MERGINET.News, March 3rd -- Now On-Line!

["Richard Bilger" <rbilger@merginet.com>]

We're pleased to bring you the latest additions to
MERGINET.News (Vol. 6, No. 3). You can view this
issue online at:

http://www.merginet.com
Select "MERGINET.News" or "Current Issue" from
the navigation menu's.

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FROM THE EDITOR:
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Click onto MERGINET.News for the March 3, 2001, issue. Now
on-line, it brings you Kevin High’s latest clinical piece; this
one is about pericardiocentesis. And if winter has you down, take
an armchair journey to the island nation of Trinidad & Tobago,
where a huge party is in progress! Good thing they updated their
EMS services last year.

If hand-off has been difficult for you lately, read in “No
Borders” how it goes for paramedics in South Africa. “The Sharps
Container” includes numerous eye-opening bits of what’s happening
in the U.S. Your MERGINET.News columnists have been working hard,
too. Valerie DeFrance is thinking about $25 million. Harold Cohen
takes a statistical look at the hot topic of ambulance diversion.
Buying a new ambulance this year? John Becknell’s new “Management
Matters” section has something for you -- and also advice about
what to do when employees make mistakes (in the district next
door, of course!). Taigman, Vic & Vern, and Straight Talk are all
there for you, as always.

Please send your comments, concerns, and compliments. We reply to
everyone who writes. Send email to publisher Richard Bilger at
rbilger@merginet.com or me at kate@merginet.com -- Be in touch!

Welcome to March, 2001!
Your editor, Kate Dernocoeur

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New in this issue!

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Features
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>> Cardiac Tamponade and Pericardiocentisis: Proceed with Caution
by Kevin High
Cardiac tamponade is a life-threatening emergency that involves
the accumulation of fluid between the heart and the pericardial
sac. Cardiac or pericardial tamponade causes a shock-like state
due to compression of the heart by accumulating fluid. The
patient will exhibit signs of shock as their cardiac output and
blood pressure decrease rapidly. The treatment of choice for the
unstable patient with cardiac tamponade is pericardiocentisis.


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Medic Life
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>> STRAIGHT TALK: Surviving Adversity
by Kate Dernocoeur
At 8:46 a.m. on January 26, a powerful earthquake measuring 7.9
on the Richter scale rocked the western Indian state of Gujarat.
The city of Bhuj, population 150,000, was devastated. In the
region, more than 25,000 people died, leaving at least 3,000
orphans. Hundreds of thousands of people were injured. No one was
left unaffected.

>> In His Own Words: Greetings From Trinidad & Tobago!
by Curt Pierre
The Emergency Health Services in the Caribbean island nation of
Trinidad & Tobago is now in full swing. Training of approximately
311 EMT-B and 11 team leaders (supervisors) has been completed.
There are also two operations managers and one Chief Operating
Officer. This person has overall responsibility for the
operational growth and development of this new service.

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Educators Corner
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>> Give Us the $25 Million
by Valerie DeFrance
Why is it a good idea to support the funding of HR 2498, "Rural
Access to Emergency Devices," (Sec. 413. Grants)? Introduced on
May 10, 2000, by Senator Russ Feingold, D-Wis, its intent is to
provide rural areas with AEDs over the next three years.

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Columns
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>> Studying a Study: A Study of Diversions
by Harold Cohen
The issue of ambulance diversion from overcrowded emergency
departments (EDs) has become a lightning rod throughout the EMS
community. Healthcare administrators, physicians, EMS
professionals, public health services, regulators, and
politicians have placed this issue at the top of their agendas.
While there are many variations of ambulance diversion policies,
little or no academic literature evaluates the effectiveness of
these policies.

>> Book Review: Built to Last: Successful Habits of Visionary
Companies
by Mike Taigman
Bill Metcalf, the former publisher of JEMS, cornered me in an
exhibit hall one day. While we were discussing the state of EMS,
he asked me if I'd read Built to Last by James C. Collins and
Jerry I. Porras. When I told him that it had been in my to-read
pile all summer, he gave me a look that said, "You of all
people."

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Management Matters
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>> For Operations: Ambulance Purchasing, Part I: Finding a Best
Practice and the Throwaway Ambulance
by Lauren Simon Ostrow and John Becknell
With time, miles, and idle hours, ambulances are continually
wearing out and need to be replaced. What is the best practice in
vehicle acquisition and replacement?

>> For Managers: When Employees Make Mistakes
by John Becknell
In the everyday, unpredictable work environment of EMS, employees
make mistakes. Protocols may be forgotten or ignored, a highly
charged emotional scene may lead to an unprofessional display of
behavior, equipment may be broken or lost, important data may not
be collected, or an inexperienced employee may blunder out of
plain ignorance.

More online!

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MERGINET.News Online!
Click here: http://www.MERGINET.com/index-news.htm

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MERGINET is a service designed to provide resources, news,
education and fun to the all in EMS, Fire, Rescue and Emergency
Medicine. Updated daily.
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