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Rural Trauma Course Helps Iowa's Small Hospitals Deal With Big Emergencies

7/29/2019

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Iowa Public Radio

One in eight Americans live in urban areas, but 60 percent of deaths from trauma occur in rural areas. In Iowa, most rural emergency rooms are only equipped for basic emergencies -- and have limited budgets for staff and equipment. But a course led by trauma specialists is helping small ERs prepare for big emergencies.In the Manning Regional Healthcare Center’s emergency room, a team of about a half dozen nurses crowded around a young woman stretched out on a hospital bed.Nurse Taya Vonnahme read off her status.
"We have a 28-year-old female. ATV rollover. Left chest in abdominal pain. Heart rate at 120," she said. Vonnahme then quickly assigned everyone a role. "So I’m on crash cart. Robyn’s on IVs. You’re on oxygen. You’re on procedures," she said. 

This may sound scary -- but it wasn't actually a real emergency. It was an exercise set up by Rick Sidwell, a trauma surgeon at Iowa Methodist Medical Center in Des Moines.

On a summer day, Sidwell was in Manning, a town of about 1,500 located 90 miles west of Des Moines.
He was teaching a course called rural trauma team development. Through exercises like this, he showed the staff efficient ways for dealing with fast-paced trauma cases -- like checking for airway or neurological issues, applying a tourniquet -- and even using a checklist. This is something he does at his hospital.
“We even have one up on our wall, just when we know a trauma’s coming in, this is the stuff we’re getting out,” Sidwell said.
For more than two decades, Sidwell has travelled to hospitals nationally -- and even internationally -- to teach this class.
"It’s a course that's been translated into French, into Spanish because this is a need that is is a universal need -- not just Iowa," he said.
Iowa is where the class started, Sidwell said, when nearly three decades ago, a Marshalltown surgeon realized many trauma concepts were geared towards urban hospitals with lots of resources.
According to Sidwell, the class is about helping ERs in rural places, like Manning Regional -- which has just 17 beds -- and is the first place many patients end up following a heart attack or hunting accident.

"It's all about how are we going to take care of injured people at the local center, knowing that that's completely different than how things occur at a big urban trauma center," he said.
That can be a matter of life and death — especially in rural areas. Research shows people in rural areas are 14 percent more likely to die from traumatic injuries than those in urban areas.
Nurse Brian Feist, who also teaches the course and works at Iowa Methodist Medical Center in Des Moines, said small hospitals know how to help patients. They just face other barriers.
"The problem they have is they don't have the necessary equipment because it doesn't happen that often for them," said Feist. "A lack of frequency is tough to justify for a $10,000 rapid infuser."
That’s why Feist said a large part of the class is focused on how to prepare patients for transfer larger facilities -- like the one he works at -- by ambulance or air.
"A huge amount of our injured patients come to us as transfers," he said, "so the better prepared we can get our critical access hospitals, the better that patient has for longevity in a great outcome."
This was one of the reasons that Manning’s ER trauma coordinator Boni Johnson was interested in the course.
Johnson said about 50 percent of their patients have to go to places like Des Moines or Iowa City.
"A lot of them are, you know, cardiology, orthopedics," she said. "We just don't have a lot of those resources right here. And not only within our facility, but within the facilities around us."
Many of the nation’s rural hospitals are under intense financial pressure. More than 100 have closed in the last nine years -- though none have closed in Iowa -- and others have cut back on services like delivering babies.

Johnson said she’s impressed that the course’s instructors seem to really understand the importance of rural providers -- and their dwindling resources.
"You are a jack of all trades, master of none, you can be asked to run a cardiac drip one minute and be taking care of an orthopedic patient next," she said.
Sidwell said the course is also about addressing the importance of rural trauma care.
"If we really want to as a state, if we really want to as a country, eliminate unnecessary disability and death from injury, then we have to address the important role that the rural environment plays," he said.
The course is provided free of charge to hospitals through the Iowa Department of Public Health. 

Link to story, pictures and audio

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Manning Regional Healthcare Center Introduces Medicare Counselor

7/27/2019

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Carroll Broadcasting

The Medicare system is one that often creates more questions than answers, but Manning Regional Healthcare Center (MRHC) is working to ensure that area seniors have the resources they need to make well-informed, important healthcare coverage decisions. A new Senior Health Insurance Information Program (SHIIP) and Senior Medicare Patrol (SMP) volunteer counselor, Dee Schmitz, is there to help area residents and safeguard them from becoming a victim of Medicare fraud. “We’re so excited to welcome Dee in her now role as a SHIIP volunteer, says CFO, Amy McLaughlin, CPA. “She will be a great resource for individuals turning 65, those who are considering changing Medicare benefits or for anyone simply wanting to learn more about their current benefits.” Schmitz will meet with individuals at the hospital on Wednesday afternoons, from 1 p.m. to 5 p.m., beginning July 31. After retiring as the business office manager at Regency Park Nursing & Rehab in Carroll, Schmitz went through a comprehensive training program to become a counselor. She chose this path, knowing it will be fulfilling to assist and educate others. “I’m looking forward to helping people with some of the confusion they experience when first approaching Medicare,” Schmitz says. I’m looking forward to meeting new people and working together to find solutions to their questions.” She will not recommend insurance companies, plans or agents, but rather help residents make informed decisions and learn how to detect Medicare scams. Schmitz and her husband, Tom, are residents of Templeton and have three children and six grandchildren. Anyone interested in setting up an appointment can call MRHC at 712-655-2072.

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Brian Joens Returns to Manning Hausbarn-Heritage Park

7/26/2019

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Audubon County Advocate Journal

MANNING – Manning-born singer-songwriter, Brian Joens, returned to Manning on Thursday, July 18 for an evening of music on the courtyard at Manning Hausbarn-Heritage Park’s Roten Bar Tavern. Brian’s unique style of Americana and folk was the perfect accompaniment to a small-town summer’s evening.
A strong breeze and growing shade on an otherwise very warm evening kept a large crowd of all ages comfortable as Joens played two hours of originals and covers. Deardorff Highland Cattle Food Truck returned for a second consecutive week to provide delicious sandwiches and sides to all those who came out for the evening.

The crowd included a group of professors and students involved with the Mandela Fellowship from Drake University in Des Moines. In what was truly a special moment for the community that had gone to lengths to make them feel welcome, one of the Fellows took the microphone, while Joens quietly strummed behind her, to briefly share a poetic tribute to their trip to Iowa and Manning.
Like and follow Manning Hausbarn-Heritage Park on Facebook to keep up to date on other activities and events we’ll be hosting throughout the year. In addition to our Thirsty Thursdays at the Hausbarn, some upcoming events held at the Konferenz Centre include a Sip & Shop event on Tuesday, July 30, and Mikayla Lane in concert on Sunday, August 18.


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Manning Utility Customers Invited To Ribbon Cutting And Appreciation Dinner

7/24/2019

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Carroll Broadcasting

The newly finished Kerkhoff Shelter House at Trestle Park in Manning will be opened up later this week for Manning Municipal Utilities annual customer appreciation event. From 4 p.m. to 6 p.m. on Thursday, July 25, electric, water, natural gas and communication services customers are invited to a brief ribbon cutting for the new shelter house as well as a free meal. The evening also includes gifts, the Lineman 360 for customers to try out, boom truck rides and the ability to take a closer look at an ambulance and police car. The first 150 customers through the door will receive a free rain gauge or coffee cup.



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Manning Again Welcomes 25 Visitors From 18 African Nations During Mandela Washington Fellowship

7/19/2019

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PicturePictured: The group stops at Brickhaus Pizza in Manning for a bite to eat following their morning presentations and tours of two local farms.

Carroll Broadcasting

On Thursday, the City of Manning welcomed a group of Sub-Saharan African leaders who were selected to participate in the prestigious Mandela Washington Fellowship through Drake University in Des Moines. The 25 Fellows are between the ages of 25 and 35 and represent 18 different nations. Program Coordinator and Asst. Director of Community Engaged Learning, Amanda Martin, explains what the Fellowship entails.
The group’s day in Manning included several presentations at the Hausbarn Konfrenz Centre, tours of the Ranniger and Muhlbauer family farms and a walking tour of the community’s historic Main Street. One Fellow, Cheu Pswarayi, is the executive director of MedTours Africa in Zimbabwe, a company she founded that helps patients travel for treatments that are not available in their home countries. Pswarayi says the most valuable lessons she learned in Manning concerned planning and investment.

Mike Mpoyi is a doctor in Kinshasa, the capital city of the Democratic Republic of the Congo. He says many people in his home country cannot afford medical treatment, and medical professionals often have to pay for patient care themselves. As part of his effort to increase access to healthcare, Mpoyi serves as the CEO of a non-profit organization that provides insurance and treatment to impoverished populations. According to Mpoyi, the lessons in leadership he has learned during the Fellowship will be instrumental in expanding the organization when he returns home.
More than 700 African leaders participate in the Mandela Washington Fellowship at universities across the United States. Pswarayi and Mpoyi say they are fortunate to have been selected for the Iowa program and called the Manning visit “enriching and fulfilling.” For more information on the 25 Mandela Fellows, follow the link included with this story on our website.
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https://www.drake.edu/yali/fellows/

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Manning To Welcome More Special Guests Thursday

7/17/2019

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Carroll Broadcasting

For the fourth consecutive year, the community of Manning will host 25 young Sub-Saharan African leaders with the Drake University-sponsored Mandela Washington Fellowship program. The group will be participating in tours, presentations and activities that showcase the economic development efforts of business owners, the City of Manning and associated organizations as well as residents. The Fellows will arrive in Manning in the first half of the nine o’clock hour Thursday for morning presentations at the Hausbarn Konfrenz Centre. The afternoon includes a tour of the Ranniger and Mulhbauer family farms and a walking tour of the historic Main Street district. The day concludes with dinner and drinks and an opportunity to mix and mingle with members of the Manning community. Residents are encouraged to join the group at BrickHaus Brews from 4:30 p.m. to 6 p.m.

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Attendees At Biden’s Manning Rally Provide Pre- And Post-Event Commentary

7/17/2019

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PicturePhoto (l to r): Kristin, Jay and Eli Dreyer and Bowe Kinkade
Carroll BroadcastingDemocratic presidential candidate and former Vice President, Joe Biden, introduced his plan for rural America to about 250 people in Manning Tuesday. Those gathered at the Manning Hausbarn Konferenz Centre included area residents who were supporters and anxious to hear how Biden’s initiatives would have an impact at home and abroad. Prior to Biden’s speech, long-time IKM-Manning school teacher, Kristin Dreyer, said she not only thinks it is important to attend events like this, she also is vested in supporting someone who will take the steps necessary to shore up the rural economy. She and her husband, Jay, thought it important to bring their son, Eli, to the event as well.
Part of Biden’s plan addressed rural economic support for children, like Eli, to have the resources and infrastructure available to them so they can compete in business while remaining in the rural areas of the state to raise their families. Dryer was also hopeful that education would be at the forefront, saying teaching is a lot different than it was 20 years ago and needs have drastically changed. On the other side of the spectrum, local business owner, Bowe Kinkade, attended, wearing a Trump/Pence ‘20 baseball cap. Kinkade said he has been trying to get to the rallies for candidates passing through the area, and so far said he has not yet heard one very important piece of the puzzle in all the proposals.

Kinkade said Biden talked about building the middle class, but he believes they always take the tax money from the middle class. Kinkade wanted to know how we can grow if we have to keep financing it all. Kinkade owns a trucking company and said his support will remain with the candidate who is largely responsible for his business still being viable.
A video of Biden’s remarks from Tuesday’s event can be found on our Facebook page. More details about the content of his plan for rural America can be found in previous stories on our website.

Story and audio link

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Former Vice President And Presidential Candidate, Joe Biden, Chooses Manning To Reveal Plan For Rural America

7/16/2019

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Carroll Broadcasting

Former Vice President to Barack Obama and current 2020 Democratic presidential candidate, Joe Biden, told more than 250 people gathered at the Hausbarn Konferenz Centre in Manning this (Tuesday) morning that he had specific reasons for choosing now to run for office, and a three-point plan for rural America. Biden says the first reason he is running is to restore the soul of this country.
The current administration, Biden says, is not promoting that ideal. The second reason he says is to restore the backbone of America.

Part of that problem is the rural/urban divide and that in rebuilding the backbone, it shouldn’t matter whether you live in a skyscraper in Manhattan or in a small town like Manning. Biden says your children deserve the same opportunities, ones that afford them the choice of staying and raise their families where they choose. Biden says rural communities power this country, they feed our bodies, fuel our engines, are the stewards that protect our lands for everyone—they are part of the soul of who we are as a country. He then unveiled his plan for rural portions of the United States and it starts with equality in care.
He says health outcomes should not be determined by our zip code or how much money we make. He is not talking about Medicare for all, but rather says he wants to expand on Obamacare. Biden says that although it is a noble idea, universal healthcare removes private insurance and Medicare reimbursement rates are too low to support rural hospitals, like Manning Regional Healthcare Center. Because when a healthcare provider closes, he adds, jobs are lost and that impacts the rural economy, the second part of his plan. Nearly everything in a rural economy is also tied to ag, and the American farmer, Biden says, is being hurt by the current tariffs.
Biden promises a trade policy that starts at home and focuses on economic investments in green energy, including ethanol and biodiesel, and rural business investments in a green infrastructure. And he says even with all the problems we are facing, he is more optimistic than when he was elected to the senate at 29. “This is the American Dream, there is not a single thing we cannot do when we set our minds to it,” Biden says. And that is why he is refusing to postpone any longer. We will bring you reaction from attendees in upcoming broadcasts. A livestream video of the event can be found on our Facebook page.

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Savor German Culture in Iowa

7/16/2019

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LeisureGroupTravel.com

Boasting of its German immigrant heritage, the Manning Hausbarn Heritage Park houses iconic cultural landmarks including an authentic German Hausbarn.
Looking for fun trip ideas? Charming, quaint and picturesque Manning, Iowa is where early settlers from Germany immigrated to in the late 1800s and early 1900s. The Manning Hausbarn Heritage Park located in Manning is not only a great place to spend the day outdoors but is also steeped in history. Housing an authentic German hausbarn, a church and a farmstead, plan a visit to this beautiful location and learn more about its many cultural landmarks by taking a guided tour offered by a great team of volunteers.
The History of ManningManning’s settlers were mostly natives of Schleswig-Holstein and Hannover, Germany. According to local church history, the first pioneers were so delighted with the fertile soil present in the Manning area that they soon wrote to their relatives and friends in Germany to come to America. As a result, many people came from the old country directly to Manning, Iowa in the late 1800s and early 1900s.
German Hausbarn
Built in 1660 in Schleswig-Holstein in the northwest part of Germany, the hausbarn is the main attraction in Manning Hausbarn Heritage Park and a tribute to the German heritage of the town and its residents. After many years of political unrest including two world wars in Germany, the hausbarn was dismantled and sent to Manning where it was reassembled on the Leet/Hassler Farmstead established in the 1910s by a local farmer. This unique thatched roof barn structure comprises living quarters for a family with traditional bedrooms, dining rooms and cooking areas along with shared spaces for farm animals and equipment all under one roof.
Trinity Lutheran Church
When northern German immigrants arrived in Manning, they organized a congregation that would meet in a school house. They soon built the Trinity Lutheran Church in 1884, which outgrew its capacity and was rebuilt in 1901. In an unfortunate turn of events, the church was destroyed by a tornado in March 1913 but the undeterred congregation immediately began reconstructing the church, which was completed in six months. This historical structure still stands in the Manning Hausbarn-Heritage Park. However, over time, the congregation could no longer sustain the church and members began leaving. In 2006, the church was closed after its 125th anniversary. In an effort to preserve this historical structure, the Manning Community Foundation opted to move the church to Manning Hausbarn Heritage Park. The move was quite the event for the residents of Manning, who raised $100,000 for the relocation of the church. It took four hours to cover a distance of 11 miles. Forty wheels supported the structure from underneath, which weighed 112 tons and was 78 feet long and 34 feet wide with a 92 feet high steeple. The church was laid on its new foundation on June 9, 2006.
Leet/Hassler Farmstead
Built in the 1910s, the Leet/Hassler Farmstead finds a place in the National Register of Historic Places. Once owned by wealthy farmers, William A. Leet and Frederick H. Hassler, the farmstead affords a one and a half story craftsman style bungalow with a three-bay garage, a braced-rafter gambrel-roofed barn, hog house, chicken house, scale house and boar house. The boar house is said to have housed an award-winning swine. There are also two rock planters, a birdbath and a fish pond constructed by a local mason and dating back to 1916. The bungalow still features the original flooring, woodwork and decorative interior accents along with plumbing and light fixtures.
Konferenz CentreNot exactly a cultural landmark, the Konferenz Centre with its Hansen Hall, dining room and industrial kitchen makes the facility a popular venue for social gatherings like family reunions and weddings as well as business conferences. The Roten Bar Tavern and accompanying courtyard is open every Thursday evening, often with music, food and drinks special for the community to gather and enjoy good company. Less than a decade old, the center ideally complements the Manning Hausbarn Heritage Park.

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University of Iowa outreach seeks to bring them home

7/15/2019

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Sioux City Journal

Manning (pop. 1,553) (the “53” are recent arrivals) sits proudly in Carroll County four hours west of Iowa City. When the city’s leaders wanted to improve publicity for the high quality of life they enjoy, they called on the University of Iowa.The collaboration between the City of Manning and the University of Iowa began with extensive planning early in the summer of 2018. In need of a client organization for his senior-level strategic communication course that fall, I contacted Travis Kraus, director of Economic Development & Sustainability in the Office of Outreach and Engagement in the UI provost’s office. Kraus was able to suggest connections with a range of organizations that had filed proposals with his office. According to Kraus, the project I led was one of four recent projects in Manning.
Faced with the challenge of developing a communication plan to recruit and retain residents, my 15 senior students considered key questions, including, “How to reach local high school grads who have moved away? How to persuade them to come home? And how to get them to stay?”
To raise their level of engagement, the class invited its “live” clients to consult throughout the semester. On the ground in Manning and later in the classroom in Iowa City via Skype, Ron Reischl, who chairs Main Street Manning’s Business Improvement Committee, listened to and discussed the students’ discussions of small-town population trends.
Reflecting on the experience, he said, “We sought an engagement with the University of Iowa to communicate and promote the high quality of life in Manning. We were thrilled with the participation of the students and their final recommendations. We have integrated elements of their recommendations into our marketing plan.”
He added, “It is especially gratifying to see students from large cities learn and begin to understand the benefits of small-town living.”
Media specialist Shelly Greving also helped the students to consider the merits of different social media platforms for use in developing their strategy.
A mainstay of the university’s service outreach to the state, these consulting projects offer professional grade resources to small towns across Iowa for little cost.
Their value is felt mutually. The chance for students to work with a live client, instead of just reading a textbook, makes an enormous difference. Taking a student group to Manning brought the whole project to life for me and the students. We immediately became peer investigators, rather than teacher and students.
UI senior Anders Bjerkness, a student in the class, praised the approach. He said, “Traveling to Manning, meeting local residents, and working alongside town leaders was important in shaping the approach to our work. Seeing their passion for the improvement of Manning gave us a sense of personal responsibility to address areas of potential growth and provide solutions.”
As an educator, I am looking forward to teaching another course at the UI for and about rural Iowans in the spring of 2020. I am ready all over again to introduce my new students to our new clients.

Frank Durham is an associate professor of journalism and mass communication at the U

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