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MEETING SUMMARY MEETING SUMMARY Powered By Docstoc
					                MEETING SUMMARY
                   March 26, 2007
  Department of Fire, Rescue & Emergency Services
                Yaphank, New York

Hospitals/Physician members-at-large represented: See attached
attendance list: Brookhaven, Eastern Long Island, Good Samaritan, J.T.
Mather, Peconic Bay, Southampton, Southside, University and the Acting
EMS Medical Director, Dr. Linda Mermelstein. Excused was Dr. Cruzen
(Southside).

Others Present: See attached attendance list. The following non-voting
members were present: Kevin Pesce, Richard Skelton, Bruce Talmage,
James Jackson, Tom Smyth, Peter Hillick and Rob Stadelman. EMS Staff
present were Robert Delagi, excused was Karl Klug.

Call To Order

      The meeting was called to order at 7:00 pm by Mitch Pollack, M.D.,
Chairman, presiding. The Secretary pro-tem reported that a quorum was
present, and official business could be conducted. A brief presentation was
made by a rep from Boussignac CPAP for the REMAC to consider. A
motion was made by Dr. Johnson, seconded to accept the previous meeting
summary (January 22, 2007) as distributed, passed unanimously.

Chairperson’s Report - Dr. Pollack
       Dr. Pollack noted that there were protocol items, Medical Review
Board issues and follow-up on the Suffolk EMS Medical Director’s position
on the agenda.

Vice-Chairperson’s Report – Dr. Tarsia
      No report at this time.

                                       REMAC Meeting Summary, March 26, 2007

                              1
Treasurer’s Report- Dr. Robert Korn
    Monthly statements are e-mailed to Secretary Klug on a regular basis.

Correspondence- Karl W. Klug (read by Mr. Delagi, list on distribution table)
Incoming
    Copy of a NYS/DOH Letter of Enforcement Notification regarding Carl
      Schottenhamel, EMT #237743, residing at 66 Bay Avenue, Hampton Bays, NY,
      11946 for violations of 10 NYCRR Part 800.15(b), and 800.16(b). Penalty includes
      suspension for 1 year effective 2/5/07, the suspension is stayed; placed on
      probation for 1 year effective 2/5/07. A review of the Suffolk EMT database
      indicates the subject is in our system.
    Copy of a NYS/DOH Letter of Enforcement Notification regarding Court
      Cousins, EMT #250593, residing at 10 Berkley Lane, Syosset, NY, 11791 for
      violations of 10 NYCRR Part 800.16(g). Penalty includes suspension for 1 year
      effective 1/22/07, the suspension is stayed; placed on probation for 3 years
      effective 1/22/07 and is assessed a civil penalty of $2,000.00. A review of the
      Suffolk EMT database indicates the subject is in our system.
    Copy of a NYS/DOH Letter of Enforcement Notification regarding Raymond
      Baez, EMT #339367, residing at 1424 Bryant Avenue, Bronx, NY, 10459 for
      violations of 10 NYCRR Part 800.16(c), 800.16(d). Penalty includes suspension for
      1 year effective 1/22/07, the suspension is stayed; placed on probation for 3 years
      effective 1/22/07, and is assessed a civil penalty of $2,000.00. A review of the
      Suffolk EMT database indicates the subject is not in our system.
    Copy of a NYS/DOH Letter of Enforcement Notification regarding Kai Chan,
      EMT #188768, residing at 33-57 77th Street, Jackson Heights, NY, 11370 for
      violations of 10 NYCRR Part 800.15(b). Penalty includes suspension for 1 year
      effective 1/22/07, the suspension is stayed; placed on probation for 1 year
      effective 1/22/07, and is assessed a civil penalty of $2,000.00. A review of the
      Suffolk EMT database indicates the subject is not in our system.
    Copy of a NYS/DOH Letter of Enforcement Notification regarding Kevin
      Klemenz, EMT #331758, residing at 10457 Mattoon Road, Prattsburgh, NY,
      14873 for violations of 10 NYCRR Part 800.16(d). Penalty includes suspension for
      1 year effective 1/8/07, the suspension is stayed and is assessed a civil penalty of
      $2,000.00. A review of the Suffolk EMT database indicates the subject is not in our
      system.


                                                     REMAC Meeting Summary, March 26, 2007

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 Copy of a NYS/DOH Letter of Enforcement Notification regarding James
  Scordus, EMT #149748, residing at 600 Edgegrove Avenue, Staten Island, NY,
  10312 for violations of 10 NYCRR Part 800.15. Penalty includes suspension for 1
  year effective 1/17/07, the suspension is stayed; placed on probation for 1 year
  effective 1/17/07, and is assessed a civil penalty of $2,000.00. A review of the
  Suffolk EMT database indicates the subject is not in our system.
 Copy of a NYS/DOH Letter of Enforcement Notification regarding Michael
  Castagliola, EMT #259970, residing at 2057 Bayliss Avenue, Elmont, NY, 11003
  for violations of 10 NYCRR Part 800.15(b), 800.16(b). Penalty includes suspension
  for 1 year effective 1/17/07, the suspension is stayed; placed on probation for 3
  years effective 1/17/07, and is assessed a civil penalty of $1,000.00. A review of the
  Suffolk EMT database indicates the subject is not in our system.
 Minutes of the December 12, 2006 SEMAC and the December 13, 2006 SEMSCO
  meetings and announcements of the February 14, 2007 and February 15, 2007
  SEMAC/SEMSCO meeting.
 Letter from Donna Gerard, Executive Secretary to NYS EMS Council regarding
  requests for sub-committee appointment nomination procedures.
 Copy of letter from Mr. Delagi to Mr. Brian Sherwood regarding additional
  information pertaining to an on-going investigation of a local EMS agency and the
  administration of controlled substances by a non-authorized agency.
 Copy of letter from Mr. Delagi to Mr. Brian Sherwood advising him of potential
  violations of narcotics administration/storage involving an agency in Suffolk
  County.
 Letter from Ms. Karen Meggenhoffen, Associate Director NYS-DOH*BEMS to
  all NYS EMS Course Sponsors and REMSCOs regarding the Bureau’s updated
  materials for the BLS Cardiac Arrest Protocol, implementation of the AHA 2005
  Guidelines and the Adult Cardiac Related Problem. Copies of all materials attached
  with letter.
 Letter from the Chief and Chair of the Medford Volunteer Ambulance
  Company/District requesting REMAC’s permission to participate in the CPAP
  program (NOTE: to be acted upon under New Business).
 Letter from the Chief of the Community Ambulance Company requesting
  REMAC’s permission to participate in the CPAP program (NOTE: to be acted
  upon under New Business).
 Letter from the Chief of the Hampton Bays Volunteer Ambulance Corps.
  requesting REMAC’s permission to participate in the CPAP program (NOTE: to
  be acted upon under New Business).
                                                   REMAC Meeting Summary, March 26, 2007

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 Copy of letter from Mr. Delagi to all Ambulance and First Response Services
  announcing the modified NYS BLS Protocols and clarifying the training
  requirements for implementation and mandated by the NYS DOH.
 E-mail from Dr. Goodman requesting that the Secretary notify the Protocol
  Subcommittee of a meeting scheduled for February 28, 1-3pm at the ED
  Conference Room at BMH.
 Signed Certified Return Receipt from an EMS for QA correspondence sent to her
  from the Medical Review Board.
 February 1, 2007 and March 1, 2007 AT&T Teleconference Services monthly
  statement and invoice.
 Copy of revised NYS Tax Exempt Certificate ST-119 with address change noted.
 E-mail from Dr. Cruzen who asked to be excused for the REMAC meeting and
  noted that Committee member Mr. Smyth will present the Committee’s findings
  on the hemostatic agent at the meeting.
 January 31, 2007 and February 28, 2007 Bank Direct statements,
 Copy of E-mail from Mr. Delagi to Chairman Pollack and REMSCO Chair Mr.
  Casara advising that Commissioner Williams at FRES has asked for REMAC and
  REMSCO participation in an interview with a candidate for the Medical Director’s
  position on Wednesday, 2/28/07 at 7pm.
 Letter with three attachments of PCRs for applications of CPAP from the Port
  Jefferson Volunteer Ambulance (to be forwarded to the New Technologies ad hoc
  Committee)
 Copy of e-mail from Dr. Goodman, Chair of the Protocol Subcommittee
  announcing a meeting on March 19, 2007 at 7pm at the Brookhaven Memorial
  Hospital Emergency Department’s Conference Room.
 Copy of e-mail from Dr. Pollack to Dr. Greenberg requesting to meet and be
  interviewed by the REMAC screening committee for the position of Medical
  Director.
 Letter from Mr. Delagi to Chairman Pollack noting that the NYS DOH has
  transmitted the 2002-2005 PCR data for the County; unfortunately, the data is
  either congruent with current programs and required significant manipulation in
  order to visualize it, or is in a format that is unusable for any realistic or timely data
  interpretation.
 Copy of e-mail from Mr. Lateulere requesting REMAC approval to allow a vendor
  to demonstrate a CPAP device at the next meeting.



                                                     REMAC Meeting Summary, March 26, 2007

                                           4
    Response e-mail from Mr. Jackson advising of his unavailability to attend the next
     Protocol Subcommittee meeting due to a scheduling conflict.
    E-mail from Chairman Pollack asking to place Mr. John Kline (Boussignac CPAP)
     on the agenda for the next meeting to conduct a brief product demonstration.
    E-mail from Vice Chair Dr. Tarsia approving the request for the Boussignac CPAP
     demo as long as the presentation is limited to a familiarization of the product as it
     relates to ED staff and not a sales “pitch”.
   Outgoing
    Meeting announcement via e-mail to all REMAC members advising of the
     Protocol Subcommittee meeting on February 28, 2007 at 1pm at the ED
     Conference Room at Brookhaven Memorial Hospital.
    E-mail to Commissioner Williams at FRES with a confirmed date of March 5,
     2007 at 4:30pm at Mather Hospital for the REMAC screening committee to
     interview the candidate for the position of Medical Director.
    E-mail to Dr’s. Pollack/Tarsia relaying the request of John Kline to demonstrate
     the Boussignac CPAP at the next REMAC meeting.
    Confirmation response to Dr. Tarsia’s e-mail approving the above request.
    Confirmation response to Dr. Pollack’s e-mail approving the above request.
    E-mail to Dr. Korn regarding the outstanding balance on the AT&T
     Teleconference Services invoice – clarified and sent.

EMS Division Staff Report: By Robert Delagi and Tom Lateulere

    Mr. Delagi introduced Dr. Linda Mermelstein, who has been the Interim Medical
     Director for the EMS Division since October 22, 2007, and has been an asset to
     the Division during the past few months.

EDUCATION
   Communicated to all EMS agencies regarding the NY State DOH extension of the
    deadline to in-service EMS providers on new CPR guidelines to July, 2007.
   Communicated to all EMS agencies regarding the release of the modified NY State
    BLS protocol, allowing EMS providers to administer aspirin (ASA) to adult
    patients with ischemic chest pain, and the training requirements and opportunities.
   Distributed educational DVDs on how to acquire and transmit biotelemetry to all
    ALS Agencies. This is the first in a series of educational DVDs that can be utilized
    in the comfort of a volunteer’s firehouse, ambulance garage, or home, to increase
    opportunities and access to training.
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     Continued with the execution of a contract to provide controlled access to web-
      based CME opportunities, further enhancing our service to CME participants.
      Currently in the “beta testing” phase to ensure all is working properly prior to
      release to the EMS community. This is another initiative to provide greater access
      to training opportunities.
     Facilitated successful National Disaster Life Support Foundation/American
      Medical Association BDLS, ADLS and Instructor courses to our Medical Reserve
      Corps and targeted emergency responders. This included a vendor-driven triage,
      decontamination and prehospital treatment evolution. Thanks to FRES, the
      Central Islip/Hauppauge VAC, and the Hauppauge FD for assisting with decon,
      triage, treatment and safety sectors.
     Delivered a Core Disaster Life Support Course to the U.S. Disaster relief
      Command – Medical Branch.
     Multiple original, refresher, and CME classes and courses underway. Twenty Three
      additional (23) providers recently completed their re-certification. This also
      includes BLS and ALS CME sessions on weekends.
     Entered into agreement with FRES, for them to provide additional training on
      chemical protective clothing and respiratory protection equipment issued to all
      ambulance agencies in effort to provide additional training opportunities.
     Working with REMAC to revise relevant ALS protocols to come into compliance
      with the AHA Guidelines and SEMAC recommendations.
     Provided support and technical assistance in the development of, and transition
      to, the new REMSCO website.
     Conducted Practical Skills Exam for EMT-CC Refresher – 10/11 passed.
     Conducted Practical Skills Exam for EMT-B Original – 93/93 passed.
     Opened one (1) EMT-B Original Weekday course and two (2) EMT-B Refresher
      courses.
     Conducted one (1) ACLS Instructor Course, one (1) CPAP Class, one PEPP
      Course and one (1) PHTLS Course.
     Developing a Summer Session CME Roadshow.

OPERATIONS

     Met with representatives of the Stony Brook Fire District to assist them in their
      decision to upgrade to the ALS level. REMAC authorization has been granted, an
      inspection has been performed, and the agency is in the process of procuring
      necessary supplies and equipment.

                                                    REMAC Meeting Summary, March 26, 2007

                                          6
   Communicated an advisory regarding the possible use of Chlorine Gas Chemical
    Bombs to the EMS system.
   Met with representatives of the Bay Shore-Brightwaters VAC, and the Coram FD
    to assist them with their respective Part 80 Controlled Substances application
    process.
   Met with FRES Commissioner Williams to continue the process of refining
    procedures regarding compliance with the “Bishop Data Collection Bill,” including
    a uniform reporting format. The Suffolk County Attorney has issued her opinion
    that compliance with the local law is mandatory, that compliance is the
    responsibility of the EMS agency, and that the agency must give its PSAP
    permission to forward its response data.
   Developed draft policies and guidelines for presentation to the REMAC for use of
    the RAD-57 Non-Invasive CO-oximetry device for use in the rehab sector, and for
    emergency response to CO emergencies. Policies and guidelines will be distributed
    after REMAC approval process is complete.
   The Division received information from the NY State DOH that an enforcement
    action (suspension and fine) has been levied against a provider from Suffolk
    County for providing clinical care outside of his scope of practice.
   Working with a volunteer EMS agency to assist in the development of the required
    Corrective Plan of Action, after the agency was cited for multiple violations.
   REMINDER- for agencies that received their last full service inspection in 2002,
    this is your renewal year. Expect to hear from the NY State DOH as they are
    actively conducting 54 full service inspections in Suffolk County this year.
   Received proposals from five (5) vendors in response to the RFP for the Regional
    EPCR Program. The proposals have been reviewed and we expect that a meeting
    to score the response and choose a vendor will occur sometime in March. We will
    provide information to the system about the hardware requirements needed to
    access the system as soon as that information becomes available.
   Provided technical support at several recent EMS-related incidents.
   Assisted the Middle Island FD and FRES with planning for the LODD Wake and
    Funeral Services.
   Division staff, working with the NY State DOH and the Regional Trauma Council,
    held a successful “town meeting”, attended by representatives from the EMS
    Community, Community Hospitals, Trauma Centers, Fire Service, Emergency
    Management, Medical Examiner, Nassau/Suffolk Hospital Council,
    REMAC/REMSCO, Medevac Service, and Law Enforcement to review the
    Regional Trauma System in its entirety. Among the many issues discussed was the

                                                 REMAC Meeting Summary, March 26, 2007

                                        7
      fact that a review of the regional data yields that 85% of patients in Suffolk County
      requiring transport to a trauma center are in fact transported to trauma centers.
      The NY State DOH acknowledged that this is the highest compliance percentage
      in the state.
     Provided technical assistance to several agencies that let their CLIA Permit
      Waivers expire with the renewal process.
     Working with event promoters and others to ensure acceptable health & safety
      plans at several upcoming events, including: Amateur Boxing Competition, LI 2
      Day Breast Cancer Walk and Overnight Camping, Balloon Festival, LI Ducks
      Baseball.
     Provided staffing at the EMS Desk at the EOC during winter storm activation.
     Staff represented the Division at several constituent group meetings to discuss
      relevant issues.
     D/Chief Karl Klug was a featured speaker at the recent FASNY EMS Conference
      at the NY State Fire Academy in Montour Falls.
     On behalf of the REMSCO, began the Program Agency contract execution
      process for the July 1, 2007 – June 30, 2008 contract period.
     On behalf of the REMSCO, completed the REMSCO contract execution process
      for the period April 1, 2007-March 31, 2008.
     On behalf of the REMSCO, submitted the 3rd Quarter Report and Voucher.
     Communicated relevant information about DST and its potential impacts on
      medical electronic devices.

DOMESTIC PREPAREDNESS

   Continue to work with FRES and SCPD to coordinate the FY 2006 & FY 2007
    federal/state grant process, to provide justifications for spending according to the
    National Priorities Objectives, and to identify future supply and equipment needs
    to support the community health care infrastructure.
   Performed final pre-delivery inspection on two (2) trailers obtained through a
    domestic preparedness grant that will be outfitted and used to support the EMS
    and hospitals community during complex incidents.
   Successfully lobbied the State Office of Homeland Security (OHS) to receive
    supplemental funding to provide additional supplies and equipment designed to
    handle medical surge.
   Continued participation with FRES and Law Enforcement in the development of a
    countywide IMAT.

                                                     REMAC Meeting Summary, March 26, 2007

                                            8
     In conjunction with the REMSCO’s Disaster Committee, continued efforts to
      develop the County’s Comprehensive Regional Transportation and Evacuation
      Plan.
     In con junction with other key stakeholders, continued working on planning for
      establishing, equipping and staffing special needs and general shelters.
     Division staff assigned the responsibility of coordinating the credentialing and
      approval process for Medical Reserve Corps (MRC) members.
     Continued work on the Special Needs/Vulnerable Populations Sheltering and
      General Sheltering plans.
     Working with the vendor and FRES to install biosurveillance software on the
      county’s CAD system.

REMSCO Report - Dr. Goodman (reported by Dr. Pollack)

       REMSCO met on 3-13-07
       Motion was approved to allow the SCPD Ambulance Service to continue to
        operate in Suffolk County. The purpose for the PD ambulance is primarily to
        support police operations in which the local volunteer EMS agencies might be
        subject to unsafe conditions, thereby placing the volunteers in imminent
        danger.
       Application was received by REMSCO from Mr. Robert Fink to conduct EMT
        courses as a Course Sponsor; the application was denied as the REMSCO felt
        there are sufficient EMT classes offered through a variety of other sponsors.
        Mr. Delagi further explained the relationship of the REMSCO and Course
        Sponsors and how it is mandated to act on these applications.
       Two EMS agencies (Huntington Community First Aid Squad and Greenlawn
        Fire Department) were granted waivers by the REMSCO until January 2008
        and June 2008 respectively to comply with the Dispatch, Crew Confirmation
        and Mutual Aid Protocol.
       New Cyanide antidote kit is being released.
       REMSCO has begun planning for a 2-day educational event in November at
        the Suffolk County Community College campus. Three specific tracks (ALS,
        BLS and Administrative levels) are being considered; REMAC will provide
        assistance with the event.
       EMS Week is coming up shortly, May 20-26. REMSCO is planning educational
        sessions throughout the week and will be giving tee shirts away to participants.
       May 8 is Stroke Awareness Day.

                                                    REMAC Meeting Summary, March 26, 2007

                                          9
Sub-Committee Reports

  Protocol Sub-Committee – Dr. Goodman
      Dr. Goodman summarized the recent actions of the Protocol Subcommittee,
        and the process of modification of the protocols and steps needed to institute
        the proposed changes. Copies of the drafts were distributed to those in
        attendance. Each of the changes were addressed by Dr. Goodman and
        explained to those in attendance. Mr. Delagi reminded everyone that if all the
        protocols are in compliance with the AHA guidelines, the State gives the
        REMAC a one-time opportunity to accept the protocols without the time-
        consuming process normally in place with the State. The carboxyhemoglobin
        monitoring protocol was reviewed as well. A lengthy review and discussion
        ensued on the protocols. A motion was made to accept the protocol changes as
        presented and amended; a roll call vote was taken as follows:
            Brookhaven                YES
            Eastern Long Island       YES
            Good Samaritan            YES
            Huntington                ABSENT
            J.T. Mather               YES
            Peconic Bay               YES
            Southampton               YES
            Southside                 YES
            St. Catherine             ABSENT
            St. Charles               ABSENT
            University                YES
            Medical Director          ABSTAIN

            The motion carried 8 Ayes, 0 Nays, and 1 Abstention.


  QA Sub-Committee – Dr. Pollack
     No report at this time.

  Medical Device Committee – Dr. Cruzen (reported by Tom Smyth)
     Mr. Smyth gave a report and overview on the Quik-Clot hemostatic product.
       Currently, there are four products for sale in this country, three of which are

                                                  REMAC Meeting Summary, March 26, 2007

                                         10
          FDA approved and one that is not. Mr. Smyth noted that Dr. Cruzen felt,
          based on his research, that the use of hemostatic agents are advantageous, and
          recommended its use as an option in Suffolk County. Dr. Tarsia stated the
          Regional Trauma Advisory Committee (RTAC) did not endorse its use as there
          may be only 1 to 2 patients a year that may qualify for its use, compounded by
          the fact that thermal burns caused by the hemostatic agent can cause additional
          injury and that “sticking things” into wounds is just a bad idea. A motion was
          made by Dr. Goodman to allow the SCPD Ambulance to use hemostatic
          agents under tactical EMS situations as a controlled study; there being no
          second on the motion, it was tabled until the next meeting and a representative
          from the RTAC will be contacted to offer their findings and recommendations
          on the use of hemostatic agents in the pre-hospital environment.

   Medical Review Board Committee – Dr. Pollack
      Dr. Pollack noted two cases were under review and asked that all non-REMAC
        members leave the room for Executive session. After discussion, it was agreed
        that the remedial action provided in both cases by the EMS Division was
        acceptable and that no further action by the Medical Review Board was
        necessary. Mr. Lateulere will report back to the REMAC Medical Review Board
        on the progress of the remediation.

   By-Laws Committee – Dr. Glantz- absent
      No report at this time.

SEMAC: – (briefed by Robert Delagi)
 Dr. Richard Daines has been confirmed by the State Senate as the new State Health
  Commissioner, who has an EMS background from New York City.
 The State Trauma Advisory Committee (STAC) is developing standards for what may
  become a Level Three Trauma Center, a.k.a. “Trauma Station”, suitable for use in rural
  areas where access to trauma care is underserved. The consideration for this type of
  service might be applicable to the east end of Long Island, but many definitions need
  to be refined. Similarly, non-trauma centers will be required to report their trauma
  cases to the Regional Trauma Centers (note: this has been done for many years here in
  Suffolk).
 Governor Spitzer issued Executive Order #3 that requires all public meetings be
  webcast in real time. Mr. Delagi noted that this will be a tremendous logistic and

                                                    REMAC Meeting Summary, March 26, 2007

                                           11
    financial burden on the EMS Division as the “instruments of the State”. The Division
    is currently looking at all of the options in order to meet the July 1 deadline.
   The process of adopting ALS protocols has been modified. A minimum protocol set
    template is being developed as a “check-off list” to ensure that when regions submit
    their protocols, all items are addressed. Regional variations are accepted as long as the
    protocols are within the scope of practice of advanced life support providers at their
    respective levels.
   The recommendations of the Berger Commission Report are now law, and the public
    comment period has passed. The State Health Department encourages the REMACs,
    REMSCOs and the Program Agencies to work collaboratively to address any EMS-
    related issues that may occur.
   Dr. Goodman’s appointment letter to the State as the REMAC letter had expired due
    to the wait for the naming of the Health Commissioner so another letter must be
    submitted; Mr. Delagi noted he had the letter ready for Dr. Pollack’s signature.
   An opinion from Medicaid and Medicare Services addresses the issue that some
    patients are being left in Emergency Departments on EMS stretchers in the presence
    of EMS providers for extended periods of time in an attempt to not formally accept
    the patient, which may be a violation of EMTALA statutes. Discussion followed. Mr.
    Delagi noted that he will be sending a letter to all EMS agencies that an orderly
    transfer of care must be done.
   Mr. Rob Stadelman noted that the Stroke Awareness Stickers design had been
    finalized and were going to print. Mr. Delagi noted that the wording is consistent with
    Cincinnati Pre-Hospital Stroke screening and New York State BLS Protocol for Stroke
    parameters and will be reviewed once again before distribution.

Old and Other Business
 Dr. Pollack reported that he, Dr. Goodman, and Dr. Johnson interviewed Dr. Maury
  Greenberg as the potential replacement EMS Medical Director and found him to be
  adequately qualified and recommended that the REMAC formally endorse him to the
  County Executive’s office. Mr. Delagi further explained the function and role of a
  part-time Medical Director from a medical perspective vs. an administrative
  perspective. A motion was made, seconded and unanimously approved to recommend
  Dr. Greenberg as the part-time EMS Medical Director.

New Business
 A motion was made, seconded and passed unanimously to approve Plum Island FD’s

                                                       REMAC Meeting Summary, March 26, 2007

                                             12
    request to be upgraded from BLS to ALS-Paramedic.
   A motion was made, seconded and passed unanimously to approve Hampton Bays,
    Sayville, and Medford’s request to be approved for CPAP within the confines of the
    program as defined. Further, a motion was made, seconded and unanimously
    approved that CPAP is approved as a procedure and that device-specific approval is
    removed.
   There seems to be an issue with non-refrigerated Cardizem™ no longer being
    available; a suggestion was made to determine if the drug is available in powder form
    from a local vendor. Mr. Jackson will check with North Shore – LIJ Health Systems as
    well.
   Dr. Tarsia spoke about 12 lead ECGs and the Receiving Station at Medical Control.
    Of the 18 cases received so far, 1 case was flagged as STEMI and the patient went to
    the receiving hospital’s CPORT for immediate catheterization. It was noted that 10
    cases had no contact with Medical Control, which effectively takes them out of the
    loop. Mr. Jackson noted that North Shore-LIJ is still receiving 12 leads from Suffolk
    County agencies despite receiving letters and instructions on how to program their
    units and send them to Suffolk Medical Control. Mr. Delagi stated that he wants
    information on the 10 no-contact cases from Dr. Tarsia and a list of the agencies that
    continue to send 12 Lead ECG to North Shore so he can follow up with each of these
    agencies and ensure compliance with the 12 Lead protocols.
   Mr. Delagi reported on the status of the ePCR project. The legislative-mandated
    review committee has made their recommendation to Purchasing and the vendor
    name has not been announced due to the fact that the Health Department’s Contracts
    Unit has not officially completed the legal contract necessary to formally award the
    project. Once this is done, agencies would be able to purchase the requisite hardware
    for the system that is compatible with the chosen vendor.

Announcements – The next meeting will be held on May 21, 2007 at the Fire-Rescue
and Emergency Services 1st. Floor Conference Room, at 7 p.m.

A motion was mad, seconded and passed unanimously to adjourn; the meeting
was adjourned at 10:00 pm.

Respectfully Submitted,

Karl W. Klug, Secretary (as taken by Mr. Delagi)

                                                     REMAC Meeting Summary, March 26, 2007

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