QUARTERLY MAGAZINE
ISSUE 2 – SEPTEMBER 2017 | WWW.ER24.CO.ZA
MY HEART STOPPED -
‘But my life outside rugby began’ FIND US ON
IN THIS ISSUE Front page story 6
My heart stopped - but my life outside rugby began
This month marks exactly two years after Daniel suffered a cardiac arrest on the rugby field.
Company interest 16
Bringing light to the Himalayas
Clinical 20
Consider every part of your life when faced with cancer Holistic care has come to mean many different things and, in the case of cancer, some of these are not necessarily very helpful.
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Ways to keep cholesterol in check Stroke: Do you know the risks? The lifesaving importance of CPR
Awareness 28
Running injuries: how to avoid them
Running is a popular sport all across South Africa, but it can be an extremely painful sport too.
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Don’t tailgate, be patient and wait Pregnancy and alcohol do not mix Tips for keeping your back healthy Road closures: Stay clear of chopper
ER24 staff 14
“I’m doing it for my kids”
Lumka Cingo on what it takes to be a single mother and a full-time medic.
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Saving lives is no nine-to-five job
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26 24
A medic of many talents Caring is part of the job
Ticking things off her now-list
ER24 events 29
A breath of fresh 42,2km air
The Sanlam Cape Town Marathon was held on Sunday the 17th of September.
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CONTACT:
Email: communications@er24.co.za Tel: 086 1084124 Web: https://er24.co.za Emergencies: 084 124
DESIGN AND LAYOUT: Mediclinic Design Studio Ineke van Huyssteen
COPY COMPILED BY: Mediclinic Infohub Ineke van Huyssteen Caryn Ross
STOCK IMAGES: iStock (Getty Images)
How to become a paramedic
NEXT EDITION:
The next edition of Priority One will be published at the end of the fourth quarter of 2017.
NEXT CONTENT DEADLINE:
Content for consideration may be sent to ER24 Communications Department by any staff member or client. Send content to communications@er24.co.za
Your angel at the time of an accident accidentANGELS is a service that provides its members with access to any private hospital after a vehicle accident. Many South Africans who own vehicles are not members of a medical aid. They may not have the funds to access a private hospital after a vehicle accident. South Africa has one of the highest accident rates in the world and 800 people are injured on South African roads daily.
to private medical care and there is no waiting period. At only R149 per principal member per month and R90 for each dependent, accidentANGELS offers transport in an emergency after a vehicle accident by ER24 or any other emergency service provider. Your membership also means that you can receive up to R10 000 for emergency medical treatment in a private hospital’s emergency room (outpatient) and up to R200 000 for treatment in a private hospital (if you are admitted).
accidentANGELS guarantees access
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If you are a motorcyclist, you can join at R249 per member per month. If the guaranteed amount is insufficient, the member’s family will be contacted to inform them that the benefit is insufficient. The family can then arrange additional funding. accidentANGELS also provides assistance with claims at the Road Accident Fund (RAF). Visit accidentANGELS’ website for more information and like their Facebook page.
STROKE: DO YOU KNOW THE RISKS?
September is heart and stroke month. The public are always drawn to the hype and drama of trauma related calls such as motor vehicle accidents, shootings and stabbings and that’s what most would believe is our core business, but when we analyse our call requests, approximately 50% of our patients have medical concerns too. We’ve experienced an increase in life threatening calls as a result of chronic lifestyle disease. It’s time to take action.
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s a responsible Emergency Service provider, we endeavour to assist our schemes in managing critical lifestyle diseases such as myocardial infarction, stroke and diabetic emergencies. We achieve this through a number of approaches on behalf of our clients. The most important is ensuring our critical patients with life threatening airway, breathing or circulation problems receive priority. We’ve invested and developed a telephonic triage system which can accurately predict severity, and once our crews arrive on scene, it identifies the closest appropriate hospital for that specific medical emergency. Getting a patient to a cardiac catheterisation lab when suffering from a myocardial infarction, or a stroke centre of excellence early will ultimately assist them on their way to recovery. Our computer aided dispatch system can identify these centres. Our nursing staff are a valuable source of information for our patients, providing information for clients regarding lifestyle changes, nutrition, and over-the-counter options for disease management. After the emergency call is managed, a specialised team reviews all accounts submitted to ER24. We have a responsibility to ensure appropriate use of emergency services. We do experience that our patients with Volupta doluptam, idel chronic lifestyle disease may use invellature, picipsa eptatiam. emergency services more frequently
than other patients, hence the importance of reviewing these cases retrospectively and counselling members regarding appropriate use of emergency services. Isn’t that what you would expect from your emergency partner? More than just an emergency service, we provide a comprehensive assistance and risk management service in the pre-hospital environment, and we’re passionate about patient care. Stroke: Although a stroke is a common and serious condition many people do not know how to determine if they are having one or brush off the early signs thinking the symptoms will go away. A stroke, which occurs when blood flow to the brain is interrupted by a blood clot or a leaking blood vessel, could lead to death or life changing disabilities. For this reason, ER24 is urging people to be aware of the early signs and to react quickly should they suspect a stroke as new therapies can minimise the volume of brain tissue affected by a clot. React quickly if a patient experiences any sudden and persistent changes, such as sudden limpness on one side; sudden decreased eye sight in one or both eyes; sudden loss of balance; sudden trouble speaking; or sudden onset of a severe and unusual headache or dizziness of unknown cause. If unsure, do the FAST test, which entails the following and will detect most strokes: Face - The person suspected of having a stroke should smile or show their
teeth. If one side is limp, they could be having a stroke. Arm - The person should raise both arms for five to 10 seconds while their eyes are closed. If one arm is limp or drifts down, they could be having a stroke. Speech - Repeat any sentence. If there is trouble understanding or repeating the sentence, the person may be having a stroke.Time - If any of the above is happening, the person must get to the nearest stroke unit or appropriate facility immediately. If an ambulance is called, keep the patient awake and calm while waiting for the ambulance to arrive. Do not give them anything to drink or eat. If the patient has collapsed, lie them on their side and make sure their airway is not obstructed. It’s important that strokes be managed in a hospital with a multidisciplinary approach to stroke care. Our EMS team will assist in transporting your patient to the closest, most appropriate facility. Don’t forget to manage the chronic causes of stroke. Risk factors include uncontrolled hypertension, diabetes, heart disease such as atrial fibrillation, obesity, excessive alcohol intake, smoking, ongoing stress and lack of exercise. Healthy living, with moderate exercise and healthy eating habits that minimise sugar, salt and bad fats while increasing good fats, reduce the chances of having a stroke.
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MY HEART STOPPED BUT THEN MY LIFE BEGAN A red scar of about 8 cm covers the left side of Daniel du Plessis’ chest. He would have liked to have boasted with the Springbok emblem on his chest, but his story turned out a little differently than anticipated.
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ER24 Medics standing with Daniel Du Plessis at Newlands Rugby Stadium. Tao Carstens (left), Daniel du Plessis, Abdur-Razak Ganie and Lenise van der Westhuizen.
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Daniel and his dad walking to the exact spot where he suffered a cardiac arrest two years ago.
A red scar of about 8 cm covers the left side of Daniel du Plessis’ chest. He would have liked to have boasted with the Springbok emblem on his chest, but his story turned out a little differently than anticipated. On 5 September 2015, Daniel du Plessis was playing for the under 21 DHL WP rugby team against the Leopards from North West Province at DHL Newlands. When the scrum collapsed at the 22-meter line, Daniel, who plays hooker, fell to his knees, got up slowly and looked very disorientated. From the sideline, keeping a close eye on the players, the ER24 team could see something didn’t look right. Daniel collapsed on the field shortly afterwards. This month marks exactly two years after Daniel’s neardeath experience. Lenise van der Westhuizen, Tao Carstens, Abdur-Razak Ganie, Waleed Nazier, Claude Saunders and Estiaan Cronje were some of the medics who assisted Daniel on that day. “We ran onto the field and Dr Karen Schwabe (the WP team doctor) started the assessment. At that point Daniel wasn’t breathing and he went into ventricular fibrillation. We had to do CPR immediately,” said Abdur-Razak, an Intermediate Life support medic. “I thought I was seeing a flat line and that this player was dead,” said Lenise van der Westhuizen. “We responded very quickly and everyone knew what they needed to do. The time frame was within the golden hour. 18 minutes to be exact from when we left the field until arriving at the hospital,” said Tao. The Golden Hour is often referred to as the first hour after a traumatic injury, when emergency treatment is most likely to be successful. Daniel was transported to Vincent Palotti hospital and put into an induced coma. He remained in the hospital for two weeks before being moved to Mediclinic Panorama for three more weeks. While Daniel suffered a cardiac arrest, his parents, Bruce and Janice du Plessis, were in Saudi Arabia where Bruce was contracted to work. “A friend of ours sent me a Whatsapp message to say that Daniel was playing a great game. Shortly afterwards she said that Daniel went down and that they are performing CPR. My hair stood up. I first told my wife Daniel suffered a concussion because I didn’t want to scare her,” said Bruce. They managed to get a flight home and arrived in Cape Town on the Monday. “The
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worst thing was waiting. We didn’t have any form of communication while we waited for our connecting flight in Abu Dhabi. We had to wait there for six hours. All that we could think of was, is he okay? Has he worsened? When we eventually got to the hospital I was shocked to see him. He was still heavily sedated and we didn’t know if he had suffered any brain damage,” said Bruce. “All I can remember of that day was eating breakfast. The rest is a blur,” said Daniel. Miraculously, and with fast and efficient medical help at the time, Daniel survived.He does sport a new device that was implanted in his heart which he jokingly refers to as something that can help him to ‘reboot’. “I have an ICD that is similar to a pacemaker. It makes sure that your heart rate doesn’t go too high or too low. It is precautionary so that I don’t have to live my life in fear. If I had to collapse now it will just give me a reboot and I will get up and continue with this interview,” Daniel laughs. Daniel doesn’t even take a moment to pause at the question if he thinks he would have become a Springbok. “I know I would have become one. Rugby was my life. It meant everything to me. But I’ve learnt over these past two years that there is so much more to life,” said Daniel. He hopes to attend UWC next year and study towards becoming a teacher. He has assisted with coaching for the last two seasons at the Paarl Boys High School. “These medical guys who were there that day; this isn’t a job for them, this is a calling. DHL Newlands, ER24 and the Western Province Rugby Union was put to the ultimate test and they came out with 200%,” said Bruce. Earlier this year, Daniel and his parents framed a letter of eternal gratitude and gave it to the ER24 staff and the doctor who were there on the day. “You don’t always get a thank you. People don’t always know who treated them or who saved their life. It is amazing to see Daniel now. I can’t believe how great he looks, I mean he could have been dead. It really is amazing!” said Lenise.“It was a token of deep appreciation because we needed to say thanks. But how do you put into words what it meant for us knowing they saved our son’s life?” said Bruce. *The family would like to thank everyone for their support over the last couple of years.
Bruce, Daniel’s dad, was in Saudi Arabia when Daniel suffered a cardiac arrest at DHL Newlands.
Earlier this year, Daniel and his parents framed a letter of eternal gratitude and gave it to the ER24 Volupta doluptam, idel staff and the doctor who were invellature, picipsa eptatiam. there on the day he collapsed.
Daniel and his girlfriend Elzanne Lawrance.
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A road is closed for a medical helicopter to land.
ROAD CLOSURES: STAY CLEAR OF CHOPPER 10
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losing a road for a medical helicopter to land might be an inconvenience for motorists, but for the patient urgently requiring the care it can be lifesaving. ER24 is urging all motorists to be patient when a helicopter rescue is underway. A medical helicopter is used for various reasons: •The seriousness of a patient’s injuries. •The patient needs to get to an appropriate facility immediately. •Considering the terrain. •To have the necessary medical expertise close by. •There are also various other factors that may influence the decision to airlift a patient. These are usually determined in conjunction with the Medical Officer on call. Gareth Staley, ER24’s Gauteng Regional Manager, explains that helicopters don’t always land on the road.“We prefer not to land on a road. It remains a safety risk. We prefer to land on a field close to the scene, but sometimes the road is the only option. We would then get the traffic police, the fire department or the police to assist. If not, our crews assist by using road cones or blocking the road with ER24 vehicles.” Reasons why a road gets closed: •Helicopter requires enough space to land. This offers more options should something go wrong. •There is no suitable space on the side of the road for the helicopter to land. This can be because of fences, barriers or uneven ground. •Especially at night the road offers better lighting. •Closer to the scene.
Jo Nieman, emergency service liaison at Flightshare, explains further.“There are certain scoring mechanisms that paramedics use when on a scene. For example, when a patient is seriously injured and the hospital is 10 minutes away, peak time traffic on this route will now take you about an hour. A helicopter is potentially the better option here.“You also need to consider the terrain. Are we stuck in the middle of nowhere? A patient might suffer from a spinal injury in a place far from civilisation. The road might be too bumpy and driving with the ambulance could potentially worsen the patient’s injury. “A patient might also need the skills of a higher qualified paramedic and the helicopter is used to transport such a paramedic to a scene,” said Nieman. According to Staley, “motorists ignore the road closures all the time.” Nieman gives an example.“We needed to close a road immediately for an emergency landing of a helicopter that needed to do an inter hospital transfer of a critically injured patient. The public got quite aggressive towards us. This could stress the pilot out. A helicopter will abort its mission if the landing pad isn’t properly prepared or if their safety isn’t guaranteed.” “Motorists also don’t realise that when they ignore a closed intersection they might not know the dimensions of an aircraft. They see we might use a quarter of the closed intersection but it is because we need space. Some motorists ignore the cones and drive through the closed intersection. They might not take into consideration the blades or the tail rotor’s size. If you knock the tail rotor, for example, it can throw the aircraft off balance and this can be catastrophic,” said Nieman. “You also need to understand that it could be your family member or someone you know that we are trying to save. Even if it might not be your family member now, if you crash into our aircraft it would mean that the helicopter is out of service when your family might need it the most,” said Nieman.
Medics assisting the patient before he/she will be airlifted to hospital.
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Faheem Essop (left), Patrick Shaw (middle) and Dean Isler (right). Patrick came to thank them personally for saving his life.
THE LIFESAVING IMPORTANCE OF CPR Immediate bystander CPR and early activation of Emergency Services are crucial when it comes to saving the life of a patient who has experienced a cardiac arrest.
Faheem Essop, an Intermediate Life Support (ILS) practitioner at ER24 knows all about this. He had to do what he knew well at a recent motor vehicle collision – save lives under unforeseen circumstances. The only difference was, it wasn’t the driver who needed the immediate help.
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“My partner Dean and I were dispatched to a single motor vehicle collision in Johannesburg about a month ago. On arrival, two men, who were on scene, had an altercation. We assisted the driver of the vehicle who had only sustained minor injuries. As we assessed him in the back of the ambulance I heard a loud noise against it.
“I thought someone must have driven into us or something. As I got out of the ambulance I saw the one guy, of the earlier altercation, clutching at his chest. I suspect he had a myocardial infarction. As I knew my partner was busy with the other patient I immediately sprang into action. “He was found to have a shockable rhythm, so I defibrillated him and immediately continued with CPR. We requested an Advanced Life Support (ALS) paramedic and while waiting I continued with CPR and defibrillation until we felt a pulse. We then rushed him to Charlotte Maxeke Johannesburg Academic Hospital. “If we weren’t there at that specific moment he probably wouldn’t have survived. There was no pulse and he didn’t breathe for quite a while. When we arrived at the hospital, the doctor said that the immediate CPR had been a tremendous help to this man. “I truly believe effective CPR can make a big difference. When you see a life-threatening rhythm on the monitor it is quite an amazing feeling when you get the patient’s pulse back,” said Faheem. Dr Robyn Holgate, ER24’s Chief Medical Officer, explains why effective CPR is of utmost importance when a patient is in cardiac arrest.“Cardiac arrest is synonymous with clinical death. Early CPR improves the flow of blood and oxygen to vital organs, an essential component of treating cardiac arrest. The earlier you give CPR to somebody in cardiac arrest, the greater their chance of survival. CPR should be started as soon as possible and interrupted as little as possible. “The component of CPR which seems to make the greatest difference is chest compressions. Once chest compressions have commenced don’t forget to place an AED on the patient’s chest if there is one available. This will help to analyze and identify a shockable rhythm. Early defibrillation (with an AED, or defibrillator as soon as the EMS arrives
within the first few minutes of cardiac arrest) is the only effective treatment in the management of ventricular fibrillation. “If defibrillation is delayed, the rhythm is likely to degenerate into asystole, for which outcomes are worse. The sequence of critical events most likely to improve survival includes early identification of the cardiac arrest and notification of emergency services (call 084 124), performing CPR with minimal interruptions to chest compressions, confirming the rhythm and early defibrillation if indicated, and advanced life support care. Learn CPR for the sake of your loved ones,” said Robyn. How to perform hands-only CPR: Make sure you are safe and not in harm’s way before you touch the person. If they show no signs of life OR are not breathing you are going to have to perform CPR. Shout for help and call the emergency number ER24 084 124. Make sure the person is lying on a hard, flat surface. Place the heel (palm) of one hand on the center of the chest, on the sternum. Place the heel (palm) of the other hand on top of the first hand, locking your fingers together. Keep your arms straight, elbows locked and position your shoulders directly over your hands. Begin chest compressions by pushing hard and fast, at least 100 – 120 compressions per minute, pushing down 5 – 7cm (in an adult). Keep doing this until help arrives.
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‘I’M DOING IT FOR MY KIDS’ In light of August being National Women’s month, we spoke to Lumka about what it takes to be a single mother of two young children and a full-time Basic Life Support (BLS) medic at ER24’s Milnerton branch.
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eing a single mother and a full-time medic is very challenging, but also good. You’re saving lives and then you go home and have to look after your kids. The concept is the same. You look out for your children but you also look out for your patients,” said Lumka Cingo. The first thing you notice when you walk into Lumka’s house in Phillipi in Cape Town is that it is very small, yet tidy. As you walk in you see her kitchen and her lounge and just next to the lounge is the bedroom that she shares with her two children. Her work boots are neatly packed next to one another and almost mirror-like the way she had polished them. Her 14-year-old son Yambathisa and her 9-year-old daughter Lilitha didn’t leave her side for a moment. Lumka, like many other medics, works night shifts that start at 18:30 in the evening up until 05:30 the next morning. “I make sure dinner is ready and that their school clothes are washed before I leave. When I am on the night shift I ask some of my neighbours to check in on them once in a while. I worry when I leave. My son usually takes care of my daughter. I also call them regularly to make sure they are okay,” said Lumka, originally from the Eastern Cape. One gets the feeling that Lumka not only manages this juggling act, but she does it really well. She has also set her sights on furthering her studies and becoming an Intermediate Life Support (ILS) medic.
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“I want to be able to do more for the patient. I don’t feel like I am being challenged enough. The money will also be better and I can do with more for my family,” said Lumka. With her salary, she raises her two children, pays the rent, buys the food and pays for their school fees.“Raising kids makes it difficult to pay for studies. I am hoping for a bursary as the course of four months is very expensive,” said Lumka. It’s her passion for people and her community that made her follow the path of becoming a medic. “I care for people. I also need to do more for the community. I want to be there to help them in difficult times,” said Lumka. Lumka’s hard work isn’t going unnoticed. “Last year I was awarded the BLS of the year award at my base. I was very happy. Hello, me? I didn’t know that people were watching me doing my work,” laughs Lumka. But what about seeing and treating injured children on the job? “It happens a lot. You can’t help but to think of your own children. You do feel something,” said Lumka. Thinking about the wellbeing of her children is her main priority. “I want them to finish school and do what they want to do. I want them to get good salaries. I don’t want them to struggle like me. That’s why I want them to do well in school and get good marks and perhaps a scholarship to university. I am not doing this for myself. I’m doing this for my kids. That’s why I go to work, for them.” Andrew Coutts, Lumka’s most recent partner at ER24, speaks fondly of Lumka. “Her attitude is one of the best I’ve come across in this company so far. She is willing to learn and not hesitant to ask questions. Working irregular hours with small children is difficult,” said Andrew, an Intermediate Life Support (ILS) paramedic. Lumka is, rightly so, very proud of herself.“We should be proud to be women. I am very proud of myself. Women should be able to do what they want. I love working with all the other women at the branch. They are all so amazing and work very hard,” said Lumka. “She should be an inspiration for other women. Being a single mother of two children and working full-time in this industry, in particular, is hard work. Lumka is a credit to women in general,” said Andrew.
To watch ER24’s video on Lumka, scan the QR code or visit youtube.com/er24ems
Lumka Cingo embracing her daughter, Lilitha (9).
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On the Global Himalayan Expedition to install solar powered LED lighting in communities living in the extreme remote Indian Himalayas.
Volupta doluptam, idel invellature, picipsa eptatiam.
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Bringing light to the Himalayas In 2016 Dr Graham Jones, a paediatrician practicing in Sandton, participated in the Global Himalayan Expedition to install solar powered LED lighting in communities living in the extreme remote Indian Himalayas. These communities are poor and have been surviving in a subsistence way of life for hundreds, sometimes thousands of years. No electricity is available in these areas and alternate light sources like candles are suboptimal. Amongst the recipients of solar lighting was a 2550 year old Phugtal Monastery. Global Himalayan Expedition is an organisation founded by Paras Loomba, an engineer, who has a passion to promote renewable energy and empower remote communities.
assist us in improving our ability to deploy resources into extremely remote environments where weight is a limiting factor and ambient weather is challenging. Although many of the expedition members had to be attended to for altitude illness, minor ailments and injuries, none were fortunately life threatening. For more information please visit http://www.ghe.co.in/
To date GHE has installed in excess of 110 micro-grids with a total capacity exceeding of 20.8 kW.
The philosophy of GHE is to help to improve the living standards of the rural population by the provision of renewable, clean energy, education and wireless connectivity access through solar power. This is achieved through the installation of solar powered DC microgrids, however beyond this the community is also empowered through training to maintain these networks themselves and to use these networks to also develop their ability to attract tourism (via so called home-stays) and allow extended productive hours per day. To date GHE has installed in excess of 110 micro-grids with a total capacity exceeding of 20.8 kW. Fifteen home-stays in the villages have been electrified which has increased the income of the 20 villages by approximately $30,000 through tourism. From an environmental perspective approximately 63 tons of Kerosene per annum has been saved and it has helped mitigate 157 tons of CO2 gases on an annual basis. In 2017 Dr Jones was invited to again participate in an expedition to reach the more remote areas within the mountainous terrain. Due to the limited medical facilities within the remote area that they were going to, he was requested to also assist as the team doctor. Mediclinic Sandton and ER24 were approached to assist with medical equipment and consumables and we took this Volupta doluptam, idel on with enthusiasm. Not only is the cause extremely worthy invellature, picipsa eptatiam. but the experience Dr Jones would gain through this would ISSUE 2 – SEPTEMBER 2017 | PRIORITY ONE |
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ABOVE: In 2016 Dr Graham Jones, a paediatrician practicing in Sandton, participated in the Global Himalayan Expedition to install solar powered LED lighting in communities living in the extreme remote Indian Himalayas. No electricity is available in these areas and alternate light sources like candles are suboptimal.
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ABOVE: Amongst the recipients of solar lighting was a 2550 year old Phugtal Monastery.
ABOVE: Mediclinic Sandton and ER24 were approached to assist with medical equipment and consumables and we took this on with enthusiasm. ISSUE 2 – SEPTEMBER 2017 | PRIORITY ONE |
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CONSIDER EVERY PART OF YOUR LIFE WHEN FACED WITH CANCER Holistic care has come to mean many different things and, in the case of cancer, some of these are not necessarily very helpful. A flower or three for the pain, a medicinal herb for the cure – these ideas are often touted by well-meaning friends and family, but they need to be taken with a pinch of proverbial salt. What really defines holistic cancer care is the ability to assess what your body needs to manage the medication, and the mental preparation your mind needs to take it on with a powerful mental attitude.
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he basic premise of holistic cancer care is that you need to take everything into account, not just the cancer and its symptoms, but the patient’s mental and social factors too,” says Dr Michiel Botha, Healthcare Practitioner and Clinical Oncologist. “If every aspect of a person’s care is well looked after, then they will be more more aware of what the treatment entails and what they need to cope with it.” The medication, the diagnosis, the impact on your life – these factors can impact on how you face your journey. A holistic treatment plan that mixes the treatment, the people, the environment and the tools to suit you is the best way to ensure you succeed. “The first step is to work on creating an open relationship with the oncologist or with another member of staff at the clinic,” says Dr Botha. “Some patients struggle to relate to their doctor or don’t want to ask questions and this can impact on their understanding of the processes and procedures involved. An oncology social worker is a fantastic resource in this situation as they can assess if a patient is in trouble and what support they need.” If a practice doesn’t have a social worker, then it is advisable to foster at least one close relationship with a member of staff. They can then answer your questions honestly and in a way that you can relate to. It is amazing
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how a clear understanding of the diagnosis and prognosis can change the way you feel and how you approach treatment. “Anybody can be the anchor person, but it is essential as you need someone who you trust and who you feel can answer your questions,” adds Dr Botha. “Another important step to take is around your diet. A dietician can help you make sense of the conflicting information out there as most patients don’t know what’s the truth and what’s not.” This comes with a warning. Dr Botha advises caution when taking advice from so-called experts, and there are plenty of them. They give people advice on cancer treatments that aren’t necessarily ideal for that particular cancer or patient, and this can impact on their health. “Many people are taking these extra alternative treatments and they don’t want to talk to their oncologist about it,” says Dr Botha. “They are slightly embarrassed, but friends and family pressure them into taking it. If they know who is on their oncology team and have someone to talk to, then they can openly discuss these treatments and get honest answers to their questions.” Honesty is also an essential ingredient for truly holistic cancer care. You need to know that the person advising you is being upfront and has your best interests at heart. It is also important to feel safe where you are receiving your treatment and to understand everything about it. “You need to know how to cope with your treatment, not just in terms of drugs for the nausea, but important things like where to get a wig, how to find a prosthesis and where to live while waiting for treatments,” concludes Dr Botha. “You need a team. Cancer isn’t a one-man show and it needs you, your GP, your social worker, your oncologist and your family to support you along the way. So, ensure you always communicate, always ask questions and feel safe and supported in your treatment environment.”
A holistic treatment plan that mixes the treatment, the people, the environment and the tools to suit you is the best way to ensure you succeed.
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Glen Mintern volunteers his free time to work.
SAVING LIVES IS NO NINETO-FIVE JOB Accidents, emergencies and life changing events happen at any time. That is why Glen Mintern, an Intermediate Life Support (ILS) medic at the ER24 West Metro branch in Cape Town, has decided to volunteer his free time to continue saving lives - even when off duty.
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n the spirit of Ubuntu and with the 18th of July being Mandela Day, we spoke to Glen on why he volunteers his free time to work.
“When I started at ER24, I worked my week shifts and on my off days I wasn’t all that busy. I wanted to do more. I joined Community Medics as a volunteer because I wanted to give back some of my own time and out of my own free will. Saving lives is my passion,” said Glen. Community Medics is a non-profit organisation that operates with approximately 100 volunteer staff. According to the website, their objective is not to duplicate existing ambulance services, but rather to assist in a limited resource environment, to prevent long delays in emergency care that could have dire consequences. But even before Glen started his journey as a paramedic, he knew he wanted to save lives. “When I was younger my mom took me to the fire department for my birthday. Someone who needed help came to the department. I intently watched what they were doing to help this person. Since then I’ve always wanted to do the same. When I started looking for a company to work for, I saw ER24 wherever I went. That is why I chose ER24 and I’ve never regretted it. I love the company and the people,” said Glen. Glen is so passionate about his profession that he doesn’t consume alcohol. Not even on weekends and not even when he is off duty. “People always need your help. I make sure that even when I am not on call, or when I am driving home from somewhere, that I can assist at any time,” said Glen. Glen recalls one specific night. “My wife and I, after an evening function, came across a man who just had a motorbike accident. I immediately got out of the car to
assess the man. My wife, who was in her evening gown, assisted me as best she could. She helped to carry some of my equipment and helped to comfort the person in need.” His wife Bernice, with whom he has been married to for four years, can attest to his passion for saving lives. “He doesn’t like being in a situation where he cannot be of help. I also believe that he is destined to help those in need. Nine out of the ten times we drive somewhere we end up in a situation where help is needed.” She laughs about the measures he has gone to, to ensure that he will always be ready, just in case an emergency occurs. “I can’t even load groceries into the boot of his car because his medical kits always take most of the space.” But, says Bernice, “it takes a special type of person to become a medic. Although it can sometimes be a thankless job, I am very proud of him.” “There are times when Bernice tells me to stop talking about work, but that’s never going to change,” laughs Glen. And what does he do in the little free time he has left for himself? “I don’t have a lot of spare time but I enjoy reading and spending time with friends,” said Glen. Ian Austin, Community Medic trustee, also speaks highly of Glen. “He is very passionate about every call. It doesn’t matter if it is a high or low priority call. He will always give the same level of care,” said Ian. “Not everybody can afford the help when it is needed. Not everybody has someone there to help them. I went through a stage of my life where I needed the help and someone stepped in. So, for the rest of my life I am going to be that person for someone else. Whether it is medical or just to sit down and talk. I will be that person,” said Glen.
… it takes a special type of person to become a medic. To watch ER24’s video on Glen, scan the QR code or visit youtube.com/er24ems
Bernice and Glen Mintern.
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Marshal Muller and Donito Barends getting ready to transport Carin Fouché to her
daughter in Mosselbay.
Caring is part of the job For the past three years ER24 has played a supportive role in both Tania Johnson and her mother’s lives. Carin Fouché, Tania’s mother, lives in an old age home in Mosselbay. She turned 70 on the 10th of July and all Tania wanted to do for her mother is have her at home. Carin is a quadriplegic and wheelchair bound. To transport her mother poses quite a challenge for Tania. This is where ER24 comes in. They’ve been picking Carin up for the past three years for one or two big occasions. Her birthday and Christmas. “You go and visit her at the old age home perhaps for an hour every day between work. But it is good to be able to take her out of her environment. Just to show her that you’ve not forgotten about her,” said Tania. On the morning before her 70th birthday, Marshal Muller and Donito Barends, two
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paramedics from ER24’s Mosselbay base, picked Carin up from the old age home and brought her to Tania’s house. “We wanted to take her to a nice restaurant but it was raining heavily. We decided to stay at home and have a braai instead. She was so happy to be with us and to also have the dogs (Slippers and Luca) around her,” said Tania. 16 years ago, at the age of 54, Carin fell and broke her neck. In hospital, she suffered a stroke which left her paralyzed. She retained the use of her left hand. “Although my mother might be bound to a wheelchair there is nothing wrong with her mind and sense of humor. She loves to be around us. She also loves to chat and she even has a few gossip stories to tell! To have her visit me is a blessing. It means a lot to have my mother with me. I sometimes wish I could do more,”
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said Tania. Johann Prinsloo, branch manager of ER24’s Southern Cape branch, sees this act of kindness as part of the job description of being a great paramedic.“It means a lot to be able to help - it is all that I know. Valuing someone’s feelings and taking care of their well-being is a big part of our job. ER24 has the tools to make a difference. It is not just about a company’s profit, it is about being a well-balanced company,” said Johann. “I appreciate the two paramedics who helped to transport my mother. They’ve been so friendly towards me and my mother and they are always full of smiles. “I always know she is safer when being transported with the ER24 ambulance and I would just like to say thank you to ER24 for always being able to help. I appreciate it so much,” said Tania.
TICKING THINGS OFF HER NOW-LIST
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arlier this year, ER24 wrote an article about Lauren de Swardt, an Intermediate Life Support (ILS) medic from the ER24 Witbank branch, who was diagnosed with Pulmonary Langerhans Cell Histiocytosis. It is similar to lung cancer but very rare. During that time Lauren had also started her first bout of chemotherapy and her family and crew members from the Witbank branch showed their support by shaving their hair off.
Recently, Lauren started to complete some things she has always been wanting to do. She is not ticking things off her bucket list because she believes she will be dying, but rather ticking things off to celebrate her life now. The annual Greatest Train Race was one of the things on her list. It is a race that starts in eMalahleni and ends in
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Middelburg. On Saturday the 19th of August, Lauren, with the help of best friend Estie Biela, completed the race. “I’ve always wanted to do the race. My friend Estie Biela (an operational paramedic at the Witbank branch) opted to run the 15km race. Estie completed the first 10km on her own and for the last 5km of the race she pushed me in a wheelchair to the end. I wasn’t allowed to run as this puts strain on my lungs,” said Lauren. This proved to be quite an emotional experience for both of them. “In the beginning, I felt quite useless and I felt bad that Estie had to help me. We teamed up together and I think it is something that we won’t forget. It was an emotional experience because she was willing to help me. It’s so fulfilling and such a great feeling to know that I have someone in my life willing to do this for me,” said Lauren.
Although the chemotherapy has been taking its toll on Lauren, the scans have showed some improvement. If her health continues to improve she will only be receiving chemotherapy once every three weeks until the end of the year. “Even though I can’t do any physical activity and I am booked off from work until the end of the year, there are a number of things I still want to do. My brain is working overtime and I’d still very much like to do the Jeep Warrior Race*,” said Lauren. *Since the article, Lauren has completed the Jeep Warrior Race. ER24 wishes Lauren all the best with her health and we will keenly follow her as she ticks things off her now-list.
Lauren de Swardt (left) and Estie Biela at the finish line of the annual Greatest Train Race.
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Nonhlanhla Edith Mhlongo at the ER24 Rustenburg branch.
A MEDIC OF MANY TALENTS Medic. Author. Singer. Motivational speaker. Radio presenter. Single mom. Nonhlanhla Edith Mhlongo wears many hats. The first of these is a hard hat.
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dith is an intermediate life support (ILS) medic at ER24 Rustenburg but she is stationed as a site-based medic at a mine in Johannesburg. From a very young age Edith knew that helping people would become her profession. Born and raised in Sebokeng, Edith
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came to Rustenburg to start her career as a medic. A few years later Edith fell pregnant with her son Karabo, now 8-years-old. Edith couldn’t finish a course she was enrolled in and had to drop out. This and a few other things didn’t demoralise Edith. Instead, it motivated her to do more and to, also, share her story,
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both verbally and in writing. “I was identified by a lady from the Rustenburg municipality who put me on stage as a motivational speaker. I mostly motivated women and as a single parent, a medic and the breadwinner, I thought there are so many women out there like me who are not aware of their worth.
“I was scared of being a motivational speaker at first. I had such stage fright, but then I realised I could do this,” said Edith. Edith also recorded a CD that was released in May this year. The CD titled Fear, is a mix of her motivational speaking on the beat of a backtrack. Writing a book was her next step. “I’ve always written down my feelings. The feelings I felt while growing up as well as what I felt during the process of becoming a medic. I felt like it wasn’t enough. I was writing this all down for myself but I wanted people to learn from it as well. Maybe my story could also change someone else’s life,” said Edith. She hopes to publish her book titled An Extreme Desire of a Medic towards the end of September this year. Although Edith motivates people through her own stories, she doesn’t let her past define her. “I learn from my mistakes, it is as easy as that. But sometimes you lose things just to gain new things again. If I completed my course and didn’t fall pregnant, I might not have written my book or I might not have been on stages motivating the youth and women. “Don’t let your mistakes become your stop street. When you make mistakes, you grow. Some of the mistakes can
be a blessing in your life. I believe in the power of the second chance,” said Edith. Although Edith might not have planned her pregnancy, she can’t imagine her life without her son. This is evident when Edith speaks about her son’s health scare two years ago. Karabo, who was six at the time, suddenly fell ill. After numerous tests, he was diagnosed with osteomyelitis. This is as a result of an infection that causes inflammation in the bones. This generally happens in the legs, arms or spine. He spent a year and a half in and out of hospital. “There was a possibility that they would amputate his leg. I was praying so hard. All I could think of was my 6-year-old son that might lose his leg. It was not an easy journey to have and probably the most hectic moment of my life. “I am used to being a medic in the ambulance and it has been fun. I’ve been treating people for a long time now but it was so difficult treating someone who is your own flesh and blood. But, I managed. If you can be a medic to the world, you can be the best medic and the best mother to your family,” said Edith.
strongest points. “She is a hard worker and very punctual. She is always on time! She is also a loving, caring person. I really admire Edith because she does a lot of jobs at the same time,” said Refiloe Mohube, co-founder of Bojanala FM. Nelisiwe Mzili, one of Edith’s colleagues at the ER24 Rustenburg branch, also speaks fondly of her. “She is such a hard-working woman. She makes sure that you can learn from her. She is a brilliant woman when it comes to multi-tasking. I look up to her,” said Nelisiwe. Edith is determined to do even more with her life but her first love, being a paramedic, won’t diminish.“My dream is to study further and become an Emergency Care Practitioner. I’d like to also continue writing books and change lives every day but the medic in me will never die,” said Edith. To watch ER24’s video on Edith, scan the QR code or visit youtube.com/ er24ems
Edith has also been presenting a radio show on Bojanala FM, a Christian radio station, for the past three months. Where she finds the time to do everything is remarkable, but time management seems to be one of her
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RUNNING INJURIES: HOW TO AVOID THEM Running is a popular sport, all across South Africa. 110 Parkruns take place every Saturday, with an average of 288 runners per event, from bustling Green Point, Cape Town, to White River in Nelspruit.
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ut it can be an extremely painful sport, too. Seduced by the ease and accessibility of the activity, too many new runners sprint headlong into an inconvenient statistic: up to 70% of recreational runners suffer from variety of overuse injury each year, according to a 2009 journal in Sport Health. In fact, a few subsequent studies suggest runner’s injury rate might be even higher – as the New York Times reported last year, some research estimates that as many as 90% of recreational runners are laid low by injury every year. What are the most common causes of runningrelated injuries? ‘I have treated many new runners for injuries,’ says Gerrie Berner, a biokineticist at Mediclinic Cape Town. ‘Running is a weight bearing, high impact and repetitive type of exercise. It puts a lot of strain on the joints and muscles of the body, and this will make you more susceptible to injuries. Yet most runners will just start running without a proper running programme or guidance.’ In their discussion of The Big 7 Body Breakdowns, Runner’s World identified the most prevalent risk areas of running: the knee, Achilles, hamstring, ankles, heels, shins and iliotibial band, a strip of muscle that runs along the outside of your thigh from the hip to the knee. Gerrie identifies 7 primary
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causes of running-related injuries: A rapid increase in weekly running distance. Wearing inadequate or worn-out shoes. Muscle imbalances. Returning to previous running distances too fast after a layoff. Abrupt changes in running surface. Not taking enough recovery days after strenuous training sessions. Not warming up and stretching properly before going for a run. Many of these risk factors are a symptom of enthusiasm, as new runners get ahead of themselves. ‘Too many new runners fall into the trap of doing too much too soon,’ agrees Chris Lippstreu from Race Fit, a Cape Town-based gym that specialises in building stronger endurance athletes. ‘Even jumping from a 5k to 10k can result in damage to the body. Running is just like strength training; you need to ease the body into it so that it can adapt accordingly.’ How can new runners avoid injuries? If you’re one of the 90%, irritating injuries will follow you long after you cross the finish line. But the fact that they are so prevalent does not mean they are inevitable. Lippstreu’s advice to new runners: take it easy. Giving your body time to adjust to your new sport will pay off in the long run. ‘Pick a running pace you are comfortable with, and run shorter distances. Don’t be persuaded to try marathon distances when you haven’t
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been running for at least a few years.’ Then, rectify imbalances by getting stronger – all over. ‘Whether it’s yoga, strength training or cycling,’ advises Lippstreu, ‘incorporating other forms of exercise to train other muscles or energy systems will not only improve your running performance but also develop other aspects of your overall health and conditioning.’ Pounding miles of tar at a time isn’t a comfortable experience, especially if your body isn’t accustomed to it. A 2016 study from Harvard Medical School pinpointed a key cause of injuries among those new to running: landing on the heel, which is associated with a far higher rate of injury risk than landing on the middle or front of the foot. To avoid this impact, take to the trail. Embrace a variety of surfaces to change up the way you land – skipping over rocks and roots will help you land on different parts of your feet. ‘Go cross-country to give your body a break from the monotonous impact of hitting the road,’ says Lippstreu. ‘This will give you a feel for other forms of running events.’ Do you need new shoes – or a running coach? They’re the final barrier between your body and the road, so your shoes play a major role in keeping you free from injuries. In a 2001 study, researched at the University of Pretoria noted that because shoes, inserts and
orthotics affect general muscle activity, they can have a major effect on fatigue, comfort, work and performance. Check your shoes regularly for signs of wear and tear that could put you at risk. Look for damage to the outer sole, and a softening of the heel. The mid-sole is particularly important, as any degradation will affect its ability to protect your arch. A great way to test your shoe’s effectiveness is to grab it by the heel and front, and twist in
opposite directions: a high resistance to distortion will keep you safe from injury. But the best thing you can do for your running health and performance, says Gerrie is seek out some expert advice. ‘Get a proper foot assessment and shoe fitting,’ says Gerrie. ‘When you wear the wrong type of shoes, your risk for injury will be very high. Make sure you start slowly and increase your running distance gradually. Don’t follow just any running programme; make
sure it is designed according to your needs. If you are not sure about how to do this, then get a running coach.’ A final word of advice: The secret to avoiding common running injuries? ‘Listen to your body,’ says Gerrie. ‘If you feel any pain or discomfort, take a rest day. If the pain persists, see a professional. And never, ever run through pain.’
A breath of fresh 42,2km air The Sanlam Cape Town Marathon was held on Sunday the 17th of September.
of Cape Town’s mountains and sea, as well as many of the city’s great attractions.
It is a prestigious global city race open to a range of running enthusiasts from elite athletes to social runners. Along the spectacular route of 42,2 km, you will take in the famous natural beauty
ER24 and Mediclinic is proud to be the official medical providers to the Sanlam Cape Town Marathon. ER24 provided real help, real fast along the route and at various water points. Mediclinic
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provided trusted expertise at the race clinic as well as along the route.The participants couldn’t have been in better (medical) hands. On the day there were 8 doctors, 8 nurses and 48 pre-hospital staff. There were also 8 ambulances in the inner ring, 4 rapid response vehicles and 1 patient golf cart.
16 000 runners participated in this year’s Sanlam Cape Town Marathon.
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How to become a paramedic South Africa has a great need for skilled, qualified emergency care providers. The profession has grown enormously over the last 25 years. It can no longer be considered a job, but rather a professional calling. A commitment to patient care, professional integrity and lifelong learning is vital to success in this career. Certain universities offer a four-year Bachelor’s degree in Emergency Care (BEMS). Graduates of this programme are qualified as Advanced Life Support practitioners able to provide the highest level of pre-hospital emergency care available. Contact the university of your choice for further information on costs and entrance requirements. A two-year National Certificate is also available, the Emergency Care Technician (ECT) course. This qualification is also offered by certain institutions and graduates will work under the indirect control of a BTech paramedic. ER24 / Mediclinic offers the ECT course in Cape Town. Short Course Education: Basic Ambulance Assistant (BAA) – Basic Life Support. Duration: Seven weeks. Please note, the short course route of training is in the process of being phased out. The entry level qualification (BAA) will no longer result in registration from January 2018. ER24 Training no longer offers this course. Ambulance Emergency Assistant (AEA) – Intermediate Life Support. Duration: a Four-month course that builds on the foundation laid during the BAA course.The mid-level course is currently still accepting applicants but will be phased out by December 2019. ER24 is still
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offering this program in Paulshof, Johannesburg. Requirements: Matric certificate, current HPCSA registration as a BAA for at least six months, 1000 documented, verifiable hours of patient care experience as a BAA. Critical Care Assistant (CCA) – Advanced Life Support. Duration: an Eleven-month course that qualifies successful candidates as Advanced Life Support paramedics. The highest level of short course training.This advanced qualification is no longer offered. Only those currently registered on the programs will complete within 2017. Which route should I choose? This is a personal choice which will depend on many factors including academic performance, finances, location and personal preference. Many candidates who have recently matriculated, have the required academic record and can afford to attend university full-time for four years choose the degree route. Short course training has been discontinued in favour of higher education standards as mandated by the Minister of Education. Only the mid-level AEA program is continuing until 2019. One should consider school subjects very carefully as entrance into the programs requires Maths, Science and or Biology with a score of 60% and above depending on the institution. A good level of fitness is required with most institutions requiring a physical assessment that includes swimming. There are two major employers in the emergency services industry, namely the government and private emergency services. Minimum requirements are typically HPCSA registration as a BAA, a valid driver’s license and a
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Professional Driving Permit (PDP). There is currently an oversupply of BLS providers in the country. BLS practitioners may need perseverance and commitment to secure full-time employment in the industry.There is a significant demand for ILS and ALS providers. As such, the demand for training in these areas is high. Please note that the ER24 Training Academy does not facilitate employment, and completion of one of our courses do not imply automatic employment with the company. ER24 does not have a volunteer programme. Registered professionals may be employed on a part-time basis to fulfil a specific need at a Branch. Please contact the Branch Manager at your nearest ER24 base should you be interested in part-time work.The Health Professions Council of South Africa (HPCSA) governs the standards of all medical training in South Africa. Their website contains a list of all institutions accredited to run emergency care training.
PREGNANCY AND ALCOHOL DO NOT MIX
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eptember 9 was International Foetal Alcohol Syndrome Awareness Day, ER24 urges pregnant women to abstain from drinking alcohol. Explaining the syndrome, Willem Stassen, ER24 Critical Care Paramedic, said that Foetal Alcohol Syndrome (FAS) is the leading preventable cause of mental retardation. “It is a clinical syndrome that occurs when the unborn baby is exposed to alcohol through maternal alcohol consumption. This syndrome is characterised by distinct facial abnormalities and other defects in the heart, muscles, kidneys and eyes. One study reports that the incidence of FAS in some South African populations may be as high as 12.2%. Unfortunately, the damage done in FAS is permanent and cannot be undone,” he said. The South African National Council on Alcoholism and Drug Dependence (SANCA) says
that Foetal Alcohol Syndrome is 100% preventable. The mother and baby are connected by the placenta and the umbilical cord. This means that the baby takes in almost everything that the mother consumes. Substances can build up in the baby’s system and can cause permanent damage. Stassen said that there is no safe level or period of alcohol intake during pregnancy as this is affected by the alcohol clearance rates, foetal sensitivity to alcohol, drinking patterns of the mother-to-be as well as genetics. “For this reason, all international guidelines recommend that pregnant women completely abstain from all alcoholic beverages during the entire duration of pregnancy. Pregnant women should always attend prenatal check-ups at a registered healthcare provider,” he said. FASD children or babies are born with irreversible mental dysfunction,
physical and central nervous system abnormalities and growth retardation caused by maternal alcohol use during pregnancy. Alcohol consumed by the mother enters the blood and reaches the foetus within 20 minutes. As a consequence of the brain abnormalities, children with FAS have learning disabilities, behavioural abnormalities and cognitive impairment. SANCA says that there are at least 500 000 South African’s suffering from FASD. South Africa with an incidence of 8-12% has the highest rate of FAS globally - De Aar having the highest prevalence of 12% in the country. Should you require any assistance with alcohol abuse, contact Alcoholics Anonymous on 0861 HELP AA (435-722). For more information on FAS, visit http://www.fasfacts.org.za
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WAYS TO KEEP CHOLESTEROL IN CHECK High cholesterol levels can cause heart disease but there are lifestyle changes you can make to keep your cholesterol under control.
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holesterol is an essential fatty substance produced by the liver that is necessary for our hormones to function properly. However, excessive cholesterol levels can be dangerous as it leads to cardiovascular diseases like heart attacks or strokes. Types of cholesterol: There are two main types of cholesterol found in the blood – HDL, ‘healthy’ high-density lipoproteins, and LDL, ‘lethal’ low-density lipoproteins which block blood vessels and ultimately cause heart disease. Factors that influence cholesterol: Our genes can play a role in determining our cholesterol levels but so can poor diet, being overweight, smoking and being inactive. Although we consume 20% of our total cholesterol from our diet and the rest is manufactured by the body, we can benefit from making lifestyle changes for our overall health. Recommended therapeutic lifestyle changes: Eat less saturated and trans fats found in butter, cream, hard margarines, ghee, fatty red meat, chicken skin and commercially baked/processed foods. Choose ‘healthy’ fats like those found in omega-3 rich fish (like salmon and mackerel), nuts, seeds and avocados. Eat more fibre-rich foods like fruit, vegetables, whole grains and oats.Avoid frying foods – rather grill, bake or steam. Get active: aim for 30 minutes of moderate physical activity, five days a week as being active can help to raise ‘good’ HDL cholesterol. Stop smoking and avoid second-hand smoke. Cut down on alcohol – the recommended limit is 1 unit (120ml wine or 340ml beer/cider) per day for women and 2 units per day for men.
People who have cardiovascular disease – those who have had heart attacks or strokes. People who have very high LDL cholesterol levels – over 190mg/ dL 4.9 (Under 100mg/ dL 2.6 is optimal). People who have diabetes. Heart attack warning signs: Symptoms in women are often different than in men. Women are more likely to experience nausea, dizziness and anxiety. Symptoms may include: Heavy pressure, tightness, crushing pain or unusual discomfort in the centre of the chest. Sweating, sickness, faintness or shortness of breath may be experienced.This may feel like indigestion, spread to shoulders, arms, neck or jaw and/or last for more than 15 minutes. It may stop or weaken and then return.There may be a rapid, weak pulse.Sharp stabbing pain in the left side of the chest is usually NOT heart pain What to do in an emergency:
… Symptoms in women are often different than in men.
Get to the nearest emergency unit as quickly as possible. Hospitals with cath labs will be able to remove the clot mechanically. Hospitals without cath labs will give medication to dissolve the clot, and then transfer you to a cath lab if needed. If someone else has a heart attack near you, call an ambulance (084 124). If he or she stops breathing, do CPR on the person until an ambulance arrives.
Controversy: cholesterol in food vs Western diet. While it’s been a firm belief that one of the main causes of heart disease is the impact of food on our cholesterol levels, there are some internationally acclaimed cardiologists who believe that it is not cholesterol in our food but rather oxidative stress and inflammation from diets rich in sugar, refined carbs and polyunsaturated oils (found in processed foods and seed oils) that are the real demons. So while cholesterol itself is not dangerous, what you do and your lifestyle choices are key to keeping the substance levels healthy. Traditional treatment: Statins are commonly prescribed to treat high LDL cholesterol levels as they may play a role in lowering good and bad cholesterol levels and preventing heart attacks. But some scientists believe there is a lack of evidence that statins can benefit everyone, especially women and the elderly. The American College of Cardiology and American Heart Association states that statins do benefit certain groups of people: Volupta doluptam, idel invellature, picipsa eptatiam.
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DON’T TAILGATE, BE PATIENT AND WAIT
Responding to any emergency is extremely stressful for paramedics. You are constantly bombarded with a loud siren noise and adrenaline pumping through your veins. You have to keep the safety of yourself, your crew, your patient and the people around you in mind at all times. You also need to know exactly what your vehicle is capable of in different driving conditions. It is not as easy as getting into a vehicle and starting to drive with lights and sirens. The last thing paramedics want to do is to consider a vehicle tailgating them too..
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R24 urges all motorists to be patient and wait when you hear or see an ambulance approach. Don’t tailgate, here’s why: “We had a patient with serious injuries in the back of the ambulance. We were attempting to go through an intersection to get her to hospital as quickly as possible. We were driving through when a gentleman cut us off completely. We stopped to let him go thinking that he might not have seen us. We carried on driving behind him and he pulled over letting us pass and then he started following us, through the centre of the two lanes. We carried on going and we slowed down as vehicles came towards us. The vehicle behind almost rear-ended us. I’ve previously been in a collision in a similar situation,’ said Kerry Gamble, an Intermediate Life Support (ILS) medic at ER24’s Johannesburg North branch. According to Kerry, this happens often. “I think initially moving through intersections is a bit of an inconvenience for motorists, especially if they have to wait while the robot is green for them. I do think some see it as a way to skip traffic or to get where they are going faster. Some don’t understand that they are putting our
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lives, our patients and their lives at risk.” These collisions also take away resources that results in less ambulances on the road. “When vehicles crash into us after tailgating, an ambulance becomes nonoperational. We could be on our way to an emergency and these types of crashes can delay or even prevent us from getting to the scene and providing the necessary help. The whole incident snowballs as we have to stop, assess for injuries, take statements and details, call a local manager and in some cases, have the vehicle towed. All of this results in traffic congestion and may lead up to a secondary collision as well,” said Kerry. Werner Vermaak, ER24 Head of Communications and an advanced driving course instructor, explains that most paramedics are skilled in driving but it does not mean one has to make their job harder than it already is. “ER24 operations personnel are required to undergo a driving test prior to their employment at the company. The company also has its own BERC programme (Basic Emergency Response Course) which is offered in-service. It is essential to teach
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personnel to respond to emergencies and to keep their surroundings in mind. Often new employees come from a service that used different vehicles or they come straight from university or college and have not received a lot of emergency responding training. This course teaches the basics and how to operate emergency vehicles in different scenarios,’ said Werner. What to do when you see an ambulance on route to an emergency: Don’t panic. Give way. Constantly check your rearview/ side mirrors. Don’t tailgate. Be patient. Check before you cross an intersection even if the light is green for you to go. Do not blindly move in a direction or slam on brakes. Observe your surroundings, paramedics do too. Do not play excessively loud music – this will hamper you from hearing the siren.
TIPS FOR KEEPING YOUR BACK HEALTHY ER24 BACK CARE AWARENESS WEEK 4 – 10 SEPTEMBER 2017 THE CORRECT WAYS TO MOVE CAN HELP TO PROTECT YOUR BACK. IF YOUR BACK HAS BEEN SERIOUSLY HURT, THE RISK OF FURTHER INJURY IS HIGH, AND IF IT IS SERIOUS ENOUGH, YOU MAY STRUGGLE WITH LIFELONG PAIN AND DISCOMFORT.
Body mechanics Here are pointers from the Nicholas Institute of Sports Medicine and Athletic Trauma (Nismat) in New York, on how to lift, sit and stand properly:
Lifting • Stand close to the object with your feet spread apart, about the width of your shoulders. • Squat, bending your knees and hips, while keeping your back in proper alignment. • Contract your stomach muscles. • Lift with your leg muscles, not your back. Take care not to lift and twist at the same time. • If you are lifting the object with another person, do it in unison. One person should say when to lift, walk, and unload. Sitting and standing Although people can make accommodations for their specific back problem, there are also general rules for proper sitting, standing, and lifting to protect your back.
Tips for standing for a prolonged period of time • Wear comfortable shoes and stand on a soft surface. • Bring your work to a comfortable level; do not bend over it. • Rest one leg on a stool to reduce stress on your back. • Change your position often. Tips for when you sit in a chair for extended periods of time • Sit in a chair that supports your lower back. If the chair does not offer enough support, use a lumbar cushion behind your lower back. • Position your chair so that your knees are at least as high as your hips when your feet are flat on the floor. • Your desktop should be slightly above your waist. • Sit close to your work; do not lean over it. • Do not slump over while sitting. • Take frequent breaks to stand up and stretch.
Push, don’t pull Whenever possible, people should push objects rather than pull, according to Nismat.
If you need to move a piece of furniture, stand close to it, tighten your stomach muscles, and push with both arms. Don’t lean forward and never push or pull with a bent back.
References WebMD Feature, reviewed by Louise Chang, MD, on 2 June 2011, World Health Organization.
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Prevention The best way to prevent lower back pain is to ensure that the muscles surrounding your spine are kept strong. The best exercise is swimming, cycling and walking, and do not need to be performed in a gym. These exercises may also assist in preventing the return of pain in your lower back if you have already injured it.
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