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February 2018

AN AUSTIN-TRAVIS COUNTY EMS PUBLICATION

Meet the New EMS HR Team

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Contents

February 2018

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ANNUAL EXPLORING AND RECOGNITION EVENT

Every year a Friends of Exploring breakfast is hosted by

the Capital Area Council to generate donations that

will help fund Explorer Posts in the area. This year

Lieutenant Commander Hannah Sanchez from EMS

Explorer Post 247 was invited to deliver her essay as a

speech at the benefit.

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ATCEMS RECEIVES A PET OXYGEN MASK DONATION

FROM INVISIBLE FENCE

On National “Love Your Pet Day” Invisible Fence Brand

of Austin donated 42 pet oxygen mask kits to Austin-

Travis County EMS. Invisible Fence and ATCEMS have

teamed up to help reduce the number of pets killed or

injured in house fires each year.

Featured

News

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ANNUAL AWARDS CEREMONY

The Annual Austin – Travis County EMS Awards

Ceremony is quickly approaching! ATCEMS will once

again encourages every employee to vote and let

your voices be heard of those who have gone above

and beyond. Recognize the accomplishments,

achievements and outstanding performance of our

employees in 2017.

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CLINICAL PERFORMANCE MANAGEMENT TEAM

Our mission is to support our field providers and

provide clinical oversight and surveillance for our

system, which exists to provide high quality clinical

care to our community. Our vision is to improve our

clinical practice through relationships and thoughtful

analysis of data.

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FLEET SERVICES

Greetings from Fleet! We have learned recently that

we are having some delays in our maintenance

requests getting to us and our partners at EMSG.

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HR TEAM ASSIGNMENTS/AREAS OF RESPONSIBILITIES

2018

Meet the new HR Team! As a strategic business

partner, the Human Resources team provides

leadership and support to successfully meet the goals

and initiatives within the departments Strategic Plan.

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YOUR PHOTOS

Catch a glimpse of your coworkers in action.

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EMPLOYEE RECOGNITION

ATCEMS employees receive kudos, special thanks and

congratulations for a job well done.

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CUSTOMER SERVICE SURVEY

Results from the ATCEMS Customer Callback Program.

In Every Issue Division News

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Reminder: Austin-Travis County has an EMS Brazilian Jiu Jitsu club! That's right! the department supports us with funding for mats etc, we meet once a week downtown at our own Medic 17. For those of you who are new, medic 17 is the station right next to Deep Eddy on Foster Ave, it houses some rescue medics (fine fellows I might add) and is conveniently located right next to a pool! One that is free for city employees to boot!

Jiu Jitsu is a great workout, an extremely effective fighting style, the most sought after martial art on the planet. It is used by law enforce-ment and military, as well as mixed martial art-ists and medics just like you! No experience required, the uniform is board shorts and t shirt or rash guard. This club is open to all city first responders and Dr. Pickett, our own Deputy Medical Director, is a frequent attendee which is nice because he holds a black belt in Judo and is always willing to show us some sweet throws.

So, if you like walking around with the confidence that you can handle any situation thrust upon you, come on down and train with us!

March Dates:

3/2 (Friday C shift)

3/7 (Wednesday D Shift)

3/15 (Thursday D shift)

3/23 (Friday D shift)

3/26 (Monday C Shift)

Don't hesitate to contact me directly with any questions

Warmest Regards,

Will Adams, Medic II / RESQ

AUSTIN TRAVIS

COUNTY EMS

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2017 Austin-Travis County EMS Awards Ceremony

The Annual Austin – Travis County EMS Awards Ceremony is quickly approach-ing! ATCEMS will once again encourages every employee to vote and let your voices be heard of those who have gone above and beyond. Recognize the accomplishments, achievements and outstanding performance of our employees in 2017. The 2017 Awards Ceremony will be here before you know it. We ask that you please take a moment to consider any memorable accomplishments or situations that you think deserves consideration for formal recognition. We need you, all of you Civil and Non-Civil employees to make this possible by submitting nominations. Individuals cannot be recognized without your input, so please take a moment and nominate someone deserving today.

DON’T DELAY NOMINATE TODAY

You can either email nominations to Milissa Warren or use the Employee Recognition Form on the departmental website at: http://coacf10i.austintexas.gov/ems/EmpRecognition/Recognition_Form.cfm Go to the “At Work Resources” box, in the lower left corner of the page to find the recognition link which is called Employee Recognition

DEADLINE TO NOMINATE: March 22nd

On the following page you will find the title of each award and the description to assist you in finding the

correct award for your nomination.

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Administrative Leadership Award - Awarded to recognize superior performance or special efforts significantly beyond regular duty requirements and directly related to fulfilling the EMS mission. The submissions for this award may be individual or group nominations. This award may not be awarded every year. Recipients may receive this award only when their actions and performance surpass expectations under extraordinary situations.

Cadet Leadership Award - Awarded to the cadet who displays exemplary leadership qualities throughout the Academy

Civic Recognition Award - Awarded for recognition from an elected or appointed official for contributions to the City of Austin, Travis County, the State of Texas, the United States or the community at large.

Clinical Excellence Award - Awarded by joint agreement Medical Director and Department for ongoing, exceptional delivery of or contributions to the advancement of the practice of medicine within the Austin-Travis County EMS System.

Distinguished Service Award - Awarded to employees who consistently, over time, demonstrate and deliver exceptional service to the community or Department that in turn reflects positively on the employee and the department.

Humanitarian Citation - Awarded for an event or action of a humanitarian nature that reflects positively upon the individual and the Department. This may affect a small group of people, family or individual.

Individual Citation - Granted for individual achievement in such areas as innovation, efficiency, effective-ness, individual projects, and personal contributions to the department or other appropriate organizations or groups. The three classifications are operations, clinical and administrative.

Life Saving Citation - Awarded for exceptional efforts taken by department employees that directly result in saving a life and/or keeping the patient from having a detrimental outcome. The patient would not have survived their illness or injury without the actions of ATCEMS personnel nominated.

MCI/Disaster Mitigation Citation - In recognition of an employees' direct contribution(s) in responding to and resolving a mass casualty situation or disaster

Meritorious Service Award - Awarded for an event or action of particularly meritorious service to the Department which reflects positively upon the individual and the Department.

Medical Director Award - Awarded by the Medical Director to an individual that is committed to and exemplifies the art & science of an exemplary practice of field medicine.

Michael Becker Humanitarian Award - Given to recognize the selfless acts of employees who volunteer to make our community a better place to live.

Outstanding Unit Award - Awarded to organizational units which have distinguished themselves by exceptionally meritorious service or outstanding achievement that clearly sets the unit above and apart from similar units.

Purple Heart Award - Awarded for suffering serious bodily injury or death in the line of duty under honor-able circumstances, which brought favorable recognition to the individual and the department.

Randy Trinkle Perseverance Award - Awarded to individuals who are dedicated, committed employees who selflessly and graciously meets the needs of others with honor, dignity, compassion and professional-ism while maintaining high standards.

Shining Star Award - The criteria used to evaluate the nomination(s) are based on our City’s PRIDE values of Public Service & Engagement, Responsibility & Accountability, Innovation & Sustainability, Diversity & Inclusion and Ethics & Integrity. The nominations received should include two (2) or more of the PRIDE values.

Stork Citation - In recognition of a provider assisted child birth in the pre-hospital setting

Unit Citation - Awarded for unit achievement in such areas as innovation, efficiency, effectiveness, projects, and unit contributions to the department or other appropriate organizations or groups.

Xavier Mokarzel Valor Award - Awarded to personnel who, above and beyond the call of duty, have acted in a manner demonstrating great heroism which clearly places them at undeniable risk for loss of life while bringing honor to the organization.

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FLEET SERVICES

Greetings from your fleet section!

Things are going well overall and we are almost

through the winter!

We have learned recently that we are having

some delays in our maintenance requests getting

to us and our partners at EMSG. A little detective

work revealed that a few of our folks believed

that entering ambulance maintenance issues on

the station log would lead to us being notified.

Unfortunately that is not true, we need to record

these issues in the correct location.

We utilize the Fleet status &repair section on the

intranet (home page) to both initiate and follow

up on any maintenance issues that our mainte-

nance folks need to address. The only other real

option, if you are at EMSG, is to fill out a work

request on paper. With one, or even both, of

these completed we will ensure that the issue is

assessed and properly corrected as quickly as we

can.

And by the way, our site is easy to access, in fact

you can get to the site on your station computer

or your MDC!

This is also the place to go to check on routine

problems that you may have heard were report-

ed, just to make sure. Keep in mind that early

reporting on some mechanical issues can prevent

long delays, increased repair cost and additional

time away from your ambulance later. Please

help us to keep your fleet in the best condition

we can by reporting any suspected mechanical or

electrical issues with your ambulance early, and

on the intranet site.

Remember though that if you believe you have

an issue which could affect the safe operation of

your vehicle, you need to address that

immediately. Stop, report and investigate.

Utilize EMS Communications and your

Commander to properly deal with those potential

repairs, or move to another unit as quickly as is

safely possible.

Please feel free to call anytime if you have

questions about our fleet or our processes.

Thank you,

Fleet Ops

R. Rutledge, Captain

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Patrick Murphy, Commander

Marco Villasenor

Patrick Murphy

Clinical Performance Management Team

Mission and Vision

Melissa Hall

Jason Gilliam

Aaron Maxwell

Our mission is to support our field providers and provide clinical oversight and surveillance for our

system, which exists to provide high quality clinical care to our community. Our vision is to improve our

clinical practice through relationships and thoughtful analysis of data.

Assumptions that we make:

Clinical care is the cornerstone of what we do and who we are.

Trust is a key element between providers, medical direction, and performance management.

Relationships are a key element in establishing trust.

Presence is required to develop relationships.

Our mission and vision is aligned with the Department and City mission, vision, and values.

Our objectives:

Develop and hardwire a culture where clinical misadventures and near misses are accepted as part of our practice, are reported without fear, and with the understanding that the information is used to improve our clinical practice.

Become a trusted clinical resource for the department, EMS system, and other healthcare partners.

Collaborate with healthcare partners for systemic improvement opportunities

Harness the power of data and relationships to take our clinical care to the next level.

Our goals:

Have a field presence. Interaction and engagement with providers and healthcare partners is key to our success.

Focus on relationships. This forces us to interact and engage. This is how good relationships are built.

Provide evidence that our clinical practice is compassionate, efficient and impactful.

Become a role model for other healthcare systems to emulate.

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Every year a Friends of Exploring breakfast is hosted by the Capital Area Council to generate donations that will help fund Explorer Posts in the area. This year a scholarship essay competition was held in tandem that allowed Explorers to send in an entry about their experience as

an Explorer, and in telling their story have the potential to be awarded $500 to go toward their continuing education. Lieutenant Commander Hannah Sanchez from EMS Explorer Post 247 was invited to deliver her essay as a speech at the benefit. She talked about how Exploring has become a significant part of her story, and detailed experiences that have stood out to her over the course of her being in the Post. After the speech she was met with much admiration about her dedication to the Post, and was congratulated by many of the attendees. The essay follows:

“Sometimes there are things that cannot

be explained by written words. Sometimes things can only be described by moments, memories, emotion, and other sensuous things. However from these things stories are formed; and in this way Exploring has become a part of my story.”

March 25, 2017. “I attended EMS Explor-

er Post 247 academy. I wasn’t entirely sure what it was, but as someone who loves to try new things I was elated about the opportuni-ty. Unbeknownst to me, that day would capture my interest as well as my heart in the best way. During the first moments of the academy I was admittedly a bit overwhelmed and confused. I had never really thought about being a paramed-ic, or even going into the medical field. Up until that time, my only exposure to Emergency Medi-cine were TV shows. Nevertheless I forced my attention to the front, and listened as this new information was taught to us. “Pit Crew CPR” “BVM” “Joint immobilization” “triangle bandage” “triage”. Words seemed to fly around, I was just a newbie standing there with a net trying to catch and hold onto the material that they presented.

It took me a while, but by lunch I could recite to you the Post expectations and compress 100 times a minute into a manikin’s chest.

After the academy I became a regular

attendee. I would show up every week as mandated in my uniform- a Post t-shirt, and pants that came halfway up my chest with one leg bigger than the other, and really start to invest myself into learning what was being taught. As I would come to understand the concepts of the field, I realized that I wanted more. It was very shortly after my first couple meetings that I decided that I wanted a career out of my experience, and began dedicating my free time to studying whatever I could to better my knowledge of EMS. I spent the days counting down to the next meeting, and savored every minute of our allotted two hours of training. Many times during those meetings we run scenarios. Typically, the advisors set up a mock scene in which Explorers act as an EMT at the BLS level. The objective of these scenarios is to have Explorers assess, treat, and transport their patient. It is a fantastic tool when learning to become comfortable running calls. My first scenario while I don´t remember the exact com-plaint, I do remember the excitement and terror of being Medic 1 (the primary Medic) for the first time. Needless to say I botched the scenario, however it was one of the milestone learning experiences during my time as an Explorer Cadet.

Annual Exploring Breakfast and

Recognition Event

“As I would come to understand the concepts of the field, I realized that I wanted more. It was very shortly after my first couple meetings that I decid-ed that I wanted a career out of my experience, and began dedicating my free time to studying whatever I could to better my knowledge of EMS.”

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May 29th, 2017. As a member of the Post you get to experience a lot of cool things. One of these things that is arguably the coolest are ambulance ride outs with real medics, on real calls. My first ride out was in a word: une-ventful. However there has never been an expe-rience more enriching, educational, and down-right thrilling than my very first call. “Priority 4 Unknown.” Could´ve been a lot of things; psychiatric patient, injury, sick person, etc. etc. I sat in the back of the truck, consumed with excitement as I responded with my advisor and her partner to my very first patient. We get out of the truck and wait as our patient walks out to us; purse and four packs of cigarettes in hand. Grumpily she tells us that her stomach hurts, she is withdrawing from meth, and just wants to get away from her rehab coaches. We load her onto the stretcher and she proceeds to ask us, lighter in hand, if she is permitted to smoke on the ambulance. Obviously our answer was no, unless she would have liked to blow up due to the oxygen tanks. Anyway, I watched my advisor assess her. With intent I observed every one of her movements; I studied how she plugged the blood pressure cuff into the machine, I listened to her get a medical history and ask pertinent questions to the case. I was in awe of a meth addict. From there on we got a decent volume of calls, none particularly exciting but all extremely memorable. By the end of the day I was exhausted, yet fulfilled and humbled to the notion that I had just experienced many of the patients worst days, even if it didn't seem like what they called for was all that bad.

After my first ride out there were more to

follow, and there are more to come. It is due to these ride outs not only have I learned skills from an EMS standpoint, but I have learned people skills in a way I never believed possible. The level in which I show compassion has changed completely. I have been forced to see life from the inside of an ambulance, not the out-side. No longer could I just pull over and watch a truck pass without thinking of the complexity of each call. Seeing lights and sirens wasn't any longer something to point out for my siblings enjoyment, it was a life in critical condition. I

have seen the dynamic of my conversations change, I realize now that I am able to com-municate better with people because I have learned how to be on the same level as the person I am conversing with.

In conclusion being an Explorer has made

me a better, more enthusiastic person. I have made key friendships, taken on leadership roles, connected with people, and managed to have so much fun in the process. It is because of being an Explorer that I will go on to EMT school in the fall, and Paramedic school after that. The opportunities I have been given are unchangeable, and unforgettable. Every day I look forward to our next meeting, and every meeting I am never at a loss. I will never not be grateful for my Post.”

From her speech Hannah not only earned

the respect of many who were in attendance, but she gave to them an insight to life as an Explorer and all of the great things that have come from her being in the program. Subsequent to hearing her (as well as a RRPD Explorer) story, the Friends of Exploring pledged over $40,000 dollars at the breakfast- double the amount from last year. Along with this, EMS Post 247 now has the opportunity to work with RRPD’s Explorer Post, and plan to collaborate with them for future events!

A scholarship competition will be held

again next year to allow more Explorers the opportunity to earn money that will contribute to furthering their education.

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HR TEAM ASSIGNMENTS/AREAS OF RESPONSIBILITIES 2018

As a strategic business partner, the Human Resources team provides leadership and support to successfully meet the goals and initiatives within the departments Strategic Plan. Activities include however are not limited to, assuring the activities and operations of all functional HR areas are accurate and timely; administering and complying with City practice, policy, procedure, statutes, ordinances, and the Meet and Confer Agreement; improving the overall diversity of the EMS department; providing pathways for personal growth and development; and timely responsiveness to employee related questions, issues, and concerns. Our Human Resources Team is committed to engagements which support the Pillars of Excellence (People, Service, Quality and Finance) and the Departments Mission (To provide excellent patient care to anyone, any time, any place in order to decrease suffering, improve the health of the community and save lives). The following is the list of current ATCEMS Human Resources Staff, immediate reporting structure, including current work assignments and contact information. Please note that these assignments are subject to change as business needs dictate. Tina Graves – Human Resources Manager 512.972.7231 (o) 512.297.1407 (m) Tina.Graves@austintexas.gov Leads and manages the ATCEMS Human Resources (HR) Division; provides strategic direction for all human resources activities; develops and implements HR standard operation practices, policies, and procedures; provides interpretation and oversight regarding policy and civil service processes for the department; provides interpretation and oversight regarding policy and civil service processes; Provides interpretation and oversight regarding the Meet & Confer Agreement as it pertains to Wages & Benefits, Leave, Promotions, Hiring, Disciplinary Actions and Appeals; oversees Statutory Civil Service and Municipal Civil Service processes and compliance; Serves as primary HR liaison with the Office of Professional Conduct; and Confers with the Executive Team to align human resources initiatives with departmental goals and objectives. Patricia Bourenane – Business Process Consultant 512.972.7037 (o) 512.940.9989 (m) Patricia.Bourenane@austintexas.gov Streamline business processes i.e. process mapping, assist HR Manager with Succession plan-ning and sustainability planning; Standard Operating Procedure (SOP) Administration i.e. conduct annual SOP review processes, SOP Overview, Inventory and Update established SOP’s; Collaborate w/HR staff for the development of training initiatives, conduct, research, administer & analyze department training needs; Administer Civil Service Promotions for all sworn staff, Encompasses statutory Civil Service process and compliance, Meet & Confer Agreement process and compliance; Liaison for OPC Investigative Case Review; Assist w/Performance Evaluation Process for sworn staffing performance reviews. Mary Hoad – EMS Recruiting Program Manager 512.974.1096 (o) 512.554.4723 (m) Mary.hoad@austintexas.gov Manages the EMS recruiting for Medic I sworn personnel. Oversees all recruiting activity and management of full-cycle Civil Service hiring processes in accordance with Chapter 143 and Meet & Confer Agreement, providing leadership for various recruitment programs ranging from tactical recruiting, strategic initiatives, social media/marketing, and employee engagement. Direct supervision of Ashleigh O’Connor and dotted line supervision of Rance Marion.

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Ashleigh O’Connor – Recruitment Coordinator 512.974.1095 (o) Ashleigh.O’Connor@austintexas.gov Facilitates the full Civil Service Sworn hiring processes. Facilitates of Lateral Transfer processes. Develops and coordinates digital content (focus on social media and blog content) and non-digital assets for advertising and promotional campaigns and strategies. Develops partnerships with external stakeholders, with the intention of increasing awareness of ATCEMS as an employer of choice (focus on high schools, community groups, and professional associations). Represents department at community and recruiting events. Designs and maintains prospect, applicant, and external client databases. Assists in over-seeing Ambassador Medics for purpose of increasing diversity-focused recruiting efforts and presence in the community. Assists in employee engagement efforts. Rance Marion – Medic II Field 512.974.1097 (o) Rance.Marion@austintexas.gov

Manages national college EMS program database, prepare and present to EMS students a college campuses to recruit potential applicants, coordinate and attend career fairs. Represents department at community and recruiting events. Participates in in full-cycle Civil Service hiring processes, develops and coordinates digital and non-digital content for advertising and promotional campaigns. Strategic recruiting planning and implementation tactics along with website maintenance and media marketing. Assists in overseeing Ambassador Medics for purpose of increasing diversity-focused recruiting efforts and presence in the community. Stephanie Menendez – Human Resources Supervisor 512.972.7061 (o) 512.965.0011 (m) Stephanie.Menendez@austintexas.gov Partners with Human Resources Manager and Business Process Consultant regarding potential policy changes based on procedural changes within the Employee Services area; Oversees Workers’ Compensation, and activities related to all leaves (paid, unpaid, FMLA, and Military); as well as managing indirect activities related to leaves of absence (ADA, Donated Leave Bank, Paid Leave Bank, Limited Duty, Line of Duty, Return to Work and Paid Parental Leave); Provides oversight/direction related to Payroll Administration (payroll processing/auditing); Oversees administration of personnel actions, personnel records management etc.; SSPR Administration, Reclassifications, MCS Employment, New Employee training, Harassment, Policy Overview and MCS employee relations issues, investigations and participation in grievance hearings. Direct Supervision of the following: Laura Maciel; Amelia “Milly” Muraida, Guillermo Mireles and Leah Schnelle. Guillermo Mireles – Human Resources Advisor 512.972.7050 (o) Guillermo.mireles@austintexas.gov Primary responsibilities include providing advice and counsel to civilian management regarding personnel action recommendations to address performance and disciplinary violations in accordance with Municipal Civil Service (MCS) Rules, City Policy and Procedures and Departmental Policies; conduct investigations/inquiries; Texas Workforce Commission Unemployment Claim prep/response including hearing participation; compensa-tion to include reclassification requests; Market studies, etc.; MCS Employment, SSPR Coordinator, Ethics Coordinator, NEO Development/presenter; Temporary Hiring/Retention process lead.

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Leah Schnelle – Human Resource Advisor 512.972.7050 (o) Leah.schnelle@austintexas.gov Primary responsibilities include administration of on-the-job injury/illness - Workers’ Compen-sation administration and analytical stats including trends based on injury types, cost etc.; Administration of off-the-job injury/illnesses; Family Medical Leave Act (FMLA); All Leave banks i.e. Donated Leave, Shared Accrued Leave, Paid Parental Leave, and Military Leave; Return to Work Administration; Limited Duty Administration; Americans with Disability Act (ADA) Coordinator, Leave of Absence Coordination and Short-term/Long-term Disabilities Coordination and Fitness for Duty. Laura Maciel – Human Resources Specialist 512.972.7230 (o) Laura.Maciel@austintexas.gov Primary responsibilities include lead payroll functions i.e. Payroll Entry and Auditing, Higher Class Pay, Pay adjustments etc.; Personnel Action processing i.e. step increases, suspensions, demotions, change of status processing, etc.; Back Pay Calculations, New Employee Training (payroll) to cadets; Employment Verifications and updates to employees data(W-4’s, Address/Name Changes), Open Enrollment Coordination (back-up). Amelia “Milly” Muraida – Human Resources Generalist 512.972.5833 (o) Amelia.Muriada@austintexas.gov Primary responsibilities include payroll functions i.e. Payroll Auditing for sworn and civilian time records; New Hire Onboarding to include new hire sign-up processing, eVerify/I-9, RMS & Telestaff entry; Tuition Reimbursement Coordinator; Bus Pass Coordinator, TRAIN Adminis-trator; HR Division Records Management Liaison; Personnel File Management; Employee Separation Notice Coordinator, Open Enrollment Coordinator.

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A TCEMS Head Quarters has a new look lining the halls at RBJ. For those of you who have not recently visited headquarters the hallway in front of the Division Chief’s offices has been repainted and a new “EMS His-tory Wall” has been added. What is a history wall, you ask? It is an ar-

ea that is dedicated to the employees who have made this department what it is today. As you look around you will notice a wide variety of pictures with fa-miliar faces...and some not so familiar. These pictures span over twenty years featuring employees past and present who are dedicated to the call of duty within our EMS family.

As you stroll down the hall if a particular photography happens to grabs your attention be sure to ask one of our illustrious Chiefs about it. Allow them the opportunity to reminisce and humor you with some entertaining stories.

We hope this wall brings back some good memories, great stories and instills pride for our EMS family. It is an honor to represent the men and women who have dedicated their time and skills to our department. It is our sincere hope that you know how proud we are of you...our EMS family.

Please extend a special thank you to Milissa Warren, Gadiel Arellano and Clemente Leal for their devotion in creating this project and turning it into a reality to be shared with all.

EMS History Wall

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When documenting the “Reason for Destination” field on the Patient Care Report (PCR) is not simply

because it is a required field. There are other factors that play a role in what selection is made in the

“Reason for Destination” field. For instance, Medicare has regulated the billing for mileage to a

further facility. This has resulted in an increase in mileage billed to the responsibility of the patient.

The “Reason for Destination” field communicates to billing when to bill the patient for excess mile-

age. While patient’s facility choice is always the first priority, it is also helpful to understand the

potential financial impact on the patient.

On October 1, 2015, Novitas Solutions, the Medicare Intermediary for Texas, released an updated

Local Coverage Determination (LCD) that clarified what mileage is considered reimbursable. Novitas

Solutions states;

“For ambulance services to be a covered benefit, the transport must be to the nearest

institution with appropriate facilities for the treatment of the illness or injury involved. The

term ‘appropriate facilities’ means that the institution is generally equipped to provide

hospital care necessary to manage the illness or injury involved. It is the institution, its equip-

ment, its personnel and its capability to provide the services necessary to support the

required medical care that determine whether it has appropriate facilities. The fact that a

more distant institution may be better equipped (either subjectively or quantitatively) does

not mean that the closer institution does not have ‘appropriate facilities.’ In the case of a

hospital, it also means that a physician or a physician specialist is available to provide the

necessary care required to treat the patient’s condition.”

The “Clinical Operating Guidelines” provides “Hospital Transport Grid CR-13” that maps the

appropriate receiving facilities for the patient’s condition. The next step is transporting the patient to

closest of the appropriate receiving facilities. The PCR “Destination Reason” field should correspond

stating the reason the receiving facility was appropriate:

Trauma Specialty - Trauma Center

Neuro Specialty - Stroke Center

Specialty Resource Center

Closest Facility

Insurance Status/Requirement

Why Is Documenting

“Reason for Destination”

Important?

T he “Reason for Destination” field

communicates to billing when to bill

the patient for excess mileage.

By, Kerri Lang, Asst.. Director of Finance

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Selecting to transport a Medicare patient to a further facility that is not considered the “closest

appropriate facility” the patient may be liable to for the excess mileage at the rate of $13.50 per

mile. Although we always want to honor the patient’s preference. We should also be mindful of the

financial burden that could result from the patient requesting a further facility.

For example: A patient states they would like to be transported to St. David ’s Medical Cen-

ter instead of South Austin Medical Center because St. David’s Medical Center is closer to their

residence. South Austin Medical Center is only 3 miles from the scene of the incident while St.

David’s Medical Center is 13 miles from the scene of the incident. The patient will be responsible for

paying $135.00 out of pocket for the excess 10 miles.

In the case, that a patient, family of the patient, or a physician requests that a patient goes to a

further facility that is not the most appropriate the excess mileage will be the responsibility of the

patient. Novitas Solutions even states that a facility is not considered appropriate because the

patient’s physician does not have privileges.

“The fact that a particular physician does or does not have staff privileges in a hospital is not

a consideration in determining whether the hospital has appropriate facilities. Thus,

ambulance service to a more distant hospital solely to avail a patient of the service of a

specific physician or physician specialist does not make the hospital in which the physician

has staff privileges the nearest hospital with appropriate facilities.”

The PCR “Destination Reason” field should correspond stating the reason the destination was

selected:

Patient's Choice

Patient's Physician's Choice

Family Choice

On-Line Medical Direction

On-Line/On-Scene Medical Direction

However, diversions are an exception to the “closest

appropriate facility” rule. When a bed is unavailable at the receiving facility the destination is

no longer considered appropriate. However, documentation must be provided that no beds were

available otherwise the patient will be required to pay for the excess mileage out of pocket.

“An institution is also not considered an appropriate facility if there is no bed available. The

carrier, however, will presume there are beds available at the local institutions unless the

claimant furnished evidence that none of these institutions had a bed available at the time

the ambulance service was provided.”

The “Destination Reason” field assists the billing office in determining if the requirements for the

closest appropriate facility as met according to Novitas Solutions Local Coverage Determination.

The billing office still have a quality review process that bills patients for excessive mileage when

the “Destination Reason” field is not filled out properly.

The patient always has a choice to select the hospital they would prefer to be transported to.

However, this information assists us in providing good information when recommending a hospital

by understanding that a further facility may financially impact the patient as well.

N ovitas Solutions states that a

facility is not considered appropriate

because the patients physician does

not have privileges.

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Austin-Travis County EMS Receives Pet Oxygen Mask Donation Pets Will Breathe Easier in Austin On National “Love Your Pet Day”, Tuesday, February 20, 2018, Invisible Fence Brand of Austin donated 42 pet oxygen mask kits to Austin-Travis County EMS. Invisible Fence and ATCEMS have teamed up to help reduce the number of pets killed or injured in house fires each year. It is estimated that between 40,000 to 150,000 pets die in fires every year in the United States.

The pet oxygen mask donation is made possible through Invisible Fence Brand’s Project Breathe Program, which has donated over 6,000 kits to first responders throughout the U.S. and Canada. The donated animal resuscitation masks, which come in three sizes, have a plastic, cup-shape that seals around the muzzle of an animal tighter than a human mask can.

In attendance was Tiberius, a 9 year old corgi who was resuscitat-

ed using a pet oxygen mask and pet of ATCEMS Paramedic Amanda Baker who helped facilitate this donation. Amanda explains “Our dogs were in the house while I was out in the garage work-ing on my Jeep. I walked back up to the house to find it on fire and filled with smoke. I was able to get inside and through the smoke to carry the dogs out, but Tiberius was unconscious and barely breathing. Williamson County EMS carries the pet oxygen masks and were able to revive him.”

This donation will provide a breath of fresh air for our four-legged furry friends in Austin and Travis County. Pet owners can rest easy knowing that their local EMS is now properly equipped with pet oxygen mask kits that will help resuscitate a dog, or cat, trapped in a smoke filled house.

Tiberius

It is estimated that between 40,000 to 150,000 pets die in fires every year in the United States.

Amanda Baker

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This fact sheet provides information on weight-loss dietary supplements, including summaries of research on the safety and efficacy of several of the most commonly used ingredients in these prod-ucts. More than two-third of adults and almost one-third of children and adolescents in the United States are overweight or obese. Forty-five percent of overweight Americans and 67% of those who are obese are trying to lose weight. Health experts agree that making lifestyle changes—including following a healthy eating pattern, reducing caloric intake, and engaging in physical activity—is the basis for achieving long-term weight loss. But because making diet and lifestyle changes can be difficult, many people turn to dietary supplements promoted for weight loss in the hope that these products will help them more easily achieve their weight-loss goals. Approximately 15% of U.S. adults have used a weight-loss dietary supplement at some point in their lives; more women report use (21%) than men (10%). Americans spend about $2.1 billion a year on weight-loss dietary supplements in pill form (e.g., tablets, capsules, and softgels), and one of the top 20 reasons why people take dietary supplements is to lose weight. Dietary supplements promoted for weight loss encompass a wide variety of products and come in a variety of forms, including capsules, tablets, liquids, powders, and bars. Manufacturers market these products with various claims, including that these products reduce macronutrient absorption, appetite, body fat, and weight and increase metabolism and thermogenesis. Weight-loss products can contain dozens of ingredients, and some contain more than 90. Common ingredients in these supplements include botanicals (herbs and other plant components), dietary fiber, caffeine, and minerals. In its report on dietary supplements for weight loss, the U.S. Government Accountability Office concluded that “little is known about whether weight loss supplements are effective, but some supple-ments have been associated with the potential for physical harm”. Many weight-loss supplements are costly, and some of these products’ ingredients can interact or interfere with certain medications. So it is important to consider what is known—and not known—about each ingredient in any dietary supple-ment before using it. People who are considering using weight-loss supplements should talk with their healthcare provider to discuss these products’ potential benefits and risks. This is especially important for those who have medical conditions, including high blood pressure, diabetes, and liver or heart disease. Yet, according to a large national survey, less than one-third of U.S. adults who use weight-loss dietary supplements discuss this use with a healthcare professional. Dietary supplements are labeled with a Supplement Facts panel and do not include meal replacement shakes or prescription or over-the-counter medications.

Dietary Supplements for Weight Loss Are they safe and effective?

The Office of Dietary Supplements (ODS) fact sheets give a current overview of individual vitamins,

minerals and other dietary supplements to make informed decisions while using diet aids.

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Regulation of Weight-Loss Dietary Supplements The U.S. Food and Drug Administration (FDA) regulates dietary supplements, including those promoted for weight loss. Like other dietary supplements, weight-loss supplements differ from over-the-counter or prescription medications in that the FDA does not classify them as drugs. Unlike drugs, dietary supplements do not require premarket review or approval by the FDA. Supplement manufacturers are responsible for determining that their products are safe and their label claims are truthful and not misleading. If the FDA finds a supplement to be unsafe, it may take enforcement action to remove the product from the market or ask the manufacturer to recall the product. The FDA and the Federal Trade Commission can also take regulatory actions against manufacturers that make unsubstantiated weight-loss claims about their products. The FDA does not permit dietary supplements to contain pharmaceu-tical ingredients, and manufacturers may not promote dietary supplements to diagnose, treat, cure, or prevent any disease. Dietary Supplements: What You Need to Know. Weight-loss dietary supplements contain a wide variety of ingredients. Not surprisingly, the amount of scientific information available on these ingredients varies considerably. In some cases, evidence of their purported benefits consists of limited data from animal and laboratory studies, rather than data from human clinical trials. In other cases, studies supporting a given ingredient’s use are small, of short duration, and/or of poor quality, limiting the strength of the findings. In almost all cases, additional research is needed to fully understand the safety and/or efficacy of a particular ingredient. Complicating the interpretation of many study results is the fact that most weight-loss dietary supple-ments contain multiple ingredients, making it difficult to isolate the effects of each ingredient and pre-dict the effects of the combination. Evidence may exist for just one of the ingredients in a finished product, and no evidence may be available for an ingredient when it is combined with other ingredients. Furthermore, dosages and amounts of active components vary widely among weight-loss supplements, and a product’s composition is not always fully described in published studies . Studies might also use different and sometimes inappropriate assessment techniques to measure the effective-ness of a given treatment. All of these factors can make it difficult to compare the results of one study with those of another. Table 1 briefly summarizes the findings discussed in more detail in this fact sheet on the safety and efficacy of the most common ingredients of weight-loss dietary supplements. These ingredients are listed and discussed in the table and text in alphabetical order. Dosage information is provided when it is available. However, because ingredients might not be standardized and many products contain pro-prietary blends of ingredients, the active compounds and their amounts might not be comparable among products.

White kidney bean (Phaseolus vulgaris)

Interferes with break-down and absorption of carbohydrates by acting as a “starch blocker”

Several clinical trials of varying methodological quality Research findings: Possible modest effect on body weight and body fat

Few safety concerns reported for up to 3,000 mg/day for as long as 12 weeks Reported adverse effects: Headache, soft stools, flatulence, and constipation

Yohimbe (Pausinystalia yo-himbe)

Has hyperadrenergic effects. Yohimbine is the proposed active constitu-ent.

Very little research on yohimbe for weight loss Research findings: No effect on body weight; insufficient research to draw firm conclu-sions

Significant safety concerns report-ed, especially for 20 mg or higher Reported adverse effects: Headache, anxiety, agitation, hy-pertension, and tachycardia

Ingredient Evidence of Efficacy Proposed Mechanism

of Action Evidence of Safety

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Ingredient Proposed Mechanism of Action Evidence of Efficacy** Evidence of Safety**

African mango (Irvingia gabonen-sis)

Inhibits adipogenesis and reduces leptin levels

Few clinical trials, all with small sample sizes Research findings: Possible modest reduction in body weight and waist circumfer-ence

No safety concerns reported for up to 3,150 mg/day for 10 weeks Reported adverse effects: Headache, difficulty sleeping, flatu-lence, and gas

Beta-glucans Increase satiety and gas-trointestinal transit time, and slow glucose absorp-tion

Several clinical trials with weight loss as a secondary outcome Research findings: No effect on body weight

No safety concerns reported for up to 10 g/day for 12 weeks Reported adverse effects: Flatulence

Bitter orange (Citrus aurantium L.)

Increases energy ex-penditure and lipolysis, acts as a mild appetite suppressant. Synephrine is the proposed active constituent.

Small clinical trials of poor methodological quality Research findings: Possible increase in resting metabolic rate and energy expenditure; inconclusive effects on weight loss

Some safety concerns reported, especially for combinations with other stimulants Reported adverse effects: Chest pain, anxiety, headache, musculo-skeletal complaints, and increased blood pressure and heart rate

Caffeine (as added caffeine or from guarana, kola nut, yerba maté, or other herbs)

Stimulates central nerv-ous system, increases thermogenesis and fat oxidation

Short-term clinical trials of combination products Research findings: Possible modest effect on body weight or decreased weight gain over time

Safety concerns not usually report-ed at intakes less than 400–500 mg/day for adults, significant safe-ty concerns at higher doses Reported adverse effects: Nervousness, jitteriness, vomiting, and tachycardia

Calcium Increases lipolysis and fat accumulation, decreases fat absorption

Several large clinical trials Research findings: No effect on body weight, weight loss, or prevention of weight gain based on clinical trials

No safety concerns reported at recommended intakes (1,000–1,200 mg/day for adults) Reported adverse effects: Constipation, kidney stones, and interference with zinc and iron absorption at intakes above 2,000–2,500 mg for adults

Capsaicin and other capsaicinoids

Increase energy expendi-ture and lipid oxidation, increase satiety, and reduce energy intake

Several clinical trials, mostly focused on energy intake and appetite Research findings: Might reduce energy intake but no effect on body weight

Few safety concerns reported for up to 33 mg/day for 4 weeks or 4 mg/day for 12 weeks Reported adverse effects: Gastrointestinal distress, increased insulin levels, and decreased high-density lipoprotein (HDL) levels

Carnitine Increases fatty acid oxi-dation

Several clinical trials with weight loss as a secondary outcome Research findings: Possible modest reduction in body weight

No safety concerns reported for up to 2 g/day for 1 year or 4 g/day for 56 days Reported adverse effects: Nausea, vomiting, diarrhea, abdominal cramps, and a “fishy” body odor; might increase trime-thylamine N-oxide (TMAO) levels, which are linked to greater cardiovascular disease risk

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Chitosan Binds dietary fat in the digestive tract

Small clinical trials, mostly of poor methodological quality Research findings: Minimal effect on body weight

Few safety concerns reported for 0.24–15 g/day for up to 6 months; could cause allergic reactions Reported adverse effects: Flatulence, bloating, constipation, indigestion, nausea, and heartburn

Chromium Increases lean muscle mass; promotes fat loss; and reduces food intake, hunger levels, and fat cravings

Several clinical trials of varying methodological quality Research findings: Minimal effect on body weight and body fat

No safety concerns reported for recommended intakes (20–45 mcg/day for adults) Reported adverse effects: Headache, watery stools, constipa-tion, weakness, vertigo, nausea, vomiting, and urticaria (hives)

Coleus forskohlii Enhances lipolysis and reduces appetite. For-skolin is the proposed active constituent.

Few short-term clinical trials Research findings: No effect on body weight

No safety concerns reported at typical doses of 500 mg/day for 12 weeks Reported adverse effects: More frequent bowel movements, loose stools

Conjugated linoleic acid

Increases lipolysis, reduc-es lipogenesis, and pro-motes apoptosis in adi-pose tissue

Several clinical trials Research findings: Minimal effect on body weight and body fat

Few safety concerns reported for 2.4–6 g/day for up to 12 months Reported adverse effects: Abdominal discomfort and pain, constipation, diarrhea, loose stools, dyspepsia, and (possibly) adverse effects on blood lipids and glucose homeostasis

Fucoxanthin Increases energy ex-penditure and fatty acid oxidation, suppresses adi-pocyte differentiation and lipid accumulation

Studied only in combination with pomegranate-seed oil in one trial in humans Research findings: Insuffi-cient research to draw firm conclusions

No safety concerns reported from one clinical trial that used 2.4 mg/day for 16 weeks, but not rigor-ously studied Reported adverse effects: None known

Garcinia cambogia (hydroxycitric acid)

Inhibits lipogenesis, suppresses food intake. Hydroxycitric acid is the proposed active constitu-ent.

Several short-term clinical trials of varying methodological quality Research findings: Little to no effect on body weight

Some safety concerns reported Reported adverse effects: Headache, nausea, upper respira-tory tract symptoms, gastrointesti-nal symptoms, mania, and liver damage

Glucomannan Increases feelings of satiety and fullness, prolongs gastric emptying time

Several clinical trials of varying methodological quality, mostly focused on effects on lipid and blood glucose levels Research findings: Little to no effect on body weight

Significant safety concerns report-ed for tablet forms, which might cause esophageal obstructions, but few safety concerns with up to 15.1 g/day of other forms for sev-eral weeks Reported adverse effects: Loose stools, flatulence, diarrhea, constipation, and abdominal dis-comfort

Green coffee bean extract (Coffea aribi-ca, Coffea caneph-ora, Coffea robusta)

Inhibits fat accumulation, modulates glucose metabolism

Few clinical trials, all of poor methodological quality Research findings: Possible modest effect on body weight

Few safety concerns reported for up to 200 mg/day for as long as 12 weeks, but not rigorously studied; contains caffeine Reported adverse effects: Headache and urinary tract infections

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Green tea (Camellia sinensis) and green tea extract

Increases energy expenditure and fat oxidation, reduces lipogenesis and fat absorption

Several clinical trials of good methodological quality on green tea catechins with and without caffeine Research findings: Possible modest effect on body weight

No safety concerns reported for use as a beverage, contains caffeine; some safety concerns reported for green tea extract Reported adverse effects (for green tea extract): Constipa-tion, abdominal discomfort, nau-sea, increased blood pressure, and liver damage

Guar gum Acts as bulking agent in gut, delays gastric empty-ing, increases feelings of satiety

Several clinical trials of good methodological quality Research findings: No effect on body weight

Few safety concerns reported with currently available formulations containing up to 30 g/day for as long as 6 months Reported adverse effects: Abdominal pain, flatulence, diarrhea, nausea, and cramps

Hoodia (Hoodia gordonii)

Suppresses appetite, reduces food intake

Very little published research in humans Research findings: No effect on energy intake or body weight based on one study

Some safety concerns reported, increases heart rate and blood pressure Reported adverse effects: Headache, dizziness, nausea, and vomiting

Probiotics Alter gut microbiota, affecting nutrient and energy extraction from food and altering energy expenditure

Few clinical trials Research findings: Little to no effect on body fat, waist and hip circumference, or body weight

No safety concerns reported Reported adverse effects: Gastrointestinal symptoms, such as gas

Pyruvate Increases lipolysis and energy expenditure

Few clinical trials, all of weak methodological quality Research findings: Possible minimal effect on body weight and body fat

Few safety concerns reported for up to 30 g/day for as long as 6 weeks, but not well studied Reported adverse effects: Diarrhea, gas, bloating, and (possibly) decreased HDL levels

Raspberry ketone Alters lipid metabolism Studied only in combination with other ingredients Research findings: Insuffi-cient research to draw firm conclusions

No safety concerns reported in one 8-week study, but not well studied Reported adverse effects: None known

Vitamin D None proposed; associa-tions exist between low vitamin D status and obesity

Several clinical trials Research findings: No effect on body weight

No safety concerns reported at recommended intakes (600–800 IU/day for adults); toxic at very high intakes; tolerable upper intake level of 4,000 IU/day for adults Reported adverse effects: Anorexia, weight loss, polyuria, heart arrhythmias, and increased calcium levels leading to vascular and tissue calcification

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online through the PerksConnect program @ coadiscountpage.com

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I am so happy you have the opportunity to share the sense of humor from one of our 90 year old patients. The following is the conversation I had with him as it unfolded: Carolyn: “Hello, my name is Carolyn and I am with the Customer Services division of Austin-Travis County EMS. I’m calling concerning the customer service our paramedics provided for you when we recently transported you to the hospital.” Patient: “Oh no! You aren’t going to ask me questions concerning things that I can’t remember about are you?” Carolyn: “Sir if you can’t remember much about your transport, we understand that. We would like to know if you can remember how well the medics provided service when they were taking care of you. Did you understand what they were doing and if your experience with them was positive?” Patient: “They were wonderful with their service. No concerns.” Patient: “I’m still in the hospital and may be able to go home soon. I’m actually going to need artery surgery soon. They have me scheduled already. And get this, they are going to use a Texas cow. Yeah, really, a Texas cow. It’s going to cost $23,000.00 dollars. Can you believe that? So I said, now wait a minute. If you’re going to use only part of the cow in surgery, and I’m paying $23,000.00, I want the whole cow. Just send the rest of it to Franklin’s Bar-B-Que, and have them cook it for me. I think that’s fair don’t you?” Carolyn [laughing]: “You know I get your point about that. Yes sir I think I just might feel the same way you feel about the rest of that cow. If you pay for it, why not enjoy the rest of it? Sir it’s been a pleasure talking to you. All of us at EMS wish the very best to you. Take good care of yourself.” Thanks for allowing me to share this conversation and sharing the humor of it with you. We really do have a lot of wonderful citizens here in Austin. He was one of our best! Carolyn Huckle, ATCEMS, Administrative Specialist

A short, humorous story told by Caroline Huckle during a phone conversation she had with a patient transported by ATCEMS medics. This shows the lighter side and humor a person can have during difficult times.

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Chuck Kingsbury Survivor Story On May 1st 2017 Mr. Chuck Kingsbery (center) suffered a cardiac arrest while playing tennis. Austin-Travis County Team quickly responded to his needs.

ATCEMS Medics worked together from the moment we received the call until Mr. Kingsbery made it to the hospital.

Five defibrillations and 3 weeks of in hospital treament, Mr. Kingsbery was discharged home.

Recently Mr. and Mrs. Kingsbery had the opportunity to meet with the med-ics who saved his life. The day was spent celebrating life and giving thanks.

(Left-Right) Communication Medic-I

Kristina Peña, Commander Bryan

Fitzpatrick, Medic-I Kim Blumberg,

& Medic-II Gil Torres

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ATCEMS Recruiting team along with a few of our dedicated Medics, attended the Annual Youth Career Fest at Palmer Events Center. Over 2,000 high school students stopped by the booth to learn more about EMS.

Villasenor

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Lydon & Chavez accepting a donation of teddy bears from the students at Austin Jewish Academy.

Hall & Murphy

Parker & Hinojosa

Sasser & Baker

Holly celebrating

Yvonne’s birthday

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FANTASTIC WELL DONE

||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||Employee Recognition

While on the phone with a potential fall client today, she asked me to pass along her thanks to Dave Curvin for his care and compassion while in his care on Jan 22nd.

Liz Yankiver, ATCEMS Community Relations/Injury Prevention

Willem Gervais received Departmental acknowledgment for Exceptional values and expectations this month.

Sesly Hawkins

Thank you for always having a kind word, big smile and an upbeat attitude every day of the week, day in and day out. You are a breath of fresh air.

Sheila Schwall & Clemente Leal

Dr. Andrew Reifsnyder called to compliment the crew of Medic 3, Evette Samarripa and Jonathan Kalinowski. He said that the patient is alive today because of the care she received from the crew. Strong work!! Good job!! James Martin BBA, LP, District Commander

THANK YOU Ms. Liz Yankiver -

My husband and I enjoyed your class last weekend. We have taken many essential classes - lactation,

newborn, and birthing, but we really felt a part of the community with the Safe Baby Academy and ap-

preciated your vested interest/passion in preventing infant death.

I left the class with a 'high' for being more safety-minded. Also, my husband and I work in healthcare

too and we know that serving the community can be challenging. Thank you for serving the Austin

community for 18 years and for keeping your passion and energy in focus. I can tell you love your job.

I told all my future parent friends about the class.

Thanks again.

Sincerely,

Melody Pham

AWESOME

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Our values and principles are Excellence in Service, by People Who Care. Your dedication and commitment serve as a vital link in the chain which drives our department. The Years of Service award symbolizes the time you’ve given to help us as we pursue those values and principles. It is also a token of appreciation for the part you’ve played in making ATCEMS what it is today. Your talents and efforts already have helped us achieve excellence in many areas.

Please join us in congratulating Captain Jason

Beggs on his selection and transfer to the

Public Information Office. Captain Beggs attended

the University of Texas Health San Antonio Para-

medic Program from 2004-2006 and has main-

tained his National Registry status since graduat-

ing. Captain Beggs joined the Department in Octo-

ber of 2007 and has nearly 13 total years of pre-

hospital experience. After five (5) years as a

Field Paramedic, Captain Beggs promoted to the

rank of Captain in April 2012. During his tenure at

Austin-Travis County EMS, he has served in a vari-

ety of roles, including Field Training Officer and is

still qualified as a Motor Medic. We look forward to

the positive impact Captain Beggs will have in his

new position with the Public Information Office. He

embodies the mission, vision, and values of Austin

Travis County EMS and has demonstrated leader-

ship in every area he has worked. Please join in

congratulating him on his selection and transfer to

this assignment as Deputy PIO.

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CONGRATULATIONS

Years of Service

Scott McCall 20 Years

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The Call of the 4th Quarter winner is Angela Vorhies, Clinical Performance Management

Communications Call of the Quarter

Congratulations to Angela Vorhies who took a 9-1-1 call for an unexpected and premature baby delivery.

She reassured the male caller and effectively used Pre-Arrival Instructions to manage both patients.

She quickly got the baby out of the toilet, evaluat-ed his breathing, initiated CPR, and assisted the caller to clear the baby’s airway. Strong work Angela!

Be sure to tell Angela congratulations when you see her! Thank you all for your dedication to patient care.

Leslie K. Stanford Captain–Communications

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GRATITUDE

GRATITUDE TRANSFORMS COMMON

DAYS INTO THANKFULNESS, TURNS

ROUTINE JOBS INTO JOY, AND

CHANGES ORDINARY OPPORTUNITIES

INTO BLESSINGS.

GRATITUDE ALSO OPENS YOUR EYES

TO THE POWER, THE WISDOM, THE

CREATIVITY AND THE LIMITLESS

POTENTIAL OF THE UNIVERSE.

ATTITUDE IS A CONSCIOUS CHOICE,

NOT AN AUTOMATIC ONE, SO CHOOSE

WELL AND PERSEVERE

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Customer Service Response:

427 calls were made during January. The questions asked focused on measurable

customer service actions.

Patient Comments:

“They were very organized, came in an attended to him right away. They talked to AFD as they were there

first, and there was no hesitation to take care of things and transport him. They were very professional.”

“They were very good about telling me everything they were doing. I'm not from here and they transported

me to the hospital based on my needs. They were wonderful, and though I hope this never happens again,

I would want them again.”

“Personable, so nice, and very helpful. Medic in the back with me made me feel calm, and the other medic

came back to me in the E.R. to wish me well. They also saw that my husband was taken care of and that

the house was locked up before we left for the hospital. We appreciate them all.”

“Even though I was stressed about how much the transport would cost, the lady medic was very kind and

calming. Her personality was very helpful in this situation. I wish they would have said goodbye as I

wanted to thank them for being so kind.”

Respondents were asked to rate the customer service provided by our medics on a scale from 1

to 5, with 5 being the best 78.95% of the patients rated the customer service they received at

a 5 and 19.3% rated their service at a 4. The average rating overall was 4.77 out of 5 for

customer service.

The response we obtained from our customers is evidence of the great medics we have and the

tremendous job they do each and every day.

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The average heart is the size of a fist in an adult.

Your heart will beat about 115,000 times each day.

Your heart pumps about 2,000 gallons of blood every day.

The heart can continue beating even when it’s disconnected from the body.

The first implantable pacemaker was used in 1958. Arne Larsson, who received the pacemaker, lived longer than the surgeon who implanted it.

The fairy fly, which is a kind of wasp, has the smallest heart of any living creature.

The American pygmy shrew is the smallest mammal, but it has the fastest heartbeat at 1,200 beats per minute.

Whales have the largest heart of any mammal.

The giraffe has a lopsided heart, with their left ventricle being thicker than the right. This is because the left side has to get blood up the giraffe’s long neck to reach their brain.

Most heart attacks happen on a Monday.

Christmas day is the most common day of the year for heart attacks to happen.

The human heart weighs less than 1 pound. However, a man’s heart, on average, is 2 ounces heavier than a woman’s heart.

A woman’s heart beats slightly faster than a man’s heart.

The beating sound of your heart is caused by the valves of the heart opening and closing.

It’s possible to have a broken heart. It’s called broken heart syndrome and can have similar symptoms as a heart attack. The difference is that a heart attack is from heart disease and broken heart syndrome is caused by a rush of stress hormones from an emotional or physical stress event. Death from a broken heart, or broken heart syndrome, is possible but extremely rare.

The iconic heart shape as a symbol of love is traditionally thought to come from the silphium plant, which was used as an ancient form of birth control.

If you were to stretch out your blood vessel system, it would extend over 60,000 miles.

Heart cells stop dividing, which means heart cancer is extremely rare.

Laughing is good for your heart. It reduces stress and gives a boost to your immune system.

About 8 million blood cells die in the human body every second, and the same number are born each second.

Within a tiny droplet of blood, there are some 5 million red blood cells.

It takes about 20 seconds for a red blood cell to circle the whole body.

Red blood cells make approximately 250,000 round trips of the body before returning to the bone marrow, where they were born, to die.

Red blood cells may live for about 4 months circulating throughout the body, feeding the 60 trillion other body cells.

Heart Fun Facts February is National Heart Health Month

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