Northwest Georgia Region 1 EMS Advisory Council Meeting Minutes

Northwest Georgia Region 1 EMS Advisory Council Meeting Minutes Subject Council Meeting Date April 23, 2015 Facilitator Lana Duff Time 12 N Location Trinity Baptist Church, Calhoun, GA Scribe David Loftin Attendees Staff Jim Cutcher, Tommy Sanders, Randy Pierson,, Scott Radeker, Lana Duff, Jill Mabley, Danny West, Dennis Kelly, Alex Case, Robert Graham, Darrell Payne, Chad Taylor, Dan Sweitzer, Bud Owens, Brian Walker, Carlton Firestone, Kevin Ballew, Larry Ballew, Mark Nettke, Kevin New, Sloan Elrod, Beth Feninger, Curtis Vincent, Randy Lacey, Will Pitt, Claude Craig, Ed O Brian, Tony Cooper, Mellisa Hunter, Jennifer King Absent: Kevin Garren, Shawn Teems, Larry Simpson, David Young, Cathy Green, Scott Stephens, Courtney Taylor, Paul Arnold David Foster, R1 OEMST PD, David Loftin Recording Secretary Absent: Dr. Patrick McDougal Key Points Discussed 1. Status of Council David Foster reported that a quorum was present after the roll call was performed. 2. Call to Order The chair called the meeting to order with a quorum present 3. Council Membership David Foster recognized two new council members. Mark Nettke has replaced Chief Joey Pelfrey and Dan Sweitzer has replaced Gordon Tucker. 4. Minutes Approval A motion was made by Jim Cutcher, seconded by Tommy Sanders to approve the minutes of the January 22, 2015 meeting. The minutes were approved as circulated. 6 EMSAC Report Bud Owens reported that the last meeting was on February 17, 2015. A Strategic Vision Committee was formed to develop a strategic plan for the future of EMS in Georgia. GAEMS has developed a 501C3 for the Georgia EMS Foundation. The next meeting will be held at Georgia Public Safety Training Center in Forsyth, Georgia on Tuesday, May 26, 2015 beginning at 10:00 a.m. The Georgia Department of Transportation will present the incident management system and a representative of the County Commissioner Association of Georgia will be present. Bud Owens will be the Chairman of EMSAC at the first meeting in 2016. 7 EMS Subcommittee on Trauma Randy Pierson called on Lee Oliver to give a report on the EMS Subcommittee on Trauma. Mr. Oliver announced that three Extrication Instructor classes will be held as follows: Gainesville, GA on May 18-20; Macon, GA on May 26-28; and Tifton, GA on May 29-31. The courses are sponsored by Georgia Association of EMS. Registration is closed at this time. A new Emergency Vehicle Operator Course (EVOC) is being developed with simulators in a large trailer for EMS. The technology is currently in use for Georgia HERO drivers. The Georgia Emergency Medical Services Information System (GEMSIS) will be updated to the National Emergency Medical Services Information System (NEMSIS 3) according to a schedule developed by Keith Wages and the Georgia Office of EMS and Trauma staff. New Georgia EMS grants will soon be available for Georgia EMS Services. The Templates by PAGE 1 of 1

EMS Leadership class is currently being held. Mr. Oliver reported on a telemedicine program conducted by Spaulding County EMS which has requested $18,000 to upgrade the equipment to improve bandwidth and sound problems. Mr. Oliver reported that the Trauma Communications Center (TCC) has been closed but the system to report status of hospitals is still available on-line. He further reported that John Cannady has resigned from his position at the Trauma Commission and Jim Pettyjohn has announced his retirement. GAEMS has established a 501C3 not for profit corporation. Shane Garrison and Brandon Fletcher are officers for the 501C3. Kevin New reported that Paulding County Fire has a driving simulator program similar to that reported by Mr. Oliver for Fire Department vehicle operators. Templates by PAGE 2 of 1

8 Education Committee Report Randy Pierson gave the Education Committee report. He reported that the PHTLS/EPC Instructor update material has been received and he is currently enrolling instructors for the update. The material received includes 40 PHTLS AND 40 EPC textbooks to be housed in a regional library available for checkout by instructors. The cost for the instructor update will be $25 per person with the rest of the expense covered by the Georgia Trauma Commission Training grant. The grant requires at least 4 PHTLS and 4 EPC courses to be conducted. 9 501C3 Report Randy Pierson gave the 501C3 report. The funding has been awarded for the DART grant and the Education grant by the Georgia Trauma Commission and will be routed through the Northwest Georgia EMS Systems Incorporated 501C3. $15,000 has been billed for the Education grant and $50,000 has been billed for the DART grant. [The DART grant also has been awarded funds from the Georgia Emergency Management Agency which will be routed through the Northwest Georgia Public Health District.] Ten percent of the Trauma Commission awarded grant amount will be retained by the 501C3 as an administrative fee. A programmatic review is currently in progress by the CPA firm of R.L. Jennings and Associates and as part of the contract the financial information will be loaded into the Quick Books program. The 501C3 will continue to meet bi-monthly with the next meeting to be held at Floyd Medical Center EMS Headquarters on May 21, 2015 at 10:00 a.m. Larry Ballew asked if there is a grant imposed time limit for the PHTLS/EPC courses. Randy Pierson stated that the courses are slated to be completed by the end of the grant period (March 2016). 10 OEMS Update David Foster gave the DART update. He reported that 22 initial education courses and 84 continuing education courses were approved. Twenty two (22) rosters have been received and 467 people were trained. Mr. Foster reported that the next EMS Educator Update to be held on June 11, 2015 will include a mandatory GEMSIS training session in conjunction with a trial program on using the GEMSIS program to record patient encounters for initial EMS course students during clinical sessions. These reports will not be included in the same program file as patient reports for EMS Services. Also Mr. Foster reported that the last GEMSIS meeting was productive and 4 subcommittees were formed to address issues. The next meeting of the GEMSIS committee will be on June 9, 2015 in Macon with a Statewide EMS Stakeholders meeting tentatively scheduled for June 10, 2015 at the Georgia Public Safety Training Center in Forsyth, Georgia to address the current issues and solutions with GEMSIS and how we plan to do the upgrade to the new NEMSIS 3. The projected process is to rollout changes over a 6 month period which will allow the vendors to modify their programs to conform to the changes. The entire process will be an 18 month process ending in possible 2017. Larry Ballew asked who should attend this meeting. David Foster stated that representatives from all EMS Services including licensed medical responders should attend the meeting. The arrangements are tentative at this time and David Foster stated that he will send out final notices when the meeting is confirmed. David Foster gave a report on the DART program. He reported that the initial Templates by PAGE 3 of 1

equipment and supplies have been ordered and should be delivered within 2-3 weeks. The two grants have been routed through the 501C3 and the Northwest Georgia Public Health District Office. The Georgia Emergency Management grant routed through the Georgia Public Health District Office has a close-out date of June 30, 2015. The lime green helmets ordered are not in stock and a decision will have to be made to change the color or to wait on the delivery after the closeout date which will require pre-payment of the vendor. David Foster stated that GSAR wears orange colored helmets and therefore the DART helmets cannot be orange. When the supplies and the bags are received, David Foster stated that he plans a packing party to assemble the 78 bags. 100 programmable portable radios have also been ordered and must be programmed. A meeting of the DART education committee is scheduled for May 28, 2015 to complete the education component as a part of the grant requirement. Fifteen thousand dollars ($15,000) will be paid to the members of the committee for their participation in developing assigned training course components in 3 phases. $5000 for development, then $5000 for each course delivery which includes any expenses for facilities, equipment, snacks, etc for each course. The first DART provider course is tentatively planned for late August or early September, 2015 with the second being around the end of October to early November. Each course must have a minimum of e 50 participants in the DART training programs to meet grant requirements. A second Basic Disaster Life Support (BDLS) course has been funded by Matthew Crumpton for EMS Region 1 DART participants with a target date of August 12 or August 19, 2015. David Foster reported that the residual funds left over from the Georgia Trauma Commission DART grant will be used to purchase supplies which will be warehoused at several locations within the region for re-stocking DART units. David Foster is proposing using some of the remaining grant funds to purchase DART t-shirts for all attending the DART training courses. Carlton Firestone displayed a polo shirt with the DART emblem. The anticipated distribution of the DART bags will be June, 2015 with three for DART unit to be carried by the deployed personnel from the units and one extra radio for the crew left with the ambulance. The DART unit will have a magnetic DART emblem to be placed on each side of the unit cab doors to identify the unit at the scene. The DART bags will not be distributed to services until the Memorandum of Understanding is signed. The states Vulnerable Populations Transport agreement (Coastal Evacuation) plan will be added to each MOU and each service is encouraged to participate however it will be voluntary. The purpose of the DART vehicles will be to relieve initially responding units from nearby EMS Services. Also to provide a staged unit for DART personnel accompanying GSAR personnel and to provide medical support and to transport patients from the scene. We are in discussions with Metro Atlanta Ambulance Service to route all calls for DART assistance through their dispatch center to provide 24/7 availability and one contact number. Templates by PAGE 4 of 1

11 Awards Committee Update 12 Report on Dr. Nassour The 2015 Northwest Georgia Region 1 EMS Awards Banquet received 317 reservations and has an attendance of 298. He thanked the 2015 Awards Committee for the great job and named the 2016 Awards Committee: Co-Chairs Lana Duff and Sherry Peace; Robert Early, Tommy Sanders, Tony Cooper and Dan Sweitzer. The 2016 Awards banquet will be sponsored by Redmond Regional Medical Center and will be held at the Forum in Rome, Georgia on March 10, 2016. The Regional award recipient s nominations have been forwarded by various individuals for the Georgia Awards. David Foster thanked all persons and services for attending Dr. Paul Nassours funeral service. He announced that the Region Lifetime Achievement Award will be renamed the Dr. Paul Nasty Nassour Lifetime Achievement Award in his honor. Johnny Hale also thanked the Region 1 EMS Honor Guard for their participation. 13 GEMSIS The report was previously given as a part of the OEMS report. 14 EMS Medical Director Report Dr. Jill Mabley gave the EMS Medical Director report. The last meeting of the Georgia Emergency Medical Services Medical Director Council (EMSMDAC) last meeting was March 6. Dr. Pat O Neal reported that Georgia Public Health will be monitoring for Ebola cases for the rest of the year. Dr. Mabley reported that EMSMDAC discussed the use of two drugs for EMS. The first drug was Tranexamic acid (TXA) which they determined to be indicated to retain clots formed in internal bleeding in the chest, pelvis or abdomen to prevent excessive blood loss. Most of the studies have been performed on young, healthy patients and the result of administration on older patients has not been fully researched. She reported that Cherokee County EMS is currently adding the drug to their treatment protocols. The second drug is Ketamine which is used for pain management and sedation. This drug is currently being also used by Cherokee County EMS. Dr. Mabley also reported that the Drug Enforcement Agency (DEA) is currently conducting inspections to include EMS agencies. She cautions EMS agencies to examine their policies for the following compliance with federal laws: 1. Make certain all order form paperwork for controlled substance drugs received are fully documented. 2. A separate DEA number must be issued for each location where controlled substances are stored. 3. Each use of a controlled substance drug must be signed by an MD or DO even standing orders. 4. Medical Directors must have a separate DEA number for each service in addition to their personal DEA number. 15 EMS-C Report There was no EMS-C report. 16 RTAC Report Randy Pierson gave the RTAC report. The last meeting of RTAC immediately preceded the council meeting and did not have a quorum. The members present discussed how to obtain data to evaluate the program. 17 Old Business Jim Fox reported that $800 had been raised from the 2014 Erlanger LifeForce Clay Shooting event last August at Barnsely Gardens. He presented the check to Randy Pierson for the 501C3 confined to be used for educational imitatives. Lifeforce is working on the 2015 clay shooting event at Barnsley Gardens again. Once the details are finalized, they will get David Foster the information and he will send it out to the Region 1 EMS Stakeholders email list. The Lifeforce 2015 Golf Tournament will be held at Bear Trace at Harrison Bay in Templates by PAGE 5 of 1

Chattanooga on May 4, 2015 beginning at 1:00 p.m. More information is available at http://www.2015erlangerlifeforceclassic.com Templates by PAGE 6 of 1

18 New Business David Foster reported a potential zoning issue in Murray County because of a potential change in ownership of zoned service Murray County EMS. The service is owned by Murray Memorial Hospital which is scheduled to be managed by Adventist Health Systems on May 1, 2015. If the hospital enters into a management agreement the ownership would not change and zoning will not be necessary but if the hospital authority does not maintain the license for EMS then zoning will be necessary. David Foster will notify the transportation committee and EMS Council as soon as he is aware of the decision. The transportation committee members are currently Danny West Chairman, Randy Pierson, Sloan Elrod, Courtney Taylor, Scott Radeker and Dr. Jill Mabley. A called Council meeting may be necessary if zoning is necessary. Traci Jennings, Neuroscience Program Administrator for Erlanger Medical Center gave a report on the Stroke Program at Erlanger Medical Center. She reported that Erlanger has been designated as a Comprehensive Stroke Center by the Joint Commission on Hospital Accreditation in December, 2014. Ms. Jennings explained the difference between the three levels of Joint Commission accreditation: Acute Stroke Ready facility can perform CAT Scan and administer TPA but must transfer the patient to Primary or Comprehensive Stroke Center; Primary Stroke Center can perform CAT Scan, MRI, administer TPA and admit; Comprehensive Stroke Center can perform CAT Scan, MRI, administer TPA or intravascular techniques such as mechanical removal of the clot and admit. The facility has seen 2,200 stroke patients annually. The goal is to administer TPA within 60 minutes of arrival and Erlanger Medical Center has an average of 27 minutes. The facility is also conducting clinical trials of various drugs and procedures for Acute Stroke. Erlanger Medical Center s Stroke Program received recognition at the International Stroke Conference on February 11, 2015 for the highest enrollment and the best outcomes for Acute Stroke patients. The results of the interventional techniques practiced by Erlanger changed the national treatment of acute stroke protocols. The facility has 24/7 availability of interventional vascular technology, neurosurgery and air transport by LifeForce Air Medical Transport. She encourages the EMS Services to consider changing their Acute Stroke Triage protocols based on last known well time to consider the Comprehensive Stroke Center at Erlanger. Outreach programs are available to include community events, churches and 5 th grade students to teach the FAST method of determining if a stroke is present. You can contact her for this outreach at: Traci Jennings at Erlanger Health System 423-778-3437 or by e-mail at traci.jennings@erlanger.org Dr. Jill Mabley asked if which stroke centers are required by Joint Commission to have MRI. Ms. Jennings stated that the Primary and Comprehensive Centers are required to have both CT and MRI. The Stroke Ready Centers are only required to have CT. A question was asked about what levels of Stroke Centers are available in EMS Region 1. The following hospitals are designated as Primary Stroke Centers by Joint Commission and the Georgia Office of EMS and Trauma: Hamilton Medical Center (Dalton), Floyd Templates by PAGE 7 of 1

Medical Center and Redmond Regional Medical Center (Rome), Cartersville Medical Center (Cartersville). There was a question about whether Kennestone Medical Center was a Comprehensive Stroke Center. [They are listed under the Joint Commission website as a Primary Stroke Center.] It was announced that they are pursuing designation by Joint Commission as a Comprehensive Stroke Center. David Loftin reported that Advanced Stroke Life Support course materials will be updated soon and instructor updates are planned for the next several months. Melissa Hunter gave an Epidemiology Report. The multistate Measles outbreak which originated at Disneyland in California did not include Georgia. However, 1 case was investigated and determined to be from an immigrant. There was an alert about Blue Bell Ice Cream of Brenham, Texas which is voluntarily recalling all of its products currently on the market made at all of its facilities including ice cream, frozen yogurt, sherbet and frozen snacks because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headaches, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women. There have been 10 cases in 4 states but none in Georgia as yet. There have been some cases of gastrointestinal illness from salmonella in Georgia. There have been some cases of rabies in animals in the area. A severe weather report was given and potential severe weather is expected on Saturday. All services are advised to review their severe weather response plans. Lana Duff reported that Angel EMS had a pulmonary hypertension patient with an indwelling infusion catheter. The continuous IV infusions used to treat pulmonary arterial hypertension are Flolan, Remodulin, and Veletri. A small pump called a Cadd Legacy is commonly used to infuse these medications. This small pump weighs about 3 lbs. The pump is carried on the patient at all times. Many patients use the standard carrying case issued with the pump for every day use but other patients have created their own systems for carrying their pumps. The medication is mixed into a plastic container called a cassette that is attached to the pump and thin plastic tubing runs from the pump to the patient s central line. These medications run 24 hours a day, 7 days a week, 52 weeks a year. They must never be interrupted except to change the cassette. 19 Adjourn A motion was made to adjourn by Carlton Firestone, seconded by Tommy Sanders and approved. The meeting was adjourned. The next meeting will be on July 23, 2015. Templates by PAGE 8 of 1

Action Plan No. Action Item(s) Owner Target Date 1. Possible Called Mtg for Zoning David Foster May 2015? 2. 3. 4. 5. 6. 7. Templates by PAGE 9 of 1