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A. R. Totten & Associates, LLC
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 Totten & Associates Co-Sponsors V.B.A.'s  "Solo & Small Firm Conference"

Totten and Associates were proud sponsors of the "Solo & Small Firm Conference" presented by the Vermont Bar Association (VBA). Totten representatives provided information and answered medical questions of the many attorney attendees at the conference.




















Totten Attends National Legal Nurse Consulting Education Conference






Totten & Associates President and founder, Drew Totten, recently attended the American Association of Legal Nurse Consultants (AALNC) "Legal Nurse Consulting Educational & Networking Forum" in Indianapolis, IN. The forum was attended by more than three-hundred Legal Nurse Consultants, educators and subject matter experts representing nearly every state in the U.S. A few of the conference topics included:

1. "Using Demonstrative evidence to enhance Personal Injury practice"
2. "Defending Motor Vehicle Catastrophic Injury Claims: From Records to Mock Trials"
3. "Evaluation of Anticoagulants in Clinical Practice"
4. "Forensic Nursing: Game Changer in Healthcare"
5. "Alternative Dispute Resolution and its Importance in Resolving Healthcare Disputes"
6. "The Psychology of Jury Trials - Preparing the Attorney and Legal Nurse Consultant"














Texting and Driving - Are Parents Positive Role Models?


Texting while driving isn't so bad, right? Well, it seems parents should be aware of the fact that they are most likely passing on this bad habit to their children. From a very young age, children are watching their parents' driving habits - and will most likely emulate the behaviors, both good and bad.

Statistics show that approximately 23% of all car accidents in the U.S. involve cell phone use. This adds up to a whopping 1.3 million crashes! And, according to a survey conducted by Liberty Mutual and Students Against Destructive Decisions, 59 percent of teenagers report that they have seen their parents text while driving. In addition, the teens reported to seeing their parents engaging in other dangerous behaviors when behind the wheel, - including speeding (88 percent), talking on their cell phone (91 percent), not wearing a seatbelt (47 percent) and driving under the influence of alcohol or drugs (27 percent). 

Not surprisingly, a number of teens reported to engaging in the same behaviors that they observed. The survey found that 90 percent of teens admitted to talking on their cell phones while driving, 80 percent say that they read and send text messages while driving (girls send more than 50 texts on an average day*) and 94 percent of teens surveyed speed on the roads at least some of the time. In addition, many teens also reported that they have driven while under the influence of alcohol or drugs and driven without wearing a seatbelt.

Lastly, the VirginiaTech Transportation Institute found that texting, whether sending or receiving, takes a driver's eyes from the road for an average of 4.6 seconds. That is enough time to travel the length of an entire football field at 55mph, which the driver is essentially doing blind.

So, remember... be safe out there. Don't text and drive!

(*Unrelated survey of U.S. teenage girls 13 to 15 years of age.)



Alcohol: Some Facts, Fiction, and Life Experiences
Written by Drew Totten, RN, BSN, BS, CLNC
Published in the Bennington Banner, Bennington, Vermont - June 5, 2011
Copyright, 2011-2015 Totten & Associates, LLC












While it  may seem socially acceptable, the use of alcohol in both the adult and teenage population continues to be a global health problem. First, let’s review some basic facts on alcohol. Alcohol is a drug and a very potent central nervous system depressant. Its depressive effects control judgment, physical coordination, risk taking behaviors (driving while impaired, for example) and most importantly, breathing. A twelve ounce bottle of beer, five ounces of wine or 1.5 ounces of liquor all have the same affect when ingested. The term “100 proof” implies a fifty-percent alcohol content.

Alcoholism is a disease. A disease not unlike epilepsy, diabetes and heart disease. Yet, we as a society, often treat the problem drinker differently. We use words and phrases such as "... you could quit if you just had some willpower" and the like. The fact is, alcoholism is a chemical dependence problem. Like any other drug addiction, it needs careful and dedicated treatment by professionals.

Current national statistics reveal that the average age of an adolescent’s first drink (one to get “high”) is twelve years old and dropping. Using statistics from 2013, there are nearly eighteen million alcoholics in the United States alone. Alcohol contributes to eighty-three percent of fire deaths, seventy-two percent of aggravated assaults, sixty percent of drowning deaths and more than fifty percent of all fatal car crashes. Children who consume alcohol before age fifteen are four times more likely to develop alcoholism than those beginning at age twenty-one (the legal drinking age). About 4.6 million youths, age eleven to seventeen, are considered “problem drinkers”. Boys have an 80% higher risk of dependence than girls and the risk doubles if both parents are alcoholics. An unintentional overdose of alcohol by teens, such as “binge” drinking can lead to acute alcohol poisoning, respiratory failure and death. 

As both an Emergency Department Registered Nurse and Medical Examiner, I have investigated and treated numerous alcohol poisoning cases, deaths and countless traumatic injuries related to its use. Unfortunately, two of those cases involved both MY children losing best friends in high school due to bad judgment and alcohol. A common myth about the use of alcohol and injury is that “it can’t happen to me”. So, if this belief is true, one might then ask this question. What are the odds that BOTH the Medical Examiner’s children lost friends they cared deeply about? Bad judgment plays no favorites. It crosses all cultural, educational and socioeconomic boundaries. Alcohol can and does kill.

As I lecture to adults and teens around Vermont, I begin each session with a simple statement... “life is full of choices.”  As experienced adults, we know this statement to be true. Many of us however, would likely agree that our teens do (at times) have a perception of invincibility. Here is where one poor choice can last a lifetime. It is imperative that parents discuss their child’s (and possibly their own) alcohol use and seek help. This help is available through your family physician, Alcoholics Anonymous, clergy or school guidance counselor. Please… make that right choice.                                                                            

                                                                                             - Drew Totten


Healthcare Workers Contaminated After Removing PPE
Posted in Medscape Nurses, October 16, 2015 


Healthcare workers (HCWs) often contaminate their skin and clothing when removing contaminated gloves or gowns, according to a report and editorial published online October 12 in JAMA Internal Medicine. Educational tools including practice with immediate visual feedback on skin and clothing may help remedy this situation.

"Personal protective equipment (PPE) reduces, but does not eliminate, the risk of skin and clothing contamination with pathogens among health care personnel," write Myreen E. Tomas, MD, from the Geriatric Research, Education, and Clinical Center, Cleveland Veterans Affairs Medical Center, Ohio, and colleagues. "Even when gloves and gowns are worn, 2% to 5% of personnel caring for patients colonized with multidrug-resistant bacteria acquire the pathogens on their hands after glove removal. In addition, 24% of personnel caring for patients with Clostridium difficile infection...had spore contamination on their hands after glove removal."Results from the study were presented May 15 at the Society for Healthcare Epidemiology of America (SHEA) Spring 2015 Conference. 

The goals of this point-prevalence and intervention study were to examine the frequency and sites of skin and clothing contamination of HCW during PPE removal and to assess the effect of an intervention on contamination frequency.




                                        Totten Attends National Simulation Conference
                                                                                     Posted on October 20, 2015

Totten president and simulation specialist Drew Totten attended the 2015 Simulation User Network (SUN) Conference sponsored by the Laerdal Medical Corporation. This annual educational program was held at the Louisville Marriott hotel in Louisville, KY on September 11th and 12th. With more than 200 attendees, there were multiple workshops on simulation and manikin technology, advances in science, and the application of new ways to enhance the participant experience. The use of simulation is critical in today's healthcare environment. It helps provide safety to actual patients by practicing on high-fidelity manikins in a lab setting. 




Drew Totten speaks with an attorney at Totten's booth during the VBA Solo Conference