EMS News

March News

Congratulations Gail

A Richmond native, Gail LeFever has been in nursing since graduating from Richmond Technical Center in 1970. She has acquired a wealth of medical knowledge that spans 40 years and numerous jobs within the field. She’s began her career as an EMT and as a Shock Trauma technician with the Abingdon Volunteer Rescue Squad, in addition to serving as a nurse from 1970-1985. In 2006, Ms. LeFever and her son and daughter became EMTs through the James City County Fire before she continued to the next level as an Intermediate with her son. In 2006, Gail and her daughter joined the Gloucester Volunteer Fire and Rescue.

Today, she serves as a captain of the Lower King and Queen Fire-EMS, where her husband was already a member. Though her crew is small in number of personnel, they provide outstanding care to the surrounding areas – a testament to the incredible hard work and dedication Ms. LeFever and her team bring every day.

Way to go Gail!

Heart Failure Signs & Procedures

According to the American Heart Association, approximately 5.7 million Americans suffer from heart failure, a condition in which the heart muscle is too weak or too stiff to pump sufficient amounts of blood throughout the body, impeding oxygen supply. The primary cause of heart failure is hypertension.

The following are clinical pearls for assessing patients experiencing heart failure exacerbation and essential information needed when calling to report to the emergency room.

  • Shortness of breath on arrival
  • Assess duration of breathing difficulty – new onset or persistent?
  • Does the shortness of breath occur with or without activity?
  • Breathing difficulty sitting up or lying flat?
  • Pulse oximetry
  • If chest pain accompanies shortness of breath
  • Assessment of lung and heart sounds
  • Assess for edema, especially facial, abdominal or lower extremities
  • Code status
  • Full
  • Partial
  • DNR
  • Medications
  • Last time medications were taken (diuretics, blood pressure, etc.)
  • Essentials to call in report to hospital:

    • Presentation of client on arrival of scene
    • Lung and heart sounds
    • Initial pulse oximetry and treatment
    • Including nebulizer treatment delivered or CPPV device in use
    • EKG findings or present on arrival if unable to transmit electronically
    • Medications delivered and outcome
    • IV access
    • Code status
    • Next of kin if patient is unable to speak

    2015 EMS Expo

    February 28th marked the start of the two-day event where first responders from across Virginia came together for one of the largest regionally held EMS training events. Over 500 EMS providers, nurses and law enforcement members took part in the 65 available classes in order to reach the required hours for recertification. Courses included techniques in CPR, advanced intervention skills and safe vehicle operations, just to name a few.

    Participants mentioned how this event is a great way to reach needed hours without having to travel. Mark your calendars for the 7th Annual Central EMS Expo, which will be held March 5-6, 2016.

    Congratulations to Garett Freeman, our First Quarter Employee of the Month

    A full-time paramedic with RAA since December of 2011, Garrett is a consummate professional with a positive attitude on and off the clock. Always wanting to help his peers achieve their goals, he is known to stay well after his EOT in order to lend assistance to other crews. Even on his personal time, Garett aids new employees with understanding protocol and documentation and gives tutorials on devices. Currently, Garett is the Chair of the Clinical Services Committee and leads by example, driving enthusiasm and engagement among his other employees. Simply put, Garett Freeman exemplifies why RAA provides world-class EMS personnel and we’re proud to have him on our team. Congratulations Garett and keep up the excellent work!

    Good help began with the EMS at Forest View Volunteer Rescue Squad six decades ago.

    Sixty years ago this year, a group of nine men assembled together with the sole mission to make South Richmond and Chesterfield County a safer place for its residents. In July of 1955, the FVVRS was officially created. Their first ambulance was a converted Buick Hearse, and a donated chicken coop served as the group’s squad building. By the end of 1956, they had 41 members, two ambulances and had run 85 calls.

    Today, the FVVRS has over 125 members and 2600 responses each year. Led by lifetime member and President John Hilliard and Operations Chief Dave Johnson, their vision for the future is as bright as ever. Armed with a new mission statement: “Pride in Service to Others” – Pride stands for, Professionalism, Respect, Integrity, Dedication and Enthusiasm. After 60 years of service, it’s clear to see the Forest View Volunteer Rescue Squad and its members back up their words.


    We Need You In The Neuroscience Know


    EMS, we can’t do it without you! We’ve known EMS providers are the key to intervention and treatment for best outcomes of early care of acute strokes, and the 2013 American Heart Association/American Stroke Association Guidelines for the Early Management of Patients with Acute Ischemic Stroke support this with evidence!

    When the 2007 guidelines were released, stroke was the third leading cause of death. The good news is since those recommendations have been implemented, stroke has now dropped to the fourth cause of death; however, it still remains the leading cause of disability.

    The chain of action for someone having good functional outcomes after having a stroke starts with the recognition of when a stroke actually begins. It is important for EMS to help with community awareness by teaching the community the signs and symptoms of stroke using the F.A.S.T. acronym (parallel to the Cincinnati scale), reinforcing the community to recognize signs and symptoms of stroke and call 9-1-1 immediately.

    F – Facial droop
    A – Arm drifting
    S – Speech difficulty
    T – Time to call 9-1-1

    Data still shows the public’s knowledge of stroke warning signs and symptoms remains at an all-time low. Fewer than half of 9-1-1 calls for stroke events were made within an hour of symptom onset according to an article entitled “Awareness of necessity to call 9-1-1 for stroke symptoms.” What is so awesome is that many studies have proven that ongoing powerful public education about the signs and symptoms of stroke does improve stroke recognition. The California Acute Stroke Pilot Registry reported the expected overall rate of clot buster tPA treatment within 3 hours could be increased from 4.3% to 28.6% if all patients arrived early, after onset of symptoms.

    The guidelines are all based on research and have been tested for years in many studies. Many of our EMS providers have implemented these guidelines and best practices, but we wanted to share with you the research of why those actions were put into recommendations. Four of the recommendations remain the same as they are the best practice, and two more were added as proven scientific-based interventions for pre-hospitalization and impact actions for EMS. The recommendations are as follows:

    1. To increase both the number of patients who are treated and the quality of care, educational stroke programs for physicians, hospital personnel, and EMS personnel are recommended. (Unchanged from the previous guideline)
    2. Activation of the 9-1-1 system by patients or other members of the public is strongly recommended. 9-1-1 dispatchers should make stroke a priority dispatch, and transport times should be minimized. (Unchanged from the previous guideline)
    3. Prehospital care providers should use prehospital stroke assessment tools, such as the Los Angeles Prehospital Stroke Screen or Cincinnati Prehospital Stroke Scale. (Unchanged from the previous guideline)
    4. EMS personnel should begin the initial management of stroke in the field. Development of a stroke protocol to be used by EMS personnel is strongly encouraged. (Unchanged from the previous guideline)
    5. Patients should be transported rapidly to the closest available certified Primary Stroke Center or Comprehensive Stroke Center or, if no such centers exist, the most appropriate institution that provides emergency stroke care as described in the statement. In some instances, this may involve air medical transport and hospital bypass. (Revised from the previous guideline)
    6. EMS personnel should provide prehospital notification to the receiving hospital that a potential stroke patient is en route so that the appropriate hospital resources may be mobilized before patient arrival. (Revised from the previous guideline)

    While Stroke Awareness Month is in May, you will see Bon Secours facilities constantly doing community outreach at every opportunity to spread the word on the signs and symptoms of stroke and emphasizing the importance to call 9-1-1 for help! Our motto at Bon Secours is Good Help to Those In Need. We need your help! Help us spread the news about the signs and symptoms of a stroke. Urge the community to call 9-1-1. Document the last known well time (no signs or symptoms of a stroke). Working together, we can help the patient suffering from a stroke.

    Check out this 60-second public service announcement. Help us spread the good word to those in need! 

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