Tuesday, February 10

Practical Translations

A one-armed legless person could read, understand and memorize every published book on bicycle riding and yet have a very difficult time riding a traditional bicycle.

There is a lot of book learning in the initial part of the EMT class I am taking. Some of this learning is knowledge we need, but some of it refers to skills we will need to carry out. I have been curious as to how well I will be able to carry out the skills component of being an EMT as I fully understand that reading about artificial ventilation techniques, for example, may be very different from performing the ventilating. You just cannot tell until you try.

EMT class last night involved “lab”. Lab, in this case, does not involve titrations and acid stained lab books. “Practical skills stations” are set up to test our ability to carry out a series of steps necessary to perform some basic life saving procedure (for example, use an oral airway adjunct and bag-valve-mask [BVM] to ventilate an unconscious individual). What a blast! To get to actually do something instead of taking notes for three hours of lecture is a treat. The fact that what we are doing involves cool lifesaving tools is a bonus. I do not mean to demean these tools or the skills required to use them to by referring to them as “cool”. But whether you want to call them “neat”, “keen”, “cool”, “rad” or even “bad” [in the way my students mean “bad”], they rock. Really. Oxygen setups, one way valves, and sticking tubes through the nose to the nasal pharynx are all fun stuff, at least in this low risk environment.

Most of the skills stations give you a scenario and ask you do deal with it. There are a series of steps you are expected to do from memory. Some people in my class are acting like you have to memorize a bunch of random bits of information in order to succeed at this task. They miss critical steps because of this approach. I see this from my students a lot. Imagine having a can opener, can of chili, stirring spoon, pan, stove, bowl, and a spoon to eat with placed in front of you. You are told “heat the chili and eat it”. This is the rough equivalent of a skills station. Do you try to memorize the steps? If you think about what you are doing and why you are doing it, it is not that difficult (at least so far). Sure, there are things to remember, but the information is all related to a major theme and instead of being random bits the information is more like a semantically related linked list. For the stations we have done it is very easy to remember what to do because you just have to think rationally.

I know the more difficult practicals are yet to come (e.g., the trauma looks scary and wicked interesting all at the same time), but I am now confident that they will be doable. What I am left wondering is how well these skills, once acquired, will transfer to actual situations. Is opening the airway on a “dummy” that is not turning cyanotic and puking all over you the same as dealing with a live (barely) person in the back of a moving rig whose family is on the way to the hospital and will be there before you leave? How can it be?