February 4, 2011 - The New EMT Program

In this issue

  1. The New EMT Training Program, In Progress
  2. New CPR
  3. Developmental Disabilities and EMS
  4. Sample Test Question(s)

The New EMT Training Program

Day 3 Saturday and Sunday
This was the first all day class of the new program. We are still in section 1 (Preparatory) of the new program. About 140 students showed up today. This was first time in my 16 year career as an instructor that I did not need equipment for such a long day. I will explain below.

Here was the schedule
8:00 AM to 9:30 AM
This was the Medical, Legal and Ethics lecture. This is chapter 3 in the new AAOS book. The lecture was taught by Craig Stewart who is an excellent lecturer and has a great deal of background in this area.

9:30 AM to 9:45 AM

9:45 AM to 10:30 AM
Continuation of the lecture by Craig Stewart.

10:30 AM to 11:45 AM
Legal and ethical scenarios were practiced during this time. Unfortunately my course coordinator is keeping the actual text of the scenarios proprietary so I cannot share the contents with you but I can give you the summary of a few.

Scenario 1
You and your partner are called to the scene of a patient who's chief complaint is difficulty breathing. After a proper assessment you package and transport your patient to the local hospital. En route you pass a motor vehicle crash (MVC) between two vehicles. There are three patients, two of which are seriously injured. You and your partner tend to these two injured patients while calling for backup. After backup arrives and takes over care you return to your original patient, still in the back of your ambulance. You find the patient slumped to one side, drool coming from here mouth and an inability to speak.

Question: Have you abandoned the patient and can you be held negligent?

Considerations: The patient appears to have suffered a stroke, what could you have done to prevent the stroke if you were still in the ambulance?

We considered several of these kind of scenarios.

11:45 AM to 12:30 PM

12:30 PM to 2:30 PM
A documentation and communications lecture from chapter 4 of the new AAOS book. The lecture was given by Aaron Hilliard. This lecture is very similar to the lectures given in the past. We normally wait will "Module 3" for this lecture but in the new program it is given early.

2:30 PM to 2:45 PM

2:45 PM to 4:00 PM
As with the morning scenarios we practiced giving radio reports. We handed out many different scenarios and asked the students to make a radio report to the hospital. This was followed by a written report.

We concluded the day with an instructor meeting to see what worked and what didn't. We found that these scenarios early on in the course got the students to work together as a team and also honed there reasoning skills. We used peer review (student on student) rather and the instructors criticizing the class. This also worked very well since no student felt that they were being unfairly criticized.

Day 4 - The Human Body

We have recovered from our full day sessions over the weekend. Now it's back to the regular evening schedule for class. To night we cover the human body up to the various bodily systems. So the lecture, given by Cliff Field, Sr., covered basic anatomy, geography and function. The next lecture will be on bodily systems.

Here was tonight's schedule:

6:45 PM to 7:00 PM
Homeroom and chapter 5 pre-quiz. The quiz did not have very good results. There were 7 questions on the multiple choice quiz and 15 were distributed. We had two 7 out of 7 (7/7) quizzes and one 1/7 quiz. The rest were in the 4 to 5 range. The class was instructed (more like implored) to read the book.

7:00 PM to 8:45 PM
Lecture on Chapter 5. This was rough, 1:45 to be sitting in class is way too much. I don't think any knowledge was gained at the end of the lecture.

8:45 PM to 9:00 PM

9:00 PM to 10:30 PM
Anatomy drills. We paired up the students and gave them flash card. On each flash card was either a portion of anatomy (such as a femur) or an anatomical position such as Supine. The student then had to show the class what that term meant. After each student went, we quizzed them on some of terms not covered. We then rounded out the night with how to read the book and do the workbook problems.

I am having the class complete each chapter in the workbook for each session and turn it in for grading. This, hopefully, will keep them up with the reading. I did find that some students were very reluctant to touch other students when pointing out body parts. This could make life difficult for them if they do EMS as a profession. It is the nature of our job to touch.


As many of you know, the American Heart Association has revised the procedure for CPR for 2010. Of course, like last time, no printed material is ready for 2011. From what I hear, printed and recorded material will be available after April 1, 2011. For those of use who are instructors, we are required to take a introductory roll-out course (on-line) and then pass a small test. The site was easy to read and test was fairly straight-forward. The site, on the other hand, crashed frequently. Here's my take on the new procedure:

  • Assess breathing an pulse first
  • If neither, start compressions
  • After 2 minutes start ventilation (still at 30:2).
  • Use an AED if present.
    • Can now use on infants less than 1 year of age
  • Skip cricoid pressure
  • Skip ventilations if you are unsure or unwilling to provide such.

Not much of a change except compressions come first. I don't know about foreign body obstructions, that was not in the roll-out.


If you are an instructor, click here to take the roll-out online course

Managing Developmentally Disabled Patients

In 2008, the State of New Jersey passed a law called "DO NO HARM - Developmental Disabilities Awareness Training for NJ First Responders" The law, PL 2008:80 became effective immediately and required all first responders at all levels to be training by December 31, 2010. All EMT-B and EMT-P are required to have this training prior to re-certification.

Speaking as both an instructor and provider, I did not do this. I only recently completed the course which is on-line. I then tried to submit my proof of taking the course only to be told to keep the record and present it only if asked. Hmm, so much public law. Do not get me wrong, the training is invaluable and did teach me about the different states of developmentally disabled patients. I learned, if nothing else, to be patient.

This law is part of a larger autism awareness training for the entire nation. The site 800.4.autism has a lot of information about this required training.


Sample Questions

In this section I will pose a question, usually in multiple choice format. As many of you have found out, I do distribute an online EMT test. I need to test new questions for the new product. Some of those questions will be displayed here. The next newsletter will have the answer I feel is correct. I welcome any feed back.


Here is last week's question.

The second component of the EMS Agenda for the Future is:
a) the patient receives assessment and stabilization in the hospital emergency department.
b) the patient receives the necessary definitive specialized care.
c) the patient recognizes an emergency and initiates the EMS system.
d) the patient is assessed, treated, packaged, and transported to the hospital.

The answer is "d"

Here is this weeks question:

The goal of standard precautions is to:
a) protect you from all infectious diseases.
b) protect you from all hazardous materials.
c) interrupt the transmission of germs.
d) prevent exposure to stressful situations.

Answers next week.

All the Best

Jim Berthold
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