Health
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This is especially true for the elderly, small children, the chronically ill, substance-abusers and individuals who stay out in the cold for long periods.
AMR suggests the following tips to help avoid two potentially dangerous conditions, hypothermia and frostbite.
Both can happen even in areas known for warm weather, especially when wind chill and the possibility of getting wet in cold water or rain are involved.
To avoid hypothermia and frostbite, wear clothing in layers.
Layers of clothes provide much more protection than one thick garment. The layer closest to the body should be thin and made of polyester or similar material to pull moisture from your skin.
The next layers should be bulkier, providing more insulation. Wool is a good insulating material, as are newer materials such as polyester pile.
When you’re outdoors, the outer layer should resist rain, sleet or snow and have zippers for venting body heat if you become too warm.
Here are some other tips:
Wear a hat. Forty percent of body heat escapes through the head.
Wear mittens rather than gloves because mittens keep hands warmer.
Immediately remove any clothing that gets wet.
In cold weather, elderly people should be checked on frequently because age can weaken the body’s ability to sense and adapt to temperature changes.
Hypothermia is a general cooling of the body’s internal temperature. Hypothermia victims go through stages of shivering, numbness, confusion and drowsiness before becoming unconscious. Unless emergency aid is provided, death can follow.
First aid for hypothermia includes removing the person from the cold setting. Give CPR if needed. Remove wet clothes and wrap the patient in warm materials. If the victim is alert, give them warm non-alcoholic drinks. Never give anything by mouth to someone who is less than fully alert.
Frostbite is the freezing of a body part, most often the fingers, toes, ears or nose. The part often feels hard and waxy and may be discolored.
First aid for frostbite includes removing the person from the cold setting. Handle the injured area gently to protect it from further injury and wrap it in dry, sterile dressing. Do not rub the frostbitten area and do not allow the victim to try to use the injured area, such as walking on frostbitten toes. Never put ice on frostbite.
Rewarm the frostbitten body part only if medical care is remote or unavailable. After rewarming, keep the injury from re-freezing.
When hypothermia or frostbite is suspected, call for help from your local ambulance service immediately.
American Medical Response Inc. (www.amr.net), America’s leading provider of medical transportation, provides services in 40 states and the District of Columbia. More than 18,500 AMR paramedics, EMTs, RNs and other professionals, with a fleet of 4,100 vehicles, transport more than three million patients nationwide each year in critical, emergency and non-emergency situations. AMR, a subsidiary of Emergency Medical Services Corporation, is headquartered in Greenwood Village, Colo.
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The state’s most recent cuts will reduce Medi-Cal reimbursement rates for paramedic level emergency ambulance transports to $104.
This rate is below the 1998 reimbursement level and is hundreds of dollars below the hard costs of providing the service.
Unlike other nonemergency health care providers, ambulance services who treat and transport Californians in a medical emergency, must take all patients regardless of their ability to pay.
“What is happening to our industry is no different than if the State forced all grocery stores to give out half of their food for free and then told stores to triple the cost for those who pay and lower the quality of their products to help make up for the loss,” said CAA Executive Director Brenda Staffan. “Medi-Cal has new policies that will negatively impact every Californian, and their position is that they are not responsible for these negative outcomes as long as all our emergency patients are impacted in the same manner.”
Private ambulance providers do not receive taxpayer subsidies and there is no reimbursement for more than 50 percent of the emergency services they provide.
Ultimately, these cuts will result in a hidden tax on privately insured Californians who already pay higher premiums, deductibles and copays in order to pay for the millions of Californians treated under the Medi-Cal system.
Reduced reimbursements will ultimately impact access to care for all Californians through extended response times to emergencies or delayed implementation of life saving procedures or equipment.
Medi-Cal is implementing a permanent 10-percent reduction in Medi-Cal rates for emergency and interfacility ground ambulance services retroactive to June 1, 2011.
The new permanent lower rate is scheduled to go into effect on Dec. 31, and will only cover about one fifth of the actual cost of emergency service.
Medi-Cal officials rejected the CAA’s request for an exemption from the rate cuts despite numerous independent studies and additional evidence from the state wide 911 EMS system that demonstrates that access to patient care is already being impacted by severely below-cost Medi-Cal rates.
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