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HILLSBOROUGH NC (22-Apr-04) Nick Waters, the director of Orange County Emergency Management Services, died Wednesday morning from cancer.

Mr. Waters was 60 and only discovered he had liver cancer about six weeks ago, officials said. His health deteriorated rapidly, and his death caught many people by surprise.

"We just hate to lose him," said Orange County Sheriff Lindy Pendergrass. "You work with somebody every day, and you think everything is all right, then all of the sudden you get hit with this. It's terrible. Orange County is certainly going to lose a valuable person."

Mr. Waters had led Emergency Management Services since 1989, a role that included supervising emergency medical services, 911 communication services and fire services for the county. He also led the county through natural disasters such as hurricanes, tornadoes, snow and ice storms.

In addition to his duties as the director of one of the county's busiest departments, he still drove to the scene of severe car accidents or fire scenes to make sure the crews had what they needed to do their best work to save lives. No matter what the tragedy or disaster, Mr. Waters always seemed to remain calm and at ease.

"I don't think I've ever seen him lose his cool," said Jeff Cabe, chief of the Hillsborough Fire Department. "He got us resources whenever we needed them."

During countywide disasters, such as ice storms or hurricanes that knocked out electricity for days and sometimes weeks, Mr. Waters often slept on a cot in his office on New Hope Church Road. In 2002, when an unexpected ice storm hit, Mr. Waters hosted an emergency meeting there for all county officials.

Mr. Waters had developed contacts and contracts with other agencies and businesses so that Orange County could respond within minutes to disasters. When Eric Peterson, town manager of Hillsborough, told Mr. Waters that Hillsborough needed an industrial-sized emergency generator to keep its water plant running, the EMS chief got on the phone and made arrangements for one within minutes.

"He was a calming, steadfast force when he faced a crisis, whether it was a tornado or a hurricane or ice storm or fire or whatever," said Orange County Manager John Link. "The more critical the conditions got, the calmer and more focused he got."

Always a professional during times of trouble, whether those troubles were big or small, Mr. Waters also spent many hours trying to find ways to improve emergency communications and increase the efficiency of the paramedic and ambulance services, Mr. Link said.

"He was really positive and really advocated an emergency response plan," said Mike Tapp, the county's EMS deputy director and fire marshal. "One of his favorite sayings in emergency services was you've always got to be proactive. You'll never succeed if you're just reactive."

Mr. Waters received statewide recognition in 1999 for implementing an innovative emergency medical service delivery model for Orange County using Initial Response Vehicles staffed with paramedics, which significantly improved patient outcomes. Counties throughout the United States often called or wrote to learn more about his system.

"[Mr. Waters] knew his business," said County Commissioner Steve Halkiotis. "He would not hesitate to tell you if he thought we needed to do this or that. He didn't play any games. He didn't mince any words. He called it like he saw it. I have never witnessed a harder-working, more dedicated person working for the citizens of Orange County than Nick Waters."

When people met Mr. Waters for the first time, they often were a bit surprised by his appearance. He kept his hair pulled back in a ponytail that went nearly to his waist, but he always kept it tucked down the back of his shirt when he was in uniform. He wore gold rings on nearly every finger, bracelets and gold chains around his neck.

Mr. Waters attended the famous Woodstock music festival in 1969 and returned for its 25th anniversary, friends said. "He said he did, and I don't doubt it," Mr. Tapp said with a laugh.

He often played jokes on people and then watched them carefully for their reactions, Mr. Cabe, the fire chief, said. Then he'd wink and laugh, and the person knew he had been tricked, Mr. Cabe added.

Mr. Halkiotis called the news of Mr. Waters' death devastating and said it reminded him of the passing of two other county department leaders over the past decade: Marvin Collins, the planning director who died in 1998, and Marti Pryor-Cook, head of the Department of Social Services, who died in 2000.

Mr. Halkiotis said he considered a forum that Mr. Waters helped to organize in May 2002 as one of the director's biggest achievements in Orange County. The forum was called "Risks and Responses: Nuclear Terrorism in the Triangle," and it focused partly on how local agencies might deal with a terrorist attack on the Shearon Harris nuclear plant in southern Wake County.

The forum came in the aftermath of Sept. 11, 2001, and in the midst of Orange County's legal skirmish with Carolina Power & Light over that company's plans for boosting nuclear-waste storage capacity at Shearon Harris. But the county also pitched the forum as an effort to start talking more about regional planning for emergencies and disasters in general.

Mr. Waters was candid that night about the shortcomings of Orange County's planning for major emergencies like terrorist attacks and said the plans relied on too many unsound assumptions.

"Nick really went to bat for the citizens of North Carolina," Mr. Halkiotis said. "Some people in the higher-up levels didn't want to participate in this [forum]. They thought we were being alarmists. Nick went out there to guarantee the safety of all citizens, not only in Orange County but the entire Triangle. It was a courageous action, in spite of some people at the state level who didn't even want to discuss the issue. Nick was a symbol of courage and strength. He's a good man, and he'll be sorely missed."

Mr. Waters began his career as a deputy sheriff in Bertie County, and then moved into civil defense. "He actually wrote the first civil defense plans for Bertie County," Mr. Tapp said.

Later he became the fire marshal of Burke County and was promoted to director of Emergency Management Services there. He took over management of the Orange County EMS in 1989.

Mr. Waters died at his home in Cary. He had been renovating a home on Pamlico Sound where he planned to live after he retired, Mr. Tapp said.

Mr. Waters is survived by three sisters, a brother, a son, a daughter and a grandson. A memorial procession that will travel throughout Orange County will begin this morning at the old Wal-Mart store in Hillsborough. Mr. Waters will be buried in Windsor, N.C., and Orange County Emergency Management Services will escort his body there following the memorial procession.

A memorial service will be held in Orange County for Mr. Waters, but plans were indefinite Wednesday. Rod Visser, the assistant county manager, is serving as acting Emergency Director.

CABARRUS COUNTY EMS ADVANCED CARDIAC PROTOCOL
by Alan Thompson, Cabarrus EMS

CONCORD NC (17-Mar-04) Cabarrus County EMS and Northeast Medical Center have worked together in the development of a plan that allows paramedics to bypass the emergency department enroute to the cardiac cath lab. The door to dilation (angioplasty) time with this plan has been cut from a national average of 104 minutes to 33 minutes. The 33-minute time is the best known for this procedure nationwide. The most obvious success of this plan is the salvaging of heart muscle. Patients are arriving in the cath lab earlier with the team standing ready to perform the procedure. This plan has been made possible through a collaborative effort of Cabarrus EMS, Northeast Medical Center, and Duke University and has been supported by grants from the Duke Endowment and the William T. Morris Foundation.

Paramedics in Cabarrus County are using WelchAllyn MRL PIC monitors to obtain 12 Lead tracings in the field. This information is then transmitted into an IPAQ PC. The information is digitally transmitted in diagnostic quality to the Northeast Medical Center emergency department and the cardiologist. The cardiologist will then advise if transport should be made to directly to the cath lab. Cabarrus EMS paramedics will initiate the advanced cardiac protocol allowing for the administration (if indicated) of plavix, benadryl, and lopressor in addition to the standard aspirin, nitroglycerin, and morphine. The paramedics will also assist the hospital staff with cath preparation as necessary. Risk factors for the procedure are also screened in the field.

Cabarrus EMS paramedics received a great deal of additional 12-lead EKG training and cath lab time in preparation for this system. A priority has also been established on community education (bilingual) to target populations.

This system is the first known system to implement digital (wireless modem) transmissions direct from the field to cardiologists and emergency department staff. The result is a digitized heart imaging information system that allows the cath lab team to be assembled prior to EMS arrival at the hospital.

Contact Alan Thompson (Cabarrus EMS), Dr. Paul Campbell (Northeast Medical Center), or Dr. Craig Corey (Northeast Medical Center) for additional information.

NATIVE AMERICAN EMS AGENCY OF THE YEAR

CHEROKEE NC (17-Feb-04) In the recent annual meeting of the National Native American EMS Association in Las Vegas, Nev., Cherokee Tribal EMS was presented an award for being the “EMS Agency of the Year” in Indian Country.  The plaque said “IN RECOGNITION OF OUTSTANDING CONTRIBUTIONS AND DEDICATION TO THE FIELD OF EMS”.

Cherokee Tribal EMS has always been dedicated to providing “state of the art” pre-hospital care to all clients with an emphasis on quick response time, the highest level of care available, and the latest in equipment.

Eastern Band of Cherokee Indians Principal Chief Michell Hicks states, “I am extremely proud of the services provided by Tribal EMS.  These Paramedics are dedicated to providing quality care to the residents and visitors of the Qualla Boundary.”

Casey Cooper, new CEO of Cherokee Indian Hospital said, “the dedication of Tribal EMS is outstanding.  Cherokee is fortunate to have the quality of care provided by the EMS staff.” 

Jerri Kinsland, EMS Program Manager provided the following comment.  “Tribal EMS is a multifaceted program that provides pre-hospital care, is an EMS Training Center, works with students head start through twelfth grades, provides Lifeline services, provides stand-by for sporting events for the schools, and assists with many other Tribally sponsored events and programs.  It is a privilege to work with this group of men and women who are continually striving to be the best in the EMS field. Recognition from the National Native American EMS Association is an honor.”

First Row: Rusty Wiggins, Jeri Kinsland, Shelly Frady, Georgeanne French, Amanda Smoker, Annette Walls, Donna Taylor, Anthony Sequoyah. 
Second Row:  Nancy Pheasant, Jerry Dugan, Brian Stevens, Darrell DeHart, Bob Dunlap, Brad Melton, Ted Lambert, Carroll Ensley, Buck Cloer. 
Third Row: Buddy *******, Todd Sumner, David Crisp, Billy Joe Grindstaff, Paul DuPree, Vance Greene, Jason Clark, Jason Hoyle, Shannon Sholar. 
Not Pictured:  David Blanton, Joey Gibson, Donna Owl, Teddy Peterson, Tony Randall, Lisa Taylor, Rob Wahnetah. 
In Iraq;  Anthony Lynn, Shane McConnell

PARAMEDIC OF THE YEAR

David Crisp, National Registered EMT-Paramedic who has worked for Tribal EMS for over 7 years, was selected by the National Native American EMS Association as Paramedic of the Year.  David is a Critical Care Paramedic with an Associate Degree in Emergency Medical Services.  He is certified in and provides instruction in Swift Water Rescue, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Basic Trauma Life Support, Basic Life Support, Search and Rescue, Rappelling, Extrication, Water Safety, and is a member of the Urban Search and Rescue Team. 

David stated, “It is a privilege to work for an EMS service that is second to none.  Tribal EMS is one of the most progressive services in the nation keeps striving to attain higher goals in order to serve the people of the Reservation and surrounding areas.” 

NATIVE AMERICAN FIRST RESPONDER OF THE YEAR

At the recent annual meeting of the national Native American EMS Association, Jonah Saunooke, a Fireman and First Responder with the Cherokee Fire Department, received the “First Responder of the Year” Award.  Jonah is credited with assisting to provide appropriate care to a patient in Cardiac Arrest and being successful in assisting with the resuscitation of the patient.

Jonah has worked with the Cherokee Fire Department for 2 years and has been a volunteer First Responder for 6 years with the Cherokee Volunteer Fire Department and Qualla Fire Department.  Jonah states “I just like to help people when they are in need.”

     Jonah, his wife Cori, son, Benjamin and Jonah reside in the Birdtown Community of Cherokee.

CJ SYSTEMS DELIVERS NEW HELICOPTER TO WILMINGTON, NC 

CASWELL COUNTY

REMEMBERING EARL BRAME

Caswell County Emergency Services Director Joe Wright has shared a story with us about one of their EMS Week celebrations, held on Wednesday, May 21st. Not only was there a steak dinner, sponsored by local businesses in Yanceyville, for EMS employees and their families, but the service took the opportunity to honor Earl Brame, one of their captains, who passed away on 7 December 2002.

Earl had worked for 36 hours during the December ice storm, finally going home to his family and leaving his uniform shirt still hanging in the apparatus bay.  He had supper with his wife and children, laid down to rest, and never got up.  He died in his sleep that evening.

For some time, no one would take the uniform shirt down from where it hung in the bay, but in a show of respect by his fellow employees for Earl, at the EMS Week dinner the shirt, now framed, was dedicated as a memorial and it will share a place of honor at the base. 

Our thanks to the folks at Caswell County Emergency Services for sharing this moment with us.