siren - western cape · 2 newsletter oct/ nov 2011 on the day of kevin’s memorial service, in...

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www.westerncape.gov.za Farewell EMS Angel “God calls his angels home and leaves the rest of us to continue struggling to learn the lesson” Every day we wake up with no idea what the day holds for us. On Tuesday August 9, 2011 what would have been a normal day in EMS turned out to be a dreadful one for staff and family members. The service stood still with emotions flooding as the day unfolded and everyone was alerted of an accident involving the college vehicle. By the end of the day Kevin Price, Rescue Technician in the city, ALS college student, colleague and friend to many was fighting for his life in Vincent Palotti Hospital. On and off duty greens flocked to the hospital in support of Kevin and his family. After spending most of the day at the hospital, the news came through that he did not make it. The entire service stood still knowing that this lively and determined young man had left us. Described by colleagues as passionate about his work and the service he provided. An ILS False Bay Volunteer for five years, two years on an ambulance in the Western Division and three years as a Rescue Technician, Kevin Price finally got onto the ALS course. A long held dream for him. Family, colleagues and friends all shared similar encounters with Kevin, proving his consistence in personality and character. “He was a fantastic person, willing to do anything. He was dedicated and passionate on and off duty and always had a smile on his face - A smile that he gave whether he was commended or reprimanded and a smile that I will always 20/08/1975 – 9/08/2011 remember.”, Alastair Christians, Kevin’s Rescue Shift Officer. “Kevin was a great person and he was down to earth and modest. If he got a new pair of shoes, he would not shine it until it was needed. For him, there were always more pressing matters to tackle. He was doing selfless work and saving lives”, colleague Darron Pick. “No one I’ve met came close to having the type of passion and dedication to emergency medical services as Kevin. He has left a legacy to aspire to, which was evident in the amount of EMS personnel that paid their respect at his funeral. There is a lesson to learn from his life. He focused on the big picture and never worried about a creased shirt or blood on his boots. Think about the lives you save as a result of the blood on your boots”, Fabian Higgins “He was a friend that I could confide in. If I felt down and I spoke to him he would always cheer me up and I would focus on something else. We are like family on the shift. It was shocking to hear that he had left us. I realised that the time we have together as a rescue family is precious and I will always miss him.” Alfred Jefta. Continued on page 2 Siren Issue 5 Oct/ Nov 2011 Emergency Medical Services

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Page 1: Siren - Western Cape · 2 Newsletter Oct/ Nov 2011 On the day of Kevin’s memorial service, in honour of Kevin’s dedication and contribution to emergency medical services, Cape

www.westerncape.gov.za

Farewell EMS Angel “God calls his angels home and leaves the rest of us to continue struggling to learn the lesson”

Every day we wake up with no idea what the day holds for us. On Tuesday August 9, 2011 what would have been a normal day in EMS turned out to be a dreadful one for staff and family members. The service stood still with emotions flooding as the day unfolded and everyone was alerted of an accident involving the college vehicle. By the end of the day Kevin Price, Rescue Technician in the city, ALS college student, colleague and friend to many was fighting for his life in Vincent Palotti Hospital. On and off duty greens flocked to the hospital in support of Kevin and his family. After spending most of the day at the hospital, the news came through that he did not make it. The entire service stood still knowing that this lively and determined young man had left us. Described by colleagues as passionate about his work and the service he provided.

An ILS False Bay Volunteer for five years, two years on an ambulance in the Western Division and three years as a Rescue Technician, Kevin Price finally got onto the ALS course. A long held dream for him.

Family, colleagues and friends all shared similar encounters with Kevin, proving his consistence in personality and character.

“He was a fantastic person, willing to do anything. He was dedicated and passionate on and off duty and always had a smile on his face - A smile that he gave whether he was commended or reprimanded and a smile that I will always

20/08/1975 – 9/08/2011 remember.”, Alastair Christians, Kevin’s Rescue Shift Officer.

“Kevin was a great person and he was down to earth and modest. If he got a new pair of shoes, he would not shine it until it was needed. For him, there were always more pressing matters to tackle. He was doing selfless work and saving lives”, colleague Darron Pick.

“No one I’ve met came close to having the type of passion and dedication to emergency medical services as Kevin. He has left a legacy to aspire to, which was evident in the amount of EMS personnel that paid their respect at his funeral. There is a lesson to learn from his life. He focused on the big picture and never worried about a creased shirt or blood on his boots. Think about the lives you save as a result of the blood on your boots”, Fabian Higgins

“He was a friend that I could confide in. If I felt down and I spoke to him he would always cheer me up and I would focus on something else. We are like family on the shift. It was shocking to hear that he had left us. I realised that the time we have together as a rescue family is precious and I will always miss him.” Alfred Jefta.

Continued on page 2

Siren Issue 5 Oct/ Nov 2011

Emergency Medical Services

Page 2: Siren - Western Cape · 2 Newsletter Oct/ Nov 2011 On the day of Kevin’s memorial service, in honour of Kevin’s dedication and contribution to emergency medical services, Cape

2 Newsletter Oct/ Nov 2011

On the day of Kevin’s memorial service, in honour of Kevin’s dedication and contribution to emergency medical services, Cape Town Rescue and the College joined in procession to the church from the False Bay Volunteer EMS ambulance base, the organisation he was volunteer and Chairperson to. Four Rescue Technicians escorted the hearse on EMS motorbikes while classmates in the ALS course walked behind. Outside the church, EMS personnel honoured Kevin by performing the ceremonial Guard of Honour, in respect of the life lost in emergency medical services.

EMS Management would like to extend their condolences to the Price family and friends. Our words may not console but Kevin’s spirit will live on through those that have been touched by his life and passion for emergency medical services.

Continuation of Farewell EMS Angel (Front page)

GREETINGS FROM THE DIRECTOR OF EMS

It’s amazing how things evolve with time. Percep-tions and contexts change with time. Green was first proposed by Mr Webster as the appropriate Medical Livery for EMS uniforms and everyone thought he was crazy and accused him of landing Martians on our planet!

However with time the Green People have become very visible and easily identifiable with the function.

It was interesting at the FIFA WC 2010 to see that EMS were clearly identifiable by our uniforms in comparison to other services who all wear blue or black and from a public access point of view that's very important. EMS personnel now identify with being green as evidenced in this issue and there is a clear identity and ownership. Green is politically and environmentally correct!

I must admit to being a bit skeptical in the beginning but having seen the public and service response to being green I think its growing on us! Excuse the pun!

We've now visited every station in the Province this year and consistently personnel are well turned out and proudly Green! Well done! Even our response times are in the Green!

Our Motto should be the Quality Lean Green EMS Machine…

I'm very conscious of the surrounding pages in relation to our recent personal loss and injury and I think the content in these articles do justice to Kevin as an example of what we would wish to be in the service of society. We deal with death every day in our work sometimes to the point where we've just had enough and then when it touches us directly its not easy to deal with. Death has its place and as Steve Job said it replaces the old and makes way for the new, if that only referred to computers it would be easier! I think what death should do for us is motivate in us the value of life and there's no doubt that in this century life has less value. Objects, money, things seem to have more value than people and we need to restore the balance. As EMS personnel we stand positioned as ideal advocates for human value and steering attitudes towards people centeredness. The levels of violence and abuse in our society do not dis-

play those values and we should be heard against the wave of perversion of normal social behaviour. Like going green was a step by step process, re-vitalizing society will require a sophisticated, com-plex and enduring process of reestablishing values.

We need to CARE …with integrity, competence, respect, accountability, responsiveness!

Lets Green the Province with peace!

Dr Cleeve RobertsonDIRECTOR

Biological Context Birth

•Social Context •Economic Context

Chilhood

•Infrastructure Context •Environmental Context

Adolescence

THREATS

Drugs, Alcohol, Family Conflict, Social dis-cohesion

Culture

INTERVENTION

Individual and collective level Home through CBS School Nurse Social Worker Early Childhood Development

INTERVENTION

School Alcohol management Sport Recreation Entertainment After School Program Social Spaces Housing Safety and security Exposure to peace

THREATS

Informal Settlements Gangs Drugs, Alcohol

NON VIOLENCE

LEARNING Violence is a

LEARNT BEHAVIOUR

The Story of David

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Newsletter Oct/ Nov 2011 3

Preparing for the memorial

LETTER FROM THE EDITOR

Writing this quarters Editor’s letter has been one of the hardest as it has been a trying and emotional quarter for the service. I am reminded of a quote by Deepak Chopra that summarises this quarterly newsletter well, “We forget sometimes that there are saints living among us. When we meet them, we are reminded, not just of the presence of pure divinity right here on earth, but also of our own potential, and of the responsibility we have to try to live up to it”. It reminds me of Kevin Price, Rescue Technician in the City and ALS student who we have loved and parted too soon (Front Page). A man that touched many lives in the service and industry. A man that’s passion exceeded his role in emergency medical care, that made his life’s work serving others and who has left a legacy to be respected and continued by his colleagues and peers. I am reminded of the volunteers who constantly provide support without monetary compensation but continue to dedicate their lives to nurturing others (see Page 15). I am reminded of the staff that came together on Mandela Day and Women’s Month to work over and above their job description to provide services to the communities. And I am reminded and inspired by the women in service who have challenged the EMS industry

by constantly breaking the glass ceiling (see page 4 & 5).

I’d like to dedicate this letter to the lady greens. Stop being apologetic - Every time you pick up the Jaws of Life or a stretcher do it with enough enthusiasm to prove that you are as worthy in the positions that you keep. At times women are victims of domestic violence, rape, marginalisation and vulnerability but in these times, in this industry, you play the role of a saviour - as a medical practitioner - Wear the badge with pride.

I would like to extend gratitude to every division and district that has contributed to this issue of the Siren. Never before, have I received so many letters, articles and photographs, you have truly made this newsletter your own and inspired me to keep on sharing your stories.

Yours sincerely,Keri DavidsCommunications Officer

Procession to the memorial

Guard of Honour

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4 Newsletter Oct/ Nov 2011

On August 9, 1956 twenty thou-sand South African Women marched to the Union Building in Pretoria singing “Wathint’Abafazi W a t h i n t ’ i m b o k o d o ! ” N o w famously referred to as, “When you strike a woman you strike a rock”,

a representation of the power of women in South Africa. With focus on August as wom-en’s month, WC Government Health: emer-gency medical services shine a light on the women in our service who have gone the extra mile to prove their worth in a male dominated environment. We profile four females in the ser-vice:

Sharon Sampie, Acting District Manager for HealthNET

Sharon joined the service in the mid-eighties as a Reservist and volunteered for a year before being permanently appointed. She became the first female paramedic in the province in 1994 and then first female Manager appointed. “In the nineties it was quite a battle to be accepted because historically the Service was male driven and I had to prove myself to be physically and mentally capable of doing the job. Today the opportunity to qualify as a Paramedic is equally open to women as it is to men. I had a rough time in the beginning and always ended up with what everybody else did not want. This includ-ed partners, vehicles and where to work yet I always made a conscious decision to enjoy the experience”. Sharon gives some sound ad-vice to women currently in service, “Behave in a ladylike manner at all times to be respected by managers and colleagues. You have been trained, just like your male colleagues to do the full job – don’t stand back and let the men do what you are also trained to do, get right in there and do your share. Work hard. Do your absolute best at all times. Respect your col-leagues & superiors. Don’t misconduct and if you do, accept responsibility. Learn from your mistakes. Humble yourself and strive for

excellence in the work you do.”

Barbara Lessing, Northern Division District Paramedic and Registered Nurse

Barbara Lessing or more endearingly known as “Barbie” joined the service in 2000 as a qualified nursing sister and BLS Practitioner. She continued to complete her Intermediate Life Support; Basic Medical Rescue, Advanced Life Support and Flight Paramedic courses to advance in her career – Evidence of her dedication to the EMS profession. Although Barbie believes that women have the same opportunities as men in the service, she still finds that one of her biggest challenges is having the physical strength to lift heavy patients/ stretch-ers and encourages that women keep in shape and stay mentally and emotionally fit. “Stop saying you cannot do things because you are female. Un-derstand that your scope of practice is exactly the same as men in the service”. “Do not stand back for anyone. Go for what you want and believe in.” “I would like to thank Mr Papu for requesting that I do an interview at EMS after completing the BLS certifi-cate course. I was currently employed as a full time midwife at Christian Barnard Memorial Hospital and since joining the service, have not looked back. So many doors have opened, bringing new opportu-nities every day. You acknowledged my need to grow professionally and gave me the opportunity to excel”

Shakira Hartley – Southern Division Paramedic and City Rescue Technician

Starting out as a volunteer in the service Shakira Hartley moved steadily up the career ladder and become the second female Rescue Technician in 2009, and then paramedic at the end of 2010. “There wasn’t any direct competition whilst study-ing the Rescue Technician qualification. As students we were expected to achieve irrespective of our sex and I had to work hard to prove myself. I was constantly doing more than the men as I wanted to challenge them and not be an average achiever. We’ve opened up doors for women in the rescue base and we challenge other females to join. Keep

LADY GREENS

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Newsletter Oct/ Nov 2011 5

on learning and edu-cating yourself in your profession, then you will become a force to be reckoned with. ” Shakira encourages women in service to change their mindset and embrace the challenges. “Con-stantly challenge your environment. Once you get the job, you are go-ing to enjoy it more if you are passionate about it. Do not become com-placent. There is always

something you can do and work hard to set ex-cellent standards by which others will either chal-lenge or rise up and meet the challenge. It is not about physicality” She believes that she has bro-ken the glass ceilings in all aspects of her profes-sion and if there ever there is more glass to break, “if they train me, I can do it”. “Thanks to Mr Ivan Naidoo who motivated and mentored me while studying the ALS certificate course. Delwyn Hay-ward, who constantly motivated and assisted me with the medical component on course. I would also like to thank Vernon Naidoo who always had an open door policy and all the Rescue Techni-cians in the Cape Town base that assisted me.

Sipokazi Rayi – Intermediate Life Support Practitioner in the Southern Division District

Sipokazi joined the service in 2005 and trusts that there are opportunities for females in EMS, evident as more women are being trained and placed in management positions. Sipokazi be-lieves men still marginalise women in the in-dustry, that it is still a male dominated environ-ment and considered a man’s job by many. Yet Sipokazi promotes that if you are firm, eager to learn and find the opportunities you can excel in the industry. “I have learnt that you must treat everybody equally irrespective of colour, race and gender. As women we must not be afraid of change because it opens up doors to grow, learn and improve standards in the emergency medical service industry.” She still believes that more posts should be provided for ladies in the service, that women can be trained to take up management positions, adding a subtle and balanced approach to the industry.

“I am reminded of a famous quote by Malcolm X, when you teach a boy, you teach an individ-ual but when you teach a girl, you educate a nation”.

ARE wE RELuCTANT TO HELP?

The HPCSA confirms that healthcare profession-als are deemed by the council to have a legal, moral and ethical duty to intervene when they are off duty and chance upon a medical emergency.

Could local healthcare practitioners be reluctant to render assistance during an after-hours emergency because of the reluctance of their overseas coun-terpart? In the US, for example, healthcare practi-tioners could face a fortune of medical litigation by unscrupulous lawyers, known as ‘ambulance chas-ers’, who are after big business.

According to the HPCSA, there have been no recorded incident in South Africa- of which the council is aware - where legal action has been taken against healthcare professionals who have rendered assistance while off-duty, or of cases where something went wrong because a health-care professional reacted inappropriately.

Dr Cleeve Robertson, the director of the Western Cape Metro Emergency Medical Services, agrees. “The failure of healthcare practitioners to render off duty emergency care is often related to insecurities regarding their abilities,” he suggests. “I think some lack the confidence to deal with emergencies because their initial training in emergency medicine was very poor and the currency.”

Robertson says that a practitioner’s response to an emergency is more about common sense and team work and less about resources.

He offers the following advice: “The brain is the best tool at an emergency scene, so a doctor with a good brain can often direct junior personnel, who may have good skills but less decision-making experience. It becomes a team game.”

He also emphases the importance of the basics: knowing who to call for help and very basic emergency care procedures save the most lives.”

Health Professions Council of South Africa

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6 Newsletter Oct/ Nov 2011

Dr Hennie Botha. Head unit for Gynaecological Oncology, Tygerberg Hospital

South Africa has one of the highest rates of cervi-cal cancer in the world. It is estimated that 1 out of every 26 SA women will develop cervical can-cer during their lifetime. An infection by cancer causing types of Human Papilloma Virus (HPV), a sexually transmitted infection, may over time lead to abnormal changes in the surface cells of the cervix which further develop into cancer. HPV in-fection can also cause other types of cancer in men and women and is quite common in young people but is usually cleared by normal immunity. If the infection does not clear, someone will have a risk of cancer. Remember that smoking adds to the risk.

The Pap smear is a well-known test to detect warning signs of cervical cancer. Most women will know about the potential of Pap smears to prevent cervical cancer and should be encour-aged to get tested. There are new tests available to check for HPV and it can be used together with Pap smears to identify those people that are at risk for developing cancer.

There are two HPV vaccines available to protect against cancer causing HPV. The vaccines are very effective in preventing infection in the first place. Unfortunately HPV vaccines will not cure someone who is already infected with the virus. It may help to prevent new infections with other types of the virus. When someone has an abnor-mal Pap smear they should get examined by a doctor who will decide if treatment is necessary to remove the abnormal cells.

No woman should get cancer of the cervix. Encourage prevention amongst your colleagues and peers.

Facts about Cervical Cancer:

•16.84 million South African women, 15 years and older are at risk of developing cervical cancer.•5743 are diagnosed and 3027 die from cervical cancer every year.•It is the 2nd most ranked cancer in women in South Africa between the ages of 15 and 44 – Breast cancer being the first. •About 84% of Cervical Cancer cases occur in developing countries.

WHO – World Health Organisation report published in September 2010

Human Papilloma Virus (HPV) and cervical cancer

MADIBA DAY

Cape winelands

Human Resources

west Coast

Northern Division

western Division - E & F shift

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Newsletter Oct/ Nov 2011 7

“Financial vulnerability is one of the greatest challenges women face today. While women have more opportunities to be leaders than previ-ous generations had, there are more pitfalls, says Karabo Morule, Strategy and Marketing Execu-tive at Old Mutual.

“As we celebrate women’s month in August, we want to encourage women to empower them-selves financially as too many women still rely on others to take care of their money matters. Whether you have a partner or not, your income is critical and can be impacted by severe illness or disability,” Morule says.

Although 70% of women have at least one store card compared to 58% of males, women are more likely to contribute to stokvels than men. Women are also more likely to save for funeral policies and children’s education, while men tend to save for home deposits and cars. Howev-er, more women compared to their male coun-terparts are planning to support their parents.

“As women we should empower ourselves and create our own financial future so that we can take care of our loved ones and ourselves in old age. There is no magic formula, just discipline and proper financial planning – the key elements in ensuring a secure financial future,” Morule adds.

It begins with preparing a household budget, settling short term debt like store cards, and work-ing towards reducing longer term debt like bonds on your house. This allows you to adopt better spending patterns and more constructive use of your hard-earned money.

Once you have prepared a budget and a plan for working towards settling your debt, you can focus on addressing all your financial needs such as life, disability and critical illness cover, as well as saving for the future. All of this must be under-pinned by a valid and current will.

No o ne can predict the future, but there are two critical elements you should consider – protect-ing your income and earning ability - and saving for old age.

“Retirement planning is a crucial part of this planning. A financial plan allows you to cope with life’s challenges,” concludes Morule.

With the focus on financial planning for women during Women’s Month, Old Mutual provides the following financial tips:

1. Budget – If you fail to plan, you plan to fail. Budgeting is an essential step to financial success. It prevents excessive spending and wastage.

2. Self-control – Don’t buy anything on credit the minute you want it. Wait until you’ve actually saved up the money.

3. Save for retirement now - Compound inter-est works for you in that you earn interest o n the interest already earned. The sooner you start, the sooner you will be able to retire.

4. Guard your health – You want to enjoy the fruits of your labour, your investments as well as your children and their children. You also want to en-sure that you protect your income-earning ability, so that you continue to draw a salary even if you are unable to do so.

5. Guard your wealth – Make sure that your hard-earned money does not vanish. Save more than inflation and ensure that you are invested in the right products that suit your risk profile.

women encouraged to flex their financial muscles

Cape winelands

Karabo MaruleStrategy and Marketing ExecutiveOld Mutual

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8 Newsletter Oct/ Nov 2011

ACADEMIC ACCOLADES THANK YOu GREENS FOR YOuR OuTSTANDING wORK

Abraham Josias & Jongephi Mntubu graduate with Motor Mechanic certificates

Alfred Jephta (Cape Town Rescue) is awarded heavy vehicle extrication certificate

Christo Bothma (HR) represented South Africa in the India Invitation Cup 2011 (In door cricket)

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Newsletter Oct/ Nov 2011 9

NEw ZEALAND RESCuE CHALLENGE 2011

Princess Gongqo, Cape Town Rescue and Darryl Bowyer, Cape Winelands Rescue represented EMS Rescue in the 2011 World and Australian Road Rescue Chal-lenge, held in Wellington, New Zealand in July. They successfully participated in the Trauma Challenge, organising their own funds to repre-sent SA in EMS Road Rescue. “I admire them. They prepared for their own career development and will do well in serving their communities”, said Nev-ille “Kussie” van Rensburg, EMS Provincial Rescue Manager, who was an assessor for the challenge. Management would like to thank Princess and Bowyer for participating and representing the service. Rescue plans to send another team to London for the 2012 Rescue Challenge.

The South African Team - Princess Gongqo & Darryl Bowyer

The team & Mentor (Neville Van Rensburg) with the Japenese team

EMS YOu HAVE MADE A DIFFERENCE IN MY CAREERI am currently studying the Rescue Modules at the EMS College and completed Basic Medical Rescue and the High Angle 2 this year, a one week course with the Provincial Rescue Manager Mr Neville Van Rensburg. The information Mr Van Rensburg taught us in class is always on my mind. I still remember how he explained the heavy duty truck extrication proce-dures, giving us practical exercises to understand how to use the rescue tools.

On completion of the course I was given the week-end off but had to resume work on Monday as a night shift rescue practitioner. On that Monday around 01H32am we received a call. A truck had over turned and there were people trapped inside. Fortunately when that call came I had already taken the heavy duty course. It was the same type of call as the practical I had done a week prior at the college.

During the course we were taught how to deal with • LGV incident• Scene assessment and safety• Stabilization and initial access• Glass management• Space creation• Full access• Immobilization and extrication• Scene assessment and safety• Type of truck• Type of construction/ load• Position of truck• Other vehicle involved• Engine off/shut off• Type of load

I can now manage to create space and full access:• Displacement of dash board• High A pillar cut• Low A pillar cut• Glass management

This method assisted me in removing the trapped patients from the truck. It is all Thanks to Mr. Van Rensburg and my Manager who gave me the opportunity to attend the heavy truck rescue course.

Francis MokoenyaneBeauford west Central Karoo District

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10 Newsletter Oct/ Nov 2011

Complete and accurate clinical documentation is a fundamental element of quality in pre-hos-pital emergency medical care. It encompasses both a clinical and administrative role1,2. The importance of clinical documentation is often overlooked and regularly neglected. Patient care report forms should provide a full account of the patient’s medical history, physical exami-nation and medical care provided while in the care of emergency care practitioners as well as show evidence of continual clinical monitoring. Emergency Care protocols, published by the Health Professionals Council of South Africa, state that documentation of care provided to patients in the pre-hospital setting are a professional obli-gation and legal requirement3.

One of the biggest challenges of proper clinical documentation is time. Daily, we care for and transport numerous patients and are regularly pressed for time. However, we need to remain vigilant in ensuring that each patient’s pre-hos-pital emergency medical care is well document-ed.

Purpose of clinical documentation in EMS:

Clinical documentation forms the basis of com-munication between health care professionals and facilitates continuity of care 1,2. It enable the emergency care practitioners to supply doc-tors and nursing professionals with a complete and clear description of the medical emergen-cy which the patient present with. Information regarding the mechanism of injury in a motor vehicle accident, for example, noted on the documentation may provide significant benefit towards diagnosis and patient care. Importantly, it demonstrates a practitioner’s level of profes-sionalism as well as accountability and respon-sibility for your own professional practice and

competence 1,2. Clinical documentation assists the process of quality improvement by allowing the evaluation of clinical practice and identification of possible patient safety concerns.

Some ideas on improving clinical documentation:SOAP (subjective, objective, assessment and plan) notes are a well-known and regularly used method of clinical documentation4,5. The different sections of the standard PGWC Patient Care Report (PRF) form is designed in a similar manner and the discus-

sion below is aimed at providing some assistance to improve writing of clinical notes.

S – Subjective: Subjective information is the details we obtain from interaction with the patient and/or their family4,5. The focus is to record, with the necessary detail, the patient’s medical history. A method of obtaining this information is the mnemonic, CAMPLEThe focused history is an elaboration of the chief complaint, an example is the use of the well known mnemonic PQRST-A, to obtain a history on pain. In patients with chronic illness, determine their pri-or baseline medical condition and/or any recent changes in medical condition. Also document any recent changes/adjustments to medication or changes in respond to medication. Aim to describe the physical position the patient was found in, upon arrival on-scene and the patient’s general appear-ance, e.g. found inside the house, sitting in a tripod position, appearing acutely ill and anxious etc. In the case of trauma ensure that a clear description of the event is provided, e.g. one light motor vehi-cle involved, vehicle left road & rolled ± 10 m down a steep embankment, the patient was found out-side & ± 4 m from the vehicle on rocky terrain.

O – Objective: This section includes measurable and observable information obtained through a physical examina-tion and includes documentation of vital signs4,5. Remember to document the time vital signs were

THE SIGNIFICANCE OF CLINICAL DOCuMENTATION

CAMPLE History:

C – Chief complaint

A – Allergies

M – Medications

P – Past Medical History

L – Last meal

E – Events leading to

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Newsletter Oct/ Nov 2011 11

obtained as well as repeated vital signs as required by the patient’s condition. Physical examination can be document according to the system exam-ined. For example, documenting the respiratory examination according to what the practitioner found on Inspection, Palpation, Auscultation and Percussion. A – Assessment:Aim to note the possible diagnoses as determined through the medical history and physical exami-nation4,5. P – Plan: Clearly document all emergency manage-

ment provided to the patient with the necessary details4,5. For example, state the percentage and rate of oxygen administered, the size OPA inserted or clearly state how the patient was extricated from the vehicle. Furthermore, it is important to ensure that we document any observed changes in the patient’s clinical condition after intervention or after the administration of medication. Continuous moni-toring and reassessment must be documented.In addition, ensure that you write with a black ball point pen and if a mistake is made, draw a straight line through and initial next to it6. Make sure that clinical documents remain confidential and that your hand writing is legible6. The EMS standard op-erating procedures state that a PFR must be com-pleted for each and every call and patient6. And in order to address possible allegations against prac-titioners for not transporting patients to hospital, ensure that you complete the PRF for patients you refuse transport with due diligence.

Although writing detailed notes is time-consuming and it receives little emphasis in training, we need to understand its value and necessity. We must make every effort to improve the proficiency and quality with which we formulate clinical notes and continu-ally grow as professionals. Always bear in mind that “if you didn’t document it, you didn’t do it.” ANDRIT LOuRENS Quality Improvement Manager - Cape winelands

Focused history of pain (PQRST-A)

P –Provoke, palliate and positional

Q – Quality

R – Radiation, region and referral

S – Severity

T – Temporal factors: Time of onset, duration, progression and previous episodes

A – Associated symptoms

THE SIGNIFICANCE OF CLINICAL DOCuMENTATION

CONTINuED...

COMMuNICATIONS:what does service delivery mean to us at EMS Communications?

Ask yourself that question. What did you come up with?

It’s about putting ourselves in the "callers shoes".

What do they experience when we take the wrong details, prioritize the call incorrectly, delay the dispatching of an ambulance and not follow up with that ambulance?

It starts from the moment the call takers retrieve a call or more negatively, when they refuse to answer a call from the community.

Ask yourself " what if it was a close relative calling in need of EMS?"

We recently received complaints of patients waiting up to 14 hours to be transported and a 90 year old lady waiting 5 hours for an

ambulance after falling down a flight of stairs. That elderly lady is now in hospital recovering from a hip replacement.

Service delivery is a vital part of the work that we do. It should be the core objective of how we work and it should be a fundamental part of our work ethic.

We play a very important role in EMS and service delivery starts with communications, in every centre in the Western Cape. We should feel proud of what we do. Ask yourself: “Am I really providing qualitative service delivery to the com-munity? Would I want myself to be the first point of reception when I have a medical emergency?”

Let's make ourselves proud and deliver a service that millions of our callers can have faith in. Let's keep working hard and strive to do better.

Dexter TimmProvincial Communications Manager

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12 Newsletter Oct/ Nov 2011

wOMEN’S DAY EVENT FOR wEST COAST LADY GREENS

A ladies event came to mind when we knew that something like this was not held in EMS. Tina (Sup-py Chain Clerk), Meagan (acting SDECP Vreden-burg), Lionel (AEA and staff health and wellness coordinator for West Coast) and Andrit (Admin clerk) got all the ladies together from West Coast EMS, from Bitterfontein up to Malmesbury.

west Coast lady greens enjoy the day off

The day started off with a short programme at the Skilpad hall in Vredenburg. The tables were all lined out with black tablecloths and maroon overlays. The particulars on the table such as chips, juice, coffee, muffins and flowers were all donated by staff.

Andrit welcomed the ladies present and read the speech from Mr Pedro as he was not able to attend the event due to exams. The ladies were flattered by his words and became quite inspired inspired as the speech was read. Sister Crossley (Prov. Chief Nurse) was a guest speaker and inspired the ladies with her speech on RESPON-SIBILITY. Lional (staff health and wellness) then proceeded with his speech telling the West Coast ladies that they are responsible for their own actions.

Beauty tips were given by another guest speaker, Heidi from the fragrance boutique. She was also the judge for Miss EMS. Mrs H Steenkamp (acting Healthnet manager) was awarded Miss EMS, Veronica Barlow (ILS, Vredenburg EMS) was second runner up and Anina Nortier-Balie (West Coast staff development co-ordinator) was chosen as the first princess.

The lucky chair game had the ladies jumping up and looking under their chairs for a small paper. If you were lucky to find a small yellow paper under your chair you would receive a gift. We had a great laugh when 6 ladies voluntary came up to participate in a game. Ladies had to draw a paper out of a box and only open the paper when their chance came. We laughed out loud when Abi-gail Van Niekerk (BLS Malmesbury) out of the 6 had to sing Micheal Jackson song and do the “moon walk”.

Mr Pedro (WC District Manager) had supported us wonderfully, he also asked the managers to give their ladies off for this day. After the short program we enjoyed lunch at Boston Barbeque, Club Myko-no’s. We look forward to doing this next year again.We had great fun.

Green ladies from west Coast District

Partaking in the activities for the day

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Newsletter Oct/ Nov 2011 13

On July 22nd, Paarl station personnel held an EMS awareness workshop at the Boland College. We were invited to mentor the grade 12 students about drug abuse; educate them about choosing a career in emergency medical ser-vices and to demonstrate a few life saving techniques.

The presentation covered various career paths in EMS and education on the abuse of Meth-amphetamine (Tik), demonstrating the before and after effects of its usage.

The EMS crew taught the learners CPR, bleed-ing control and Basic First Aid. Many of the fe-male students displayed a keen interest in EMS Rescue and seemed impressed by the techni-cal component.

We feel that this is a stepping stone in the right direction when we inform our community of what we really do, when to call, what to ex-pect and what they can do while waiting for an ambulance. In this way we know that we are shaping the perception of EMS in the com-munity and lessening the perception that we are only “drivers”.

Cape Winelands Management would like to thank the staff that participated in the aware-ness project. It was a job well done.

Staff give Medical & Rescue demonstrations to the students

PAARL COMMuNITY ACTIVITY FOR THE QuARTER

wESTERN DIVISION TREAT THE wOMEN OF GARDEN VILLAGEOn August 8, Western Division staff spent a day treating the women of the Garden Village neigh-bourhood, held at the local creche, Village Tots. The women were treated with lunch, cake, tea, gifts, dance and some inspiring words by the Principal of the school. An initiative organised by Western Division Station Officer, Karen October, division staff pitched in to assist gladly. Mr Griffiths brought smiles to everyone’s faces as he danced with the ladies.

The Principal of Village Tots, Carol Booysen shared an inspirational message to the guests, encour-aging them to believe in their purpose in society - “Women create positive social structures that build communities, paving the way for future South African leaders (the children of the na-tion)”.

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14 Newsletter Oct/ Nov 2011

EMS management would like to thank the Rohlandt family (of late Johannes “Kieper” Rohlandt, Rescue Technician in the city) for their generous donation of out door tables and chairs to Southern Division and a wall clock for the city’s Rescue base.

On August 17, Ms Rohlandt presented the donation to the City Rescue base and Southern Division which included a finger luncheon. Mr Naidoo, Southern Division District Manager pre-sented a certificate of appreciation to the Roh-landt family.

THANK YOu GREENS FOR YOuR OuTSTANDING wORK

THANK YOu ROHLANDT FAMILY FOR YOuR

DONATION

District Managers and Ms Rohlandt

I would like to convey my sincere appreciation to two of your staff for the excellent and extremely efficient services rendered when one of our cli-ents had a medical emergency. The crew re-sponded to my call within 5 minutes and acted in a friendly and professional manner. Well done to Herschel Sampson and Jefferine Claasen. Keep up the good work!

Tanette BurdenService AdvisorParow Branch First National Bank

I have a one and a half year old baby boy who is very sick and on “home oxygen”. I do appreciate the staff who work for EMS as they have helped me many times to get my son to the hospital. I’ve always had problems with getting through to the call centre through the MTN network.

Things have changed recently because the para-medics are now familiar with me and I call them regularly to assist with my problem. They gave me the direct number to the call centre so that I have no problems getting an ambulance to my house.

Once I’ve logged the call, the paramedics arrive within two minutes and I am grateful for what they are doing for my son.

I would like to thank the paramedics and the Control Centre staff for going the extra mile and rendering an excellent and caring service.

The call taker was Ms Samuels and Dispatcher Mr Lutta.

Regards,

Nosipho Skepe and her son Mpho Jonathan

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Newsletter Oct/ Nov 2011 15

“Everybody cannot be famous but everybody can be great, you must be able to produce a good service to become a great person” says Ezra Fredricks who has been volunteering for 14 years.

Volunteers devote considerable time, effort and skill to contribute to the success of EMS and of society. They selflessly offer their services with no expectations and they impact positively on the success of the service. Fredricks enjoys the sense of satisfaction and fulfillment he gets from helping others but it is also his passion to help the injured and sick that inspired him to volunteer.

Volunteers are an important part of EMS because they assist the service in continuing to serve the communities. Hospitable greens makes this jour-ney a warm and memorable experience for vol-unteers by welcoming them in their stations and accepting them in the EMS family. This keeps our volunteers motivated and they get work done. “I love the people at EMS. They have taught me a lot and they continue to teach me. I always look forward to my shifts” says Nick Sales who has been volunteering for EMS for two years. He says he never walks away from any call not having learnt something and he finds every way to share his passion and love for EMS.

Ziyaad Adams joined the service in 2009. He has become so involved and attached to his shift that he cannot imagine doing anything else. He would love to become a permanent staff mem-ber because he enjoys working in the organisa-tion. “I would consider myself lucky to be paid to do what I enjoy the most” said Adams. Working in this service is like a calling for him.

Our societies would be such great places if we could stand together. Let us raise the spirit of UBUNTU. Let us work together to make the differ-ence in our communities. Julian Slater has been volunteering for the past 12 years. He says volun-teering should be for the love of helping people and bettering our communities. “Do not go after the money but do it for the love and passion” said Julian.

It is an honour to have such wonderful people in our service who are driven by passion and love to help others. We should continue to make them a part of our family. We should acknowledge them for being part of the movement that makes a difference in so many lives.

wORKING TOGETHER AS ONE

It is good to see that the public service is not as bad as everyone makes it out to be. Instead I think Emergency Medical Services is world class.

On Wednesday July 27, 2011, we requested ambulance assistance, within 5 minutes the ambulance was on the scene and ready help. It was nice to see things taking place quickly.

I would like to thank the crew that attended to the call, Mr M. S. Makinana and Mev. M. Le Roux was caring and acomodating to the patient, they re-ally made it easier to believe in and trust public emergency medical services.

Thank you for your great service, it was truly awesome.

Greetings,

willem van wyk

THANK YOu GREENS FOR YOuR OuTSTANDING wORK

ROBERTSON SHOw

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16 Newsletter Oct/ Nov 2011

Management would like to acknowledge the Overberg, Southern Division and Cape winelands staff for their hard work and dedication

WE WANT TO HEAR FROM YOU!

Have something to say? Voice youropinion.

Send us all your ideas, article leads(tips), stories and photographs to:

The [email protected]

083 286 4227alternatively articles and photographs

can be dropped off at:Room 112

Communications OfficerEMS Head Office

Karl BremerBellville

Cape Town

Please note: Due to space constraintsand editorial discretion, not all articles

will be published.

Thank you to everyone that contributed to this issue of the Siren. It is much appreciated.

COLIN POWELL LEADERSHIP ADVICE

1. It ain't as bad as you think. It will look better in the morning. 2. Get mad, then get over it. 3. Avoid having your ego so close to your position that when your position falls, your ego goes with it. 4. It can be done! 5. Be careful what you choose. You may get it. 6. Don't let adverse facts stand in the way of a good decision. 7. You can't make someone else's choices. You shouldn't let someone else make yours. 8. Check small things. 9. Share credit.10. Remain calm. Be kind.11. Have a vision. Be demanding.12. Don't take counsel of your fears or nay-sayers.13. Perpetual optimism is a force multiplier.

wELL DONE EMS!