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July 11, 1997     Cape Gazette
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July 11, 1997

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CAPE , Friday, July 1I- July HEALTH & FITNESS 17, i.- Dispatcher delivers baby- by telephone Sussex Emergency Operations Center dispatcher Kevin Ritchie is shown at his work station with the emergency protocol card system file he used to as- sist a woman who helped deliver her friend's baby. The friend suceemfully helped the new mother deliver a healthy baby girl before paramedics arrived to transport the pair to Nanticoke Memorial Hospital on Saturday, July 5. By Kerry Kester Kevin Ritchie, a dispatcher at Sussex Emergency Operations Center who works at a desk, started his shift on Saturday, June 5. He didn't expect to be delivering a baby - over the phone. However, when an emer- gency call came in at 3:07 a.m., and an im- patient little girl decided not to wait for an ambulance, Ritchie had no choice but to help the baby find her way outside of her mother's womb and into the world. "It was the middle of the night. I took a call, and a lady,on the phone said her friend was going to have a baby," said Ritchie. He followed procedure and took some pa- tient history, then accessed the Emergency Medical Dispatch protocol card file system to advise the friend how she could help the mother until emergency personnel arrived. "Once I got all the way through it, she said she thought she was going to have it," said Ritchie. His next step was to continue using the protocol to talk the friend through the delivery. "The mother vas in pain - I could tell. Apparently it was her second child. We got to the delivery part rather quickly." The friend, he said, remained "fairly calm with what she was going through." The little girl was born healthy at 3:15, only eight minutes after Ritchie took the call. After the delivery, Ritchie said, he con- tinued to give instructions about caring for the mother and baby, including how to tie the umbilical cord and clean the newborn. "After the baby was born, she had done everything I had asked her to do," he said. Both mother and child were in good con- dition when a few moments later para- medics arrived and transported them to Nanticoke Memorial Hospital. Just before the ambulance arrived, the fa- ther, who was also present and apparently taking care of another child, spoke to Ritchie. "He was just excited that he was having a baby," said Ritchie, grinning with the rec- ollection. An hour later, Ritchie talked to a para- medic to find out how his patients were do- ing. "He said baby and mother were fine as far as he could see," said Ritchie. "Her friend called me back about an hour later and thanked me." Addition of Wallace increases access to primary care physicians By Kerry Kester said Wallace. "I feel confident in keep up with, he said, because re- Scientists are hard at work tackling those treating many things, but I also make full use of physicians in the area when I feel a referral is need- ed." Wallace believes in the value of preventive medicine. "It's the cor- nerstone of outpatient practice," said W'llace. Typically he advises patients about screenings such as pap smears," mammographies, prostate specific antigen (PSA) tests, cho- lesterol and blood tests, as well as other screenings that may be appropriate for a pa- tient. Experienced in treating patients who are HIV positive or who have AIDS, Wallace also keeps current on new developments in treating the disease. "I've done a lot of work in HIV," he said. "We had an indi- gent population in Bridgeport [Conn.]." Changes in the treatment are difficult to WALICE searchers on the disease are mak- ing progress with incredible speed. "I read all the current journals each week," he said. For example, he said, a recent journal article suggests that a new protocol for HIV/AIDS patients should be pre, scribing a three-drug "cocktail" soon after diagnosis. Prior to the recommendation for a three-drug cocktail, a two-drug cocktail was the typi- cal method of treatment. Cocktails usually include a mixture of protease inhibitors and other drugs such as AZT. The new drugs have proven success- ful in abating the disease that only a shori time ago was an automatic death sentence. A problem for physicians, however, is that sometimes, for some patients, the drugs were ineffective. "People really didn't know what to do when one cocktail failed." issues as well as rapidly developing new drugs, said Wallace, and physicians now have other treatment options for their HIV/AIDS patients. ""One of the most im- portant thingsto give people now is hope," said Wallace. "It's not always appropriate, but when it is..." Like with the HIV/AIDS drugs currently marketed, many medicines are extremely expensive. 'Tm sensitive to prescription costs," said Wallace, "and I am willing to talk to people about the costs of medicines and the various options that may be avail- able." Often, he said, for common medicines, generic drugs are available that offer pa- tients a considerable cost savings. "PeolSle ask about that all the time," he said. 'Td want to know about that if it ws an op- tion." Continued on page 40 Community members from the Cape Re- gion experiencing difficulty finding a pri mary care physician who is able to accept new patients have a new resource available. Kevin Wallace I M.D., has joined Nancy Union, M.D., afAssociates in Medicine in Lewes. Wallace, a primary care physician who practices internal medicine, treats adults age 18 and older. His parIicular areas of in- terest include infectious disease. "I also have a budding interest in alternative medi- cine," said Wallace. Wallace's practice includes seeing and treating patients for wellness visits, and he diagnoses and treats the normal range of ailments, including cardio-vasc.ular condi- tions, bronchitis, asthma, acute problems such as gastroenteritis, and a vast array of other medical conditions. "I'11 treat a very broad set of diseases," .This is the first of a two-part se- ries on exercise during and after pregnancy. One question that we are fre- quently faced with from a preg- nant patient is, "Can I continue to maintain my exercise program, and if it needs to be altered, what are the things I need to do?" In today's health conscious so- ciety, physical fitnbss and active recreation are integral parts of a woman's lifestyle. Pregnancy, as I tell my patients, should not be a state of confinement. It is a state of health and it can be expected that the pregnant woman who maintains a moderat- ed level of physical training can Although we maintain that pregnancy should not be a state of confinement, it is important to re- alize that some limitations, as well as contraindications, potential risks and warning signs may exist. It is important to recognize these because of an individual's physio- logical adaptation to pregnancy. During pregnancy, there is an increased awareness by the patient of her body image, and there is a perception that she needs to estab- lish certain healthy habits to en- sure a good pregnancy. This makes it an optimal time for behavior contraindication, pre- viously sedentary pregnant women may safely engage in ex- ercise programs modified to be activity, many will be motivated during the pregnancy to achieve health benefits and maintain car- diovascular and muscle fimess. Physicians or mid-wives should make patients aware of guidelines on the difference between the ac- tive pregnant woman interested in maintaining a healthy lifestyle or the very active pregnant athlete who is interested in performance. These guidelines are based on physiological rationale and back- ground intended to minimize ma- ternal and fetal injury. Also, because of potential risk for the fetus, it is our position as obstetricians/gynecologists/mid- wives that the aim of physical training in pregnancy should not wish to continue with their active sports participation should b e able to, under medical supervision. Current literature does not al- low us to completely conclude whether physically active preg- nant women derive specific health benefits that can improve preg- nancy outcome. Conversely, there is no informa- tion to indicate that a sedentary pregnancy will have an adverse outcome. It does, however, seem logical to assume that pregnant women who engage in exercise training of moderate intensity can and should achieve cardiovascular and mus- cle fitness. Part II of this article will ad- Vincent Killeen, M.D., is an obstetrician, gynecologist and president of Bayside Health Association.