List Archives

Sun Apr 22 04:42:14 BST 2007

Layperson trainings vary greatly in terms of time and content. There is no
generally accepted standard as to what constitutes an appropriate first aid
curriculum other than the recent ILCOR first aid proceedings and the NFGATOS
project. Formal training organizations may grant more structure as
completion of given programs require certain skills to practice (American
Red Cross, AHA, ASHI, NSC, and others).

OPAs are a skill at the 40-hr First Responder curriculum... but should not
be taught at any level under that.

I think that simply not teaching it would be counterproductive. A student
who sees that you do not teach them how to insert an OPA may feel
short-changed by you in terms of not learning something he/she might find
valuable/cool/useful/important (or any other adjective). If it is so
widespread and common to teach, if I were you, I would simply dedicate less
than 1 minute to say why anybody who is not  a healthcare provider should
NOT insert an OPA without further knowledge on airway anatomy, proper sizing
and proper practice time if the current training program does not allow for
all of them.

Just my $0.015's worth of opinion.

Gustavo E. Flores Bauer, MSIII EMT-P :.
Iberoamerican University School of Medicine
Santo Domingo, Dominican Republic

web: www.emergencyteam.net
e.mail: gflores at emergencyteam.net

"My karma ran over your dogma."

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of oded private
Sent: Friday, April 20, 2007 1:43 PM
To: trauma-list at trauma.org
Subject: Re: OPA, lay persons,and regulation of training in Israel and world
wide

Of course, both the EMS and the army teach this (to EMT's, paramedics, etc.,

not to lay persons) with the apropriate manikins, but I'm talking about 
private firms. Most training is for lay persons, but some is for EMT's who 
don't work for the EMS but for private transport ambulance companys, and 
need refreshment, and rarely there are courses who train people as "medics" 
(I have no idea what they are realy authorized to do by law). These people 
are trained for work places as responders, and go through about 2 weeks or 
even more of training. This is done WITHOUT proper manikins.

About the NPA- it's actually very rarely seen here.

Just to make clear, I do not teach lay persons the OPA, but this is an 
exception and in contrary to "policy" if one can call it that way.

>From: "Forrest Robleto" <farcpr at gmail.com>
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: "Trauma &amp, Critical Care mailing list" <trauma-list at trauma.org>
>Subject: Re: OPA, lay persons,and regulation of training in Israel and 
>world wide
>Date: Fri, 20 Apr 2007 13:22:11 -0400
>
>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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>trauma-list : TRAUMA.ORG
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OPA, lay persons, and regulation of training in Israel and world wide