ADVISORY

TO:	All MA ALS-Licensed Ambulance Services, Accredited Training Institutions
CC:		EMCAB Members
FROM: 	Dr. Jon Burstein, State EMS Medical Director
		Iyah Romm, Director of Policy, Health Planning and Strategic Development
		DPH/Bureau of Health Care Safety and Quality
DATE:		November 14, 2012
RE:	Reminder and Clarification of Upcoming Implementation of ALS Waveform Capnography Equipment
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The purpose of this advisory is to remind all Massachusetts ambulance services that perform endotracheal intubation, either at the ALS-Paramedic or ALS-Intermediate level, that as of January 1, 2013, you must be equipped to have waveform capnography capability on every ALS ambulance. 

Further, this advisory is also issued to clarify that appropriate waveform capnography capability means using a device that has the capability to record and print a waveform. This capability is a key to the original intent behind this requirement, which was to confirm and document correct endotracheal tube placement in intubated patients, especially when such patients are moved or there is reason to suspect the ETT tube has become dislodged. It is also critical to quality assessment/quality improvement and ultimately better patient care, for ambulance services be equipped to record and have available for review the waveform produced by the capnograph. 

If you have any questions, please contact Phil Bonaiuto, field supervisor, ambulance regulation program, at phil.bonaiuto@state.ma.us.