How to prevent sepsis: 5 actions you can take to reduce your risk – Mission Health Blog

What is sepsis?

Sepsis is a potentially life-threatening and life-altering system response to infection, Dr. Guy explains. “It causes an exaggerated immune response that can end up damaging key organs like the heart, lungs and kidneys, and potentially lead to death.”

He compares sepsis to an ember that sparks from a small campfire, suddenly threatening the whole forest. If it isn’t treated early, sepsis can progress into septic shock. Patients may need medications to support their blood pressure and a ventilator to breathe. “Their kidneys are at risk, and they could go into kidney failure and need dialysis,” says Dr. Guy. “These are the folks who are at highest risk of losing their lives.”

Sepsis can affect anyone, but taking action to reduce the risk of infection can help prevent sepsis before symptoms begin.

Sepsis is more common than one might think. It can happen in response to any kind of infection — a wound, an illness or even poor dental care. According to the Centers for Disease Control and Prevention, more than 1.7 million adults in the U.S. develop sepsis each year, and nearly 270,000 people die as a result. Sepsis is a leading cause of death in hospitals, but most of the infections that lead to sepsis start outside of hospitals.

Infections caused by bacteria are most likely to cause sepsis. This includes infections in the lungs (pneumonia), urinary tract, skin or digestive tract. Viral infections, including the flu and COVID-19, can also lead to sepsis. In fact, the inflammatory cytokine storm that happens in severe COVID-19 is sepsis, Dr. Guy says. He adds that viral sepsis can be especially hard to treat.

Recognizing the signs

The key to successful treatment for sepsis is timely recognition and prompt use of antibiotics and IV fluids. “The chance of death goes up with every hour of delay,” says Dr. Guy.

The initial signs of sepsis, including fever, chills, rapid heartbeat, lower blood pressure and difficulty breathing, can be easy to confuse with other conditions. One of the most common symptoms is mental confusion, which can look like a stroke, a neurological condition or a diabetic event. This can make the condition difficult to recognize and diagnose.

Dr. Guy and his Care Process Design team partnered with HCA Healthcare’s Data Science and Information Technology teams to develop an award-winning way of recognizing sepsis early. It’s known as Sepsis Prediction and Optimization of Therapy (SPOT). SPOT continuously monitors vital signs, lab results, nursing reports and other data to detect often subtle changes in a patient’s condition and alert clinicians to signs of sepsis, as much as six hours earlier than previously, so they can take appropriate action. This system speeds treatment and saves patients’ lives.
While these advancements are making a difference for patients, it’s important to know how to prevent sepsis, as it’s better to keep it from occurring than to treat it after symptoms appear.

Who’s at risk?

Anyone can develop sepsis from any infection. While there’s no way to predict who will develop sepsis and who won’t, the type of infection, its severity and how long it goes untreated can all play a role in the risk of sepsis.

Some people are at higher risk of developing sepsis, including people who have weakened immune systems, and people with cancer, or kidney or liver disease. Diabetes also raises the risk, especially if it is not managed well. People who are over 65 and children younger than 1 also have an increased risk of developing sepsis.

Some medications can lead to a higher sepsis risk, Dr. Guy points out. Taking antibiotics too often or not finishing a course of antibiotics can make you more likely to get an infection that doesn’t respond to antibiotics. It’s also important to note that antibiotics don’t help with viruses and aren’t always needed for sinus infections or ear infections. Taking steroid medications, like prednisone or hydrocortisone, suppresses the immune system and may mask the early signs of infection, delaying treatment.

How to prevent sepsis

Remember: Sepsis can happen to anyone in response to any infection. To protect yourself and your loved ones, take these five critical steps:

1. Stay up to date on vaccinations. This includes COVID-19, the flu, chickenpox, pneumonia and other vaccines recommended for your age and health conditions. Vaccines can prevent or limit the severity of these conditions and reduce their potential to lead to sepsis. “There’s clearly a survival advantage to being vaccinated,” says Dr. Guy.

2. Manage chronic illnesses. Keeping blood pressure, diabetes, kidney disease and other conditions under control helps keep your body strong and able to fight off infections. A healthy diet also feeds your immune system and helps it function properly. Seeing your doctor regularly and seeking care for chronic conditions can reduce your risk of sepsis as well.
3. Practice good hygiene. Wash your hands using soap and water, or use hand sanitizer, especially after using the bathroom or blowing your nose, before eating, and after exposure to large groups or public places. Keep cuts clean and covered until they are healed.

4. Know the warning signs of sepsis. These include high heart rate, low blood pressure, fever, chills, confusion, shortness of breath, extreme pain and clammy skin. Sometimes people feel faint or dizzy.

5. Seek care early. Sepsis is a medical emergency. If you experience any of the warning signs, seek care immediately, especially if you have any of the risk factors described above.

Dr. Guy is proud of HCA Healthcare’s SPOT system and its track record of detecting and treating sepsis early and effectively. “Our efforts have resulted in a dramatic improvement in sepsis survival in our hospitals,” he says. “I’m so excited about the lives we’ve saved.”

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Types of suicide prevention: What they are and how to get help – Mission Health Blog

What are the warning signs of suicidal behavior?

There are several warning signs that someone may be considering suicide.

“The first two are helplessness and hopelessness, as if their life doesn’t have meaning, or what they do doesn’t make a difference,” says Dr. Frank Drummond, national medical director for Behavioral Health at HCA Healthcare. “You might hear them make statements like, ‘No one would care if I wasn’t here anymore,’ or ‘What’s the point of going to work,’ or ‘What’s the point of taking a shower?’”

Access to care, including mental health hotlines or therapy, is important for suicide prevention.

However, suicidality — the risk of suicide, which is usually indicated by suicidal ideation or intent — can also be a symptom of depression, Dr. Drummond says. Other symptoms of depression can include:

  • Increased or decreased sleep
  • Loss of interest in usual activities
  • Crying spells
  • Withdrawal from loved ones and community

Who is at risk?

Suicide rates vary based on a number of different factors, including age and ethnicity, Dr. Drummond says. Where you live can also play a role in determining your risk. For instance, people who live in the Southeast have a lower rate of suicide than people who live in the Midwest. Non-Hispanic American Indians or Alaska Natives and non-Hispanic white populations have higher rates of suicide, as do people who live in rural areas. Social determinants of health, which are the nonmedical factors that affect health outcomes, can also impact suicide risk. These can include homelessness, unemployment or financial distress.

In addition to depression, mental health conditions such as substance use problems, bipolar disorder or anxiety disorders can increase suicide risk, according to the American Foundation for Suicide Prevention. Previous suicide attempts or a family history of suicide can also increase risk.

Types of suicide prevention

Suicide prevention can take a number of different forms, focusing on economic, social or medical factors, says Dr. Drummond. “Strengthening economic supports is important in communities,” he notes. “A big determinant is homelessness, so a focus on the homeless population and what services — including housing stabilization policies — are available to them can really change the rates of suicide.”

Another important factor is access to care, including awareness of suicide or mental health hotlines and how to access them. For example, anyone in the United States can now call or text 988 to reach the Suicide & Crisis Lifeline, which offers free, confidential suicide and crisis counseling. There is also a live chat feature at

“Points of access to care tend to be emergency rooms in a lot of cases,” Dr. Drummond says. “These emergency rooms need to make sure they have all the resources they need to help someone who’s having thoughts of suicide, including the appropriate level of assessment needed at the time of crisis and the right type of treatment.”

Peer support, after-care programs, and instruction in coping and problem-solving can also help with suicide prevention.

How to support a loved one who is having suicidal thoughts

While it can be uncomfortable to talk about suicide and suicidal thoughts, contrary to some beliefs, talking about suicide does not increase the chances that someone will commit suicide. It’s important to understand that no one who is having these feelings wants to feel like that, Dr. Drummond says, and it is OK to ask them directly if they are having any thoughts about hurting themselves.

“If you want to be a little less direct, ‘Have you had any thoughts of hopelessness?’ can be a lead-in question, or ‘You seem different, I notice you’re not socializing as much, has something changed? Are you feeling OK?’ can be an indirect lead-in, if that feels more comfortable,” Dr. Drummond says.

Loved ones should always seek help if someone they care about is having thoughts of suicide, but the appropriate level of help can vary. “That might be an emergency room if the person doesn’t feel safe, or if the situation doesn’t seem safe, including when there’s access to firearms, or a lack of family or connections that would reinforce or strengthen their ability to get through this episode,” Dr. Drummond says. “If the person does seem safe or doesn’t seem at risk of hurting themselves, definitely seeking out psychotherapy, supportive therapy or at least talking to someone about what kind of support might help.”

If you are the caregiver or a loved one of someone who is having suicidal thoughts, it’s equally important to make sure you are taking care of yourself and your own mental health. “Talking about the experience and having a safe person to talk to about what it’s been like is important,” Dr. Drummond says. “It’s not uncommon for someone to seek out therapy for themselves because of the experience that they’ve had caring for a loved one with any mental illness.”

Suicidal thoughts are a symptom of an underlying problem, but they can improve over time with support and treatment. Recognizing the warning signs in yourself or a loved one is an important first step toward prevention, but “the bottom line is to talk about it,” according to Dr. Drummond.

If you or someone you know is in crisis, contact the 988 Suicide & Crisis Lifeline, or call 911 in the event of an emergency.

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When to visit the emergency room for an allergic reaction – Mission Health Blog

What are the different types of allergic reactions?

“An allergic reaction is a hypersensitive reaction that your immune system has to a certain substance,” says Dr. Josephin Mathai, medical director of the emergency department at HCA Florida St. Lucie Hospital. “Every person can have a different trigger, and the level of reaction you have is different for everybody.”

Allergic reactions can range from mild to severe. With severe allergic reactions, it’s important to administer epinephrine and go to an emergency room.

Shellfish is the most common allergen for adults, followed by peanuts and tree nuts, according to the Asthma and Allergy Foundation of America (AAFA). For children, the most common allergens are milk, eggs and peanuts. Some people may have only a mild reaction if they are exposed to an allergen, while others may have a more severe reaction.

There are four main types of allergic reactions:

1. Anaphylactic: Symptoms appear within a few seconds to minutes.
2. Cytotoxic: Symptoms appear within a few minutes to hours.
3. Immune complex: Symptoms set in after several hours.
4. Cell mediated (delayed): Symptoms set in after several hours or days.

What are the symptoms of an allergic reaction?

The symptoms of an allergic reaction vary and typically develop within a few minutes of exposure to an allergen. Potential symptoms include:

  • Sneezing and a blocked, itchy or runny nose
  • Itchy, red and watering eyes
  • Rash (hives)
  • Wheezing, shortness of breath or cough
  • Nausea or vomiting
  • Diarrhea
  • Abdominal pain or cramping

For many people, the symptoms of an allergic reaction will go away within a few hours or days with either Benadryl or a combination of Benadryl and steroids. But having more than one of these symptoms at a time can be cause for concern. “Whenever there is multi-symptom involvement, like you have a rash and you’re vomiting, or you have a rash and you start to have chest pain or dizziness, that always points toward a much more significant reaction,” Dr. Mathai says.

When to go to the ER for an allergic reaction

Many allergic reactions are mild and won’t require a trip to the emergency room. “Allergic reactions are kind of like a spectrum,” Dr. Mathai says. “If you have a simple rash, and you’re itching, you can probably go to urgent care. But if you have a rash and vomiting, you should go to the ER.”

An anaphylactic allergic reaction can be life-threatening and requires immediate medical treatment. If you or someone else is experiencing an anaphylactic allergic reaction, the first course of action should be to administer epinephrine (via an EpiPen) if it is available. Epinephrine helps bring blood to your vessels and opens up your airways if you are having trouble breathing. If an EpiPen is not available, go to an ER right away. You will still need to call 911 or go to the ER after administering epinephrine because one injection may not be enough, and you may have a delayed reaction, according to Dr. Mathai.

“Anytime your breathing is compromised, or you feel like your face or tongue are starting to swell up, or you start to have stridor — that squeaky kind of breathing — you need to make sure you’re calling 911 and getting to the nearest emergency room,” she adds. If you’re having trouble breathing, an ER is your best bet because urgent care doesn’t have the capacity to intubate, which is when a tube is inserted through the mouth or nose and then down into the windpipe.

Another sign that you should go to the ER for an allergic reaction is when it comes with gastrointestinal issues. “GI symptoms, which are vomiting or diarrhea, can be part of anaphylaxis and part of the anaphylactic shock reaction,” Dr. Mathai says. “If you’re experiencing that along with a rash, you need to go the emergency room. That’s more than one system involvement.”

How to avoid an allergic reaction

If you know what your allergy triggers are, it is important to avoid them as much as possible to prevent an allergic reaction. You should also be sure to carry an EpiPen just in case you are exposed to an allergen and have a severe reaction. However, many patients who go to an ER don’t know what their triggers are, so it can be difficult for doctors to pinpoint the cause of the reaction. “It could be anything from detergents to soap to something you ate or something environmental,” Dr. Mathai says. “But if you had an allergic reaction that was significant enough for you to come to the emergency room, then you need to make sure you see an allergist and get a full panel of tests, and then you can know what your triggers are.”

Knowing when to go to the ER for an allergic reaction can save your life, or the life of a loved one. If you do visit the ER for an allergic reaction, expect to stay there for at least four hours to make sure your symptoms are under control.

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The Great 100 Nurses 2022 – Mission Health Blog

A special congratulations to the following Mission Health nurses, for being recognized as part of the 2022 Great 100 nurses for North Carolina. The award exists to recognize and honor Registered Nurses in North Carolina for their commitment to excellence and to promote a positive image of the nursing profession.

  • Teressa Neill, MSN, RN
    Mission Health- Blue Ridge Regional Hospital
    At the beginning of Covid, team members came together to pray for staff, facility, community and healthcare family across the world. Blue Ridge Regional Hospital did not waiver in its support for patients and families. Teressa’s slogan was “no one celebrates alone and no one dies alone,” and nurses were encouraged to call her day or night to sit with dying patients. This slogan was adopted by every member of the team.Teressa event assisting staff in taking a patient “back to Italy” for their last anniversary, which included checkered tablecloths, Italian dinner music, pizza and candlelight.This leader advocated and supported Nursing Professional Governance Council for the health system since the inception. Teressa believes that nurses must have a voice, and she supports their growth professionally by demonstrating how they can own their practice. This is also shown through the national workplace excellence designation that she championed.
  • Betsy Powell, MSN, FNP-C, COHN-S, CEAS, BBA
    Mission Health- Mission WorkWell
    This excellent nurse exhibits strength of character through personal accountability and by supporting the NC Nurse Practice Act. She held providers, leaders, teams and herself accountable for practice during the pandemic at a time when ?ow of information changed rapidly.Betsy’s reputation led her to be asked to stand up hospital and community based COVID vaccine clinics in rural parts of the state with no public health departments. She engaged, scheduled, and oriented local university nursing, pharmacy faculty and students to vaccinate employees and the community. She evaluated student scope of practice ensuring activities and documentation performed in the clinic were aligned. She advised local and regional schools of nursing and telehealth programs regarding Covid. This nurse’s integrity and sound decision-making is forti?ed by her resolve to seek expert consultation to validate legal, accreditation requirements and standards to inform ethical decisions during the pandemic despite an emotional and charged culture.Betsy helped implement a new mobile application to track symptoms of exposed employees while they were at home.
  • Kristy Stewart, MSN, RN, ONC
    Mission Health
    This outstanding nurse understands how critical accurate outcomes are. She developed a reporting structure for the health system CNE and hospital CNOs for quarterly reporting. Her reputation for data integrity is beyond reproach. She is respected for high ideals even in the face of challenges.
    Kristy also created a new, innovative report for patient experience for nursing. This was used with a national excellence in nursing designation. She is sought out nationally to educate and present at nursing collaboratives on a regular basis.She participates in departmental meetings and always brings a sense of enthusiasm for education and quality which she has successfully married. Her work on graphing outcomes from inpatient, ambulatory and procedural areas contributed to a successful ?rst time designation in nursing excellence for a facility in the health system.
  • Lisa Clark, MSN, RN, PCCN-ASC
    Mission Hospital, Asheville Surgery Center
    This clinical nurse received her health system’s Humanitarian Employee award for her dedication to improving the patient experience in her work setting and community. She developed and implemented the Autistic Link Program for kids on the Autism Spectrum, which is used across the health system and was presented at a national conference. One mother said, “having my son’s needs met this way gave me peace and provided the ?rst calm, healing environment for him.”Lisa was recognized as the “Citizen of the Week” by local news outlet for her devotion to the homeless by sewing sleeping bags, pillows, and backpacks. Materials were reused surgical instrument wrapping, resulting in cost savings for the hospital, decreasing a footprint in the land?ll, and providing a water-resistant insulated option for those less fortunate. Lastly, she is committed to colleagues through her zeal for preceptorship/mentoring. One new nurse stated, “I’m not afraid when she is here to teach me. She makes me step outside my comfort zone.”
  • Ashley Hudson MSN, RN, CPN, NPD-BC
    Mission Hospital
    This nominee exemplifies moral excellence by the work she does with a local foster care agency. She volunteers her time to provide training to foster parents and staff that serve medically complicated and high-risk children in our community. The training she provides is on CPR, first aid, and safe medication administration.Ashley radiates energy, enthusiasm, and positivity in all she does and provides creative and engaging educational opportunities for our organization. She utilizes real-time data for pediatric hospital admissions across a 6-hospital division to tailor population-specific education offerings for hospitals who do not routinely provide specialty pediatric care. She has equipped nurses, physicians, and respiratory therapists through innovative simulation-based learning opportunities to provide safe and developmentally appropriate care in their local community hospitals, helping to ensure children get the same standard of care in their home communities.She has committed countless hours to support the opening of a new pediatric emergency department. During this endeavor she was ardent in ensuring that staff had the knowledge, skills, and abilities to care for pediatric emergency patients. She shows dedication to the advancement of her fellow nurses’ knowledge by going above and beyond by serving for 4 years on the planning committee for a regional Neonatal/Pediatric Spring Symposium, as well as volunteering her time to the annual Pediatric Trauma Symposium. Both of these offerings reach pediatric providers across an 18-county region.
  • Leah Frady, MSN, RN
    Mission Hospital McDowell
    This nurse promotes and advances the profession of nursing by being quite an accomplished nurse, including maintaining instructor status for many different programs. She is a PALS, BLS, and an ACLS instructor for the American Red Cross and the American Heart Association. She is a nonviolent crisis intervention instructor for the Crisis Prevention Institute. She recognized the rural nature of her facility and gained instructor status for all of these courses so that nurses at the facility would be able to attend classes onsite and not be required to travel great distances.This nurse volunteers her time to assist at local Covid vaccine clinics supporting healthcare workers and her community. She collaborated with church members to develop an emergency response team. She assisted the church by providing Heart Code classes, developing protocols, and assembling a medical bag for emergencies. Her work with the AWANA program gave her the ability to connect with local children and encourage them to continue their education.Leah supports new and current colleagues with an immeasurable amount of warmth and caring. She deeply cares for each and every person that she works with. She takes the time to hand write notes for those who may have had a difficult day or notes of celebration for those who have achieved their goals. She encourages staff to reach out anytime they have a need, day or night. She quickly integrates new team members early on by introducing them to their preceptor and team long before they arrive. She meets with new team members weekly at a minimum offering them support and mentorship. She ensures that they feel accepted and welcomed in their new role. She helps to precept new educators to their role and often travels long distances to ensure that they feel supported and not isolated. She led as co-chair of her department professional governance council so that those who are new in the role feel inspired and encouraged.In 2020, Leah won a national mentor award recognizing her for the outstanding support and encouragement she provides to the colleagues she works with.
  • Margo Eatmon, MSN, APRN, ACCNS-AG, OCN
    Mission Hospital
    Margo is unwavering in her commitment to exceptional care. She was the only bedside nurse representation on a multidisciplinary team for sepsis. She championed this initiative by collaborating with the team to develop a sepsis screening tool, created a poster and by doing audits on her unit. As a bedside nurse she co-chaired the nurse practice council for 5 years. Utilizing her expertise, she facilitated the revision of the geriatric admission history thus streamlining nursing time, and created a flu blood pressure assessment EMR.As a bedside nurse, she developed a LGBTQ sensitive care and violent injury program for staff. She advocated for this population and supported staff development resulting in staff having more confidence in caring for LGBTQ trauma patients. She presented the program and the results at the NC-NACNS annual education conference. She also collaborated on a team that developed spinal cord injury clinical guidelines after recognizing a gap in clinical care. She is Chemotherapy and Biotherapy certified, ACLS certified, and has End of Life Nursing Education Consortium Core Training.Margo has been teaching new graduate nurses who start on oncology an end-of-life care class for over five years. She learned when she was a new nurse the importance of having quality of life at the end of life and felt it her duty to continue to pass that knowledge to her new colleagues. She has a special love for helping staff feel comfortable with end of life care.
  • Angie Chandler, MSN, RN, ONC
    Mission Hospital
    Angie has a passion for teaching in all aspects of healthcare- including teaching those not working in the healthcare field. She collaborates with leaders at her church to teach a first aid course to the youth group, including hands-only CPR. She also created an emergency response committee at the church.Angie piloted and implemented team-based care units which included multidisciplinary rounding in her area, bringing the entire care team together to discuss the patient plan of care. This improved patient outcomes and increased physician and staff engagement.This nurse is a preceptor and mentor to new educators who join the hospital. She precepts and guides them through orientation at their own pace and meets their individualized needs.Angie also volunteered to lead the sharps committee in her organization. This commitment to safety led to the implementation of a new insulin syringe, which decreased nurse injuries. She led the effort to ensure that all needles used in the hospital system had a safety mechanism and she introduced new sharps containers that reduced employee safety events. Her dedication to patients and colleagues directed her to lead the initiative to schedule discharge times for patients in her area. This improved patient satisfaction, patient outcomes, and throughput. This project not only improved the patient experience, but also improved the workflow and satisfaction of the nurse.Her devotion to her colleagues shows in many ways, including her efforts each year for Ortho Nurses Day. Each year she organizes a celebration for those working in the Orthopedic, Spine, and Trauma areas to celebrate the Ortho nurse. She includes continuing education hours in this celebration to promote lifelong learning and certification.

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Not Just for Babies: The Critical Role Vaccines Play in Community Health – Mission Health Blog

Life was turned upside down when COVID-19 arrived more than two years ago. There were a multitude of changes we had to make in terms of how we lived and moved around in our worlds, from work meetings transitioning from in-person to video calls, to masking up whenever we left the house.

The single most important development that allowed us to picture living more as we did pre-pandemic was the development of the COVID-19 vaccines. Being vaccinated drastically reduces the chances of being hospitalized or dying if you contract the virus, and now we’re fortunate that all children, from six months to 17 years of age can receive the vaccine.

I was very invested in becoming involved in the Highlands-Cashiers Plateau COVID-19 Vaccine Initiative. There were more than 20 vaccine clinics held, and we were able to vaccinate more than 14,000 community members. It’s hard to describe how impactful such an effort has been to our community wellbeing. We all know how virulent COVID-19 is, especially after knowing that more than one million died of COVID in America alone.

Although the COVID-19 vaccine has been what we have focused on primarily during this period, I want to highlight the importance of keeping up to date on all of our vaccines throughout our lives.

Important vaccines for babies and children include:

  • Measles, mumps, and rubella (MMR)
  • Diphtheria, tetanus, and pertussis (DTaP)
  • Hepatitis A (HAV)
  • Hepatitis B (HepB)
  • Haemophilus influenza type B (Hib)
  • Pneumococcal (PCV13)
  • Polio (IPV)
  • Rotavirus (RV)
  • Varicella (Chickenpox)

Starting at six months of age, children should receive an annual flu shot, and those should continue every year throughout adulthood.

When children are older, at around age 11 or 12, it’s imperative for them to receive an HPV shot, which protects them from the human papillomavirus, an STD that is linked to cervical cancer in women, and mouth and throat cancers in both men and women. They should also receive the meningococcal vaccine at this age.

If you’re an adult, it’s important to speak with your primary care physician about any boosters you may need, and adults age 65 or older should do the same, as well as make sure that they receive yearly flu shots, COVID-19 vaccines and boosters, and the two pneumonia vaccines, PCV13 and PPSV23. Adults 50 and older should receive the shingles vaccine as well.

I know that some people question the safety of vaccines, for both their children and themselves. If you do have concerns, talk to your physician about them. Often they can explain what side effects are possible after receiving a vaccine, and how very rare serious ones are. Though the decision you make about vaccines affects you and your family, it also impacts our entire community.

Being vaccinated means that you’re not only protecting yourself, you’re protecting babies, older people, and individuals with compromised immune systems, like those undergoing cancer treatment. We must remember too, that we no longer have to worry about the threat of dreaded diseases like polio and smallpox, thanks to vaccines.

Since August is National Immunization Awareness Month, there’s no better time for you to take stock of what vaccines you and your family might need, and schedule an appointment to get them.


Tom Neal, RN, MBA, MHA, is the Chief Executive Officer and Chief Nursing Officer (CNO) of Highlands-Cashiers Hospital. Neal is a proven leader with more than 30 years of progressive healthcare experience. Prior to his role at Highlands-Cashiers Hospital, he held the position of Chief Executive Officer of Community Health Systems (CHS) and served as Chief Executive Officer of both Berwick Hospital Center in Berwick, Pennsylvania, and Greenbrier Valley Medical Center, Ronceverte, West Virginia. Tom has an MBA from the University of Louisville, MHA from the California College of Health Sciences, BSN from Regents College of New York and an ADN from Jefferson Community College.

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The Ongoing Opioid Crisis: Resources, Events, and the Role of BRRH – Mission Health Blog

The devastation of the opioid crisis has not spared our community, sadly. The statewide statistics are sobering. Opioid overdose deaths outstrip those from auto accidents, and in the 18-year span between 1999 and 2017, 13,169 state residents have died from unintentional overdoses, with a 32% increase in deaths just between 2016 and 2017. This is an especially appropriate time to talk about this issue, because International Overdose Awareness Day is August 31st.

What does this translate to for healthcare facilities? Unintentional opioid overdoses sent an average of nearly 125 people a week to the Emergency Department in North Carolina, just in 2017.

Readers who are struggling with opioids themselves or concerned about family members or friends should know that whether you live in Yancey or Mitchell County, the Vaya Health Access Center offers a mobile help line that you can call 24 hours a day, seven days a week. Their specialists can help you connect to a crisis provider who can address your specific needs. You can reach them by calling 800-849-6127, or for TTY, contact NC Relay at 711 if you are deaf, hard of hearing, or speech impaired. If you already have a provider; it is best to contact them first, since they are already familiar with you.

Mobile crisis teams are also accessible 24 hours a day in Yancey and Mitchell counties. Professional counselors come to you, since it has been found that crisis intervention often goes better when it is performed in the home. This service is provided by RHA Health Services at 888-573-1006 and the average response time is two hours.

You can also visit a walk-in crisis center. No appointment is necessary, and you can get a crisis assessment done and be referred to additional services you may need. The crisis center for Yancey County is run by RHA Health Services. It is located at 72 Blue Ridge Lane in Burnsville and their phone number is 828-682-2111. In Mitchell County, the crisis center is at 129 Skyview Circle in Spruce Pine. They can be reached by phone at 828-765-0894. Both facilities are open Monday through Friday, from 8am to 5pm.

NARCAN® (naloxone) is also available in both Yancey and Mitchell counties. This is the indicated lifesaving medication that is used in emergency situations that can reverse an opioid overdose. The Toe River Health Department has NARCAN available for Avery and Mitchell Counties, while Yancey County has a paramedic program that provides county residents, within 72 hours of an opioid misuse event, NARCAN, education, and information about additional services to access.

BRRH also hosts regular medication take back events, when community members can safely and anonymously dispose of unused or expired prescription medications. The next one is our Crush the Crisis event scheduled at 78 Broad Street in Spruce Pine, on October 29. We partner with the Spruce Pine Police Department and the Mitchell-Yancey Substance Abuse Task Force to hold these important community take back days, which rid us of pounds of medications.

There are also four permanent drug drop off locations in our area where you can dispose of prescription medication anytime. It’s important, if possible, to deposit the medication in its original labeled bottle for medication identification purposes, but be sure to obscure personal information, like your name, with a black marker before disposal. The four drug drop boxes are at the following locations:

  • Yancey County Sheriff’s Office, Main Entrance
    4 East Main St, Burnsville
    Drop off hours: 24 hours a day, seven days a week
  • Burnsville Town Hall
    2 Town Square, Burnsville
    Drop off hours: Monday through Friday, 8:30am-4:30pm
  • Mitchell County Sheriff’s Office, Main Entrance
    63 Crimson Laurel Way, #8, Bakersville
    Drop off hours: Monday through Friday, 8am-7pm
  • Spruce Pine Police Department
    193 Valley Rd, Spruce Pine
    Drop off hours: 8am-5pm

Another helpful resource for families and individuals is SAMHSA, the Substance Abuse and Mental Health Services Administration, a federal government entity that is part of the National Institutes for Health (NIH). They spearhead public health initiatives that address mental health issues on the national level, as well as work to lessen the devastating toll that substance abuse has on our communities.

The Mitchell/Yancey Substance Abuse Task Force is another local organization that is working to combat the opioid crisis through many channels, from physician education and programs for at-risk youth, to free medication lockboxes.

They work in conjunction with EMS to treat people medically who are dealing with opioid misuse, and our Emergency Department is equipped to provide treatment in case of emergency.

If we stay aware of this problem and talk to our primary care providers or anyone in the position of prescribing medication to us, we can ask the right questions about appropriate usage guidelines, and whether a medication is safe to use.

It is my hope that this country, and our own region, can witness a downturn in opioid addiction and overdose deaths as soon as possible. We are committed to doing our part to help overdose patients, and to collaborating with other organizations and services to assist those in need.

Tonia W. Hale, DNP, MAOM, BSN, RN, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Hale is a proven leader with more than 35 years of progressive healthcare experience. A native of East Tennessee, she holds an associate’s degree in nursing from Walters State Community College, a baccalaureate degree in nursing from the University of Tennessee, a master’s degree in organizational management from Tusculum University, and a doctor of nursing practice degree in executive leadership from East Tennessee State University. Ms. Hale is currently a resident of Burnsville.

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Angel Medical Center Focuses on Overdose Awareness, Exceptional Team Members, and New Facility for August – Mission Health Blog

Hello summer! It’s hard not to love this season of flowers growing, warm days, afternoon showers, and beautiful, cooler nights that only those of us lucky enough to live in the mountains get to enjoy.

Summer also finds me restless for the weekend at times and anticipating fun activities — and I know I’m not alone. It’s human nature. We’re programmed to look at the next step, and often evaluate it quickly, labeling it as a positive or a negative. I’ve tried to build a hopeful outlook throughout my life, and tend to lean toward being positive, but it’s also common to dwell on the negative. Unfortunately, many people don’t see hope on the path ahead, especially when significant life stresses or an issue like depression is present.

Unfortunately, the mental health crisis is real, and a major issue across the United States, in North Carolina, Macon County, and right here in our town of Franklin. Some cope by using drugs, and they are all around us. Even though we may not hear their collective cry for help, it’s there. We must realize that the addiction crisis and the mental health crisis are also intertwined.

Rather than judging those who struggle with addiction, it’s important to understand that there’s nearly no one who hasn’t been affected somehow by the drug crisis. According to the North Carolina Department of Health and Human Services (NCDHHS), more than 28,000 North Carolinians died from drug overdoses between 2000 and 2020. Each of these represents a tragedy for families and loved ones. Sadly, the COVID-19 pandemic lead to increased drug misuse and abuse as more people feel hopeless and lose sight of their value.

Though the solutions to this overwhelming problem are complex, we have to turn the tide, through better treatment, destigmatizing addiction and seeking mental health services, and meeting those struggling where they are, with compassion and hope.

August 31st is International Overdose Awareness Day, and when I consider the types of dangerous drugs we’re dealing with now, it makes my youth growing up in western North Carolina seem tame in comparison. The only illicit substances we were aware of then were tobacco, alcohol and maybe a mimosa tree seed pod, which were said to give those who chewed them a “high” feeling. Like how the mimosa tree can grow almost anywhere, there’s no household that’s immune to the risk of addiction.

The Centers of Disease Control (CDC) states that overdose deaths have risen by a staggering 30% in just 2020, and an additional 15% in the following year, 2021. Across the country, 107,622 overdose deaths were reported for that period.

I hear many people express relief that our community isn’t affected, but this couldn’t be further from the truth, sadly. The NCDHHS reported overdose deaths rising by a startling 37% in 2020 across the state. In 2021, Macon County experienced a rate of 44.5 deaths per 100,000 people, significantly higher than the state average of 33.5 .

This data weighs heavily on my heart. Angel Medical Center (AMC), along with our community partners, see and feel this reality every day. Again, it also pains me to hear people declaring that, with regard to these drug casualties, “they are not that person,” that they’d never get caught up in the spiral of addiction, or possibly the worst, that if someone loses their life through an overdose, they somehow deserve it.

We again have to return to the CDC data, which reflects that a full 83% of deaths by overdose were not intentional. In 2021 alone, North Carolina lost 1,600 to heroin, 800 to cocaine, and 1,800 to commonly prescribed household medications. We must remember that failing to secure prescription medications or using medications for any purpose other than what they were prescribed for is a leading cause of overdose deaths.

I want to encourage our community to embrace those with mental illness and addiction challenges, lock up your medications and discard any unused ones, and to do all you can to support those struggling. It might mean volunteering for a local community organization, or supporting a friend as they discuss a problem. On October 29, Angel Medical Center will hold its Crush the Crisis drug take back day. More information to come on that event.

Now for some positive news: AMC nominates four people annually who have shown outstanding pride and work for the hospital and this community. In the Excellence in Nursing Category, we chose two outstanding Emergency Room nurses, Patricia “Janie” Key and Duane McHan.

Both provides excellent care and demonstrate the passion and compassion that make Angel such a special place.

In the Frist Humanitarian Award category, we chose Gay Todson, a long-time volunteer with a heart for the staff and people that come to seek care at Angel. She has accumulated more than 12,000 volunteer hours, and is such a help and blessing to our team.

The last award is the Innovators award, and we’ve nominated Rick VanGilder for his special talent of finding ways throughout the pandemic to bring a smile to the faces of our staff and patients.

Congratulations to these four outstanding employees. It’s hard to nominate just a few when there are so many passionate people serving the healthcare needs of our community with such dedication.

Finally, a new facility update! We are still slated to open on September 18, 2022 at 6:00 am. We will have a time for the community to come out and see the facility and get the exciting behind-the-scenes tour. This is a great step and enhances our ability to provide excellent care, close to home, to this special community.


Clint Kendall, FACHE, MBA, MSN, BSN, RN, is Chief Executive Officer/Chief Nursing Officer of Angel Medical Center. He started his career as a nurse, and that perspective still informs his work and passion for the patient experience. Clint holds a Master’s Degree in Business Administration, Nursing, and Health Care Management from the University of Phoenix, and a Bachelor of Science in Nursing from Western Carolina University. Clint has also earned the Certified Professional in Patient Safety (CPPS) certification, and is a member of the American College of Healthcare Executives (ACHE), the American Organization of Nurse Executives (AONE), and the American Nurses Association (ANA).

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Transylvania Regional Hospital Welcomes New Physicians; Refreshes and Renames Two Facilities – Mission Health Blog

In an effort to provide even better care to our community members, two facilities affiliated with Transylvania Regional Hospital (TRH) have recently undergone improvements and renovation in preparation for serving new purposes. We look at our role as one that must continually change, as our patients’ need for services does.

Medical Associates of Transylvania has been under construction since early 2022. Primary care services returned to the space, and patients began getting served on July 19th, with Brevard Orthopedics expected to join the practice this coming fall. The facility is located at 377 Gallimore Road, and you can schedule a consultation or appointment by calling 828-884-9030.

Improvements to the building include new wood flooring, bright white walls, and a more modern front desk area that’s designed for optimum efficiency. The building also houses a new X-ray machine in a renovated space tailored to X-ray. We anticipate updating the building’s exterior drainage system in the near future as well.

You may also be familiar with Brevard Family Practice, which is now Mission Health Center Brevard. It houses General Surgery services provided by board-certified general surgeon Dr. James B. Osborne, Jr., as well as urology services under Dr. Brian Cohen and Kristy Rutan, PA.

This facility has also received a new wood floor, an updated front desk area, and fresh paint. Mission Health Center Brevard’s address is 187 Medical Park Drive, and appointments can be made by calling 828-884-9362.

Both practices were refreshed and designed with patient comfort in mind, and to aide providers in delivering the best care possible.

We welcomed Dr. Osborne recently, after serving at SIMED Health in Gainesville, Florida. He performs colonoscopies and other endoscopic procedures, gallbladder surgery, appendectomies, bowel surgeries, and laparoscopic abdominal procedures. Dr. Osborne also has special training in hand/upper extremity surgery.

As we work to make our facilities adapt to patient needs, we take into account several broad factors as we attempt to make our offices and the hospital as patient-centered as our care. First, we ensure that our buildings are fully accessible for all people, whether they are fully mobile or need assistance walking or a wheelchair. This means that our entrances are wide enough to accommodate patient and family needs for entrance, as well as offering spaces that are easy to move around within. Our office technology also allows our team members to access patient records easily and universally.

Light, clean interiors, comfortable furniture, and a simple aesthetic contribute to a space that’s both functional and easy for clinicians to work in and welcoming so that patients feel at ease.

Finally, as with all our facilities, safety and security remain top of mind. This applies to the building itself and patients feeling safe, and that patients feel secure about how their medical information is stored and handled, with HIPAA guidelines observed.

We’re excited to welcome patients to our refreshed facilities. I’m certain visitors will be pleased with yet another example of excellent care, close to home.


Michele Pilon, MS, BSN, RN, NE-BC, is the Chief Executive Officer and Chief Nursing Officer of Transylvania Regional Hospital. Her diverse professional experience includes service as a bedside nurse and over a decade as a leader at healthcare institutions in Virginia, Florida, and North Carolina. Ms. Pilon earned a Bachelor’s in Nursing from Ohio’s University of Akron and a Masters in Health Services Administration from the University of St. Francis in Illinois; she is also a Board-Certified Nursing Executive.

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Are dogs good for mental health? – Mission Health Blog

Promoting endorphin-rich exercise

Dogs need exercise, and people do too. When you commit to the responsibility of dog ownership, you’re in for a lot more walks around the block than you might take otherwise — about 22 minutes more per day, according to a study in BMC Public Health. All of that physical activity stands to generate more endorphins, known as the brain’s “feel-good chemicals,” and that’s on top of the other feel-good chemicals that dog play brings, such as oxytocin and dopamine.

Staying active doesn’t just help to manage stress, improve sleep and boost your mood; it’s also a key part of an overall healthy lifestyle. Aerobic activity supports good heart health, which can, in turn, protect against mental health concerns like depression. Evidence also shows a cyclical effect between the two, as a healthy body supports a healthy mind, and vice versa.

For their part, dog owners have an advantage here: They have a lower risk of hypertension and heart disease, which are two conditions that can contribute to poor mental health.

Dogs can provide companionship, promote exercise and allow people to feel needed — all of which can improve mental health.

Fighting loneliness with companionship

Dogs and humans may not speak the same language, but our bonds are no less powerful. In studies, many folks have reported that their canine companions help them feel less lonely, both in the short- and long-term. Many programs that bring therapy dogs into hospital rooms and nursing homes are a testament to that.

This effect was especially critical during the early stages of the COVID-19 pandemic, when the world found itself more lonely due to social distancing. It may also be why, at least in part, dog adoptions temporarily surged 250% from 2019 to 2020.

Feeling needed by someone else

There’s a lot to be said for taking care of someone who needs you, and there’s no shortage of that when you’re caring for a dog. Science has demonstrated a link between that kind of responsibility and positive mental health effects, including high self-esteem.

But it’s not just a feeling of self-worth that dog ownership, and all of the responsibilities that come with it, can provide. Taking care of a pet might encourage you to take better care of yourself, too. One study found that when teenagers with diabetes cared for a pet fish, they more diligently checked their blood glucose than teens without that responsibility.

After all, dogs need you to be around for them, and that’s a pretty big motivator to put in effort.

The caveats of dog companionship

While there are known health benefits of pet ownership, it’s not always a walk in the park. Regular caretaking is a big and costly responsibility, and the around-the-clock nature of caretaking can come with its own stressors, too. In combination, these factors might not add up to increased happiness.

Pet companionship has been associated with reductions in stress, depression and anxiety, and it can give people joy and greater meaning in life. However, many studies have found that pet owners aren’t necessarily happier, per se. Interestingly enough, the same phenomenon has been found with childrearing.

So do dogs make us happier? They certainly can, but they might not in all cases. Are dogs good for mental health in general? Unequivocally, yes.

Mission Health continues to make significant progress on the build of a new behavioral health hospital in Asheville. The Sweeten Creek Mental Health and Wellness Center is slated to open in early 2023. Located just off Sweeten Creek Road in Asheville, this 120-bed center will offer advanced therapies, technologies and evidence-based best practices to improve the health and well-being of our community.
At Mission Health, we’re committed to breaking the stigma of mental illness and providing care that focuses on your well-being. Life changes quickly, and those changes can cause real distress. We’re here to remind you that you are not alone. Get started by calling 828-213-4696 to schedule your assessment or click here for more information to schedule or learn more now.

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Heat-related illnesses explained: Symptoms and prevention – Mission Health Blog

What is a heat-related illness?

Heat-related illnesses are caused by high temperatures and humidity. They can occur when someone is exposed to heat for a prolonged period without adequate fluid intake or relief, such as standing in the shade or going into a building. There are several types of heat illnesses, some more serious than others. Fortunately, they are often preventable if you know how to prepare for the heat.

Heat-related illnesses can affect anyone who is exposed to heat for a prolonged period of time without relief or adequate hydration.


Heatstroke, also known as sunstroke, is the most severe heat illness. It occurs when the body cannot control its internal temperature, and it can be fatal if it is not treated quickly. There are two types of heatstroke:

Heatstroke can typically be prevented by staying hydrated and wearing appropriate clothing. It’s also important to take it easy if you’re going to be outside during the hottest parts of the day.

Heat rash

Heat rash, also known as prickly heat or miliaria, occurs when sweat gets trapped in the pores, causing a very itchy rash that looks like a cluster of blisters. It most commonly appears in skin folds and areas where clothing rubs against the skin. Heat rash can be prevented by wearing loose cotton clothing and drinking plenty of fluid to avoid dehydration. If you do get heat rash, you can soothe it by applying a damp cloth or ice pack to the affected area for up to 20 minutes.

Heat exhaustion

Heat exhaustion is the body’s response to losing large amounts of water and salt, usually due to excessive sweating. The symptoms can develop suddenly or over time. Symptoms include:

  • Dizziness
  • Fatigue
  • Faintness
  • Muscle cramps
  • Nausea
  • Headache

Similar to preventing heatstroke and heat rash, heat exhaustion can be prevented by wearing lightweight, light-colored and loose-fitting clothing. Sunblock or sunscreen can also help to prevent heat illnesses. Be sure to reapply it as necessary. Additionally, be sure to pace yourself if you’re going to engage in any kind of physical activity outdoors.

Heat cramps

Heat cramps are painful, involuntary muscle spasms that occur as a result of dehydration and a loss of electrolytes. They can lead to other heat illnesses, such as heatstroke, and can be caused by strenuous activity in hot weather. Heat cramps are usually brief, but they can also come and go. They typically go away on their own, but they can be relieved by hydrating and resting.

Who is at risk for heat illnesses?

While heat-related illnesses can affect anyone, infants and children up to age 4 and people 65 and older have the greatest risk. People who are on certain medications, have an underlying illness, or are overweight are also at risk.

If you suspect that you or someone else has a heat illness, the first thing you should do is get out of the heat and into a shady or air-conditioned area. Note that a fan alone may not provide enough relief. You should also remove any heavy or restrictive clothing, and cool down and rehydrate by drinking cold water or a sports drink with electrolytes.

If your, or someone else’s, condition worsens due to heat-related illness, call 911 or a local emergency number right away. If left untreated, heat exhaustion can lead to heatstroke, which can be life-threatening.

Taking proper precautions when the weather is hot can help prevent heat-related illnesses. If you or a loved one develop a heat illness, it is important to act quickly to prevent further injury or illness.

Access to emergency services remains available to all, and patients with urgent health concerns, whether COVID-19 related or not, should not put off medical attention. If you are experiencing emergency symptoms of any kind, such as chest pain, shortness of breath, or stroke symptoms, it is both safe and necessary to seek medical attention. We’re here for you. Click to learn more.

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