Tri-County Health Care Recognized as CALS Hospital


Featured in the CALS recognition photo (from left to right) are Assistant Director of Nursing, Sharyl Rinkel, Family Medicine Physician, Dr. Keven Walters, Emergency Department Supervisor, Deb Zacharias, Family Medicine Physician, Dr. Stephen Davis, CALS representative, Dr. Paul Van Gorp, Interim Chief Nursing Officer, Laurie Bach, and Emergency Department Physician, Dr. Amadin Osayomore.


Tri-County Health Care Recognized as CALS Hospital

Wadena, MN – November 8, 2016 — Tri-County Health Care has once again been designated a Comprehensive Advanced Life Support (CALS) hospital by a coalition of Minnesota health care organizations and individuals. Minnesota’s CALS program provides advanced life-support education to rural health care providers.

“We are proud to be one of the eight CALS certified hospitals in Minnesota,” said Deb Zacharias, ER Nursing Supervisor. “This designation recognizes our commitment to the care of rural emergency patients and emphasizes teamwork.”

The CALS educational program includes extensive print and electronic material, interactive education, and hands-on skills training. Features that distinguish CALS from other life support courses are:

  • CALS is comprehensive: While other courses are limited to a single type of emergency such as trauma or cardiac problems, CALS prepares the participant to deal with trauma, cardiac, general medical, OB, pediatric and neonatal emergencies as well.
  • CALS maintains a rural focus: the program is designed for health care teams working in rural areas and other settings in which the full complement of resources such as specialists and specialized equipment may not be readily available.
  • CALS adheres to the team approach to training and real-world practice. Some life support courses train just part of the team; others provide uniform training to all participants, regardless of scope of practice. CALS brings together teams of physicians, nurses, PAs, NPs and paramedics and provides practical training that includes development of the team itself.
  • CALS advocates a systems-based approach that links health care institutions and providers at all levels and stages of emergency care in a continuous network of support for the victim of a serious illness or injury.

“The primary focus of CALS curriculum is to train medical teams in rural areas to anticipate, recognize and treat life-threatening emergencies,” said Dr. Steven Davis. “Because of the dedication of the entire staff here at Tri-County I am absolutely confident that our team is prepared to respond to any number of medical emergencies that may arise.”

The first CALS program was developed in Minnesota in 1996 as a result of collaboration among emergency medicine and family physicians, rural practitioners and academic specialists, and nurses, nurse practitioners, PA’s, paramedics and others. The CALS program has gone on to be adopted in much of the United States, in parts of Canada and throughout the world.

State Trauma Advisory Councils of both Minnesota and Wisconsin have approved CALS as one of the training programs that can be used to qualify hospitals for specified levels of trauma designation. CALS has been selected by the US State Department as the preferred source of medical training for our US Embassies around the world.

For more information, contact Deb Zacharias, ER Nursing Supervisor, at (218) 632-8767.


Tri-County Health Care is a private, not-for-profit health care system located in Wadena, MN. Offering a complete spectrum of care services from minimally invasive surgery and cancer care, to leading edge diagnostic imaging capabilities, obstetrics, and rehabilitation services, Tri-County operates a 25-bed hospital and medical clinic in the city of Wadena. It also operates six satellite clinics and three physical therapy clinics throughout Todd, Wadena, and Ottertail Counties. Satellite clinic locations include Henning, Bertha, Ottertail, Sebeka, Verndale, and Baxter.



Keeping Rural Trauma Care Strong

Keeping Rural Trauma Care Strong

by Chad Cooper | Posted: Friday, October 14, 2016 5:00 am

A heart attack strikes. A motor vehicle accident causes serious, life-threatening injuries. A child’s airway becomes blocked.

We depend on hospitals to offer life-saving care every day. In a rural area where distance to the nearest hospital is typically much greater than in a metro area, getting advanced life support care in a timely manner is more critical than ever.

At Riverwood Healthcare Center, our emergency department staff trains intensively and regularly to deliver comprehensive advanced life support. In 2008, Riverwood Healthcare Center became the third hospital in Minnesota to receive the prestigious certification of excellence in emergency care – the CALS Hospital designation from the Comprehensive Advanced Life Support Program. In mid-September at our annual gala event in Aitkin, two representatives of the CALS program presented  Riverwood with a plaque of recertification as a CALS Hospital.

CALS is a national program designed to provide lifesaving emergency medical education for rural health care providers. Developed in Minnesota in 1996 as a result of collaboration among emergency medicine physicians, family physicians, rural practitioners, academic specialists, nurses, nurse practitioners, physician assistants and paramedics, CALS is now one of the premier education programs for rural healthcare providers.  Riverwood’s emergency department medical director, Dr. James Harris, a CALS instructor, played a leadership role in the development of the CALS program.

Each year, Riverwood offers CALS training for its own healthcare providers and nurses, as well as area hospitals and emergency medical technicians, with about 30 participating in each class. The CALS classes offer an opportunity to learn and practice life-saving skills for the care of critically ill or injured patients with a wide range of emergencies. Course content includes trauma, cardiac, stroke, pediatrics, obstetrics, neonatal, airway compromise and sepsis.

Participants report that taking the CALS course enhances their skills, confidence and teamwork abilities, leaving them better prepared to treat critically ill or injured patients. CALS recertification for healthcare professionals is required every four years. Between courses, CALS offers health care providers the ability to refresh their skills and update their emergency medical knowledge.

Riverwood’s emergency department trauma team is made up of one emergency care  physician and two to three registered nurses, an x-ray technician, a lab technician and a certified registered nurse anesthetist – all available 24/7. CALS and other ongoing training ensures that all who are staffing our emergency room are well qualified and prepared to respond to critically ill or injured patients, including those suffering from heart attack or stroke.

Riverwood has a Level 1 Heart Attack Hospital Program, a stroke-ready designation, and participates in the Minnesota  Department of Health statewide trauma program with a Level III Trauma designation. In 2006, Riverwood became the first rural hospital in Minnesota to be approved for a trauma care designation.

Since 2004, we have partnered with the Minneapolis Heart Institute and Abbott Northwestern Hospital in Minneapolis on a treatment protocol for heart attack patients. Within 30 minutes of arrival at Riverwood, our emergency staff is specially trained to quickly assess and identify the needs of cardiac patients and transfer those in need of angioplasty surgery to Abbott Northwestern via medical airlift service.

The stroke-ready designation means that our hospital is equipped to evaluate, stabilize and provide emergency care to patients with acute stroke symptoms. We always have a stroke team available who can administer a key clot-dissolving drug called tPA.

In the event of a critical illness or injury, remember that time is critical in obtaining emergency medical care.  Stress the importance of calling 9-1-1 immediately with all your family members, including children. The paramedics who arrive on scene can take immediate actions to stabilize patients for transport to the hospital.

Riverwood is committed to delivering excellent emergency care for patients in our rural service area. Providing our staff with comprehensive education through the CALS program helps build their advanced life support skills and keeps local trauma care strong.

Chad Cooper is the chief executive officer for Riverwood Healthcare Center, overseeing a 25-bed hospital in Aitkin and three clinics in Aitkin, Garrison and McGregor.

CALS Returned to Cap Haitien, Haiti — August 2016

Haiti Medical Education Project continues to partner with the CALS (Comprehensive Advanced Life Support) Global Program and partners in Haiti to train physicians and nurses in emergency medical training. Twenty-one (21) new CALS Providers and 6 new CALS Instructors were trained in Cap Haitien, Haiti August 15-19, 2016.

The CALS Essentials course teaches the CALS universal team approach to managing life-threatening injury and illness. CALS E providers learn to work together in a systematic way during cardiac, trauma, pediatric, obstetric and adult medical emergencies.

CALS Essentials (CALS-e) was designed for physicians and nurses in places like Haiti that have limited resources.

Full report

Rutgers researchers debunk ‘five-second rule’: Eating food off the floor isn’t safe

Rutgers Biomedical and Health Sciences News, 09/10/2016

Sometimes bacteria can transfer in less than a second.
Rutgers researchers have disproven the widely accepted notion that it’s okay to scoop up food and eat it within a “safe” five–second window. Donald Schaffner, professor and extension specialist in food science, found that moisture, type of surface and contact time all contribute to cross–contamination. In some instances, the transfer begins in less than one second. Their findings appeared online in the journal Applied and Environmental Microbiology. The researchers tested four surfaces – stainless steel, ceramic tile, wood and carpet – and four different foods (watermelon, bread, bread and butter, and gummy candy). They also looked at four different contact times – less than one second, five, 30 and 300 seconds. They used two media – tryptic soy broth or peptone buffer – to grow Enterobacter aerogenes, a nonpathogenic “cousin” of Salmonella naturally occurring in the human digestive system. Transfer scenarios were evaluated for each surface type, food type, contact time and bacterial prep; surfaces were inoculated with bacteria and allowed to completely dry before food samples were dropped and left to remain for specified periods. All totaled 128 scenarios were replicated 20 times each, yielding 2,560 measurements. Post–transfer surface and food samples were analyzed for contamination. Not surprisingly, watermelon had the most contamination, gummy candy the least. “Transfer of bacteria from surfaces to food appears to be affected most by moisture,” Schaffner said. “Bacteria don’t have legs, they move with the moisture, and the wetter the food, the higher the risk of transfer. Also, longer food contact times usually result in the transfer of more bacteria from each surface to food.” Perhaps unexpectedly, carpet has very low transfer rates compared with those of tile and stainless steel, whereas transfer from wood is more variable. So while the researchers demonstrate that the five–second rule is “real” in the sense that longer contact time results in more bacterial transfer, it also shows other factors, including the nature of the food and the surface it falls on, are of equal or greater importance. “The five–second rule is a significant oversimplification of what actually happens when bacteria transfer from a surface to food,” Schaffner said. “Bacteria can contaminate instantaneously.”