By Kimberly Sherman

The average ambulance response time in Visalia is seven minutes. Those harrowing moments become devastatingly long when a loved one collapses and lies crumpled on the ground.

Should that happen, what would your initial reaction be? What would be your response? Using CPR (Cardio Pulmonary Resuscitation) to help save lives has been the standard procedure for many years, but performing the traditional chest compressions and breaths are simply not enough.

Wrap your mind around a new acronym: AED, or Automatic External Defibrillator. Used in combination with CPR, the AED can—and has—sparked lives back from the brink of death within Tulare County.

The combination of CPR and AED needs to be performed within five minutes of the victim’s collapse. Since the average ambulance response is seven minutes, our knowledge of AED use could make the difference between life and death. Every minute thereafter, the chance of survival decreases by 10%.

You may have seen the signs with the crisp letters “AED” above a lightning bolt-flanked red heart throughout the city of Visalia and reaching into more remote areas of Tulare County.

“Bystander CPR is paramount to saving lives. In 2005, the American Heart Association (AHA) changed the CPR procedures. It is now easier to learn, thus increasing hopes of greater public education,” says Larraine McElroy, Registered Nurse and Coordinator of the Visalia Breakfast Rotary Heart Safe Community Program. “Sudden cardiac arrest is usually due to an electrical disturbance in the heart. The only thing that can convert the rhythm back to (that of) a beating heart is a defibrillator.

“Although CPR will not actually re-start the heart, it is an imperative first step in helping maintain the viability of the major body organs. Performing CPR at a thirty to two ratio of chest compressions to breaths buys the victim time while awaiting the arrival of the AED. You must use both, not just one or the other,” says McElroy.

The Visalia Breakfast Rotary Club’s heart-felt project, the Heart Safe Community Program started about eight years ago through the energy of Dru Quesnoy, the Rotary President at that time, and has flourished over the past several years. The program has been instrumental in introducing AEDs and their proper usage into the community.

“Each year we try to place at least ten AED units. So far the Rotary Club has donated/implemented seventy-five units, thanks to our annual golf tournament and crab feed fundraiser. In addition, we’re managing another thirty that have been purchased elsewhere,” says Marvin Hansen, a Visalia Breakfast Club Rotarian and Administrator of the AED program.

The Visalia Breakfast Rotary’s goal is to outfit the county with AEDs where they will provide maximum benefit for the community. The primary focus is to place units in non-profit and governmental facilities where large groups of people congregate.

The Fox Theater, city facilities, county courthouses, recreation/senior centers, the YMCA, and the Boys & Girls Club are just a few of the local places and organizations sporting the life-saving machines. Aside from providing training assistance on the AED units, the Visalia Unified School District has two to four machines in each high school and middle school, as well as inside the district office.

With the amount of time, money, and energy placed into implementing the AED system for Tulare County residents, the Visalia Breakfast Rotary Club feels that should one life be saved, all efforts make the venture a successful one. To date, two lives in Tulare County have been saved thanks to the implementation of AEDs.

Tom Bush is one thankful fellow who lives to tell about his life-saving experience. In 2004, Bush, then 72, routinely spent his days exercising at the Visalia Boys & Girls Club facility. After working out one day, Bush was on his way out and suddenly collapsed. A sudden cardiac arrest pummeled Bush to the floor, blackening his eyes and bruising his extremities.

“There was a nice girl who worked there. They had just received this AED thing, and she had received instructions on it about a week earlier,” says Bush. “She said she (shocked) me twice before my heart started again and the paramedics came and took me to the hospital.”

Bush woke up after being comatose for eleven days in the hospital. A double bypass and two valve replacements later, Bush is alive and kicking, thanks to immediate CPR and use of the AED.

“Thank goodness she saved my life,” Bush says. “They ought to have one of those AEDs just about everywhere you go.”

Each facility that keeps an AED under the umbrella of the Visalia Breakfast Rotary Heart Safe Community Public Access Defibrillation Program must do monthly checks of the system and have two people certified in CPR and the use of the AED. Keep in mind, however that anyone can use the system, and McElroy insists that if you simply turn the machine on, its voice commands will talk you through the life-saving procedure. The most important part of having access to an AED is knowing that it is there and not being afraid to utilize it.

The Heart Safe program has a partnership here in Visalia. The Visalia Breakfast Rotary provides the management and funding, the City of Visalia and the Visalia Fire Department do the monthly monitoring of the AEDs as required by the FDA and AHA, and the Visalia Unified School District provides the AHA Training Center for CPR/AED certification. Kaweah Delta Medical Center has been an instrumental partner in the past.

Dr. David Cislowski, Cardiologist and Medical Director of the Visalia Breakfast Rotary AED Program, has high accolades for McElroy and her persistence in keeping the program running in top order. “Larraine has trained hundreds of people in the use of AEDs. She is the heart of this program,” he says. “The more people who know about them, the better off we will all be.”

“We would like defibrillators to be out there like fire extinguishers.”

Please visit our website for additional heart healthy tips.

By Carole Firstman

Andrea Brown is a California Highway Patrol paramedic flight officer. She’s used to emergencies, accidents and rescue missions, but it was just over a year ago that she faced her most challenging task, and she recalls every detail as if it were yesterday. “A hiker was headed towards Italy Pass along the Pacific Crest Trail when he went missing,” she says.

High in the Sierra Nevada Mountains, a lone hiker had been stranded for six freezing
nights after he fell from the top of a 12,000-foot cliff during a snowstorm. It was on a Wednesday that he tumbled down a rock slope and lost his glasses, compass, map, and walking stick. He broke his wrist and hit his head, finally landing on a narrow ledge, a 10-foot wide sliver of rock overhanging a sheer, long drop. For days he was trapped and unable to move.

Brown and her partner, pilot Bill Dixon, were one of the search and rescue air units that set out to find the hiker. Seven rescue teams and two helicopters searched an area of approximately 100 square miles.

The stranded hiker could see the helicopters but they couldn’t see him. The man was so high up on the mountain that he was actually looking down at the helicopters as they searched. Days passed. By the following Wednesday the man resigned himself to not being found, convinced that the search was over and he would die alone on an icy precipice.

At approximately 7:30 that same morning, the pilot of a small plane spotted the stranded man waving a red piece of material. The pilot radioed the CHP helicopter directly, and Brown was once again on the scene.

This time Brown saw the injured climber clinging to the narrow edge of a cliff. The helicopter would not be able to land, so the plan was for the chopper to fly close enough to the rock face for the hiker to step onto the skid then into the craft. Brown readied herself inside the helicopter as it flew along the face of a vertical rock mountain, just 300 feet below the mountain’s 12,000-foot peek.

Heavy winds whipped through the sky, swirled about and rapidly changed direction. Pilot Dixon skillfully maneuvered the H-40 aircraft close to the granite face; the rotors barely cleared the rock outcroppings. He lowered the helicopter to the ledge, placing the spinning blades inside a horizontal notch in the rocks. The blades whirled just two feet from the stony wall. If the wind currents shifted again it would have been a deadly disaster.

The chopper hovered precariously close to the 10-foot ledge. From the open door Brown called for the hiker to step onto the skid. She would help him inside the helicopter, she told him, he just needed to step off the ledge and onto the skid. There was about a two-foot gap from the cliff’s edge to the narrow skid. The man was paralyzed with fear and unable to make the step. Brown called out again. But still the man pressed his back against the mountain.

“He’s not coming,” Brown said to the pilot. She leaned out the open chopper door, placed her feet on the skid, and grabbed the hiker above the break on his fractured arm. He used his good arm to help pull himself aboard, grasping the handle on Brown’s seat.

In a daring team effort, flight officer Brown and pilot Dixon had plucked the hiker to safety. A life was saved. Mission accomplished.

///

As an experienced flight medic with the CHP Central Division Air Operations Unit in Fresno, Brown is no stranger to emergency response. She is assigned to an H-40 helicopter, a specialized aircraft for search and rescue, medical transport, and law enforcement. The chopper is equipped with the same medical tools found in an ambulance as well as communication and tracking tools. While high mountain search and rescue operations for missing hikers get the most media press, law enforcement calls are much more common.

“We’re here to assist any officer, emergency response or law enforcement agency,” she says. “CHP, police, sheriff, fire—we do everything we can to make their job a little easier so they don’t put themselves at risk.” To that end, Brown and her cohorts may spend four hours of an eight-hour shift in flight on patrol. While every scene call is different, a vast majority of the calls are for crimes in progress. “Shootings, stabbings, and following the bad guys from above so the ground officers can back off of a 100-mile-an-hour chase.”

Advances in CHP helicopters and onboard auxiliary equipment have improved the ability of police, sheriff, and CHP ground officers to fight crime and maintain public safety. From their observational vantage point, the helicopter pilot or flight officer can safely monitor a vehicle and provide pertinent information to ground pursuit officers.

Forward Looking Infrared (FLIR), for example, allows air patrol officers to see at night by sensing body heat. “From the air we can remain in close proximity to the suspect while tracking the location and direction without being noticed,” Brown says. This enables officers on the ground to take action once the suspect has stopped or left the vehicle. The versatility and range of the helicopter decreases the use of high-speed pursuits and increases apprehension rates. “With FLIR and spotlights we can observe, track and illuminate people or places on the ground. We then communicate with ground units and provide information. We direct them either towards an intended position or away from a dangerous one.”

Brown has had a long career in emergency response. She worked as an ambulance paramedic for five years before enrolling in the CHP academy in Sacramento. She spent seven years as a CHP road officer, including three years in Bakersfield and three years in Fresno, before entering the CHP Central Division Air Operations Unit in 1994.

Her husband, Mike Brown, is a retired CHP pilot. “He started the program here in Fresno, back in 1979.” Together the couple has three children: 13-year-old Erik, 15-year-old Anna, and 11-year-old Benjamin. “You should have seen the other kids’ faces a few years back on Career Day when Mike and I came to the school in a helicopter,” she says with a laugh. “The other kindergarteners in class were in awe. They couldn’t believe it.”

Well, believe it. Andrea Brown certainly lives life on the edge—from the edge of a skid and the edge of a mountain cliff, that is. And she wouldn’t have it any other way. She likes the constant change. There’s always a new challenge, and this powerhouse of a woman is ready for whatever comes next. “Really, I have the best job on the Highway Patrol. I get to fly around in a multi-million dollar aircraft, all the calls are interesting, and I get to chase the bad guys. What we do makes a difference every single day.”

By Robert Robinson
Firefighter, Agency

When a man fell from the Oak Grove Historical Bridge on November 19, it was everyone’s business to rescue him. Crews and individuals from many corners sprang into action for this unknown victim. He was lucky that firefighters, paramedics, and even a bystander, put their instinct for self-protection aside and came together as a life-saving unit.

A witness to the fall said the man looked like a rag doll as he plummeted those 50 feet down the rocks. He had narrowly missed falling into the river.

The Rescuers
At the Tulare County Fire Station in Three Rivers, Capt. Scott McCorkil and Firefighter Dennis Villavicencio got the call alerting them that someone had fallen from the historical bridge, seven miles up Mineral King Road from Highway 198, above Three Rivers. Lt. Francisco Benitez and Firefighter Mark Barlow responded from Tulare Co. Fire Station 11 in Exeter, as did six Sequoia National Park rangers from Ash Mountain. One Cal-Fire engine was on scene and Battalion One Chief Bill Whitendale was too.

When the first responders arrived, they found a forty-year-old man had dropped over 50 feet off a cliff near the Oak Grove Bridge. A local resident had already climbed down—barefooted—to see if the man had survived the fall.

He did survive it, but was badly injured, bleeding and had lost some teeth. The victim had suffered head trauma and “seemed to be drifting in and out of consciousness,” said Exeter Ambulance Paramedic Jeff Ray.

The Rescue
The team worked to get a rope system in place and harnessed for the rappel down the side of the steep, rocky cliff. Ray, Villavicencio, and one of the park rangers descended with a basket to the fallen man and the barefoot citizen who helped in the rescue.

“When we got to him he had almost no pulse and was in shock,” Ray said, “but as soon as we got some oxygen on him and blankets he started to pick his pulse back up and respond more.”

They stabilized the man and secured him in the basket as emergency team members above helped pull the victim up the cliff side. Ray and a park ranger went up with the basket, and Villavicencio stayed below with the barefoot man who had climbed down to help.

The victim was whisked through the hillside brush to an awaiting ambulance on the road to be transported down the mountain to the Three Rivers Golf Course where a Highway Patrol helicopter was waiting to airlift him to Fresno Community Medical Center.

One of the park rangers, in a show of great teamwork and kindness, took off his boots and lowered them down to the barefoot resident-rescuer to make it easier on his feet as the crew helped him up the cliff.

Reflections
As nightfall set in and rescue crews loaded their equipment, they discussed the day’s events and congratulated each other on a job well done. It was a successful multi-organizational effort marked by a quick response and impeccable coordination that saved a life. “Thanks to everyone’s cooperation and teamwork. Things went smoothly and quickly to get this man to safety and on his way to the hospital,” reflected Capt. McCorkil.

Fast response time and a great effort along with remarkable teamwork by these responding agencies resulted in a smooth quick rescue that undoubtedly saved this man’s life.

By Bill Corliss
Owner, Corliss Driving and Traffic School

At a recent “Young Drivers” night at Golden West High School, a mother expressed concern about how to know when it is safe to let her son drive in the fog. At Corliss Driving School, we are frequently asked if we cancel driving lessons when it is foggy. The reality of living in the San Joaquin Valley is that the winter brings fog so we all must learn how to drive safely during foggy conditions.

Although drivers must pay attention to many things when driving in the fog, including not following too closely and selecting safer routes to a destination, the most important consideration is figuring out the appropriate driving speed. In my years of teaching driving, I have learned that even many mature drivers don’t have a process for choosing a safe speed while driving in the fog or other conditions of impaired visibility.

Safety in Numbers
Common sense tells us to slow down in the fog, but what number on the speedometer is safe? Crashes that make the headlines are not caused by fog, they are caused by drivers going so fast that the vehicle doesn’t have enough distance to stop safely. Drivers are estimating safe speeds incorrectly.

“If visibility is 100 feet, then drivers can safely drive 30 mph.” This information is buried in the 2008 DMV Handbook in a section titled “Driving in Rain or Snow!” Drivers can estimate distances in the fog using houses in a residential area or power poles in rural or highway areas. Two average houses are about 100 feet long and power poles are slightly more that 100 feet apart. So, if drivers can see two houses, 30 mph or less is a safe speed. In the country, if your vehicle is next to a power pole and you can see the next power pole, a safe speed is also 30 mph or less.

If visibility is 300 feet, then drivers can safely drive 60 mph. On our freeways (65 mph speed limits) or rural two-lane roads (55 mph speed maximum), drivers must be able to see three power poles or six houses (300 feet) to drive safely in the fog. Automobile testing has shown that we need three seconds to stop a car at 60 mph. At 60 mph, a car will travel 88 feet per second, so in three seconds a car will travel 264 feet, which is just less than the 300 feet of visibility.

Keep it Simple
It is simple. A safe speed with 100 feet of visibility is 30 mph and a safe speed with 300 feet visibility is 60 mph. On freeways, in areas with many fog related crashes, Fog Visibility Checks help drivers estimate the visibility. The first sign displays a zero, then 100, 200, and 300 so that the farthest sign you can see tells you how many feet of visibility exist. Then you apply the same rules: If you can only see the 100, then 30 mph or less is safe, if you can see the 300, then the safe speed would be 60 mph. A few years ago, 400 and 500 feet signs were added for semi-trucks, which take nearly twice as long to stop at 55 mph as cars.

I have taught this theory to thousands of novice drivers in the last twenty-eight years. It is simple and it is safe. We cannot tell our young drivers just to slow down “a little” for mild fog and slow down “a lot” for thick fog, as there are not any “a little” or “a lot” stickers on our speedometers and their safety is too important to leave to guesswork. Keep it simple: 30 mph at 100 feet; 60 mph at 300 feet.

Some wonder why police, fire and EMS personnel are all required on scene in a cardiac emergency. Aren’t there plenty of other things for the cops to do, like arresting criminals? Why is the fire department needed if the house isn’t on fire?

Law enforcement personnel are on hand to control the crowds that can impede EMTs on any scene, especially ones with notable victims. Law enforcement personnel can provide basic life support if they arrive sooner than the EMTs. Many are trained to EMT-1 level, and may carry an Automated External Defibrillator (AED), a portable electronic device that automatically diagnoses arrhythmias. (For more information about AEDs, please read the article on page ____.)

Occasionally, Fire Department personnel are often closer than other EMS branches. And they are more likely to carry defibrillators than are police. Plus they are trained in more advanced life support than are law enforcement personnel. When paramedics are on board, they can perform several advanced procedures and administer a wide array of emergency medications on scene.

By Aaron Collins

By the time Irene O’Hearne became a West Coast big city mayor’s wife, she was considered by many to be a pretty tough character. Central Casting couldn’t have found anyone better for her no-nonsense supporting role in the political drama that was her life.

But those who had known her over the years witnessed the ongoing eclipse of her otherwise light-hearted, unassuming demeanor. Due to all the dutiful campaigning, numerous public speaking engagements, and social demands, stress had taken a toll on her easy laughter and a sweet, shy side. Her husband thrived in the limelight, but it was not her natural habitat.

Away from the spotlight, many politicians’ spouses endure periods of crushing boredom and unrelenting anxiety. And Irene was no exception. No matter how resilient she seemed in public, the duties that frequently took her husband away for long periods of time meant that loneliness was inescapable. Irene, though in her 50s much younger than many in her position, would pay the price for the burdens of public life.

Though Irene endured a life of quiet desperation on the sidelines of public political life she managed to avoid becoming notorious herself, like former First Lady Betty Ford, the patron saint of suffering politicians’ wives. Ford’s struggles and recovery are enshrined by the addiction medicine clinic bearing her name—thereby placing in the historical record a political wife’s sufferings perhaps on par with her presidential husband’s accomplishments.

But like Ford and many other political spouses, Irene hitched her wagon early on to a fate beyond her control: to the whims of the electorate. Irene married Peter—handsome son of rural immigrants and future mayor of one of the largest cities on the West Coast— when he was a common-as-dirt ranch hand with barely two nickels to rub together. She was young and pretty, and they were both ambitious. And they could hardly wait to get out of the small cow town where they met to head for the big city.

In retrospect the roots of Irene’s troubles are traceable. The O’Hearnes’ religion meant ten kids were the norm. And over seventeen years’ time they met that reproduction quota as Peter ascended the ranks of the big city political machine that would eventually grind Irene up and spit her out.

When Peter’s political career took off, so many others wanted aboard his bandwagon, that there was little room for Irene. She felt bumped off or worse—thrown under. While her obligations as mayor’s wife demanded a smiling public game face and grace under pressure without fail, jealousy and loneliness were overwhelming. No such demands could be placed upon Peter’s many mistresses, who, to Irene seemed to get only the benefit of Peter’s political life. She resented them bitterly.

After Peter was elected mayor, he frequently traveled overseas on junkets. While he spent long hours at City Hall, Irene was left home alone raising their litter of ten with little money to feed them. Out of public view, she smoked like a coal plant. She ate when stressed. She drank more than she should. She rarely exercised, aside from the exhausting task of tending such a large family.

As her kids grew older at the edge of their father’s constant media spotlight, a few veered into delinquencies. Publicly embarrassing to Peter, these youthful indiscretions caused Irene considerable private pain.

By her late 50s, Irene was casting a pretty wide shadow. Yet she was a shadow of her former self, the young bride on the ranch with Peter. Her large Irish blue eyes twinkled as ever, but she was often anxious. Worse, she showed some of the same quirks that her large brood quietly feared were the telltale signs of impending mental illness that seemed to beset the women in her family, at a certain age.

In short, she was a stress mess.

By the time voters sent Peter packing in an upset election, Irene was a ticking time bomb, about to become one of the casualties that few count when entering the brutal arena of politics. One of the downsides of having power is that no one may intervene. As happened with John F. Kennedy Jr., only later some would say that maybe he was too inexperienced to be flying in the conditions in which he and two others lost their lives. But when one hails from one of the most famous political families in the country, no one wants to tell you when you’re heading for a fall.

Similarly, no one wanted to tell the big-fish mayor’s wife, “You’re killing yourself.” No one spoke up, save for her physician—whose voice was largely tuned out.

So that is when the first responders entered the story. Irene’s lifestyle was just too much for her fifty-something-year-old body. Her heart had had enough. By the time emergency personnel arrived on scene, she was in full cardiac arrest.

Her fate was again in someone else’s hands. Her life would depend on the outcome of each of the following crucial stages of care.

Any responsible health care professional would say, prevention is the truest and best first step in any cardiac arrest survival strategy. Best to avoid risk factors like smoking and lack of exercise in the first place. But Irene was the poster girl for what not to do. Those preventative steps were forgone long ago. Her choices began with her advance to the first official stage that unfolded in a whirlwind all around her: Pre-hospital care.

Stage 1: Recognizing the Symptoms

Perhaps the one thing Irene had done right in advance was to learn what constituted heart attack symptoms. Unlike some sufferers, she knew that she was experiencing an acute myocardial infarction, though she may not have known the technical term.

Women can have different heart attack symptoms than men. Instead of, or in addition to, the familiar symptoms such as chest discomfort and shortness of breath, women can experience breathing difficulty and dizziness that can appear with symptoms that are more flu-like than the typical chest clutching that TV has trained us to associate with heart attacks. In fact, some afflicted do not even know they are experiencing this too-common heart ailment. And women are more likely than men to die from a first heart attack.

Stage 2: Engaging the Authorities

One thing Irene knew from her husband’s role in establishing public policy: Where you have a cardiac arrest matters. If you are in a city known for advanced medical care like hers, you are much better off. But even less urban areas like Central California are known for high-quality response and above average survival rates.

So for Irene two important factors worked in her favor: she recognized the symptoms and she experienced them in a place where qualified help was close by. If only those had been the only factors at play.

Dave Sanbongi, RN, the prehospital EMS coordinator in the Emergency Department at Kaweah Delta Health Medical Center in Visalia, attributes a city’s success in heart attack response to citizen awareness and training. When “a high percentage of citizens are trained in CPR” a city will have “a high survival rate for victims of cardiac arrest,” says Sanbongi.

Irene knew that calling 911 was her best bet. Her conditioning on the stump for her husband had engrained a presence of mind in stressful situations that enabled her to calmly answer the questions from the 911 operator, and to listen to the operator’s instructions prior to the ambulance’s arrival.

She was little more than 15 blocks from two of the best cardiac care facilities in the nation. EMS personnel arrived on the scene in less than five minutes. But if she had been on the ranch where she once lived, she would have been 45 minutes from the nearest small town hospital. Even so, Irene’s healthy survival was not assured.

Minutes were precious as EMTs began treatment. In cardiac arrest, for every minute that passes without defibrillation, the chance of survival decreases by 10 %. But with qualified professional help so close at hand, Irene wouldn’t need her neighbors to drive her—or worse, to drive herself—to the hospital, as some dangerously choose. That’s the choice of last resort for someone in Irene’s shape.

Once Irene was stabilized on scene, ambulance personnel, staffed by a paramedic and an EMT-1, had the job of getting her to the hospital.

Stage 3, ER Diagnosis: Assessing the Severity

As with her early self-assessment, early accurate diagnosis in the ER was crucial to Irene’s advancement through the emergency response system. Because she had been stabilized and was conscious, she was able to offer information, and her flock of children who had descended at the hospital filled in the gaps. ER staff was able to piece together the nature of Irene’s problem, her medical history, and the treatment already rendered, etc. The attending ER physician ordered diagnostic studies like blood tests, 12 Lead EKG, chest X-ray, etc. The Emergency Department staff monitored her overall condition, vital signs and heart rhythm.

In other words, everything went right, under the circumstances—up through that stage.

Stage 4, Charting a Course in the Cardiac Catheterization Lab

Once the ER had stabilized Irene, she went on to the next department in the process: the Cath Lab. By injecting dye into her vascular system, the physicians were able to locate the blockages that required stents, the balloon-like devices that reopen a coronary artery through the process called angioplasty.

The hospital had an “interventional” facility to treat patients experiencing active heart attacks. This widens the range of treatment options, such as the choice to administer clot buster medication. But not every patient has the medical history to undergo this course. In the most severe cases, coronary artery bypass surgery may be needed. Irene was one of them.

Sadly, Irene’s story came to an end there.

Irene made it through surgery, but the anti-clotting drugs were not enough to prevent a stroke during her recovery, and that stroke was massive and fatal. The brain pressures had built up, forcing her into the autonomic convulsions that signaled the very end for her. With her large clan at her side, Irene succumbed as they sang her favorite songs, offering comfort perhaps more to one another than to her.

Epilogue

In considering Irene’s untimely death, it is important to underscore just how avoidable many of her risk factors were. Her inactivity, the smoking, the lack of stress management, and her failure to manage her weight all took a decisive toll that even the best health care providers could not counteract. Flummoxed by depression, her mental health state made it that much harder for her to escape those physical manifestations of her emotional state. Despite quality emergency care that went right at every step, as did her surgery at the hands of one of the nation’s most respected doctors, she entered her end-stage crisis at a great disadvantage.

It’s tempting to think she’d have survived if she had been in better shape to start with, but it is impossible to say. All that is certain is that Irene’s mortality fit the statistics of people with identical risk factors with alarming yet obvious precision.

If you believe you may have experienced a heart attack, or are concerned about your cardiac health, see a health care provider. If symptoms merit, a cardiologist may give you an electrocardiogram to detect any heart damage from a previous heart attack and will assess your risk factors so that you can make the best decisions about how to protect your health.

Heart attacks are survivable, but mortality from full-on cardiac arrest from any cause, (anaphylactic shock, drug overdose, or any of the many other causes of total heart stoppage) depends on the combination of precious minutes and random circumstance of the emergency. But the knowledge and systematic responsiveness of those on scene—professional, layperson, and bystander alike—are the result of choices that greatly affect the difference between a dramatic episode in your life, or a final scene.

Have you prepared?

Editor’s note: To protect family privacy, names were changed and, while based on a true story, some details fictionalized.

A big thank you to our readers! I was overwhelmed by the positive response to the first issue of Valley Response Magazine. Within one week of its release, I received close to 100 emails and phone calls from readers offering supportive feedback, ideas for future editorial topics, and inquiries about subscriptions to the magazine. After months of hard work preparing for our launch, it is very gratifying to find that the Valley Response team’s efforts have been so well received. We will continue working to live up to the standards we have set for ourselves and hope that you, our readers, will continue to share your thoughts, suggestions, and any information that will help us to continually improve and grow as a community-oriented publication.

In the current issue, my wonderful staff of contributors has helped put together another great issue. In honor of February being Go Red for Women Month, the theme for this issue is Cardiac Awareness. There are two great articles promoting the importance of maintaining a healthy heart. Based on a true story, Political Ends: Life or Death in the Public Eye details the life of a woman who allowed a stressful lifestyle to lead her into a profusion of unhealthy habits. In Jump Start a Heart, we discover why it’s important to understand how to operate an Automatic Electronic Defibrillator in addition to knowing the basics of CPR—it can save a life.

The Special Feature captures the essence of our publication in a story about multiple agencies working together with volunteers and bystanders to help rescue a victim who took a dangerously steep fall near Three Rivers. In a remarkable stroke of journalistic timing, one of our photographers was at the scene (off-duty) and was able to get several amazing shots of the heroic rescue.

For the new year, my resolution is to establish Valley Response Magazine’s reputation as the community’s resource guide for health and safety and to let you in on the lives of the people that save lives in our community. Please continue to let me know the information you and your family deem the most important, entertaining, and interesting. It does my heart good to get your perspective.

From the staff at Valley Response Magazine, we wish all of you a safe and healthy new year!

by Paul Main

We’ve made it through the holidays and the myriad college football bowl games. And January brings Martin Luther King Jr. Day and the presidential inauguration. But if you’re a sports fan or just a party-goer, the next big national holiday is February 1st: The Super Bowl

To honor this exalted day of sheer sports talent, intense fan loyalty, and unabashed feasting, I offer you the public safety twist on the Super Bowl—the super bowl of chili!

Paramedic Lester Costa of American Medical Response shares his award-winning chili recipe—a great side-kick to the rest of your Super Bowl fare. Based upon Costa’s reputation as a host and a cook, this chili is sure to be a winner with your guests or make you the star of the potluck.

Lester’s Chili

Ingredients:
5 tablespoons of canola oil
2 cups chopped onion
Salt to taste
1 tablespoon cayenne pepper
5 pounds of stew meat, cut into 1-inch cubes
4 tablespoons chili powder
1 tablespoon cumin
1 tablespoon crushed red pepper
3 chipotle peppers in adobo sauce
4 teaspoons dried oregano
3 tablespoons chopped garlic
5 cups crushed tomatoes
5 cups beef stock
24 oz. dark beer
6 oz. semi-sweet chocolate, chopped
4 tablespoons masa harina

Method:
In a large dutch oven or stew pot, heat the canola oil. When the oil is hot, add the onions and sauté for 4 to 6 minutes, or until they start to wilt. Season with salt and cayenne. Stir in the stew meat, chili powder, cumin, crushed red pepper, chipotles and oregano. Brown the meat for 8 to 10 minutes. Stir in the garlic, tomatoes, beef stock and beer. Bring the liquid up to a boil and reduce to a simmer. Simmer the liquid, partially covered for 1-½ to 2 hours, stirring occasionally, or until the beef is tender.

Mix the masa with about 5 tablespoons of water. Slowly stir in the masa slurry. Then add the chocolate and continue to cook for another 30 to 45 minutes. Season with salt and cayenne as necessary.
Makes enough for a big, hungry crowd.

Other Super Bowl Party Food Suggestions

The Super Bowl only comes once a year, and the food supersedes team loyalties. The key to Super Bowl snacks is that they are full of flavor and easy to pick up and eat. Each item can be personalized—your extra effort may be rewarded with a resounding “Score!” from your guests.

Pizza—Order in ahead of time or bake them yourself. Pick up a ball of dough at the grocery store or at your favorite pizza joint the day before. You can load it with everything you like and skip what you don’t. You want to be sure to cook your raw meat toppings ahead of time, but pepperoni, ham, salami—these are all ready to top your pie and hit the oven.
Chicken Wings—spicy Buffalo, teriyaki, or BBQ. They all are great finger food, so stock up on napkins,
Grilled Sausages—beyond the typical hot dog, you can find some outrageous fare including bratwurst, linguica, or hot links. Put out sauerkraut, grilled onions, good rolls, and deli mustard for a total top dog experience.
Chips & Dip—Crunchy, salty and always a crowd pleaser. With a bunch of people noshing, take this opportunity to try out a new dip recipe and see if it gets cheered or shouted down. If it’s a hit, it’ll become a classic, if it’s panned—no harm no foul.
Veggie and Fruit Trays—Your arteries will love you for it, and it will give your tongue a rest before you go back for a second (or third) pass at the buffet table.
Dessert Tray—Keep the kids happy with some cookies, cupcakes, and muffins. For a healthier twist on sweets, try some sliced apples and pears with a low-carb/low-fat caramel sauce or make a dip with non-fat cream cheese with chopped nuts and caramel swirls.

Cooking Safety Tip:

Since we are talking party food, and your team of eaters are people you like and probably even want to come back sometime, let’s talk about how to keep the food safe. An easy rule of thumb is to remember the 40-140 rule. Cold food should be kept at or below 40 degrees Fahrenheit and hot food should be kept at or above 140 degrees.

There are a number of party-friendly ways to do this if you’re away from home. Keep cold items covered and on ice. Keep food in an ice chest, cooler, or refrigerator when it’s not being served. For hot foods, use a slow cooker, warming plate, or chaffing dishes. Use a thermometer to monitor the temperature so you know you’re in the safety zone. You can find them in the cooking section of most stores.

To learn more about food safety, go to HYPERLINK “http://www.foodsafety.gov” www.foodsafety.gov. Keep safe and keep cooking! More recipes will be available soon at HYPERLINK “http://www.valleyresponsemagazine.com” www.valleyresponsemagazine.com.

Imagine a child, a teenager, hanging out in a room full of kids roughly the same age. They chat, talk about school, sports, their favorite music. Soon though, the conversation becomes much more adult, maybe even explicit. Now a handful of adults enter the room; they look around, chatting with teenagers. An older man pulls aside a thirteen-year-old girl. He wants to know everything about her, and she tells him. They agree to meet later, outside the room, for a “date.”

That could never happen, right? Somebody would see something; there would be chaperones. Groups of teenagers would not be left in a room with strangers, and certainly those teenagers wouldn’t start opening up about themselves, saying where they live, saying “Yes, it would be fun to meet up later.” That would never happen. But every day, in chat rooms across the country, this scenario plays itself out. It happens in Tulare County, too. Only now there is a team that is trying to put a stop to it.

The Sexual Assault Felony Enforcement (SAFE) Team is a group of local law enforcement officials that, according to its website, is “dedicated to proactively preventing sexual assault crimes and keeping convicted sexual assault offenders off the streets of Tulare County.”

Before the Internet was a part of children’s daily lives, rules for children were more straightforward: Never talk to strangers. Do not accept rides or gifts from somebody you don’t know. If a stranger approaches you, yell for help and run. Before the Internet, sexual predators seemed, somehow, more tangible; they had faces, you could see them up close. With the Internet, however, the dangers have changed, and that makes the Tulare County SAFE Team’s job much more difficult.

According to the Federal Health and Human Services Department, 900,000 cases of child abuse—including sexual abuse—are reported annually; because abuse is often underreported, that amount is estimated to be only one-third of the actual total. The SAFE Team was created to attempt to bring Tulare County’s portion of this number down. But as Sergeant Chris Douglass of the Tulare County Sheriff’s Department explains, it becomes more difficult when dealing with the Internet.

The Internet and chat rooms allow for anonymous conversation; both children and adults can pretend to be somebody they’re not. There is a false sense of security for many children and teens and suddenly talking to strangers or accepting gifts doesn’t seem so dangerous. But chat rooms are where many sexual predators lurk these days, Douglass says.

“One in five children ages ten to seventeen who are regular Internet users are sexually solicited online,” Douglass says. “One in four receives unwanted sexual contact online.”

This can include solicitation, sexually explicit pictures or emails, and chat room invitations that are sexual in nature. While that number is troubling, the next is even more staggering: Solicitation of minors for sex online is growing at the rate of 1,000% every month.

The SAFE Team has four objectives: Monitor sex offenders who have a high propensity to commit another sexual assault crime; identify and apprehend sexual predators and track convicted predators; assist other law enforcement agencies with sexual assault investigations; and teach the community to recognize predatory behavior and where to seek help.

The last objective—education—may be most critical to fighting the presence of online sexual predators. Many times, parents are unaware that anything is going on until it is too late. In fact, Douglass says, “fewer than 15% of parents feel they know more about PCs than their teenage sons or daughters.”

This can make it difficult for parents to know exactly what is taking place when their children go online. Chat rooms differ from the real world in many ways; not only do people act differently inside chat rooms, but the language itself changes. Ask the SAFE Team for a list of common acronyms used in chat rooms and you’ll get a twelve-page list. (See sidebar.) Many of these acronyms are specifically designed by privacy-seeking teens to be indecipherable to parents—a fact that predators can use to their advantage. But a parent’s knowledge can take that weapon out of a predator’s arsenal. Learning exactly what all of these acronyms mean can seem a daunting task but Douglass says that’s part of what the SAFE Team does; it can help parents and children understand the risks and dangers associated with going online.

With so many facts and numbers, it can seem there is no safety from online sexual predators, but Douglass says that by coupling SAFE Team efforts with safe online practices within the community, kids can go online much more safely. A big part of ensuring your child’s safety is monitoring their online activity, Douglass says.

“Use of chat rooms should be heavily monitored,” Douglass says. “If your child is spending large amounts of time online, especially at night, if you find pornography on your child’s computer or if your child turns off the monitor as your enter the room, you should have a discussion.”

Better yet, Douglass says, discuss safe online practices with your children before they go online.

“Spend time with your child online,” Douglass says. “Let them teach you about their favorite online destinations.”

The SAFE Team, meanwhile, will be doing its best to ensure the community is safe from sexual predators. This includes monitoring chat rooms and websites, but extends beyond cyberspace. There are still many dangers lurking in the community besides online sexual predators, and recently the SAFE Team received a $639,000 grant to continue its work in Tulare County.

The grant, awarded by the governor’s Office of Emergency Services, will be used to continue investigating and capturing sex offenders and providing education to the community. Sheriff Bill Whittman says the grant money will help the SAFE Team continue pursuing its objectives.

“I appreciate the help of the governor’s Office of Emergency Services in these efforts,” Whittman says. “This proactive approach will enhance the safety of those living in and visiting Tulare County.”

Part of that proactive approach is the creation of OffenderWatch, an online database that monitors the whereabouts, conduct and compliance of registered offenders in Tulare County. The information is available to the public, so residents can go online and find out what is going on in their neighborhoods. To view the database, please visit www.tularesheriff.info

In addition, the team will be able to purchase fingerprint processing equipment, video capture and enhancement software, and computer forensic software. With better surveillance equipment and an increased education program, the SAFE Team hopes to make Tulare County a much safer place—both on the streets and in cyberspace.

If this is active, an OffenderWatch URL would be a good infobox

Sometimes wishes do come true! They did for one young boy named Marco, thanks to California Law Enforcement’s Wish Upon a Star program. Marco, 18, was diagnosed with osteosarcoma, a form of bone cancer in his right wrist and is being treated at the Children’s Hospital of Central California in Madera. Most of the fifty-five to sixty kids who are granted wishes by the Wish Upon a Star program each year are referred by the Children’s Hospital.

Recently, it was Marco’s turn to get his wish—to be the proud owner of his dad’s classic car, which badly needed refurbishing. On December 11, 2008, after six months of repairs at Above and Beyond Auto Body Repair and Paint, Marco’s wish came true. It was a day of happiness and gratitude for Marco and his family.

The work was done on a strictly volunteer basis—and it was no cakewalk. It was a challenge to find all the parts and refurbish the car.  But thanks to the generosity of Above & Beyond’s Larry Nelson and Tony Bonilla and the entire staff and the they time spent to make this a dream come true for Marco, the job was completed beautifully. They not only put their labor and guidance in this project, but knowing that they were going to make a difference in this young man’s life, they put their whole heart was in the job.

This project could not have been done without the support and kindness of Todd Trim and the help of Classic Upholstery & Trim and Todd Son, who took on the upholstery. The final touches really completed the package. Thanks to M&M Tires who took on the wheels, Promotive Auto, Inc. who did the mechanical repairs, FinishMaster Automotive & Industrial Paint who provided the paint products, and Cesare’s Collision Repair & Towing’s Gabriel Jacques for his cash donation.

Each person who worked on this classic car made a difference in this boy’s life. Every person involved in this project showed that, even with hard times in the economy, together we can make this sad old world a brighter place—one kid at a time.