TransCare is a proud sponsor of the Silt Party at the Pavilion Summer Concert Series, which for the first time ever, included an amazing fireworks show right over the top of Stoney Ridge Pavilion. Swerve and Dreamboat Annie opened for Under a Blood Red Sky who performed U2 covers and provided the music during the fireworks.
In August, TransCare began providing transportation for patients who had special needs (such as a wheel chair) but did not require an ambulance. Initially, the service was only available within Garfield County. Due to the community response, TransCare has begun a similar service in the Montrose Division. It began service February 13, 2015. A link to the online article can be found below.
Ebola has been very much in the news recently. With so much attention on this particular disease, there is the potential for a lot of incorrect information being distributed and for confusion among EMS providers as to how to treat patients with Ebola symptoms while keeping themselves safe. To help with this confusion, the CDC has released an information sheet for EMS agencies. A copy of the release can be downloaded using the link below.
TransCare recently participated in a drill to simulate an active shooter and mass casualty incident at Rifle High School. Several Garfield County emergency agencies participated in this drill as well as both local hospitals, the local school district and many student volunteers. The drill was highlighted on KKCO News and a link to their coverage is provided below.
Like many other ares in the United States, Colorado is now being effected by a respiratory disease called Non-Polio Enterovirus D 86 (EV68). This year's version seems to be hitting kids with reactive airway diseases like asthma particularly hard. The Children's Hospital of Colorado recently sent the following email to all EMS agencies in Colorado.
Dear EMS Community,
We've received several recent requests for guidance on how EMS crews can best manage the growing number of kids infected with EV68 (Enterovirus 68). The following are some suggestions and advice based on our clinical experience with these children and advice from our Critical Care, Emergency and Infectious Disease physicians. As with all EMS care, please work with your local medical directors to develop local protocols that are within your scope of practice. Our advice is not meant to be a substitute for local medical control or to replace sound independent clinical judgment.
The majority of severe respiratory infections we're seeing at Children's are testing positive for EV68. See attached "Bug Watch". While not a new infection, we are certainly seeing more severe, high acuity patients compared to years past. In particular, patients with reactive airway disease and asthma seem to be hit the hardest. In some cases, these patients are not responding well to traditional therapies, such as Albuterol or Duo Nebs (albuterol and ipratropium) alone. Children without a prior history of asthma are also presenting with wheezing.
While much of the increased volume you may be seeing is likely from EV68, there is no way to distinguish this particular virus from other respiratory viruses in the field. In general, for any patient in moderate to severe respiratory distress with asthma or wheezing, we recommend early and aggressive management. Early experience with EV68 suggests that children with this virus should be managed in the same way. The following suggestions may closely match many existing agencies asthma protocols. This includes, but may not be limited to: back-to-back or continuous nebulizer treatments with Duo Nebs and/or Albuterol, early administration of steroids such as IV/IM methylprednisolone (2-4mg/kg), fluid resuscitation with 20ml/kg normal saline bolus (repeated as necessary), SC terbutaline (0.01mg/kg max .5mg), magnesium (25-50mg/kg max 2g over 30 minutes) and consideration of racemic epinephrine. IM epinephrine (0.01ml/kg of 1:1000, max .5ml) may also be indicated for patients in extremis who are unresponsive to the above. Some patients have required placement of an advanced airway; however, this is rare and should be reserved for severe cases in which all other means of treatment have been exhausted.
As with all infectious patients, particular attention should be paid to using good PPE, including gloves, masks, and the thorough disinfection of the ambulance and equipment after calls. As should always be a priority, please also remember the importance of frequently washing your hands before and after all patient encounters to help reduce spread of the virus.
We recommend the following resources should further questions arise: (CDC website, Children’s website) http://www.cdc.gov/non-polio-enterovirus/ or http://childrenscolorado.org
Joe Darmofal, EMT-P
Director, Transport & EMS Outreach and Education | Children's Hospital Colorado
TransCare Ambulette begins service on Monday, August 18, 2014. This service will provide transportation for people confined to wheelchairs or otherwise requiring special consideration but not needing an ambulance. This service is beginning in Garfield County but will be available across Western Colorado.
The Montrose Division recently provided medical standby for the local Relay For Life. The Relay for Life is an event supporting the American Cancer Society. All funds raised go to the American Cancer Society to help in their efforts to find a cure for this disease. TransCare Ambulance is proud to support such a fine charity.
We were recently invited to participate in the 2nd Annual Glenwood Cruise-A-Thong benefiting river education in Garfield County. Participants were encouraged to dress up in costume for the event that included a 5 mile bike ride, a 1.5 mile walk in flip flops and a 1.5 mile float down the Roaring Fork river on whatever floating device a person could scrounge up. Participants were also lectured on the benefits of being average. People who completed the bike leg too quickly were held out in a "Penalty Box" while the more average competitors caught up. The event was enjoyed by all of the participants and volunteers and we look forward to participating again next year.
Below is a slide show with pictures from the event.