> -----Original Message-----
> From: Andrew Mowat [mailto:[log in to unmask]]
> Sent: Tuesday, April 24, 2001 12:00 PM
> To: [log in to unmask]
> Subject: Re: Scenario - Intubation and IV access
>
>
> So IHCD, PHEC, PHTLS and other BASICS courses have no standard?
> I think the Royal College of Surgeons of Edinburgh, who academically
> accredit PHEC and other courses, would beg to differ!
No standard is putting it a bit strongly. These courses provide a basic
introduction. I would be surprised, however, if the RCS felt a course
lasting under a week with no live patient exposure trained practitioners to
an appropriate standard for unsupervised practice. (RSI alone is felt by the
many anaesthetists to need several weeks of supervised practice before you
can do it unsupervised; adding in central lines, surgical access, surgical
airways, tube thoracostomy etc may take longer)
> The problem with training in Pre-Hospital Care is not really
> the initial
> training, Matt, but the skill retention.
No, as long as we have people performing difficult procedures vaguely
remembered from books, or from an afternoon prcticing on a model,
unsupervised, in conditions of poor light and poor patient access, initial
training is a problem. Skill retention is also a probem, but at present most
prehospital doctors have not aquired any skills to retain. (I include myself
within this group).
> Paramedics, Pre-Hospital Nurses and Doctors all find that
> there are not
> enough opportunities to apply skills to enable retention.
My point exactly: 'There can be few interventions appropriate for
all prehospital docs to do.' I apologise, I should have said 'practitioners'
Matt Dunn
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