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MAY 2019

PMREMS newsletter

regionalresource

Taking Teamwork to Heart

IN THIS EDITION 2 EMS HONORS

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aking the term “teamwork� to heart; Pocono Mountain Regional Emergency Medical Services considers collective professional planning and preparation key to overall area success.

From embracing valuable emergency medical transport and hospital coordination as an efficient and effective community resource; to sharing preventive measures and transparent details on what, where, how and why we do certain things. It all brings things full circle to best serve the community.

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for videos, photos and up to the minute news PoconoMountainRegionalEmergencyMedicalServices

Recognizing Our Pros

3 TICK TALK

LVHN Physician Facts

4 READY FOR ROUND III The Road to Roundup 2019

6 ASK EMS:

Clearing Community Inquiries


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May 9th

Pocono Mountain Regional Emergency Medical Services Paramedic Jody Hutton and EMT Gregory Gueiss received the STEMI cup award from Lehigh Valley Hospital – Pocono. This award is presented annually to the ambulance crew who brought in a STEMI (heart attack) with the shortest door-to-balloon time, meaning, from the moment a heart attack patient is brought through the emergency room doors to when the affected artery is successfully opened up with a stent or balloon. Our honored PMREMS team was able to diagnose, call ahead, and transmit the pre-hospital EKG to the cardiac team at the hospital achieving an astonishing 23-minute door-to-balloon time. According to the American Heart Association, the nationwide goal for door-to-balloon time is less

than 90-minutes with a national average of 64.5 minutes. This successful outcome was possible thanks to teamwork and coordination between PMREMS and the Lehigh Valley Health Network. Pocono Mountain Regional EMS is proud of our medical professionals for always recognizing and providing the highest level of pre-hospital care possible.


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Ask the Doctor Be Wary of Ticks

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With warmer than usual weather, will we see more instances of ticks sooner?

A: Danielle Deitrick, DO As warm weather approaches and people spend more time outdoors, we will soon see an increase in tick bites. Tick bites account for a frequent number of emergency department visits in the spring and summer months. Deer ticks have been found in all of Pennsylvania’s 67 counties, and the state has led the nation in confirmed cases of Lyme disease in recent years. (CDC data 2014-16 lists PA as #1; no data for 2017 yet). It’s important to know that ticks carry more than just Lyme disease. Other transmitted diseases include Rocky Mountain Spotted Fever, anaplasmosis, babesiosis, and Powassan virus disease. It is possible for a deer tick to transmit more than one illness simultaneously. The bite of an infected deer tick/(Ixodes scapularis) can transmit the Lyme disease bacterium. Deer ticks typically require dense vegetation with high animal traffic and humidity. They rest on grasses and shrubs in a position called “questing” – holding their upper pair of legs, which contain barbs, outstretched waiting to climb onto a passing host. Deer ticks will attach to any location of the body, but prefer areas with abundant blood supply such as the scalp, groin, and armpits. The Ixode tick is typically on the host for hours to days before it begins feeding. In most cases, the tick must be attached for 36 to 48 hours or more before the bacterium can be transmitted. The sooner you remove a tick, the less likely your chance of getting Lyme disease as it takes time for the Lyme t disease-causing bacteria bacteria to move from tick to host. Although we see more tick bites in the spring and summer, deer ticks can survive the cold winter months but move more slowly in these temperatures.

Symptoms To Look Out For Lyme disease has many symptoms, with the most common being vague muscle and joint aches, headache, fatigue, and neck stiffness. The disease is typically divided into three stages. Stage 1: This typically occurs 7 to 10 days after a bite (range 3-32 days) with a localized erythema migrans rash (“bullseye rash”). Approximately 75 percent of patients will develop this rash. The rash is initially about 2 inches across with an area of central clearing that becomes apparent as the lesion expands. The bullseye rash is often confused with local immune reaction to the tick salivary proteins which usually occurs within hours of the tick bite. Secondary bacterial skin infections typically occur a few days after the bite and lack central clearing. Other Stage 1 symptoms include low grade fever, fatigue, muscle/joint ache, lymph node enlargement and neck stiffness.

Stage 2: If untreated, Lyme disease may enter the second stage, within days to weeks. A rash composed of many smaller red areas that lack central clearing may occur. Neurologic symptoms such as facial nerve paralysis, nerve pain or even meningitis can occur. Cardiac symptoms can occur in 10 percent of cases. The most common cardiac manifestation of Lyme disease is conduction delay (irregular heart beat) which could potentially lead to the need for a pacemaker. Stage 3: This stage may occur a year or more after initial presentation with more severe symptoms.

Treatment Options Lyme disease is often diagnosed based on history of being bitten by a tick in an area with widespread tick population, as well as the presence of an erythema migrans rash. Lab tests may be ordered to confirm the diagnosis. Signs and symptoms, especially a history of a deer tick bite or rash will lead your doctor to order a two-step lab test. This first step entails an “EIA” (enzyme immunoassay) or “IFA” (immunoflorescence assay). If this step is negative you do not have Lyme disease. If the second test is positive or indeterminate, a “Western Blot” test is used. Both the EIA/IFA and Western Blot tests need to be positive for a diagnosis of Lyme disease. Children are also typically treated for 21 days with oral antibiotics such as amoxicillin. If a child is 8 years of age or older, they can be treated with doxycycline. If stage 2 symptoms are present intravenous antibiotics may be used.

Not All Ticks are the Same Not every tick is a deer tick. For instance, dog ticks do not transmit Lyme disease. Adult dog ticks are somewhat larger and have characteristic white markings on their top side. Deer ticks are typically smaller than dog ticks. In their larval and nymph stages they are about the size of a pinhead. Adult deer ticks are about the size of a small apple seed. Most patients are infected when the deer tick is in the nymph stage. In most cases the tick must be attached for 36 to 48 hours or more before the bacterium can be transmitted. The sooner you remove a tick, the less likely your chance of getting Lyme disease as it takes time for the Lyme disease-causing bacteria to move from tick to host.

Preventative Measures If you are in the outdoors use a repellant that contains 20 percent or more DEET, picaridin or IR3535 on exposed skin. There is also commercially available pretreated clothing. When hiking, try to walk in the center of trails and avoid high grass areas. If you suspect a tick bite, seek help from Lehigh Valley Hospital-Pocono Emergency Department, ExpressCARE or see your family physician. Professionals can help identify a tick, remove it appropriately, and test/treat if need be. Lyme disease is not typically an emergency unless rare, late stage neurologic and cardiac symptoms are present. Nonetheless, if you are feeling sick or worried LVH-Pocono is always available to see you 24/7.

Danielle Deitrick, DO, is an emergency medicine specialist at Lehigh Valley Hospital (LVH)-Pocono. She is the Assistant Director LVH-Pocono Emergency Department, and FAWM (Fellow of the Academy of Wilderness Medicine). Deitrick is Board Certified by the American Osteopathic Board of Emergency Medicine.


ROUND III


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Returns August 22 SKYTOP LODGE

Plans are well underway to create another day of music and fun for an amazing cause. August 22nd consider an evening to sit-a-spell at Skytop Lodge as Regional Roundup readies for Round III.

the task of replacing these vital units. Each monitor costs nearly $36,000 with four needed to accommodate PMREMS’s Advanced Life Support (ALS) trucks and area events. Regional Roundup tickets are $75 with a table for 10 taking each ticket down to $70. emergency responders including EMS, police, and firefighters receive respectable ticket rates of $50 each.

Inviting all to consider sponsorship and ticket opportunities, Pocono Mountain Regional Emergency Medical Services shares a view where dollars will continue to be dedicated– Physio Control Lifepak 15 V4 Heart Monitors. As current cardiac monitors will become obsolete in 2022, with no parts manufactured or service provided, emergency responders are faced with

WATCH4MORE

Watch for sponsor packages coming soon that include outstanding recognition opportunities plus tickets to take in all the action.

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learn about PMREMS at PMREMS.org

REGIONAL ROUNDUP is a fundraising benefit created by Pocono Mountain Regional EMS, a nonprofit 501c3; to raise funds for vital equipment and training for our professionals serving the community.


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The best way to ensure accurate answers is to go right to the source. So of course, Pocono Mountain Regional Emergency Medical Services strongly agrees in transparency. Residents are encouraged to ask questions to understand what, where, why and how our team can be on-scene ensuring efficient, professional medical care when needed. Let’s share a common inquiry about where and why we see ambulances on standby in some curious spots.

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Why do I always see an ambulance parked at Burger King in Mount Pocono or other various areas like Mount Pocono Plaza and Hoffman’s on Route 940 just sitting there?

Question

Answer Have a question, you’d like clarified straight from the source?

No… the crews are not always enjoying a Burger King meal as the joke goes. Instead, Pocono Mountain Regional EMS utilizes a system designed to improve response times and respond to emergencies in the communities we serve as fast as possible in order to provide better outcomes to our patients. This system is called “System Status Management”. System Status Management is the fluid deployment of ambulances based on the hour-of-the-day in order to match supply in an attempt to provide faster response by locating ambulances at “posts” nearer their next call. This practice has a sound foundation both in research literature dating back to the 1980’s as well as in practice today. Experience has shown that ambulance response times can be and have been dramatically decreased using this type of dynamic deployment. For instance, if our Advanced Life Support unit housed in Paradise Township, which is designed to respond to emergencies in Paradise and Barrett Townships, is dispatched to an incident; a unit from our Coolbaugh Township location will relocate to the Burger King parking lot. This is to be closer to Paradise and Barrett townships if a second incident occurs. However, this unit also remains available to respond to our communities outside those two municipalities as well. While this is just one example of how the system is deployed; there are several other similar examples to meet all Pocono Mountain Regional EMS coverage area needs, efficiently and effectively.

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PMREMS May 2019 Regional Resource Newsletter  

PMREMS May 2019 Regional Resource Newsletter