1. MARAA FALL 2008 Meeting Orlando, FL

2. Where do we stand on the debate?
Old Business
Ambit v. Gemstar
Where do we stand on the debate?

3. Old Business Joint Regional Anesthesia & Analgesia Tracking System JRAATS
Capture data regarding the mechanism of injury
Capture data needed to create Pain Procedure Notes
General Pain
IV PCA Pain
Epidural Catheter
Peripheral Nerve Block
Continual Peripheral Nerve Block
Single Injection Peripheral Nerve Block
Capture the data needed for Clinical Pain Notes
Capture the data needed for Transfer Pain Notes
Provide the same level of capability as currently provided by RATS via existing enterprise systems
Serve as the primary tool for integration, tracking, and research into pain care improvements throughout the evacuation chain

4. Old Business Joint Regional Anesthesia & Analgesia Tracking System JRAATS
MARAA Committee Coordination (includes anesthesia consultants for Air Force, Army, Navy)
-Project approved by MARAA 25 April 2008
TFWG Coordination
Dec 2007 – Concept accepted by TFWG
Jul 2008 – Requirements and CONOPS Formal Staffing Complete
Two comments, both incorporated
All Other Respondents Concurred
September 2008 – TFWG has approved ConOps and forwarded the package for funding and implementation.

5. Old Business
Should other drugs or medications be recommended as part of PCA infusions or given prior to air evacuation?
Hydromorphone PCA discussion
Ketamine PCA infusions (Ultra-low Dose)
PCA opioid dosing recommendations

6. Old Business MARAA Book

7. MARAA Landstuhl Pain Survey
Old Business
MARAA Landstuhl Pain Survey

8. Old Business
MARAA representative (or one from each service) on the monthly continuum of care VTCs.

9. Old Business James Ray – Ortho-McNeil Janssen Scientific Affairs
IONSYS – Iontophoresis Patch Update

10. New Business DVPMI Anesthesia Acute Pain Service
Chronic Pain Therapies
PM&R
Physical Rehabilitation
Behavioral Health
Co-existing Psychiatric Diseases
Cognitive Therapy
Substance Abuse and Addiction Medicine
Pediatric Pain Clinic
Cancer Pain & Palliative Care
Pain Treatment
Quality of Life
Hospice
Complementary and Alternative Medicine Techniques
Acupuncture
Biofeedback
Guided Imagery
Family Education and Support
Pain Rehabilitation Center
Focus on patients with refractory maladaptive pain coping behavior
Inpatient Hospitalization
Intensive Outpatient
Outpatient Program

11. Pain Management Missions
Acute Chronic
Optimum pain care for our warriors requires both Acute and Chronic pain management specialists

12. USA Today – The world presented at an 8th grade reading level

13. New Business Ceramatec Inc.
Low Rate, Volume Efficient Implantable Drug Delivery with On/Off Capability
John Gordon

14. New Business
Towards Development of an Electrochemical Propofol Biosensor for Closed-Loop TCIA
Edward Chaum, MD, PhD

15. New Business