President : Mr. Geoff Keith
President : Mr. Geoff Keith
39 Broderick Rd
Carrum Downs Vic 3201
Vice President : Mr. Noel Stedwell
4/1 Stiggant St
Warrandyte Vic 3113
Secretary : Mrs. Robyn Stark
3 Naples St
Box Hill Vic 3128
Treasurer : Mr. Lorrance Lancaster
14 Hoddle St
Sale Vic 3850
Assistant Treasurer: Mr Noel Stedwell
Past President :
Editor : Mrs. Robyn Stark
Committee :
Mr. Harry Hudson Mr. Bill Durrant
Mr. Alf Glover
Subscription : Fifteen dollars a year, payable January.
Note: Receipts will only be issued if requested, and a stamped self addressed envelope would be appreciated.
Loan of Speech Aids : A loan instrument is available for members while awaiting for provision under A&EP or when a member has to return instrument to a supplier for repair.
Mr. John Fardell 9302 1742 Mob: 043 206 4807
Mr. Lorrance Lancaster 5143 3307
All correspondence:
Laryngectomee Association of Victoria
14 Hoddle St SALE VIC 3850
(03) 5143 3307
l
Following items available by post or at meetings.
Stoma Covers: White and Navy stocked
Single (1 bib on a neck band) $5.00 + p/p
Double (2 bibs on a neck band) made to order only.
Shower Collar: (vinyl bib type) $22.00 +p/p
Shower Shield: (molded pvc ‘nose’) $25.00 +p/p
Stoma Patch Kits: (foam + double-sided tape)
Make-Your-Own $22.00 +p/p***
Double sided tape: $9.00 +p/p***
Ready Made Patch: 30 pack $22.00 +p/p
Battery rechargeable Ni-Mh:
Suit ‘Servox’ ‘Romet’ $25.00 +p/p
Postage and packing please allow $5.00 minimum on each order.
Sorry AustPost charges have been increased over recent times.
SPOUSE’S SUPPORT
Ring if you need a sympathetic ear.
Mrs. Robyn Stark, (03) 9808 9264
MEETINGS:
Normally held on the THIRD SUNDAY of each month Support Group at 11am.
Followed by a light lunch and a General Meeting
(no meeting December / January).
Venue: 383 Toorak Rd. South Yarra.
(Melway 2M-B6) Tram Rout 8, Stop 33. Met Station is on this route, or a stroll of four or so blocks along Toorak Rd will find us.
Next Meeting: July 15th 2012
1
MEETING WELCOME
Geoff welcomed members and carer’s to our June Meeting. We had twenty members and their carer’s in attendance this month which was just great. Our very special guest speaker was from Ambulance Service Victoria, Kristi Cook, who answered our questions and provided us with some important information regarding the operations side of the Ambulance Service as well as listening to our concerns as laryngectomees in regard to our unique resuscitation and breathing issues.
NEW REGISTRATIONS THIS MONTH
James Hart of Warrandyte
Leslie Cavanagh of Ascot Vale
Vasile Stanagoiof Shepparton.
We welcome you to attend our meetings.
VALE
Lorrance has been notified by phone of the passing of
Setieos (Steve) Biatscos and
Les Simpson. Smithton. Tas. Deceased Sept '11.
Condolences to his family and friends.
SICKNESS REPORT
Gwen is back in hospital and waiting to go to rehabilitation at Wantirna before going back home into low care. We wish you all the best Gwen and hope it won’t be too long before you are back at the meetings.
Dot Rickard. Dot has broken her hip and is in Dandenong Hospital. We hope that you go well in rehabilitation and you will also be back at our meetings Dot.
Dot Pockett is to have surgery on her eyes in the coming months, we hope all goes well Dot. Dot tell us she is settling in well in her beautiful new unit. She said it will be one year on the 26th of June since her husband Brian passed away.
LARYNGECTOMEE BIRTHDAYS AND ANNIVERSARIES
Nil.
MEMBERS HOLIDAY ADVENTURES
Our President Geoff and wife Laurel visited Sydney recently and were quite astounded by the continual heavy rain. It seemed like they were scrambling for cover all the time they were there. Jennifer Ong and Alf Glover recently visited Halls Gap and Jennifer said there was no rain but the weather was icy with beautiful sunshine. The only upset was that she lit a bonfire to toast some marshmallows and ended up burning her lip so now it hurts to talk.
Geoff said that he had no problem with the security at Melbourne Airport but security at Sydney Airport seemed much stricter. Last time they confiscated his shaving cream. John Ritchie found a similar problem when he went to Surfers Paradise recently. Geoff said he wished there was more uniformity in regard to security at all Australian airports.
A decision was made recently at a separate meeting of the executive committee to use the money donated by Waverley Masonic Lodge, to perpetuate our late President Bob Young’s name, to purchase a new speaker and head phones which would be used at our school presentations (a project dear to Bob’s heart). The current speaker is quite old and cumbersome and a new speaker and headphones would definitely improve the quality of sound in school presentations and also enable the presenters to walk out in amongst the students to answer questions. Lorrance was given the task because of his knowledge to purchase this equipment which he has done. It is intended that we will attach a plague to this new speaker in memory of Bob.
Dot Pockett said she had had a phone call from Bev (partner of our late member Rudi) advising us that Rudi had made a substantial donation to the Oncology Department at the Alfred Hospital and that there was a seat in the gardens surrounding the hospital with his name on it as a laryngectomee. Dot said she had also had a phone call from Noelle (wife of the late John Howitt) saying she had shifted into a new home. Our best regards to you both.
SPECIAL GUEST SPEAKER KRISTI COOK FROM AMBULANCE VICTORIA
Kristi has been a qualified paramedic for four and a half years and she said she was interested in what we wanted to talk about today. Our main concern is if we collapsed in the street and an ambulance was to come where would they put the mask? A couple of our members shared their experiences where an ambulance came and they didn’t have the appropriate mask or didn’t realize that they needed to put it over the stoma rather than over the nose and mouth. Another member commented that the ambulance even actually got lost and couldn’t find their address. Kristi said that at this stage ambulances in Victoria don’t have a GPS and she was surprised at the fact that they had got lost as the ambulances tend to work in a suburb which they would be familiar with to a point where they even know the shortcuts.
Kristi said that not every patient was automatically given oxygen as was the case in the past. Oxygen levels are measured using a finger pulse oximeter which is used to measure oxygen saturation in the blood. The oximeter provides a non-invasive method of determining the amount of oxygen that gets pumped from your heart through your circulatory system. By placing a pulse oximeter over your fingertip, it measures your blood oxygen saturation. Here are some general guidelines to understand oximeter readings. For a regular healthy person, the normal blood oxygen saturation level (SpO2) should be around 94% to 99%. For patients with mild respiratory diseases, the SpO2 should be 90% or above. Supplementary oxygen should be used if SpO2 level falls below 90%, which is unacceptable for a prolonged period of time. (Reference A study showed that giving extra oxygen to people who have had strokes the body will automatically try to send more oxygen to that area. When we add more oxygen on top of this the body tends to hold back its supply. So if your oxygen level reading is 94% or higher then we don’t give supplementary oxygen as it can be more harmful then beneficial. Kristie said that they do not carry trachie masks in their ambulances. The main type they carry is the Hudson Mask. Mavis said she has a mask which she carried which could be used for resuscitation if she got into difficulties.
Ventilation in total neck breathers
The actual CPR for neck breathers is generally similar to the one performed on normal individual with one major exception. In neck breathers ventilation and oxygen administration is done through the stoma (mouth to stoma) or using a mask (infant/toddler or adult turned through 900). It is useless to try mouth-to-mouth ventilation.
Oxygen mask ( Available from Association 'Shop' less tube and adapter).
Infant mask used with a rescue breathing bag.
Communication during respiratory distress
Laryngectomees may have difficulties in communication during respiratory distress and if possible they should be allowed to do so by writing or through flash cards. Laryngectomees and other neck breathers can assist in preventing life threatening mishaps by carrying an emergency card, displaying an emergency card in their car, and/or wearing a bracelet or a neck chain that identifies them as a neck breather. It is also important for them to carry a list of their medical conditions, the medication they take, the names of their doctors and contact information.
Laryngectomees and other neck breathers are at great risk of getting inadequate acute care when they experience breathing difficulties or need cardiopulmonary resuscitation. It is essential that medical personnel learn to identify neck breathers and differentiate partial neck breathers from total neck breathers. Respiratory problems unique to neck breathers are mucus plugs, and foreign body aspiration. Although partial neck breathers inhale and exhale mainly through their stoma they still have a connection between their lungs, and their nose, and mouth. In contrast there is no such connection in total neck breathers. Both partial and total neck breathers should be ventilated through their tracheostomy site. However, the mouth need to be closed and the nose sealed in partial neck breathers to prevent air escape. An infant or toddler bag valve mask should be used in ventilating through the stoma.
(Reference ITZHAK BROOK MD Mt Voice: Urgent Care CPR).
Dot Pockett said Brian had been very low in oxygen a number of times when she had called an ambulance and he had become quite stressed when the ambulance attendant put the mask over his face first until he was told otherwise. They adjusted the mask to fit over his stoma. Dot said they ended up carrying a mask in the car as a precaution. The first time this happen was on the way to the Dandenong Hospital. The ambulance attendant said that he had learnt so much that day as he had never seen a laryngectomee before and had not known what to do.
Kristi said that you now needed a university degree to become a paramedic. It’s a three year course and then a further twelve months on road training program.
Some of our laryngectomee members have had bad experiences when they have rung an ambulance especially when a problem unique to being a laryngectomee was involved. Other members have had very positive experiences when they have rung the ambulance service. Jennifer Ong said she had a very favourable experience with the ambulance service after she was flown down by air ambulance from Wangarratta after she almost choked on a bone.
The experience of having to ring for an ambulance in an emergency can be improved for all laryngectomees by simply completing a form which can be input into an ambulance database called “Location of Interest System”. This is a great idea and was previously mentioned in our March Newsletter but it is certainly worth including it again this month as it is so important. Please all larygectomees register yourself with this system, it’s free and it may save you a lot of trouble.
Location of Interest System (LOI)
The Location of Interest system (LOI) is a database that allows emergency services to attach information such as known medical conditions to specific phone numbers. With this information, the 000 call takers and dispatchers can relay instructions to responding crews - Police, Fire and Ambulance - to enable them to best manage the patient.
Laryngectomy patients can flag their phone numbers using this system to alert emergency services that they may have difficulty communicating. If one of these numbers calls 000 and no voice is heard or the caller is unable to be understood, services will automatically be sent to the address saved on the system.
The following information is required to register with the LOI system:
- Patient/resident’s name
- Address (if the LOI is for a person who has more than one regular address such as their school, the secondary address can also be flagged with the LOI)
- Contact phone number
- LOI details: Access: keysafe location/code, keypad combinations, gate numbers etc
Medical: a letter from a doctor/specialist outlining patient’s medical conditions
LOI requests can be sent via the following methods:
- Fax: 9803 2892
- Email:
- Post: Ambulance Victoria QRT
1 Lakeside Drive
Burwood East 3151
Once the information has been received, an LOI can be entered into the system. The system is refreshed once per week and so it may take up to 5 business days before an LOI becomes active.
If there are any changes which need to be made to existing LOIs, or they are no longer valid and need to be removed, you can contact the Quality Review Team and we can have this information amended accordingly.
For any questions or enquiries regarding LOI, please contact the Quality Review Team at Ambulance Victoria on 9881 5503 or email
Thank you again Bobbi Lenham-Horn for this information it is exactly what we need and I hope our members will registered on this excellent system. Thank you also to Michael McQuade who back in August 2010 contact Ambulance Victoria to enquire about registering with them his laryngectomee status.
Getting into locked premises can be a major issue for ambulance paramedics. Keylock boxes are available from Bunnings. You put your spare key into these boxes which are secured using a 4 digit code. You can register this code with the LOI and it will show up on the data system should you call an ambulance to your address. There is a Confidentiality Agreement so no one else will disclose your code.
Kristi said when you ring for an ambulance and speak to the call taker be prepared to answer questions. Some of the questions that will be asked include: What is your address or current location? What is your Call Back Number? What is the problem? (What exactly happened?) Is the patient conscious? Is the patient breathing normally? Is the patient having difficulty breathing? Are they anxious? Are there secretions you can’t clear? Do they have shortness of breath? The more information you can provide even small detail is important. Most experienced call takers with their vast knowledge will decide on the degree of urgency of your call and dispatch the appropriate ambulance. Once the ambulance arrives and the paramedics assess the situation he/she will ask further questions covering your previous medical history, allergies, and current medication. After providing appropriate interim treatment a decision is made as to what hospital you will be taken to. In most cases it will be the nearest hospital either public or private with emergency facilities for ambulances. Even if a hospital has an emergency department it doesn’t mean that you will be accepted there, as some hospital emergency departments may full to capacity all ready.
Hospital Bypass
Hospital bypass is a period of time when a public hospital emergency department can request that ambulances bypass it and take patients to other hospitals. However, even when a hospital is on bypass, urgent patients will be accepted. Bypass may last for one hour this gives the hospital time to clear backlogs of patients and make beds available.
Hospital Early Warning System
The Hospital Early Warning System (HEWS) is a standardised internal hospital response to increased pressure in an emergency department (ED). It is instigated where occupancy and workload within the emergency department is at a level that there is a likelihood that bypass criteria will be reached within the next hour.
The goal of HEWS is to better manage access for emergency patients by improving communication across and within both the hospital and the emergency system. The benefit of HEWS is derived from the internal escalation processes within hospitals that create additional capacity to deal with demand pressure.
On receiving advice that an ED is on HEWS, Ambulance Victoria advises relevant crews of the change in status and seek an alternative destination for non urgent patients, patients without a significant past history and patients not already in transit.
The average duration of a HEWS escalation between July and December 2010 was 1 hour.
Other types of ambulances include MICA (Mobile Intensive Care Ambulance).
MICA Paramedics, as the name implies, MICA paramedics have a higher clinical skill set and can perform more advanced medical procedures. MICA paramedics training goes beyond practical skill precision to include more detail in anatomy, physiology, pathophysiology and pharmacology to greater increase capacity to make complex clinical decisions without medical consultation. A number of procedures performed by MICA paramedics are world first. These include the ability to paralyse a patient and insert a breathing tube (intubate) into their lungs. MICA paramedics can perform advanced airway management, complex management of patients with head injuries or life threatening chest injuries and advanced management of cardiac conditions. MICA paramedics operate either as part of a two person crew on a MICA response emergency ambulance or as a single responder. MICA ambulances carry more complex equipment ECG and more drugs. Other types of ambulances include: Air Ambulances, Air Helicopters, Single Response Units (SRU) (small sedans one man operated) even Bicycle Response Units for major sporting and cultural events etc.
There are 480 ambulances in the whole of Victoria with 200 of these working in the metropolitan area. There are 6 motorbike ambulances these have three wheels and are currently on trial at the moment (this is a Government incentive). The only drawback is that they do not work in the dark or when it is raining. The 200 ambulances which are in the metropolitan area are not always on the road at the same time. All shifts are 12 hour shifts. Fatigue issues arise for longer shifts which are a problem the ambulance service. Friday and Saturday nights are most challenging. There is always an ambulance in every suburb 24 hours a day. If the ambulance is held up at a hospital trying to get a bed then it may delay an ambulance from being available within the set response time.