Introduction to ALS material

[mobey]

I am continuously training BLS staff that have worked in a BLS service for 10+ years to be competent to work as a team with Paramedics.

I am looking for topics or material or delivery ideas anyone may have.

[Just Plain Ruff]

Give them a day in the life of a code or critical patient and what they can do to affect the outcome of the patient.

What will the medic want in a particular situation.

What will the emt's see and be expected to do when the code happens?

You could run them through a generic ACLS class that gives them a basic understanding of each drug, basic understanding of airway control and a myriad of other things that happen in the thick of things.

you could also teach them to drive not like their lives depended upon it but the patients. I say this because usually the emt is driving like a bat out of hell to the hospital tossing me around like a cheap hooker in a dingy hotel, er I mean like a cheap suit. Teach them to take the corners easy, take the acceleration and braking easy and try not to kill me in th eback. The patient is already dead, don't make me dead.

I have physically had to have the driver stop the ambulance, tell him to reboot his fricking head and start driving again, but safer. Once done with the call I then place a cpr dummy in the back on the cot, have the idiot driver do cpr while I drove a little bit erratic but not enough to throw him around the back. Every emt/driver that I have done that to has become a better more cognizant driver.

[systemet]

I am continuously training BLS staff that have worked in a BLS service for 10+ years to be competent to work as a team with Paramedics.

I am looking for topics or material or delivery ideas anyone may have.

* How to draw up meds. They'll enjoy playing with the syringes and needles, and it's nice to have a set of hands that can help with an RSI, or even just draw up some pain control. I'm not suggesting they should be calculating dopamine drips, but they can take the fentanyl or morphine from the vial and put it into the syringe.

* Prep'ing for intubation. Chances are they'll never have to do it, but it's nice if you're elbow deep in the airway, decide to use a smaller tube / drop it on the floor, etc. and they can pass it to you.

* Sequence of drugs in a code, how to assemble and give preloads.

* 12-lead placement. It's really nice if someone else can do this sometimes.

* The point behind ETCO2, so they also know how to point out that the tube is no longer where it should be.

* Give them an idea of how an IO works, so they don't get terrified on the first ped code you run ALS.

* Sim.run, or scenario a few potential critical calls, e.g. cardiac arrest, airway burns / stridor, severe anaphylaxis / life-threatening asthma, crashing CHFer.

* See how sharp their triage skills are. If you're the only paramedic, it might be nice to know that you can run with a critical and not have the scene fall apart, if you have to.

* Review basic skills, make sure they know how to bag an ET tube if they don't have a lot of experience doing it. Make sure they know to be careful with it and not extubate the patient.

I would suggest that as important as what you teach is how you teach it. Especially if any of these guys have more time in the field that you. If you can emphasise that it's a team-based approach, and that they're contribution is equally valid, you'll have a better team. Try and develop a culture of constructive call review / critique, see if you can get them thinking like a paramedic. Do some con/ed.

Just some suggestions.

Edited November 15, 2011 by systemet

[tcripp]

In the back of the EMT text (specifically AAOS, Care and Transportation of the Sick and Injured), there is a chapter on ALS. Start there?

And, I agree with Ruff's points on the driving. I truly would rather go code one regardless of the issues in the back because once the lights/sirens go on, the quality of the ride goes down and it wasn't that good to start with.

[rock_shoes]

I would focus on the parts of EMT training they're most likely to have forgotten because they haven't worked with a paramedic for so long. Things like anticipating when you're going to want a twelve-lead and proper lead placement, preparing airway supplies for you on the fly, recognising when a patient will most benefit from ALS care. Simply introducing them to your SOP and what you can do will probably do wonders in helping them to anticipate your overall needs on a call.

The fact that you're asking alludes to me you have a respectful eager to learn group of EMT's to work with. That's a giant leap in the right direction already.

[DwayneEMTP]

One thing that I believe is often overlooked when you're elbows deep in shit is the dynamic nature of scene safety that can sometimes exist during critical calls.

Get them involved and focused in a bloody domestic dispute trauma and then have the mate return and stab everyone to death. This may sound tongue in cheek, but it's truly not. I believe it's a vital component that I often see lacking in teams.

Man, I tried, but couldn't find a single idea listed above that didn't make me think, "Holy shit! That's a great idea!" though I'd have not thought of the majority of them if I'd been given a month to work on it.

Cool thread Mobes. And though I doubt that the advice was needed, I do believe the 'how you teach is as important as what you teach' comment was spot on. I know the situation you're dealing with and you have such a great opportunity to instil the wonder and commitment of learning that's so vital to EMS.

Dwayne