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Fri Apr 20 18:22:11 BST 2007

I teach lay providers all the time and we do not teach OPA.  It is part of
the EMS basic training that I teach but we teach them on a intubatable
manikin and teach them how to insert on an unconscious person with NO gag
reflex.  If they have a gag reflex they are taught to go with an NPA if
indicated (No head trauma etc.)

On 4/20/07, oded private <tangentcarrot at hotmail.com> wrote:
>
> Hello dear list. My two subjects concern trauma and EM training of lay
> persons, a field in which I've been working lately (but not anymore,
> probably, as I'm just about to quit).
>
> First subject- OPA's
> Lay persons are routinely trained to use the oropharyngeal airway in
> uncouncious victims.
> Not only that the literature says that OPA's are to be reserved for use by
> health care providers only (and my own common sence and expreince tell me
> just the same), "training" usually occurs with manikins such Laerdal's
> "Little Anne", which are not designed to have an airway inserted and CAN'T
> have an airway inserted. Meaning, training is done, as we call it here,
> "methodically".
> By the way, the airway IS relevant to lay persons in terms of
> availability-
> since they do sell it in first aid packs.
>
> I find it very disturbing- I don't think lay persons can always accuratley
> determine unresponssiveness, not to mention absence of gag reflex.
> Moreover,
> the use of the OPA requires training  either with appropriate manikins or
> in
> the OR. You can't get it right- neither the technique  of insertion not
> the
> thechnique of measuring the right size from having someone tell you "it's
> done that and that way".
>
> What do you think?
>
> Second subject-
>
> In the diffrent countries and districts you come from, how is the subject
> regulated?
> Here, as far as I know, the answer is quite simple- it's not...
> As far as I know, private companies don't have standarts for competency of
> instructors, nor do they have committing guidelines from the ministry of
> health or the ministry of education.
> A freind of mine just had a 4 days long first aid&CPR course. After the
> first day he showed what he was taught in CPR- and I had to tell him
> "that's
> not right, that's obselete, that's wrong, that's irrelevant..."Turns out
> his
> instructor is a former instructor from the military (perhaps a good one, I
> don't know), and according to her age she has been out of the army for 5-6
> years. I find it hard to believe she has had formal training or
> "refreshment" since then. Besides teaching things that arw wrong, he was
> taought many things that are simply unimportant- on the expense of hands
> on
> practice.
> Even instructors who just got out of the military my be under-trained in
> istructing lay persons, as guidelines differ between health care providers
> and lay persons.
>
> I'd like to hear your opinions, thoughts, and local knowledge on
> regulation
> as well. It's quite disturbing my rest.
>
> I know that some of the giants of Israeli trauma- Michael Stein, Avi
> Shapira
> and Eran Tal-Or write here. I'd be more then happy to hear any comments or
> insights you may have. Perhaps you do have some information about this
> subject which I don't know.
>
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-- 
V/R

Forrest Robleto
R House Health & Safety
www.RHouseTraining.com
FRobleto at RhouseTraining.com
609-792-9047

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OPA, lay persons, and regulation of training in Israel and world wide