Letter from Chair
Submitted by Craig Spector, 2008 National Advisory Council Chairperson

As we enter the final months of 2008, I would like to thank all of you for the outstanding support you have shown toward ECSI during my tenure as Advisory Council Chairperson. I have been honored and excited to be the ECSI National Advisory Council Chairperson for the past 2 years and have enjoyed working with you to contribute to the rapid growth and development of ECSI.

In 2008 we grew as both a national and international training organization in a manner whereby everyone can truly experience the ECSI difference! Our growth included new Educational Centers, instructors, programs, products, and layperson and professional customers on many levels, including national contracts. 2008 has already brought us these new programs: Fleet Driver Safety, Health Care Provider CPR, Oxygen Administration, Pet First Aid and Disaster Response, and Sports First Aid and Injury Prevention.

I encourage all of you to continue to be involved in ECSI and to seek positions, such as those on the National Advisory Council and National Faculty, in the upcoming years. I would like to also encourage you to submit articles to be considered for publication in our newsletters.

We need to remain committed to moving forward stronger than ever. I would like to congratulate all of those working toward making ECSI's programs the preferred programs for all agencies and instructors. I would also like to remind everyone who promotes ECSI that our strengths continue to be the quality of our products, the pricing, the administrative ease, and the customer service we provide through delivery of the programs.

Our pride in ECSI makes other instructors want to make the change and "Experience the ECSI Difference!" This slogan could not be any truer. It is our strength as an organization.

As always, the National Advisory Council and National Faculty are here for you to help guide the continued success of ECSI and to be resource consultants for all of ECSI's Instructors and Educational Center Coordinators.

Best of luck to all of you, and wishes for a prosperous new year!

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The Big Picture
Submitted by Dr. Larry Newell, ECSI National Executive Director

We need your help!

ECSI is growing rapidly, so fast that we are preparing to expand our National Advisory Council for 2009. We are looking for a few great people who want to champion ECSI as part of the National Advisory Council. While our current members can nominate others to fill the positions, we also go directly to the field to look for individuals who may be active with ECSI programs but are flying just under our radar. If you know of someone that you want to nominate to be a member, including yourself, please contact Lani Byrd, ECSI's National Membership Director. The 2009 National Advisory Council will be announced after the first of the year.

As we enter the final quarter of the year, we want each of you to know that we remain committed to our original mission, which is shared by our medical publishing partners, AAOS and ACEP, including:

• Provide the most comprehensive list of education programs to help better the lives in all your communities.
• Provide high quality, low cost products that meet a variety of layperson and professional users' needs.
• Provide comprehensive instructor ancillaries so that our instructors can continue to choose among various tools and methods to deliver course content.
• Use technology to our advantage, including our online courses for blended training.
• Save ECSI Educational Centers money on instructor training.
• Provide tools that help increase your business opportunities.
• Expand our program offerings to meet newly identified needs, such as our recent Pet First Aid and Disaster Response course and our newest Sport First Aid and Injury Prevention course.
• Secure all necessary regulatory approvals for programs.
• Provide one-stop shopping for all your program needs.
• Make our programs the most administratively-friendly programs available.

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News and Announcements

Fleet Driver Safety is Here ECSI's Fleet Driver Safety student manual has just been published and is now available for order. The Fleet Driver Safety course provides drivers with skills to operate safely on the roads, the ability to protect themselves from injury and accidents, and the knowledge to best represent the company for which they drive. The course covers defensive driving strategies and incidence avoidance, basic traffic laws and procedures, and more. Fleet Driver Safety is a 4-hour course, and the student receives a 3-year course completion card, which comes free with the student manuals when ordered by an approved ECSI Educational Center or Instructor. The list price for the student manual is $8.95, and the Educational Center price is $6.45. The instructor ancillaries for this program should be available soon; stay tuned for more details.

Note on Health Care Provider CPR Supplements For those of you who are teaching CPR to healthcare professionals, the ECSI Health Care Provider CPR Instructor ToolKit CD-ROM, while currently not available as a hard copy, can now be ordered and downloaded online here. Please note that Health Care Provider CPR is a separate program from the ECSI Professional Rescuer CPR program, which is specifically designed for prehospital professionals. This allows you the freedom of offering provider-specific programs to your clients.

PedFACTs Course Sees Flood of Recent Regulatory Approvals ECSI is pleased to report that our Pediatric First Aid for Caregivers and Teachers (PedFACTs) course has been recently approved for pediatric first aid and/or CPR/AED training by numerous state regulatory agencies for use in their respective states.

Hands-Only CPR
Because of the buzz circulating about hands-only CPR, a new insert is available for our instructors to print and issue to students for discussion during their classes. This insert can now be downloaded and copied from the Tools section of the ECSI website's Member Area.

Schneider National, Inc. Conducts Mass Training with ECSI

Schneider National, Inc. is a leading provider of transportation, logistics, and related services, and it is the largest truckload carrier in North America. Schneider operates 14,000 tractors, 40,000 trailers, and has partnerships with over 6,000 carriers. Covering more than five million loaded miles per day, Schneider is utilized by two-thirds of the Fortune 500 companies. So when Schneider decided to place AEDs at its facilities and implement CPR/AED/First Aid training, it turned to Allied 100 (AED Superstores) and its national training partner, ECSI.

On September 5, ECSI conducted training in CPR, AED, and First Aid at Schneider's Green Bay, Wisconsin headquarters. According to course instructor Carla Campbell, with Schneider's Occupational Health Division, "Meeting OSHA requirements, as well as providing a broad range of lifesaving training that our employees can use on the job, at home, and in the community is something that we really value at Schneider."

With this philosophy, it should have come as no surprise that nearly 140 employees volunteered to complete the 1-day training, and now some of the employees are part of the company's emergency responder team. "The training was incredibly well attended and received. Everyone worked hard. Our folks were excited about the ECSI training course and felt they got so much more out of this than other courses they have attended in the past," said Campbell.

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Featured Articles

Wilderness First Aid in Action
Submitted by Larry Keyes, MS

The northwest corners of Montana and Wyoming contain some of the largest and most beautiful wilderness areas in the lower 48 states. Montana's Crown of the Continent Ecosystem features Glacier National Park and the Bob Marshall Wilderness Complex, while Wyoming's Greater Yellowstone Ecosystem contains two national parks-Yellowstone and Grand Teton-and eight wilderness areas. These areas are home to the country's most complete assortment of wildlife, including lynx, wolverine, mountain lion, black bear, and grizzly bear.

These wilderness areas are home to Bridger Institute, an Educational Center for ECSI Wilderness First Aid programs. Bridger Institute conducts a variety of wilderness workshops, outdoor education classes, professional outfitter and guide schools, and educational expeditions on horseback. The ECSI Wilderness First Aid program is at the core of all of the Bridger Institute programs and is a great foundation for Wilderness First Responder and Wilderness EMT programs.

Glacier has four horseback riding concessions at different locations throughout the park that conduct over 15,000 rides and pack trips each summer. Although just a few years ago the park service required only basic first aid training for organizations that work in the park, all of the wranglers that work at these stations are now trained in ECSI's Wilderness First Aid course, a program much more suited for their unique needs. We've also started to provide this training to our outfitter and guide schools and wilderness search and rescue organizations.

Over the years, through contact with past students who now work in wilderness occupations, we have been able to identify the most common types of wilderness emergencies in the aforementioned areas of the country. As might be expected, most injuries occur to clients and wranglers who participate in daily trail ride programs. Most are minor horse-related injuries; however, riders do occasionally fall from horses and suffer more serious injuries. Fortunately, helmets have greatly reduced the number of head trauma injuries.

In addition to horse-related injuries, outfitters, guides, and mounted search and rescue members do see other common wilderness-related emergencies that often change with the seasons. During fall hunting season, which often entails a longer stay in the wilderness with very unpredictable weather, hypothermia is common. Altitude sickness is a problem in the Wind River Range, where clients may come from sea level and travel to elevations of over 10,000 feet on horseback. Insect bites and stings are common on summer fishing trips, and a real concern in both Montana and Wyoming are encounters with grizzly bears. Encounters with all wild animals-especially grizzly bears-is an important part of our training.

Another important skill that we emphasize during training is the ability to improvise with available equipment and resources that you have with you in the wilderness. I'm amazed at the different types of stretchers, splints, and rescue equipment that have been improvised from horse-packing equipment.

Wilderness medicine has come a long way in the past 20 years. Wilderness first aid training programs are more available than ever and are becoming the standard of training in many areas of the country. I've had the opportunity to participate in a great number of wilderness EMT, wilderness first responder, and wilderness first aid training programs over the past 30 years, but in my opinion, ECSI's Wilderness First Aid program is at the top of the list!

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Cat Crisis
Submitted by Joanne Poesch, www.AnimalAttraction.com

When my kids get hurt, I immediately kick in to "mom mode." A sense of calm comes over me and I know exactly what to do. When my cat, Tom, was recently injured, I ran around the house screaming with arms flailing. I don't think Tom reacted nearly as badly as I did!

I thought we were prepared for any type of pet crisis: We've got the numbers for the vet, emergency clinic, and poison control center on the refrigerator; an ASPCA emergency sticker on the front door; and plenty of food and water in case of a natural disaster. But learning pet first aid wasn't something that had even crossed my mind. Boy, could it have come in handy that night. Here's what happened:

Tom and his sister Bella are barn cats who, after 5 years, are still having a hard time adjusting to life in the climate-controlled suburbs. They make a mad dash for any open door, and before you know it, they're out running through the grass. On the night in question, one of our guests shut the door just as Tom was making his bolt. He made it 98% out the door, with the other 2% (the tip of his tail) laying limp in the foyer.

As I mentioned, I was completely unprepared, and Tom was just plain scared. Had I taken pet first aid training, I would have known to how to stop the bleeding, safely wrap the wound, and, most importantly, calm down my cat.

In the end, everything worked out fine. Tom is back to his normal self, just a few inches shorter in length due to his "tailectomy," as we like to call it. But I've signed up for training so I'll know just how to take care of all my babies in case of an emergency.

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Tech Tips

High Tech on a Budget
Submitted by Bill Kimball, ECSI Distance Learning Manager

As I watched my daughter's college tuition drain into the gas tank yesterday, it occurred to me that instructors face quite a challenge these days in balancing the inclusion of technology against an ever-evaporating budget.

Several tools and products are available for download and use, completely free of charge. The catch is that some of them require additional items to be purchased (e.g., microphone), are not as robust as their commercial twins, or are less intuitive than others and require more time to learn.

Let's address the "if it's free, it can't be any good" notion. While there will always be lemons in the world of software, the recent explosion of open source projects, along with shifts in software marketing, have brought about a wave of great applications that are supported and used globally.

What's Open Source?
"Open source" means software that can be modified, redistributed, or used in whole or part without legal restrictions. Essentially, a user can run the product as is or add new features, customize the product, and freely hand it out to anyone. If you're interested in learning more about what the open source movement is all about, check out the Open Source Initiative or Free Software Foundation.

Why Would Companies Give Away Their Product?
Great question! Not all free tools are open source. Software companies have taken a page from the gaming industry's playbook. The basic idea is to offer you a fully functional, watered-down version before selling you on a premium product. With that said, most of these "lite" versions work nicely for educators. A great example is Dimdim Web Conferencing. The free version of this product is full featured, but it has a limit of 20 attendees. The paid subscription version allows up to 100 attendees.

Here are a few recommended applications:

OpenOffice Suite

Don't feel like paying for a fully functional suite of office products? OpenOffice.org has an impressive lineup of tools for you to use, including a word processor (Writer), a robust PowerPoint alternative (Impress), and an Access-like database (Base). There is no cost to use these tools, and the OpenOffice Suite is compatible with all major Microsoft Office suites. This means you can create all the Impress presentations you want, and PowerPoint users can view them with ease, without downloading anything extra.

Skype P2P Telephony

You live in Boston, you want to call Houston, but you'd rather not pay the toll charges. Skype is a program that allows you to make Internet calls from computer to computer, using only a headset or microphone (easily found at any electronics store for under $25) and your Internet connection. For a real party, connect your webcam and fire up Skype videoconferencing, also free of charge. Several plug-ins (Pamela Call Recorder to create podcasts, for example) help to further enhance the experience.

GIMP

When it comes to cool factor, GIMP takes the cake. This fully functional image editor, and direct rival to Photoshop, is chock full of features. From making simple edits to existing images or creating your own original works of art, if you're willing to spend a weekend familiarizing yourself with the layout, you'll be designing in no time. Thanks to the community of users who support the product, new plug-ins and features are always available through the relevant discussion forums.

Audacity Audio Editor

This recording studio rivals similar products that cost over $500 and is one of the most widely used editing applications for podcasters and audio media developers. You'll have complete control over new recordings to mix, edit, and split tracks. You can even import MP3 files from your computer.

Where Can I Search for Free Stuff?

In addition to the Web sites previously mentioned, there are many other free resources at your disposal. Searching Google with terms such as "open source" and "free teacher resources" should yield excellent results. Here are three more sites that will help you get started:

• SchoolForge—This incredible repository of tools is easily categorized by application type. Educational tools, free antivirus/spyware programs, utility programs, and multimedia applications are also available.
• SourceForge—This site is similar to SchoolForge, except SourceForge offers many more resources beyond those primarily targeted at educational technology.
• Centre for Learning & Performance Technologies—This site is one of the most comprehensive collections of both free and paid tools that instructors might find useful. The layout is intuitive by category.

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In the News
Submitted by Dr. Alton Thygerson, FAWM

Brazil—A disposable diaper saved the life of an 18-month-old boy, breaking his fall from a third-floor apartment window. The boy survived a 30-foot fall because his diaper snagged a security spike embedded in the concrete wall around his apartment building in the northeastern Brazilian city of Recife.
Associated Press, 8/29/2008

Trenton, NJ—Cries for help inside a home turned out to be for the birds. Neighbors called police after hearing a woman's persistent cry of "Help me! Help me!" coming from a house. When no one answered the door, they kicked it in to make a rescue. But instead of a damsel in distress, officers found a caged cockatoo with a convincing call. It wasn't the first time the 10-year-old bird named Luna said something that brought authorities to the home. About 7 years ago, the bird cried like a baby for hours, leading to reports of a possible abandoned baby and a visit to the home by state child welfare workers.
Associated Press, 9/7/2008

Raleigh, NC—A woman was trapped for 5 days in her mangled pickup truck, hidden under vines in a steep ravine in western North Carolina only 150 feet away from a four-lane highway. Seriously injured and without food and water, she might have died if a rescuer hadn't spotted tire tracks and damaged foliage by the side of the road. When he stepped farther down into the ravine to investigate, he saw part of a white truck. The 21-year-old woman recovered in a hospital from a fractured skull and limbs.
Associated Press, 8/28/2008

New Bedford, MA—A lucky cat owes one of its nine lives to a firefighter who revived it with mouth-to-mouth resuscitation. The firefighter rescued the cat from a burning apartment and began performing mouth-to-mouth as he carried it outside. The cat was revived. The rescuer said that it "tasted like fur" to give mouth-to-mouth to the cat.
Associated Press, 9/11/2008

Kansas City, KS—A 66-year-old man and his son were electrocuted while trying to put up an antenna behind their home. The incident occurred near high-voltage electric lines over the backyard. A metal antenna similar to those used by ham radio operators was found on the ground.
Associated Press, 7/18/2008

Austell, GA—A teenager was decapitated by a roller coaster after he hopped a pair of fences and entered a restricted area at Six Flags Over Georgia. Witnesses said the teenager jumped the fences to retrieve a hat he lost while riding the roller coaster.
Associated Press, 6/29/2008

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Medical Journal Abstracts

Sports Drinks, Exercise Training, and Competition
Many studies that examined fluid intake before, during, and after training and competition have suggested that a lack of adequate fluid intake will impair or decrease physical performance. Depending upon the type of training or competition, individuals who are training for prolonged endurance events should drink fluids that contain carbohydrates and electrolytes during and after training or competition. Inadequate hydration will cause significant decrements in performance and accelerate fatigue. However, overdrinking may cause sodium depletion and, in some cases, lead to hyponatremia (water intoxication). Proper hydration will help reduce heat stress, heat exhaustion, and possibly heat stroke.
Source: 2008. Current Sports Medicine Reports (July-August): 7(4): 202-208.

Recreational Injuries in Washington State National Parks
During a 4-year time period, there were 535 cases of recreational wilderness injuries (including 19 deaths). The mean age of the injury victims was 34 years. Males were more likely to sustain injuries than were females (59% versus 41%). Most injuries occurred during summer months between noon and 6:00 p.m., and 90% occurred during daylight hours. The most common preinjury activities included hiking (55%), winter sports (15%), and mountaineering (12%). The most common types of injuries included: sprains, strains, and soft tissue injuries (28%); fractures or dislocations (26%); and lacerations (15%). There were 19 deaths in the two national parks; all victims were adults. The mechanisms of death included: falls (37%); medical (e.g., myocardial infarction) (21%); drowning (5%); and suicide (5%).
Source: 2005. Wilderness and Environmental Medicine (Winter): 16(4): 192-197.

Analysis of Horse-related Injuries in Children
Questionnaires were mailed for follow-up information regarding horse-related injuries in children, and the parents of 112 children answered the questionnaire. The survey found that the female to male ratio of the 112 victims was 101 to 11. Trauma that occurred during horseback riding accounted for 76.8% of all cases, while the remaining trauma occurred while handling a horse.
Source: 2008. Pediatric Surgery International (August 12).

Rodeo Injuries and Prevention
Rodeo is a fast-moving sport with highly talented and tough athletes. The prevalence of injury is high, especially in rough stock events, which include bareback, saddle bronc, and bull riding. While a number of different injuries can occur during bull riding, concussions are often the most alarming. Rodeo athletes want to return to their sport despite injuries and rarely seek medical care; nonetheless, arena-side health care is still utilized and appreciated by rodeo cowboys.
Source: 2007. Current Sports Medicine Reports (October): 6(5): 328-332.

School Teachers' Knowledge of Tooth Avulsion and Dental First Aid
School teachers can play an important role in improving the prognosis of avulsed permanent teeth of school children. A study describes the effectiveness of a short lecture about tooth avulsion and replantation. After these lectures, tooth avulsion and replantation improved from 39% to 97%, and knowledge of avulsed permanent and primary teeth increased from 8% to 71%. The researchers believe that many avulsed permanent teeth in school children can be saved by replantation if school teachers learn what to do when a tooth is avulsed.
Source: 2008. Dental Traumatology (February): 24(1): 43-49.

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No one is safe anymore. Rich or poor, whatever your status in life, safety is an issue everywhere in the world. An emergency drill held at a five-star hotel in Dubai illustrated this point after staff members failed two out of three medical emergency scenarios. The drill was led by Ahed Al Najjar, Middle East and Africa Training Manager for International SOS MEA, Dubai, an ECSI Educational Center.

The drill, held by the Department of Health and Medical Services (DOHMS), involved several scenarios in which heart attacks were simulated to see how quickly hotel staff members responded. Although hotels in Dubai are advised by both the Department of Tourism and Commerce Marketing (DTCM) and DOHMS to have at least one AED on hand, staff members performed poorly in various drills. It was determined by Najjar and others that the problems stemmed from the lack of staff members who were trained to use the AED and the lack of program awareness.

DTCM and DOHMS looked to address the deficiencies by creating the AED Implementation Project in conjunction with various government agencies and the hotel industry. In 2007 regulation was passed to support the findings of the project. Here are some of the recommendations:

• Any hotel establishment that practices its activity in the Emirates of Dubai shall provide an AED at the main reception hall, sports clubs, and other buildings in which activity is practiced.
• Hotel establishments must provide a person, available 24 hours a day, that has completed Basic Life Support (BLS) training, including first aid and CPR.
• No new hotel establishments shall start receiving guests until they provide the required aid services, and administrative penalties shall be imposed on any hotel establishment that does not provide adequate aid services.

It was concluded that placing an AED in a workplace, home, or community setting is an essential component of onsite emergency medical readiness. The program should contribute to a reduction in sudden cardiac deaths in Dubai and throughout the Middle East.

In addition to his role as an ECSI Instructor and Training Manager for International SOS MEA, Ahed Al Najjar is also an EMS International Consultant of the CHEERS Foundation in Philippines and an EMS assessor with Technical Education and Skills Development Authority in Philippines. He has spoken at several international conferences and is a member of the National Association of EMS Educators, National Association of EMTs, and Center of Emergency Medicine. In summer 2006 he was the Emergency Medical Consultant for United Nations-UNOPS in Kabul. To contact Ahed Al Najjar, e-mail ahed.najjar@internationalsos.com.

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Corporate Partner Spotlight

How Ezy can Chest Compressions Be?
Submitted by Terry Jacobs, Northwestern Medical LLC

According to a recent survey of more than 1100 adults, 89% said they were willing and able to do something to help if they witnessed a medical emergency, yet only 21% were confident that they could perform CPR. Survey respondents reported lack of confidence, concern about legal consequences, and fear of hurting a victim as reasons they would not take CPR action.

One solution is the CPREzy Resuscitation System, a new manual External Chest Compression Assist Device (ECCAD). The core of the CPREzy Resuscitation System is the CPREzy Chest Pad, which was developed by an Australian physician who was concerned about his hospital's CPR training and SCA rescue quality improvement. The CPREzy Chest Pad is easy to use. Simply turn it on, align the crosshairs at the centerline/nipple axis, and compress the Chest Pad by hand using the same interlaced fingers technique that is taught today.

Here is how it works. As the student/rescuer presses on the Chest Pad, and it instantaneously transfers the depth of compression to the manikin's/victim's chest. The Chest Pad's electronics provide simple audible and visual rate guidance and a ladder of visible depth-of-compression feedback lights. The feedback light ladder shows the rescuer the depth-of-compression level being administered with each compression stroke. Further, the light ladder is uniquely sectioned off into five patient-size target groups starting at 90 pounds. The light ladder allows the student/rescuer the advantage of knowing that he or she is hitting the target or fatiguing. The Chest Pad also has a flashing timing light and mutable 100 beat metronome to pace compression stroke frequency.

If you are an instructor or rescuer, the FDA-approved CPREzy External Chest Compression Assist Device Chest Pad is an inexpensive and reusable tool that can reduce hands-on time and increase class size. If you would like further information, or to obtain full clinical papers on this tool, visit www.cprezy.us or e-mail cprezy@frontiernet.net. ECSI Instructors can obtain special price considerations before December 31, 2008, by mentioning this Corporate Partner Spotlight.

Upcoming Conferences for ECSI/Jones and Bartlett Publishers

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