Dedicated to those brothers and sisters
that gave their lives to save others
9/11/01

RCEMS                  The PULSE
STEMI ST Elevation Myocardial Infarct		Above and Beyond the Call July 13, 2009
Recent research has shown that emergent percutaneous coronary intervention (PCI) in patients demonstrating ST-elevation myocardial infarction (STEMI) patterns on 12 lead ECG significantly improves overall patient outcomes as compared to thrombolytic therapy. Delays in patients with acute STEMI obtaining cardiac catheterization and subsequent angioplasty  have been associated with increased morbidity and mortality. Therefore, to achieve treatment within these time constraints, RCEMS will implement a destination guideline for STEMI patients. Proper notification and 12 lead transmission will also be addressed in this new protocol.		On June 10th, 2009 at 5:58pm unit 1 responded to a “Cardiac Arrest” at the Best Western Hotel on Church Street. David Meador and Jennifer Hershey arrived at the scene to find and elderly man in cardiac arrest. They immediately began advanced life support and transported the man to Middle Tennessee Medical Center.   David knew the family had a dog that needed to be cared for. He called his wife Pam, also a paramedic with RCEMS, and asked if she could assist this family in need. Without hesitation Pam made arrangements for the family pet. David and Pam offered the wife their home to stay in while the husband was in the hospital. They made sure that she had meals and other amenities until other family members arrived from out of State.   Pam and David visited the patient and his wife regularly at the hospital and Pam was there with the wife when her husband died a few days after admission. They continued to console family members and offer assistance.  David and Pam are not only exemplary Paramedics, but their actions beyond the call are in keeping with the finest traditions of Rutherford County EMS.
Interested in a Career in EMS? People’s lives often depend on the quick reaction and competent care of emergency medical technicians (EMTs) and paramedics. Incidents as varied as automobile accidents, heart attacks, slips and falls, childbirth, and gunshot wounds all require immediate medical attention. EMTs and paramedics provide this vital service as they care for and transport the sick or injured to a medical facility. In an emergency, EMTs and paramedics are dispatched by a 911 operator to the scene. Once they arrive, EMTs and paramedics assess the nature of the patient’s condition while trying to determine whether the patient has any pre-existing medical conditions. Following medical protocols and guidelines, they provide appropriate emergency care and  transport the patient to the hospital.  Emergency treatment is carried out under the medical direction of physicians. EMTs and paramedics may use special equipment, such as backboards, to immobilize patients before placing them on stretchers and securing them in the ambulance for transport to a medical facility. We work in teams. During the transport of a patient, one EMT or paramedic drives while the other monitors the patient’s vital signs and gives additional care as needed. At the medical facility, EMTs and paramedics help transfer patients to the emergency department, report their observations and actions to emergency department staff, and may provide additional emergency treatment. After each run, EMTs and paramedics replace used supplies and check equipment. If a transported patient had a contagious disease, EMTs and paramedics decontaminate the interior of the ambulance. Beyond these general duties, the specific responsibilities of EMTs and paramedics depend on their level of qualification and training. The State of Tennessee licenses emergency medical service providers at five levels: First Responder; First Responders do not work on Ambulances in Rutherford County; Emergency Medical Dispatcher, EMT-IV; Paramedic, and Paramedic Critical Care. The EMT-IV represents the first component of the emergency medical ambulance team. An EMT-IV trained at this level is prepared to care for patients at the scene of an accident and while transporting patients by ambulance to the hospital under medical direction. The EMT-IV has the basic emergency skills to assess a patient’s condition and manage respiratory, cardiac, and trauma emergencies. EMT-Paramedics provide the most extensive pre-hospital care. In addition to carrying out the procedures of the other levels, paramedics may administer drugs orally and intravenously, interpret electrocardiograms (EKGs), perform endotracheal intubations, and use monitors and other complex equipment.		H1N1 Information We're in preparation mode -- not emergency mode -- on this illness. Currently RCEMS has vaccinated over 300 first responders and 911 Telecommunicators. We plan to continue offering the vaccine to first responders ONLY. Below are some H1N1 facts.  The H1N1 virus is a combination of swine, human and bird genetic components.   The virus is spread the same way as seasonal flu: via respiratory droplets expelled when a person coughs and sneezes.   This is a large-particle virus and requires close contact for transmission. Droplets do not remain suspended in the air and travel only a short distance in the air (less than or equal to 1 meter or 6 feet).   As with any respiratory illness, place a surgical mask on the patient to contain secretions.  EMS personnel should be familiar with state pandemic plans. Screen all persons with respiratory symptoms for a travel history, such as recent travel to Mexico. Stay home if you're ill. Keep this all in a proper perspective. Each year, there are at least 26,000 deaths in the U.S. from seasonal flu.
		Pandemic Preparedness
		Rutherford County Emergency Medical Services is engaged in developing pandemic flu preparedness plans by addressing the needed coordination among all levels of government and the private sector.
		The Pandemic Flu has complex issues facing EMS, public health departments, business, and the public. Concerns regarding outbreaks of pandemic flu require preparedness efforts to be enhanced.
		A pandemic influenza occurs when a virus (usually originating or preexisting in one or more species of bird) evolves or mutates into a form that can infect and also be transmitted by people.
		Pandemic diseases have occurred throughout history. One of the worst on record, a strain known as the "Spanish influenza," caused the death of an estimated 40 to 50 million people worldwide in 1918. Less virulent pandemic influenzas occurred in 1957 and 1968, taking a combined 3 million lives. By contrast, in a more typical year, 250,000 to 500,000 people die from influenza or other respiratory-related illnesses.
Work environment. EMTs and paramedics work both indoors and out, in all types of weather. They are required to do considerable kneeling, bending, and heavy lifting. These workers risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from mentally unstable patients. The work is not only physically strenuous but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others. Rutherford County EMTs and paramedics are employed by the County and work 24 hours and are off for 48 hours. For more information about becoming an Emergency Medical Technician contact your local College or call MTSU at (615) 898-2462. www.MTSU.edu/learn To Register for EMT class at MTSU use this link https://www.onlineregistrationcenter.com/register.asp?m=203&c=7365		For more information about Pandemic Flue you can check out these sites: www.pandemicflu.gov www.cdc.gov/flu/Pandemic After Pandemic plans are completed, Rutherford County Emergency Medical Services Education Division will be conducting training and exercises with the entire staff. For more information contact Randy White, Director of Education and Planning.