PULSE Magazine | February 2019 Issue PE

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

February 2019 P U L S E ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION February 2019

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February 2019

Contents

Featured

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ATCEMS ATTENDS ANNUAL JEMS CONFERENCE

Last week Austin-Travis County EMS Medics attended the EMS Today Conference & Expo in National Harbor, Maryland. Among those who attended were Chief Ernesto Rodriguez, our Nightwatch Nation cast members, our Austin EMS Association President Selena Xie, and an ATCEMS JEMS Games team.

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CELLULAR INFLAMATION: THE STEALTH BOMBER WITHIN Most of the time, inflammation is a lifesaver that enables our bodies to fend off various disease-causing bacteria, viruses and parasites. The instant any of these microbes slips into the body, inflammation marshals a defensive attack any tissue it may have infected. Then just as quickly, the process subsides and healing begins .

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FLASHBACK: FORMER ATCEMS DIRECTOR SHARES NEWS ARTICLES AND PICTURES FROM THE EARLY DAYS

Recently we were contacted by former EMS Department Director, Dennis Simmons, who began his career with the City of Austin’s EMS Department in December 1975 as an EMT/Paramedic. He quickly rose through the ranks, serving as Shift Supervisor, Operations Supervisor, and Deputy Director before becoming Director.

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FEBRUARY IS NATIONAL HEART HEALTH MONTH

Is it too late to change your unhealthy lifestyle? Maybe you’ve eaten one too many hamburgers or made it a daily habit to buy salty chips from the vending machine. Maybe you’ve purchased a gym membership only to stop going after a month. Poor food and exercise choices over prolonged periods of time may lead to severe health consequences.

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Division News

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COMMUNIITY RELATIONS: ANNUAL TEDDY BEAR DONATION FROM THE AUSTIN JUNIOR FORUM Austin-Travis County EMS and local first responder agencies received their annual teddy bear donation from the Austin Junior Forum Teddy Bear Program yesterday. The AJF Teddy Bear Program provides Teddy Bears & Dalmatians for local public safety agencies to give to children involved in traumatic events.

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EMERGENCY MANAGEMENT DRILLS & EXERCISES

Over Austin- Travis County EMS medics participated in numerous regional exercises, drills, and trainings. These exercises better prepare ATCEMS to respond to infrequent yet dangerous incidents. the last few weeks

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EMPLOYEE RECOGNITION

CHP POP-UP RESOURCE CLINIC

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

This months Pop-Up Resource Clinic (PURC) was the largest to date! On Thursday, February 21st, our A TCEMS Community Health Paramedics and their partners served over 100 people experienc- ing homelessness.

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Annual Awards Ceremony Call for Nominations

The Austin – Travis County EMS Awards Ceremony is approaching soon! ATCEMS will once again recognize the accomplishments, achievements and outstanding performance of our employees in 2018. More information will be sent out soon on the date and location. Nominations - Please take a moment to consider any memorable accomplishments or situations that you think deserves consideration for formal recognition. To view the complete award program document, please click here – ATCEMS Awards Program. You can either email nominations to Milissa Warren or use the Employee Recognition Form on the departmental website.

DEADLINE TO NOMINATE: March 15, 2019

Review Team - We strongly believe that recognition comes from all levels of the organization and that employee and peer feedback is a vital part of the process. As such, the second critical component of the nomination process is reviewing the nominations and providing recommenda- tions to the Executive Team regarding the level of award that should be considered for an individ- ual or team. In order to provide a thorough review, we need sworn and non-sworn employees from all areas of the Department to participate. Participation in the nomination review process provides a great opportunity for you to see what we are accomplishing throughout the Depart- ment and allows you to help shape how we recognize our successes. Typically, the review team meets just once or twice to discuss the nominations so it isn’t a huge time commitment but does have a big impact.

DEADLINE: If you would like to participate in the Awards Nomination Review Team, please contact Milissa Warren by March 1 st

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February is National Heart Health Month What are the facts?

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Last week Austin-Travis County EMS Medics attended the EMS Today Conference & Expo in National Harbor, Maryland. Among those who attended were Chief Ernesto Rodriguez, our Nightwatch Nation cast members, our Austin EMS Association President Selena Xie, and an ATCEMS JEMS Games team. The JEMS Games is a challenging and educational clinical competition for emergency medical personnel, highlighting cutting-edge simulation technology. The competition challenges teams to appropriately assess and provide efficient patient care during realistic high-pressure scenarios. The EMS Today Conference was attended by 4,600 EMS professionals from around the world to learn about the most innovative products and services available to the EMS Industry.

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FLASHBACK: ATCEMS Director and EMS Trailblazer Dennis Simmons

Recently we were contacted by former EMS De- partment Director, Dennis Simmons, who began his career with the City of Austin’s EMS Depart- ment in December 1975 as an EMT/Paramedic. He quickly rose through the ranks, serving as Shift Supervisor, Operations Supervisor, and Deputy Director. He was named Director in February of 1983 when Sue Edwards was transferred to the Tax Office and was subsequently named Assistant City Manager. During his nearly 10 years with EMS Department, Dennis was part of the rapid growth and dramatic increase in sophistication of the service, and his many accomplishments highlight his aggressive and innovative leadership. He served on the City’s original 911 Committee to help plan and imple- ment the emergency phone system and presided over the City’s Disaster Management Committee. Mr. Simmons was instrumental in developing and implementing a station location study conducted with the LBJ School of Public Affairs and in devel- oping the department’s basic service delivery sys- tem. His commitment to public education led him to develop contractual arrangements to have CPR taught in all AISD schools. Simmons’ commitment to excellence in all aspects of the service provided the groundwork for the department to achieve national recognition when

it received the EMS System of the Year Award in 1984. But perhaps Simmons’ proudest achievement was the development and implementation of the STAR Flight helicopter ambulance program, operated cooperatively with Brackenridge Hospital and Travis County. Simmons has said STAR Flight was the most significant development of the EMS pro- gram, second only to its original establishment as a city department. Simmons’ loyalty and long years of dedicated ser- vice left a deep and indelible impression on the entire EMS Department developing it into what he calls a “First Class EMS System” and because of the support and dedication of all EMS personnel throughout the years this is never more true than today. After leaving the City of Austin Mr. Simmons spent two years in the managed healthcare indus- try in Temple Texas before becoming a consultant to foreign governments and companies. He was stationed in the Middle East from 1987-1992 and participated in Desert Shield and Desert Storm. From 1992-1999 he consulted with Physician Practice Management and two public companies located in St. Louis and New York City.

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Mr. Simmons pictured with Chief Rodriguez last year.

From 1999 to present he is the CEO of a private company, which owns and operates ambulatory surgery centers in New Jersey. He currently lives in Chappaqua, New York with wife Laura and stepson. Last year we were very honored when Mr. Simmons stopped by Austin-Travis County EMS Headquarters and visited with Chief Rodriguez and members of our executive staff. Mr. Simmons’ also shared an article published in JEMS Magazine in January 1985 written by Jim Page in which Austin EMS is awarded the NAEMTs prestigious Service of the Year Award for 1984. The article tells the important historical story about how the City of Austin’s EMS Department was conceived and details the early challenges and champions for the system who laid the groundwork that allowed for the innovation and progress we enjoy today.

The article follows this one on the next several pages.

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This article was written and published by Jim Page in the January, 1985 Issue of JEMS Magazine

Last May when I learned that the Leo Schwartz EMS Service of the Year Award would go to the City of Austin EMS Department, I wished that Leo himself could be at the NAEMT annual conference to celebrate the event. Mr. Schwartz, throughout his long and productive career at the National Highway Traffic Safety Administration, always had pushed for high quality in prehospital care and transportation. He was never reluctant to offer his opinion that quality could best be achieved through a separate “third service” municipal EMS agency. The EMS Service of the Year Award is one of several high points of the yearly conference of the National Association of EMST’s. The award which is sponsored by the Wheeled Coach Corporation, is based on an evaluation of entry materials submit- ted by EMS services competing for the distinction of being designated as the best in the nation. We enjoy the privilege of presenting the award on behalf of Wheeled Coach and then publishing a pictorial story about the winning service in our January Almanac issue. As it has developed, the EMS Service of the Year award is a fitting tribute to the winners of the awards and to the career of the man for whom the award is named. In our trips to Sheldon, Iowa, Durand, Michigan and Dallas, Texas, We have found organizations that are exemplary — provid- ing high quality EMS despite the typical obstacles and difficulties. In every case we have found a “can do” attitude and an unwavering commitment to reliable, state of the art of prehospital care and transportation. The Austin EMS Department is no exception. Whether volunteer or career, private, third services or fire department based, building an exemplary EMS system is an ongoing challenge. The job is never complete and there’s never an appropriate time for resting on the laurels of past achievements. I’ve been to Austin several times, and I’ve used the Austin example in speeches to

groups throughout the country.

Austin has impressed me for many reasons, but mostly because everybody in the system seems to realize that the system is being tested with each and every call. Even when things are running smoothly , the people of the Austin EMS system act hungry—they seem to possess a drive for constant self-assessment and improvement. The Austin EMS story can be traced back about 10 years. At that time, the city relied on a subsidized private ambulance service. The operator of that service demanded a big increase in the subsidy and City Manager Dan Davidson decided to study the whole issue of EMS. Davidson widely recog- nized as an exceptional manager, always sur- rounded himself with staff of bright young public administration generalists—and he delegated lots of responsibility and authority. Thus, Joe T. Austin director of urban transporta- tion, was given the task of studying the options for ambulance service. Working with a committee appointed by the city council, Joe traveled to other communities, reviewed the literature, and estimat- ed the cost of various alternatives. In January 1975, he presented a report to the city council which included three alternatives: Implement a new system through the Austin Fire Department, continue the arrangement with a subsidized private service or create a new municipal EMS agency to be financed through city general funds. City Manager Davidson recommended the third alternative and the city council agreed. A one year planning and implementation schedule was devel- oped and a quality assurance team was created. It consisted of several members, only one of whom was a physician. Chairman of the quality assur- ance team and still an active member was Michael Levy, publisher of Texas Monthly magazine. Levy is often mentioned as one of Americas most successful publishers and businessman and recently was honored by Esquire as one of 1984’s

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outstanding young citizens and he undertook EMT training himself to prepare for his role in monitor- ing the Austin system. The quality assurance team has been expanded to 30 members, in the mean- time six of whom are physicians. During 1975, the city recruited a director for the new system and began to put the pieces of Austin EMS department in place. It was launched on January 1, 1976 as a combination emergency and non-emergency service. Five of the original six am- bulances were committed to emergency work (both basic and advanced life support) and one unit was used strictly for BLS non-emergency transfer calls. The original units were based in rented apartments throughout the city and at the EMS department headquarters. Presently the Austin system operates 12 emergency ambulances (five ALS and seven BLS). In 1980 the city did away with the non-emergency transfer services, it is now handled by a private service operating under a city franchise. Each emergency ambulance is commanded by a senior crew member (senior paramedic or senior EMT). In addition , there are two field supervisor on duty at all times, they cover the north and south sectors of the city in non transporting vehicles. Austin is one of the fastest growing city in the US, and that growth is reflected in ever greater use of the EMS system. In 1984, the system handled nearly 34,000 calls with a city wide average response of 5.35 minutes. The dual tier system of BLS and ALS units relies on its dispatchers to determine whether a basic or advanced unit is re- quired. A basic call screening protocol is used to determine whether an ambulance is needed and, whether a BLS or ALS unit should be dispatched. Austin is located in Travis county. Since 1977, the Ems department has been serving the entire county as well as the city. The county population is 492,365 of which 403,723 is within the city limits. Inside the city the Austin Fire Department provides first responder services. In the unincorporated county areas, volunteer fire departments serve as first responders. Where other ambulance systems have become pawns as battles between competing hospital emergency departments the Austin system did not face that problem in its early days. There was only one emergency department in the city, Bracken- ridge Hospital, which is operated by the city. Currently there are four emergency departments and policies have been established to assure a fair distribution of patients between them. Bracken- ridge houses the city's only trauma center. There are 138 authorized positions in the Austin Ems department, including a director, assistant director, three program mangers of operations, training and evaluation, and support services and six shift supervisors. The system also employees a full time public information officer. More than half

the administration and supervisory staff has been with the system since it started. The systems open recruitment policies have brought a rich collection of people and experiences from throughout the country. Employment opportunity ads for the Austin EMS Department have regularly appeared in JEMS and other publications. The campaign generates about 200 applicants each year, about 70% from outside Texas. Out-of-state applicants must be certified in their home state and must have a least six months emergency ambulance experience. Regardless of prior training , certification and experience all new personnel are hired by the Austin system as EMT’s (BLS). They must then go through a six month probationary period. Probationary employees spend their first six months working as a third person with a training crew on a BLS ambulance. Even though most peo- ple who come to the system have already served as a paramedic somewhere else. Employees of the Austin system become paramedics by a process of promotion, which includes succeeding in the Ems department s certification program. At least one new employee was promoted to paramedic in 10 months, but for most it takes longer. When the process was first described to us, we wondered about decay of skills for the paramedic who comes to Austin from Illinois, Ohio, Georgia or elsewhere. Wouldn’t there be some regression in the year or more of starting over at the BLS level? Not necessarily, advised Victoria Lummur, assistant director of the EMS department. Basic life support skills—especially patient assessment is the area of greatest decay among active paramedics she pointed out, and those skills are actually emphasized or enhanced by the BLS ambulance experience preparatory to Austin’s advancement to the paramedic level. The very few scientific studies of paramedic skill decay support Lummur’ view- point. After promotion to paramedic, there is an addition- al period of performance review and scrutiny. For the first 48 hours in his new position, the Austin paramedic is accompanied and observed by a field evaluator. For the first six months new paramedics are on a six month probationary status under the watchful eye of a senior paramedic. Starting salaries for new employees currently are set at $15,500 per year, with top salary levels for EMTs at $23,063. Probationary paramedics earn $21,049 per year and can advance to senior para- medic at $25,494 per year. The Austin EMS system operates from 11 stations: eight of those stations are shared quarters with Austin Fire Department, but three of the are independent EMS stations. In 1982 I had the pleasure of speaking at the dedication of one of those independent stations a spacious, attractive

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well equipped facility with abundant room for sleeping, recreation and equipment maintenance.

facing Sue Edwards when she was assigned as director of the Austin EMS Department. She is another of Davidson picks who managed several other city programs before coming to EMS. Sue Edwards proved to be the right person for the Austin EMS department as it passed through its fifth and sixth years with notable calm. Edwards stream-liner the organization, concentrated on concept and programs that nurtured the organiza- tions people and their commitment to quality patient care. During her tour of duty Ms. Edwards implemented bottom-to-top systems of planning and goal setting. Every member of the agency participated in setting its goals, planning the future and evaluation the quality of service. When Sue Edwards was reassigned to the city tax department, her replacement was from within the ranks of the EMS department. Dennis Simmons was appointed officially as director in January 1984. Simmons knows the Austin system as well as anyone, he came to it in 1975 after working for the duplicated private provider. When he stood at the podium to accept the EMS Service of the Year Award on behalf of his department and its people, he embodied the pride and happiness of one who has traveled a long road of trial and progress. After Simmons returned home with the award City Manager Jorge Carrasco added to the honors. At a special ceremony, he provided the City Managers Excellence Award to each member of the EMS department. The award and photos of all members of the department at the time of the award are on display at the city's new EMS head- quarters building. Though I had no role in selecting Austin as the winner, I was pleased by the choice. In the past I have used Austin as an example of excellence, of what can be done in EMS. At the same time, I have shared with my friends at Austin the opinion that success and the symbols of permanence can be intoxicating lures one into self satisfied isolation and indifference. Being designated as the best in the nation can be a heady experience, but it takes a special effort to stay at the top of the heap. I have few doubts that the Austin EMS system will master that challenge. The commit- ment to patient care has become a cultural bond between the people in the system. The solid infrastructure constructed by Dan Davidson administration generalist is complemented by the street wise experience and ideas of people recruit- ed to the system from throughout the nation are harvested by Austin's form of participative management. We look forward to revitalizing Austin in a year or two. I look forward to telling Leo Schwartz, who is retired and living in Virginia, that the award that bears his name inspired an even greater effort toward long-term excellence in EMS.

There is no doubt that Austin EMS system is expensive, and that fact frequently has been cited by EMS evaluators and observers. But it doesn't seem to bother taxpayers in Texas’ Capitol city. In recent years, they have approved issuance of revenue bonds to expand the system to build EMS substations and to provide a permanent head- quarters building. On one visit to Austin, I ap- peared as the guest of a call in television talk show. It was impossible to get any controversy going, the callers simply wanted to praise the Austin EMS system. If the people who pay the bills are satisfied, who are we to criticize the cost? It has not always been a bed of roses for the Austin system. Starting a new Ems system in any community is tough. Very few implementers survive the start-up process in Austin, the first director of the system left after two years. When the asked me to recommend a replacement, I sent them a list of talented people to contact. Instead, they appointed Bill Bullock, who worked with the assistant director of the urban transportation department. I remember being disappointed, and predicting that the system would suffer without the leader- ship of an EMS professional. But, I seriously underestimated the brilliance of Dan Davidson’s system of administrative generalist. Before he left his post to enter private enterprise. City Manager Davidson’s regularly shuffled his cadre of bright young managers from department to department. Most often, they proved themselves very capable in mastering the technical mystique and manage- ment demands of a new discipline. Bill Bullock headed up the EMS department from August 1977 to May 1980. During that time, the system stated to settle down and concentrate on its legitimate task high quality patient care and transportation. With stable management and good relations with the city council and the quality assurance team, the system started to build the underpinning of permanence. Surely, Mike Levy has had a role in the change of attitude. On one trip to Austin I found myself in Levy’s high-rise office with Dennis Simmons director of the system, F. Watson manager of training, and G. Burge Shift Supervisor all looking at me. Levy challenged every aspect of my presumed bias toward fire service EMS programs. Thinking faster than a computer and speaking at machine-gun speed Mike Levy, one of the most influential people in Texas, left no doubt that he believed in the Austin EMS system and would fight like hell to defend it. But the powerful citizen advocate who makes him- self available to middle managers, paramedics and EMTs can be a real headache for the administrator of an EMS system. That was one of the headaches

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The system that earned the award in 1984 has demonstrated one of the most important lessons we can learn. That is, only the people of the organization can create and maintain excellence, regardless of the structure or form of the organization .

Right: Medic 5 was Austin’s first free standing EMS station. Photo credit Linda Aronosky. Below: Ribbon cutting ceremony at the new RBJ EMS Headquarters .

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Ribbon cutting ceremony and designation of the RBJ Health Center as the City of Austin’s EMS Headquarters building. Mr. Simmons is pictured 2nd from the left.

Former EMS Director Dennis Simmons farewell party in 1985. On page 17 the letter Mr. Simmons received from Texas State Representative J.J. Pickle in 1985.

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ATCEMS Received Annual Bear Donation from Austin Junior Forum Bears ride with local first responders and bring comfort to children in crisis

Austin-Travis County EMS and local first re- sponder agencies received their annual teddy bear donation from the Austin Junior Forum Ted- dy Bear Program yesterday. The AJF Teddy Bear Program provides Teddy Bears & Dalmatians for local public safety agencies to give to chil- dren involved in traumatic events. These stuffed animals have a calming effect, providing comfort and something tangible to hold during times of crisis. In recent years, more than 5,000 children have been involved in crisis situations, and the numbers continue to rise with the growth of our city. Over the years, Austin Junior Forum's Teddy Bear Program events have evolved from a simple picnic to include children's carnivals, outdoor concerts, golf tournament, 5K fun runs,

celebrity bear silent auctions, the Bikerz Bearz & Dogz Benefit Ride, and most recently participat- ing in the Amplify Austin Day to raise funds to support this valuable community service program. Wednesday's bear donation to ATCEMS will kickoff the 5th year of online fundraising for the AJF Teddy Bear Program with Amplify Austin Day , February 28-March 1, 2019. This year's goal is $15,000 , which provides 3,000 teddy bears and Dalmatians to children in crisis.

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Special thanks to the Medic 3 crew Hank Moore and Tim Nadeau for helping out!

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Emergency Management Drills & Exercises

Over Austin- Travis County EMS medics participated in numer- ous regional exercises, drills, and trainings. These exercises better prepare ATCEMS to respond to infrequent yet dangerous incidents. The lessons learned from these exercises are incorporated into future plans and training. The exercises ranged from an active shooter incident to practicing trans- ferring a simulated Ebola patient. February 5th: Regional Capital Area Council of Governments CAPCOG / Capital Area Trauma Re- gional Advisory Council CATRAC exercise in Round Rock, Texas. (Actually 3 different exercises in one day) The first exercise was an active shooter drill with multiple patients. Second exercise focused on an explosive device. The third exercise was a haz- ardous material and radiological incident. The training to place with multiple Police, Fire, and EMS departments from Travis, Williamson, and Hays Counties. February 6th : Also three different exercises. The first was a mock Emergency Operations Center (EOC) activation involving a coordinated attack in the region. The second exercise was a Medical Operations Center (MOC) exercise simulating a surge of patients in the region. The Ambus partici- pated in the third exercise where ATCEMS Medics transported multiple patients to Seton Medical Williamson County hospital. February 8th: ATCEMS Medics participated in an infectious disease respond unit exercise with Seton Healthcare Family. The exercise simu- the last few weeks

lated transferring a suspected patient with Ebola to an emergency room. ATCEMS practiced the most dangerous part of this type of call, the donning and doffing of personal protective equipment (PPE). Medics interacted in their PPE with hospital staff during a patient handoff phase. ATCEMS will be training approximate 30 medics in April to become part of the state wide infectious disease response unit. This unit will be part of the Texas Emergency Medical Task Force (EMTF) program. ATCEMS has many other personnel and units available to the Texas EMTF program includ- ing the Ambus, ambulance strike teams, and single role incident command personnel. February 20th: ATCEMS participated in an active shooter exercise at Camp Mabry. The exer- cise involved multiple patients, practicing our active shooter plan, mass causality plan, and pa- tient tracking. Patients were tracked to six differ- ent hospitals. The ATCEMS Homeland Security and Emergency Management Division plans most exercises with different agencies in the region. Our department normally participates in several large scale regional exercises each year and multiple smaller drills. If you have any questions about exercises or the Homeland Security and Emergency Management Division you may contact Commander Keith Noble at keith.noble@austintexas.gov.

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Cellular Inflammation

The Stealth Bomber Within

Most of the time, inflammation is a lifesaver that enables our bodies to fend off various disease-causing bacteria, viruses and parasites. The instant any of these microbes slips into the body, inflammation marshals a defensive attack any tissue it may have infected. Then just as quickly, the process subsides and healing begins. However, chronic inflammation is literally a stealth bomber, damaging your body just as deadly and silently as an invisible odorless poison gas. It has been linked to diseases as diverse as Cancer, Alzhei- mer’s, obesity, Congested Heart Failure (CHF), and Diabetes (DM). Inflammation is truly what Time Magazine called it decades ago: “The Silent Killer” As scientist have searched for the mysteries behind the diseases most likely to afflict us, they have alighted on one factor common to virtually all of them: inflammation. Chronic inflammation, has a role in a host of common and often deadly diseases. Scientist have not yet answered the major questions about inflammation, it remains a mystery. What scientist have discovered has led them to an understanding of how lifestyle choices like diet, dental health, and exercise may influence inflammation and its potentially damaging downsides. Nearly everything that’s an irritant to the system the air we breath, the tobacco smoke we inhale directly or indirectly, the some 80,000 chemicals we are exposed to in our environment has the potential to produce some level of inflammation. The food we eat can produce an inflammation reaction, and frequently does. Some foods, like sugar and excess vegetable oils, have the effect of turbo-charging our inflammation production pathways, while some foods like wild salmon (rich in omega-3s and antioxidant astaxanthin) have precisely the opposite effect.

Some of the anti-inflammatory superstars that you should include in your diet on a regular basis are:

Onions

Garlic

Leeks

Leafy greens (spinach, kale, chard)

Tomatoes

Bell Peppers

 Brassica Vegetables (Brussel sprouts, cabbage, broccoli, cauliflower)  Beans (all types)  Nuts and seeds  Spices (ginger, turmeric, cinnamon, cloves)  Herbs (parsley, rosemary, thyme, oregano, mint, tarragon, dill)  Tea (all types especially green teas)  Red wine (in moderation)  Cocoa/chocolate (darker varieties with minimum sugar)  Flaxseeds and flax oil

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Inflammation is a vital part of the immune system. When harmful bacteria, viruses or foreign substances enter the body, the body's defense system kick into gear. Chemicals ramp up the body to fight, centralizing the damaged area with blood, fluid, and protein: creating swelling and heat setting the stage for healing. When our body’s powers of correction go wrong, however, they can work against us. Unlike the inflammation that follows a sudden infection or injury, the chronic kind produces a steady level of inflammation within the body that can contribute to the development of disease. It’s the result in part, of an over firing immune system. Low levels of inflammation can get triggered in the body even when there is no disease to fight or injury to heal, sometimes the system can not shut itself off. Arteries and organs then began to break down under the pressure, leading to other diseases, including but limited to cancer, diabetes and heart disease. Scientist don’t fully understand how the immune system becomes short-circuited, but they have long known that some disease such as rheumatoid arthritis, emerge after the immune system has gone haywire and attacked healthy tissue. Researchers have discovered that fat cells can trigger the release of a steady, low hum of cytokines that go after healthy nerves, organs, or tissue. As we gain weight. The release becomes prolific, affecting our body’s ability to use insulin, sometimes leading to type 2 diabetes. Additionally inflammation cells can have an effect elsewhere in the body, chronically infected and inflamed gums within the mouth can cause damage that leads to heart attack and stroke as well as contribute to congested heart failure. Researchers continue to find answers about how chronic inflammation leads to cancer. Inflammation cells produce free radicles that destroy genetic material, leading to mutations that cause cells to endlessly grow and divide. Inflammation is the behind-the-curtain invading factor in many diseases. What can we do to keep it at bay? Currently, there are no prescription drugs that specially target chronic inflammation. Finding a drug that both interrupts the immune cycle and maintain a healthy immune response is important for all of us because as we age inflammation increase within the body. Researchers point to simple lifestyle measures we can all do to help prevent, and or control chronic inflammation. It is recommended to drop the extra pounds you carry around your middle and avoiding high fat and sugar diets. Losing weight can have a profound effect on lowering inflammation. Eating a diet rich in fruits and vegetables and low in fats, processed foods, and sugars. Exercising, causes an acute inflammation response in the short term, but an anti-inflammation one when we regularly get moving, is another strong step to take. In addition it is advised to get plenty of sleep, lower stress levels and seek out treatment for inflammation inducing culprits, such as gum disease. For the most part keeping inflammation in check comes down to common sense basics: eat healthy, exercise, obtain more rest, and stop smoking before chronic inflammation becomes rampant.

Data obtained from John Hopkins Medicine, Cardiovascular Medicine at Brigham, and ASN.

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Naveed Saleh, MD, MS, for MDLinx |

HOW TO HIT RESET FOR HEART HEALTH after years of unhealthy living

Is it too late to change your unhealthy lifestyle? Maybe you’ve eaten one too many hamburgers or made it a daily habit to buy salty chips from the vending machine. Maybe you’ve purchased a gym membership only to stop going after a month. Poor food and exercise choices over prolonged periods of time may lead to severe health consequences. But does that mean it’s too late to change? Can a history of inactivity and unhealthy eating be reversed? More specifically, can the damage done to your coronary arteries in the form of atherosclerosis be undone?

Can switching to a healthier lifestyle reverse a lifetime of bad diet and inactivity? It’s worth a try.

It turns out that successfully countering years of poor lifestyle choices and plaque buildup is complicated and requires plenty of elbow grease, but it’s not impossible.

Plaque According to the most recent report from the American Heart Association (AHA), nearly half of American adults suffer from some form of cardiovascular disease, and the number of related deaths in the US is on the rise, although it continues to drop globally.

Plaque buildup in the coronary arteries increases the risk of heart disease. Plaques can be shrunk and stabilized through intervention, but they can never be zapped out of existence.

Results from some studies indicate that intense lifestyle changes may shrink plaques. But a more realistic goal is to halt the progression of the plaque to decrease risk of heart attack and stroke. Preventive strategies have been linked to an 80% risk reduction in heart disease. Statins, such as lovastatin and pravastatin, play the most important role in fighting plaques. These medications lower low-density lipoprotein (LDL) levels, and LDLs are what deposit cholesterol into blood vessel walls. Diet Changing your diet at any age to mitigate the risk of heart disease requires real dedication. The number one recommendation from the AHA is to lose weight and then maintain a healthy body weight. Here are some recommended steps to take to do so, per the AHA:

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Eat plenty of fruits and veggies.

Eat fish twice a week.

Eat whole-grain, high-fiber foods.

 Decrease saturated fat intake to less than 7% of calorie intake.  Decrease trans fat to less than 1% of calorie intake.  Decrease cholesterol to less than 300 mg/d per day.  Balance calorie intake with exercise.  Switch to lean meats and low-fat or fat-free dairy.  Minimize the consumption of hydrogenated fats.  Minimize the consumption of foods with added sugar.  Prepare food with little or no salt.  Drink alcohol only in moderation.

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Dietary change can be simplified just by adhering to a Mediterranean-style diet. This diet on its own can drop heart disease risk by 30%. The Mediterranean diet is rich in fruits, vegetables, olive oil, nuts, and fish, while low in red and processed meats. It also includes modest amounts of cheese and wine. Ultimately, the diet is balanced and varied. Exercise Regular exercise can increase high-density lipoprotein (HDL or “good cholesterol”), burn fat, and decrease blood sugar levels. Exercise can also decrease LDL levels when coupled with dietary changes. Strive for a total of 150 minutes of moderate-intensity exercise per week.? Smoking Because smoking cigarettes damages arteries, smoking cessation is one key to mitigating heart disease risk. Moreover, smoking cessation increases HDL levels. Blood pressure The AHA now characterizes high blood pressure as 130/80 mm Hg or above, which is lower than the previous mark of 140/90 mm Hg. Hypertension is a big cause of heart disease, and if your blood pressure is higher than 130/80 mm Hg, it’s best to watch your diet and exercise more regularly to decrease your risk of illness, and perhaps begin taking antihypertensive medication. Aspirin Low-dose aspirin therapy might help mitigate the risk of heart disease in people aged between 50 and 69 years who have a 10% or greater chance of developing heart disease during the next 10 years. Please note that there are contraindications to aspirin use, including ulcers and bleeding disorders. Understandably, it’s hard to make major lifestyle changes—even when faced with the stress of future heart disease. Don’t be too hard on yourself if you can’t make such changes immediately. The process of changing health behaviors has been proposed to occur in the following four steps:

1) contemplation; 2) preparation; 3) action; and 4) maintenance

In other words, once you ponder and prepare yourself, which can take some time, you’ll be ready to make lasting changes and counteract years of unhealthy choices at any age.

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St. David’s North Austin Heart Attack Survivors Celebration Reunites Survivors with First Responders

On February 4, 2019 ATCEMS Medics were honored to attend the St. David’s North Austin Medical Center’s 5th annual “Heart Attack Survivors Celebration”.

Watch the video to hear from St. David’s North Austin staff, cardiac arrest survivor Justin Ballou, as well as ATCEMS Medical Director Mark Escott, Commander T. Thomas, & Captain M. Villasenor.

Learn CPR, the life you save may be a loved one’s!

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CHP’s Pop-Up Resource Clinic the Largest to Date Walk up clinic connects homeless to resources and services

This months Pop-Up Resource Clinic (PURC) was the largest to date! On Thursday, February 21st, our A TCEMS Community Health Paramedics and their partners served over 100 people experiencing homelessness. Over 60 Medical Assistance Program (MAP) cards were issued, over 20 CommUnityCare appoint- ments were made, as well as other services provided to connect people to needed resources. Great job everyone we are so proud of the excellent work and dedicated service this group provides to the citizens of Austin!

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Whether you view the glass as half empty or half full may help determine your risk for heart disease. Just as negative emotions such as depression, anger, and hostility are risk factors for heart at- tack and stroke, happiness seems to protect the heart. Researchers followed 1,739 healthy adults for 10 years to determine whether attitudes affected their health. At the start of the study, trained profes- sionals assessed the participants' degree of expression of negative emotions like depression, hostility, and anxiety and positive emotions such as joy, happiness, and excitement. A Happy Heart is a Healthy Heart

Happiness and the Heart After accounting for known heart disease risk factors, the researchers found that the happiest people were 22% less likely to develop heart disease over the 10 years of follow-up than people who fell in the middle of the negative-positive emotion scale.

People with the most negative emotions had the highest risk for heart disease and people who scored highest for happiness had the lowest risk.

Don’t Worry, Be Happy When it comes to keeping your heart healthy, sometimes laughter is the best medicine. Not only is it free of charge, research shows that laughing can actually strengthen your immune system, boost your energy, alleviate pain and protect you from the damaging effects of stress.

So, How can something as simple as humor help your heart and health?

 Laughter relaxes the whole body . A good, hearty laugh relieves physical tension and stress, leaving your muscles relaxed for up to 45 minutes after.  Laughter boosts the immune system. Laughter decreases stress hormones and increases im- mune cells and infection-fighting antibodies, thus improving your resistance to disease.  Laughter triggers the release of endorphins, the body’s natural feel-good chemicals. Endor- phins promote an overall sense of well-being and can even temporarily relieve pain.  Laughter protects the heart . Laughter improves the function of blood vessels and increases blood flow, which can help protect you against a heart attack and other cardiovascular problems With so much power to heal, the benefits of laughter don’t stop there. Be at peace . Control of mind can be more difficult to achieve than control of the body, but it is well worth the effort. Train yourself to accept things you cannot change and you will have more energy to change the things you can control. Breathe easy . Slow, deep breathing is relaxing and helps slow and smooth out body motion. Avoid taking short, jerky breaths or holding the breath when using the arms or when in a hurry. Slow, deep breathing uses more of your lungs and gets more oxygen into your blood. Simplify work . When tackling individual tasks, break down the operation into steps and figure out the most efficient way of accomplishing the task. Do them in the same way each time as repetition will make you more proficient and save time and energy. When you work more efficiently, you reduce the strain on your heart and cardiovascular system. Plus, you’ll minimize fatigue, shortness of breath and back pain, prevent injury and increase your energy level. When laughter is shared, it binds people together and increases happiness and intimacy.

additional strategies that could help people become happier, including:

 Express gratitude on a regular basis.  Practice being optimistic.  Engage in frequent acts of kindness.  Visualize one's best self.  Savor joyful events.  Practice forgiveness.

Data from Harris Regional, Piedmont , NIH Health News

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People Who Play This Sport Live Longest Any physical activity is better for health and longevity than no physical activity—but that doesn’t mean that all physical activities are equally beneficial. Researchers in Denmark have found that people who take part in one particular type of exercise generally live longer than people who do other forms of exercise. Which one is it? Take a guess—the ball’s in your court. However, more time spent on the activity didn’t translate to greater longevity. People who did health club activities (eg, treadmill, elliptical, stair -climber, stationary bikes, and weightlifting) worked out for an average of about 2.5 hours per week, yet tennis players played for only about 1.7 hours per week. Cyclists spent the most time doing their activity—an average of 6.4 hours per week—while swimmers spent the least time at 58 minutes per week.

The answer: tennis. People who regularly play tennis have the longest life expectancy compared with people who do other activities, such as jogging, swimming, or bicycling. In fact, tennis players live an average 9.7 years longer than people who do no exercise, according to re- searchers of the Copenhagen City Heart Study. “The sports that were linked to the best life expectancy gains typically require interval bursts of exercise using large muscle groups and full body movements, whereas the sports typically performed in a continuous manner showed less impressive life expectancy gains,” wrote corresponding author and cardiologist Peter Schnohr, MD, DMSc, Frederiksberg Hospital, Copenhagen, Denmark, and coauthors in Mayo Clinic Proceedings . Play hard, live less? For this study, Dr. Schnohr and colleagues reviewed data on 8,577 participants in the Copen- hagen City Heart Study, a prospective population study begun in 1991 that followed participants for up to 25 years for all-cause mortality. Among all participants in the study, 12% reported sedentary behavior (no physical activity) and 66% engaged in at least one type of physical activity.

Play together, live longer Notably, activities that involve more social interaction were associated with the greatest longevity, the researchers found. Sports that require participants to play together and socially interact (tennis, badminton, and soccer, for example) were associated with the best improvements in longevity. On the other hand, activities that are typically more solitary (like jogging, swimming, and cycling) had less longevity benefit. “The smallest improvement in life expectancy was noted in people who predominantly did health club activities,” Dr. Schnohr and colleagues wrote. “The reason for this could be that their working heart rate was lower than for the other sports, but the reason could also be due to the tendency for people to exercise alone on stationary machines with weights in the health clubs, thereby missing out on the social interaction mandated by racquet sports and soccer, for example.” Go play with your friends “It appears that the single most important feature of one’s exercise routine is that it should involve a play-date. Play is Mother Nature’s remedy for stress,” said one of the study authors, cardiologist James O’Keefe, MD, medical director, Charles and Barbara Duboc Cardio Health & Wellness Center, Saint Luke’s Mid America Heart Institute, Kansas City, MO. He added: “If we are looking for an exercise to improve longevity, we would do well to get to- gether regularly with at least one other person to do some physical activity that feels like fun.” The authors acknowledged that, although the study has many strengths, one limitation was that it was an observational study, so it doesn’t show whether the relationship between activity and longevity was causal or merely an association.

When compared with sedentary behavior, the activities associated with longer years of life ex- pectancy were tennis (9.7 years), badminton (6.2 years), soccer (4.7 years), cycling (3.7 years), swimming (3.4 years), jogging (3.2 years), calisthenics (3.1 years), and health club activities (1.5 years).

Study supported by the Danish Heart Foundation John Murphy, MDLinx | February 20, 2019

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Employee Recognition

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Our values and principles are Excel- lence 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. Thank you for your unwavering dedication and serviced to our community and EMS family.

K. Bostick 20 years

K. Pena 15 years

R. Migl 15 years

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