Emergency Medical Services (EMS) Awareness Week

By Nurse Diane

This week we are honoring the Emergency Medical Services (EMS).   Who are they? And what do they do? EMS are a type of emergency service dedicated to providing out-of-hospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency.  The term emergency medical service evolved to reflect a change from a simple system of ambulances providing only transportation, to a system in which actual medical care is given on scene and during transport. In some jurisdictions, EMS units may handle technical rescue operations such as extrication, water rescue, and search and rescue.

History

Documentation of the first EMS is found in the Bible with the story of the Good Samaritan.   Luke 10:34 (NIV) - "He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him."  The first known hospital-based ambulance service operated out of Commercial Hospital, Cincinnati, Ohio (now the Cincinnati General) by 1865.  This was soon followed by other services, notably the New York service provided out of Bellevue Hospital, which started in 1869 with ambulances carrying medical equipment, such as splints, a stomach pump, morphine, and brandy, reflecting contemporary medicine.

Purpose

Emergency medical services exist to fulfill the basic principles of first aid, which are to:

• Preserve Life,
• Prevent Further Injury, and
• Promote Recovery.

This common theme in medicine is demonstrated by the "star of life". The Star of Life, where each of the 'arms' to the star represent one of the 6 points. These 6 points are used to represent the six stages of high quality pre-hospital care, which are:

1. Early detection - Members of the public, or another agency, find the incident and understand the problem
2. Early reporting- The first persons on scene make a call to the emergency medical services and provide details to enable a response to be mounted
3. Early response- The first professional (EMS) rescuers arrive on scene as quickly as possible, enabling care to begin
4. Good on-scene care - The emergency medical service provides appropriate and timely interventions to treat the patient at the scene of the incident
5. Care in transit- the emergency medical service load the patient in to suitable transport and continue to provide appropriate medical care throughout the journey
6. Transfer to definitive care - the patient is handed over to an appropriate care setting, such as the emergency department at a hospital, in to the care of physicians

Members:

• First Responder
• Ambulance Driver
• Ambulance Care Assistant
• Emergency Medical Technician (EMT)
• Emergency Medical Dispatcher
• Paramedic
• Critical Care Paramedic
• Nurse
• Doctor

EMS does more than just provide a taxi service to and from the hospital.  They are usually the first responder to an accident or any emergency situation.  They assess the situation, provide initial care to stabilize the injured or ill person and perform life saving techniques while transporting to a medical facility.  I had several occasions in which I relied on the EMS here to transport my husband to the hospital.  This was not an easy task.  He weighed around 220 pounds, dead weight. It took two EMTs and me to transfer him to a stretcher, and then they had to maneuver their way out of the house, which was also complicated considering the turns they had to make.  Once they got him into the ambulance they would initiate oxygen and start an I.V. for fluids before racing him to the hospital.  Not only did I call them during emergency situations, but also on special occasions when he wanted to get out of the bed for holiday celebrations.  They would help me transfer him to his wheelchair, then return to put him back in the bed.  Not only did they not charge for this service, but also they did it willingly and cheerfully.

Being a part of the EMS team is not an easy job.   They work 12 to 24 hour shifts, all kinds of weather, and any time of the day or night.  The conditions in which they find their victims is not always the best.  And on top of that they are in charge of doing all they can to save lives while also dealing with confused, upset or irrational people.  They all deserve our respect and gratitude for the hard work they do.  So as we honor them this week, reach out to them, give a pat on the back, and let them know how vital they are to your community and how much they are appreciated.

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National Disability Employment Awareness Month

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By Terry Orr

Held each October, National Disability Employment Awareness Month (NDEAM) is a national campaign that raises awareness about disability employment issues and celebrates the many and varied contributions of America's workers with disabilities. This year's theme is "A Strong Workforce is an Inclusive Workforce: What Can YOU Do?"

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During nearly five plus decades of working, I have worked with many people disabilities and to the person – they all excelled in the workplace. 

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The AbilityOne Program is the largest single source of employment for people who are blind or have significant disabilities in the United States, providing employment opportunities to more than 50,000 people. More than 600 participating, community-based nonprofit agencies (NPAs) train and employ these individuals with disabilities nationwide. But there are hundreds of thousands of Americans who are blind or have other significant disabilities that are still waiting for their chance to work. That’s why building awareness of the Program during NDEAM and throughout the year is so crucial to its success.

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References and Links:

http://www.dol.gov/odep/

http://www.consultspringboard.com/2012/ndeam-what-can-you-do/

http://www.nablement.com/2012/08/national-disability-employment-awareness-month-moving-beyond-the-tagline/

http://blog.capabilitiesinc.biz/?p=863

http://www.abilityone.gov/media_room/ndeam.html

Heat Stroke

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By Terry Orr

This is article is a follow-up to our “Beating the Heat: Preventing Heat Exhaustion & Stroke” (http://kisbyto.blogspot.com/2011/07/beating-heat-preventing-heat-exhaustion.html) last July.

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This year in our Nation’s Capital, we have experiences several days of extreme heat – where just the simple act of walking from a building to your car is difficult for many folks.

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Heat Stroke 

Definition (Mayo Clinic):

Heatstroke is caused by prolonged exposure to high temperatures or by doing physical activity in hot weather. You are considered to have heatstroke when your body temperature reaches 104 F (40 C) or higher. High humidity, certain health problems and some medications increase your risk of heatstroke. So does being a young child or older adult.

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Heatstroke symptoms include:

• High body temperature. A body temperature of 104 F (40 C) or higher is the main sign of heatstroke.
• A lack of sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel moist.
• Nausea and vomiting. You may feel sick to your stomach or vomit.
• Flushed skin. Your skin may turn red as your body temperature increases.
• Rapid breathing. Your breathing may become rapid and shallow.
• Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
• Headache. You may experience a throbbing headache.
• Confusion. You may have seizures, hallucinate, or have difficulty speaking or understanding what others are saying.
• Unconsciousness. You may pass out or fall into a state of deep unconsciousness (coma).
• Muscle cramps or weakness. Your muscles may feel tender or cramped in the early stages of heatstroke, but may later go rigid or limp.

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When to see a doctor

If you think a person may be experiencing heatstroke, seek immediate medical help. Call 911 or your local emergency services number.

Take immediate action to cool the overheated person while waiting for emergency treatment.

• Help the person move to a shaded location and remove excess clothing.
• Place ice packs or cold, wet towels on the person's head, neck, armpits and groin.
• Mist the person with water while a fan is blowing on him or her.

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Prevention:

Heatstroke is predictable and preventable. Take these steps to prevent heatstroke during hot weather:

• Wear loose-fitting, lightweight clothing.
• Wear light-colored clothing if you're in the sun.
• Drink plenty of fluids.
• Take extra precautions with certain medications.
• Never leave children or anyone else in a parked car.
• Take it easy during the hottest parts of the day.
• Get acclimatized.
• Be cautious if you're at increased risk. 

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