PULSE Magazine | September 2015 Issue

September 2015

AN AUSTIN-TRAVIS COUNTY EMS PUBLICATION P U L E

1 Exploring the Path to EMS

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Contents

August 2015

Cover Story + Features

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COMBINED CHARITIES

The Annual City of Austin Combined Charities Campaign starts October 1st and runs throughout the month. The theme for this year remains “City of Austin Employees Care,” an apt description of the way we approach our interactions with others whenever we see a need.

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A LION’S HEART

Explorer Post 247: Today’s youth taking on the challenges of EMS with the heart of a lion. Welcome to Exploring. Exploring is a program for youth ages 14 to 20. Focusing on career and education, Exploring is a program for young men and women to learn about a career field and grow into young adults.

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ATCEMS RECEIVES AN EMMY

In the summer of 2014, ATXN submitted the “Shattered Dreams” production to the Lone Star Chapter of the National Academy of Television Arts and Sciences for EMMY® consideration in the category of Children/Youth/Teen - Program Feature category.

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SITUATIONAL AWARENESS

Each of us need to exercise these skills every day in the performance of our duties and in our daily lives. Drill each other in situational exercises such as “What if…” scenarios to remain mentally sharp and aware of our surroundings at all times.

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In Every Issue

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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.

Division News

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SNIPITS

HONOR GUARD—GOLDEN OPPORTUNITY

This year, for the first time, the Austin-Travis County EMS Honor Guard has been invited to present the colors at two International races at the COTA track.

Get to know your coworkers a little better. ________________________________________

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COOKS AMOUNG US

DIRTY SOUTH SWEET MEAT TACOS

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A healthy meatless full flavor taco recipe provided by Shannon Cook

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COTA TRACK MEDIC PROCESS

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We have had track medics working at Circuit of the Americas for the past three or four years. The list of the original group that we began with has been exhausted. The team we tested initially consisted of 70 employees.

CUSTOMER SERVICE SURVEY

Results from the ATCEMS Customer Callback Program.

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TO FALL OR NOT TO FALL

Falls have become the leading cause of preventable injury and death for our elders—age 65 and older. According to the Center for Disease Control (CDC), millions of older people fall each year. In fact, one out of three older people falls each year, but less than half tell their doctors.

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The Annual City of Austin Combined Charities Campaign starts October 1st and runs through out the month.

The theme for this year remains “City of Austin Employees Care,” an apt description of the way we approach our interactions with others whenever we see a need.

The City of Austin Combined Charities Campaign has been a part of our organization for more than two decades and is one that I have supported and have worked on for many years.

I was the citywide Campaign Coordinator 10 years ago. Through that experience I gained an appreciation for how your sacrifices help thousands of people in our community, the nation and the world.

Today, I am humbly and enthusiastically ready to lead the campaign as Chair to achieve even greater things to help meet those increasing needs.

As you know, COACCC is one of the strongest payroll contribution giving campaigns in Central Texas, both in total giving and percentage of participation. Last year, City employees raised $517,000. Since its inception 22 years ago, COA employees have contributed more than $12 million. Your contribution to the many organizations that make up the Combined Charities Campaign is a great way to support the causes that impact the lives of so many – people whom you live near and work with on a daily basis or people in our global community. I want to encourage you to take the time to read about the many worthy charities included in this year’s campaign. All of us know someone who has been touched by these organizations. That’s why your support is so important. The COACCC Online Secure Pledge System allows you to go a special website through the City’s CitySpace intranet site and research charitable organizations, calculate your payroll contribu tions, and submit your donations electronically. One-time donations can also be made online with a credit card. We understand some employees may not have easy access to a computer so we’ve asked Department Directors to have printed forms and a printed booklet available for employees to use for the campaign. Just check with your Departmental Campaign Coordinator for assistance.

Again, I want to thank you for your support of the 2015 Combined Charities Campaign and for continuing to show our community that City of Austin employees care.

Rosie Truelove, Director Contract Management Department 2015 City of Austin Combined Charities Campaign Chair

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ATCEMS Receives an EMMY Award

On March 6, 2014, Austin-Travis County EMS, TCSO, STAR Flight , APD, AFD, TCME took part in a Shattered Dreams program sponsored by Vandergrift High School. While ATCEMS has participated in many of these events throughout the years, this was the first time that we collaborated with the City of Austin’s News Channel 6 (ATXN) as a key element throughout the planning, coordination, production, and post-production phases. In the summer of 2014, ATXN submitted the “Shattered Dreams” production to the Lone Star Chapter of the National Academy of Television Arts and Sciences for EMMY® consideration in the Children/Youth/Teen - Program Feature category. In the fall of 2014 the production was the Award Winning Entry. Due to the level of participation and contribution that ATCEMS provided, we were eligible to receive an EMMY® Statuette and an accompanying plaque that recognizes ATCEMS as a Co-coordinator / Technical Advisor in the award winning production.

In August of 2015 ATXN Station Manager Keith Reeves, Senior Producer/Videographer Jonathan Uhl, and Video Production Specialist James Williams presented ATCEMS with the award. Chiefs Rodriguez and Shamard accepted the award on behalf of our Department.

You can view the EMMY® Award winning video here: https://youtu.be/kLdfB0UPo5A

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HONOR GUARD’S GOLDEN OPPORTUNITY By Eric Whiteman , Commander

It is common knowledge that at this time each year, a few very prestigious International auto racing events are held at the Circuit of the Americas track. These events draw thousands of fans not only from the local region, but International guests and fans as well. In addition, these events are broadcast on television networks across the world. For those not familiar with auto racing, these races always have a pre-race ceremony that often includes an Honor Guard presenting the Nation’s flag and the singing of the National Anthem (usually by a celebrity). This year, for the first time, the Austin-Travis County EMS Honor Guard has been invited to present the colors at two of these International races: the 2015 Lone Star Le Mans race in September and the 2015 Formula 1 U.S. Grand Prix in October. This is an amazing honor for our team to represent our city, state, and country at an Interna tional event that will be seen across the world! Through the hard work and dedication of several members, our team has gained recognition and respect, and built a very positive reputation that we are proud of. We hope this opportunity at COTA is simply the first of many more to come.

Left to Right —Amanda Baker - Mll, Ricardo Aguilar-Ml, Eric Whitman -Commander, J.C. Ferguson MII, Lisa DeMayo Mll

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Peer Support Black Team

Professional~Effective~Empathetic~Respectful PEER SUPPORT

PEER SUPPORT team members open up and share a part of themselves, allowing us into their personal lives to shed some light on what motivates them.

Wes Hopkins I have been with Austin Travis County EMS for 14 years. I have worked as a Medic-II, FTO, Captain, Rescue Medic and now a Com mander, hopefully making Special Events an enjoyable work assign ment. I joined Peer Support because I truly believe the best thing about ATCEMS is the people. This diverse group of medics is truly impressive and I get to witness it in action at every event we work. The most rewarding part of my job is helping the men and women that help our patients. I hope being a member of Peer Support allows me the opportunity to do more and I’m humbled to get to serve in this capacity.

Liz Yankiver

I have been here at ATCEMS since August 2001. I became a Peer Support team member to provide support to my co-workers who are in need. This need for me arose when I went through some hard times in 2013, both professionally and personally. I am lucky that I have a wonderful group of friends who recognized a need for me. I don't want anyone else to have to feel alone in their processes, what ever they are. In my spare time I am an Olympic weightlifter, and am the Texas State record holder in my sport. I also enjoy shooting, swimming, and spending time with friends. I have two cats, Jacey and Waylon, who are my fur children.

Sam Latta

I wanted to join Peer Support Group as a way to offer my support to others who may be going through difficult times. I think letting others know there is someone who will listen and can keep confidentiality is very important. We are our brother’s keepers.

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Courtney Remington

I joined the peer support team because I've faced my own strug gles and know what it's like to feel alone. I also have been fortu nate enough to have a wonderful, open support system of family and friends who will be there no matter what. My hope is to pro vide an outlet for anyone who might feel comfortable talking with me, and if not me, I will refer them to another peer support member who might be better suited to help them.

Neda Oskouee

I have been with the department since October 2004. Peer support is truly important to me. Believing that we are never alone and that we have someone that can understand the challenges we face or is there to just listen has been priceless in my own life. I believe this team in conjunction with all our peers will be one of the catalysts for incredible growth and unity in this department. It is a sincere honor to serve my peers.

Heath Holt

I am 29 years old and have been married to my wife Ali for 8 years. We have a daughter named Rosie who is 3 and another on the way. I grew up on a cotton farm in the panhandle of Texas. I went to school at Texas State University. After college I worked with the YMCA of greater Tulsa Oklahoma as a camp and aquatics director. I basically ran a summer camp and all the pools. I found this job very stressful and unfulfilling so I became an EMT basic and was half way through paramedic school before actually doing an EMS ride along. I worked for several years as medic supervisor at Muskogee county EMS. Yep, same place as the Merle Haggard song. It was a great place to learn but, Texas is home and my wife is from Georgetown so we moved back. I was hired here in February of 2013. It has been a great experi ence this far we are happy to have put down some roots in Leander. Outside of work I love hanging out with family and being active in our church. If it's October February any spare time I have is spent duck hunting. I am very proud to be part of the peer support team. There have been some great people throughout my career that have walked with me through things. My hope is that I can pay that back through peer support if ever needed.

Amber Price

I've been a field paramedic at ATCEMS since 2004. I enjoy being on the truck and getting the opportunity to see numerous co-workers throughout the day. It’s a bright spot for me every shift. My peers are important to me and it just felt natural to go through the training and support my ATCEMS team.

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COTA Track Medic Process By Wes Hopkins, Commander

We’ve had track medics working at Circuit of the Americas for the past three or four years. The original group that we began with has been exhausted; the initial team we tested consisted of 70 employees. When it came time to send them to training some of them had moved on to other things such as captains or the Academy, or it just wasn’t their thing anymore and chose not to continue with the training. With the increase in events at COTA we are now in need of more track medics and felt it was time to proceed with another process. This year we included Medic I’s in our delivery model. Special Operations uses the same delivery model in their testing process with pronounced success and a great participation rate in the process. I am hopeful to have a 20- 25% training combination of Medic I’s, Medic II’s and Captains. The group we have been testing is top notch. The process involves a letter of interest, a commander feedback form and a physical assessment. Once the track medic physical assessment has been passed they will be sent to COTA for a detailed, week long training that will hopefully take place in late August. The week long training is actually paid for by COTA, who flies in a special instructor to train our track medics in safety protocols and use of gear on tract, tools and specialty cars. When it comes to Formula One motor GP Debussy the medic ones are on the track in track suits with helmets. controlled by race control working on an active live racetrack the medics are there for the participants. When it comes to X games we use the track medics because they’re familiar with the very confusing Cota track so we utilize them for the athletes during the x games.

Track Medic Program Physical Skills Assessment

The Physical Skills Assessment is conducted in full bunker gear, gloves and helmet. There is not a time limit, how ever once the assessment begins all stages must be completed without breaks or setting down the equipment.

Stage 1: Candidate will walk/run from the start line for 40 yards to the beginning of stage 2.

Stage 2: Carry two (2) 20 pound buckets 40 yards and place them in the designated area.

Stage 3: Carry designated rescue extrication equipment (or simulated equipment) weighing no more than 100 lbs. total for a distance of 40 yards. Stage 4: Move a 120 lb. mannequin utilizing a patient immobilization device (with assistance from a test moderator) for a distance of 40 yards.

Stage 5: Drag a 165 lb. mannequin under the shoulders and backwards for 20 yards.

Stage 6: Finally, the candidate will walk/run for 20 yards to the finish line.

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Overview :

Personnel who become members of the Track Medic Program will be part of an all hazard, multi-discipline team that will work together to provide a total safety experience for the drivers of high profile racing and other motor events. Track Medic Program members will be providing emergency medical care and rapid extraction of a patient or mitigation of hazards while on the track; with vehicles traveling at a high rate of speed in close proximity to them. At all times, Track Medics must be able to provide care or mitigate the hazard while remaining acutely aware of the vehicles that are around them and be prepared to take evasive actions. For these reasons, members of the Track Medic Program must meet physical requirements that are more rigorous than the Field Medic. Track Medic members will be required to wear Nomex suits, gloves and racing helmets for long periods of time in all weather conditions. Team member duties will not be exclusive to patient care. Members may be required to perform patient rescue utilizing rescue tools, perform hazard mitigation, as well as track cleanup which may include mending and fixing track walls and oil or fluid clean up.

Team membership is strictly voluntary and does not receive a stipend.

On the last day of evaluations we captured some of

the applicants hard at work.

Commander Wes Hopkins stepped up and completed the physical skills assessment as well.

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TO FALL OR NOT TO FALL?

By Randy Chhabra , Captain

ATCEMS Injury Prevention Provides the Answer

Falls have become the leading cause of preventable injury and death for our elders—age 65 and older. According to the Center for Disease Control (CDC), millions of older people fall each year. In fact, one out of three older people falls each year, but less than half tell their doctors. These falls can be devastat ing, causing a tremendous amount of morbidity, mortality and use of health care services including premature nursing home admissions. Retrospective studies have identified certain risk factors that can be addressed in order to remedy this growing problem. These risk factors include:

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Lower body weakness

 Vitamin D deficiency (that is, not enough vitamin D in your system)

 Difficulties with walking and balance

 Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.

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Vision problems

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Foot pain or poor footwear

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Home hazards or dangers such as

Broken or uneven steps

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 Throw rugs or clutter that can be tripped over, and

 No handrails along stairs or in the bathroom

Solution Austin-Travis County EMS has joined both St David’s Medical Center and Seton Health Network to provide the Stepping On program; a seven week class that includes individualized follow-up that addresses the identified risk factors. In addition to the Stepping On program, ATCEMS has created a home inspection process for those elders who are unable to attend the seven week class. The home inspection will allow trained staff to conduct home visits to address the identified risk factors and provide our community elders with solutions.

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Fall Home Inspection Specialist

ATCEMS now has 18 trained personnel who will be conducting home visits to assist community elders. Personnel will provide strengthening and balancing activities, review of co-existing medical conditions and provide environmental inspection and hazard reduction. They will work in collaboration with other local organizations like Handy Wheels (branch of Meals on Wheels) and the Texas Ramp Project to address home hazards that are identified during the home visit.

Families can be referred for a home visit by ATCEMS personnel or by local hospitals. These referrals will be received by the ATCEMS Injury Prevention team and families who qualify will be enrolled in an upcoming Stepping On Program or scheduled with a with a home inspection appointment.

To qualify for either program, a person needs to be living independently, able to ambulate without the need of significant assistance and have no mental capacity issues such as dementia or Alzheimer’s.

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A LION’S HEART

By Marc Peek , MII

Explorer Post 247 takes on the challenges of EMS

Sweat rolled down the Explorer’s forehead and his arms were starting to ache. The adrenaline was rush ing through his body as he focused on his task. Repeated skills practices gave him confidence in what he was doing. Beaming with pride, he was part of a team. This was something that had a purpose, some thing that held consequences and affected the very life in front of him, the life of a man. At fifteen years of age and just becoming a man him self, the teenager certainly wasn't what the audience at the bus stop was expecting to see as he leapt from the back of the ambulance. He was a clean slate and with a youthful lust for the job, he stood in stark con trast to the medic preceptors with him today. These medics who pay the price for lost souls and hide the pride of lives still being lived. Together, what they symbolized would be lost on the anxious spectators in front of them. But, the picture couldn't be more apparent as old gives way to new and present to fu ture. EMS is in a constant state of evolvement. Silently counting out a rhythmic cadence, 97…98…99… 100, his hands popped off of the man’s chest as the paramedics checked for a pulse and quickly acknowl edged the rhythm darting across the heart monitor. Sirens from the responding apparatus grew louder as the fire fighters approached. On their arrival, he would step back and let them fall into position. As CPR continued, he observed everything he could.

Welcome to Exploring. Exploring is a program for youth ages 14 to 20. Focusing on career and educa tion, Exploring is a program for young men and women to learn about a career field and grow into young adults. The Explorer program is regulated by Learning for Life, a youth organization that is an affiliation of the Boy Scouts of America. Explorer posts are found in all different career fields. Police, firefighting, and EMS are prevalent, but careers such as doctors, lawyers, pilots, accountants, veterinarians, and many more are also represented. Really, just about any organization can start an Explorer Post. Each post is unique to its environment. Post organiza tions, advisors, and participants decide how their indi vidual post will look and run. All of the posts are com mitted to educating youth about their respective career fields and helping to instill values such as responsibil ity, leadership, teamwork, character, and life skills. Founders of ATCEMS Explorer Post #247 (for 24/7), Bryan Green and Rob Yarger, pursued the idea because of their interest in mentoring. Both had bene fited from their involvement in the Boy Scouts when they were youth and continue to have a deep connec tion with the organization. ATCEMS is committed to the success of ATCEMS Post #247.

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Our post has a chain of command that includes Com mander, Tracy Hardy; Assistant Chief, Teresa Gard ner; Division Chief, Pete Didonato; and Chief of EMS, Ernesto Rodriguez. They have been very excited about the post and have been instrumental in our success. We have received a great deal of support from our command structure and look forward to an exciting future. The post has seen explosive growth in youth participa tion. This has caused some growing pains as we try and transition to a more structured practice. It is a lot of work planning and executing day to day administra tion tasks and post events. There are five main post advisors; Paramedic/Captain, Bryan Green (lead advisor); Paramedic, Rob Yarger (lead advisor); Para medic, Marc Peek; Paramedic, Fiona Campbell; and Paramedic, Amanda Baker, who have volunteered in upwards of 600 hours each in non-compensated time this year alone. Many other advisors give their time in

Teamwork and team cohesiveness are the primary goals of these camps. The youth get to stretch their boundaries and limits. It is a lot of hard work, but very rewarding for all of us. Most of our youth go on to get their E.M.T. certifica tion. One of our long range plans is to have an in house E.M.T. certification course for the youth. As they graduate high school, we have seen many of them start their adult careers right here at ATCEMS. You might know some of them. Melody Malone was our first Explorer to be hired followed by Conner John son and Rachel Lerma. We are very proud of them. Not all of the explorers want to work EMS. There are diverse interests from veterinarian to a fighter pilot. If mentoring youth or just bestowing your vast knowledge of EMS to a teenager who yearns to be more is something that you are interested in, we can always use volunteers. You can volunteer in whatever capacity works for you. We can always use more preceptors for the youth to ride out with. If you wish to do more, such as teaching or helping out at our camps, we can use that as well. However you see fit to participate, I can promise you, it is a very rewarding experience. If this is something that interests you, contact any of the advisors by emailing emspost247@austintexas.gov.

Greatness is not measured

by money or status.

It is measured by

capacities that fit their schedules. Advisors can help out at our weekly meetings, with ambulance ride outs, and with our many activities. The post is run by the youth with the help of the advisors. There is a command structure staffed by the youth. It follows a basic format of Commander, Lieutenant Commander, Treasurer, Secretary, and Quarter Master. These are voted positions. There are two platoons comprised of two squads each where the youth are assigned and led by a platoon Lieutenant and Sergeant. Each explorer works hard to promote through the ranks. Each promotion includes a combi nation of ride out hours, volunteer hours, certifications such as AHA BLS Healthcare Provider and AHA First Aid, as well as demonstrated proficiency in skills. The post actively participates in cross training with APD and AFD explorer posts, weekly meetings, and public service projects. Each year we also provide a winter camp and a summer camp where the youth get to learn exciting skills such as rappelling, land naviga tion/rescue, and water rescue. This also gives them the opportunity to practice skills such as patient assessment, treatment, and patient packaging/ movement in real world environments.

courage and heart

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Developing Situational Awareness Developing Situational Awareness

Situational awareness is really just another word for mind fulness, and developing it will make you more cognizant of what’s going on around you and more present in your daily activities. While the focus is primarily on developing your situational awareness to prevent or survive a violent attack, the principles discussed will help hone your powers of observation. Situational awareness can be cultivated by generally keeping tabs on your surroundings — “checking your six” and “keeping your back to the wall.” The OODA Loop is a learning system and decision-making process that was first laid out by Air Force fighter pilot and military strategist John Boyd. The four steps of the OODA Loop are Observe, Orient, Decide, Act. In a head-to-head competition, like air-to-air combat or a violent confrontation in a parking lot, the person who can cycle through the OODA Loop the fastest wins. Obviously, the Observe step in the loop is what most people associate situational aware ness with. It is the second step in the OODA Loop – Orient — Orientation tells us what we should look for when we’re observing, and then puts those observations into context so we know what to do with the information. So Observe + Orient = Situational Awareness. But how can we become better observers so that we can improve our situational awareness? And how should we orient ourselves so that we observe the right things and understand the context for what we’re seeing? Observe + Orient = Situational Awareness :

specific threat situation, but you have your head up and you’re taking in your surroundings with all your senses. Most people associate situational awareness with just visual stimulation, but you can also learn a lot about a particular scenario from the sounds (or lack thereof) and even smells in the environment. Even though your senses are slightly heightened it’s also important to stay relaxed. By adopting a calm demeanor, you won’t bring any unnecessary attention to yourself. If you look antsy and your head is swiveling frantically while you scan your surroundings, people are going to notice you. Additionally, staying relaxed ensures that you maintain an open focus, which allows you to take in more information about what’s going on around you. Research shows that when we get nervous or stressed, our attention narrows, causing us to concentrate on just a few things at a time. A narrow focus can therefore cause us to miss important de tails about our environment. Situational awareness isn't just about the human variety. Look up from your smartphone or tablet, don’t zone out, open your eyes, ears, and nose, and calmly scan your environment to take in what’s going on. Put yourself in a position for optimal observation. To achieve effective situational awareness, you need to be able to observe as much of your surroundings as possible. Positioning yourself in obstructed spots will inhibit the flow of information coming in. For example, something might be in your way that prevents you from seeing a bad guy enter a theater or restaurant. You also don’t have eyeballs in the back of your head, so you can’t see what’s going on behind you. So whenever you enter an environment, put yourself in a position that will allow you to see as much as you can.

Observe: Stay in Relaxed Alert Condition

The Relaxed Alert Condition is best described: There’s no

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Find a place where you can view all or most of the exit points, and that allows you to put your back to the wall. This position readies you to make a quick getaway, and eliminates the possibility of failing to see a threat material ize behind you. Hone your observation skills by playing the A-Game. To play, when you go into a business, make note of a few things about your environment: the number of workers behind the counter, the clothing and gender of the person sitting next to you, how many entry/exits there are, etc. When you leave ask your partner questions like “How many workers were behind the counter?” “Was the person sitting next to us a man or a woman?” “What color was his/her shirt?” “How many exits were there?” This trains you to be more mindful of your surroundings. Being more observant isn’t enough to master situational awareness. You have to know what you’re looking for, and then put that information into context so it has meaning and becomes actionable. That’s where the Orient phase comes into play. The Orient step provides three things to help us achieve situational awareness: 1) baselines and anomalies for our particular environment, 2) mental models of human behavior we should look for, and 3) plans of action depending on our observations. Every environment and person has a baseline. A baseline is what’s “normal” in a given situation, and it will differ from person to person and environment to environment. For example, the baseline at a small coffee shop will usually entail people reading a book or working on their computer or at a rock concert would be loud music and people looking at the stage while either jumping up and down to the mu sic. We establish baselines so that we can spot anomalies. According to Patrick Van Horne, situational awareness expert, instructor of the Marine Combat Profiling system, and author of Left of Bang, “Anomalies are things that ei ther do not happen and should, or that do happen and shouldn’t.” Anomalies are what direct our attention as we take in our surroundings and what we need to focus on to achieve situational awareness. Orient: Baselines, Goals, and Action Plans

Behavioral Clusters to Look For:

Our inability to pay attention to everything all at once makes it impossible to obtain complete situational aware ness. The human mind can only handle so much information at a given time. Thus in the domain of personal safety, where things unfold quickly and seconds are often the dif ference between life and death, how we direct our attention is paramount. So we need to focus on a few things at a time that provide the most bang for our attentional buck. This is done by relying on heuristics. Heuristics are quick and dirty problem-solving decision-making mental shortcuts our minds use to figure things out when minimal information is available and time is limited. Human behavior that Marine Combat Profilers use on the battlefield in order to quickly determine whether someone is a friend or foe. Within the domain of kinesics, three clusters of body language are of particular interest for situational awareness. They are: dominance/submissive behavior, comfortable/uncomfortable behavior, and interested/ uninterested behavior. Dominance/submissive behavior . Most people try to get along with others, so for the most part people act in accommodating and submissive ways. Dominant behavior “is an expression of the limbic system’s fight response” and often manifests itself in “gestures and postures that make a person look larger to intimidate ‘smaller’ individuals into submission.” This does not relate to size but also to positions of power. Dominant behavior often constitutes an anomaly, and the person displaying it deserves more atten tion. If someone acts in a pushy, authoritative, or overbear ing way, it doesn’t necessarily mean they’re a threat; con text matters. You’d expect a boss to act dominant in rela tion to their employees and the employees to act submis sive to their boss, but seeing extreme dominant behavior exhibited by a customer towards an employee isn’t as com mon. That’s something to keep an eye on. Comfortable/uncomfortable behavior . Most people are going to look relatively comfortable in most situations. If someone looks uncomfortable, that’s an anomaly that warrants extra attention, but it doesn’t mean they’re neces sarily a threat. They could be distressed because they heard some bad news about a relative. A common display of un comfortable behavior you’ll see from individuals up to no good is that they’re “checking their six.” This is when a per son looks over their shoulder to see what’s behind them or generally scans their surroundings. People who are comfortable generally don’t do this because they don’t feel any threat. So if you see a guy looking over his shoulder a lot when he should be standing there aloof, that’s an anomaly that should get your attention. On the flipside, someone acting comfortable when everyone else is uncomfortable would be an anomaly.

Baseline Questions:



What’s going on here?



What’s the general mood of the place?

 What’s the “normal” activity that I should expect here?

 How do most people behave here most of the time?

Anomaly Question: What would cause someone or some thing to stand out?

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Interested/uninterested behavior. Most people aren’t paying attention to their environment. So individuals who are showing interest in a particular person or object that most people wouldn’t be interested in is an anomaly that warrants further ob servation. These three body language clusters establish baselines for every situation in which we find ourselves and allow us to direct our limited attention towards things that are potentially more important and/or dangerous. If their behavior doesn’t fit the baseline, they’re an anomaly and you should observe them more closely. Shifty hands. Military and law enforcement officers typically check the hands first on any person with which they’re engag ing. This is for two reasons. First, “checking the hands of a person ensures that the person is not holding a weapon and is not preparing to strike,” Second, hands often telegraph hidden nefarious intentions. People who are concealing something they don’t want discovered, like a gun, knife, or stolen object, “will often touch or pat that area on the body where that object is concealed, as if to ensure the object has not been lost or is still hidden from view.” “Acting Natural.” It’s difficult to “act natural” when you’re not completely focused on whatever it is you’re really supposed to be doing. People “acting natural” will appear distracted and over- or under-exaggerate their movements Animals are creatures of opportunity. They’ll typically only attack another creature if they look vulnerable. The same goes with humans. Criminals are typically going to go after a person who looks vulnerable, whether the victim is physically weaker or will simply be easy to catch off guard. Practicing situational awareness goes a long way in keeping you from appearing like an easy target. When you’re out and about, look alert. Get your nose out of your smartphone. When you’re walking back to your car at night, have your keys at the ready and constantly scan your surroundings. The less vulnerable you look, the less likely someone is going to mess with you. Other Behavioral Threat Indicators Situational Awareness as a Preventive Tactic

Practice, Practice, Practice

Situational awareness is a mindset that you have to purposefully cultivate. You want to get to the point that it’s just some thing you do without having to think about it. To get to that point, you have to practice it regularly.

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Your Safety Concerns

There are currently a lot of "discussions" floating around the field about our medics while in uniform being confused for police officers. One going as far as saying a communications chief while at a gas station in uniform being called a "pig" with the confronting party putting his hands under his shirt around his waist band making gestures as if he had a gun. I know how details of stories such as this can sometimes grow out of proportion. But this coupled with what is going on nation ally, and big city departments in the local area instructing their providers to not wear their uniforms to and from work doesn't help the rumor mill. I will tell you that I have seen fear in peoples faces when they are talking about this.

I think this is a fantastic opportunity for our leadership to address the front line staff, either squashing it or providing direction as appropriate.

Thank you as always for your time and all that you do.

David LeClere , Mll/FTO

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Mikel J. Kane, Division Chief:

Department, it really is a larger issue related to the nexus of governmental authority and the perception of “any uniform” is a member of Law Enforcement.

It is unrealistic to expect the department to remedy the current “blue shirt” with a patch or screen-print to differentiate our responsibility or mission, however the design of future shirts is being explored. I have also encouraged those staff members that if the explanation remains an unsatisfactory answer, to please take it upon themselves, given their level of concern, return to wearing the white shirt, wear the provided ballistic vest, or wear the reflective “EMS” traffic vest as these options might provide the organizational separation they require. It is my opinion that given the nature of our profession in public safety, the greatest protection remains vigilance, situational awareness, mental preparation and street survival skills. Each of us need to exercise these skills every day in the performance of our duties and in our daily lives. Drill each other in situational exercises as “What if…” so we remain sharp mentally and remain committed to physical readiness through solid PT and nutrition. Study the procedures for Emergency Activation of your radio equipment. Placement of the external microphone; can I reach it or do I have it on at all?

It is a combination of all the above that will give us the greatest chance for success and survival in this ever changing world we live. I hope this helps. Please feel free to contact me directly (for any reason) should questions remain.

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Bigger, Badder, Better

By Clemente Leal , EMT-P

BMW1200RT

Chief James Shamard has always shown a great interest in the PULSE Magazine, and definitely liked the unique way the mag azine tells the story of upcoming events. Chief Shamard told me that I should seek out Randy Vickery and ask him about the new motorcycles the department is proud to be purchas ing. So I caught up with Randy at a COTA medic testing process, and Randy explained, “What I’d like to see when you pull up on a Medic scene is a blue and yellow motorcycle. So when the ambulance is there, no matter who pulls up, you’ll know who the medical team is because we have blue and yellow ambulances and blue and yellow motorcycles. APD is identified as black and white and AFD is red.” These new motorcycles are going to be used on some of the bigger standbys; these are bigger bikes, going from a 650 to a 1200. They are full sized, water-cooled, it’s exactly what the police department has ordered, except ours will be blue and we took the radar holders off. BMW is the industry leader in police bikes. BMW will be manufacturing the blue bikes in Sep tember and we are hoping for delivery sometime in October/ November. Randy says “I’d like to have them here by December for Motor Training, we are going from 4 bikes to 6 bikes, and these will be the ones we put out in the street for 911 response. We will also use these bikes at the bigger events, like the Half Iron Man in October. It’s a 56 mile bicycle course and our small motors are running on a large loop. That’s a long run for a small bike. The first set of bikes we got are dual sport and the new ones are built for the street, but they can go on small trails like the hike and bike trail but not like the dual sport can. We really truly don’t do much off road though.”

Randy adds “90-95% of the bikes out there are black or black/ white color scheme. We were going to do something like we have now with a solid white, but we realized Hays County and Travis County have solid white bikes and we need to look different from the police officers. This will be the next level of our motor program.”

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“The only pitfall we foresee, is that the new bikes are bigger and taller so shorter riders are going to have to deal with that. The new bikes are not that much heavier, probably around 100 pounds and BMW has a state of the art brake system, the best brakes out there” he adds. Every new police motorcycle model is tested by the Michigan State Police and BMW has received the highest rating every year. It is the best bike out there, that’s why APD runs them. This is going to be a much more comfortable ride for our motorcycle medics. The new bikes have a full wraparound faring windshield for better protection during a rain so you’re less likely to get wet. The current bike’s windshield is only 6 inches tall (pictured left). We know these new bikes will be well received by our motorcycle med ics and we look forward to taking delivery on them later this year.

The department has had motorcycles on the street since 2009, but this is the first time the department has ever purchased motorcycles. We have four motor cycles and we have never spent a dime on them. One of the bikes we received through a grant and three were donated to us. “The drivers course will continue to be the same, which is based on Northwestern Universities Public Safety Officers Course and is a Nationally Certified Course. If you are police officer trainer, you take that course to learn and teach the same course. Our course will be the same, we will just integrate the new bikes” Randy says. “Our plan is to start riders out on the small bikes to get you warmed up and lead with everything we train, then put power to the rear wheel and turn in a tight circle. If it can be done on a Harley, you can do it on this bike which is 250 pounds lighter than a Harley. Most of our medics all ride full size bikes, so it’s not that much different, the ergonomics will be a little different, but they all ride like full size bikes” he states.

BMW’s Rendition of Delivered Motorcycles

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Appreciation

Can make a day, even change

A life. Your willingness to

put it into words is all that is

necessary

to make a difference ...

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COMMANDER BRAGGING POST

Photo Submissions by Commander Karonika recognizing the unwavering dedication of hard working crewmembers and the unique calls they encounter .

M21/DC4/SF 2 patients from a 30 ft fall, one TA GCS-3, other with a femur fracture, both by SF to UMCB

SAH : No words needed

Steve Bush working M17, the streets of Austin and the tablet!!

Brad Lines: contact rescue

Male in the water neck deep for over 8 hours having physical issues. M17 arrived on scene and deployed a rescue swimmer, Brad made contact and carried him to safety.

K2 pt. jumped from pedestrian bridge on Lamar into Lady Bird lake, M17 (Bush/Gastelum) and I were staged for the EPD portion (running around the bridge yelling) of the call when he jumped in. When APD located the subject he was having trouble keeping his head above water and appeared in distress. Aaron was sent into the water assisted by AFD for a contact rescue. Crew transported to UMCB, pictures to prove it.

M02 (McDaniel/ Jacob Chavez), E20, E29 and DC4. Cad traffic from APF

David radio.

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Minnie Lopez & Maria Vallenzuela

Bryan Mason, Mll

Assistant Chief Jasper Brown

Flashback! Clemente Leal AKA Robomedic

Emmy Award winning Chief Rodriguez

Amira Del Rosario—Scheduling

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Freddie Garcia, Mike McDaniel, Noe Leiva, Karen Hill

Emmy award winning Chief Shamard

BAR team’s David Andersen

Elizabeth Campbell, Mll

Commander Broadwater

Matt Clark, Captain

Trevor Burrier, Mll

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&

M08 Mccall, Scott Oakley, Breanna

Note with payment:

“I just wanted to thank the people who cared for my husband, William. I really do appreciate how kind you were to me and William. He passed away on April 11 at Seton. I just felt that you guys don’t get enough kudos. “ Thank you,

Catherine Gill

Submitted by Margaret A. Hackett A/TCEMS Patient Account Supervisor

I was driving Kevin Wald and our patient to SAH when we got flagged down by the public for a gentleman who had fallen down a couple of times and hurt himself. I evaluated the man down and determined he was a BLS pt in need of transport. Kevin took on the burden on an additional patient without hesitation. There were 15 calls working South and it was after 1900 hrs, when Kevin was scheduled to be off duty, when Kevin stepped up for the man who had fallen and our system. Kudos to Kevin Wald for walking the extra mile without complaint to ensure Austin and Travis County have the best EMS service possible. I was working M24 last week when we were assigned a call at COTA for a concert goer who had succumbed to the combined effects of ETOH and GRAVITY. There was no pre-event briefing to reference when we were trying to figure out exactly where the Gator unit and their pt was. Wes Hopkins was running the show at COTA and monitoring our response channel. As soon as we came up on the radio attempting to contact the unit taking care of the pt Wes responded with clear directions to the pt and prompted the Gator crew to move to an area more accessible to our ambulance. We drove directly to the pt’s side and the transfer to our unit was smooth as butter. Thank you, Wes, for anticipating the problems we would have and solving them quickly.

Michael McDaniel, Captain/Mll

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

John Villanueva,

Thank you very much for your role as a Volunteer Mentor in the 2014-2015 American Heart Associa tion and Ross CPR in Schools Program. With your support, 1131 participating middle schools in the program trained 334,610 students! Your assistance has resulted in a tremendous impact on students and communities. We couldn’t have trained this many students without your expertise and help.

Please take a look at the following video that highlights the success of the program:

https://

www.youtube.com/watch?v=3vZuIeYAmAI&feature=youtu.be

Students have come away from the program with increased knowledge about CPR and increased comfort in performing Hands-Only CPR. Before the training, the average score on our 5 question pre -test was 50%. After the training, the average score was 84%. The percent of students answering 4 or 5 questions correctly was 27% of students trained at pre-test and 82% of students trained at post -test. We are incredibly proud of the students and facilitating teachers and Champions for this exceptional performance on the post-test. After the training, 76% of students said they would feel comfortable performing Hands-Only CPR if someone had a cardiac arrest. The program has been such a success this year that Ross has generously agreed to sponsor a similar program for 250 high schools in the 2015-2016 school year. High schools with greater than 50% of students eligible for free and reduced-price lunch will choose one or more grades in which to imple ment the CPR in Schools educational program using two free CPR in Schools Training Kits (a total of 20 manikins). Please share the following website with any teachers, high schools, or colleagues in your area and beyond that might be interested in the 2015-2016 program: www.heart.org/ rosscprschoolgrant With your help, this program has increased CPR knowledge in communities that will greatly benefit from it. We sincerely appreciate your assistance as a Volunteer Mentor for this program.

Sincerely,

Timothy E. Williams Director of Training Center Operations and Quality

Comilla Sasson, MD, PhD, FACEP

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