Every 2 years we all shuffle in and watch the video offerings from the vendor of choice (AHA) wondering why the videos seem to be 2 years behind the science, but hey, we need to sell books and videos.
Then we go to the skills stations where we pretend to do things via the checklist, rarely deviating from the script lest we have to stay any longer than required.
This year's class had the same content we've been teaching after the regular class, since our policies have included High Performance CPR for years. In the past his meant teaching a class to pass the vendor's test, then a few hours unlearning everything to make sure we provided care to match local policy. It was like learning to drive a car, then being told, "Yeah, now we drive a train."
That's the problem with a national standard curriculum, then hundreds of local policies and protocols shifting with the trends and *gasp* science. It is what it is, we do the skills and move along.
At a recent class we were going through the motions of the Bradycardia station when the students at my station got into a deep discussion about stable vs unstable.
We all know that looking at a patient's skin color and mentation will guide us as much as the BP will in establishing the need for an intervention, but this patient had a heart rate of 42, respirations of 6, but was alert with good skin signs and a BP of 80/50.
I mirrored this patient to match me post surgery recently when they gave me PO pain meds before the propofol wore off. The goal was to paint them a grey picture and see where they went.
The book and the vendor say pace me.
The students began to walk through a secondary assessment, spending 10 minutes discussing the benefits and detriments of intervention. We had wandered away from the "Do the skills" portion of the vendor's outline and into my favorite place "Why are we about to do this and will they benefit as much as we hope or create a more complicated situation?"
The Why outweighed the When and, just like me in the recovery room, alarms going off every 30 seconds when I simply didn't want to take a breath, this crew monitored me, looked for other causes of my condition and weighed interventions.
That 10 minutes was more beneficial to their careers as Paramedics than the other 8.5 hours of the course; the same course they took 2 years ago and the same one they'll take again in 2 more. My only hope is that we can introduce more discussion and grey areas rather than a skills sheet that gets memorized to pass the class and get the merit badge.
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