PCMH Emergency Services

The Emergency Room and Emergency Medical Services currently work together to ensure that patients with Stroke or Heart Attack get care which is begun quickly and communicated readily. If a patient calls for an ambulance and is suspected of having a heart attack, the EMS can do the EKG and send it directly to the ER to be read by the ER physician. The EMS also start the treatment with initiation of an IV and drawing blood to be sent to lab as well as giving oxygen, nitroglycerine and aspirin. The rapid recognition and treatment of patients experiencing symptoms of a heart attack saves time, which saves heart muscle.

Patients who call the ambulance or present to the Emergency Room with signs of a Stroke will be cared for by a team which is trained in stroke care. The Emergency Room and Emergency Medical personnel have been trained in recognizing the symptoms of a stroke, leading to a decrease in time from arrival to treatment. Currently, PCMH has the ability to transmit CT scans of the brain to select stroke centers to be evaluated by a neurologist immediately for an expert consult. This expert consult can suggest treatment options up to and including TPA, often referred to as the "clot buster" to treat strokes-which can be given at PCMH. Patients who have bleeding in the brain can also benefit from the early recognition and treatment of symptoms such as elevated blood pressure and high clotting times.

PCMH ER and EMS staff have worked hard to develop protocols and treatment options which maximize the chance for early recognition and treatment of these potentially deadly conditions.

PCMH Emergency Medical Services

Two ambulances are staffed around the clock to serve the emergency needs that arise throughout Pike County, MO. One of the ambulances is located at PCMH and has the east side of Pike County as a primary responsibility. The second ambulance is at the satellite EMS base in Bowling Green and this unit primarily serves the western side of the county.

• PCMH EMS staff includes 7 full time paramedics and 7 full time emergency medical technicians.
• PCMH EMS is licensed through the state of Missouri as an Advanced Life Support (ALS) and Basic Life Support (BLS) service.

Contacting the PCMH Emergency Department is gained by phoning 9-1-1. The call is routed directly to PCMH ER through the 9-1-1 centers in Bowling Green and Louisiana.

The Bowling Green Clinic and the Louisiana Clinic are primary medical clinics owned and operated by Pike County Memorial Hospital. The clinics offer the residents of Pike County the following services: Family Medicine, General Surgery, Orthopedics, Pediatrics, Rheumatology, Neurology, Allergy, Podiatry and Internal Medicine. PCMH clinics offer a convenient health care option to patients and deliver sophisticated medical care close to home.

Our Mission

It is the goal of the Physical Therapy Department at Pike County Memorial Hospital to provide the highest quality patient care in order to achieve the greatest outcomes. We strive to ensure that our patients achieve their goals and the goals of the physicians (the patient, physician, and physical therapist). We offer many different services within our department including:

• Orthopedic Rehabilitation
• Pre- and Post- Surgical Rehabilitation
• Sports Medicine
• Cardiac Rehabilitation
• Work Hardening
• Functional Capacity Evaluations
• Functional Job Analysis
• Pre-work Screenings
• Spinal Rehabilitation with a Focus on Function and Posture
• Wound Care
• Wellness Programs
• Outreach Services and Community Education

Our Facility

As part of the overall renovation of Pike County Memorial Hospital, the Physical Therapy Department has recently moved to a new space within the hospital. We now have new, state-of-the-art equipment including force gauges for work hardening and functional capacity evaluations, and a "Functional Squat" machine for functional, objective measurements and training of the lower extremities (including printed reports).

Why Pike County Memorial Hospital Physical Therapy?

We strive for excellence in our care. Patients are scheduled so that our patient to therapist ratio is very low and allows for more one-on-one care, which produces the best outcomes. Goals are set together with the patient to ensure appropriate outcomes-oriented interventions. Patients are educated about their condition and are encouraged to ask questions regarding their rehabilitation. In addition, lines of communication with physicians are kept open in order to ensure that we administer the treatment and achieve the outcomes desired by the physician.

Isernhagen Work Systems Work Injury Prevention and Management Program:

We Offer a continuum of care for the injured worker through comprehensive intervention including job-site analyses, pre-work screening, functional capacity evaluations, and work conditioning/work hardening. The functional capacity evaluations are based on Isernhagen Work Systems, an internationally recognized program based on a progressive kinesiophysical assessment of function. Objective data validated through research is available, which provides sound objective guidelines for when and in what capacity a worker can return to the workplace. This data is very specific to the worker and his/her abilities and includes information regarding frequency, weight capacity and physical restrictions of each task assessed.

Monitored Rehab Systems - Functional Squat

The Functional Squat machine utilizes interactive activities to develop and train the neuromuscular system. Sensors are mounted on the functional squat machine which is interfaced to a computer and allows for real-time training and testing. The computer screen allows the patient to participate in interactive video "games" that assist the patient in achieving the ultimate strength, control, and coordination of the lower extremity muscles. The use of the computer screen is intended to give the patient automatic feedback, which then activates various muscles and aspects of the nervous system. This activation is essential in order to produce the best outcomes with rehabilitation. The Functional Squat machine is another tool that has been added to our department to assist in the delivery of a very comprehensive rehabilitation program.

Keith Oakes

Keith Oakes, MPT Staff Physical Therapist

Keith Oakes, MPT, Director of Physical Therapy, graduated in 1999 from Rockhurst University in Kansas City with a bachelor's degree in biology and in 2001 with a master's degree in physical therapy. He has worked in an outpatient orthopedic setting since 2001. Keith is experienced in treating a wide variety of musculoskeletal disorders and is knowledgeable in post operative rehabilitation. Additional education includes training in manual therapy throughout the North American Institute of Orthopedic Manual Therapy.

Stacey Meers

Stacey Meers, PT Staff Physical Therapist

Stacey Meers graduated in 1991 from Maryville University in St. Louis with a Bachelor of Science in Physical Therapy. Her experience includes 16 years of outpatient orthopedic physical therapy with an emphasis in sports medicine and spinal rehabilitation. She has extensive advanced education in "The McKenzie Method" spine rehabilitation. She has been employed with Pike County Memorial Hospital since 1997.

Lindsey Krieg

Lindsey Krieg, MPT Staff Physical Therapist

Lindsey Krieg is a 2009 graduate of Truman State University with a Bachelor of Science degree in Exercise Science. She completed a Doctorate of Physical Therapy at the University of South Alabama in 2012. Lindsey has experience in outpatient orthopedic physical therapy since graduating. She has been employed with Pike County Memorial Hospital since April 2013.

Brett Dockery

Brett Dockery, ATC Certified Athletic Trainer

Brett graduated in 2008 from Truman State University with a Bachelor of Science degree in Exercise Science with focus on an Athletic Training Pattern. She has experience in the sports medicine field having spent four years working and traveling with various Division II collegiate athletic teams, including football, basketball, baseball, softball, track and cross country.

Angela Gardner

Angela Gardner, PT, DPT

Angela Gardner, DPT, MBA, graduated in 2000 from Maryville University in St. Louis with a Bachelor of Science in Physical Therapy. Her practice is concentrated in outpatient orthopedics with experience also in home health, acute care and long-term care. She received a Masters of Business Administration degree from Lindenwood University in 2005 and a Doctorate of Physical Therapy Degree from Washington University in St. Louis in 2007.

Pat Cuppy

Patrick Cuppy, DPT

Pat Cuppy, DPT, earned his Doctorate of Physical Therapy in 2011 and his Bachelor’s of Science in Health Studies, in 2009 from Maryville University. He joined the Pike County Memorial Hospital team in March 2012.

Pulmonary Function Testing

• Screening Spirometry
• Pre / Post Spirometry
• Lung Volumes
• Diffusing Capacity
• Airway Resistance

Oximetry

• Rest
• Exercise
• Overnight Readings

Other Testing

• Treadmill Stress Test
• EKG's
• Cardiac Event Monitor
• Holter Monitor
• EEG
• Stress Echocardiogram
• Nuclear Stress Test

Cardiology and Pulmonary Consultation / Evaluation Services

Evaluations are offered to in-patients and out-patients. Clinic services are available through physician referral as well as self-referral. Services are provided by physicians who are specially trained in cardiology and pulmonary skills and diagnostic services.

• Alexander M. Bollis, MD
• Arun Vankat, MD
• Howard Goldberg, MD
• Manojpal Dahuja, MD
• Natalie Bryant, RN, BC, ACNP

Cardiac Rehabilitation

PCMH offers a comprehensive, long-term program including medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This is an out-patient medically monitored program that is typically initiated 1 - 3 weeks after hospital discharge and provides appropriate electrocardiograhic information.Cardiac Rehabilitation Benefits Include:

• Increased Exercise Tolerance
• Symptom Improvement
• Blood Lipid Level Improvement
• Improved Blood Pressure Readings

Medicare covers Cardiac Rehabilitation exercise programs for patients who meet the following criteria:

• Stable angina pectoris; or
• Coronary artery bypass surgery; or
• Have a documented diagnosis of acute myocardial infarction within the past 12 months; or
• Have had a heart valve repair / replacement ; or
• Have had percutaneous transluminal coronary angioplasty or coronary stenting; or
• Have had a heart or heart-lung transplant.

Sleep Lab Services

Pike County Memorial Hospital provides sleep lab services in conjunction with Sleep Diagnostic Services. Pike County Memorial Hospitals Pulmonary physicians and Cardiopulmonary Department coordinate a sleep lab to help determine proper treatment for sleep disorder problems.

Obstructive sleep apnea and snoring (OSAS) and the resulting daytime sleepiness is one of the leading casuses of many automotive, agricultural and industrial accidents. If you have moderate to severe OSAS you are twice as likely to be involved in an automobile accident and are more likely to develop hypertension, coronary heart disease, myocardial infarction, pulomonary hypertension, congestive heart failure, stroke, neuropyschiatric problems, cognitive impairment and sexual dysfunction. Children and adolescents with OSAS are often misdiagnosed with Attention Deficit Disorders as they are usually underweight and are hyperactive.

Fortunately, proper treatment of sleep related disorders can prevent or reverse these debilitating conditions.

Are you at risk?

Vascular Clinic

Dr. Arun Venkat, MD along with a trained staff of technicians provides a Vascular Clinic on a monthly basis through the PCMH Cardiopulmonary and Radiology Departments.

The ability for modern medicine to analyze, diagnose and control vascular disease is greater than ever before. Vascular diseases are very common, especially as people age Many people have vascular diseases and aren't aware, because symptoms are rare in the early stages. People with risk factors or any signs of vascular disease, should be evaluated by a physician.

Are you at risk?

To contact the PCMH Cardiopulmonary Department call: (573) 754-5531, ext. 218

Diagnostic Imaging Services:

The Pike County Memorial Hospital Radiology department uses the most innovative technology. We use speech recognition for dictating x-ray results. Speech recognition converts spoken words to text. This technology offers real-time reporting. This report appears instantly, which speeds the time to produce critical results. This quick reporting increases productivity, which allows for faster turnaround time of reports and reduces waiting times for patients and referring physicians.

• PCMH Radiology services are located on the first floor of the hospital.
• Licensed by the Joint Commission on Accreditation of Healthcare Organizations.
• Additional accreditation awarded by the American College of Radiology.
• Patient care is handled by an experienced and caring team of technologists and board certified radiologists.
• Safe and efficient testing combined with the latest technology and expert interpretation by experienced physician specialists provides your doctor with a prompt report on test results.

Ultrasound

This technique uses high frequency sound waves that reflect off a body structure to form an image. Ultrasound does not expose a patient to radiation. The sound waves create an echo that allows a technician to interpret the size, distance and uniformity of an organ. These sound wave echoes are recorded and displayed on a monitor.

• Dress comfortably - you may be asked to change into a gown
• Pelvic Ultrasound - a full bladder is required (drink 32 oz. of water one hour prior to exam
• Abdominal / Gallbladder Ultrasound - no food or drink after midnight the night before this procedure, no smoking or gum chewing.
• Renal Ultrasound - a full bladder is needed - patient should be well hydrated 24 hours prior to this procedure.

DEXA, bone densitometry:

Bone densitometry has become the standard for measuring the density of bones and is the test for evaluating osteoporosis. The measurement of bone minerals is closely related to bone strength and the potential for bone fractures.

Factors that bring about the need for DEXA, bone densitometry:

• Menopause lowers estrogen levels, thus increasing the rate of bone reabsorption.
• Testosterone levels dropping in men due to the aging process, creating an increased risk of bone reabsorbtion.

Dress comfortably - apparel should have no metal buttons, buckles or zippers.

Mammography

A mammogram is an X-ray of the breasts using low-dose radiation. This is a procedure that should be done by women annually beginning at age 40. The role of mammography is to identify breast cancer at the earliest stage.

Preparation: Dress comfortably; there will be the need to undress above the waist.

Mammography patients should not use powders, deodorants, ointments or creams prior to this procedure. If possible do not schedule a mammogram just before or during your menstrual period.

CT-Computed Tomography

A CT (Computed Tomography), sometimes called a CAT scan, uses special x-ray equipment to obtain many images from different angles around the body. CT imaging is extremely helpful in analyzing and diagnosing because it can show several types of tissues - lung, bone, soft tissue and blood vessels. A CT scan is one of the best tools for studying the chest and abdomen.

Preparation: Dress comfortably; avoid clothing with snaps or zippers. Patients may be asked to wear a gown. Some CT exams require the patient to drink a contrast material 1-2 hours prior to the exam.

MRI - Magnetic Resonance Imaging

An MRI or Magnetic Resonance Imaging is a non-invasive and painless procedure in which radio waves and powerful magnets linked to a computer are used to create detailed pictures of internal organs and tissues without the use of radiation.

Preparation: Dress comfortably. Patients will be asked to remove jewelry, hairpins, hearing aids, glasses and removable dental work.

Fluoroscopy

Fluoroscopy studies use a special x-ray unit with a monitor attached that allows the physician to see the movement of the intestines, stomach, or esophagus. Prior to the procedure the patient drinks a barium solution that assists the physician in the analysis of the fluoroscopy. Fluoroscopy studies through PCMH include the Upper GI, Barium Enema and Barium Swallow.

General Radiography

General Radiography examinations visualize different body areas including;

• Chest
• Abdomen
• Skull / Facial Bones
• Spine
• Pelvis
• Extremities (Arms and Legs)

Preparation: Dress comfortably; avoid clothing with snaps and zippers, patients may be asked to wear a gown.

Digital Imaging

Utilizing the Picture Archiving Communication System (PACS), radiology images are captured digitally and can be accessed through a secure online network. Digital images can be manipulated for a closer and better look at particular spot allowing both the radiologist and physician to better assess what is being viewed.

The Surgical Team

The Surgical Team provides economical and cost effective patient care without compromising quality. We maintain our skills with scheduled in-services, seminars, growth and development and clinical competencies. Our team strives for customer satisfaction by delivering professional and friendly care to patients. Our dynamic and technical services include general, laparoscopic surgery, orthopedics, podiatry, ophthalmology, and endoscopy surgical procedures. Anesthesia also provides pain management through the administration of Epidural Steroid Injections. Outpatient surgery procedures, which do not require an overnight stay, enable patients to be in and out of the hospital within hours.

Surgical Services

Surgical services at Pike County Memorial Hospital are outlined in the sections listed below covering Preoperative and Ambulatory Care procedures, Intraoperative procedures and Post Operative procedures.
Preoperative & Ambulatory Care Unit
Preoperative & Ambulatory Care Unit provides pre-operative care and non-surgical procedures. Nonsurgical procedures include, but are not limited to: epidural steroid injections, port-a-cath flushes, therapeutic phlebotomy, blood transfusions, intravaneous medication infusions, medication injection, abdominal paracentesis.
Intraoperative Procedures
Intraoperative Procedures are performed in one of our two major operating rooms, and one minor procedure room within the surgical area. Included, but not limited to:

• General/Laparoscopic
• Gynecology
• Podiatry
• Ophthalmology - Removal of cataracts
• Orthopedics - Knee Arthroscopy, Carpal Tunnel, Trigger Finger
• Urology
• Endoscopy

Laboratory

Pike County Memorial Hospital Laboratory provides quality laboratory collection and testing. Laboratory testing is used to assist your physician in determining your health, diagnosis and treatment.

• PCMH lab is staffed 24 hours a day
• PCMH has working relationships with specialty labs to be used for unusual testing needs.
• Outpatient lab collections are available on a walk-in basis with a lab request.
• Lab tests can be performed on blood, urine, stool or other body fluids.
• Lab results may be obtained through your health care provider or by contacting the PCMH Medical Records Department.

Pike County Memorial Hospital's Laboratory is accredited by the College of American Pathologists.

Results of testing are sent directly to your doctor and are kept on file in our Laboratory Information system and your Medical Record. If you are admitted to Pike County Memorial Hospital, your doctor will have access to all of your previous test results.

Regulations prohibit any release of laboratory results to an individual other than a health care provider. Contact your health care provider or the Hospital's Medical Records Department to obtain copies of your results.

To contact the PCMH Laboratory call: (573) 754-5531, ext. 137