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Winners of Nicholas Rosecrans Award Embrace a Commitment to Injury Prevention


From his office window at Piedmont Medical Center EMS in Rock Hill, S.C., Robert White can see a series of stones nestled in the grass, each engraved with the name of a child who died from traumatic injury. There are markers for 10-year-old Spencer Lee and 11-year-old Larell Huey, killed when the car a relative was driving veered off the road. Neither boy was wearing a seatbelt. There are markers for children who drowned, who were killed by drunk drivers, and the victims of child abuse and suicide.

"When I look out there today, I can see a little toy truck laid on one of the stones, and a cross and a candle on another," says White, community relations coordinator for Piedmont Medical Center EMS, which provides 9-1-1 medical response to York County. "When families come visit the stones, I give them a few minutes for their quiet time. Then I go out, meet them and talk to them. The first time I met the dad of one of the little girls, he had tears in his eyes. He said, ‘Thank you for remembering my child. Thank you for advocating for children.’ He pulled $200 out of his wallet and handed it to me. He said, ‘I want you to do something in honor of my child.’"

For White, moments like those have inspired a career dedicated to preventing injuries and accidental deaths among children from preventable causes. The memorial garden is one component of Safe Kids York County, a nonprofit organization led by White, his team at Piedmont Medical Center EMS and a cadre of community volunteers who host more than 200 events each year related to car seat safety, gun safety, bicycle safety and drowning prevention. In February, their efforts were recognized when Piedmont Medical Center EMS received the Nicholas Rosecrans Award, given annually to an EMS agency that demonstrates leadership, commitment and innovation in preventing accidental death and injury to children.

"Preventable injuries are the No. 1 killer of kids. We are the men and women responding to these emergencies. Our goal should be education and prevention," White says. "Every EMT and paramedic needs to take a proactive role in injury prevention and coaching people on what to do until the ambulance arrives, whether it’s how to do CPR or how to stop bleeding."

The award, presented annually at the EMS Today Conference, memorializes Nicholas Rosecrans, a toddler who drowned in 1996 after he wandered away from a day-care center into the unfenced pool of the house next door. The boy’s death prompted one of the responders, Paul Maxwell, to co-found EPIC (Eliminating Preventable Injuries in Children) Medics, a group of like-minded first responders in San Diego aimed at primary injury prevention. In addition to EPIC Medics, the award, now in its 12th year, is sponsored by JEMS, the federal Office of EMS within the Department of Transportantion, the RedFlash Group and Laerdal Medical.

Starting on a Shoestring

Safe Kids York County got started in 1997 when White, then working as a paramedic, approached management with the idea of working to prevent some of the heart-wrenching injuries he was seeing on the job. "My boss said, ‘I don't have the budget. You can't have overtime.’ But a core group got together anyway and kept pushing forward, getting nonprofit status and recruiting community volunteers."

In 2007, White was promoted to EMS director, then took a job as the EMS agency's first community relations director in 2010 so he could devote more of his time to injury prevention. Today, Safe Kids York County relies on more than 30 volunteers and multiple community partners who in 2013 donated a combined 4,500 hours to the cause. "We couldn’t do it without our community partners like the hospital, police, fire, the city, the health department and department of social services, even a pediatrician's office that allows staff to volunteer for us and helps get the word out about our events," he says.

Activities White and his team of volunteers did last year include:

Bike and pedestrian safety: Safe Kids York County holds several types of bike-safety events, including "bike rodeos," during which volunteers set up a bike safety course with a working stop light and road signs. Kids are taught traffic safety and hand signaling and are fitted for a helmet. In 2013, the group gave 1,500 bike helmets to children in need. One giveaway was done during an annual event known as COOLfest (Celebration of Our Lives Festival), which is sponsored by a local substance abuse service.

"You could tell these people didn't have much. We gave a little girl a helmet and the kid was so happy. She had gotten a dollar because she lost her tooth," White recalls. "She said, ‘Mommy, Mommy, can I give that dollar to them?’ She heard me telling the mom that all donations we take go back into the safety program to buy helmets, car seats, gun locks and flotation devices. That’s the energy that drives us. That little girl is going to pay it forward somewhere down the road."

The group also worked with the school district to put the entire sixth grade through a two-week, 10-hour bicycle safety program.

Gun safety: In partnership with law enforcement, White and his team speak to school children with the help of the Eddy Eagle gun safety mascot, Boy Scout troops, church groups and other community groups about keeping guns away from children. They also provide gun locks free of charge.

Car seat checks: The county has four car seat checking stations, where members of the community can make an appointment or stop by during certain hours to learn how to properly install a car seat. One is at EMS headquarters; another is held monthly at a free health clinic; a third is every other month at Britax, a car seat manufacturer located in nearby Fort Mill, S.C.; and a fourth is at the York County Coroner's Office.

In fact, the entire Coroner's Office staff are certified child passenger safety technicians, a course White teaches. "The coroner [Sabrina Gast] gets mad just like I do when I go to a car crash and I see a child whose car seat was ejected because it was improperly installed," White says. "Her job is to pick up dead people, but she wanted to see what she could do to prevent that."

Car seat safety is a central mission of their group. "Of the hundreds I have personally checked, I can almost count on one hand the times they have been installed 100% right," White says. "It might be minor, but in a crash, it could make a difference."

Water safety: In a new initiative, Safe Kids York County is working to place loaner life jackets and water safety information near popular swimming and boating areas along Lake Wylie and the Catawba River. Swimmers or boaters spotted wearing the vests by lake patrol or law enforcement will be given a voucher for a free ice cream.

Returning the vests will rely on the honor system. "We know some of them will walk off," White says. "But if I can save one life and I lose 100 life vests, I'll do it again tomorrow. It's one life you can't put a price tag on."

Inspiration from the Garden

If he ever needs inspiration to keep going, White looks out at the memorial garden and thinks of Spencer and Larell, the first boys to have their names placed in the garden.

When he arrived on scene of their accident years ago, it was clear the two boys were dead. A third child who had been in the car was badly injured but alive. As his partner was rendering aid, he began having chest pains—his partner was having a heart attack.

As the third child was airlifted to the hospital, a second ambulance arrived on scene to take his partner to the hospital. Both the child and his partner survived.

Years later, while volunteering at a camp for underprivileged children sponsored by the police department, White was approached by a teenager. He didn't recognize him at first, until the boy told him he was the third child who had been in that tragic car wreck. "I hugged him and cried," White says.

In the memorial garden, a blue flag flies next to the American flag and the South Carolina state flag on days when there are no accidental deaths of children in their county. A red flag is raised half-mast on days after a child has died. After giving the family time to grieve, White reaches out to them to ask if they would like a memorial stone placed in the garden in honor of the child.

"When I stop and take a deep breath and I look at that memorial garden, I'm reminded that's why we do what we do," he says. "We need to continue moving forward. Those children didn’t get a second chance. These other kids do."

Read more about Safe Kids York County at yorkcountysafekids.org.

Injury Prevention, Richmond Style

This year the sponsors of the annual Nicholas Rosecrans Award for Excellence in Injury Prevention by an EMS Agency recognized two agencies. In addition to Piedmont EMS, organizers Paul Maxwell and Lynn Ortiz Rosecrans recognized the Richmond (Va.) Ambulance Authority (RAA) for its outstanding work, with Rob Lawrence, RAA’s chief operating officer, receiving the award.

What set Richmond apart was not just a single initiative, Maxwell said, but like Piedmont EMS, a commitment to ensuring that injury prevention is embraced by EMS as a public health necessity. That commitment took a variety of forms, including:

  • Rider Alert: This was a simple solution to a major problem. In the event of a motorcycle crash, who can talk to the EMS provider if the rider cannot? A card, filled in with key information to aid the first responder, is inserted inside a rider’s helmet. The program has a variety of sponsors and public safety partners, and has achieved global outreach.
  • Crossing Alert: Richmond was experiencing a significant number of pedestrian injuries, with one occurring nearly every three days. Data analysis identified traffic “hotspots” and high-risk areas, as well as particular demographics to target messages. The RAA Crossing Alert program was created to raise awareness of the dangers to distracted pedestrians in a busy inner city. To deliver the message, RAA volunteers created an entertaining video with dance and a rap-style message to appeal to their primary audience. The campaign, shown on local TV stations, was very successful, resulting in a downturn in incidents of more than 20%.
  • Great Days of CPR: For many years, RAA partnered with the Richmond Technical Center (part of the city of Richmond public schools) to deliver CPR to the masses for one week a year. This program grew into a regional program called Great Days of CPR and is being administered under the Central Virginia CPR Council, initiated and led by the RAA. Thousands of citizens have been trained using the American Heart Association Hands Only CPR Kit. RAA has now declared that “Every day is a great day for CPR training,” with partnerships formed and grants obtained to offer CPR training at every opportunity. A further strand of the program has crafted a relationship with the Richmond public schools to provide CPR training for students, staff and bus drivers.

“EPIC” in Scope

As RAA’s Rob Lawrence explains, theirs is a high-performance EMS system and is adept at the collection, collation and analysis of information. This use of information also informs a function that is not only a key tenet of EMS but also of public health and trauma systems: that prevention is better than cure. They use the acronym EPIC to explain their approach:

“Every possible metric was employed to advance the safety cause. The presence of information highlighting key issues, in all cases was the driving force to identify preventive measures to reduce behavior that leads to accidents. We are also committed to use our data and influence to raise awareness to enhance safety and therefore prevent further injury.”

“Participation is encouraged. Our programs are freely available for replication by any public safety oriented organization and maximum participation by all providers is actively encouraged. All Richmond Crews, for example carry a quota of Rider Alert cards to pass to motorcyclists they may happen upon in their travels. Road shows are used to highlight all campaigns and indeed a small quantity of AHA ‘Hands Only’ CPR kits are taken to every event to create impromptu CPR classes in line with our ‘Every day is a good day’ philosophy.”

“Integration of RAA’s safety programs is conducted from the first possible opportunity in an employee’s time with the organization. RAA maintains a holistic culture of safety and indoctrinates all staff in health, safety and injury prevention. The public health agenda and safety programs also form part of our culture by ensuring that staff firstly know of their existence and secondly whether it is during actual ‘street time’ or for special event activity, they actively participate in prevention.”

“Collaboration, sponsorship and partnership have been essential ingredients to the success of RAA’s programs. Additionally the pursuit of grant funding has also considerably aided each and every program. The Rider Alert has partnered with many sponsor organizations including Bon Secours Health Systems, Geico Insurance, The American Automobile Association and many more. It has also established ‘Safety Partners’ primarily Public safety agencies both in the US and now internationally. The key US 2013 Safety Partner is the Virginia Department of Motor Vehicles (DMV) and its associated Rider Training Program, with whom every trainee rider receives a Rider Alert Card during their initial rider training course. Internationally, Rider Alert has partnered with the Federation of International Motorcyclists (FIM) and is collaborating to create a truly global safety program.”

Watch the Crossing Alert video below, and for more information on RAA’s injury prevention programs, go to raaems.org


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