AUGUST 2018
PMREMS newsletter
regionalresource
safety for all ages S haring a look into Pocono Mountain Regional EMS resources for all ages; learn how medical professionals in our area are prepared to serve.
We’ll also explore another edition of Lehigh Valley Health Network’s “Ask the Doctor” plus “Para-Points” provided by one of our own PMREMS professionals.
IN THIS EDITION 2 EMS FOR KIDS
PMREMS Master Level Status
Take a view into school bus safety rules from Pocono Mountain School District as area students start another school year.
3 LVHN: PHYSICIAN POINTS
Then, wrap things up with an onscene peek into September community events to come by and say “hi” to our pros and checkout the latest PMREMS equipment on display.
6 PARA-POINTS
Stay connected
for videos, photos and up to the minute news PoconoMountainRegionalEmergencyMedicalServices
Skin Cancer Risks
4 SCHOOL BUS SAFETY Know the Rules
Carbon Monoxide Poisoning
7 REGIONAL ROUNDUP Sharing Success
8 ON SCENE
September Community Events
Ever evolving through solving the needs of our area, Pocono Mountain Regional Emergency Medical Services proudly holds Master Level status under the Pediatric Voluntary Recognition Program (PVRP). Pennsylvania Emergency Health Services Council reports,“74,350 children were transported via ambulance in Pennsylvania in 2012–that's one transport every 7 minutes”* Created by the EMS for Children program, in partnership with the Pennsylvania Department of Health Bureau of EMS; the Pediatric Voluntary Recognition Program was developed “To ensure EMS agencies are prepared for pediatric patients.” Under this multi-phase recognition program, agencies who wish to establish standards to improve their capability to deliver pediatric care may volunteer to participate. An annual review process, plus future phase achievements ensures growth, fostering skills to master care for kids across the area. As a Master Level provider, PMREMS has gone “above and beyond” meeting all standards established as part of Pennsylvania Emergency Medical Services for Children (EMSC) Voluntary Recognition Program. Though not required, particular pediatric devices can be found on PMREMS transport vehicles. Under the program, mandatory advanced pediatric-specific continuing education is required each year. Look for the EMSC logo recognizing a “Commitment to Pennsylvania’s youth,” confident in PMREMS’ dedication to serving the region with unique quality care for all ages.
*Source Pennsylvania Emergency Health Services Council 082316 www.paemsc.org
Ask the Doctor Skin Cancer Risks
Q
A few times I’ve had some really bad sun burns that blistered and peeled – how does that impact my risk of skin cancer? A: Victor Catania, MD This can very much increase your risk for skin cancer. In addition to the other risk factors such as being male, having a fair complexion, tobacco usage, and having a family history or personal history of atypical moles, a single sunburn is sufficient enough to increase the risk for skin cancer. Skin cancer is an indiscriminate cancer that affects any age. Anyone with sun exposure, sun burning, or tanning history is at risk for skin cancer. Consider this: Skin cancer represents the most common cancer that is diagnosed in patients in the United States. The rates of melanoma (a type of skin cancer) within the state of Pennsylvania have doubled since 1975. Our county, Monroe County, has the highest rate of this disease in the state and is 59 percent higher than the national average. Skin screening It is vitally important to be screened on a regular basis for skin cancer, because there are different kinds of skin cancer and signs of skin cancer. Here are the skin changes your doctor will look for: • Actinic keratosis: This is a precancerous lesion which may become squamous cell carcinoma. These precancerous lesions are often found on the backs of hands and along the hair line as small hornlike lesions. • Squamous cell carcinoma: This is the second most common skin cancer. Squamous cell carcinoma is a moderately fastgrowing cancer. It appears like a flesh colored nodule that may become crusted over or irritated looking. • Basal cell carcinoma. This is the most common skin cancer. Basal cell carcinoma is generally a slow growing cancer that may resemble an inside out pimple or irregular mole. • Melanoma: This is considered the most dangerous type of skin cancer. Melanoma may start out as a nonsymmetricallyshaped or -colored flat mole, often shades of brown or black, that can increase in size and shape.
Victor Catania, MD, is the Assistant Medical Director for LVPG–Pocono and sees patients at Family Medicine–Tobyhanna. He is board-certified in family medicine and a member of the American Academy of Family Physicians and the Pennsylvania Academy of Family Physicians.
When I conduct a free skin cancer screening at the Dale and Frances Hughes Cancer Center at Lehigh Valley Hospital (LVH)–Pocono, it involves a head to toe evaluation for any new or suspicious lesions as well as any lesions of concern to the patient. This may be done with the naked eye or with devices that may magnify lesions and provide additional light, such as a dermatoscope. Different providers have different methods of documenting lesions; a body map is one such tool that allows a clinician to note location, size and characteristics of a lesion for future reference. Know your ABCDEs You should always pay attention to changes in your skin. The ABCDE rule can provide a quick and ease remember method of assessing a mole that may be worrisome for melanoma. Moles you should pay attention to have one or more ABCDE irregularity. Asymmetry: If a line is drawn down the middle of the mole or lesion, the mole does not have a mirror image of the other side. Border: Mole has uneven outer edges. Color: Nonuniform mole color (that is, not the same color throughout the lesion). Diameter: The mole is larger than a quarter inch. Evolving: Mole has changed over a period of time. Always be mindful of any moles that are painful, red, irritated looking, having any discharge, or change in physical characteristics. While some skin conditions may cause moles or lesions to suddenly appear, it is strongly recommended that any new skin lesion that you are not sure about is evaluated by a medical provider. Preventing skin cancer Prevention is key with respect to skin cancer. The most important thing that can be done is avoidance of sun burn. Here are ways you can protect your skin (and eyes) from the harmful effects of UV radiation: • Wear sunscreen: Apply a broad spectrum (meaning blocking ultraviolet A and B; UVA, UVB) with a sun protection factor (SPF) rating of at least 30. • Reapply regularly: It is also important to reapply sunscreen every 90-120 minutes, depending on water exposure and how much you are sweating. • Block UV: Wearing protective clothing, such as long sleeve shirts, pants or a wide brimmed hat also goes a long way to protect your skin from sunburn. • Protect your eyes: If you wear sunglasses, ensure that they state they have 99 to 100 percent UVA/UVB protection. • Time it right: Avoid going out when the sun is at its most intense, generally between 10 a.m. and 4 p.m., and pay attention to the UV index on the weather forecast to further reduce your exposure to the sun’s harmful rays. • Avoid tanning machines: Finally, as ultraviolet light can come from a variety of sources, it is strongly encourage to avoid sun tanning booths which are a risk factor for skin cancer.
PREVENTION PA R A - P O I N T S : C A R B O N M O N O X I D E P O I S O N I N G Carbon Monoxide Poisoning (CO Poisoning) occurs when carbon monoxide is inhaled through the lungs, then absorbed by hemoglobin in red blood cells that carry life sustaining oxygen throughout the body. When exposed, these red blood cells absorb over 200 times more carbon monoxide than oxygen blocking it from traveling to your heart and brain. Primarily occurring during the cooler months as propane, coal, wood and oil are used to heat homes, carbon monoxide is produced by the incomplete combustion of fossil fuels. If this odorless, tasteless, essentially toxic gas fills the air undetected, it could lead to serious consequences. First affecting infants and children, even pets, due to their body size and increased metabolism; as well as the elderly with heart or lung medical conditions, CO Poisoning carries clues that can queue detection. Symptoms include headache, dizziness and nausea. Sometimes called the "Great Imitator," mild carbon monoxide poisoning can often be mistaken for flu-like symptoms. Carbon Monoxide Detectors aid in unveiling this elusive hazard with a continuous alarm that echoes should the gas reach dangerous levels. While most situations resulting in alert activation are not life threatening, like a low battery beep every few minutes, to determine if a 9-1-1 emergency is at hand a few simple steps can help save a life.
look
Does Anyone Appear Disoriented
listen
Ask if Anyone Feels Sick
leave
Evacuate Immediately & Call 9-1-1 for Emergency Medical Assistance Lee V. Rosato, NREMT-P, CCEMT-P Pocono Mountain Regional EMS EMS Deputy Chief Advanced Life Support Coordinator
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Getting on the school bus •
Make sure children arrive 10 minutes prio Parents should NEVER try to catch a • When waiting for the bus, instruct c • Keep children away from the stree Make sure your child is mindful of • Children should stay 10 feet awa • Instruct children to wait until the
Behavior on the bus •
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Please share with your child th Children should never put t • Keep aisles clear -- book • Children should wait for • Children may only brin
Getting off the schoo •
If your child must cro until they can tu
or to the arrival of the bus. a bus if their child misses the bus. Instead, please drive your child directly to school to ensure his/her safety. children to stay away from traffic and avoid roughhousing or other behavior. et or road as the school bus approaches f the Bus Danger Zone – the area around a bus where children are in most danger. ay from the bus and never go behind it. bus has stopped completely and the bus driver signals that it’s OK to approach the bus before stepping onto the roadway.
hat loud talking or other noise can distract the bus driver. It is required that students respect those around them and the requests of the bus driver. their head, arms or hands out of the window, nor should they throw anything out of the windows ks or bags are tripping hazards and can block the exit in an emergency. r the bus to stop completely before getting up from their seat. ng items onto the bus that will fit in their laps. If large projects need to be brought to school, please arrange alternative transportation for your child.
ol bus
oss the street in front of a bus, make sure they know to walk at least 10 feet ahead of the bus along the side of the road, turn around and see the driver signal to them that it is OK to cross the street. • Children should always make sure bus drivers can see them. • When the driver signals, children may walk across the road, keeping an eye out for sudden traffic changes.
Crossing the street
• Children should always stop at the curb or the edge of the road and look left, then right, and then left again before crossing. • They should continue looking in this manner until they are safely across the street. • If students’ vision is blocked by a parked car or other obstacle, they should move out to where drivers can see them and they can see other vehicles -- then stop, and look left-right-left again.
What can parents can do to help ensure children’s safety
• Reinforce safety awareness among children by reviewing bus safety procedures with them. • Arrive at the bus stop 10 minutes prior to the arrival of the bus. Please, NEVER, follow or try to flag down a bus if you are late in dropping off your child at the bus stop. If your child gets ut of the car and tries to “catch” a bus, it puts them in grave danger. • The best response would be to continue to drive your child directly to school. • Continue to update your emergency contact information with the school that your child attends. • Work with other Safety Team Members such as the school nurse for medical concerns, school bus driver for bus safety concerns, etc. • When you see a school bus, be mindful of children getting on or off of the bus. • When you meet a school bus with red signal lights flashing and stop arm extended, you MUST STOP. • DO NOT MOVE until all the children are safely loaded or are 10 feet off of the road and have reached a place of safety.
RULES
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SEPT EMBE 15 R Co o lbau gh T
On Scene...
Keeping Regional’s resources at the ready, PMREMS professionals attend Pocono Mountain High School home football games througout the season.
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