Named one of the Best Places to Work in the Philadelphia region by the Philadelphia Business Journal, 2008. Recognized as one of the a€?Best Places to Work in PA,a€? 2007 by Team Pennsylvania Foundation, the state Department of Community and Economic Development, the Pennsylvania Chamber of Business and Industry, and the Central Business Journal.
Excellent benefits, including medical, dental, sick time, vacation and holiday pay, tuition assistance, discount parking, direct deposit, credit union and more! Abington Memorial Hospital is a 570-bed community teaching hospital and comprehensive regional health center with a level II trauma center located in the Philadelphia suburbs.
Under the supervision of the Director of Materials Management, the Operations Manager controls and directs budgeted resources to ensure maximum productivity of the supply chain. The citya€™s security preparations for Pope Francisa€™ 48-hour visit have been going on for more than a year.
Samantha Phillips, Philadelphiaa€™s director of emergency management, said she was preparing for any and all infrastructure problems and working with city departments to set up contingency plans. The final day of the Philadelphia delegation’s trip to Rome focused largely on getting input from Roman and Vatican City authorities on security and infrastructure for large-scale events featuring the pope. Chief Inspector Joe Sullivan, who heads the Philadelphia Police Homeland Security and Counter-Terrorism unit, said Philadelphia would have all agencies and resources at its disposal. Still, he said, it is nerve-racking to prepare for an estimated 1.5 million people and a popular pope who likes to wander into swelling crowds. Sullivan, who had never been to Europe before this trip, said that talking with officials here made him confident in the city’s security plan. Samantha Phillips, director of emergency management for the city, said she was preparing for any and all infrastructure problems and working with city departments to set up contingency plans.
The job also has its lighter moments, such as determining whether certain gadgets will be allowed at the papal events. One challenge for this event, Phillips said, is that the World Meeting tends to attract an older crowd that will be expected to do a lot of walking. Moments after Train 188 careened off the tracks, emergency calls went out across the city and scores of first responders rushed to the scene to find the mangled bodies of those killed and more than 200 injured and bloodied passengers. I must confess, I’ve been one of the many providers who just went through the motions and “bagged” the life right out of my patients. This article will address the most basic of our airway maneuvers: opening and maintaining the airway. The Problem is the Tongue!Providers are really good at trying to ensure the head is hyperextended in obtunded patients, but simply tilting the head back often does not remove the tongue from the post-oral pharynx. With the two-person approach, the provider responsible for opening and maintaining the airway has the distinct advantage of using both hands to exert enough pressure to move the mandible and tongue anteriorly. Once this has been achieved, you have to maintain that position throughout the time you are providing bag-mask ventilations.
Of course, it’s important to use airway adjuncts (oropharyngeal or nasopharyngeal) to assist with maintaining the tongue’s anterior placement. I realize most EMS textbooks don’t go to this extent to describe this procedure, but I think they should. Once you open the airway and are ready to hold it open, use the following Difficult Airway Course: EMS-recommended hand positioning on the mask to ensure you maintain an open airway and mask seal at the same time.
Although opening and maintaining an airway is taught in the earliest days of any EMT class, the importance of this critical skill is often not conveyed well, nor is the importance of this skill carried into daily practice. Michael Keller is a curriculum faculty member at Gaston College, Department for EMS Education. The homicide rate has dropped by more than 35 percent, while violent crime in general continues to tick down. On the national level, Nutter has been a leading voice on issues such as gun control, combating obesity among residents trapped in low-nutrition food deserts, greener building and stormwater runoff, and maintaining funding for Community Development Block Grants. At home, Nutter has made a government never well known for good customer service run more smoothly, both through strong appointments and his endless interest in tinkering through his Office of New Urban Mechanics. Philadelphia still has big challenges, but Nutter has presided over a government that is more open and honest and a city that is more populous and prosperous.
Every year since 1994, GOVERNING has honored individual state and local government officials for outstanding accomplishment by naming them Public Officials of the Year. GOVERNING annually receives several hundred nominations from individuals in the public and private sectors.


The award recognizes AMH's achievements in creating a positive work environment that attracts and retains employees through a combination of benefits, working conditions and company culture. You will also ensure the distribution of supplies and equipment is performed in an effective and efficient manner in compliance with all federal, state, local and JCAHO regulations and laws through continuous evaluation and review. Before returning to Italy, he worked as a transplant surgeon for more than a decade at Thomas Jefferson University Hospital, where he gave a commencement speech this year. That’s a very different population from Made in America and many of the larger concerts held on the Benjamin Franklin Parkway. Mayor Nutter receives a call at his Wynnefield home from Samantha Phillips, director of the city's Office of Emergency Management.
Nutter arrives at the crash site, where he is met by Phillips and Gillison, along with Police Commissioner Charles Ramsey, Deputy Fire Department Commissioner Jesse Wilson, city Managing Director Rich Negrin and Director of Public Safety Michael Resnick. Dozens of firefighters and paramedics are on the scene, using ladders to scale tipped over train cars and reach windows to rescue passengers. The city's Office of Emergency Management sends out its first derailment-related tweet, urging people to call an Amtrak hotline for information about passengers.
More than 200 Philadelphia police officers are already on the scene helping victims and assisting the Fire Department. Emergency workers, wearing orange safety vests and carrying flashlights, continue to search grassy areas for victims thrown from train cars.
Multiple light towers and portable light units are on site to help first responders scour the area for victims. Investigators with the National Transportation Safety Board begin to arrive from Washington, and federal officials work with local Red Cross and Amtrak employees to help passengers, who were newly released from the hospital and transported to 30th Street Station.
Emergency workers bring in heavy equipment, including a cherry-picker lift and crane to hoist pieces of wreckage in search of victims. But do we actually understand the physical dynamics of how to open an airway and keep it open for artificial ventilation? I wish I had hard scientific evidence to support my belief, but unfortunately I only have 30 years of personal experience to rely on.
Please, for the good of our profession and the patients we serve, read it carefully and then begin employing the techniques we teach in The Difficult Airway Course: EMS.
To perform this action well, the first step is to open the mouth fully, then place the thenar pad (the area of the hand where your thumb attaches to the hand) on the zygoma (cheek). If sufficient pressure is not maintained to ensure the condylar process is kept forward of the TMJ, in the absence of some mitigating TMJ disorder, the mandible will move posteriorly back into place, reintroducing the tongue into the pharynx.
Do not allow your thumbs to come across the bridge of the nose, as with the “double C & E” technique.
Please consider the ideas and procedures of this article very closely and begin employing these concepts into your daily practice. But Mayor Michael Nutter has undoubtedly made an outsized impact on the city, creating a Philadelphia that’s cleaner, safer, smarter and more fiscally sound than the city he began leading in 2008. The city’s public schools, which are largely run by the state, are still a work in progress, but the high school dropout rate has come down 20 percent in recent years. It’s far from perfect, but citizens who interact with the city now can expect to get a result -- without having to rely on the pay-to-play ways that formerly dominated dealings with city hall.
Elected, appointed and career officials from any branch of state or local government are eligible. In addition, GOVERNING staff consults experts and scholars in the field, and also nominates outstanding individuals they encounter in the course of their work.
He said Philadelphia’s plans were in good shape for the visit, which he will also attend. Around that time, the Emergency Operations Center, housed within Fire Department headquarters on Spring Garden Street near 3rd, is activated. I can recall far too many cases where I arrived to hear the dreaded sound of air blowing out around the mask of the bag-valve device. The tongue is securely fastened to the mandible and by moving the mandible anteriorly, the tongue will follow and prevent obstruction of the pharynx. The most important aspect of maintaining the open airway is ensuring the mandible and tongue are pulled forward.
Most providers do not understand the extent and force it takes to move the tongue and maintain the open airway.


A well-executed jaw thrust moves the mandible, tongue and, by association, the epiglottis anterior and opens the airway.
As a profession, we need to do a better job of maintaining airways and appropriately ventilating the pulmonary fields, while minimizing gastric inflation. Becoming mayor just as the recession was deepening prevented Nutter from launching many grand new initiatives. In September, Nutter helped persuade Harrisburg to allow a cigarette tax that will help patch the school district’s shoddy finances. Our readers are invited to nominate individuals who have had a notable positive impact on their department or agency, community or state. Nominations are evaluated by a selection committee, which, after painstaking research, chooses the winners. Throughout the night and morning, more than 200 people are transported and treated at hospitals. Michael Murphy and a wonderful CRNA named Judy Leftwich brought reality crashing down on me. The problem becomes applying enough force under the chin to adequately move the mandible, and thus the tongue, anteriorly. Now, apply significant anterior pressure to ensure you move the head of the mandibular condylar process out of the temporomandibular joint (TMJ). Instead, run your thumbs down the mask and allow your fingers to fall into position to pull the jaw anteriorly into the mask. He is a founding faculty member and the southeast regional course director for The Difficult Airway Course: EMS. Instead, he has done the dig-in-the-ground dirty work that has put the city on a firmer financial footing and fostered in Philadelphia a new sense of energy and innovation. Nutter didn’t get everything he wanted from a pension overhaul, but he did update an antiquated, opaque and clearly unfair property assessment system.
Nutter jumps on the phone with chief of staff Everett Gillison, who is also deputy mayor of public safety. Notice I say every three to four seconds; that’s because we know hyperventilation is a problem, but it’s a topic better left for another article. The often-performed one-man BVM with C&E technique is very hard to perform, and even harder to master.
In other words, nearly dislocate the jaw, which is called ‘translating’ the mandible anteriorly. I want you to watch the following two videos to see how a well-placed jaw thrust will ensure your patient’s airway is open.The first video is a lateral fluoroscope of an airway being manipulated.
It is critically important to pull the jaw up into the mask, not push the mask down onto the jaw. Even if we’re able to move the mandible with one-hand, maintaining that forward position is a daunting task, especially during prolonged artificial ventilation.
This procedure, although it sounds dramatic, will ensure the mandible and tongue are sufficiently moved forward to make certain the pharynx is unobstructed.
This position allows for a much more secure and comfortable position for prolonged ventilations.
For these reasons, we at The Difficult Airway Course: EMS, strongly encourage all agencies to dedicate two providers to airway management when providing bag-mask ventilations.
Watch as the jaw is pulled forward and you’ll see the tongue move forward out of the pharynx, and the bright backlight will shine through showing what we hope to achieve.
Unfortunately, even though we teach the jaw lift with the head tilt, more often than not patients are only afforded the hyperextension.
Now, at about 10 seconds into the video, watch very carefully as a proper jaw thrust is performed.



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