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Inspiring Health WINTER 2018

Answering All of the Questions Staff keeps a young appendicitis patient and his family informed during their hospital stay

Safety Behind the Scenes Brookings Hospital’s new sterile processing area

PET/CT Scans Providing more precise imaging for diagnoses

Melissa Wagner Named Chief Financial Officer Melissa Wagner was recently appointed by Brookings Health System as the organization’s new Chief Financial Officer (CFO). As CFO, Wagner is responsible for the development and maintenance of accurate financial information for the general ledger and financial statements. She is also responsible for establishing, updating and maintaining financial policies, procedures, and records necessary to meet the goals of Brookings Health System. A South Dakota native, Wagner has lived in Brookings for eight years. She joined Brookings Health in 2014 as a financial analyst. Before that, Wagner worked in finance at Fishback Financial. She currently serves as treasurer for both the Volunteer Service Bank and Brookings Friends of Baseball. Wagner holds a master’s in accounting from Kaplan University and a bachelor’s in business administration from Arizona State University. She has over 13 years of professional business and accounting experience.

Vaccines for Preteens 2

We often think vaccines are important for babies and toddlers, but it is important kids receive the appropriate immunizations as they enter the middle school years, too. According to the CDC, 11 and 12-year-olds should receive: Tdap: this is a booster for tetanus, diphtheria and pertussis. Most children receive this vaccine initially when they are infants. HPV: this immunization protects against genital warts as well as cancers caused by HPV infection, including cervical, vaginal and vulva cancers in females and penile cancer in males. The CDC recommends all 11 and 12-year-olds receive a two-shot series of HPV vaccine at least six months apart.

MenACWY: this immunization protects against bacteria that causes meningococcal disease, like meningitis or septicemia. All 11 and 12-year-olds should get a single shot of MenACWY. The CDC recommends a booster shot at age 16. For more information, visit for the CDC’s guidelines on vaccines.

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POST-BIRTH Warning Signs Having a baby is an emotional, life-changing experience. After birth, many new moms immediately focus on caring for their infant. It is just as important, however, that mothers continue to care for themselves and monitor for serious health conditions that may arise. POST-BIRTH is an acronym to help mothers identify problems in the hours, days, weeks and months after giving birth (see the sidebar chart). “It’s important for new moms to be aware of these warning signs because they can be indications of at times life-threatening conditions,” said OB-GYN Dr. Kirstin Sholes from the Avera Medical Group Specialty Care clinic. “It’s really important for them to be aware and in-tune with their body and what’s going on.” Critical warning signs such as chest pain, obstructed breathing and shortness of breath can signal a heart problem or a blood clot in the lungs. Seizures may indicate eclampsia and thoughts of wanting to hurt herself or her baby may indicate a mother has postpartum depression. In these cases, call 911. Signs or symptoms where moms should call their health care provider include having a painful headache that doesn’t go away with medication or that includes vision changes. This may indicate post birth high blood pressure. Dr. Kirstin Sholes Heavy bleeding may mean a woman has an obstetric hemorrhage; redness, warmth, swelling or pain in the leg calf may indicate a blood clot. Also, incisions that are not healing or a 100.4°+ F temperature could signal an infection. “Anyone who has a baby is at risk for potential complications, but we do know certain things put women at higher risk,” said Dr. Sholes. “Women who have had a C-section are at a higher risk for infection and blood clots. Women that have had complications during their pregnancy, like high blood pressure or diabetes, have an increased risk of certain conditions.” It’s also important that women keep their postpartum care checkups with their providers, even if they are feeling fine. In addition to making sure moms are recovering well from labor and delivery, the appointments help providers spot and treat health conditions. Want to learn more about POST-BIRTH warning signs? Visit

winter 2018



Pain in chest

Obstructed breathing or shortness of breath


Thoughts of hurting yourself or your baby



Bleeding, soaking through one pad/hour, or blood clots the size of an egg or larger

Incision that is not healing

Red or swollen leg that is painful or warm to the touch

Temperature of 100.4° F or higher Headache that does not get better even after taking medication or bad headache with vision changes

TELL 911 OR YOUR HEALTH CARE PROVIDER: “I had a baby on [date] and am having [specific warning signs]”

Answering All of the Questions Appendicitis, an inflammation of the appendix, is most common in people ages 10 to 30. It is a medical emergency that cannot be prevented and requires quick removal of the appendix. When a child needs an appendectomy, clear communication from the health care team can reassure the entire family. On a Friday morning this past fall, Matthew Knippling’s 11-year-old son, Liam, woke up with stomach cramps and not much of an appetite. He came home early from school that day and Matthew and his wife treated Liam’s symptoms like a stomach bug. But when Liam hadn’t improved by Sunday morning, his parents knew it was something more. “We brought him here to Brookings,” said Matthew, who lives in Flandreau with his family. “The ER staff asked him a few questions and brought him in for a scan. Right away they could tell that his appendix was either having problems or ruptured.” The OR team and General Surgeon Dr. Jeffrey Johnson immediately sprang into action, preparing Liam and his family for surgery.


“I thought they did a really good job talking to Liam, not just explaining to us what was happening and answering our questions,” said Matthew. “They made sure he understood what was going to happen and what needed to happen. He’s at the point where he likes to know what’s going on and how things are going to come out.”

Surgery went well, but during the procedure, Dr. Johnson discovered Liam’s appendix had ruptured. That meant Liam needed to stay in Brookings Hospital’s inpatient care unit for two days to recover and receive strong antibiotics to prevent further infection. While Liam recovered in the hospital, Matthew said the family felt like VIPs. Inpatient care staff continued to explain things to Liam in terms he could understand. They made him the focus of their communication, making Liam’s parents feel better, too. “I think what I appreciated the most was just the way they put us at ease and the amount of attention they gave us,” said Matthew. “It made us feel really welcomed and they really understood what the seriousness of the situation was.” The high-quality, compassionate and personalized health care Brookings Health’s team provided Liam and the support they showed his family helped them manage a stressful situation. “When we first got here, we were kind of worried about what it was, and then when we found out it was his appendix, we were pretty worried,” said Matthew. “It’s not something as a parent you always want to go through, but I think the staff and doctors really put us at ease just answering all of our questions and all of Liam’s questions.” Watch more on the Knippling family’s story at

Behind the Scenes As a part of the hospital expansion and renovation project, Brookings Health invested in a high-tech sterile processing area to increase instrument reprocessing efficiency. It also maintains and improves infection safety standards.

Mechanically cleaned instrumentation goes through an ultrasonic cleaner which forms air bubbles that implode on an instrument’s surface. The air bubbles reach small crevices and hard-to-reach surfaces.Once devices are cleaned, they are sent through two washer disinfectors. Instrument sets enter from the dirty, decontamination side and exit out clean on the sterilization side.

Sterile processing ensures instruments and equipment used in medical and surgical procedures are properly cleaned, disinfected, inspected and sterilized prior to patient use. It is essential for preventing infections, checking instrumentation functions well and ensuring all safety standards are met to deliver safe patient care. “The new sterile processing department was designed for an efficient work flow from the OR surgical suite to decontamination, washing and disinfecting to packaging and sterilization and distribution to the OR, facility and clinics. We also have the latest sterilizing equipment,� said OR Central Sterile Reprocessing Supervisor Roxanne Johnson, CSPM. The decontamination room is the first stop for soiled instruments from surgery and other areas of the health system. Here instruments and devices are fully cleaned in accordance with the Association for the Advancement of Medical Instrumentation standards to prepare them for the sterilization process. Manually cleaned devices go through a three-bay sink process. First staff immerse instruments in an enzymatic solution to begin breaking down soils. In the second sink, instruments are immersed in a detergent solution and manually brushed. Finally, instruments are thoroughly rinsed with water supplied from a reverse osmosis system that removes impurities.

Before sterilization, staff reassemble and package instrument sets. Once packaged, the instruments are ready for sterilization. A main sterilization method is an autoclave, a device that uses steam to sterilize heat and moisture-stable items. For heat-sensitive devices, a hydrogen peroxide sterilization system is used. In this system, hydrogen peroxide vapor fills the sterilization chamber, contacting and sterilizing exposed surfaces. At the end of the sterilization cycle, staff review the sterilizer printout to verify all sterilization parameters have been met. In addition, biological and chemical indicators monitor the sterilization process and indicate if the instruments were exposed to appropriate conditions to achieve sterility. These indicators help ensure instrumentation is sterile and safe to use. Once staff have verified all sterilization parameters have been met, they re-distribute instrument sets for use in medical and surgical procedures in the hospital, clinics and The Neighborhoods at Brookview nursing home. Once used, the instruments will again be reprocessed by the sterile processing department. Want to learn more about the quality care at Brookings Health System? Visit

winter 2018


PET/CT Scans Brookings Health System has expanded its outreach efforts to now include diagnostic imaging services. As of this fall, Brookings Health now hosts a Positron Emission Tomography/Computed Tomography (PET/CT) mobile imaging unit on its campus the second and fourth Monday of each month.


“We constantly look for opportunities to bring services closer to home for our community,” said CEO Jason Merkley. “By having our partner, DMS Health Technologies, bring their mobile PET/CT unit to our campus, area patients can conveniently receive critical diagnostic imaging tests here in Brookings.” PET/CT scans combine nuclear medicine and x-ray imaging to provide comprehensive information about a person’s anatomy and metabolic function. The resulting images help physicians pinpoint the location of abnormal activity within the body. “A PET/CT scan allows physicians to diagnose and determine the extent of various cancers, neurological disorders such as Alzheimer’s disease, and damage to cardiac muscle after a heart attack,” said Diagnostic Imaging Director Tim Watson. “By merging two imaging procedures in one unit, PET/CT provides a more detailed picture than either test does alone, resulting in more accurate diagnoses and appropriate treatment plans for patients.” PET/CT images can be shared with any medical provider from any health organization. Area patients may ask their physician to refer them for a PET/CT scan at Brookings Health by having their physician call Central Scheduling at (605) 696-8888. PET/CT is just one of the medical imaging services offered at Brookings Health System. Local patients can also receive MRI, CT, ultrasound, nuclear medicine and x-ray procedures close to home, saving them time and travel expenses. Images can be shared with any provider at any health organization. For more information, please visit

Support Our LIFESAVERS! The need for emergency services continues to grow within the Brookings community and surrounding area. From 2009 to 2017 the ambulance service realized a 40% increase in call volume. To help build the new Ambulance Station & Education Center, Brookings Health System Foundation has launched the SUPPORT OUR LIFESAVERS capital fundraising campaign. The Foundation’s overall goal is to raise $200,000 to help offset 20% of the total building cost. The new facility will include a garage, living quarters, supply storage and an education center that will host community training classes like First Aid and CPR. Access to emergency care is what everyone in the Brookings area should expect and receive.

You can help make a difference! Visit to support the new Ambulance Station & Education Center by donating today! Call the Foundation at (605) 696-8855 for more information.

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Inspiring Health is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

Are you at risk for Type 2 Diabetes? 1

Write your score in the box. Height

How old are you? Less than 40 years: 0 POINTS  |  40–49 years: 1 POINT  50–59 years: 2 POINTS  |  60 years or older: 3 POINTS


Are you a man or woman?

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5’-2” 5’-3”

If you are a woman, have you ever been diagnosed with gestational diabetes?


No: 0 POINTS  |  Yes: 1 POINT

5’-5” 5’-6”

Do you have a parent or sibling with diabetes?

5’-7” 5’-8”

No: 0 POINTS  |  Yes: 1 POINT



5’-9” 5’-10”

Have you ever been diagnosed with high blood pressure?


Less than the amount in the next column

Woman: 0 POINTS  |  Man: 1 POINT


No: 0 POINTS  |  Yes: 1 POINT





Are you physically active?

6’- 2”




Yes: 0 POINTS  |  No: 1 POINT





6’- 4”








What is your weight status? (see chart at right)

0 POINTS Add up your score.

SCORE (Total POINT value) If you scored 5+, you’re at risk for type 2 diabetes. Talk to your physician about additional testing to determine if you have type 2 diabetes or prediabetes. If you have type 2 diabetes or prediabetes, ask your physician to refer you to Brookings Health System for diabetic education. Learn more at

Inspiring Health Winter 2018  
Inspiring Health Winter 2018