Your Physical and Mental Jumpbag

Your Physical and Mental Jump-bag

By Alan Perry

September 19, 2013

The jump-bag is the one item you should always take into any EMS call, it must be equipped with the basics needed to save a life and start treatment for a variety of illnesses and injury. Your brain, mental preparedness and training are a similar set of tools, equally important, requiring your daily check-off and replacement and repair of expired or damaged items. Occasionally old items are removed to make use of new tools with proven efficacy or updates. The tools in the jump-bag should be those needed to deal with true emergencies and routine patient assessment while remaining highly portable, easy to carry, and easy to navigate. We all know this is not always the case, we also know that the information and training we have accumulated is perishable and needs to be organized in our head so that we can access it quickly and reliability. The next time you are checking off your jump-bag do a little mental check off; do you have all of your protocols memorized? Is your knowledge of basic A&P sufficient to determine what illness or injury may be present and how best to treat it? Do you know the indications, contra indications and side effects of the drugs in your drug box and common prescribed medications? Do you have tools in your head that need cleaning, repair or replacement? Have you taken action to correct it through study or repair/replacement through your training division?

I know you have grabbed a jump-bag at some point in your career and found that some critical item, perhaps oxygen, or a stethoscope was either missing, empty or broken, preventing you from doing what is required for the best patient care. It happens, and we do the best we can with what we have until we find someone else with what we need or we gain access to our back-ups. In our minds, if we draw a blank, forget or are unsure of what to do our back-up is the protocol book. I am not an advocate of “cookbook” medicine, if the protocol book has become your source for patient treatment options you are doing the equivalent of leaving your jump-bag in the truck. My “take-home” message is that you need mental preparedness just as much as physical preparedness, if not more. 

Doing a mental check-off, like doing an equipment check-off, requires some type of check-off sheet to identify the required items, there condition, and status if out for repair or on order. For a provider you can look at your protocols, pharmacology, certifications and education requirements; if you had to test out again today, would you pass? I would avoid simply meeting the expectations of your employer, agency or the public, this leads to complacency. You should be prepared to deal efficiently and effectively with every possible patient and scene presentation within, and maybe slightly beyond, your scope of practice. You didn't get into this business because it was easy, so let the fun begin.

Be Safe,
Alan

Limitations of Web-Based Instruction

The Limitations of Web-Based Instruction

By Alan Perry

Online and web-based instruction have become very popular over the years due to the limitations of individuals time and resources. Many public safety organizations have discovered its benefits due to shrinking training budgets and greater personnel resource utilization. Without on-line and web-based options many individuals and organizations would have no other alternative to provide necessary and frequently required training. But where does this leave us as instructors and students? We all know the cognitive, affective & psychomotor domains of education, how can this satisfy them all? I am not alone in my concern for the outcome of this situation.

The risk is that online and web-based training options may be used to completely replace other forms of training. This presents a problem when it comes to training that requires conveying a technique or psychomotor activity. Take intubation as but one example; you can discuss the anatomy, the procedure, look at videos of it being done, and answer multiple choice questions to get your airway CE. We all know that does not work, how does this get passed-off as somehow being adequate? For some providers that is as close as they will get to performing an actual or simulated intubation. No wonder our skills are declining.

Most of us as providers recognize that the training we receive at times is more of an exercise to satisfy some administrative requirement than a true attempt to impart a meaningful and beneficial education experience. We take it upon ourselves, for our patient’s sake, to obtain and maintain the required skills and knowledge that will benefit them. I take my EMS training seriously; I do not rely on my organization to provide all the education I need to do my job and stay on top of my profession.

As an instructor and education coordinator I know how challenging it can be to find good quality training offerings, especially for large organizations. The ease and consistency of on-line programs is tempting, however the training must match the needs of the providers, especially when QI programs indicate a need for specific training such as intubation. It may be necessary to collect the necessary training equipment, find the space, and schedule hands-on training for your staff. If you know that a problem exist and you fail to effectively mitigate it you are culpable for the failure of the system and the provider when things go wrong. My advice: don’t wait till then.

For those general refresher topics, and routine procedural reviews web-based training is an excellent choice. You still need to do your homework and make sure the program you select is relevant for your service, mirrors your protocols, and is not prone to errors and omissions. Don’t assume that the flashy training website has reviewed the material for accuracy and consistency, that’s your job. Providing online training that is confusing, irrelevant or incorrect will only make things worse and sour your staff’s attitude towards it in the future.

EMS and EMS training are both changing rapidly, not all change is good so we still need to do our homework whether we are the trainer or the trainee. Always remember that your skills can and will make a big difference in the outcomes of your patients. Staying on top of developments in the practice of EMS as a profession and of training opportunities available for your staff will always be a challenge, but that’s why you got into this business in the first place, right?

Be safe, do good work