Brayden CPR Manikins

 

The Brayden CPR Manikin lets students see the real point of CPR pressure and getting the blood flowing to the brain and other organs.

I didn’t like them at first but the Brayden CPR manikin is a big success in our first aid and CPR classes. It uses animated LED lights under the skin, so you can see the effect their CPR Compression Depth, Speed and Recoil and the quality of your CPR

The visual learning keeps you going, pressing at the correct rate and depth with just the right recoil is difficult and tiring.  The nature of this manikin instantly reinforces CPR Technique and the feel of what is right for CPR students. The Brayden CPR Manikin’s dual modes help structure CPR training: from learning effective CPR to perfecting CPR technique, in accordance with the current ARC guidelines.

It shows you how tiring CPR can be, and a recent study showed the compression rate and depth are variable among rescuers and compressions may be worse in the first 5 minutes of the arrest.

One study of rescuer CPR showed that compressions became shallow within one minute, but providers became aware of fatigue only after 5 min.

 

 

When performing compressions, if feasible, change rescuers at least every two minutes to prevent rescuer fatigue and deterioration in chest compressions quality and particularly depth.

Changing rescuers performing chest compressions should be done with a minimum of interruptions to compressions. Quality CPR improves success rates

CPR CHEST COMPRESSION INDICATING LIGHTS

These LEDs represent the volume of blood being circulated by the depth of the chest compressions.

They fully animate when the depth of compressions is over 5cm – too shallow or without full recoil, they will only partially illuminate.

 

 

 

 

BLOOD CIRCULATION

These LEDs represent the flow of blood from the heart towards the brain.

The speed of the blood flow shown varies according to the depth and speed of compressions, only fully animating when the depth is effective and compressions are at a rate of 100-120 per minute.

 

 

 

 

CPR QUALITY INDICATING LIGHTS

These LEDs indicate when blood flow is reaching the brain.

These will only light when the depth and speed of the compressions are both correct.

Effective CPR is a difficult skill to master and you can become fatigued easily. You need quality CPR training.

articles by International Paramedic College

 

Paramedic Jobs

How do I become a paramedic?

Paramedic training is great but if it doesn’t end in a job then, I agree with you, what was the point. You can spend a lot of money learning to become a paramedic and just be poorer at the end of it. A diploma in Paramedic science and the vocational entry point we offer is not for everyone. Sometimes you may be better off completing a paramedic degree at university. So what are the “pros and cons” in a nutshell and what should I do? If you follow our 5 point plan you may be able to work out what is best for you.

Step 1

I want to become a paramedic?

Well, sometimes that just ain’t enough if there are not enough paramedic jobs available when you finish your paramedic degree or diploma. Do your job and career research. Look and understand what qualifications and experience employers are seeking. Do they only want experienced paramedics or are new graduates getting jobs? You can get a taste of what is on offer in the job market by looking through Facebook sites for paramedic jobs or websites that specialise in Paramedic and pre-hospital care jobs like paramedic and first aid jobs based in Australia

 

STEP 2

Consider, can I afford to go back to university as an adult?

Returning to learning is a hard gig, I know I have done it most of my adult life. Lifelong learning is something we think sounds great but it is hard to find the time and the commitment that University study requires. Learning through a Diploma based system with more flexibility and an understanding that the bills of life just don’t disappear because you want to make a career change is a better, more sustainable, viable choice for many adults wanting to change horses midstream.

 

STEP 3

Do I have the stomach for it?

In more ways than one, you need to have the stomach for it, the internal fortitude and the drive to push through obstacles. It is the hallmark of a good paramedic and it is a natural requirement for an adult returning to learning later in life. As the years leave its experiences and scars upon us we suffer the slings of outrageous fortune that is life.

To be or not to be, whether to float with the tide or to swim for that goal is life’s juggle as we steer a course through our busy adult lives. What weight and measure we apply to these choices and manage the lifelong learning demands of this change driven world we have inherited as paramedics, is often the choice we must make. Helping us to find the right paths should be prudent, supportive and mentoring learning choices to guide us.

 

STEP 4

“Suck it and See” Put your foot in the water of a new career

Well three years of University and a degree and now you find out you don’t like the site of blood. Jobs are always different on the inside from what we though on the outside going in and never has a truer word been spoken than when you think of a career as a paramedic. Not everyone is going to love you or be pleased to see you. You may be entering the “most trusted profession” but not everyone loves you, In fact, you are entering one of the most dangerous professions as a first responder to emergency situations. Vocational entry allows you to see not only if the uniform fits but gives you the chance to try before you fully commit to a full degree and a HECS debt.

 

Step 5

Put yourself first “Care for the Carer”

You have to look after yourself a bit you know. Freud talked of an economy of pity and really you can only care for others when you take care of yourself. Find some balance and don’t be driven by the extremes that are the nature of paramedics on the street. Like life education has a middle way.

 

Parents First Aid – Choking

Parents First Aid Choking management

Our mums and parents first aid course or what to do until the ambulance arrives teaches new parents, mums and dads some important lifesaving skills about how to deal with kids in an emergency. Choking and kids is the first of a series of articles by International Paramedic College to help new parents and overcome common childhood emergencies

Choking First aid management and the use of the abdominal thrusts or as Wikipedia calls it theHeimlich maneuver or Heimlich manoeuvre comes up in just about every first aid course.

We have had a question from a student today asking about the treatment for choking and if the Heimlich Maneuver is still used.

It is a question that pops up in nearly every first aid course so I thought I might address it today.

All first aid courses and CPR courses in Australia should follow the Australian Resuscitation Council (ARC) guidelines. The ARC refers to choking as:

Management of Foreign Body Airway Obstruction

The Australian Resuscitation Guideline 4 on airway management says this about choking;

“A Foreign Body Airway Obstruction (FBAO) is a life-threatening emergency. Chest thrusts or back blows are effective for relieving FBAO in conscious adults and children”.

The ARC says that abdominal thrusts are not recommended as 32 cases of the use of the Heimlich manoeuvre have resulted in “Life-threatening complications”

Instead, it says that back blows and chest thrusts should be used in a rapid sequence until the obstruction is relieved. Based on the evidence before it, the ARC says there is insufficient evidence to determine whether back blows or chest thrusts should be used first.

So the ARC does not recommend abdominal thrusts as a treatment for choking. 

It goes on to say that the simplest way to assess the severity is to assess for an effective cough. If the person can cough and talk they should try to expel the object by coughing to relieve what they categorise as a mild airway obstruction.

Choking Severe Airway Obstruction

If the person is conscious, The ARC recommends you send for an ambulance and give up to five back blows with the heel of your hand between the shoulder blows with the aim of relieving the obstruction.

With infants, gravity helps by positioning the head downwards. In the event that the back blows are unsuccessful, they recommend up to five chest thrusts which are similar to CPR compressions but are described as sharper and at a slower rate. Once again if they relieve the obstruction you don’t need to complete the cycle

You can download a flowchart outlining the full current treatment on choking from the ARC website here

I recommend the Kids Health website of the Children’s Hospital at Westmead for a couple of great reasons. You can download a factsheet about choking and importantly you can look at preventative strategies and a choke check tool. We often say “prevention is better than cure” 

Also, it has a fantastic free online training module of how to help a choking baby or child. This is a great resource and I thoroughly recommend it.

Also, each guideline on the ARC website lists the evidence to support the ARC’s conclusions.

I ask people in our first aid course to be prepared to do CPR if required. It might be time to update or refresh your First aid qualifications with a local course

A survey by the children’s hospital found 8% of parents in Australia had done CPR on a child

It is a fear all parents have, I have it too. Anecdotally, I take some solace in the fact that everyone who I have asked who has treated a choking child tells me the object came out.

References:

Australian Resuscitation Council (ARC)

Kids Health at Westmead Hospital

Abdominal Thrusts Wikipedia

Shark Attack Pack

Shark Attack First Aid Treatment Pack

Shark attack first aid treatment and training is a frequent topic at International Paramedic College local first aid classes we run on the northern rivers of NSW. We are based in the Ballina, Evans Head Byron Bay corridor that has seen several shark attacks and a number of “incidents” over the last few years.

In response we have developed the “Shark Attack Pack”. It combines a number of first aid products to deal with traumatic life threatening haemorrhage and training in their use.

 

What is in the Shark Attack Pack?

The kit consists of a Combat Application Tourniquet (CAT) tourniquet an 2 emergency bandages sometimes referred to as an Israeli bandage a pair of paramedic shears to cut wetsuits and gloves and training in their use.

Can you teach us how to use it in an emergency?

Yes we can. Just as important as the contents is that we will teach you how to use them in an emergency. This can be done for community groups or local emergency services or we can do it one on one or for groups via video conference like skype. We think it is important to have the right stuff but it is equally important that someone knows how to use it in an emergency.

Contact us to arrange group training or call 0413244994 and we can discuss your needs, The pack costs will vary with the amount of training time required.

If you live locally in Ballina, Lennox HeadLismore, Byron Bay or Evans Head or anywhere in Northern NSW you could attend or organise group training onsite for your crew.

We can also deliver this training Australia wide.

 

 

 

Blow Backs, its childs play

First Aid Back Blows for Choking

 

The first aid treatment for choking is serious. Every parent should understand that one of the ways kids learn is by feeling touching and of course putting small things  in their mouths. Their small airways can be easily blocked and they don’t have well developed cough and gag reflexes so they can quickly get into trouble.

First Aid training for new parents can help parents to cope should they be faced with an emergency and did you know that a survey by the children’s hospital found a surprising 8% of parents had performed CPR on a child.

In this video the babysitting kids show you what can go wrong and have a bit of fun with a serious subject. The idea being to ask parents and those that care for children to learn the basic skills to save a life

Click here to access a link to the Children’s Hospital fact sheet on Choking  so you can keep up to date with the latest first aid and safety/preventative advice.

The Children’s hospital highlights the problem with Button batteries which when swallowed it can burn through tissue in just two hours, causing severe injury or death.  If a child swallows a button battery, go to your nearest hospital emergency department immediately and do not induce vomiting.

Product safety information in Australia is available from Product safety Australia

CAT 7 Tourniquets for Serious Bleeding

Combat Application Tourniquet

You can survive severe life threatening arterial bleeding but only if you are quick. Just the thing for those nasty bites at the beach or the slip of a chain saw.

Watch the video to see how to apply on yourself in a severe bleeding event.

Discounted Genuine Cat 7 Tourniquets

Now available in single or bulk lots. $35 each plus postage. Bulk discounts are available

We can supply the genuine CAT 7 Tourniquets in bulk or individual units at a discounted price. The are brilliant at stopping arterial blood loss.

  • Surfers should learn to carry them so they can apply them at the time of any incident.
  • Chain saw operators or those who work with any dangerous equipment
  • A vital part of any first aid kit

Do the Maths – You need to help yourself, not wait for help

Do the maths, 5 to 6 liters of blood in the body.

Heart beats 70 times a minute and ejects about 70 mls of blood.

That equals 4.9 litres of blood circulated by the heart each minute.

So your heart can eject your entire blood volume in minutes from arterial bleeding.

Yes I understand the variables, but the principle remains the same.

The CAT Generation 7 Tourniquet is the official tourniquet of the U.S Army. Learn to apply on yourself like the military do because given the maths you are unlikely to last until help arrives without an emergency tourniquet.

We ask that you Contact International Paramedic College on 0413 244 994 to order by phone or email to order so we can provide you with free training, an ebook and personal instruction in how to use the genuine Combat Application Tourniquet.

Continue for more information on how to access our products and training

The Fastest, Safest, Most Effective Prehospital Field Tourniquet

  • Proven to be 100% effective in occluding blood flow in both upper & lower extremities by the U.S. Army’s Institute of Surgical Research
  • NEW Single Routing Buckle for faster application, decreased blood loss, effective slack removal, fewer windlass turns, and simplified training with single protocol application standards
  • Includes reinforced windlass, stabilization plate, windlass clip and writeable windlass security strap

 

Snake bite first aid with the Setopress bandage

Snake Bite First Aid and the Setopress bandage 

A practical approach to diagnosis and Snakebite first aid with the Setopress

Snakebite first aid treatment – What to do if you are bitten by a Snake?

Snakebite first aid treatment was published in a clinical article in the Medical Journal of Australia and it is interesting to look at its findings so we can understand envenomation from snakebite in Australia and better provide better first aid management of snake bites.

Snakebite is a potential pre-hospital care medical emergency for paramedics, first aiders or first responders to an envenomation event, even though patients may initially appear well. This article by International Paramedic College talks about using a marker to achieve good compression with the Pressure Immobilisation Bandage (PIB)

While snake envenoming is rare, it is potentially life-threatening. Interestingly the article states that “Most snakebites will not result in significant envenoming and do not require anti-venom” (Isbister 1989)

Dry bites, whereby no venom is released, are painful and cause localised redness and swelling.

If the bite is venomous, other symptoms may include a stinging or burning sensation on the skin and feelings of nausea, dizziness, anxiousness and confusion. In severe cases, the bite may result in paralysis or coma.

Are all snake bites venomous bites

If someone is bitten by a snake, you won’t know if it’s a dry bite or a venomous bite – so to be safe, always treat any bite as a venomous bite.

The various venomous snake groups each cause a characteristic clinical syndrome, or set of medical signs and symptoms and when you combine this with local geographical distribution information you can determine the probable snake involved and appropriate anti-venom to use. The Snake Venom Detection Kit may assist in regions where the range of possible snakes is too broad to allow the use of monovalent anti-venoms.

However, while the clinical evidence base on pressure bandaging in snakebite is limited a review of 96 subjects, 78 from the health field and 18 from the general public concluded that the PIB was poorly applied by both groups. (Canale ,2009)

How much pressure is just right? –  PIB and the “Goldilocks Effect”

Snake venom is carried in the lymphatic system and not in the bloodstream, as many mistakenly believe. That’s why the main aim of snake bite first aid is to reduce lymphatic flow by applying continuous firm pressure over the affected limb. This is known as the Pressure Immobilisation Technique (PIT) but what the “Goldilocks measure” is how much pressure is just right.

Snakebite First aid?

1 bandage is long enough for an entire limb

 

The Australian Venom Research Unit (AVRU) has recently recommended the Setopress High Compression Bandage for use as a Pressure Immobilisation Technique (PIT) for the treatment of all Australian Snakes, Funnel Webbed Spiders, Blue Ringed Octopus and Cone Shell stings.

While the Setopress High Compression Bandage has long been popular with high-risk groups, the visual application guide makes it easy for the general public to apply the Setopress bandage consistently and correctly.
Offering two compression options, the Setopress bandage has brown rectangles printed on one side, and green rectangles on the other.

When stretched correctly the rectangles become squares which provide over 30mmHg (brown square) and 20mmHg (green square) of pressure.

The optimal pressure recommended by the AVRU at the University of Melbourne is slightly firmer at 40mmhg for an arm and 55mgHg for a leg.

Apply the correct tension for snake and spider bites

However, when you apply this bandage it gives you a great marker of how firm an effective PIB should be, making it easier to feel and use the visual guide to apply the correct amount of pressure needed for effective application of the PIB.

Unlike other bandages, you only need one, as the Setopress is 3.5m long un-stretched. This is long enough to treat even the longest of limbs. Being able to completely bandage a limb is a must with snakebite as is effectively splinting the limb and laying the patient down to minimise any movement.

 

 

 

What should I do to treat snake bite?

  • DRS ABCD – is the initial step in the management of all first aid emergencies. If you don’t know what it means get yourself along to a reputable first aid course ASAP.
  • Retreat – away from the snake if you necessary
  • Calm the patient – lay them down and keep them still, the recovery position may be useful to protect their airway.
  • Remove rings and bracelets – and any restrictive objects from the bitten limb because swelling may occur and cause harm by restricting blood flow.
  • Remain with the person – who has been bitten until help arrives. If you have no choice but to leave them then return as quickly as possible.
  • Mark the bite site – by using a pen to circle the area of the bandage over the bite site

Snakebite first aid- What things you should never do after a Snake Bite?

  • Never try to catch or kill the snake as you may get bitten
  • Never give Alcohol, tea, stimulants, food or medications without medical advice
  • Never wash the wound, apply hot or cold packs, cut the wound, use ligatures or tourniquets., apply electric shocks and do not suck the wound or use suction from any device.
  • Never allow the patient to walk or run after a snake bite
  • Never remove the Pressure Immobilisation Bandage unless advised by medical personnel.
  • Never ignore the urgency of obtaining medical assistance in favour of reliance on traditional medicines or home remedies

 Be prepared

Only a handful of people die from a venomous snakebite in Australia each year. Knowing what to do if bitten by a snake and giving proper first aid is essential in keeping those numbers down and reducing them even further.

Book a first aid course and buy yourself a Setopress bandage from suppliers like International Paramedic College who can take the time to show you how to apply the PIB correctly and immobilise the limb.

The Australian Venom Research Unit (AVRU) at Melbourne University recommends the Pressure Immobilisation Bandage

Down load the AVRU fact sheet here

References:

Isbister, G. K., Brown, S. G., Page, C. B., McCoubrie, D. L., Greene, S. L., & Buckley, N. A. (2013). Snakebite in Australia: a practical approach to diagnosis and treatment. Med J Aust199(11), 763-8.

Welton, R. E., Williams, D. J., & Liew, D. (2016). Injury trends from envenoming in Australia, 2000‐2013. Internal medicine journal.

Canale, E., Isbister, G. K. and Currie, B. J. (2009), Investigating pressure bandaging for snakebite in a simulated setting: Bandage type, training and the effect of transport. Emergency Medicine Australasia, 21: 184–190. doi: 10.1111/j.1742-6723.2009.01180

Queensland Ambulance Service Clinical Practice Guidelines accessed February 2017. from https://ambulance.qld.gov.au/docs/clinical/cpg/CPG_Snake%20bite.pdf

 

Paramedic training and education

Paramedic Education How to Become a Paramedic

I have a love for education and adult learning, but I needed to grow up to grow into it. The excesses and exuberance of my youth had left a young man with a strong ambition but lacking guidance, support and in need of mentoring. As a Young Ambulance Officer with The Ambulance Service of New South Wales here in Australia (ASNSW) I read an early paper on Paramedic training by Dr Bob Wright from St Vincent’s hospital in Sydney. It gave me a sense of where I needed to be and how to get there. Dr Bob Wright developed the early Paramedic system and its protocols. I think all paramedics in Australia owe him a debt of gratitude.

“Great maturity, an ability to think clearly under extreme pressure, teamwork, critical time management skills, dedication focus and commitment are just some of the personal qualities and characteristics that Paramedics must have to work in continuous life threatening situations that are their daily work. Wright (1979)

The truth is however, in many remote places I worked as a young ambulance officer, inspiration and productive learning experiences were hard to find. It existed but you had to seek it out, not wait for it to come to you. I learnt that everyone can teach you something, you just had to understand what that lesson was. As an Intensive Care Paramedic (ICP) trainee in Sydney, I was lucky to be guided by a handful of excellent clinical mentors along the right (Wright) path.

In training as an Intensive Care Paramedic I was supported and mentored through an apprenticeship type of process, learning and being supported by very generous senior clinicians in medicine and emergency care. I was amazed at how the people around me were so willing and able to share their clinical and life experiences and help a young inexperienced, driven but unfocused youth find simple solutions to what had previously seemed insurmountable obstacles, beyond my meagre scope and abilities. Their patience and ability to drill down the complex to the simple left a lasting impression about the importance of keeping it simple and explaining things simply.

Their generosity of knowledge and an impressive ability to impart that knowledge into useable chunks makes you want to pay it forward, to lob that chuck of knowledge into the pond to create the ripple effect of producing better clinicians and with altruism in full bloom, a better world for sure.

Educational guidance or understanding how adults learn came to me from one educator, a principal of a local community college. He instilled a passion for lifelong learning and a methodology of how to hand that knowledge over, not in a lecturing way but in a way that makes a reasoned argument that puts you alongside, not in front of the learners and adapting to that individuals person’s needs, depending on the vibe from them.

How to become a paramedic

In the caring professions you have to start by wanting to make others better, as a paramedic educator I am driven by the desire to make my trainees and colleagues better than me. I can only do so much in one career. But as a mentor I have an opportunity to influence patient care in regions of space and time beyond my moment.

Taxpayer’s money funded my education as a paramedic through the NSW Ambulance Service. I was paid to work and learn, the cart was not before the horse like students who have to spend 3 years at university studying a Bachelor of Paramedic Science degree before applying for work as a paramedic in Australia. You graduate now with a paramedic degree and a HECS debt. There is a lot to be said for the vocational pathway that delivered you a Diploma of Paramedical Science. I have since returned to university to complete a Paramedic degree through Charles Sturt University as I felt it was important to keep up with the new paramedic students graduating from university.

So having funded my initial learning, taxpayers really deserve to get some value for their money invested in my medical and paramedical education. Taxpayers’ money paid my salary as I trained as an Ambulance officer and Paramedic, but more importantly, thousands of patients put their trust in me as I did my best to learn my trade by treating them, sometimes getting it right, but always learning along the way. I owe all of them. I owe it to them, and to myself, to make it all count as much as possible.

Creating a spark, a lightbulb moment inspires us all. If I share a memorable clinical tip or plant a seed through a story that gets recalled and applied at a critical case in a resuscitation months or years from now, then all that investment, all that sacrifice, is so worthwhile.

Here’s a list of the principles I try to apply, especially when running paramedic training courses. To paraphrase a Guy Clark song, it’s got to come from the heart if you want it to work. Learning must come from the heart, training that comes from a genuine concern to help others, not to profit by them enriches us all.

10 Paramedic Clinical Teaching Tips

Know thyself, understanding how you learn makes you learn better

 

Be ethical

Paramedic education should develop decision making skills and judgement, two important clinical skills in the field.  You are given your skills and training to use judiciously, to intervene, when a patient’s condition is such that they may not make it to hospital without that intervention. Intervention itself has its risks and rewards. Finding the balance, requires judgement. You can read more about how to find that balance here

Focus on Clinical Cases

People with different skill levels can learn together better when you keep the learning on clinical cases. They can see the treatment modality from their own clinical perspective. When we’re considering patients, everyone can learn something that is relevant to their scope of practice.

Adults as learners

Two theoretical thinkers who taught me a lot about adult education of paramedic students were Paulo Freire and Jack Mezirow.

“Problem-posing education affirms men and women as beings in the process of becoming. “Paulo Freire (1972)

Understanding Freire taught me to respect the learner, to learn through action and reflection and apply this in equal doses in all learning activities. It is particularly powerful in “trial and error” practical activities.

Mezirow believed that “adult educators must be aware that helping adults learn how to move from an argumentative mindset to an empathetic understanding of others’ views is a priority.”

This educational methodology is vital in developing the “bedside manner” and empathy, the “street smarts” that paramedic students need in a dynamic street environment. Creating a perspective transformation in adults returning to learning makes better paramedics.

Make it fun

Learning is great fun. We should have a good time together. If you’re bored, you won’t learn effectively. Funny or unusual stuff is more memorable, too.

Connect emotionally

Paramedic treatment and patient relationships stir emotions in us all, we are all human. During patient contacts we have powerful interactions with ourselves and our emergency response colleagues, sometimes negatively. Learners who are experienced clinicians have all felt pain or frustration of a case that has, for whatever reason, not unfolded as it should. Being real and working through these issues in a training environment creates a powerful reflective learning environment. Addressing these issues, by focusing on what could be done better, from a self, team, environment, or systems point of view.

When we share our own feelings about cases it demonstrates we have all worked in those shoes, we have all come on a similar journey. You can better equip learners when you understand their concerns, needs and drivers. It is the reality of our human experience that enhances our knowledge.

Make scaffolds and connect the webs

Adults as learners need a framework to add new knowledge to existing knowledge and build upon it. Sir Isaac Newton is credited with the expression “If I have seen further it is because I have stood on the shoulders of giants” We build knowledge upon knowledge as adult learners. We need the linkages; we can’t recall the islands of knowledge. Build webs and layers for your learners not islands.

Tell Fables 

This helps to connect emotionally; Humans have communicated information and ideas through storytelling since the dawn of civilisation. We are hardwired so that our attention is captured by stories. However, the stories must have a learning point to them, a way to craft the language so that in an emergency it can be retrieved

Use mnemonics songs or rhymes

Mnemonic tools like DRSABCD, SAMPLE History or PQRST in chest pain give students the prompts and flow in their routines

Create lightbulb moments

I love it when you see the penny drop, the moment when they just get it. I love the look on their faces when their minds have joined the dots and they see the conceptual framework.

Practice routines

Any sports psychologist will tell you when you are under the pump at a critical incident the routine is your friend. Practice it so when you need it it’s there. Don’t try to life your game on the big days but practice it on every case so when you need it, you have that automated response that helps calm you and the patient.

References:

Wright, R. C. (1979). Patient Management: A symposium page 39-42 August.

Freire, P. (1972). Pedagogy of the oppressed. New York: Herder and Herder.

Mezirow, J. (2006). An overview of transformative learning. Lifelong learning: Concepts and contexts, 24-38.

 

10 Vital Lifesaving First Aid Skills

Survival medicine guidelines – 10 lifesaving first aid skills

What lifesaving first aid or remote survival medicine skills, remote first aid or essential first aid skills are necessary for those who want to be medically prepared for any disaster or emergency event where help is NOT on the way or may be delayed by storm, weather conditions, natural or man made disasters. We have compiled a list, in no particular order, of what we believe are the 10 most valuable first aid skills to enable you to survive until help arrives or you can get to definitive care at a hospital. Keep  on reading

 

1. How to use a AED Automated External Defibrillator

AED Drones may provide a way to get an AED to a patient in Sudden Cardiac Arrest (SCA) quickly in the future, but now the Australian Resuscitation Council guidelines state that “the time to defibrillation is a key factor that influences survival. For every minute defibrillation is delayed, there is approximately 10% reduction in survival if the victim is in cardiac arrest due to Ventricular Fibrillation (VF)”. CPR alone will not save a person in VF”. (ARC Guideline 7)
So a  defibrillator should be applied to a person in SCA as soon as it becomes available. AEDs are now a readily available and easy to purchase item that is an essential part of any First Aid Kit or First Aid Supplies that individuals or companies can provide that just may help you survive a sudden cardiac event.

 

2. How To manage an Unconscious patient and provide them with an Airway

No airway equals dead, providing a patient with a clear airway is a vital first aid skill. When a patient is unconscious all their muscles relax and it is easy for the tongue to occlude  the airway. They are unable to cough or swallow any foreign material so the foreign material may enter the lungs. Care of the airway of an unconscious person takes precedent over any injury. Learning the correct way to posture a patient and monitor the airway is lifesaving.

3.Controlling life threatening bleeding

We only have so much blood in our bodies, once it’s gone we can’t get oxygen to the cells and we die. In essence, hypovolaemic shock from traumatic life threatening hemorrhage needs immediate first aid attention. That requires stopping arterial bleeding with direct or indirect pressure. An Emergency Bandage or Tourniquet may be required to stem arterial bleeding so you can survive until help arrives.

 

4. Recognising the potential in a head injury

Recognising that a blow to the head is serious and need need medical attention. Often head injuries are not given the respect they deserve. Blows to the head can rattle the brain and any bruising and swelling. Traumatic brain injury (TBI) is a major cause of death world wide. Early recognition of the symptoms and prompt management are the key to survival. A brain injury should be suspected in all head injuries, especially if there is an loss of consciousness.

 

 

5.Cooling burns

 

Immediate cooling of a burn with cool running water helps with the pain but it can achieve so much more.

Australian burns specialist Fiona Woods recently had a few words to say in the Perth Sunday Times on how first aid can dramatically alter the outcome for a patient.

Cooling a burn wound with clean cool running water between 15 and 18 degrees for 20 minutes within one hour of injury for a paediatric scold will change both the health budget and that persons life. She gives a vivid picture of how life changing this can be when she says “You will change that person from one that needs surgical intervention, pressure garments, reconstructive surgery as a 16 year old, to one that doesn’t need any after the first three months”.

6. Splinting Fractures

Pain, tenderness, deformity and loss of function can all be signs of a fracture. Immobilising the fracture to stop it from moving and creating further damage to the surrounding tissues has been a factor in the first aid management of fractures. Fractures to the upper leg can cause significant internal bleeding which may lead to hypovolaemic shock. Wounds around fracture sites will also need to be treated. It can be difficult for a first aider to tell whether the injury is a fracture, dislocation, sprain or strain. X-ray is often the only way.  If you are in doubt, always treat the injury as a fracture and remember, you should not attempt to force a fracture or dislocation back into place.

7. Recognising warning signs of stroke

Stoke is an interruption of blood flow to the brain. Early recognition of stroke symptoms with simple screening tools to help you remember the signs of a stroke like FAST  which is critical for ensuring optimal outcomes for patients with suspected stroke. Educating yourself about the warning signs and facts of stroke can be done with this interactive module from the stoke foundation here .

Remember F.A.S.T.

Facial weakness – can the person smile? Has their mouth or eye drooped?
Arm weakness – can the person raise both arms?
Speech difficulty – can the person speak clearly and understand what you say?
Time to act fast – seek medical attention immediately – Call for an ambulance.

8. Treating chest pain as a heart attack until proven otherwise

Current treatments for heart attacks like clot dissolving drugs that clear blocked arteries are most effective if used  as soon as possible after the onset of any symptoms. that is why we say any chest pain is a heart attack until proven otherwise. The problem is in getting you to seek help. When we have a pain in our chest we often want to convince ourselves it is anything but or heart. Call for help early is the best thing you can do, place yourself at rest and reduce the workload of the heart until help arrives.Treating venomous bites and stings

9. Treating venomous bites and stings

Most snake and spider bites occur on the arms in Australia. The Australian Venom Research Units (AVRU) recent snake bite fact sheet recommends the use of Setopress High Compression bandages when applying the Pressure Immobilisation Technique. You can download the latest snake bite fact sheet here

 

10. Managing Yourself

The hardest thing to do is manage yourself. If your duress response is one of stress you have to have techniques to help calm you down. If you can keep yourself calm and think logically, first aid is a really logical thing.  You have to be able to get it from the head to the hands, first aid is common sense, step back take a deep breath, nobody dies because you take a deep breath. Treat what you see and don’t become overwhelmed by it. A little preparation makes all the difference when you are under the pump. Try a First Aid Course and our “10 essentials first aid kit” from our Facebook shop as part of your bug out plan, SHTF or Prepper strategy.

Paramedic career skills law and ethics

Paramedic Clinical Skills, Law and Ethics are a firm base on which to build a Paramedic career.

Seldom is a subject so misunderstood and full of misinformation in public first aid courses and pre-hospital emergency care, so I will try to cover a range of issues that arise as a consequence of the very nature of your daily work as a paramedic or first aider or if you want to become a paramedic.

The very nature of emergency medicine for paramedics means that most times you can’t “sit on the clinical fence” Paramedic law and ethics shape how we make time critical decisions on our patient’s clinical pathway, our choices evolve in dynamic and fluctuating situations. Hamlet’s self-seeking question “To be or not to be” to go with the flow of the unfolding events or intervene in an attempt to change things is as much of a clinical question as it is a life question. Paramedics must make choices. People’s lives are in the balance and as a paramedic you are expected to intervene in that time between when you arrive at a scene and you finally arrive at the hospital.

Paramedic education should develop decision making skills and judgement, two important clinical skills in the field.  You are given your skills and training to use judiciously, to intervene, when a patient’s condition is such that they may not make it to hospital without that intervention. Intervention itself has its risks and rewards. Finding the balance, to return to homeostasis so to speak is the paramedic’s version of the balanced legal scales.

Every decision you will make as a paramedic is finely balanced upon the pillars of three conceptual foundations, the clinical, the ethical and the legal pillars. For every clinical procedure out in the field, there are corresponding legal and ethical obligations to consider.

Your practice, as a paramedic, has its duties and obligations and these are expressed in legal and ethical frameworks that guide and rule your practice. Peak bodies like Paramedics Australasia had an expert panel of educators and clinicians from the Network of Australasia Paramedic Academics and international paramedic professional associations develop a set of competency standards for paramedics .

Your clinical judgement and the paramedic skills in your scope of practice are informed by your protocols, procedures and pharmacology, using your current knowledge to apply the skills appropriate to your level of training. Understanding how all this fits together will enhance your everyday clinical decision-making.

Professionalism involves ethical conduct, integrity and the upholding of laws and values. It is an often quoted maxim that it is values that can enrich our lives.

Amongst other things, we as consumers of medicine, expect honesty, fairness caring and confidentiality in our health system.

Perhaps seeking and finding this balance is one of the reasons that Paramedics are often voted as “the most trusted profession”. Professional research and its evidence in the field is the key to maintaining that trust. If you want to become a paramedic then finding this balance is the key that unlocks a satisfying long-term career in the caring professions.

Evidence Based Practice – The driver of change in first aid teaching, techniques and practice

Teaching first aid or CPR  classes in locally in Ballina, Lismore, Alstonville or teaching student paramedics in Australia or internationally , I am often asked by students why first aid or paramedic pre-hospital care treatments seem to change all the time.

It’s a good question, as we all find change a little confronting, particularly the pace or rate of change now. What was good one day seems to be bad the next. It seems to us sometimes, like the experts can’t agree. While evidence based practice drives much of this change it is really the opposite of this. Evidence based practice is more about agreement and consensus.

 

Evidence based practice 

Paramedic education is driven forward by evidence based practice (EBP). EBP simply means that we need to base what we do to help a patient based on the strength of evidence and research as to what are the best ways to do that, the best way to meet that individual patient’s needs and requirements. What we currently do may cause more harm than good. Let’s use a scientific process to work out what works and what doesn’t and treat our patients based on that.

So as our body of knowledge changes and evolves, that research improves our understanding and drives changes in our practice of emergency medicine, first aid and CPR. So while it may seem from the outside that it is simply change for change’s sake, it is not. Simply put, we get better at helping others as we know more and understand our patients better. If you think about it like that it seems to make better sense.

I recall reading the writer and futurist Alvin Toffler who said “The illiterate of the 21st century will not be those who cannot read or write, but those who cannot learn, unlearn and relearn.”

So when I think or change in the health sector I see it as relearning and a chance to refresh my thinking, not as a threat but as a challenge. If you want to learn first aid or become a paramedic here in Australia or overseas then you are accepting a life driven by change as the evidence evolves. In some ways you could say change is the “new experience.” How you deal with that change will shape your career in the caring professions.

Finding, critiquing, using and evaluating information is essential to professional development and practice in first aid and paramedic education, learning and development. Evidence based practice requires a review of quality evidence, not something you heard from someone or found someone talking about on the internet. Because it is said loud and often doesn’t make it right.

There are rules around the assessment of evidence and research. If you look up the Australian Resuscitation Council (ARC) guidelines which form the basis of out of hospital patient care, emergency treatment and first aid here in Australia you can see at the bottom of the guidelines a list of the evidence and research that has led to their recommendations. Evolving evidence is driving change and practice.

Practising skills is important but if you are sitting in the same boring lecture that you have had several times before then you are not learning with a learning organisation, creating new ways to see the problems of pre-hospital care. International Paramedic College supports the growth and development of paramedic legal and ethical standards.

Paramedic Education – The Way Ahead

We strongly support the push for national registration in Australia and are currently working with international paramedic organisations in developing ethical training and mentoring programs based on integrity, honesty and respect. The used car sales approach to training and development should have no place in training lifesaving clinical skills and mentoring students to deal with the complexities of paramedic care.

 

Free Childrens Burns Course

Free Online Learning Module for CPD on Kids Burns

As I keep saying, the emergency treatment of kids is different, they are not smaller adults. Kids skin burns deeper, quicker and at lower temperatures than adult skin.

Not only that but burns from scalds can cause lifelong problems for children. Skin damage causes scarring that can lead to serious body image and self-esteem issues. Families can also suffer guilt and blame about the accident.

An ounce of prevention is better than cure so understanding risk situations is he important. Soups, noodles, tea and coffee are common causes of scalds for children under the age of five. These can take less than a second to cause a serious burn.

This is a great resource for free online burns training and posters about burns to kids for schools.

Every year over 600 Kids under 5 go to hospital with burn injuries. Its interesting to see how and where these injuries occur.

Parents can learn how to provide first aid management in an emergency at one of our HLTAID004 Childcare first Aid courses locally in Byron Bay, Lismore, Alstonville or Ballina.  International Paramedic College can come to your Childcare Center and deliver a free seminar about emergency management and Kids CPR with our program free course called “What To Do Until The Ambulance Arrives.”

Call your childcare center and have them contact us to deliver to parents the skills to manage family emergencies. We run these sessions all over the north coast of NSW or northern rivers region. Contact us for to discuss how we can run this course at your center or community organisation.

You can Click HERE to complete a FREE online e-learning module to give you knowledge on how to perform correct first aid for burns. It is great

Information on posters that were developed for schools aimed at preventing burn injuries in the school environment, Click HERE  to visit the burns resources for schools page.

You can even access on online game for kids to play and learn about burns.

 

EpiPen Adrenaline Autoinjector

EpiPen Firing Demo and Free Course

 

Do your staff at your Childcare centre school or your community group need Continuing Professional Development (CPD) or just to brush up on some skills and feel more confident about anaphylaxis management.

If you are interested the “Australasian Society of Clinical Immunology and Allergy” (ASCIA) has developed an e-training module on anaphylaxis for first aid or community groups, parents,  carers, patients, workplaces, schools or anybody who may be interested

Blue to the Sky, Orange to the Thigh

Free Online Learning

This free online learning programme allows you to gain a certificate at the end of the online training. This can provide a record for industry CPD training or just improve your knowledge of the subject. See the link below.

Free Family Kids Emergency Management Learning

As experts in emergency medicine and pre-hospital care. International Paramedic College gives back a lot to our local community. We offer a free training to parents at child care centres and community groups to deal with family emergency care. Titled “What to do to the Ambulance Arrives” covers family emergency care for kids. (share this post with your childcare centre so they can contact us for details)

As part of our nationally recognised Childcare First Aid Course for Kids called “Provide an Emergency First Aid Response in an Education and Care Setting HLTAID004” We cover anaphylaxis, asthma, and first aid training

The Australian Children’s Education & Care Authority (ACECQA) has endorsed HLTAID004 as meeting their requirements for anaphylaxis, asthma, and first aid training. We also offer 22282VIC – Course in the Management of Asthma Risks and Emergencies in the Workplace and 22099VIC – Course in First Aid Management of Anaphylaxis, but we prefer HLTAID004.

Click on this link to complete the free online course in anaphylaxis training.

http://www.allergy.org.au/patients/anaphylaxis-e-training-first-aid-community

International Paramedic College Youtube Channel

More videos like this are available on our Youtube channel

 

Burns

First Aid Class Lismore Ballina Byron Bay Answers for Questions

A question was raised about burns treatment in a First aid class in Lismore recently. Australian burns specialist Fiona Woods recently had a few words to say in the Perth Sunday Times on how first aid can dramatically alter the outcome for a patient.

Cooling a burn wound with clean cool running water between 15 and 18 degrees for 20 minutes within one hour of injury for a paediatric scold will change both the health budget and that persons life.

You can make a big difference by simply using water

They will go from needing, pressure garments, surgical intervention and reconstructive surgery as a 16 year old, to not needing  any after the first three months. Burns first aid like this in the last 20 years has decreased decreased hospital, surgical and intensive care time which quite simply makes things better for the patient and saves our health system a whole lot of money and resources because people can provide first aid management.

Free North Coast first aid course

International Paramedic College can come to your Childcare Center in Lismore Ballina, Byron Bay or anywhere on the North Coast of NSW and deliver a free seminar about emergency management and Kids CPR with our program free course called “What To Do Until The Ambulance Arrives.” Call your childcare center and have them contact us to deliver to parents the skills to manage family emergencies.

Darwin Awards Batman V Bull

Batman V Bull

The “Darwin Awards” pay tribute to the improvement of the human genome by honoring those who accidentally remove themselves from it. In this series of posts we will look at some potential award winners.

Voting for the winner will be by the most likes or shares of these posts.

Here Batman shows us his invincibility in the face of danger.

 

 

 

 

 

 

 

 

 

 

 

 

Penetrating Injuries can present certain challenges when you need to Provide First Aid

Consequences

Maybe the “Caped Crusader” needs to think about the consequences a little more.

DRSABCD is the first step

Kids CPR

Free Local Courses and Online Resources

I understand it’s your child and your freaking out about the situation but controlling your duress responses is vital. Somebody has to do something and today that person is you.

If your child stopped breathing today would you know what to do?

Fenton O’Leary and the team from the Children’s Hospital at Westmead  asked 348 parents and carers that question.

  • Only half had received formal CPR training
  • Only 11% knew the correct rate for chest compressions and the correct ratio of compressions to breaths.
  • A surprising 8% had performed real CPR

They reported the major reason for not performing CPR was a lack of knowledge.

Parents and carers of high-risk children are usually trained in basic life support but everyone could be trained in the simple process. Controlling your duress response to comfortably AND confidently perform basic CPR is vital here, someone has to do it.

Our Childcare First aid course (HLTAID004) includes CPR and AED training or you could attend a 3 hour CPR course. Our “freedom from fear” approach focus on convincing you that any attempts  at resuscitation is better than none at all.

Free “hands-on” training Course

We also offer a free course to parents that can be organised through your childcare centre, school or community group. Titled “What to do until the ambulance arrives” an Intensive care paramedic educator can   teach you basic CPR and other emergency skills

 

Free online Training Module

This great free resource is great to give parents and understanding of CPR and AED. Learning to use a defib and having a simple action plan can work for you too.

The free module can be found at www.cprtrainingforparents.org.au

Resources are also available for the non-English speaking members of our community.

Head Injuries

Paramedic Recognition of Traumatic Brain Injury

 

The “Darwin Awards” pay tribute to the improvement of the human genome by honoring those who accidentally remove themselves from it. In this series of posts we will look at some potential award winners.

Here we see a historical  photo of a local inventor with a lot of faith in his product. As a human crash test dummy, literally throwing himself into his work Mr W T Warren shows off his helmet design to some interested onlookers around 1912

Providing First Aid and dealing with head injuries presents special challenges. This great image of the way the brain gets bruised and banged around from a blow to the head is from Dr. Giza from UCLA

 

One Punch Can Kill  (OPCK) offer a number of programs dealing with violence The One Punch Can Kill Campaign aims to prevent senseless violence among young people. Making split-second decisions can ruin their lives or the lives of others.

Helmets and reducing violence will help reduce head injuries.

If your workplace has the potential for head injuries to occur we can organise specific workplace training in how to manage them.

 

Provide First Aid – Emergency Bandage

Why The World Needs More Paramedics Part 1

Thanks to all those people creating employment opportunities for Paramedics

The “Darwin Awards” pay tribute to the improvement of  the human genome by honoring those who accidentally remove themselves from it. In this series of posts we will look at some potential award winners.

It seems we all do stupid things sometimes, Paramedics get to see people when action becomes accident. You only have a limited amount of blood to loose.

Emergency Bandage in Serious Bleeding

Controlling bleeding via direct and indirect pressure is one of the most important things that people first on the scene can do do to give that person the best chance of survival until the ambulance arrives. Now is when you can provide first aid and it can make a big difference.

Come along and learn the “tricks of the trade” and how to manage bleeding with an emergency bandage  and treat hypovolemic shock.

10 items that should be in every first aid kit – the minimalist approach

The emergency bandage is one of the 10 items I believe should be in every first aid kit. It can be applied with one hand and was developed for military use. The emergency bandage is an elasticized bandage with a non-adhesive bandage pad . The bandage has a built-in pressure bar, that can be twisted to create pressure on the wound. A closure bar at the end of the bandage means that it clips into place and can be used to increase pressure if required.

Contact Us for prices

Our Utube channel video about the emergency bandage 

The Emergency Bandage

CPR success Rates

CPR success: TV v Reality

The Emergency Law blog of Michael Eburn is something I recommend to all our Australian students as a great source of legal information for emergency care providers, even first aiders.

Like the problems often attributed to self diagnosis trends using “Dr Google” This article on CPR Success  is important as makes what i think is an important point about the artificial expectations that TV may create, and how those expectations could lead to feelings of guilt in the first aider and families etc, that not all was done that could have been.

He goes on to remind first aid instructors to communicate the reality of CPR success to their students, to ensure they make informed decisions and appropriate emotional responses and don’t rely on misinformation from TV.

Further he says that CPR training should give information on success rates so people can feel confident to have a go, that doing something is better than nothing and they should not have unrealistic expectations of CPR.

These are important points in managing an often traumatised aftermath in cardiac arrests for the general public,first aid responders and paramedics.

Our CPR course is 3 hours and we try to focus on these areas, not just the mechanics of a process.

You can book our local CPR courses which explain how to use an Automated External Defibrillator (AED) online 24 hours a day here on the North Coast of NSW in Alstonville, Ballina and Lismore. Just follow this link to book yourself in to one of our regular courses.

 

Back Blows or Blow Backs Baby Sitting Bloopers

Kids Choking management

Back Blows or Blow Backs, the kids of comedy have a series of baby sitting bloopers. This is a bit of fun produced by the kids. Rated KD (kind of Dumb). Subscribe to our Youtube channel at International Paramedic College Youtube Channel

 

Back blows for choking children

Blow backs, back blows and bloopers as the kids are left in charge of babysitting on their holidays. Baby Annie needs help and the kids try to work it out. Children are different, they are not just smaller adults and can require different emergency responses. Treating children places additional stress on first aiders or paramedics as we feel the added pressure to help a young life, with all of that unrealised potential of their life that is yet to be fully lived. This adds to the pressure we feel emotionally making it difficult for childcare workers or those involved in caring for kids to think clearly in emergency situations involving children. Our “freedom from fear” approach to emergency management helps to make this stress work for you in managing paediatric emergencies.

What to do when your child is choking

The First thing you should do is to be prepared. Come along to one of our Childcare first aid courses (HLTAID004) and learn the tricks of the trade from experienced Intensive Care Paramedics or you could Contact us here organise one of our free courses on “what to do until the ambulance arrives” for your local North Coast of NSW community group.

International Paramedic College can help you with hands on workplace training tailored to your specific needs.

Free online training on the choking child

Choking occurs when an object of fluid blocks the airway. Babies and toddlers exploring their environment often place small items they find in their mouths. The human body often reacts protectively by tightening the airway around the object in an attempt to stop it going deeper into the throat.

What action you take depends on wheather they have an effective or ineffectve cough. You should also remember to call 000 in an emergency and be prepared to start CPR if required.

Learn online now by downloading a fact sheet on choking from the children’s hospital or completing a free online training module on the management of choking in children that they have produced.

Christmas Accidents

Christmas Accidents

1000 people receive injuries from their Christmas tree

Careful of the christmas danger in your lurking in your lounge room and that fridge too

Just when you thought I had survived all my over indulgences this festive season I read that in a British NHS Choices report about keeping safe at Christmas, that every year in the UK about 1000 people receive injuries from their Christmas tree.

Well I thought, maybe it is just a British thing but in the United States 240 house fires start each year when a Christmas tree catches alight. Look on utube, there are a number of really frightening videos which will show you how fast a Christmas tree can be engulfed in fire and burn.

Again in Britain about 350 people a year are hurt by Christmas tree lights mainly while they putting up their lights, getting burns or electric shocks from bulbs or faulty lights and children swallowing bulbs

You are 50% more likely to die in a house fire during Christmas than at any other time of year. While smoking and drinking are risk factors, candles accounted for about 1,400 fires in houses, killing 18 people and injuring over 500 other people according to statistics in 2008.

Danger lurking in the Fridge

And just when I thought the fridge was safe, 2010 and 2011 figures by the ONS say there were 30 deaths a year in England and Wales caused by food poisoning. 1 in 5 people there risk food poisoning by eating old turkey left overs, thank goodness for the Aussie BBQ in our summer. Even though more food poisoning occurs in summer in the UK, there is a spike at Christmas that maybe due to the fact that 80% of people wash their turkeys before cooking them which apparently significantly increases the risk of spreading germs to kitchen surfaces.

I can here, the kids now, “ow dad not microbes again this Christmas”. Soon they will be missing the years of jocks and socks.

The number of accidents rises significantly at this time of year as people break with their routine. So maybe a first aid course, some refresher training in first aid, CPR or how to manage the minor Christmas falls and spills might not be such a bad idea.

Learn First Aid

All I want for Christmas is a first aid course

Knowledge of  the important or vital first aid skills, a well-stocked first aid kit, or a ChildcareCPR or first aid course voucher under that watered down Christmas tree might not be on the Christmas list of many of us, but statistics show it may well come in handy long after the batteries have died in the kids toys and the Boxing Day cricket test is just a dim memory.