STATE TRAUMA ADVISORY COUNCIL (STAC)

OCTOBER 11, 2006

MEEING MINUTES

Members Absent

Karen Brasel

Cecile D’Huyvetter

Others in Attendance

Note:  If your name is spelled wrong, we apologize, however, it is imperative that you write legible.

1. Introductions - Dr. Randy Szlabick (Chair)

Dr. Szlabick called the meeting to order at 10:30 AM with introductions around the room.

2. Approval of August Meeting Minutes - STAC

Dr. Szlabick asked for a review of the August meeting minutes. Jeff Grimm made a motion to approve the minutes, with a second from Barb Larson.  Unanimous approval, motion carried.

3. Bureau of LHS & EMS Updates - Dan Williams

·        Funding issues are a major concern for the EMS office.  The Medical First Responder Coordinator position has been eliminated and the work has been reallocated to Nora Stofflet as the contact person for all Medical First Responder programmatic issues.  There are potential 8 out of 12 other positions that may be at risk.  The Trauma Coordinator position is less at risk, however, there is not increased funding available from DOT to meet the costs of the trauma coordinator position.

·        There were significant last minute renewals received.  Some problematic issues that has slowed the process includes, inadequate/incorrect paperwork and lack of signatures.  The licensing staff has done an outstanding job, working with individuals and services to work through these issues in a timely manner.

4. EMS Advisory Board Updates - Steve Bane or Cal Lintz

·        The EMS Advisory Board completed the EMS Advisory Board Strategic Planning meetings.  In this atmosphere of limited resources and collaboration, the board is reconfiguring the committees to streamline important projects.  There are six identified priorities for the board this year:

1.      Funding (Priority),

2.      Data Collection,

3.      Disaster Management (potential funding source),

4.      EMT Basic refresher roll out,

5.      Legislative rules - combining HFS 110, 111, 112 and possible Trans 309, and,

6.      Develop an EMS leadership program.

                         There will be a consolidation of committees resulting in an Education &  

                         Training, EMS Administration & Management, Disaster Management and   

                         EMS System Development.

                         For more in depth information , please see the EMS Advisory Board   

                         meeting minutes.

5. HRSA Update - Dennis Tomczyk

        (See Attachment)

6. Trauma Registry Update - Debi Peters

(See attachment of trauma registry report information)

·        The response from the facilities for entering data into the Trauma Registry                                                             

has been outstanding!

·        Reports are the next priority.  Debi Peters and Marianne Peck are testing the canned reports and training to access reports will be available in the future.  Report data can be statewide, regional or trauma care facility specific.  The scheduled completion date for making reports available is the end of the year.

7. Marketing Update - Lynne Sears

The marketing campaign with Staples has run out of funding.  The committee is working with the Department of Transportation, to collaborate resources for the campaign to continue.  With the current fiscal situation, the RTAC’s may need to contribute money to keep the website up and running.  There will be access for the site reviewers to sign up for their site reviews at: www.wisconsintraumacare.org in the near future.  The South Central RTAC, through Lynne Sears's leadership has made available funding to start the secure site reviewer's website.  Looking for RTACs to consider donating $500.00 from each RTAC to help maintain the website.

8. Working Subcommittee Report - Dr. Szlabick

1. Update on Site Review Process - Cecile D'Huyvetter

The working subcommittee is working in collaboration with DHFS Legal Counsel to enable the Designation Site Review Committee to be able to meet in a closed session.  There will be sensitive information, including physician identification which must not be shared among hospitals.  DHFS has requested that site reviewers be from separate facilities for a specific site review at this time.  This may be addressed again in the future.  The other issue is whether email exchanges can occur in lieu of open vs. closed meeting issues.

Summary of some questions:

1.      Most labs will have a massive transfusion policy available due to certification requirements.  The trauma coordinator should confirm that the lab policy is not in opposition with the trauma protocols.

2.      The American College of Surgeons (ACS) which is used as a template for Wisconsin's designation process defines:

"promptly available" to mean within 30 minutes, and

"immediately available" to mean 15 minutes or less, (likely would need to be in-house).

3.      The expectation for Level III's is that the surgeons meet the threshold of 80% compliance for arrival within thirty minutes of patient arrival.

4.      As part of the trauma team, x-ray and lab should also be available within 30 minutes of the patient's arrival.

5.      The operating room personnel should arrive within 30 minutes of being notified by the surgeon (hospital) that they need to come in for a surgical trauma case.

6.      A reminder for hospitals that the following six criteria is the minimum that trauma activation should occur.  Any trauma care facility may add to the criteria.

·        Confirmed BP < 90 at any time in adults and age specific hypotension for children;

·        Respiratory compromise/obstruction and/or intubation

·        Transfer patients from other hospitals receiving blood to maintain vital signs;

·        Emergency physician's discretion;

·        Gunshot wounds to the abdomen, neck, or chest;

·        GCS < 8 with mechanism attributed to trauma.

The most important concept to remember when developing your trauma program and policies, is to avoid a delay in care for the critically injured patient.  Issues that arise should be part of your performance improvement process.

2. Update on PI template for RTACs - Dr. Szlabick

Eric Wendorf, DHFS Legal Counsel is working with the group to clarify the question of what sanctions can be posed to an individual who breaches confidentiality in the RTAC PI process.

9. CALS - STAC

1. Third day lab vs. didactic portion only for Level IV's

Level IV's that opt for the CALS course as an option instead of ATLS do not need the third day lab.  The didactic portion which includes a manikin lab will meet the needs at this time.   

10. Surgeon Expectations for Level III's - Kelly Jung  & STAC

Taking call at more than one facility

If a surgeon is on call at more than one facility, there must be a back-up surgeon available.  You cannot have a surgeon on call at two facilities without this backup available and posted.  The second surgeon must also be available within 30 minutes of patient arrival.  Make sure the other facility is aware to notify the backup surgeon.

11. Other Business

Ed Mishefske is resigning from STAC due to his increased traveling and responsibilities.  Ed Mishefske has been a valuable member of STAC and has been a great resource of information and an instrumental component to the Wisconsin Trauma Care System and the Trauma program.  Though Ed is irreplaceable, his position needs to be filled.  STAC has recommended a rural Emergency Medicine Physician which is not represented on STAC. 

There being no further business, Aimen Shaaban made a motion to adjourn with a second from Jeff Grimm.  Motion carried and meeting adjourned at 12:18pm.

12. Next Meeting - December 6, 2006 at the Sheraton Madison Hotel from 10:30am to 12:30pm.

Respectfully submitted,

Helen Pullen and Marianne Peck

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