August 3 release of MERGINET.News now on-line!

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

We're pleased to bring you the latest additions to
MERGINET.News (August 2001 Vol. 6, No. 8).
You can view this issue online at:

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

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FROM THE EDITOR:
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For six years, your worldwide website for emergency responders has offered
regular updates and new information. Now, the August 3, 2001, MERGINET.News
is online for you to read and enjoy. Please click onto the oldest emergency
care site on the Internet and see what’s new.

This time you’ll find features about children. Liz Criss has written a fine
article about the dreadful subject of child abuse. To go with it, Dr. Keith
Wesley’s “Death of a Child” gives rescuers some coping skills. Also, Alan
Eade’s Adventures in East Timor continues to remind us of how truly
difficult emergency medical care can be (guaranteed to help you appreciate
your own circumstances!).

Your regular MERGINET columnists, too, have good things to say. Valerie
DeFrance’s striking series on “Problem Children” continues with her look at
difficult teaching situations. Vic & Vern have an “Ultra-EMS Encounter.”
Harold Cohen reviews an interesting study about perceived pain. Mike Taigman
reviews a book about the “Fourth Generation.” In Management Matters, John
Becknell gives administrators some thoughts on being a “learning
organization” and encourages operations personnel to “Be Like FedEx.” Go see
what that means! Tom Scott gives invaluable pros and cons about “To Bill or
Not To Bill.” And my regular column, Straight Talk, turns 50! My fiftieth
column for MERGINET looks at “Learning Curves.” It’s about a young adult
(mine!) learning to (gasp!) drive.

We have updated our staff page with photos, if you’re curious about the
faces behind the words. Click on “Who We Are” on the green bar at the top of
the site for that and other MERGINET information.

As always, feel welcome to 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 editor@merginet.com – be in touch!

Welcome to August 3rd, 2001!
Your editor, Kate Dernocoeur

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New in this issue!

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Features
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>> Case Study: Child Abuse
by Liz Criss, NREMT
The time of year doesn't seem to matter much. It can be the holidays,
someone's birthday, the middle of summer, or just about any day. Stress
invades our lives anytime, anywhere. We're rushing around, never quite
getting it all done. Stress manifested in a variety of ways — road rage,
rudeness in line, or, worst of all, child abuse.

>> Dealing with a Child's Death
by Keith Wesley, MD
First of all, let's get this clear. You never learn to deal with the death
of a child. Much has been written on the subject of grief. However, most of
it is oriented to the layperson and not the EMS professional. For the
layperson, the death of a child is a rare event and the loss is a personal
one associated with such issues as denial, guilt, acceptance, and all the
rest of the Kubler-Ross stuff.

>> Alan's Adventures in East Timor, Report #3
by Alan Eade
We were dispatched to the Bairo Pete (pronounced Byro-peaty) clinic for a
one-year-old boy with a ruptured trachea. The Bairo Pete clinic is operated
by an American ex-patriot, Dr. Dan Murphy, and is very well established in
comparison with others. He only calls for help when the patients are
genuinely very sick.

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Medic Life
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>> STRAIGHT TALK: Learning Curves
by Kate Dernocoeur
It's hard to believe, but in a brief 15 years the infant who was my baby
then has now earned her learner's permit. On a recent hallmark day, I tossed
her the keys, she got behind the wheel, and we took to the public roadways.
Although for the most part I'm marveling at her ability to drive well so
far, I'm also chewing a lot of gum.

>> Ultra EMS Encounters of the 3rd Kind
by Vic & Vern
While on a Code UHSLNLDT (Ultra High Speed Late Night Long Distance
Transport) while passing through Roswell, Wisconsin, Vic & Vern ended up on
a light speed "transport" a long distance from planet Earth.


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Educators Corner
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>> What Is Disruptive Behavior?
by Valerie DeFrance
Part One of this series reviewed some general aspects about adult learners.
Now let's look at some of the potential causes, and two specific problems
(disrespectfulness and tardy behavior). Examples gathered from my own
experiences and those of colleagues follow.

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Columns
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>> Studying a Study: Painfully Immobilized
by Harold Cohen
The issues regarding spinal immobilization continue to receive considerable
attention from the EMS community. Who should you immobilize? Who shouldn't
you immobilize? Can EMS providers make this determination? This study looked
at another aspect of spinal immobilization (or restriction): What should you
use to immobilize a person?

>> Book Review: Fourth Generation Management
by Mike Taigman
It's not often that someone recommends a business book with the phrase, "It
reads like a novel." But that's what my statistical wizard friend Davis said
about Fourth Generation Management, by Brian L. Joiner. The father of
quality management in this country, W. Edwards Deming, wrote the forward.

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Management Matters
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>> To Bill or Not to Bill, That Is the Question
by Tom Scott
According to most industry statistics, there are 18,000 to 20,000 ambulance
providers in the United States. According to the Centers for Medicare and
Medicaid Services (CMS, formerly HCFA), about 10,000 providers bill
Medicare. This means almost half of the U.S. providers apparently do not
bill for their services. My assumption is that these providers are primarily
non-profit volunteer or local government services.

>> For Operations: Be Like FedEx
by Lauren Simon Ostrow and John Becknell
Imagine your daily call volume was 500,000 and that you were managing a
fleet of 43,500 vehicles to transport 3.1 million patients. That's the
volume handled by Federal Express every day. What can EMS learn from this
gargantuan of the shipping industry?

>> For Administrators: The EMS Organization
by Lauren Simon Ostrow
The term "learning organization" is one of those fancy consultant inventions
like "process reengineering" and "servant leadership" that has been making
the rounds in American business for the last decade. Ever since Peter Senge
and his colleagues at MIT's Sloan Center for Management included the term on
the cover of their 1990 bestseller, The Fifth Discipline: The Art and
Practice of the Learning Organization, management experts have likened the
idea to apple pie and motherhood. After all, who could object to an
organization that valued continuous learning among employees and on an
organizational level?

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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