The Dispatch: Spring 2023 Vol.2 No.1

EMS agencies help UTMB Health improve health care across Texas

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Coping with tragedy on the job

Page 08

Chief Rita Camarena born to lead South Houston EMS

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6 questions with Emile “Sam” Miller from Galveston Campus

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Earn 7 CEUs with ABLS hands-on course

Page 02

Medics practice airway skills at hands-on skills lab

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UTMB Health started The Dispatch last year to communicate with our Emergency Medical Services partners.

Crossword Puzzle

EMTs and paramedics working in EMS agencies are not only critical first responders in our communities, but they are also essential to the care we provide at UTMB. See more on page 03

Santa Fe Fire Assistant Chief Vic Boudreaux shares what he learned from his heart attack surprise. See more on page 14

EMS WEEK 2023

PARTNER SPOTLIGHT

EMS WEEK 2023

Earn 7 CEUs with ABLS hands-on course

Advanced Burn Life Support (ABLS) Provider Course

About THE DISPATCH

The Dispatch is a publication of the University of Texas Medical Branch (UTMB Health) and is produced by UTMB Health’s Office of Marketing and Communications for our EMS partners. The purpose of this publication is to celebrate the incredible work of the EMS agencies in our communities while sharing news about the services available at UTMB Health’s Emergency Rooms.

This newsletter is focused on telling your stories, answering your questions and sharing your successes. Send us your questions, your story ideas, your photos or any EMS-related news you’d like to brag about to ems@utmb.edu

Crossword Puzzle

EMS Dispatch Crossword Puzzle

The Advanced Burn Life Support Provider Course is an eight-hour course for physicians, nurses, physician assistants, nurse practitioners, therapists and paramedics.

This live, hands-on course provides the how-to of emergency care of the burn patient through the critical first 24 hours.

Following a series of lectures, groups will discuss case studies. Participants will also work with a simulated burn patient to reinforce the assessment, stabilization and American Burn Association transfer criteria to a Burn Center. Testing consists of a written exam and a practical assessment. The course offers 7.0 CEUs or 7.25 CMEs.

Course fees are $150. The East Texas Gulf Coast Regional Trauma Advisory Council (RAC-R) will cover the cost for its members. The member must submit the appropriate documentation prior to the course along with proof of payment. Once the member has completed the course and submitted proof of completion, the member will be reimbursed.

Email Monica Hutson at mnhernan@utmb.edu for available course dates.

Solution is on the back page*

Across:

You help us improve health care in Texas

UTMB Health started

The Dispatch last year to communicate with our Emergency Medical Services partners.

EMTs and paramedics are not only critical first responders in our communities, but they are also essential to the care we provide at UTMB Health.

May 21-27 is National EMS Week. It’s a time to show you how much we appreciate you.

Some of us prefer to say that every week is EMS Week. We respect and admire all you do every day of every single week, not just one week of the year.

UTMB Health sees you on the front line of medical care. We see what you do. You save lives. You calm scared children. You reassure people on the way to an emergency room. You don’t waste time.

We see some of you working more than one shift. Some of you are raising families. Some are taking classes to further careers or learn new skills.

We know the stress that comes with your job and your other obligations.

You show up every day, despite that stress. Every day, EMS crews show up to help. You show up at traffic accidents, at backyard patios and at community events. You

respond to living rooms, football fields and grocery stores.

We see all of that when you show up at our emergency rooms.

We hear a lot, too. We hear kudos and praise from our providers about your prehospital skills. We hear from patients who are grateful you showed up at their most terrifying moments.

We hear from your bosses who want you to have a balanced, happy life.

We also hear your jokes, and you make us laugh. We speak the same language. We understand each other.

We all get busy in our day-to-day routines and work, but we always notice your hard work and we notice the specific ways you make a difference with each call.

We will keep watching and spreading the word about your work all year long.

EMS WEEK 2023

HEALTH PROVIDERS TELL US WHY THEY APPRECIATE EMS MEDICS

UTMB

“I really appreciate my EMS partners. I really think they are my eyes and ears on the scene. And when they come and they give me the report and tell me how the home was or the accident scene was, it helps me clinically figure out how to prioritize the workup.”

Dr. Nadim Islam, assistant professor of emergency medicine, Clear Lake Campus

“Their skill and expertise in the prehospital setting sets the providers up for success.”

Dr. Joshua Person, trauma medical director, Galveston Campus

“It’s hard for people to understand how difficult their job is since they experience so much that others will never experience. We greatly appreciate their efforts and the care they provide to our patients.”

Dr. Michael Erickson, trauma assistant professor, Galveston Campus

“I

“They are the true front line of health care.”

Dr. Kent Harkey, assistant medical director of Emergency Medicine, League City Campus

“We appreciate our EMS partners for all that they do in the prehospital setting!”

Michelle Vu, service line director, neurosciences

“We depend on them heavily.”

Dr. Phillip Singer, Angleton Danbury Campus trauma medical director and emergency medical director

“I appreciate the EMS groups very much. They are part of the team. They’re always eager to help. They want to learn, and they appreciate every time we give input. They receive it gracefully. Again, they’re really part of the team.”

Dr. Gabriella Cardone Richard, assistant professor, emergency medicine, Clear Lake Campus

‘They are the true front line of health care’

love our EMS partners because they are our front line. They really take care of the patients in the field and get them as stabilized as possible and get them here as quickly as they can to get them the best care. Without them, there’s no way our patients, a lot of times, could even survive.”

Merry Philip, associate chief nursing officer, Clear Lake Campus

Chief Rita Camarena born to lead South Houston EMS

South Houston EMS Chief

Rita Camarena was born in the back of a pick-up truck in 1976. The man who delivered her—Mike Telschow—also founded the South Houston EMS.

She was born and raised in South Houston and pretty much also in the South Houston EMS.

Camarena started working for the department when she was 15 through a high school program called Health Occupations Students of America (HOSA). When considering which health field to explore, she was drawn to EMS.

She started volunteering with South Houston EMS as part of her

schooling. She enjoyed it and took the next step. At 18, she became a certified EMT with the agency.

And her boss was Chief Mike Telschow.

“He’d always tell me that he delivered me,” Camarena said.

The reminder was always kind and friendly but with a joking tone that let her know he was the boss.

She continued to volunteer with the agency—and with Telschow—before transitioning with the rest of her colleagues to a paid position about 20 years ago.

Now, she is chief of South Houston EMS, a department of the city of South Houston. She manages a staff of 22 to 25 employees. “It fluctuates,” she said.

The EMS agency held its 6th Annual Crawfish Boil in March, a fundraiser and a community event that she credits Assistant Chief Anna Aina-Stine for starting and organizing each year.

“It’s just something different, and it brings the morale of our department up,” Camarena said. “The kids hang out with each other.”

The EMS agency has grown and evolved since Telschow retired in 2001. Camarena stayed and continued to advance in the department.

She still remembers Mike Telschow’s influence on her career and life.

“He always told us, ‘People come into your life, and you never know what they mean to you until they’re gone. He meant a real lot. You know, I learned a lot from him.”

Telschow passed away in 2005.

She responded to the medical call at Telschow’s home.

“That was my call. It was like the beginning to the end,” Camarena said.

“It opened a book and closed a chapter.”

Chief Rita Camarena’s life story started with South Houston EMS. Camarena, front and center in this crew photo,has fond memories of Chief Mike Telschow, who founded the EMS agency.

Why did you choose emergency medicine? Did someone or something influence you?

Since I was a child, I’ve always been excited by emergency situations. I can remember having my father chase fire trucks so I could see the firemen fight fires. I was intrigued by the way they crawled inside of these burning structures to extinguish the fire. When I turned 17, I joined the local fire department and became an EMT. The rest is history.

Q A

6 questions with Emile “Sam” Miller

Nurse Manager, Emergency Services, UTMB Health Galveston Campus

How do you get through a tough shift?

A

By focusing on the positives of the day. We have a lot of people who come here in pretty bad shape secondary to some horrific traumatic and medical emergencies. Some of them we are not able to save because of the damage that is done. However, every day we show up to work, we make a positive impact on patients. Some of these positive impacts are not grandiose, but nevertheless very impactful. It can be something as simple as comforting a child who is scared to have stitches or shots, and then have them give you a big ol’ hug at the end of a visit. You know, sometimes it’s just the simple things.

A I cannot speak on a specific recent event, but I will say this: Our EMS partners are some of the best in the industry. They go out into some of the most austere environments and provide excellent prehospital care. EMS has come a long way in the past 10 to 15 years. The advancements in prehospital care are directly related to our patients having positive outcomes. Some of the areas include stroke recognition and treatment, STEMI recognition and treatment, airway management, administration of antibiotics in the field, hemorrhage control and the initiation of blood products in the field. Make no mistake about it, without the prehospital care that is provided, some of these patients would never even make it to the hospital. I tip my hat to those guys. 05

What is your favorite type of food? Do you have a recipe for that?

What do you do to relax when you are not at work? And why do you do that?

A

I spend time with my wife and hang out with my friends.

I do this because my wife tells me I’m going to do it. LOL. I like hanging out with my wife because she brings a great deal of peace to my life. It’s just cool to be around her. My friends are also very important to me. When I’m with my friends, I get to wild out a little bit, smoke cigars, cook and watch sports. My wife is not fan of smoke.

04

What can you tell us about a recent EMS-related case that was a success? Was there a medic who made a difference? Tell us about it.

A That’s easy—BBQ! Man, I love some good BBQ. As mentioned earlier, cooking and BBQ-ing is one thing that I find to be very relaxing. I have actually won BBQ competitions. I can’t tell you my recipe, but if you go down the dirt road, behind the fourth tree, across from the pond, buried under a rock you’ll find the recipe. If you find it, you can use it. 06

What’s something you want people to know about you?

A I hate public speaking.

Coping with

Witnessing tragedy comes with the job for EMTs and paramedics. Don’t ignore its effects on your health. After responding to a multi-vehicle accident or a mass shooting, it’s not unusual for medics to have traumatic grief.

Dr. Kimberly Gushanas, a psychologist with UTMB Health, offers some tips to cope with the added stress of tragedy.

Basics

Start with intentionally slowing down your breathing.

“Sometimes when we are in ‘go mode,’ we tend to hold ourselves very tight, bracing for impact physically even when the stress is psychological,” Gushanas said. “That’s just our nervous system doing its thing, but we can regulate it. Sometimes the body is easier to regulate than the mind, so we start there.”

Focus on breathing slow and low—with the diaphragm—and try to keep a slow, controlled pace.

“Imagine breathing in through the nose, out through a straw,” she said. “You might even imagine an X-ray slowly moving down your body zapping any muscle tension it notices along the way when you breathe it out. We call this a body scan, and it’s easy to find videos to practice with online.”

Next, get your essentials met, Gushanas said. Do what you need to do. Did you eat today? Have you had any water? Do that.

Self-compassion

Once you’ve covered the basics, Gushanas recommends a quick self-compassion break. “It’s important to have compassion for ourselves in moments like this because, as

Dr. Kimberly Gushanas

“Recognize that it is not selfish to take a break, nor is it a sign of weakness that you need to.”

Need

833-EMS-IN-TX

Heroes Helpline is for Emergency Medical Services first responders who want to talk to someone about mental wellness or substance abuse.

The helpline number is 833-EMS-IN-TX (833-3674689). Calls are anonymous, and the helpline is available 24/7.

medics, you are trained to respond to others first. But you must also respond to yourself, or you can’t maintain that role,” she said.

Gushanas offered the following ideas for a self-compassion break.

• Say to yourself, “Wow, that was really hard,” “That was stressful” or “I wish I could have done more.” Just acknowledging that you experienced suffering is enough without getting into it.

• Remind yourself of your humanity. “Suffering is part of life,” Gushanas said. “Yes, it sucks. And part of being human is recognizing that we all experience this and that doesn’t make you deficient or weak.” Tell yourself the truth: “I know I’m not the only one feeling this.” Or, “Anyone would struggle with this.” Or, “This is part of being a first responder. We do hard things.”

• Offer yourself some kindness and validation. That can be physical comfort like a self-hug or a warm hand over the heart, or it can be words of affirmation. Try these phrases: “I can be patient with myself for a bit.” “I will get through this.” Or “It’s normal to grieve.”

• Try loving-kindness meditation phrases if it feels right for you. Here’s an example.

May I give myself the compassion that I need.

May I learn to accept myself as I am.

May I forgive myself.

May I be strong.

May I be patient.

May I be kind.

Decompress

Plan for how you’re going to decompress. “Recognize that it is not selfish to take a

break, nor is it a sign of weakness that you need to,” Gushanas said. “It’s just a natural way to activate the parasympathetic nervous system.”

Find one small thing to allow yourself a moment of rest or distraction that is connected to something you value. Maybe it’s watching a YouTube video on that new DIY project you’ve been wanting to start. It could be reading a book or listening to your favorite standup comic. Maybe it’s blasting Metallica or Taylor Swift, going for a run, calling a friend who makes you laugh or having a 30-second private dance party. And remember that you really aren’t alone.

THE DISPATCH AN EMERGENCY SERVICE NEWSLETTER CREATED BY UTMB HEALTH | 09

- Dr. Kimberly Gushanas Psychologist, UTMB Health

Medics practice airway skills at hands-on skills lab

EMS crews from Brazoria, Galveston and Harris counties took part in the lab in January at the Health Education Center on the UTMB Health Galveston Campus.

The lab was part of the EMS Lecture Series that is offered by UMTB Health. At this event, trauma faculty lectured on airways and Emergency Department faculty lectured on resuscitation. After the lectures, participants worked on airway skills with guidance from Anesthesiology faculty as well as some of the other professors.

Medics who attended the lectures and this skills lab earned four continuing education units.

Dr. Dietrich Jehle, UTMB Health Chair of Academic Emergency Medicine, took part.

Debbie Thomson, City Ambulance Service, took a turn.

Baylor Maxwell, UTMB Health Anesthesiology resident, and Michael Kunder, League City Fire Department

Chris Treat, League City EMS Deputy Chief, and Josh Hernell, League City Fire Department

Michael Byrum-Bratsen, Lake Jackson EMS; Makenzie Savage, Lake Jackson EMS; and Mel Flenniken, La Marque Fire Department

Michael Kunder, League City Fire Department

Anna Aina-Stine, South Houston EMS

Lindsay Nowa, Anna Aina-Stine and Alan Aina, South Houston EMS

Susan Britton and Emile Miller, UTMB Health Galveston Campus ER nurse manager

Anna Aina-Stine and Alan Aina, South Houston EMS

Michael Byrum-Bratsen, Lake Jackson EMS; Makenzie Savage, Lake Jackson EMS

Kamal Actkins, League City Fire Department

Anna Aina-Stine, South Houston EMS

Dr. Jehle; Nikki Grant, League City Fire Department; and Rebecca Williams, City Ambulance Service

Michael Byrum-Bratsen, Lake Jackson EMS; Makenzie Savage, Lake Jackson EMS; and Mel Flenniken, La Marque Fire Department

Skye Prefontaine

Dr. Jehle and Susan Britton

‘EMTs are the worst patients’ Heart attack opens medic’s eyes

One night last November, Santa Fe Fire & Rescue Assistant Chief Vic Boudreaux, 53, thought he had heartburn from tomato sauce he ate, so he took antacids and went to bed.

Boudreaux discovered the next day that he had had a heart attack with a blocked coronary artery—a STEMI— when he went to the UTMB Health League City emergency room.

“EMTs are the worst patients,” Boudreaux said.

When he got home from his full-time job as an operator at a chemical plant, he had a burning sensation in his chest. Boudreaux argued with his wife, who is a registered nurse at a hospice. She wanted him to go to an emergency room. He thought he just needed more heartburn medicine.

Boudreaux also had a headache that night. The next morning, his headache was still there, so he went to the Santa Fe Fire Department to talk to a colleague, a senior paramedic.

The paramedic did three different EKG 12-lead readings.

“The first thing it said was a STEMI, which of course scares the bejesus out of me. My pulse rate went up

“I need to make sure not just me but all the people under me who work for EMS are taking care of themselves more.”

- Vic Boudreaux

Assistant Chief, Santa Fe Fire & Rescue

a heartbeat. My blood pressure went up. Everything went up,” Boudreaux said. “The second reading was different than the first, and then the third one was normal.”

“You need to get a blood test,” the paramedic stressed.

“I drove myself over to the urgent care to see if they could do a blood test to make sure that there was nothing there,” he said. “And, of course, it was like they were giving away a free toaster with every blood pressure check or something because the place was packed.”

He checked out the emergency room instead and decided it didn’t look busy.

“Of course, the intake nurse and staff recognized me from working in EMS,” he said. “I had just brought a patient there maybe two or three days earlier.”

“Don’t you usually bring patients in?” a nurse asked him.

The staff ran an EKG on Boudreaux, then did the bloodwork. About 15 minutes later, the ER doctor walked in and handed him a pile of baby aspirins.

“Start chewing,” the doctor said.

“As soon as he said that, I was knew it was definitely cardiac,” he said.

The doctor told Boudreaux he had a significant blockage and a cath lab team needed to find the blockage before it got worse.

He told the cath lab team how scared he was of dying. One of the nurses kept telling him, “We got you. We’re here. We’re not going to let that happen.”

“I couldn’t have been in a better place,” Boudreaux said. “It was just that reassuring feeling. They were absolutely outstanding. They’re just very, very helpful in explaining everything that was going on for them.”

Everyone in the cath lab introduced themselves to Boudreaux, something that really impressed him. The team also told him the next time he brought in a patient headed for the cath lab, he could go along and see what it was that the team was about to do to him—put a stent in.

He had 99% blockage in his right coronary artery.

While he was in the hospital, he got a bad headache, maybe the worst one he has ever had in his life.

“It was because of all the different drugs they put me on,” Boudreaux said. “They tell you that in class, but now I’ve actually experienced that. I know we’ve seen that when we give nitro to a patient, and then they say, ‘Oh, my head.’ It gives me a whole new perspective when you’re saying the same words that you’ve heard from a patient. It’s humbling.”

It’s why Boudreaux said he feels more compassion and understanding as an EMT. “It was a life-altering experience to go from not taking any medications and living a pretty decent life to having a heart attack,” he said. “It’s eye-opening.”

He realized he needed to focus more on his health, what he eats and how he moves, he said. Last year, he had COVID and stopped smoking then. He wonders what effect all that smoking has had on his body.

“I need to make sure not just me but all the people under me who work for EMS are taking care of themselves more,” he said.

The heart attack didn’t damage his sense of humor. He knows he was in denial the night he had the heartburn argument with his wife. “The worst thing about it was I had to call my wife and tell her, ‘You were right.’”

Assistant Chief Vic Boudreaux wants all EMS workers to take care of their health. His heart attack taught him it’s crucial to watch what he eats and how he moves.

Earn credit at EMS Lecture Series events

Medics can earn continuing education credits at upcoming EMS Lecture Series events on UTMB Health campuses.

• July 21 at UTMB Health League City Campus

• Sept. 15 at UTMB Health Galveston Campus

• Nov. 17 at UTMB Health Angleton Danbury Campus

The UTMB Health Stroke Program and Trauma Program staff will discuss EMS outcomes, facility capabilities and treatment updates. Participants can earn 4 CEUs for attending in person and taking part in the skills portion, and 3 CEUs for attending the virtual meeting. To register or to get details, contact Richard Arocho at riarocho@utmb.edu