PULSE Magazine | June/July 2019 Issue

PULSE Magazine is the interactive monthly news magazine of Austin-Travis County EMS. Click, open, read, share, enjoy!

P U L S E June/July 2019 ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION

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June/July 2019

Contents

Featured News

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ATCEMS SENDS FIELD PERSONNEL THROUGH EXTENSIVE CE TRAINING AT NEW MEDTOMARKET FACILITY MedToMarket is a new approach to introducing health care technology and techniques to the marketplace in their new a 32,000-square-foot facility in Austin, Texas. ATCEMS personnel had the unique opportunity to con- duct CE in this state of the art facility before it was officially opened to the general public.

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ACADEMY 0419 GRADUATION

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Congratulations to our newest members of the Austin -Travis County EMS family! Cadet Class 0419 graduat- ed the Academy on June 21, 2019. We are proud to share with you two inspiring speeches from the ceremony, Field Medic Nolan Roberts and Communi- cations Medic Rose Bean.

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ATCEMS ANNUAL AWARDS CEREMONY

The annual ATCEMS Awards Ceremony was held on May 24, 2019 at Austin City Hall. We’ve included the names of all award recipients and some great pictures of your coworkers with their awards. Congratulations everyone!

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OUTSTANDING CITIZEN AWARDS

The ATCEMS Outstanding Citizen Award honors our citizen heroes by recognizing and acknowledging their Good Samaritan efforts through their courage and willingness to help a fellow citizen in need. The award is presented to persons who initiate lifesaving (bystander) CPR or provide help to others through an extraordinary act of courage, kindness or compassion. ATCEMS recently presented two local citizens with the award.

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CHP OPIOID RESPONSE PROJECT

Field medics take center stage by providing emergency care to patients who overdose. But when the ambu- lance pulls away from the hospital and the patient’s chart is filed away, there still exists a crisis in the patient’s life. The opioid project seeks to address this problem and provide navigation for funding, treatment, and other aspects of recovery for opioid addicts. Article by Lia Bermudez.

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Division News

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SAFETY SCORECARD

The Department has a responsibility to provide all personnel a safe working environment, free from recognized hazards. However, working in the EMS field, is not a risk free job, whether on the scene of calls, responding to and returning from calls, or at your station.

In Every Issue

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EMPLOYEE RECOGNITION

MEDIC 36 GROUNDBREAKING

ATCEMS employees receive kudos, special thanks and congratulations for a job well done.

On June 5th ATCEMS broke ground for a new Fire/ EMS station. The new station is located at 7014 Elroy Rd. in Del Valle across from Popham Elemen- tary. This is the first of the five new stations to be built during the next six years, approved in May 2018 by Austin City Council Resolution No. 20180524-035.

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WHAT IS:

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The association between diet drinks and strokes among post-menopausal women?

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CUSTOMER SERVICE SURVEY

Results from the ATCEMS Customer Callback Program.

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The Battle of the Badges is the annual blood drive sponsored by We Are Blood that engages Austin Police Department, Austin-Travis County EMS and Austin Fire Department in a friendly competition to help increase donations and sustain the local blood supply during the crucial summer months. Your donation helps We Are Blood supply local hospitals in Austin and 10 surrounding counties in Central Texas. Austin-Travis County Emergency Medical Services is the smallest of the three departments but we held our own in terms of donations. We’ve won the trophy for "Highest Percent Participation" for the past three years in a row! All three departments battled it out again this year to see who can recruit the most blood donors. The donations took place from July 1st through July 7th at various locations throughout the city. This year the donation stats are listed below: 251 85 169

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Thank you!

WE ARE BLOOD

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Austin-Travis County EMS

Awards Ceremony

Austin City Hall

May 24, 2019

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YEARS OF SERVICE The following employees are recognized for their dedication and years of service.

5 YEARS OF SERVICE

Bermudez, Lia Bible, Robert Cadena, Claudia Cantu, Jason Chorzewski, Matthew Clark, Allen Coleman, James Eaves, Patrick

Ferguson, Tom Hwang, Christina Johnson, Conner King, Albert Kuehn, Gage LaSalde, Starr Malone, Melody Martinez, Travis

McGarrh, Brandon Montana, Danielle Mooney, Loretta Olivo, Nicholas Owen, Rebecca Pailes, Kenny Paul, John Quarles, Pamela

Ramirez, Erica Rawn, Madison Rosenacker, Kristy Ruiz, Erin Samarripa, Evette Stempel, Adam Wald, Kevin

10 YEARS OF SERVICE

Hengst, Katie Howell, Luisa Kelter, Chris Kline, Paul Morgan, Dena

Paul, Matt Rasmussen, Nathan Risinger, Rusty Stubbs, Brian Thompson, Andre

15 YEARS OF SERVICE

Bakhtiari, Cheryl Capra, Andres Gordon, Eric Gregg, David LaFuente, Neda Lang, Kerri

Monson, Nancy Parch, Brian Pena, Kristina Price, Amber Quiroz, Chris

20 YEARS OF SERVICE

Almodovar, Alex Bostick, Adam DeMayo, Lisa Garcia, Freddie Gardner, Terésa Hall, Johnnie

Hardy, Blake Hardy, Traci Hawkins, Sesly Hernandez, Rosa Hernandez, Raul Holmes, Vivian

Israel, Pete Maciel, Laura

Mudge, Jonathan Rust, Charlie Rutledge, Rick Thomas, Dave Treffer, Randy Villanueva, John

Marquardt, Tony McDaniel, Mike Mezayek, Tammy Moreau, Gerry

25 YEARS OF SERVICE

30 YEARS OF SERVICE

Wadham, Gary

Williams, Dennis

Thomas, Temple

DEPARTMENTAL RETIREES

Lapham, Kurt

Saunders, Ken

Shipley, Michael

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UNIT CITATION Granted for unit achievement in such areas as innovation, efficiency, effectiveness, projects, or unit contributions to the Department or other appropriate organizations or groups.

Special Events

Recruiting Callis, Veronica Hoad, Mary Marion, Rance

Gaytan, Jeff Hinojosa, Juan

Parker, Kevin Vickery, Randy

INDIVIDUAL CITATION

Granted for individual achievement in such areas as innovation, efficiency, effectiveness, individual projects and personal contributions to the Department or other appropriate organizations of groups.

Adams, Will Bostick, Ken Bumpus, Ross Cohee, Lynn Elmore, Dee

Harvey, Esme Hoad, Mary Huckle, Carolyn Larose, Kyrstin Penson, Beulah

Rangel-Hernandez, Virginia Sanchez-Rodriguez, Edwin Schnelle, Leah

STORK CITATION

Given in recognition of a provider assisted child birth in the pre-hospital setting.

Barquer, Philip Bermudez, Lia Bostick, Ken Cole, Michael Fleming, Haley Gaytan, Jeff Holman, Tom

James, Ryan Jeans, Christopher Kalinowski, Jonathan Marks, Chris McNaughton, Jenna Monroe, Jonathan Moore, Hank

O’Connor, Brett Powell-Evans, Simon Pruiett, Craig Quiroz, Chris Reed, Alyssa Rosenacker, Kristy Sitorius, Lukis

Stanislaw, James Thompson, Andre Thurmon, Jacinda Turner, Cole

MEDICAL PHOENIX Awarded for confirmed cardiopulmonary arrest saves that are discharged from the hospital.

Aarniokoski, Dean Adams, Meghann Almodovar, Alex Alvarez, Paul Anderson, Scott Arnold, Douglas Barr, Jaelithe Belliveau, Michael Benefield, Morgan

Bermudez, Lia Bess, Luke Bostick, Adam

Bundick, Keith Butler, Dana

Didonato, Peter DuBose, Cory

Cadena, Claudia Clark, Matthew Coleman, Jonathan Copland, Ross Crowley, Nathan Cummings, Daniel Daves, Matthew

Eeten, John Elias, Jeffery

Bostick, Kenneth Branning, Walt Bregenzer, Brian Broadwater, Michael

Fairbrother, Amy Ferdous, Noshin Finch, Walter Flanagan, Michael Fleming, Haley

Brown, Kurtis Bumpus, Ross

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MEDICAL PHOENIX (cont’d)

Sprenger, Courtney Stanford, Leslie Stedman, Christina Stevenson, Adam Stewart, Michelle

Fogley, Damon Fuentes, Tim Garcia, Hector Gaskin, Terry Gastelum, Aaron Gaytan, Jeffery Gilliam, Jason Gordon, Mallorie Granberry, Seth Green, Tyler Hadas, Brian Hagood, Will Hall, Johnnie Hall, Melissa Hammon, Nathan

Krampitz, Casey Krasher, Daniel Krasher, Robin Krueger, Barbara Kutra, Aaron Lara, Marcos Latta, Samuel LeClere, David LeFevre, Eric Leiva, Noe Lester, Christopher Lewellen, Scott Lewis, Austin Lidster, Matthew Lorenz, Anna Mackay, Daniel Martinez, Henry Mason, Michael Maxwell, Aaron McLane, Jessica Michaelsen, Daniel Migl, Ray Mireles, Lupe Monks, James Monson, Nancy Mooney, Loretta Moore, Hank Morgan, Dena Morton, Rebecca Mudge, Jonathan Nadeau, Timothy Nichols, Kevin

O'Connor, Brett Olin, Daniel Owen, Rebecca Palmer, Brandon Pati, Melanie Patterson, Roger Peek, Marc Pena, Kristina Phillips, Katherine Pierce, Carol Pursley, Shaun Rangel, Virginia Rawn, Madison Redding, Jacob Renard, Kenneth Richter, Eric

Stowe, Chad Stubbs, Brian

Sweet, Dru Tait, Grant Thomas, Temple Thorn, Erin Thornhill, Caitlin Thurmon, Jacinda Ticianeli, Clara Todd, Joshua Torres, Raul Trujillo, Javier Villasenor, Marco Walters, Ryan Warren, Michelle Webber, Gabriel Weeks, Laurel Weller, Gregory Whiteman, Eric Willenburg, Matthew Winslow, Geoff Wise, James Wooley, Darae Yankiver, Lizabeth Yarger, Robert

Hanes, Rodney Harner, Kevin Harvey, Esme Haston, Ryan Hedrick, Tim

Rodriguez, Paula Rosenacker, Kristy Rupp, Dylan Samarripa, Evette Sanchez, Kyle Sanchez-Rodriguez, Edwin

Hernandez, Raul Higgins, Matthew Hofmeister, Andrew Holman, Thomas Jacobsen, Patrick James, Ryan

Saunders, Kenneth Schneider, Richard Settlemyre, Walter Shadden, William Simmons, Jessica Sitorius, Lukis

Jirasek, Kelsie Johns, Edward Karonika, Mark Kelter, Chris

Smith, Craig Smith, Tony Smith, Tyler Smith, Zach Spencer, Tara

Kennedy, Elizabeth Kenson, Christopher Kline, Paul Koesterer, Shannon

Yasui, Benjamin Zapata, Amelia

Noble, Keith Norton, Sean

LIFE SAVING CITATION

Given in recognition of exceptional efforts taken by Department employees that directly result in saving a life and/or keeping the patient from having a detrimental outcome. The patient would not have survived their illness or injury without the actions of A/TCEMS personnel nominated.

Copland, Ross Luk, Leor

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SHINING STAR AWARD

Awarded to individuals who exemplify our City’s PRIDE values of Public Service & Engagement, Responsibility & Accountability, Innovation & Sustainability, Diversity & Inclusion and Ethics & Integrity.

Castillo, Lisa

RANDY TRINKLE PERSEVERANCE AWARD

Awarded to individuals who are dedicated, committed employees who selflessly and graciously meets the needs of others with honor, dignity, compassion and professionalism while maintaining high standards.

Castleberry, Jason

OUTSTANDING UNIT AWARD Awarded to organizational units which have distinguished themselves by exceptionally meritorious service or outstanding achievement that clearly sets the unit above and apart from similar units.

Public Information Office

Beggs, Jason

Benavides, Mike

Noak, Darren

MERITORIOUS SERVICE AWARD Awarded for an event or action of particularly meritorious service to the Department which reflects positively upon the individual and the Department.

Active Shooter Cantu, Jason

Traffic Accident Tait, Grant

CLINICAL EXCELLENCE AWARD Awarded by joint agreement of the Medical Director and Department for ongoing, exceptional delivery of/or contributions to the advancement of the practice of medicine within the A/TCEMS system.

Copland, Ross

LeClere, David

Rangel-Hernandez, Virginia

MEDICAL DIRECTOR AWARD Awarded by the Medical Director to an individual that is committed to and exemplifies the art and science of an exemplary practice of field medicine.

Todd, Joshua

XAVIER MOKARZEL AWARD Awarded to A/TCEMS personnel who, above and beyond the call of duty, have acted in a manner demonstrating great heroism which clearly places them at undeniable risk for loss of life while bringing honor to the organization.

Baker, Nick

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In The News More fatal youth drownings reported this year than all of 2018

Excerpts from Fox, KXAN, KVUE

Austin-Travis County EMS is reporting three drownings of people under the age of 18 so far this year as compared to only one in all of 2018.

Travis County has reported an uptick in children drowning. Since the first of the year, there have been at least 15 drowning incidents involving children under age 18 with- in the response area of Austin-Travis County. “Of those 15 three of them have been fatal. Which surpasses our total numbers from last year," ATCEMS Commander Mike Benavides said. "We had one last year in Travis County, and we’re barely starting to enter into the summer season.” All of the drowning incidents that have taken place in 2019, 14 involved children under the age of seven. Nine of the incidents took place at local pools. First respond- ers and water safety advocates stress that drownings can, and have happened everywhere -- bathtubs, buckets, even toilets. ATCEMS Captain Randy Chhabra said as of Wednesday afternoon, the five-year-old was in the intensive care unit at Dell Children’s Medical Center of Central Texas. In nearby Williamson County, a girl died recently after a drowning incident at Cedar Park’s Buttercup Pool. The Cedar Park Police Department says the child was given CPR by lifeguards at the time of incident. EMS took over and transported her to a local hospital where she died the following day. The circumstances surrounding the drowning remained under investigation Wednesday. Chhabra says the “trending characteristics” in each Travis County drowning incident were lack of supervision and flotation. Guardians must utilize the “safer three” approaches to prevent drownings:

Safer water Safer kids

  

Safer response

Safer water means barriers, such as isolation fences, alarms and pool covers. Safer kids means swim lessons. Safer response means appropriate supervision. Additional safety advise given while enjoying the outdoors include:

 Know where you are and your surrounding at all times  Know who and what is in the water  Wear appropriate clothing and shoes  Put away all distractions such as your phone  Don’t be impaired by drugs or alcohol  Have safety rules and practices with your children and yourself

The most common distraction for adults is phones. Guardians need to remain at an arm's reach from children and become aware of and the location of available rescue devices. In addition guardians need to remember that drowning is a silent event. All guardians should be CPR certified.

“If children were to receive bystander CPR within the first five minutes of an arrest, they have a 300% greater likelihood of having a positive outcome” said Chhabra.

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Governor Abbott Signs Bill Recognizing

Why classification of 911 dispatchers as first responders in Texas is important

The people you speak to on the other line when you dial 911 will soon have a new title. Governor Abbott signed on House Bill 1090, telecommunication specialists will officially be classified as first responders come September 1. 911 dispatchers are the first to know about an emergency, and sometimes what they’re told, and what they hear affects them as much as it affects the police, fire and emergency medical services who respond to these calls. They may not be on the front lines, but emergency dispatchers still grapple with the emotional impacts of dealing with crises. That's one reason why Texas will soon classify 911 dispatchers and other public safety telecommunications professionals as first responders. Texas is one of only a few states who have made this change, however, there’s currently a push to classify 911 dispatchers as first responders on the federal level as well. This bill will put dispatcher on par with their brothers and sisters who respond on the streets. Day in and day out, they hear some of the worst calls, they take the brunt of the caller who often times is in great distress. Listening to the agony and chaos of somebody in need takes an emotional toll on all 911 dispatchers. This change will give dispatchers a degree of recognition alongside police, fire and emergency medical services as an equal that they deserve. There are many challenges 911 Telecommunicators face on a daily minute by minute bases. the stress they are put under, and the critical importance of their work. The work performed by Public Safety Telecommunicators is nothing short of extraordinary. Dispatchers play an essential role in saving lives and in helping EMS, APD and AFD do there job safely. They are their eyes and ears before arrival on scene. They receive advanced training to effectively assess a situation, ask the right questions, and communicate vital information so that the responding crews know what to expect upon arrival of the scene of an emergency. Telecommunicators deserve the benefits and respect a first responder classification affords.

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D. Craig MacCormack

MedToMarket is Taking Health Care Technology in Innovative New Directions MedToMarket merges stakeholders, end users and entrepreneurs under one roof the challenge is finding the right health care technology to accommodate it.

Dr. Aaron Ali and his two fellow co-founders are trying to do something in the medical world that’s never been done before: bring stakeholders, end users and entrepreneurs under one roof without looping in a college or university to serve as the base of their operation. Introducing MedToMarket, a new approach to introducing health care technology and techniques to the marketplace in a 32,000-square-foot facility in Austin, Texas, that already has Ali thinking bigger, not just expanding on the original foot- print but replicating it across the U.S. and around the world. To achieve those lofty goals, Ali and his fellow co-founders scoured the world looking for the right health care technology partner to facilitate the large-scale AV integration, which includes:  a theater equipped with two 85-inch displays and a drop-down screen  an area in the heart of the space where the proctor stands amidst two pan/tilt/zoom cameras equipped with a microphone Little did Ali know when he put his vision to paper a couple of years ago that his search for an AV partner would eventually end in his own neighbor- hood, where he brought on AV Helpdesk and VP Collin Hogan.  a 150-seat auditorium

AVHD paired up with St. Louis-based Conference Technologies Inc. to do the actual AV integration for MedToMarket, which was set to open last month. “This idea is really progressive,” says Hogan. “What they’re doing to foster medical innovation, we wanted to be part of it. It’s an exciting project for us.” The MedToMarket Model Under the MedToMarket model, large medical device companies train physicians on their new products, while entrepreneurs mull over whether to invest in what could become the next big thing in the field. As the doctors operate on cadavers, up to 150 people will watch from the auditorium and the recordings of the “surgeries” can be shared around the facility to conferencing spaces for further discussion, from analyzing the procedure itself to making future procedures more efficient. “We are training physicians on highly precise pro- cedures that are incredibly difficult to teach and learn,” says Ali. The spaces will be rentable, and Ali’s vision is to have the MedToMarket IT staff have as little involvement as possible thanks to the intuitive, simplified nature of the health care technology,

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which has a Crestron NVX control system as its heartbeat. “We want to create a super-ecosystem for medical innovation, but also bypassing a lot of bureaucracy and red tape,” says Ali. “We need it to be seamless. The world of medical education and innovation is difficult when you’re trying to pass it along to others. One of our big- gest issues has always been lag. It really throws you off, especially when you’re talking about doing a very delicate surgery. “Having all that technology integrated is incredibly difficult. I need this to feel like it’s live. We wanted to make sure that vision came to reality. We need people to be able to come in a room and not be babysat by my IT staff. We’ll keep on pushing the limits on this,” he says. 20 Surgeries at Once Once MedToMarket gets fully functional, the facility has space for 20 surgeries to occur at once. That means a lead surgeon can conduct training while other surgeons can replicate the surgery as it is being performed. There are also glass walls at which observers can sit behind to see the techniques of the surgery. Their view is aided by cameras focused on the surgeon that provide greater details of the surgery on the massive displays throughout the space.

Tech Specs MedtoMarket will utilize Crestron’s Pixel Perfect Technology to ensure zero latency to allow for real -time interaction with the students. The conference rooms feature AirMedia for wireless presentation capabilities. AV Helpdesk has worked with biotech and pharma- ceutical clients in the past but this was its first time in a medical facility, says Hogan. The company overcame early issues related to “very strict” oversight on funding and budgets by providing detailed engineering drawings to elimi- nate the need to ask for more money later in the process, says Hogan. This was also AV Helpdesk’s first experience with Crestron NVX, but likely won’t be its last. Could the next opportunity come in the next MedToMarket facility? Ali envisions expanding the operation to the Midwest, then to the east coast, west coast then overseas. “Our vision is to scale this,” he says, but notes he wants the future locations to follow the initial template. “I don’t want to have to do this over again.” Ali is already considering adding a large animal lab, wet lab and a larger auditorium. “We want to make sure when we take the next step, it’s very seamless for us,” he says.

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EDWD

Austin-Travis County EMS was among the first to embark on a monumental Continuing Education endeavor, by putting over 500 of their uniformed medics through an Advanced Tactical Anatomical Skills Course. This awesome opportunity could not have been possible without the tireless efforts of Captain Angela Carr. Captain Carr devoted a great deal of time and effort to make this incredible learning opportunity for our medics a reality. “The MedtoMarket facility provides a one-of-a-kind location for training that is unprecedented for our team,” said Carr. “The bioskills resources and technology avail- able in the lab create the perfect environment for our providers to learn and refine their most important job– saving lives. M2M Labs provides the ideal training environment and is completely customizable to our needs. Even the door to the lab allows an ambulance to fit inside. We are very lucky to have this facility right here in Austin, Texas” said Carr. Austin-Travis County EMS is dedicated to providing excellent service. This includes service to patients, their families and loved ones, service to the community, and service to the people who make up Austin- Travis County EMS. Training and evaluation are critical to fulfilling this goal and improving performance. This partnership will allow us to enhance our skills at a level far above any other previously available. It will enable our medics to perfect their medical skills even more so than before. Allowing ATCEMS to continue to provide the exceptional service our community expects from us.

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2019 Mission: Lifeline EMS Recognition GOLD PLUS

Congratulations to the Clinicians of Austin-Travis County Emergency Medical Services on receiving yet another Gold Plus EMS Recognition from the American Heart Association Mission Lifeline for excellent STEMI care.

Mission: Lifeline EMS recognition is a program designed to showcase Emergency Medical Service organizations across the nation for excellent ST Elevation Myocardial Infarction (STEMI), or more commonly called "heart attack". Prehospital personnel are the first providers of care to patients suffering from cardiac emergencies.

The role of EMS in the system-of-care for these patients is crucial and often sets the course for the patient's outcome. The Mission: Lifeline EMS recognition program was launched in 2014 and continues to celebrate the achievement of the pre-hospital providers and their collaboration with

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CADET ACADEMY 0419 GRADUATION

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Congratulations to our newest members of the Austin-Travis County EMS family! Cadet Class 0419 graduated the Academy on June 21, 2019. We are proud to share with you two inspiring speeches from the ceremony, Field Medic Nolan Roberts and Communications Medic Rose Bean. “I would like to thank you all for coming out, and say a special thank you on behalf of class 0419 to all of the chiefs, commanders, captains, training officers, medics, and of course, our academy staff, for all the time and hard work invested in our fu- ture, and the future of the department. I would also like to personally thank my fellow cadets of class 0419, for making the last 10 weeks bearable, and for making me laugh, supporting me as I tried to support each one of you, and showing me 12 different perspectives while teach- ing me something new every single day I spent with all of you. A little bit about us, class 0419 is made up of 13 amazing people from every corner of the United States, From all the way Up in New England, across the north to Washington (state not DC, as we heard him say 1000 times), and even down into California (actually mostly from California) and even 2 from right here, born and raised in Austin. But no matter where we all came from, we all arrived here for the same reason, because we all wanted to be the best versions of ourselves, push ourselves toward greatness, and have the resources, support, and to earn the right wear the uniform of the best EMS department in the country.

adopted the motto “if it doesn’t challenge you, it doesn’t change you,” and certainly, every day brought challenges that, once conquered, helped refine us into who we are today. We have learned that Challenge is uncomfortable. Challenge isn’t pleasant. I can tell you first hand that challenge will stain some shirts and scuff some boots, but challenge is how you become the best. (Funny enough, the biggest challenge we faced was getting our uniforms on time, sized right, and spelled right.) As much as I would love to take 2 hours of your time and explain just what makes each my 12 classmates the amazing, hard working, unique, and beautiful people they are, I was specifically told I couldn’t do that, so I’ll leave you with this. Every Friday, we would do a workout called “tower day” After every tower day, we would hear an encouraging speech, pushing us to focus on our mindfulness, and focus on greatness. On one tower day it just so happened that it was my birthday, and all the good speakers happened to be absent, so after exhausting every other option, I was allowed to speak.

The short speech I gave then, I think rings true tenfold now.

These have been 10 of the best weeks of my life, surrounded by 12 of the greatest people I have ever met, in the best city I have ever lived in, at the best job I have ever had.”

Nolan Roberts

During the course of our 10 week academy, 0419

Nolan Roberts Field Medic

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I am honored to be apart of the Austin-Travis County EMS academy and here on graduation today. I feel fortunate to have gone through it all with my class, 0419. I couldn’t be more delighted and proud to have met you all and I am excited to call you all my colleagues. With some of us being on the communications side, & majority being in field, I am happy to have gone through it all together. We all have important roles to play, even if our duties lie in what seem to be different worlds, I cherish calling you all my team. Our first week here at the academy was unlike anything I had ever experienced. That first week was the first of many obstacles. PT being our number 1 obstacle, in a literal since. Although, I ran cross country and considered myself reasona- bly fit. Hilary and Sebasian’s programs left me the most sore and worn out I had been in a long time. Add in all the double timing we had to do in be- tween, my hamstrings were definitely calling out to me. I can recall the last time I had been so sore, when I thought it was an excellent idea to try out for my middle school basketball team. I am sure you can all guess how that turned out, considering I am here and not slam dunking baskets on a court somewhere. Plus, my skills may have had little to do with it. So forth, when I thought I had adjusted to the intense weeks of PT then came SWIFT water training. I think the term “SWIFT” will always send chills up my spine. So I think that's all that's left to say there.

Testing was nerve racking, yet in the heat of it all... we still rooted for one another. I am gratified to say that today we ended with the same number of cadets that we started with day one. Furthermore, fear and joking aside, I am over- joyed to be here in front of you all today. Friends, Family, colleagues...and my team. As we move forward into this next phase of our journey’s and into clearing, I have to thank the Cadre in playing such a beneficial role in shaping us along in these ten weeks. A special thank you to Captain Renard in Comms for pushing us Comm cadets along and sharing his experiences with us. His examples to me are priceless and something I can never forget as I continue to shape my skills. I want to thank T.O. Cluskey for briefing us Comm cadets on how to be dramatic actors during scenarios. Captain Crouch for being so attentive to us all; Captain Cinquina for pushing us all in PT along with her words of inspiration! And a big overwhelming Thank you to the rest of the academy staff, and everyone else who helped guide us along the way. I am so grateful to be apart of such a prestigious organization. Class 0419, let's continue to make slam dunks and show them what amazing medics we will all turn out to be! We did it guys!

Rose Bean

Rose Bean

Communications Medic

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WARNING! Do Not Keep Water Bottles Inside Cars on Hot Days

While It’s so important to drink plenty of water throughout your day to stay healthy and hydrated, so grabbing a water bottle on your way out the door is a smart move. However, there’s one thing you should never do when you’re taking bottled water out with you: NEVER LEAVE IT IN THE CAR

A recent story about a local man who experienced this danger firsthand.

Dioni Amuchastegui, a power station’s battery technician, explains how he discovered first-hand how an innocent plastic bottle of water can instantly create a dangerous situation. He said he was eating lunch when he started to “notice some smoke out of the corner of my eye.” He looked over and noticed that light was being refracted through a water bottle and “was starting to catch the seat on fire.” A water bottle can carry the heat from the sun’s rays. The sunlight will penetrate through when it’s filled with liquid, and act as a magnifying glass as you would with regular optics. The rays use the liquid and the clear material to develop a focused beam which can cause a fire. Sunlight magnified through a bottle of water can reach 250 degrees. The intensified heat can then focus on other interior materials of the car, including the fabrics, seats or mats—potentially setting those materials on fire. Obviously, the ideal thing to do is to keep plastic water bottles out of your car. However, if you still want to keep one in the vehicle make sure that they’re kept out of direct sunlight. Not only can water bottles cause a fire hazard when left in your car, but they can also become unsafe to drink. Research studies conducted in the past few years have shown that when plastic bottles are left in a hot enough environment for long periods of time harmful chemicals may be released into the water. It takes some serious heat and at least a week or so to make this water dangerous to drink. It’s an important precaution to take, so the next time you find an old water bottle in your vehicle consider watering your plants with it instead of drinking it.

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OUTSTANDING CITIZEN AWARDS

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The ATCEMS Outstanding Citizen Award honors our citizen heroes by recognizing and acknowledging their Good Samaritan efforts through their courage and willingness to help a fellow citizen in need. The award is presented to persons who initiate lifesaving (bystander) CPR or provide help to others through an extraordinary act of courage, kindness or compassion. ATCEMS recently presented two local citizens with the award: Amy Gaither “Amy Gaither, an off duty school nurse, performed CPR on a patient at a local restaurant. The patient had collapsed in the parking lot, was blue and not breathing due to choking on a large piece of meat. Amy performed 2-3 rounds of CPR and the food dislodged. If not for her actions the patient would have had a much worse outcome.” Commander Keith Noble Nicholas Ellis Nicholas Ellis was driving down IH-35 at 1:00 in the morning when he came upon a truck that apparently just had an accident under the bridge near Manor Rd. Nick thought he saw flames coming from the truck and pulled over to help. When he got out of his car he realized the driver was still in the truck. Nick did not hesitate, he ran over to the truck and started to pry the door open with his bare hands to get the driver out of the vehicle. A couple of other bystanders ran to the truck to help him and together they got the door open, Nick helped the driver out of the vehicle to safety just moments before the car was fully engulfed in flames. “The bystander’s (Nick) intervention unquestionably changed the outcome for the patient and his family.” Commander Eric Richter

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Safety Division

19%

25%

52%

Oji due to body movement

Oji Exposures occur Back of unit

Oji caused by Combative patient

59%

30%

Preventable Fleet Collision

Preventable hours between 1400-1800

ATCEMS FY19

All percentages are for FY19 Quarter 1, 2, & 3

Fleet Collisions

1. 59% of our total collisions have been preventable by the driver.

2. 22% of our preventable collisions are due to spatial awareness on the right side of the unit.

3. 12% of our preventable collisions are due to pivot point errors.

4. 8% of our preventable collisions are due to backing skill errors.

5. 30% of our preventable collisions happen between the hours of 1400-1800.

6. 27% of our preventable collisions occur on Friday

Driving Pearls

 To avoid following too closely, allow yourself at least 3-4 seconds following distance in good condi- tions, more if weather and road conditions are less than optimum.  A vehicle’s Total Stopping Distance is the combination of perception distance plus reaction distance plus braking distance. As a reminder, our ambulances weigh 4 to 5 times more than the average passenger car or mid-sized SUV and they take longer and further to stop. “Recalibrate” your needed stopping distance to allow for the heavier ambulance when on the job.  When backing or maneuvering on a scene, you may need more than one backer just because of sce- ne circumstances. Don’t hesitate to enlist the aid of firefighters or police officers to act as a ground guide / backer. Some of our backing collisions could have been prevented by use of a second back- er / ground guide.  When backing, don’t forget to think about the front end of the unit. When turning and backing, the front end will swing and can easily strike objects.

 Drivers, do a 360° walk around of your ambulance, before getting in the drivers seat.

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OJI’s and Exposures

1. 25% of our reported OJI’s dealt with body movement. 28% of those involved getting in and out of the ambulance.

2. 28% of our reported OJI’s were exposures. 52% of exposures occurred in the back of the unit.

***You can prevent your exposure***

3. 19% of reported OJI’s involved a combative patient.

Prevention is Key

 Utilize good body mechanics

 Get plenty of rest prior to your shift and come prepared to work

 Exercise and good diet are proven methods to prevent injury and illness

 Recognize high risk patients for exposures

 Wear your PPE

As a reminder, our Sharps Shuttles are single use devices . Once used, they should be locked closed and promptly disposed of in a larger Sharps Container as biohazardous waste. They should not be reused.

Your Safety is Priority!

The Department has a responsibility to provide all personnel a safe working environment, free from rec- ognized hazards. However, working in the EMS field, is not a risk free job, whether on the scene of calls, responding to and returning from calls, or at your station. You are responsible for your personal safety and have personal responsibility to:

 Know your surroundings and maintain situational awareness.

 IF you feel you are in immediate danger, protect yourself and notify someone:

Shout for help,

 Utilize the orange emergency ID button on your hand held radio,

Call 9-1-1

 Lock your vehicle and keep valuables out of sight.

 Keep your station and unit secure at all times.

 Report any safety concern to your commander or report it via the Safety Concern report in RMS

 Report any facility maintenance needs via a Facility Repair Request

STAY SAFE

REMAIN ALERT

EXPECT THE UNEXPECTED

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By Lia Bermudez , EMT-B

CHP

CHP OPIOID RESPONSE PROJECT

The Opioid Response project seeks to address clients addiction crisis and provide navigation for funding, treatment, and other aspects of recovery for opioid addicts. CHP medics lead clients to resources that will increase their quality of life.

Narcan. At ATCEMS, we utilize Narcan daily, sometimes as the sure fix to an apneic patient with pinpoint pupils, other times as an educated guess as to what they have ingested. In some ways, Narcan is a miracle drug, reversing deadly effects of opioids within seconds. As exciting as it is to see the good that Narcan can do, it’s even more exciting to know that the distribution of Narcan is just a small part of a broader, more encompassing project within the Community Health Paramedic Program. The Opioid Emergency Response Project is a fast-paced, effective piece of what CHP medics engage in every day on the job. Field medics take center stage by providing emergency care to patients who overdose. But when the ambulance pulls away from the hospital and the patient’s chart is filed away, there still exists a crisis in the patient’s life. The opioid project seeks to address this problem and provide navigation for funding, treatment, and other aspects of recovery for opioid addicts. At the Austin Transitional Center, there was a resident who we will call Laura. Craig Fairbrother, who devotes his hours on the job to the incarcerated population, met Laura when she arrived at the Transitional Center, and was told by the staff that Laura would likely be looking to score some drugs while she was there. Craig promptly addressed Laura in his bold but friendly manner. He explained that he could help Laura get into suboxone treatment so that she could get off of heroin. The next day, CommUnity Care held their scheduled services at the Transitional Center, and Craig facilitated a private meeting between Laura and the nurse practitioner. Laura’s suboxone induction was scheduled, and Craig stayed in close contact with her until her induction date, including coaching her about going into withdrawals for her induction. Laura walked out of the Dove Springs Medically Assisted Treatment clinic feeling much better, having successfully been inducted into suboxone treatment. Craig also facilitated connections to counseling for Laura to work in conjunction with her treatment. Still, Laura was not in the clear. She was surrounded at the Transitional Center by people who would encourage her to re-engage in drug-seeking activity, threatening to undermine the work she had done by

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going through with induction.

resources for HIV patients had been provided to get Kim and Sean an apartment. They were no longer homeless! At their most recent contact, Sean told Mike that he and Kim are still on methadone, and that Sean is now receiving treatment for his HIV. Because of the efforts of the Community Health Paramedic program, Kim and Sean’s options for better, healthier living were laid out for them. At the right time, they both got the help they needed.

Craig’s persistence paid off. One day, he offered Laura a ride to the clinic, and she said she was ready to go by herself. Laura went to the clinic weekly, of her own accord, to get her doses of suboxone. Eventually, she was out on parole. Laura went to west Texas, where she found herself struggling to get her weekly dosages, and in danger of relapsing. Craig quickly collaborated with the nurse practitioner from CommUnity Care, who had her prescription sent to her location in west Texas, where she had it filled and continued her treatment. Laura is clean, no longer bound by her old drug habit. She sends Craig a text now and then to assure him that she is doing well. More often than not, the initial CHP contact does not align with the client’s readiness to take the next steps toward wellness and sobriety. A client may acknowledge that they need help, but are not quite ready to do the work necessary to affect change. Mike Sasser experienced this with a couple that he met on Street Med, Kim and Sean. Sean had recently tested positive for HIV, and he and Kim were homeless and addicted to heroin. Kim was promptly tested for exposure to HIV. Mike and the Street Med team made multiple attempts to help Sean get connected to a clinic that could properly address his HIV. Appointments were made, courtesy rides offered, cab vouchers given, but Sean consistently missed his appoint- ments. Mike also took steps to connect both Kim and Sean to the MAT clinic so that they could start on suboxone treatment. Kim attended her induction, but did not feel that suboxone was the right treatment mode for her. Sean adopted her same views and decided not to attend induction, but wanted to seek methadone treatment. Sean overdosed on heroin during this time, which Mike addressed by issuing a Narcan kit and counseling Sean on its proper use. He urged Sean to get into methadone treatment if he was not open to suboxone. Ultimately, Mike ceased efforts to get Sean the help he needed. He remained available, but knew that Sean would decide when the time was right. With the help of partnering agencies, Kim and Sean both successfully got into methadone treat- ment in January and began to feel more functional. At the end of March, Sean contacted Mike to let him know they now had a place to live. City

Because of the efforts of the Community Health Paramedic program, our clients have options for better, healthier living.

Community Health medics are always reminding each other, “You can lead a horse to water, but you can’t make him drink.” Stories like Laura’s, and like Kim and Sean’s, encourage the CHP’s to keep leading clients to the resources that will increase their quality of life.

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LEGAL RAMIFACATIONS OF ASSAULT ON A PUBLIC SERVANT

There is a special section in the Texas Penal Code for assault on a public servant. A public servant is someone who works for the government at the state or local level. The concept of a public servant is broad includes many different types of professions. If these tempers rise and frustrations reach a level where a person reacts physically, they can find themselves facing serious criminal charges. There can be heavy penalties if you are facing this accusation. Assault public servant is significantly more serious than a normal assault. Assault on a Public Servant is a Third Degree Felony The Texas Legislature who drafted the law wanted to make assaulting a public servant harsher than a regular assault. Assault is already a serious crime that can have consequences for your future. How- ever, assault bodily injury is a class A misdemean- or. Assault public servant is a third degree felony in Texas. This means that it carries a range of punishment of between two and ten years in Texas prison and up to a $10,000 fine. When you are dealing with a charge that carries the possibility of prison time, this is not to be taken lightly. Defend- ing a felony means the stakes are higher. If you are facing a felony, your case will be in District Court, instead of County Court. Your case will be indicted. To be indicted, the case goes through the grand jury process. Assault of a public servant is exactly the same crime as assault bodily injury, but with two added elements: the alleged victim must be a public servant, and the person being charged knows the victim is a public servant. Section 22.01. Assault Assault means to inflict physical injury on another person. This kind of assault is often referred to as ABI or assault - bodily injury. The injury must be done either intentionally, or by reckless accident. Paramedics face violence on a daily basis so a new law which will bring in tougher sentences for those who attack emergency workers when they are on duty is needed. It is hoped it will act as a deterrent because offenders currently escape what many would see as meaningful justice (attackers are charged with common assault resulting in a maxi- mum sentence of six months). The new law will double this with an option for a longer sentence, dependent on the seriousness of the case. The damage to those affected by this violence can be long lasting and have widespread implications for their physical and mental health. Violence

against emergency workers should not be seen as an “occupational hazard”. More needs to be done to highlight this increasing and dangerous issue affecting today’s paramedic workforce. A paramedic’s main focus is to care for the patients they are sent to. They are there to help. But it is all too easy for families, friends, bystanders and even the patients to feel they need to vent frustra- tions against the medical crew. The effects of an assault can be devastating and ever lasting. Post Traumatic Stress Disorder, mental health issues, lack of confidence to go back to work and fear of it happening again are too all common. Raising Awareness First responders – police, fire and EMS– are profes- sionals trying to save the community from danger by putting themselves in harm’s way. Yet the incidence of assaults against them has grown to shocking levels around the world. While assaults against first responders are not new in the public safety profession, they are seemingly becoming more serious with each passing year  The rate of nonfatal injuries among US paramedics was 34.6 per 100 full-time workers per year, a rate more than 5x higher than the national average for all workers. In regard to fatal injuries, a retrospective cohort study of nationally registered emergency medical technicians (EMTs) in the U.S. found that 8% of fatalities were due to assaults. These are just the assaults that were reported many go unreported. Not every emergency situation is life-threatening and, equally so, by the pure nature of being a first responder, the very crux of the job demands an insertion of personnel into an unstable circum- stance. Admittedly, some perils cannot be avoided. However, learning to avoid predictable situational awareness red flags to potential violence and developing specific skill sets to address it after it begins are fundamental, consequential tactics needed in every responder’s performance toolbox. In the mean time it is important for all public serv- ant, Police, Fire and Emergency Medical Techni- cians need to remain vigilant at all time and to understand how to react to and prevent violence before it starts if at possible by recognizing and employing de-escalating techniques. Below are a few statics of this growing problem.

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De-escalation Techniques

 A person clenching his or her fists or tighten- ing and untightening their jaw.  A sudden change in body language or tone used during a conversation.  The person starts pacing or fidgeting.  A change in type of eye contact.  The “Rooster Stance” chest protruding out more and arms more away from the body.  Disruptive behaviors such as yelling, bullying, actively defying or refusing to comply with rules.

We must continually improve our ability to devel- op and maintain situational awareness under stress. As first responders it is imperative to have a thorough understanding of situational awareness what it is, how challenging it can be to develop, and how easy it can be to lose. The term " situational awareness " refers to a per- son's ability to be aware of what's going on around them. I call it being " mentally engaged " though you may hear the oft cited military term " keep your head on a swivel " which means to always be looking around you, being aware of your surroundings. we need to remain vigilant and observant at every phase of these calls and assess every changing situation. Crew members need to watch everyone around them at all times. These seemingly innocuous calls might be setups for an attack on first responders. When you arrive, and while interacting with the public , responders need to watch the hands and mannerisms of each person. Weapons can come from anywhere and are in all shapes and sizes; they don’t have to be conventional things you would think of such as knives and guns. The weapons can be anything. Assessing scene safety is paramount during every call for service that a first responder answers, and it is critical to remember that every call is unique. “never turn your back” and “try to position your- self in a room where you have easy access to the door. Arguably the most important part of situational awareness is how to recognize potentially violent patients and de-escalate situations and interac- tions. Risk factors in violent patients include a history of aggression, psychiatric disorders, substance abuse, feeling powerless, and the perception that violence is tolerated. A person during a crisis and in the heat of the moment can- not always communicate their thoughts, feelings or emotions clearly. They may find it difficult to understand what others are saying. Therefore, it is important to empathize with the person’s feelings, stay calm and try to de-escalate the situation.” Anticipating potential conflict is important for pre- paredness, and there are many verbal and non- verbal cues to be mindful of as situations unfold. For recognition, here are some signs of conflict escalation:

De-escalation techniques that include the follow- ing outwardly expressed traits and emotions by first responders:

• Open, honest, genuine;

• Self-aware, confident but not arrogant; calm appearance to convey control of situation; • Non-judgmental; non-threatening, non- authoritarian manner; • Awareness of body language like eye contact, facial cues, posture to ensure it expresses concern; • Actively listen to understand what the aggressor is saying;

• Use soft tone of voice that is calm and gentle;

• Use short sentences and simple vocabulary; provide aggressor time to respond before continu- ing;

 Repeat messages when talking, setting limits, offering choices, or proposing alternatives.

 People respond positively to their own name and can make the dialogue more personal.  Listening to the persons concerns. Acknowledge there feelings without passing judg- ment.

 Empathy needs to be shown during conflict situations.

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