4th of July Parade and Carnival Start Time Changed

Beaver Island�  - � In view of the 5th ferry run slated to arrive on Beaver Island at about 1:45 PM on July 4th Chamber of Commerce directors voted unanimously to delay the parade start until 2:30 PM. The new Kids Carnival managed by Chamber VP Diane McDonough will start at 3:00 PM.

What's New at the Library?

There are 15 new bestsellers, 18 new children's books, and 78 other new books, including one that is available online. The new bestsellers this week include "The Road to Character," "Dead Wake: The Last Crossing of the Lusitania," and "Bill O'Reilly's Legends and Lies: Into the West."

The Worst and the Best Runs in a 28 Year Career

by Joe Moore

Well, it must be confession time, because this paramedic has nothing to gain and nothing to lose regarding the many patient encounters that have occurred over the last twenty-eight years.  That doesn’t mean that the EMS stories about rural EMS on Beaver Island is over, but it does mean that every single run is not a mundane experience.  Some of them are quite routine, and all you are doing is providing a method to get an emergency patient to the hospital.  Some of them are very depressing because you do everything that you can do, and the patient still dies.  Some of them are so exhilarating, and these are the ones that keep you responding to emergencies of your friends and neighbors.

Let’s get to the worst runs first.  BIEMS is paged to a residence down the west side of the island.  This is a somewhat short run compared to the ones that happen down at the south end of the island, but a few minutes by emergency response vehicle gets me to the residence.  Already in the driveway is another paramedic who is a friend to the patient and his wife.  I enter the house and hear them saying, “Up here,” meaning up on the second story of the house finding the patient in bed.  The assessment of the patient has already been begun by the family’s paramedic friend, so I suggest that he continue as lead paramedic, and he nods.

The patient is complaining of pressure in the area below the sternum, but in a location that could be considered chest pain as well as the pain area of the intestines, gall bladder, and other abdominal organs.  The vital signs are taken and are pretty much in the normal range for someone in pain.  Our protocols suggest that the patient should be treated as if he is having a heart attack until we can reasonably rule out a heart attack.  An aspirin is given.  A nitroglycerin tablet is given.  Oxygen is placed with a nasal cannula at two liters per minute.  The nitroglycerin table does not relieve the pressure.  The IV is started and run with just a very slow drip to give an access to provide intravenous drugs if necessary.  The SAMPLE history (Signs and Symptoms, Allergies, Medications, Previous medical history, Last Meal, and Events leading up to this episode)  doesn’t reveal anything except that this pressure has been building up since lunch, and it is now about 7 p.m. in the evening.  The patient did not eat dinner yet.
We load the patient up and begin the process of getting the patient from the second floor down to the ground floor before loading him in the ambulance.  Luckily there is a ramp, and the ambulance cot is able to maneuver the ramp with one of the EMTs backing down the ramp, and yet another EMT behind him making certain that the EMT on the bottom of the inclined cot does not trip and have our patient riding a roller coaster down to the ground.  We arrive safely down to the bottom and begin wheeling the patient across the grass and paver pad walkway.  All the while, the paramedic friend is running down the walkway to make certain the door of the ambulance gets opened and ready to receive the patient.

While we are bumping down the walkway on the way to the ambulance, the male patient in his late fifties lets out a big “BUUURRRRP.”  He is loaded into the ambulance, and the paramedic friend climbs into the ambulance and asks me, “Are you okay?  Where are we going? I’ll meet you there.”

I respond, “We are headed to the medical center.  I don’t think that this is cardiac, but we’ll see you there.”  The paramedic drives away ahead of the ambulance.  “I’m calling the medical center provider on the radio,”  I say.  “Beaver Island Rural Health Center provider on call; We are transporting one patient to the rural health center.  We request that you meet us there.”

Now, the roadways are quite bumpy, so we go quite slowly to keep from jostling our patient.  We hit another big bump, and the patient burps again.  While we are in route to the medical center, a 12-lead EKG is done after a short stop of the ambulance to get it.  The 12-lead does not indicate anything serious going on with the patient’s heart, so I ask him, “How is the pressure now?  You said it was a four on the scale of zero to ten at the house.  What is it now?”
The patient responds, “I don’t feel that it’s there anymore.  Well, if it’s there, it’s certainly it’s very low, a zero or a one.”

So, we arrive at the medical center, and the friend paramedic is already there.  He has already provided a report to the provider there, and he begins speaking about a “one millimeter rise of the ST segment that could indicate a cardiac event.”  The patient is brought into the exam room, still on the ambulance cot, and another 12-lead EKG is performed that is interpreted in the same way as the first by both the paramedic friend and the provider.  I’m thinking to myself, “Why don’t we ask the patient how he is doing?,” so I report that the patient burped twice and says that he no longer has any pressure or, at least he doesn’t have the pressure he had before.

Now, the next step is pretty clear to me, but the other paramedic and the provider decide that the patient is having a heart attack, and a call to the doctor by the provider seems to confirm this decision.  The decision is to have the patient flown off the island and taken to the hospital to take the tests necessary to determine that this is not a heart attack.  The arrangements are made for the flight, and the patient is not complaining about having to go, so I step back and don’t say anything.
The next thing I know, the provider is right in my face and speaking to me.  I don’t know where I was during that short period of time.  I just wasn’t there, and I only came back to reality when the provider asked me about starting a nitro drip.  All I could get out of my mouth was, “That’s not in our protocol anymore.”

So, arranged flights are completed, and a flight to Harbor Springs is to be made in the dark.  The patient is loaded back into the ambulance and is taken to the airport for a flight to the mainland.  I ask the other paramedic, the one who basically took over the call, to fly with me and help monitor the patient.  With the arrival and loading of the patient into the plane, I grab the headset with a noise cancelling microphone, so I can give a radio report.  As this was reported to the hospital as a heart attack with ST segment elevation, I report it as a STEMI, which stands for an ST segment heart attack on the radio to the hospital.  We land at Harbor Springs Airport, and turn the patient over to the ambulance crew there.  I give them the report, and we turn around and fly back to the island.  We did our job, but I was not feeling very good about this one.  The patient got to the hospital, but I wasn’t functioning at the top of my game.  I had not stood up to the other paramedic.  I had not stood up to the medical center provider, and I was questioning my evaluation of the patient and the treatment that I would have provided.  It was time to take some time off, and re-evaluate what I was doing and why I was doing it.
The patient came home two days later with no diagnosis of heart attack and with only the possibility of some gas or indigestion causing the issues the night before.  I should have suggested the treatment that I had wanted to try, but I couldn’t get myself to do that.  I wanted us to try a “GI cocktail” but no one, including me, put that into the discussion of treatment at the medical center.

The reason that this was the worst run in twenty-eight years was that I had begun to question my knowledge and had given up my position too easily.  Luckily, the patient turned out just fine, but I was not fine.  Too many questions came at me, from others and from me.  It just wasn’t worth the fight, and I decided that I needed to take some time off.  Even as I write this, I begin questioning myself with the why did I not step up and suggest that the diagnosis was wrong, and that I would do something differently than shipping the patient to the hospital.  Now, it doesn’t really matter, but the questions are still there.

The second worse ambulance run during my career so far was my first cardiac arrest many years ago.  The individual was driving down the west side of Beaver Island, and he did have a heart attack.  We were paged to the intersection of West Side Road and Fox Lake Road for a male patient in cardiac arrest with CPR in progress.  This was not a good day for the patient or the patient’s family, but I drove the ambulance lights and sirens for a priority one (life and death) response.
This goes way back to the beginning of my EMS career.  There was male registered nurse in charge of the Beaver Island Medical Center, and he had become a friend.  We had responded with the gift ambulance from Mackinac City to that location, and we both jumped out of the rig, went over to the patient who was laying in the road, and I began CPR.  I was doing mouth to mouth resuscitation and chest compressions while Mark, the RN, hooked up the EKG.  I was a basic EMT at this time, and I knew nothing about a cardiac rhythm, good or bad.  Mark looked over at me and said, “What are you doing?”

I answered between compressions, “I’m doing CPR.”

Mark answered, “I know that, but you are doing mouth to mouth when the bag with the bag-valve-mask (BVM) is sitting right next to you.  You don’t need to do mouth to mouth.  Use the BVM.”

Just as Mark finished his sentence, the air in the patient’s stomach brought a large quantity of vomit right into my mouth since I had not registered what he had said before this happened.  I ran to the ambulance spitting the crap out of my mouth on the way, and I grabbed the suction and returned to doing CPR using the BVM instead of mouth to mouth.  The BVM was hooked up to 100% oxygen, so there was nothing better available at that time.  I continue to do CPR, breaths and compressions, but I was getting tired.  A couple of my students ran up to me, and they started telling me about them finding this patient and about running about a half mile back to the house to call for the ambulance while the other one did CPR that I had taught them in school.  Gosh that felt pretty good to know that I had taught them and they had used it.  I should have felt pride, but with the patient’s vomit still dripping off my shirt, I didn’t feel so prideful at that moment.
Mark said, “Stop CPR,” so he could get a rhythm strip.  As the strip was printing out, I was getting ready to continue doing CPR.  Mark said, “Joe, we’re going to call this right now.  There is no electrical activity of the heart.  He’s in asystole.  There is nothing more that we could do for him.”

I was more than disappointed.  Here I thought that we might save this person’s life.  Mark said, “No more.  There’s nothing we can do.  He has died.”

I got up, walked behind a big tree, and vomited and vomited.  I don’t know whether it was the stress of the moment or the CPR or the mouth to mouth, but it didn’t matter.  I emptied my stomach on the ground and then walked back to the ambulance to rinse out my mouth. And then I learned how the rural EMS folks handle the death of a patient.

We loaded the patient into the back of the ambulance on the ambulance cot out of sight of the onlookers, and we put the patient into a body bag.  We drove the dead patient to the airport to fly him over to the funeral home.  Mark made all the arrangements after talking to the doctor on the other end of the phone.  I just watched, not so happy with what had happened.

Unfortunately, I’ve had to do this several more times over the last twenty-eight years, and I still don’t like it.  I haven’t had any other physical reactions like the first one, and I haven’t done mouth to mouth on anyone since.  I guess I learned my lesson the first time.  I finally learned what Mark was trying to teach me.  There are times that even doing the best that you can, the patient may still die.  You give them the best that you can provide, but the result isn’t in your hands.  It is in the hands and the will of someone greater than you, greater than death, greater than life itself.  Thank you, Lord, for teaching me to care and to learn that I can’t fix everything or everyone.

One more bad situation has happened to me several times that I find it necessary to talk about.  We have been paged to some serious emergencies over the years, and one of the most frustrating situations continues to happen.  Beaver Island did not require house numbers or numbers at the end of the driveways.  I believe it is required now, but the lack of the ability to find the residence where there is an emergency really drives all of our EMS people crazy.  If you are having the “big one” or something very serious is going on, it is pretty important for you to be able to get to that location to be able to use your skills.  There really isn’t anything more frustrating to the EMS provider than not being able to find the patient.
“Beaver Island EMS, respond to 32268 East Side Drive, for a patient in cardiac arrest.  CPR is in progress,”  Central Dispatch has paged us to this address.  It’s after dark on a early fall evening.  I’m driving my car down to the ambulance garage to wait for another EMT before we can respond to the call.  In less than two minutes, the ambulance gets under motion with me driving.  We are heading down the Kings Highway going lights and siren, trying to get to the residence as quickly as possible.  One of the first responders calls us on the radio and asks us to pick him up at the end of the highway.  We turn off the pavement and head across McCauley Road to the East Side and turn right onto the East Side Drive.  As we are heading south down the gravel road, we keep track of mailboxes and the cutesy signs that name the cottages on the water side of the road.

We see the numbers on the mailboxes and some are placed on posts.  We see 36300 and the numbers are continuing to decrease.  The last number we see is 33140, and then there are no other numbers on mailboxes, posts, or anywhere, and there are no names for the cottages.  All the cottages are now set back from the road quite a way, and there are no lights that can be seen through the trees even though it is after dark.  We slow down looking for any indication of which driveway to turn down.  We call on the radio to Central Dispatch, “Can you give us a name on the residence?”

The name given us does not give us a clue.  It’s at “Domino’s Hideaway,” is what Central tells us.  We don’t have any idea where that is.  All of a sudden, we see a mailbox with a number on it.  The number is 31446.  “Crap,” I say out loud.  “We missed it. It’s got to be one of those driveways that we passed that didn’t have a mailbox or a number.”  We have to turn around and head back north.

We just have to go in every driveway looking for a light on.  Luckily, we go in the third driveway, and the resident came out to greet us.  I said, “We’re looking for ‘Domino’s Hideaway,’” I yell at the person outside.  He tells us that it’s four driveways north of his and then turn left and down two houses.  We follow the directions given to us, and finally, finally we arrive at the residence.  It has taken us almost fifteen minutes to find the right house.  The chance of survival from a cardiac arrest after fifteen minutes is very low even if the CPR being done was perfect.  The patient does not survive, and we are once again frustrated because we didn’t get a chance to provide the care that we were trained to provide.  Time is our enemy when the heart stops beating.

Now for the best of the runs over the last twenty-eight years, I have to say the wonderful teamwork lays at the heart of all of these.  Perhaps the most rewarding run of my EMS career involved a cardiac arrest in the hardware store.  Early CPR was started by the hardware store employees.  BIEMS arrive very quickly after a page by Central Dispatch.  EMS took over the CPR, compressions and ventilations, and I remember the deputy at the time, who was also a paramedic, walked in the door with the AED and said, “Here’s the AED.  I’m sure you wanted it in here.”  He was completely correct.  That is exactly what this patient needed.  The pads were placed on the patient, and the AED charged and shocked.  This shock did not restore a heartbeat, but the automatic external defibrillator wanted to shock again.  I pushed the button after the machine charged and pressed the “Push to Shock” button.  I know that I shouted, “He has a pulse,” and we moved the patient into the back of the ambulance.  I will never forget the moment when the patient’s facial features came back to normal, and I recognized who he was.  The second moment happened shortly after the first one, and the patient reached up with his hand a pushed the mask off of his face, and looked around not knowing what had happened.

The patient was taken via ambulance and air transport vehicle to the hospital.  Beaver Island EMS got a very nice letter from the cardiologist congratulating us on the skills that were performed correctly and on our success.  He further stated that it was quite unusual for a cardiac arrest in a remote location would survive, but our patient not only survived and was alive, but he also had not received any neurological deficit, no brain damage, and was a completely whole person, and he got to spend thirteen more years with his family.  I am very proud that I had a hand in this most positive outcome.

I also need to express the very many thanks to the crew that responded on that day.  They are all friends and the patient was a friend as well.  Mike, Bev, Jim, Gerald, and any that I missed.  I have been proud to be an EMS provider alongside some of the most caring EMS people that I have encountered anywhere.  Thank you for your service to your community, and thank you for caring enough to take the many hours for the education and skill training.

Another absolutely rewarding situation occurred once again without any possibility of transporting a patient off the island to a hospital.  It was a very foggy day which continued into a very foggy night.  On the mainland that just means that the ambulance has to drive a little slower, but eventually the ambulance gets to an emergency room in a hospital.  On Beaver Island, we don’t always have that luxury.  This night was one of those nights.  No luxury, no transport, no emergency room.

Thank goodness that we have a rural health center and providers that we love to work with for the benefit of our patients.  The patient had a very fast heartbeat.  Normal pulse rates are in the range of 60-100 beats per minute for the majority of adults.  This patient had a pulse rate in the 160-170 range.  The patient was pale and sweaty.  The patient was headed on a downhill slope, and the hill was steep and he was approaching a cliff with a very deep crater at the end. 
The patient was young, in his late forties or early fifties, to have any cardiac issues.  He was the father of some of my favorite students that had graduated from Beaver Island Community School.  He was having a serious cardiac emergency called SupraVentricular Tachycardia (SVT) which had come on about three hours ago, had ended once after sitting down and relaxing in a quiet environment, and then started going faster again in the same place just sitting in a chair.  He called 911 when he got sweaty and was weak and light-headed.

BIEMS responded to his home with the emergency response vehicle arriving within two minutes of the page.  After getting his vital signs and an EKG, it was determined that, with the fog, the patient should go to the medical center, a better environment than the patient’s living room, for any treatment and a wider variety of medications for treatment of his condition.  The patient refused to go in the ambulance.  He would get to the medical center by his own personal vehicle.  The patient’s wife agreed to drive him directly to the medical center.  We disconnected the EKG monitor wires, leaving the electrodes stuck to his skin, so we could hook him back up when we got to the medical center.  We drove the short distance to the medical center to await the patient after calling the medical center provider on the phone and asking that she meet us there.  We got to the medical center, placed the patient in the treatment room for cardiac conditions,  had the patient hooked up to their cardiac monitor, had run another 12-lead EKG, hooked the patient to low flow oxygen, and had started an IV all before the provider arrived.

When the physician’s assistant arrived, one look at the patient and the verbal report given caused a quick call to the medical control physician.  The doctor wanted the patient transported immediately, but was informed that there was no physical way to get the patient to the hospital.  The fog prevented any flight by even the Coast Guard helicopter.  There was no way to fly into any Beaver Island Airport, and the fog prevented any aircraft from taking off from any airport north of Cadillac including the Upper Peninsula.  We had another one of those Beaver Island situations where whatever treatment the patient was going to receive would have to take place right here on the island.  Normally, this treatment would take place in a hospital emergency room or in a cardiovascular unit in a hospital.  Instead the treatments would have to take place in our little clinic treatment room.

After talking to the doctor in the Charlevoix ER, he transferred medical control of this patient to McClaren Northern Michigan Hospital in Petoskey.  The next phone call was to the hospital in Petoskey.  The next thing that we knew, the house supervisor nurse at Northern was calling us on the phone asking questions, and the cardiologist on call was advising us on the treatment plan for this patient.  Both of these individuals seemed sincerely interested and completely aware of our location and our limitations for transport.  The treatment plan was determined jointly between these two individuals, the provider at the medical center, and I had very little to do with the plan, but I did recognize that this plan was part of the Advanced Cardiac Life Support (ACLS) promoted by the American Heart Association (AHA) and part of the curriculum for ACLS that I as instructor of that program knew fairly well.

What was truly interesting is that these professionals accepted my skills without question.  The next steps were part of the plan.  The ACLS protocol for SVT, a very fast heart rate that does not allow the chambers of the heart to fill properly before squeezing the blood out of them, involves some very specific treatments.  The treatments are different if the patient is not stable, but this patient was stable, and we had some time to try all the possibilities.  The first one is described quite well as taking a deep breath and then push down like you are trying to push out a big solid ‘turd.’  We had tried this three times at the patient’s home, but there is no reason not to try this again.  The fancy names for this treatment is ‘vagal maneuvers.’  These vagal maneuvers did not do anything to the patient’s heart rate.

The next step in the ACLS protocols for SVT is to make certain that you have a good IV, then use a drug that basically ‘chemically stops the heart.’  The idea here is that there is a loop in the electricity of the heart and there is no time for the heart to reset itself.  The plan is to stop the conduction of the electrical impulses inside the heart to give the heart a chance to reset itself.  We used a syringe to draw up the 6 mg of Adenosine.  A second syringe is used to draw up 20 milliliters of fluid.  Since the half-life of this drug is very short it needs to be pushed into the heart quickly in order to be able to do its job.  That job is to stop the electrical activity of the heart, to chemically defibrillate the heart, to temporarily stop the beating of the heart.  The hope is that this stopping will allow the normal pathway of the electrical activity to resume and ‘short circuit’ the electrical loop.  Okay, we’re both ready.  We both have the needles of our syringes in the same IV port right close to the vein with the IV catheter in it. I have the Adenosine in my syringe and Kate, the medical center provider, has the fluid.  “On the count of three, we both push the medication,” I say.  “One, Two, Three.”  The drug and the following fluids are pushed quickly into the patient’s vein and arrive in the heart quickly.  The cardiac monitor strip is printing while we wait for the drug to do its job.

Kate says, “It slowed the rate for just a short time, and now its creeping right back up to the 160s.  We both look at the EKG printout to make certain that there is no underlying atrial fibrillation, a quivering of the top of the heart.  There isn’t anything there that suggests that we shouldn’t go on to the next step.  This time, I draw up 12 mg of the Adenosine drug. Kate draws up her 20 ml of normal saline, the fluid that is chemically the same as the fluid part of the blood.  Once again it is, “One, Two, Three,” and the drug and the fluid pushes the drug quickly to the heart.  Once again a period of time with no heart beat, then a slow heart beat, and then accelerating heart beats back up to 170 beats per minute.  We have not been successful a second time.  We will be trying the third time in a few minutes, and while we are drawing up the 12 mg of Adenosine again and the NS fluid, the phone rings.  It is the house supervisor nurse from Northern Michigan Hospital, and she asks, “How are things going?” 
Kate lets me do the talking while she walks to the medical center pharmacy to get the next drug in the protocol.  I explain to the nurse that we are getting ready for the third dose of Adenosine, and that we’ll move on to the next step if necessary.  The nurse says, “Good, you’re following ACLS guidelines, so the next drug will be Cardizem as a bolus.  I’m going to contact the cardiologist on-call and have him contact you.  Keep doing what you are doing,” and she hung up.

So, another 12 mg of Adenosine was drawn up into the syringe in my hand, and another 20 ml of NS fluid was drawn up by Kate.  She had brought in a whole box of Cardizem in case this didn’t work.  One last try with a “one, two, three” and the drug was pushed in quickly, and once again it did not work the way we wanted it to work.  The pulse slowed for a short time and then returned to the 160-170 beats per minute.  It was time to step up to the next step.  Instead of stopping the electrical activity and hoping it would start back up with a slower rate, we were going to use calcium-channel blockers to slow the sinus pacemaker and inhibit atrioventricular conduction to get the pulse rate down to something more normal, say 60-100 instead of 168.  We were going to actually slow the rate of the heart.

As we were preparing the Cardizem, drawing it up  after mixing and calculating the dose of approximately 25 mg, the phone rang again.  This time Kate spoke with the cardiologist who suggested that this dose should work and that we could do a repeat dose if it did not.  In any case, a cardizem drip should be started and run.  So, not only were we doing an IV drug not in the typical paramedic drug box, but we were also going to set up an IV pump and run the drug in at a specific rate per minute.  I couldn’t contain myself any longer and spoke out loud, but not in front of the patient, “Kate, this is so cool.  You realize that we are providing a patient on Beaver Island with the same treatment that he would be receiving in the cardiovascular floor at the hospital, and that this is the same care he would be getting from his cardiologist?  How cool is that?”

The Cardizem bolus of medication was given, and the pulse rate decreased, but did not come down below the 120 rate, so the IV drip of the medication was the next step based upon the nurse and/or cardiologist in Petoskey.  I’m not sure how many paramedics in the urban area have time to set up a cardiac drug drip before arriving at a hospital.  I’m sure that these same paramedics encounter the drips when transporting patients during facility to facility transfers, but there certainly aren’t many doing so in an emergency.  The patient in the ambulance would more often get to the hospital before this step in the ACLS protocols.  It has been at least three years since either Kate or I had used the IV pump for a patient.  I had some experience with the pump and knew that the primary issue with this particular pump was making certain that the special administration set of tubing was completely emptied of air, so Kate added the drug to the 100 ml bag of NS fluid, and I made certain that there were no bubble of air in the tubing.  We hooked it up and ran it at 10.  While most paramedic or nurse readers would be interested in the mixing process and what the 10 means, most of the other readers wouldn’t really care, so that will be left out of this writing.  The IV pump tubing was connected to the regular IV tubing and taped in place.  The patient was now receiving an IV drug at a very accurate measured dose.

At this point the pulse rate was still above 120, but our hopes were that this IV drip medication would bring it down.  It must have been quite an interesting process going on inside this patient’s heart.  We stayed with the IV drip for a while, and about every 20 minutes, the heart rate decreased five beats per minute.  It was pretty amazing to watch and be a part of this emergency.  We watched and took vital signs and maintained the low flow oxygen by nasal cannula.

After about two hours, the heart rate was bouncing between 85 and 90 beats per minute.  Additional phone calls had been made to Valley Med, an air transport out of Iron Mountain in the UP.  Our local weather had not improved, and Valley Med predicted that the fog would continue until about 11 a.m. which was quite a few hours away.  The US Coast Guard would not be able to fly until the fog cleared also.  We were just stuck here on Beaver Island, but we were fixing the patient’s cardiac issue.  At some point the cardiologist and the medical center provider had a conversation about what to do.

It was determined by their joint discussion that the patient should be given one dose of 60 mg of Cardizen by pill and sent home with the addition of this medication twice per day until the patient scheduled an appointment with the cardiologist.  Amazingly enough, in the following week, the patient visited the cardiologist and was cleared from this emergent condition.  What a wonderful outcome for the patient and for Kate and me to have shared in this experience with this patient and this family!

BIEMS had previously had a patient with the same condition, much earlier in our history.  With this patient, the Adenosine had worked on the second dose, the short circuit loop had been stopped when the heart stopped all activity and scare even those experienced in the procedure.  Luckily the complete lack of electrical activity and the complete lack of beating of the heart had resumed after the third dose of Adenosine, and no further treatment was needed.  And YES, it was also another one of those times when there was no way to transport the patient off the island.  Excitement abounds in rural EMS, especially on the isolated island in Lake Michigan named Beaver Island.

 

Men's Summer Golf League Delayed

The men's summer golf league was scheduled to begin on June 3, 2015. Due to some work on the golf course, this league start will be delayed on week and will start on June 10, 2015.

Rural EMS is Different--HOW?

by Joe Moore

 

(Many thanks to the patient involved in this emergency for his willingness to allow me to share his story.)

A Quick Collection of Ticks

by Jeff Powers

Using the techniques learned yesterday, May 18, 2015

 

BICS Graduates at Banquet

with Banquet Speaker Jenna Wilk

Emily Jines, Hannah Robert, Jenna Wilk, Maddie Martin, Meg Works

Beaver Island Music Festival Receives Grant From Charlevoix County Community Foundation

Beaver Island Music Festival (BIMF) located at 28599 Hideaway Trail, Beaver Island, Michigan has been awarded a grant this Spring 2015 from the Charlevoix County Community Foundation to be used toward the purchase of an enclosed equipment trailer. BIMF is a non-profit organization founded in 2003 to promote variety and tradition of music and art.  BIMF creates opportunities for artists and strongly encourages community and family involvement in an outdoor environment combining nature, renewable energies, music, and artwork.  The main goal is to bring focus to the beautiful world that we live in (especially Beaver Island) by uniting art and musical talents with people. To date the Beaver Island Music Festival has brought over 650 talented artists, 190+ groups, to perform on the island covering many genera of music.

The trailer will be used to safely transport and store the valuable instruments and sound equipment belonging to musicians and artists that participate in the 3-day festival each July. The main priority is to protect these items that are key components to providing the amazing music that is heard by thousands of festival-goers every year.  When not being used for equipment transportation, the enclosed trailer will be a safe and secure place to store the sound and stage equipment, as well as other items required to produce the festival.  This trailer will also be offered for use throughout the year to support other events and programs.

The Charlevoix County Community Foundation is a local charitable organization dedicated to enhancing the quality of life for all citizens of Charlevoix County by building permanent endowment, addressing needs through grantmaking, and providing leadership resources to serve the community. More information about the Charlevoix County Community Foundation may be found at www.c3f.org or by calling 231-536-2440.

More information about the Beaver Island Music Festival may be found at www.bimf.net or by calling 231-838-2883.�  More information about the Charlevoix County Community Foundation may be found at www.c3f.org or by calling 231-536-2440

BICS Interim Administrator Job Posting

Stop By and Thank Chris VanLooy

The BIRHC board and staff are having a little drop-by reception to thank Chris for coming back to help us these past months. Light refreshments from 3-5 pm in the community room on Tuesday, May 26.�  Everyone is invited - come as you are. Hope you can come!

Tick Presentation at Community Center

Live Streaming of this presentation took place at Noon, May 18, 2015, at the Beaver Island Community Center. The presentation took place with approximately eighty people in the audience. The planned half hour presentation took almost an hour and a half with a wonderful question and answer period following the PowerPoint presentation with excellent information provided. The two presenters were Dr. Jennifer Sidge, DVM and PHD candidate (sidgejen@msu.edu) and Erik Foster, MS, (fostere@michigan.gov) from the Michigan Department of Health and Human Services. This presentation was made possible and was coordinated by Dr. Jeff Powers.

Dr. Jeffrey Powers, DVM, introduced the presenters

Dr. Jennifer Sidge, DVM

The objectives of the presentation

Erik Foster, MS, of MDHHS

Additional resources can be found at these websites.

The question and answer period began.

Both presentations were very informative and provided much needed information considering the Jeff Powers, DVM, report of Lyme Disease in twelve of the fifteen dogs tested right here on Beaver Island.

Dr Jeff Powers answers a question.

Animated and obviously very knowledgeable answers to the questions posed by the audience

The audeince asked excellent questions, but also related the fact that at least one individual on Beaver Island had been infected with Lyme Disease and is currently being treated for that disease by the providers at BIRHC and confirmed by a dermatologist.

Video of the event HERE

Collecting Ticks Prior to the Presentation

Thanks to Jeff Powers for his photos of the collection.

Here are some pictures of the collection and a close up of a adult female deer tick:

Baccalaureate at the Beaver Island Christian Church for BICS Seniors

These pictures are courtesy of Deb Plastrik.

Our BICS graduating seniors

The cake for after the service by Patrick Nugent.

BICS Banquet and Senior Bash

The Banquet, Sunset Cruise, and the Senior Bash all took play this past Saturday beginning at approximately 6 p.m. with the Banquet. The Banquet is traditionally held at the Holy Cross Parish Hall, but this year it was not traditional. Instead of a full meal, this year the juniors decided that hors d'oeuvres and deserts would be the substance of the food presented. There also appeared to be a dance, making this more like a prom than previous Banquets. From the hall, the students went down to the Beaver Island Boat Company Dock and boarded the Emerald Isle for the Sunset Cruise. After the cruise, the students went back up to the Beaver Island Community School Gymnasium for some interesting games which included blown-up structures. The final part of the evening into the early morning included games and refreshments and snacks in the High School Commons.

There were a large volume of pictures taken by BINN reporter Deb Bousquet, who had to work at the Banquet as a junior parent. You can view the pictures HERE.

Phyllis' Daily Weather

for May 18, 2015

We're starting out the week with a nice, clean, fresh Monday morning. All that rain last night, about 3/4 of an inch, washed away the dust. Right now it's 52°, wind is at 15 mph from the south, humidity is at 83%, pressure is rising from 1009 mb, and visibility is at 9.7 miles. Today: Partly sunny. Highs in the lower 70s. Southwest winds 10 to 15 mph with gusts to around 25 mph. Tonight: Partly cloudy in the evening then becoming mostly cloudy. Lows in the lower 40s. West winds 5 to 15 mph. Gusts up to 25 mph in the evening.

On this date of May 18, 1652 - In Rhode Island, a law was passed that made slavery illegal in North America. It was the first law of its kind.

Did you know that per person France consumes the most cheese?

Word of the day: devolve (di-VOLV) which means verb tr., intr.: To transfer or be passed (duties, rights, powers, etc.) on to another. verb intr.: To deteriorate or degenerate. From Latin devolvere (to roll down), from de- (down) + volvere (to roll). Ultimately from the Indo-European root wel- (to turn or roll), which also gave us waltz, revolve, valley, walk, vault, volume, wallet, helix, and voluble. Earliest documented use: 1420.

Thank an EMT for National EMS Week

HEAR ME AMERICA, I AM, THE EMT

I see your people as you never see them.

Mighty and small they are beggars before me,

their faces all frightened, beseeching, bewildered and hopeful of help from one more frightened than any...

I see their pitiful nakedness, their limbs twisted,

their bodies tattered, their blood on the asphalt, their children crying. They trust me to help them. They know I will help them.

I see their illness too in your big cities. Their fevers I feel

as you dream at midnight in little towns. They call to me

whose hearts are aching and whose dreams are shattered

and they touch me with their weariness.

Sometimes they seek me who are simply alone and

who cannot bear the night, and I am their servant too.

Fallen from tractors in fields I find them, and in stilled cars they are silent and pale on cold rainy nights. The crunching of glass under black heavy boots tells my coming. I fold them in blankets.

My beacons light up your streets as their babies are born. My wail carries down your boulevards, past your shiny glass walls, your stockyards and quiet farms, and your people look up from their work as I go by.

Time is metered in heartbeats.

I fight the battles to keep them alive.

I cover their eyes when they breathe no more.

My partner is a hero, but no one knows his name.

Author Unknown

Michigan Rural EMS is proud to recognize and support the efforts of EMS professionals across Michigan. Thank you for all you do to� provide the highest quality prehospital care to those in� your community!

In 1973, President Gerald Ford authorized EMS Week to celebrate EMS, its practitioners and the important work they do in responding to medical emergencies. At that time, EMS was a fledgling profession and EMS practitioners were only beginning to be recognized as a critical component of emergency medicine and the public health safety net. EMS has� evolved considerably� over the� years,� and continues to� expand its role to address thecurrent healthcare climate and meet community needs.� � EMS Week is our opportunity� to celebrate how far EMS has come, to remind communities�  bout� the� professionalism,� dedication and sacrifice of EMS, and to look forward to the expanding role of� the EMS profession in maintaining the health and safety of those they serve.

When Things Fall Apart

by Cindy Ricksgers

St. James Township Job Posting

for Sewer Billing Bookkeeper

Ticks Are a Serious Problem This Year

BINN spoke with Jeff Powers, DVM, and he said, "I just recieved reports from the first round of ticks I submitted to the Michigan Department of Agriculture for identification. Over the last two years 100% of the ticks found on Beaver Island were Black Legged Deer Ticks, Ixodes scapularis. This underscores the importance of learning more about protecting yourself and your pets from lyme disease."

BINN Editor Joe Moore was bitten by a tick, but it was not on his skin for very long, just long enough to cause some concern on the part of the person bitten. The tick was removed, killed, and disposed of. This tick looked exactly like the ones shown below.

Thank you to Jeff Powers for these pictures and for the copy of the report below.

There is a scheduled tick presentation on Monday, May 18, 2015, at noon, at the Beaver Island Community Center.

Beaver Island Health Occupations Class Compete at State

In April 2015, Emily Burton and Emily Jines went down to the Health Occupations Students of America State of Michigan competition having moved forward from the regional competition. Their instructor is Kathie Ehinger, BIEMS paramedic and owner of Daddy Franks Restaurant and Ice Cream Parlor

.

Emily Burton....................Emily Jines

Nothing quite like this on Beaver Island

Down in the big city..left, Emily Burton and Kathie Ehinger, right Emily Burton and Emily Jines

Congratulations to the two Emilys and their instructor for a job well done!

Students Attend CE Intermediate District Awards Banquet

Some additional students, besides the two above, attended the Charlevoix-Emmett Intermediate School District Career and Technical Education Banquet. These students and their parents were invited to attend the banquet where some additional awards were presented.

Katie LaFreniere and Courtney Smith received awards in Business Administration and Management.

Picture of Emily Burton and her mother Carol at the awards banquet

Beaver Island Citizen of the Year

And the winner is.........

Approximately fifty people attended the dinner for the Citizen of the Year. The weather kept the speaker for the Citizen of the Year Banquet on the mainland due to the fog. Also kept on the mainland was President of the Chamber of Commerce Rachel Teague. Steve West, Executive Director of the Beaver Island Chamber of Commerce announced this information as well as giving accomlades to Frank Solle and Elaine West for their pictures in the Beaver Island Visitor's Guide

. He then introduced former Chamber President Kathy Speck who read Rachel Teague's descriptions of the nominees.

The nominees were:

• Beaver Island Club of Grand Rapids
• Richard Gillespie
• Ed Wojan
• Fire Department Auxiliary
• Bud Martin
• Pete Plastrik
• Bill McDonough
• Darrell Butler
• Donna Kubic

And the winner of this year's Beaver Island Citizen of the Year is the Beaver Island Fire Department Auxiliary.

Congratulations to all the volunteers of the Beaver Island Fire Department Auxiliary and the Ladies of the Island Treasures Resale Shop!

BICS Special Board Meeting

on 5/15/15 at 2:30 pm

The main two purposes of this meeting were to appoint a board member to replace the leaving Dusty Cushman and to discuss the process of hiring an Interim Superintendent/Principal. There were fourteen people at the meeting in addition to the six board members.

The agenda of the meeting specified process and each individual interested in joining the Board of Education was given an opportunity to speak with five to eight minutes of time to be interviewed. The board of six then had the opportunity to discuss the qualifications of each candidate. Each member of the board of six then were asked to give the first two choices out of the five candidates. With the six board members, the individual with the most 'votes' was a prior member of the school board, Dawn Marsh, who received four votes with Mark Englesman and Andy Kohls each receiving three votes. So Dawn Marsh will be the individual to replace Dusty Cushman on the Board of Education.

There will be a special meeting of the Board of Education on May 21, 2015, at 2:30 p.m.

Video of this May 15th meeting is available HERE

Bill Kohls Requests Survey Completion

(This was posted on the Beaver Island forum, and I took it from there.)

On March 28th I distributed a memorandum to Peaine Township board which discussed the cost of paving approximately 7 miles of roads. That memorandum is available at http://www.charlevoixcounty.org/peainetwp.asp

The township board would appreciate your input on road paving and asks that you complete a survey which is available at https://www.surveymonkey.com/r/PeaineRoadPaving

You may address any questions relating to the survey to peainetownship@gmail.com

Thanks for your valuable input.

Bill Kohls

Bike Festival Scheduled

A little about the Bike Festival organizer:

I am a Traverse City cycling enthusiast and help organize a bike race called the Cherry-Roubaix which became a Michigan State Championship road race. I was looking to do something more fun I have visited Beaver Island a few times by boat.�  A friend introduced me to Bill and Tammy Mcdonough 6 years ago and they thought the bike festival would be a great idea.�  It started out with in 2010 with about 60-70 cycling friends and has grown to over 120. The locals on the island treat us like we are part of the family so I believe we will continue to do this as long as people are riding bicycles.

I am a technology sales rep currently working for Charter Communications.�  A single father who will be 54 years old this year and have a special needs daughter who will be 14 this month.

John Sohacki

Red Cross Blood Drive July 30th

� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 

The annual Rita Gillespie Memorial Blood Drive will take place on July 30 beginning at 12:30 PM at the Gregg Fellowship Hall.�  Picture ID or Red Cross Blood card are now required in order to donate.
Both new and repeat donors are needed to make our goal. � The Red Cross will be sending two extra nurses this year to speed the process of donating. Calls to donors will be made in July. Please make time to save up to 3 lives with your donation. The life you save could be a child, a brother, sister, mother or father. Give something of the highest value that costs no money: the Gift of Life.

Connie Wojan

Vacation Bible School

New BIRHC Provider

The BIRHC is happy to announce that Carolyn Space, Family Nurse Practitioner-Certified, will be joining the staff. Carolyn and her family will be moving here from Ohio. She has experience in many clinical settings, most recently as Emergency Nurse Practitioner at Wood County Hospital in Bowling Green. We will announce when she is available to see patients here. Carolyn will join Sue Solle, FNP-C, as the Island's providers.� 
We also want to thank our wonderful Chris VanLooy, Physician Assustant, who came out of retirement last fall to help us out during our search for a new provider.� 

BIRHC Early Bird Brochure

BI Music Festival Schedule

Funeral for Rod Nackerman

Beaver Island Music Festival

July 16-18, 2015

First Meeting of Five for Emergency Services Authority

Eight interested community members and five authority members gathered at the Peaine Township Hall for the first meeting of the five members of the Beaver Island Emergency Services Authority. The board members are Bill Kohl, Rick Speck, (the first two on the formed ESA), Brad Grassmick, Donna Kubic, and Jim McDonough. The board set their regular meeting date as the last Thursday of the month at 2 p.m. The board has a large learning curve related to overseeing of the Beaver Island Emergency Medical Service and the Beaver Island Fire Department.

View Video of this meeting HERE.

Job Opportunity with CC Road Commission

The Charlevoix County Road Commission will accept applications for Road Maintenance Worker/Truck Driver at their Beaver Island garage. Applicants shall be experienced in Construction and Utility Work, and shall possess a Class “A” CDL with Air Brake and Tanker endorsements. Applicants shall be required to take a road test in a Road Commission supplied vehicle. Applications shall be received at the Charlevoix County Road Commission office, 1251 Boyne Avenue, PO Box 39, Boyne City, MI 49712-0039 until 3:00pm May 15, 2015. Application forms are available at the Boyne City office, by calling (231) 582-7330 or online www.charlevoixcounty.org/ccrc.asp. The Charlevoix County Road Commission is an Equal Opportunity Employer.

Community Center (PABI) Job Available

July 4th Parade Theme

Theme: “Once Upon A Time”

Chamber of Commerce directors wish to thank Dawn Martin who suggested the theme idea. The Big Parade & Island Airways Flyover, featuring the missing man formation at 2:00. Line up for the parade� starting at Holy Cross Church starting at 1:00. Cannon fire by John Works.
July 4th 2015

BINGO Announcement

Beaver Island Association's Newsletter 2015

This newsletter succeeds in proving information about activities and improvements of the island ecologies and non-native, invasive species. It provides information about changes in laws in Michigan. There is truly a lot of good information in this newsletter. It is presented here with permission of the BIA.

Visiting Providers at BIRHC

call Betty, if you have questions 448 2275

 

Dr Jon VanWagnen, O.D.
Charlevoix Eye Center
Friday, May 29, 2015
9 am until 4 pm
Call his office for appointments
231 547 7800

Any additional questions call Betty 231 448 2275

Dr. Patrick Richmond, D.P.M., P.C., Petoskey Foot Specialists & Heel Pain Centers has offered to travel to Beaver Island to see patients if there is enough interest to make it worth Dr Richmond’s time.
Please call the Health Center 448-2275 if you would make an appointment to see Dr Richmond so we may determine if the need is great enough for Dr Richmond to make plans to see patients here on the island at the Clinic.