A stitch in time. Rethinking refresher courses.
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Biomedical subjects
Publications and source records attributed to R Elling.
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There appears to be a self-perpetuating trail of misinformation surrounding the issue of ambulance accidents. As with all problems, we must first acknowledge that a problem does exist and clearly distinguish the facts from the myths. The intent of this article was to clarify some of those misconceptions by using an analysis of one state's four-year experience with ambulance accidents. The next step in solving this problem is to create driver education programs that modify the behavior of ambulance drivers, adjust their attitudes about driving an emergency vehicle and make them fully aware of the hazards encountered in driving an ambulance. In addition, consider adjusting the agency standard operating procedure so that all ambulances must come to a complete stop at all stop signs and red lights to minimize the number of accidents that occur in the intersection. Readers who would like to learn more about this subject should contact their state EMS offices to determine if they offer emergency vehicle operator courses or continuing education programs that deal with ambulance driving. New York State has developed a network of 90 instructors who are qualified to teach the Ambulance Accident Prevention Seminar, a nine-hour classroom-based ambulance driver "attitude adjustment" program. Two other organizations that have developed driving courses geared specifically for ambulance driving are: Failsafe Driving Inc. Alvin F. Davenport, president 2529 San Pablo Ave. Pinole, CA 94564 National Academy for Professional Driving Dick Turner, chairman 1001-A South Interstate 45 P.O. Box 649 Hutchins, TX 75141.
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Three hundred twenty emergency medical technicians (EMTs) were tested for their ability to ventilate a precalibrated Recording Resusci-Annie (Laerdal Medical Corporation) using both a bag-valve-mask and a pocket mask. More than 50% of the EMTs were not capable of ventilating to the minimum standard using a bag-valve-mask. The study demonstrates that the pocket mask method is far superior to the bag-valve-mask method. If these experimental results are confirmed by clinical findings, we recommend that future educational courses teach the bag-valve-mask as a four-hand/two-person skill, with one rescuer squeezing the bag with both hands and the second rescuer maintaining hyperextension.
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