PULSE Magazine | January 2020 Issue

P U L S E ANAUSTIN-TRAVIS COUNTY EMS PUBLICATION January 2020

Martin Luther King Day Celebration 2020

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January 2020

Contents

Featured News

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HEALTH & SAFETY ALERT: WUHAN CORONA- VIRUS A new virus understood to be a new strain of corona- virus that has not previously been identified in humans is sweeping through eastern and central China now has confirmed cases in the United States.

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HOW TO SET UP A MEDICAL ID ON YOUR iPHONE

Remember those "in case of emergency" cards people used to carry? Well, your Medical ID on Apple Health is a digital version of that card, and it can be critical in case of a medical (or otherwise) emergency. If you have your Medical ID enabled in Health, paramed- ics, first responders and anyone else can access your critical information from your home screen.

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JANUARY IS BATH SAFETY MONTH

January is National Bath Safety Month, which is a great time to reflect on the safety of your bathroom.

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TEXAS EMS ALLIANCE LEGISLATIVE INFORMATION MEETING CTECC

On Wednesday January 15th the Texas EMS Alli- ance (TEMSA) held an informational meeting for legis- lative aides at the Combined Transportation, Emergen- cy & Communications Center (CTECC).

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Division News

In Every Issue

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RECRUITING’S MEET-A-MEDIC: JASON CANTU

EMPLOYEE RECOGNITION

I am an original Austinite and have been all my life. I graduated from Austin High School (Loyal Forever) and earned my paramedic degree from Austin Community College. My wife and I stay very busy planning trips and working on our travel Vlog.

ATCEMS employees receive kudos, special thanks and congratulations for a job well done.

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WHAT IS: THE POWER OF GRATITUDE?

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Research into the physical effects of gratitude report tangible results. Focusing on the positive and feeling grateful can improve your sleep quality and reduce feelings of anxiety and depression.

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TACTICAL RESCUE

Multiple assets from ATCEMS & AFD came together to rescue a patient that had been stuck/lost in drainage system tunnels between 24-48 hrs. It took around 1.5 hrs. to locate & assist the patient out of the system when the closet manholes did not have access to the patient. The patient was transport- ed to Dell Seton for evaluation and treatment of minor medical issues.

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CUSTOMER SERVICE SURVEY

Results from the Customer Callback program.

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Health and Lifestyle Expo February 12, 2020

We hope to see you at the Health and Lifestyle Expo on Wednesday February 12th 7:30am—1:00pm at Palmer Events Center located at 900 barton Springs Rd. Obtain you “health numbers” and earn 8 hours of WADL once you complete the BlueCross BlueShield online Health assessment at BCBSTX.com/coa

You will need to register for a Health Screening appointment to avoid wait time.

Highlights include:  Free health screening for City employees  Learn more about the City’s Naturally Slim weight loss program  11am Heart Walk (earn $25 in healthy rewards)  Learn about BlueCross BlueShield program and benefits  Healthy snacks at the Farmers Market Display & Hydration Station  Free chair massages, spinal and diabetes screening  Join the City’s Diabetes Control Program  Learn about HealthyConnections Wellness Program and incentives  Refresh your living space with home improvement and green living exhibitors  Over 100 health and lifestyle vendors will be present

Employees wanting to get a City Health Screening and earn 8 hours of WADL can register for an appointment at: https://my.onsitehd.com/signup/coa

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The 100 Club of Central Texas Wishes You Happy 2020!!

To kick the year (and decade) off on a great note, The 100 Club has been selected to participate in the Tiff's Treats Charity Competition to celebrate their 21st anniversary. Share the code below with your friends, and place your order with Tiff's Treats today! The non-profit organization with the most sales in January will win a $10,000 donation!

100CLUB20

Here's how it works:

 During checkout, you will find a box under the "I have a coupon or charity promotional code" section where you'll put our code.  Please note you cannot also use a coupon on these orders.  You cannot use a promotional gift card to pay for your order.  Ten percent of your sale will go to The 100 Club of Central Texas.  Remember to use your code when ordering. Codes cannot be added after an order has been placed.  The code will deduct a penny off each order and that's your indication that this sale has been recorded.  Offer valid for orders delivered or picked up now through January 31st.  Offer cannot be used to purchase gift cards.

Eleysa Richards The 100 Club of Central Texas 512-345-3200

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WUHAN CORONAVIRUS

(2019-nCoV)

A new virus understood to be a new strain of coronavirus that has not previously been identified in humans is sweeping through eastern and central China now has confirmed 5 cases in the United States. The Centers for Disease Control and Prevention (CDC) confirmed that it had identified the first case of 2019 Novel Coronavirus in the state of Washington, the second case just confirmed this is in Chicago. The virus, called 2019-nCoV, also known as Wuhan virus, is a coronavirus which is one that infects the nose, throat, or sinuses and has pneumonia-like symptoms including fever, cough and difficulty breath- ing. So far, according to official statistics, 100 have died and over 4,500 have been confirmed to be infected, but estimates of infections run much higher, in the thousands. Medical professionals who were tending to patients have themselves fallen ill. These numbers are rapidly climbing each day. The United States and other nations and territories have been preparing response plans, even quarantines, for weeks. This in response to this coronavirus now being transmitting from human to human through respiratory track. In general coughs and sneezes are highly effective means to spread the virus. This is a rapidly evolving situation. It is common for viruses to mutate, but them doing so makes them more dangerous as they may become immune to any treatments designed to tackle them. The flu is an example of a virus that mutates, and that mutation is why different flu vaccines are needed every year. The World Health Organization recommends that any person who might have a respiratory illness should seek medical attention and share their travel history with their physician. Especially if individuals have passed through East, South, and Southeast Asian countries.

How the virus has spread

 31 December: China alerts the WHO about a spate of pneumonia-like cases in Wuhan

 1 January: The seafood/animal market believed to be at the center of the outbreak is closed

 9 January : WHO says the infection is caused by a new type of coronavirus

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11 January: First death confirmed

 13 January: Virus spreads abroad, with a suspected case in Thailand

 16 January: A case in Japan is confirmed

 17 January: Second death - a 69-year-old in Wuhan

 20 January: Number of cases triples to more than 200, and outbreak spreads to Beijing, Shenzhen and Shanghai; third death confirmed; Chinese officials confirm human-to-human transmission

 21 January: US authorities announce the first case in USA - a man from Washington

 22 January: Death toll climbs to 17, with more than 400 cases confirmed

 24 January: Second case in USA — a woman in Chicago

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January is National Bath Safety Month, which is a great time to reflect on the safety of your bath- room. Bathing is such a routine activity that we often neglect to take proper precautions while we’re in what is absolutely one of the most dangerous places in our homes. But there are a lot of things we can do to minimize the risk of injury. Each year thousands of people of all ages visit the emergency room due to bathroom-related slips and falls. The accidents that occur while bathing are often overlooked, but remind us the importance of recognizing bathroom safety. Before you grab the bubble bath and have a good soak, make sure you take a few precau- tionary measures to prevent an accident from happening to you or a loved one. Never take for granted the importance of taking care of our bodies and our health. Tips for Adults While we may not think we need to be reminded of safety rules – after all, we’ve been bathing successfully for years – there is no harm in being conscious of, and minimizing the risks of, slip- ping and falling, especially as we get older. Grab handles should be installed, as towel racks and sliding glass door handles aren’t meant to steady people. Non-slip mats are a must for exiting the shower to minimize the risk of slipping on a wet SAFETY TIPS FOR ALL AGES

floor, as well as within the bathtub/shower floor. All toiletries should be kept within arm’s reach, and hallways that lead to the bathroom should be well lit. As we age it becomes more difficult to rise from a sitting position thus putting a strain on joints and muscles leading to potential falls. With that in mind it would be important to place a riser on the toilet seat. Children ages 4 and under should always have a caregiver present when they are near water, including the bath tub. Always wait until the tub is finished filling up before placing your child in the water, and make sure the water is no hotter than 120 degrees. Affix a slip-resistant plastic mat that suctions to the bottom of the tub and make sure there is a non-slip mat outside of the tub. A grab bar is great for kids as well as adults, so remind them to use it and not the towel rack or door handle. Always fill the tub with water before placing your child in the water, checking to be sure it isn’t too hot or too cold. Make sure bath toys do not have hard edges or points that could be hazardous. Use a rubber cover over the faucet head. Tips for parents With Young Children

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HEALTH AND RELAXATION

Guidelines for adding essential oils

 100 lbs. and up, add approximately 10 drops  60 lbs. to 100 lbs., add 6 drops  under 60 lbs. and over 2 years old, add 4 drops So, take a good look around and see what chang- es you need to make your bathroom safer for all. Taking these steps toward preventing injuries in your bathroom could definitely help save a life, so put them into practice right away as part of National Bath Safety Month.

Epsom Salt for All Ages

I recommend adding Epsom salt to a bath. It improves relaxation and sleep when used in baths, according to the Epsom Salt Council. Natural-Homeremedies.org states that stress can lead to reduced magnesium levels in the blood, resulting in the production of adrenalin, which makes one feel more alert. The magnesium in Epsom salt is absorbed through the skin and binds with serotonin in the brain, facilitating relaxation. Epsom salt also has been shown to reduce pain and inflammation, flush out toxins, soften skin, and strengthen the immune system.

When adding Epsom salt to a warm bath, follow these guidelines

 100 lbs. and up, add 2 cups or more  60 lbs. to 100 lbs., add 1 cup  under 60 lbs., add 1/2 cup

Essential Oils for All Ages

High-quality, therapeutic-grade essential oils are also beneficial in the bath. To create a blissful bath ritual with calming and relaxing effects, add essential oils like lavender, roman chamomile, vetiver, peppermint, cedarwood, marjoram or use a few drops of each of your favorites.

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Meet-A-Medic: Jason Cantu, Medic-Field

I’m Jason Cantú. I am an original Austinite and have been all my life. I graduated from Austin High School (Loyal Forever) and earned my paramedic degree from Austin Community College. My wife and I stay very busy planning trips and working on our travel Vlog. You can find us exploring Austin and trying out all the good eats in our free time. After 27 years of living here I’m still discovering the great experiences this city has to offer.

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Where are you from originally and what brought you to Austin? I’m an Austinite through and through but I take special pride in being raised on the East Side. East Side represent!

What inspired you to become a medic/What attracted you to this career choice? I initially wanted to be a firefighter — go figure! — but after taking my EMT course I fell in love with medicine and wanted to learn so much more. I wanted to be the best and most capable provider for someone in need. Because of that, I started my paramedic training. How long have you been with ATCEMS and what motivated you to work here? This is my first ever full-time job and I have been here for just a little under six years (shout out to Academy 0114!). I was motivated to work here because I wanted to serve the community that I grew up in.

What is your favorite part about working here at ATCEMS? My favorite part about Austin-Travis County EMS are the people I work with. I have made so many friends and have formed strong relationships with not only those in our department but within the entire public safety family. If you had guests visiting Austin for the weekend, where is the first place you would take them? That depends on the weather! If it is nice out I would probably take them to Twin Falls or Barton Springs for a swim. If it’s cold or rainy out I would take them to the Alamo Drafthouse or enjoy one of the many escape rooms.

What is your favorite taco joint in town? Yikes! How can you pick just one?! If you are north in Medic 13’s district I would say Ken’s Tacos is the spot. They are huge tacos and will leave you full for the whole day. If you’re south I would have to say Casa Moreno’s tacos. The tortillas are one of my favorites and they also give you quite the bang for your buck. Pro Tip: Come to both of these places very hungry!

What do you do on your days to relax and unwind?

I really enjoy going to Barton Springs to lay back, listen to an audiobook, catch up on some podcasts, meditate, and enjoy the cool water for a bit. If I’m not doing that you will likely find me editing our next YouTube video or vegging out on the couch. Who inspires you? David Goggins or E.T. The Hip Hop Preacher — they are both pretty inspirational. I mean, c’mon, have you seen their Instagram? But at the end of the day I would say my parents inspire me the most. Because of their sacrifices and lessons in work ethic I am able to have made it this far. They are a constant inspiration to me. What is the next place you would like to visit? Why? Somewhere with a beach! We just got back from Japan where it was cold and rainy. We are thinking of visiting Thailand or somewhere in the Caribbean where we can just sit back and enjoy the sand beneath our feet. Word of advice for an aspiring medic? My best advice for someone looking to become a medic is to put in the work up front and grind it out because the payoff is well worth it. The struggle was so real while I was working on this career path but I’m glad I stuck it through. This has been the most challenging and rewarding career I could have ever hoped for.

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It’s not every day that you run a call of this nature!

Multiple assets from ATCEMS & AFD came together to rescue a patient that had been stuck/lost in drainage system tunnels between 24-48 hrs. It took around 1.5 hrs. to locate & assist the patient out of the system when the closet manholes did not have access to the patient. The patient was transported to Dell Seton for evaluation and treatment of minor medical issues. ATCEMS assets on-scene: Demand-5 (Captain B. Green & Medic W. Hatten), District Command-4 (Commander R. Patterson), Medic-17 (Rescue Clinical Specialists A. Azel- ton & P. Dedich, & Cadet R. Clark), CHP-11 (Community Health Medic O. Jones), & Designated Medical Officer-2 (Captain A. Maxwell). Great work everyone!

Photo and video credits to ATCEMS Medics, KXAN News, FOX 7 Austin, CBS Austin, & KVUE.

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How to set up a Medical ID on your iPhone

Remember those "in case of emergency" cards people used to carry? Well, your Medical ID on Apple

Health is a digital version of that card, and it can be critical in case of a medical (or otherwise) emergency.

If you have your Medical ID enabled in Health, paramedics, first responders and anyone else can access

your critical information from your home screen. They would accomplish this by tapping "Emergency" and

then "Medical ID" -- no need to even unlock the phone. For your privacy, this feature is disabled by

default.

Your Medical ID will tell people essentially anything you want

it to. You can enter your demographic information (age, sex,

height, weight), as well as medical conditions, medications

and allergies. You can also enter emergency contacts and

phone numbers on your Medical ID.

Here's how to set up your Medical ID:

 In the Health app, tap the "Medical ID" button.

 On the edit screen, tell Medical ID who you are by select-

ing your own contact card from your iPhone's contacts.

 Enter any information you want, including your emergen-

cy contacts, blood type, allergies and organ donor status.

 Enable "Show When Locked" (toggle to green) so others

can access your Medical ID card from your iPhone's lock

screen.

Anyone who has an iPhone should fill out and enable their Medical ID -- it could be life-saving.

NEXT MONTH: HOW TO SET UP MED ID FOR ANDROID

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JANUARY 2020

Medics of the Month

D. Krasher & J. Flynt

St. David's Round Rock Medical Center Medics of the Month Krasher & Flint. These two gentlemen were also recognized for a Stroke Alert that was called in December 2019. Great work by great medics.

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JANUARY 2020

St. David's ER staff nominated him for his enjoyable disposition and great patient care. "We enjoy seeing him every time he comes through the doors at St David’s Main!" Doug Schulz

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OUT IN THE COMMUNITY

Nate Hair with family

visiting Station 25

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Employee Recognition

Tara & Michelle,

I wanted to take a moment and say thank you for the compassion- ate care you demonstrat- ed on this call. It often seems like a tough and cynical world, then I read about your actions and am humbled by your initi- ative and unwavering drive to do the right thing. Incredible job!

Guarding Angels

Tara Neal Michelle Warren

These two medics went above and beyond the call of duty providing excellent customer service. On 1/16/2020 M37 was requested to assist TCSO with a patient who was reported to be altered, as she was walking down the road without shoes. M37 arrived and provided patient care and offered her assis- tance. MCOT was also requested and while waiting, M37 crew contacted me and asked if they could take pt. to the store and buy her shoes while they waited for MCOT. After making sure the crew was safe, I of course granted them permission to move to the closest store. M37 crew purchased the pt. shoes, pants, jacket, socks, shirt, and food. They remained with pt. until MCOT arrived. The crew went above and beyond what we normally ask of our provid- ers. Without being prompted or asked, the crew used their own money and provided assistance to a person in need. Outstanding customer service and job well

Thank you,

Wesley Hopkins Division Chief

RETIRING

Congratulations To each of you on your retirement, thank you for your years of dedicated service. You’ve all made a lasting impact in this sys- tem. We wish you good health, good luck and great success in retirement. May you have a relaxing new life chapter ahead.

Happy Retirement!

done. Excellent job ladies. Ray E Migl, Commander

Mike Fontana

Steve Stewart

Diana Price

Carolyn Huckle

Vivian Holmes

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TEXAS EMS ALLIANCE LEGISLATIVE INFORMATION MEETING CTECC

On Wednesday January 15th the Texas EMS Alliance (TEMSA) held an informational meeting for legislative aides at the Combined Transportation, Emergency & Communications Center (CTECC).

TEMSA, in coordination with Austin-Travis County EMS (ATCEMS), had to honor of educating legislative aides on the ever growing challenges of funding, education, mental wellness, retention, and costs associated with operating an EMS system in Texas.

The Texas EMS Alliance was founded to provide an informed and collaborative voice for the future of Emergency Medical Services in the state of Texas. This mission is accomplished through a diverse organizational structure that calls for direct representation from the many agency types that comprise the Texas EMS system. The Texas EMS Alliance believes that our credibility starts with a strong group of EMS Providers from across the state who have demonstrated their individual commitment to the communities they serve through strong ethical practices and a desire to provide the best patient care possible. ATCEMS demonstrates this community commitment on a daily basis with honor and pride. It is a distinct privilege to collaborate with Texas lawmakers in an effort to positively effect the EMS industry as a whole.

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Treatment of Migraine Attacks Transcutaneous Electrical Nerve

A randomized control trial treatment of TENS therapy in treatment of migraines in the ER.

PURPOSE

The primary purpose of this trial is to evaluate the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy application in the emergency depart- ment.

METHOD

The patients were divided into 2 groups: a sham group, and a verum group. Patients in the verum group include those who use the device for the first time. Both groups were connected to visually indistinguishable devices. Both groups underwent therapy for a total of 20min. Using the Visual Analog Scale (VAS), the patients' perceived changes in pain intensity were recorded at the 20th and 120th minutes after initiation therapy. After the 120th minute, patients' individual needs for additional treatment were assessed. Additionally, their self-reported well-being was assessed using a Likert-type verbal scale.

RESULTS

In total 151 patients that were admitted to the emergency ward were assessed, with the sham and verum group being assigned 39 patients each from this pool. For the verum group the VAS change from 0 to 120min was −65 ±25 and for the sham group it was −9 ±2 ( p <0.001). Verbal scores in the 120th minute were found to be 1.2 for sham group and 4.5 in the verum group ( p <0.001). Thirty patients (76.92%) in the sham group and 1 (2%) in the

verum group had additional analgesic requirement after 120min.

CONCLUSION

TENS therapy is a fast-acting, effective therapy for the treatment of acute migraine in the emergen- cy department.

American Journal of Emergency Medicine: Hokenek, Erdogan, Algin, Tekyol and Seyhan. January 2020

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Livescience, NPR, Human Neuroscience-CMH

WHAT IS... THE MOST COMPLEX OBJECT IN THE KNOWN UNIVERSE? which you might think should arm you against stiff joints and other ailments. But as we age, the body's repair mechanisms get out of shape. In effect, your resilience to physical injury and stress declines. Theories for why people age can be divided into two categories: 1) Like other human characteris- tics, aging could just be a part of human genetics and is somehow beneficial. 2) In the less optimistic view, aging has no purpose and results from cellular damage that occurs over a person's lifetime. A handful of researchers, however, think science will ultimate- ly delay aging at least long enough to double life spans. In the long-running battle of whether our thoughts and personalities are controlled by genes or environment, scientists are building a convincing body of evidence that it could be either or both! The ability to study individual genes points to many human traits that we have little control over, yet in many realms, peer pres- sure or upbringing has been shown heavily influ- ence who we are and what we do. Nature vs. Nurture Laughter is one of the least understood of human behaviors. Scientists have found that during a good laugh three parts of the brain light up: A thinking part that helps you get the joke, a movement area that tells your muscles to move, and an emotional region that elicits the "giddy" feeling. But it remains unknown why one person laughs at your brother's foolish jokes while another chuckles while watching a horror movie. John Morreall, who is a pioneer of humor re- search at the College of William and Mary, has found that laughter is a playful response to incongruities stories that disobey conventional expectations. Emotions

The most complex object in the known universe is essentially ourselves, our own brains. It is an enigma in that it is “us,” and yet it may seem to be an utterly alien system.

Mysteries of the Mind

Encased within your skull is an organ capable of feats of computation, creativity and understand- ing unrivalled in the known universe – and all us- ing the power of a 20-watt light bulb and weighs around 3 pounds. Much of what we don't under- stand about being human is simply in our heads. The brain is a perplexed organ, as are the very questions of life and death, consciousness, sleep, and much more. Consciousness is a body-wide process and not limited to individual cortical sites which suggest that it is actually an interactive process between the brain and body. When you wake up in the morning, you might perceive that the Sun is just rising, hear a few birds chirping, and maybe even feel a flash of happiness as the fresh morning air hits your face. In other words, you are conscious. This complex topic has plagued the scientific community since antiquity. Only recently have neuroscientists considered consciousness a realistic research topic. The greatest brainteaser in this field has been to explain how processes in the brain give rise to subjective experiences. So far, scientists have managed to develop a great list of questions Consciousness

Mystery of Aging

Living forever is just for Hollywood. But why do humans age? You are born with a robust toolbox full of mechanisms to fight disease and injury,

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One thing scientists do know: Sleep is crucial for survival in mammals. Extended sleeplessness can lead to mood swings, hallucination, and in ex- treme cases, death. There are two states of sleep non-rapid eye movement (NREM), during which the brain exhibits low metabolic activity, and rapid eye movement (REM), during which the brain is very active. Some scientists think NREM sleep gives your body a break, and in turn conserves energy, similar to hibernation. REM sleep could help to organize memories. However, this idea isn't proven, and dreams during REM sleep don't always correlate with memories. If you were to ask 10 people what dreams are made of, you'd probably get 10 different answers. That's because scientists are still unraveling this mystery. One possibility: Dreaming exercises brain by stimulating the trafficking of synapses between brain cells. Another theory is that people dream about tasks and emotions that they didn't take care of during the day, and that the process can help solidify thoughts and memories. In general, scientists agree that dreaming happens during your deepest sleep, called Rapid Eye Movement. Neuroscience has made tremendous progress in deciphering the activities of almost 100 billion neurons in a single human brain, however there are many more mysteries to be explained. In time we will have more answers to the mysteries of the mind as we continue to search and research the most complex object in the known universe. Sweet Dreams

Others in the humor field point to laughter as a way of signaling to another person that this action is meant "in fun." One thing is clear: Laughter makes us feel better.

Memory Lane

Some experiences are hard to forget, like perhaps your first kiss. But how does a person hold onto these personal movies? Using brain- imaging techniques, scientists are unraveling the mechanism responsible for creating and storing memories. They are finding that the hippocam- pus, within the brain's gray matter, could act as a memory box. But this storage area isn't so discriminatory. It turns out that both true and false memories activate similar brain regions. To pull out the real memory, some researchers ask a subject to recall the memory in context, some- thing that's much more difficult when the event didn't actually occur. Residing in the hypothalamus of the brain, the suprachiasmatic nucleus, or biological clock, pro- grams the body to follow a 24-hour rhythm. The most evident effect of circadian rhythm is the sleep-wake cycle, but the biological clock also impacts digestion, body temperature, blood pressure, and hormone production. Researchers have found that light intensity can adjust the clock forward or backward by regulat- ing the hormone melatonin. The latest debate is whether or not melatonin supplements could help prevent jet lag — the drowsy, achy feeling you get when "jetting" across time zones It's estimated that about 80 percent of amputees experience sensations, including warmth, itching, pressure and pain, coming from the missing limb. People who experience this phenomenon, known as "phantom limb," feel sensations as if the missing limb were part of their bodies. One explanation says that the nerves area where the limb severed create new connections to the spinal cord and continue to send signals to the brain as if the missing limb was still there. Another possibility is that the brain is "hard- wired" to operate as if the body were fully intact meaning the brain holds a blueprint of the body with all parts attached. Mission Control Phantom Feelings

Sleep

Frequently elusive to millions . We don’t ever seem to get enough of it. Sleep is so crucial we spend more than a quarter of our lives at it. Yet the underlying reasons for sleep remain as puzzling as a rambling dream.

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Ashlee Whittemore, MA, LPC, LCDC, CSAT Transformations Treatment Center/ Help For Our Heroes In the Austin Area Call 512-915-6932 ashleew@transformationstreatment.com

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Customer Service Response:

385 calls were made during December The questions asked focused on measurable

customer service actions.

Patient Comments:  “They arrived promptly! Very professional. They were very professional, super- efficient, no wasted steps. Tell the guys I really appreciate all they did for me. And they need a raise.....”  “They were true trained professionals, and the response time was incredibly fast. They were out- standing. They retrieved my personal items from my car and my driver's license, so that was plus. If you see them tell them I think they are top notch and I appreciate them.”  “They communicated well and help with the small child who was with us on our transport. We were very satisfied. And there were two of us in the same transport with the child.”  “They just made me feel really comfortable as I was very nervous. They were really good, and ex- plained a lot to me.”  “They were real great! One of the medic stayed with me until a someone was able to see me at the hospital and I surely do appreciate him for doing that.” Respondents were asked to rate the customer service provided by our medics on a scale from 1 to 5, with 5 being the best 91.49% of the patients rated the customer service they received at a 5 and 7.45% rated their service at a 4. The average rating overall was 4.90 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.  “They were excellent, let you know everything before they did it. Kept us informed.”

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