Post Number: 2
|Posted on Saturday, October 27, 2012 - 12:29 am: ||
What are your thoughts on increased BLS level airway management training for the AMFR level?
In the AMFR course you learn the some of the "how" of the BLS airway techniques, but not much other than that. Thus, there could be a possibility that one may have a PT that is not responding to initial attempts at airway management. What is your plan B? Without more BLS training (and through skills practice for normal and difficult BLS airway) one may not be able to effectively manage a situation.
See the excellent series of BLS airway articles on http://emsbasics.com/tag/resuscitation/.
I am aware that some of this may be outside scope, but 98% of it just comes down to knowing the WHY behind your procedures and having enough practice to be able to apply it.
Is anyone aware of any way to obtain more knowledge (as in practice) of BLS airway for personal CME if I can't obtain it through SJA?
It is just surprising that we must do CME for AED (due to the medical directives) for example, but that there is no CME requirements for the other areas of the MFR skill-set and knowledge, which for some subjects/skills can be extremely complex.
Post Number: 90
|Posted on Saturday, October 27, 2012 - 08:57 am: ||
You raise some valid points, but I have to disagree with some of them.
While understanding the "why" is always beneficial, skills such as using a bag valve mask are very much tactile skills that require practice and experience. Unfortunately using a mannikin for practice (while necessary and for most of our volunteers the only exposure they will have) just isn't the same as ventilating a person. It's important to understand that the BVM is a difficult skill, understand your limitations, and be ready to revert to the more basic (but easier to perform) skill of using a pocket mask for ventilation. These should still be stocked in the kits for just this situation.
We are also limited in the formal education we can provide in a forty hour course. As far as ongoing education is concerned, you are correct that you are required to complete CME for AED recertification. You are also expected to be participating in ongoing training at the divisional level, which could include many topics. Don't forget that you are also required to complete HCP-CPR renewal each year, so at a minimum you should be receiving BVM practice at least once a year (though I agree that this probably isn't enough for anyone not using a BVM regularly).
As far as external learning opportunities, assuming you are not a healthcare professional you are likely limited to things such as the website you have linked to. Most external training opportunities pertaining to airway management are likely geared towards healthcare professionals and usually are more related to advanced airway management. I reviewed the link you provided briefly and it looks like a reasonable resource, but SJA volunteers need to remember that they can only perform to the standard and scope that they were trained to by St. John Ambulance (the AMFR-1 Level).
So what can you do if you have concerns or feel you need more training? Speak with whoever is responsible for training for your unit. If a unit chief or training officer have questions or require some assistance with planning their local training, they can always contact me to discuss their needs.
Thanks for the discussion
Post Number: 3
|Posted on Saturday, October 27, 2012 - 11:26 am: ||
Regarding what you said about airway being a tactile skill, I'm in 100% agreement. I may not have worded my question right.
I wasn't so much intending that skills practice be put into the AMFR 1 curriculum, as like you stated it is a 40 hour course and the instructors are limited as to what they can teach in that time.
All i meant is that in an ideal situation, the divisions would provide practice with airway and difficult BLS airway procedures, as in what to do if your plan A fails. For example it is not often emphasized that the CE BVM grip may be ineffective, and a two hand mask seal may be all that is required to fix the issue and provide effective ventilation.
We practice spinal immobilization often, as this is a skill that is critical to "get right", yet we do not need to use often. The same can be said for many other skills, including airway and running a code.
Will this happen? Probably not. Is it a good idea - probably.