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DEC 26 198 <br />BOOK .75 PALE 411 <br />Dr. Teel explained that once the paramedics arrive on the <br />scene, they assess the problem and, based on written protocol, <br />they follow certain orders based on their diagnosis. If they <br />wish to deviate from that protocol, they contact the on -duty <br />Emergency Room physician to receive clarification or further <br />orders. The paramedic is in constant radio contact with the <br />Emergency Room physician and there can be direct communication <br />between them to serve the patient appropriately. Sheets of the <br />run are reviewed by the Medical Director daily. Dr. Teel noted <br />that no matter which plan is chosen, for an ALS to be licensed <br />you must have the radio contact; that part will not change. <br />Chairman Scurlock asked how we get the thought that some <br />entity other than a physician is going to be in control. He did <br />not see that even as a possibility, and Commissioner Eggert <br />pointed out that is against the law. <br />Dr. Teel explained that the concern of the medical staff is <br />that the physician must be Board certified in emergency medicine <br />and work full time in the Emergency Department. <br />Commissioner Eggert clarified that what we have said is that <br />we hoped that we would have our Medical Director in the Hospital <br />emergency room. The alternative to that would be to turn to <br />someone like Dr. Berman in the Health Department who has had many <br />years of experience. Our first option, however, is to go to the <br />Hospital emergency room. <br />Emergency Management Director Doug Wright took the floor to <br />present the County plan. He explained that the county proposal <br />was predicated on known problems that we currently have in the <br />EMS system. It is also based on the James Ward report with the <br />concept of utilizing our existing resources with a single focus <br />of management while keeping the taxpayers' dollars keenly in <br />mind. The report identified three structures - the Hospital, the <br />Fire District, or County government. Director Wright advised <br />that he sat down with a majority of the providers and asked for <br />their input. After all that input, he felt it was not feasible <br />12 <br />