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BASIC TRAUMA LIFE SUPPORT FOR FIREFIGBTERS

AiiDRBW KENT GREATER MANCHESTER FIRE SERVICE, HOPE HOSPITAL, SALFORD MANCHESTER ADVANCED LIFE SUPPORT GROUP, MANCHESTER

ORJRCTIVES: Train firefighters who have an immediate response capability. in the use of life supsort &ills. both cardiac and- trauma: To assess and ms.intsl~‘life until’tbe arrival of the paramedical esrvice. MFXHODS: Establish s three tier training progremme in basic cardiac and trauma csre. The final tier of training establishes the fire fighter as a trauma technician. This includes a one week hoapital placement in the emergency room. of six local hospitals. Establish s self audit system to determine use of skills and skill retention within the fire fighters. RESULTS: By January 1996 230 one day technicians will have completed the course. following one year from conception. 40 trauma technicians have completed the full module courts. In total one ninth of the brigade have been trained. 26 casualties have had airways cleared by the trained fire fighters. 90casualtiea have had their cervical spine immobillsed. 7 cardiac arrests have been initially msnaged by the fire fighters. (XINCLIISTON: A training progrsmme .to allow fire fighters to assess and maintain s casualty until the arrival of the paramedics is apparently effective when the fire fighter is left to fill the ‘therapeutic vacuum’ whilst awaiting the arrival of qualified medical help.

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TllAIttIUG

OK (CPU) SKILLS OP II OP pft-rog

D.ELLIOTT, S.PARBOTEEAH,M.CREIG, L.WILKS,

School of Health Studies, university of Portsmouth Portsmouth, “ants, England

~‘ntraductian:~hr effectiveness of bas:‘c life support (BLS) skills among nurses varies considereblv. This longitudinal comparative srlldy seeks to identify the effect of regular practice and 1:6 teacher student ratio on BLS performance. Methodalogy:BLS skills of student nurses (n-S?-) receiving thirteen hours of CPR training in the curriculum, were evaLuated and compared to a study group (n=6) who received additional BLS practice consisting of one hour, bi-monthly, over a three year period. In accordance with current European guidelines for BLS testin::, the following skills were considered mandatory for effective CPR; assessment of responsivenass, airway, breathing and circulation; call for advanced lite support (ALS); performance of ventilation and chest compression using correct position, ratio, rate and depth. Results: Percentage of atudcnts passing each

phase of the test AsseaaalruL ALS Call A” ECC O"C!CC.II

P.3SS Study Group 100% 100% 100% 100x 100%

ConLLol GL”“P 79% 44% ‘3% 19% 5%

COPC‘“aiOPr3: The results demonstrare ttl*t CYrrent BLS training for student nurses is ineffective. Future tratiing should LOCUS on small group teaching and regular, frequent practice on manikins

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ASSESSMENT OF THE BASIC LIFE SUPPORT (BLS) SKILLS OF MEDICAL STUDENTS AS PART OF THE MBBS FINAL EXAMINATION FWhimster. P Kopelman, J Dacre, G Holsgmve, S Gooda, St Bartholomew’s and the Royal London School of Medicine and Dentistry, lomdon, England Objectives: To astzas practical akills in BIS as part of the Final MB BS examination. Metbodr: 199 atudenta sitting a Pilul MB BS cxaminacion undertook an Objective Struchld CIiical Examb&on (OSCE) to assess practical clinical akills. The BLS station required atudenta to ~EICS a collapsed patient (L.aerdal SkillMeter) and commence one-person BLS. Performance was apsesstd over two cycles of BLS using a M-point checklist designed to test knowledge of the ABC sequence and pmctical akills. Raaultl: The 199 students amesaed were the product of two merged medical schools: 111 had commeoced their medicsI training at School A and 88 at School B. The maximum possible mark was 20. The range of marks awarded was 6 - 20 with a significant difference @=O.Ol) between the mean scare for School A students of 13.6 (68%) and for School B shdcnts of 14.7 (73.5%). 172 students achieved the Pass mark of 11 (55%) on the BLS station. 118 students scored at least 14 (70%). There was a significant difference hehvcen t!! prucfiml skills of the two groups of students. Three students failed the OSCE, all three failed the BLS statiun. Conclusion: BLS skills have significantly improved since Skinner et al assessed them in 1985 6t 19W’ and tbii can be attributed to the increased emphasis on the subject in the cuniculmn. EMI hospitals now employ Resuscitatlor~ Tmininp Officers with an input to medical student education. In acidltion, School B arudents had gained extra practical experience through attending their hospital’s community resuscitation training programme during their first and fourth years. The assessment of practical skills, including BLS, in final medical examinations is strongly recommended. This subject must be taught, and practisad regularly, during undergraduate training. Reference?: 1. Skinner DV, Camm Al. Miles S. CPR skills of preregistration house officers. BMJ 1985;290:1549-50. 2. Morris F, Tordoff SO, Wallis D. Skinner DV. CPR skills of preregistration house officers: five years on. BMJ 1991:302:62x5-7.

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LIFE SUF’PORT TRAINlNG IN THE FIRST YEAR OF SECONDARY SCHOOL Carolvn Lester, Peter Dormelly. Centre for Applied Public Health Medicine, University of Wales College of Medicine, Cardiff, Wales, U.K. Clive Weston, Pinderfields Hospital, Waketield, England, U.K. Objectives. To investigate the feasibility of teaching cardiopulmonary resuscitation (CPR) in the first year of secondary school. and the effect of pupil instructors (peer tutoring) on skills and self perception of ability. Method. Of nine first year mixed ability, mixed sex classes (age 11-12 years) four (106 pupils) were htstructed by teacher only and five (137) by teacher assisted by older pupils. Before training each child completed a registration form collecting demographic details and information on previous CPR training and family members with heart problems. Post training pupils were tested in practical skills and completed questionnaires on CPR theory. attitude and willingness to perform in an emergency. Results. Forty-eight per cent were aware of one or more relatives with a heart problem and thirty-six per cent had some previous knowledge of CPR. Post instruction skill testing showed no significpnt difference between teaching methods. but 81% of girls achieved marks of 90% or more compared with 57% of boys (p < 0.001). Of the girls 75 % believed that they would be capable uf saving a life in an emergency compared with 55% of boys (p<O.Ol). Those instructed by teacher only showed greater confidence with 74% who thought they would be able to save a life, compared with 56% instructed by teachers and older pupils (pCO.01). but overall 95% believed that everyone shontd he instructed in CPR. Conclusion. It is feasible to teach CPR in the first year of wcondary school using peer Ntoring but instruction by older pupils may he detrimental to confidence.