Weekly Wrap Up December 16, 2016

Service Pen Awards

On Wednesday the annual Employee Appreciation Luncheon was held at HAAK Vineyards and service pen awards were presented to employees throughout Galveston County Health District. Galveston Area Ambulance Authority had several ranging from 5 years to 25 years of service. Congratulations and thank you for your service to the following:

  • Nathan Kohn - 5 Years
  • Veronica Doxey - 10 Years
  • Lora Franklin - 10 Years
  • Ralph Tims - 10 Years
  • Kimberly O'Rourke - 20 Years
  • Steven Coker - 25 Years

Single Car Rollover

Sunday Medic 4 with a crew of Naomi Evans and Justin Leibee responded alongside Engine 8 for a single car rollover. They arrived on scene to find the patient had either self extricated or was ejected and had no complaints. He did however have a fractured clavicle and was transported for treatment of his injury.

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.

H1469 Update

Bacliff, Meet your new unit...

H1469 is officially done with the remounting process and deliver of H1469 will occur on Monday. Previously it had been stated that H1469 would be assigned to Galveston 911, however this unit is a Galveston County unit. My apologies for that miscommunication. This unit is expected to enter service within 30 days of delivery due to the need to be stocked, registered and licensed with the State of Texas.

IV Fluid Update

The national shortage on normal saline has finally hit Galveston Area Ambulance Authority. As you may recall all crews were requested to use normal saline sparingly until an alternative vendor or source could be identified.In addition this message was also sent over to GFD to request that they verify with the EMS crew that fluids were warranted prior to setting up an IV infusion of normal saline.

Dr. Vincent has approved the use of Lactated Ringers which was sent out in the form of a letter from Dr. Vincent in an email through the Clinical Compliance Coordinator.

December 13, 2016 Dear Katie, Mark, and GAAA Field Staff: I have been made aware of impending shortages of normal saline supplies, due to national shortages. In the setting of limited supplies: 1) Do not give IV fluids indiscriminately or “reflexively” for any patient. Consider holding IV fluids EXCEPT for patients with a known or suspected volume-depleted state. 2) LR may be used as a substitute for NS throughout the protocols when indicated. As LR may be detrimental to patients in a shock or hypoperfusion state, carefully weigh the risks of aggressive LR use, versus holding fluids and/or optimizing transport time to the hospital, in these patients. Please let me know if I can help in any other way. James Vincent, MD Medical Director, GAAA

Ralph Tims and Mark Hummel have started the process of ordering Lactated Ringers which we should have on the units prior to the end of the year. In addition to this we have already notified GFD to make them aware that we will be carrying both Normal Saline and Lactated Ringers and to verify which is being requested by the EMS crew prior to setting up an IV infusion. Over the next week we will include the authorization letter in the protocols so that it is in place prior to the arrival of the LR.

Protocol Changes

Within the next two months a few changes to the protocols will be occurring which are centered on the administration of antibiotics to patients with amputations, penetrating trauma, burns and road rash that is bad enough to warrant debridement. Sheri Jones, Katie Horton and Dr. Vincent are working on the appropriate applications for antibiotic administration. Once we are closer to implementation more information will be sent out.

Hiring Update

This week Sheri Jones wrapped up another new hire orientation class and soon you will see three new faces here at Galveston Area Ambulance Authority. Joining us is Corby Saunders, Paramedic (part time) which a few of you may recognize from UTMB where he works full time. In addition we have Kaleb Howard, EMT-B (full time) who is coming from Schiltterbahn where he was a seasonal EMT and Brian Dandridge, Paramedic (full time) whom comes to us from Harris County. Please join me in welcoming all three of these gentlemen to our agency!

Our next new hire orientation class will be on January 3 and features three more medics that will be coming aboard. We have a few more expected to be in this class that are making their way through the hiring process with some great candidates that were interviewed today.

Some of you will notice on this next Flex schedule that two times of two flex days in a month are starting to fall by the wayside as we fill the open positions. A big thank you to everyone who has helped out filling the open shifts, recommending candidates, and conducting new hire field training!

Toughbook Failures

Just a reminder that if you encounter an issue with your laptop please do not attempt to troubleshoot it. Furthermore, please do not attempt to open up the case of the laptop as this can create another problem in itself. A frequent issue found by IT is this panel is found to have been opened in the field, which contains the RAM utilized by the laptops.

Also please do not affix any stickers, tape or bands to any GCHD or GAAA equipment. This includes the laptops, desktops, X-Series, stretchers, or radios. Most of our equipment is now covered by warranties, protection plans or service agreements which can prove problematic when sent back to the vendor for service.

Patient Care Awesomeness

This week have two great examples of patient care that had a positive outcome for their patients. Katie will be providing more feedback like this when she receives it or follows up on patients. If you encounter a patient that you would like to know what the outcome was you can always drop her an email or give her a call.

STEMI Alert

Earlier this month Josh Hale, Ian Davis and Jasmin Wiley responded for a 55 year old male with chest pain call to find a patient having a STEMI. They acquired their 12-Lead within 2 minutes of being on scene with a total scene time of 7 minutes. The patient went to the cath lab after a STEMI alert was activiated and found to have a 80-90% occlusion of his LAD. The patient was discharged after receiving a stent placed.

From Katie:

This is a copy of the 12-lead. You have 56 y/o male with a medical history of only HTN. Sudden onset of a “sharp and crushing, heartburn like pain”. Patient was pale, cool and diaphoretic. You can see the elevation in the anteroseptal leads. These show that “tombstoning” pattern that we hear about.

Stroke Alert

In addition to the email regarding the STEMI above that was sent out by Katie Horton, she also received great feedback from Allen Sims of HCA Healthcare on a stroke that was caught by Tommy Leigh and Veronica Doxey. The patient was a candidate for tPA, however he refused the treatment. Despite refusing the treatment he is reported to have improved and is doing well.

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.

Weekly Code Report

There was only one code this week and that was a 73 year old female that Medic 1 responded to with a crew of Rico Aldape, Chris Sirois and Jasmin Wiley. GFD assisted on the call and despite their valent efforts they were never able to obtain ROSC and the patient remained in asystole for the duration of the code. Nevertheless, another great effort to give the patient a chance.

Upcoming Training

Currently there are three training classes that are in the works which will be spread out across the next couple of months. The first one will be training on Operative IQ which is our inventory software and electronic apparatus checkoff forms. This training will be put on by Amy Weber as we look to move towards a more efficient means of tracking and ordering medical supplies and medications. 

The second class in the works is focused on the Pit Crew approach to CPR and critical calls. The goal of this class will be to help streamline calls, reduce the potential for errors and better utilize the assistance that is on scene when working with Galveston Fire Department. This was originally suggested by Michael Pregeant and recognized as a benefit by Katie Horton for us to implement.

Finally the third training will be a 12 Lead class which we are hoping will be our first class that we issue continuing education credits for. The anticipated class date is going to be around March and is something that would benefit not only the Paramedics, but those of you in Paramedic school or thinking about going to Paramedic school. 

Also please do not forget the Advanced Stroke Life Support (ASLS) class that is available in January. This class is free, however they do require a check to hold your seat and this check would be returned once you attend the class. Fore more information check out the flyer below. 

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. Last week Katie sent out an email with training materials regarding this CPAP. Please review her email or check out last week's Weekly Wrap Up for more information.

Up for grabs this week we have a Starbucks gift card to the person who can answer the trivia question. What is the name of the Paramedic in the banner picture that is holding the radio?

Made with Adobe Slate

Make your words and images move.

Get Slate

Report Abuse

If you feel that this video content violates the Adobe Terms of Use, you may report this content by filling out this quick form.

To report a Copyright Violation, please follow Section 17 in the Terms of Use.