FRANKLY SPEAKING 6-11.pub

Frankly Speaking
Monthly Publication for San Luis Ambulance
Volume
Edition
XII
VI
Editor: Betsey Kelton
Assistant Editor: Karen Weatherby
Frankly Speaking
From the desk of FIK
On Tuesday, May 17, 2011, Joe Piedalue was
recognized by the Board of Supervisors for all of the
work he has done on the Trauma Committee and the
County’s QI Committee. Joe has spend countless
hours working on these committees and others on
behalf of the pre-hospital care setting. He has a
beautiful new plaque in his office so stop by and see it.
Joe, congratulations from Betsey and me for the work
that you have done and continue to do.
Next, Jody Soule has been notified by the California
Ambulance Association that she is the recipient of the
Chairman’s Award of Excellence for all of her hard
work regarding payer issues and prison contracts on
behalf of the membership of the CAA. She will be
honored at their annual convention on June 16, 2011.
Jody, thank you so much for everything that you do!
Betsey and I were informed by the French Hospital
Foundation that we were selected (as a couple) to
receive the Lou Tedone Humanitarian Award on
August 27, 2011 at their annual gala. Betsey has
served on numerous nonprofit boards for over 25
years and is currently the President of the Women’s
Shelter Board along with being a member of the
Project Life Saver Advisory Committee, and she works
on the French Hospital Golf Tournament. She also
served as president of the Downtown Association and
is a past president of the American Heart
Association. This is on top of all of her work for our
company.
Note from Betsey: As you all know, for over forty years, Frank
has supported countless groups and organizations with donations
from his own pocket (NONE of this comes from ambulance
fees!). Small groups such as Beach Cities Little League and
Paso Robles High School Sober Grad Night, to Hospice
Partners and Special Olympics. He has just done this quietly for
decades, never expecting any recognition for it.
May 2011
Changes In Our Health Insurance
Announcing Good News
Dangerous Suspension
Healthier You
Milestones
Your Car
Field Supervisors Update
Weird News
OmniPod Insulin Device
Joint Replacement
Welcome Quinn Elise Garrity
CCPP Dennis Rowely
2
3
4
6
7
8
9
13
14
15
16
17
We are extremely proud because of our
relationship with Lou Tedone, an exceptional
person who has touched so many lives in San Luis
Obispo County.
We are extremely honored but also speechless!
As I am writing this I am getting tears in my eyes.
We do not do things for awards or to be
recognized.
~~ Frank
Frankly Speaking
Changes In Our Health Insurance
Connie Framberger will be at HQ on June 9th and 14th at
9 AM, to discuss changes in our health insurance
coverage and specifically the plans that are being
discontinued. If you are covered under one of these
plans, you will need to choose alternative coverage.
Connie will specifically discuss the PPO $20 Copay plan
and the Lumenos HSA 3500 plan, as these plans will no
longer be offered. You will want to be informed as to
your options so you can choose another plan that will be
best for you and your situation.
Additionally, some other plans will be discontinued in
the very near future, so it would be a good idea to attend
these meetings so that you may determine the best
choice for your future coverage. Anthem has
announced plans to discontinue the following plans in
addition to the two already mentioned: Lumenos HSA
2000, Lumenos HSA 3000, Lumenos HSA 5000,
Lumenos HSA 1500, and Lumenos HSA 2500. Connie
will give us a good description of the advantages and
disadvantages of each alternative plan offered, and you
can ask her about your own specific situation and what
is best for you.
May 2011
Page two
An Ounce Of Prevention

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

Medical imaging tests such as x-rays and CT
scans account for 36% of our exposure to
man-made radiation.
At least 6 million Americans are vegetarians.
1 oz is the amount of sunscreen you should
apply every 2 hours.
Very happy people watch 30% less TV than
their unhappy counterparts.
61% is the percentage of pet owners who travel
with their four-footed family members.
Please call HQ to reserve your space at one of the
meetings.
401(k) Meeting
Wednesday, June 15th
10am at Headquarters
Frankly Speaking
May 2011
Page three
Very Very Personal
Betsey and I would like to announce that we, (San Luis
Ambulance) just received a new 5 year contract with a 2
year extension from the County Board of Supervisors on
Tuesday, May 24, 2011. This is the smoothest a contract
extension has ever gone for us.
A big thanks to Mike Stevens, Deputy County Health
Director and Contract Manager and to Public Health’s
Dr. Penny Bornstein for their work in getting this
approved along with Health Director Jeff Hamm.
And to APOC (Ambulance Performance Operations
Committee) for their work in reviewing the contract and
recommending this extension to the County.
This is testimony to all of you who make San Luis
Ambulance such a great place to work and the great
service we deliver to the community.
~~ Frank
First day
of Summer!!
Tuesday June, 21st
Look your best on match-making Web sites.
Photos taken at twilight are more attractive—the angle
of beams from the setting sun makes faces look
better and may increase romantic associations for
those viewing your photo. A shallow depth of
field—in which you are in focus against a fuzzy
background—seems to make viewers feel more at
ease. Late-night photos also are effective, possibly
because subjects are dressed up or because they
look more relaxed, perhaps after a glass of wine.
~~Psychology Today
Milk cures garlic breath. Drinking milk while
eating raw or cooked garlic neutralizes much of
garlic’s sulfur odor. Full-fat milk is more effective
that skim milk—the fat seems to play a significant
role in the deodorizing. Drinking milk after eating
garlic is less effective.
~~ Sheryl Barringer, PhD
Department of Food and Technology
Frankly Speaking
Although rare, I found this article interesting and hope you learn
something new as I did.
Dangerous Suspension:
Understanding suspension syndrome
& prehospital treatment
for those at risk
William Raynovich, NREMT-P, EdD, Jems August 2009
This clinical review feature article is presented in
conjunction with the Department of Emergency
Medicine Education at the University of Texas
Southwestern Medical Center, Dallas.
Introduction
Those who work at heights on scaffolds and other
structures higher than six feet often wear safety
harnesses. The technology of safety harnesses has
progressed in recent years, and state-of-the-art safety
gear for workers is now designed as fall arrest systems.
Even with the best designs in safety gear, however,
those who fall in an upright position are at risk of death,
even after a relatively short and effective rescue,
especially if the rescuers are unaware of the risks of
suspension trauma.
Several types of deaths occur after upright suspension in
a harness and are categorized as rescue deaths. These
include suspension syndrome, suspension trauma
syndrome, orthostatic hypotension and reflow syndrome. In these closely related syndromes, patients may
appear stable and uninjured while suspended and before
being freed. Sometimes, the patient will feel faint or
have already fainted prior to the release but will not have
suffered any physical injuries. These patients, including
those with no injuries at all and no feeling of faintness,
are at risk of death upon rescue if the responders are not
aware of appropriate care.
May 2011
Page four
Because patients can deteriorate very quickly and
the wrong intervention can mean the difference
between a rescue and a recovery mission, first
responders and EMS providers must know the
current recommendations for suspension trauma
rescues and the underlying theories and
pathophysiology of suspension trauma syndrome.
Pathophysiology
When a person is suspended in a harness or held
immobile in an upright position, gravity pools
blood in the lower extremities. Depending on the
underlying health of the patient’s cardiovascular
system and the ability of the patient to compensate
for the pooling blood in the lower extremities, the
patient may remain free of symptoms for several
hours. Ultimately, however, a loss of consciousness
will occur, soon followed by death. It’s important
to realize that even an individual who is symptomfree is at risk of sudden death due to myocardial
rupture and infarct when moved rapidly to a
horizontal position after being released from
suspension and especially if they were motionless.
Suspension Trauma
Injuries sustained from being immobilized in a
vertical position when the legs are relaxed. Injuries
include hypoxia; syncope; hypoxemia; acidosis;
ventricular fibrillation; myocardial infarction;
damage to the liver, kidneys and brain; and possibly
death.
Cont. on pg. 5
Frankly Speaking
Dangerous Suspension:
Cont. from pg. 4
Reflow Syndrome:
May 2011
Page five
The lethal surge of blood return to the central
circulation and the heart is known as reflow syndrome,
in which the metabolism in the extremities with pooled
venous blood shifts to anaerobic metabolism as the
blood becomes hypoxemic. When the patient is placed
supine, the acidotic and hypoxic blood rapidly returns to
central circulation and the heart. This can result in
immediate ventricular fibrillation, a rupture and infarct
of the heart, and lethal damage to the liver, kidneys and
brain.
Further Effects:
Orthostatic Hypotension:
Speed of Onset
Orthostatic hypotension and syncope are quite common
and are natural physiologic responses. The fundamental
cause of orthostatic hypotension is venous pooling,
which is the accumulation of blood in the veins
(typically in the legs) due to gravity. Some venous
pooling is normal when a person remains in an upright
position. Muscular activity in the legs, together with the
one-way valves of the arteries and veins in the legs,
normally assist in circulation and return blood to central
circulation. However, when the legs are held completely
immobile, the muscles of the legs provide insufficient
circulation to prevent venous pooling. It’s important to
realize that the veins in the legs are capable of
considerable expansion and a large volume of blood can
pool in the lower extremities.
If the legs of someone who’s immobilized in a
harness are relaxed, the first signs of discomfort
and shock can begin in as little as three minutes,
with an average onset between five to 20 minutes.
Fainting generally soon follows the onset of
pre-syncopal symptoms. When fainting occurs, the
natural response is to move to a horizontal position
with a return of circulation. If fainting occurs in a
forced upright position, death can occur within
minutes. Another complication that can hasten
death is the loss of a patent airway when the head
flexes forward.
Metabolic byproducts in healthy and mobile individuals
are continuously removed by the cardiovascular system.
In an individual suspended upright and motionless in a
harness, however, venous blood pools in the lower
extremities and metabolic toxins, such as ketones and
lactic acid, build up to dangerous levels.
Loss of consciousness ensures that a suspended
person will not be moving their limbs, so venous
pooling will increase, which will in turn reduce the
circulating blood volume even further. In addition,
any restrictions of the femoral arteries and veins
caused by harness straps would contribute to
venous pooling. Thus, the detrimental effects are
compounded.
The speed of onset is completely unpredictable.
Some individuals survive longer, up to an hour,
without losing consciousness or dying, and one person may react differently from one day to the next.
Race, gender and body mass don’t seem to predict
tolerance, but age is a factor in the onset of suspension trauma. The very old are most at risk due to
less responsive arteries and veins and a less robust
heart; in contrast, young children seem to be immune, largely because their legs are shorter and
have more resilient vasculature.
Cont. on pg. 6
Frankly Speaking
Dangerous Suspension:
Cont. from pg. 5
Although it’s unclear at what age the risk of dying from
suspension trauma begins, it seems that when a person
reaches five feet in height, the risk increases.
Rescue Prehospital Care
It’s very important to realize that the emergency
treatment for suspension trauma is not the standard and
intuitive rescue response! If the rescuer follows the
normal protocol for syncope, death is the likely
outcome. It’s critical that the rescuer avoids the natural
and intuitive step of immediately moving the patient to a
supine position but instead makes sure to keep the
patient’s upper torso upright at least at a 30-40 degree
angle (i.e., a semi-Fowler’s position) and then slowly
moves the patient to a supine position over a period of
approximately 30-45 minutes by adjusting the stretcher
in increments.
If access to a conscious patient is hampered due to
structural instability or the patient is inaccessible due to
their elevation, rescuers should attempt to communicate
with the patient to see if they’re able to respond verbally.
If so, then the rescuers can encourage the patient to
position their legs as high as possible and keep the leg
muscles working vigorously.
Summary
Suspension syndrome and suspension trauma have been
largely overlooked and underappreciated in EMS and
rescue training. The appropriate life-saving treatment of
patients who have been suspended in an upright and
motionless position is counterintuitive; the intuitive and
routine rescue procedures that would involve
immediately placing patients supine are highly lethal due
to reflow syndrome.
~~ Submitted by Serena Gennuso
Division Supervisor
May 2011
Page six
Healthier You
Orange juice and apple juice affect medicines.
Grapefruit juice often increases drugs’ potency,
but orange and apple juices have the opposite
effect—drinking them within two hours of
taking certain medications can weaken the drugs’
effectiveness. These medications include
beta-blockers for blood pressure, the allergy
treatment fexofenadine, the antibiotic ciprofloxacin
and the anticancer drug etoposide. Best: Avoid
fruit juices for four hours before and after taking
medicines. Drink a glass of water with
medicines.
~~ David G. Bailey, PhD
Professor of Clinical Pharmacology
Spanish Terms of the Month
Arm
el brazo
(ehl ‘brah-soh)
Back
la espalda
(lah ehs-’pahl-dah)
Frankly Speaking
May 2011
Page seven
Happy Anniversary!
June
Patrick & Andrea Patton
Chris & Connie Javine
Jason & Crystal Davis
Joe Piedalue & Diana Stanton
Crhis & Krista Anderson
Joe Piedalue
Justin Bramlette
Patrice Owens
Brian Merrill
Cathy Sherman
Brian Bernay
Taylor Schindler
Shannon Chamberlin
Tim Hallmark
Jane Mallett
Serena Gennuso
Kimberly Hughes
Penni Daugherty
Lori Tobey
June
2nd
2nd
3rd
4th
5th
5th
7th
10th
12th
13th
15th
23rd
25th
27th
4th
6th
12th
21st
23rd
Happy Birthday Kids of SLA!!
Abby Vierra
Maddy Vierra
6/14/1999
6/14/1999
Parent
Matt Vierra
Matt Vierra
Frankly Speaking
Your Car
Top vehicle safety awards for 2011 models go to 45
cars, 28 SUVs and two minivans. The 75 winners did the
best job for protecting people in front, side, rollover and
rear crashes. Highest-rated manufactures include
General Motors, with 11 top models...Volkswagen and
its Audi brand, as well and Hyundai and its affiliate, Kia,
with nine awards apiece…Ford and Toyota, each with
eight awards. The top-rated minivans were the Honda
Odyssey and the Toyota Sienna. For the entire list go
to : Insurance Institute for Highway Safety (IIHS),
www.iihs.org/ratings.
~~ Adrian Lund
President Insurance Institute for
Highway Safety
May 2011
Page eight
Happy Fathers Day
Sunday, June 19th
Very Very Personal
Depression traps to avoid. Depression often causes
behaviors that may worsen the condition. Social
withdrawal—resist the urge to pull away from others, and
instead, reach out to family and friends. Self-medicating
with alcohol—alcohol may temporarily relieve the
anxiety that accompanies depression, but it also
depresses the central nervous system, interferes with
sleep and may interact with antidepressant medications
you are taking. Eating more sugar—sugary products may
temporarily elevate mood, but the inevitable sugar crash
depresses mood. Not exercising—exercising increases
levels of mood-boosting brain chemicals serotonin and
dopamine.
~~ Stephen Ilardi, PhD
Professor of Clinical Psychology
Tuesday, June 14th
Frankly Speaking
Current and Ongoing
Field Supervisors Update
May 2011
Page nine
John Dunkel
Other
Radios
I have had a lot of difficulty recently getting staff to
call in for LDs, sick calls etc. Apparently nobody
needs any extra money.
One handheld radio is currently at Coast Electronics for
repair.
~~ John Dunkel
Field Supervisor
The narrow banding project remains on track.
The new Radio Manual has been put into service.
I purchased one new handheld in May and I got two
refurbished radios back from repair.
Jessica Otter
Controlled Substances
Uniforms
Uniform purchases seem to be up slightly.
Staff Member Health/Safety
I have been continuing to edit and revise the Hazard
Assessment plan.
No new exposures to report.
Units
Unit 911 was picked up April 14th and was put into
service on May 5th.
Unit 87 is at Leader for re-chassis.
April balanced with few discrepancies.
Quarterly audit May 27, 2011- this is why we need
all your proper paperwork.
Looking for better tagging options for valium.
Hiring
Still looking to do another process in the Fall 2011.
Just reviewed and destroyed about 40 applications
that had no response from three emails regarding
our most recent process.
One medic coming to take SLA test this month
Answering the plethora of inquiries from
applicants.
Unit 74 is out of the shop and at it’s new home Station
86.
Cont. on pg. 10
Frankly Speaking
Field Supervisor Projects,
Cont. from pg. 9
May 2011
Page ten
Training
June CE class( environmental emergencies) is 27th- Sign
up ASAP especially if you need CPR.
Mike Groves
SIMON
Airway assessment paperwork is due to the EMSA by
the end of the month. Those of you who still need
intubations either have been, or will be contacted.
Next APR class is in August hosted by SLOFD and SLA
will host in October.
Next FTO meeting is July and new test for APR will
hopefully be ready for August class.
APS
More frequent reports coming in. Thank you to all as
you are mandatory reporters (even if another agency is
on scene and they are filling out a report) and we must
turn one in.
We will start testing wireless uploading at Station
85B in late May or early June. If it works well, we
will institute wireless uploading at all stations. We
will probably keep the cradle brackets as a way to
sit the computers upright, but the connecters will
all be removed. Printing and keyboards will be
accessed by USB and the computers will charge
using the side charge port with a charging cord. We
believe that worn cradle connecters may be partly
responsible for computer problems. That, plus the
fact that new cradles cost $600.00, are good reasons
not to use them. As a bonus, upload and download
speeds appear to be about 10 times faster with a
wireless system than the direct connect system we
are currently using.
Training
MISC
New members being selected for CISD team.
Thanks to all the people who have stepped up these last
very busy weeks!
~~ Jessica Otter
Field Supervisor
Everyone from the April new-hire academy has
completed training and ride-along shifts. They are
all picking up shifts, LDs, stand-bys, and quite a
few pager shifts. Please remember to fill out their
daily evaluation forms and to give them all
appropriate, constructive, feedback.
HazMat recert classes were held May 24th – 27th.
We had a number of guests join us this year in the
form of Fish and Game, Port San Luis Harbor
Patrol, and Morro Bay Harbor Patrol. Along with
all of our staff, the classes were very full.
Cont. on pg. 11
Frankly Speaking
Field Supervisor Projects,
Cont. from pg. 10
June CE will be held on the 27th. Casey Hidle is the
presenter this month on a topic yet to be determined.
Stay tuned. As always, if you need CPR, please sign up
early and notify Roxane so that we can get a CPR
instructor. If you wait until the last minute, we may not
be able to find someone to teach.
Schedule
The last half of May has been very busy. During the
weekend of May 21st and 22nd, SLA ran about 135 calls.
That represents a 35% increase over an average
weekend. I am writing this prior to the Memorial Day
weekend, but given the volume of calls recently, it looks
like we will have a very busy holiday.
To everyone who has been picking up overtime, LDs,
stand-bys, and pager crews, a huge thank-you. The
new-hires are having an impact, and as we get some of
our long-term vacancies filled, the need for so much
overtime will decrease. There is light at the end of the
tunnel, and it’s not a train!
As a friendly reminder, we ask that you not call Bobbie
after 1130 hrs, even if she is still in the office. If you
have a staffing question after 1130 (or before 0900),
please call Justin or the on-duty Field Supervisor.
After last month, I’m going to keep this short. Thanks
for everyone’s hard work, and stay safe out there.
~~ Mike Groves
Field Supervisor
May 2011
Page eleven
Nate Otter
MSDS
We have received all of the new MSDS forms from
the copier so they are ready for disbursement. You
may already have them by the time this is printed,
but either way please be sure you know where the
MSDS book is at your station. Remember that
anything in addition to what is already in the book
must have Division Supervisor approval and an
MSDS before it can be kept at the station.
Equipment Inventory
I will be taking an inventory of the hard equipment
in all the units to see what is in need of repair or
replacement. Please report any damaged or worn
items to your Division Supervisor so they can
forward me the information.
CPAP Hoses
I have had to replace the main green hose on one
of the CPAP machines because it had a significant
hole in it due to the way it was stored. The hose
had too much of a bend in it near where it attaches
to the machine and was stored in a manner that
constantly put pressure on the hose causing it to
kink and break open. Please be sure the machines
are stored in a way that allows the hose to be free
of pressure or too sharp of a bend.
Cont. on pg. 12
Frankly Speaking
Field Supervisor Projects,
Cont. from pg. 11
May 2011
Page twelve
New Bags
I have purchased a few new bags and will continue to
purchase a few each month until all of our bags are in
good condition.
Monitors
At the end of May Joe and I will be meeting with Brian
Pank who is our Zoll representative to discuss the new
monitor purchase.
Did you know that…
… car-crash fatalities are down 10%? Deaths in
the US due to car accidents dropped by nearly 10%,
33,808 in 2009, versus 37, 423 in 2008. The number of injured people fell by more than 5% to 2.2
million.
~~ Anne McCartt, PhD
National Highway Traffic Administration
~~ Nate Otter
Field Supervisor
To Fight Tooth Decay
We know that sugary beverages and foods
promote tooth decay. To help prevent it…
Drink green or black tea. Both provide a naturally
occurring form of tooth-protecting fluoride.
Eat crunchy fresh vegetables and fruit, such as
carrots and apples, to remove sugars and food particles
from the mouth. Swishing with plain water also helps
remove debris lodged between teeth.
Have cheese for dessert. It is believed to neutralize
acids found in plaque and boost the production of saliva
to wash away sugars.
Chewing sugarless gum also helps clean the mouth.
… fishing is more dangerous than police work?
The fatal-accident rate for fishermen and related
fishing workers is 200 per 100,000 full-time
workers...compared with a rate of 13.1 for police
and sheriff’s patrol officers and 4.4 for firefighters.
Farming also is dangerous. The rate of fatal
occupational injuries for farmers and ranchers is
38.5 per 100,000 full-time workers.
~~ US Department
of Labor
Frankly Speaking
Weird News
“Famed Magnetic Boy is Probably Just Very Sticky.”
May 2011
Page thirteen
“Atom Smasher Could Be Used as Time Machine.”
“Worm Therapy Stimulates Gut Mucus.”
I love reading offbeat news articles. Nothing to scare me
about what’s going on in the world. Nothing to make
me sad. Nothing to browbeat me into changing bad
habits. Here are some Web sites that I go to for an
energizing break in my day...to get my brain thinking
“out of the box”… and for fascinating tidbits that make
great conversation starters…

Weird News. For an electric mix of stories about
sword swallowing, UFO sightings and other truth-isstranger-than-fiction stories, I like AOL News.
www.AOLNews.com/category/weird-new
In a similar vein, former government attorney Chuck
Shepherd offers weekly digests of tales about inept
criminals, frivolous lawsuits and strange happenings
around the world. Readers can check the US map to
find items of local interest and send in clips for possible
use. www.NewsOfTheWeird.com

Snopes.com. I often use this urban legends/
rumor-debunking resource to check the veracity of
widely disseminated e-mails. Recently I discovered
it’s “Daily Snopes” feature, which runs headlines
from peculiar news stories and links to the original
publications so that you can read them in full.
Recent postings: “Teen cancels party after her
Facebook invitation went viral and close to 200,000
people said they would turn up at her house.”
www.Snopes.com/daily

The Body Odd. This offers medical curiosities
and other news about the “wonderfully weird”
human body. Recent posting: Researchers
tricked participants’ brains into believing that
their bodies had extra arms.
http://BodyOff.msnbc.msn.com

Strange Science. The Web site Live Science
offers fascinating news stories abut zombie
ants, a gorilla that walks like a man—
accompanied by an amazing 18-second video—
and other nature and science oddities.
www.LiveSciene.com/strange-news
~~ Margie’s Blog
Publishers Note Bottomline Secrets
Frankly Speaking
OmniPod Insulin
Administration Device
May 2011
Page fourteen
In this decade, technology seems to be everywhere.
From the GPS that literally tells you directions, to cars
that park themselves. You can set your DVR to record
from your iPod and check your email on your cell phone.
Most of us are familiar with the Bluetooth technology we
so frequently use to talk on our cell phone “hands free”.
This same technology is creeping into the medical field
and becoming available to the public in need of frequent
medication administration, specifically diabetics.
Patients may forget to carry the control or may
have left it too far away to be useful. Additionally,
if you do not look for the small device or do not
recognize it for what it is, you may miss this vital
information altogether. The control piece also
contains a history of BGM and insulin doses
making it very useful for both pre-hospital and
emergency room staff.
The OmniPod insulin administration device pictured is
the newest development for diabetics requiring multiple
injections of insulin per day or who currently have an
insulin pump. This small “pod” can be attached
anywhere you could have an insulin shot; stomach, upper
arm, upper leg, lower back. The actual pump is housed
within the pod which is remotely controlled via
Bluetooth. A diabetic simply inputs their BGM and
quantity of carbohydrate consumption into the hand
held control that is about the size of an iPhone. The
control calculates how much insulin the patient needs
and delivers it. The pod inserts a small cannula and is
prefilled with enough insulin for 3 days. Without external pumps and cords, patients are free to swim and dress
as they please with fewer restrictions.
Although this is a dream come true for many diabetics, it
can be problematic if not recognized in the field. Just
knowing what you are looking at is a large part of the
battle. The pod can only be controlled with the remote
device and must be within 24” of the pod to
communicate with it. This can pose a problem if the
pod malfunctions and needs to decrease insulin
administration.
Being aware of the latest technology and
medication administration devices can assist us in
our effort to provide the best patient care possible.
~~ Leslie Javine
Division Supervisor
Frankly Speaking
Joint Replacements For Baby Boomers
We're becoming a nation of bum knees, worn-out hips
and sore shoulders, and it's not just the Medicare set.
Baby boomer bones and joints also are taking a
pounding, spawning a boom in operations to fix them.
Knee replacement surgeries have doubled over the last
decade and more than tripled in the 45-to-64 age group,
new research shows. Hips are trending that way, too.
And here's a surprise: It's not all due to obesity.
Ironically, trying to stay fit and avoid extra pounds is taking a toll on a generation that expects bad joints can be
swapped out like old tires on a car.
"Boomeritis" or "fix-me-itis" is what Dr. Nicholas
Din bile, a suburban Philadelphia surgeon, calls it.
"It's this mindset of `fix me at any cost, turn back the
clock,'" said Din bile, an adviser to several pro athletic
groups and a spokesman for the American Academy of
Orthopedic Surgeons. "The boomers are the first
generation trying to stay active in droves on an aging
frame" and are less willing to use a cane or put up with
pain or stiffness as their grandparents did, he said.
Joint replacements have enabled millions of people like
King to lead better lives, and surgeons are increasingly
comfortable offering them to younger people.
But here’s the rub: No one really knows how well these
implants will perform in the active baby boomers getting
them now. Most studies were done in older folks whose
expectations were to be able to go watch a grandchild’s
soccer game—not play the sport themselves.
Even the studies presented at a recent orthopedics
conference that found knee replacements are lasting 20
years come with the caveat that this is in older people
who are not stressing their new joints by running
marathons, skiing, or playing tennis.
May 2011
Page fifteen
Besides the usual risks of surgery—infection, blood
clots, anesthesia problems—replacing joints in
younger people increases the odds they’ll need
future operations when these wear out, specialists
say.
If you have a good result from a joint replacement,
don't spoil it by overdoing the activity afterward,
experts warn. Better yet, try to prevent the need for
one.
"Being active is the closest thing to the fountain of
youth," but most people need to modify their
exercise habits because they're overdoing one sport,
not stretching, or doing something else that puts
their joints at risk, said Din bile, the "boomeritis"
doctor.
Experts recommend:
Cross training. People tend to find one thing they
like and do it a lot, but multiple activities prevent
overuse.
Balance your routines to build strength, flexibility,
core muscles and cardiovascular health.
Lose weight. Every extra pound you carry registers
as five extra pounds on your knees. The good news
is, you don't need to lose a lot of weight to ease the
burden.
Spend more time warming up. Break a sweat and
get the blood flowing before you go full blast.
Cont. on pg. 16
Frankly Speaking
Joint Replacements For Baby Boomers
Cont. from pg. 15
May 2011
Page sixteen
Let muscles and joints recover and rest in between
workouts.
If you've had a joint replacement, do the physical therapy
that's recommended.
"I tell patients, 20 percent of the outcome is the technical
stuff I do in the surgery, and 80 percent is them," said
Hillock, the Las Vegas surgeon. "I can do a perfect
surgery, but if they don't do the rehab they're not going
to have a good outcome."
Congratulations!
Jennie Reed & Colin Garrity
On the arrival of
Quinn Elise Garrity
On May 18th, 2011 at 8:16pm
9lbs 9 oz, 22 inches
~~ AOL Healthy Living
Marilynn Marchione
Frankly Speaking
May 2011
Page seventeen
Hello everyone,
I hope this note meets all my fellow SLA citizens well.
First, let me start by letting you know how the Central
Coast Paramedic Program (CCPP) is doing. I can
honestly say everything is going well! If I can sum up
the program with one word it would be “GROWTH”.
In the last few years many areas of our program have
had more growth with continued good statistics than we
have ever seen before. In other words, we have had
more growth and positive change in the past 2 years
than in the whole history of the program. Most
importantly, we continue to see really good Paramedics
graduate from CCPP and most move into the “working
in the field” aspect, including here at San Luis
Ambulance. I am also happy to report that we once
again had more applicants than space available for our
upcoming fall 2011 program. This means another 24
eager Paramedic Students waiting to be the next Johnnie
or Roy (It was a show called “Emergency”. You can
view the reruns on TV land).
Secondly, I wanted express gratitude as I know that the
program can not be successful without you. Thank you!
I am truly appreciative of your willingness to support the
CCPP and the students who cross your paths. With that
being said, I want to make you aware of the events that
are coming up in the near future.
Ride-a-longs: San Luis Ambulance has been
incredibly gracious with allowing our CCPP
students the opportunity to “Ride-a-Long” with
working crews. I can’t tell you how crucial this
has been with the recent events of the program.
One of the big topics being discussed in our
county and across the state is the lack of prior
field experience paramedic students have when
entering the internship portion of their training.
We have been working on this concern and
Paramedic Program Directors throughout the
state are engaged in thoughtful discussion and
brainstorming to find solutions.
One of the many things that we use to help with
this problem has been utilizing the Paramedic
Prep Course. We strongly recommend that all
incoming paramedic students take this 6 week
course to better prepare themselves for their
training. The lab component of the Paramedic
Prep Course is designed to include four 8 hour
Ride-a-Long shifts…this is where many of you
come in.
Speaking from personal experience, I know that
having a student on a ride-a-long for an entire 8
hour shift can be exhausting. While realizing
that it puts extra demands on you, I’m hoping to
inspire you to view the Paramedic Prep Course
students a little differently than other ride-a-long
students which you have had in the past.
Cont. on pg. 18
Frankly Speaking
Central Coast Paramedic Program
Cont. from pg. 17
If you are a paramedic reading this, please know that all
of the paramedic prep students are guided to be there
specifically to watch YOU. Learning your skill
techniques, how you manage scene presence, how you
present yourself and interface with hospital staff,
multitasking, quick decision making, etc… They are
told to learn and soak in all that they can about what it’s
like to be on the “box” and how much different it might
be from what they have experienced on a fire engine or
in a hospital. It is also important for them to feel what it
is like to work in the
back of a moving
ambulance.
Some general
information in a nut
shell:

The ride-along is
not intended as a
substitute for their lack of experience, but it
provides an avenue for us to help them understand
what they don’t know and how much they need to
learn before the internship phase of their training.

Students will be dressed in a tan polo shirt with the
CCPP emblem and a name badge.

They will be apprised of and should respect all SLA
policies for Ride-a-Longs, including filling out the
Ride-a-Long release form upon their arrival.

Students will begin their ride-a-longs in mid June
and complete their hours by the end of July.

There are still interns in the field from last year’s
class so you are likely to see students that you may
not already be familiar with in addition to the faces
you recognize.
May 2011
Page eighteen
I apologize in advance for the inconveniences
students might impose on your “down time” and I
want you to know that I am grateful for your
involvement to the success of the CCPP students.
Thank you for taking care of them and for
mentoring them into their future success of EMS.
I guess I owe you one? Please call me if you have
any problems or questions.
Respectfully your mutual SLA EMS responder in
the trenches with you,
~~ Dennis Rowley
Central Coast Paramedic Program Director
p.s. Everyone is invited to see the upcoming
CCPP graduation Class 5 - September 9th, 2011 at
6pm. Call me if you want more details.