PULSE Magazine | September 2019 Isssue

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

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September 2019

Contents

Featured News

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E-CIGARETTES AND THE DANGERS THEY POSE

Austin Public Health is warning people about the increasing trend of e-cigarette related illnesses. The CDC reports seven deaths linked to the use of e- cigarettes in the United States. The fruit-flavored elec- tronic devices have become popular amongst teenag- ers and young adults.

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UNDERSTANDING ASSAULTS ON EMS PERSONNEL

At least one national research study indicates that approximately 60% of EMS personnel have experi- enced physical violence in the workplace and some- where between 21-78% have experienced verbal abuse. Internet searches reveal that communities across the United States are reporting increased violence against EMS providers.

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IS THIS WHAT WAVE POOL ADDICTION LOOKS LIKE?

ATCEMS Clinical Specialist Steve Ward loves to ride waves in his spare time. His 140th session at the Waco Texas Wave Pool might just make him the single most frequent wave rider outside of the pool’s own employ- ees .

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ATCEMS UNION CALLS FOR THE CREATION OF A “MEDIC IN DISTRESS” DISPATCH CODE If police had realized that a patient was attacking an Austin medic inside an ambulance a few weeks ago, Austin-Travis County EMS Union President Selena Xie believes officers would've arrived sooner than the eight minutes it took them to get there. Article from the Austin-American Statesman.

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MEET-A-MEDIC

Recruiting’s Meet-A-Medic series continues with four more interesting profiles that will help you get to know your coworkers better and what they like to do outside of work.

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Division News

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UPCOMING CE SESSIONS: CHP OPEN HOUSE

The ATCEMS Community Health Paramedic program is evolving and expanding and will be hosting an Open House during the October CE sessions. This is an opportunity to stop by and find out what CHP medics do, ask questions and get information about the programs goals and objectives.

In Every Issue

CHP OPEN HOUSE DATES:

Tuesday, October 8th

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Thursday, October 10th

EMPLOYEE RECOGNITION

Tuesday, October 15th

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

Thursday, October 17th

Friday, October 18th

Tuesday, October 22nd

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Thursday, October 24th

Friday, October 25th

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Tuesday, October 29th

CUSTOMER SERVICE SURVEY

Thursday, October 31st

Results from the ATCEMS Customer Callback Program.

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36

WHAT IS: A CURE FOR FATTY FOODS?

Going on a short-term, low-fat diet can retrain your taste buds to better sense fatty foods, according the authors of a study in the American Journal of Clinical Nutrition. And when you sharpen your sense for the taste of fat, you’ll feel fuller faster and stop over- eating—and then you’ll lose weight, they concluded.

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3

WARNING

and the dangers they pose

Austin Public Health is warning people about the increasing trend of e-cigarette related illnesses. The CDC reports seven deaths linked to the use of e-cigarettes in the United States. The fruit-flavored electronic devices have become popular amongst teenagers and young adults.

Dr. Mark Escott w ith Austin—Travis County EMS and Austin Public Health said youth usage is on the rise.

"Our big concern at this stage is the impact on our youth we know the rates of e-cigarette use between 2017 to 2018 almost doubled to 78% which is particularly alarming," Escott said. "What we see is a pattern of massive inflammatory reaction in the lungs which affects the lungs ability to exchange oxygen ultimately resulting in respiratory failure." “Parents of middle and high school aged students need to be aware of the health risks associated with e-cigarettes. There was a 78% increase in use between 2017 and 2018 in high school aged teens. This increase, means that 20-25% of high school teens are vaping. This is both dangerous and illegal since the Governor signed into law a bill raising the smoking age to 21 on September 1st.”

Austin Public Health and the CDC is urging parents to talk with their teens about the health hazards and uncertainty surrounding the use of e-cigarettes.

QUICK FACTS ON THE RISKS OF E-CIGARETTES

What’s the Bottom Line on the Risks of E-cigarettes for Kids, Teens, and Young Adults?

 The use of e-cigarettes is unsafe for kids, teens, and young adults. Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s. 1

 E-cigarettes can contain other harmful substances besides nicotine.

 Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

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What Are E-cigarettes?

Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items.

 E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.

 E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liq- uid.

 Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or “mods,” do not look like other tobacco products.

 E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”

Using an e-cigarette is sometimes called “vaping” or “JUULing.”

How Do E-cigarettes Work?

 E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and oth- er chemicals that help to make the aerosol.

 The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called “e-juice,” “e-liquid,” “vape juice,” or “vape liquid.”

 Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.

 E-cigarette devices can be used to deliver marijuana and other drugs.

What Are the Other Risks of E-cigarettes for Kids, Teens, and Young Adults?

 Scientists are still learning about the long-term health effects of e-cigarettes. Some of the ingredi- ents in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e- cigarette flavorings may be safe to eat but not to inhale because the gut can process more substanc- es than the lungs.

 Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.

 Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes.

Excerpts, quotes and information obtained from FOX 7 Austin News article and CDC

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Fleet

ATCEMS Fleet Division oversees all of the departments motorized assets and trailers. This includes writing vehicle specifications, acquisitions, repairs, and replacements. We have 84 ambulances including reserve units and Sprinter’s. We have a grand total of 184 assets, consisting of ambulances, command units, administrative vehicles, trailers, and specialized response assets that augment the 911 System. The Fleet Division is led by Commander R. Rutledge, Clinical Specialist S. Anderson, Clinical Specialist R. Bumpus, and civilian employee G. Kincl.

FLEET ASSETS ADDED/REPLACED SCHEDULED IN 2020 AND BEYON D :

FLEET ASSETS ADDED/REPLACED OR SET IN MOTION 2018/2019:

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TAHOES

PASSENGER VANS A/TCEMS Academy Community Relations

2

HYBRID VEHICLES Administrative Personnel

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2

TAHOES

COMMAND VEHICLES

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COMMAND VEHICLES

2

SPRINTER AMBULANCES Special Events

2

BMW 1200 Special Events

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1

SUPPLY TRUCK

TRAILER Community Health Paramedic

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NEW REPLACEMENT AMBULANCES Fleet

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REMOUNTED REPLACEMENT AMBULANCES Special Operations

2

AMBULANCE ADDITION

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New Del Valle Station At Moore’s Crossing

REPLACEMENT AMBULANCES

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TRAILER Community Relations Sponsored by Toyota

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6

Saving Lives, Making a Difference

Austin-Travis County EMS

Advanced Tactical Anatomical Skills Course

ATCEMS teams recently partnered with Med To Market to host an Advanced Tactical Anatomical Skills Course that all of our EMS clinicians attended in June. This course was one of the first of its kind to benefit EMS clinicians in the Austin-Travis County area. Our in-house media team created a video summary that gives the viewer an in depth look at the course, the facility, and how valuable this training is to our clinicians.

Dr. Ziebell has seen first-hand the success of the training ATCEMS clinicians obtained during their Advanced Tactical Anatomical Skills Course. Dr. Ziebell and his team have received patients in the ER who’s life has been prolonged simply because of the recent finger thoracostomy training. Below is a quote recently received by Dr. Ziebell:

“One thing that we have noticed at the hospital is the new skill that paramedics have engaged in for the benefit of patients is the finger thoracostomy. We’ve seen this used successfully in trauma patients to relieve tension pneumothoraces.”

Christopher M. Ziebell, MD, FACEP Assistant Professor Division Chief – Emergency Medicine Department of Surgery and Perioperative Care

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Written by Bryan Dickerson for Wavepoolmag.com

Is this what wave pool addiction looks like?

Symptoms. Signs. Warnings. It all started with a blurry photo of a clear plastic back full of brightly colored wristbands. The image showed up in an Instagram DM and soon we began to unpack the story: Two years that included 140 sessions, 2,000 expert waves and roughly 200 cumulative hours driving through the Texas heat. “I recently saw that someone got Employee of the Month from you guys because he had surfed the Surf Ranch 20 times,” said Steven Ward in the message. “That’s obviously insane, but I thought I could maybe beat that.” The message came after Steve Ward’s 140th session at Waco’s premier pool along with the photo of spent wristbands. “If you don’t want to believe me check with Cheyne Magnusson or Brian Fillmore.”

We took a stroll through his Instagram feed and verified that, yes, outside of the employees, he might surf BSR more than anyone else.

Ward lives in Austin and makes the 90-mile drive (145 Kilometer) drive whenever he can do multiple sessions in a single day.

“The sessions aren’t really set. If something is open I book it. But if I’m going, I do at least three sessions. No need to drive from North Austin for just one session. With BSR being open for about nine months now, I average about four sessions a week.” Ward started surfing in 1984 Orange County on a Chris Cahill Twin Fin. But adult life took him to landlocked Austin where he now works as a paramedic for the city. When the American Wave Machines pool turned on in Waco, he was on it.

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“I’ve surfed approximately 140 sessions (probably more than anyone on the planet except “patient zero” Brian Filmore). If my math is right that’s about 2000 waves, if I lowball it and say that I’ve caught about 15 waves per session. I’m sure its well north of it because I have had several opportunities to surf sessions that were during the testing periods.”

Steven Ward spends a lot of time behind the wheel driving from Austin to Waco just he can drive through tubes like this one. Photos by Rob Henson.

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One of the saving graces of wave pools is that surfers can plan their sessions way ahead of time and maximize their wave time. Pools will never replace ocean surfing, but then you don’t have to shirk a life- time of responsibility to be free enough to chase waves. This is the “crossroads” choice all hardcore surf- ers are faced with at some point in their lives. Which led us to question whether Mr. Ward was a lifelong bachelor driving to Waco whenever he wasn’t performing CPR to someone on an Austin shopping mall floor. “The Fam – this comes up all the time as a question – as everyone thinks I’m at BSR constantly and that’s really not true. I’m married and have a 9-year-old and a 12-year-old. I try really hard to make sure when I go to BSR that it doesn’t conflict with being present as a husband or father. Of course, there have been some bumps in the road and my wife has come at me like BSR is the ‘other woman.’” But Ward says his trips to BSR include family time with both his kids learning to surf there and his part- ner embracing an adopted beach lifestyle “My wife has been there as well and loves it. She’ll describe it to her clients (she cuts hair) ‘The sand beach, music, nice umbrellas, beautiful lounge chairs – where else can you get that?’ But she never mentions the surf!”

ATCEMS Clinical Specialist Steve Ward’s bag of 140 wristbands he’s saved from every visit to the wave pool.

Surfing wise, Ward said the hardest thing about the BSR Surf Resort is positioning and timing. And alt- hough he’s tuned into it now, it’s a big challenge for most visitors. “The hardest thing to dial in is positioning for taking off. The announcers will say ’I want you at chamber number 5 or 6, six feet off the wall, and then paddle at a 45-degree angle. The water moves you around and pulls you out of position, when the wave stands up behind you, this is where you need to be. People have a super hard time getting that, it doesn’t take much to paddle in, it takes a lot of work to stay and be in the right spot.” So is the BSR Surf Resort Steven Ward’s “other woman?” It could be. Like a siren’s song, he’s pulled to the waves whenever he can. But there’s more for him to be smitten with in Waco. “BSR has been so epic. I have gotten to surf WITH the world. So many visitors, almost every current and former pro (so many stories on that), and it’s provided me with literally a lifetime of waves and I’ll be eternally grateful.” *********************************************************** Do you have a fun hobby you would like to share with PULSE readers? Send your story and pictures with the name of the photographer (for photo credit) to our editor lisa.sepulveda@austintexas.gov for inclusion in upcoming issues of PUSLE Magazine!

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AUSTIN-TRAVIS COUNTY EMS COMMUNITY HEALTH PARAMEDIC PROGRAM

CHP OPEN HOUSE INFORMATION AT OCTOBER CE SESSIONS

COME FIND OUT

WHAT WE DO —

MULTIPLE POSITIONS

COMING SOON!

DETAILS CONTACT COMMANDER BLAKE.HARDY@AUSTINTEXAS.GOV 512.765.3702

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Meet-A-Medic: Obie Jones, Clinical Specialist-Field

I’m Obie Jones I’m currently assigned to the department’s Community Health Paramedic Team as one the BLS providers. Before I came to the department I was in high school at Westlake High School (GO CHPAS!) I was also involved in the department’s Explorer Post for 3.5–4 years. I started working for ATCEMS October 2016 and wouldn’t change a thing about it! My husband and I stay busy with our 3 dogs and house projects! If we aren’t working on a house project you can catch us downtown hanging out with our friends.

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Where are you from originally and what brought you to Austin? I am a born and raised right here in Austin! I’m one of the few!

What inspired you to become a medic/What attracted you to this career choice? Growing up I always wanted to help others and be able to have a positive impact in someone’s life! I think what really attracted me to this career was doing ride-outs as an explorer.

How long have you been with ATCEMS and what motivated you to work here? When I was in my senior year in high school I was introduced to the department’s explorer program. I was able to do ride outs and learn from first hand experience what this amazing department has to offer!

What is your favorite part about working here at ATCEMS? It’s hard to say what my favorite part about working here is. I love the position I’m in now with the Community Health Paramedic Program. I get to make a lasting impact in someone’s life! I also love being able to work all of the cool and fun events that Austin has to offer like SXSW and ACL!

If you had guests visiting Austin for the weekend, where is the first place you would take them? That’s a tough one. It would either be the 360 overlook so they can get a sneak peek of the city they are about to see or Zilker Park/ Barton Springs.

What is your favorite taco joint in town? Pacos Tacos DUH!

What do you do on your days to relax and unwind? When I’m not at work you can either catch me vis- iting with friends or hiking some of the amazing trails Austin has to offer!

Who inspires you? My best friends have always been my inspiration.

What is the next place you would like to visit? Why? I would love to visit Australia within the next year! I have a friend down there that I haven’t seen in a while and who wouldn’t want to go to Australia?!

Word of advice for an aspiring medic? It’s going to sound cheesy but set your goals high and never give up on them!

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Meet-A-Medic: Kristina Pina, Clinical Specialist Communications

Hi, my name is Kristina Peña. I am a Clinical Specialist in Communications and have been with the department for 15 years. I have an amazing wife and two beautiful little boys! When I’m not at work you’ll find me soaking up every minute I can get with my loves at any, kid-friendly event or location in Austin!

Where are you from originally and what brought you to Austin? I am originally from a small town outside of Houston. I used to visit my aunt and uncle in Austin during the summer and fell in love with this city. I once wrote a letter to myself as a freshman in High School that said I was going to move to Austin and, once I graduated, I moved as soon as I could. What inspired you to become a medic/What attracted you to this career choice? I’d always been interested in the medical field and saw this as a great opportunity to be able to help people but in a different way. To use my patch and provide lifesaving instructions to, literally, hundreds of patients a week is pretty incredible. It’s a very fast paced, often stressful job and it takes a special kind of person to do it. How long have you been with ATCEMS and what motivated you to work here? I have been with ATCEMS for 15 years and it has FLOWN by! The first real job I got in Austin was as a dispatcher with the UT Police Department. I worked there for 5 years before a friend of mine told me of an opening for a dispatcher for a private ambulance company. Once I decided to pursue a career as a Communications Medic, working for Austin EMS was always the goal. I worked for Rural/Metro Ambulance for 1 year and, after gaining some experience and getting my EMT-Basic, I applied with ATCEMS. I had heard so many great things and knew I wanted to work with the best! I love a challenge and I knew this was the place for me.

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What is your favorite part about working here at ATCEMS? My favorite thing about our depart- ment is the comradery. We are like a family and, when you need it, the support is there in spades. Especially from your peers. I also love that I get to serve a city that I have always loved! There is NO place like Austin!

If you had guests visiting Austin for the weekend, where is the first place you would take them? I would probably take them to town lake for a morning jog/walk then to Kerby Lane for some pancakes, SoCo for some shopping and then Gueros for lunch and drinks. What is your favorite taco joint in town? My favorite taco joint would be any place with homemade tortillas. I grew up eating them freshly made and it turned me into a bit of a tortilla snob. lol What do you do on your days to relax and unwind? With two small children, there isn’t a whole lot of relaxing and unwinding going on lately. But, my wife and I try to take days off together where we send the boys to daycare and spend the day relaxing. That usually involves having a quiet breakfast, going to a movie, kayaking on the lake or having a glass of wine somewhere with a view. Who inspires you? Strong women inspire me. Moms are among the strongest women I know. You never know how strong you are until you are entirely in charge of a tiny person’s well-being and happiness. They depend on you for EVERYTHING. It is the absolute hardest and most fulfilling job I’ve ever had.

What is the next place you would like to visit? Why? Our next trip, and first trip as a family of 4, will likely be back to Colorado. We’ve been several times but are eager to take the boys. There’s something about the crisp mountain air and naturally beautiful landscape in Colorado that easily clears your head and makes you stop and appreciate nature. Word of advice for an aspiring medic? In this line of work, I would say empathy and a load of patience is your best friend and what will keep you here till retirement. It’s not always saving lives and playing rescue ranger. Most of our patients end up needing us in a different role. Sometimes it’s medic but it can also be social worker, psychiatrist or just a friend that listens. Try and remember that people that call are calling for help. What- ever that may be for them.

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Meet-A-Medic: Ashley Faulstich, Medic – Field

Hello, my name is Ashley Faulstich and I am currently a Clinical Specialist — Field candidate with ATCEMS. This is my first time working on an ambulance, although I have worked a couple of jobs in the health field. I am a single mother to a wonderful and vibrant 5-year-old girl. I love watch- ing her grow and am enjoying every minute of it!

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Where are you from originally and what brought you to Austin? I was originally born in northern California, but I was raised in the Cedar Park/Leander area. I lived in the Los Angeles area for 3.5 years, but decided to move back to Texas where I knew I belong! I am currently living in Leander. What inspired you to become a medic/What attracted you to this career choice? I’ve always had an itch for being a first responder. I started out with a fire department, but ultimately knew I loved the medical field. I love being out in the field and being there for our citizens in their time of need. How long have you been with ATCEMS and what motivated you to work here? I will have been with ATCEMS for a year in October and have many, many years to go! What attracted me the most was how innovative our system is and the dedication to becoming excellent providers for our citizens.

What is your favorite part about working here at ATCEMS? All the resources we have here to make Austin a better city than it already is. We also have so many opportunities within the department to grow as providers. The greatest thing here is that you gain a HUGE family!

If you had guests visiting Austin for the weekend, where is the first place you would take them? The Oasis! You can’t beat that view!

What is your favorite taco joint in town? Torchy’s Tacos! Plus the queso! Put the queso on the tacos!

What do you do on your days to relax and unwind? I have a 5-year-old, so “relax” really isn’t in my vocabulary! I love going to the pool or park with her and watching the joy on her face.

Who inspires you? My daughter. I am constantly striving to be the best role model for her. I also would not be where I am without the help of my family. They are a huge part of my life. What is the next place you would like to visit? Why? Anywhere tropical! I need the white sand and blue water on my toes! I have been snorkeling once and would love to do it again! Word of advice for an aspiring medic? Keep going. It can get hard and life will test you, but believe in your goals and JUST. KEEP. PUSHING.

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Meet-A-Medic: Roman Flores, Medic – Field

My name is Roman Flores, I currently serve as a medic for ATCEMS. I’ve been in EMS for 13 years and was previously a Combat Lifesaver Instructor in El Paso TX. I worked for a few private ambulance services prior to moving to Austin and started working for the City of Austin in February, 11th of 2013. Since then I’ve joined the Peer Support Group, Disaster Medical Response (DRE) team, am an ambulance bus (AMBUS) operator, and participate in driver training. I obtained my Paramedic through our department in-house paramedic school.

Where are you from originally and what brought you to Austin? I am originally from El Paso, TX and came to Austin for this job. The people of Austin are genuinely nice and that also played a factor into my move.

What inspired you to become a medic/what attracted you to this career choice? My Father was a firefighter/EMT for 22 years. Essentially, I am following in his footsteps.

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How long have you been with ATCEMS and what motivated you to work here? I’ve been with ATCEMS over 6 and a 1/2 years. ATCEMS is well-known as a progressive department with an outstanding reputation in medicine and operations.

What is your favorite part about working here at ATCEMS? The employees, the autonomy, and our medical direction. We have such amazing individuals that work here with extensive backgrounds in medicine or related fields. I have learned so much from fellow employees who have years of experience in this field.

If you had guests visiting Austin for the weekend, where is the first place you would take them? BBQ is a must!!! Blacks, Franklins, Valentina’s, Hays County BBQ. Summer Moon Coffee is always a good place to hang out! Also, floating the river or going to the lake.

What is your favorite taco joint in town? Coming from El Paso, my favorite tacos are the ones I make myself. LOL!

What do you do on your days to relax and unwind? Having an Old Fashioned, working out, or gardening. Best thing about the Austin area is there is always something to do.

Who inspires you? My family and my wife. They support me in every endeavor and push me to be a better person.

What is the next place you would like to visit? Why? I’d like to visit Ireland. I hear the scenery is amazing and you can never go wrong with a Guinness or Jameson.

Word of advice for an aspiring medic? This is one of the best EMS departments to work for. I come to work every day enjoying what I do. Always remember the learning process never ends, make time for yourself and family. Leave work at work. AND ENJOY LIFE!

“ ENJOY LIFE”

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Understanding Assaults on EMS Personnel:

City of Austin EMS Department Assault Survey Results

Background : At least one national research study indicates that approximately 60% of EMS personnel have experienced physical violence in the workplace and somewhere between 21-78% have experienced verbal abuse. 1 Internet searches reveal that communities across the United States are re- porting increased violence against EMS providers. Even so, it is likely that assaults on EMS personnel are largely under-reported in the industry as clearinghouses for gathering EMS personnel assault data in the United States are under-used. Objectives : To improve our understanding of assaults on ATCEMS personnel: Identify the number of personnel experiencing assaults in the workplace; assess the effectiveness of training provided by the department; evaluate reporting practices; assess the support provided to personnel who have been as- saulted; and better understand the beliefs, attitudes, perceptions about assaults held by our personnel. Methods : Two broad surveys were developed using Survey Monkey and distributed to two groups in the department for participation: Field personnel (445) and Communications personnel (50). Each survey was customized for each group; therefore, the surveys were not exact duplicates. Personnel were asked to answer the surveys on a voluntary and anonymous basis. Although some personnel skipped several questions, many answered most of the questions. Microsoft Excel was used to tabulate the results and the results were placed into tables in this report. Results: Surveys were distributed via email to 445 Field personnel and 50 Comm personnel. The overall response rate was 47.19% (210) of field personnel and 52% (26) of communications personnel. In the field personnel group (Field) 79.52% were male and 19.52% were female while in the communi- cation personnel group (Comm) 37.5% were male and 58.33% were female. In the Field group the largest age group of respondents was 30 to 39 (39.52%) and 40 to 49 (37.5%) in the Comm group. The majority of respondents in the Field group had 0 to 14 years of tenure (166 or 79.4%). In the Comm group, two tenure groups represented the majority of responses with 41.67% indicating a tenure between 0 to 4 years and 29.17% with tenure from 15 to 20 years. Most of the respondents in both groups were Clinical Specialists with 53.59% in the Field group and 37.50% in the Comm group.

Responses to Multiple Choice Questions :

If you have ever reported an assault to your supervisor at ATCEMS, did you supervisor follow up with you?

Field

Comm

Yes

56.05% (88)

18.18% (2)

No

43.95% (69)

81.82% (9)

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My supervisor encourages me to report assaults if they occur.

Field

Comm

Strongly Agree

30.00% (54)

13.33% (2)

Agree

46.11% (83)

26.67% (4)

Disagree

18.89% (34)

46.67% (7)

Strongly Disagree

5.00% (9)

13.33% (2)

My supervisor has discussed with me the importance of reporting assault incidents when they occur.

Field

Comm

Yes

41.11% (74)

26.67% (4)

No

58.89% (106)

73.33% (11)

If you have been assaulted at ATCEMS, did you file charges with law enforcement?

Field

Comm

Yes

43.59% (78)

NA

No

56.42% (101)

NA

How often have you been assaulted at ATCEMS within the last 2 years?

Field

Comm

Once

36.87% (66)

NA

More than once

63.13% (113)

NA

If you have been assaulted, did you report the incident to your supervisor?

Field

Comm

Yes

54.95% (100)

25.00% (4)

No

45.05% (82)

75.00% (12)

Provider assaults are an unavoidable risk of working in EMS as an industry.

Field

Comm

Strongly Agree

21.05% (44)

NA

Agree

48.80% (102)

NA

Disagree

23.92% (50)

NA

Strongly Disagree

6.22% (13)

NA

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Verbal assaults are an unavoidable risk of working in EMS as an industry.

Field

Comm

Strongly Agree

NA

47.06% (8)

Agree

NA

47.06% (8)

Disagree

NA

5.88% (1)

Strongly Disagree

NA

0% (0)

Have you ever been assaulted during your EMS career?

Field

Comm

Yes

92.38% (194)

70.83% (17)

No

7.62% (16)

29.17% (7)

Have you ever been verbally assaulted at ATCEMS within the last 2 years?

Field

Comm

Once

NA

13.33% (2)

More than once

NA

86.67% (13)

Have you ever been verbally assaulted while on duty with any EMS provider?

Field

Comm

Once

NA

6.25% (1)

More than once

NA

93.75% (16)

Have you ever been assaulted while on duty with any EMS provider?

Field

Comm

Once

19.34% (35)

NA

More than once

80.66% (146)

NA

I have received training at ATCEMS to recognize individuals exhibiting aggressive behavior.

Field

Comm

Strongly Agree

8.61% (18)

25.00% (6)

Agree

51.67% (108)

37.50% (9)

Disagree

26.79% (56)

33.33% (8)

Strongly Disagree

12.92% (27)

4.17% (1)

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I have received training at ATCEMS to recognize individuals that might exhibit aggressive behavior.

Field

Comm

Strongly Agree

7.18% (15)

12.00% (3)

Agree

47.37% (99)

52.00% (13)

Disagree

34.45% (72)

32.00% (8)

Strongly Disagree

11.00% (23)

4.00% (1)

I have received training at ATCEMS to help me initiate escape options when encountering individuals with aggressive behavior.

Field

Comm

Strongly Agree

5.29% (11)

NA

Agree

30.29% (63)

NA

Disagree

46.63% (97)

NA

Strongly Disagree

17.79% (37)

NA

I have received training at ATCEMS on how to deescalate a situation with an aggressive individual.

Field

Comm

Strongly Agree

3.85% (8)

13.04% (3)

Agree

33.17% (69)

47.83% (11)

Disagree

45.19% (94)

34.78% (8)

Strongly Disagree

17.79% (37)

4.35% (1)

Are you aware that ATCEMS has PEER Support and other counseling services available for employees involved in workplace assault.violence?

Field

Comm

Yes

90.95% (191)

100% (24)

No

9.05% (19)

0% (0)

When assaulted, I feel ATCEMS provided adequate support for me

Field

Comm

Strongly Agree

8.00% (14)

0% (0)

Agree

43.43% (76)

46.67% (7)

Disagree

35.43% (62)

33.33% (5)

Strongly Disagree

13.14% (23)

20.00% (3)

23

Other Findings

Most Field personnel said they were providing direct patient care (91.8%) when they were assaulted and that most assaults occurred in the back of the unit (92.9%). The top three conditions that field personnel thought contributed to violence included an attacker showing signs of impairment, exhibiting aggressive behavior, or possibly experiencing a mental or behavioral health condition. In the communi- cations center, personnel identified people exhibiting aggressive behavior, experiencing a highly emotional environment, or possibly experiencing a mental or behavior health condition as contributing factors to verbal assaults. Personnel at ATCEMS are experiencing high numbers of assaults. Over 86% of Communication staff re- port having been verbally assaulted more than once in the last two years and 63% of Field personnel report being assaulted more than once in the same time period. It is estimated that even these high numbers do not reflect the true magnitude of assaults on ATCEMS personnel because assaults are likely under-reported and only cases involving injuries are reported most commonly. Although 100% of ATCEMS personnel receive situational awareness and self-defense training, additional training in recognition of the potential for aggressive behavior, escape planning, threat avoidance, and de-escalation may be needed. Collaborative training with law enforcement officers and members of the legal system could improve reporting and prosecution of persons who assault EMS personnel. Equipping EMS Commanders with better training and tools for responding to personnel who report assaults could improve agency responsiveness, follow-up, engagement, and support when assaults happen. Personnel who are assaulted seem to be divided as to whether the department’s support mechanisms are adequate and effort needs to be aimed at learning what kind of support is needed, when it should be delivered, and what personnel need and expect. Finally, an important finding of this survey is how EMS personnel perceive the workplace violence that they are experiencing. More than 69% of Field personnel agreed with a statement that said assaults are an unavoidable risk of an EMS career and 94% of Comm personnel said that verbal assaults while on duty in the communication center are an unavoidable risk. There needs to be further study about this cultural element, its drivers, and how it connects to industry ideals such as the “EMS Culture of Safety” and the EMS Agenda 2050 vision of being People Centered and its principle of becoming “Inherently Safe and Effective.” 2,3 Ultimately, assaults on a public servant should never be tolerated, even by those who believe the risk to be inherent in this industry. The department recently trained a group of Improvement Leaders in improvement science. The training was based on the Model for Improvement established by the Institute of Healthcare Improvement (IHI). An improvement team will be assembled to continue work to reduce assaults on ATCEMS personnel and to begin to address the findings of this survey report. The team will focus on better reporting, enriched training, and work with law enforcement to learn more about recognition of potentially dangerous situations, de-escalation techniques, and other important strategies. Ultimately the team’s aim will be to reduce the number of assaults on ATCEMS personnel. Next Steps Conclusions and Discussion

Ernesto M. Rodriguez, LP, MA, Eric Gordon, LP, BS, Patricia Bourenane, BA, Keith Simpson

24

In The News

By Katie Hall—Austin American-Statesman

Texas EMS union calls for the creation of a 'medic in distress' dispatch code. The Austin-Travis County EMS union is calling for the creation of a police dispatch code that informs officers whenever a medic is in distress.

AUSTIN — If police had realized that a patient was attacking an Austin medic inside an ambulance a few weeks ago, Austin-Travis County EMS Union President Selena Xie believes officers would've arrived sooner than the eight minutes it took them to get there.

"The patient took off all his restraints — his seat belts — and then just started pounding on the medic," giving him a black eye and a busted lip, Xie said.

The proposal to create a new police dispatch code comes in the wake of survey results that showed that 63% of Austin medics were physically assaulted more than once on the job in the past two years. (Photo/Tribune News Service, Ralph Barrera, American-Statesmen)

The incident illustrates the need for a 911 dispatch code called "medic in distress," Xie contended during Austin's Public Safety Commission meeting Tuesday.

"I do believe that if the officers saw that it was 'medic is down,' we'd receive a different kind of re- sponse," she said.

Xie's proposal comes in the wake of survey results, released earlier this summer, that showed that 63% of Austin medics were physically assaulted more than once on the job in the past two years.

The data was alarming, Xie said.

"Every time this event happens, I am very concerned that one of our medics is going to be severely hurt," she said.

At Tuesday's meeting, Austin police officials said they are discussing the possibility of creating this code.

"We're committed to working with EMS — with the leadership and the association ... If we need to make changes, we'll do that immediately," Assistant Police Chief Troy Gay said.

Commissioner Meghan Hollis pointed out that medics don't have the same tools police officers have.

"They don't have the weapons to protect themselves," Hollis said. "They're not wearing vests. They're almost at a higher risk."

Austin medics who know self-defense came to a recent EMS union meeting to teach other medics some techniques they can employ in the back of an ambulance, Xie said. A few medics also recently traveled to Dallas to learn self-defense. "We have quarterly continuing education, and I really hope that the (Austin-Travis County EMS) depart- ment invites these medics who did this training to teach self-defense to everybody in the department not just those who choose to come to our meetings," she said. In June, an EMS union member created a form medics can use to track these assaults, Xie said. In the incident where a medic received a black eye, he reported the attack to his supervisor, but EMS Chief Ernesto Rodriguez wasn't aware of the incident until the union spoke to him about it, Xie said.

"There has to be a way that our chief is aware of these assaults happening," Xie said.

25

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

J. Mudge & R. Hernandez 20 years

R. Rutledge 20 years

26

Employee Recognition

27

Employee Recognition

AWESOME

CONGRATS

Clinical Specialist Ross Bumpus will be transferring to the Operations Support – Fleet and Facilities team. Ross has been with the department for 11 years and worked in several different facets of our organization. Ross has previous experience in warehouse management and fleet maintenance. Ross brings with him a strong work ethic, attention to detail, and solution oriented approach to problem solving. Operations Support is excited to have him join our staff.

Clinical Specialist James Yarbrough Medic Katie Lorenz

While working Medic 33, K. Lorenz and J. Yarbrough stepped up to help a fellow crew who had been running almost their entire shift without a break. The crew at Medic 5 had run multiple calls during the day and had been up most of the night without a break and was nearing the end of their shift when they were dispatched to another call that most likely would have made them get off late. Medic 33 had just returned to station from a call when they volunteered to take this call for Medic 5 so that the crew could have a break and get off of their shift on time. This is a great example that shows a dedication to teamwork and a dedication to the mission of our depart- ment. Thank You to Anna Lorenz and James Yarbrough for stepping up and helping your fellow coworkers.

We are pleased to announce: Elaina Lopez as our new Muni-Prog Administrative Support reporting to the EMS Billing department.

Darrell Debish as the new Contract Management Specialist III for the Supply and Purchasing Division.

Nick A. Baker Captain - Austin/Travis County EMS

Please congratulate Captain M. Villasenor he is now credentialed to the Provider Level-6

Awesome work by the following individuals who were deployed to a disaster area in southeast Texas. TXTF1 Boat squad consisted of Smith, and Paul, the EMTF Ambulance Strike team consisted of Noak, Harris, Rose and Malone were all deployed to Jefferson County when Tropical Storm Imelda dumped 40 inches of rain causing extensive flooding.

TXTF1 Boat Squad

Commander C. Smith

Captain M. Paul

EMTF Ambulance Strike Team

Commander C. Lester

Captain D. Rose

Captain D. Noak

Clinical Specialist C. Harris

Clinical Specialist M. Malone

28

KUDOS

Clinical Specialist J. Saunders Medic C. Hunter

We received a note from a very appreciative spouse of a patient today that wanted to convey their thanks to the Crew from Medic-1 J. Saunders & C. Hunter as well as the Austin Fire Department crews that arrived to assist with the call: “Can you please convey my sincere thanks to the EMS and Fire Crews who responded to a call at [our residence in early September]. My [spouse] needed to be transported to the hospital, but getting [them] down from the upstairs bedroom was a challenge. EMS decided that our narrow spiral staircase was not suitable and alerted the Fire department who came with two trucks and five ladders. I so appreciate everyone’s courtesy and professionalism. A special Thank You to the EMS crew member who came twice to the ICU that morning to check on my [spouse’s] status.”

EXCEPTIONAL

MEDIC OF THE MONTH

St. David's Medical Center August Medic of the Month Medic Katie Lorenz

The emergency room night shift recently presented her award. Staff states, “Lorenz is always confident, knows her stuff, and is enjoyable to work alongside. She is also always willing to help out and communicates effectively.”

WORK

29

Employee Recognition

Aaron, Alvin and Matt

12/18/2019 you responded to a call I made on behalf of my wife, Karla. You responded to our home in a few minutes, faster than I expected. When you arrived my wife was scared, and in great pain. You quickly assessed her needs, and through your skills, kind- ness, and reassurance got her down the stairs into your ambulance and to the hospital safely. Afterwards, she told me how much she appreciated all that you did for her in those very frighten- ing moments. Karla died on 12/20/2019 following a second surgery that was believed could save her life. She suffered a ruptured colon with complications. In my heart, you three men gave me an extra three days with my wife of 33 years. She was the love of my life and those three days meant everything! Karla was a professional artist. The cover of this card is one of her paintings. It is about “pain and loss” specifically rising from “pain and loss” through God’s grace and our own determination. You men deal with a lot of pain and loss in your work. Please know that it has helped me to rise from my pain and loss knowing that Karla was well taken care of , and that there are men like you in this world who are there to help. The picture on the back of this card is my wife and son, Ryan taken right before Christmas. God bless you gentleman. My best wishes and good health to your loved ones.

Michael N.

30

Captain Tony Smith Clinical Specialist Samantha Caffery

Below is the letter sent in from a patient:

“These two medics were so caring and kind. They knew their stuff. They settled me right down and took such great care of me. Come to find out I had a mini stroke with slurred speech, but that has come to pass. Your staff was truly wonderful. This was not my first experience with a stroke. My daughter Jennifer, was a beautiful girl and a physicists as well as a founding member of the Texas Rollergirls. She worked at NASA on two projects. One of which was the Mars Rover and created Virtual Earth for the International Space Station. Jennifer was also a musician, she played Bass. She played all over San Francisco, Austin and Las Vegas. She was truly a gift to us. Jennifer was brutally murdered while in Idaho helping her grandparents who had reached their 90’s. The grief of her murder is killing me. So far your medics are saving me. The first crew who came to our house had to bring me back from wherever I went, I was gone. I tried to look at my daughters Facebook page and I dropped. I just cannot take the stress of all this horror. Your crew literally saved me. I want to thank your medics for the great and difficult job they do. We all need first responders so much, they are a blessing for everyone. I would hug each one of you if I could. They are very special and I cannot thank them enough.”

Nancy Nalley

Nancy Nalley

Jennifer Nalley

31

Customer Service Response:

629 calls were made during June The questions asked focused on measurable

customer service actions.

Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 83.71% of the patients rated the customer service they received at a 5 and 15.17% rated their service at a 4. The average rating overall was 4.81 out of 5 for customer service.

The response we obtained from our customers is evidence of the great medics we have and the

tremendous job they do each and every day.

Patient Comments:

32  “They were phenomenal! I have been with other patients being transported many times, by other sys- tems, and these medics were by far, the best. They made the transport better for both of us. They were calm and professional.”  “They were very professional and explanatory with what to except. They made a very compelling argument as to why I need to go to the HSP as I was thinking about not going. They were spot on with the situation, and gave a complete download of information to the HSP staff. I really do appreciate everyone who was there helping me and I am very thankful for them.”  “They were great! They talked to me, were concerned about me and I have nothing negative to say about them. Thanks you for your call and concern.”  “They are the best group, so courteous and loving. They saved my life and I surely do appreciate them. They have serviced me several times and always given the same great service. They even help my son and made sure my door was locked. There is not a high enough rating for them. They take care of people and save lives. They're the best!.”