AUGUST 2020
PMREMS newsletter
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News and Para-points
IN THIS EDITION 2 STAFF SPOTLIGHT
A View into an EMS Pro
S
haring news about your area healthcare providers is where you’ll find this month’s insider edition of Pocono Mountain Regional EMS Regional Resource newsletter.
Read about recognition of emergency medical professionals, along with LVHN, then learn “An ounce of prevention” points to keep you and yours safe indoors.
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3 LVHN: NEWS
Stroke Care as Good as Gold
4 ST LUKE’S APPRECIATION Thanks to First Responders
5 PARA-POINTS
Carbon Monoxide Poisoning
6 LESS THAN 40 FROM THE GOAL Close to Subscription Success
by Sunshine VanGorder
Meredith Hamill is a full time Paramedic and has been with PMREMS for about a year and a half. Born and raised in Honesdale, PA, she attended ELON University in North Carolina to be an Athletic Trainer. While doing so, an athlete broke his leg, causing her to be curious about the EMS side of things and supplement her career. In 2006, she took the EMT course in Wilmington, NC, where she lived by the beach. Where she started her EMS career after college moving on to her paramedic certification by 2009. With 14 years experience in EMS, Meredith occasionally taught at the university. She moved back to Pennsylvania 5 years ago to be near her family and adores playing with her niece and nephew, swimming, and watching tv shows. When it comes to being a paramedic, she comments on her favorite thing about working in EMS saying, “This is a unique job. I like helping people… not just medically, but helping patients with their lives, based on my own personal experiences.” Adding, “My 27-year-old cousin overdosed on heroin and died, and I’ve been through having cancer, those types of things make it easier to understand patients.” Admiring the book ‘If I Get to Five,’ by Fred Epstein, she recites a favorite quote, “Compassion is not a passive state.’” A love of teaching and helping other providers at PMREMS, Meredith considers a future career in nursing; though a passion for education may draw her toward an EMS related field, athletic training, or anatomy and physiology. When asked what the biggest impact has been on her at EMS, she reflects, “How we [Emergency Medical Professionals] get to know someone [a patient], in the span of 20 minutes. We see patients when they are the most vulnerable, on their worst days, in the worst possible settings, and we’re entrusted with that. That’s really amazing, when you think about it.”
l Medicine for Internal Medicine and ard of Psychiatry and Neurology for currently accepting patients at the practice in East Stroudsburg, for the Stroke, seizure disorders, multiple muscular disorders, infections of the neurodegenerative disorders, spinal headaches and neuropathies.
LVHNnews
Ask the Doctor Migraines
ura of a migraine is y a headache, making sing for the patient and se auras can be confused emic attacks, or in other
s
A headache that starts after neck trauma, chiropractic manipulation or a ride at an amusement park should not be ignored. This can mean a tear in the blood vessels that supply the brain that can cause a potentially disabling stroke.
Headaches associated with visual symptoms, especially visual loss should prompt a visit to your neurologist. A neurologist can look inside your eyes to detect raised pressure inside the important to pay attentionoftothis thecondition headachecan brain. A timely diagnosis characteristics and pattern. avoid permanent vision loss.Any change in these characteristics or patterns should be Treatments for Migraine Sufferers discussed with your physician to make sure Depending on the it’s not a stroke or headache a bleed. frequency, patient preference, coexisting medication conditions, A headache that starts after neck trauma, several medication options are available to chiropractic manipulation or a ride at an treat migraines. Some medicines are supposed amusement park should not be ignored. This to be taken on a daily basis and others are to can mean a tear in the blood vessels that be taken only when a headache happens. supply the brain that can cause a potentially When headaches disabling stroke. are resistant to these medications, patients can be referred for botox Headaches associated with visual symptoms, injections. especially visual loss should prompt a visit to As strange as it sounds, overusing your neurologist. A neurologist can headache look inside medications actually a headache. your eyes to can detect raisedcause pressure inside the This isAcalled ‘medication overuse brain. timelyasdiagnosis of this condition can headache’. I see itvision frequently avoid permanent loss. in people who take headache medications three or more Treatments Migraine times a week, for or 15 plus daysSufferers a month. Depending on the headache frequency, Regular follow up with a neurologist is patient preference, conditions, necessary tocoexisting make suremedication you are taking the several medication options available appropriate medications in aaremanner thattois treat migraines. Some medicines are supposed both safe and effective. to be taken on a daily basis and others are to When to See a Neurologist be taken only when a headache happens. When headache stops responding to over When headaches are resistant to these the counter pain medications, becomes too medications, patients can be referred for botox frequent or starts affecting your school or work injections. performance, it’s time to see a neurologist. As strange as it sounds, overusing headache medications can actually cause a headache. This is called as ‘medication overuse headache’. I see it frequently in people who take headache medications three or more times a week, or 15 plus days a month. Regular follow up with a neurologist is necessary to make sure you are taking the appropriate medications in a manner that is both safe and effective.
BY KATIE CAVENDER August 25,2020
adaches are located on ggers are uniqueor , they that are pulsating ommon triggers are associated with sensitivity k of people sleep, hormonal Most feel nauseous such as around the time a migraine. People dg not eating. Some other around during a migraine wine, aspartame, ese, the symptoms worse. her, dehydration, ache usually lasts bright between ells. I ask my patients diary wherein they can f a migraine that happens he triggers and avoid omething called as are available on IOS and ’. This means feeling pain track of an individual’s li that are not supposed to rs. brushing your hair, shaving oms enses.
Are migraines hereditary?
• Very rarely, the aura of a migraine is unaccompanied by a headache, making things very confusing for the patient and their doctors. These auras can be confused for transient ischemic attacks, or in other words, strokes.
Ask the Doctor A: Anirudh Kapoor, MD, LVPG-Neurology
Migraines
Yes, Migraines do have a strong genetic component. Most people with migraines have a first degree relative with migraines. However, not all people with predisposing genes develop AreWhen migraines migraines. these predisposing genes interacthereditary? with certain environmental factors such as stress, lack of sleep, hormonal changes, it leads to migraines. A: Anirudh Kapoor, MD, LVPG-Neurology
important to pay attention to the headache characteristics and pattern. Any change in these characteristics or patterns should be discussed with your physician to make sure it’s not a stroke or a bleed.
Migraine Triggers
Every patient has triggers that are unique • Very rarely, the aura of a migraine is to them. The most common triggers are unaccompanied by a headache, making emotional stress, lack of sleep, hormonal things very confusing for the patient and changes in women (such as around the time their doctors. These auras can be confused of menstruation) and not eating. Some other for transient ischemic attacks, or in other triggers are chocolate, wine, aspartame, There are some rare variants of migraines Yes, Migraines do have a strong genetic words, strokes. changes in the weather, dehydration, bright which are inherited in an with autosomal dominant component. Most people migraines have lights and strong smells. I ask my patients Migraine Triggers meaning you with only need one copy of apattern, first degree relative migraines. However, to keep a headache diary they the all faulty genemigraines frompredisposing one of your genes parentsdevelop to get not people with •Every Verypatient rarely, the triggers aura of awherein migraine is can Are has that are unique identify their andmaking avoid the disorder. migraines. When these predisposing genes unaccompanied by atriggers headache, to them. The headache most common triggers are hereditary? them. Several apps areofavailable on IOSand and interact certain factorsof things very confusing for the hormonal patient emotional stress, lack sleep, At a verywith basic level,environmental there are two types Android now to keep track an individual’s such as stress, lack sleep,LVPG-Neurology hormonal their doctors. These auras can be the confused changes in women (such asofaround time A: Anirudh Kapoor, MD, migraineswith and of without aura. Auras can headache and triggers. changes, it leads to migraines. for transient ischemic or in other of menstruation) and not attacks, eating. Some other be ofMigraines many types: Yes, do have a strong genetic words, strokes. triggersand are chocolate, wine, aspartame, There are Most some variants migraines Signs Symptoms component. Most people withofmigraines • Visual: ofrare the patients I see have have a changes in the weather, dehydration, bright which are inherited in an autosomal dominant Migraine Triggers a first degree with migraines. visual aura.relative Many patients describeHowever, seeing Usually migraine headaches are located on lights and strong smells. I ask my patients pattern, meaning onlylines, needareas one copy of not all people withyou predisposing genes flashing lights, zig zag ofdevelop vision one side of thehas head, they that are pulsating or Every triggers are unique to keeppatient a headache diary wherein they can theloss faulty gene from onepredisposing of your parents to get migraines. When these genes in the visual fields. throbbing in quality, associated with sensitivity to them.their The most common triggers are identify headache triggers and avoid the disorder. interact withNumbness certain environmental to light andstress, sound.lack Most people feel nauseous emotional sleep, hormonal • Sensory: or tingling infactors either the them. Several apps areofavailable on IOS and such asorstress, lackofofthere sleep, At face a very basic level, arehormonal two types of and throwinup during a migraine. People changes women the time one side the body. Android now to keep(such trackasofaround an individual’s changes, leadsand to migraines. migraines-it with without aura. Auras can usually avoid moving around during a migraine of menstruation) and not eating. Some other • Language: Patients can experience slurred headache and triggers. be of many types: headache it makes the symptoms worse. triggers areaschocolate, wine, aspartame, There are some rare variants of difficulties migraines speech or have word finding The untreated headache usually lasts bright between Signs and Symptoms changes in the weather, dehydration, which arebefore inherited in patients an autosomal dominant • Visual: Most oforthe I see have a either during a migraine episode. 4Usually to 72and hours. lights strong headaches smells. I askare mylocated patients pattern, youpatients only need one copy of visualmeaning aura. Many describe seeing migraine on • flashing Some experience vertigo, ringing to keep headache wherein theyhappens can the faultypatients gene from one your parents to get lights, zig zag of lines, areas of vision A unique symptom ofdiary a migraine that one sideaof the head, they are pulsating or indisorder. their ears, double vision, unsteadiness identify headache triggerscalled and avoid theloss in the visual fields. in sometheir patients is something as throbbing in quality, associated with sensitivity which is called as a brainstem aura. Brain them. appsMost areThis available onfeeling IOS and ‘cutaneous means pain to lightSeveral and allodynia’. sound. people feel nauseous At a veryisbasic level,part there arebrain. twointypes • Sensory: Numbness or either stem the rear of tingling the Someofthe Android now keep atrack of an in response stimuli that are notindividual’s supposed to and throw uptotoduring migraine. People migraineswithside andofwithout aura. Auras canin face or one thedevelop body. patients consistently vision loss headache and triggers. be painful, such as brushing your hair, shaving usually avoid moving around during a migraine be of many types: one eye, before onset a migraine,slurred such • Language: Patients canofexperience or wearing contact lenses. headache as it makes the symptoms worse. Signs and Symptoms • Visual: Most of the patients have aor migraines been termed as retinal speech or have word findingI see difficulties The untreated headache usually lasts between Warning Signsheadaches of a Stroke or Serious visual Many patients describe seeing ocular aura. migraines. The vision loss usually either before or during a migraine episode. Usually migraine are located on 4 to 72 hours. Issue lights, zag lines,vertigo, areas ringing of vision lasts less than zig an hour. one side of the head, they are pulsating or • flashing Some patients experience A unique symptom ofassociated a migrainewith thatsensitivity happens in the visual fields. throbbing in quality, When someone suffers from migraines for • loss Motor: Rarely, migraines canunsteadiness be in their ears, double vision, in some patients is something called as to light and sound. peopleevery feel headache nauseous long time, it’s easy Most to dismiss • Sensory: Numbness or tingling in either the accompanied byasweakness on one side which is called a brainstem aura. Brain ‘cutaneous allodynia’. This meansPeople feeling pain and up during as a throw migraine. Seriousa migraine. brain bleeds have face one side can of the of theorisbody that look similar to a stem the rear part of body. thevery brain. Some in response stimuliaround that areduring not supposed to usually avoidtoas moving a migraine been missed a result of this. It is very stroke. consistently patients develop vision slurred loss in • Language: Patients can experience be painful,as such as brushing your hair,worse. shaving headache it makes the symptoms one eye,orbefore onsetfinding of a migraine, such speech have word difficulties or wearing contact lenses.usually lasts between The untreated headache migraines have as retinal or either before or been duringtermed a migraine episode. 4 to 72 hours. Signs Stroke or Serious ocular migraines. The vision loss usually Anirudh Kapoor, MD, isWarning Board certified byof theaAmerican • Some patients experience vertigo, ringing Issue lasts less than an hour. Board A unique symptom of a migraine that happens of Internal Medicine for Internal Medicine and in their ears, double vision, unsteadiness some patients is something called asfor thebe American Board of in Psychiatry and Neurology for migraines When someone suffers from • which Motor:isRarely, can calledmigraines as a brainstem aura. Brain ‘cutaneous allodynia’. This pain Neurology. He is currently patients at themeans longaccepting time, it’s easy to dismiss everyfeeling headache accompanied bypart weakness on oneSome side stem is the rear of the brain. in to stimuli not supposed LVPG-Neurology in East Stroudsburg, for are thebleeds as response a migraine. Seriousthat brain have to of the body that can look very similarloss to ain practice patients consistently develop vision painful, such brushing yourIt is hair, shaving following areas: Stroke,be seizure disorders, multiple been missed as aasresult of this. very stroke. one eye, before onset of a migraine, such or wearing contact lenses. sclerosis, neuromuscular disorders, infections of the migraines have been termed as retinal or nervous system, neurodegenerative disorders, spinal Warning Signs of a Stroke or Serious ocular migraines. The vision lossdisorders, usually headaches cord and neuropathies. Board certified by the American lasts less than an hour. Anirudh Kapoor, MD, isIssue Board forsomeone Internal Medicine and migraines for When suffers from • Motor: Rarely, migraines can be of Internal Medicine Psychiatry andeasy Neurology for every headache time, it’s to dismiss accompanied by weaknessthe onAmerican one side Board of long Neurology. He is currently the bleeds have as aaccepting migraine.patients Seriousatbrain of the body that can look very similar to a LVPG-Neurology practice in East Stroudsburg, been missed as a resultfor of the this. It is very stroke. following areas: Stroke, seizure disorders, multiple sclerosis, neuromuscular disorders, infections of the nervous system, neurodegenerative disorders, spinal Anirudh Kapoor,headaches MD, is Board by the American cord disorders, andcertified neuropathies. Board of Internal Medicine for Internal Medicine and the American Board of Psychiatry and Neurology for Neurology. He is currently accepting patients at the LVPG-Neurology practice in East Stroudsburg, for the following areas: Stroke, seizure disorders, multiple sclerosis, neuromuscular disorders, infections of the nervous system, neurodegenerative disorders, spinal cord disorders, headaches and neuropathies.
Migraines
Q
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Campuses across Lehigh Valley Health Network (LVHN) have gone gold again, receiving gold plus awards from the American Heart Association/American Stroke Association. The Get with The Guidelines® Awards recognize an organization’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. For more than a decade, LVHN hospital campuses have received gold plus awards and we are happy to announce that this year is no different. Multiple LVHN hospitals were awarded:
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Lehigh Valley Health Network Stroke Care is Q American Heart Association/American Stroke Association Doctor Good as Gold for More ThanAskatheDecade awards campuses across Lehigh Valley Health Network
ggers that are unique ommon triggers are k of sleep, hormonal such as around the time d not eating. Some other e, wine, aspartame, her, dehydration, bright ells. I ask my patients ura of awherein migraine is can diary they y atriggers headache, he andmaking avoid sing for the patient are available on IOSand and setrack auras be confused of can an individual’s emic rs. attacks, or in other
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important to pay attention to the headache characteristics and pattern. Any change in these characteristics or patterns should be discussed with your physician to make sure it’s not a stroke or a bleed.
Lehigh Valley Hospital (LVH)–Cedar Crest
Stroke Gold Plus – Target: Honor Roll Elite Stroke Gold Plus – Target: Advanced Therapy Honor Roll Stroke Gold Plus – Target: Type 2 Diabetes Honor Roll
When to See a Neurologist
When headache stops responding to over the counter pain medications, becomes too frequent or starts affecting your school or work performance, it’s time to see a neurologist.
LVH–Muhlenberg
Stroke Gold Plus – Target: Honor Roll Elite Stroke Gold Plus – Target: Type 2 Diabetes Honor Roll
Treatments Migraine times aheadaches week, for or 15 plus daysSufferers atomonth. When are resistant these
Regular follow up with a neurologist medications, can be frequency, referredisforpatient botox Depending onpatients the headache necessary tocoexisting make suremedication you are taking the injections. preference, conditions, appropriate medications in aaremanner thattois several medication options available As strange as it sounds, overusing headache both safe andcan effective. treat migraines. Some medicines supposed medications actually cause a are headache. to beistaken onasaa‘medication daily basis and others are to This called overuse When to See Neurologist be taken only when a headache happens. headache’. I see it frequently in people who When headache stops responding to over take headache medications three or more When headaches are resistant to these the counter pain medications, becomes too times a week,patients or 15 plus a month. medications, candays be referred frequent or starts affecting your schoolfororbotox work Regular follow up with a neurologist is injections. performance, it’s time to see a neurologist. necessary to make sure you are taking the As strange as it sounds, overusing headache appropriate medications in a manner that is medications actually cause a headache. both safe andcan effective. This is called as ‘medication overuse When to See headache’. I seeaitNeurologist frequently in people who take three ortomore Whenheadache headachemedications stops responding over times a week, or medications, 15 plus days becomes a month. too the counter pain Regular up affecting with a neurologist is or work frequentfollow or starts your school necessary to make sureto you taking the performance, it’s time see are a neurologist. appropriate medications in a manner that is both safe and effective.
LVH–Hazleton Stroke Gold Plus – Target: Type 2 Diabetes Honor Roll
When to See a Neurologist
LVH–Pocono Stroke Gold Plus – Target: Stroke Honor Roll
When headache stops responding to over the counter pain medications, becomes too frequent or starts affecting your school or work performance, it’s time to see a neurologist.
LVH–Schuylkill Stroke Silver Achievement Award
According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.
Advanced stroke care In October 2012, LVH–Cedar Crest became the first stroke center in Pennsylvania, and one of the first in the United States, to earn advanced certification as a Comprehensive Stroke Center by The Joint Commission and American Heart Association/American Stroke Association. This means they offer the highest standard of care for stroke and it recognizes our expert staff and their advanced training in treating patients with complex strokes. LVH–Muhlenberg, LVH–Hazleton, LVH–Schuylkill and LVH–Pocono are all certified Primary Stroke Centers. A Primary Stroke Center is a hospital that has developed special procedures to rapidly diagnose and treat a stroke emergency.
About Get With The Guidelines American Heart Association/American Stroke Association Get With The Guidelines® is the American Heart Association/American Stroke Association’s hospital-based quality improvement program that provides hospitals with tools and resources to increase adherence to the latest research-based guidelines. Developed with the goal of saving lives and hastening recovery, Get With The Guidelines® has touched the lives of more than 9 million patients since 2001.
Our St. Luke’s family thanks ALL firstLuke’s responders Our St. family for thanks protecting and keeping ALL first responders forour community safekeeping and healthy. protecting and our community safe and healthy. Nick Dewitt, Paramedic, Business Manager, Pocono Mountain Regional EMS Nick Dewitt, Paramedic, Business Manager, Sgt. Charles Brown,Pocono Stroud Area MountainPolice Regional EMS Regional Department Sgt. Charles Brown, Stroud Area Mike McMann, 2nd Assistant Regional PoliceTownship Department Chief, Pocono Volunteer Fire Company Mike McMann, 2nd Assistant Chief, Pocono Township Volunteer Fire Company
prevention para - point S : C arbon mono x ide poisoning Carbon Monoxide Poisoning (CO Poisoning) occurs when carbon monoxide is inhaled through the lungs, then absorbed by hemoglobin in red blood cells that carry life sustaining oxygen throughout the body. When exposed, these red blood cells absorb over 200 times more carbon monoxide than oxygen blocking it from traveling to your heart and brain. Primarily occurring during the cooler months as propane, coal, wood and oil are used to heat homes, carbon monoxide is produced by the incomplete combustion of fossil fuels. If this odorless, tasteless, essentially toxic gas fills the air undetected, it could lead to serious consequences. First affecting infants and children, even pets, due to their body size and increased metabolism; as well as the elderly with heart or lung medical conditions, CO Poisoning carries clues that can queue detection. Symptoms include headache, dizziness and nausea. Sometimes called the "Great Imitator," mild carbon monoxide poisoning can often be mistaken for flu-like symptoms. Carbon Monoxide Detectors aid in unveiling this elusive hazard with a continuous alarm that echoes should the gas reach dangerous levels. While most situations resulting in alert activation are not life threatening, like a low battery beep every few minutes, to determine if a 9-1-1 emergency is at hand a few simple steps can help save a life.
look
Does Anyone Appear Disoriented
listen
Ask if Anyone Feels Sick
leave
Evacuate Immediately & Call 9-1-1 for Emergency Medical Assistance Lee V. Rosato, NREMT-P, CMT-P Pocono Mountain Regional EMS
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