EMS Policy Minutes 05/21/2010 R
May 21, 2010
MINUTES OF THE MEETING OF THE COLLIER COUNTY
EMERGENCY MEDICAL SERVICES
POLICY ADVISORY BOARD
Naples, Florida, May 21, 2010
LET IT BE REMEMBERED that the Collier County Emergency Medical Services
Policy Advisory Board, having conducted business herein, met on this date at
3:30 PM in REGULAR SESSION at the Neighborhood Health Clinic, 121 Goodlette
Road N., Naples, Florida, with the following Members present:
CHAIRMAN:
Vice Chair:
James Talano, M.D.
Chief Robert Metzger
Chief Walter Kopka
(Vacancy)
(Vacancy)
ALSO PRESENT:
Fred Coyle, Collier County Commissioner
Dr. Robert Tober, Collier County Medical Director
Jeff Page, Chief, Bureau of Emergency Services
Jennifer Florin, Administrative Assistant, EMS
Dan Bowman, Deputy Chief, Bureau of Emergency Services
COLLIER COUNTY EMERGENCY MEDICAL SERVICES
POLICY ADVISORY BOARD
AGENDA
MEETING TO BE HELD:
NEIGHBORHOOD HEALTH CLINIC
121 Goodlette Road North, 1 st Floor Reception Room
Naples, Florida
DATE: May 21,2010
TIME: 3:30 P.M.
1. CALL TO ORDER AND PLEDGE OF ALLEGIANCE
2. AGENDA AND MINUTES
A. Approval of Today's Agenda
B. Approval of Minutes from January 15th Policy Advisory Board Meeting
3. OLD BUSINESS
4. NEW BUSINESS
A. Current Vacancies
B. Brief Overview of the Blue Ribbon Committee
C. Review of Statistics - Data Subcommittee of Blue Ribbon Committee
D. The Golden Hour
E. Insights from the Gathering of Eagles
F. Review ofNFPA 1710
G. Review of EMS First Aid Courses
5. PUBLIC COMMENT
6. BOARD MEMBER DISCUSSION
7. ESTABLISH NEXT MEETING DATE
8. ADJOURNMENT
May 21,2010
1. Call to Order and Pledge of Allegiance
Chairman James Talano called the meeting to order at 3:40 PM and a quorum was
established.
The Pledge of Allegiance was recited.
Commissioner Fred Coyle attended.
2. Agenda and Minutes
A. Approval of Today's Agenda
Chief Walter Kopka moved to approve the Agenda as submitted. Second by Vice
Chairman Metzger. Carried unanimously, 3-0.
B. Approval of Minutes from January 15,2010 Meeting
Vice Chairman Metzger moved to approve the Minutes as submitted. Second by Chief
Walter Kopka. Carried unanimously, 3-0.
3. Old Business
(None)
4. New Business
A. Current vacancies
· Linda Mitchell, R.N., and Steve Shafor resigned from the Advisory Board. They
represented the Nurse and Pharmacist components of the Committee.
· A letter was sent to the Medical Society asking for recommendations to fill the
vacancies and the nominations will be presented to the Board of County
Commissioners for approval.
B. Brief Overview of the Blue Ribbon Committee
· Membership: local professionals, community leaders, and citizens (14)
o Sheriff's Office
o EMS personnel
o Chamber of Commerce
o Physicians Regional and NCH
· Goal: to determine ways to improve the EMS system
· Will try to enlist assistance from statisticians and industrial mathematicians from
the Industrial Engineering Department of Florida Gulf Coast University to
develop a statistical report
o FGCU has requested funding of approximately $40,000 to develop the
statistical program/model
o County Manager Leo Ochs has been contacted
· Results of meeting will be presented to the Board of County Commissioners on
June 22, 2010
Commissioner Fred Coyle noted the Blue Ribbon Committee was a civilian committee
and not under the auspices of the Board of County Commissioners.
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May 21,2010
C. Review of Statistics/Data from Subcommittee of Blue Ribbon Committee
· FGCU will identify the Key Elements and Bench Marks
. Will narrow the scope
o Better allocation of resources and improved response time
· Approximately four months will be required for analysis of data
D. The Golden Hour
· Definition: The first hour after the onset of out-of-hospital traumatic injury
· Dr. Tober stated he was not impressed by the article which was published in
Volume 55 of the Annals of Emergency Medicine (March, 2010)
o Lacked information - was confusing
o Insufficient segregation of patients
o No meaningful impact
· The article illustrated controversy regarding trauma centers and did not utilize ISS
SCOrIng
Discussion ensued concerning the MedFlight emergency helicopter, maintenance
schedules, and the amount of out-of-service time. A request was made to obtain the
statistics from the Lee Memorial Trauma Center. Lee is the first choice for back-up
service and is the preferred destination for trauma patients while Naples is preferred
for cardiac patients. Occasionally, assistance has been requested from Dade and
Broward Counties when the Naples helicopter is not in service. The Collier County
Sheriff's Office has two helicopters but neither is equipped for emergencies and can
carry only the pilot and one passenger.
Dr. Tober stated the helicopter is not certified for Auto Pilot during night flights, It
is not possible to lease equipment during down times because there is no rental
agency available.
E. Insights from the Gathering of Eagles (EMS Network News, March, 2010)
· Meeting: February, 2010
· Participants: medical directors from the U.S., Canada, and United Kingdom
· Research papers published in 2009 were reviewed
. Findings presented:
o Survival to discharge rate for out-of-hospital cardiac arrest patients has not
changed since 1970s, i.e., still at 5.5%
o Advanced Life Support ("ALS") intervention made little impact in patient
outcomes in almost all life-threatening patient conditions
o ALS patients survival rate - 5.1 % and BLS ("Basic Life Support")
patients survival rate - 5.0%
· Emerging trends for study: Field Termination of Cardiac Arrest Cases;
Community Health and Advanced Practice Paramedics; Transport of CPR cases
in non-light/siren ambulances
F. Review ofNFPA ("National Fire Protection Association") 1710 (2010 Edition)
· Topic: "Standards for the Organization and Deployment of Fire Suppression
Operations, Emergency Medical Operations, and Special Operation to the Public
May 21,2010
by Career Fire Departments"
. Chapter 5 - Fire Department Services (5.3.3.3 - Service Delivery Deployment)
o Under 5.3.3.3.2: "Thefire department's EMSfor providing a first
responder with AED ("Automated External Defibrillator '') shall be
deployed to provide for the arrival of a first responder with an AED
company within a 240-second travel time to 90% of the incidents as
established in Chapter 4. "
o Under 5.3.3.3.3: "When provided, thefire department's EMSfor
providing ALS shall be deployed to provide for the arrival of an ALS
("Advanced Life Support'') company within a 480-second travel time to
90% of the incidents providedfor afirst responder with AED or BLS
("Basic Life Support'') unit arrived in 240 seconds or less travel time as
established in Chapter 4. "
G. Review of EMS First Aid Courses
. The Medical Examiner's Office training department will begin a series of basic
first aid courses (8-hours) for Collier County employees - first to be trained will
be the Parks and Recreation employees and the Water Department employees.
. Working with the CCSO to enhance the CPR capabilities of Deputies. It was
noted almost every police vehicle is equipped with an AED ("Automated External
Defibrillator") .
· Several deaths have occurred due to anaphylactic shock caused by bee or wasp
stings. It was also noted that Deputies, who are usually first on the scene, are not
permitted to administer EPI-Pens due to State legislation.
5. Public Comment
(None)
6. Board Member Discussion
· Chief Walter Kopka distributed a memo to the members entitled, "Improving Fire
District Responses to Medical Calls." He stated the closest fire department unit does
not always respond, especially to certain areas of the county (incorporated versus
non-incorporated) and gave examples.
During discussion, it was noted the issue should be directed to Board of County
Commissioners for possible discussion with representatives for the City of Naples.
Anticipated obstacles: jurisdictional concerns, as well as a lack of a coordinated dispatching
system
Commissioner Coyle volunteered to speak with the Mayor and the Naples City Council.
He suggested an agreement between municipalities may be required and stated it would be a
complex process.
Chairman Talano stated the issue merits further study and suggested forming an Ad Hoc
Committee.
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May 21, 2010
. By consensus: A letter will be sent to the Blue Ribbon Committee inviting a
representative to attend the next Policy Advisory Board Meeting to discuss their
progress.
7. Next Meeting Date: September 17 at 3:30 PM
There being no further business for the good of the County, the Meeting concluded by
order of the Chairman at 5:00 PM.
COLLIER COUNTY EMERGENCY MEDICAL
SERVICES POLICY ADVISORY BOARD
Robert Talano, M.D., Chairman
The Minutes were approved by the Board/Committee Chair on
as presented , or as amended
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