EMS might participate in study
Mar. 30—Would look at physical toll to first responders
At Tuesday's Lawrence County Commissioners meeting, they got a proposal from a pre-med student to have the county's EMTs participate in a study about the effects of their job on their body.
Lawrence County EMS Executive Director of Operations David Hahn, said one of his employees, who is in her final year in the pre-med program at Marshall University, came to him with the idea of doing the study with her professor.
The study would "look at the physical toll this job takes on the body. If approved, they would bring a mobile MRI on some of the employees who have signed an agreement to allow them to do that," he said. The study would then be compiled and submitted to the state governments of Ohio and West Virginia.
Hahn said he wanted to run the idea before the commissioners before agreeing to it.
Commissioner Colton Copley asked if the study would only involve Lawrence County EMTs or whether it would include Cabell County EMTs.
Hahn said at this time, it would only be Lawrence County but it may be expanded to other EMTs.
There is no financial responsibility to the county for the study.
Copley said they would run it by Brigham Anderson, the county's legal counsel, to see if there were any legal issues for the county.
"In theory, I think it sounds like a great opportunity for her and for us to further the knowledge of how to improve EMS," Copley said. "It's exciting. Hopefully, we can help with the project after we talk to Brigham."
In other actions, the commissioners took the following actions on agenda items:
—Approved floodplain permits submitted by the Soil and Water Conservation District for a renewal of a permit for Danny Holschuh, filling and grading project located at 2131 County Road 9.
—Approved appropriations and transfers dated March 25, 2025, under $75,000, submitted by Dylan Bentley, acting administrator.
—Received and filed the Certificate of County Auditor that the total appropriations from each fund do not exceed the Official estimate of Resources.
—Approved and signed the DJFS IV-D contract with Lawrence County Child Support and Lawrence County Common Pleas Court in the amount of $127,674.15, beginning Jan. 1, 2025, through Dec. 31, 2025.
—Approved and signed the DJFS IV-D contract with Lawrence County Child Support and Lawrence County Clerk of Courts in the amount of $19,326.94, term beginning Jan. 1, 2025, through Dec. 31, 2025.
—Approved and signed the IV-D Contract Security Addendum for the Department of Job and Family Services.
—Approved and signed the DJFs IV-D contract with Lawrence County Child Support and Lawrence County Juvenile Court in the amount of $140,694.02, term beginning Jan. 1, 2025, through Dec. 31, 2025.
—Approved Danny Larsen from part-time EMT to full-time EMT effective March 26, 2025.
—Approved the first and final change order for PID 117369 TR101.40 Bridge Replacement, submitted by Patrick Leighty, County Engineer.
—Approved the Preliminary Resolution and advertise to publish for public viewing and public hearing for Private Road 3467.
—Approved the appointment of James Hayes to the Lawrence County Regional Planning Commission beginning April 1, 2025, through March 31, 2025.
—Received and filed the 2024 Annual Storm Water Report submitted by Kim Carrico, Urban Education Specialist, Soil and Water Conservation District.
—Approved and signed the CCAO Worker's Compensation Plan agreement.
The commissioners meet at 10 a.m. Tuesdays in the commissioners' chamber on the third floor of the Lawrence County Courthouse.
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And let's be honest: The legacy of medicine has not always inspired trust. For female patients, the impact of historic injustices like nonconsensual gynecologic procedures on enslaved women or the abuses of Dr Larry Nassar continue to reverberate — especially among marginalized communities. For many, mistrust of medical settings is not just personal, but generational. What the Literature Offers (and What It Doesn't) General guidance on trauma-informed care is plentiful but rarely offers concrete, actionable, step-by-step guidance on treating patients who have severe trauma responses with pelvic exams. Talli Rosenbaum's mindfulness-based pelvic floor physical therapy stands out as a specific protocol for working with clients with sexual pain. As a sexual medicine specialist, I also wanted to develop a process rooted in patient autonomy, explicit consent, and nonexploitation — skills that benefit patients in medical settings as well as in their sexual relationships. I designed my approach to: Equip patients with self-advocacy tools. Teach patients their rights, such as requesting an exam under anesthesia or their right to stop a medical procedure at any time. Coach patients on how to use clear, assertive language to communicate their needs effectively to medical providers. Teach patients their rights, such as requesting an exam under anesthesia or their right to stop a medical procedure at any time. Coach patients on how to use clear, assertive language to communicate their needs effectively to medical providers. Honor the body's wisdom. I've explored a variety of trauma-informed approaches, including Somatic Experiencing, Eugene Gendlin's Focusing, and Gina Ogden's 4-D Wheel, and these modalities sharpened my ability to notice subtle bodily signals. By recognizing these signals, providers can help their patients listen to the quiet voice of their body's discomfort before it escalates and needs to 'shout.' I've explored a variety of trauma-informed approaches, including Somatic Experiencing, Eugene Gendlin's Focusing, and Gina Ogden's 4-D Wheel, and these modalities sharpened my ability to notice subtle bodily signals. By recognizing these signals, providers can help their patients listen to the quiet voice of their body's discomfort before it escalates and needs to 'shout.' Make space for internal conflicts. Internal Family Systems language helps patients acknowledge the parts of themselves that seek healing alongside those that deeply fear vulnerability. My Protocol: Principles and Process Three core principles shape my patient encounters: No exam unless necessary for the patient's goals or questions. Proceed only if the exam aligns with your collaborative care plan and if the patient explicitly consents. The patient is in control of every step of the exam. Encourage self-advocacy and support and validate any request to slow down or pause the process at any point. No enduring is allowed. Although we cannot guarantee that a patient won't experience moments of discomfort, we can shift, adjust, or stop if anything feels mentally, emotionally, or physically uncomfortable. We do not want any patient 'white-knuckling it' through the exam. Share these core principles with your patient before any exam. Then, describe the exam in detail and ask the patient if there are any components they'd like to adjust or exclude. Stepwise, Patient-Led Approach Assessment and window of tolerance. Start in a talking office — not the exam room — to establish the patient's 'window of tolerance,' which is the range in which patients can engage without shutting down or becoming overwhelmed. Ask the patient, 'How will I know you're uncomfortable?' and 'How does your body let you know when it's not okay?' During medical exams, individuals with a history of trauma can unknowingly push through their body's early warning system. To avoid escalation, together we identify early signs of discomfort (eg, elevated heart rate, shallow breathing, muscle tension, mental haze) and plan on grounding techniques (eg, breathing exercises, humming, orienting) we can implement if or when they arise. Gradual exposure. Proceed step by step. First describe the exam, then have the patient imagine the exam, then enter the exam room, and continue to advance in that fashion. Each session progresses only as far as the patient's window of tolerance allows. Cultivating interoception. Treat early warnings as vital information. If a patient notices and reports a sensation of discomfort, welcome it as an important indicator that something in the environment needs to shift. If a patient gets the 'shakes' after accomplishing a difficult step, reframe this reaction as a sign of resilience, as the body has completed a stress cycle. 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We discovered that her initial psychogenic seizure was probably due to a typical vasovagal response. As a result of our sessions, she now uses grounding tools with new providers — proudly advocating for herself in both medical and personal settings. At the end of our sessions, my female patients often tearfully ask, 'Why isn't it always this way?' Barriers and Realities Let's not sugarcoat it: The doctor-patient power imbalance is real and demands our constant vigilance. Furthermore, systemic barriers such as limited time, inadequate space, and liability-driven policies often make trauma-informed approaches challenging to implement in routine care. Although not every provider may be able to fully adopt a practice like this, we can all work to move the field toward more patient-led, trauma-informed care. Ultimately, the goal is a future where trauma-informed exams are the norm, not the exception. Takeaway for Clinicians Clinicians should screen for past traumas of all types and recognize that routine medical care is inherently vulnerable and boundary crossing; as such, trauma responses will inevitably arise. We all need to be prepared with tools and attitudes that can help our patients move through them. So, the next time you perform a pelvic exam: Slow down. Center consent and bodily autonomy. Listen to bodily cues, not just spoken words. Equip yourself with tools to help patients when trauma responses are activated. Empower patients to lead the process. Evaluate the necessity of your planned exams and always explain their rationale. Collaborate with the patient to create an environment for exams that feels empowering and safe. Let's move away from 'getting it done' and start 'getting it right.'
