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Children’s Hospital & Wash U Host Free Pediatric Conference Page 4

February 2014

Important Ambulance Page 2

Maintenance Info

E-450 Ambulance Do’s & Don’ts By Robert Kemna The rollout of the 2013 E-450 models means there are some changes you need to be aware of as ambulance operators. Attention to the three points below will help to make these trucks safely perform as designed and reduce down time for the rest of the fleet. 1. The new trucks use gasoline for fuel. Pay attention to

what nozzle you grab at the pump. Make sure it delivers the correct fuel to the tank.

2. No E-20 or E-85. The fuel tank,pump,injectors etc. are NOT compatible with high percentage ethanol blended fuels.

3. Check the engine oil level. The V10 6.8L engine will burn/use oil especially in the “break in” period 0 to 20K miles. The oil capacity of the V10 gas engine is less than half of the 6.0L Turbo Diesel we currently use. This makes it very important to monitor the dipstick level and oil pressure gauge. Lack of oil is the most common cause of failure with this engine. FAQ’s

Why the gas engine?

Ford does not offer the diesel engine in the E-450 van model. Why not change chassis to GM or Dodge?

The box/module that we have been using since 1999 are floor structured to fit the E-450 chassis frame. In order to remount on a different chassis/frame would require modifications that are costly and stand the chance of failure because of many variables that are difficult to test. The short box/module extended cab version is one example of a past modification. What if I put the wrong fuel in the tank?

Turn off the vehicle. Contact your supervisor immediately. The truck is out of service. You will have to switch out. The truck will have to be towed to the service center for repair. Improper fueling of a vehicle is not covered by warranty.

Monthly Totals Annual Totals

Medic Dec-13 Dec-12 2013 2012

1 124 134 1522 1492 2 202 188 2118 2100 3 208 193 2318 2291 4 176 148 1958 1802 5 175 165 1883 1880

205 168 158 1900 1892 6 180 155 1903 1855 7 134 138 1557 1502 8 173 171 1946 1828

208 0 2 57 202 9 166 150 1695 1750

14 173 129 1555 1506 15 227 132 2005 1679 215 23 137 985 1646 17 94 73 1119 1093 30 44 39 515 431 703 82 76 1023 992 803 84 77 709 815 804 106 95 1062 1095 715 94 86 1028 934 815 98 86 1059 971 821 85 86 1003 943 822 100 76 961 925

Other 5 15 334 336

December Property Cost Report

Base / Building Dec-13 Cost

1 679.43 2 702.02 3 1044.16 4 1075.44 5 935.02 6 744.42 7 657.82 8 722.40 9 661.24

10 704.10 14 789.82 15 805.44 17 2262.76 30 2166.49 20 411.51 40 950.03 HQ 4816.49

Training 1007.12 Maintenance 2872.28

December Fuel Consumption

Business Breakdown

Truck Number

Dec-12 Usage (gal.)

Chief 49.50 Spcl Ops 19.13

Ops Coord 61.25 Shift Off 0

PIO 48.79 South Sup 277.80 West Sup 177.52 East Sup 218.93

Lead 18.30 9611 23.98 9612 8.87 9619 0 9620 241.47 9621 0 9623 233.54 9625 340.69 9626 0 9627 0 9628 274.83 9629 248.36 9630 263.39 9631 0 9633 54.03 9636 164.02 9637 232.68 9638 365.63 9639 253.90 9640 165.64 9641 246.88 9642 56.99 9644 226.89

Truck Number

Dec-12 Usage (gal.)

9645 183.00 9346 348.22 9347 322.77 9648 241.84 9649 304.79 9650 239.22 9651 359.06 9670 107.15 9671 264.31 9672 84.56 9673 0 9674 0 9675 229.30 9676 27.25 9678 57.10

Prop Mgr 103.00 Maint Van 57.78

Maint Truck 72.95

Porter 18.87 Porter Van 93.86 Prtr. Truck 36.82 Veh Tech 57.59 Veh Tech 54.42

9690 – Trng. SUV 14.58

9691 – Trng. SUV 0

9697 – USAR tow 0

9698 – Adm. SUV 20.05

December Overall Call Summary

2013 2012 Variance Transports 2,046 1,931 +6.0% Non-Transports 316 293 +7.8% Other (disregard, etc.) 559 485 +15.3% TOTALS 2,921 2,709 +7.8%

Year To Date Overall Summary

2013 2012 Variance Transports 22,945 22,767 +0.8% Non-Transports 3,691 3,925 -6.0% Other (disregard, etc.) 5,579 5,275 +5.8% TOTALS 32,.215 31,967 +0.8%

CEU Opportunities Friday, February 7 7:30 a.m. – 3:30 p.m. Children’s Hospital & Washington University Physicians Present: 3rd Annual EMS Conference & Clinical Save Awards

• Presentations include: o Sport-related concussions o Pediatric Readiness in the ED o EMS Recognition & Response to Child

Abuse o Disaster Management of Pediatric Pts o Update on DKA Management for Pre-

Hospital Providers o Interesting case presentations

• Course Fee: Free • CEU Category: Pediatric • Number of CEUs: 6 • Course Location:

Eric P. Newman Education Center 320 S. Euclid, St. Louis 63110

• Pre-registration is required. Two options: o Online at stlouischildrens.org/med_ed,

select “3rd Annual EMS Conference” o By Phone at 800.678.4357

Tuesday, February 25 or Wednesday, February 26 Pharmacology of Commonly Used Emergent Meds

• Case-based presentation of the pharmacology of medications used to treat common emergent conditions such as tachycardia, bradycardia, atrial fibrillation, pneumonia with sepsis, acute coronary syndrome and more.

• Course Fee: Free • CEU Category: Medical • Number of CEUs: 2 • Course Location:

Missouri Baptist Hospital Clinical Learning Institute, Room 421 4th Floor of Main Parking Garage 3015 North Ballas, St. Louis 63131

• Pre-registration is required. o By phone to EMS Coordinator Crystal

Crump at 314.996.5757.

“Lunch With Lewen” Program Returns For 2014 Barnes St. Peters & Progress West are teaming up once again in 2014 to offer a series of free ‘lunch & learn opportunities’ to care providers. Dr. Missler will be joining Dr. Lewen as a presenter this year. Each event will provide one hour of CEU credit. Dates and locations for the year are as follows: February 20, 11 a.m. – 12 p.m. Healthwise Building (BSP) Presenter: Dr. Lewen June 19, 11 a.m. – 12 p.m. Healthwise Building (BSP) Presenter: Dr. Missler October 16, 11 a.m. – 12 p.m. Healthwise Building (BSP) Presenter: Dr. Lewen December 18, 11 a.m. – 12 p.m. Large Conference Room, Progress West Presenter: Dr. Missler Advance registration is kindly requested for all events. If you will be attending, please contact Clinical Education Specialist Maureen Falcone at 636-344-1363.

RPA Corner How To Manage An Inheritance Over half of American retirees expect to leave an inheritance for their loved ones, with an average value of more than $176,000.1 If you have recently received a bequest or are anticipating inheriting sizeable assets, now is the time to plan. Here are some tips to help you manage an inheritance.

• Wait and develop a strategy. Start by parking the money in the bank and take an inventory of your financial life. Are you on track for retirement? Do you have adequate insurance? Do you have significant debt? Are you supporting a family?

• Pay down your high-interest debt. Near the top of your priority list should be eliminating consumer debt, especially high-rate credit card debt. But think twice about paying off your mortgage, unless owning your home outright is an important goal for you. Your mortgage interest rate is likely low, and the money may be better used elsewhere. The same goes for paying off college loans at low interest rates.

• Save, save, save. Next step should be to turn to your savings, which may include funding an emergency fund of about six months' living expenses, putting aside money for retirement, and setting up accounts for your children’s education and other life expenses.

• Don't rush to spend. Ideally, the money should bring you closer to financial independence, but many heirs don't know how to handle a windfall and end up no better off than they were before. Take small steps when making your decisions. Instead of quitting your job right away, consider working part-time. If thinking about purchasing a luxury sports car, try renting one first. The goal is to avoid making irrational decisions you might later regret.

• Do your research. If you've inherited a traditional IRA, research the options available before making changes. If you're not a spouse, you can't roll the inherited IRA into your own. Non-spouses are required to take taxable minimum distributions every year based on life expectancy. Instead of treating the distribution as an annual windfall to be spent, plan to integrate it into your long-term strategy.

• Find a suitable long-term investment strategy. Constructing a portfolio that generates passive income is the slow-and-steady approach that will lead to financial independence. To achieve stability and income growth, you'll need to mix stocks and fixed-income investments, but don't speculate by sinking it all into volatile equities or go too conservative by keeping it too heavily invested in cash or fixed-income securities. The point is to make the money work for you without unnecessary risk.

• Hire an expert. Managing an inheritance gets easier with professional financial help. Consulting a financial planner, investment professional, or tax accountant will help you maximize your current plan or help you develop a plan if you don't have one. If you know you'll inherit, you can begin planning ahead of time, but if the inheritance comes as a surprise, a professional can provide a better idea of your options. Be sure to get an objective opinion that is based on your entire financial picture and a thorough understanding of your goals.

This communication is not intended to be legal and/or tax advice and should not be treated as such. Each individual's legal and/or tax situation is different. You should contact your legal and/or tax professional to discuss your personal situation. 1Source: HSBC, "The Future of Retirement: Life after work?" December 2013.

© 2014 Wealth Management Systems Inc. All rights reserved. Registered Representative, Securities offered through Cambridge Investment Research, Inc., a

Broker/Dealer, Member FINRA/SIPC. Investment Advisor Representative, advisory services offered through Retirement Plan Advisors, a Registered Investment Advisor. Cambridge and Retirement Plan Advisors are not affiliated.

February Birthdays Chris Picker February 6 Beau Lewis February 4 Taz Meyer February 4 Brian Webb February 4 Tim Maguire February 8 Heidi Bohrmann February 14 Kelly Conner February 17 Janet Schulte February 17 Steve Scott February 25 Erin Helfrich February 27

District Anniversaries Kathy Meadows 30 years Jim Fingerhut 29 years Heidi Nabzdyk 27 years Donna Baker 25 years Brian Schnelle 19 years Nikki Mergenthal 19 years Dan Grizard 16 years Kelly Conner 8 years Scott Cooke 8 years Carissa Palermo 8 years

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SAFETY FIRST: The thought of being in a motor vehicle crash while driving an ambulance is something we don’t like to think about. But in the interest of safety (our own as well as our patients’), we ought to be prepared for the worst case scenario, taking whatever measures are within our ability to control.

Prevention is always better than crisis management. That fact became very personal for m when I was involved in a front-end ambulance collision. In addition to a concussion and several lacerations, I suffered fractures to my cervical spine, scapula, wrist, and ribs. I know a number of our medics have similar stories. Thankfully no patient was on board; that would have been disastrous given the condition of the patient compartment which was crushed and ripped apart like tin foil. If a patient had been on board, supine on the stretcher without properly secured shoulder straps, I doubt he or she would have survived.

Personally, I have noticed an increase in the use of shoulder straps in recent months, and I applaud everyone who has made this practice a habit. However, one other thing I have observed is the tendency to apply the straps over the patient’s pillow. And as a result, the straps are so loose that they can be easily slipped off the patient’s shoulders or would allow too much forward movement in a front-end collision. Thus, while there are certainly other ways to properly utilize the shoulder straps, I would like to recommend the following method: Secure the straps first, and then place the pillow over the straps and beneath the patient’s head, as shown in the photographs.

But don’t take my word for it. Give it try for yourself and see if you agree that this simple practice has the potential to make shoulder strap application more safe and secure.

Shoulder Straps By Dave Dalton & Kim McKenna