Describe the evolution and purpose of the National Ski Patrol?s OEC program.
Dr. Bowman created the concept of intermediate outdoor medical care, where OEC technicians would initiate care in the wilderness, continue care during transport, and further continue care in a first aid room or clinic.
Describe the history of the National Ski Patrol.
Founded by Minnie Dole 1936, Warren Bowman wrote OEC in 1985 (Father of OEC), Federal Charter 1980
Identify the founder of the National Ski Patrol.
Describe the role of National Ski Patrol in the formation of the U.S. Army?s 10th Mountain Division.
Army needed a Cold Weather unit after seeing the air force search and rescue, NSP was authorized to recruit 7000 volunteers
Compare and contrast the OEC textbook and OEC course/curriculum.
OEC Text is core curriculum, training includes local protocols
Describe the organization of the OEC worktext and its use during an OEC course or OEC refresher course.
First learn basic anatomy, then assesment, then critical intervention, documentation
Describe the OEC certification and recertification processes.
Initial course, then written and practical exam, certified for 3 years, but need refresher every year covering 1/3 of the course, recertified after 3 years. Must do CPR and AED training every year.
Contrast the standard of training and standard of care.
Standard of care isa level of care an OEC Technician must render based on OEC training, local medical protocols, and the requirements of a state's emergency medical system. Standard of training is the training of National Ski Patrol OEC Technicians as set forth in the OEC course, using this text as a reference.
to withdraw one's support or help from, especially in spite of duty, allegiance, or responsibility.
placing somebody into a position where he or she reasonably fears that battery will occur.
the act of touching someone without his or her consent.
breach of duty
the failure to perform a promised act or obligation of due care.
to give permission or approval to something proposed or requested.
duty to act
a person's legal obligation to provide something to another individual.
the failure to exercise the care that a reasonably prudent person with similar training would exercise in a similar circumstance.
consent given when a competent injured person gives permission to provide first aid treatment and transportation.
a form of consent that is not expressly granted by a person, but instead is inferred from a person's actions and the facts and circumstances of a particular situation.
consent a person gives based upon an appreciation and understanding of the facts, implications, and possible future consequences of an action.
consent a parent or legal guardian gives for the treatment of a minor because legally the minor is not competent to give consent to medical treatment; the ability to provide such consent varies among states.
Describe the impact of Good Samaritan laws on volunteer rescuers.
laws that protect a person from legal liability when the person volunteers to perform an act to help someone else.
List six attributes of an emergency care system.
Integration of Health Services Research, Legislation and Regulation, System Finance, Human Resources, Medical Direction, Education System, Public Education, Prevention, Public Access, Communication Systems, Clinical Care, Information, Evaluation
List four nationally recognized prehospital emergency care provider levels.
EMR, EMT, AEMT, Paramedic
Compare and contrast direct medical oversight and indirect medical oversight.
direct oversight is communication over radio/telephone, indirect is preauthorized permissions to administer oxygen, etc. to speed up routine care
Describe the purpose of quality improvement.
Quality Improvements are to improve care. Prospective QI is training and protocols, Concurrent QI is online medical direction and instructor presence at scene, Retrospective QI is case reviews, after action reports and remedial training.
Describe how the body regulates temperature.
Temp regulation occurs automatically and is controlled by the brain's Hypothalamus, using neural feedback mechanism from temp receptors located thoughout the body.
Describe the four mechanisms of heat exchange.
Convection (Air), Radiation (heat escaping), Evaporation (perspiration), Conduction (direct touch)
Describe the ?fight or flight? response.
The body's response to stress is release of epinephrin (Adrenaline), causing elevated heart rate and blood pressure, pupil dilation, increased respiratory rate, airway capacity,and increased blood flow.
Describe the steps an OEC Technician can take to be prepared when responding to a request for assistance.
Environmental Consideration (prepare for coming weather), Mental Preparedness, Physical Fitness (Sleep and Fatigue, Food and Nutrition, Alcohol and substance abuse), Proper Equipment (First Aid and Survival Pack, Clothing (3 layers), Skin and Eye Protection), Hydration.
Describe how layering clothing can help preserve body heat.
1. Base layer (tight to body, wick away moisture, made of of synthetic or silk), 2. Middle Layer for Insulation (Fleeze, wool, down), 3. Outer Layer for water and wind repellant.
Describe the five modes of disease transmission.
1. Direct Contact 2. Indirect Contact (touching soiled object) 3. Airborne Transmission 4.Ingestion 5. Vector borne (ticks, mosquitos)
an infectious agent that can cause disease or illness.
the practice of protecting health care workers from exposure to bodily fluids based on the assumption that all patients are potentially infectious.
body substance isolation (BSI)
the practice of isolating all bodily substances (blood, urine, tears, feces, and so on) of patients from rescuers in order to decrease disease transmission.
substances that have the potential to harm people, animals, or the environment.
List common personal protective equipment used by OEC Technicians.
Disposable Gloves, Eye Gloves (goggles), Surgical mask, Medical Gown (Ski clothing)
Describe the four components of the scene size-up.
Scene Safety, MOI or NOI, # of patients, additional resources
Describe and demonstrate how to ensure scene safety.
Look for danger from steep hills, electricity, other terrain obstacles, other skiers, etc. Place people / skis in a position to mark the rescue spot
Describe chain of custody.
Secure a scene, do not touch or remove any objects unless absolutely necessary for the rescue, document anything moved or changed. Use the most experienced ski patrol, minimum number, and let law enforcement dictate how a scene is entered.
the study of human and animal structures, including gross anatomy (structures that can be seen with the unaided eye) and microscopic anatomy (structures visible only through a microscope).
a group of organs and other structures that work together to perform specific functions.
the basic unit of all living tissue.
A stable condition for all bisy systems
a structure containing similar tissues that act together to perform specific body functions.
the study of how living organisms function (e.g., movement or reproduction).
a collection of cells acting together to perform a specific body function.
Identify various anatomical terms commonly used to refer to the body.
Anterior/posterior, Superior/Inferior, Medial/Lateral, Proximal/Distal, Superficial/Deep, internal/External, Right/Left
Identify at least four body positions.
1. Normal Anatomical, 2. Supine, 3. Prone, 4. Right or left lateral recumbent position (recovery position), 5. Semi-Fowler, 6. High Fowler, 7. Trendelenburg
1. Normal Anatomical
4. Right or left lateral recumbent position (recovery position),
6. High Fowler,
Upper body at 90 degrees, knees may or may not be flexed
List the five body cavities.
1. Cranial, 2. Spinal, 3. Thoracic, 4. Abdominal, 5. Pelvic
Identify and describe the fundamental anatomy and physiology of the 11 body systems.
1. Respiatory System, 2. Cardiovascular System, 3. Nervous System, 4. Gastrointestinal System, 5. Urinary System, 6. Endocrine System, 7. Integumentary System, 8. Skeletal System, 9. Muscular System, 10, Reproductive System, 11. Lymphatic System
a group of organs and other structures that transport blood and other nutrients throughout the body.
a group of organs and other structures that produce chemical substances that act as messages throughout the body.
a group of organs and other structures that break down food and absorb nutrients into the body.
a group of specialized tissues that protect the body, retain fluids, and help prevent infection; the skin.
a group of organs and other structures that remove extra fluid from tissues, absorbs and transports fats from the circulatory system, and transports immune cells to and from the lymph nodes.
a group of specialized tissues that allow movement of the body, movement within the organs of the digestive system, and the beating of the heart.
a group of organs and other structures that regulate all body functions.
a group of organs and other structures responsible for human reproduction.
a group of organs and other structures that bring oxygen in the air into the body and eliminate carbon dioxide into the air through a process called breathing or respiration.
a group of specialized tissues that provide support to the body, provide attachment points for muscles, protect internal organs, allow movement, store minerals, and constitute one of the sites where blood cells are made; the bones.
a group of organs and structures that remove wastes and toxins from the blood and excrete them in urine.
Describe homeostasis and its importance for good health.
The process which the body maintains a stable internal environment. If disrupted can cause organs and systems to fail
Identify and properly use various anatomical terms to describe body direction, location, and movement.
Describe the two parts of the overall assessment process.
Scene Size up and Patient Assesment
Describe the importance of scene safety.
Use all senses (sound, smell, vision) to understand potential danger, manmade or natural, only enter scene if safe to do so.
List the two parts of a patient assessment.
Primary Assesment (ABCD, life-threathening conditions), Secondary Assesment (Vitals, MOI, NOI, DCAP-BTLS)
Describe and demonstrate how to perform a primary assessment and manage the ABCDs.
1. Check for response by tapping and shouting, 2. open airway and check pulse (10 sec) 3. If breathing continue 4. If no pulse, start CPR, 5. If pulse but no breathing, start rescue breathing, ABCD
Describe and demonstrate how to perform a secondary assessment.
SAMPLE, complete assesment by touch and vitals
the act of determining the nature of a patient's injuries and illnesses.
the symptom or group of symptoms about which the patient is concerned.
a mnemonic for assessing trauma-related injuries; represents Deformity; Contusions; Abrasions and avulsions; Punctures and penetrations; Burns, bleeding, and bruises; Tenderness; Lacerations; and Swelling.
any objective finding that can be seen, heard, smelled, or measured; typically discovered during a physical exam (e.g., a bruise, the patient's blood pressure).
a subjective finding that a patient experiences and can be identified only by the patient (e.g., pain, blurred vision).
List and describe the key components of a patient history.
Asking patient, bystanders, getting subjective data on symptoms like pain, nausea, weakness, fatigue, blurred vision, impending doom
Describe how environmental conditions can affect patient assessment.
If cold, limit removal of clothing, pulse may be hard to find in extremities, Wind, rain dust may infect a wound, prevent proper assessment, sun can prevent pupil checking
Describe and demonstrate how to obtain a SAMPLE history.
an acronym used to obtain medical history information during the assessment process; refers to Signs/symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading up to present incident.
Describe and demonstrate how to assess pain using the OPQRST mnemonic.
a mnemonic that is used in the assessment of a patient's chief complaint: represents Onset, Provocation and palliation, Quality, Radiation, Severity, and Time.
Describe and demonstrate how to assess the eyes (pupils and movement).
a mnemonic for assessing the eyes (i.e., Pupils Equal, Round, Reactive to Light).
Describe and demonstrate how to assess a patient?s level of responsiveness using AVPU
a mnemonic for assessing neurologic function; represents Awake or alert, responds to Verbal stimuli or Pain, Unresponsive.
Describe and demonstrate how to assess a patient?s level of responsiveness usingGlasgow Coma Score
a method for assessing neurologic function (i.e., level of responsiveness, movement).
Describe and demonstrate the procedure for obtaining the respiatory rate
Watch the number of inhalations for 30 sec, multiply by 2. Normal is 12-20 breaths per minute. Do not let the patient see that youo are counting breaths.
Describe and demonstrate the procedure for obtaining the Blood pressure
Normal for adult is 120/80. Listen for the first sound, that is systolic. When sound goes away or alters is diastolic.
Describe and demonstrate the procedure for obtaining the Heart Rate
Radial pulse is hand, carthoid is neck, Brachial is Upper arm (Blood pressure)
Normal rates are 60-100 for adults.
Describe and demonstrate how to reassess a patient.
Continual check of vitals and ABCD's, for stable patients every 10-15 min, for patient with ABCD issues every 3-5 min
List the major anatomical structures of the upper airway.
Upper airway begins at the mouth and ends at the larynx. In between are the Pharynx and epiglottis
a thin, leaf-shaped structure posterior to the tongue; covers the larynx when swallowing, preventing food or liquid from entering the airway.
the passageway that extends from the nose and mouth to the larynx; consists of three parts: nasopharynx, oropharynx, and laryngopharynx.
Describe and demonstrate how to manually open the airway or mouth using the Head tilt, chin Lift
a method to open a patient's airway; a process that involves tilting the patient's head backward while simultaneously lifting the patient's chin.
Describe and demonstrate how to manually open the airway or mouth using the Jaw trust
a method used to open a patient's airway by displacing the jaw forward; commonly used whenever spine injury is suspected because it helps to maintain cervical spine alignment.
Describe and demonstrate how to manually open the airway or mouth using the Crossed Finger
1. Dominant hand, cross index finger under thumb 2. Place thumb and finger against patients upper and lower teeth 3. Spread thumb and finger apart o open patient's mouth
Describe how to clear a patient?s airway using Gravity
Conscious: ask patient to lean forward, Unconsious: place patient in recovery (with help if spinal injury)
Describe how to clear a patient?s airway using the Finger Sweep
Only for unresponsive patients, do not stick finger in further than you can see, hook the object out.
Describe how to clear a patient?s airway using Suction
Place suction device in mouth, THEN turn on suction. Not farther than you can see, sweeping back and forth. Adults 10-15 sec, kids 5-10 sec. Pre oxygenate patient before if possible.
Describe how to place a patient into the recovery position.
1. Kneel by the left side of the patient, knees near patient's hip or chest 2. extend patient's left arm so it extends over the patient's head 3. Gently roll patient towards you on their left side so that head rests on the straightened arm 4. head should be tilted in slight forward angle, mouth open 5. Flex patient's right knee at 90 degree angle to anchor patient 6. position patient's right arm so that it is in front of the patient without blocking access to the airway 7. check to make sure the airway is still open
Compare, contrast, and demonstrate the usage of a rigid suction catheter and a flexible suction catheter.
Yankauer: rigid, larger opening, Frenchie, flexible, smaller opening. Frenchie is used for smaller openings such as the nasopharynx.
List the indications of and uses for and demonstrate the Oropharyngal airway adjuncts, and demonstrate the proper methods for choosing the correct size and inserting them: Oropharyngeal airway
Relieves airway obstruction caused by the tounge, relatively easy to insert, Must not be used in a responsive patient or a person with intact gag reflex, can be placed in patients with nasal trauma. Measured from the corner of the mouth to the tip of the earlobe, using the curvature of the device. SIC Size the adjunct, Insert the adjunct (insert halfway with tip sideways, then rotate to "cup" the tounge), Check the airway. Remove if patient starts gagging.
List the indications of and uses for and demonstrate the Nasopharyngal airway adjunct, and demonstrate the proper methods for choosing the correct size and inserting them: Nasopharyngeal airway
Relieves airway obstruction caused by the tounge or by mucus and nasal swelling, Relatively easy to insert, can be safely used in responsive and semi-responsive patients or in a patient with intact gag reflex, Caution required if used in patients with oral trauma. Measured from base of nose to tip of earlobe. Insert with opening towards middle of nose. SLIC Size the adjunct, Lubricate the adjunct, Insert adjunt by twisting halfway down, Check the adjunct
Describe how to calculate the oxygen flow duration rate.
Flow duration rate = (Gauge pressure in cylinder - Safe residual pressure (200psi)) X Cylinder size constant (.16 for D)/ Flow rate in LPM
Describe and demonstrate how to properly set up an oxygen tank for use.
Green tank, valve with 3 prongs; 1. let air out to clear valve, 2. verify o-ring, 3. place regulator, do not overtighten, 4. open tank to verify seal, if not sealed, reset rhe regulator, if not work, replace the o-ring, 5. Hook up oxygen delivery mechanism, 6. turn on, 7 place mask. To remove, 1. remove mask, 2. turn off oxygen regulator, 3. turn of tank. 4 bleed off regulator, 5. close regulator, remove regulator.
List four tips for the safe use of oxygen.
1.Never use oxygen near a spark or flame (candles, camp fire, stove, heater) 2. Do not allow patient or bystanders to smoke 3. Keep oil, grease and petroleum based combustibles away from oxgen tank and regulator 4. Turn oxygen tank off when not in use 5. Protect the valve stem from damage 6. leave protective caps in place until cylinder is ready for use 7. Clear valve stems of dust and debris before attaching regulator, 8. Do not overtighten valve stem, saddle screw, or regulator knobs
Describe and demonstrate how to use the Nasal cannula
Two pins are inserted prongs down, pushing air into nose, wrap hose around ears and tighten. Never go around the head. Flow rates are 1-6 LPM, typical 2-4 LPM
Describe and demonstrate how to use the Nonrebreather mask
Hook mask up to oxygen, partially fill the bag, then place on patient. Flow rate is 10-15 LPM, typical 12-15 LPM. Some people do not like the mask on their face
Describe and demonstrate how to use the Pocket mask
1. remove pocket mask from package, 2. Open mask by pulling on the connector 3. Connect the 1 way valve, 4. connect the breathing tube to the mask If used manually, assemble as previously explained, kneel at the top of the head and open the airway using either the head tilt/chin lift or jaw trust manuever, Place the mask on the patient, place your thumbs on the mask near the bridge of the nose, while simultanously placing index finger at the base of the mask, place remaining fingers under the mandible and pull upwards (not pushing down), deliver rescue breaths.
Describe and demonstrate how to use the Bag-valve mask
Hook up to oxygen (although it can be used to deliver ambient air), flow rate 12-15 LPM. Inflate bag, then place over patient, ensure a good seal. Press the "bag" slowly, in step with your own breaths. Do not push to hard or too often as hyperextend stomach can occur.
Describe and demonstrate how to use the Face shield
1. Kneel at either side of patient's head 2. Remove face shield from protective package, place on patient 3. Seal patient's nose and place lips on the shield and provide rescue breaths.
Demonstrate how to safely put on and remove disposable medical gloves.