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Emergency Medical Services
Mar 26, 2008

Your Community Fire Protection District Paramedics and EMTs are pleased to welcome you to our section of the web site. We hope you find the articles helpful, if you have questions or suggestions please email the medical officer at: mcashion@communityfpd.org. Thank-you for visiting - your good health is our primary goal.

 


Mar 14, 2008
Bee & Wasp Stings
With the start of warm weather we begin to prepare for the onslaught of our small winged friends the bee and wasp. While often the sting is only a painful nuisance, it can be much worse. Your Community Fire Protection District medics want you to know how to tell the difference, and how to avoid a sting.  
It is estimated that between one and two million people in the United States are severely allergic to stinging insect venom. Each year 90 to 100 deaths from sting reactions are reported, but many more deaths may be occurring, mistakenly diagnosed as heart attacks, sunstrokes or attributed to other causes. More people die each year from the effects of insect venom than from spider or snake bites.
Extreme human sensitivity to stings resulting in serious or fatal reactions is confirmed almost entirely to cases involving bees, wasps, hornets, bumble bees and ants (Order Hymenoptera).
Unlike most other allergies, insect allergy can cause a life-threatening disruption to breathing and circulatory systems called anaphylactic shock. For one person in 100, the sting of an insect can be fatal.
Allergic Reaction Symptoms
Most people stung will experience a "local" reaction with redness, pain, swelling and some itching only at the sting site. If the reaction progresses quickly to sites other than the sting site or is followed by difficult breathing or choking at the throat, the person is experiencing a "systemic" allergic reaction (anaphylaxis) requiring emergency medical treatment.
Remember that if you are stung on the hand and your face begins to swell or hives break out all over your body, this is a serious condition requiring emergency room attention.
Normal Reaction:--Lasts a few hours. Sting site is painful, reddened, may swell and itch, but will quickly dissipate.
Large Local Reaction:--Lasts for days. Sting site is more painful, swelling and itching may be present both at the sting site and in surrounding areas.
Severe Allergic Reaction:--Can commence rapidly (in a few minutes) after the sting occurs. The whole body is involved. The patient may feel dizzy (lightheaded), nauseated and weak. There may be stomach cramps and diarrhea. There can be itching around the eyes, a warm feeling or coughing, hives breaking out, followed with vomiting and swelling. There can be wheezing, difficult breathing (shortness of breath) or swallowing, hoarse speech, drop in blood pressure, shock, unconsciousness and darkened skin following. Reactions may occur in a few minutes with most deaths within 30 minutes, but some within 15 minutes and some in five minutes or less.
Systemic Sensitivity
Doctors believe that once systemic sensitivity occurs, it almost always increases in severity with each following sting (varies in individual persons). The more quickly symptoms appear after the sting, the more severe the reaction. (Some beekeepers can no longer keep honey bees after several years due to severe allergic reactions developing). The problem occurs when some individuals produce excessive quantities of antibodies in their immune system. The excess antibody production usually follows the initial sting to which there is no reaction. However, when the person is stung again, the insect venom entering the body combines with the antibody, produced by the first sting, which triggers a series of internal reactions, resulting in severe allergic symptoms.
Stings
Whenever stung, try to capture or know the identity of the insect to help doctors diagnose the trouble. When a bee or wasp stings, it injects a venomous fluid under the skin. Honey bees have a barbed stinger. Only the honey bee leaves her stinger (with its venom sac attached) in the skin of its victim. Since it takes two to three minutes for the venom sac to inject all its venom, instant removal of the stinger and sac usually reduces harmful effects. Scrape away with a sideways movement (one quick scrape) with a fingernail. Never try to use the thumb and forefinger or tweezers to pinch out the stinger since this maneuver forces (injects) more venom from the sac down into the wound.
Wasps, yellowjackets and hornets have a lance-like stinger without barbs and can sting repeatedly. They should be brushed off the victim's skin promptly with deliberate movements, then quietly and immediately leave the area.
Sting Prevention
People, especially allergic to stings, should practice certain simple precautions to avoid being stung.
Outdoors
Spray the patio, picnic and garbage areas with permethrin (Astro, Dragnet, Flee, Permanone, Prelude, Torpedo) or pyrethrins (Kicker, Microcare, Pyrenone, Pyrethrum, Synerol). Some formulations are restricted use. A licensed pesticide applicator or pest control operator can apply restricted use pesticides such as bendiocarb + pyrethrins (Ficam Plus), bifenthrin (Biflex), cyfluthrin (Tempo), cypermethrin (Cynoff, Cyper-Active, Demon, Vikor), deltamethrin (Suspend) and tralomethrin (Saga). Other labelled pesticides include acephate (Orthene), amorphous silica gel (Drione), bendiocarb (Ficam), carbaryl (Sevin), chlorpyrifos (Dursban, Empire, Tenure), diazinon, propoxur (Baygon) and resmethrin (Vectrin).
If you destroy the nests (aerial and ground) yourself, use a commercially available stinging insect control aerosol containing Baygon, pyrethrin, permethrin or resmethrin which can shoot a high-volume spray stream 15 to 20 feet, giving excellent quick knockdown and kill of wasps and bees hit. After dark or in the evening, most have returned from foraging to the nest. Thoroughly saturate the nest with spray, contacting as many insects as possible. Do not stand directly under an overhead nest, since some insects receiving some of the spray may fall but retain their ability to sting for some time. Repeat treatment if reinfestation occurs.
Again, it is always best, if allergic, to hire a professional exterminator to remove a nest. Never try to burn or flood a nest with water since this practice will only make these stinging insects angry and aggressive.
When eating outdoors, keep food covered until eaten, especially ripe fruit and soft drinks. Any scent of food, such as outdoor cooking, eating, feeding pets or garbage cans, will attract many bees and wasps (especially yellowjackets).
Keep refuse in tightly sealed containers. Dispose of refuse frequently (two times per week or more) during late summer and early autumn when most activity occurs.
Be careful not to mow over a nest in the ground nor disturb a nest in a tree or eaves of the home. Any disturbance often will infuriate and provoke stinging.
Should a bee or wasp fly near you, slowly raise your arms to protect your face and stand still or move slowly away through bushes or indoors to escape. Never move rapidly, which often provokes attack. Never strike or swing at a wasp or bee against your body since it may be trapped causing it to sting. If crushed, it could incite nearby yellowjackets into a frenzied attack. The wasp venom contains a chemical "alarm pheromone," released into the air, signaling guard wasps to come and sting whomever and whatever gets in their way.
If a bee or wasp gets into a moving car, remain calm. The insect wants out of the vehicle as much as you want it out. They usually fly against windows in the car and almost never sting the occupants. Slowly and safely pull over off the road, open the window and allow the bee or wasp to escape. Unfortunately, many serious accidents have resulted when the driver strikes or swings at the insect during operation of the vehicle. A small insecticide aerosol can for control of stinging insects, kept in the car away from children and pets, can be used in an emergency.
Pick fruits as soon as they ripen. Pick up and dispose of any fallen fruit rotting on the ground. Keep lawns free of clover and dandelions, which attract honey bees. Avoid close contact with flowering trees, shrubs and flowers when bees and wasps are collecting nectar. Vines, which may conceal nests, should be removed from the house, if practical.
Individuals
Since perfume, hair spray, hair tonic, suntan lotion, aftershave lotions, heavy-scented shampoos, soaps and many other cosmetics attract insects, they should be avoided. Avoid shiny buckles and jewelry. Wear a hat and closed shoes (not sandals). Don't wear bright, colored, loose-fitting clothing, which may attract and trap insects. Flowery prints and black especially attract insects. To avoid stings, the beekeeper wears light-colored (white) clothing, preferably cotton (never wool).
Beginning beekeepers use bee gloves, a head veil, long sleeves and coveralls with the pant legs tucked into boots or tied at the ankles to prevent unnecessary multiple stings. A bee smoker is always used before opening up an established hive. To avoid stings, stay away from any bee hives for an hour or more (depending on weather) after the beekeeper has gone. Bees are more angry on cloudy, dark rainy days in early spring of the year.
Hypersensitive persons should never be alone when hiking, boating, swimming, golfing, fishing or involved outdoors since help is likely needed in starting prompt emergency treatment measures if stung. It is wise for the person to carry a card or to have an identification bracelet or necklace, such as "Medic Alert," identifying the person as hypersensitive to an insect sting. It will alert others to the condition in an emergency when sudden shock-like (anaphylactic) symptoms or unconsciousness (fainting) occurs after one or more stings. Medic Alert tags can be purchased at Medic Alert Foundation, 2323 Colorado Avenue, Turlock, California 95380, (Telephone: 1-800-922-3320).
Normal Reaction Sting Treatment
For stings causing itch, irritation, redness and swelling at the sting site, the following may be useful:
  • Ice
  • Baking Soda
  • Meat Tenderizer--for people not allergic to bee stings. Use any brand with Papain. Make a paste with a few drops of water to a teaspoon of meat tenderizer and quickly apply to the sting to reduce pain and inflammation (breaks down components of sting fluid).
  • Ammonia Solution--Apply a 1 to 2.5 percent solution no more than three to four times daily.
  • Oral Antihistamines--Tablets may be chewed for faster relief, but liquids are more readily absorbed after oral ingestion (Chlortrimeton, Dimetane, Teldrin).
  • Epinephrine Inhaler (Bronkaid mist, Primatene, Medihaler-Epi)
  • Topical Steroids (Cortaid, Dermolate, Lanacort, etc.)
  • Local Anesthetics (Benzocaine, Americaine, Dermoplast, Bactine, Foille, Lanacaine, Solarcaine)
  • Oral Steroids--Prescription only.
These medicines can be located in a tackle box, in camping gear, in the car and in the home. Store at room temperature away from room lighting or sunlight.
Emergency Kits for Insect Stings
Highly-sensitive persons should have two emergency kits prescribed for them by their physician within easy access at all times. One kit should be carried at all times and the other kept in the family car. It is best to store kits in a cool, dry place (refrigeration) with easy access. The kit contains one sterile syringe of Epinephrine (adrenalin) EPIPEN, ready for injection, four chewable, yellow tablets of Chlortrimeton (antihistamine), two sterile alcohol swabs for cleaning the injection site and one tourniquet. Inject the syringe into the thigh (subcutaneously) under the skin as soon as the first sting symptoms show. A tourniquet placed above the sting site, when on an arm or leg just tight enough to obstruct blood return but not so tight as to stop circulation, will help until medical treatment is obtained. Loosen the tourniquet every 10 minutes.
Other kits include ANA Emergency Insect Sting Kit and Insect Sting Kit available by prescription only at the drugstore or pharmacy.
Hypersensitivity Testing and Desensitization Program
Diagnostic skin testing with insect venom(s) is recommended for those who have experienced immediate systemic reaction to an insect sting. About half of adult patients will react similarly or worse to another sting unless desensitized with a series of appropriate venom injections. The percentage of serious reactions to another sting is less with children, but may still occur. Immunotherapy is given about every four weeks, indefinitely, unless skin tests indicate the patient is no longer sensitive. Freeze-dried venom from honey bee, yellowjacket, baldfaced hornet, etc. is available. They are believed to be 98 to 99 percent effective.
The first year of insect sting shots costs about $1,000 for a single venom. Subsequent years, when shots are given less often, run about $500 each. Sometimes shots are stopped after five years, if one has had a negative skin test, never had a life-threatening reaction and received several stings without ill effect. Shots are not stopped on those who have had a life-threatening reaction and there is uncertainty about the patient being resensitized.
 

Feb 29, 2008

We are often asked what the numbers represent on our equipment. You can actually tell a lot from them.

 

 

 

County Fire Department Numbering Scheme

The composition of the unit number is as follows.

                               12 3 4
                                | | |
                                | | |
                                | | +------------ Apparatus Type
    Area -----------------------+ |                0 = Pumper
                                  |                1 = Pumper
                                  |                2 = Aerial, Pumper/Aerial, or Quint
                                  |                3 = Tanker or Pumper/Tanker
    Engine House Number-----------+                4 = Rescue Pumper
                                                   5 = Pumper/Rescue/Aerial
                                                   6 = Rescue Squad
                                                   7 = Ambulance (EMS Unit)
                                                   8 = Brush Unit
                                                   9 = Specialized Equipment
     
    Our department number is 38
    Our house numbers are: 0 for command units
    1 for House #1 (8847 St. Charles Rock Road in St. John)
    2 for House #2 (9411 Marlowe in Overland)
    3 for House #3 (9923 St. Martha is St. Ann)
    9 for reserve equipment
    Therefore our EMS fleet is 3807 (EMS Command), 3817 (Ambulance from #1 House), 3827 (Ambulance from #2 House), 3837 (Ambulance from #3 House), 3897 (Stand-by Ambulance)
    Our Fire fleet is 3810 (Pumper from House #1), 3822 (Ladder from House #2), 3830 (Pumper from House #3), 3890 (Reserve Pumper)
    Our Command fleet is 3800 (Chief's car), 3801 (Assistant Chief's car), 3802 (Duty Officer's car), 3803 (Fire Marshal's car), 3804 (Department Pick-up), 3807 (Medical Officer's car)
     

Feb 22, 2008

A Tip from your Community Fire Protection District Paramedics

 

Every year we run calls for diabetic patients in acute hypoglycemia. In this article we will discuss what hypoglycemia is and how to prevent it. As always, the personal physician is the best source of on going medical care. Always advise your physician of hypoglycemia episodes.

Basics of Hypoglycemia

In general, hypoglycemia has been defined as a blood sugar level less than 80, though some medical centers define it as a value that is less than 60. There may or may not be accompanying symptoms.

Generally, hypoglycemia can be caused by too little food intake when compared to insulin, too much insulin when compared to food intake, exercise beyond normal, medication side effect or non-diabetes-related illness.

Symptoms include: sweating, nausea, confusion, dizziness, hunger and weakness.

Treatment is relatively simple: provide a complex carb with a protein to bring the blood sugar level up. Combining a carb and a protein provides for a fairly rapid upswing in blood sugar (from the carb) and a level of stability of blood sugar (from the protein). This decreases the risk for rebound hypoglycemia, which is often seen in those who utilize simple carbs, alone, to treat low blood sugar.

If hypoglycemia occurs 2 days in a row, or at least 3 times within 1 week, see your doctor, to help trouble-shoot your medication, activity and diet regime.

 

Symptoms of Hypoglycemia

It is important to be able to recognize the symptoms of hypoglycemia, in order to treat it quickly. Glucose feeds all of the organs in the body, including the brain. Low blood sugar, for prolonged periods can result in injury to your organs.

"Mild" hypoglycemia is characterized as hypoglycemia that occurs when the person is still able to self-treat. This is in contrast to a "severe" hypoglycemic reaction, in which the person cannot self-treat and needs outside help.

The symptoms of hypoglycemia include:

1) Feeling shaky or nervous
2) Fatigue
3) Blurred vision, or visual changes,
such as sparks or auras
4) Difficulty concentrating or in doing
tasks which are normally easy for you
5) Sweating
6) Pale, clammy skin
7) Slurred speech
8) Rapid pulse

If you experience these symptoms, or just "don’t feel right," the best course of action is to suspect hypoglycemia, check your blood sugar, and then treat it. This is especially true if you are on medication that can lower blood sugar levels.

Keep track of your blood sugars and notify your doctor if you have low blood sugars two days in a row, or three times during one week. They can help you adjust your diet, exercise or medications to stabilize your sugars

 

 

 

 

 

    

Preventing Hypoglycemia

Hypoglycemia, or low blood sugar, is a known complication of diabetes, and it is defined as a blood sugar value below the "normal" range, i.e. less than 80 mg/dl.

As you know, hypoglycemia presents with nausea, dizziness, sweating, cool pale skin, and anxiety. If left untreated, low blood sugar can result in coma and injury to key organs including the brain.

Here are some tips to prevent hypoglycemia:

1) Make sure that meal times are regular, especially if they are timed around your insulin peaks.

2) Do not skip meals when on glucose lowering medication - it is important to eat a regular times to keep your sugar on an even keel.

3) Plan ahead for exercise and have a snack before vigorous exercise.

4) Plan for when you are not going to be able to eat a regular meal, and
keep a meal substitute handy, so that you can stay on your eating routine.

5) Avoid quantities of simple sugars. These cause sudden increases in your sugars, followed by sudden decreases (hypoglycemia).

6) Talk to your doctor about any diet, activity or medication changes, so that he can guide you and monitor your status, to avoid fluctuating sugar levels.

7) Keep a diabetic diary - track blood sugars, exercise, symptoms and food intake, so that you can anticipate when your sugar may become low, and be prepared to treat it.

8) Be prepared and treat at the first sign of low blood sugar, to avoid a more serious drop in your glucose.

When all is said and done, knowing your own body and following your diabetes care plan are the best ways to prevent complications such as hypoglycemia.


Feb 21, 2008

A Tip From Your Community Fire Protection District Paramedics

 

Every year the medics of Community Fire Protection District respond to accidental injury calls resulting from falls in ice and snow. Just stepping out to retrieve the morning paper from the yard has often resulted in a trip to the hospital. In this article we will outline a few tips on avoiding falls, as we as how to reduce your Chance of injury should you fall.

 

It's important that individuals recognize the hazards of slippery surfaces. Here are helpful hints from winter-safety experts that will reduce the risk of falling when slippery conditions exist:

 

  • Wear boots or overshoes with soles. Avoid walking in shoes that have smooth surfaces, which increase the risk of slipping.

     

  • Walk consciously. Be alert to the possibility that you could quickly slip on an unseen patch of ice. Avoid the temptation to run to catch a bus or beat traffic when crossing a street.

     

  • Walk cautiously. Your arms help keep you balanced, so keep hands out of pockets and avoid carrying heavy loads that may cause you to become off balance.

     

  • Walk "small." Avoid an erect, marching posture. Look to see ahead of where you step. When you step on icy areas, take short, shuffling steps, curl your toes under and walk as flatfooted as possible.

     

  • Remove snow immediately before it becomes packed or turns to ice. Keep your porch stoops, steps, walks and driveways free of ice by frequently applying ice melter granules. This is the best way to prevent formation of dangerous ice patches. Using a potassium-based melter, such as Safe Step, instead of salt will prevent damage to concrete, grass and other vegetation or to carpets and floors should you track in some.

Falling Safely

Even when you practice safe walking habits, slipping on ice is sometimes unavoidable.

It takes less than two seconds from the moment you slip until you hit the ground.That's precious little time to react. In that instant, the risk is an injury to your head, a wrist, hip or shoulder.Knowing how to fall will help you reduce the risk of injury. It's important to tuck your body, lift your head and avoid trying to break the fall with a hand, which can cause a wrist injury.The idea is to make yourself as small as possible by rolling up into a ball.

Experts  suggest you practice the techniques as follows:

     

  • Sit on the floor with your legs out flat in front of you. To simulate a backwards fall, slowly begin to lie back toward the floor and quickly tuck your head forward, chin to chest. At the same time, lift your knees to your chest and extend your arms away from your body and "slap" the ground with your palms and forearms. This maneuver will help prevent your head, wrists and elbows from hitting the ground.

     

  • Assume the original position. To practice a sideways fall - which usually causes a shoulder, hip, elbow or wrist injury - begin to roll to one side or the other. As you do so, lay out your arm parallel to your body so that your forearm, not your wrist or shoulder, is first to contact the floor. Also, lift your head toward your shoulder opposite the fall. Next, practice the procedure in the opposite direction.

     

  • From a kneeling position, practice for a potential front fall. Begin to lean forward and as you fall, roll to one side, laying out your arm parallel to your body, again so the forearm and not your wrist makes contact with the floor. Lift your head to the opposite shoulder and continue to roll.

Feb 19, 2008

Download: stats 2007.pdf , 2008 stats.pdf , modified 2009 stats.doc , modified 2010 stats.doc

Feb 15, 2008

Man and woman's best friend bites more than 4.7 million people a year, and key experts believe that public education can help prevent these bites.  The third full week of May is National Dog Bite Prevention Week, and the American Veterinary Medical Association (AVMA), the United States Postal Service, and the Centers for Disease Control and Prevention are each working to educate Americans about dog bite prevention.

related topics

Learn about Rabies:
What it is and what you can do about it

Each year, 800,000 Americans seek medical attention for dog bites; half of these are children. Of those injured, 386,000 require treatment in an emergency department and about a dozen die. The rate of dog bite-related injuries is highest for children ages 5 to 9 years, and the rate decreases as children age. Almost two thirds of injuries among children ages four years and younger are to the head or neck region. Injury rates in children are significantly higher for boys than for girls. (See CDC MMWR article.)image of boy with puppy

CDC is committed to reducing this public health problem by working with state health departments to establish dog bite prevention programs and by tracking and reporting trends on U.S. dog bite injuries. Dog bites are a largely preventable public health problem, and adults and children can learn to reduce their chances of being bitten.

Things to Consider Before You Get a Dog

  • Consult with a professional (e.g., veterinarian, animal behaviorist, or responsible breeder) to learn about suitable breeds of dogs for your household.
  • Dogs with histories of aggression are inappropriate in households with children.
  • Be sensitive to cues that a child is fearful or apprehensive about a dog and, if so, delay acquiring a dog.
  • Spend time with a dog before buying or adopting it. Use caution when bringing a dog into the home of an infant or toddler.
  • Spay/neuter virtually all dogs (this frequently reduces aggressive tendencies).
  • Never leave infants or young children alone with any dog.
  • Do not play aggressive games with your dog (e.g., wrestling).
  • Properly socialize and train any dog entering the household. Teach the dog submissive behaviors (e.g., rolling over to expose abdomen and relinquishing food without growling).
  • Immediately seek professional advice (e.g., from veterinarians, animal behaviorists, or responsible breeders) if the dog develops aggressive or undesirable behaviors.

Preventing Dog Bites

Teach children basic safety around dogs and review regularly:

  • Do not approach an unfamiliar dog.
  • Do not run from a dog and scream.
  • Remain motionless (e.g., "be still like a tree") when approached by an unfamiliar dog.
  • If knocked over by a dog, roll into a ball and lie still (e.g., "be still like a log").
  • Do not play with a dog unless supervised by an adult.
  • Immediately report stray dogs or dogs displaying unusual behavior to an adult.
  • Avoid direct eye contact with a dog.
  • Do not disturb a dog who is sleeping, eating, or caring for puppies.
  • Do not pet a dog without allowing it to see and sniff you first.
  • If bitten, immediately report the bite to an adult. 

A CDC study on fatal dog bites lists the breeds involved in fatal attacks over 20 years (Breeds of dogs involved in fatal human attacks in the United States between 1979 and 1998). It does not identify specific breeds that are most likely to bite or kill, and thus is not appropriate for policy-making decisions related to the topic. Each year, 4.7 million Americans are bitten by dogs. These bites result in approximately 16 fatalities; about 0.0002 percent of the total number of people bitten. These relatively few fatalities offer the only available information about breeds involved in dog bites. There is currently no accurate way to identify the number of dogs of a particular breed, and consequently no measure to determine which breeds are more likely to bite or kill.

Many practical alternatives to breed-specific policies exist and hold promise for preventing dog bites. For prevention ideas and model policies for control of dangerous dogs, please see the American Veterinary Medical Association (AVMA) Task Force on Canine Aggression and Human-Canine Interactions: A community approach to dog bite prevention.*

Information from CDC

Click on the link below to report a dog bite to St. Louis County Health

mailto:animals.doh@stlouisco.com&Subject=Report%20of%20an%20animal%20bite


Feb 06, 2008

The Community Fire Protection District under the leadership of the Board of Directors have embarked on a recycling program that is saving the tax payers a minimum of 40% on ambulance replacement. We have upgraded our fleet from open seamed ambulances to unitized all welded, all aluminum ambulances. The resulting ambulance is stronger and resist compartment intrusion in an accident. A benefit to the stronger ambulance is an enhanced ability to remount the box. Watch this page for updates as we go through our Fourth remount.

August 28 2008 - Specifications reviewed for chassis for next remount. Release date for chassis bid January 2009

November 20 2008 - Meeting to be held in December to review needed repairs during remount process.

Members of the department reviewing needed repairs.

Narrowing of bumper to body gap.

rust from road salts

Tear in rear head knocker.

Puncture wound to attendant seat.

Crack in L1 interior door.

Electrolysis L2-3 hinge

Electrolysis L1 hinge

Electrolysis R2

Electrolysis

Due to heavy road salt use in the area electrolysis is present around the lower edge of doors more pronounced at hinges. However due to extensive prep work at time of painting we have not experienced paint break though nor do we expect to prior to remount.

January 2 2009 - Remount specifications are being drawn up expected release this month.

January 12 2009 - Remount specifications printed and are under review by staff.

January 21 2009 - Bids released for chassis and remount

February 4 2009 - Remount Bid awarded to Excellance,inc.

February 9 2009 - Production number RM-943 assigned.

February 11 2009 - Chassis Bid awarded to Lou Fusz

February 12 2009 - Chassis: Estimated build date is first week of April with an estimated delivery date to be about three weeks after that.

February 12 2009 - Update portal opened at Excellance

February 27 2009 - Tentative date for pre-construction conference set for July 29 2009 at the factory

April 22 2009 - Chassis arrived at ExcellanceReviewReviewCustomerProduction

Paperwork Released for Internal Review
27-Jul-09
Internal Review
27-Jul-09
All Questions Answered by Customer
27-Jul-09
Unit Paperwork Released to Production
28-Jul-09

Remount arrival at Factory

On July 27th a pre-construction meeting was held at Excellance and the ambulance was turned over to the factory. We expect delivery of our refurbished ambulance in September.

Striped and dismounted

Strip
13-Aug-09
Dismount
18-Aug-09
Welding
19-Aug-09

 

in body shop

 

Grind - Rough welds ground smooth, flush with body.
24-Aug-09
Body - Body filler used to make smooth surface.
27-Aug-09

In Buff Forward View

In Buff Aft View

Prime - Body prepared "primed" for paint.
28-Aug-09
Paint
31-Aug-09
Buff - Final stage of paint to smooth paint surface.
02-Sep-09

In Final aft view

In final interior

In final forward view

Mount - Body and chassis are bolted together.
04-Sep-09
Final Assembly - Exterior lights, upholstery, etc., & final detail.
08-Sep-09


Feb 06, 2008

 

 http://www.ssmhc.com/internet/home/physiciansearch.nsf/search4physicianII - This link will take you to the DePaul Hospital search page

 http://www.missouribaptist.org/mobaptist_sharpfocus.aspx?page=PhysicianSearch - This link will take you to the Missouri Baptist search page

http://stjohns.photobooks.com/ - This link will take you to the St. John search page

http://slmms.org/find.php - This link will take you to the st. louis medical association search page

http://www.co.st-louis.mo.us/Doh/hlthctrs/services.html - This link will take you to the St. Louis County Clinic page

 


Feb 05, 2008

http://www.cdc.gov/ncipc/pub-res/toolkit/Falls_ToolKit/DesktopPDF/English/booklet_Eng_desktop.pdf - a checklist for fall prevention at home

http://www.cdc.gov/ncipc/pub-res/toolkit/Falls_ToolKit/DesktopPDF/Spanish/booklet_Spa_desktop.pdf  - a spanish version of the fall checklist

http://www.cdc.gov/ncipc/pub-res/toolkit/Falls_ToolKit/DesktopPDF/English/Posters_Eng_desktop.pdf  -fall prevention posters


Feb 05, 2008

https://familyhistory.hhs.gov/   - A good way to document family history

http://assets.aarp.org/www.aarp.org_/articles/learntech/wellbeing/MyMedicationRecord.doc - A form to list your medications

http://www.acep.org/patients.aspx?LinkIdentifier=id&id=26276&fid=896&Mo=No - Special needs kids


Feb 05, 2008

Download: TakeThree-v2.pdf , Take3-Spanish-V1.pdf

Feb 01, 2008
A tip from your Community Fire Protection District Paramedics:

 

Building a Home First Aid Kit

Accidents can happen to anyone almost anywhere. It is important that every home, and especially those with children, have a first aid kit on hand in case of accidental injuries.
"Appropriate members of the household should know where the kit is stored and how to use each item," said Greg Walker, MD, of the American College of Emergency Physicians. "The 'how to' part is critical-buy a first aid manual and read it thoroughly. The items in the kit will be of little use unless you know how to use them."
The American College of Emergency Physicians recommends including the following items in your Home First Aid Kit, all of which are available from your local pharmacy. For the kit itself, ACEP suggests choosing a container that is clean, roomy, durable, and easy to carry and simple to open-for instance, a tote bag. Medicines should be stored in their proper containers and properly marked with dosage and instructions on how and when to take them.
The kit should also include a list of the contents it contains. In addition, keep in the kit emergency phone numbers for the family physician and pediatrician, and the regional Poison Control Center. If 911 is not available, include phone numbers for emergency services such as the local police, fire department and ambulance service. Also, if family members have life-threatening allergies to food, medications or bee stings, include a list of allergies for each family member, as well as medications used by each person.
"Remember to store first aid kits in places that children can not reach, but that are easily accessible for adult family members," said Dr. Walker. "Also, check the kit regularly to replace missing items and make sure that the items haven't passed their expiration dates."
ACEP also recommends taking a first-aid class, learning CPR and always seeking immediate medical attention when you need it.

The American College of Emergency Physicians suggests that these items be in your Home First Aid Kit:

 ·                          Acetaminophen, ibuprofen and aspirin tablets   

                 Aspirin should not be used to relieve flu symptoms or be taken by children   

                            
Cough Suppressant
                             Antihistamine
                             Decongestant tablets
                            Oral medicine syringe (for children)
                            Bandages of assorted sizes
                            Bandage closures; safety pins
                            Triangular bandage
                            Elastic wraps
                            Gauze and adhesive tapes
                            Sharp scissors with rounded tips
                            Antiseptic wipes
                            Antibiotic ointment
                            Hydrogen peroxide
                            Disposable, instant-activating cold packs
                            Tweezers

 
After taking a CPR class we suggest you include a CPR barrier mask. A smaller version of the First Aid Kit should be in every vehicle.

Feb 01, 2008
A tip from your Community Fire Protection District Paramedics:
 
When to Call an Ambulance
Recognizing Emergencies
How do you tell the difference between a true emergency and a minor problem? Certain symptoms are so alarming that the need for emergency care-or even an ambulance-is obvious. But what should you do about more common illnesses and injuries?
Only a doctor can diagnose medical problems. But, you can protect your family's health by learning to recognize certain symptoms.
Know which symptoms to watch for. According to the American College of Emergency Physicians, the following are warning signs of a medical emergency:
  • Difficulty breathing, shortness of breath
  • Chest or upper abdominal pain or pressure
  • Fainting
  • Sudden dizziness, weakness or change in vision
  • Change in mental status (such as unusual behavior, confusion, difficulty arousing)
  • Sudden, severe pain anywhere in the body
  • Bleeding that won't stop
  • Severe or persistent vomiting
  • Coughing up or vomiting blood
  • Suicidal or homicidal feelings
You should also be familiar with the symptoms of common illnesses and injuries.
Talk to your regular doctor before you have an emergency. Ask what you should do if you think someone in your family needs emergency care. Should you call the doctor's office first? Should you go straight to the emergency department? What should you do when the doctor's office is closed?
Trust your instincts. Parents are usually very good at recognizing signs of unusual behavior or other symptoms that indicate an emergency. Many other factors, including the time of day, other medical problems, or state of mind, can make an otherwise minor medical problem an "emergency."
 
 
 
When to Call an Ambulance
When should you call an ambulance instead of driving to the emergency department? Ask yourself the following questions:
  • Is the victim's condition life­threatening?
  • Could the victim's condition worsen and become life­threatening on the way to the hospital?
  • Could moving the victim cause further injury?
  • Does the victim need the skills or equipment of paramedics or emergency medical technicians?
  • Would distance or traffic conditions cause a delay in getting the victim to the hospital?
If the answer to any of these questions is "yes," or if you are unsure, it's best to call an ambulance. This is true even though you can sometimes get to the hospital faster by driving than by calling an ambulance. Paramedics and emergency medical technicians communicate with the physician in the emergency department by radio. They are trained to begin medical treatment on the way to the hospital. This prevents any delay that could occur if the patient is driven to the emergency department. The ambulance can also alert the emergency department of the patient's condition in advance.
Fortunately, if you live in St. Louis County, calling for help is easy. Just dial 9-1-1. When your call is answered, speak calmly and clearly. Give your name, the address, phone number, location of victim (such as upstairs in the bedroom), and nature of the problem. Don't hang up until the dispatcher tells you to. They may need additional information or need to give you instructions.
Information provided by the American College of Emergency Physicians
http://www.acep.org/

Dec 07, 2007

Download: Fire Report Request with Patient Information.pdf

Dec 07, 2007

Download: Ambulance Report Request Form.pdf

Dec 05, 2007

Download: policy practices pdf.pdf

Jun 23, 2009

The Following are power points used in training classes.


Download: swine flu.ppt , Documentation_EMS_Lecture_.ppt , Hemoglobin (Hb).ppt , Methemoglobinemia.ppt

Jan 21, 2009

Your Community Fire Protection District Medics are concerned about your vision. Every year we see eye injuries that can often be prevented. Does your child wear glasses and play sports? If so he should have a pair of sport glasses to lessen the chance of eye injury from broken glasses. Do you do yard work? If so you should have a pair of safety glasses to keep rocks and sticks from impacting your eyes. Always wear protective eye wear when using power tools or household chemicals. We hope you find the information in this article helpful. If you need further information contact your eye care provider.

CHOOSING AND USING EYE PROTECTION

Safety Glasses And Goggles

Safety Glasses

Safety Goggles

Shields and Helmets

Using Protective Eye wear

 

Safety Glasses And Goggles

No matter where we work, flying particles, dusts, fumes, vapors or harmful rays are apt to expose us to potential eye injury. Fortunately, we can protect against these hazards by using the appropriate protective eye wear for our jobs and by following our companies' established safety guidelines. The following is a guide to the most common types of protective eye wear and the specific hazards they can guard against.

Safety Glasses

Standard safety glasses look very much like normal glasses, but are designed to protect you against flying particles. Safety glasses have lenses that are impact resistant and frames that are far stronger than regular eyeglasses. Safety glasses must meet the standards of the American National Standards Institute (ANSI). (Safety glasses are also available in prescription form for those persons who need corrective lenses.) Standard safety glasses can be equipped with side shields, cups, or tinted lenses to offer additional protection.

Safety Goggles

Like standard safety glasses, goggles are impact resistant and are available in tinted lenses. Goggles provide a secure shield around the entire eye area to protect against hazards coming from many directions. Safety goggles may have regular or indirect ventilation. (Goggles with indirect ventilation may be required if you are exposed to splash hazards.)

Shields and Helmets

Face shields and helmets are not in themselves protective eye wear. But, they are frequently used in conjunction with eye protectors. Full-face shields are often used when you are exposed to chemicals or heat or glare hazards. Helmets are used when welding or working with molten materials.

Using Protective Eye wear

You can guard against eye injury by making sure that you are wearing the appropriate protective eye wear for the particular eye hazards you face. It's important to remember that regular glasses alone do not offer protection from eye hazards. Follow your company's established safety procedures, and never hesitate to ask your supervisor if you have any questions about what you can do to protect your sight for life.


Jun 11, 2008

A nebulizer can be a real life saver for the patient in respiratory distress. However, while having a bout of acute respiratory distress is not the time to learn how to use one. When the doctor orders a nebulizer for home treatment or when changing models of nebulizer or medication, you should take a few minutes to go over the instructions and procedures. Your Community Fire Protection District medics recommend the following:

 


 

Read the equipment instructions completely before you use a nebulizer.  Even if you received personalized home instruction prior to use, follow these directions before you use a nebulizer as they will vary from one manufacturer to another.

Follow these steps to use a nebulizer: 

1. Wash your hands thoroughly before you use a nebulizer and make sure the equipment is clean..

2. If using a multi-dose bottle of medicine when you use a nebulizer, use a dropper to administer the correct dosage of medication into the cup with saline solution.  If the medicine is in single-use vials, twist the top off the plastic vial and squeeze the contents into the nebulizer cup.

3. Connect the mouthpiece, or mask, to the T-shaped elbow.  Fasten the unit to the cup.  For children older than 2, using a mouthpiece is recommended because it will deliver more medication than a mask.

4. Connect the nebulizer tubing to the port on the compressor.

5. Turn the compressor on and check the nebulizer for misting.  When using a finger valve, cover the air hole to force air into the nebulizer.  If you are not using a finger valve, the nebulizer will mist continually.

6. To use a nebulizer correctly, hold it in an upright position.  This will prevent spillage.

7. When you use a nebulizer, sit in a comfortable, upright position.  Place the mouthpiece between your teeth and close your lips around it.  When using a mask, be sure it fits well so the mist doesn’t get into your eyes.

8. Gently exhale. As the mist starts, inhale slowly through your mouth.  Take over three to five seconds for each breath while keeping your finger over the valve hole.

9. Hold your breath for up to 10 seconds before exhaling. This allows the medication time to deposit in the airway.

10. At the end of a deep breath, uncover the finger valve hole to stop the mist.

11. When you use a nebulizer, occasionally tap the side of the nebulizer to help the medication drop to where it can be misted. 

12. Continue until the medicine is gone from the cup.  The nebulizer will most likely begin sputtering when it is empty.

Follow these tips before and after you use a nebulizer:

• Order replacement supplies now so they will be on hand when needed.

• After you use a nebulizer, clean it according to instructions.  Neglecting to do so will promote bacteria growth. 

• Store your nebulizer and supplies in a clean, dry, and dust-free location.

• Dispose of nebulizer tubing that becomes cloudy or retains moisture.

• Replace disposable parts, tubing, and filters according to manufacturer’s instructions.  Using a nebulizer cup longer than indicated will result in slower, less efficient delivery of medication.

• When you use a nebulizer, always use a mask or mouthpiece when giving or taking a treatment.  Simply aiming the mist at a baby’s face does not ensure that any medication reaches small, swollen airways. 

• If treating infants and toddlers, purchase supplies that can be used when the child is in a reclined position or sleeping.

• Keep nebulizer batteries charged or have replacement batteries handy.

• Only use medications made specifically for nebulizers.  When you use a nebulizer, only use medications approved by the Food and Drug Administration as manufactured by a pharmaceutical company or licensed agent only.  These agents are sterile, contain no contaminants or unwanted particles, and are mixed in exact proportions.


May 23, 2008
Home Oxygen Safety
 
This bulletin provides general safety information for oxygen concentrators, compressed gas cylinders, oxygen-conserving devices, and liquid oxygen systems used for medical purposes in private homes, apartments and condominiums.
 
Oxygen
Oxygen is not flammable, but it can cause other materials that burn to ignite more easily and to burn far more rapidly. The result is that a fire involving oxygen can appear explosive-like. Oxygen is of great benefit to those in need of oxygen therapy but it should always be handled with caution and awareness of the potential hazards.
 
The Equipment
There are three common ways of providing oxygen therapy. Oxygen can be delivered to your home in the form of a gas in various-sized cylinders or as a liquid in a vessel. The third way to provide oxygen therapy is by using an oxygen concentrator. Each method is examined in more detail below.
 
Compressed Gas--Oxygen is stored under pressure in a cylinder equipped with a regulator that controls the flow rate. Because the flow of oxygen out of the cylinder is constant, an oxygen-conserving device may be attached to the system to avoid waste. This device releases the gas only when you inhale and cuts it off when you exhale. Oxygen can be provided in a small cylinder that can be carried with you, but the large tanks are heavy and are only suitable for stationary use.
 
Liquid oxygen--Oxygen is stored as a very cold liquid in a vessel very similar to a thermos. When released, the liquid converts to a gas and you breathe it in just like compressed gas. This storage method takes up less space than the compressed gas cylinder, and you can transfer the liquid to a small, portable vessel at home. Liquid oxygen is more expensive than the compressed gas and the vessel vents when it is not in use. An oxygen-conserving device may be built into the vessel to conserve the oxygen.
 
Oxygen concentrator--This is an electronically powered device that separates the oxygen out of the air, concentrates it, and stores it. This system has a number of advantages because it doesn’t have to be re-supplied and it is not as costly as liquid oxygen. Extra tubing permits the user to move around with minimal difficulty. Small, portable systems have been developed that afford even greater mobility. You must have a cylinder of oxygen as a backup in the event of a power failure.
 
Quantity Limits
* Do not use individual compressed gas oxygen cylinders that exceed 250 cubic feet at normal temperature and pressure.
* Do not use liquid oxygen vessels that exceed 10 gallons.
 
 
Safety
Never smoke while using oxygen.
* Warn visitors not to smoke near you when you are using oxygen.
* Post at least one NO SMOKING sign in a prominent place at the entrance to your home.
* When you go to a restaurant with your portable oxygen source, sit in the nonsmoking section and away from any open flame such as candles or warming burners.
* Stay at least five feet from gas stoves, candles, lighted fireplaces and other heat sources.
* Keep oxygen cylinders and vessels in a well-ventilated area (not in closets, behind curtains, or other confined space). The small amount of oxygen gas that is continually vented from these units can accumulate in a confined space and become a fire hazard.
* Keep oxygen cylinders and vessels a minimum of 8 feet from heaters, heat producing and electrical appliances.
* Secure oxygen cylinders and vessels to a fixed object or place in a stand.
* Oxygen cylinders and vessels must remain upright at all times. Never tip an oxygen cylinder or vessel on its side or try to roll it to a new location.
* Always operate oxygen cylinder or container valves slowly. Abrupt starting and stopping of oxygen flow may ignite any contaminant that might be in the system.
* Turn the cylinder valve off when not using your oxygen.
* Only use a properly grounded wall outlet for your oxygen concentrator, notify power company that you have a oxygen concentrator so you can be placed on priority repair status.
* Do not use extension cords for your oxygen concentrator.
* Do not place the electrical cord or oxygen tubing under rugs or furniture.
* Do not use any flammable products like cleaning fluids, paint thinner, or aerosol sprays while using your oxygen.
* Keep all grease, oil and petroleum products (even small amounts) and flammable materials away from your oxygen equipment. Some organic materials can react violently with oxygen if ignited by a hot spark.
* Use water-based lubricants on your lips and hands. Don’t use an oil-based product like petroleum jelly, petroleum based creams or lotions.
* Do not use bedding or clothes made of wool, nylon or synthetic fabrics as these materials have the tendency to produce static electricity. The use of cotton material bedding and clothes will avoid sparks from static electricity.
* Do not allow children or untrained individuals to handle or operate oxygen equipment.
* Always have your gas supplier’s number handy, check your disposables stock weekly, and order well in advance to prevent running out.
* Ensure that you have an all purpose fire extinguisher close by and familiarize yourself with its use.
 
!WARNING!
RISK OF COLD-CONTACT BURNS
Liquid oxygen is extremely cold (-297 degrees Fahrenheit). Touching liquid oxygen or parts of an oxygen system in contact with liquid oxygen can quickly freeze the skin. The vapors from the liquid oxygen are also extremely cold and can damage delicate tissues, such as eyes. To prevent injury from freezing, never allow any unprotected skin to contact frosted parts of liquid oxygen vessels and stand clear of vapors.

Apr 19, 2010

The Community Fire Protection District of St. Louis County is proud to announce it has received recognition from the pediatric subcommittee of the Missouri State Advisory Committee for EMS. The review was administered by a representative of the pediatric subcommittee and consisted of an on-site inspection of equipment, policies, and protocols. Although participation is voluntary, the department was eager to assure that we meet all recommendations for treatment of our most precious of residents.


Nov 20, 2008

Download: Protocols 2007 draft.ppt



Page Last Updated: Aug 28, 2008 (10:43:00)

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