Every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can lessen this recurring loss by learning Continuous Chest Compression CPR, a hands-only CPR method that doubles a person’s chance of surviving cardiac arrest. It’s easy and does not require mouth-to-mouth contact, making it more likely bystanders will try to help, and it was developed at the University of Arizona College of Medicine.

• It is easy to remember
• Does not require certification
• Increases the chance of survival
• Does not require mouth-to-mouth breathing

Learn the technique by viewing this video today so you are prepared to help save a life!

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I have been working with a trust client lately to develop a life care plan for an autistic child.  These kinds of life care plans are made to determine if the trust will have enough funds to maintain the child through his or her life expectancy with the types of care and support services they require.

In working on this particular plan, I have had to research sources available to those with autism.  Many of these resources are available for others as well and I felt they would be a valuable edition to the resources listed within this blog.

Please note that some of this information may be outdated as not every link was double checked before posting.  If you find any information in error, please note by commenting below.

Summer Camps and Weekend Respite Camps

• Camp Aldersgate – www.campaldersgate.net 501-225-1444, week long overnight summer camp and weekend respite camps.  Camps designed for children and ages vary.
• Camp Mitchell- www.campmitchell.org 501-727-5451
• Camp Barnabus – www.campbarnabus.org 417-476-2565
• Camp Believe – www.centersforyouthandfamilies.org 501-666-6833, 10 week day camp, ages 6 to 12
• Little Rock Parks/ Recreation www.littlerock.org/parksrecreation/therapeuticrec/summerdaycamps.aspx 501-918-5359, 6 week day summer camp, ages 8 to 18
• ARC Performing Arts Camp – www.arcark.org 501-375-7770 –  week long overnight performing arts camp for adults, campers can choose if they would like to do theatrics, singing, music and set design, camp is held at the CA Vines Arkansas 4H Center in West Little Rock.
• A-Camp – Email at a.camp4kids@gmail.com – 6 week therapeutic day summer camp for children with autism spectrum disorders, ages include children who have completed kindergarten through fifth grade.  Camp is held at Camp Aldersgate.
• Camp Connect (Community Connections) – www.communityconnections.org – 501-329-5459, one week day camp for children with autism spectrums disorders, ages include children who have completed kindergarten to 15 years old.
• Easter Seals Outreach Basic Training Program – www.aroutreach.com – 501-221-8414 – educational day program utilizing the STAR curriculum for children with autism spectrum disorders, ages include children entering kindergarten through fourth grade.
• Geyer Springs First Baptist Church, Little Rock – 501-351-2232 – One week day camp – Membership is not required. For more information call Bekka Middleton at 501-351-2232.
• Therapeutic Recreation in Parks-T.R.I.P. – (Arkansas Federation of Families for Children’s Mental Health) – www.affcmh.org – 501-374-7218 – weekend respite trips to State parks for individuals ages 8 to adults.

Gyms

• YMCA Metropolitan Little Rock – www.ymcalr.org

Westside YMCA, 4701 Sam Peck Rd, Little Rock, 501-227-8343

G. W. Carver YMCA, 1116 W. Daisy L Gatson Bates, Little Rock, AR, 501-376-0458

Heflin YMCA, 6101 JFK Blvd, North Little Rock, 501-758-3170

• Little Rock Athletic Club – www.lrac.com – 501-225-3601, 4610 Sam Peck Road. Little Rock, AR 72223
• Bess Chisum Stephens Community Center – www.centersforyouthandfamily.org – 501-664-4268, 1200 South Cleveland Street, Little Rock, AR 72204
• Jim Dailey Fitness and Aquatic Center – www.littlerock.org/parksrecreation/warmememorial – 501-664-6976,  300 south Monroe Street, Little Rock, AR 72204
• Jacksonville Community Center – www.cityofjacksonville.net – 501-982-4171 – # 5Municipal Dr, Jacksonville, AR

Hippotherapy/Therapeutic Horseback Riding

• Hearts & Hooves – www.heartsandhooves.com – 501-834-8766– 2308 Kellogg Acres Rd, Sherwood, AR 72120
• Harmony & Hooves – 501-470-5185/501-563-5211 – 1300 Jimmy Lane, Benton, AR 72019
• Beyond Boundaries – www.beyondboundariesar.com – 501-259-8333 – 2195 Peyton Street Hwy 319, Ward, AR 72176

Sports

• Miracle League Baseball – www.miracleleaguear.com – 501-940-3405 – Little Rock, AR
• Special Olympics – www.specialolympicsarkansas.org – 501-771-0222
• EXCEL – 501-843-2677
• Top Soccer, Community Connections – www.communityconnecctionsar.org – 501-329-5459 -  Conway and Little Rock, AR
• RUFL Flag Football, , Community Connections – www.communityconnecctionsar.org – 501-329-5459 -  Little Rock, AR and a summer camp in Conway

Miscellaneous Activities

• New Beginner’s Dance for Adults, Easter Seals Arkansas Adult Outreach Center – 501-221-8445 –  monthly dance held on the third Friday of the month 
• I Can! Dance – Community Connections – www.communityconnecctionsar.org – 501-329-5459 -  Conway, Little Rock and  North Little Rock, AR
• ACTS Jr. – Community Connections – www.communityconnecctionsar.org – 501-329-5459 -  Conway and Russellville, AR
• Parents Night Out – Geyer Springs First Baptist Church, Little Rock – 501-351-2232 – Parents night out is held on the second Friday of the month from 6pm to 8pm- Membership is not required. For more information or to RSVP, call Bekka Middleton at 501-351-2232.

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by Stephen Appelbaum

The genesis for the use of demonstrative evidence during a mediation, deposition, or trial actually goes back to biblical times. Remember that Moses did not come off the mountain and tell the Children of Israel the words spoken to him by God . . . he brought charts. Six-hundred and thirteen commandments in the Bible, digested down to two boards, with five key items on each chart, numerically indexed. This may have been the first use of Federal Rule 1006, which allows for the use of summary charts of otherwise voluminous material.

As the courts are becoming more liberal with the use of visuals during opening statements, the trial attorney has an increasing obligation to use that portion of the trial to organize the case for the jury. The process of jurors’ hearing testimony is similar to that of being given pieces of a jigsaw puzzle, one at a time, with the objective to assemble the final picture. Imagine how difficult this could be if one is not first shown the picture on the cover of the box. Using visuals during the opening statement is like showing the jury the cover of the box. Now they know what they are supposed to do with the pieces (testimony), and like the pieces of a puzzle, there is only one way they will fit together to make the picture that the attorney has proposed. During the opening statement each attorney has a chance to show the picture on the cover of her or his box as it illustrates the theme and focus of the case.

The laws of primacy (what the jury heard at the beginning of the case) and recency (what the jury heard last) dictate the innovative use of visuals during opening statements and closing arguments and should be considered when planning for these points in the trial presentation. Visual evidence should be incorporated into the presentation of every key point in both the plaintiff’s and the defendant’s case. It helps to focus jurors on the strength and logic of the attorney’s case and the weaknesses of the adversary’s.

Demonstrative evidence plays an increasingly larger role in trials for several reasons. Jurors now expect to have engaging presentations of the facts. They have come to believe that big cases, both civil and criminal, will have substantial visual components incorporated into them. The pioneering efforts of Attorney Melvin Belli in the last half of the twentieth century toward the effective use of visual aids set the stage for the attorney to think in terms of courtroom persuasion.

Law, by tradition, has been a profession of words and oratory in the courtroom, but we are living in a visual society. The baby boomers and Generation X’ers have been brought up in front of television sets. They are more accustomed to seeing and hearing news than reading it from a printed page. The success of the newspaper USA Today is an example of color visual support (in the form of maps, charts, and graphics) to supplement the printed story. Even the television medium has maximized the use of visual support for the spoken word, by going to the video of the actual event as opposed to the reporter’s summary and retelling of the events. When introducing a story for a news segment, there will usually be a graphic icon or symbol of some kind on the screen next to the reporter to visually anchor the general theme of the story. Anchoring is an important technique to be considered throughout the trial and should be considered for each key witness or expert. Careful use of demonstrative evidence provides opportunities to anchor concepts and drive home points to the jury.

This article was extracted from Appelbaum, S., Iyer, P. and Parisi, J., Demonstrative Evidence in Iyer, P., Levin, B., Ashton, K. and Powell, V., (Editors) Nursing Malpractice, Fourth Edition, in press, Lawyers and Judges Publishing Company, 2011. Join Steve Appelbaum and Pat Iyer during a webinar that defines an integrated approach to the preparation of demonstrative evidence that merges the medium with the message in the most effective and cost efficient manner possible. Get details at http://www.webmarketingmagic.com/app/?af=1059614

Learn more about Stephen Appelbaum at www.evidencestore.com

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Is that time again.  School time that is.  With the school year just beginning, sports related injuries are on the rise. Each year there are more than 25,000 cheerleading injuries, often sprains and bruises. But in 2007, one girl was not so lucky.

Elizabeth Nicks, now 15, was a cheerleader performing a human pyramid when she toppled to the ground. She was rushed to the hospital and found to have a subdural hematoma, observed for five days, and released.

A subdural hematoma is a collection of blood on the surface of the brain. Subdural hematomas are among the deadliest of all head injuries, as the bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury.

Those suffering from brain injury require extensive medical treatment which is ongoing.  Just as an example, a local head injury facility charges $1,100 per day for treatment consisting of occupational therapy, recreational therapy, psychotherapy, recreational therapy, and speech therapy services in conjunction with room and board.

A Nurse Life Care Planner can assist the family and legal counsel to determine what the lifelong medical care will consist of and it’s related costs.  This plan can then be used for budgeting purposes throughout the life of the individual.

Although a subdural hematoma can easily be diagnosed with an MRI or CT scan, the hospital chose not to do a follow-up CT scan before discharging Ms. Nicks. Otherwise, they would have seen that the hematoma was increasing in size. This near-fatal mistake cost them; to the tune of $5.5 million.

You can read more about the case at Contra Costa Times.

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The 17 year old, Case Management Society of America (CMSA), has announced the celebration of National Case Management Week.  This special week-long event seeks to unify case management professionals, educate the public about case management, and increase awareness and recognition of the significant contributions case managers make the quality healthcare for patients, healthcare providers, and payers.  This week is celebrated nationally during the second full week of October each year.

CMSA is an international organization of case managers and healthcare professionals, committed to promoting the growth and value of case management, and to support the evolving needs of the case management professional.  Founded in 1990, CMSA now has over 11,000 members and over 70 affiliated and pending chapters. I am one such member and proud to be a part of the Little Rock Chapter.

For those who are unfamiliar, Case Management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals heath needs through communication and available resources to promote quality cost-effective outcomes.  My case management practice is primarily associated with workers compensation clients.  Injured workers need prompt assistance in finding the appropriate healthcare provider who will diagnose them quickly and provide the treatment plan to help get them back on their feet and productive again.  My job is to first assess the situation which includes not only the injury itself, but also the claimant’s situation at home, emotionally, mentally, physically, socially, etc.  The next step involves locating the provider, arranging the appointments; all while educating those involved.  The plan is ever changing as the situation changes.  I am advocating for my patients to help them get their needs met all the while working to save the insurance carrier money by preventing unnecessary testing, negotiating reduced rates for services, limiting loss time wages, and eliminating waste.

Establishing a nationally recognized Case Management Week is vitally important as the field of case management becomes an increasingly recognized as a strategy of great significance across the continuum of care.  Not only does case management support patients and their families in navigating the healthcare system, it decreases the fragmentation of services, encourages health team communication, and contributes significantly to patient safety, quality of life, and cost-effective management of limited resources.  It should be recognized by the healthcare industry as a crucial element of giving.

If you wish to learn more about Case Management or CMSA, contact Cheri Lattimer, Executive Director or visit www.cmsa.org.  The association headquarters are located right here in Arkansas at 6301 Ranch Drive, Little Rock, AR 72223.  501-225-2229

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I am so proud to be a nurse case manager.  I have worked in this industry since 1999 and became certified in 2003.  October 10-16, 2010 marks National Case Management Week, recognizing the contributions and commitments case managers make and educating the public about the significant work we perform. When employed by an agency or hospital, activities typically include banquets and recognition dinners, state and city proclamations, continuing education seminars, and other community events. Case Managers are typically honored with gifts, dinners, and flowers coworkers such as doctors and administrators, and patients who want to show their appreciation.

As an independent case manager, I do not get to participate in such activities, but I can still celebrate.  Here are a few ways each of us can participate in National Case Management Week.

• Tell 10 other professionals you are a case manager
• Offer to speak at community events on case management
• Wear your CMSA Member Pin
• Promote case management by sponsoring or volunteering at a health fair, preventive screening or organizing services in your community
• Host a reception in your community
• Host a professional seminar for health professionals in your community
• Highlight a different case management practice setting each day of the special week in your newsletter or blog
• Encourage your mayor, county executive or governor to issue a local proclamation establishing October 10-1th as National Case Management Week
• Invite a politician to accompany a case manager at their place of business for a day
• Decorate with banners, posters, or flyers
• Publish newsletters focusing on CM week
• Speak to nursing organizations about case management careers
• Create a publication of case management stories
• Write a letter to your local paper
• Contact radio and TV stations to let them know about CM week
• Write a guest editorial to newspapers, journals or magazines regarding the positive impact of case management
• Distribute a press release announcing CM week

I am committing to several of these activities this year.  (I just completed one by posting this!)  I am glad I have an opportunity to impact my patient’s lives everyday.  The very things that seem so simple to me, make a big difference in the lives of others.  I just hope I can continue this for many years to come.

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Everyone is searching for a way to stay young, healthy and in shape. Modern medicine tends to focus on scientifically proven areas of care, though a growing sect has been helping patients find alternative methods to treat their illnesses and deal with pain. There are hundreds of types of alternative medicines, but in the end it is up to the patient whether they wish to try an alternative method.

Here are five common alternative treatment/therapies one might consider.

1. Acupuncture – this method has been used for over 2000 years starting in China and is now common in the USA. This method is also covered by many insurance carriers. The licensed acupuncture specialist inserts tiny needles into different pressure points along the body called meridians. Once inserted the needles cause no pain or bleeding but have been shown to relieve pain, nausea, high blood pressure, asthma, and internal swelling. There are also few if any side effects of this method. A typical session can last anywhere from 45 to 60 minutes and it usually requires 6-12 visits.

2. Biofeedback – this method uses an electronic monitoring device. Using this biofeedback device, a patient can learn how to recognize and control different parts of the body such as muscle tension or heart rate without medication.  It can also be used to alleviate nausea and high blood pressure. Most hospitals have staff trained on how to use and teach a patient this method, and similar to acupuncture many insurance companies are starting to approve payment for this treatment. A typical session can last anywhere from 45 to 60 minutes and it may require several visits as well as work with relaxation methods at home.

3. Healing Touch – this method allows someone to channel or focus their body’s own natural energy fields by laying their hand near or on someone to stimulate healing. Even though this may seem like something out of a science fiction novel, it has been used for hundreds of years and is now practiced in some medical centers in America.

4. Meditation – this method has become accepted across the country.  Some universities and sports gyms offer it as a course.  This very old method started with eastern religious groups and involves a process of focusing on calming your mind and body to bring about a relaxation response. Scientists that have studied this method have shown that during proper meditation certain regions of the brain activate which produces a calming effect on the nervous system. This method is ideal for helping with stress, high blood pressure, enhanced immune response, and pain relief.

5. Yoga –Yoga has also become widely accepted across America with centers and courses built around learning the proper use of yoga techniques. Yoga was developed in ancient India and focuses on breathing, stretching, and various exercise positions. The most difficult positions are meant to strengthen the body. Most hospitals, assisted living facilities, gyms, and senior centers have classes to show people how to effectively use yoga. Yoga has been shown to help reduce heart rate, lower high blood pressure, build up muscles, decrease anxiety, and relieve pain.

We are all faced with health issues as our bodies and minds age. These alternative methods might help provide use with one more chance to find relief.

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Have you ever had the difficult task of convincing your senior person they need assistance with their daily life.  Typically these conversations don’t go over very well.  It is a difficult decision to make when a family member is no longer able to live alone without assistance in order to ensure safety and maintain quality of life.  In my family full of stubborn folks, (see, I get it honestly) I have seen first hand the resistance in bringing in a home health aide. When my grandmother finally agreed, several persons were brought in, but she disliked each one.  She found fault in what was done, and even accused one aide of stealing things she herself misplaced. Worrying about a senior loved one can take a toll on everyone. 

Take responsibility by looking out for the signs that can help indicate it is time to bring in a trained certified home health aide either part time or for more severe cases full time.   For example, does your family member:

1. Gets lost while driving their car in their community
2. Misplace or continue to lose things
3. Require frequent hospitalizations
4. Mix up medications
5. Battle with depression
6. Isolate themselves from friends and family
7. Fall and hurt themselves
8. Have a fear of being robbed when they are not
9. Have difficulty with travel
10. Have trouble preparing their own food
11. Becoming confined to a wheelchair or walker
12. Failure to properly care for their own personal/ hygiene needs
13. Wander

A certified home health aide can provide companionship for your senior loved one, assist in daily activities such as cooking, dressing, bathing, cleaning, bathroom, administering the proper medication, as well as accompanying or driving a senior person to a doctor, and laundry.   The ideal way to attain a home health care aide is to contact an accredited and insured agency.  Do your research and make sure the agency is accredited and insured.  Check to see what training the employees providing care for your loved ones have had as well as what type of background checks were completed. 

There is no easy way to tell your senior loved one that they require a home health aide, though you can make it as painless as possible by working with a patient advocate.  Case Managers can act as a third party and mediator to  determine when they might require some extra help.  Losing your independence is difficult.  With a caring family and a well trained and insured aide the transition can help prolong a senior person’s quality of life.

*adapted from American Care Manager

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Dr. Randeep Mann was found guilty of orchestrating a bombing that severely injured the chairman of the Arkansas State Medical Board; Dr. Trent Pierce. Mann was also found guilty of obstructing the investigation, possessing nearly 100 grenades found partially buried in a wooded area next to his London, Ark. home in Pope County and possessing an unregistered machine gun. He was found innocent of one count of possession of unregistered shotgun.

Dr. Mann was one of five doctors who had recently been before the board before the bombing too place. Mann’s permit to prescribe controlled substances was suspended in 2006 after complaints that he was overprescribing painkillers.

A spare tire had been booby trapped with a grenade and left against Dr. Pierce’s car. When the tire was moved, the blast severely injured Dr. Pierce resulting in loss of his left eye, damaging his face, his hearing and his sense of smell, fracturing an arm and a leg and sending debris into his abdomen.

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A home-care nurse was awarded nearly $1.7 million in damages by a Syracuse jury to compensate her for permanent nerve damage caused when she was given an injection following the delivery of her baby. A state Supreme Court jury of four women and two men awarded Tina Holstein $140,000 for past pain and suffering plus $1,550,000 for future pain and suffering according to Syracuse News.

Many of my workers compensation patients suffer from sciatica which is a condition that refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or compression of the sciatic nerve. The nerve runs from the spine across the mid buttocks region. This plaintiff now suffers from as a result of an injection being improperly administered.

All nurses are taught to give intramuscular injections into the upper outer quadrant of the buttocks. The reasoning behind this is to prevent an injury to the sciatic nerve.

Patients suffering from sciatica have difficulty sitting at a desk to work, standing doesn’t necessarily help and the pain is nearly unbearable at times. Driving just to the corner grocery is a nightmare for some when the sciatica is at its worst, as is bending from the waist.

Given that this woman is a home health care nurse, I would expect that she drives quite a bit to visit her patients. In addition, to perform their jobs, all nurses must do a great deal of bending, lifting, etc. This is compounded when working with patients in a home setting where you may or may not have the proper equipment to aid in caring for the patient as you would in a hospital setting. Will accommodating this nerve damage by assuming awkward positions to sit, bend, lift create other health issues in the future? Those are just a couple of question that come to mind as a Nurse Life Care Planner when considering the amount the jury awarded her.

I also think it is interesting that: “…the Department of Health investigated the birth of Holstein’s child and found problems with her treatment and the documentation of that treatment during the delivery.” While those issues were not part of the lawsuit, it does seem to support that the care this patient received was not up to par.  Unfortunately this is an all too common occurrence found when reviewing medical records in my work as a legal nurse consultant.

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