Wednesday, October 15, 2014

An EMS Instructor's Opus

by Steven P. Velasquez, NREMTP

Of all the courses I teach, I am probably most proud of teaching The Difficult Airway Course; EMSTM. (DAC).

There are many reasons for this sense of pride, not the least of which is how a student can immediately put these assessment techniques to work, immediately begin practicing airway management more safely and based upon best evidence, can begin driving better outcomes for patients.


Mark Bober NREMTP, Difficult Airway Course; EMS Instructor
and Clinical Manager - JFK EMS
 
Less than a week ago, our team took the DAC to J.F.K. Medical Center's EMS Department in Edison, N.J. The audience included everything from the newest paramedics in search of good information (and perhaps a couple of CEU's) to seasoned practitioners, flight paramedics and critical care transport nurses.

I personally have a near panic attack every time I get in front of a group of people and this group particularly because I directly work with many of them. I prefer the relative anonymity of being the "visiting team" where no one knows me, but that's just me.

Occasionally, someone pulls me aside weeks, months or years after they have taken one of my classes and they regale me with a story where some valuable nugget I shared or seed I once planted, emerges during a patient encounter and they say "thank you" for helping them - help someone else. There is no bigger reward in the life of an educator.

Richard Dreyfus playing the roll of Glenn Holland, a frustrated
composer who finds fulfillment as a high school music teacher
in "Mr. Holland's Opus".
Now I am no "Mr. Holland" and this may not amount to my "Opus," but I am as moved as Richard Dreyfus' character was in the award winning 1995 box office hit, by a few text messages I received today.

A young lady sent me a message describing a patient she encountered today. She detailed how the patient presented, highlighted the abnormalities that would certainly prove challenging if the patient decompensated, and ultimately told of how what she learned a few short days ago, changed her approach to said patient today. Her name will be left out, but the messages were as follows (my replies  have been omitted as they are not important):


"Just took a 450lb patient to the hospital.. In respiratory distress with a sat that started at 65% hellooo difficult airway class"
 
"todays job was such a great case.. granted i think the EMT thought i was crazy and thought i just kept talking to myself…. when really i was just thinking about plans in my head .. of the what if this happens."
 
"i swear when i walked in and saw this guy…….. first thing i said was….. can i bag him with a bvm… no… ok he's not getting a paralytic…. nor do i want to intubate him… failed 3:3:2. not a good cric can't landmark…. i was like this could get difficult."
 
"before the difficult airway class… i would have just walked in the doorway and shit my pants….. at least today….. i shit my pants and then went through the algorithms lol"

And there you have it folks, taking the DAC may not eliminate the biological stress responses one has when faced with a challenging patient, but at least you'll have evidence-based algorithms to follow as you make better decisions and reduce the possibility of harming patients.

Now go clean up and register for the next Difficult Airway Course; EMS!