2018 outdoor emergency care cycle b traditional refresher

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2018

Outdoor Emergency Care Cycle B

Traditional Refresher Instructor Guide

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INTRODUCTION Welcome to the 2018 Outdoor Emergency Care Cycle B Refresher Instructor Guide. This guide is designed to provide information for Instructors, Instructors of Record (IOR), Instructor Trainers and other members of the OEC team responsible for quality delivery of the OEC Cycle B Refresher. In 2017, the NSP Medical Advisory Committee concluded that current medical evidence demonstrates that the practice of “spinal immobilization”, where backboards with straps are used to secure a conscious victim of trauma during extrication and transport for a possible spinal injury, may be overused or unnecessary. In many cases typically encountered by patrollers, spinal immobilization may be causing harm to the patient while not providing any benefit. In this Instructor Guide, we will introduce the selective use of backboards for possible spinal injuries that were approved by the NSP Medical Advisory Committee on March 8, 2017, presented to the National OEC Committee and supported in April and approved for inclusion in the Cycle B Refresher by the NSP Board of Directors on April 2017. Some portion of this material will be included in the 6th edition of the OEC text and is intended for use in training new OEC technicians and for use at OEC refreshers beginning June 1, 2018. This information is to be used as the standard of training for the NSP Outdoor Emergency Care program. Patrols may be required to follow local or state EMS guidelines, policies or law that would supersede this level of training. A listing of Historical Papers reviewed by the Medical Advisory Committee detailing the latest literature regarding back boarding and/or spinal immobilization (now called spinal protection) is posted on the NSP Website in the Instructors Resources section. NEW TO THE INSTRUCTOR GUIDE Based on suggestions from last year’s refresher, the Instructor Guide has been divided into two distinct guides, the Traditional Refresher Instructor Guide and the Hybrid Refresher Instructor Guide. Please keep in mind, no matter which format is chosen for a refresher, all skills and knowledge objectives outlined in the OEC Cycle B Instructor Guide and OEC Cycle B Refresher Study Workbook must be covered in the annual refresher. If using the hybrid model, the didactic objectives will be completed using the online modules. If using the traditional model, all didactic objectives must be covered utilizing other methodologies and support materials (i.e. lectures, posters, small group discussions, etc.). For both the hybrid and traditional models, the Refresher Workbook must be completed as a transition and a review of the materials needed for the skills portion of the refresher. The Sample Refresher section identifies how to meet both models. We listened to your feedback and sincerely hope that you like the new format. Please let the Refresher Committee know what you think of these changes. Contact information for NSP can be found at www.NSP.org. As a reminder to instructors, IORs and instructor trainers, the changes to the NSP IT system regarding registration for your 2018 Cycle B Refresher are listed here:

1. There will be only one course offering when registering a course for the 2018 OEC Cycle B Refresher. It will not matter which type of refresher you are offering as an IOR when you register your class there will only be one option to choose.

2. After a course is registered, each student must be contacted by the IOR with the course number and the student will be required to go online and enroll in the course on the NSP website. See the OEC Refresher Workbook for detailed instructions.

3. Prior to the start of the Refresher, the IOR will be able to print out an attendee list to ensure that everyone has enrolled. Anyone attending the refresher who has not enrolled must do so prior to the

2018 Outdoor Emergency Care Cycle B Refresher Instructor Guide

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class roster being submitted. The Visiting Patroller Completion Form is now at the end of this guide, please print out a number of copies and bring to your refresher.

4. The course completion record will be completed when the IOR electronically closes the course online. The directions for how to complete this step are published on the NSP website. All attendees meeting all of the refresher requirements will receive credit for the refresher after the IOR closes the course, and Instructor Trainer approval of the course roster online. The IT for the class must ensure that only those that attended this training are selected on the electronic roster as being successful. Check your member profile education classes to ensure you have received credit.

A significant portion of an OEC instructor's responsibility is to support local patrols and members during their OEC refreshers. As an OEC instructor, the information we provide to OEC technicians must be correct and meet the requirements of the Outdoor Emergency Care Fifth Edition (OEC 5th ed.) and approved supplement on spinal protection. Each OEC instructor must be committed to the program as the "standard of training" while balancing the different ways OEC technicians learn. The "standard of training" is what each OEC technician needs to be able to discuss and demonstrate. OEC instructors must be enthusiastic, have a great imagination, be sincere to the needs of the program and the students/participants, be knowledgeable of the OEC 5th ed., and, above all, practice their teaching and OEC skills. Understanding the language in the 2018 Cycle B OEC Refresher Instructor Guide will help the instructor best meet the standards of the refresher. Each requirement is written as though looking through the student's eyes. "List," "describe," "identify," and "demonstrate" are key verbs that OEC technicians going through the refresher must complete. It is up to the OEC instructor to engage each student so that they meet these requirements. Therefore, the method an instructor chooses to deliver the training or skill or information should be interactive, energetic, and fully engage the OEC technician in the activity. The OEC instructor will notice that certain key verbs relate to knowledge-based objectives, while others relate to skills-based objectives. Key verbs such as "perform" and "demonstrate" will become the focal point of the hands-on portion of the refresher. Posters and other information available on the NSP Instructor Resources pages on the NSP website (nsp.org) will help support the hands-on portion of the refresher as review material.

FOR THIS REFRESHER, PATROLLERS ARE TO KEEP THEIR REFRESHER WORKBOOKS FOR REFERENCING THE NEW SPINAL PROTECTION INFORMATION.

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SPECIAL UPDATE TO OEC 5e on SPINAL PROTECTION Assessment (See: Spinal Protection “The Backboard Redefined” at www.nsp.org) Protection (See: Spinal Protection Flow Chart on Page 34) Cervical Spine Precaution Requirements (Patrollers to keep their Refresher Workbooks)

RESCUE BASICS (Chapter 3) ANATOMY AND PHYSIOLOGY (Chapter 6)

• Nervous System • Muscular System • Skeletal System • Urinary System • Gastrointestinal System

PATIENT ASSESSMENT (Chapter 7) CRITICAL INTERVENTIONS (Chapters 9 and 10)

• Airway Management • Shock

MEDICAL EMERGENCIES (Chapters 14 and 16) • Allergies and Anaphylaxis • Gastrointestinal and Genitourinary Emergencies

TRAUMA (Chapters 5, 20 and 21) • Musculoskeletal Injuries – Lower Extremities

o Hip o Pelvis o Femur – Proximal

• Head and Spine • Helmet Removal • Abdomen and Pelvic Trauma • Lifts, Loads and Carries

ENVIRONMENTAL CONDITIONS (Chapters 26, 27, 28 and 29)

• Heat-Related Emergencies • Plant and Animal Emergencies • Altitude-Related Emergencies • Water Emergencies

SPECIAL POPULATIONS (Chapter 32)

• Outdoor Adaptive Athletes

CASE REVIEWS

2018 OEC Refresher Key Topics

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PROGRAM PROCESS OEC technicians must complete an OEC refresher each year. This program offers OEC technicians an opportunity to update, renew, and demonstrate their competency in specific OEC skills and knowledge. The OEC Refresher Program is a traditionalized program. During each refresher cycle, every OEC technician reviews required material and demonstrates proficiency in specified skills. Every required skill must be demonstrated during the annual refresher as outlined in the Skills Checklist in the OEC refresher workbook or OEC refresher instructor guide for both Hybrid and Traditional refreshers. The knowledge based Objective checklist for traditional refresher IOR’s is located in this Instructor Guide only. With every refresher, OEC technicians have the opportunity to hone and improve their clinical skills. Verification of OEC technician competency in fundamental knowledge, skills, and scenario management is the basis of the OEC Refresher Program. OEC technician certification is maintained by completing three consecutive annual refreshers. All NSP members must complete each of the refreshers (Cycles A, B, and C) to maintain their OEC certification. The only NSP members exempt from this requirement are mountain hosts, registered candidate patrollers enrolled in an OEC course, members who complete a full OEC course after May 31 of the current year, and members registered as physician partners (M.D. or D.O.). The OEC Refresher Program does not provide a means for a person with previous emergency care or medical training to challenge the OEC course. Additionally, the annual refresher covers a third of the OEC Program curriculum requirements and does not meet the requirements for certification under the full OEC Program. An inactive NSP member returning to active status must hold a current OEC technician card, complete any missed cycle(s) that occurred during the inactive period, and pay dues for any missed seasons(s). If the OEC technician card expired during the inactive registration period, the member may need to retake an OEC course. Please refer to the National Ski Patrol Policies and Procedures for guidelines on registering as an NSP member and other OEC technician refresher requirements. The current Policies and Procedures document can be found on the www.nsp.org website under the topic “Member Resources”. Sign in to your member page, select Governance from the banner on the right side of the page. The P&P is near the bottom of the page. THE REFRESHER For each refresher, OEC technicians must complete ALL of the following components:

• the didactic, or information, portion (in person at a refresher event); • the Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B, and • the skills component at a refresher event.

In order to receive credit for this refresher cycle, OEC technicians must successfully complete either the TRADITIONAL or the HYBRID refresher types:

• The "traditional" refresher format consists of two steps: 1) The OEC technician reviews and completes the assignments, skills, and case presentation in the Outdoor

Emergency Care Refresher Workbook 2018 OEC Cycle B; and, 2) They complete a knowledge and skill-based refresher event, where they will demonstrate their OEC skills

and discuss the knowledge based objective requirements and the cases they have reviewed. Note: The Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B must be reviewed by the IOR or their designee for completeness prior to completion of the refresher.

• The "hybrid" refresher format consists of three steps:

1) The OEC technician reviews and completes the assignments, skills, and cases in this Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B. Note: The Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B must be reviewed by the IOR or their designee for completeness prior to completion of the refresher.

2) Complete the online refresher exercise that reviews the knowledge-based portion of the refresher.

Preparing for and Completing the 2018 Refresher

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3) Complete a skill-based refresher event, where they will demonstrate their OEC skills and discuss the cases they have reviewed.

In the 2018 Cycle B refresher, there are a number of injured/ill patient assessments to be completed. All OEC technicians must complete at least one assessment during that specific skill sign-off. Other skill objectives that are identified as “assess a specific part of the body or chief complaint (CC) may have the assessments shortened”, but should include determining scene safety, permission to treat, traditional precautions associated with the CC, followed by assessment and care of the CC and treatment for shock.

INSTRUCTIONS FOR COMPLETING THE TRADITIONAL REFRESHER (to be sent to attendees) 1) Review/complete the material.

a. Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B – must be completed; b. Outdoor Emergency Care Fifth Edition is the reference source.

2) Update your NSP record. a. Check your personal profile in the "Member Resources" section of www.nsp.org to ensure that your information

is correct, or call the national office at 303-988-1111. b. Enroll in the OEC Refresher B course online.

3) Gather materials for the refresher event. a. Bring the completed Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B, AND the printed

completion certificate from the online portion (hybrid only). b. Bring your current OEC, CPR, and NSP member cards. Your OEC card should have a blank space in the Cycle

B section. c. A fully stocked aid belt, vest, or pack, and any additional items required at the refresher you will attend. d. Weather-appropriate clothing for both indoor and outdoor refresher activities.

4) Practice the skills that are identified in the Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B.

a. Check the refresher checklist on page 29 for the knowledge & skills you will be reviewing and demonstrating. b. By being proficient at Outdoor Emergency Care Fifth Edition skills, you will feel more comfortable during the

skill and scenario stations. 5) Attend the refresher.

a. Check with your local patrol to ensure that you are completing the appropriate refresher format requirements (traditional vs. hybrid).

b. If you complete a refresher with another patrol, contact their IOR before you attend to ensure that you are preparing for the appropriate refresher format (traditional vs. hybrid). Also, be sure that your host IOR signs the Visitors' Completion Form found on www.nsp.org (a copy is included in this instructor refresher guide and IOR’s should have copies for use on refresher day).

OTHER PROGRAM REQUIREMENTS

• CPR for active NSP members: Active NSP members must ensure that they maintain a current professional-rescuer level CPR certification and demonstrate their CPR skills annually to an agency-approved certified CPR instructor, regardless of the requirements of the certifying agency or the expiration date on their card. This requirement is not meant to be part of the annual OEC refresher. For a complete list of the NSP-approved CPR certifying agencies, please see the National Ski Patrol Policies and Procedures.

• Local patrol training, such as local patrol requirements, area needs, lift evacuation, CPR, AED, and other on-

hill/on-trail training, is arranged through your home patrol and is NOT officially part of the OEC refresher process. The NSP is not responsible for the content, instruction, or scheduling of this training, so it is important to communicate with your local patrol regarding these requirements.

HOW TO FIND THE REFRESHER WORKBOOK ANSWERS The Refresher Committee's task was to create a refresher workbook that would enhance the overall refresher experience. There are six modules, each directed at different subject matter. You will find it helpful and necessary to use your Outdoor Emergency Care Fifth Edition when completing the workbook. Use your Outdoor Emergency Care Fifth Edition and Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B together to review the topics and chapters as indicated by the title of each workbook module, and answer the questions and complete each exercise. The title of each module refers to a portion of the chapter(s) you will be reviewing in a particular module. The title and concluding objectives are shown in bold print. Consider this example: "Critical Interventions: Airway Management, Shock" (workbook module title); and 10-9. Describe and demonstrate the management of shock. The first number refers to the chapter the answer can be found in, Chapter 10 in this instance. The second number (9 in this example) tells you that this is the 9th topic to be discussed in the chapter. From there, find the objective in the book, review it, and hopefully the answer will present itself. Please note that some objectives have been combined to shorten the list.

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For those OEC technicians that use an electronic version of the Outdoor Emergency Care Fifth Edition textbook, we have included keyword searches in bold and italics. Remember, completing the workbook is an important part of your refresher, and a requirement. The workbook must be brought to the OEC refresher and reviewed by the IOR for completeness; patrollers are to keep their workbooks. INSTRUCTOR RESOURCES Up to date Instructor Resources including the answer key for the Refresher Workbook, any corrections to the Refresher Workbook, posters and other materials may be found on the NSP website under the pull-down tab "OEC Instructor Resources." THINGS TO KEEP IN MIND WHEN TEACHING TO THE ADULT LEARNER When teaching, instructors should embrace a variety of methods to engage their students and bring their subjects to life. Learning is not only more fun, but also more deeply engrained when it is done actively and involves the whole person. In fact, if a person sees, hears, and physically participates in a learning activity, they are 80 percent more likely to remember what they learned than if they used only one or these types of learning.

The following list provides a variety of terms that instructors and students can use in their concluding objectives to make learning more memorable. These verbs are to be used in the concluding objectives established by the instructor. Concluding objectives state what the OEC technician will do in order to meet that objective, and they provide guidance for instructors as they select an instruction method that supports the outcome.

CONSIDER: To think about carefully; to examine and think about in order to understand. DEMONSTRATE: Through physical actions reveal, make obvious, or exhibit a skill. Make clear by showing examples. DESCRIBE: To create a mental picture through detailed description. DISCUSS: To discuss, consider, and argue the pros and cons of; to support with reasoning and evidence. EXPLAIN: To make clear and understandable through meaning; to give explanation. IDENTIFY/NAME: Be able to recognize, list, or classify items. INTEGRATE: To put together, include, incorporate, and assimilate several components together. LIST: Provide a series of words, names, or items of relevance to a related topic. PARTICIPATE: Being actively involved, taking part in, joining in, sharing, and adding to a discussion or comments. PERFORM: To carry out or execute an action; an exhibition of a skill. PRACTICE: To carry out, perform, or apply a skill in a classroom setting; to do repeatedly to learn or become proficient. REVIEW: To look at, look over, or re-examine.

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SUGGESTED TIME LINE Available on the web at: www.nsp.org 8 WEEKS BEFORE REFRESHER DATE: ___________________

□ Review, address, and act upon 2017 Patroller Refresher Evaluations. □ Determine the date, time, and location of the following:

• Choose the refresher format: Hybrid (online and skills refresher) or Traditional Refresher. • Refresher planning meeting: Date: ______ Time: _______ Location: ___________ • Annual OEC refresher for instructors: Date: _____ Time: _____Location: _________ • OEC refresher: Date: ________ Time: ________ Location: ____________________

7 WEEKS BEFORE REFRESHER DATE: ___________________

□ Notify all patrol members of the date, time, and location of the OEC refresher; provide preparatory instructions and a list of items members must bring to the refresher. □ Send the region OEC administrator a notice to get name of assigned Instructor Trainer (IT). Once assigned an IT, register the refresher at www.nsp.org. □ Notify OEC instructors, assigned IT, OEC region administrator (if available), or other OEC supervisory staff of the date, time, and location of the following:

• Refresher planning meeting. • OEC refresher for instructors and OEC refresher. • How to access the online refresher, if it's being used.

□ Ensure that all OEC instructors are current. 6 WEEKS BEFORE REFRESHER DATE: __________________ Refresher Planning Meeting (refer to planning tool that follows)

□ Identify and implement a plan for quality management of this refresher. □ Determine station format, logistics, and flow (see sample refresher schedules) by considering the following areas:

• Number of patrollers expected to attend: ________________________________ • Number of stations needed: ___________________________________________ • Number of "patients" required: Adult _______________ Pediatric _____________ • Number of instructors and facilitators needed: _____________________________ • Instructor assignments (notify all participants of assignments, including specific station performance

objectives). 5 WEEKS BEFORE REFRESHER DATE: __________________

□ Formalize instructor assignments, share refresher schedule/outline course information with assigned IT. □ Determine equipment supply needs, i.e., medical/first aid, audiovisual, chart paper and easels, tape, markers and pens, station signs, poster board, index cards, trash receptacles, and refreshments.

4 WEEKS BEFORE REFRESHER DATE: __________________

□ Delegate administrative responsibilities: • Identify responsible person(s): ________________________________________ • Have the IOR print a roster prior to the start of the refresher to review and make additions and deletions

of those in attendance. • Ensure access to www.nsp.org with electronic support for attendees that did not enroll.

2018 Cycle B Refresher Planning Checklist

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4 WEEKS BEFORE REFRESHER CONTINUED

□ Determine and obtain logistical support in the following areas: • Communications, including radios. • You are encouraged to have an OEC instructor lead each station or activity. Stations can be

supplemented by specialty instructors who are knowledgeable about the material covered in the OEC 5th ed. standard of training. This is an opportunity to develop new instructors and involve local members of EMS, hospital staff; and administrative support.

3 WEEKS BEFORE REFRESHER DATE: __________________ During the Interim

□ Remind patrollers of items they must bring, i.e., current NSP membership and OEC cards, CPR card, a stocked belt or vest, and the completed Refresher Workbook. Also apprise patrollers of local needs, dress requirements, and necessary lunch arrangements. □ Confirm the source and delivery of equipment, supplies, and refreshments for both the annual OEC refresher for instructors and the OEC refresher. □ Confirm the instructors' commitment to teach, their understanding of assigned performance objectives, use of six-pack format, and the need to present their entire assignment at the annual OEC instructor refresher. □ Confirm the commitment of extra personnel. □ Ensure that the refresher facility is prepared (heat, cleanliness, restrooms, furniture, etc.). If you are not using a ski patrol facility, ensure that proper releases are secured with the facility owners.

2 WEEKS BEFORE REFRESHER DATE: __________________ Annual OEC refresher for instructors (this is not a refresher planning meeting)

□ Verify all refresher knowledge and skill requirements for participating instructors; all instructors must personally complete all refresher objectives and skill requirements. □ Teach or present assigned objectives to fellow instructors. □ Critique and fine-tune presentations with help from the assigned IT.

REFRESHER DATE: __________________ OEC Refresher (the following items must be completed by instructors attending the instructor refresher)

□ Collect the patroller evaluation forms and Visitor Patroller Completion Forms. □ Collect the national or division release forms prior to starting the refresher.

□ Verify each patroller has their OEC Refresher Workbook, DO NOT COLLECT. 1 WEEK POST REFRESHER DATE: _______________ Post Refresher

□ Hold post-refresher meeting with instructor of record, assigned IT, and patrol representative to review the overall refresher. □ Review the patroller evaluation forms. Make notes for improvements at the 2018 refresher. □ Forward IT QA form only to [email protected] and to others as requested/required. □ Be sure everyone that attended registered themselves online.

3 WEEKS POST REFRESHER DATE: ________________

□ Complete the online OEC Refresher Close a Course Record under Course Tools and submit to the national office and others as requested/required. □ Prior to course closure print a final roster and make additions and deletions and forward to the IT of Record. Confirm that the IT of record has approved the course closure with the national office. Do not delay submission of records for those requiring additional training. □ Please make a special effort to complete your documentation in a timely manner.

2018 Cycle B Refresher Planning Checklist

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It is the responsibility of the OEC IT to engage the instructor of record (IOR) as often as necessary to ensure that the OEC refresher meets all of the objectives of the annual OEC refresher cycle as outlined by the OEC Refresher Committee.

The IT has the critical responsibility of supporting the IOR and reviewing all of the steps necessary to complete the OEC refresher. Along with reviewing each individual objective to ensure compliance with the program, the IT has the responsibility to make sure that all notifications are made in a timely fashion and that all completion records are submitted within the recommended two-week timeframe after the completion of the course.

The IT should also help to identify instructors who need further development in the delivery of materials using the NSP Instructor Development platform. Instructor reviews need to be documented, and are usually conducted at the request of the region OEC administrator. Please remember that all instructors must be reviewed by an IT for competence at least once every three years as part of the recertification process.

Further, the IT has the responsibility to ensure that any non-OEC instructor who is used to support the OEC refresher is clearly using only Outdoor Emergency Care Fifth Edition material during the training exercise. These instructors must be experts in the topic they are covering. Allowing a patroller to review material is not acceptable.

Instructor trainers should ensure that all evaluations are collected, OEC technician cards are signed for the attendees, and that all attendees are enrolled and listed on the course roster. The IT should ensure that the IOR has a complete list of all attendees from the class enrollment that reflects all attendees at the class. A computer may need to be accessible the day of the event in order to ensure everyone has access and is enrolled in the refresher.

Any OEC technician who has attended an annual refresher, but who does not meet the skills objectives, must successfully complete remedial training and be re-evaluated before they are given credit for course completion. This may or may not be done on the same day as the OEC annual refresher. Further, it is the responsibility of the IOR and IT to ensure that any additional training and completion of the refresher is reviewed and documented.

It is the responsibility of the IOR and IT to ensure that all other skill objectives have been completed. If a traditional refresher is being offered, all objectives in the skills checklist must be covered to meet the requirements of Cycle B as well as the knowledge based checklist in this instructors guide.

ITs are not exempt from the requirements of attending a full OEC refresher and completing the Outdoor Emergency Care Refresher Workbook 2018 OEC Cycle B and meeting all of the requirements of the "2018 Objective and Skills Checklist." An IT must be knowledgeable of all the materials prior to teaching any portion of an OEC refresher if they have not attended a refresher first.

An OEC instructor who has not been refreshed prior to teaching in a refresher must attend a refresher other than the one in which they are teaching. The IOR and IT who are using a subject matter instructor or an OEC instructor who has not attended an OEC refresher prior to teaching at the refresher must be confident that the instructors they use are professionals in their field or are OEC instructors who are updated and reviewed on any topics which they are teaching at the refresher.

Quality assurance is the primary responsibility of the IT. He or she must document all findings on the QA form included in the Outdoor Emergency Care Refresher Instructor Guide 2018 Cycle B and send it to the appropriate individuals outlined on the form.

Note: Be aware … the numbering on the various modules does not necessarily align; however, all material is covered.

A special note to the OEC instructor trainer who is assigned to perform QA at an annual OEC refresher

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Please refer to the new Cycle B Lesson Plans which can be found in the Instructor Resources section on the OEC Instructors webpage at: www.NSP.org

PRE-STATION GROUP DISCUSSION, Entire group presentation: review new spinal protection information

STATION 1 (Lesson Plans Modules 1 & Module 4): Knowledge Objectives (Suggested 30 minutes): Using lecture or guided practice, games etc. review the anatomy and physiology of Musculoskeletal Injuries & Gastrointestinal/Genitourinary Emergencies.

Part 1: Describe the fundamental anatomy and physiology of the Skeletal, Muscular, Nervous systems, including: Identify various anatomical terms commonly used to refer to the body, list the five body cavities, correctly identify the major anatomical components of the central nervous system, define and describe homeostasis and its importance for good health, and describe the functions of the following structures: Bones, Cartilage, Joints, Muscles, Synovium, & Tendons (Focus on Hip, Pelvis, Femur).

Part 2: Describe the fundamental anatomy and physiology of Gastrointestinal/Genitourinary Emergencies, including: Identify and locate the major anatomical structures within the abdominopelvic cavity, list the functions of the major anatomical structures within the abdominopelvic cavity, list and describe at least six possible causes of emergencies involving the gastrointestinal and genitourinary systems, List the signs and symptoms of emergencies involving the gastrointestinal and genitourinary systems, and compare and contrast visceral pain and parietal pain.

Skill Objectives (Suggested 45 minutes):

For this station, the following two objectives must be worked into each skill or scenario station:

1. Describe and demonstrate the management of shock (see poster). 2. Describe and demonstrate how to ensure scene safety (see poster).

Equipment for this rotation: Moulage for evisceration of the abdomen; impaled object for abdomen (the impaled object should be small and not overly cumbersome to control); makeup for simulating bruising to the lower quadrants; moulage for bruising color, Long board for immobilization of the pelvis fracture; sheets or manufactured pelvic sling; moulage for swelling of hip; long board splints; bed sheets, extra blankets.

3. Describe and demonstrate how to assess the abdomen (each OEC technician must demonstrate). 4. Describe and demonstrate how to assess a patient with abdominopelvic trauma (each OEC technician must lead

one). 5. Describe and demonstrate the management of a patient with a severe GI/GU emergency [Refer to

Chapter 16] (perform as a team). 6. Describe and demonstrate how to manage an evisceration, an impaled object in the abdomen or pelvis, and a

pelvic fracture (each OEC technician must lead one and participate in all others). 7. Describe and demonstrate how to assess and care for a hip injury and a proximal femur injury (each OEC

technician must lead one and participate in all others).

In groups of three, the following scenarios can be used to meet the objectives above.

a.) Its lunch time and you just finished your morning patrol shift; you decide to head to the cafeteria for a quick lunch. As you are standing in line waiting to order you notice a young girl sitting at one of the tables and she seems to be in pain. As you approach you find her couched over the table and she seems to be guarding her lower abdomen. She can’t get comfortable and complains radiating abdominal pain and nausea. (Abdominal illness, the OEC technician needs to ensure scene safety and the primary assessment; the OEC technician should also focus their secondary assessment on the abdomen for this scenario. Once that is complete, that portion of the scenario can be stopped).

b.) You are called to a scene to conduct an assessment of an injured person that was riding a trail bicycle, struck a large stone, and fell forward and struck their abdomen on the handlebars of the bike, causing pain. The pain should be located in the inferior area of the lower left and right quadrants across the front with point tenderness in the

Sample Traditional Refresher (Knowledge & Skills), no On-Line portion: Cycle B 2018

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center of the body, with immediate pain upon impact with the handlebars. The rider got off the bike on his own. (Abdominopelvic Trauma, the OEC technician needs to ensure scene safety and the primary assessment; the OEC technician should also focus their secondary assessment on the abdomen and pelvis for this scenario. Once that is complete, that portion of the scenario can be stopped).

c.) You are the first to respond to an incident where a female boarder went over an obstacle that had a pipe sticking up and she slid across the pipe, causing a laceration to the abdomen. This resulted in an evisceration of the intestine. The female patient in lying on her back in the middle of the landing zone of the park feature. (The gash does not need to be large, but should include some "blood." The OEC technician needs to ensure scene safety and a thorough assessment of the abdomen, taking immediate action to treat the patient before help arrives. The scenario can be stopped after the assessment and immediate treatment. BSI and scene safety must be included in this portion of the assessment).

d.) You’ve been called to respond to an accident on the downhill race course at mid station. A male ski racer has gone off course while trying to negotiate a high-speed turn and has gone off trail into a tree branch; the branch enters the abdomen and breaks off at approximately 6 inches of length outside the body. (The wound is deep and bleeding, and the OEC technician must complete a thorough assessment of the abdomen. Clothing should be in place that needs to be removed so that the wound can be assessed and immediate treatment rendered. There should be a focus on the assessment, BSI and scene safety must be included in this portion of the assessment).

e.) You respond to a call at the rope tow lift on the beginners slope, you arrive to find an older women lying on the ground complaining of severe hip pain. She was taking her granddaughter up the rope tow between her legs when she caught an edge, came down hard on her hip, the leg is turned in, and now can’t get up. (The patient has right or left posterior HIP deformity and the OEC technician must complete a thorough assessment of the abdomen, hip, pelvis, and femur. This is meant to be a dislocated hip or proximal femur fracture scenario. There should be a focus on the assessment, BSI and scene safety must be included in this portion of the assessment).

f.) You are working at the Zip Line Park of your local resort, it’s a bright sunny day and you hear a call on the radio for immediate EMS help at station 2 of the zip line complex. You arrive to find a middle-aged male, still in harness lying on the ground at the base of the 20 foot platform. He is complaining of severe pelvic pain, witnesses claim his connection line detached at the platform and he fell to the ground. (The patient has a pelvic fracture and pelvic palpation reveals movement and increased pain. The OEC technician must complete a thorough assessment of the abdomen, hip, pelvis, and femur. This is meant to be a pelvic fracture scenario. There should be a focus on the assessment, BSI and scene safety must be included in this portion of the assessment).

Treatment of the above scenarios can be done with each scenario set up so the assessment runs directly into the treatment; then the three technicians rotate from one station to the other. There is an option to run the treatment stations separately if you have enough support.

STATION 2 (Lesson Plan Module 2)

Knowledge Objectives (Suggested 30 minutes): Using mini presentations, Small group discussions, demonstration and/or lecture, review Disease Transmission, OEC Basics, Shock, & Lifts & Drags.

Part 1: Describe the five (5) modes of disease transmission, list the common personal protective equipment used by OEC Technician, describe the components of the scene size up, describe chain of custody, and define body mechanics.

Part 2: Define body mechanics, describe and explain the difference between an urgent and non-urgent move, list and describe various devices used to move and transport patients.

Part 3: Define shock, compare and contrast the three stages of shock, list the four types of shock, describe how the body compensates for shock, and list the classic signs and symptoms of shock



1. Describe and demonstrate the management of shock, including a focus on neurogenic shock (see poster). 2. Describe and demonstrate how to ensure scene safety (see poster).

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Equipment for this rotation: Manikin that can take airways (both OPA and NPA); variable sizes of OPAs and NPAs; oxygen tank; regulator; O-rings; tubing and different delivery devices (non-rebreather, pediatric non-rebreather, and nasal cannula).

3. Describe and demonstrate how to manually open the airway or mouth using the following techniques: Head-tilt chin-lift; jaw thrust; and crossed finger.

In a group of three, each OEC technician must properly demonstrate how to open the airway or mouth on a manikin using a head tilt/chin lift, jaw thrust on a suspected neck injury patient, and how to open the mouth using the crossed finger technique.

After the first technician completes the three tasks, the next technician can start.

4. Demonstrate the proper methods for choosing the correct size and inserting them: Oropharyngeal airway and nasopharyngeal airway.

When the group has completed the task above, the same three technicians will then demonstrate how to properly size and insert an OPA and an NPA. This will include the SIC (Size, Insert, Check) and SLIC (Size, Lubricate, Insert, Check) acronyms.

5. Describe and demonstrate how to properly set up an oxygen tank for use.

In a group of three, each OEC technician must set up an oxygen tank as if it were newly assigned tank and complete through the administration of oxygen using a delivery device.

The first OEC technician should start by cracking the tank, insert the regulator with an appropriate O-ring in place, then set the flow rate for the first delivery device, which would be a non-rebreather mask.

When the first OEC technician completes the task, the O2 tank is disassembled or a second tank is put into use and the same exercise is completed with the delivery device being a nasal cannula. The third technician would do the same with a pediatric non-rebreather mask being used as a delivery device.

6. Describe and demonstrate the following drags, lifts, and carries: Choose Power Grip and Power Lift, plus at least three of the following: Shoulder Drag; Extremity Lift; Bridge/BEAN Lift; Human Crutch; Fore and Aft Carry; Chair Carry; BEAM Lift; and Draw Sheet Carry.

To complete this station, set up teams of three to six. Each OEC technician must demonstrate successful lifts using the power grip and power lift. In addition, in teams, select three other lifts listed above and demonstrate them. Again, some lifts require more than one person. If those lifts are chosen, each person should lead the lift and use the same rotation as stated in the station above.


Knowledge Objectives (Suggested 20 minutes): Using mini presentations, Small group discussions, demonstration and/or lecture, review Head & Spine Injuries.

Part 1: Define traumatic brain injury, describe common traumatic injuries involving the head, neck, and back, describe the signs and symptoms of potential head injuries involving the brain, describe the signs and symptoms of potential spinal injuries, and list the signs and symptoms of increased intracranial pressure.

Part 2: Using the new Spinal Protection Protocol, describe how to properly assess a patient with a suspected neurological injury, including neck and spine injury. MOI, Reliability of Assessment, and Exam



1. Describe and demonstrate the management of shock, including a focus on neurogenic shock (see poster). 2. Describe and demonstrate how to ensure scene safety (see poster).

Equipment for this rotation: Long board for immobilization; cervical immobilization device (CID); blankets; O2; helmets.

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3. Describe and demonstrate how to assess and treat a patient with head, neck, and spine injuries. Everyone completes an assessment specifically focused on spinal assessment in accordance with new protocols.

4. Describe and demonstrate how to maintain proper spinal alignment while placing a patient onto a long

spine board from the lying position. The focus must be on placement, strapping is not necessary. (Could include Helmet Removal as part of the scenario)

To complete these two objectives, OEC technicians should be broken into teams of three to five and must lead and demonstrate the assessment and care of one of the following:

a.) The first OEC technician is called to respond to a patient fall in the parking lot. You respond and find a patient in a lying position complaining of neck and midline back pain. The injured patient is found lying on an icy sidewalk outside the resort main lodge. The OEC lead technician will assess and treat the patient using the new Spinal Protection Protocol. The team will work together at the direction of the OEC lead and properly place the patient onto a long spine board.

b.) The team will then change leads and completes the same skills with a second patient. You are called to the scene of a suspected customer fall in the main lodge. As you approach the scene you notice a young women lying on the floor under one of the tables crying and in obvious pain. She is conscious and claims to have slid on the wet floor, landed on her back, and slid under this table. (There should be obstacles, requiring a long axis drag to be completed, she has a helmet on). The patient is complaining of lower back and head pain. The OEC lead technician will assess and treat the patient using the new Spinal Protection Protocol. The team will work together at the direction of the OEC lead and properly place the patient onto a long spine board.

c.) The team will then change leads and completes the same skills with a third patient. You are traversing through a mogul run as part of closing sweeps when you notice a skier to the side of the trail lying on their back in the snow. As you approach you can hear the patient moaning, he is conscious and alert but complains of severe lower back pain. (This patient requires a log roll to complete the assessment, the patient should present with midline back pain from T11 to L5, the patient has a helmet on). The OEC lead technician will assess and treat the patient using the new Spinal Protection Protocol. The team will work together at the direction of the OEC lead and properly place the patient onto a long spine board.

d.) The team will then change leads and completes the same skills with a fourth patient. You are working the medical team for an early spring mountain bike trail event and have been positioned at the mid-point of one of the steeper sections of the course. As riders pass by to climb the hill, two riders collide on the hill; the first rider falls to the side and is unharmed. The second rider falls backwards down the slope while still on his bike, the rider and the bike tumble down the slope numerous times and both come to a stop at the bottom. As you make your way to the scene and approach the patient you notice he has a large chuck of his helmet missing and he’s unconscious. (When palpating the neck, deformity is discovered at C1/C2 junction, the patient will stay unresponsive throughout the scenario) The OEC lead technician will assess and treat the patient using the new Spinal Protection Protocol. The team will work together at the direction of the OEC lead and properly place the patient onto a long spine board.

e.) The team will then change leads and completes the same skills with a fifth patient. You are called to the parking lot of your resort for a potential car accident at the main exit. You arrive on scene to find a middle-aged man standing and leaning against his car displaying facial expressions of severe pain; he has his right hand placed on the lumbar section of his lower back. As you start your assessment he claims to have a prior injury in the form of a herniated disk, he claims that any movement induces severe pain and that he doesn’t want to move. This is an unsafe area and you know he has to be moved. (This will require a standing BB takedown using the new spinal protection protocol, the man still has his helmet on) The OEC lead technician will assess and treat the patient using the new Spinal Protection Protocol. The team will work together at the direction of the OEC lead and properly place the patient onto a long spine board.

In each scenario, a new OEC technician lead completes a full spinal assessment using the new Spinal Protection Protocol and the skill is taken from assessment through the loading on the spine board to simulate transport.

5. Describe and demonstrate how to remove a helmet on a supine patient

To complete this activity, set up in teams of three. Each OEC technician demonstrates how to remove a helmet from a supine patient. One technician wears the helmet, one is the lead, and one assists. Rotate through the team with the helper becoming the lead, the patient becoming the helper, and the lead becoming the supine patient. All technicians must be a lead; the helmet can be the patroller's own helmet that is removed.

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Knowledge Objectives (Suggested 30 minutes): Using mini presentations, small group discussions, demonstration and/or lecture, review Environmental Emergencies.

Part 1: List and define the four mechanisms of heat loss, list the signs and symptoms of cold exposure, injury from the cold can be localized or involve the whole body, list and explain the two classifications of hypothermia, direct exposure of skin to the cold can result in frost nip or frostbite, if the body temperature continues to drop then hypothermia can set in, explain the way the body normally adjusts to a hot environment, list the signs and symptoms of a patient with each of the four types of heat-related illness, explain what one can do to prevent heat-related illness.

Part 2: Compare and contrast dry drowning and wet drowning, describe the physiologic response of the mammalian diving reflex, define the following terms: submersion injury, drowning, near-drowning, arterial gas embolism, and decompression sickness, list nine ways in which a water-based emergency may be prevented, list the signs and symptoms of the following water-related emergencies: arterial gas embolism, decompression sickness, describe how to manage a patient who has suffered a water-related emergency.

Part 3: List the signs and symptoms of a patient who is a victim of a lightning strike.

Part 4: Define altitude, define the principles of altitude physiology, list risk factors for the development of altitude sickness, describe strategies to prevent altitude illnesses, list the signs & symptoms of the following altitude illnesses: Acute Mountain Sickness, High Altitude Pulmonary Edema, High Altitude Cerebral Edema, describe the assessment and treatment of a patient with altitude illnesses, describe safe backcountry travel and list some indicators of avalanche dangers.

Skill Objectives (Suggested 45 minutes): For this station, the following For this station, the following two objectives must be worked into each skill or scenario station:

1. Describe and demonstrate the management of shock, including a focus on neurogenic shock (see poster) 2. Describe and demonstrate how to ensure scene safety (see poster).

Equipment for this rotation: Red rash moulage; blankets; O2

3. Describe and demonstrate the assessment and care for a patient with a cold injury, frostbite, and emergency care of an

avalanche victim (each OEC technician must lead one and participate in all others).

In groups of three, the following scenarios can be used to meet the objectives above. Each OEC technician must lead and demonstrate the assessment and care of two of the following:

a.) Just prior to evening sweeps, you are called to the summit to investigate a report of a lift operator who was found in the summit lift control building, when you arrive you discover he was helping the snow making crew with water hose transfer and was sprayed with high-pressure water during a valve check. He is completely soaked and shivering, complaining of being very cold, his hands and fingers are numb, and hasn’t eaten all day.

b.) You are returning from a full day of back country searching for a lost skier with a number of ski patrollers and mountain search & rescue staff. You notice one of your colleagues is starting to slow down and needs to stop, complaining that his feet are cold and have been for some time. You ask to take a look at his feet as you can tell he’s laboring and something doesn’t seem right. In a wind-blocked area, you help him to take off one boot the primary assessment notes multiple toes on both feet show signs of frostbite.

c.) You are the only patroller on scene of a recent avalanche, when the avalanche search teams radios that a person has been found and recovered from the avalanche wash. The patient was rescued and recovered within 15 minutes of the avalanche event, but is found to be unconscious.

4. Describe and demonstrate the assessment and emergency care of a patient suffering from each of the four types of heat- related illness (each OEC technician must lead one scenario and participate in all others).

5. Describe and demonstrate how to place the patient in the recovery position (each OEC technician must

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demonstrate).

In groups of three, the following scenarios can be used to meet the two objectives above. Each OEC technician must lead and demonstrate the assessment and care of two of the following:

a.) A competitive runner at a trail race runner is found stopped on the trail complaining of stomach cramps and feeling nauseated and sweating. It is a hot day and she is wearing dark clothes. You arrive as first on scene. (Full assessment, demonstrate placing patient in recovery position)

b.) During an off-season visit to your resort, you witness a number of grounds staff huddled around a non-air conditioned cab of a mowing tractor, you notice the windows do not allow for air movement. The driver is found to be sweating profusely, has not had a chance to drink any fluids, is slightly confused, has a racing heart, has dizziness, and is complaining of thirst. (Full assessment, demonstrate placing patient in recovery position)

c.) You are bicycling in a state park on a very hot day and you come upon a park official sitting on the side of the bike path holding his head. The man is complaining of a throbbing headache, and he feels disoriented and was staggering so he sat down. You note his skin his red, hot, and dry, with no sign of sweating. You find a rapid heart rate during your assessment with a weak pulse and rapid shallow breathing. (Full assessment, demonstrate placing patient in recovery position)

d.) A construction worker has been working outside on a retaining wall and standing all day in the sun. This is the first day above 90 degrees in four months. The worker sat down for lunch (sitting on the wall) and when he got up from lunch, he felt dizzy and passed out. He is found sweating profusely and is pale; he still feels weak, has tunnel vision, and has a weak pulse. (Full assessment, demonstrate placing patient in recovery position)

STATION 5 (Lesson Plan Module 6):

Knowledge Objectives (Suggested 30 minutes): Using mini presentations, small group discussions, demonstration and/or lecture, review Allergies, Anaphylaxis, Plant and Animal Emergencies, & Adaptive Athletes.

Part 1: List the four routes by which an antigen enters the body, list four potential allergy sources, list the signs & symptoms of an anaphylactic reaction, compare and contrast poison, toxin, and venom, list and describe common toxic plants encountered in wilderness settings, list and describe various land and marine creatures that may be harmful to humans, describe how to assess a patient that has been injured following an encounter with a toxic plant or animal, describe how to manage an exposure to toxins, describe the proper management of wounds caused by animals, including reptiles, insects, and spiders.

Part 2: Define and contrast the following terms: Disability, Handicap, Impairment; List two disorders that cause progressive physical disabilities, describe four elements of effective communication with a person who has an intellectual disability, and list the signs and symptoms of autonomic dysreflexia.



1. Describe and demonstrate the management of shock (see poster). 2. Describe and demonstrate how to ensure scene safety (see poster).

Equipment for this rotation: epinephrine auto-injector training tool, adaptive athlete chair or other equipment.

3. Each OEC technician must demonstrate how to assist a patient with their epinephrine auto-injector.

Each OEC technician must demonstrate how to assist a patient with their epinephrine auto-injector.

4. CASE PRESENTATION

All OEC technicians will group together to discuss the Case Presentation as a mini discussion. Time must be taken to set

17

up the scenario, discuss what would happen, and discuss how to treat both individuals with injuries.

Discussion of the different ways to treat adaptive patients must be covered during this discussion. The Case Presentation can be done first before breaking up into any groups or to regroup after the case scenarios. The Case Presentation review should be conducted prior to completing the adaptive skier assessment skill portion of the station.

5. Describe and demonstrate how to assess and care for an adaptive athlete who is ill or injured with intellectual disability, perform a full assessment containing the following assessment steps:

• Describe and demonstrate how to perform a primary assessment and manage ABCD’s. • Describe and demonstrate how to perform a secondary assessment. • Describe and demonstrate how to obtain a SAMPLE history.

6. Describe and demonstrate how to assess and care for an adaptive athlete who is ill or injured with physical disabilities.

• Describe and demonstrate how to perform a primary assessment and manage ABCD’s. • Describe and demonstrate how to perform a secondary assessment. • Describe and demonstrate how to obtain a SAMPLE history.

Each OEC technician must lead and demonstrate the full assessment and care of a scenario involving an adaptive athlete with an intellectual and physical disability.

These schedules are suggested timeframes and may vary with station variation, patrol\group size, and refresher location

settings. 7:00 – 8:00: Sign-in.

• Pre-assign OEC technicians into five evenly divided teams to facilitate the start of station visits and eliminate unbalanced rotations. These teams will remain together throughout the refresher, and move from station to station.

• Distribute to each participant a copy of the Complete Sample Knowledge and Refresher Skills Checklist (or locally developed participation tracking tool) and a copy of the Cycle B 2018 Refresher Evaluation Form to be completed and turned in at the end of the refresher. Ensure that all participants have signed an activity release form prior to starting the refresher.

8:00 – 8:15: Welcome, announcements, overview of refresher goals, and OEC 5th ed. objectives. 8:15 – 8:40: PRE-STATION GROUP DISCUSSION, Entire group presentation: review new spinal protection information 8:40 – 8:45 Five pre-assigned teams of OEC technicians move to the designated individual station location (see table below). For large patrols/groups, stations may need to be replicated to maintain the optimal size of no greater than 12 OEC technicians per team. The preferred ratio of instructors to participants should be no greater than 1:6. 8:45 – 12:30: Station rotations. All stations are 75 minutes in length, which includes five minutes to rotate to the next station. Start with teams as assigned. Providing adequate attention to the refresher material will require timely launch of each station's activities, with an orderly and rapid rotation between stations during the five minutes allotted in the schedule. See a detailed description of each station's activities following the table of station assignments. 12:30 – 1:30: lunch (bag lunch or box lunch provided onsite). 1:30 - 4:00: Continue station rotations. 4:00 – 4:20: Refresher group wrap-up, complete and collect participant refresher evaluations. 4:20 – 4:45: Assist station takedown and cleanup. 75 minutes includes 70 minutes of performance and 5 minutes of rotation.

Anatomy & Physiology; Musculoskeletal Trauma; Homeostasis Gastrointestinal and Genitourinary Emergencies (Chap 6,20,21,16,24) Lesson Plan Modules 1, 4

Rescue Basics; Lifts, Loads, and Carries; Shock, Airway Management (Chap 3,5,9,10) Lesson Plan Module 2

Head and Spine Injuries; Assessment (Chap 7, 21) Lesson Plan Module 3

Environmental Emergencies (Chap 25,26,28,29) Lesson Plan Module 5

Allergies, Anaphylaxis, Plant and Animal Emergencies, and Adaptive Athletes, Assessment (Chap 14,27,32) Lesson Plan Module 6

Station 1, 4 – 75 min.

Station 2 – 75 min.



Station 6 - 75 min.

Review knowledge-based objectives (30 minutes)

Review knowledge based objectives. (30 minutes)

Review knowledge-based objectives. (20 minutes)

Review knowledge-based objectives. (30 minutes)

Review knowledge based objectives and case review 30 minutes

45 Minutes Scenarios Skills




45 Minutes Scenarios/Case Study Skills

The following is a generic timeline to accomplish a traditional refresher.

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(To be completed by the IOR when developing the OEC refresher and made available to the IT for evaluation purposes.) IOR Refresher location

Patrol/Group participating Refresher Date

Refresher Topics

(Chapter Reference)

Objective(s)

Skill Guide (SG)

or OEC Skill Number (OECS)

Station

Reference Number

General

Ideas (Evaluation

Notes)

Section 1: Rescue Basics

Skill Objectives are in italics

Rescue Basics

(Ch. 3)

• Describe the five modes of disease transmission. • List common personal protective equipment used

by OEC Technicians. • Describe the four components of the scene size-up. • Describe chain of custody. • Describe and demonstrate how to ensure scene

safety at all stations

(All)

Lesson Plan

Module 2

Moving, Lifting,

and Transporting

Patients (Ch. 5)

• Define body mechanics. • Explain the difference between an urgent and non-

urgent move. • List and describe various devices used to move and

transport patients.

Describe and demonstrate the following drags, lifts, and carries: Choose Power Grip and Power Lift, plus at least three of the following:

• Shoulder Drag • Extremity Drag • Extremity Lift • Bridge/BEAN Lift • Human Crutch • Fore and Aft Carry • BEAM Lift • Draw Sheet Carry

OECS 5-2 SG pg. 162

Section 2: Basics of Patient Care

Anatomy

and Physiology

(Ch. 6)

• Identify various anatomical terms commonly used

to refer to the body.

Lesson Plan Module 1 • List the five body cavities.

Refresher Planning Matrix: 2018 Cycle B

20

• Identify and describe the fundamental anatomy and physiology of the:

• Gastrointestinal • Nervous • Muscular • Skeletal and • Urinary body systems

Lesson Plan All Modules

• Identify and properly use various anatomical terms to describe body direction, location, and movement.

• Describe homeostasis and its importance for good health.

Patient Assessment • Describe and demonstrate how to perform a primary

assessment

• Describe and demonstrate how to perform a secondary assessment.

SG pg. 252

• Describe and demonstrate how to obtain a SAMPLE history

Section 3: Critical Interventions

Airway

Management (Ch. 9)

• Describe and demonstrate how to manually open

the airway or mouth using the following techniques: • Head-tilt/chin-lift; • Jaw thrust; and • Crossed finger.

OECS 9-1

Lesson Plan Module 2

• Describe and demonstrate how to place a patient into the recovery position.

OECS 9-12

• Demonstrate the proper methods for choosing the correct size and inserting them:

• Oropharyngeal airway; and • Nasopharyngeal airway.

OECS 9-3, SG pg. 324 OECS 9-2, SG pg. 323

• Describe and demonstrate how to properly set up an oxygen tank for use.

OECS 9-4 SG pg. 325

Shock

(Ch. 10)

• Define shock (Neurological focus). • List the four types of shock. • Compare and contrast the three stages of shock. • Describe how the body compensates for

shock. • List the classic signs and symptoms of shock.

• Describe and demonstrate the management of

shock, with a neurological focus. (Treatment of shock should be included in all stations.)

OECS 10-1

SG pg. 351


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Section 4: Medical

Emergencies

Gastrointestinal and

Genitourinary Emergencies

(Ch. 16)

• Identify and locate the major anatomical

structures within the abdominopelvic cavity. • List the functions of the major anatomical structures

within the abdominopelvic cavity. • List and describe at least six abdominopelvic injuries. • List at least six possible causes of emergencies

involving the gastrointestinal and genitourinary systems.

• List the signs and symptoms of emergencies

involving the gastrointestinal and genitourinary systems.

• Compare and contrast visceral pain and parietal pain. • Describe and demonstrate how to assess the abdomen.

• Describe and demonstrate how to assess a patient with

abdominopelvic trauma. • Describe and demonstrate the management of a

patient with a severe GI/GU emergency. • Describe and demonstrate how to assess and manage

an evisceration. • Describe and demonstrate how to assess and manage

an impaled object in the abdomen or pelvis.

OEC 16-4 SG pg. 508


Section 5: Trauma

Musculoskeletal

Injuries (Ch. 20)

• Describe and demonstrate how to assess a

hip/proximal femur injury. • Demonstrate how to care for a specific injury to

the hip/proximal femur (team of three to five). • Describe and demonstrate how to manage a pelvic

fracture (apply a pelvic sling skill only).

OECS 24-1 SG pg. 809

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Head & Spine

Injuries (Ch. 21)

• Correctly identify the major anatomical components of

the central nervous system. • Define traumatic brain injury. • Describe the signs and symptoms of potential

head injuries involving the brain.

• Describe common traumatic injuries involving the head, neck, and back.

• Describe the signs and symptoms of potential

spinal injuries. • List the signs and symptoms of increased

intracranial pressure.


• Describe and demonstrate how to properly

assess a patient using the Spinal Protection Protocol, maintain proper spinal alignment while placing a patient onto a long spine board.

• Describe and demonstrate how to assess and

treat a patient with head, neck, and spine injuries.

• Describe and demonstrate how to remove a

helmet on a supine patient.

OECS 21-2, 21-3, 21-4 SG pg. 733, 734 OECS 21-8 SG pg, 736

Section 6: Environmental

Conditions

Cold-Related Emergencies

(Ch. 25)

• List and define the four mechanisms of heat loss. (3-2 heat exchange)

• List the signs and symptoms of cold exposure. • List and explain the two classifications of hypothermia.

• Describe and demonstrate the assessment and emergency care of a patient with a cold injury.

• Describe and demonstrate the assessment and emergency care of a patient with frostbite.

• Describe and demonstrate the assessment and emergency care of an avalanche victim.


23

Heat-Related Emergencies

(Ch. 26)

• List and define the four mechanisms of heat exchange. • List the signs and symptoms of a patient with each

of the four types of heat-related illness. • Explain what one can do to prevent heat-related

illness. • Describe and demonstrate the assessment and

emergency care of a patient suffering from each of the four types of heat-related illness.

• List the signs and symptoms of a patient who is a

victim of a lightning strike.


Plant and Animal Emergencies

(Ch, 27)

• Define the following terms: • Allergy • Allergic reaction • Anaphylaxis • Antigen • Hypersensitivity

• List the four routes by which an antigen enters the

body. • List four potential allergy sources. • List the signs and symptoms of an anaphylactic

reaction. • Describe and demonstrate the steps for properly

using portable epinephrine auto-injectors. • Compare and contrast poison, toxin, and venom.

• List and describe common toxic plants encountered in

wilderness settings. • List and describe various land and marine creatures

that may be harmful to humans. • Describe and demonstrate how to assess a patient

that has been injured following an encounter with a toxic plant, animal, or some marine life (choose one).

• Describe and demonstrate how to manage an

exposure to topical toxins.

• Describe and demonstrate the proper management of wounds caused by animals, including reptiles, insects, and spiders.

OECS 14-3 SG pg. 453


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Altitude-Related Emergencies

(Ch, 28)

• Define Altitude.

• Describe the principles of altitude physiology.

• List risk factors for the development of altitude illnesses.

• Describe strategies to prevent altitude illness. • List the signs and symptoms of the following

altitude illnesses: • Acute Mountain Sickness • High Altitude Pulmonary Edema • High Altitude Cerebral Edema

• Describe the assessment and treatment of a patient

with altitude illnesses.


Water Emergencies (Ch, 29)

• Compare and contrast dry drowning and wet drowning.

• Describe the physiologic response of the mammalian diving reflex.

• Define the following terms:

• Submersion injury • Drowning • Near-drowning • Arterial gas embolism • Decompression sickness

• List nine ways in which a water-based emergency

may be prevented. • List the signs and symptoms of the following water-

related emergencies: • arterial gas embolism • decompression sickness

• Describe how to manage a patient who has

suffered a water-related emergency.


25

Section 7: Special Populations

Outdoor

Adaptive Athletes (Ch. 32)

• Define and contrast the following terms:

• Disability • Handicap • Impairment

• Describe four elements of effective communication

with a person who has an intellectual disability. • List two disorders that cause progressive physical

disabilities. • List the signs and symptoms of autonomic dysreflexia. • Describe and demonstrate how to assess an

adaptive athlete. • Describe and demonstrate how to care for an

adaptive athlete who is injured or ill.


Section 8: Beyond OEC

Case

Presentation Local Needs

Provide opportunities for participation in discussions of the case presentation.

Complete "Skill Guides" with CPIs for all activities can be found at the end of each chapter in the Outdoor Emergency Care Fifth Edition. For the “describe and demonstrate” objectives, the patroller should verbalize what they are doing while demonstrating the skill.

26

Station: _______ Station Location: _____________________ Topic: ______________________________ OEC 5th ed. Chapter Reference: ____________ Station Cross Reference? (Does any content of this station overlap with other stations?) If so, where? Objectives: (From Refresher Station Planning Matrix).

Assigned Instructor(s): ___________________ _____________________________________ _____________________________________ _____________________________________ Station Resources: Station Materials: (e.g., tables, chairs, A/V equipment, flipcharts, etc.) Personnel and Patients: (e.g. instructors, assistants, patients, bystanders, moulage, etc.) Equipment Needed: (e.g. backboard, splints, bandages, O2 and adjuncts, skis, snowboards.)

Instructional Strategy: ___ PG - Group Presentation (not lecture) ___ GD - Group Discussion ___ HP - Hands-on-Skill ___ HS - Hands-on-Scenario ___ GA - Group Activity or Game ___ OT - Other (describe) Considerations for Integrated Topics:

1. Scene safety.

2. Body substance isolation. 3. Mechanism of injury/Nature of illness.

Station Planning Worksheet: 2018 Cycle B Use in concert with the Refresher Station Planning Matrix. Duplicate as needed for each station

27

Notes:

28

2018 OEC Refresher Cycle B Knowledge Objectives Checklist Reference Instructor Page Sign-Off

Overall Objectives (to be covered in each station)

3-6. Describe the five modes of disease transmission. 80-81 3-8. List common personal protective equipment used by the OEC Technicians.

77-80

3-9. Describe the four components of the scene size-up. 82

3-11. Describe chain of custody. 87

Section 1 Lifts and Carries (Chapter 5)

5-1. Define body mechanics. 128-129 5-5. Explain the difference between an urgent and non-urgent move. 136-

140

5-6. List and describe various devices used to move and transport patients.

131-135

Section 2 Anatomy and Physiology (Chapter 6 Neuro, Musculoskeletal, Genitourinary, Gastrointestinal)

6-1. Define the term: Homeostasis. 206 6-2. Identify various anatomical terms commonly used to refer to the body.

169-170

6-4. List the five body cavities. 171 6-5. Identify and describe the fundamental anatomy and physiology of the Gastrointestinal, Muscular, Nervous, Skeletal, Urinary Systems.

183-201

6-6. Describe homeostasis and its importance for good health. 206 Section 3 Shock (in all scenarios) (Chapter 10) support neurological injury, management focus

10-1. Define shock. 329

10-5. Compare and contrast the three stages of shock.

335-336

10-6. List the four types of shock.

336-343

10-7. Describe how the body compensates for shock. 331-334

10-8. List the classic signs and symptoms for shock. 346

Section 4 Allergies and Anaphylaxis (Chapter 14)

14-1. Define the following terms: • allergy • allergic reaction • anaphylaxis • antigen • hypersensitivity

435-438

14-2. List four routes by which an antigen many enter the body. 437

14-3. List four potential allergy sources. 438

14-4. List the signs and symptoms of an anaphylactic reaction. 445

Section 5 Gastrointestinal and Genitourinary Emergencies (Chapter 16)

16-1. List at least six possible causes of emergencies involving the gastrointestinal and genitourinary systems.

500-504

16-2. List the signs and symptoms of emergencies involving the gastrointestinal and genitourinary systems.

505-507

29

16-3. Compare and contrast visceral pain and parietal pain. 500

Section 6 Musculoskeletal Injuries Lower Extremity focus on the HIP, PELVIS and FEMUR (Chapter 20)

20-1.1. Describe the functions of the following structures: (Anatomy and Physiology)

• bones • cartilage • joints • muscles • synovium • tendons

602-609

Section 7 Head and Spine Injuries (Chapter 21)

21-1. Correctly identify the major anatomical components of the central nervous system.

699-700

21-2. Define traumatic brain injury. 705

21-3. Describe common traumatic injuries involving the head, neck, and back.

702-710

21-4. Describe the signs and symptoms of potential head injuries involving the brain.

705-707

21-5. Describe the signs and symptoms of potential spinal injuries. 711 21-6. Using the new Spinal Protection Protocol, describe how to properly assess a patient with a suspected neurologic injury, including neck and spine injuries.

714-725

21-7. List the signs and symptoms of increased intracranial pressure. 703

Section 8 Abdomen and Pelvic Trauma (Chapter 24) 24-1. Identify and locate the major anatomical structures within the abdominopelvic cavity.

794-795

24-2. List the functions of the major anatomical structures within the abdominopelvic cavity.

795

24-3. List and describe at least six abdominopelvic injuries. 798-801 Section 9 Cold Related Emergencies (Chapter 25) 25-1. List and define the four mechanisms of heat loss. (3-2 heat exchange)

816-817

25-2. List the signs and symptoms of cold exposure. 818 25-4. List and explain the two classifications of hypothermia. 819 25-6. Define after drop and explain how to prevent it.625-6. 820

Section 10 Heat Related Emergencies (Chapter 26) 26-1. Explain the way the body normally adjusts to a hot environment. 839-841 26-2. List the signs and symptoms of a patient with each of the four types of heat-related illness.

842-844

26-4. List the signs and symptoms of a patient who is a victim of a lightning strike.

848-849

26-6. Explain what one can do to prevent heat-related illness. 850-855 Section 11 Plant and Animal Emergencies (Chapter 27) 27-1. Compare and contrast poison, toxin, and venom. 862 27-2. List and describe common toxic plants encountered in wilderness settings.

863-871

27-4. List and describe various land and marine creatures that may be harmful to humans.

878-881

27-5. Describe how to assess a patient that has been injured following an encounter with a toxic plant, an animal, or some marine life.

885-887

27-6. Describe how to manage an exposure to topical toxins. 887-888

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27-7. Describe the proper management of wounds caused by animals, including reptiles, insects, and spiders.

888-889

Section 12 Altitude Related Emergencies (Chapter 28) 28-1. Define altitude. 898 28-2. Describe the principles of altitude physiology. 898-899 28-3. List risk factors for the development of altitude illnesses.

902-908

28-4. Describe strategies to prevent altitude illness. 909-911 28-5. List the signs and symptoms of the following altitude illnesses:

• acute mountain sickness • high-altitude pulmonary edema • high-altitude cerebral edema

904-908

28-6. Describe how to assess a patient with altitude illness. 911-912

28-7. Describe the treatment of a patient with altitude illness. 912-914 Section 13 Water Emergencies (Chapter 29) 29-1. Compare and contrast dry drowning and wet drowning. 921

29-2. Describe the physiologic response of the mammalian diving reflex. 921

29-3. Define the following terms: • submersion injury • drowning • near-drowning • arterial gas embolism • decompression sickness

924-928

29-6. List nine ways in which a water-based emergency may be prevented.

931

29-7. List the signs and symptoms of the following water-related emergencies:

• arterial gas embolism • decompression sickness

933-934

29-8. Describe how to manage a patient who has suffered a water-related emergency.

934-936

Section 14 Outdoor Adaptive Athletes 32-1. Define and contrast the following terms:

• disability • handicapped • impairment

1011-1014

32-3. List two disorders that cause progressive physical disabilities. 1015

32-4. Describe four elements of effective communication with a person who has an intellectual disability.

1029-1030

32-6. List the signs and symptoms of autonomic dysreflexia. 1016-1017

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2018 OEC Refresher Cycle B Skills Checklist

Each OEC Technician

must perform the

following skills

Each OEC Technician

must participate as a team member

Instructor Sign Off

Overall Objectives: (to be covered in each station) Describe and demonstrate how to ensure scene safety, including use of BSI.

x

Describe and demonstrate the management of shock, neurological focus. x Section 1 Each OEC Technician must perform the following skills:

describe and demonstrate how to perform a primary assessment and manage the abcd's.

x

describe and demonstrate how to perform a secondary assessment-focus on detailed assessment of the entire spinal column.

x

describe how to obtain a sample history. x Section 2 Each OEC Technician must perform the following skills:

Describe and demonstrate a power grip. x Describe and demonstrate a power lift. x Describe and demonstrate the following drags, lifts and carries. (IN TEAMS, CHOOSE THREE of the following.)

Shoulder drag x Extremity lift x BEAN (bridge) lift x Human crutch x Fore and aft carry x Chair carry x BEAM lift x Draw sheet carry x

Section 3 Each OEC Technician must perform the following skills:

Describe and Demonstrate how to manually open the airway or mouth: Head-tilt chin lift x Jaw thrust x Crossed finger x Describe and demonstrate how to place a patient into the recovery position.

x

Demonstrate the proper methods for choosing the correct size and inserting:

Oropharyngeal airway x Nasopharyngeal airway x

Describe and demonstrate how to properly set up an oxygen tank for use.

x

Section 4 Each OEC technician must perform as indicated: Describe and demonstrate the steps for properly using portable epinephrine auto-injectors.

x

Describe and demonstrate how to assess the abdomen. x Describe and demonstrate how to manage a patient with a severe Gastrointestinal/Genitourinary emergency.

x

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Section 5 Each OEC Technician must lead one and participate in all others:

Describe and demonstrate how to assess and care for each specific injury:

Hip injury x Proximal femur x

Section 6 Each OEC technician must perform an assessment and participate in placement onto a spinal protection device (backboard). Strapping not necessary.

Using the new Spinal Protection Protocol, demonstrate how to properly assess and treat a patient with head, neck, spine, or back injury.

x

Demonstrate how to maintain proper spinal alignment while placing a patient on to a long spine board from a lying position. Strapping is not necessary.

x

Describe and demonstrate how to remove a helmet from a lying position (teams of two).

x

Section 7 Each OEC technician must: Describe and demonstrate how to assess a patient with abdominopelvic trauma.

x

Each OEC technician must lead one and participate in all others: Describe and demonstrate how to manage an evisceration. x Describe and demonstrate how to manage an impaled object in the abdomen or pelvis.

x

Describe and demonstrate how to manage a pelvic fracture (pelvic sling). x Section 8 Each OEC Technician must lead one and participate in all others:

Describe and demonstrate the assessment and treatment of a patient with cold related injury.

x

Describe and demonstrate the assessment and emergency care of a patient with frostbite.

x

Describe and demonstrate the assessment and emergency care of an avalanche victim.

x

Section 9 Each OEC technician must lead one and participate in all others:

Describe and demonstrate the assessment and emergency care of a patient suffering from one of the four types of heat-related illnesses.

Heat syncope x Heat cramps x Heat Exhaustion x Heat Stroke x Section 10 Each OEC technician must lead one and participate in all others:

Describe and demonstrate how to assess and care for an adaptive athlete who is ill or injured.

Intellectual disability x Physical disability x Section 11 Group Case Review discussion x

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Case Review: One

You are on your usual Saturday mountain ski patrol. It is a sunny but cold day. Your rotation takes you to an intermediate rated slope when you come across a group of folks huddling over a skier.

Once you have made the scene safe, you then radio your location and the injury location to your patrol dispatch. At the scene is a 50+-year-old male lying on his right side strapped into his sit-ski. His friends are very concerned. Your general impression finds this patient in extreme discomfort. His host who was skiing with him tells you he is a disabled skier and this is rare for him to fall over. After the scene size up you identify him as a 54-year skier who describes to you that he lost his balance and flipped his sit-ski on top of himself as he slid. He stated he tried to stop sliding with his right arm and came to rest on his right side.

He has an autonomic reflex disorder and he is experiencing a “lot of anxiety” since he fell. His chief complaint is pain to right arm, which took the brunt of the fall, and is showing as “deformed”. It appears that the wrist is deformed and angulated. Exam will find a pulse.

He is alert and oriented and is communicating appropriately with you. He describes the pain as an 8 out of 10. Your exam produces no other findings other than the possible fracture of the right arm.

You ask his friend who is the host for the day to assist you with removing his sit-ski as you focus your care on the fractured right arm.

1. What considerations should you have used during your primary and secondary assessment? 2. What communication skills make for a safe, consistent and effective exam? 3. How might it be best to manage his extreme anxiety? 4. What concerns do you have about the equipment? 5. What might be the best way to have his host help you with the equipment? 6. Discuss your method of transportation for the patient and the equipment.

Case Review: Two

It is a sunny and busy day at your resort. You are a mountain bike patroller and get a call of an injury on the upper half of the trail called “Terror”. You respond that you are in route to the injury. You arrive 5 minutes later to find a dad with his 15-year-old son off the side of a trail. The dad had called 911 to report his son was injured. You arrive to find the 15-year-old male with a severely deformed left ankle. Attempting to obtain a sample report you find his answers to your questions, are not making sense. Patient avoids eye contact and seems delayed in responding. It is concerning to you until his Father tells you his son has Autism Spectrum Disorder. The child is rather quiet and other than tears you depend upon the communication with the Dad to help assess your scene and situation. There is no bleeding, but the deformity is very apparent, and he is guarding the injury. You alert the mountain all-terrain vehicle team to bring you equipment and to help with the transport down the mountain. 1.What is Autism spectrum disorder? 2.How does your knowledge of his disorder change how you would manage this patient? 3. Why is a careful exam important with this patient? 4. How would you have the parent interact with you in caring for his son? 5. Does your first aid care differ for this patient?

Case Presentations

34

Spinal Protection Key points Determine the Mechanism of injury High Speed collision? Falling from a ski lift? Avalanche burial? A fall greater that 2.5-3 times a patient’s height? High sped motor vehicle accident with fatality, ejection, or unrestrained occupant? Pedestrian or bicyclist struck by a motor vehicle? Major bicycle or motorcycle wreck? High-voltage electrical shock or lightning strike? Other serious mechanism of injury? If mechanism of injury supports possible spinal injury Reliability of Assessment • Is the patient alert and oriented? • Responding normally to verbal commands? • Can they respond appropriately when asked about sensory stimulus? • Can you rule out any signs of intoxication with Needs Spinal Protection alcohol or drugs or any altered mental status? Including c-collar and • Can they respond appropriately to questions head blocks. and your exam? • Can the patient focus on your questions, rather than a distracting injury? (i.e. severe pain from fracture) • Can a younger pediatric patient answer your questions appropriately? Exam Findings • Deformity or step-off of spinal alignment • Midline tenderness over the spine, not flank, or rib tenderness • Loss of sensation (numbness) or motor function distal to possible injury Needs Spinal Protection • Flexor or extensor posturing to painful stimuli • Skull depression or fracture • Cerebral spinal fluid leak from nose or ears • Sacral or posterior pelvic pain when side to side compression is performed Do you need a c-collar? *When positive findings indicate the A c-collar with backboard cervical spine is the site of the injury and head blocks is required. *The patient is unresponsive *The neck cannot be adequately examined

If you answer NO to any of these

If the Exam reveals any of these

YES

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NATIONAL SKI PATROL SYSTEM OEC REFRESHER RELEASE FORM I agree I am voluntarily participating in this OEC REFRESHER. I understand that the OEC REFRESHER may involve extensive field work on first aid scenarios, skiing, and toboggan-handling, along with other activities which ski patrollers encounter in their duties of patrolling a ski area. I realize there are inherent risks in this type of activity, including changing weather conditions, changing snow surface conditions, ice, bare spots, rocks, stumps, trees, and the possibility of collisions with manmade and natural objects or other skiers, and such activity can be dangerous and can result in serious injury or death. I knowingly assume the risk of participation and understand I can withdraw from this OEC REFRESHER at any time. I understand that by participating in this OEC REFRESHER I may also encounter additional risks not inherent to a normal participant to the sport of skiing. I agree to personally assume all of these risks. I also agree that I will rely solely on my own judgment regarding my personal safety and ability with regard to the terrain, circumstances and conditions in which I may be placed upon and asked to demonstrate or perform to accomplish the tasks involved in OEC REFRESHER, and that I will decline to perform any activities if I believe I am placing myself in an unsafe situation or subject to possible injury or death if I proceeded. As a requirement of this OEC REFRESHER, I acknowledge that I agree to waive any right I might have to file a lawsuit for any injury or death resulting from my participation in this OEC REFRESHER and I hereby remise, release, and forever discharge the ski area hosting the event, the National Ski Patrol System, Incorporated and its members, both individually and jointly, and I agree that no one else may file a lawsuit in my name related to my participation in this OEC REFRESHER. If any part of this Release shall be determined to be unenforceable, all other parts shall be given full force and effect. Participant Signature: __________________________________________Date: ________________________________ Participant Name: (printed) __________________________________________________________________________ Address: ____________________________________________________Phone: _______________________________

ADDENDUM TO RELEASE The above Participant is less than 18 years of age; the undersigned parent or guardian hereby consents to the above Participant participating in the OEC REFRESHER and signs this Release on behalf of the Participant. Parent/Guardian Signature: ______________________________________Date: _______________________________ Parent/Guardian Name: (printed) ______________________________________________________________________ Address: _____________________________________________________Phone: ______________________________ Not part of Release and for record keeping purposes only. To be completed by instructor: Date: __________________________ OEC Refresher: ____________________________________________________ Location: ___________________________________________________________________________________________________

36

Refresher Quality Assessment Form Cycle B 2018

Name of IOR or assigned IT: _______________________ Patrol/Organization: ____________________________ Assigned IT: __________________________________ Refresher Location: _______________________ Date: ___________ NSP Division: _______________________ Check type of event: □ OEC IT Refresher □ OEC Instructor's Refresher □ OEC Technician Refresher □ Refresher Planning Meeting This form is designed as a quality assurance tool to assess the planning and implementation process of the annual OEC refresher. The station format section of this form can be completed as part of the refresher planning discussion between the IOR and IT. During the refresher the assigned IT will verify the station format section and complete the remaining sections of the QA form. Upon completion of the refresher the assigned IT will provide feedback to the IOR regarding the QA form. Copies of the form will then be distributed to the appropriate individuals listed at the end of the form. Station format: Using the following key, please indicate how the format in which the refresher topics were presented. (The IOR Refresher Planning Matrix may be attached instead of filling out this section.)

KEY GP = Group presentation

GA = Group activity

HO = Hands-on single practical skill

D = Demonstration by instructor

HS = Hands-on full scenario problem

O = Other (explain)

GD = Facilitated small group discussion

INC = Incorporated into scenarios throughout refresher (IT to identify station)

Topics SPECIAL UPDATE TO OEC 5E Spinal Protection ______ Assessment

______ Protection

______ Cervical Spine Precaution Requirements

Rescue Basics ______ Scene Safety, BSI, PPE, Grips\Lifts

Anatomy & Physiology ______ Nervous System

______ Muscular System

______ Skeletal System

______ Urinary System

______ Gastrointestinal System

Patient Care

______ Patient assessment, (SAMPLE)

Critical Interventions ______ Airway management (O2, Airway, O2 Tank)

______ Shock management

Medical Emergencies ______ Allergies and Anaphylaxis (Epi) ______ Gastrointestinal and Genitourinary Emergencies Trauma ______ Musculoskeletal Injuries

1. Pelvis 2. Hip 3. Proximal Femur

______ Head and Spine – to include helmet removal

______ Abdominal and Pelvic Trauma

Environmental / Medical Emergencies ______ Heat-related Emergencies

______ Plant and Animal Emergencies

______ Altitude-related Emergencies

———- Water Emergencies

Special Populations ______ Outdoor Adaptive Athletes ______ Case Presentations ______ Integrated Topics

____ REMINDER TO HAVE PATROLLERS KEEP WORKBOOK

37

The following questions are for use by the assigned IT to evaluate the refresher. Please answer all applicable questions. (Attach any additional pages used for your answers and comments.) 1. What type of planning meeting was held in preparation for this event? How far in advance of the refresher was the meeting?

Did you attend? _____ In-person or electronically (telephone, Skype, etc.)? 2. Was an instructor refresher held in preparation for this refresher? Did you attend and/or monitor it? _____ If yes, did you attend in-person or via electronic means (Skype, etc.)? 3. How was this refresher developed? _______ From the "ground up" in addition to using the "Refresher Planning Matrix." _______ By using the entire sample refresher, or various parts of it. _______ Combination of the above. _______ From scratch, without using any of the refresher planning tools. 4. Did the IOR, instructors and participants seem to understand the refresher objectives? 5. Were all objectives met? ______ If no, please explain why they were not. 6. Were there any shortcomings discovered at the refresher? ________If, yes, please mark all that apply. _____ Missed topics? _____ Shortage of instructors? _____ Equipment failure? _____ Other? If so, what action was taken to remedy them? 7. Please comment on the quality and content of the mini-presentations. Were any of them exceptionally good? (Please describe.) Did each presenter involve the entire group in the presentation, as opposed to lecturing to them? ____ If no, please specify? 8. How was the "Case Review" presented? Was it interactive, thought provoking, and/or generate discussion? 9. What audio/visual aids were used in the refresher presentations and stations? _______ Material available from the NSP "Instructor Resources." _______ Slides/PowerPoint presentations. _______ Posters and charts. _______ 3-D models. _______ Other (describe). Which A/V aids worked well? What did not work well and why? 10. Were the relevant objectives, skill guides and/or Critical Performance Indicators available at all stations? ______ If no, how was this remedied?

38

11. Do you feel that there was adequate opportunity for every OEC technician to demonstrate their hands-on skills according to this year’s OEC cycle’s objectives?

12. Were there any OEC Technicians who needed to go through remediation stations? ______ If yes, please comment on how this

was handled. (How were these OEC Technicians identified? How was the remediation process presented to the OEC Technician, etc.?)

13. Please comment on the quality and availability of equipment used at the refresher and the suitability of the refresher facility. 14. How would you describe the organization of the refresher? Was it well-organized? What recommendations would you make to

improve this refresher? 15. What two improvements could be made to the Instructor Guide?

1. 2.

16. What two improvements could be made to the Refresher Workbook?

1. 2.

The OEC refresher is meant to be a stand-alone event. Were any of the following included as part of the OEC refresher?

_______ CPR

_______ Chairlift evacuation

_______ Patrol administrative business

_______ Management concerns or training

_______ Other (please describe) You are now asked to forward this completed form and related refresher documents to the appropriate OEC personnel, as listed below: ATTACH A COPY OF THE SCHEDULE FOR THE REFRESHER YOU ARE REFERRING TO WITH THIS QA FORM. A COPY OF THE SCHEDULE MUST BE SUBMITTED TO THE NATIONAL OFFICE VIA THE EMAIL LISTED BELOW ____ Copy of QA form sent to patrol representative/IOR. ____ Copy sent to ROA or designee. ____ Copy sent to division OEC supervisor. ____ Copy sent to national office. (Send to [email protected].)


39

This half is for your Patrol Representative Have this portion of the form signed by the Instructor of Record (IOR) at the refresher, and then return it to your NSP patrol representative. DO NOT SEND TO NSP. This verifies that you have attended and successfully completed all requirements for the 2018 OEC Refresher. Please print. OEC Technician Name: ___________________________________________________________

NSP ID #: _____________ OEC Refresher Course Number: _______________________

Name of Patrol where you completed the refresher: ______________________________________

Date you enrolled in course: ________ IOR confirmed name on enrollment roster: YES NO

Online Refresher Certificate of Completion verified (if applicable) YES NO

The above candidate successfully completed the requirements of the 2018 OEC Refresher and has been added

to the electronic roster for course completion.

Instructor of Record (print name)______________________________________________________

Instructor of Record Signature: _______________________________________________________

This half is for the Instructor of Record (IOR)

VISITING OEC technician: Fill out this portion and leave it with the Instructor of Record (IOR). This will enable the Instructor of Record to confirm that you enrolled correctly and successfully completed the 2018 OEC refresher. DO NOT SEND TO NSP Please print. OEC Technician Name: ______________________________ NSP member ID #: ___________

OEC Refresher Course Number: _________________ Date of electronic enrollment: __________

Certificate of completion (online) provided to IOR: YES NO

Email: ______________________________________Phone: _____________________________

OEC technician’s patrol/affiliation: __________________________ _________________

Refresher Location/Date: ___________________________________________________________

OEC Instructor of Record: __________________________________________________________

2018 Cycle B OEC Refresher Visiting Patroller Completion Form IOR

2018 Cycle B OEC Refresher Visiting Patroller Completion Form

40

THE NATIONAL SKI PATROL 133 S. Van Gordon Street, Suite 100 Lakewood, CO 80228 Phone: 303.988.1111 Fax: 800.222.4754 2018 Cycle B OEC Refresher Committee Statement The mission of the OEC Refresher Committee is to provide assistance to all Outdoor Emergency Care technicians so that they may effectively review Outdoor Emergency Care content and skills each year and render competent emergency care to the public they serve. The objectives of the program are to:

• Provide a source of continuing education for all OEC technicians;

• Provide a method for verifying OEC technician competency in OEC knowledge and skills;

• Review the content of the OEC curriculum over a three-year period; and

• Meet local patrol and area training needs in emergency care.

Please take a moment and let us know how we can make your refresher better!

Email the Refresher Committee at [email protected].

2018 OEC REFRESHER COMMITTEE William Devarney (Chair) NSP OEC Refresher Committee Eastern Division Administrative Patrol [email protected] George Angelo Utah Olympic Park Ski Patrol [email protected] Anne Donadio Appalachian Ski Patrol [email protected]

Kathy Glynn Three Rivers Ski Patrol [email protected] Dave Hemendinger Yawgoo Valley Ski Patrol [email protected] Eva Kunkel 7 Springs Ski Patrol [email protected]

MEDICAL REVIEW PANEL David Johe, M.D., NSP Medical Adviser INDEPENDENT REVIEW PANEL Deb Foss, Eastern Division Michelle Goldsmith, Eastern Division Aileen Cassidy, Southern Division William C. Smith, Southern Division

Jason Erdmann Tyrol Basin Ski Patrol [email protected]

Tim Thayer Afton Alps Ski Patrol [email protected]

OEC EDUCATION STAFF David Johe, M.D., NSP Medical Adviser Deb Endly, NSP OEC Program Director Sheila Summers, NSP Education Director

DESIGN Candace Horgan, NSP Communications Manage

The Outdoor Emergency Care Instructor's Guide is published annually by the National Ski Patrol Systems, Inc., a nonprofit association of ski patrollers which is located at 133 S. Van Gordon Street, Suite 100, Lakewood, CO 80228. 303.988.1111. © 2014 by National Ski Patrol Systems, Inc.










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