Duke Regional Advisory Committee Meeting Minutes

Transcription

1 Duke Regional Advisory Committee Meeting Minutes Date: April 28, 2017 Time: 10:00 am- 1:00 pm Location: University Tower, 3100 Tower Blvd, Durham, NC Attendees:, Carolyn Foley, Sean Gibson, Nicole Mills, René Borghese, Norma Smithwick, Doug Young, Jason Zivica, Susan Schreffler, M.D., Lou Ann Reaves, Glen Labar, Kaci Kirby, Amy Douglas, Whitney Adams, Kevin Mumma, Chloe Hallberg, Brenda Lanan, MD, Javier Plummer, Keenya Locklear, Ken Shaw, Kevin Underhill Items Discussion Facilitator Action Plan Welcome Approval of last meetings minutes First motion approved by Introduction of everyone in attendance Javier Plummer. Second motion approved by Glen Labar Introduction of Brenda Lanan, MD Duke RAC Chair Education and Training Emergency Medical Services Fellow, Emergency medical Services, University of New Mexico School of Medicine, Emergency Medicine Resident, Emergency Medicine, University of Texas Health Sciences Center at Houston, M.D., Ross University School of Medicine (West Indies), 2012 New RAC meeting Chair will assume role Safe Trauma Patient Transport Reminder regarding scope of available ground transport for trauma patients. Discussion among the group of varied scope amongst agencies. BLS Staffed by at least 2 EMTs certified by state ALS- Staffed by at least 1 EMT and either AEMT/Paramedic certified by the state Critical Care Needs care at a level of service beyond the scope of the local Paramedic

2 2 Duke Life Flight Guidelines for Air Medical Transport Physiologic criteria Systolic BP < 90 mmhg GCS 13 Respiratory rate <10 or >29 breaths per minute Airway compromise/need for ventilator support René Borghese Plan to develop clear trauma transfer criteria for the RAC and also flight activation criteria Anatomical criteria Penetrating Injury to head, neck, torso, or proximal to elbow or knee in extremity. Chest wall instability or deformity (e.g. flail chest) Two or more proximal long-bone fractures Crushed, de-gloved, mangled, or pulseless extremity Amputation proximal to wrist or ankle Pelvic fractures Open or depressed skull fracture Paralysis Group discussed need or desire for clear transfer criteria guidelines PowerShare Presentation on PowerShare and its rollout for trauma transfers within the RAC Cloud based storage for transfer of information between hospitals. Currently used mostly for outpatient. All RAC hospitals currently have access. Will NOT be used to determine acceptance. Will reduce issues with system incompatibilities and reduce need for repeat imaging Education to follow with each entity ED and Radiology Plan to develop RAC hospital work flow that may be different for each entity Sheet available in room for radiology contact information if known.

3 3 Trauma Program updates Upcoming ACS/State site survey 2018 for Duke hospital Currently in the process of hiring a new Injury Prevention Coordinator for Duke Trauma, program. Introduction of Sean Montgomery MD, Trauma Attending Carolyn discussed registry staffing and current state of data entry Sean Gibson Carolyn Foley NC Triangle Coalition update Federally, HPP program has gradually shifted its focus from building organizational capacity to strengthening Regional collaborative systems capable of meeting response needs at the most local level. As we begin the new budget period, ASPR has identified two primary program measures: medical surge and continuity of healthcare operations to inform state and federal partners of underlying preparedness, response capabilities and progress evaluation. There are 21 performance measures that impact both the Coalition and the State as the Awardee. Regional full-scale exercise Operation Safe Corridor was executed on March 14 through March 16. The three Coalitions (Duke, Mid Carolina, and CapRAC) participated. Many lessons learned. The After Action review is scheduled for May 8, 2017 at 1:00 pm. Organizations that participated should be receiving the notifications of the AAR review. If you have not and participated, please contact the Coalition to get your name on the list. The Coalition completed a workshop on April 7, The tentative work plan and budget were discussed, along with notification that residual funds were available for project proposals. The deadline to receive requests was April 24, Ken Shaw

4 4 Duke RAC Coordinator Updates Return to play- Concussion discharge instructions/plan/follow up that will be going home with children discharged from Duke following a concussion. Education and informative sessions to be done with RAC hospitals and associated pediatric clinics in the coming months by Pediatric surgery group. Georgina was invited to Durham Co EMS academy to talk with group around Duke Trauma. Enjoyed opportunity and hopes to go back. Recent Rural Trauma Team Development at Southeastern Regional Medical Center. (2 attendings, 7 residents, 10 RNs) Thoroughly enjoyed ride-alongs with Granville, Vance and Durham Co EMS. Hoping to continue with Caswell and Person Co EMS in the next few months Anyone that would like follow up on a trauma patient that was transported to Duke Hospital to e- mail Georgina with patient information Upcoming ENPC is scheduled for May 1&2 at Maria Parham Durham VA C-collar education Trauma Day for new grad RNs at Maria Parham If anyone knows of community pediatric group that could see these patients please let Georgina know Rural Trauma Team Development Course Course developed by ACS to look at the resources in each facility and tailor make each class to entities team Keenya discussed benefits of recent class. Georgina currently developing an action plan for SRMC that highlights the opportunities their group identified during the class Keenya Locklear Regional Updates Caswell EMS-interim director is Gaither Clayton, Brad moved on to new opportunity out of state

5 5 Nurses week and EMS week Family Medical Center- Hired new NP Kristen Price who will be assisting with Urgent Care as well as Primary Care. Currently looking for Orthopedic group to provide outpatient services Durham EMS-received AHA Mission Lifeline Silver plus recognition for STEMI Care Duke ED-not present Duke regional- nothing to report VA- not present Granville Medical Center- nothing to report Person EMS- not present EMS- received AHA Mission Lifeline Silver plus recognition for STEMI Care. Currently fully staffed. Asking for fourth full-time truck in 2017/2018 budget. Looking to implement RSI this year. Person Memorial Hospital- not present Robeson EMS- not present Southeastern Regional Medical Center Department has been very busy and staffing has been a challenge. Recently implemented trauma activation criteria (red/yellow) which is helping with trauma patient preparation, continues to be a work in progress Wake Duke Raleigh-not present Thank you to all Nurses and EMS personnel for their hard work Lou Ann Reaves Kevin Underhill Glen Labar Keenya Locklear

6 6 Education opportunities information TNCC May Teer House June 8-9 Teer House August Teer House ENPC May 1 and 2 Maria Parham May Teer House Sept Teer House Advanced Burn Life Support (ABLS) June/July $50.00 Georgina also mentioned ABLS now course $ Non Physicians $ Physicians which is an online version of ABLS Opioid Misuse & Overdose Prevention Summit June Raleigh $65/$75http://

7 7 State Updates Injury Prevention key bills Motorcycle helmet repeal (S66/H91) Require only helmets for ages 21 or less From public health perspective, this change would result in many more serious injuries and additional cost to the state. Stop Act (S175/H243) Overdose prevention legislation including restrictions on prescribing and use of CSRS Fireworks (S590/H873) Proposal to allow NC to have same type of fireworks as SC Both fire and public health community not supportive. Community Paramedicine (S424/H536) Enable local EMS to provide additional behavioral health services that would not require transport to ED (mental health, drug overdose, etc.) Amy Douglas RAC data collection and sharing Group discussed the sharing of data amongst the group and all present agreed that they were willing to share data freely within the RAC meeting. EMS will share Total volume of trauma patients Average scene times for trauma patients TXA administrations (if applicable) Needle decompressions Hospitals will share Volume of trauma patients ED LOS for trauma transfers Number of trauma patients that received blood products Trauma deaths Each entity to bring data to future RAC meetings

8 8 Case Study Multiple GSW patient case study review Carolyn Foley Meeting adjourned 1:00pm Next Meeting July 28 th, 2017 University Tower 3100 Tower Blvd, Durham