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Nyack EMS News
ELECTRONIC PATIENT CARE REPORTS -- another NCAC first
11-04-2011
After training our member and paid EMTs in its use, and after a test period and approval from the NY State Department of Health, we went live in October 2011 with our new ePCR system. We are using the NEMSIS Gold ePCR system from ESO Solutions. Nyack Community Ambulance Corps is the first corps in Rockland County to be approved by regional and state authorities to use Electronic Patient Care Reporting.
This is just another first, among many, for Nyack Community Ambulance Corps. We were the first volunteer agency in the county to do blood glucometry on the BLS level, and the first to have Drive Cams in our rigs.
The ePCR system is designed to enable more complete patient care, with prompts and reminders about all the pertinent questions and examinations the EMT must go through with the patient. This helps the EMT focus in more detail on each systemic area.The ePCR system will also save time by eliminating redundant data entry (as often occurs with the traditional paper PCR).
The system resides on Panasonic Toughbook laptop computers, one of which is kept on each rig. It is operated mainly by touchscreen with finger or stylus. The laptop keyboard is used for narrative data entry. After a relatively brief learning period, it is quick to operate, yet thorough in its data collection. If any necessary items are missing, the EMT is prompted to go back and complete these items before being allowed to “lock” and submit the ePCR. Even after an ePCR is “locked,” the EMT can go back and add additional narrative, for those momentarily-forgotten facts and impressions.
NCAC will benefit from ePCRs with increased and faster revenue recovery -- no more PCRs returned for missing information or illegible handwriting. Paper insurance billing forms, which we’d have to get signed by the patient or a representative, are now part of the ePCR: the screen of the laptop is rotated around and the patient signs with a stylus. Receiving facility and RMA signatures are also collected this way on the ePCR. PCRs no longer need to be logged into the ReAct system on the crew room computer. And statistical information is a snap -- resulting in better quality control all around.
It took a little faith and a lot of hard work to roll out this new technology, but after a brief shakedown cruise we expect it to bring benefits to the corps, and to our patients, for many years to come.
Please contact Captain Paul Morer for more information about ePCRs.
Unit 24B3 Goes to School
05-21-2011
There is something magic about bringing together small children and a big ambulance. On April 11, 2011, volunteers Tom Neff and Cathy Radziemski played magicians to a class of 4/5 yr. olds at Nyack’s Montessori School by giving them a tour of 24B3 after parking it outside the school play yard. 
Before inviting them inside the vehicle,Tom treated them to a brief show of the flashing lights and a short burst of the siren. The children were alerted to cover their ears, and most took advantage of the warning.
Then it was on to a peek inside. With the kind assistance of the teachers, the class lined up to take turns, three at a time, for an on-board visit. While there, each group received a simple explanation of the equipment, answers to questions, and the opportunity to have a stethoscope placed on their chest for a “check-up”.
As the children exited the vehicle, they were given gold-foil Jr. EMT stickers. The teachers then
were entrusted with coloring books for each child, designed to show the youngsters all the good work done by emergency workers. With that, the big blue & white ambulance drove away, leaving a happy group of pre-schoolers and a couple of beaming NCAC volunteers.
Cathy Radziemski
see our photo gallery for more pictures of this visit!
NCAC EMT Is a Volunteer at a Guatamala Hospital
05-05-2011
Carissa Borton began as a Youth Corps member at Nyack Community Ambulance Corps. The world has opened up to her, as she brings her dedication and skill to those in need of the kind of basic heath care that most of us in the United States take for granted. This article appears in the May 2011 "Salute to Health Care in Rockland County" edition of Rivertown Magazine, serving the lower Hudson River villages surrounding Nyack, New York.
By Cathy Radziemski
A young woman walks into the emergency room of a small rural hospital. She sees the curtain pulled and wonders what is going on behind it. She takes a deep breath and walks into the room. A doctor is kneeling to examine a 5 year old girl with what looks to be a bad burn to her foot. The doctor requests sterile gloves, triple antibiotic ointment, and sterile gauze, and the young woman brings them. It seems a family member had accidentally spilled boiling water on the child, resulting in 2nd and 3rd degree burns. The family tried to treat the burn with home remedies, four days earlier, without success. The concern now is infection. The child’s injury is treated and the appreciative family returns to their village. She is happy to have had the opportunity to provide treatment, so the little girl’s foot can make a full recovery.
This scene and others like it are repeated every day in Emergency Rooms across the US. But this ER is located in Guatemala and the young woman is Carissa Borton, a Nyack native. Carissa is no stranger to volunteer medical activity. Currently an active riding member of the Nyack Community Ambulance Corps (NCAC), she is a certified New York State Emergency Medical Technician. She began her work with NCAC as a teenage Youth Corps member, then went on to complete EMT training. Carissa dedicates several weekend hours to a regular shift with the Ambulance Corps. Her father, Steve Borton, is also a volunteer driver with the Corps.
When I first spoke with Carissa about writing this article, I wanted to know, “Why did you go”? She was quick to respond.
“Ever since I spent two weeks in the hospital in eighth grade, I have
been fascinated with the medical field. I started volunteering with
the local ambulance corps in my hometown when I was 16 years old.
Being a member of a productive team in such critical circumstances has
helped me gain hands-on medical training, as well as communication
skills. My motivation for the medical field continued to grow during
college years, and I realized there was much more to learn and see
beyond our borders. While studying at the University of
California-Santa Barbara, I traveled to Honduras twice with fellow
students and volunteer doctors as a part of UCSB’s Global Medical
Brigades. Our purpose was to initialize a sustainable health care
system for those with little to no access to medical care. I was so
inspired by the patients; even though they had so little, they were so
happy and appreciative of any help we gave them. After my experiences
in Honduras, I wanted to travel to other parts of Central America, and
use my skills to better the lives of others. I was thrilled to find
out about this opportunity to volunteer in Guatemala.”
The clinic that benefited from Carissa’s skills is called Hospitalito Atitlan, and since its founding in 2003, volunteers have been welcomed to work alongside local medical personnel from the town of Santiago Atitlan. When the hospital first opened it was the only hospital to serve the Mayan community in more than 12 years. In addition to immersing themselves in the Mayan culture, volunteers find themselves working with clinicians from all over the world. The hospital is dedicated to serving a very impoverished population, and so has a limited budget. Consequently, volunteers like Carissa are responsible for their own travel and living expenses.
With obvious pride, Carissa’s Dad offered his view:
“When our daughter first mentioned that she would be volunteering to assist in a hospital in the mountains of Guatemala, we were very excited for her, but not surprised. She had been on two other medical volunteering missions to Central America and she was interested in medicine for underserved populations. What was different about this trip is that she planned on going alone. She had researched it, contacted the volunteer coordinators, raised donations and packed clothes and medication to donate to the patients of Hospitalito Atitlan. We have always been proud of her determination and this was no exception.
"One morning a couple of years ago, I was taking Carissa to work and we witnessed an accident at the intersection of Storms Road and Route 303 -- a notorious and dangerous crossing. Without hesitation, Carissa jumped out of our car. She proceeded to evaluate the extent of the injuries, call for assistance and assure dazed and injured victims that help was on the way. Her proud father watched in amazement. This is one of the reasons why we were not surprised that Carissa spent her winter break volunteering in the mountains of Guatemala.”
Such is the spirit of service that is alive and well in our community. Nyack Community Ambulance Corps is one of many volunteer ambulance organizations in Rivertown’s readership which provide Emergency Medical Service to its citizens. NCAC is always ready to accept volunteers, and there is a place for people of all ages who have, or will get, the required EMT certifications. Drivers are not required to have EMT certification, but receive special training in the operation of an ambulance. Youth Corps volunteers may join at age 16, and retirees or anyone with a flexible schedule is particularly welcome.
Contact information: www.hospitalitoatitlan.org
Bedbugs, Yuk! An Old Pest Makes a Comeback
04-18-2011
By Sue Hellauer, from NCAC Siren, October, 2011
My mom has many stories about growing up in the South Bronx during the Great Depression. One of the most gruesome concerns the blight of bedbugs, and how her mother tried to kill them with kerosene (NOT recommended!). Fearful to sleep because of the bugs, and sick with the stench of kerosene in her mattress, those old Bronx nights were long, and no fun.
The advent of DDT during World War II was the temporary downfall of the bedbug. Dusted around a mattress, DDT could kill bedbugs for a year or more. But DDT was banned in 1972 because of environmental and health risks. Before the ban, resistance to DDT was already noticeable: bedbugs, like most other pests (including germs), develop resistance through natural selection. Other pesticides have been less effective than DDT, and increased resistance to them is a problem as well. And so, the fight is on once more, throughout the US, and around the world.
Here is some information from the US Environmental Protection Agency website
Bed Bug Biology
The common bed bug (Cimex lectularius) has long been a pest – feeding on blood, causing itchy bites and generally irritating their human hosts. The Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention (CDC), and the United States Department of Agriculture (USDA) all considers bed bugs a public health pest. However, unlike most public health pests, bed bugs are not known vectors for the transmission and spread of diseases.
Knowing what to look for is the first step in controlling bed bugs. Generally, adult bed bugs are 1/4 to 3/8 inch (4-5mm) long, brown in color, with a flat, oval-shaped body; while young bed bugs (also called nymphs) are smaller and lighter in color.
When not feeding, bed bugs hide in a variety of places. Around the bed, they can be found near the piping, seams and tags of the mattress and box spring, and in cracks on the bed frame and head board.
If the room is heavily infested, you may find bed bugs in the seams of chairs and couches, between cushions, in the folds of curtains, in drawer joints, in electrical receptacles and appliances, under loose wall paper and wall hangings -- even in the head of a screw. Since bed bugs are only about the width of a credit card, they can squeeze into really small hiding spots. If a crack will hold a credit card, it could hide a bed bug.
Preventing Bed Bug Infestations
Bed bugs are very successful hitchhikers, moving from an infested site to furniture, bedding, baggage, boxes, and clothing. Although they typically feed on blood every five to ten days, bed bugs can be quite resilient; they are capable of surviving over a year without feeding.
A few simple precautions can help prevent bed bug infestation in your home:
- Check secondhand furniture, beds, and couches for any signs of bed bug infestation, as described below before bringing them home.
- Use a protective cover that encases mattresses and box springs which eliminates many hiding spots. The light color of the encasement makes bed bugs easier to see. Be sure to purchase a high quality encasement that will resist tearing and check the encasements regularly for holes.
- Reduce clutter in your home to reduce hiding places for bed bugs.
- In hotel rooms, use luggage racks to hold your luggage when packing or unpacking rather than setting your luggage on the bed or floor.
- Check the mattress and headboard before sleeping.
- Upon returning home, unpack directly into a washing machine and inspect your luggage carefully.
Much of the time, a bed bug infestation is only suspected when bites appear on a person. Oftentimes, the bites are misidentified, thus allowing infestations to go unnoticed, which gives the bed bugs time to spread to other areas of the house.
When cleaning, changing bedding, or staying away from home, look for such as:
- dark spots (about this size: •) which are bed bug excrement and may bleed on the fabric like a marker would,
- eggs and eggshells, which are tiny (about 1mm) and white, skins that nymphs shed as they grow larger,
- live bed bugs, and
- rusty or reddish stains on bed sheets or mattresses caused by bed bugs being crushed.
U.S. Environmental Protection Agency - Recognition and Management of Pesticide Poisonings
04-18-2011
from the NCAC Siren, January 2011
With the recent increase of bedbug infestations in our region, there is an increased risk of pesticide poisonings in homes and institutions. The EPA wants you to be able to recognize pesticide poisoning, which may manifest with symptoms similar to a number of other acute or chronic illnesses, and is making this document available to you online. Of the 2,000,000 annual incidents, 50% involve children under 6, and 90% of these incidents occur in the home.
Acute exposure may cause: headache, dizziness, weakness, nausea, tingling sensations, muscle twitching.
Long-term exposure may cause: birth defects, learning disabilities, behavioral changes, asthma, cancer
Go to http://www.epa.gov/oppfead1/safety/healthcare/handbook/handbook.htm
New NY State Laws Put Focus on EMS
04-18-2011
from The Siren, January 2011
Jack Shea’s Law (by Sue Hellauer)
Jack Shea, then 91 years old, and a speedskating gold medal winner in the 1932 Olympics, was killed on January 23, 2002, in a collision with a drunk driver near his home in Lake Placid. No doctor was on duty at the small regional clinic where both Shea and the drunk driver, Herbert Reynolds of Saranac Lake, were brought for treatment after the crash. The physician’s assistant and the registered nurse on duty treated Shea, the more severely injured of the two, and an advanced emergency medical technician drew the driver’s blood at the request of a police officer. The drunk driver consented, and his level showed a .15 BAC, .05 higher than the impairment limit at the time (the limit is now .08 BAC).
Because there was no doctor present, the district attorney was not able to use the blood as evidence and all charges against the driver were dismissed. The district attorney appealed the ruling but the Appellate Court felt compelled to uphold the suppression of evidence due to current law. The Appellate Judge, however, called on the Legislature to amend the statute to remedy what they saw as an unnecessary restriction in the law.
Jack Shea’s Law (S.46B/A8601B), signed by Gov. Patterson in July 2010:
Expands the list of personnel who are allowed to withdraw blood without supervision if directed by a police officer. Currently, only physicians, registered professional nurses, and registered physician assistants are permitted to withdraw blood from an intoxicated driver without supervision. The proposed law would also extend that authority to certified nurse practitioners and advanced emergency medical technicians.
Allows other medical personnel who are trained to draw blood, such as clinical laboratory technicians/technologists, phlebotomists, and medical laboratory technicians/technologists, to withdraw blood at the request of a police officer, as long as they are under the supervision & direction of a physician, registered physician assistant or certified nurse practitioner or receive the consent of the adult from whom the blood is being drawn.
In practice, an AEMT asked by the police officer to draw blood from a DUI suspect can refuse to do so, but for the sake of so many already-heartbroken families, one can only hope that police and medical personnel will work together to insure that no more families have to suffer the double injustice that the Shea family endured.
[Article compiled from the website of NY State Senator Betty Little. See further articles and information at North Country Public Radio and thegovmonitor.com]
The MOVE OVER Law (by Jeremy Griffel)
On January 1, 2011, the "Move Over" law went into effect. This law should hopefully improve our safety when operating on scenes. You can view full history and text of the law at http://open.nysenate.gov/legislation/bill/S4647B-2009.
To summarize: the law requires motorists to "move over" to the next lane or slow down when approaching a stopped emergency vehicle with lights on operating on a scene.
However please remember this law should not change the fact that we all need to be wearing our safety vests when operating on MVA and other scenes in which we are standing in the road. Remember should something happen on a road and the investigation finds you were not wearing your vest, Workman's Comp may decline your claim. While it takes only a second to put the vest on it could save your life!