From the ECSI Advisory Council Chair:

As we approach 2006, we must prepare ourselves and our providers for the changes that will result from the 2005 International Resuscitation Consensus on ECC and CPR Science and Treatment Recommendations. The new science recommendations will be released beginning in November/December of this year. Actual guideline proposals can be viewed by category by visiting the Consensus 2005 website at: http://www.c2005.org/presenter.jhtml?identifier=3026177. ECSI and Jones and Bartlett Publishers are already gearing up to incorporate the necessary changes into its existing and new materials. These changes will be reflected in materials released in 2006. We will be updating you on changes that affect our programs in the next newsletter along with the approximate dates that you can expect to see the new materials.

As always, thank you for your continued support of ECSI and the quality programs that it supports!

Best regards,

Hudson Garrett Jr., MSN, MPH; Community Health Associates

Interesting News Stories
Submitted by Alton Thygerson, Ed.D.

Macon, GA - A manhunt ended with the suspect surrendering, saying he was bitten by a snake. The man, wanted on theft and gun charges, eluded police for more than 36 hours before he was surrounded in a wooded area.
Source: Associate Press, June 2, 2005

Canmore, Alberta, Canada - A grizzly bear attacked and killed a woman jogging on a popular hiking trail near this Canadian Rockies resort town, just days after authorities moved the animal from another neighborhood for threatening humans.
Source: Associated Press, June 7, 2005

Milwaukee, WI - The driver of a day-care center van was arrested for the death of a 2-year-old girl who was left in the vehicle for hours on a hot, muggy day. The girl's body was discovered when her mother arrived at the day-care center. Police say she could have been in the van since she was picked up 8 hours earlier.
Source: Associated Press, June 11, 2005

Flagstaff, AZ - A man struck by lightning at Grand Canyon National Park died. The man and a female companion were struck west of the Bright Angel Trail, one of the main trails that leads down into the canyon. The woman suffered burns to her legs and chest.
Source: Associated Press, June 17, 2005

Detroit, MI - Two Detroit-area pediatricians performed CPR on a fan who had a heart attack during the second quarter of Game 2 of the NBA Finals. The man began breathing on his own and was taken to the hospital.
Source: Associated Press, June 15, 2005

San Marcos, TX - A man, who rescued a swimmer from the swirling currents of the San Marcos River, was arrested. Police say he disobeyed repeated orders by emergency personnel to leave the water. He was charged with interfering with public duties.
Source: Associated Press, July 6, 2005

Fresno, CA - Lightning struck a group of Boy Scouts taking shelter from a storm, killing the troop leader and leaving a 13-year-old boy brain-dead. Two teenagers ran for 25 minutes to a ranger station after the strike, and five helicopters flew in to evacuate the group. This came just days after four Scout leaders were electrocuted while putting up a tent at the National Scout Jamboree in Virginia.
Source: Associated Press, July 29, 2005

Honolulu, HI - A young man impaled by a crocodile needlefish, left the hospital after a weeklong stay. The 4-foot fish plunged into the stomach of the 19-year-man while he was spearfishing. The resulting wound stretched down his abdomen and required 45 stitches. Experts say he was lucky to survive the attack from a needlefish, often referred to as a "living spear."
Source: Associated Press, August 1, 2005

Camden, NJ - The father of a missing 6-year-old boy found his son's body and those of his two young friends in the trunk of a car, two days after the children disappeared form a nearby yard where they were playing. The boys had been the subjects of a massive search since their disappearance.
Source: Associated press, June 25, 2005

Deming, NM - A teenager bitten by a rattlesnake was recuperating at a hospital in El Paso, Texas. The 17-year-old girl was bitten in the ankle while walking around the city's baseball fields. The police chief said it was the first time someone has been bitten by a snake in the city limits in 14 years.
Source: Associated Press, May 27, 2005

Farmington, NM - A girl died when she climbed on an oil and gas pump jack and the pump jack's arm picked her up and crushed her. The 12-year-old girl was riding her bicycle with other children when she climbed on the pump jack. The pump jack was surrounded by a safety rail marked with a danger sign.
Source: Associated Press, March 6, 2005

Animal-Related Fatalities in the United States

Injuries and illnesses from animal encounters continue to be a major public health problem. Millions of injuries, hundreds of thousands of ED visits, and thousands of hospitalizations, at a cost of hundreds of millions of dollars, occur yearly because of animal encounters.

From 1991 to 2001, 1,943 people died in the United States after venomous and nonvenomous animal encounters. An average of 177 fatalities per year were recorded. Venomous animals were involved in 39% of the deaths. Most of the fatalities occurred in the southern United States.

Source: Wilderness and Environmental Medicine, Summer 2005

DEET-based Insect Repellents: Safety Implications for Children and Pregnant and Lactating Women

Reducing the risk of mosquito bites is currently the only way to reduce the risk of West Nile virus infection. Methods for avoiding mosquito bites include limiting the time spent outdoors at dawn and dusk, wearing protective clothing, and using an insect repellent. Repellents containing DEET (N,N-diethyl-m-toluamide, also known as N,N-diethyl-3-methylbenzamide) are the most effective and most widely used. However, concerns have been raised over the risk of adverse toxic effects, especially in young children and pregnant and lactating women.

The CDC has advised that pregnant women take precautions to reduce their risk of West Nile Virus infection and other arboviral infections by avoiding mosquito bites and using protective clothing and DEET-based repellents. There is no evidence that the use of DEET by pregnant or lactating women poses a health hazard to unborn babies or children who are breast-feeding.

Source: Canadian Medical Association Journal, August 5, 2003

Human Water Needs

Healthy people regulate daily water balance remarkably well throughout their lifespan despite changes in biological development and exposure to stressors on hydration status. Acute or chronic body water deficits result when intakes are reduced or losses increase, but day-to-day hydration is generally well maintained so long as food and fluid are readily available. Total water intake includes drinking water, water in beverages, and water in food. Daily water needs determined from fluid balance, water turnover, or consumption studies provide similar values for a given set of conditions. A daily water intake of 3.7 L for adult men and 2.7 L for adult women meets the needs of the vast majority of persons. However, strenuous physical exercise and heat stress can greatly increase daily water needs, and the individual variability between athletes can be substantial.

Source: Journal of Nutrition Reviews, June, 2005

Epidemiology of Epistaxis (Nosebleed) in US Emergency Departments, 1992 to 2001

The epidemiology of emergency department (ED) visits for epistaxis is unknown. This study identified ED visits where epistaxis occurred from 10 years of the National Hospital Ambulatory Medical Care Survey. From 1992 to 2001, epistaxis occurred at 4,503,000 ED visits. The age-related frequency was bimodal, with peaks among those younger than 10 years and those aged 70 to 79 years. Epistaxis accounts for about 1 in 200 ED visits in the United States. Although there is an early age peak (age <10 years), the frequency increases from age 20 onward, with the highest rates in the elderly. Epistaxis visits are more common in the winter. Future efforts to decrease epistaxis visits might focus on education of the elderly and parents of young children about nasal mucosa care and basic approaches to home management.

Source: Annals of Emergency Medicine, July, 2005

Non-Work-Related Finger Amputations in the United States, 2001-2002

This study focused upon non-work-related finger amputations treated in US hospital emergency departments (EDs). Finger amputation data from 2001 and 2002 was obtained from the National Electronic Injury Surveillance System All Injury Program (a nationally representative sample of 66 US hospital EDs). An estimate of 30,673 persons with non-work-related amputations were treated in US hospital EDs annually. Of these persons, 27,886 had amputations involving 1 or more fingers and 19.1% were hospitalized or transferred for specialized trauma care. Male patients were treated for finger amputations at 3 times the rate of female patients. The rate of persons treated for finger amputations was highest for children younger than 5 years, followed by adults aged 55 to 64 years. For children aged 4 years and younger, 72.9% were injured in incidents involving doors, and for adults aged 55 years or older, 47.2% were injured in incidents involving power tools. National estimates of finger amputations among US residents indicate that young children and older adults are at the greatest risk. Parents or other responsible adults should be aware of the risk to small children's fingers around doorways, and adults should take safety precautions when using power tools.

Source: Annals of Emergency Medicine, June 2005

Staten Island Save!

On July 19th, 2005 a remarkable save from cardiac arrest was performed. Reinauer Transportation, Inc., an AAOS Training Site affiliated with Safety Matters!, Inc., an AAOS Training Center in Bedminster, New Jersey, experienced how effective an AED can be in a critical cardiac arrest emergency. A 41-year-old male, one of Reinauer's tug boat captains, was experiencing cardiac chest pain. Another employee offered to take the captain to the local emergency room to seek treatment. The company's office manager saw what was happening and stopped them from transporting the victim and placed him in their main office.

Reinauer has approximately 50 Automated External Defibrillators on their vessels and other barges. They also have two AEDs in their main office. Two certified rescuers and AAOS Instructors, Lenny Kinnear and Frank Kuziemski began to treat the victim. He shortly collapsed after being placed in a chair, waiting for EMS arrival. Both Lenny and Frank saw that the victim was not breathing and had no circulation. Immediately, one of the two AEDs in their office was used and put into place. After approximately 2 minutes of performing both defibrillation and CPR, the captain's circulation and breathing returned. The victim became conscious and began wondering what had happened. They then waited for the New York Fire Department to arrive with both an engine truck and advanced life support. The captain later received coronary bypass surgery and is recovering from his incident. FDNY paramedics Russell Shewchuk and Michael Esposito said, "This is an amazing save, because we have almost never seen a patient conscious after defibrillation".

Reinauer Transportation located in Staten Island, New York underwent an AAOS Instructor Development Course, which made the company a training site. They also placed AEDs throughout the company and their tug boats and barges. Ken Frucci, former NYC Paramedic and Instructor, Trainer, and President of Safety Matters!, Inc. and Dave Cozza, New Jersey Emergency Medical Technician and Senior Instructor of Safety Matters!, Inc. completed Reinauer's instructor training back in February this year. Ken mentioned, "This really shows that the system does work when you have all of the links in the chain of survival in place. The important thing to remember here is they had proper training, proper equipment, and definitely a great response time. These really made the difference. It's important to remember how important on going training is and that companies or organizations should never overlook the importance of proper training."

Great job to Safety Matters!, Inc., but most importantly great job to Lenny Kinnear and Frank Kuziemski of Reinauer Transportation, Inc. This was the first successful save this year in New York City from an Automated External Defibrillator.

Top: Ken Frucci and Dave Cozza giving live demonstration of an AED to staff at Reinauer Transportation.  Seen here from left are: Councilman James Oddo; Frank Kuziemski, AED Rescuer, AAOS Instructor and Supervisor at Reinauer Transportation; Victim Gary Sahlberg; Lenny Kinnear, AED Rescuer, AAOS Instructor and Director of Safety & Compliance for Reinauer Transportation.

Bottom: Seen here from left are: FDNY Paramedic Michael Esposito, AED Rescuer and Administrator and AAOS Instructor Dean Reinauer, AAOS Instructors / AED Rescuers Lenny Kinner and Frank Kuziemski, and FDNY Paramedic Russell Shewchuck.

Online Training - An Effective Method

Nearly every day, I receive a call from a company that needs CPR or First Aid training for just one or two persons. I call them "onesies," the students I would love to accommodate, but would go broke if I did. Running a commercial training agency, I needed a way to cater to these individuals who seek quality safety training, but do not need a full class at their location. For some time I was referring them to the local YMCA or even to my competition. Now there is an alternative solution.

Using the ECSI SafetyCampus.org online training programs has opened up a new opportunity for my agency to provide quality service to the community without sacrificing valuable resources such as instructor time and travel. When a potential student calls to inquire about individual classes, I offer them an ECSI online course. So far, the response has been very positive. The employer appreciates that I can cater to a very small group for a reasonable fee, while the participant enjoys the flexibility of completing the majority of the training online at his own pace.

We arrange for monthly skills verification days, currently at the local volunteer ambulance service. This allows any participant who has completed an online course to demonstrate the skills and receive an ECSI course completion card. As a special bonus, we allow any participant to return to a skill session free of charge during the following 12 months.

Surely, different types of training agencies can utilize the online programs to fill a training gap in their communities. Private companies with internal instructors can make good use of this format to allow distance learning among employees and reduce the need for full day training. Community organizations can help to promote safety awareness by allowing course participants to complete didactic training in their own time, while allowing for regular hands-on evaluation sessions. With the internet becoming available to so many people, this combined online and in-person training method is surely the learning method of the future.

Joel Demers is the Executive Director of Safety Concepts LLC, a commercial training agency and serves as the Director of EMS Training for Westbrook Ambulance Association in Westbrook, Connecticut. He also serves on the ECSI Executive Advisory Board as National Faculty. Contact him at jdemers@shorelinesafety.com or 860-399-6090.

Help Your Students to Help Themselves:
In Case of Emergency = ICE

Paramedics will turn to a victim's cell phone for clues as to that person's identity. You can make their job much easier with a simple idea that they are trying to get everyone to adopt: ICE.

ICE stands for In Case of Emergency. If you add an entry in the contacts list in your cell phone under ICE, with the name and phone number of the person that the emergency services should call on your behalf, you can save them a lot of time and have your loved ones contacted quickly. It only takes a few moments of your time to set this up.

Paramedics know what ICE means and they look for it immediately. ICE your cell phone now!

E.S.C.A.P.E., Inc. Offers Safety Tips

Heat

Overheating can cause muscle cramps, chills, nausea, and dizziness, among other symptoms. At its worst, it can lead to heat stroke, a medical emergency.

• Don't do too much, too soon. The body is not ready for strenuous exertion in hot temperatures.
• Drink plenty of water before and during hard or strenuous work in the heat. You'll need to drink more water than your thirst indicates. Take frequent small drinks, which are more effective than gulping down large amounts at once.
• When possible, schedule heavy work for the cooler hours of the day, such as early morning or late evening.Take frequent rests, lower the workload as the heat increases.
• When possible, start with less strenuous work and gradually build up the intensity so you can acclimatize yourself to the heat.
• Never leave children alone in a car during hot days-even for a few minutes with the windows rolled down.

Sun

Protect yourself from the sun's ultraviolet (UV) rays.Overexposure can lead to eye problems, sunburn, and even skin cancer. Use UV protective sunscreens with a protection factor of at least 15 whenever you are in the sun for long periods. Even on cloudy days UV rays can get through.

• Minimize your exposure when the sun's rays are the strongest, from 10 a.m. to 4 p.m.
• Wear wide-brimmed hats in the sun; baseball caps don't cover enough of your face and neck.
• Choose sunglasses that block 99 to 100 percent of UV light. Wraparound glasses are best.
• Babies under 6 months should be kept out of direct sunlight.

Biking

It's important to wear a protective helmet while bike riding. The American Medical Association reports 75% of cycling deaths are caused by head injuries.

• Wear a protective helmet when in-line skating and using scooters.
• Ride near the curb, single file, in the same direction as traffic.
• Keep to safer, less-traveled routes.
• Don't do stunts-they can lead to serious injury.
• Be alert to road hazards such as potholes, rocks, and glass that can cause you to lose control.
• Make yourself visible. Wear bright clothing during the day, wear a reflective vest or use reflective tape on clothes at night.
• Never ride at dusk without a headlight and red taillight or large reflector in the back.
• Know traffic laws and signals.
• Make sure your bike is well maintained.

Playgrounds

According to the Consumer Product Safety Commission, each year about 200,000 children are treated in emergency rooms for playground equipment-related injuries.

• Make sure protective surfacing such as double-shredded bark mulch, wood or rubber chips, fine sand, or fine gravel is 6-12" deep under and around all playground equipment.
• Make sure all equipment is carefully maintained and checked for loose hardware, projections, splinters, rust and chipped paint, moving parts that may crush or pinch, scattered debris, and tree roots.
• Supervise and teach your child how to play safely.

Gasoline

As summer comes to an end many people will use gas-run tools from lawn mowers and trimmers to leaf blowers and saws to tidy their yards.

• Use an approved safety container with a self-closing lid so vapors cannot escape, and never bring gas inside your living quarters.
• Don't smoke while handling gas.
• Don't use gas near sparks, flames, hot surfaces, or sources of static electricity.
• Don't use gas to start a fire.
• Don't use gas to clean paintbrushes.

Lawn Mowing

• Before you mow, clear the yard of rocks, sticks and anything else the mower might fling.
• Wait for grass to dry before mowing. Wet grass might make you slip or clog the mower chute.
• Clear a clogged chute using a stick-never your hands-with the mower off.
• With a riding mower, mow up and drown the slope so you're less likely to tip.
• Never leave a running mower unattended.
• Keep kids and pets away while you're mowing.
• Never refuel a hot mower.
• Never mow in bare feet or sandals. Wear heavy-duty shoes with non-slip soles.
• Avoid wearing loose clothing that could get caught in the machine.

Severe Storms

In the event of an electrical storm:

• Get inside a house, large building, or automobile.
• Don't stand near a single, tall tree or the tallest tree in a group.
• Get out of and away from water.

In the event of a tornado:

• Buildings: Go the basement, interior room, or hallway on the lowest floor
• Car /mobile home: Go immediately to a substantial structure or designated shelter.
• Outdoors: Lie flat in the nearest ditch or depression, cover your head with your hands.

In the event of a flash flood:

• Leave the building you are in immediately if ordered to evacuate.
• Go to higher ground. Do not try to walk through flowing water more than ankle deep.
• Do not drive through a flooded area even if it looks shallow enough to cross.

Picnics/Camps

• Carry an insect sting kit, if you have a known allergy. To decrease the risk of insect bites avoid wearing perfumes and clothes with floral patterns.
• To help prevent food poisoning, keep cold foods cold and hot foods hot. Don't store perishable foods in a hot car.
• Keep kids away from grills and lighter fluid.
• Keep grills away from anything that can burn.
• Be aware of tiny deer ticks that carry Lyme disease. When in a potentially infested area, apply insect repellant that contains DEET, wear light-colored, long-sleeved shirts, pants, and socks, and know which symptoms to watch out for.
• Learn to identify poison ivy, poison oak, and poison sumac. Wash the contact area with soap and water as soon as possible.
• Do not build a fire near tree trunks, fallen trees, or overhanging branches.
• When extinguishing a campfire, let it die down, then break up the coals or logs, spread the pieces, soak them, and then cover the area with dirt or sand.

For more information, please CONTACT:
Michael McLeieer, President - E.S.C.A.P.E.
(a non-profit public charity dedicated to teaching children & adults techniques in fire prevention, CPR & first aid.)
269-978-4400 or 800-707-1718, ext. 0
www.escapeinc.org

Strengthening the Chain of Survival Always and Forever

As instructors of emergency care programs, each one of us values the Chain of Survival, especially the 911 response system. Studies across many disciplines are indicating the value of preventative medicine. One of the largest contributors to teenage deaths is motor vehicle collisions (MVC). According to the National Center for Injury Control and Prevention, motor vehicle collisions were the leading cause of deaths in people between the ages of 1 and 34 years in the year 2000. Two out of five teenage deaths are a result of MVCs. An alarming forty-one percent of all MVCs involved alcohol abuse as a contributing factor.These accidents resulted in over 21 billion dollars in medical costs!

As instructors and believers in providing quality emergency care, you should attempt to emphasize preventative actions in your courses to prevent deaths caused by MVCs. Offer a free awareness course to your local Boy or Girl Scout troops. Set up an information booth at a local health fair. Enlist the support of your local media agents to encourage safety while operating a motor vehicle. The Centers for Disease Control's Community Guide to Prevention suggests three recommendations to reduce mortality from such crashes:

• Increase proper use of child safety seats
• Increase use of safety belts
• Reduce alcohol-impaired driving

By teaching our students and community members about these three simple techniques, you will indeed make a positive impact in the lives of many potential victims. Remember, education is a powerful tool and may prove to have lasting effects.

Hudson Garrett Jr., MSN, MPH

This edition of Technicians Tips comes from the American Academy of Pediatrics' new PedFACTs program. If you are an instructor looking for a few key safety and care points to pass on to your students regarding caring for pediatric patients try these:

• Avoid using plastic-backed dressings for children under 3 years of age. These dressings can pose choking hazards for young children who remove them and place them in their mouths.
• A wound on a child should be evaluated by a medical professional if it requires 5 minutes or more of direct, sustained pressure to control the bleeding.
• A child can suck on a popsicle to effectively apply cold and pressure to cuts on lips or under the tongue, or to injured teeth.
• If a child has a foreign object such as sand, dirt, or insect in the eye, rubbing the eye can cause a corneal abrasion that can also lead to an infection.
• A child who suffers one or more blistering sunburns is two times more likely to develop skin cancer later in life.
• Acetaminophen is a leading cause of childhood poisoning, resulting in significant liver damage and death.
• Antivenin for black widow spider bites is usually reserved for young children (under 6 years) and those experiencing severe reactions. There is no antivenin available for brown recluse spider bites.
• Did you know insects are attracted to bright colors and floral patterns on clothing? White, green, tan, and khaki are the least attractive colors to insects.

Learn more at www.PedFACTsonline.com

Pediatric First Aid for Caregivers and Teachers (PedFACTs) is an essential resource for any childcare provider!

Introducing a new pediatric first aid program from the American Academy of Pediatrics:

Pediatric First Aid for Caregivers and Teachers (PedFACTs)
ISBN: 0-7637-3090-4 * $12.95 (Sugg. US List) * Paperback * 248 Pages * © 2005

As a caregiver or teacher, you have the important task of nurturing and providing care for children. A critical aspect of caring for children includes maintaining a safe and healthy environment. Learning first aid skills is an important step in ensuring a secure environment for those children in your care.

Pediatric First Aid for Caregivers and Teachers (PedFACTs) is a new educational program designed by the American Academy of Pediatrics (AAP) specifically to prepare caregivers and teachers to appropriately recognize and respond to the ill or injured child.

Each topic is divided into three sections:

• What You Should Know provides background information.
• What You Should Look For provides assessment information.
• What you Should Do provides first aid treatment information.

Key Features of this exciting new title include:

• First Aid Tips provide instant experience from masters of the trade.
• Did You Know features provide a better understanding of the topic.
• First Aid Care features provide short, step-by-step visual review of first aid procedures.
• Algorithms are flowcharts designed to reinforce the decision making process and appropriate first aid care.
• Check Your Knowledge features provide an opportunity to test your knowledge of the first aid skills presented in the topic.

Table of Contents

1: What is Pediatric First Aid?
2: Finding Out What is Wrong
3: Difficulty Breathing
4: Controlling Infection, Bleeding, and Swelling
5: Bone, Joint, and Muscle Injuries
6: Loss of Consciousness, Fainting, and Head Injuries
7: Convulsions and Seizures
8: Allergic Reactions
9: Bites and Stings
10: Poisoning
11: Burns
12: Heat and Cold-Related Injuries
13: Eye Injuries
14: Oral Injuries
15: Prevention

Instructor Resources

PedFACTs is the cornerstone of a stand-alone course offering an intensive 4-hour format, divided into two sessions. The sessions can be given at one time or on two separate days.

• Resource Manual
  ISBN: 0-7637-3640-6
  $30.95 (Sugg. US List)
  Paperback * © 2005
  
• PedFACTS DVD
  ISBN: 0-7637-3643-0
  $55.95 (Sugg. US List)
  DVD * © 2005
  
• PedFACTS VHS
  ISBN: 0-7637-3642-2
  VHS * © 2005

For information on becoming a PedFACTs instructor, please contact your Public Safety Specialist either online or by calling (800) 832-0034 or visit www.PedFACTsonline.com.

Live and Learn Training Services (LLTS)

ECSI is proud to recognize Live and Learn Training Services (LLTS) in Malaysia. LLTS made great strides promoting both their own Educational Center and ECSI at major international events this summer, including:

• The 10th Asian Oil, Gas & Petrochemical Engineering Exhibition (OGA) in June at the Kuala Lumpur Convention Center, Malaysia
• The first Men's Health and Aging Conferences in June at the Hilton Hotel Kuala Lumpur, Malaysia
• The Conferences of Occupational Safety and Health (COSH) in June at the Putra World Trade Center, Malaysia

LLTS is the first private Educational Center accredited by both the Malaysia Department of Occupational Safety and Health (DOSH) under the Ministry of Human Resources, and the Ministry of Health (MOH)!

LLTS is also in the process of training members of the Academy of Family Physicians of Malaysia in ECSI's Professional Rescuer CPR (about 1,500 students)!

We are proud to have Live and Learn Training Services as an ECSI member.

If your Educational Center is making great strides training your community, please let us know!

A Heavy September Conference Schedule for ECSI:

9/16-9/18/2005
New Jersey State EMS Conference, Princeton, NJ

9/18-9/20/2005
Georgia EMS Educators, Macon, GA

9/21-9/23/2005
National Safety Council Congress, Orlando, FL

9/16-9/192005
Indiana EMS, Indianapolis, IN

9/26-9/28/2005
American College of Emergency Physicians, Washington, DC

9/25-10/2/2005
Kentucky EMS, Owensboro, KY

9/13-9/16/2005
North American Fire Training Directors, Murfreesboro, TN

9/30-10/1/2005
West Virginia EMS, Snowshoe, WV