NEWS FOR EMS TEAMS AT SAINT ALPHONSUS HEROES SAINTS ISSUE 7 DECEMBER Eagle ER Ski & Mountain Trauma Conference Video Laryngoscopy

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1 NEWS FOR EMS TEAMS AT SAINT ALPHONSUS HEROES SAINTS ISSUE 7 DECEMBER 2013 Eagle ER Ski & Mountain Trauma Conference Video Laryngoscopy

His memory will live on in the work we do and be a constant reminder of the fragility of life - both our own lives and the lives of those we serve.

2 SAINT ALPHONSUS EMS NEWSLETTER LETTER FROM THE EDITOR A HERO S DEDICATION AIMEE STEIN Emergency & Trauma Services Relationship Manager & Editor It s with a heavy heart that we dedicate our 7 th issue of Heroes & Saints to the memory of Captain Brandon Erickson. He was a brother, a friend and a leader to many in the EMS community. His memory will live on in the work we do and be a constant reminder of the fragility of life - both our own lives and the lives of those we serve. Our prayers are with Bonni, Jack, Meghan and all of Brandon s loved ones. I would like to wish each and every one of our Heroes and your families a Merry Christmas and joyous holiday season. ETYMOLOGY OF HEROES Coined in English 1387, during the time of King Arthur s round table, the word hero comes from the Ancient Greek. Hero, warrior, literally protector or defender. It is also thought to be a cognate of the Latin verb servo (original meaning: to preserve whole) and of the Avestan verb haurvaiti (to keep vigil over). Reflections from SISTER BETH MULVANEY Heroes. Saints. They have a lot in common. When the Catholic Church names someone a saint, it is official recognition that during the person s lifetime, he or she was outstanding in the way they responded to God s love and demonstrated it to others. Saints respond to needs. Saints overcome all kinds of obstacles to make good things happen. Saints often put other people s hopes ahead of their own. Yes, our present day emergency medical responder Heroes and the Saints as described above, have a lot in common. 2 Want to share your story? sahs-ems@sarmc.org

SARMC.ORG HIGHLIGHTS EDITORIAL BOARD TABLE OF CONTENTS AIMEE STEIN Emergency & Trauma Services Relationship Manager & Editor JENNIFER KRAJNIK Communications Manager & Editor DR.

BEN CORNETT IEP/Ada County Medical Director PAT BERGEY RN, BSN DR. KARI PETERSON IEP/Canyon County Medical Director DR.

ANDREW NELSON Nampa ER Medical Director BRAD HOAGLAN PR & Communications Director 2 LETTER FROM THE EDITOR 3 HIGHLIGHTS 4 LOOKING AT US 8 LIFE FLIGHT NETWORK 10 EAGLE ER SOCIAL MEDIA BUZZ 11 AWARDS &

3 SARMC.ORG HIGHLIGHTS EDITORIAL BOARD TABLE OF CONTENTS AIMEE STEIN Emergency & Trauma Services Relationship Manager & Editor JENNIFER KRAJNIK Communications Manager & Editor DR. BILLY MORGAN Trauma Medical Director & Medical Staff President CHRISTINE SHIRAZI MS, APPN, ACNS-BC Cardiovascular Clinical Program Manager SISTER BETH MULVANEY Mission Education DR. BEN CORNETT IEP/Ada County Medical Director PAT BERGEY RN, BSN DR. KARI PETERSON IEP/Canyon County Medical Director DR. ERIC ELLIOTT IEP/Medical Director NICHOLE WHITENER MSN, CNRN, NE-BC Neuro/Stroke Director JANA PERRY RN, MSN Trauma/ER General Surgery Director DR. HEATHER HAMMERSTEDT Eagle ER Medical Director DR. ANDREW NELSON Nampa ER Medical Director BRAD HOAGLAN PR & Communications Director 2 LETTER FROM THE EDITOR 3 HIGHLIGHTS 4 LOOKING AT US 8 LIFE FLIGHT NETWORK 10 EAGLE ER SOCIAL MEDIA BUZZ 11 AWARDS & RECOGNITION STAY CAUGHT UP WITH SAINT ALPHONSUS EMERGENCY & TRAUMA NEWS BY LIKING HEROES & SAINTS ON FACEBOOK! facebook.com/heroesandsaints UPCOMING EVENTS PLEASE WELCOME JOHN AND BRITANI TO THE TRAUMA TEAM STROKE CASE REVIEW Coughlin Conference Room 2 7-9am 3 rd Wed. of the month TRAUMA ROUNDS Coughlin Conference Room 2 7-8am 1/15, 1/29, 2/12, 2/28, 3/12, 3/28 SARMC CARDIAC GRAND ROUNDS Friday January 31 7am NATIONAL EMS WEEK May 18-24, 2014 John C. Mayberry, MD, FACS Britani Hill, MD Education: Oregon Health & Science University, Portland, OR Residency: Oregon Health & Science University General Surgery Fellowships: Oregon Health & Science University Trauma & Critical Care, General Surgery Board Cert.: General Surgery & Surgical Critical Care Specialties: Trauma & Acute General Surgery Education: University of Washington School of Medicine Seattle, WA Residency: University of Utah, Salt Lake City, UT Fellowships: Emory University, Trauma & Critical Care Atlanta, GA McKay Dee Hospital, Rural Surgery Fellowship Ogden, UT Board Cert.: General Surgery Specialties: Trauma & Acute General Surgery DECEMBER

4 SAINT ALPHONSUS EMS NEWSLETTER LOOKING AT US Ski & Mountain Trauma Conference HITS RECORD ATTENDANCE IN ITS 8 TH YEAR! Aimee Stein Emergency & Trauma Services Relationship Manager & Editor SKI & MOUNTAIN TRAUMA CONFERENCE HITS RECORD 450 ATTENDEES! When it comes to exceeding expectations, the Saint Alphonsus Ski & Mountain Trauma Conference knows no boundaries. Providing great education and hands-on training in the spectacular setting of world-class Sun Valley Resort, the conference is considered the fastest growing conference for pre-hospital providers anywhere in the US. Now in its eighth year, this unique conference attracted over 450 attendees from the Pacific Northwest, East Coast, Canada and Scotland. Ski patrol members, search and rescue units, National Guard medics, firefighters, EMTs and paramedics joined in the fun and education which included cutting edge presentations from national experts and hands-on training. Keynote speakers from the Scottish Mountain Rescue Team opened and closed the conference providing insights from rescues in their rugged terrain and often treacherous hurricane-force wind conditions. This has become a must-attend event and is even gaining international visibility, said Jana Perry, RN, Trauma & Emergency Director. It is one of the leading conferences that gives hands-on training scenarios that you just don t often see or where practice is critical to ensure the outcome for the patient is positive. Save the date for next year s conference - November 6-8, 2014! If you are interested in learning more, contact Jana Perry, Trauma & Emergency Director at (208) or janaperr@sarmc.org. 4 Want to share your story? sahs-ems@sarmc.org

Idaho State University, Idaho National Guard, Saint Alphonsus Family Maternity Center, Sun Valley Ski Patrol, Caribou

Neonate Trauma Sim + Pediatric Penetrating Trauma Sim + Pediatric Blunt Force Trauma Sim + Permissive Hypotension Sim +

5 SARMC.ORG LOOKING AT US The conference provides workshops and simulations that give EMS hands-on experience they typically don t see. This year we were able to organize the following sessions with the help of Ada County Paramedics, Life Flight Network, Idaho State University, Idaho National Guard, Saint Alphonsus Family Maternity Center, Sun Valley Ski Patrol, Caribou Adventures, and Mountain Education & Development LLC: + Lower Extremity Injuries Sim + Head & Facial Trauma Sim + OB & Neonate Trauma Sim + Pediatric Penetrating Trauma Sim + Pediatric Blunt Force Trauma Sim + Permissive Hypotension Sim + Basic Airway Management Sim + 10 Essential Systems of Survival + Wild Wilderness Wounds + Avalanche Survival & Rescue + Creative Splinting & Improvised Traction Splinting + Dislocation Management + Cardiac Contusions + High Angle Rescue Demonstrations + Gondola Rescue Demonstrations + Litters & Evacuations + Landing Zone Safety DECEMBER

Forensics + Cold Water Immersion + Wilderness Medicine + Frostbite & Hypothermia +

Management SAINT ALPHONSUS SKI & MOUNTAIN TRAUMA IS ONE OF THE BEST, MOST WELL

MY TEAM KEEPS ON COMING BACK BECAUSE OF THE CONCENTRATION ON EVIDENCE BASED

6 SAINT ALPHONSUS EMS NEWSLETTER LOOKING AT US Saint Alphonsus was privileged to bring in leading experts in the field to present the latest findings on: + Trauma Forensics + Cold Water Immersion + Wilderness Medicine + Frostbite & Hypothermia + Rural Trauma Care + Myocardial Contusion + Wildland Fire Injures + Pediatric Burn Management SAINT ALPHONSUS SKI & MOUNTAIN TRAUMA IS ONE OF THE BEST, MOST WELL ORGANIZED AND EDUCATIONAL CONFERENCES I ATTEND, SAID ONE SUN VALLEY FIREFIGHTER. MY TEAM KEEPS ON COMING BACK BECAUSE OF THE CONCENTRATION ON EVIDENCE BASED PRE-HOSPITAL CARE.IT BUILDS CONFIDENCE IN MY PERSONNEL. 6 Want to share your story? sahs-ems@sarmc.org

Dr. Bill Morgan, Trauma Medical Director, Saint Alphonsus + Dr.

Eric Johnson, Wound Healing & Hyperbaric Medicine, Saint Alphonsus + Dr.

Benjamin Cornett, Emergency Physician, IEP + Lance (& Cami) Taysom, Life

renowned mountaineer Lou Whittaker was joined by his son Peter Whittaker,

7 SARMC.ORG LOOKING AT US Joining the presenters were our own local physicians (and staff): + Dr. Richard Moore, Orthopedic Surgeon, Ada Othopedics & Conference Founder + Dr. Bill Morgan, Trauma Medical Director, Saint Alphonsus + Dr. Dale Strawn, Trauma Surgeon, Saint Alphonsus + Dr. Eric Johnson, Wound Healing & Hyperbaric Medicine, Saint Alphonsus + Dr. Renee Bobrowski, Maternal-Fetal Medicine, Saint Alphonsus + Dr. Benjamin Cornett, Emergency Physician, IEP + Lance (& Cami) Taysom, Life Flight, Portneuf Medical Center Conference mainstay and internationally renowned mountaineer Lou Whittaker was joined by his son Peter Whittaker, a nationally acclaimed climber and skier in his own right. Peter shared his lessons learned in managing the risks associated with working in remote mountainous locations and continued to be a perfect fit for the conference. DECEMBER

8 SAINT ALPHONSUS EMS NEWSLETTER LIFE FLIGHT DOES VIDEO LARYNGOSCOPY IMPROVE INTUBATION SUCCESS RATES? Suzie Brennan, RN, MSN, CFRN Director of Clinical Operations, Life Flight Network (The following is a summary of a clinical presentation made at 2013 s Air Medical Transport Conference in Virginia Beach, VA.) IT IS IMPORTANT TO HAVE APPROPRIATE TOOLS AVAILABLE TO INCREASE THE OPPORTUNITY FOR A SUCCESSFUL INTUBATION. Airway management is a fundamental skill for EMS providers. When needed, it is imperative advanced airways are established with a minimal number of attempts. Each attempt increases the risk of complications such as hypoxemia, aspiration, airway trauma, hypotension and bradycardia, while decreasing the likelihood of a successful intubation. Multiple obstacles to intubation success are encountered by medical crews. Patients often have a full stomach, blood or foreign bodies in the airway, cervical spine immobilization, or have had previous intubation attempts. In addition, personnel may be asked to intubate a patient without warning or preparation after paralytics have been administered; at times in less than ideal physical environments and with minimal on-scene resources. All of these factors lead to a higher degree of difficulty encountered in intubations. Given these factors, it is important to have appropriate tools available to increase the opportunity for a successful intubation. To this end, C-MAC PM Video Laryngoscopes were purchased and added to Life Flight Network s (LFN) intubation protocol beginning January 1, Video Laryngoscopy Benefit Hypothesis Tested LFN set out to determine if Video Laryngoscopy (VL) improves intubation success rates as compared to intubation with conventional tools. Success in this case is defined as achieving intubation by the second attempt, with an attempt defined as any time the laryngoscope blade enters the oral cavity. After a two-month training period, the C-MAC PM laryngoscopes (blade 8 Want to share your story? sahs-ems@sarmc.org

9 SARMC.ORG LIFE FLIGHT sizes 3 and 4) were placed in service. Crew members were instructed to use the C-MAC for all adult intubation attempts. Extensive training was provided to crew members prior to adding the C-MAC VL to the intubation protocol. A competency form was utilized to ensure crew members had proficient understanding of all aspects of use. In addition, each base in Idaho, Oregon and Washington had a C-MAC for at least one month prior to implementation, giving the crews opportunity to intubate mannequin heads and become familiar with the operation of the C-MAC. All epcr s from January 1 through September 30 in both 2012 (pre-vl) and 2013 (post-vl) which had advanced airways documented or attempted were utilized in the analysis. Intubation success data from January 1-September 30, 2012 was compared to the same data from January 1-September 30, There were 125 intubation attempts in the 2012 time period, of which 103 were successful (82%). There were 117 intubations utilizing the VL performed during the specified time frame in 2013; 107 were successful (91%). King Airway use decreased from 11 in 2012 to 6 in This increase in intubation success rates occurred even though an analysis of 2013 epcr s revealed a significant increase in intubation difficulty. This determination is based on the number of intubation attempts made prior to arrival of air medical transport. In 2012, there were 10 unsuccessful intubation attempts made on 7 patients prior to transition of care to LFN crews. In 2013, that number increased to 27 unsuccessful attempts made on 17 different patients. LFN introduced the use of the C-MAC VL on January 1, Since implementation, intubation success rates increased from 82% to 91% year over year. Ongoing data collection will be required to determine if the trends persist, but early analysis appears to show patients requiring intubation are benefitting from the C-MAC Video Laryngoscopes being an integral part of LFN s intubation protocol. DECEMBER

This month, Canyon County EMS brought in an acute hemiplegic stroke patient who was examined, imaged, diagnosed and given IV TPA in 29 minutes.

10 SAINT ALPHONSUS EMS NEWSLETTER EAGLE ER HEATHER HAMMERSTEDT, MD MD MPH FACEP Director EAGLE S ED: QUICKEST IN THE VALLEY WE CARE FOR ALL EMERGENCIES AND URGENCIES. Saint Alphonsus Eagle Health Plaza ER door to nurse time is less than 5 minutes, and our door to doctor time is consistently around 15 minutes. We care for all emergencies and urgencies. This month, Canyon County EMS brought in an acute hemiplegic stroke patient who was examined, imaged, diagnosed and given IV TPA in 29 minutes. LifeFlight Network Paramedics, stationed at Eagle Health Plaza, quickly transferred the patient to Saint Alphonsus Boise, where she urgently underwent further imaging and thrombectomy. The patient has made a nearly complete recovery to baseline in part due to the efficient, quality emergency care she received at Eagle s ER. Kudos to our EMS colleagues for recognizing the need for immediate ER evaluation and to our Eagle ER staff for the best door to TPA time the Stroke Team has seen. Way to go! 10 Want to share your story? sahs-ems@sarmc.org

SARMC.ORG AWARDS & RECOGNITION ROB HILVERS, MD Emergency Medical Specialist EMERGENCY RESPONDERS HEALTH CENTER Dr.

It is imperative for the physician to understand the unique risks and adverse working environments of EMS, including psychosocial stressors, knowledge of toxic and chemical exposures, effects of

IN MEMORY OF A COMMUNITY HERO BRANDON WAS ONE OF THE BEST INSTRUCTORS - ONE OF THE BEST PEOPLE - I VE EVER KNOWN We are mourning the loss of our brother, Eagle Fire Captain Brandon Erickson.

11 SARMC.ORG AWARDS & RECOGNITION ROB HILVERS, MD Emergency Medical Specialist EMERGENCY RESPONDERS HEALTH CENTER Dr. Rob Hilvers has the ideal background to care for the spectrum of health-related adversities facing firefighters and EMS personnel. It is imperative for the physician to understand the unique risks and adverse working environments of EMS, including psychosocial stressors, knowledge of toxic and chemical exposures, effects of medications on essential job tasks, and to be mindful of the importance of strict confidentiality. IN MEMORY OF A COMMUNITY HERO BRANDON WAS ONE OF THE BEST INSTRUCTORS - ONE OF THE BEST PEOPLE - I VE EVER KNOWN We are mourning the loss of our brother, Eagle Fire Captain Brandon Erickson. As many of you know, Brandon died Thursday, November 21 after a complication from back surgery. He underwent surgery on Wednesday and passed away a day later. Brandon started working for Eagle Fire in April. He came to Eagle after spending the previous five years working for the Meridian Fire Department as a firefighter and paramedic. Brandon is a community hero, not just for helping our citizens in need but for bettering the lives of all who knew him, said Meridian Fire Chief Mark Niemeyer. Brandon was so compassionate, he had a continued thirst for knowledge and always worked to find the good in humanity. When we were waiting for our new EMS Chief, Brandon gladly filled the role for 6 months and was an incredible asset for us. To know Brandon was to love him. He will be greatly missed. Brandon hurt his back while working for Meridian Fire in His surgery on Wednesday was related to that injury. Brandon was one of the best instructors one of the best people I ve ever known. If I had a firefighter who was having trouble mastering a skill, I took him to Brandon. He found a way to connect with everyone. It was his gift, said Eagle Fire Chief Mike Winkle. This is a tremendous loss for our agency and for fire/ems personnel across the country. Brandon leaves behind a wife, son and daughter. An account has been set up in Brandon s name at Idaho Central Credit Union for anyone wishing to help the family. DECEMBER

Saint Alphonsus Regional Medical Center 1055 N.

Rd. 208.463.5000 NAMPA HEALTH PLAZA 4400 E. Flamingo Ave. 208.288.

12 Saint Alphonsus Regional Medical Center 1055 N. Curtis Boise, ID NON-PROFIT ORG. U.S. POSTAGE BOISE, ID PERMIT NO. 333 EMERGENCY DEPTS. BOISE 1055 N. Curtis Rd EAGLE 323 E. Riverside Dr NAMPA th Ave. Rd NAMPA HEALTH PLAZA 4400 E. Flamingo Ave ONTARIO 351 SW 9th St N E W Nampa HP BAKER CITY 3325 Pocahontas Rd S

Curtis C. Sandy, MD EMT-T FACEP

Curtis C. Sandy, MD EMT-T FACEP 1711 Bachelor Circle Pocatello, ID 83201 (208) 705-7752 ccsandymd@gmail.com EDUCATION 2000-03 1996-00 1993-96 Residency in Emergency Medicine St. Vincent Mercy Medical Center