> The foregoing appears, on face value, a tad worrying i.e. seeing one arrest
> per year and teaching on resus courses. Can I assume, Robbie, that you see
> arrests in your "other" jobs, but the one arrest per year is while being a
> GP?
Thanks for your concern Adrian.
This comes under "Credibility" in the instructor selection process. I, and
the few other GP instructors, do not see many cardiac arrests per year.
However, in remote areas this is unavoidable (remember I cover 500-1000
square miles single handed with between 300-2000 patients as a time). It
should also be bourn in mind that the average paramedic sees one seriously
injured trauma call every 18 months so reduced exposure is a widespread
problem in prehospital care compared with A+E.
The reverse of this is that few hospital based members of ALS faculties have
ever managed a prehospital cardiac arrest as a team or one, so you could say
our credibility gaps overlap.
The point is a serious one, though. To retain skills I do A+E locums..
However, I must admit that due to pressures of finance I have not managed
any this year (the pay is only a third of my GP income). So, I have only
managed about 10 arrests in the last 3 years, and only one in the last 12
months.
However, I guess I have been involved with about 250 arrests during the last
10 years, probably about 30 of which were prehospital.
I think this currently gives me adequate credibility to be an ALS
instructor. If I feel my skills had deteriorated to the point that I was
loosing credibility as an instructor then I will be even more concerned
about my ability to offer an emergency service and will arrange an A+E or
ambulance attachment of suitable duration.
Reassessment should also throw up any major problems.
I think it is important to bear in mind that there are other factors to
being a good instructor. Different members of the faculty bring different
strengths and variety in a faculty is a strength. Few have my pre-hospital
experience. I also make a great cup of tea.
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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