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CONTENTS
EMS PRO PHOTOS FROM THE FIELD A Seat Belt Could Have Saved A Life .............................................. 04 News & Technology CDC Cost Finished .......................................................................... 08 Halls Receives Scholarship ............................................................. 09 Cypress Creek Dedicates New Vehicles ...........................................10 OGSI Introduces New Remote Monitoring .....................................10 HHS Propose Changes in Privacy Rule ............................................11 Special Feature Personal Wellness, Mind, Body, Spirit ............................................14 Feature - Immobilization B.E.A.R. Device Handy and User-friendly ........................................18 EP+R Raises the Bar With Their Improved Traction Device ............20 Feature Point-of-Care Testing Advances Save Lives.....................................22 NEMSPA Advisory Circular Rewrite ................................................24 Cardiac Care....................................................................................26 AHA Makes Discoveries in Study of the Heart ................................28 Products Panasonic Toughbook 53® ..............................................................30 Ziamatic’s Strapless “D” Cylinder Bracket ......................................31
PUBLISHER Jenae Rubin jenae@emspromag.com PRESIDENT/MANAGING EDITOR Ron Whitney ron@emspromag.com CHIEF FINANCIAL OFFICER Clay Branum clay@emspromag.com VICE PRESIDENT/CAO Rick Weatherford rick@emspromag.com CREATIVE & PRODUCTION DIRECTOR Dana Maxfield dmaxfield@emspromag.com COPY EDITOR Ashley Dempsey ashley@emspromag.com STAFF PHOTOGRAPHER Sarah Kritner sarah@emspromag.com CIRCULATION DIRECTOR Pam Fulmer pam@emspromag.com
Gratitude A Simple Message of Thanksgiving ................................................32
PRESIDENT Ron Whitney Executive and Advertising Offices 2080 Valleydale Road, Suite 10, Hoover, AL 35244 toll free: 877.768.5550 fax: 205.978.2925 www.emspromag.com EMS PRO™ is published twelve times a year and mailed out by Oak Mountain Media, LLC, 2080 Valleydale Road, Suite 10, Hoover, Alabama 35244. EMS PRO™ is distributed free to qualified subscribers. Non-qualified subscription rates are $57.00 per year in the U.S. and Canada and $84.00 per year for foreign subscribers (surface mail). U.S. Postage paid at Birmingham, Alabama and additional mailing offices. EMS PRO™ is distributed to qualified readers in the Emergency Medical Services industry. Publisher is not liable for all content (including editorial and illustrations provided by advertisers) of advertisements published and does not accept responsibility for any claims made against the publisher. It is the advertiser’s or agency’s responsibility to obtain appropriate releases on any item or individuals pictured in an advertisement. Reproduction of this magazine in whole or in part is prohibited without prior written permission from the publisher.
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POSTMASTER: Send address changes to: Oak Mountain Media, 2080 Valleydale Road, Suite 10, Hoover, AL 35244 PRINTED IN THE USA
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PHOTOS FROM THE FIELD GRATITUDE
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A Seat Belt Could Have Saved A Life by Barry McRoy, Chief, Colleton County S.C. Fire Rescue
On Sunday, June 5th, one person died and eight others were injured, in a two vehicle accident on I-95 at the 63 mile marker in Colleton County, South Carolina. The accident was reported at 10:13 p.m.. Witnesses stated both vehicles were traveling northbound in the left (fast) lane. A Toyota pickup truck had just cleared the bridge when it rapidly approached a slow moving or nearly stopped Dodge van. The pickup truck struck the rear of the van causing heavy damage to both vehicles. The van was knocked out of the highway into the wooded median where it struck several trees. A 69-yearold, unrestrained passenger in the pickup truck was killed on impact. The 69-year-old male driver received multiple traumatic injuries. The van was carrying seven adult Haitians, only one
of whom spoke English. All received multiple traumatic injuries; four of the seven were in critical condition at the scene. The northbound lanes of the Interstate were completely blocked by the pickup truck, debris and a gasoline spill. Very little information was provided to 9-1-1 on the initial call. An off duty FirefighterParamedic arrived from his home approximately 4 minutes after the dispatch. He advised of multiple critical patients and requested additional ambulances along with two medical helicopters. The first Fire-Rescue units arrived several minutes later. One patient went into respiratory arrest shortly after units arrived. A second suffered a head injury requiring FirefighterParamedics to perform RSI to secure her airway. A third patient
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suffered multiple fractures with a head injury. The remainder of the patients suffered multiple traumatic injuries. Only two suffered non-life threatening injuries. Omniflight responded with two helicopters, one from Charleston and the second from the Savannah (GA) area. Lifenet’s
from the scene at MUSC and then flew back to CMC to transport a second patient. Lifenet 3 responded to the ED to fly one patient to MUSC. Fire-Rescue Medic 9 transported one critical patient from the ED to MUSC and a private ambulance service transported one patient
helicopters were tied up with other responses, but dispatched a third helicopter. It was cancelled due to the extended ETA and the patient was ground transported to Colleton Medical Center. Five Fire-Rescue ambulances responded and one Dorchester County EMS unit was requested as mutual aid. Dorchester County transport two patients to CMC.
with serious injuries. The Coroner’s Office transported the fatality. The SC Highway Patrol is investigating the crash. MAIT was to investigate the scene Monday. I-95 northbound was completely blocked for over an hour, with traffic rerouted to Jefferies Highway (US Highway 15). It was opened to one lane for another hour, before the scene was cleared of vehicles and debris. A SCDOT sand truck spread sand over the accident site to absorb a large quantity of gasoline that was expelled onto the roadway. u
After arriving at the Emergency Department, the patients were treated and stabilized. Two were later flown from the ED in critical condition to the Trauma Center at MUSC. One helicopter dropped off its patient 06
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study was not configured to develop an explanation for the variation in state costs. “Deaths from motor vehicle crashes are preventable,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “Seat belts, graduated driver’s license programs, child safety seats, and helmet use save lives and reduce health care costs,” Frieden explained.
CDC Cost Finished Motor vehicle crashrelated deaths in the United States resulted in an estimated $41 billion in medical and work loss costs in a year, according to state-based estimates released today by the Centers for Disease Control and Prevention (CDC). Half of this cost ($20.4 billion) was in 10 states, the report says.
CDC’s data analysis, show below, found the 10 states with the highest medical and work loss costs. These cost findings are based on 2005 data, which is the most recent year for which comprehensive data on costs associated with crash deaths is available. The
State
Work Lost Cost
California
$4.16 Billion
Texas Florida Georgia Pennsylvania North Carolina New York Illinois Ohio Tennessee
$3.50 Billion $3.16 Billion $1.55 Billion $1.52 Billion $1.50 Billion $1.33 Billion $1.32 Billion $1.23 Billion $1.15 Billion
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CDC is releasing new fact sheets highlighting state-based costs of crash deaths, to coincide with the May 11 launch of the Decade of Action for Road Safety. The United Nations General Assembly has proclaimed 2011 to 2020 the Decade of Action for Road Safety, a period of enhanced focus on protecting lives on the world’s roads. CDC also found the cost related to crash deaths among children and teenagers from birth to 19 years old was nearly $856 million. The highest percentage of costs related to children and teen crash deaths was seen in Vermont (34 percent, $25 million), and the lowest was in Nevada (17 percent, $66 million). Despite the higher percentage in Vermont, its cost is lower due to the much lower total cost of injury.
“It’s tragic to hear that anyone dies on our nation’s roads. But it’s especially so when the person who loses his or her life is a child or teenager,” said Linda Degutis, Dr. P.H., M.S.N., director, National Center for Injury Prevention and Control. “Child passenger safety laws and comprehensive graduated driver licensing laws are proven to protect young lives. We encourage states to strengthen and enforce these laws to help keep more of our young people safe,” she said. To prevent crash-related deaths and reduce medical and work loss costs, CDC’s Injury Center recommends that states consider the following strategies: Primary seat belt laws, which allow motorists to be stopped and cited for not wearing seat belts. Seat belts reduce the risk of death to those riding in the front seat by about half. Strong child passenger safety policies, which require children to be placed in age- and sizeappropriate child safety and booster seats while riding in vehicles. Comprehensive graduated driver licensing (GDL) systems, which are proven to reduce teen crashes. GDL systems help new drivers
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EMS PRO gain experience under lower-risk conditions by granting driving privileges in stages. The most comprehensive GDL systems have been associated with up to 40 percent decreases in
crashes among 16-yearold drivers. Universal motorcycle helmet laws, which require riders of all ages to wear helmets. Helmet use can reduce the risk of death in a motorcycle
crash by more than onethird and reduce the risk of brain injury by 69%. “These preventable costs are a reflection of the terrible suffering of American families whose loved ones are
killed or injured on the roads,” said Norman Mineta, chairman of Make Roads Safe North America and the longest serving Secretary of Transportation in U.S. history. u
the public hears of the good work done by the emergency and critical care transport community, in addition to ensuring the transparency that the public demands and deserves. Earlier this month, Chris completed the first year of MTLI coursework. MTLI participants develop leadership and management skills specific to medical transport through formal education programs emphasizing both management theory and its direct practical application.
Halls Receives Scholarship MedEvac Foundation International has bestowed its 3rd annual Medical Transport Leadership Institute Scholarship to Mr. Christopher Hall, BS, FP-C, NREMT-P of PHI Air Medical Services. The 2-year scholarship is awarded based on active involvement, industry achievement level and commitment to critical care transport services, and is made possible through a gener-
ous donation from Metro Aviation, Inc. As a novice EMT Chris became interested in the air medical field while working in a medical tent in a line camp on a U.S. Forest Service Complex fire in Idaho. Now having worked for over 15 years in his chosen field, providing education informally and formally, he happily found himself in the position of Coordinator Clinical
Education for PHI. By stretching beyond the traditional role of educator into non-traditional role of business development, industry relations, and government affairs, he has been allowed to fulfill the desire to promote emergency and critical care transport. Chris’s future goal is to work toward a public information position to advocate for engaging the media to ensure that
“I am very grateful for the opportunity to attend MTLI. This was an exceptional and exciting opportunity to network with Air Medical professionals from all fields, and to learn from industry leaders who believe in contributing to educational growth and professional success,” said Chris. u
2012 MTLI Scholarship will open October 2011 and will be available online at www.medevacfoundation.org. EMSPROMag.com
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Cypress Creek Dedicates New Vehicles
On June 9, Northwest Houston residents joined Cypress Creek EMS for a dedication ceremony, welcoming three new emergency trucks before they to take to the roadways. “It’s a good time for the community to come out and see the vehicles that we’re using and where all their tax dollars and donations are going,” said paramedic Graig Temple, who spearheaded the event. Members of the community braved the heat for the celebration as it took place in the CCEMS parking lot, 7111 Five
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Forks. As well as hearing from the executive director of Cypress Creek EMS Brad England, attendees were treated to a speech by Harris County Judge Kent Adams. “It’s a privilege to be here and actually congratulate this great group,” Kent said. Pastor Jay Van Hooser then led the community in prayer. He placed a blessing on the vehicles and all those who will enter the trucks in the future. At the end of the festivities, residents convened indoors for desserts, refreshments and fun. u
OGSI Introduces New Remote Monitoring Oxygen Generating Systems Intl. (OGSI) of North Tonawanda, NY announced a new remote web-based monitoring option for its Oxygen Generators. OGSI is the first manufacturer in the industry to offer this option on small and fractional tonnage size oxygen plants. Customers taking advantage of this will realize reduced maintenance and repair costs with the added benefit of factory support.
with a system. This option allows you to view the actual touch screen in real time anywhere in the world that there is an internet connection. OGSI can remotely reprogram or upgrade your touch screen or control program from our factory without the need of a service call. Software to view and monitor the customer machine’s operation from any internet connected PC is also provided.
This option allows the service and engineering staff at OGSI to communicate directly with the control system of a machine at its point of use. This communication allows for troubleshooting and diagnosis of potential or existing problems
Your OGSI system will provide you with years of dependable performance. It is perfect for remote locations and is used in conjunction with OGSI’s Touch Screen panel providing the highest level of service and capability available. u
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HHS Propose Changes in Privacy Rule A Notice of Proposed Rulemaking concerning the accounting of disclosures requirement under the Health Insurance Portability and Accountability (HIPAA) Act Privacy Rule, is available for public comment. The proposed rule would give people the right to get a report on who has electronically accessed their protected health information. The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) is proposing changes to Privacy Rule, pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act. “This proposed rule represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard private health information,” said OCR Director Georgina Verdugo. “We need to protect peoples’ rights so that they know how their health information has been used or disclosed,” he said.
People would obtain this information by requesting an access report, which would document the particular persons who electronically accessed and viewed their protected health information. Although covered entities are currently required by the HIPAA Security Rule to track access to electronic protected health information, they are not required to share this information with people. The proposed rule requires an accounting of more detailed information for certain disclosures that are most likely to affect a person’s rights or interests. The proposed changes to the accounting requirements provide information of value to individuals while placing a reasonable burden on covered entities and business associates. People who believe a covered entity has violated their (or someone else’s) health information privacy rights or committed another violation of the HIPAA Privacy or Security Rule, may file a complaint with OCR. u
People may now read the proposed rule at: http://www.federalregister.gov/ and submit comments to http://www.regulations.gov/ EMSPROMag.com
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Scholarship Winners Congratulations to the MTLI Scholarship winners Christopher Hall and Allen Wolfe! Earlier this month Chris completed the first year of MTLI coursework. Allen returned to MTLI and earned the designation Certified Medical Transport Education, CMTE. MedEvac Foundation awards an annual scholarship to the Medical Transport Leadership Institute (MTLI). This is made possible through
a donation from Metro Aviation, Inc. “I am very grateful for the opportunity to attend MTLI. This was an exceptional and exciting opportunity to network with Air Medical professionals from all fields, and to learn from industry leaders who believe in contributing to educational growth and professional success,” Christopher Hall BS, FPC, NREMT-P.
Congratulations to the 2011 MTLI Scholarship winner, Chris Hall. In addition to his job duties providing both internal and external education, Chris is also actively involved in government affairs and industry relations. While Chris believes safety is the highest priority in air medical transport, he also feels public education and outreach to both the general public as well as our elected representatives are incredibly important as well. “This course has taken me out of my comfort zone and introduced me to concepts and information I will use in development of my staff in my current position and as well as corporate committees,” Allen Wolfe Jr., RN, MSN, CFRN, CCRN, CMTE. Congratulations to Allen Wolfe for earning the designation CMTE. Al-
len was awarded a 2-year scholarship to Medical Transport Leadership Institute (MTLI) in 2010. As a role model for critical care transport nursing Wolfe has been instrumental in training nurses, and medics for extended scope-ofpractice. He is an active participant in the community and a respected international lecturer. MTLI participants develop leadership and management skills specific to medical transport through formal education programs emphasizing both management theory and its direct practical application. The scholarship is awarded based on active involvement, industry achievement level and commitment to critical care transport services. The 2012 MTLI Scholarship will open October 2011 and will be available online at www.medevacfoundation.org. u
Life Core Technologies Announces New CEO Life Core Technologies, a medical device company that has developed a series of products that improve outcomes by preventing brain damage through a novel approach to therapeutic hypothermia, recently announced Michael Burke as president and chief executive officer. 12
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Burke will be joining the existing executive team and founders: Dr. Aqeel Sandhu, M.D., current president and CEO, Brian Seitz, chief compliance officer, and Scott Raybuck, chief operating officer. Dr. Sandhu will assume the position of chairman of the board. “The addition of Mike
to our executive team adds a strong individual with a proven track record of success. Mike brings an impressive variety of knowledge and expertise in helping launch new technologies through strategic sales and marketing efforts. It is proven that he has the capabilities to guide
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EMS PRO us into a market that is one of the most important topics in medicine today,” founder Dr. Sandhu, commented. Burke, the former president and CEO of Imalux, Inc., has over 35 years of experience in the health care industry. He is skilled in integrating his executive leadership skills having a diverse background growing both start-up and Fortune 100 companies. Burke’s career includes 10 years in domestic and international management positions at Scientific Products, American Hospital Supply Corporation (now Cardinal Health). At Picker International (now Philips
Medical Systems) he was one of the founders of the Health Care Products Division, which later became Source One. In 1995 he joined a private company, AccuMed International, and was key in taking AccuMed public. In 1999 Burke arranged to acquire the microbiology assets of AccuMed International, founding TREK Diagnostics Systems. In 2006 he successfully arranged a high value exit to Magellan Bioscience. Mr. Burke currently sits on a number of boards providing advice to middle market companies,
a founding board member of Medical Growth Fund, LLC and is treasurer of the North East Ohio’s Chapter of the Leukemia Lymphoma Society serving on its executive board. Burke is a member of the Leadership Cleveland Class of 2010. “I am extremely excited to join the Life Core Technologies team. Following my time at Imalux, I was eager to get started on a new venture and found Life Core Technologies to be the perfect opportunity.
Each day, I continue to be impressed with the innovative product Life Core has developed, the diligence and dedication of the Life Core team, as well as the strong market need for our product,” Burke stated. ◆
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FEATURE
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Personal Wellness Mind, Body, Spirit by Pamela Aloia and Michael Aloia
In the previous Personal Wellness article installment, we introduced the concept of mind development and care as the first of three articles dedicated to the mindbody-spirit balance and interconnectivity of our overall wellness health. The importance of recognizing the mind’s potential, challenging the mind‘s limits and nurturing the mind’s evolvement was covered. In this article, the health of the body will be our focus of discussion. We are all aware that the benefits of a healthy lifestyle are plentiful and proven to provide a vibrant and fulfilling life. Enough information has been presented to the public’s attention over the last several decades that it seems improbable that society would still choose to risk their personal well-being with choices that would be less than advantageous. Our media continues to flood our senses with new health products to try and exercise methods to integrate into our
daily or weekly routine. The quests for a pleasing physique or feeling good, alert, and fit, are all incentives that keep some of us investigating and considering new ways of healthy living. For some of us, we become overwhelmed and unmotivated with where to start and flounder our way through, or at worst, choose to do nothing. Our choices, our bodies, the way our bodies feel and the way we feel about our bodies, are a direct reflection of the care, or lack thereof, that we provide them on a regular basis. Some liken the body to a temple, for it is the house in which each of us resides for our lifetime. How we choose to live that lifetime depends on the choices made throughout that duration. These choices are made on a daily basis. The body makes living possible in the present physical world. Without it, all activity - exercise and sports, attending family gatherings, going
to work, playing with our children, walking in the park with a pet or enjoying a sunrise - would not be possible. The body requires attention, maintenance and good old fashion tender, love and care. We don’t need to be a doctor or scientist, sports hero or fitness guru to make a healthy lifestyle a reality. What is required, however, is the selfdiscipline, responsibility and consistency to care for our bodies. Decades ago the adage ‘garbage in, garbage out’ became the means of describing a nation that was edging towards obesity and malnutrition. It demonstrated that convenience can lead to carelessness - where too much opportunity can lead to overindulgence. This adage still holds true today. Ironically, the media has played a dual role in the education and confusion of our world’s ability to get the facts straight and make smart choices. On one hand we preach the benefits of
health, fitness, a balanced diet and nutrition. Yet, on the other, mass campaigns are launched to promote and propagate fast food, fad diets, substance dependency and quick-fix weight solutions. These ads have only served to create more questions with unclear answers. In the most basic of terms, what we put into our bodies with regard to high nutrition or low nutrition, substance or care, is truly what we reap. If our diet is unable to sustain the necessary nutritional and energy levels to perform our daily tasks then the body will most certainly not withstand moments of high intensity and durations of employed stress related to activity and/or profession, with any amount of grace and composure. Adequate fuel equals adequate results. Optimal fuel produces optimal results. The better the in, most definitely, the better the out. We can all imagine, by our own standards, a
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perfect world - one where illness, disease and aliments are non-existent. A life that is healthy, happy, prosperous and peaceful. In essence, this sort of reality does exist and it is achievable. This reality, however, needs to be selected and chosen, and then, worked towards diligently. It is a life choice. Healthy body choices are not found in a box, a pill or a television ad, but rather in time, attention and care. If your lifestyle already involves and revolves around making smart and healthy choices, then you are aware of the initial effort and regular maintenance it takes to be successful. Yet you also already realize how these choices increase the quality of life with beneficial results on not only your physical health, but your emotional and mental outlook as well. For those who have yet to make the leap to a better body tomorrow, there is no time like the present. Consider for a moment your daily routine. Do you find what would be considered common, daily activity such as getting dressed, tying your shoes or walking a flight of stairs, to be a bit of a struggle? Does carrying a litter, transporting emergency gear or getting to the ground and back up again to aid 16
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a victim feel cumbersome? If so and barring no physical implications, you may need to re-evaluate your fitness level and your current health status. This is not to say you may be unhealthy, it just demonstrates a need for reassessment and possible improvement. Long and grueling shifts packed with countless calls can range from a courteous shuttle service from residence to local hospital to a multiple victim calamity. Time spent during a routine series of shifts can be depleting. Energy levels will most certainly decrease without proper rest and replenishing. Time in is time spent regardless of the intensity level of the activity. Our bodies crave a balance of proper nutrition, adequate exercise and sufficient rest to meet the demands of the day. Once we learn how to meet the body’s needs, meeting the needs of the day becomes a whole lot easier. Drastic changes to our routine can prove difficult to adhere to and potentially shock our system. Making small changes in our daily meal plan/choices and regular fitness regimen is a great place to start. Exchanging a bag of chips for pretzels decreases our fat intake. Swapping out the pretzels for a piece of fruit provides us more
carbohydrates for energy. Ingesting a handful of almonds instead of a candy bar provides a healthy dose of good fat and protein to boot. Adding small increments of cardiovascular exercise and resistance training will help burn additional unwanted fats and build muscle tone while improving both our strength and appearance. When we tailor exercise with a sensible and balanced diet – ample proportional amounts of carbohydrates, fats and proteins to fuel and repair muscles - along with proper hydration with water - our bodies respond with greater endurance and flexibility, and our mental self perceptions shift as well. With the addition of ample rest and sleep, this balanced combination results in stable and consistent performance – one void of the extreme highs and lows. While it may take some trial and error in the beginning to find out what combination works best for us, making the first step of exploration is key. Work shifts can swing from the intense to the routine, on any given day and at any given moment. Just because our work shifts may swing from the highs and lows does not mean that the body needs to follow the same path. The body
should be up to the task. Through nurturing and treating our bodies with care and awareness, our bodies will learn what feels good and what doesn’t and what it responds to versus what it doesn’t. With such a wealth of and easy access to the health, fitness and wellness industries, we all are somewhat or innately familiar with the “shoulds” of a healthy lifestyle. If we turn the “shoulds” into “coulds,” they become opportunities and choices rather than obligations. With the choice of and awareness on an overall increased health wellness mindset, we can shape the success rate of all our physical goals. u Authors
Pamela Aloia is an instructor and practitioner of alternate methods of self-healing, including meditation and Reiki. She conducts regular workshops to assist in changing individual lives through topics such as leadership and energy awareness. Pamela currently works in the hospice and bereavement fields, and has authored the book, 52 Pick Me Up and has co-authored Rescuer Mindset. For more information visit www.solangel.com. Michael Aloia is a martial arts instructor and certified personal trainer and nutritionist with schools in Southeastern Pennsylvania. Michael conducts workshops on leadership, fitness and personal protection. He is the author of several books including How Aikido Can Change the World, Essential Basics of Self Defense, Converging of Energies and coauthor of Rescuer Mindset. For more information visit www.asahidojo.com or www. rescuermindset.com.
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B.E.A.R. Device Handy and User-friendly By Tracy Burns
Products for EMS have traditionally come from the adaptation of an existing product or idea. While it serves us well it, it leads to products that serve us as well as they should. For economic reasons a lot of these products stray from their original ideas to meet dual-service roles. However, the Bariatric Equalizing Abdominal Restraint device, or B.E.A.R. device, doesn’t fit any of these. It was developed by a paramedic for paramedics while staying economically friendly. The device is well built and durable. It is easily stored and lightweight. Cleaning is simple and takes no time at all. The B.E.A.R. is easy to use and training minimal. In a time of shrinking budgets and a fight for funding, the affordability of the device compared to one injury and less manpower for completing one call allows the unit to pay for itself. The idea of the B.E.A.R. device is to comfortably secure the central girth of our bariatric patients without harm to them or EMS providers. By securing the abdomen, the weight is centered
to the transport device, minimizing tip and roll. Caregivers in all areas have done this in the past in many ways with varying success, many which resulted in causing harm or discomfort. The B.E.A.R. provides the success of these many ways in a uniform system. The device consists of the large canvas section with abdominal straps to secure the patient. It secures to the cot or transport device with adjustable straps. When tested, the device came in a carrier that was stored nearby. This caused issues of availability in emergencies and forgetting it on non-emergent scenes. This has been remedied by mounting it to the cot with a storage case for leaving it in place. Unlike branded devices, the B.E.A.R. was built to be universal. It requires no kits or extra straps for use on any transport device. While designed to be used in EMS, it has been given good reviews from radiology and emergency departments as well. The biggest and best feedback came from bariatric transport units. u
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Emergency Products + Research Raises The Bar With Their New Improved Traction Device Reinventing the wheel is no easy task if it has yet to be accomplished. Improving the wheel takes place each and every day, and that is what the people at Emergency Products and Research have accomplished with the Improved Traction Device, or ITD. An old concept was taken and drastically improved by the engineers in the company to make a more effective user and patient-friendly traction leg splint. The process started by going from top to bottom. The old concept was researched from the groin area all the way down to the ankle to see what could be improved to come up with the idea of the ITD. The groin strap is the receptacle that holds the pole, 20
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then to the thigh, on to the knee which comes attached to the pole and finally the ankle hitch, which is padded, and offers disconnects for placement without ever having to lift the heel. But application of this piece of equipment doesn’t work in such an order and the results are a mere process of “straightening” it out. The padded groin strap is positioned first, next is the padded ankle strap. Now, during this, upon extension of the ITD carbon fiber pole, the applicator leaves the pole sized long enough for one segment to go past the foot and just above the thigh. The secret to the success of not moving the ankle is to have the pole longer rather than shorter on the leg to
which the device is being applied. After this, it’s as simple as painting by numbers. The yellow loop goes on the end, then the knee strap, followed by the red strap. After the applicator uses the plastic pull ring, the leg will straighten. It is even designed to be easily useable with gloved hands. With the traction applied attach the splint, and then thigh strap, followed by the shin strap and the patient is ready to be placed on the backboard. The ITD is both stronger and lighter than the old concepts of this same product. Also, due to being made of carbon fiber and traction point polymer, there is no interference with X-ray, CT, or MRI machines. The patient can physically
go from the scene of an accident, all the way to the ER, and have an image taken of the damage to the bones without the ankle ever moving out of place. The typical human always has an extra part when putting something together or looses something when packing it up. The ITD prevents the confusion of second guessing if you collected all your pieces. The storage bag makes it incredibly easy to return their contents to their home with reference numbers to match your pieces to their proper home. So those out there who need streamlined success in patient transportation and immobilization, the Improved Traction Device could make your life easier. u
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Point-of-Care Testing Advances Save Lives ing technologies for point-of-care testing. These instruments combine multiple analytical functions into self-contained, portable devices that can be used by non-specialists to detect and diagnose disease, and can enable the selection of optimal therapies through patient screening and monitoring of a patient’s response to a chosen treatment.
In the earliest days of medicine, health care was similar to point-ofcare in that it was delivered in the patient’s home through physician house visits.
The emphasis of care is shifting toward prevention and early detection of disease, as well as management of multiple chronic conditions. Pointof-care testing gives immediate results in non-laboratory settings to support more patient-centered approaches to healthcare delivery.
Sensor technologies enable the rapid analysis of blood samples for several critical care assays, including blood chemistry, electrolytes, blood gases and hematology. Biosensors are used clinically for toxicology and drug screens, measurement of blood cells and blood coagulations, bedside diagnosis of heart disease through detection of cardiac markers in the blood, and glucose self-testing. Current developments in point-of-care testing are addressing the challenges of diagnosis and treatment of cancer, stroke, and cardiac patients. Circulating tumor cells (CTCs) that spread, or metastasize, from a primary malignant tumor to distant organs are responsible for 90% of cancer-related deaths, a number that exceeds 500,000 every year in the United States alone. Early detection of cancer might be possible through capture and analysis of CTCs. In addition, the ability to capture and analyze CTCs in peripheral blood may be used in the development of therapeutic strategies that can be tailored to the individual patient and monitor an individual’s responses to cancer therapies.
As medical discoveries were made and new technologies developed, care then shifted to specialized hos-
The National Institutes of Health, supports the development of sensor, microsystem and low-cost imag-
Researchers supported by NIBIB (National Institute of Biomedical Imaging and Bioengineering) have
Point-of-care testing allows patient diagnoses in the physician’s office, an ambulance, the home, the field or in the hospital. The results of care are timely, and allow rapid treatment to the patient. Empowering clinicians to make decisions at the “point-of-care” has the potential to significantly impact health care delivery and to address the challenges of health disparities. The success of a potential shift from curative medicine, to predictive, personalized and preemptive medicine could rely on the development of portable diagnostic and monitoring devices for point-of-care testing. Yesterday
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pitals with an emphasis on curative medicine. Large centralized laboratories were established, with cost-savings realized through the development of automated systems for analysis of patient samples. Point-of-care devices were used on a limited basis in the hospital for rapid analysis in intensive care units and for simple home testing, such as with pregnancy test kits. Today
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EMS PRO developed a unique microfluidic device capable of efficient separation of CTCs from whole blood. This technology has broad implications both for advancing cancer biology research and for the clinical management of cancer, including detection, diagnosis and monitoring. Tomorrow With the development of miniaturized devices and wireless communication, the way in which doctors care for patients will change dramatically and the role patients take in their own health care will increase. Health care will become more personalized through tailoring of interventions to individual patients. The next decade will bring a new realm of precision and efficiency to the way information is transmitted and interpreted and thus the way medicine is practiced. In the future, clinicians may be able to improve the regulation of diet in infants with inborn errors of metabolism through bedside monitoring.
widely available, particularly in remote or rural communities and small hospitals that do not have ready access to these technologies.
could provide both diagnosis and treatment of cervical cancer at the same time. u
A new method using an optical probe for cervical cancer detection and treatment could significantly lower the mortality rate worldwide. Combining a small optical imaging device with a treatment modality
Currently, management of such diseases requires complex testing in a hospital setting. However, researchers are developing a chemical sensor, using a small sample of blood from a finger stick, which changes color in response to metabolic irregularities. When such abnormalities are found, the diet of the infant can be adjusted immediately to prevent adverse effects such as mental retardation. Low-cost diagnostic imaging devices can be used at the pointof-patient care for disadvantaged and under-served populations in the U.S. as well as in the developing world. The development of lowcost imaging devices could make affordable diagnostic imaging more EMSPROMag.com
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FEATURE
NEMSPA Advisory Circular Rewrite By Rex J. Alexander
In answer to the many questions regarding the FAA’s new heliport advisory circular rewrite efforts I would like to offer up the views of the National EMS Pilots Association (NEMSPA). Given the huge impact and importance this particular advisory circular has on the entire 24
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helicopter industry and our community at every level and the fact that a rewrite of this magnitude does not occur very often, the last being in 2004, NEMSPA is reviewing it very carefully. With the new adoption of the FAA Heliport A/C as a requirement by the
NFPA for fire code compliance this past January, the FAA A/C is now mandatory for all new and upgraded heliports in most areas. While the FAA A/C is advisory only in the eyes of the FAA, it is now 100% regulatory for the obtaining of building and fire permits. Hence the
importance to assure this A/C is well-founded on the needs of the industry for safe, cost-effective and mission-responsive heliports. NEMSPA, along with every other facet of the helicopter community will be putting together comments over the next few weeks to share with the rest of industry and the FAA. This will encompass what our
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EMS PRO meeting in Alexandria, VA July 12th and 13th. This meeting was held at HAI’s headquarters office where representatives from the whole industry sat down with the FAA’s airports division, along with several other liaisons from other FAA departments, to discuss the newly rewritten heliport advisory circular. This task force reviewed the new advisory circular’s merits, justifications and any concerns that needed to be addressed prior to this document progressing further into the system.
the entire industry and has no unintended consequences which could
be crippling to the helicopter community. ◆
Rex Alexander has over 25 years of helicopter experience with 17 in the HEMS industry. He is an experienced Regional Manager, Base Manager, Safety Manager and Line Pilot in the HEMS industry. He wears many industry hats to include President of the National EMS Pilots Association, past President of the Indiana Association of Air Medical Services, HAI heliport committee member, HAI air medical services committee member, NFPA418 heliport guide committee member and JHSIT infrastructure working group committee member. He is an alumnus of Parks College of St. Louis University, is a former member of the U.S. Army and also owns and operates RJ Alexander Consulting, L.L.C.
The FAA’s Airport’s Division has posted a draft of the new A/C on the FAA web site just a little over a week ago for review and has asked that industry review the new advisory circular and make comments back to them by the end of July.
opinions are and any concerns that we may have with the myriad of new changes that have been proposed in this new heliport advisory circular rewrite effort by the airports division of the FAA and their consultants. My understanding is that the Helicopter Association International (HAI), along with the FAA, has co-hosted a two-day
It is our hope that all parties involved from industry and the multiple disciplines within the FAA will work together to insure that the end product is a well written and fully vetted industry/FAA document which represents the best interests of all involved. NEMSPA will work diligently with all groups to insure that this advisory circular is a positive for
Link to draft A/C: http://www.faa.gov/airports/resources/draft_advisory_circulars/ EMSPROMag.com
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FEATURE
the life expectancy of the average American increased by 6.6 years; 4.7 years—over 70%—of the increase is due to reductions in deaths from cardiovascular disease. We can attribute this remarkable improvement, in large part, to NIH (National Institutes of Health) research.
Cardiac Care YESTERDAY In the 1960s, it was not uncommon for Americans to die of heart attacks in their 50s or 60s. The effects of smoking, cholesterol, high blood pressure and obesity on the development of heart disease were unknown. Following a heart attack there were limited treatments for the damage suffered by the heart. Those patients who did not die from their heart attack remained severely debilitated. The U.S. death rate for coronary heart disease rose steadily during the first half of the 20th 26
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century, reaching a peak in 1968. Had this rate of coronary heart death continued to rise, today, more than 1.7 million lives each year would be lost to heart disease. TODAY Fortunately, the toll is much less — there are about 425,000 deaths each year from heart disease. In addition, the death rate from stroke, the third most common cause of death, has declined by about 75 percent since the early 1960s. The gain in longevity has been remarkable! Between 1970 and 2005,
The concept of risk factors for heart disease— which include high blood pressure, elevated serum cholesterol, smoking, obesity, diabetes and physical inactivity—is well established. Findings from the Framingham Heart Study and subsequent studies have been translated into messages for health care professionals, patients and the public, and have guided prevention and treatment for many years. Public health campaigns are helping people control their risk factors. For example, The Heart Truth, an NIH-sponsored national awareness campaign about women and heart disease, provides tools to help women reduce their risks of heart disease (http://www.nhlbi.nih. gov/educational/hearttruth/). Advanced technologies are dramatically improving diagnosis and treatment. For example, if a heart attack is detected early, procedures to open blocked blood vessels can
be performed to stop the heart attack before the heart muscle is severely damaged. In addition, implantable cardiac defibrillators significantly reduce sudden cardiac death in those who survive a heart attack but sustain extensive heart muscle damage. Following angioplasty to widen a blocked section of an artery of the heart, the artery often re-clogs even when a small mesh stent is inserted to hold it open. NIH scientists were instrumental in the development of a stent embedded with a drug that is slowly released and inhibits artery-closing scar formation. Although careful follow-up and anti-clotting medications are required, use of this drug-device combination has been shown to decrease the need for repeated procedures on the same blockage. TOMORROW Consortia of individual studies that collectively include tens of thousands of participants are helping scientists identify genetic markers of disease risk. Data from these consortia are being analyzed to pinpoint genetic variations that predispose to the development of high blood pressure, high cholesterol, diabetes, obesity and heart disease. This knowledge will lead
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EMS PRO to early detection and improved treatments tailored to an individual’s risk profile. The NIH has launched a large clinical trial— Systolic Blood Pressure Intervention Trial (SPRINT)—to test whether intensive lowering of systolic blood pressure to a goal that is lower than the current recommended level will further reduce risk of heart disease and stroke. The NIH-supported Cardiovascular Cell Therapy Research Network is exploring the use of bone marrow stem cells to repair acute or chronic heart damage.
Network researchers are investigating the types of cells suitable for therapy, optimal numbers of cells to use, and methods for cell delivery, and they are testing for improvement in heart muscle function after treatment in patients with heart disease. The NIH supports comparative effectiveness research to assess commonly used therapies to determine which of them provide better patient outcomes so that doctors and patients can choose the most appropriate treatments. One such study, the Catheter Ablation vs. Antiarrhythmic Drug Therapy for Atrial Fibrillation
(CABANA) trial, is comparing outcomes in patients with atrial fibrillation (a common type of heart arrhythmia) who are receiving medication versus outcomes in patients who undergo a procedure to alter the heart’s pathways that initiate or sustain the abnormal heart rhythm. Another clinical study, the Aldosterone Antagonist Therapy for Adults with Heart Failure and Preserved Systolic Function (TOPCAT) trial, is testing whether a drug in common use for other purposes is effective in treating heart failure with preserved systolic function, a type of heart
failure that often results from high blood pressure. Results are expected to help doctors and patients make treatment decisions. The “obesity epidemic” experienced by the United States over the past several decades threatens to reverse important progress against heart disease. The NIH has undertaken several efforts to prevent or reduce obesity in children and young adults, including a set of randomized trials to identify effective approaches in individuals and a large project to evaluate community approaches to reduce obesity in children. u
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FEATURE
AHA Makes Discoveries in Study of the Heart The size and pumping ability of the right side of the heart differs by age, gender and race/ethnicity, according to the first large imaging study of the right ventricle. The study, reported in Circulation: Journal of the American Heart Association, also suggests that understanding the fundamental differences in the right side of the heart gives doctors and researchers a basis for determining what is abnormal. The researchers think that changes in right ventricle size
and function may be a sign of cardiopulmonary disease (conditions that involve both the heart and lungs). “The right ventricle pumps blood to the lungs to pick up oxygen, so all types of lung diseases — chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pulmonary hypertension, and sleep apnea — can affect the right side of the heart,” said Steven Kawut, M.D., M.S., study author. “These results show underlying differences in people without
clinical heart disease and could explain the variability of the right ventricular response in people with cardiopulmonary disease.” The researchers found that the right ventricle is: A. smaller but pumps harder in older adults. B. larger in men than women. C. smaller in AfricanAmericans and larger in Hispanics, compared with Caucasians. D. In most studies on the heart, researchers
have focused on the more-easily-imaged left ventricle, the region of the heart affected by systemic high blood pressure and other common conditions. Some of the relationships between gender, age and race/ethnicity found in the new study are different from what’s known about the left ventricle. For example, the left ventricle increases in mass with age and is larger in African-Americans than Caucasians. “It’s not surprising that the relationships are different, since the right and left ventricles differ in their development in the embryo, their shape, and the area of the body they serve,” said Kawut, associate professor of medicine and epidemiology and director of the pulmonary vascular disease program at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. The researchers examined magnetic resonance images of the right ventricles of 4,204 men and women, average age 61.5, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). MESA is a multicenter research project track-
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EMS PRO ing the development of cardiovascular disease in 6,814 Caucasians, African-Americans, Hispanics and Chinese-Americans who did not have clinicallydiagnosed heart disease at the beginning of the study. Using norms derived from the study, 7.3 percent of the participants would be considered to have right ventricular hypertrophy and 5.9 percent to have dysfunction of the right ventricle. If validated in future research, the norms can help physicians identify patients with ARC125BuildFinal.qxd
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abnormal right ventricle structure or function. “If right ventricle abnormalities are found, it should heighten suspicion for underlying cardiopulmonary disease,” Kawut said. When the right ventricle
loses its pumping ability, blood can back up into other areas of the body, producing congestion (right-sided heart failure). The new findings may help test effectiveness of treatments that could be developed for right ven-
tricle dysfunction, adding “This study is a first step, but we need to see how the right ventricle changes over five to 10 years in these ‘normal’ people, many of whom have COPD, sleep apnea and other common lung problems.” u
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PRODUCTS GRATITUDE
Panasonic Introduces the Toughbook® 53 Panasonic Solutions Company recently announced the Toughbook® 53, a 14” High Definition LED display, semi-rugged notebook. Starting at only 5.6 pounds and delivering up to 10 hours of battery life, the Toughbook® 53 provides mobile professionals, such as inspectors and claims adjusters, a highly reliable and versatile device that delivers high performance computing. The latest in the line of products that created the semi-rugged category, this new notebook is the first Toughbook® device offering optional 4G LTE mobile broadband and a host of other features designed to improve productivity and maximize return on investment. The Toughbook® 53 is powered by a second generation Intel® i5 or i3 processor and maintains the ruggedness Panasonic’s customers have appreciated with the current semi-rugged line. The Toughbook® 53 is designed to survive 30” drops on six faces, features a spill-resistant keyboard and passes nine MIL-STD-810G tests. The Toughbook® 53 is also the first Panasonic notebook to support a high definition LED display and offers an optional 2-800 nit sunlight-viewable 30
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Panasonic CircuLumin™ touchscreen plus an adjustable backlit emissive keyboard, making the Toughbook® 53 the ideal candidate for use in any lighting condition. Panasonic has also increased the size of the touchpad by 25% while giving it multi touch with zoom and scroll capabilities. The Toughbook® 53 also offers USB 3.0, VGA, HDMI and an SDXC slot for even greater flexibility. “The next-generation Toughbook® 53 was designed with a substantial amount of customer input and is the result of Panasonic’s goal to offer the most functional and reliable devices for today’s mobile workforce,” said Kyp Walls, director of product management, Panasonic Solutions Company. “The Toughbook® 53 is ideal for mobile professionals in industries such as insurance, construction and field service, where a standard commercialgrade laptop does not provide sufficient durability. Panasonic has added enhanced features to this new device
providing added flexibility for professionals who spend a significant amount of time working from the road.” The Toughbook® 53 offers a variety of embedded wireless technologies, including Wi-Fi 802.11a/b/g/n, optional Bluetooth® 2.1 and Gobi2000™ 3G mobile broadband technology from Qualcomm. The device is certified on the Sprint and Verizon Wireless 3G networks, allowing workers to stay connected at all times. The 53 is also the first member of the Toughbook® family to offer embedded support for 4G LTE networks, with certifications coming later this year.
The Toughbook® 53 also delivers an optional dual antenna pass-through for in-vehicle use in passenger cars and light-duty trucks, perfect for professionals whose vehicles regularly serve as mobile offices. The Toughbook® 53 also offers options for an integrated webcam, plus fingerprint and SmartCard readers for enhanced security. Enhanced connectivity includes options for FireWire, 56K modem or 2nd LAN port. u For more information, visit: www.toughbook.com or call 888-223-1012
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EMS PRO
Ziamatic Corp. Introduces Strapless “D” Cylinder Bracket Ziamatic Corp. (Zico) presents the QUICRELEASE Strapless Cylinder Bracket, Model QR-D-2. With the selflocking QR-D-2, simply place a “D” cylinder in the bracket and press back through the latch to lock it into place – no straps required. The heavy-duty backspring holds the cylinder snugly against the latch and prevents annoying rattling. To release the cylinder, slightly press it towards the backplate, squeeze the levers to disengage the latch, and allow the
backspring to push the cylinder forward. The QR-D-2 is designed to hold standard aluminum, jumbo aluminum, and steel “D” gas cylinders with or without most regulators and is made with durable, easy to clean stainless steel. The bracket’s latch is plastisol-coated to protect your cylinders. The latch handles are plastisol-coated for easy gripping and operation. The Strapless Cylinder Bracket has three (3)
holes for mounting vertically or horizontally as well as solo or side by side. u For more information, visit: www.ziamatic.com or call 800-711-FIRE
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GRATITUDE
Simple Thanks By: Brandy Nixon
On the Saturday following the first round of tornados that came through Cahaba Heights, Alabama, my 5 year old daughter, Bella, and I were driving around our sweet town assessing the damage. She was so sad. I believe her initial words were “Momma, it used to be so beautiful here.” It was heartbreaking to witness things unfold through her innocent eyes. I gently promised her that it would be beautiful again. I then found myself trying to find a reason in such devastation. Why do things like this happen? That same morning I was talking with a friend who works for an energy company and he encouraged us to find a way to say “Thank you”
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to the people working so diligently to restore power for us. So Bella and I decided to write a simple letter of thanks. She wrote it herself and I made copies of it at my office and
we drove around passing it out to the local linemen. Such a simple gesture but so incredibly appreciated. The workers were lining up to have their picture taken with Bella and the note, and one group of linemen even taped the note to the side of their utility truck. I can remember realizing what a wonderful opportunity this had been to teach my daughter about the spirit of compassion. That’s when it occurred to me that these things happen to remind us that we’re in this together. The way that our community, as well as countless others, has come together in this time of tragedy and uncertainty has been so incredibly inspiring. As difficult as it may be to see positive in these situations, one thing is for sure - there is still beauty all around us. Whether in our ability to come together and help those in need, or in our boundless determination to lift each other up, it’s there. As I sit here and look out my office window at a tree line that is forever changed, I feel so blessed to still have my home and to be alive and my heart goes out to those who were less fortunate. You are all in our prayers. God Bless. u
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“Since switching to online scheduling [EMS Manager], I’ve reduced my hours in scheduling preparation from two days to less than four hours. If time is money then online scheduling will give you an instant return on your investment.” Nelson Pedro, Operations Coordinator LifePACT Critical Care Transport Team | Rhode Island Hospital-Hasbro Children’s Hospital
Online Scheduling – Workforce Management.
To try our FREE online demo visit www.emsmanager.net or call 888-749-5550
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