Weekly Wrap Up December 9, 2016

Staff Meeting - This Tuesday

There will be a mandatory meeting at 8:00 AM on Tuesday, December 13 at the Coastal Health & Wellness Clinic on Galveston Island in the Community Room. The address is 4700 Broadway and again this meeting is mandatory.

Banana Boat Rescue

Rachael Ginn & Kory Dominy work with GFD to extricate a patient that fell.

Medic 1 crewed by Rachael Ginn and Kory Dominy responded to a call for a 42 year old male that had fallen from a ladder and landed on not one, but two forklifts and was complaining of back pain with numbness in multiple locations. They were able to initiate care while GFD worked with the longshoreman to ready a crane for extrication of the patient. Rachael is quickly surpassing Tom on not only the most diverse types of trauma calls that occur, but the frequency as well.

Employee Appreciation Luncheon

On Wednesday, December 14th at Haak Vineyards from 11:00 AM until 1:00 PM the Galveston County Health District will host the annual Employee Appreciation Luncheon. On menu is BBQ from Texas Pit Stop BBQ and the Service Pin ceremony will start at 11:40 AM. If you have not RSVP, please do so by using the link below. For those of you on shift lunch will be delivered so no need to RSVP if you are on shift Wednesday.

New Equipment Purchases

The process of purchasing equipment budgeted in the FY2017 budget has already started. We have already received quotes back on a number of our items and those orders will start getting submitted next week. Soon we should have some new stair chairs, vents, mechanical CPR devices, and radios on the streets.

In our second wave we will have a replacement for 1484 (the F250) and 1482 will be going to remount in late February. Replacement furniture is also in the second wave, however we will replace the office chairs first as those are badly needed. 

Upcoming Stroke Class

The flyer below for the Advanced Stroke Life Support class is free and being hosted by UTMB. Stacey Bouse took the class and said it was a great class and I know that Katie Horton our new Clinical Compliance Coordinator is planning on taking this class in January. It is free, however they do require a check for $50 to hold a seat which is returned when you show up for the class. It is rare that we get high quality, free training so I would encourage those of you that can attend to sign up and take advantage of this opportunity.

CPAP Training

As many of you are aware we are phasing out the old ventilators and CPAP units for a new product called the AEV which will be able to provide ventilator support, BiPAP and CPAP. In addition we are also moving towards a disposable CPAP device that will allow for easier application of CPAP and is small enough to fit in your airway bag. This device will free us from concerns of moisture, sand, etc. Earlier this week Katie sent out an email regarding training for the CPAP.

Hey all, The first link to a video is mandatory for EVERYONE to watch. I’ve attached an acknowledgement form for you to sign and email back to me. Copy Mark on that email as well. As you know, we are getting new CPAPs on the trucks. For right now, we will continue to order our current ones, but we will also have some new ones. The hope is to get away from the older ones and go to this simpler version. This CPAP connects directly to the oxygen tank or wall. We don’t need that little box to adjust our CPAP settings. YAY for less stuff to keep track of! This CPAP has 5 choices for PEEP settings. The idea here, is to start low (5, or 7.5) and titrate up. I believe the choices will be 5, 7.5, 10, 12.5 and 15. We can also adjust the FiO2 (fraction of inspired oxygen). The choices are 30%, 60%, 90%. The higher the percentage, the more oxygen the patient gets. I am attaching a few images. The first one shows the inline neb. That little blue plug is actually so that you can shoot more medication into the nebulizer without having to take it apart. Don’t pull the plug out, it actually has a little hole in it for you to use. Also take note of the PEEP valve above it.
The next image shows the Fi02 attachment that we will use. I’ve attached an image showing how it connects to the CPAP circuit as well
Finally, I attached a handy little brochure from the company. There are some additional training videos below. The supervisors are also trained, so please ask them to look over it with you. You can call me with any questions too! This is the link to the O2 Max training video: THIS IS MANDATORY FOR YOU TO WATCH. RETURN THE ACKNOWLEDGE FORM TO ME AND COPY MARK ON IT.

Documentation

In addition to the CPAP email, Katie also sent out an email regarding documentation. While reviewing some PCRs she came across some areas in which things were being left off of reports. In addition she also came across a great example of a well written patient refusal that was the work of William Masone.

While looking over some reports, I came across this report. I am inserted some pictures below, for your viewing pleasure.
Basically, this is an awesome report. It goes over and beyond. It has two sets of vital signs, with a GCS and with pain scores. Even a temp on a patient refusal! Whoop! The assessment tells me everything I need to know about the patient without having to read the narrative ( I included part of the initial and ongoing assessments). Although, this is a refusal and does not require a secondary assessment, if something changes with the patient while you are there, it is not a bad idea to chart a second assessment.
This comment section is here for comments. For example, if you have a patient with a laceration to their arm. Select laceration from the drop down. Then in the comments section, chart the approximate size of the laceration. Tell me if the bleeding is minor, moderate or heavy, ect. It is ok to be redundant in your report. In fact, it helps provides validity. Always elaborate!
Believe it or not, this refusal narrative has more information in it than most transport reports. The narrative paints a picture of the patient. It provides reasons why they patient is refusing. It writes that the EMT explained the resources available at the hospital, some possible reasons for her distress, and the risks associated with refusing treatment. He charts that she continued to refuse treatment on three occasions. I also really appreciate that he charted the words “against medical advice” in the narrative.
Everyone charts differently. The key is to put in as much information as possible. We aren’t going to remember every call we ran. It is important to chart so well that we don’t need to. This means charting the type and condition of a residence, charting the pertinent negatives, explaining why you chose to, or not to, give a medication or a certain treatment and so forth.
Anyway, I thought this was a great report and wanted to share. Hope everyone enjoys their day!

Cultural & Linguistic Competency Training

Just a reminder that previously Rocky Mosquera, Compliance Auditor for GCHD sent out an email with the annual training that is required for cultural & linguistic competency training. If you have not completed it please review his email and do so before the close of business on December 16. 

H1496 Update

It is official, 1485 is no longer a unit and is now H1469. The chassis is in the chassis shop getting outfitted and readied for the patient module to be mounted. 

The new front wall has been completed and will feature the "W" light pattern with red/green lights in the corners similar to how the other City of Galveston units have been configured. 

All new entry and compartment doors have been installed.

Anticipated completion is just prior to Frazer's holiday shutdown. 

Weekly Code Report

Over the past seven days we had two patients in cardiac arrest. The first one was a traumatic arrest of a 37 year old male that was the result of being shot. Despite the efforts of Medic 3 which had Jerod Upton and Brittany Sanders-Fletcher ROSC was never achieved.

Our second code of the week was a 60 year old female with an extensive history. The crew of Medic 1 which consisted of Chris Sirois and Rico Aldape with Stacey Bouse conducting Rico's Team Captain check ride. Sheri Jones responded as 60 and GFD assisted during the call. They were able to obtain ROSC after defibrillation.

Great job to both of crews this week on these calls!

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