 |
 |
| Spring 2009 | Copyright 2010 Emergency Care and Safety Institute |
Letter from ChairSubmitted by Dave Magruder, 2009 National Advisory Council ChairpersonMany years ago, I found a statement about quality written by Mike Love, an Assistant Chief for the Montgomery County Fire and Rescue Service in Rockville, Maryland. Many years later, I still find this statement invaluable and applicable in almost all aspects of my life and business. Mike wrote: "Quality is not just a finished product or a goal achieved. It cannot be determined by the amount of resources applied, so the haves and have-nots can achieve quality equally. Quality may not be apparent when you have it, but you sure as heck can see when it's absent." Mike went on to say, "I also think a real big ticket item in regard to quality is that it is loaded on the front end as opposed to the back end. The whole premise is to make the service or product good from the start, not spending wasteful time going back to correct mistakes. That requires this front-end loaded process to be continuous. Look for improvement opportunities, and start over again." I can assure you that there is quality in all of ECSI's Educational Programs, although I can't guarantee that the same quality exists in the program delivery. I encourage each and every Educational Center and individual instructor to remain focused on the quality of your programs or courses. Emphasizing quality in training does not necessarily cost you anything. In fact, in these difficult economic times, a focus on quality may even boost your bottom line. The people who attend your classes may forget some of the things you taught them, but they won't forget that the class was well-organized and high quality. ECSI is a quality organization, and you are a vital part of that. Please let any of the Advisory Council members know if there is anything we can do to assist you. Remember that National CPR-AED Week is June 1—7, 2009. ECSI's Announcements
In the NewsSubmitted by Alton Thygerson, FAWMLong Beach, CA—A deckhand on a charter boat full of
elementary school children choked to death on a bait fish he put in
his mouth as a joke. The 54-year-old man lost consciousness after
the fish lodged in this throat. Pacolet, SC—A girl was attacked by a rabid coyote while
waiting at a school bus stop. Neighbors came out to help the
9-year-old girl. A teenager kicked the coyote and held it down while
his grandfather shot it. The coyote tested positive for rabies.
Farmington, UT—A 48-year-old man was bucked off his horse
while riding on Antelope Island in the Great Salt Lake. He spent the
night lying on the ground after sustaining severe pelvic injuries.
He was rescued about 12 hours after the accident. Temperatures had
dropped to about 16F. He suffered hypothermia and was flown to a
Salt Lake area hospital. Tulsa, OK—A truck driver was electrocuted when he touched
power lines that had become tangled in the load he was hauling.
Firefighters say the man had stopped his truck and climbed on top of
his load to try to free it. He received a 4200-volt shock.
Firefighters performed CPR but the driver was pronounced dead at a
local hospital. Washington, DC—Air-ambulance helicopters have the worst
fatal crash record in aviation, and their crews are among the most
likely to die on the job. The rate of fatalities per 100,000
air-ambulance employees over the past 10 years exceeds other
dangerous professions such as logging or deep-sea fishing. Since
1972, 264 people have died in air-ambulance crashes.
Denver, CO—There wasn't time to look up any books on
obstetrics before a woman gave birth in the Denver Public Library.
The woman walked into the library, said that she had been riding a
city bus, and was in labor. She gave birth just inside the library
entrance. Staffers and security guards helped until paramedics
arrived and took the mother and newborn girl to the Denver Health
Medical Center. Spokane, WA—A man whose car slammed into a snow bank and
caught fire was saved by a nearby resident. The driver was
unconscious and the rescuer used a snow shovel to break a window and
pull the victim to safety as the car went up in flames. The driver
was arrested for driving under the influence of alcohol. The rescuer
was treated for a cut hand and smoke inhalation. Medical Journal AbstractsSubmitted by Alton Thygerson, FAWMObesity Winning Out Against Firefighters and ParamedicsA Harvard School of Public Health study indicates that more than 75% of young firefighter and paramedic recruits in Massachusetts are overweight or obese. The researchers showed that increasing body mass index was associated with cardiovascular risk factors, as in the rest of the population, including:
Source: The Obesity Epidemic and Future Emergency Responders. Obesity, 2009;March. Magnitude of Dental TraumaDental injury is a sizable public health problem. Dental injuries
occur frequently. They also tend to occur at a young age during
which growth and development take place. Treatment of dental
injuries can often continue for the rest of the victim's life and
can be complicated and expensive. Data showed that one-third of all
preschool children have been victims, one-fourth of all school-age
children, and almost one-third of all adults have suffered an injury
to permanent teeth. Males experience a dental injury at least twice
as often as females. Helmet Use and Related Spinal Fractures in Motorcycle Crash VictimsThe relationship between helmet use and cervical or thoracic
fractures sustained in motorcycle crashes remains controversial. A
study published in the Journal of Trauma reviewed helmeted and
non-helmeted crash victims. Of the 422 motorcycle crash victims
treated over the course of 3 years, 190 had a traumatic brain injury
(TBI) and 75 sustained some form of spinal fracture. The researchers
concluded that there was no relationship between helmet use and
cervical or thoracic fractures. The protective effect of helmet use
in TBI was verified. Lay Rescuer DefibrillationA study published in the Annals of Emergency Medicine
evaluated the cost-effectiveness of using CPR and AEDs by lay
responders versus CPR-only for cardiac arrest. The data showed that
CPR alone had 14 survivors to discharge and CPR plus AED use had 29.
The University of Washington researchers concluded that training and
equipping lay volunteers to defibrillate in public places may have
an incremental cost-effectiveness that is similar to that of other
common public health interventions. Featured ArticlesAutomated External Defibrillators (AEDs)—An Unbiased LookSubmitted by Dave Magruder, Life Safety Solutions
Do you have an automated external defibrillator (AED)? If so, where is it? Where should you place it? How many do you have and how many do you need? Which AED should you choose? How do you store it? Does your staff need to be trained to use it? Do you need to notify local authorities? How do you maintain the AEDs? Do you need to keep any records? Should you have a policy or procedural guidelines? How will your staff know when to use it? Is it functioning and ready to be used? Can it be used on children? How much should you budget? Do you need help with these questions? Where is it located? AEDs should be placed in an area that is unobstructed and clearly marked. They may be secured in wall-mount brackets or wall-mount AED cabinets. Options include a local audible alarm signal, a strobe light, and direct dialing to your alarm company; these options are only activated after the cabinet door is opened and these features can be turned off by key switch. You should not store your AEDs in file cabinets, desk drawers, closets, or other areas where staff may not be able to locate them during an emergency. Waterproof cases are available for transporting AEDs and storing them in extremely wet environments or on vessels. The waterproof case should be clearly marked to indicate that it contains an AED. How many do you need? Research indicates that the best chance for survival during sudden cardiac arrest (SCA) includes the use of an AED in the first 3 to 4 minutes. These studies indicate that the chance for survival from SCA is reduced by 10% each minute that an AED use is delayed. Obviously, you need to have your AED conveniently placed in order to facilitate its use within the first few minutes of a cardiac emergency. Many corporations place their AED in a location that is no more than a 1.5-minute brisk walk from any spot in the facility. This placement allows a rescuer to leave the victim and return with an AED within 3 minutes if no other means of acquiring the AED is available. Many factors need to be considered if you want to achieve this goal in your facility, including restricted employee access, square footage, acreage, height of buildings, banquet areas, physical fitness facilities, and outdoor activities such as golf and swimming. Monetary constraints may preclude a facility from meeting such an aggressive placement goal, so placing an AED in a secured area with trained staff nearby who could bring the AED to the scene of an emergency is a wise plan. Additional AEDs can always be added to your program. Which AED should we have? There are currently nine manufacturers of AEDs worldwide. All AEDs have similar functions and capabilities. When used properly, all AEDs give the rescuer voice and audible rescue prompts, analyze the heart's electrical rhythm, and indicate that a shock is or is not required. Beyond those basic functions, AEDs vary in many ways, such as cost, warranty, accessories, size, battery type and length of use, expiration periods for accessories, and medical therapy algorithms. There is a significant difference the semi-automatic devices and the fully-automatic AEDs. A semi-automatic device will recommend a shock (if needed) and then it will advise to clear the patient and prompt the rescuer to press the shock button. This action performed by the rescuer will deliver the medically necessary shock as determined by the device. With a fully automatic AED, the rescuer does not need to press the shock button. The device performs similarly to the semi-automatic unit and then advises the rescuer(s) to move away and to stay clear from the victim before delivering the shock automatically. Both types should be evaluated when making AED purchasing and placement decisions. If lay rescuers will be part of your response to SCAs, special attention should be given during your AED selection process to the ease of use of the AED. You may also want to have special reduced-energy pediatric electrodes that can be used in SCA victims under 8 years of age. What about training? All AEDs have audible and visual prompts and aids. Rescuers should be able to use one without hesitation. However, human nature dictates that during times of extreme stress, such as during an SCA event, humans can make mistakes and quite possibly may not use an AED when it is needed most. Training an adequate number of willing staff will play a major role in the successful use of an AED. A recognized training program should be used. This training should follow the most current internationally approved guidelines for CPR and AED use. A typical CPR-AED training class is 2 to 4 hours. Training could possibly be the most important component of your life-saving program. We know that approximately 50% of SCA victims will require a defibrillation shock and 100% will need CPR. High-quality CPR instruction and employee training is imperative. What about the laws relating to AEDs? Local, state, and national laws vary from location to location. An effort should be made to ensure that placement of an AED abides by any regulation that may apply. There may even be local laws or ordinances that require an AED(s) at your facility. Every state has some form of immunity for the rescuer who uses an AED on a perceived victim of SCA. In some instances, AEDs can only be purchased with a medical prescription from a licensed physician, and some states and jurisdictions require ongoing medical oversight and supervision. The subject of laws and medical oversight is complex. Each facility should be evaluated for compliance. Each facility should have a written AED procedure and policy for their AED program. Make sure that your written policy does not include items that you cannot or will not abide by. All records of training, maintenance, and AED inspections should be maintained. It is also important to ensure that your AED placement has been recorded by the distributor or manufacturer. All major AED manufacturers have had recent recalls or announced corrective actions that were needed for certain devices. It is extremely important to keep good records of AED serial numbers and exact placement. How should you maintain your AED? All AEDs currently sold have automated and user-activated internal diagnostic capabilities. The automated self tests that AEDs perform include battery strength, electrode pad integrity, internal circuitry, and others. AED self tests vary in regularity from daily to weekly or even monthly. All AEDs have some form of a visual and or audible indicator of user-readiness. If a self test fails or a problem is found that needs some form of attention, the visual-readiness indicator will change from its normal appearance. On some AED models, an audible "chirp" or "beep" will alert the owner of the need for attention. It is imperative that you review your user manual to understand the various ways your AED can illustrate its user-readiness or its need for attention. AED owners are often unaware of the expiration dates that apply to disposable parts and components. The battery and electrodes (pads) have factory-designated expirations, and these also vary from model to model. The expiration dates are printed on the packaging of the electrodes. The electrodes should be replaced on or near the printed expiration date. Battery expirations may be more complicated; some have defined expirations and are clearly indicated on the battery, while others have an "anticipated duration." Some batteries have a date printed on them that users may interpret as an expiration only to find that the printed date is actually a "shelf-life." This is the date by which the battery should be inserted into the device. That battery may last another 4 years after insertion. Some batteries have the date of manufacture printed on them. Clearly, battery expiration dates should be carefully reviewed and monitored so a misunderstanding does not lead to a failed rescue attempt or increased liability. How much should you budget? How long will an AED last? AEDs typically cost between $1,200-$3,000 plus the cost of accessories. The expected useful life of an AED is approximately 10 years. However, because of the technological advances in this industry you should plan to replace your AED at least every 7 years. The cost to repair a device that is not under warranty will exceed its value. Current AED warranties are either 5 or 7 years. If you currently own an AED, you should budget approximately $100 per year to properly maintain it and replace the disposable parts and supplies as necessary. Summary. The debate over whether to have an AED will go on for some time. Issues such as liability will continue to be evaluated. The one point that is beyond debate is that the timely use of an AED in conjunction with a call to EMS and early CPR can save tens of thousands of lives each year. If you assume risk by having an AED at your facility, you should manage your program correctly; doing so will keep any associated liabilities to a minimum and still enable you to potentially save a life. Not having an AED may very well expose you to unnecessary liabilities and lawsuits. Life Safety Solutions can assist you with all your needs when it
comes to your AED program. We can help you.
888-748-0004 American Electric Power Counts on ECSISubmitted by Michael McLeieer, E.S.C.A.P.E.
The Lineman's Rodeo attracts the best linemen from around the world to compete in events based on traditional lineman tasks and skills. The first Lineman's Rodeo was held in September 1984, with twelve participating teams from Kansas and Missouri. The Rodeo, which is held annually in Kansas City, Missouri, has grown to over 200 teams and 250 apprentices. Some of the Rodeo events include:
Each year, E.S.C.A.P.E. trains various AEP employees at multiple locations throughout Northern Indiana and Michigan including its Linemen in CPR, First Aid, AED, and Bloodborne Pathogen Awareness. Nick McClain (Elkhart, Indiana), Anthony Patten (Marion, Indiana) and Jason Scoles (South Bend, Indiana) scored extremely well. Out of 228 contestants, the three scored at the top 25% for their CPR with AED skills and at the top 14% overall. "We are very proud of these three participants", says Michael McLeieer, President of E.S.C.A.P.E. "Each of these men is well prepared should an emergency situation arise and are an asset to their colleagues and AEP." McLeieer continues, "With the hazards the linemen encounter on a daily basis, even the healthiest worker could become a victim of sudden cardiac arrest if they accidentally make contact with the highly energized electric lines." The purpose of the CPR with AED event is for the linemen to demonstrate proper care of a coworker who suffers sudden cardiac arrest. This is a two-part event consisting of a demonstration of the physical skills needed for the performance of CPR with AED followed by a written test based on these same skills. The skills portion is a timed event and follows the protocols of the ECC 2005 Guidelines for One-Rescuer CRP Adult with AED. American Electric Power is one of the largest electric utilities in the United States, delivering electricity to more than 5 million customers in 11 states. E.S.C.A.P.E., Inc. is a nonprofit charity, headquartered in Kalamazoo, Michigan, with a branch office in Merrimac, Massachusetts, that works full time to teach children and adults techniques in fire prevention, CPR, and first aid. Pet PointsSubmitted by Lani Byrd, ECSI National Membership DirectorDid you know that approximately five million people are bitten by animals in the United States each year? Half of those bitten by animals are children. About a dozen people die each year from dog attacks. Half of all cat bites become infected. Seventy-seven percent of biting dogs belong to victim's family or friend, and 61% of animal bites happen at home. Tips to prevent becoming a statistic of animal bites:
Reading the animal's body language:
ECSI's Pet First Aid & Disaster Response program will give you additional tips for pet safety, as well as what to if you or your pets are bitten by another animal. To offer this program in your community, please contact your ECSI specialist for further information. Educational Center SpotlightECSI Hits the Ground Running in New HampshireSubmitted by Captain Chris Rousseau, New Hampshire Fire and EMS AcademyThe New Hampshire Fire & EMS Academy became an Emergency Care and Safety Institute (ECSI) Educational Training Center last year. Since that time, we have been working hard to successfully integrate professional rescuer CPR/AED and standard first aid training into our firefighter and EMS programs. For those of us here at the Division, it is finally report card time! Time to see just how successful our efforts have been in bringing this process to our organization and to see if it has made things more streamlined. I am happy to say that, so far, it has exceeded our expectations. Since we began, we have trained and brought on board 32 instructors who can teach all levels of CPR/AED, first aid, and bloodborne pathogens. We will continue to offer Instructor Development Courses (IDC) in order to support the growing numbers of instructors with the Division. We have successfully migrated away from individual instructors teaching from a wide range of outside certifying agencies in our firefighter programs, to all ECSI instructors teaching ECSI courses. We have documented students' training and produced certificates in less than 3 days, in most cases. This has meant more efficient administrative support and processing time, which equates to faster receipt of certification for our students. We are also beginning the first phases of providing support to EMS instructors who are teaching CPR/AED certification to their EMT programs and providing refresher and recertification programs to their services. I can only foresee this continuing to grow as time goes on. We are extremely pleased by this great achievement over the last year. It has made a very positive impact on the way we conduct business at the Academy, and, most importantly, it has benefited our firefighters, EMS personnel, and instructors. East Carolina UniversitySubmitted by Rod Compton, East Carolina UniversityThe Pirate First Aid Instructors
Special shirts were designed and provided to the instructors this year. The shirts serve several important purposes. They give recognition to these fine instructors, bring attention and provide promotion to the program, and are an additional point of professional pride for the staff. They also show the program's commitment and involvement with the Emergency Care and Safety Institute as an official Educational Center. Our program's association with the American Academy of Orthopaedic Surgeons' Emergency Care and Safety Institute has provided many key benefits to insure a successful educational program. The outstanding, high quality educational materials, the always-available professional support, and their caring staff make our efforts much easier in a first-class manner. We are proud of this affiliation! International SpotlightSubmitted by Dr. Jacob Tieffenberg, ECSI Iberoamerica
ECSI Iberoamérica has developed a website (http://www.ecsi-iberoamerica.org/) in Spanish and Portuguese, with all the information on the courses, forms, and requirements to participate in the courses or become an instructor. Our main goal is to expand the ECSI Iberoamérica network without sacrificing the quality required by ECSI. These courses are supervised by the ECSI Iberoamrica staff, headed by Juan Sebastian Vilas, who are responsible for the quality control and the development of rollouts for the different courses. Vilas is a long-time instructor of Wilderness First Responder and trauma courses, a former Red Cross BLS instructor, and a member of Physicians of the World NGO. ACINDES has developed all the training manual and training materials in Spanish and Portuguese to make possible the ECSI Iberoamérica courses in the local languages. The training programs translated by ACINDES for the ECSI Iberoamérica Training Network include: 
SPANISH:
PORTUGUESE:
During May, rollouts for Wilderness First Aid, PEPP, and GEMS are taking place in Spain; in June, PEPP and APLS courses are being run in Argentina. Visit the ECSI Iberoamérica Web site: http://www.ecsi-iberoamerica.org/, or e-mail Juan Sebastin Vilas, Director ECSI Iberoamérica at jsvilas@ecsi-iberoamerica.org ACINDES is a private, international, nonprofit institution founded in 1985 in Buenos Aires, Argentina, with subsidiaries in Sao Paulo, Brazil, Mexico, and Madrid, Spain. Its primary goal is the promotion and organization of educational programs for the healthcare team (physicians and other healthcare providers) and for the lay public, in different regions of the world. ACINDES organizes consensus conferences and promotes and develops training, continuing education programs, and publications. Since 2005, it has been in charge of ECSI Iberoamérica. Corporate Partner SpotlightWorldPoint
All of the materials and products WorldPoint carries support training, including CPR and first aid, pediatric life support training, including neonatal resuscitation, and more. Carrying products from training manikins, to BLS and advanced simulation, to barrier devices and AED trainers, WorldPoint continues to offer new, top-of-the-line medical products. Some of the new products include the Instructor Roster Tool and the VitalSim line. WorldPoint also has a wide selection of rescue equipment such as AEDs and airway management tools. WorldPoint's newest line of educational materials from ECSI includes lay person emergency care as well as EMS and fire training materials. WorldPoint has recently started carrying products from ECSI/Jones and Bartlett Publishers. This new line of products is one of the main focuses for 2009 and will help WorldPoint become more of a one-stop shop for our customers. WorldPoint, based in Chicago, has expanded its market to Asia, Europe, Central America, South America, and the Caribbean. The company prides itself on offering attentive service with a personal touch from the experienced and dedicated field sales team. ConferencesThe following conferences will be attended by representatives from the Emergency Care and/or Safety Institute or our publisher, Jones and Bartlett.
|
E.S.C.A.P.E., an ECSI Educational Center
headquartered in Kalamazoo, Michigan, announces the results from the
25th International Lineman's Rodeo held in 2008 with one of its
clients, American Electric Power (AEP), participating.
These energetic and dedicated young
professionals are the graduate assistant instructors for Health
2125/26 "Safety Education & First Aid" ("Pirate First
Aid") at East Carolina University within the Department of
Health Education and Promotion. These ECSI Certified Instructors are
responsible for teaching the skills and applying the knowledge
involved in CPR, AED, and First Aid to over 380 ECU students each
year.
More than 30 ECSI Iberoamérica
Training Centers have been created by the Association for Health
Research and Development (ACINDES) during the last 2 years. These
training centers are located in Latin America, Spain, and Portugal
(in the Iberic Peninsula). The ECSI Iberoamérica Training Network
includes 7 centers in Argentina, 15 in Brazil, 2 in Chile, 2 in
Mexico, 2 in Colombia, 1 in Costa Rica, 1 in Portugal, and a large
network in Spain, with more than 70 instructors. New centers are now
being formed in Peru, Portugal, and Spain. Key to this fast growth
is the strict adherence of ECSI Iberoamérica to quality standards
and the ECSI requirements, which are making a significant difference
in the field.