The FDA warning says the suspected counterfeit C-A-Ts have “subtle differences in stitching, printing of the logo and molding of plastic parts. They may be packaged and labeled for [an unauthorized] distributor.” If you suspect you have a counterfeit C-A-T, contact Special Agent Alex Alvarado, FDA Office of Criminal Investigations, at 240/276-9407.Pro BonoAssisted-Living Facility Patient TransfersConsider this scenario: You’re called to an assisted living facility, nursing home or other patient residence, and the staff (or a family member) tells you they want the patient to be transported to the hospital. The patient emphatically tells you, however, that they don’t want to go. How do you reconcile these conflicting instructions? Richard Rucker, executive director of the Ohio Department of Public Safety’s Division of EMS, says the law is geared for situations occurring in more rural areas where the run to the hospital could be 45 minutes because police have only two hours after an incident to gather accurate blood samples. A new law in Ohio allows EMT-Is and EMT-Ps to draw blood from accident victims for which police suspect drug or alcohol involvement, but the law is getting a lukewarm welcome from the EMS community. It remains to be seen how many EMS organizations will agree to participate. But, a key provision worked in by the state’s EMS board is the word “may” rather than “shall,” which allows EMS agencies to decide whether they’ll participate. JEMS Editorial Board Member Jerry Overton, MPA, has accepted a new position as chairman of the emergency clinical advice system and standards board for International Academies of Emergency Dispatch (IAED). According to an IAED statement, Overton’s new position will “oversee the processes that clinically and technically combine emergency medical dispatch protocols with nurse triage for health-care access management.”This article originally appeared in November 2010 JEMS as “New Ohio Law Allows Providers to Draw Blood: EMS could take samples for suspected drunken drivers.” Mack, like many others, says the participation challenges are in no way a suggestion that the EMS community doesn’t care. Indeed, EMS providers are usually the first to see the devastation of drunken driving. “The reluctance is not because we don’t care about making sure these people are held responsible for their actions. It’s more about the logistical issues,” he says. Richard Huff, NREMT-BPediatric Transportation Guidelines ReleasedThe National Highway Traffic Safety Administration (NHTSA) U.S. Department of Transportation recently released “Recommendations for the Safe Transportation of Children in Ground Ambulances.”David Bryson, highway safety specialist with the Office of EMS at NHTSA, stresses the report offers recommendations, not mandates or requirements. The working group was made up of experts from children’s health, medical and emergency organizations, as well as NHTSA and Health Resources and Services Administration personnel. They didn’t intend to provide the perfect solution to every situation, but rather a starting point for discussion. The idea is to be prepared so EMS providers aren’t caught unaware if they encounter a car full of kindergartners in a vehicle crash.Nationwide standards or protocols for the transportation of children in ground ambulances haven’t yet been developed, so EMS agencies, advocates and scholars looked to NHTSA for guidelines. The 54-page report contains literature review findings, child safety seat and car bed installation instructions and recommendations for governmental entities and manufacturers to consider. Most importantly, it presents an outline of five situations with an accompanying ideal arrangement. And, if those arrangements aren’t practical or achievable, alternative protocols are available. The five situations range from a child who is uninjured/not ill to a child whose condition requires continuous and/or intensive medical monitoring. –Ann-Marie LindstromThe draft is available at www.nasemso.org/documents/EMS_Child_Transport_Working_Group_July_Final_Draft_7-2-20105.pdfGoing Green The Missouri Bureau of EMS is going paperless. The new, more environmentally friendly system allows providers to submit or renew their licenses via e-mail. “Nobody loses in this proposition,” says Missouri Bureau of EMS Chief Greg Natsch. According to Natsch, the electronic system speeds up the licensing process and improves customer service, as well as eliminating unnecessary paper use. In the past, the application process could take up to three weeks, Natsch says. Now, with the electronic system, the process can be completed in as short as three days. In addition, this increased efficiency gets applicants out into the workforce faster. To apply for a license online, applicants simply e-mail their information to the bureau. The bureau replies, sending the license as an e-mail attachment. If an individual doesn’t have a computer, they can have their license sent to their department or the e-mail address of their choice. As a security measure, a Star of Life has been added to the licenses, which are otherwise identical to paper licenses.The transition to the electronic format has been a smooth one. “We haven’t run into any problems,” Natsch says. As the law is written, EMS providers could be asked by law enforcement on the scene of an accident to draw blood as evidence. It can only be collected in cases in which EMS staff provided care. Therefore, EMS can’t be called just to draw blood, and police are responsible for getting the patient’s permission. The blood would also have to be drawn following evidence collection procedures, which are outside of the normal EMS scope of care. Rucker is planning 11 regional information sessions in November through late December with EMS, law and medical officials to discuss the parameters of getting EMS involved with the new law. Quick TakesCounterfeit C-A-TThe FDA issued a warning in August about counterfeit combat application tourniquets (C-A-T). The C-A-T is a one-handed tourniquet that’s widely used by the U.S. Army and some EMS, fire and police departments. When tested, the windlass in suspected counterfeit tourniquets broke or bent before there was enough pressure to stop blood flow. The EMS provisions of a larger bill were signed into law in September by Ohio Governor Ted Strickland. The law is designed to increase the options police have for getting blood drawn, especially for areas in which the local hospital is far away. Until now, only doctors, nurses, phlebotomists and technicians could draw blood in such situations. Finally, be sure to fully document the situation, your assessment of the patient’s mental status and your decision on whether to transport. Obtain a release signature from the patient (or their legal decision-maker) in all refusal cases. What if an EMS provider follows the instructions of the caregiver or family member and transports a competent patient against their expressed wishes? Courts in some civil cases have held that this could constitute false imprisonment or battery. Although such cases are rare, providers could be found liable for monetary damages. However, on the criminal side, it’s extremely unlikely that EMS providers would be charged with a criminal offense, such as kidnapping, if they made a good-faith decision to follow a caregiver’s wishes to transport an ill or injured patient. In fact, we’re unaware of any such cases.For a sample patient refusal form, visit www.pwwemslaw.comNames in the NewsThe National Association of EMS Educators (NAEMSE) honored National Registry of Emergency Medical Technicians (NREMT) Executive Director William E. Brown Jr., RN, MS, NREMT-P, with a Lifetime Achievement Award. NAEMSE has only presented this honor three other times in 15 years. Brown was nominated by his peers and recognized for his 25 years of service with NREMT. Purchasing agents may have inadvertently bought counterfeit tourniquets after shopping around for the best prices. The C-A-T is manufactured by Composite Resources and distributed by only five companies in the U.S.: North American Rescue, LLC, Greer, S.C.; Cardinal Health, Mcgaw Park, Ill.; Owens and Minor, Mechanicsville, Va.; American Purchasing Services, Opa Locka, Fla.; and Phoenix Textile Corporation, O’Fallon, Mo. First, you must determine whether your patient has decisional capacity. This means they must have legal and mental capacity. In most states, legal capacity means the patient is at least 18 years old, although some states have exceptions that permit persons under 18 to consent to medical care (or, by implication, to refuse it). Mental capacity means the patient must be able to make an informed decision about their medical care and understand the risks if they refuse care. If the patient has decisional capacity, they have the right to make their own health-care decisions and to override the wishes of caregivers or family members. If the patient lacks decisional capacity, then the wishes of a legal guardian, power of attorney, family member or caregiver (usually in that order of precedence) generally can be followed. Rucker says the EMS community has multiple concerns, such as training requirements, increased costs and staffing. EMS officials are also concerned the law could negatively affect volunteers, who make up about 70% of the state’s EMS workforce. “If they draw blood, there’s a possibility they could be subpoenaed, and that could affect their day job,” Rucker says. Also, if a competent patient refuses treatment or transport, it’s imperative that EMS providers fully inform the patient of the risks that might arise from that decision. The specific risks you must advise the patient on will depend on their condition. For example, a patient with chest pain must be advised that the cause might be a heart attack and that refusing care could result in death, but a patient with a possible broken toe doesn’t require such dire warnings to make an informed refusal decision. “A lot of the agencies in our area, as well in the other parts of the state, do not plan on doing blood draws,” says Daniel Mack, NREMT-P, assistant chief of the Miami Township Fire and EMS Department. “We need to get together, so we all understand what the law says and what it doesn’t say so we don’t have an incident at the scene of an accident where law enforcement is getting into a confrontation over what the law says,” Rucker says.Since the law was signed, Ohio Medical Director Carol Cunningham, MD, a JEMS Editorial Board member, has been urging local agencies to write their own policies. “I encourage medical directors to have a protocol, even if they elect not to participate,” she says.
SALT LAKE CITY — Some may not even call it a football rivalry, considering that Utah has won 12 straight games against Utah State and 20 of 22 stretching back to the 1980s and has outscored the Aggies 154-16 in its last three visits to Logan.Still, the Utah-Utah State series is the 12th longest in the nation and third-longest in the West. The two schools, 90 miles apart, have been playing each other for 120 years ever since the first Ute-Aggie duel in November of 1892 on the Aggie quad with the home team taking a 12-0 victory.But it’s looking like the longtime series may be coming to an end, at least in Logan, just when the rivalry is starting to look competitive again.If you listen to Utah State athletics director Scott Barnes, the chances are slim the two schools will play more games in Logan.While he says “it’s hard to say we’ll never play again” he also said there’s nothing in the works between the two schools beyond the end of the current contract that ends in 2015.Utah athletics director Chris Hill has also indicated this might be the last game in Logan for awhile.Hill doesn’t discount the idea that this could be the final game in Logan, but leaves the door open as far as future games being played there. However, with the Utes’ recent inclusion into the Pac-12 and a limited non-league schedule, it can’t continue on a home-and home basis as it has since the late 1960s. Already the Utes have broken up its rivalry with BYU with no games to be played in 2014 and 2015.Right now, the only two games scheduled between Utah and USU in the future are in 2013 and 2015 and both games are scheduled for Salt Lake. There was a game scheduled in 2014 for Logan, but because the Utes scheduled a two-game series with Michigan beginning that year, they got out of the game by paying Utah State $500,000 (the Aggies filled the gap well, however, by scheduling Boise State at home for that spot).Barnes says he is not interested in playing Utah if it can’t be on an equal basis. When asked about the possibility of a 2-for-1 type arrangement similar to the one the Aggies have had with BYU in recent years, Barnes was resolute.”It’s not something we’d be interested in,” he said bluntly.So if the Utes won’t play a home-and-home and the Aggies won’t agree to a 2-for-1, its unlikely there’ll be more games in Logan, unless it is on a very spotty basis.It’s not like the idea of an unequal amount of home games hasn’t happened in the past. Of the 109 previous games between USU and Utah, just 36 games were played in Logan. The vast majority of the games have been played in Salt Lake, a 3-to-1 ratio over the years.Utah hosted 19 straight games between 1916 and 1935 and nine straight games between 1954 and 1962. However since 1968, the two schools have had a home-and-home arrangement until 2009 when the series took a two year hiatus before the present contract was signedIf you ask the coaches, they’ll say they want to continue playing.”I hope that we do — it is an important game for us and we want to play the in-state games,” said USU coach Gary Andersen. “I believe that all of the coaches involved would like to play this game, but you know there are a lot of things that control that other than the coaches, so we will see.”While Utah’s Kyle Whittingham talks fondly of games he’s played and coached in Logan, he punted on the idea of Utah playing more games in Logan, saying, “That’s really a Chris Hill decision. It’s something for the A.D.’s to decide.”Most people assume Utah is the one that is keeping the series from continuing because of its membership in the Pac-12. However, Barnes says his school will also have a hard time fitting in all the non-league games it wants once it joins the Mountain West Conference next year.Right now the MWC plans on an eight-game schedule, but Barnes said that could change and a nine-game slate would make it hard to fit in the in-state games.”It’s eight right now, but who knows?” he said.Because the Aggies want a breather or two on their schedule, like all teams, as well as some intersectional games they’ve always played in the past, it would be difficult to schedule both Utah and BYU or even one of them on a regular basis.As pessimistic as Barnes is about playing the Utes beyond 2015, he said, “It’s a stretch to say we will never play Utah again.”But after next year, the Utes and Aggies will not be playing on an annual basis like they have for most of the past century. And perhaps never playing in Logan again.Battle of the Brothers Utah (1-0) at Utah State (1-0)Friday, 6 p.m. MTRomney Stadium, LoganTV: ESPN2Radio: 700 AM, 97.5 FMEmail: [email protected]
1 of 6 In this Saturday, July 20, 2019 photo, a raft of Atlantic puffins gather near Eastern Egg Rock, a small island off the coast of Maine. The birds were virtually wiped off all Maine islands in the late 1800s by hunters and egg-gatherers. After more than four decades of work Project Puffin has restored over 1,000 puffin pairs to three Maine islands. (AP Photo/Robert F. Bukaty) In this Saturday, July 20, 2019 photo, Atlantic puffins gather on Eastern Egg Rock, a small island off the coast of Maine. One of the most beloved birds in Maine is having one of its most productive seasons for mating pairs in years on remote islands off the state’s coast.(AP Photo/Robert F. Bukaty) In this Sunday, July 21, 2019 photo, an Atlantic puffin comes in for a landing on Eastern Egg Rock, a small island off the coast of Maine. One of the most beloved birds in Maine is having one of its most productive seasons for mating pairs in years on remote islands off the state’s coast. (AP Photo/Robert F. Bukaty) In this Friday, July 19, 2019 photo, an Atlantic puffin beats its wings after emerging from it’s nesting burrow on Eastern Egg Rock, a small island off the coast of Maine. One of the most beloved birds in Maine is having one of its most productive seasons for mating pairs in years on remote islands off the state’s coast.(AP Photo/Robert F. Bukaty) PORTLAND, Maine | One of the most beloved birds in Maine is having one of its most productive seasons for mating pairs in years on remote islands off the state’s coast.Atlantic puffins, with their colorful beaks and waddling walks, are one of New England’s best recognized seabirds. Maine is the only state in the U.S. where the birds breed, and they do so on hard-to-reach places like Seal Island National Wildlife Refuge in the Gulf of Maine, a body of water that touches New England and Canada.The birds are well on their way to setting a record for the number of breeding pairs, said National Audubon Society scientist Stephen Kress, who has studied the birds for years. Kress said nearly 750 pairs nested on Seal Island and Eastern Egg Rock in 2018, and this year’s number will likely be higher.The birds are thriving due to multiple factors, including an abundance of the type of fish they’re best suited to eat, such as young haddock and hake and herring. In some previous years, the birds have suffered because those fish were less available, replaced by fish that are more difficult for them to digest. The appearance of the more ideal fish could have to do with the Gulf of Maine running somewhat cool recently.A lot of puffins also laid eggs slightly early this year, which suggests the parents are in good condition, Kress said. He cautioned that the birds’ breeding success has fluctuated in the past, so this year’s good news might not be evidence of a long-term trend.“This is a good year. But I think the message really is this — in recent years, especially since the big heat wave of ’12 and ’13, we’ve seen a pattern of good year alternating with not so good year,” Kress said. “We’re very much in a system of a roller coaster as far as the puffins go.”Atlantic puffins are listed as vulnerable by the International Union for Conservation of Nature, and they number about 1,300 pairs in Maine. The birds live on both sides of the northern Atlantic Ocean, and face threats such as warming ocean temperatures, fluctuations in food availability and predators.The largest puffin colony in the Gulf of Maine is on Machias Seal Island, a disputed island on the U.S.-Canada water border that is home to 5,000 to 6,000 pairs. Those birds are also having a successful year, said Heather Major, associate professor in the biological sciences department at the University of New Brunswick in Canada.The birds can suffer when waters warm and squid and butterfish, which aren’t good puffin food, dominate local waters, Major said. But the Gulf of Maine is a little cooler than last year, and good prey has been abundant, she said. The island is around its long-term average of 56% of eggs producing a successful chick, Major said.“There were lots of puffins around this year,” she said. “This year it seems more stable.”The puffins of Seal Island National Wildlife Refuge are the subject of a popular “puffin cam” hosted by Explore.org, said Keenan Yakola, Seal Island supervisor for Audubon, who helps maintain the camera.Environmental groups have made the case recently that Northeast Canyons and Seamounts Marine National Monument, which former President Barack Obama designated in 2016, is important to the survival of the puffins. Fishermen have sued to overturn the creation of the monument, which they believe creates an unfair hardship in the form of fishing restrictions.But Audubon and other environmental groups have said the monument, which creates a protected area off New England, provides birds with a reliable food source.“Having that area that they are known to use in a protected condition is certainly a plus for the puffins,” said Peter Shelley, senior counsel with Conservation Law Foundation. In this Friday, July 19, 2019 photo, an Atlantic puffin flies with fish in it’s beak as it returns to it’s nesting burrow at sunset on Eastern Egg Rock, a small island off the coast of Maine. One of the most beloved birds in Maine is having one of its most productive seasons for mating pairs in years on remote islands off the state’s coast. (AP Photo/Robert F. Bukaty) In this Thursday, July 18, 2019 photo, National Audubon Society scientist Dr. Stephen Kress watches Atlantic puffins from a blind on Eastern Egg Rock off the coast of Maine. In 1973 Kress began his project to restore puffins to to their original nesting colonies on Maine islands. This year he expects the birds to set a record for the highest population of breeding pairs. (AP Photo/Robert F. Bukaty)
By Danielle Kutchel A Nar Nar Goon grandmother is calling for Cardinia Shire Council to construct a footpath outside her grandchild’s school, to…[To read the rest of this story Subscribe or Login to the Gazette Access Pass] Thanks for reading the Pakenham Berwick Gazette. Subscribe or Login to read the rest of this content with the Gazette Digital Access Pass subscription.