-------------------------------------------------------------------------------------------------------------------------------------------------- THE BEAT The e-zine for health, safety, and EMS instructors and coordinators ------------------------------------------------------------------------- Issue: 4 Volume: 1 ------------------------------------------------------------------------- In this issue: * THE TRUTH IS OUT THERE - by John Mateus * HELP WANTED * FEEDBACK * OPINION POLL * COOL SITE -------------------------------------------- THE TRUTH IS OUT THERE by John Mateus The difficult thing about teaching in a variety of different environments is knowing what the truth is. I understand that must sound strange to you when read this article, but what I have come to understand from being exposed to many different audiences is that the truth (in our case, the best procedure to teach in a class) varies according to who we deal with and what their goals are. As a new instructor, I taught what was taught to me. I passed on the bastion of truth as I knew it because someone with more experience taught it to me that way. Now I try to factor in who I'm teaching, and try to do some research about what their needs are. I've realized the truth is not universal. I realized this first when the nursing exam I was taking challenged me with a scenario in which a seizure patient collapsed in convulsions. "Ha", I thought "acute care - this is my thing!" as I promptly circled the answer to clear the surroundings. My mouth dropped as I saw the answer key and it called for "Insert bitestick into patient's mouth" as the correct answer. I furiously shuffled though the pages looking for a copyright date - certainly this book as from the mid-70's. The copyright was 1997. This was the correct answer. I thrashed about in pure frustration - EVERY manual I've read on first aid and pre-hospital care called for nothing in the patient's mouth! Could I be wrong? Could some organization have slipped in a new guideline without telling me? No, of course not. It just happens that in other care setting, priorities change. While I never got true satisfaction on this question, the author of the book felt that it was an important part of care in their setting. Perhaps in a more controlled environment like CCU or med-surg preventing mouth injury is a bigger piece of providing for that patient than in pre-hospital care. Ipecac has just about been eliminated from the national EMT-B curricula. It was felt that in a professional healthcare setting where preventing and reversing side effects is the goal that charcoal is a better option. Poison control centers, however, still advise it's use to parents, and it can be useful for treating the majority of cases (80% of poisonings don't require medical care) where the patient does not require medical attention. This is one of the reasons you still see it first aid books. Epi-pens were another classic dilema. A relatively new addition to the EMT-B curricula, they are a heavily regulated intervention in EMS, often involving medical control, protocols, and many scope-of-practice issues. Many EMS providers still can not use them in their line of work because of various certification issues. Coaches and daycare providers have been using them for years on a bystander basis without incident, and legally speaking are more likely to have trouble for not using one than for using it. I feel it has helped me tremendously to be able to see the various truths of different groups. If you teach the same type of student all the time, you probably can't relate. If you teach to a variety of audiences, get to know the truth for the group you teach - it may shock you... ------------------------------------------------------------ HELP WANTED This newsletter is not free - the price of receiving it is that you pass on a good tidbit of teaching or coordinating safety and health programs to the rest of the group. Send your comments, opinions, or observations to thebeat@lessstress.com ----------------------------------------------------------- FEEDBACK This came to use today: I read your article on CPR DIALECTS with great interest. As an American Red Cross CPR & First Aid Instructor, I find the hardest part of teaching the classes is using 10-year-old textbooks. There are inconsistencies & inaccuracies scattered throughout the texts, one that comes to mind is the statement "there is no vaccine for chicken pox." And in the CPR portion of the text, there is a wonderful description of heart attack symptoms for males, but no mention of the fact that women experience different symptoms, barely any mention that women have heart attacks at all. The skillsheets are certainly accurate, and I teach the manual skills to the letter, but the extra information I give could save a life as well....do I stop telling people about these things because the information isn't part of the approved text?" - Z.M. I too find myself wishing that some texts explained certain concepts better. Circulatory emergency recognition is a tremendously important part of a CPR course, and something that should be well covered. The book lists a set of common and gender-generic symptoms. I feel it is very appropriate to add some of the more common female symptoms. That won't necessarily put you in conflict with the manual, unless preceded by the sentence "Forget what's in the book, this is how you spot an MI!". An issue like this can be phrased "These symptoms you see in the manual are very common, and in my experience women often present with XX, XX, XX, and XX." In summary, it is not supplementing the book that can lead to problems, it's substituting it that gets us in trouble as instructors. ---------------------------------------------------------------- CPR MANIKINS Still collecting your opinions on CPR training equipment. Send your opinions on the best, worst, and truly tragic manikins you've ever used to thebeat@lessstress.com ---------------------------------------------------------------- DID YOU KNOW? You can purchase a range of instructor supplies such as ASHI manuals, AHA manuals, and CPR PROMPT manikins from our on-line store? Check it out at http://www.LessStress.com/shop3.htm ---------------------------------------------------------------- OPINION POLL Should non-healthcare/public safety workers teach CPR and related topics such as AED use? We'd like to hear what you think - thebeat@lessstress.com ---------------------------------------------------------------- COOL SITE Ever wonder what the compression-ventilation rate for adult CPR is in Dublin? I had a great time going through http://ambulance.ie.eu.org/ . It is the Irish Emergency Ambulance Services Resource. Besides a terrific set of photos (ever see a Peugeot Ambulance?) and equipment, they also have a fairly comprehensive first aid manual on-line. Most of the recommendations are european but certainly worth having a look. ---------------------------------------------------------------- ARCHIVES We have begun archiving past issues of "The Beat". You can check out past editions at http://www.LessStress.com/archive.htm