Suck it up Sunshine vs. Educating Students about Critical Incident Stress

"Suck it up sunshine, if you can't handle what you just saw, then this isn't the job for you"

It's December 1996 and I'm sitting in the ambulance having just responded to a call that was emotionally and physically challenging. I was a new paramedic and my partner had been in the industry for 20 years. I remember the scene clearly, the location, smells, sounds, the patient and my gut reaction. I didn't eat a certain type of food for 8 years after that call... I had wanted to discuss the call with my co-worker but he did not want to discuss anything. 

20 years in emergency response has given me a collection of calls that have affected me. Some have changed my appetite, affected my sleep patterns, social behaviour and are most likely responsible for the way I view the world. 

Above Cartoon by Paul Combs, 2015

My daughter was 5 when it became necessary for a friend to teach her how to ride a bike. Flashbacks from a 10 year old call had made it unsafe for me to teach her. It was this incident that inspired me to look at the influence emergency response had on me. I started counselling for Post Traumatic Stress Disorder (PTSD).

20 years ago it wasn't often that I heard the term Critical Incident Stress (CIS). Fast forward 2 decades and now it's commonly discussed with co-workers. I am part of a CIS management team and respond to co-workers who have been exposed to traumatic incidents.

CIS if gone undiagnosed can lead to PTSD.

Historically, emergency response courses primarily focused on hard skills. These days, courses are being adapted to include CIS awareness. Employers are seeing the benefits of CIS management teams that respond to employees who have been exposed to traumatic incidents. CIS debriefings are designed for the victims of trauma. 

There are many online courses an instructor can take to learn about CIS. One course, which is offered by the JIBC, is a 14 day Critical Incident Stress Management Certificate Program. In the description of the course, the JIBC states,

the certificate will be of specific interest to front line responders such as crisis intervention workers, victim services workers, firefighters, paramedics, and law enforcement personnel.

I believe they should also include the category "instructors in these professions."

As instructors we introduce students to new concepts. When we expose students to the benefits of CIS debriefings, I believe we create a platform for discussion. If an instructor has knowledge of the subject matter, then students can be guided through discussions to debunk the "stigma" attached CIS. The ultimate goal is for students to become aware of the effects, and learn how to recognise the effects and how to reduce the possibility of CIS leading to PTSD.

It is a win, win situation!

Canine Support Center

Read this today, I couldn't help posting it!

Music and the Brain

I've been wondering why "Staying Alive" or "I'm Bringing Sepsy Back" triggers a recollection of medical procedures. I question, how does music tickle memory? University of California conducted a study on the music-memory link.

Dr. Peter Janata, associate professor at University of California, Davis, and member of the Centre for Mind and Brain, decided to examine the possible music-memory link when he saw the same region of a brain light up in response to self reflection / recall of autobiographical details and music-processing / music-memories.

He found, "What seems to happen is that a piece of familiar music serves as a soundtrack for a mental movie that starts playing in our head." "It calls back memories of a particular person or place, and you might all of a sudden see that person's face in your mind's eye."

I wonder what effect we could have on our students, if we played music at strategic moments of instruction? Perhaps next time I'm teaching a course I'll play Bach or Mozart. Perhaps in the future students will hear classical music when responding to a train emergency?

Dr. Peter Janata describes how the brain creates an autobiographical soundtrack from our memories in the podcast titled Music, Memories, and the Brain from the Library of Congress series Music and the Brain.


Image: Brain areas showing music tonality-tracking behavior. Different colors represent the number of subjects who showed significant tracking behavior.
Credit: Cerebral Cortex/Janata.
Source: Health, Jeremy Hsu, (24 February 2009). Retrieved from: http://www.livescience.com/health/090224-music-memory.html

 http://www.loc.gov/podcasts/musicandthebrain/podcast_janata.html

Bringing Sepsy Back

A recent ambulance call reminded me of this instructional video. It has sparked a curiousity of the link between the mind and music.

I'm interested to see when and if other songs come into my mind while working.

I've got an app for that!

The other night I was at a high school play. There was a skit based on phone apps. The apps ranged from prostrate exams to a built in defibrillator. An actor fell onto the floor and another shocked them back to life! What a great idea, maybe one day a defibrillator will fit in my back pocket?

On my cell I have apps for drug calculations, IV rate, side effects of drugs and other medical procedures. While I was looking for Web 2.0 tools ... one search led to another and next thing I know I came across APPCRAWLR. I could access medical reference, first aid skills, games, study tips... There were so many options!

Want to learn anatomy? Check this out Anatomy Light or Muscle and Bone Anatomy 3D.

Updated Infographic on May 15, 2016

Creating Infographics has quickly become my favorite way to create and share valuable information. Three weeks ago, I didn't know what an infographic was. During the last week I have discovered several programs and created many versions of a CPR infographic. I used Vennage to create this infograph. Creative Commons will be the next step!

Disco saves lives?

Retreived from British Heart Foundation

Ever been asked “what would you do if…..?” It’s a common question when teaching first aid. During a recent class I was asked, “What should you do if a person was in cardiac arrest and you didn’t have a pocket mask? Should you give the person mouth to mouth?”
This is an important question and I don't believe the answer should be addressed with a simple resonse. It is important for students to think about this, so I ask a series of questions to facilitate discussion.

• “Do you want to swap spit with a person you don’t know?”
• “Can viruses, bacteria or any life changing diseases be transmitted through saliva, blood or vomit?”
• “Do you consider this a safety risk?”

Students putting themselves at risk and performing mouth to mouth respirations is a concern of mine. Another concern is students taking the “all or nothing” approach. Withholding chest compressions because they don’t want to perform respirations.
Out of hospital cardiac arrests have a high mortality rate. 

Last week I was reading David Smekel's 2013 dissertation, Safety with Mechanical Chest Compressions in CPR. I found one statement absoultely relevent for students learning CPR.

Survival after cardiac arrest depends on prompt and effective CPR. Several factors influence the outcome: naturally, the most important factor is whether CPR is performed or not.

Luckily there is a solution for responders who don't have a pocket mask when responding to a cardiac arrest. Hands Only CPR! It's endorsed by the Canadian Heart and Stroke Foundation! Their website says,

Hands-Only CPR. This means pushing down hard and fast on the centre of the chest at a rate of 100 compressions per minute.

In the first chapter of Jose Antonio Bowen's book Teaching Naked, he states that important and complex content and skills are being taught online. I found the British Heart Foundation and the American Heart Foundation videos on Hands Only CPR were bang on. They use humour and star power to teach a life saving skill. 

British Heart Foundations take on Hands Only CPR with Vinnie Jones

And now for the American Heart Foundation version with Ken Jeong

Now that you have watched these videos, I have a few questions for you!

• Are these videos enough to learn the skill?
• Would you be able to perform Hands Only CPR?
• Do you believe disco could save lives?