PULSE Magazine Nov-Dec Issue PE

P U L S E November/December2018 ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION

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November/December 2018

Contents

Featured News

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CADET CLASS 1018 GRADUATION

Congratulations to Cadet Class 1018 who gradu- ated from the Academy on Friday, December 7, 2018. Cadet Christopher Waters, who is a return- ing ATCEMS medic, gave an inspirational speech that we share with you.

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30th ANNUAL CHUY’S CHILDREN GIVING TO CHILDREN PARADE This year marked the 30th anniversary of the annual Chuy’s Parade. The ATCEMS float was once again decorated for the occasion and many EMS personnel and their families participated in this very special event.

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VIOLENCE IN EMS

First Responders, more so those of us in EMS systems, have one job risk that is not only rising in its frequency but is increasing in scale and se- verity. It's violence. Article by Walt Settlemyre.

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COMMUNITY HEALTH PARAMEDICS MAKING A DIFFERENCE The ATCEMS Community Health Paramedic Program seeks to connect people in need with resources that improve their health and increase their overall quality of life. Article by Lia Bermudez.

HOLIDAY CELEBRATIONS

We’ve put together a special section of EMS folks enjoying themselves at a few celebratory events.

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Division News

In Every Issue

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YOUR PHOTOS

Catch a glimpse of your coworkers in action.

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EXPLORER SPOTLIGHT

This month’s Explorer in the spotlight is Michael Gonzales. Michael is striving to one day become an anesthesiologist. He will be graduating in May 2019 and will continue his education at the University of North Texas.

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EMPLOYEE RECOGNITION

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

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YEARS OF SERVICE AWARDS

The Years of Service award symbolizes the time EMS employees have dedicated to serving their community and helping ATCEMS achieve its vision, goals and legacy of excellence. It is also a token of appreciation for the part you’ve played in making ATCEMS what it is today.

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Outstanding First Responder Nominations The 100 Club of Central Texas honors first responders for exemplary acts of duty. We are excited to announce that Outstanding First Responder Nominations have opened for the 36th Annual Awards Banquet. Nominations will be accepted until end of day Friday, January 18th.

Completed nominations may be emailed to: ea@100clubcentex.com

or mailed to:

The 100 Club of Central Texas, 3200 Steck Ave. Suite 240 Austin, Tx 78757

Please take a few moments to review the category guidelines

Administrative Technician

 Provides exemplary assistance to field personnel  Creates systems or processes to simplify office work  Provides a product or attitude which the department could not work without

Emergency Communications Operator

 911 Operator who goes beyond the call of duty to protect the lives of first responders or the general public

Emergency Medical Technician/Firefighter/Law Enforcement Officer

 Goes above and beyond the call of duty in a particular incident  Showed exemplary bravery or skill *one award will go to each

Team Award

 Demonstrated ability to work seamlessly as a team  Outstanding group work ethic, including ability to protect public and each other

Lifetime Achievement

 Additional community service or contributions to the department throughout career  Going beyond job description or call of duty to streamline processes, assist the public, ect.

Questions regarding nominations may be directed to Eleysa Richards at The 100 Club of Central Texas. 512-345-3200 / ea@100clubcentex.com

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29th Annual Feast of Sharing This years Feast of Sharing took place on Wednesday November 20th. Chief Brown, Chief Gardner and Chief Hopkins volunteered during this years event. In addition Lisa Sepulveda staffed an information table on the various events, classes and programs ATCEMS provides.

Join in the festivities and experience the joy as we stop in 24 different communities all over Texas to provide holiday meals and good cheer at our annual HEB Feast of Sharing holiday dinner. Feast of Sharing is the culmination of a year round commit- ment HEB makes to fighting hunger. In addition to a holiday meal you can enjoy music, arts and crafts, and kids activi- ties. Our December dinners may even feature an appearance by Santa himself.

An average Feast of Sharing dinner serves:

• 3,000 pounds of sliced turkey • 2,500 pounds of cornbread dressing • 750 pumpkin pies • 380 gallons of mashed potatoes • 140 gallons of turkey gravy

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Cadet Class 1018 Graduation

Congratulations to Cadet Class 1018 who graduated from the Academy on Friday, December 7, 2018. Cadet Christopher Waters , who is a returning ATCEMS medic, gave an inspi- rational speech that we share here with you. “Ladies and gentlemen, Friends, family, and distinguished members of the department. On behalf of the cadets of the Austin-Travis County EMS Department Academy Class 10/18, I would like to welcome you, and to offer our sincere and heartfelt thanks for your presence on this very special day, which is a culmination of many long weeks of hard work and perseverance. My name is Cadet Christopher Waters, and before I begin, I would like to thank my fellow cadets for selecting me to deliver this speech today. It is an honor to do so, and I was immensely moved to have been chosen by my peers to stand before you today. I have served in the public safety profession for 17 years, as a paramedic, a law enforcement officer, and a firefighter, and, most significantly, I am a former member of this department with 10

years of service. I say this not to focus the attention of the day onto myself, or my profes- sional accomplishments, but to reveal to you my unique perspective on the experiences I have shared with these amazing professionals who stand before you. I am no stranger to training academies, having been through several over my career, and indeed each academy I have attended has been unique both in structure and in substance. That being said, public safety training academies share one universal quality, that they take groups of individuals, and though weeks and months of intense and unrelenting effort, turn those individuals into a cohesive group of professional public servants. To quote Theodore Roosevelt “ Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty. I have never in my life envied a human being who led an easy life. I have envied a great many people who led difficult lives, and led them well”.

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This journey we undertook 10 weeks ago has been one of effort, pain and difficulty in varying degrees, and each cadet you see before you persevered through adversity and hardship to achieve success, and the honor of standing on this stage today. Academy training is not designed to be easy, as indeed the career we have chosen is not an easy one. Academy train- ing is designed to test the will and character of each individual, and to build that individual up in every way. Over the last 10 weeks we have witnessed our fellow cadets improve themselves in ways that they had not imagined possible, and I have witnessed, and experienced for myself, personal triumph and success through difficult and challenging circumstances. Academy train- ing is a process of bonding, of personal growth, and of becoming a team. It is a process of learn- ing to think and to act not as individuals, but as part of something far greater. It is a process of becoming a family. To quote Abraham Lincoln “ Next to creating a life the finest thing a man can do is save one.” This is the class 10/18 motto, and I believe it exemplifies what our profession represents. EMS is not merely a career, but a lifestyle. This lifestyle we lead is one of difficulty at times, but also offers great rewards for those who feel the calling to serve and to protect those in need. To my fellow cadets I offer this wisdom and insight: this life will not always be an easy one. In my career I have suffered loss and pain, I have sacri- ficed time with loved ones, and I have cried many tears. When you face these moments, as you all will, look to those around you for support, because you will always have it. This is a family which supports each other in times of

need, and in this department you are never alone. This calling offers many challenges, but it also offers joy, love, happiness, and the true satisfaction of knowing that you have made a difference in someone’s life. Hold these things dear, and always stand by those in need. In conclusion, 10 weeks ago we began this process as strangers, all starting out on a new adventure together. Today we stand together as one, ready to move on to the next challenge, knowing that we do not face anything alone. I am proud to have spent 10 weeks with each one of my fellow cadets, and I am honored to have been a member of this fine academy class. Finally, on behalf of the class, I would like to thank the academy instructors, and all the department members who dedicated their time to this process. Without your hard work, sacri- fice, and true dedication to our success this day would not have been possible. To quote our favorite and oft repeated running cadence “this is my family”

Who are we? 10/18!”

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Graduating Class of 1018:

Anderson, Keenen

Broussard, Kevin

Caffery, Samantha

Castellanos, Christopher

Davis, Alexander

Delle, Jacob

Eguia, Eduardo

Faulstich, Ashley

Fonnesbeck, Blaine

Hatten, Blu

Hindman, Justin

Homan, Patrick

Horton, Diamond

Jeppesen, Andrew

Johnson, Katherine

Kartchner, Tyler

Kipp, Oliver

Leibin, Michael

Lotfalian, Iraj

Macias, Christie

Morgan, Micah

Rodriguez, Kendrick

Schold-Bourland, Chris

Smith, Jesse

Thomas, Patrick

Valadez, Daniel

Ward, Christopher

Waters, Chris

Westby, Andrew

Wines, Matthew

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By Walt Settlemyre, ATCEMS Clinical Specialist

VIOLENCE IN EMS A New Strategy

What makes our chosen profession inherently dangerous? You could name the big ones that come to mind, driving code 3, exposure risks to disease, blood and respiratory pathogens, as well as the ever presence of PTSD. These all certainly pose great risk and the list is varied and fairly long, however we as First Responders, more so those of us in EMS systems have one job risk that is not only rising in its frequency but is increasing in scale and severity. It's violence. Violence isn't new to our profession by any means. If you've been in this job for any length of time you've likely been both a witness and victim to some level of violence. Statistics show violence toward medical personnel, especially First Responders in EMS are not only rising, but the severity of these attacks is also increasing. Fire

Service is also certainly at risk for violence howev- er a fire crew's numbers, usually four, if the department follows NFPA 1530, can help mitigate physical violence secondary to their numbers how- ever it does happen. Sadly the evidence also shows that violence against medical personnel and again more so with EMS workers, is highly under reported! There isn't a tremendous amount of data actually for this very reason. Health care workers often do not report these incidences unless they receive some kind of severe injury. Most seem to assume that bumps, bruises, and a little pain are part and parcel with the jobs they've chosen. EMS professionals, Nurses, and Doctors,

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of those were death by animal however the statis- tics I viewed didn't detail what the nature of those animal incidences were...but I'm curious! Falls, slips, trips were a close third with 849 incidences but you get the point. Remember these are just the fatalities for 2016. These do not include inju- ries. According to statistics kept by OSHA, the Federal Occupational Health and Safety Admin- istration, serious workplace violence was more common in health care than any other private sec- tor industry. EMS workers are little different. The NAEMT found that four in five EMS workers have experienced some kind of on the job injury with the majority, 52%, coming from assault. The problem of violence against EMS personnel is not only widely underreported but it is overlooked by EMS executives, researchers, and educators as well as practitioners. Our profession is not like that of Law Enforcement and Fire Service where they highly promote a culture and training geared specifically to personal survival. In EMS we are patient safety centric and the vast majority of our training goes specifically towards patient care and other operational considerations. And, honestly the problem of violence towards medical providers while slowly escalating over the years was rarely addressed by anyone in the profession because of the stigma involved. Much like PTSD reporting in the field of health care, admitting there's a prob- lem by providers and administrators alike has his- torically been slow in coming. The ATCEMS system is a rare one in that our cadets receive training in defensive tactics while in the academy. That's actually very progressive compared to the rest of the country in regards to our profession. Recently some of us here in ATCEMS have been working towards making train- ing available to our employees who want to learn self defense and how to better control a combative patient. DEFENSIVE TACTICS

especially in Emergency Rooms are the front lines of medicine in our society and while these groups bare the greatest amount by percentage, violence towards Doctors, Nurses, and Technician type jobs such as Xray, Respiratory, and many others also have their fair share of both physical and or verbal abuse from patients and family members. VIOLENCE IS THE SECOND LEADING CAUSE OF INJURIES FOR MEDICAL PERSONNEL In a study published 2017 by the US Bureau of Labor Statistics, Fatal Occupational Injuries by Major Event For Medical Personnel for 2016 showed that violence was the second leading cause. Transportation being first with 2083 deaths. Violence was 866 incidences. Oddly, some

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About a year ago, Clinical Specialist Will Adams began an off duty program here called First Responder Jiu Jitsu. He wrote a proposal to the department and was able to persuade them to purchase mats for Medic 17's station where he now holds training regularly. For those of you who don't know him, Will is a high level Purple belt at Paragon Jiu Jitsu here in Austin and has trained for years in BJJ and striking. He saw a need for this kind of training and is teaching our people on a regular basis. Going to a Jiu Jitsu school can be a bit intimidat- ing, especially if you've never trained before. His program allows folks to come and learn in a friend- ly, non-threatening environment with friends and colleagues they know. And it's free. Dr. JR Pickett, ATCEMS Deputy Medical Director, has come on board and is also a Judo Black Belt. He also offers Judo classes to any employees who want to learn! It's quite rare that an EMS system has that kind of talent much less offering free training to the employees. Building on Will's program, Andre Thompson and myself, both Jiu Jitsu practitioners as well, wanted to offer something a little different. We were look- ing for a program that incorporated not only the physical tactics but more importantly fear psychology, pre-fight contact cues, and ways to de-escalate potentially violent encounters. We put in a proposal to our union, Austin Travis Co. EMS Employees Assoc. to fund a train the trainer class for self defense. We saw an amazing opportunity to attend a course that offered all that we were looking for, was easily taught, easily learned, and was in line with what the body already does in the “jack in the box” moment of sudden violence, the startle flinch response. The association agreed and we were able to attend The Spear Certification Course.

oped by Tony Blauer, a long time martial artist and self defense coach. He's been coaching people on how to be safer for over 30 years. What makes Spear so unique is it is based in human psycholo- gy, physiology, and the startle flinch response all humans possess. Spear, is an acronym for Sponta- neous Protection Enabling Accelerated Response. In Coach Blauer's own words, “The Spear System utilizes the speed and reliability of the startle flinch mechanism to convert the sudden attack into a tactical counter. It's a bridge between the reactive brain and the cognitive brain. This improves reaction time during confrontations. The Spear System combines the old brain's most important function, to survive, with the new brain's intelligence, to think and decide, this awakened a nonperishable personal defense system that can make every human safer!” What it means for us as First Responders is that it allows us to gain and maintain positional dominance in a violent encounter, especially the “ambush” or surprise attack. Arguably the most dangerous of attacks because it's the attack you aren't prepared for or expecting. Spear methodology utilizes a thought process regarding violence called the Three Ds: Detect, Defuse, Defend. The best self defense move is to avoid the need for self defense. So the first D, Detect , refers to understanding those moments before violence occurs, not only the pre fight contact cues but that weird “something is wrong' feeling that most people describe getting before a situation turns violent but often dismiss. The second D, Defuse refers to tactics to defuse a possibly violent person, whether that's verbal judo, walking away, or however you can defuse and de-escalate the situation. And finally Defend , the physical aspect of the Spear System. Spear takes what the body does naturally using the startle flinch response with the hands coming up to protect the head and face and

WHAT IS SPEAR?

Spear is a very unique self defense program devel-

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weaponizes the flinch response to push away danger. Tony Blauer often describes this as an organic airbag deploying! In fact the Spear thesis statement is, “What does the body want to do naturally prior any training? Does this response have a combative application? If so, why aren't we integrating it? This sums up the use of the startle flinch response as a self defense mechanism very well. Another aspect of the Spear training that I found invaluable is the Cycle of Human Behavior, or The Neuro-Circuitry of Fear which is a schematic that Blauer came up with that will actually help you understand not only how and where you are in the fear loop but gives you a better understanding on how to get out of it. Further, there are five basic tenets of Spear and these explain very well why the Spear System is such an excellent program for not only First Responders, but anyone wanting to be safer! First, science . The Spear System is the only behaviorally based self protection method based entirely on physiology, kinesiology, physics, and psychology. Second, its simple . All the Spear movements are based on how humans actually move. Spear does not teach memorized patterns or any compli- cated techniques. Third, the legal issue. In real world confron- tations force must parallel danger. The Spear Sys- tem is in line with all moral, ethical, and legal di- rectives. This is exceptionally important as a First Responder where the line between a patient and an assailant must be defined and is often a grey area. More on this later. Fourth, Totality. The Spear methodology is a holistic approach to self defense. It is based on emotional awareness, intelligence, modern psy- chology, as well as practical and functional move- ment. It also teaches how to avoid, deescalate, BEHAVIORALLY BASED SELF PROTECTION

Series of SPEAR program movements

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and if necessary how to protect ones self.

And lastly, it's proven . Coach Blauer has been training law enforcement and military personnel since the early 90s, but actually formed the base of what is now the Spear System back in the 1980s. He and his staff have been training LEOs, military, and civilians around the globe.. The system has been field tested and proven in many departments and agencies throughout the world. At the end of this article I will provide links to studies and information on the safety and efficacy of the Spear System including medical information and scope of technique on use of force. Yet another reason we leaned toward the Spear System is the amount of research and self analysis Tony Blauer and his company do. One unexpected bonus to this training Andre and I found came in the form of the gentleman who taught our class. James Pierson, who is the recent- ly retired Police Chief of Henderson, in East Texas. Chief Pierson spent 29 years in law enforcement before retiring this past July. Although these days he's an Adjunct Professor for the Police Academy and does occasional work as an investigator for the DA as well as expert witness work, he's been teaching the Spear System since the mid 90s and has been with the Spear Mobile Training Team training instructors since 2016. His experience in law enforcement was certainly helpful but it was his teaching style, his breadth of life experience, and his life long quest for learning that really brought another dimension to the class. Whenever you come across an instructor that cares about the knowledge they are passing on and is able to look at that knowledge from an open- minded vantage point, it speaks volumes. Many people in any community of training will make whatever it is they do, teach, or practice a dogma. Often not opening their mind or body to any other disciplines or thought processes. RELEVANT FOR THE EMS ENVIRONMENT

Walt & Andre with Instructor James Pierson

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From the very beginning this was not Chief Pierson! He discussed his interest and training in multiple martial arts and fitness in the form of power lifting and how they all lend something to both his life philosophy and his self defense thought process. In fact he's a high ranking black belt, 7th Dan, in the Korean style of Hapkido and still competes in that martial art. However, unlike many martial artists he has sought out other disciplines to be more well rounded. He's trained in Boxing, Brazilian Jiu Jitsu, and the Filipino Martial Art of Arnis which consists of stick fighting and edged weapons. Just a few weeks before his retirement he won the State Powerlifting Title at the Annual Texas Police Games as well as two Bronze Medals in Karate at the same games. Bringing that kind of experience and knowledge to a class on self defense as well the body mechanics and propri- oception needed to articulate how the Spear System can interweave with whatever your own personal style of self defense is, is priceless. To that point, one of the main tenants of Spear is that it is not a martial art. It is adjunct to whatever system or style you want to use what- ever that may be. Chief Pierson was also able to make the class relevant for the environment of EMS for Andre and I. For someone with such an extensive law enforcement background and given that we were the only two EMS providers in a class full of LEOs he very effectively showed us excellent examples of the applications of Spear methodology in relation to the types of situations we in EMS find ourselves everyday. He also gave us some great examples of training evolutions and methods he has utilized for Fire and EMS in Henderson in the past. Though we were extremely fortunate with having Chief Pierson, these are the main reasons we chose Spear as the best program to learn and bring back to train our folks here in ATCEMS and the region.

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The efficacy of the techniques and the easy appli- cation to the EMS work environment. When Andre and I were researching this project our end goal was to have techniques and a methodology that worked and was effective in our environment, the back of an ambulance, one that we could pressure test under duress, did not com- promise patient or provider safety, was easy to learn and employ, and was usable by most any provider regardless of weight, size, gender, and ability as well having ambidextrous applicability. But especially the pressure tested issue! Most self defense systems and techniques are taught as both some kind of pain compliance and, or learned gross motor skills and are scenario and situation dependent such as getting out of head- lock or bear hug. These moves not only require repetitive drilling once learned correctly, but again are entirely situation dependent. We felt that avoiding the headlock or bear hug for example by seeing, interpreting and acting on the pre fight contact cues to move away from danger would have a much higher amount of efficacy than teach- ing someone first how to be in a headlock or bear hug then getting out. I realize that seems very simplistic but think of most any self defense train- ing you've received. Were you taught to detect and avoid danger or did you learn what to do if some- one put you in a specific hold? Do you still remember the moves if that was the case? While getting out of headlock or bear hug have a valuable place in self-defense, for what we do as EMS professionals, these techniques not only rarely occur but must be drilled repeatedly to maintain competence. Further, most use of force violations occur because a technique that was taught and drilled on a compliant training partner rarely if ever works on an uncooperative and com- bative person resisting with all their strength. When a technique is applied to an actual high stress, high intensity situation where a person is combative and actively fighting and that technique isn't working, the natural human tendency is to

apply more strength, more power, and go to baser instincts of striking when the technique is ineffec- tive. Also it's noteworthy to mention here to never let ego or pride dictate your actions in any hostile or violent encounter. The risk and implications of allowing this to occur are all bad. Real violence looks nothing like the movies and mutual combat is not what routinely occurs. Sudden violence is just that. Attackers look for the element of surprise and act impulsively. When speaking of use of force, especially in regards to First Responders, force must parallel danger. You must apply the minimal use of any technique to gain and maintain positional dominance. Striking or kicking a patient should be an absolute last ditch effort where a provider truly fears for their life in a violent encounter. Again this shows the need for us as a profession to better define not only what constitutes, but what separates a patient from an assailant. Spear teaches that in any violent confrontation or fight, there are actually three fights. The first is the realization that the situation could turn violent. This is an emotional attack. Your heart rate increases with the adrenalin spike you feel and your body begins the pathophysiology of fight or flight. The second is the actual fight itself. When the violence occurs. The third is the fight after the fight, the confrontation with your supervisor, the department, and even the judicial system possibly. You must be able to articulate why and how the actions you took were necessary. If the force you applied does not parallel the danger you faced you can be held liable for damages and injury as well as your employer if you're on duty. In this day and age of cell phones and videos going viral quickly, the court of public opinion can carry a lot of weight. IN ANY VIOLENT CONFRONTATION OR FIGHT, THERE ARE ACTUALLY THREE FIGHTS

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We as First Responders must be able to detect these incidences as they are playing out and be able to deescalate them and if necessary be able to use nonviolent postures that can easily and effectively segue to defensive techniques that allow us to gain and maintain positional domi- nance. This is the one of the very best aspects of the Spear methodology and why we are so passionate about bringing it to our providers! When both myself and Andre pitched our idea to the Association we offered to pay our own travel expenses to the course in Grand Prairie, near Dallas. When we announced our plans to go to the Spear course after the Association graciously agreed to pay our tuition, a very interesting thing happened! Many of our fellow medics here in ATCEMS as well as a Hays Co. EMS employee and a few good family and friends donated their own money for our travel expenses! This was not only unexpected but a bit overwhelming. When we entered in to this project, we had no idea how much support and interest we would ultimately receive. It's been pretty amazing to say the least! In fact, while initially working on this project I contacted Tony Blauer himself via email explaining what Andre and I saw as the issues facing our particular job specialty and how we had adapted Spear techniques to the back of the ambulance before we had any formal Spear training. Basically we got in the back of ambulance with MMA gloves and boxing head gear and truly pressured tested what we saw as the most common situations we encounter. We found using the limited understand- ing we had of Spear to be highly effective! Much to our surprise Coach Blauer himself responded to my email and wanted to speak with us personally over the phone to see what he could do to help us with our research and answer any questions we may have! In fact we ended up speaking several times via phone and email. Coach Blauer is the founder and CEO of his company, Blauer Tactical Systems. He certainly has plenty of well qualified instructors that could have spoken with us. Honestly I was never so bold as to ask to actually speak with him.

I emailed his assistant, Jenny Montes, who is always helpful in answering my many questions. It was Tony himself that asked us to jump on a call with him to answer our questions and see how he could help us! That’s not something you see a lot of CEOs of any company doing! He asked that we send him some videos of what we were doing with Spear in the ambulance environment to see both what we had come up with and how he might improve on what we were doing! Again, I don't know of any CEO that takes that kind of personal interest! Coach Blauer runs his company and still teaches both nationally and internationally. To say he's busy is an understatement, yet he took that valuable time for us. We were already Spear advocates however Coach Blauer's personal assis- tance certainly sealed our conviction. Andre and I are planning on offering Spear classes in the same delivery model that Will has pioneered for his Jiu Jitsu classes. We've also spoken with the CE folks about possibly offering a Spear class as part of CE in some capacity. We may also be offering Spear training at the Union Hall. Something we've also been working on is bringing this training to other departments in the region. Our larger goal is to help not only our people here at ATCEMS be safer, but all of our First Responder brothers and sisters. I've already spoken with Hays Co. EMS as well as a few key individuals with Star Flight who are personally interested in learning some of the Spear methodology and we are working on coordinating with them on possibly doing some Spear introduc- tion training with some of their folks who are inter- ested. Andre and I also had the opportunity to show a few of the folks from both Cedar Park Fire and Westlake Fire some of the Spear Proof of Principles Drills. These drills and the explanations behind the SO WHERE DO WE GO FROM HERE?

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system along with the thought process are pretty remarkable in their ability to convince folks of the efficacy of Spear in its application to sudden violence.

We hope to see you at one of upcoming training sessions. We are working on better ways to sched- ule and put out information on when and where. Till then be safe, keep your head on a swivel as they say, get some training, and we'll see you out there!

FREE SPEAR CLASSES

While reading this article you may feel as though I am working hard to sell you the Spear program and in a way I am, but not for money. The classes Andre and I are offering are no charge! The ATCEMS Employees Association was kind enough to finance our Train the Trainer class and our mission is quite simple: we want to make our people and all First Responders safer! Our profes- sion is already fraught with danger and uncertainty however, we can mitigate a great deal of that danger if we approach these issues in very methodical and thoughtful ways. That is our main objective. We've started a Facebook page called First Responder Defensive Concepts where we post information on training opportunities and articles of interest on violence and self defense in the realm of First Responders as well as advocate for getting formal training of some kind. We want to make all First Responders safer. No small task! If you're interested in learning more or have ques- tions for Andre and I about training, like and sub- scribe to our Facebook page or you can contact us via email listed below. There are some restrictions on where and who we train for liability reasons regarding training locations and liabilities and we are not a “for profit” training group in any way. Whether you get to one of our Spear training sessions or Will's and Dr. Pickett's training or not, it's important to learn some kind of self defense strategy as well as keep a situationally aware mindset. Most violent confrontations can be avoid- ed with simple situational awareness and good judgement but a pressure tested skill set and an understanding of human behavior can certainly tip the odds in your favor.

Contact Walt or Andre with any questions:

Walt.settlemyre@austintexas.gov

Andre.thompson@austintexas.gov

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Class photo of Walt and Andre with Grand Prairie PD, Grand Prairie Texas

Links to Spear Information

Spear website https://blauerspear.com

Spear medical information https://blauerspear.com/medical

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By Lia Bermudez, BA, EMT-B, Community Health Paramedic Program

Community Health Para

Field providers are always prepared to swoop in and save the day when there is an acute medical emergency or severe trauma that threatens life or limb. ATCEMS crews are the best of the best in making our patients’ worst days a little less scary, and a lot less devastating. At some point, though, every provider grows weary and frustrated when the patient’s needs go beyond the scope of emergency medicine. Many patients slip through the cracks of society, leading to a vast population of needy and underrepresent- ed citizens. The ATCEMS Community Health Paramedic Program seeks to connect people in need with resources that improve their health and increase their overall quality of life. The vision of the program is to make healthcare available and accessible to a vulnerable and underserved population. Through the utilization of local resources and partnerships with other organiza- tions, CHP envisions a city with increasing equality of healthcare and a decrease in disparity of healthcare options. Clients are often aware that resources exist, but do not know how to get from Point A to Point B. A large part of CHP is navigating these clients to the right place, walking with them through the application process, and anticipating what other services they may need. While the CHP program is constantly evolving, as is the role of the CHP medic, there are currently several programs and functions in place to serve the target population. Enter the CHP’s.

The Street Med Collaboration and HOST are two programs that work specifically with the homeless population. Street Med is a pilot program that brings medicine and services to where homeless clients live. An ATCEMS Sprinter is outfitted as a mobile clinic, with a Nurse Practi- tioner on board. Field crews have likely seen the Sprinter under various overpasses, with CHP medics engaged in care with homeless clients. A partnership with CommUnity Care allows a Nurse Practitioner to do full medical assessments, write prescriptions, and make referrals to specialty providers and imaging. The Homeless Outreach Street Team (HOST) engages the homeless population in downtown Austin through collaboration between ATCEMS, the Austin Police Department, the Downtown Austin Community Court (DACC), and Integral Care. The HOST team helps their clients obtain essential items such as valid identification, birth certificates, and access to many other services that can address their needs. They help people begin the process of getting off the street and into housing. Both Street Med and HOST offer clients assistance in filling out applications for MAP, many times beginning their medical coverage the same day. Referrals to mental health services and substance abuse treatment are also performed on a regular basis. Coordinated Assessments are administered to assess clients’ eligibility to receive housing. A key element to both programs, and central to CHP’s overall vision, is preventive and proactive measures that reduce unnecessary hospital transports. Both HOST and Street Med make a regular practice of using alternate transport to

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edics Making A Difference

clients’ healthcare destinations, including use of the ATU. Clients are frequently transported to appointments and other resources, freeing up ambulances to attend to critical patients within their districts. Another valuable CHP program that is gaining momentum is the Opioid Emergency Response Project . PCR’s that capture data about opioid overdoses in the field are forwarded to CHP, activating a response process. When possible, a CHP will meet the patient at the hospital, or will follow up at the patient’s home to offer a Naloxone kit and connections to healthcare resources. Through CHP, clients have access to medically assisted treatment options, as well as peer recovery coaching. Because of the efforts of the Opioid Emergency Response Project, CHP medics are seeing clients who were once homeless become housed. Those who were once jobless are working for the first time in years. Some are entering class- rooms to pursue their dreams, no longer bound by addiction. The Incarcerated Program serves clients that are in Travis County Jail and at the Austin Transitional Center. Incarcerated individuals are historically at risk for increased reliance on emergency medical systems during incarceration and upon release from the criminal justice system. Proactive methods used by the CHP program help to create a healthier environment within the criminal justice system and connect inmates with needed resources prior to release. This involves a partner- ship with CommUnity Care and Central Health that administers regular screening, assessments, pre- scription services, and coaching, as well as access to MAP. The Incarcerated Program also works to

decrease the number of 911 calls to the Travis County Jail and to the Austin Transitional Center. Preventive measures and prompt follow-ups help reduce the number of preventable EMS calls to these locations. The Pop-Up Resource Clinic (PURC) is an integration of multiple agencies and resources, made accessible to the homeless population in one location. September’s PURC, for example, included Central Health, CommUnity Care, Integral Care, ECHO, the VA, the CARE team, Harm Reduction, and HOST. With a clinic on-site and no appoint- ments needed, attendees can be seen by a provider immediately. They also have access to services for mental health, substance abuse treatment, housing, and medical funding.

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After carefully studying the needs of the most vulnerable populations in Austin, a remote monitoring pilot is developing in the Community Health Paramedic program. Through a new part- nership with local hospital networks, the vision consists of patients being educated about their medical conditions and learning how to properly monitor their health. Community Health medics have recently been trained in the use of remote monitoring equipment to be installed in clients’ homes. Clients will be empowered to participate more fully in their healthcare by checking their

-encompassing machine that can affect change in virtually every aspect of a client’s life. Each program has a specific function, but all share the common goal of lessening the load on emergency response crews, while increasing the quality of life for a needy population. The Community Health Paramedic program has evolved from a focus on mental health services to an all-encompassing machine that can affect change in virtually every aspect of a client’s life.

vital signs daily, with support and regular follow-ups from CHP med- ics. This fits into the preventive approach that the CHP program already employs, and prevents unnecessary costs associated with readmission not be covered by their insurance. Other healthcare systems have proven the effectiveness of this model. Now CHP is hoping to spearhead the effort of joining forces with Austin’s hospitals to put this program into motion. Throughout its short life, the Community Health Paramedic program has evolved from a focus on mental health services to an all

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Chad Stowe

Please read below regarding the AWESOME work and dedication this crew has! We can't brag on how much the crews on M23 are like family and what they wouldn't do for the community.

Thank you, Ryan Smith

Fire Chief - Fire Marshal Travis County ESD No.12

I wanted to commend Chad Stowe for going above and beyond the call of duty on his shift November 12, 2018. Medic 23 along with Star Flight, DMO2 and our crews from ESD12 ran a medical call off of Littig. I was not on this scene so I was not witness to what happened that night, however long story short the ambulance became stuck in mud. In the process of removing it, there were deep ruts left in the yard.

The part that I witnessed and the reason for this email is when I came on duty the morning of the 13th, I saw Chad putting up some of our spare fire rakes and tools. I then asked him what he was up to and if he needed help. He reluctantly told me that he asked to use those items to fix something from the night before. He had driven home, felt bad about the callers situation and the ruts that were left so he drove all the way back out to do what he could in order to repair the yard. He stopped and purchased bags of soil, and borrowed tools to fix the yard as best he could! I wanted to be sure to send this up his chain of command and express how grateful we, the members of TCESD12, are that he cared enough to do this act of kindness.

Respectfully,

Chris McKenzie Battalion Chief / Training Officer Travis County ESD # 12

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EDWD

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Congratulations ATCEMS Paramedic Program

James Coleman , Clinical Specialist Kim Blumberg , Clinical Specialist Tyler Smith , Clinical Specialist Austin Peele , Clinical Specialist

Did you know we just cleared our first Clinical Specialists that came through the ATCEMS Paramedic program? James Coleman and Kim Blumberg have spent most of the last 2 years busting their butts in the first ATCEMS Paramedic process and then the latest Clinical Specialist process in addition to working full-time. Way to go! The inaugural ATCEMS Paramedic program was a combination shakedown cruise/trial by fire with staff changes at TEEX, weekly schedule changes, changing plans for ride outs, and a myriad of other issues the students and instructors conquered with patience and grace. Many of you probably heard little or nothing about the process but Donny Rose and Trevor Burrier did a fantastic job leading the program through all the difficulties and over all the obstacles inherent in a new process. The students in the program put in a ton of hard work and were excellent ambassadors while completing clinicals and ride- outs in other EMS systems. The latest Clinical Specialist process ran like a Swiss clock thanks to another outstanding effort from Chris Parker at the OMD, the Medical Directors, and ATCEMS Academy staff. Those folks do their job so well the process looks smooth like butter to a casual observer but it is not easy. I have only mentioned a few names but everybody here helped out. Thanks to the folks who did all the dirty work to get the Paramedic program approved and worked out a deal with TEEX to make it happen.

Thanks to all the training officers who came in to teach and run scenarios.

Thanks to everyone who helped a classmate get through the Academy/ Paramedic P rogram/ Clinical Specialist process.

Thanks to everyone who worked OT shifts, voluntary and otherw ise, so the folks in the Clinical Specialist program could attend classes.

Thanks to everyone whose professionalism makes this place work every day, gives ATCEMS the great reputation we enjoy, and makes this the place so many medics want to work.

You make me proud to work here. Mike McDaniel, Captain

Since starting with the department in August 2015, Tyler Smith successfully completed the depart- ment's paramedic program, tested # 1 in the Clinical Specialist promotional test, and is now among the newest esteemed credentialed Clinical Specialists that persistently worked hard to earn their position. Austin Peele was also part of this last Clinical Specialist academy who not only successfully credentialed, but as my ALS cadet proved that he just didn’t want to “get through this,” but rather better himself as a provider. Austin’s efforts were unparalleled as he not only did a superlative job on weekly homework assignments and tests, but also managed to study for, and successfully pass the CCP-C (Critical Care Paramedic) exam issued by the IBSC.

Congratulations to Tyler, Austin, and ALL of the recent credentialed Clinical Specialists!! Tony Smith , Captain

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WAY TO GO!!!

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Captain Brian Hadas re- cently talked to students about his job in EMS and educational requirements.

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by Allyson Hall

Explorer Spotlight

Future career goal?

Michael is striving to one day become an anesthesiologist. He will be graduating in May 2019 and will continue his education at the University of North Texas.

Interests?

He loves anything and everything related to medicine. He also enjoys playing tennis at his high school.

Favorite Aspect of Exploring

He is thankful for the opportunity to partic- ipate in scenarios either in a first respond- er role or as a proctor. He appreciates the opportunity to practice skills as well as help others learn them.

Accomplishments

Michael Gonzales Platoon B Lieutenant Member since March 2018

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Mental Health Awareness Training

Interested in getting to know more about Michael and the other members of Explorer Post 247?

Visit emspost247.org to learn more and register to join .

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Employee Recognition

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SPECIAL THANKS

A very special thank you to Medic Obie Jones , Commander Paul Alvarez and EMS Explorer Post 247 for their participation in the Chuy’s Parade. Obie Jones drove the ambulance, Paul Alvarez drove the command vehicle pulling the float and the Explorers showed up early to help decorate and put the finishing touches on all vehicles. Commander Alvarez also helped me take all of the decorations off the float at Headquarters after the parade and drove the float trailer back to EDWD when we were finished. Thank you Obie, Paul and the Explorers for outstanding teamwork and your continued dedication to helping with community events like these.

Sincerely,

Lisa Sepulveda

Shop with a First Responder event at Target Southpark Meadows. Thanks to the EMS personnel who participated: Jason Cantu, Jason Beggs, Ed Piker, Mike Benavides, Eric Jakubaskas, Darren Noak, Eric Gordon, Brian Bregenzer, Wes Hopkins, Rick Rutledge and Jasper Brown.

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Employee Recognition

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APPRECIATION

CONGRATULATIONS

Mark Hawkins Matthew Paul

Eric Gordon, Commander

It is with great pleasure to announce the promotion of Eric Gordon to Commander. In his new role, Commander Gordon will continue to focus on the wellbeing of our employees through his work in the Safety Office.

A patient contacted our office today and wanted us to relay that he really appreciates the gentlemen that helped him. He stated he was in pretty terrible shape, the guys were great, actually excellent, and he appreciates them very much.

Thank You, Jodi Hassinger, Ambulance Billing and Coding Supervisor

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