PULSE Magazine | September 2018 Issue

P U L S E September 2018 ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION

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September 2018

Cover photo courtesy of the Patriot Flag Project

Contents

Featured News

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SEPTEMBER IS NATIONAL PREPAREDNESS MONTH

Every family should have an All-Hazards Emergency Plan and an All Hazards Emergency Kit/supplies in place for major emergencies and natural or man-made disasters. We’ve included a Life Saving Skills section this year that you may not think about needing during and after an emergency.

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EXPLORER SPOTLIGHT

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This month’s Explorer Spotlight is on Hope Rodriguez! Hope has been a Post member since December 2016 and is currently an Events Captain. She has been an Honor Guard member since February 2018.

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WARN CENTRAL TEXAS EMERGENCY NOTIFICATION SYSTEM

The Capital Area Council of Governments and its regional partners are pleased to offer an emer- gency notification system to residents of Central Texas. Registering with WarnCentralTexas.org allows local officials to contact their communi- ties by phone, email and text during times of disasters or public safety events

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WHAT’S NEW THIS FLU SEASON

There are many different flu viruses and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated as needed to match circulating flu viruses.

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Division News

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COMMUNICATIONS CALL OF THE QUARTER

Congratulations to Edwin Sanchez-Rodriguez and Ken Bostick for winning the Communications Call of the Quarter for Q1 and Q2 this year.

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REALIGNMENT OF DIVISION CHIEFS AND RESCUE OPERATIONS OVERSIGHT Recently we evaluated the current roles and responsibilities of Division Chiefs and realigned oversight of shifts and special programs. These changes were made based on Division Chief input and business needs of the organization.

In Every Issue

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YOUR PHOTOS

Catch a glimpse of your coworkers in action.

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NEW COMMUNICATIONS DIVISION CHIEF

EMPLOYEE RECOGNITION

Congratulations to former Commander Brian Bregenzer who has been appointed as the new Division Chief assigned to Emergency Communica- tions.

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

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CUSTOMER SERVICE SURVEY

Results from the ATCEMS Customer Callback Program

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What You Should Know About Life Saving Skills

 Know basic preparedness skills to protect your family and home.  Eliminate common electrical and fire hazards around your house and property.  Install smoke, carbon monoxide, and natural gas alarms and test them monthly.  Teach children what to do when they hear smoke, carbon monoxide, and natural gas alarms.  Place natural gas detectors on every level of your home and test them monthly.  Know how to turn off utilities like natural gas in your home.  Talk to your landlord or building manager about evacuation routes and fire safety.  Develop and practice a family communication plan and discuss it with your family.  Have emergency supplies in place at home, at work, and in the car.  Pay attention to alerts and warnings.  Know two ways out of your home in the event of a fire and practice evacuation plans.  Set some money aside from your income in case of an emergency.

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How To Prepare For Emergencies Every family should have an All-Hazards Emergency Plan and an All Hazards Emergency Kit/supplies in place for major emergencies and natural or man-made disasters. This makes emergency preparedness simple and attainable. You plan only once, and are able to use your plan to respond to all types of hazards no matter where you are. These emergencies may include:

Hurricanes

Violence

Chemical Spills

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   

   

Floods

Fires

Accidents

Tornados

Explosions

Medical Emergencies

Terrorist Attack

Storms

Black Outs

While it is difficult in today’s world to predict when disasters will occur, we do have the power to choose how severely they might affect us. By acting now you can prepare yourself and to deal with natural or man-made disasters at home, at work, at school, or on-the-go. Having an emergency preparedness kit and supplies may save lives, prevent illness or injury, and maintain calm in a crisis situation. Prepare with a 72 Hour Emergency Kit Because help may not be immediately available after a major emergency or disaster, it is recommended that you plan to be self-sufficient for at least 3 days (72 hours) or more. Having a 72 hour emergency kit that is compact, light-weight, and durable may be critical to your survival and comfort after a disaster or major emergency. Prepare with Emergency Supplies that meet your “10 Basic Emergency Needs” Being secure in an unsure world means preparing for the possibility of not having things we take for granted. Prepare in “All Places” As a disaster or emergency may happen at any time of the day or night, it is important to have an emergency kit and other disaster supplies at home, at work, at other places where you spend significant time, and in all vehicles.

Drinking water

Alternative communication

    

    

Breathing protection Emergency lights Trauma/First aid kit

Sanitation & Hygiene

Food

Shelter Warmth

Emergency tools

These emergency supplies should have a long shelf-life, be packed in compact and portable containers or bags.

Emergency Car Kit

BACKPACK OR DUFFLE BAG

MEDICAL KIT Gauze bandages adhesive bandages Cloth tape Eyewash cup Absorbent pads for bleeding Antiseptic wipes and latex gloves Burn ointment CPR mask Elastic bandage, SAM splint Scissors, tweezers, safety pins Aspirin and non-aspirin pain relievers Nausea medication Benadryl Chemical heat/ice packs Sunscreen Moleskin for blisters

Water/refillable water bottle/filtration device Protein bars Blanket Flash light with extra batteries/glow stick Crank radio Cell phone charger Whistle Tarp Folding shovel

TOOL KIT

Pliers Wrench Screwdrivers Ratchet/sockets Hex keys Leatherman Tire gauge Foam tire sealant

toilet paper Baby wipes Zip lock bags Trash bag Zip/wire ties Hand sanitizer Duct tape Fire Extinguisher Lighter/matches Compass

Bungee cords Jumper cables

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LIFE SAVING SKILLS Every family member should take time to learn these important skills:

CPR/Take 10

    

AED

Chocking First Aid

Control Bleeding

The following pages outline the process of several obscure but vital life saving skills that you may not think about needing during and after an emergency, such as what we saw in Puerto Rico last year.

How to purify water

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 How to open a can of food without a can opener  How to cook without electricity, gas or charcoal

Below you will find information detailing multiples ways on how to take care of yourself and your family after a disaster. These skills will come in handy should you find yourself without electricity & water for extended period of time.

Why Do You Need to Purify Water? Always purify water from an outdoor or unsure source before you drink it! It may not seem like such a big deal to drink a bit of dirty water (or even water which appears clean) if you are lost in the wilder- ness. But, sadly, most natural water sources are grossly contaminated.

Unpurified water – even from water which appears clean – often contains contaminants like:

Giardi intestinalis

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Cryptosporidium

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Campylobacter

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Salmonella

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E. coli

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Shigella

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Enterovirus

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Hepatitis A

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The CDC lists some of the possible effects of drinking these contaminants, the main ones being diarrhea and vomiting . Diarrhea and vomiting can KILL YOU when you are in a survival situation! They will cause you to further dehydrate, and can also limit your mobility (not to mention that they aren’t very fun to deal with). When the water is from sources near urban or agricultural environments, there are also risks of pesticides, herbicides, feces, chemical runoff, and much more. Boiling Water This is the best way to purify water if you don’t have a camping water filter. Simply boil the water for a minimum of 5 minutes, though it is even safer to boil the water for about 20 minutes. The problem is that this will require you to have some sort of fire-proof vessel. If you don’t, then you can try rock boiling.

1. Create a vessel to hold your water (such as out of pine bark) 2. Make a fire 3. Heat rocks in the fire 4. Put hot rocks in the vessel with the water 5. The rocks will cause the water to boil 6. Continue adding hot rocks to keep the water boiling

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Solar Still A solar still is great because it doubles as a water collection method (great for situations where there aren’t any streams, creeks, etc, such as in the dessert) and also a purification meth- od. You will need to have a plastic tarp, but a clear rain poncho would work too. 1. Dig a hole 2. Put grass, leaves, cacti, or any other moisture-containing things into the hole 3. Put a water collection vessel into the middle of the hole 4. Cover the hole with your plastic tarp 5. Put a rock in the center of the plastic tarp so the tarp angles downwards towards the water collection vessel

The idea behind the solar still is that, as the sun shines through the tarp, it will cause moisture to evap- orate from the hole and the things in it. The water vapor will go upwards, hit the tarp, and cool down. This will create a greenhouse effect and cause condensation to form on the bottom of the tarp. The drops of condensation will drip down into the collection vessel. Since the drops are from water vapor, the water should be (mostly) clean.

Build a Grass-Gravel-Charcoal Water Filter There are a few different ways to build these DIY water filters. They all work on the same basic principle though: the water goes through various layers of grass, gravel/sand, and charcoal. During each step, impurities in the water are removed. It is really important that you use charcoal as this is what will absorb the harmful bacteria, protozoa, and viruses. The other materials are more for filtering out big pieces of dirt. If you have spare cloth, then you can build the water filter this way. If you don’t have

spare cloth, then you can make a water filter in a found plastic bottle (luckily, there is usually trash around). If you can’t find a plastic bottle, then you can make a cone out of birch bark for the filter.

Bleach for Purifying Water In urban emergency situations where you are without clean water, bleach will likely be the best way to purify water. The EPA says bleach will kill most disease-causing microorganisms (though it will not remove chemical contaminants). They give these instructions: 1. If the water is cloudy, let it sit so particles settle on the bottom. Only filter the clearer water on the top. Or, you can filter the water through cheesecloth or a coffee filter. 2. Locate some bleach with 8.25% sodium hypochlorite. It should be unscented and have no additional cleaners added to it! 3. Add 6 drops to each gallon of water (2 drops per quart) 4. Let the water and bleach sit for 30 minutes. The water should slightly smell of chlorine. If it doesn’t then repeat the dosage and let it stand for another 15 minutes before drinking.

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edge of this lip with the bowl of the spoon facing outward from the can. Move your hand quickly back and forth over a small area at the crimped edge.  The friction from the spoon will eventually weaken and break through the top of the lid. STEP #2 : REPEAT AROUND THE PERIMETER OF THE LID  Once you have broken through the seal of the can, continue the same process around the lid of the can.  Rotate the can slightly so you can rub the spot right next to the first area you broke through. Repeat the process of breaking through the seal making your hole in the can slightly bigger around the edge each time. METHOD #3: KNIFE, SCREW DRIVER, CHISEL, ETC… This method of opening a without a can opener is rather intuitive. All you need is an object such as a knife, screw driver, chisel or similarly shaped tool combined with a little bit of muscle. If you have a hammer or other tool you can use to baton the top of your tool of choice, it can make this even easier. STEP #1: GATHER YOUR TOOLS Like any field expedient techniques, the tools you need for this one are common items that can be easily located. Whether you use your survival knife, the knife from your titanium cutlery set, a regular old household butter knife, flat screw driver, chisel, or putty knife, you just need to find one of these items or a similar tool. If you can also get your hands on a hammer, large rock, or sturdy piece of wood, it can be a bit easier to puncture the top of the can. STEP #2: BREAK THE CAN’S SEAL  Place your can right-side-up on a hard surface such as the ground, tabletop, or work bench.  Hold your tool so the tip is pointing down into the can on the top along the edge where the can was sealed.  Using either your free hand or hammering device, lightly strike the top of the tool until it punctures through the top of the can. Rotate the can slightly and continue puncturing through the lid in the can around the edge until you can access the contents.. Canned food is without a doubt one of the best assets you can have in your survival supplies. And yet, without one simple tool most people would be stuck in a survival situation. That’s why learning alternate techniques and how to be resourceful in a survival situation is so important.

THREE METHODS FOR OPENING CAN FOOD

METHOD #1: CONCRETE AND A CAN If you’re stuck trying to get a can open it doesn’t get any better than needing virtually zero equipment to get it done. You will always have access to a hard, slightly abrasive surface such as a concrete side- walk, street, brick, or rock, with a bit of elbow grease you can have a can open in less than 60 seconds. The strategy behind this technique is using the abrasive surface to wear down and loosen the top seal on the can.  To do this, all you need is a firm grip and a little bit of muscle.  place the can top down onto a hard, abrasive, surface such as a concrete sidewalk or brick.  Next, forth like you’re scrubbing a cast iron pan.  Once the top of the can begins to loosen, you may see liquid start to emerge around the edges or small breaks in the seal. At this point, you’re ready to open the can. STEP #1: LOOSEN THE TOP OF THE CAN  STEP #2: POP THE LID (The next step is removing the loosened lid so you can enjoy the food inside).  Holding the can right-side-up, carefully squeeze the sides of the can about one inch below the top.  If the lid doesn’t pop off immediately, rotate the can and squeeze from a different side.  You may need to do this all the way around the can until the top breaks free. METHOD #2: EVERYDAY METAL SPOON Whether it’s the titanium spoon from your bug out bag, or a regular old metal spoon from your kitchen drawer, spoons are one of most common items you should have no trouble locating in an emergency. With just a little bit of friction on the top of the can using your metal spoon, you will have the can open in no time. STEP #1: BREAK THROUGH THE SEAL  place your can right-side-up on a hard flat sur- face such as a table, bench, or even the ground.  hold the spoon in one hand like you would hold a hammer with the “bowl” of the spoon closest to your pinky finger. With the other hand, firmly hold the can in place.  On the top of the can, there is a raised lip around the edge where the manufacturer sealed the can. Position the tip of the spoon against the

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Camping Stove There are all sorts of camping stoves which can be used safely. If you live in an apartment and are serious about prepping for emergency situations, I’d recommend getting a good camp stove suitable for the indoors and stocking up on fuel. Tuna Can + Toilet Paper Stove This one was learned while hiking with a former Israeli Special Forces guy. Apparently, the Israeli army gets fed a lot of canned tuna. Here is how it works. 1. Open a can of tuna in oil. It would work with something else oily too. 2. Take 3 pieces of toilet paper and place them over the tuna. They will absorb the oil. The toilet paper should create an air-tight seal around the lid of the can. 3. Set the toilet paper on fire. Best to do this out- doors or in a safe indoor area away from anything that could ignite. 4. It will burn for a LONG time (up to 25 minutes)! Not only does it cook the tuna, but you can put something over the flame to cook it too. 5. Remove the toilet paper and enjoy your tuna. This also works as a great emergency light source and emergency heat source!!!

Cooking without Power

BBQ Grill This is the most obvious solution. If you want this to be your emergency cooking method, then choose a BBQ which is coal powered and not gas powered! Open Fire This is the simplest solution. You can just set a BBQ grill plate over the open fire and cook. If you don’t have a grill, then things get a bit more com- plicated. You will have to put two or three branches (about 2in thick) over the fire and set your pan/pot on top of these. As the branches start to burn away, you will have to slip a new branch in their place. Good luck not spilling the food while you do this! Or you can create an A-frame out of branches and suspend a soup pot from it. Another option for cooking over an open fire is to use a big rock. Just prop a wide, flat rock over the fire. It will get hot and you can put your pot or pan right on it. Ember Roasting Make a fire and get some serious embers going on. Then let the fire burn out (or keep the fire to one side of your pit only). Put some food on the em- bers. Go ahead and bury it in the embers. The em- bers will cook the food. Since the outside of the food is going to get covered with ash, this method is best for foods like corn on the cob and potatoes. But you can cook almost anything like this if you put it in tinfoil first. Dutch Oven Dutch ovens are big, heavy cooking pots made from cast iron. You set them right on top of the fire and/or cover them up with coals. These are espe- cially great for making stews. Earth Oven In simple terms, an earth oven is just a pit with a fire built inside of it. But there are a lot of different ways to make an earth oven. Native Americans used a cool method where they’d dig a pit, put hot stones at the bottom and then cover it with branches. On top of this would go the meat and veggies. It would be covered by something moist, which would create steam. Then would come a layer of soil to retain the heat. Reflector Oven A reflector oven is a box with metal inside of it. There is a shelf in the middle for supporting the food. It works by using radiant energy from a camp fire to bake food inside of it. You will need to make a big fire to bake in a reflector oven, and the heat source will need to be consistent.

Example of an Earth Oven

Brick Rocket Stove An outdoor stove can also be created by stacking bricks to create a chimney. Stack one layer of bricks into a “U” shape. Next, put a steel mesh grate on top of the bricks and stack another layer of bricks around the U shape to secure the grate leaving the middle of the grate open. Continue stacking the bricks around the grate to create a chimney about 3-4 ft. high. Build your fire on top of the grate inside your chimney. Place a metal cooking rack on top of the chimney opening so you have a surface to set your cookware on and viola! Outdoor stove!

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The Capital Area Council of Governments and its partners are pleased to offer an emergency notification system to residents of Central Texas. Registering with WarnCentralTexas.org allows local officials to contact their communities by phone, email and text during times of disasters or public safety events.

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What’s New This Flu Season?

A few things are new this season:  Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].  For the 2018-2019 season, the nasal spray flu vaccine (live attenuated influenza vaccine or

“LAIV”) is again a recommended option for influenza vaccination of persons for whom it is other-

wise appropriate. The nasal spray is approved for use in non-pregnant individuals, 2 years

through 49 years of age. There is a precaution against the use of LAIV for people with certain

underlying medical conditions. All LAIV will be quadrivalent (four-component).  Most regular-dose egg-based flu shots will be quadrivalent.  All recombinant vaccine will be quadrivalent. (No trivalent recombinant vaccine will be available

this season.)

 Cell-grown flu vaccine will be quadrivalent. For this vaccine, the influenza A(H3N2) and both

influenza B reference viruses will be cell-derived, and the influenza A(H1N1) will be egg-derived.

All these reference viruses will be grown in cells to produce the components of Flucelvax.  No intradermal flu vaccine will be available.  The age recommendation for “Fluarix Quadrivalent” was changed from 3 years old and older to 6

months and older after the annual recommendations were published last season to be consistent

with Food and Drug Administration (FDA)-approved labeling.  The age recommendation for Afluria Quadrivalent was changed from 18 years old and older to 5 years old and older after the annual recommendations were published last season to be con- sistent with Food and Drug Administration (FDA)-approved labeling.

What flu vaccines are recommended this season?

For the 2018-2019 flu season, providers may choose to administer any licensed, age-appropriate flu

vaccine (IIV, RIV4, or LAIV4).

Options this season include: 

Standard dose flu shots. These are given into the muscle. They are usually given with a needle, but two (Afluria and Afluria Quadrivalent) can be given to some people (those aged 18 through 64 years) with a jet injector.  High-dose shots for older people.  Shots made with adjuvant for older people.  Shots made with virus grown in cell culture.  Shots made using a vaccine production technology (recombinant vaccine) that does not require the use of flu virus.

Live attenuated influenza vaccine (LAIV) – or the nasal spray vaccine – is also an option for use during the 2018-2019 season for persons whom it is otherwise appropriate.

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What viruses will the 2018-2019 flu vaccines protect against?

There are many different flu viruses and they are constantly changing. The composition of U.S. flu

vaccines is reviewed annually and updated as needed to match circulating flu viruses. Flu vaccines

protect against the three or four viruses (depending on vaccine) that research suggests will be most

common. For 2018-2019, trivalent (three-component) vaccines are recommended to contain:

 A/Michigan/45/2015 (H1N1)pdm09-like virus

 A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus (updated)

 B/Colorado/06/2017-like (Victoria lineage) virus (updated)

Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, are

recommended to contain:

 the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus

Can I get a flu vaccine if I am allergic to eggs?

The recommendations for people with egg allergies are the same as last season.

 People who have experienced only hives after exposure to egg can get any licensed flu vaccine that is

otherwise appropriate for their age and health.

 People who have symptoms other than hives after exposure to eggs, such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who have needed epinephrine or another emergency medical intervention, can also get any licensed flu vaccine that is otherwise appropriate for their age and health, but the vaccine should be given in a medical setting and be supervised by a health care provider who is able to recognize and manage severe allergic conditions. (Settings include hospitals, clinics, health departments, and physician offices). People with egg allergies no longer have to wait 30 minutes after receiving their vaccine.

Implications of Cell-Based Vaccines

Why is it significant that cell-grown vaccine reference viruses are used to produce some components of one type of flu vaccine?

Cell-grown reference viruses do not have the changes that are present in egg-grown reference viruses, so they should be more similar to circulating “wild-type” viruses. Vaccine effectiveness depends in part on the match between the vaccine virus and circulating flu viruses.

Is flu vaccine made using a cell-grown reference virus and cell-based technology more effective than vaccine made using an egg-grown reference virus and egg-based technology?

While the use of cell-grown reference viruses and cell-based technology may offer the potential for better protection over traditional, egg-based flu vaccines because they result in vaccine viruses that are more similar to flu viruses in circulation, there are no data yet to support this. There is no preferential recommendation for one injectable flu vaccine over another.

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By Amanda Baker, Captain

The Austin-Travis County EMS Honor Guard was founded in 2003. Paramedic TJ Callis was motivated to create an Honor Guard after witnessing the honors extended to his brother, a Corpus Christi firefighter tragically killed in a vehicle accident. The department supported the establishment of the Honor Guard, though initial equip- ment expenses were the responsibility of the members. The initial 12 members were dedicated to the cause and were willing to do whatever it took to form the unit. Their commitment and necessity would be realized sooner than they imagined. Only months after the Honor Guard’s inception, the Austin-Travis County EMS family lost one of their own. Paramedic Mike Becker, knowing he was losing his battle with cancer, asked the Honor Guard to perform his funeral services upon his death. The Honor Guard performed remarkably under the most difficult of circumstances. This event helped justify and solidify the existence of the Honor Guard in the Austin/Travis County EMS system. In the years since, the ATCEMS Honor Guard has rendered honors at countless other memorial services, marched in several parades each year and recently has become the primary Honor Guard team to perform opening ceremonies at Circuit of the Americas. The unit has grown from the initial 12 dedicated members to a roster of 20 members. The Honor Guard also represents ATCEMS at State and National events. Each year, members of the team participate in the annual luncheon at the Texas EMS Conference where the opening of the luncheon serves as a memorial for Texas EMS providers who have lost their lives in the line of duty over the past year. Additionally Captain Mark Hawkins and Captain Geoff Winslow have also traveled to the Air Medical Memorial service in Colorado and also to the National EMS Memorial service in Washington D.C. Though the roster may have changed with time and the events the Honor Guard performs are often not memorials, the Honor Guard’s primary mission remains to honor our brothers and sisters in the public safety realm. The Honor Guard stands ready to answer the call and if requested to render honors, will remain with the fallen from the time requested until their interment. The Honor Guard also supports and guides the family through steps to be taken. The members of the Austin Travis County EMS Honor Guard demonstrate the utmost professionalism when called and serve with honor, compassion and dedication to the cause. The team’s motto inscribed on the team’s challenge coin sums up this calling, Sempiternus Honos et Respectus. Everlasting Honor and Respect. History and Mission of AUSTIN-TRAVIS COUNTY EMS HONOR GUARD

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List of current Honor Guard Members are:

Captain Amanda Baker (Team Lead)

Clinical Specialist Ariel Jewell

Commander JC Ferguson (Team Captain)

Clinical Specialist Lisa DeMayo

Captain Eric Gordon (Team Captain)

Clinical Specialist Ricardo Aguilar

Captain Mark Hawkins (Team Captain)

Clinical Specialist Kimberly Blumberg

Commander Blake Hardy

Medic Pieter Ingerman

Commander Millie Zapata

Medic Michael Ruiz

Commander Temple Thomas

Medic William Morse

Captain Bryan Green

Medic Rachel Green

Captain Geoff Winslow

Medic Coty Baker

Clinical Specialist Fiona Thomas

Medic Melody Malone

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Explorer Spotlight

Future career goal?

She would like to become an author.

Interests?

She enjoys learning new things, riding her horse, writing, and looks forward to resuming archery soon. Most memorable experience? Her most memorable experience was when she fully convinced her fellow post members that she was paralyzed during a scenario. She adds that they “performed their duties splendidly.” Accomplishments



Community Service Recognition

 Recipient of an Individual Recognition Citation

Take Away

Hope Rodriquez

Hope acknowledges that the post has brought out her “inner nerd” and has no regrets about joining!

Events Captain

Honor Guard member since February 2018

Post member since December 2016

Interested in getting to know more about Hope and the other members of Explorer Post 247.

Visit emspost247.org to learn more and register to join

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COMMUNICATIONS CALL OF THE QUARTER

1st quarter

Edwin Sanchez-Rodriguez – Call of the Quarter (Jan, Feb, March)

On February 13th Edwin took a call from a 2nd party caller requesting EMS for an elderly female that was complaining of being dizzy and short of breath. During triage, the patient lost consciousness and stopped breathing. Edwin moved flawlessly into CPR instructions. Edwin continued to coach his caller through compressions until first respond- ers arrived on scene and took over resuscitation efforts Edwin demonstrated exceptional caller manage- ment skills and provided timely and appropriate care for the patient. Please join us in congratulating Edwin on a job well done.

2nd quarter

Ken Bostick – Call of the Quarter (April, May, June)

On May 15th Ken took a call from a 1st party caller advising that she was 24 weeks pregnant, alone, and the baby was crowning. Ken moved quickly through triage and began to give instructions for the delivery. He reassured her that medics were on the way and that he was going to help her until they reached her. Less than 5 minutes later, Ken was moving to post-delivery instructions for the baby boy that could be heard crying in the background. Ken was able to reassure mom and provide excellent care for her and her son until first responders reach the patients. Please join us in congratulating Ken for his assistance in the birth of a screaming baby boy!

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Folding up the flag with a tour group from Scotland who graciously volunteered to help

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ATCEMS PIO team and EMS Explorers help stretch the American flag across the Capitol steps for the Patriot Flag Project

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REALIGNMENT OF DIVISION CHIEFS and RESCUE OPERATIONS OVERSIGHT

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Recently we evaluated the current roles and responsibilities of Division Chiefs and realigned oversight of shifts and special programs. These changes were made based on Division Chief input and business needs of the organization.  Division Chief Pete Didonato w ill continue oversight of A Shift and assume responsibilities for Special Events.  Division Chief Eric Jakubauskas w ill continue oversight of B Shift, Scheduling, Tactical, Blood Draw and Honor Guard.  Division Chief Adam Johnson w ill assume oversight of C Shift and continue responsibilities of Emergency Management.  Division Chief Wes Hopkins w ill assume oversight of D Shift and continue responsibilities in Fleet and Facilities.  Division Chief Ed Piker w ill assume oversight of the Community Health Paramedic program and Education Wellness and Employee Development.

Oversight for Rescue Operations will be handled accordingly:

 Day-to-day operations will be the responsibility of the Division Chief over the shift

 Training will be coordinated through EDWD

 Equipment will be Division Chief Wes Hopkins

 Deployments will be coordinated through Emergency Management

Thank You,

Teresa Gardner, Assistant Chief - Operations

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UPDATE FROM THE CHIEF

I am pleased to announce that I have appointed Commander Brian Bregenzer as the new Division Chief assigned to the Emergency Communications Division.

In his new role, Division Chief Bregenzer will be overseeing the department's activities in Emergency Communications, Community Health Paramedic communica- tions activities, and Homeless Outreach Street Team support services.

During his tenure, he participated in the Communications Supervisor Internship Program, and held the position of Communications Supervisor and Communications Commander. He has completed the Communications Center Managers Course, is a certified ALERRT instructor.

Division Chief Bregenzer currently oversees Technology Management for Communications and recently implemented a major upgrade of Live Move-Up- Module. He also leads the Aviation Communications Specialist Program and the Communications Special Events Response Team. He maintains certification as a Licensed Paramedic, Emergency Medical Dispatcher-Q, and American Heart Association Health Care Provider.

Ernesto Rodriguez, Chief

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Employee Recognition

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KUDOS

WELL DONE

Herrera, Jason Milburn, John

Risinger, Rusty Jeans, Chris

We are writing to commend you for having in your employ two most outstanding gentle- men Medics Jason Herrera and John Milburn. On Friday, August 18, these young men answered a call to 911 for help. They came to our home, rendered the services required in an efficient, knowledgeable and thorough manner; they were polite and respectful as they methodically carried out their duties; and they were skilled in allaying the fears and uncertainty one experiences regarding an illness by their calmness and caring manner. These two gentlemen are fine examples on a level to which others should aspire. Thank you for having selected them to become a part of your organization.

On August 29th you took excellent care of my teenage son. I would like to thank you from the bottom of my heart for the care you gave him. He is improving every day and doing great.

Tammy J.

Watkins, Jeff Marquardt, Anthony

The patient wanted to let us know that she was very pleased with our services, stated there were so many people out there that helped her and they were very, very nice. She stated her neighbors were so happy and we should be proud. She mentioned the paramedics wanting to go into her house to look at her medications to complete their job.

Sincerely,

Margaret Hackett Ambulance Billing/Coding Supervisor

CONGRATULATIONS

Please join us in congratulating Commander Ed Piker on his new appointment to Division Chief. In his new role as Division Chief assigned to Employee Development & Wellness Division he will be overseeing the departments activities in:



Continuing Education



Training Academy



Employee Wellness and Wellbeing



Community Health Paramedic

 Homeless Outreach Street Team (HOST)

Congratulations Division Chief Piker!

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EXCELLENT

Kyrstin LaRose / Esme Harvey

On August 17th Kyrstin took a call from the grandfather of a 15-year-old female that was having a seizure. The patient was reported as unconscious and “gasping” for air. At the completion of triage, the patients breathing was not returning to normal and Kyrstin evaluated it. It was determined that the patient was not breathing adequately and Kyrstin moved to CPR instructions. Early in the instructions, the call disconnected. Kyrstin made multiple attempts to get the grandfather back on the line and was unsuccessful. During this time, the grandfather called back to 911 and Esme took the call when transferred. Esme quickly realized she had Krystin’s caller back and continue providing CPR instructions where Kyrstin had stopped. Esme continued to coach both of the grandparents through the process until first responders arrived and took over resuscitation efforts. The grandparents were so distraught they apparently didn’t realize that the nameless, faceless individual that helped them was actually two people working cohesively toward a single goal from miles away. Please join us and the family in thanking Kyrstin and Esme for their seamless management of this call and their contribution to its positive outcome. Strong Work Ladies!

Below is the letter from the family.

Dear Austin EMS,

As I write this, it is exactly two weeks ago that we called 911. When I called, I was hoping that Catherine would suddenly come back to normal. She had been so fine in the minutes before we called. We are so fortunate to have reached the right person. We found the address of our daughter's home pretty quickly. We knew the event was medical. We knew she wasn't breathing, but every once in a while she would gasp. We thought it was breathing, but afterwards we found out it was not productive. You asked if we had an AED, and we said no.

You asked to clear her air way and if we knew CPR. I said no and in clear, calm, yet forceful words, you told me what to do. We started CPR. I will say we started it together. You asked us to say “now” if she did breathe. We were kind of a mess at this point. She really wasn't breathing, but you had also sent help. All the help was amazing and you probably know the results. Catherine went home today, just two weeks later, with no physical or neurological problems. We learned some things as we waited for Catherine to recover. What is done in the first 4 to 6 minutes has a great deal to do with determining the outcome. In Catherine's case the CPR saved her life and her future. We owe that to you and that is significant. We don't underestimate all the events that followed, the CPR, the shocking of her heart, all the medication, and all the care that got her to the hospital includ- ing her first helicopter ride, the great care at the hospital by dedicated people, and many, many prayers from all over the country, but you got it started on the right track. What you did was amazing and even though I don't know a name or a face, we will be eternally grateful for what you did.

Ron and Lorraine N.

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Hello,

I am a Victim Services Counselor for APD. Today, I worked a call where we requested EMS and were unsure of if they would be able to help or how. The medics who arrived were Allen Clark 2684 and Jeff Elias 2284 in M2. They went above and beyond so I wanted to express my gratitude and make sure their kindness was acknowledged. The community is lucky to have them and I felt so fortunate to have their help as well. Today in this case they were called to the home of a 74 year old woman with numerous medical prob- lems. Her husband was walking today when he was struck by a vehicle and taken to South Austin Hospi- tal for an emergency surgery. Before the husband went into surgery he was able to tell officers that his wife was at home alone. Officers went to their residence and initially did not get a response at the door. Officers decided to hop the fence and see if they could spot her in the home from the back win- dows. They were able to find her sitting in her wheelchair in the kitchen. She was hard of hearing and not able to get to the door on her own to let them in. Fortunately they had the key to the residence from the husband and were able to get in and check on her. They noticed that her catheter was leaking and she had defecated herself. She was dependent upon oxygen and seemed to have memory issues. She only has home health care once per week but they attempted to get the home health care nurse out in an emergency situation. We were told they were going to be unable to send a nurse to help. Officers had requested us, Victim Services, to assist. We exhausted phone numbers to potential family/friends and had no luck with home health care or Adult Protective Services. Eventually we heard back from a friend but she was two hours away. We were unable to spend two hours sitting with the wife, so we contacted EMS. It did not seem safe to leave her by herself and we were not qualified to deal with her catheter issue nor did it seem humane to leave her in her soiled cloth- ing for that length of time. When EMS arrived the wife adamantly refused transport. The medics were extremely patient and kind with the wife. They did everything they could to make her as comfortable as possible to stay in her home until her friend arrived. They also had the idea to ask neighbors if they could sit with her for the time being and fortunately the next door neighbor was familiar with the wife and her husband. The neighbor agreed to stay with her until her friend arrived to be with her. I had not thought to ask neighbors for help. I was so impressed with their critical thinking and creative solutions in addition to their overall care displayed towards this woman. They sat with her and us until we had made sure there was a solid, safe plan in place. They even contacted home health care and were able to get them to agree to come to the residence tonight, although home health care had told us no earlier.

I was extremely grateful for the medics help and felt it would have been easy for most people to have the wife sign the refusal screen and leave quickly, but they were invested in this woman’s wellbeing and truly cared about helping her.

Thanks for taking the time to read this, and I hope they will be commended for their exceptional actions. These medics truly went above and beyond.

Stephanie Burgess Austin Police Department Victim Services Unit Crisis Response Team Lead Counselor

Allen Clark

Jeff Elias

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K. McSherry 5 years

Our values and principles are Excellence in Service, by People Who Care. Your dedication and commitment serve as a vital link in the chain which drives our department. The years of service award symbolizes the time you’ve given to help us as we pursue those values and principles. It is also a token of appreciation for the part you’ve played in making ATCEMS what it is today. Your talents and efforts already have helped us achieve excellence in many areas.

FAREWELL

THANK YOU

Meagann Wade , EMS Customer Care Program Manager

Amanda Baker, Captain

A very special thank you to Captain Amanda Baker for helping out Community Relations and Injury Prevention during her light duty assignment. Amanda attended community events, car seat events, tagged along on Fall Prevention home visits and caught us up on some overdue data entry. Thanks so much Amanda!

Meagann has been with ATCEMS for 2 years and served as the EMS Customer Care Program Manager. Meagann will be leaving us at the end of the month and although we are sad to see her go, we wish her the very best in her future endeavors.

Lisa Sepulveda

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Mark Karonika

Doug Arnold

Rilie Flanagan

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Customer Service Response:

319 calls were made during August. The questions asked focused on measurable

customer service actions.

27  “The crew was very nice, very patient and actually helped convince him to go to the hospital as he was about to change his mind. I appreciated their attention and help. If we were to need your service again we would like it to the these same medics.”  “Mike was absolutely fantastic, talking to me explaining everything and was very calming. They both came back to my room, assured me I was in good hands. They were both wonderful and caring.”  “Those guys were awesome. Very professional. I was very happy as I couldn't ask for better care in my situation. The medic’s who came out to help me came to an emergency call at my job. I was very, very impressed with the medic’s as they worked very professionally and hard to save a co-worker that didn't make it. I really, really appreciate them.”  “They were really honest with me about my situation. Couldn't believe I was standing and handling my shoulder separation as well as I was. Looked like it way be worse than it seemed and the doctor need do check it out.” Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 70% of the patients rated the customer service they received at a 5 and 20% rated their service at a 4. The average rating overall was 4.55 out of 5 for customer service. The response we obtained from our customers is evidence of the great medics we have and the tremendous job they do each and every day.  “They were incredible, amazing, and very helpful in a tough situation. Everything is much better now.” Patient Comments:

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