Search and Rescue test their high mountain skills

Oliver Search and Rescue has never been called upon to do a wintertime, high-mountain search. Given our topology and climate, however, it is only a matter of time before they will have to do so. This weekend’s exercise near Mount Baldy was an opportunity to practise survival skills and to discover problems with their techniques and equipment before lives depend on them performing successfully.

President Rob Selsing had, by Sunday morning, discovered a very important truth about surviving a night on the mountain. He and three other members had come up on Saturday afternoon and dug three feet into the snow cover to set up tents for the night, cooked a meal over a small emergency stove and attempted to spend the night.

"First thing we learned was that it takes about twice as long as you would expect to prepare the camp," he said. As well, staying warm when condensation inside the tent cooled things down wasn’t easy. Selsing admitted to having sought the comfort of his vehicle in the early morning although two members stuck it out for the whole night.

The other piece of useful information the group acquired was that their electrical generator for the command tent didn’t like the cold. Only after the propane heaters had warmed it did it agree to start. But these were the sort of things they needed to know before they were in a real situation.

The exercise near the McKinney cross-country trails, 26 kilometres up McKinney Road, was also an opportunity to give four new members a taste of winter conditions and opportunity for them to practise survival skills. The group was broken up into two teams, each with a mix of old and new members. They were given a GPS device and snowshoes and asked to locate a packsack that had been left at a location with known coordinates. Their challenge was to find the packs, which contained basic survival gear, and set up hooches (a lean-to), start a fire, boil some water and then call into base to advise them of their location. Each team could use only what was in the pack and on their bodies.

Selsing noted that although there was no time limit, each team was made aware of the need to budget the time due to the weather conditions and time of day. The teams’ natural competitiveness took care of this, he added.

"My team found out how it sucked when you break your saw and you have to cut tree limbs with a Leatherman, Swiss army knives and a saw with only a third of its blade left. It takes more time and you work harder," Selsing said.

The teams then built a signal fire to aid location by a search plane as well as training in the use of signal flares. Finally Search and Rescue manager Jim McConnell critiqued the exercise.

Future exercises are planned. Selsing hopes to have his group participate in an urban search next month. They will create a scenario in which a child is lost or a hospital patient wanders, and then practise a coordinated search. The next mountain exercise will wait until June when Oliver Search and Rescue will participate in a joint exercise in the Ashonola area with groups from Penticton and Keremeos.

Oliver Search and Rescue welcomes new members. Anyone interested can contact Selsing at 498-3193.

SOGH in the forefront of wireless technology

South Okanagan General Hospital (SOGH) is quietly proving to be the little hospital that could. Three-quarters of the way through a five-phase pilot project that unites quality patient care with avant-garde wireless technology, health care professionals at SOGH are confident they are uniquely placed to implement and evaluate the new system.

Those five phases are: Positive Patient Identification, Electronic Nursing Documentation, Bedside Medication Verification, Physician Care Manager, and E-Summaries from the Physician’s office. All are being evaluated on an ongoing basis throughout the implementation process and afterward, with a final evaluation taking place later this year.

Nancy Serwo, director of health services in Oliver/Osoyoos and diagnostic services in Penticton said the focus of the project, funded and instigated by the Interior Health Authority, is to get the right information to the right place and health care professional at the right time for safe, quality patient care.

And they are achieving that through the implementation of wireless technology, mobile computers wheeled to patients’ bedsides, barcodes and scanners and ‘smart’ programs designed to catch inadvertent errors, such as adverse drug interactions, before they are made.

And the eyes of health care delivery services across the province, country and the United States are monitoring their progress, because SOGH’s ultimate success or failure with the new technology could determine whether it can be adapted to the needs of other larger hospitals. While some other centres have incorporated a few of the phases into their regimens, no one else is trying to work with all five components.

"Right now we feel like we have been a real huge success because we just went online with the fourth phase" said Serwo, adding they are fine tuning the process and writing the rule book as they go.

SOGH was considered the ideal candidate for the project; a small community-based 18-bed facility, it has a strong complement of nurses, doctors, pharmacists and physiotherapists who work within the system, and therefore has enough personnel to wrestle the bugs and kinks out of the program. So the perfection of the project has involved everyone from admitting to lab technicians to the records department and radiology.

And there have been challenges since the first phase was implemented in September 2004. While there is a certain cachet in being chosen to ride point in a new field, it comes with headaches—there is no one else to ask for solutions when unexpected difficulties arise.

And it was the curve of a human wrist that posed the most problems from the outset.

Josie Wilson, a registered nurse and clinical practice specialist has been in charge of the training process. The first modification to the accepted way of doing things was the introduction of armbands with barcodes for every patient who came to Emergency as well as those who were admitted to the hospital.

"During that phase we were testing the barcode’s ability to correctly identify the patient and the labs were using scanners in order to match a patient’s lab profile with the test orders," explained Wilson. "But we have had to change where the barcode is located because scanning on the curve of a wrist is a challenge."

The second phase came with its own logistical problems too. Electronic nursing documentation changed the way nurses did their patient charting and assessments, switching it from paper-based at the end of a shift to laptop-driven in real time at the patient’s bedside. The specially formulated electronic chart’s information is then readily available through wireless technology to all inter-disciplinary health care providers. The program, called NUR, does addition, subtraction, and weight calculations and comes with graphs that show trends in a patient’s data.

Although the transition went well, the equipment is posing spatial problems. The laptops are mounted on mobile carts that are proving cumbersome in small hospital rooms already loaded with beds, wheelchairs, walkers, tables and intravenous pumps. More compact hand-held units would be ideal, but unfortunately technology hasn’t caught up with need at this point.

The third phase has been equally resource intense. Bedside Medication Verification or BMV, which went online in October 2005, governs the medication administration record of every patient electronically and meets one of the requirements of the Safer Health Care Now initiative.

Every medication is barcoded and when the nurse calls up the patient’s list she sees immediately what medication has been prescribed for this individual; which ones are due, when, and in what dosage; the correct route of administration (either orally or through an injection); and the reason for the drug. There is also space for the nurse to document whether the medication was given/not given on schedule, reasons, comments and observations.

And here again a system of safeguards has been placed within the program to ensure patient safety is maintained and the correct medications are being given to the right patients.

"If any of those conditions are not met, such as wrong medication, wrong dose or wrong time, a flagging system will alert the nurse," said Wilson.

The fourth phase is the Physician Care Manager, which is an online ordering system for physicians and provides upfront clinical decision support. Doctors ordering medication for a patient can refer to the background information on the patient, see their lab work, drug history, any drug allergies or drug reaction possibilities, as well as whether there are any adverse drug interactions between what the doctor is prescribing and what the patient is already taking. If a problem is detected, the computer ‘red flags’ the input, alerts the doctor and suggests an alternate medication.

This is particularly important where seniors are concerned, because they may be on as many as eight or nine medications concurrently already—a situation that increases the possibility of a drug interaction.

Physicians are able to do their medication and lab test orders from their offices too and the information goes immediately to the pharmacist and hospital lab.

The last phase will involve electronic summaries coming from the doctors’ offices to SOGH thereby "closing the loop of care" as Serwo puts it. It enables a doctor covering another physician’s patients in the hospital to fill in his gaps in vital information regarding the patient with respect to drug history and allergies to certain classes of medication etc.

Once the phases are complete and evaluated, any necessary adjustments will be made and at that point the decision will be made on the future of the program.

"I expect we will keep it here," stated Serwo. "But in the broader sense, decisions will have to be made whether to roll it out to other places in Interior Health and if so, whether it will include all or just some of the phases. It may be found that all of the phases are just too resource-intense for larger hospitals, because as you add more people it exponentially adds more difficulties."

Would she do things differently? "A few of the things could have been tested before we went with the program; things like the armband technology should have been tested because they were the pivotal point in the technology."

Three cougar sightings have residents on alert

Oliver residents are being asked to be extra vigilant with their children and pets, due to recent cougar sightings in the area.

According to a Southern Okanagan Secondary School bulletin that went out on February 16, the RCMP and conservation officers confirmed that there have been three cougar sightings within the last several days—near the Rocky Ridge Vineyard on 71^st Street in the Tuc-el-Nuit area, as well as near Gallagher Lake.

To prevent any mishaps, parents are asked to be alert when supervising their children near bus stops and while they are playing outside, ensuring they are directly supervised. If children are not supervised by an adult, then parents need to make arrangements for their children to travel in groups to and from bus stops and other activities.

Owners are asked to keep an eye on their small pets too and to call the R.A.P line’s 1-877-952-7277 if they need to report a sighting.

Neither the RCMP or conservation officers could be reached for comment on Monday. However, Vivian Piercy reported that her son Lucas took some photos of a treed young cougar on Saturday, February 18. The 16-year-old and a friend, Will Zackoknik encountered two juvenile cougars cowering in some bushes on the east hike and bike trail in the Tuc-el-Nuit area.

Piercy said the owner of the property called a conservation officer, but something spooked the animals and one ran away while the other climbed a tree.

A conservation officer attempted to bring it down with a dart, but unfortunately the dart hit in the rib area and perforated the cougar’s lung, killing it.

It may have been a blessing. According to Piercy, the cougar cub was little more than bones with a covering of skin, leading her to believe they had been orphaned or abandoned.

There have been unconfirmed reports the other cub has been killed also, but that could not be verified before press time.

How will we respond?

The failed response by the U.S. federal government to the flooding of New Orleans gave people around the world pause as they contemplated what would happen in their backyard should they be faced with a disaster either natural or man-made. Here in Canada with our huge spaces, small population and limited federal resources it is hard to imagine what could be done in the way of immediate outside relief should we face an emergency on the scale of Hurricane Katrina.

What we will need to do is take care of ourselves to the best of our abilities.

It is why groups such as Oliver Search and Rescue, the Oliver Fire Department, the police auxiliary and other volunteer organizations are such an important part of our small town life. It is they who will respond. Suddenly the emergency preparation that had been only an exercise up to that point will give guidance as the community cobbles together a coordinated plan and takes whatever action is possible.

We have no way of predicting the emergency or to anticipate what local resources will still be available to the survivors. It is why we need a large and active group of emergency responders because they will form our leadership. Nor will the participation be limited to the official members of these groups. Every volunteer group in the community becomes the core around which services can be organized. Emergency food, water, housing, transportation or medical care may be the priority and the speed with which all of us come forward, prepared to place ourselves under the command of our emergency leadership, the more effective we will be.

One is reminded of the power outage that put most of the east coast in the dark several years ago. In Toronto ordinary citizens stepped into the breach when all the traffic lights failed. They put themselves in the middle of the intersections and took on the responsibility of directing traffic. Local drivers accepted their direction and every one got home in a reasonable time. It’s a small example but it suggests the type of response that will save us from the destructive anarchy we all fear.

We may never face such an emergency but it shouldn’t stop us from taking the steps now to prepare. Offer to join one of our volunteer groups. Encourage your own organization to think about what role they might play and then explore with our emergency responders how you might assist. Let’s not wait for the emergency. Let’s do it now.