Emergency First Response Instructor /instructor trainer courses

[Dive-aholic]

What was wrong with the ACLS renewal course specifically? Just curious...

fisherdvm already described pretty much the same thing I experienced in my last renewal. I'll add that during my renewal was a joint initial/renewal course. The folks in there for their initial had to come back with their food at lunch and watch 2 20 minute videos. Everything else was exactly the same. When I did my initial, it was 2 8 hour days, and we had to actually participate to pass. Megacodes were no more than 4 people and we each had to take turns being the code leader. Now, I'm pretty much the code leader by default because I know the steps and want to just get out of there. I probably am one of the few in there that actually works codes on a regular basis, though. ACLS is in a sad state these days. Heck, even the new ACLS book is about 1/4 the thickness of the old ones I still have!

 

[BrianMac]

I feel I need to throw my 2cents worth in, I am and Emergency First Responer/ Medical Attendant in Ontario Canada, I am also a First Aid / CPR / AED / O2 instructor and run a small training agency for buisness and industry in Canada.

I was recently approaced by my local dive shop to provide a First AId Course for there DM's, although the instructor in the shop can teach EFR he felt it better left to someone with more experiance and I have to agree, i my be a good First Aid Instructor I may not be a good Dive instructor (if i ever decided to go that route). I think the biggest issue is the same issue people have with dive instructors, you get good and bad instructors for any agency, it's all in the teaching.

The courses I teach follow Heart and Stroke and Canadian Medical association guidelines and meet the requirements for First Aid in the Workplace under Workers Health and Safety Association of Ontario and all other provinces in Canada Except Quebec (go figure, Canadians will get that dig). The EFR program by PADI DOES NOT MEET WORKPLACE REQUIREMENTS IN ONTARIO. Since the shop Pays WSIB to its workers they were required by legislation to have First AId trained staff, so my program was a better fit.

The only issue i have with the EFR / PADI program is that in my humble opinion I feel it falls short of what these people actually need, the course is marketed as a 6 hour course including O2,..The program I teach is 16hrs plus time for add on's like ADE and O2. I feel that this program will sell it's students short.

Thanx
Brian

 

[fisherdvm]

How often do these types of accidents occur? I've only done 1,100+ dives, and have only been nearby when one diver was hit by a prop from a dive boat. I wasn't at the scene, just diverted from diving there by the coast guard. This was in Florida in 95. No first aid at the scene would have helped this guy, apparently.

How often does cardiac arrest occur in my office? None in over 10 years. Only one was not even my patient, who walked in off the street and wants to be seen.

Head lacerations are hard to bandage, and take less than 10 minutes to teach and demonstrate.

Pressure bandage are easy to apply, and easy to demonstrate.

I agree, a tourniquet is more than most folks will ever need. But when you need it, a stick and a torn T shirt will suffice, and can be taught in less than 10 minutes. An arterial limb injury will require alot more than direct pressure. By the time you get the bleeding to stop with direct pressure, it probably means that they are out of blood and in shock.

Never hurt to learn how to put a touniquet on, as long as the students understand you don't use it until you have a large arterial pumper or a severed limb.

 

[nitroxnut]

I'll comment that PADI's QA program is one that if you are the one under the gun on an investigation, you better have your ducks in a row because PADI is TIGHT and hardcore with QA violations. They may or may not give the death penalty..depending on severity of the violation. Typically, if an EFR complaint on improper teaching where safety isn't a primary factor (in the conduct of the training) then probation is possible. gross negligence or not teaching within the core standards, PADI may yank an instructor's cert. I know of a former PADI MI reduced to rubble because of failure to issue certification cards to students..he is no longer affiliated with PADI in any fashion and prohibited to teach PADI..so yes, PADI QA IS good.

 

[nitroxnut]

On another note, PADI is upgrading the EFR program with training requirements that will allow it to compete with other EFR training agencies in better fashion so changes and needs have been recognized. Implementation does take time and PADI is working on this issue

 

[Dive-aholic]

And I know an instructor that was skipping parts of CW training he didn't agree with. I reported him specifically outlining the half dozen or so standards violations. The instructor continued to teach with no change in status.

 

[aparatchiki]

I agree with this point. Giving lay responder simple enough skills to rely upon when responding to emergencies works. EFR is not teaching responders care more than the basic... because the simple works and it is easy to retain and to apply especially under a stressful situation. I guess when one student has the aptitude and wishes to pursue advanced medical training... then there is really no reason preventing him to pursue further education. and first responder training (whether taken from Red Cross, AHA, EFR, ASHI, etc) is the logical first step towards furthering advanced education.

Also speaking particularly about the EFR philosophy... the presumption that there is readily available EMS that has been alerted and notified to respond to the emergency is also one of the reasons for the curriculum design. In developing nations, where EMS may be significantly delayed... First responders also become part of transporting the patient to the hospital from the emergency site and provides care en route. but certainly even in a situation where advanced medical care is needed the basic skills taught to them are the ones that responders go back to and apply.

Many may miss the fact that First Responders are the link between the emergency recognition and the EMS. and that first responders are simply that ... first responders. they are first to have seen and recognized the situation as a medical emergency and provided care to the patient/victim until the patient receives more advanced care from professionals.

How often do these types of accidents occur? I've only done 1,100+ dives, and have only been nearby when one diver was hit by a prop from a dive boat. I wasn't at the scene, just diverted from diving there by the coast guard. This was in Florida in 95. No first aid at the scene would have helped this guy, apparently.

But in reality its a very rare accident, and one that even a very experienced dive instructor is unlikely to come across.


ILCOR, the international umbrella group that covers the Australian Resus Council, AHA and other national bodies, now only recommends direct pressure and pressure bandage for serious bleeding. Forget tourniquets and even pressure points.

In Australia, EFR has a First Aid at Work course which is fully compliant with national standards for first aid and CPR that are required for the workplace. These standards are in line with and in some cases exceed, global standards.

For the EFR First Aid at Work program, there are a handful of additional skills. For serious bleeding we do have to teach pressure points (in addition to direct pressure and pressure bandage), but thats it.

The "standard" EFR Primary and Secondary Care courses are great for the layperson. For workplace compliance (in Australia), a little more must be done, and the EFR First Aid at Work does that really well.

It still comes down to a simple point - we want more people to do the training for simple skills, and we want them to be comfortable using those skills as best they can when called upon. Not freeze up out of fear of being inadequate.

I personally think that any organisation that promotes this concept, EFR and others, is doing a really important thing.