and other non-sharp items should not be disposed of in sharps containers.
• Idling ambulances:  (Helmken) Please shut down ambulances when offloading patients at the emergency department.  Other services offloading patients are exposed to the exhaust, and the fumes make their way into the ED.  (O’Neil) The City of Burlington has enacted a no-idling law.
• Blankets/cool weather:  (Helmken) As colder weather approaches, please consider using wool blankets in addition to the cotton blankets provided by FAHC.  The linen department cannot keep up with the demand of every service taking arm loads of blankets on every transport.  Please be reasonable and consider adding wool blankets to supplement hospital linens.
• Decontamination of equipment:  (Helmken) The process of decontaminating EMS equipment seems to be going better.  Keep working with us.  (Baron) Our cervical immobilization device is disposable. 
• Mop/bucket:  (Jaquith) A soap dispenser is being installed in the decon room for use with the mop/bucket.
• Cell phones/updates:  (Jaquith) Please, please, please utilize cell phones or landlines as much as possible for updates.  The ED Comm Center has seen an increase in the number of radio transmissions lately.  A direct conversation with EMS allows for better facilitation of online Medical Direction and interactive communication.  Other hospitals that share HEAR1 are getting busier and this has resulted in more radio traffic on that frequency.  (James) Should another frequency be considered?  (Jaquith) Possibly.  (Lasker) What about using the private line again? (Jaquith) PL may limit outside agencies ability to contact us.
• 10-93 with Medical Direction:  (Jaquith) Please fax a copy of the service 10-93 documentation any time a patient is not transported, but received online medical direction.  First responders are also requested to fax a copy of their patient care report when online medical direction is received prior to the arrival of the transporting ambulance.  The fax in the ED Comm Center is 847-5721.
• EMS Room PCs:   Robyn Joseph-Robar RN, ED Nurse Manager, would like to know how many services can complete PCRs online as part of a utilization review of the computers in the EMS room.  (Group) We don’t use them b/c they require a FAHC login.  (Jaquith) We will convert all of the computers to Kiosk/multi-user setting.  FAHC Information Services is concerned about misuse of the computers in the setting of open access.
• Good work!:  (Helmken) The providers and nurses in the Emergency Department have noted some excellent care by all of you – keep up the good work and thank you for all you do!

TRAINING (Malone) 

• Course updates: (Malone)
  • Modules 4 – 6 participants, going well
  • EMT-B 2x weekly – 20 participants, going well
  • EMT-B 1x weekly - ~21 participants, just underway
  • EMT-B Refresher – 21 participants, halfway through
  • EMT-I – 16 participants, going well
• Course proposals: (Malone)
  • FR-ECA/Underhill (Goss) – Expected start date mid-November; cost $50-100/student with possibility of subsidy; anticipate open slots; lead FR-ECA instructor = Brian Longe, with assistance from Mike Conti & Jackie Goss.  Direct all inquiries to Craig Butkus, Essex Rescue Inc. 878-4859 or cbutkus@essexrescue.org.  Motion to approve course as presented (Adams/Boise).  Motion approved.
• Upcoming training opportunities: (Malone)
  • FR-ECA/Vergennes (see 9/06 minutes)
  • EMT-B 2x/January ’07, applications due 12/14/06
  • Elder abuse & neglect conference at the Sheraton – “DAIL”, Friday 12/1/07.  Presenters include Dr. Shapiro from the Medical Examiner’s office and Jo Jo Leahy from VSP.
  • (Phelps) VTEMSD#7 will be presenting an EMT-Basic course that begins Monday 11/20/06, with sessions on Mondays & Thursdays, and one Saturday per month.  Contact Charlene Phelps for information at luvtwins@gmavt.net.
• Certification/recertification issues: (Malone)
  • Fall recertification dates:  Wednesday evenings, 11/8 & 11/15, @ 1800.
  • New AHA CPR standards – not discussed
  • NREMT computer based testing will commence January 1, 2007.  The current EMT-Basic courses underway will complete initial certification testing using this new model.  Updated info confirms that the level of difficulty is randomly assessed; and the cost of administering the exam has increased dramatically.  The State EMS Office will cover the initial attempt for all EMT-B candidates.  Subsequent attempts will be at the expense of the student and will cost ~$70.  (Helmken) Will the students receive a grade or is the exam pass/fail?  (Malone)  The exam is similar to the nursing licensure exam, NCLEX, with assessment statements that indicate above-, near-, or below-standard.  (Phelps)  Students are notified via e-mail within 24-hours of their performance.

RESOURCE MANAGEMENT (Adams)

• No activity – Darren’s last meeting.  Mutual gratitude was expressed by all.
• MCI – not discussed.
• Grants
  • (Phelps) AEDs have arrived, will deliver soon

ADMINISTRATION (Soons)

• Personal laptop has crashed, resulting in total loss of all documents and e-mail messages.  (O’Neil) District #3 should provide Clerk with serviceable lap top to maintain records.  Motion to allocate $1500 for purchase of VTEMD#3 laptop to be used by Clerk (Adams/Lindquist).  Motion approved.
• UVM maintains an archive list of all messages posted to EMSISSUES & EMSTRAIN, inclusive of attachments:
  • http://list.uvm.edu/Archives/EMSissues.html
• 3^rd Quarter ALS/OOS reports due tonight
• Applications for service license renewals due to Administration Committee for review by Thursday 11/2.  Drop off at FAHC ED (ATTN:  Kate Soons, VTEMSD#3 Clerk).  Please confirm membership status and provide brief explanation of expired certifications.  Inquiry received today from VT EMS Office regarding Sept 06 minutes in which services were directed to omit non-certified members from the license renewal application.  Information received indicates that VT EMS will soon have a functional database that can track all members, certified & uncertified, via the service license.  As a result of the EMS response to Hurricane Katrina & Rita, the lesson learned was to keep track of all who can help – including uncertified drivers.  Several reps indicated that they have not received their license renewal packet yet.  (Soons) Hopefully, services have maintained a copy of their license renewal from each previous year.  Pull out the copy and begin collecting the usual information – it shouldn’t take too long, and we know that this is a recurrent event every fall.
• EMT-Intermediate Policy & Protocol Document delayed due to the aforementioned lap top crash of ’06.  Lee Jones will begin constructing a draft.
• (Jones) OOS report template online updated with Lee’s address removed.
• (Soons) Reiteration: please maintain a copy of all documents submitted by services (i.e. service license applications, ALS/OOS reports, etc.).
• (Soons) The vacancy in the Vice-Chair position has been warned.  As per VTEMSD#3 By Laws, a qualified nominee will presently serve as the representative to the Board from their service.  Please forward nominations to the Clerk, katesoons@adelphia.net.  Nominations will be accepted from the floor prior to a paper ballot vote next month.

PUBLIC INFORMATION (Soons) 

• 2007 National EMS Week is May 20-27, 2007.  More information at ACEP website:           
  • http://www.acep.org/webportal/Advocacy/EMS/Week/default.htm

 OLD BUSINESS (O’Neil) 

• (Soons) District Goals – still sorting, would welcome assistance with this project.

NEW BUSINESS (O’Neil) 

• (Jaquith) “Baby Safe Haven Law” (No. 124, www.leg.state.vt.us) signed into law earlier in summer.  Law allows for any child <30 days of age to be left at a designated “safe haven” including staffed health care facility, fire/police station, place of worship, as well as accepted by individual 911 emergency responders.  (Malone) Kirsten’s message from the list serv forwarded to Dan Manz at the EMS office for clarification of ambulance station inclusion.  VT EMS checking with VDH attorney.  Unfortunate that communication did not come directly from VT EMS.
• (O’Neil) There is a new physician leader in the Emergency Department.  Steve Leffler, MD began October 1, 2007 as Director of the FAHC ED.  It is anticipated that the issue of our current level of care within the District will be raised at some point.  Without an objective needs assessment performed by an outside group, the District does not have concrete data to move forward with any plans to increase the level of care.  There was a statewide study performed by NHTSA in the mid-90’s that the then Commissioner of Health did not accept.  We need to control our own destiny and actively participate in the process.  It is a worthy goal, and certainly many of the citizens of each of our communities expect the highest level of care possible.  It was clear from the Single EMT-B hearing that EMS coverage in Vermont truly spans the gamut.  (Baron) If the cost of the survey is high, will District dues increase?  (O’Neil) The District has ~15K in its coffers and could pursue grants and other sources of funding from legislators.
• Following group discussion, these action points were put forth:
  • Committee chairs will convene to discuss the possibility of a formal needs assessment, with each committee vista in mind.  
  • The legislators for our area need to be brought into the loop (task assignment TBA).
  • The District needs to contact neighboring areas who have completed needs assessment to obtain their feedback and suggestions (task assignment TBA).
• (Brent) Was there a gathering to celebrate Dr. Uphold’s retirement?  (Soons) There was a department party, sponsored by the ED.  There were some issues with getting the invitations out to all appropriate individuals.  Dr. Leffler apologized for any unintentional oversight, including District #3 leaders.  (Brent) Would the District be interested in presented Dr. Uphold with a plaque of appreciation?  (Soons) The clerk can manage the plaque and a cake.  Motion to purchase plaque of appreciation with light refreshments to honor Dr. Uphold (Barron/Brent).  Motion approved.
• Motion to adjourn at 1937 (Adams/Kellogg).  Motion approved. 
• Next meeting Thursday November 9, 2006 at 1830 in the Hall of Fame room at SMC campus.

 Respectfully submitted on October 25, 2007, 

Kate Soons/VTEMSD#3 Clerk 

Note well:   mintues from the introduction through medical direction were taken by Leslie Lindquist in the absence of the Clerk.

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Last updated: December 13, 2006