EMT-Basic Course; Good, Basic Preparation For Medical Emergencies

Readers of this blog know that as an emergency volunteer, I take basic, common sense preparedness quite seriously. I have published articles on this blog about emergency communications using amateur (HAM) radio as well as by other means when power, Internet and phones (cellular included) inevitably fail during disasters such as tornadoes, hurricanes, etc. MANY "prepper" oriented folks forget the "band-aids" part of the "beans, bullets and band-aids" equation. As a nurse's aide as well as in my emergency volunteer training, I have had plenty of "first aid" training. But a situation at work a year or so back where an office girl passed out, as well as my step daughter falling and injuring her ankle, raised some serious questions in my mind about the real value of the training I had. I decided to do something about it. A buddy of mine, who is an RN at a major hospital, suggested I go for EMT-Basic training. He proposed it because it would be the less expensive option - both in terms of money and time, and that it "would still put me way ahead of the typical layperson" in an emergency. I did considerable research, and indeed ended up getting my EMT-Basic patch as of Summer 2017, and also have taken some additional training in "austere" medicine. I'll discuss the austere medicine training in another post.

There are several levels of EMT: EMT-Basic, EMT-Intermediate (in some jurisdictions), and EMT-Paramedic. EMTs are registered with the National Registry of EMTs (NREMT - as shown on the patch in the above photo) as well as at the state level. EMTs generally work for fire departments, but some also work for private ambulance services and in hospital emergency rooms and ICUs (Intensive Care Units).

I think of EMT-Basic as "first aid on steroids". EMT-Basic focuses on the "ABCs" - airway, breathing, circulation - as well as delves into performing assessments on a patient to determine how much of an emergency it truly is. In other words, "is the patient going to die or otherwise suffer grievous injury within 10 minutes unless immediate intervention is given, or can they wait an hour or so while one gets them to the hospital?" Or is a hospital visit even needed? In addressing the "ABCs", the EMT verifies the patient has an open (or patent) airway, controls/stops any serious bleeding, and makes sure the heart is pumping adequately. If breathing and heart function is not sufficient or gone entirely, then high quality CPR is started. EMT-Basics can insert certain devices such as a "King" airway, an oropharyngeal (OP) or nasopharyngeal (NP) airway to help a patient whose own airway is collapsed. The EMT will administer spinal stabilization to protect the spinal cord from (further) damage, place a "C-collar" (short for cervical collar) on the patient in the event of possible neck injuries, as needed. Splinting of bones, safe moving and transport of patients, safe extrication of patients - such as from a wrecked vehicle or a structure collapse, are also covered. Medical assessment skills for determining if a patient is in shock, is having a possible stroke or heart attack, is having a diabetic or hypoglycemic issue, etc. are emphasized. We also covered mass casualty incidents, terrorist situations, biological/chemical hazards, plant poisons, insect stings and snake bites, water emergencies such as from boating accidents, burns, electric shock, etc.

EMT-Basic training generally takes 4-5 months; exact number of class hours vary as per jurisdiction. We had a certain quota of clinical hours we spent on ambulance ride-alongs and in hospital ER situations. Part of the ER time dealt with adults in a regular hospital and part of the time was in a pediatric ER. This was very important, as children are NOT merely miniatures of adults; there ARE some different considerations in treating a child. My training took 4 months and cost about $1500 for everything - tuition, books, mandatory drug testing, the NREMT exam, ...

EMT-Intermediate is somewhat of a gray area. Not every state has this classification. But generally it is EMT-Basic with some Paramedic skills thrown in. EMT-Intermediates are sometimes allowed to give injections, do EKGs (electrocardiograms), and certain other things associated with Paramedics.

EMT-Paramedics do ALL the above PLUS can give injections of certain medications, run EKGs, intubate patients - meaning insert endo tracheal airways, and generally need a year or sometimes more of classroom training. The requirements on clinical hours are far more stringent as well. Cost may be anywhere between $5000 - $10,000 for the training.


Reading this, you may be saying to yourself "That's great, Karl. What does this have to do with me?" Quite possibly, PLENTY. If you are an outdoors person, canoe/kayak paddler, backpacker, shoot archery or firearms, camp, etc.; ALL these sorts of activities can place you in situations where YOU or whoever you are with ARE the "first responder(s)" available. Ambulances and paramedics may be HOURS away. If you are caught up in a natural disaster such as a hurricane, tornado, flooding, severe snowstorm, etc. you may also find yourself dealing with injuries or other medical situations on your own for some period of time UNTIL someone else can get to you. And if it is a man-made disaster, depending on the nature of that, all bets for finding another EMT,a doctor, nurse or hospital may be off.

On a more mundane level, what if a family member or friend suddenly gets hurt, or goes into cardiac arrest? In the latter situation, SECONDS COUNT! The SOONER high quality CPR is started, statistically the BETTER THE OUTCOME. Those several minutes while waiting for the ambulance can be spent performing CPR, stopping blood loss - or otherwise improving your loved one's chances of survival. And back to my step daughter's ankle for a minute - knowing how to perform an assessment of a traumatic injury can help determine "do we simply put ice on it, have her take an ibuprofen and stay OFF the foot, and reevaluate in the morning, OR is it truly ER time?"

THINK about this: Avoiding the cost of ONE unneeded ER visit could PAY FOR THE TRAINING.

FWIW

Amateur "Ham" Radio, Shortwave Radios, and Preparedness

On this blog, I have written about the need for having a shortwave radio for monitoring breaking news events. Good shortwave radios are expensive and hard to come by - hence my building the TenTec radio I mentioned in my last post. Hopefully with the Spring semester over I can catch up on supplying content to this blog and my video channel on YouTube. http://www.youtube.com/user/KarlsLabReport

One of the things I have wanted to do is a post on what to look for in a shortwave radio.

During civil emergencies, communications such as landline phones, Internet, and even cell phones often fail. While a cell tower may continue to operate on emergency backup batteries or fuel cells for some time after a crisis, that tower can be taken out by a tornado just as surely as phone and electric wires can be. Service may be deliberately cut off by terrorist acts or by government edict as well. Both in Egypt during the unrest in 2012-2013, as well as the incident at the Bundy Ranch in Nevada this past April (2014), government officials cut off most telephone and Internet access to the area. None of our media outlets covered the Bundy Ranch incident until Alex Jones exposed on his website the connection between a certain politician and a Chinese corporation as the main driver behind the whole fiasco. Then there was the near-mishap in 2011 at the Fort Calhoun plant in Nebraska, caused when the Missouri River flooded, which was NEVER to my knowledge covered in the American media. I think it is safe to say that this type of information blackout will be Standard Operating Procedure from here on out whenever anything controvercial happens.

In the case of the bundy Ranch episode, amateur radio (ham) operators were helpful in getting news in and out of the area and even transmitting pictures via some of the digital operating modes available nowadays.

I have several ham radios - a VHF handheld for the 2-meter band, a ham radio I inherited from my dad that will cover all the "HF" bands below 30 MHz, and some homebuilt equipment for the 7 Mhz (40 meter) band. Recently, I got the handheld out, dusted it off, and discovered it still works after 15 years of non-use. This past week, I took the HF rig of my dad's to a buddy's house and we almost immediately were able to talk to someone several hundred miles away. Imagine for a minute if your local landline and cellular communications stopped working - how valuable would it be to you to be able to flip on the ham radio and hear what is happening in the world outside, or even talk to someone who has information? One afternoon a week ago, my buddy and I talked to a guy in Slovenia on the 17 meter band (18.068-18.168 MHz) using 40 watts of transmitter power into a random-length wire antenna. The propagation conditions were favorable and his signal came in so clear he literally sounded like he was across town. Now, I'm NOT saying one would radio Slovenia to find out about a situation a few states away in the USA, but the point is amateur radio potentially gives you tremendous communications reach. The following link gives you an idea of what you can hear and, given the appropriate license, can transmit on which frequencies:

http://www.arrl.org/band-plan

Licensing: NO license is required to LISTEN to amateur radio transmissions. In order to TRANSMIT, you MUST have a license or have a licensed amateur radio operator present when you are doing so. In recent years, the FCC has eliminated the Morse code requirement from any of the 3 license levels. For decades this was a stumbling block for many folks and while many amateurs STILL use Morse code, and thus is is a good idea to learn it, you DON'T need it to get a license anymore. The three license levels are Technician, General, and Extra class. The main difference between the levels is the amount of frequencies and operating modes you can use; also as you go higher in license level the amount of electronics and radio knowledge required goes up. Testing, which is required to get your license, is conducted by a network of "volunteer examiners", or "V.E.s". VEs are radio amateurs who volunteer their time to give the required FCC exams to new folks wanting amateur licenses. VEs can be found through local amateur radio clubs and by going online to the ARRL's (Amateur Radio Relay League) website at www.arrl.org.

The written tests for Technician and General consist of 35 multiple choice questions taken at random from a standardized FCC question pool; the Extra exam consists of 50 multiple choice questions. On the Technician and General, you are required to get at least 26 of the 35 questions right (75%) to receive a passing grade. For the Extra, you must get 37 out of the 50 (again, 75%) correct.

How to get started and Where to go for help:

Here are a couple very helpful sites for practice quizzes and more information:

http://aa9pw.com/radio/

This site has more practice exams and reviews of radios and equipment:

http://www.eham.net