Emergency Nurses Association

Mid-Maryland Chapter (

May 12, 2015

Mission: The mission of Emergency Nurses Association is to advocate for patient and excellence in emergency nursing practice.

Attendance: / Presiding / Secretary
Aquino, Kaitlyn, SGMC; Bradley, Helen, DCH; Carvalho, John, HCH-SS, Secretary, MMC ENA; Dorosz, Emily, CNMC; Fox, Pam, SGMC, President MMC ENA; May, Anne, MMMC; Rawlinson, Chris, DCH; Tenny, Lisa, HCH-SS; Vessel, Tonia, DCH; Waak, Sandy, Treasurer MMC ENA / Pam Fox / John Carvalho
Topic / # / Discussion / Actions / Status
Educational Session / 1 / At 19:10, Lisa Tenney welcomed ENA members and guests to the educational presentation. She then introduced the presenter:
Dallas A. Lea II, MD, Assistant Professor, Spinal Cord Injury Medicine Program, Med Star National Rehab Hospital
“Botox Management of Chronic Spasticity”
The objectives of the presentation included:
◦Recall the definition of spasticity
◦Describe how spasticity is tested and graded
◦Discuss treatment options and referral; resources for the management of chronic spasticity
Disclosures:
◦Speaker is principle partner of Lea Medical Therapies and Lea Medical Partners LLC
◦Speaker has done work for Allergen in education about Botox
Discussion during the presentation included:
◦What is spasticity?
▪difficult to define
▪more a process than a thing
▪occurs with CNS injury
TBI - 13.9%
Adult cerebral palsy - 52%
MS - 84%
Stroke - 42%-60% (at some point)
spinal cord injury - 71% 4 years post injury
▪tonic - brain
▪clonic - spinal column
▪it is NOT paralysis as there is coordination of movement
◦Medication, uses, and risks/side effects
▪Baclofen - antispasticity, may cause sedation, may not be appropriate for MS, stroke or TBI
▪Tizanidine - related to clonidine, centrally acting sedation, may cause hypotension
▪Dantrolene - weakens spastic muscles, may be good for stroke and TBI, may weaken all muscles
▪Neurontin - good if cause of spasticity is neuropathic pain
▪Valium - sedating
▪Cannabis - sedating, not goood for functional goals
▪Flexeril/Soma/Skelaxin - sedating, good for spasms, not for spasticity
▪Botox - good for focal spasticity, non-sedating, possible for functional goals, may cause dry mouth and aches. FDA approved for upper extremities, off-label for lower extremities
▪Baclofen pump (intrathecal) - good for global spasticity, not as sedating as regular baclofen, if pump goes dry may cause withdrawal that may appear as schizophrenia / Informational / Completed
Opening / 2 / After the educational presentation, President Pam Fox called the business meeting to order at 20:45 / Informational / Completed
Approval of minutes / 3 /
  1. Discussion and correction of draft March minutes.
    Motion to approve March minutes as amended, Chris Rawlins, seconded by Lisa Tenney. Motion carried.
/ Action Item / Completed
Treasurer’s Report / 4 /
  1. Current Balances:
Checking - $3674.27
Savings - $10,376.44
Course Revenue $0.00
of savings, Knapp grant amount, $2421.18
Treasurer will shift funds as appropriate to maintain $2000.00 in checking to avoid bank fees.
  1. New Expenses
◦Reimbursements for the State and Chapter Leaders Orientation awaiting reimbursement forms. / Informational / On-going
IQSIP Report / 5 /
  1. Deferred
/ Informational / On-going
Military Matters / 6 /
  1. Wounded Warriors Cookout and Injury Prevention Event April 29, 2015, 4-6 pm.
◦Injury prevention activities to include poison/injury prevention trifold with auxiliary materials and information.
▪Duck Pond for child involvement and education
▪Car seat information and availability for seat checks
▪Poison control information and literature
▪Domestic violence resources
▪Good parenting resources
◦Attendees included Sue Sheehy, Emilie and Monty Crown, Paul Lewis, Pam Fox, Lucy McDonald, Lisa Tenney, and John Carvalho / Informational / On-going
President's Report / 7 /
  1. Membership: MMC currently has 308 members
  2. MD State ENA Meeting update
◦Executive Board is reviewing the State Budget
◦Board Meeting will be held at ENA By The Bay
◦CPEN Review is in planning stage
◦Website is being updated with current information
  1. MMC ENA Silent Auction Donation for ENA By The Bay - Pearl Necklace. Proceeds of auction to benefit the ENA Foundation
  2. Two Minutes of news
◦Synthetic Caannabinoids - great concern of poison control centers and EDs. Cause agitation, CNS depression, HTN, and many other symptoms of concern. Do not show up on tox screens.
◦Women in Healthcare Positions of Authority
▪77% of hospital employees
▪78% of social workers
▪26% of leadership at the CEO level
◦Pain Management Guidlines (State???)
▪spcecific criteria for giving narcotics
▪medical, family, social, and pain histories
▪physical exam
▪check the state system
▪determine risk for abuse
◦News of the day: NPs now allowed full practice authority in Maryland
  1. Words of encouragement
◦Happy Nurses Week. / Informational / On-going
Old Business / 8 /
  1. Membership trifold is currently with Lisa Tenney, HCH
  2. IQSIP board is with Lisa Tenney
  3. Barbara Proctor Conference scheduled for Friday, October 30, 2015 at Montgomery County Public Safety Headquarters
  4. Sandy Waak has sign up sheet for volunteers
  5. Need 5 Speakers total
  6. Documentation
  7. Lucy McDonald, RN, HCH - Pediatric Orthopedic Emergencies
  8. Dan Sherk, MD, HCH - management of sickle cell pain
  9. Levy Hopkins - Aircraft Medical Emergencies
  10. Need one additional clinical topic
  11. CNE information needs to be to Lisa Tenney
  12. Vendors communication Anne May with John Carvalho
  13. Upcoming Classes
◦TNCC at Calvert is delayed
◦TNCC at Doctor's Community Hospital, August 21 and 22, 2015
◦ENPC June 26 and 29, 2015
◦ENPC October 15 and 16, 2015
  1. Delegate Point Sheets for National ENA due to Pam Fox by June 8, 2015
/ Action Item / On-going
New Business / 9 /
  1. Report from ENA on the Hill, April 28 and 29, 2015
    (Sally Martin, Lisa Tenney, John Carvalho)
◦Educational sessions on how to contact and how to interact with members of Congress and their staff
◦Two areas of focus for this year: funding trauma centers and comprehensive mental health legislation
◦Funding trauma centers
▪House has passed bill on trauma funding, but not appropriated the funds
▪Encourage support of $28 million in funding for trauma and emergency care under the Public Health Services Act
▪Would support funding for rural trauma centers, collection of data for coordination, and assist in curtailing losses from uncompensated care
◦Comprehensive mental health reform legislation
▪Request support and cosponsorship of bipartisan legislation being written by Rep. Ted Murphy and Rep. Eddie Bernice Johnson
▪Comprehensive rather than piecemeal approach
▪integrate communication and care
▪Protect information privacy but allow caregivers to obtain necessary information for patient safety and care
▪Modify Federal reimbursement under Medicaid and Medicare to allow simultaneous treatment of medical and psychiatric conditions
▪Increase telepsychiatry for rural and underserved populations
▪Expand training for law enforcement
◦Participants from Chapter met with staff and/or elected leaders both Senate and appropriate Legislative districts
  1. Triage Course at University of Maryland June 10 and 11, 2015
  2. MMC ENA unscheduled Board Meeting
◦April 18, 2015
◦Teleconference 9:00 am
◦Attendees: Carvalho, John, HCH-SS, Secretary MMC ENA; Crown, Emilie, MCFRS; Fox, Pam, SGMC, President MMC ENA; McDonald, Lucy, HCH, President-Elect MMC ENA; Tenny, Lisa, HCH-SS; Waak, Sandy, Treasurer MMC ENA
◦Resolved: MMC in an effort to support our members and the stability and success of MD State ENA and the MMC ENA chapter, will begin operating TNCC and ENPC Courses through the MMC Chapter treasury. It is the belief of the MMC Board, that this will ease the burden of tracking and cash flow responsibilities for MD State ENA. / Action Item / On-going
Chapter Activities / 10 /
  1. Between Riding and Driving
◦In association with Doctors Community Hospital and the Maryland State Highway Administration
◦May 9, 2015
◦2 courses, 16 participants aged 12-15
  1. Stroke Lectures
◦Anne May
◦Recognising signs of stroke
◦2 Scheduled
  1. Wounded Warriors Cookout and Injury Prevention Event
◦April 29, 2015
  1. ENA on the Hill
◦April 28 and 29, 2015
  1. Signs and Symptoms of Stroke for children
◦Julie Jacobs and Carla Luncford of Doctor's Community Hospital
◦4 presentations
◦Reached approximately 120 4th graders
◦With rise of grandparents caring for children, assist children in recognising signs of stroke and how to react and call for help / Action Item / On-going
Adjourn-ment / 12 / The meeting was adjourned at 21:38.
The next meeting will be held at 7 pm Wednesday, July 8, at Holy Cross Germantown Hospital. / Informational / Completed

Respectfully submitted by John Carvalho, RN, CEN, Secretary MMCENA

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