SPEAKER: INCREASE IN VIOLENCE AFFECTS HEALTH CARE PROVIDERS

Sally Frese is a clinical nurse specialist and consultation liaison nurse at St. Louis University Medical Center.

She can talk with ease about "humor in the workplace" and turn serious with her discussions of "guns, knives and gangs."

Frese discussed both topics in Cape Girardeau Saturday as a guest speaker at the 7th annual LifeBeat Safety Conference.

"Although we live in the Midwest where people feel things are safe, quiet and a good place to live, we actually rank sixth in the nation in violent crime," said Frese, citing crime statistics nationally and from Missouri.

More than 200 health professionals from the region were on hand for the annual conference, which is directed toward emergency and primary care physicians, registered nurses and emergency personnel.

Other speakers during the day included a welcome by Dr. Nancy Weber-Bornstein, medical director of LifeBeat Air Medical Service; Brad Golden, LifeBeat emergency/flight nurse; Joy Goodman, LifeBeat Service; Karen Mazzola, LifeBeat Outreach educator; Dr. Jesse R. Ramsey, emergency services physician at Southeast Missouri Hospital; and Dr. Steven C. Bailey, who discussed cardiovascular surgery and chest trauma.

"Violence today is one of the primary concerns of Americans," Frese told the group. "In 1992, police made 14 million arrests in the U.S. Two million of those arrests were for violent crimes. Since 1990, more than 90,000 people in this country have been murdered -- more than 20,000 a year. Many more have been injured in violent crimes."

National statistics reveal that more than 2.2 million people suffer non-fatal injuries as a result of violence each year.

"This is a big challenge to health care," she added. "And, it's a problem what won't go away."

Violence affects health care providers, says Frese. "We are the people who have to take care of the victims of violence."

More and more children, ages five through high school, are becoming victims of violence, noted Frese. "One in six children will witness violence by the time they are 18," she adds.

"As long as we have poverty, unemployment, racism, and uneducated people, we'll have violence."

Gangs and gang activity can be the result of violence, said Frese. "Gangs can be described as groups of people who form an allegiance for a common purpose, with many of them engaging in unlawful or criminal activity," she said.

"We didn't have serious gang activity in St. Louis 10 years ago," she said. "And, even today, a lot of gangs are not involved in drug trafficking in the St. Louis area."

But, gang activity often has a negative impact on local businesses, resulting in property damage, lost customers and higher insurance costs in some areas, according to a "Gang Awareness" report by the St. Louis Metropolitan Police Department.

"Gang activity is not limited to the big cities," said Frese. "I know of communities with populations under 5,000 with gangs."

Operation SafeStreet, an organization in St. Louis, says "graffiti" is one of the first signs of gang activity in a neighborhood.

"It serves as an underground newspaper for gangs," explains Frese. "Graffiti is used to mark territories and claim responsibility for certain acts."

There are some warning signs parents can look for in children's behavior -- changes of friends, late hours, isolation from family activities, use of a new nickname, tattoos, sudden change in clothing styles.

Gang activity has resulted in increased violence, both in metropolitan and rural areas, said Frese.

In her role as a health care provider, Frese says, "We're seeing a resurgence in certain types of drugs, heroin in particular. Heroin was popular in the 1970s. Heroin cases at in our emergency room have increased as much as 20 percent."

Crack cocaine has also increased over the past year.

With drugs and gangs, violence increases, which puts a new load on emergency rooms and medical transportation services, including air and surface.

The delivery of emergency care to the region has been a part of Southeast Missouri Hospital's mission since the hospital initiated its comprehensive Emergency Services in 1977.

LifeBeat Air Medical Service was inaugurated in 1987. A year later, the first LifeBeat Emergency Conference was held.

During the past year, LifeBeat responded to 794 requests for emergency services in five states. Ninety-eight percent of the calls were in Missouri and Illinois. Other calls were made to Kentucky, Tennessee and Arkansas.

Thirty-two percent of the calls involved trauma/neuro, and 30 percent of the cases were cardiac.

Earlier this year, Southeast's Emergency Service and LifeBeat Air Medical Service moved to new quarters in the hospital's new Clinical Services Building. Included in the new emergency services on ground level are 18 treatment areas for major and minor trauma, full-body X-ray and treatment rooms.

The new quarters feature a "floating" helipad, designed so that it can be moved if future hospital expansion dictates. Quick, direct access from the helipad to Emergency Services is provided by two over-sized elevators.