Is this not correct or practical?
Not under any training program I am familiar with and I've been an EMS clinical and adjunct classroom instructor (with a focus on airway management), CPR and first aid instructor, ACLS instructor, PALS instructor and NONE of those courses have ever suggested (so far as I am aware):
you set up the AED and instruct them how to use the BVM.
I was taught, and I'm sure this never happens,
Are you sure you're not confusing what you were taught in preparation for your practical skills exam (where you are pretty much assuming they are trained in the use of the equipment....the "ghost" helper scenario as we called it) and what is taught to actually be done in real life? I know in many of the cardiac stations I've precepted, the scenario involved responding to a situation where another EMS provider was doing CPR awaiting the arrival of the AED and additional equipment. Normally the "instruct them" clause was taken to mean "How many compressions to ventilations do you want? What's the proper rate of ventilation?", etc. It is more a way of measuring the ability of the person being tested to rapidly recall the basics of cardiac resuscitation rather than being an indication you should be "instructing" in the literal sense.
An emergency is not the situation to be teaching an unskilled bystander to bag someone with an unprotected airway. That is really about all I should have to say. It's not exactly a complicated concept.
Why is BVM difficult skill to master?? What about it makes it difficult, I'm curious because I've only done a couple of times. There is not many components to it. Do people find it difficult to obtain a tight seal on the face because Ive had difficulty with that.
It has to do mostly with several common errors and the limited amount of time people spend practicing BVM ventilation. The fact that they view it as a "simple" technique without a lot of "components" is the main reason for this and the attitude that causes such overzealous underestimations of the procedure and its permutations is something to definitely avoid.
The mistaken belief that you push the mask onto the face is a major reason why people- of all training levels and often experienced providers- fail to achieve good ventilation. The trick is to pull the face into the mask. This is where the C-E clamp technique (it's described in most EMS textbooks and the ACLS manual) comes in handy. Also keep your fingers on the edge of the mandible and not the soft part of the neck under the jaw to avoid shoving the tongue up and back thereby occluding the airway. Those are the two main problems (along with poor head positioning or inadequate jaw thrust) that I've seen causing issues with BVM ventilation both in-hospital and out of hospital.
But seriously, check the ego
No ego....just being blunt. I see no point in trying to make it "nicer" which would have just made the points less clear. This is a technical and professional discussion and it gets a little pointed at times. That doesn't mean "ego" is at play. It's just how things come across when explained bluntly without the body language to imply that the person posting is not being a jerk but rather just firm with the reader. I'm sorry if I offended you. That wasn't my intention...
many "old dogs" (and I am referring mostly to the service I work for) seem to forget they were new once and don't realize all the knowledge they have I won't obtain in a week of working EMS
Not many of us truly forget it, but we do become particularly aggressive in correcting the same mistakes we see time and again (often the same ones we ourselves made as rookies). How do you think most of us obtained that knowledge? We screwed up, made the same mistakes or were misguided in the same way you are and someone chewed on our a** for it. We're all adults, we should be able to handle a little criticism and even a little browbeating should it become absolutely necessary without pulling a Cartman ("Screw you guys, I'm taking my ball and going home!").
"OH my god!! you don't how to do that!! What the hell!! You are stupid/ignorant/incompetent and you will never be as brilliant as me!"
I've had all of those yelled at me at one point or another (actually I've had most of those said to me by rookies on this forum who think their excrement is not particularly odorous)....and so has just about every veteran member of this forum. What's your point?
It makes me wonder why anyone would want to continue being an EMT.
Because we realize the criticism is not usually directly personal (it could be just as easily aimed at anyone who makes the same mistake, and not just at you) and take it for what it is: An indication that we need to work on something, be it a skill, our attitude, our knowledge of the science underpinning our practice. Instead of being a sore-tailed cat in a room full of rocking chairs looking for the way out, how about taking the criticism as an impetus to become the best damn EMT in Monroe County? If you have any questions and don't feel like airing them publicly, PM me and I'll be happy to help or to direct you to someone on here who can.
I had to convince him that "maybe" it is a bad idea to do exactely what the Chiefs are complaining about (hence the deputies that would have no issue forcably removing people) and thereby hindering the FFs ability to stay safe while trying their hardest to save lives...
