O C TO B E R 2 018
PMREMS newsletter
regionalresource season ofpreparation As we prepare for the winter chill,
let’s look back at another amazing community Halloween Spooktacular event and how Pocono Mountain Regional Emergency Medical Services joins area professionals sharing ways we’re prepped for the season. From an awesome fleet that keeps us on the streets throughout our massive 250 square mile coverage area; to
Tobyhanna Township Volunteer Fire Company’s fire preventation points. Lehigh Valley Health Network even adds physician health notes defining and for detecting an illness. Then, wrap up with a signup to receive updates and facts to learn why PMREMS’s Annual Subscripton Drive starting in February is a phenomenal benefit to our nonprofit YOU too!
Stay connected
for videos, photos and up to the minute news facebook.com/ PoconoMountainRegionalEmergencyMedicalSer vices
IN THIS EDITION 2 Always on the Road A Look at our Fleet 3 Some EMS Hands On Halloween Spooktacular Success 4 An Ounce of Prevention Fire Company Facts 5 LVHN: Physician Facts Drs. Defining & Detailing
ALWAYS ON THE
ROAD
The Ford F-450 Braun ambulance– massive four-wheeled resources in Pocono Mountain Regional Emergency Medical Services fleet continue to tackle tumultuous Pocono Mountains terrain. Accumulating over 5000 miles each month due to heavy call volume in seven municipalities covered, these trucks replaced ambulances bearing excessive mileage that no longer have a warranty, helping to offset repair costs for the organization. With several small communities across our expansive 250 square mile coverage area dependent upon private third party contractors to plow roads, many may not get to a specific road or community before an emergency arises. Equipped with four wheel drive and positioned at three sub-stations strategically placed within Coolbaugh, Paradise and Tobyhanna Townships these ambulances are being utilized as Advanced life Support (ALS) units enabling PMREMS to safely and efficiently respond to calls despite the region’s woeful winter climate. Taller, longer frames and a significant difference in handling than the previous ambulances, called for unique driver training for our professionals to safely operate the trucks. All PMREMS employees were specially trained on the functions and operations, including a closely monitored drive through competency course under the supervision of two PMREMS Emergency Vehicle Operations Instructors. Prepared for the Future with Positive Progress to stay always on the road, Pocono Mountain Regional Emergency Medical Services continues its focus on forecasting necessary equipment needs for our community.
“Enabling PMREMS to safely and efficiently respond to calls despite the region’s woeful winter climate” Mark A. Lemley
Pocono Mountain Regional EMS Basic Life Support (BLS) Coordinator Fleet Manager
r e h t ano
e m o awes
. n o s hand
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S M E R
those iate all apprec we ded & spent who atten ing for our th time prepar
r 27 e b o t vent oc nity e commu
n e e w Hallo ular c a t k Spoo
u u u u u u o Y o t Thanks
prevention Be prepared
firefighters across the region agree with being prepared reasoning when talking fire safety. all too often these tragedies could have been prevented. Stressing simple steps could save a life, tobyhanna township Volunteer fire Company’s assistant Chief ed tutrone tallied a few do’s and don’t’s tips to share. learn more at www.tobyhannatwpfire.com
How you measure up? Cleaning out the fireplaCe Do you:
toss ashes in a Bag
Make sure everything’s cool then metal can it
plugging in outletS Do you:
load’em up
use a ground fault power strip
outdoor firepit Burning Do you:
Set it anywhere... those marshmallows can’t wait no s’more
Steer clear of fallen leaves & twigs
outSide lighting Do you:
Situate the bulb tucked in close from the cold
BYHANNA TO
TO
W NSHIP
face bulbs & hot hot bases away from places & clear out any critter nests
you see..Here’s THe Key
if you checked off all answers in column two, you’re right
Ask the Doctor Identifying Sepsis
Q
My grandmother recently had minor surgery and I’m worried about the likelihood of sepsis since she’s much older.
A: Steven Zanders, DO, FCCP First, let’s discuss the definition of Sepsis. The definition for sepsis has recently been refined and currently we are in a state of modification as the medical community “polishes” the designation. This is to bring uniformity and conformity to a complex disease. Basically, Sepsis is the body’s prodigious response to an infection whereby body organs and, ultimately, life are threatened. The severity is often governed by the patient’s dysregulated (out of control) immune system in an attempt to control the infection. One of the unfortunate reasons for the excess mortality in sepsis is that signs and symptoms are often covert and therefore, treatment delayed. Patients don’t present with a chief complaint “I have sepsis”. They are often un-like patients with a heart attack who present with a complaint of chest pain. The screening tools we use to look for symptoms and signs are also in revision but we look for certain issues: • Infection – in order to have sepsis you have to have an infection somewhere. This could be as simple as a urinary tract infection or as significant as bacteria in your blood stream • Patients prone to infection • Elevated respiratory rate (breathing fast) • Mental status changes • High heart rate • Low blood pressure – lower than 90-100 mmHg • Feeling faint • Fever or very low body temperatures. We often see “cold” temps in older patients. The key point is that an infection has to be found in parallel with above descriptors. To keep this in perspective, I could run up and down the stairs and have a high heart and breathing rate but I obviously do not have sepsis.
Steven Zanders, DO, FCCP, is a Critical Care Specialist and Directs the Critical Care Services at Lehigh Valley Hospital– Pocono. He has 19 years of experience in Critical Care and Internal medicine.
Often, patients present with these signs but an infection is not found immediately. Because the mortality for sepsis worsens each hour appropriate treatment is not given, we often treat with broadspectrum antibiotics and IV fluids then de-escalate or scale back as we obtain more information. Individuals prone to sepsis include anyone with a defining predisposition: elderly, patients in medical facilities like nursing homes, diabetes, heart disease, kidney disease, previous sepsis, cancers or those on immune modulating drugs like chemotherapy and monoclonal therapy. However, even the healthiest person can become susceptible to sepsis if they have an infection that goes untreated or their immune system is dysfunctional. There are levels of severity for sepsis and although you can recover from each tiered severity, as the condition worsens so does the likelihood of a poor outcome. Lehigh Valley Hospital–Pocono has begun an education program which will be disseminated to “at risk” individuals. Treatment for Sepsis The Centers for Medical Services (CMS) reviews and monitors what we do and has come up with prescribed guidelines and timeframes for what needs to be done in patients diagnosed with sepsis. The CMS monitors these and requires these measures to be completed within 3-6 hours. This is essential—mortality increases each hour by 7-8% if appropriate treatment is not rendered. As with sepsis definitions, these times are under revision. We believe in timely treatment so in an effort to save lives, we have adopted the mindset of the “golden-hour”. Get treatment quickly within the first hour of presentation. We came up with a unique plan here at LVH-Pocono to exceed the guidelines and provide more timely care for patients. Much like education for heart attack and stroke symptoms has facilitated earlier diagnosis and treatment, we are involved with educating the local communities, EMS and clinicians to recognize signs/symptoms for potential sepsis. The earlier sepsis is recognized and treated the better the outcome. This is paramount as the overall mortality rate can be as high as 40 percent depending on how the disease presents. The paradigms of treatment are timely recognition, and source control, giving IV fluids and rapid antibiotics – all within an hour. When To Seek Medical Help You need to seek medical help immediately if you’re not feeling well. Sepsis is an infection that affects the entire body and it is an emergency situation. Go to the hospital’s ER rather than risking what could become a lethal situation.
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Headquarters135 Tegawitha Road, Tobyhanna, PA 18466 WebPMREMS.org Phone570.839.8485