VIRGINIA LIFELINE - VAVRS July-August 2012

VIRGINIA LIFELINE

JULY / AUGUST 2012

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Deadline for the Upcoming Issues of the LIFELINE Articles may be submitted by any member of the VAVRS, AVAVRS and VAJVRS. Feature articles are encouraged. Photos and/or Graphics are acceptable and can be returned if requested. Contact the Editor if you need assistance in writing an article at gdalton@vavrs.com Deadline for future issues as follows: August 10, 2012 for September/October September 1, 2012 for Convention October 10, 2012 for November/December December 10, 2012 for January/February

For a complete list of the current courses being offered by the VAVRS go to www.vavrs.com

THE VIRGINIA LIFELINE ISSN 0279-6023 is the official bimonthly publication of the Virginia Association of Volunteer Rescue Squads, Inc. Editorial material should be sent directly to the VAVRS Editor at P O Box 522, Woodstock, VA 22664 (H) 540-459-4849—(W) 540-536-2758 (FAX) 540-459-4925—(C) 540-481-0125 (E-MAIL) gdalton@vavrs.com

Requests for advertising rates, material specifications and deadlines should be directed to the Editor.

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Executive Committee Meetings August 11, 2012 VA Beach Resort and Conference Center 9:00 a.m.

September 27, 2012 VA Beach Resort and Conference Center 10:00 a.m.

Upcoming Events September 26—29, 2012 VAVRS Convention Virginia Beach November 5—11, 2012 Virginia EMS Symposium Norfolk Waterside Marriott

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Officers

Committee Chairs

President Edward B. “ Bubby” Bish Jr.

Nominating—R. Bruce Stratton Membership/Personnel—Rickey Hodge Life Membership—Ronnie Slough Bylaws—Bruce Edwards Hall of Fame—A. Page Entsminger Convention—Ford Wirt EMS Representative—Dreama Chandler EMS Representative—Wayne Myers, Jr. Rescue College Co-Chair—Rickey Hodge Rescue College Co-Chair—Wayne Myers EMS Advisory Board—Dreama Chandler EMS Advisory Board—Wayne Myers Grant—Elizabeth Enos JSW/FEW Scholarship Fund—Carolyn Brand National EMS Memorial Service—Kevin L. Dillard EMS Exchange Program—Jane LaVerne Recruitment and Retention—Fran Phillips Course Development—Doug Eberhardt Facility Manager—Lin Matthews Redistricting Study—Wanda B. Morehead Volunteer Management—J. C. Phillips Legislative—Dreama Chandler

Vice President Rickey Hodge Secretary Connie Moore Treasurer Steven Dove Training Officer Scott Davis Chaplain/Editor Gary Dalton Historian Mike Smoot Immediate Past President Steve Grayson Legal Advisor S. Craig Lane Medical Advisor

James R. Dudley, MD, MBA

Parliamentarian Lobbyist Office Manager

J. C. Phillips

Ed Rhodes Frances Brooks

Training Coordinator Kathy Eubank Administrative Secretary

Shirley Bagby

District 1 V. P. Scott Masincup District 2 V. P. Carolyn White District 3 V. P. Thomas Gwaltney District 4 V. P. Karen Wagner District 5 V. P. James Fontaine District 6 V. P. June Ann Wilkes District 7 V. P. Thomas E. Harris “Ted” District 8 V. P. Teresa F. Whitlock District 9 V. P. Claude Graybeal District 10 V. P. Ronald Ridgley

Diamond Reflections

"Diamond Reflections" a book regarding the first 75 years of the Virginia Association of Volunteer Rescue Squads is now available from the VAVRS Office by calling the VAVRS Office at 800-833-0602 - The more than 250 page hardback book has chapters about our history, our Past Presidents, Life Members, Hall of Fame members, VAVRS/AVAVRS/VAJVRS officers, State Conventions, Rescue College, and much more. For only $30.00 plus $5.00 shipping, you can own your own copy of this beautiful documentation of 75 years of the VAVRS. V I R G I N I A

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The 60 Second Parliamentarian Tip Submitted by J. C. Phillips, VAVRS Parliamentarian Since more and more meetings are being held by teleconference, I thought it would be a good idea to write about it again in more detail. I first wrote about this briefly in the Sept./Oct. 2002 issue of the Lifeline when I talked about video conference and teleconference. The VAVRS has meetings all the time by teleconference because it saves money by not having to pay for travel, lodging and meals of those that need to participate in the meeting.

The type of teleconference I will be talking about is when an organization has a meeting at their squad building and some members can't be there in person but want to participate in the meeting.

A meeting can be held by teleconference by some or all of it's members as long as it is covered in your organization's bylaws. I know some squads allow members to participate in meetings by teleconference even though it is not mentioned in their bylaws If you allow members to participate in a meeting by teleconference, be sure that the members present at the meeting know who they are and that they can be heard by everyone. Although. some organizations use a standard telephone with a speaker, it is better to use a telephone designed for this purpose.

When speaking by teleconference, the member must first state their name. If a vote is taken each person that wants to vote must state their name and say "yes" or "no." These teleconference votes must be added to the votes of the members present and voting at the meeting. Of course, it would be impossible to hold a ballot vote by teleconference.

When your bylaws say something like it takes a majority vote of members present and voting to accept a motion, the members participating by teleconference are considered present at that meeting. They are also counted towards a quorum.

Remember, it can be quite confusing if a lot of members participate by teleconference in a meeting where other members are actually at the meeting. The most common problem is that it is difficult for everyone to hear what the people are saying on the telephone. Each organization must decide if they want to allow members that can't be at the meeting to participate in the meeting by teleconference.

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R&R Committee

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JUNIOR SQUADS ARE AWESOME!

Submitted by Fran Phillips, Chair-VAVRS Recruitment and Retention Committee Go back in time - way back - when you were a 16 year old. What did you have to do to expel your energy? Some of you worked, some of you were into sports and others of you were BORED! What would it have been like, for you, if you were given the huge responsibility of helping a fellow person in their time of fear and need?

We are now back from the ancient world to the present time. You are 16 and are in a Volunteer Rescue Squad. You are expected to behave as an adult. You are responsible for keeping your school grades to a C or better and to take classes to further your education in the squad [EMT, CPR, EVOC, etc.]. You are responsible for your actions 24/7 because you do not want to bring unwanted attention to your squad and to your family. You proudly wear your uniform and are responsible for pulling your assigned duty. You are an exceptional young person.

Colonial Beach Junior Volunteer Rescue Squad Junior and Cadet program provides the squad leadership for the future—You may enter our Junior Program at the age of 8. Although due to rules and regulations, those juniors or cadets under the age of 16 cannot participate in actual emergency calls, their help around the station is invaluable to the squad.

The squads who have a Junior Squad have found that the enthusiasm of their young people have a positive effect on everyone involved in the squad. These young people are placed on a crew, pull their duty, wash units, etc., and learn what it takes to make it in today’s world. They see the not so nice outcome of auto accidents, drug overdoses and the joy of welcoming a new person into the world.

These exceptional young people go on in life to be doctors, lawyers, running their own ambulance service, Fire Department Chiefs, nurses, police officers and all the other millions of jobs that require responsible persons to make a difference.

If you do not have a Junior Squad, you may want to consider what your squad would be like with the enthusiasm of youth. Take a chance! You may be very pleased when in ten years one of these Juniors becomes the Chief of your squad. You know that they have been trained properly and are responsible.

BE A HERO TO A YOUTH! V I R G I N I A

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District Eight News VAVRS District 8 Competitions Submitted by Teresa Whitlock, District 8 Vice President When: Saturday August 18, 2012 Where: Tappahannock-Essex Volunteer Fire Department & Surrounding Areas Start Time: Dependent on number of entries

Basic Life Support (BLS): Team is not to exceed five members. Members must have current

certification at the EMT-B level. Team members may be comprised of ―assists,‖ however at least two team members must be of the EMT-B level, one of whom must serve as the lead.

Advanced Life Support (ALS): Team is not to exceed five members. Two members must hold current Advanced Life Support certification at the EMT-I or EMT-P level, and two members must hold certification at the EMT-B level. An ALS credentialed team member must serve as lead.

EVOC: Individual competition. Must have current VA Driver’s License and Current VAVRS/VDFP EVOC certification in the respected level of the vehicle being used for competition. Class II&III vehicle awards will be given.

Vehicle Rescue: Team is not to exceed 8 members, but a minimum of 5 members is required. All

members must be certified in Vehicle Rescue Awareness and Operations with the exception of the operator of the Squad Truck (Crash Truck). At least one member of the team must possess at minimum of EMT-B certification. One IC and one Safety will be chosen at random while the remaining members will serve as Extrication Technicians. ***Pre-Registration is required to participate in a respected to competition. Registration deadline is August 5, 2012 by 5 p.m. To register, contact Blake Byrd at 804-313-7562 or blake09@vt.edu.

District Four News Submitted by Gary Dalton, District 4 Training Officer

VAVRS District Four sponsored an EVOC Class at the Stanley Volunteer Rescue Squad, Stanley, VA in April. The course was taught by Gary Dalton, Karen Wagner, Scott Higgs and Karen Richards. The next regular meeting will be held on July 8, 2012 and hosted by the Greater Manassas Volunteer Rescue Squad. An EVOC Instructor Update will be held at 2:00 pm that day taught by Gary Dalton, VAVRS CoCoordinator/District 4 Instructor Trainer.

The trailer owned by District 4 has been taken to a vendor to be painted and/or wrapped. The trailer should be finished by the July 8, 2012 District Meeting.

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District Three News Submitted by Cindy Swann, District 3 Historian

District 3 meeting was held Saturday, May 5th at Surry VRS. Again not enough people signed up for us to be able to hold any competition. Hope we will be able to have competition at our next meeting, which will be held at Southside Emergency Crew on Saturday, August 4th.

Super Saturday’s Training date had to be changed from May 5th to May 19th and then had to be canceled and temporarily postponed. Peggy Vorous District 3’s Training Officer was involved in a pretty bad car accident and was not in any shape to hold the training.

Spoke with Peggy and was very glad to find that she is doing real well. We still will be having Super Saturday Training as soon as Peggy can get things back together and will be setting up a date.

EMS Exchange Program: Got a good report, Jane LaVerne has been working hard to get everything together.

Again as always we had our 50-50 raffle and drawings for gifts and Walmart Gift Cards. We want to thank Surry for a good time and a great meal.

District Ten News Submitted by Steve Dove

On June 3, 2012 District 10 held a meeting at Colonial Beach Volunteer Rescue Squad. The day began with an EVOC Competition and Junior EVOC Competition. Colonial Beach Volunteer Rescue Squad allowed the Juniors to participate in the Junior EVOC Competition with their new Polaris ATV. Not yet fully outfitted for EMS use, the Juniors really enjoyed maneuvering this apparatus around the cone course.

Prior to the meeting starting a training lecture was held for all that wished to participate. Barbie Scerbo, RN with Mary Washington Healthcare Forensic Department presented a seminar on Child Abuse and Sexual Assault. ALS and BLS providers received OEMS Continuing Education hours for taking part in this exciting training at the District meeting.

When the training concluded District 10 VP Ronald ―Sparky‖ Ridgely called the meeting to order. Before any business took place those in attendance were treated to a wonderful meal provided by the Colonial Beach Volunteer Rescue Squad Support Group.

During the meeting there was discussion about changing the date of the August District 10 meeting so it would not fall on the same weekend as the VAVRS Executive Committee (Continued on page 10)

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(Continued from page 9)

meeting being held in VA Beach. Please continue to check the VAVRS website and District 10 Facebook page all meeting locations and dates. Members also suggested moving the November District 10 meeting to another host agency, this information as well will be posted on the VAVRS website and District 10 Facebook page when the new location is selected.

District 10 would like to remind everyone that the 2012 District 10 Fall Rescue Camp will be held on Saturday, October 13, 2012 at the Fredericksburg EXPO center. Additional information about the camp can be found at www.vavrsdistrict10.com.

We look forward to providing a fun filled educational day for the kids that participate.

We look forward to seeing everyone at our next meeting in August at REVA Volunteer Rescue Squad. Please check our Facebook page to confirm the meeting date and the training topic to be offered at the August meeting.

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NOTES FROM THE TREASURER Submitted by Steve Dove, VAVRS Treasurer As many of you may be aware, since beginning my role at the Treasurer with the VAVRS several changes have been made in the accounting department. I would like to take an opportunity to briefly go over some of those changes. First, immediately after taking on the position I realized that the financial institute that housed our operational account and money market accounts was charging monthly service charges to hold our funds.

Why VAVRS was paying these fees was beyond me, since so many financial institutes are vying to be competitive in the current market and offering free accounts to businesses. Attempts to rectify this concern with the financial institute were unsuccessful, so in early 2012 I made the decision to switch to another institution and began closing the accounts at the previous bank. All funds have since been transferred to Union First Market Bank.

I found in reviewing the financial records that the Association was also paying a substantial amount of fees to our Merchant Services Account holder. This is the service for processing credit card payments. I began seeking a new company to handle this account and chose Heartland. The cost savings annually are very significant in switching to Heartland and we also now have the opportunity to process Discover credit card payments as well. We will also be activating the system to accept American Express credit card payments prior to and during the Annual Convention.

During this time the Personnel Committee was meeting to select a candidate to replace the previous Office Manager at the State Office. I had the privilege of being part of the selection process to hire a new Office Manager and as you are aware, Frances Brooks was chosen to begin employment in February 2012. With the transition of me becoming Treasurer and prior to Frances coming on board, I worked very closely with Kathy Eubank and Shirley Bagby at the State Office. Without the knowledge and commitment that these two have for the Association I would have struggled in making heads or tails of the records that had been maintained in the past. Even those there were many hurdles to overcome, these two made the process seamless and confirmed, in my opinion that we have top notch individuals running the daily operations of the State Office.

Frances was unlucky enough to begin her employment during the middle of our 2011 financial audit and tax preparation.

When working with the auditing firm I had begun to ask many questions, and soon realized that the answers seemed concerning. As Frances began working directly with the auditing firm she also had many concerns about issues involving the auditing process for VAVRS. With the audit coming to an end, I realized it was time to investigate our relationship with the auditing firm and to make a decision whether to continue utilizing their services in the future. I had little hesitation when I decided to meet with another firm and ultimately suggested to the Finance Committee that we begin working with a new auditing firm (Continued on page 13)

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from Charlottesville. After the Spring BOG I entered into an agreement with Hantzmon Wiebel, LLP to conduct our future year-end audit and tax preparation.

Shortly after reviewing the financial documents of the VAVRS, Frances learned that the employer contributions to their IRA plans was not in compliance. After working closely with Mutual of America we discovered that some participants had been under contributed while others had been over contributed. This issue went back as far as 2003.

After countless meetings, email and telephone conversation with Mutual of America we brought the plan into compliance and currently have a system in place to ensure this issue does not occur in the future.

As we were working through the day-to-day functions of the finances with the Association, Frances and I realized there were no policies and procedures related to standard accounting practices. In fact, I also realized there was no official job description for the role of Treasurer with VAVRS. While I came into this position with some general knowledge of accounting principles, I had no formal mentoring by my predecessor and at times it seemed challenging to recover any information related to my position. I made the determination to avoid this confusion in the future, that a job description would be developed to address the roles and responsibilities of the VAVRS Treasurer. I also support establishing a written policy and procedure manual related to the accounting practices with VAVRS. As we work through this I have already begun to implement some minor changes at the State Office related to security practices involving financial documents. Frances and I are working closely with Hantzmon Wiebel, LLP to develop policy and procedures that are applicable to VAVRS and these should be completed by the 2012 Convention.

To ease the process of the year-end audit, I suggested to President Bish that he appoint a standing committee called the Audit Committee to help review all financial records of VAVRS prior to submitting for the audit. This would save time and money to the Association, if our books had already had an internal review. President Bish agreed to this and approved this standing committee. I am currently soliciting individuals to serve on this committee with a goal to announce those that are serving on it at the 2012 Convention.

Working with our accounts in QuickBooks, Frances immediately recognized how unmanageable the information was in that software immediately after beginning to work in the system. Frances (Continued on page 14)

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(Continued from page 13)

approached me about condensing many of the line items in the chart of accounts. In addition I found that streamlining the chart of accounts would not only make them much for manageable, but we could get a more clear understanding of where funds were being distributed amongst the many committees in the Association. Changing the chart of accounts will make committee chairs and officers accountable for the funds spent in their respective areas of the budget and will also provide a true detail of where expenses are categorized. Frances has established the new chart of accounts and we have begun to use this for the 2012 financial record keeping. Over the last several weeks I have meet with the Auxiliary of the VAVRS, Rescue College Committee, Convention Committee, Training Officer and many others to discuss the new chart of accounts as it relates to 2013 budget preparation. I realize as we transition into this new system there are a lot questions so Frances and I have made ourselves available to meet with anyone that would like to address concerns or would like additional information about the changes.

As I write this, I am anxiously waiting to prepare the 2013 budget. As we all have felt the state of the current economy is still unknown and budget cuts are still affecting many government organizations.

VAVRS is no different in having to take a long hard look at our expenses and determine what expense may have to be cut. The Finance Committee will set a goal to strive in maintaining our services while balancing the 2013 budget. The Finance Committee will meet in mid-July to begin working on the 2013 budget and I will present this information at the 2012 Convention for approval.

Finally, with so many changes to the accounting practices and to provide clarity of why changes have been implemented Frances, a representative from Hantzmon Wiebel, LLP and I will be conducting a presentation on Thursday, September 27, 2012 in VA Beach after the BOG Meeting. This is a great opportunity for anyone considering a leadership position within VAVRS in the future and everyone else to see the future of the account division of VAVRS. At this seminar we will review the policy and procedure manual as it relates to the accounting practices and have a brief Q & A session to address any concerns you may have.

As I move forward as your Treasurer I continue to set out with one goal – to save VAVRS money without affecting the quality of the professional programs that we offer to our members. I look forward to seeing you all in VA Beach at the 78th Annual Convention.

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Drowning Submitted by Brian F. Talty CC-EMT-P - Forest View RS and Richmond Ambulance Authority ~You’re so dumb you could drown on dry land! Ever been told that? I have….by my Mom…every day until I was 24….It’s that time of year, near drowning at pools, the calls to Belle Island, drunks on inner tubes, we are all going to see our fair share of water related injuries this summer. Let’s break down a few terms. ~Wet drowning – This occurs when a person is submersed in a liquid and inhales said liquid into their lungs preventing ventilation (air in and out of lungs) and respiration (O2/CO2 exchange in cells). ~Dry drowning – A dry drowning can occur in a liquid, the mammalian reflex prevents them from inhaling the liquid and they suffer asphyxiation while in the liquid, nothing ever enters their lungs. This will be explained later. Dry drowning is widely misused as a term for somebody who almost drowns, is rescued, but then dies 30 hours later in bed. The media is famous for using this term with kids who die at home after an incident at a pool. ~Near drowning – The patient experiences an event in a liquid but survives for greater than 24 hours. This also includes a person who is found in cardiac arrest secondary to drowning and is resuscitated and survives greater than 24 hours. If they are pronounced dead within 24 hours of the initial injury than it is a drowning, if they are pronounced past 24 hours than it is a near drowning. Doesn’t make sense I know, but this is what the experts say. ~Primary drowning – Somebody who experiences an event in a body of liquid and dies within 24 hours, whether it be dry or wet drowning. ~Secondary drowning – When a person survives the initial event in the water and greater than 24 hours after the incident they unexpectedly die. This is usually due to a wet near drowning, this is where the media incorrectly calls it dry drowning. ~The mammalian reflex occurs when the face is submerged in cold water less than 70*F. It is a protective mechanism to preserve body function during a dive in water, kind of an energy saving mode for the body. The colder the water the greater the effect and it has three main effects on the body.

The first is bradycardia, this means the body will slow its heart rate by up to 50%. Peripheral vasoconstriction occurs in order to restrict blood flow to the extremities and increase blood flow to vital organs, especially the brain. Then the shifting of blood to the thoracic cavity to increase intrathoracic pressure in order to decrease the chances of lung collapse during deeper dives. This reflex is automatic and allows a person to survive longer underwater than on dry land for similar times.

This also is the reason that people who have been submerged in extreme cold can survive longer than warmer waters. ~Whether it is dry or wet, near or actual, all drowning have similar consequences to the patient. Upon entering the water the patient will panic and have frantic, rapid body movement. This uses up more (Continued on page 17)

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oxygen and reduces the time people have until they go unconscious. The breathing reflex quickly begins to act on the body, this is not related to how much oxygen we have in our blood but is more related to how much carbon dioxide. While you are not breathing the body’s cells are still using oxygen and wasting it out as carbon dioxide. This results in a decrease in oxygen and increase in carbon dioxide making the body’s will to breathe stronger and stronger until you get to the ―breath hold breakpoint‖. This is where the patient can no longer hold their breath. This differs from person to person but typically occurs at the arterial pressure of carbon dioxide of 55 mmHg. Training and hyperventilation can extend this effect by flushing out carbon dioxide. Unfortunately, our patients usually do not have time to prepare to drown and flush their system of carbon dioxide. Our patient’s our usually already hypoxic from physical exercise and their carbon dioxide is relatively normal. ~This is the intro to drowning, next week will be laryngospasm and the effects on the lungs and body from drowning. Any specific questions, be sure to send them to me! ~An education is expensive but knowledge is free, please feel free to distribute this to whoever you like. ~The person that knows HOW will always have a job, the person that knows WHY will always be their boss. ~Remember to always act in your patient’s best interest, always use sound clinical judgment and always follow your protocols. ~Laryngospasm was mentioned last week as a result of drowning, let’s explore why this happens. When water enters the airways of a victim, they will try to swallow or cough it up which involuntarily allows them to inhale water into their lungs. When water enters the airways, victims experience laryngospasm.

This means that the larynx and vocal cords in the trachea constrict and seal the ―wind pipe‖. This prevents any more water from entering the lungs. Ever have your drink go down the wrong pipe? That feeling you get in your throat and temporarily not being able to breathe is a lessened response of this.

Because of laryngospasm, water enters the stomach in the initial phase of drowning and very little water enters the lungs. This is good for the lungs initially, but can interfere with air getting into the lungs later, like when we are trying to ventilate a rescued patient. Usually when the patient goes unconscious the reflex will relax and water enters the lungs, however some victims are able to maintain this seal until cardiac arrest occurs. On autopsy, water in the lungs means the patient was alive to some extent while submerged, absence of water may be a dry drowning or they died before they were submerged. ~Cardiac arrest is not the standard for determining death from drowning, it is brain death, we can fix the heart and lungs, we cannot fix the brain.

Continued lack of oxygen, possibly combined with cardiac arrest will cause deterioration of brain cells and then brain death. Not only will deficient oxygen lead to cardiac arrest, but large electrolyte disturbances, such as swallowing large quantities of salt water, can lead to cardiac dysrhythmias and then death. Again, we can fix the heart and lungs, once the brain goes (Continued on page 18)

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there is not much we can do. ~The type of liquid also plays a huge factor, is it muddy lake water or pool water? Fresh or salt? Freshwater contains less salt than blood and is easily absorbed by the bloodstream through osmosis (movement of solutes in liquid through cells). Sea water is much saltier than other liquids and through osmosis, fluid will leave the bloodstream and enter the lungs thickening the blood and making a mess of liquid in the lungs. The thicker blood requires more work from the heart and leads to cardiac arrest quicker. ~What about these people that are rescued by bystanders and go home and die in bed? This is the result of secondary drowning. Any liquid inhaled into the lungs will damage the inside surface of the lung, collapse the alveoli and cause pulmonary edema. All of these lead to a reduced ability to exchange air. Inhaled water can wash away surfactant on the interior of the lungs, this reduces their ability to expand and contract and move air in and out, this can lead to respiratory arrest. Alveoli collapse will lead to continued hypoxia resulting in cardiac arrest. Depending on what type of liquid is inhaled, the different components will interrupt with the body’s homeostasis and lead to electrolyte disturbances.

These can lead to cardiac arrest, acute renal failure or severe sepsis, all resulting in death up to 72 hours past the initial insult. ~So what in the world do we do? Symptomatic care is the name of the game. If they are not breathing, breath for them, if their heart is not pumping, make it pump. If they are not in cardiac arrest, your goal is to prevent them from going into cardiac arrest. Oxygenate, oxygenate and oxygenate. Any of our patients who have suffered a near drowning, with or without cardiac arrest have all succumbed to some amount of hypoxia. Regardless of the amount, they require at a minimum, non re-breather at 15 liters to a maximum of intubation with 100% oxygenation with careful attention to capnography to maintain an adequate pH level in the body. Be sure that the patient is clear from water when shocking them, enough said. Use caution when infusing fluids, you do not know what they have already ingested into their lungs or gut and what is circulating in their blood. Our goal is to not disrupt the body negatively anymore than we already have. Our medications and resuscitative efforts do not change just because it is a drowning.

Our efforts are focused on restoring circulatory collapse and correcting hypoxia. Make it so. ~The following was submitted by Ashley Shiraishi, paramedic with Richmond Ambulance Authority, great reminder on the implications of hyperventilation. ~This is one really important thing to point out that kills good swimmers. It usually happens when people try to see how far they can swim underwater because they hyperventilate thinking it will increase their O2 levels, but it really just lowers their CO2 levels with dangerous consequences. Shallow water blackout/drowning occurs when people hyperventilate believing it increases O2, but really it reduces their CO2 levels. People believe it extends their time underwater which it can because the 'need to breathe' reflex is reached slower, but if you push too far hypoxia 'blackout' levels are reached before hypercarbic 'breathe' levels are reached, so they blackout and can drown. Hyperventilation before breath-holding swimming is extremely (Continued on page 19)

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dangerous. I'm a very proficient swimmer, but I did this before I understood the patho behind it. I blacked out in the water and nearly died; I got really, really lucky. I would definitely recommend you touch on this next week, hopefully it can explain why good swimmers drown in shallow water and maybe save someone from doing something really stupid. There is also a really good diagram of the CO2 and O2 levels demonstrating shallow water blackout on wiki (haha terrible source I know!). ~Who of us can say we didn’t do that when we were kids having breath holding competitions? I Know I did, that probably explains the memory lapses and involuntary drooling……… ~An education is expensive but knowledge is free, please feel free to distribute this to whomever you want. If you wish to receive these emails directly, email your name and address and I will add you to the mailing list. ~The person that knows HOW will always have a job, the person that knows WHY will always be their boss. ~Remember to always act in your patient’s best interest, always use sound clinical judgment and always follow your protocols. *This is supplemental educational material that is researched and distributed by Brian Talty. I attempt to ensure accuracy but there may be some instances of incorrect facts or material or grammatical errors that mislead the reader. These are written from experience, EMS books in my library and research done on the internet. These are meant to bring out things that you have forgotten in the back of your brain and to encourage critical thinking. The base of the subject is given here but the core must be researched on your own and application is pursuant to your agency protocol. These in no way replace your protocols and should never jeopardize patient care. Please remember that I try to ensure 100% accuracy but I am human and mistakes may be sent out. If there is something that does not look right, question it or research it on your own to eliminate confusion. I may be reached at 804-874-8724 or by email, btalty@raaems.org. * Lt. Brian F. Talty NREMTP, FPC Assistant Operations Supervisor Richmond Ambulance Authority The information transmitted is intended solely for the individual or entity to which it is addressed and may contain confidential and/or privileged material. Any review, retransmission or other use of, or taking action in reliance upon, this information by persons or entities other that the intended recipient is prohibited. If you have received this email in error please contact the sender and delete or destroy the material and any attachments.

Thank you Brian for sharing your wisdom and research!

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In Honor Of Our Departed Members Virginia M. Adams - Henrico VRS Auxiliary James E. Arnold - Goshen FAC John S. Bell - Westvaco RS John Gose Bogg - Bristol LSC John H. Brandt - Lake of the Woods VRS James R. Carroll Jr. - Staunton-Augusta FA & RS James P. Catron Jr. - Saltville RS Rawleigh G. Clary - Brunswick VRS Tracy D. Crabtree - Washington Co LSC Clarence Deaner - Campbell Co VRS William Dickson - White Oak VRS Bernard H. Ferron - Cool Branch VRS Floyd Foster, III - Staunton-Augusta FA & RS William G. ―Sonny‖ Frank - Colonial Beach VRS Auxiliary Herbert Leroy Gardner - Stafford VRS Mary Anna C. Greene - Manchester VRS Sidney A. Hall - Franklin Co RS Elworth Johnson - Franklin Co RS Mary Lou Lail - Colonial Beach VRS Auxiliary David V. Lawless - Fieldale-Collinsville VRS William G. ―Bill‖ Laws - Davis Corner VFD & RS Carolyn H. Layne - Holly Grove VRS Carol Jean ―Jeannie‖ Lindsay - Westvaco RS Clyde E. May Sr. - Prince George EC Earl W. Newman - Bassett RS Alex R. O’Bryhim - Fredericksburg VRS James V. Pelter - Buena Vista RS Jameson G. ―Jamie‖ Powell - Henrico VRS Sonny Ragland - Amherst LS & FAC William A. Ragland - Nottoway Co ES Helen S. Reece - Clifton Forge RS Thomas ―Kyle‖ Southern - Waynesboro FAC Franklin D. Taylor Sr. - Rescue 945 Opal Long Taylor - Clifton Forge RS Charlsie Thompson - Glade Spring LS Malvin L. Wells - Elliston VFD Edwitt Witt - Bent Mountain FAC & RS Bobbie Lee Wood - Westvaco RS V I R G I N I A

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These thirty-eight providers and support personnel are no longer with us and are remembered for their service and dedication to our communities and to the delivery of quality patient care in the Commonwealth of Virginia.

The 2012 VAVRS Memorial Service will memorialize these VAVRS members whose death occurred between September 1, 2011 and September 1st, 2012. If your agency has additional members that should be recognized please submit the member’s information and photo along with a scan of your agency patch to the VAVRS Chaplain Gary Dalton by mail to P O Box 522, Woodstock, VA or by email to gdalton@vavrs.com. For assistance with any issues you have you can also call 540-481-0125.

VAVRS Chaplain Submitted by Gary Dalton, VAVRS Chaplain I don’t normally take the time to explore videos in YouTube but recently, at a business meeting, two were shared with me and I would like to share both with you. One, is a depiction of my kind of ―humor‖ and though it starts by showing an example of ―WOW!‖ customer service it ends in such a humorous way it would make any viewer smile. The other is touching and drives home the point that our words make such a difference.

Link: http://www.youtube.com/watch?v=sWn_6kxxBI4 Link: http://www.youtube.com/watch_popup?v=Hzgzim5m7oU&vq=medium or go to www.vavrs.com and click on our News Page for links to these two videos.

The second video reminds us all that the ―Power of Our Words‖ refers to the most powerful thing that man possesses, that he may use to influence others, either for good or for evil….WORDS! In the Gospel According to Mark (Mark 4:35-50) the writer tells a story that during the trip across the Sea of Galilee, a large storm comes up - so large that the boat threatens to sink. Jesus was asleep and the disciples woke him asking if he cared that they were about to drown. Jesus spoke three simple words, ―Peace, Be Still‖ The wind died down and it was completely calm. In our lives we can choose three little words that have powerful influence over the listener. I Love You, You Are Important, Your Life Matters, I Need Help, You Are Wonderful, Life is Great, I Missed You, Love You More, Can I Help, I Was Wrong, I Am Sorry, Please Forgive Me, I Am Thankful, and many more!

I just watched the ―live‖ stream of the 20th Annual National EMS Memorial Service. I was deeply touched by the words of the keynote speaker. He was a remarkable speaker and captured many feelings that I have heard from fellow EMS providers regarding out profession. He also gave us three words to ponder, ―Doors to Open1‖ In our lives we have many doors that open for us and shut in our face. I should mention that leadership courses have consistently taught me that one of the first skills of a conversation is the art of listening. There is a major difference between hearing and listening. We hear music, an action in which we may miss some lyrics or some part of the music, but we hear what is important to us and what we should pay attention to. During a conversation we one should remind ourselves to hear, understand and keep in mind what the speaker is really saying. A true art that I have only begun to understand.

Ephesians 4:29—Let no corrupting talk come out of your mouths, but only such as is good for building up, as fits the occasion, that it may give grace to those who hear.

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VAVRS District 10 Received Award for Annual Fall Rescue Camp for Kids Submitted by Steve Dove, VAVRS Treasurer On June 5, 2012 VAVRS District 10 was awarded the Outstanding Contribution to EMS for Children at the Rappahannock EMS Council’s Regional Awards Banquet. Without the hard work and dedication of those that help with coordinating and organizing for this event it would not be possible. I would like to thank those that have helped with the past camps and those planning to assist in the future. Because of the public safety agencies and business that generous financial support the camp, the adult chaperone’s and

mentors, the activity and seminar presenters and most of all the kids that participate, District 10 would not be able to do it alone. I appreciate all that everyone has done to make this such a successful event and am thrilled that you help share this prestigious award given to VAVRS District 10.

When I was elected at District 10 Vice President in 2009 I set out on a goal to look at the future providers of public safety. Realizing without grooming someone to take my place in the EMS field, the system in general would continue to lack recruiting volunteers. It was my opinion then and still is that enough focus was not being emphasized on the younger population to generate interest in the public safety field. We all know that every kids wants to grow up to be a fire fighter or police office, but seldom is anything geared towards that interest for them accept what they seen on a television screen. I set out to change that belief in the Fredericksburg region.

Incorporating the help of Debbie Rice and Denise Weaver, I set out on a mission to develop the first Fall Rescue Camp for Kids to be held on October 2, 2010. My goal was to offer an opportunity for kids to have hands-on experience and take part in educational events that would stick with them and not only generate interest for the future but help prepare them for everyday emergencies they may come across. I maintain a (Continued on page 23)

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goal that despite the downturn in the economy I wanted kids to be able to attend this camp at no cost and not restrict it to only kids that may be affiliated with a public safety agency. Finally as the day approached for the first camp to kickoff we finalized logistics and prepared for the kids to learn Friends and Family CPR, basic first aid skills, proper use of a fire extinguisher and actually having handson practice extinguishing a small fire, practicing basic ropes techniques by demonstrating knots in a classroom setting, and informative overview of a heavy rescue squad with an introduction to the extrication tools, and a meet and greet with a search K-9.

At the conclusion of the Fall Rescue Camp for Kids it was a reality that the kids thoroughly enjoyed the events we had them participate in and there was a demand to continue the camp on an annual basis. In the spring of 2011 Debbie and I met again to begin the planning phases of our second Fall Rescue Camp for Kids. I was thrilled to know that everyone was talking about the camp and the kids continued to ask when the next camp would be.

Debbie and I decided to expand the Fall Rescue Camp for Kids in 2011 and allow children 8 – 18 years of age to participate. We again maintained our goal that we wanted the camp to be solely supported by sponsorships from public safety agencies and possibly local businesses.

To our surprise the generous financial support of these organizations and businesses helped us expand the camp and provide a superior experience for the kids. We also began to identify that we needed a facility large enough to hold up to fifty kids and also functional enough to be able to do different events whether indoors or out. The Fredericksburg EXPO center graciously stepped up and offered their facility which (Continued on page 24)

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would more than adequately meet our needs.

Debbie and I decided that we would not repeat any of the events from the previous year so the kids could have a whole new experience if they attend the camp again. However, during the planning phases and at the request of the kids we have decided to make CPR training an annual activity at the camp. The 2nd Annual Fall Rescue Camp for Kids met some challenges in determining activities that the younger groups could do that would not seem to simplistic to

the older teenagers. When the doors opened for the 2nd Annual Fall Rescue Camp for Kids we would offer an introduction to 911, Friends and Family CPR, back boarding and immobilization for the older kids while the younger one would practicing splinting and bandaging, we conducted ambulance tours and practiced removing the stretcher, the older kids were able to practicing their firefighting skills using a fire hose to extinguish a simulated fire in the woods, the younger folks practiced their skills evacuate a structure where smoke was filling the rooms while learning about the importance of smoke detectors and escape plans. The PHI Air Medical crew from Fredericksburg flew in and gave a brief overview of the helicopter and the kids had an opportunity to sit in and pretend to be part of the crew. Finally a brief (Continued on page 25)

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lecture was offered in seat belt use and then the older kids were able to practice their driving skills on ATV’s and golf carts through a traffic cone course, while the younger kids set in the passenger seat of the ambulance pretending to respond with lights and sirens to an emergency call.

At the end of the 2nd Annual Fall Rescue Camp for Kids we realized the growth this camp had accomplished in just one year. The input the kids and participants had has helped in pre-planning for future camps. We continue to set out to host a Fall Rescue Camp for Kids at no cost to them. We are so proud to have financial contributors that support the camp which helps pay for lunch and camp t-shirts.

The kids have become so excited about their annual t-shirts that they are given input in the next years color. We also conduct a brief graduation ceremony for the graduates of the Fall Rescue Camp for Kids and the participants each receive a certificate of completion and a medal to proudly display. Each year local businesses, public safety agencies and health organizations have come together to provide items to put in a goody bag that we provide the kids at the end of the camp.

The 3rd Annual Fall Rescue Camp for Kids is currently in the planning stages. The camp will be held on Saturday, October 13, 2012 at the Fredericksburg EXPO Center. This year’s camp is open to 8 – 18 year olds and is free of charge. Kids do not have to be affiliated with a public safety agency to take part in the camp, but must register to attend. We have created a website this year for the camp and the forms associated with it – www.vavrsdistrict10.com. Space is limited in the camp so kids should register early. There is also information about sponsoring the camp if your agency would like to make a generous financial donation to the camp, contributions over $100 includes you agency or business logo on the camp t-shirts. Anyone interested in assisting the day of the camp as a counselor can also find information on our website.

We are in the initial phases of planning, but we do believe this year’s will include activities such as repelling, Friends and Family CPR, and wilderness survival and search and rescue. Those are just some of the exciting events planned.

It has truly been an honor to watch this camp grow each year and see the excitement in the kid’s eyes while they participate in the events. I do have to thank Barbara Branham and Debbie Rice for all their help the last two years in (Continued on page 26)

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planning and administrative work that makes the camp function. I appreciate all the support from VAVRS District 10 for standing behind me in making this camp an annual event.

Recently I held a conversation with the father of one of the rescue camp participants from the first Fall Rescue Camp for Kids. He informed me that his daughter attended the camp and left for college not long after. Her experience in the camp has driven her to change her career path to the medical field.

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AVAVRS Committee Chairs

President - Fern Puckett

Convention - Janis Slough

Vice President - Sharon Campbell

Convention Co-Chair - Vickie Arnold

Secretary - Dolores Hudson

Life Membership - Ruth Swicegood

Treasurer - Kitty Campbell

Nominating - Carolyn Brand

Chaplain - Clara Craig

Resolutions - Harry Householder

Historian - Heather S. Fox

Emergency Care - Ailease Short

Parliamentarian - Harry Householder

Membership - Sharon K. Campbell

Immediate Past President - Joan Smoot

Finance - Kitty Campbell

Midwestern VP - Sheila Gordon

Roll Call - Jean Garrett

Northeastern VP - Eddie Ann Orndoff

Roll Call Co-Chair - Valarie Becker

Southcentral VP - Patsy Wingfield

Recruitment & Retention - Marie Householder

Southeastern VP - Gary Frame

Fund Raising - Linda Berkstresser

Southwestern VP - Jean Garrett Western VP - Curtis Preston

From the AVAVRS Convention Chair Submitted by Janis Slough Hello from The AVAVRS Convention Chair.....

It's finally summer and time to start making your plans for the 2012 VAVRS Convention. Don't forget to meet your deadlines f or the reports, register, and make room reservations. Have a great summer and we look forward to seeing you in September at Va. Beach. Let us know if we can help you in any way.

From the AVAVRS Secretary Submitted by Dolores F. Hudson Summer is here and it is time to think about convention. I have travelled to different districts throughout the state and it was a pleasure seeing each of you.

I need the auxiliaries to let me know when they change officers and please send me all their information.

My deadline for your auxiliary reports that go into the Auxiliary Booklet is July 28. Please send me your report as soon as possible so that I can type them and send them to be printed.

I have enjoyed working with all of you as Fern’s secretary. I’m looking forward to seeing all of you soon.

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Auxiliary to Lexington Fire and Rescue Submitted Janis Slough, Treasurer ALFRD The Lexington Fire and Rescue Aux. has been busy.

We continue to serve meals to The Lexington Kiwanis Club on Tuesday nights, The Rockbridge Realtors quarterly, and participate in Western District and state activities. We helped to feed our local firemen and those from around the state of Va. recently during the Rich Hole fire by making a large food donation. During EMS week, we held an event honoring our fire and rescue, deputies, police officers, and all those that contribute to EMS. We offered blood pressure checks, free food, had law enforcement and our department on hand to give out literature to our area children. Lexington Fire and Rescue was involved in training that day and we provided lunch for them also. We are currently selling raffle tickets for the AVAVRS. Four of our six members are district/state officers, so we are busy now with rescue college, district meeting in June, and convention. Hope to see our friends from around the state in September at Va. Beach.

From AVAVRS Vice President Submitted Sharon Campbell, AVAVS Vice President At each District meeting I attend, I try to stress that you all are my eyes and ears. The AVAVRS needs new members and you are the ones out on the front lines. The knowledge that can be gained by working together and sharing ideas is so important to us all. Please check around your district and see if a local rescue squad has an auxiliary or support group interested in joining our association or if they are interested in having a group to support their needs. I am always up for a road trip.

We did lose an auxiliary this year but they re-grouped and are going strong. Welcome Colonial Beach Support Group! I have also sent information to several other groups and hopefully we will hear something by the time we all meet in Virginia Beach.

As I travel around the state, I am always amazed at all of the hard work and dedication you provide to your squads. The time spent and the money earned is an inspiration to us all. I am proud of you and your accomplishments.

Please don't forget the July 28th deadline for entering the "Auxiliary of the Year Award". What a wonderful way to have the members of your auxiliary recognized for all of their hard work. If you have any questions on this application, please email me or give me a call.

I wish you a safe summer and please know that I am only a phone call away.

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“Busy Spring� Cave Spring RS Auxiliary Submitted by Sharon Karlet Campbell, Cave Spring RS Auxiliary The members of the Cave Spring Rescue Squad Auxiliary certainly did not take a Spring Break this year. We were selling Easter Eggs up until the last minute and I can proudly we say were a huge success. Everyone pitched in with the decorating, boxing, packaging and selling of the 850 plus eggs and even with the increased cost of our supplies, we realized a very nice profit. People would buy some eggs, taste them and come back for more. This year our flavors were: Peanut Butter Cream, Butter Cream, Coconut Cream, Chocolate Cream, Strawberry Cream and Raspberry Cream, YUMMY. The Egg project wrapped up and then it was time to start planning for our Annual Spring Yard Sale.

This was held on April 28th at the crew hall. We were lucky because everyone seemed to be cleaning out closets and drawers and their donations were much appreciated. We never make a killing but we always make money and our customers leave with a bargain. The items left from our sale were donated to the Bent Mountain Fire Department as they planned a yard sale for June 2nd to raise money for their chief who is battling cancer. We also donated bake sale items to them to show our love and support of Tim. The next week (May 5th) was the date of our Annual Spring Chicken Barbecue. Doing this project twice a year is a huge undertaking and our biggest money making project. People can preorder their tickets by calling a voice mail number and we hold their tickets until 6:00 the day of the barbecue. This year the response was overwhelming and we had completely sold out by 2:00 and we don't even start serving until 4:00. Our supplier had shorted us 79 chicken halves so that certainly cut into the profit and again, the price of supplies had increased slightly.

Even with those problems, we realized a profit of over $4,200.00. We have been trying to keep our prices the same with any of our projects due to the bad economy and I think it has paid off. We did have increased advertisement thanks to the hard work of our youngest member, Katie Arnold.

Emma Duff brushes barbecue sauce on the chicken halves as Crew May 22nd, found us at the crew Life Members, Brian Hughes and Dave Podruchney get ready to hall cooking for the EMS Bikers (Continued on page 33) turn one of the racks, May 5, 2012 V I R G I N I A

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who were coming through Roanoke on their way from Kentucky to DC. In DC they will meet up with the group of bikers coming from Boston. The men and women are so appreciative and we enjoy meeting them and hearing about their adventures. This year there were 7 bikers and 4 support members. The duty team got to enjoy the meal also between answering rescue calls. Brian and his group go a long way in honoring the Fallen EMS workers and they are welcome at any time.

Our next project is fixing lunch for 80 All-Star football players and their coaches. These boys come from Wytheville to Central Virginia and from Harrisonburg to Danville. They will spend part of the week at Ferrum College and then arrive in Roanoke on Friday morning, June 22nd, in preparation for their game that night. I anticipate that these boys will be hard to fill up but we are certainly up to the challenge. Another group fed them last year and they arrived at the start of their game still hungry, I assure you they will not have that problem when they leave our building.

Our best to each of you for a safe and fun summer and before you know it we will be at Virginia Beach for convention .

―Thank you all for everything you do in your organizations, for your communities and for the VAVRS, VAJVRS and AVAVRS. You are heroes to us all and irreplaceable to your immediate families, so please be SAFE out there!‖ Kathy Eubank, VAVRS Training Coordinator

Officers President Christina Stanley Vice President Cora Fearnow Secretary/Treasurer April Harris Chaplain Dylan Coalson Historian Stephen Martone District 2 V. P. Jennifer Winston District 3 V. P. Cora Fearnow District 9 V. P. Christina Stanley Advisor, Chair Katherine Eubank Advisor Woody T. Connor Advisor Micky Grodski Advisor Alfred Smith Advisor Kim Craig Advisor Brandon V I R G I N I A

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Here are your humorous captions to this photo of Dolores Hudson and Ruth Swicegood: Submitted by a 22 year old Rescue Ranger Fan: Dolores says, ―I wonder if Ruth knows I a secretly Wonder Woman?‖ Submitted by KC, Northwestern AVAVRS member: Ruth is thinking, ―I love you, red solo cup, Let’s have a party.‖ Submitted by HH, Northwestern AVAVRS member: ―Ruth is thinking, ―Where in the heck is Jack, I have no idea how to get home from Woodstock!‖ Submitted by a 61 year old Rescue Ranger: Dolores is saying to herself, ―Almost finished knitting this this sweater for Ruth.‖ THE WINNER: Submitted by June Ann Wilkes, -Taken from the movie Thelma & Louise; Delores has just finished reading a note from Ruth. It reads "Jack has the van gassed up & running, the passenger side front & sliding doors are open, I'll cause a distraction & you make a run for it., we can be outta this meeting before they realize were gone!!!!!"

In each of the 2012 issues VIRGINIA LIFELINE we have been having a photo caption contest. This is our last submission and we are soliciting your humorous captions to this photo. You are asked to forward your captions to this photo of VAVRS Training Officer Scott Davis (far left) and participants in the Tactical Medic Course at the 2012 VAVRS Rescue College. All entries will be (after censoring) printed. Send your captions by email to gdalton@vavrs.com

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Our thanks to SSV/Southeastern Specialty Vehicles and Super Shoes—vendors displaying during the 2012 VAVRS Rescue College in Blacksburg Visit—www.SuperShoesToGo.com and www.ssvsales.com to support these VAVRS friendly businesses.

Congratulations to Layne Lusk, Bassett Winner of a flat screen TV as a result of a drawing during the 2012 VAVRS Rescue College V I R G I N I A

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Dear Rescue Ranger, I need some quotes to use during EVOC classes that will be something that my students will remember for a long time. Any suggestions?

Doug Dear Eberhardt, I like this one, ―It takes 8,460 bolts to assemble an automobile, and one nut to scatter it all over the road.‖ On a serious note, use ―Leave sooner, drive slower, live longer.‖ On a not so serious note you can try these, ―Any man who can drive safely while kissing a pretty girl is simply not giving the kiss the attention it deserves‖ and ―A tree never hits an automobile except in self defense.― Dear Rescue Ranger, I know you don’t like electronic gadgets but really, don’t you have a GPS in your ambulance?

Ronnie Dear Mr. Slough, I made sure our squad placed GPS units in all of our ambulances. I don’t use them because I know our first due area like the back of my hand and….recently I got the GPS lady so confused, she said, "In one-quarter mile, make a legal stop and ask directions.

Dear Rescue Ranger, I am getting ready to buy a used car and I found three that I like a lot. One is a Chevrolet, one is a Dodge and the third is a Ford. Any help you can give me would be appreciated.

Scott Dear Mr. Davis, The only rule I have when buying a used car is to punch the buttons on the radio. If all the stations are rock and roll, there's a good chance the transmission is shot.

Dear Rescue Ranger, Heard you demolished a police car many years ago.

How did that happen?

Karen Dear Mrs. Wagner, Well it is not a story I am proud of and the story proves that when someone calls you a name it isn’t always a bad thing. I was a deputy sheriff for V I R G I N I A

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several years and one day I was driving down a narrow road when I met a car coming the other way. Although there was room to pass easily, the car forced me to slow down, rolled down their window as I passed and shouted, ―Pig!‖ I was enraged, I looked into my rear view mirror to get his license number and hit a hog that was standing in the middle of the road.

Dear Rescue Ranger, My wife was driving me to the squad last week when she inadvertently made an illegal turn at some traffic lights. Realizing her mistake, she said: "Oops, I just made an illegal turn." I said, "It's OK Honey, the police car behind us did the same thing." I bet you can’t beat that story!

Eli Dear Proud, Believe I can, I arrived home from the squad last week and my wife was waiting for me. She sat me down and told me she had good news and bad news about the car. I said, ―What is the good news?‖ She said, ―The air bag works.‖ Dear Rescue Ranger, Do you have the height of all of your ambulances displayed somewhere on the dashboard? I heard that it is a very good idea.

Joe Dear Mr. Wright, Yes we do and it is a good idea. In fact a new nursing facility was built in our area and one of your hot-shot drivers drove under the entrance and got the ambulance stuck under the awning. I remember it being investigated by our local police.

The cop gets out of his car and walks around to the ambulance driver, puts his hands on his hips and says, "Got stuck huh?" Our driver said, "No, I was delivering this nursing home and ran out of gas."

PO Box 279 2535 Turkey Creek Road Oilville, VA 23129 ISSN 0279-6023

NON-PROFIT ORGAN..

U.S.POSTAGE PAID WOODSTOCK, VA PERMIT NO. 82

Virginia Association of Volunteer Rescue Squads, Inc.

Phone: 804-749-8191 Phone: 800-833-0602 Fax: 804-749-8910 E-mail: vavrs@vavrs.com

"Greater Love Hath No Man Than This, That A Man Lay down His Life For His Friends."

- St. John 15:13

2012 VAVRS RESCUE COLLEGE PHOTOS