June pre-hospital 2010

Meeting minutes from May approved.
Dates for agency run reviews need to be finalized. Tish will send out the schedule that
was previously created with the month each agency requested. Each agency needs to give
a couple possible dates to schedule so a date can be confirmed with Dr Burns schedule.
Patch format:

1 set of vitals for a BLS refusal is acceptable.
2 sets of vitals are required for ALS refusals.
The patch form does not become a part of the patient’s permanent record.
Tish asked the agency how they want to use this form. The initial intention was to create
some format to the flow of patches. The RN patch sheet was unorganized and didn’t
correspond to the information the medics were giving. It was requested by many medics
at the Annual Updates to have a flow sheet reflecting how patient information is to be
presented. At this time none of the agencies wanted any formal change to their Field
Worksheet. It was suggested to have the patch sheet copied on the back of the field
worksheet.
Final decision was to leave it up to each agency. The patch format will be sent out once
the last revisions are made. If the information presented on the patch improves no other
action will be necessary. We will revisit the quality of the patches in 3months.
Exposure packets:

EMS Exposure packets were handed out to the committee again. Committee members are
expected to present the information to the trainer. Please make sure that the senior
personal are trained proficiently on the process. No further questions/discussion.
Orientation:

Initial orientation period was further discussed from last meeting. Chiefs were receptive
of having the new hire/ new certification medics have a mentor. The committee decided
that the mentor would be someone on their shift to provide direct feedback and review
their treatment/documentation initially. The agency QI person will also review their
documentation and provide a monthly report to VVMC Prehospital Department of the
calls and whether they met guidelines or needed some coaching/improvement.
New business:
Drug shortages:

There are several drug shortages at this time from the vender Hospira.
EPI 1:10000, Lasix, Dextrose, and Sodium Bicarb
As of right now we have EPI 1:10000 still available. Supplies have been pulled from
hospital crash carts and given to EMS.
Bumex will be replacing Lasix. We will do PowerPoint training for this drug.
When we have exhausted the supply of Dextrose and Sodium Bicarb Abbojetts, Dextrose
and Sodium Bicarb will be supplied in single dose bottles in the medication Pixis, and 60
cc syringes will be supplied in the EMS supply Pixis.
Keep the expired drugs until the last day of the month, unless the expiration date is
otherwise specified. Please do not return drugs to pharmacy until it is time for them to
expire.
SHARE:
As of January 1st all the agencies are suppose to be submitting the codes on their own.
Send them a copy of the patient care report. CWFD is having a difficult time getting into
the system due to the fact that VVAC is the transporting agency. Tish will look into this
issue with Paula Brazil and get back to Tim Wills
Pre-Hospital Care supervisory action report:
NOT meant to just be used as a disciplinary form. This form will allow for potential
mistakes to be caught prior to a large problem occurring.
Discussion took place in regards to the “type of action” included in the form.
Take out boxes and leave blank for the agency to fill out.
There was some concern over the name of the form. Provider improvement plan was
agreed on.
Agencies were asking about a “positive” form as well. It was decided that such a form
should come from individual agencies.
Code of Conduct:
Medical Direction needs to know of these incidents as well. IE: DUI, etc.
Poison Control:
Please use 1-602-253-3334
This number is the phoenix number and has trained RN’s and MD’s online.
CE and Run Review Credit:

Run Review credits are given ONLY when attending a monthly or agency run review.
CE credits are given for items such as AR meetings (in depth) for large events.
Schelly will be making CE forms for Peer Review meetings for the providers that our on
that committee.

Airway/RSI:
Matt Robertson suggested that a group of agencies get together and train on airway and
RSI.
Airway 911: a group in New Mexico that Dr. Burns would like to get for us to train with.
Bougees, lighted scopes, and trach lights should be considered as intubation adjuncts.
Valium and Versed are not a good alternative to RSI for a difficult intubation.
Trauma guidelines state that BLS airway with ventilations is preferred.
King Airway cost is expensive for smaller agencies. VVMC will not be stocking King
Airways. It was discussed that maybe agencies could get together to purchase in larger
quantities and share cost.
Tish is leaving next wed for 9 weeks. Cathy and Schelly will be in the office.
Combi tubes:
ALS is preferred, but BLS is allowed as long as there is documented training for the BLS
providers.
King Airway is only ALS.

Next Meeting:

Next Meeting is set for August. July will be cancelled for Peer Review and Pre-hospital
Care Committee.

Source: http://verdevalleyems.org/Documents/Minutes/Pre-Hospital/06152010.pdf