December 2, 2005 newsletter.pub

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December 2, 2005 newsletter.pub
A Monthly Newsletter for Employees of Greenville County EMS
Volume 1, Issue 7
December 2, 2005
Inside this issue:
Commendations
2
Communications Corner
3
Emails you may have
missed
4
Last month’s “strip-Tease
5
TeleStaff/Character First
6
Training Announcements
7
Grrrowl Public Safety
Night
8
EKG Corner
9
My heartfelt thanks to all of you that made it possible for me to have a fence. I really do not have words to express what I felt when I pulled and saw that everyone was working together, I started to do like my dog does
when she gets excited, she runs in and out of the house and around in circles, but I realized that I had broke
leg and ankle, and probably would have had an asthma attack in the midst of it, so I just made ugly faces and
cried.
I have never worked with a group of people with such big hearts, and who are willing to go the extra mile to
help a co-worker. I want you to know that I am truly blessed and I consider myself lucky that you are in my life.
Again I thank you for your kindness, thoughts, and prayers.
May God bless you all!
Audrey
Volume 1, Issue 7
Page 2
Commendations
Receiving compliments from the public brightens our workday. It helps to offset some of the problems we
might encounter during our shifts. Compliments from our co-workers are even more appreciated and really
touch us deeply because they are able to make very discriminating observations about what we do. If you
would like to commend one of your co-workers, e-mail me, I will ensure it gets in the next newsletter.
Paramedics
Dena Gaston
Lorri
Andrew:
For
service
they
Corporal
Raymond
Sass:and
As you
may
or may not
beoutstanding
aware, I had customer
the opportunity
to as
witness
cared
for theawife
a cardiac
arrestat
patient
this
month.Now,
Captain
Tracy
Krein
you
approach
veryofbusy
intersection
6pm last
Friday.
I’m sure,
unfortunately,
that this
incident that I’m about to describe probably wasn’t unusual for you, but I felt compelled to write a
Paramedics
Robert
Merck
and Jennifer
For their
recent
participation
at incithe
note
of thanks as
often our
employees
only hearWhitmire:
about the negative
habits
when
counseled for
dents
in
which
they
are
involved.
Western Carolina University Health Care Career/Job Exploration fair in Cullowhee, NC.
Captain
Tracy
On
Friday,
whenKrein.
you approached the intersection of Church and University in front of County
Square, you avoided what I believe would have been a potential accident. As you were coming up
Paramedics
Jennifer
Cooper
Leoncautious
Harrison:
“compassionate
and profesChurch,
running
emergent
traffic, and
you were
whenFor
youthe
approached
the intersection
and
slowed
your
vehicle
appropriately.
That
you
were
approaching
the
intersection
with
caution
sional” care given to a patient and her family during a very critical and difficult time in was
their
excellent as a vehicle in front of me began to enter the intersection to turn left, saw your approach,
lives. Deputy Director Clark.
stopped abruptly but then went forward again before coming to a complete stop. Had you been
traveling a higher rate of speed and not been so attentive and aware of your surroundings, I believe
Paramedics Bill Cain, Matthew DeJong, and Sgt. Keith Jensen: For the outstanding asan accident could have occurred as this driver, while aware of the emergency vehicle, still acted
sessment
and treatment
of a difficult cardiac
patient
teamwork
displayed
between
crewwithout
warning
and in an unpredictable
manner.
I alsoand
believe
that your
approaching
the intersection
in this
your
partner
give continuous
to what
was obviously
a critimembers
andmanner
the ERallowed
staff that
“saved
thetopatient’s
life that care
day.”
Dr. Marty
Lutz.
cal patient without worrying about their safety or stability in the back of the ambulance.
Paramedics Keith Eudy, Tabitha Darby, Eric Longino, and Mike Hawthorne: For
Your driving and cautiousness showed great care, safety and professionalism on your part. I am
care rendered
to patient
and hisCounty
friend at
recent
MVA.
Hulsey,
EMS
Billing.
proud
you represented
Greenville
EMS
so well
and Rhonda
proud that
you took
time
to assure not
only your safety, but also the safety of someone who wasn’t paying attention to the intersection or
Paramedics
Trish Klimbal:
renderedfor
to your
patient
of recent
the
emergency Patrick
vehicles Sherren
they were and
approaching.
You are For
to becare
commended
actions.
Thank
againexpressed
and pleasethat
keep
up the
work.
Captain
Krein.at what they do and are
MVA. you
Patient
crew
wasgood
“very
calming
andTracy
very good
definitely in the right career.” Deputy Director Clark.
Paramedics Jennifer Cooper and Leon Harrison: For your professionalism and de-
meanor “by going above and beyond what was expected.” Apparently, you made phone
calls to gain additional and vital information concerning the patient and were able to calm a
somewhat bad situation. CHS RN via Pam Jenkins.
Paramedics Tonya Henson and Jeannie Mosley-Babb: For volunteering your time to
help deliver “turkey baskets” to 9 needy Greenville county families last week. Sergeant
Dean Huston.
Volume 1, Issue 7
Page 3
By Sergeant Brahmer
Do you ever wonder why your
times are off when you do your patient
care report? We all know that the MDBs can be a tricky piece of equipment, but
there are some things you can do to help decrease this problem. Each time the
status of a unit is changed on a call the time is updated in CHART. Therefore, the last
time entered is the only time you see. If you press ‘en route’ again after dispatch
changes your status to ‘hot’ or ‘cold’, then that en route time is the one you see in
CHART. Please check your status at the bottom of the MDB screen. If you have successfully changed your status, you do not need to change it again. The same applies
if you log yourself off of the MDB while on a call. When dispatch places you on the
call again, you will have altered times. If your MDB is showing a call already dispatched to it at shift change, do not log off the previous crew and log back on as the
new crew. This will change the en route time, as well as necessitate an additional
run number for the new crew and increase the number of reports required for the
call.
By the numbers:
Incoming and outgoing calls by position
Telephone traffic for the month of October
•
Call take
10,022
•
EMS calls
4720
•
Fire
2238
•
Fire calls
608
•
EMS
2800
•
Incoming 911 calls
3349
•
Incoming 7 digit calls
5593
Volume 1, Issue 7
Page 4
Beanie Babies Have Arrived!
Road Closure at LEC
Recently, a lady whose aunt
had a gift shop in Hilton Head
that sold Beanie Babies, has
donated 500 brand-new stuffed
animals to us for distribution to
our pediatric patients. Please
contact Lt. Adair for future replacements on your assigned
vehicles as the current supply
of Beanie Babies is in Supply.
In addition, if you would like to
Just a reminder… the Stone
Ave. access ramp will remain
closed during construction of
the new jail facility This is expected to take approximately
20 months. Please use an alternate route when responding
to the LEC for calls or training.
give these stuffed animals out
to children at a special event,
please contact Lt. Adair ahead
of time and he can supply you
with additional Beanie Babies
to distribute.
New Forms Have Been Printed
As you may already know by now, several departmental forms have been updated and printed for
your daily use. These forms include the following forms printed in both English and Spanish to assist
you in communicating with your patients: Notice of Privacy Practices, Waiver Form, and the Billing
Authorization/Patient Responsibility Form (the old orange form). You will notice that the Billing Authorization/Patient Responsibility Form has a specific area for you to note the Call Number for that
patient. Please insure that the patient both prints their name and provides their signature on the
form.
In addition, both the Ambulance Check List and Charge Form have been revised to better suit your
needs. The newly printed Ambulance Check List Form no longer contains call activity and instead
has the checklist information on both sides of the form thereby enabling the day and night shifts to
use the same document for a 24 hour period. Remember that assigned units must be inventoried
and an Ambulance Check List documented each shift. Much of the previous information on the
Charge Form has been deleted and this revised version more closely resembles the billing screens
in CHART. Please remember to complete a paper Charge Form (if applicable) when completing a
paper report for your call.
Lt. Adair has already distributed these new forms to all the stations and has added them into the Inventory section in CHART for future orders. Please order additional forms through Supply using this
channel rather than copying your own forms. Lt. Bolton is tasked with cleaning up the common drive
of all the miscellaneous forms.
Corporals are tasked with ensuring that crews assigned to their stations are no longer using outdated forms. Zone supervisors and/or Shift Commanders will ensure this for stations without a Corporal. On behalf of Lt. Adair, we thank you for your assistance and cooperation in this matter.
Volume 1, Issue 7
Page 5
When you look at this ECG, you are not immediately bowled over by any obvious abnormalities. Closer inspection,
however, leads you to the AMI. Begin by examining the limb leads. There is ST depression in leads I and aVL. Remember, downward sloping ST segments in aVL are the first sign of an inferior AMI, a reciprocal change. Could
this be such a case? Yes, when we look at II, III, and aVF, we see ST elevations in those leads. ST elevations
and reciprocal ST depressions always indicate an AMI. This is definitely an IWMI.
Whenever we see an IWMI we need to consider the three other regions of the heart that are associated with IWMIs: the right ventricular MI, the lateral MI, and the posterior MI. Is there any evidence of an RV infarct? Yes, the
ST segments in III are taller than those in II. Get right-sided leads to verify your suspicions. Is there any evidence of a lateral extension of the AMI? No. How about evidence of posterior wall involvement? Yes. Note the ST
segment depressions in V1to V3 with flipped T waves! Also note that the ST segment depression in V2 is more
than half the ST segment elevation in aVF. This is consistent with involvement of the posterior wall in the AMI.
Posterior leads would be helpful in verifying your diagnosis. To summarize, this patient has an infero-RV-posterior
AMI. This puts a large amount of myocardium at risk, and the patient should be treated aggressively to reperfuse
the areas involved.
Kudos to paramedic Robert Woerner who nailed this “Strip-Tease” and provided the correct treatments.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
-SAMPLE/VS
-ASA 324 mg
-oxygen
-IV
-monitor with 12 lead, transmit to chest pain center
-get a 2nd IV
-call for code 5
-consider need for transport by air
-complete thrombolytics check sheet
-avoid NTG for pain control--right side MI?--pt is borderline hypotensive
-consider fluid bolus for BP (by improving pre-load)/consider and ask MC for morphine prn pain---watch BP!!!
-administer weight based heparin bolus if no CIs
-consider transport time/consult with MC---thrombolytics vs. catheter lab
-ask for orders for Retavase if no CIs
- if time, right side EKG to check for right ventricle MI also (look for elevation in V4R and Q wave)
-support ABCs, monitor VS q 5mins, watch for bradyarrhythmias, transport STAT, observe for reperfusion arrhythmias
Volume 1, Issue 7
Page 6
Character First!
GCEMS PEER Committee
By Lana Swaffer
INITIATIVE
Recognizing and doing what needs to
be done before I am asked to do it
At our recent PEER Committee meeting we
had an exciting time as we discussed some upcoming plans we are working on. These include opportunities to promote our departmental unity and increase public awareness.
Look for more information in the near future
about some exciting challenges we would like
to give you the opportunity to be part of.
Additionally we are looking for more members. We feel we can be more effective with
increased involvement by YOU. We are looking for individuals excited about what EMS
does and willing to make a difference, starting
with ourselves. So, jot down your ideas and visions for GCEMS, store up on energy bars, and
come volunteer your involvement; but don’t
be surprised if we approach you about joining.
Prepare for the opportunities of tomorrow
by responding to the needs of today
Gene Tennes – A shift, Michael Koch – B shift,
Amanda Braswell – C shift, Lana Swaffer – D
shift, Jennifer Harmon – dispatch
Please see this month’s Character First! Bulletin Series 3 – No. 19
TeleStaff
Date
For Date Range
Time
Dec. 19
Jan. 1
Jan. 3
0800-1530
Dec. 20
Jan. 4
Jan. 6
0800-1530
Dec. 21
Jan. 7
Jan. 9
0800-1530
Dec. 22
Jan. 10
Jan. 12
0800-1530
Dec. 27
Jan. 13
Jan. 15
0800-1530
Dec. 28
Jan. 16
Jan. 18
0800-1530
Dec. 29
Jan. 19
Jan. 21
0800-1530
Dec. 30
Jan. 22
Jan. 24
0800-1530
Jan. 3
Jan. 25
Jan. 27
0800-1530
Jan. 4
Jan. 28
Jan. 31
0800-1530
Volume 1, Issue 7
Page 7
Paramedic Refresher Course
Follows NREMT Guidelines
Includes ACLS
February 20 – 27, 2006
Spring classes begin January 9th - May
1st
Critical Care class will meet every
Wednesday from 9am - 5pm
0900 – 1700 – 6 consecutive
business days
Exam in May 2006 if needed
To be eligible to register, Paramedic
must have:
•
Greenville Technical College
•
Two years of field experience
Supervisor recommendation letter
Main Campus
EMT Department
For more information please contact
Michael Fisher
at 864-250-8490 or by email at
For more information please contact
Michael Fisher
at 864-250-8490 or by email at
[email protected]
[email protected]
Volume 1, Issue 7
Page 8
THE GRRROWL WANTS YOU!!!
To be recognized for what you do…
Join the Grrrowl for Greenville County & Public Safety Night!!!
Get your departments together and bring your group out for a
night of fun and recognition.
Have your department leader call and reserve your group outing today!!!
Intermissions will include:
Police vs. Fire Dept ON-ICE Tug of War!!!
“Cash” the police dog of the K-9 Unit
December 10th Public Safety Ticket Prices
Section
BLUE
YELLOW
GREEN
ORANGE
Discount Price Individual Ticket
$12
$10
$9
$7
$21
$14
$10
$7
Price Savings with Discount
$9 per ticket
$4 per ticket
$1 per ticket
----
Tickets must be ordered in advance for discount
To Order Tickets, please call Mike Bays at 864-250-4922
For More Information, please log on to www.grrrowl.com
A Monthly Newsletter for
Employees of Greenville County EMS
301 University Ridge Suite 1100
Greenville, South Carolina
29601
Phone: 864-467-7009
Sergeant Dean Huston, Editor
E-mail: [email protected]
This week’s strip-tease from a 52 year old
female with syncope. Patient reports she
had some chest pain the night before but it
got better with one of her husband’s NTG.
She is now conscious and alert but presents with HR of 56, RR 24, and BP 80/40.
She is orthopneic and states the chest pain
has returned. What is the underlying
rhythm and how would you treat this patient?