ECSI has recently released several key programs just for you. Click on the programs below to learn about each program's student and instructor resources.

These programs are also offered online! For a glimpse at these online programs, click on the links below.

Coming this Fall -
ECSI is proud to announce the following programs also releasing this fall. Your next newsletter will provide all the information.

Welcome to the inaugural issue of the AAOS Emergency Care and Safety Institute (ECSI) newsletter. You are receiving this Newsletter because you are either one of our valued Instructors or Educational Centers, or someone who we hope will join with us in providing high-quality First Aid, CPR, AED, and other emergency care and safety programs in your community. We are dedicated to our Educational Centers and Instructors, offering them unsurpassed customer service. You will enjoy our high quality, but low cost ECSI programs, and we invite you to join us and experience the difference.

If you are not already an Educational Center or Instructor, I encourage you to visit our website. Our frequently asked questions (FAQs) section will answer many of the questions that you may have about ECSI. If you have additional administration questions, or want to purchase course materials, please contact us at (800) 71ORANGE or send Email to director@safetycampus.org.

About Our Partners
We are pleased to have the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Emergency Physicians (ACEP) as partners in this new endeavor.

The American Academy of Orthopaedic Surgeons (AAOS) provides education and practice management services for orthopaedic surgeons and allied health professionals. The AAOS also serves as an advocate for improved patient care and informs the public about the science of orthopaedics. Founded in 1933, the not-for-profit AAOS has grown from a small organization serving less than 500 members to the world's largest medical association of musculoskeletal specialists, serving approximately 24,000 members internationally. The AAOS name and training programs are recognized and revered worldwide by fire, EMS, and law enforcement agencies, as well as businesses, industries, and colleges/universities.

The American College of Emergency Physicians (ACEP) was founded in 1968 and is the world's oldest and largest emergency medicine specialty organization. Today it represents more than 22,000 members and is the emergency medicine specialty society recognized by organized medicine. As the acknowledged leader in emergency medicine, ACEP exists to advocate on behalf of emergency physicians and promote the highest standards of patient care. The College works in the state and federal legislative and regulatory arenas to protect and promote the interests of emergency physicians and their patients. ACEP is pleased to join with the American Academy of Orthopaedic Surgeons to provide emergency care and safety products and training programs of exceptional quality and value.

Robert Nixon
Program Director

Flint, MI - A woman was killed and several other people were injured in a multi-vehicle crash. A group of Good Samaritans stopped to help the occupants of an overturned vehicle. The crash occurred while the Good Samaritans were assisting the accident victims out of their overturned vehicle.
Source: USA Today

Springfield, VA - A motorist who had gotten out of his car to fix a flat tire died when he was struck by an SUV and then dragged for eight miles. The driver of the SUV was charged with manslaughter, driving while intoxicated, and felony hit-and-run after calling police to report that a man's body was caught in his vehicle's front-end suspension.
Source: USA Today

Grand Junction, CO - A man who was mauled by a pit bull two years ago is starting a campaign to ban the breed. Denver, Louisville, Fort Lupton, Commerce City, and Castle Rock all have banned ownership of pit bulls.
Source: USA Today

The Centers for Disease Control and Prevention (CDC) recently released the National Hospital Ambulatory Medical Care Survey: 2002 Emergency Department Summary. This report describes ambulatory care visits to hospital emergency departments (EDs) in the United States. Data highlights include:

From 1992 through 2002, the number of ED visits increased from 89.8 million to 110.2 million visits annually (up 23%). This represents an average increase of almost 2 million visits per year. The number of hospital EDs in the U.S. decreased by about 15% during the same period.

About 60% of all hospital EDs were located in metropolitan areas but they represented 80.9% of the annual ED encounters.

In nearly 1 out of every 100 ED visits, the patient required immediate attention (e.g., unconscious or required resuscitation efforts).

Abdominal pain, chest pain, and fever were the most commonly recorded principal reasons for a visit.

The most frequently reported primary diagnoses were contusions, acute upper respiratory infections, open wounds (excluding head), and abdominal pain.

From 1992 through 2002, visit rates for intracranial injuries among children under 18 years decreased by 75%. During the same period, visit rates for depression among persons 18-44 years increased by 106%.

Injury, poisoning, and adverse effects of medical treatment accounted for 35.5% of ED visits. Falls, being struck by or striking against something, and motor-vehicle traffic incidents were the leading causes of injuries presenting to the ED, accounting for about 40% of such visits.

Medications were provided at 75.8% of visits.

The patient was referred to another physician or clinic for followup at 44.6% of visits, and 12.2% of the patients were admitted to the hospital.

The duration for two-thirds of ED visits was between 1 and 6 hours. On average, patients spent 3.2 hours in the ED.

Source: National Center for Health Statistics, Advance Data from Vital and Health Statistics, Number 340, March 18, 2004.

Getting Students to Complete Reading Assignments

It important to let students know that they cannot simply pass their eyes over the words as one does when reading for pleasure. They should make an effort to grasp the information and apply it to a particular situation. Here are a few approaches that might encourage students to be more engaged when reading:

This edition's tips involve airway and ventilation care for pediatric patients and are provided by Marianne Gausche-Hill, MD, FACEP, FAAP.

Providers are often anxious when managing a child's airway and providing ventilation. The results of this anxiety can unfortunately lead to complications such as rapid and forceful ventilation, gastric distention, vomiting, and reduced tidal volume. It may help you to remain calm by reciting a phrase to yourself when providing ventilation via a bag-valve-mask (BVM), such as "squeeze, release, rest." This will enable the provider to give 1 breath approximately every 3 seconds for an infant or child.

The amount of air volume you need to deliver is probably smaller than you think. For example, in a neonate weighing about 3 kg, the amount of air necessary to make the chest rise is only about 30 ml or 2 tablespoons; in a 1 year old, the amount is only about 7 tablespoons of air.

Use the right size BVM and squeeze the bag gently, with the correct volume to just make the chest rise gently.

Gunshot Wounds
Alton Thygerson, Ed. D.

Watch the evening television news or read the morning newspaper, and most likely you will see or hear a report of a gunshot victim on almost a daily basis. Most involve a deliberate act while others are unintentional. The results of both are the same: a devastating injury often resulting in death.

Firearm-related deaths and injuries pose a major public health problem in the United States. The Centers for Disease Control and Prevention report that injuries from firearms is the ninth leading cause of death overall. The total number of firearm deaths are still increasing.

Guns and Ammo

Small arms can be divided into three categories: handguns, rifles, and shotguns. Handguns come in four basic types: single-shot pistols, derringers, revolvers, and auto-loading pistols.

Handgun and rifles are identified by their caliber (the diameter of the cartridge fired by the gun). Caliber is expressed in millimeters or in 100ths of an inch (e.g., 9 mm, 10 mm, .22 (22 caliber), .38 (38 caliber) or .45 (45 caliber).

Shotguns are identified by their gauge. A representation of the diameter of the gun's bore. A smaller number indicates a larger gauge. Twelve- and twenty-gauge shotguns remain the most popular models sold in the United States.

Wounds

Shotgun wounds differ greatly from those of handguns and rifles. Shotguns create massive tissue damage by propelling multiple projectiles into the body. Wound size and formation vary greatly, depending on the type of shotgun. At close range, a mass of shotgun pellets can cause extensive crush-type tissue disruption and avulsion. At more distant ranges, a wider pattern of multiple pellet wounds results.

Body injury from a bullet (rifle, handgun) depends not necessarily on bullet size, but rather on the bullet's velocity, weight, shape, construction, deformation, and fragmentation with impact as well as the type of tissue it impacts. The major determinant is the bullet's velocity.

Firearms are often referred to in terms of low-velocity and high-velocity. Bullets traveling at high-velocity (typically from a rifle) contain a great amount of energy and thus have a higher wounding potential than bullets traveling at low-velocity. Most high-velocity bullets (and some low-velocity bullets) lose stability on impact and begin to tumble. This exposes a greater surface area of the bullet to the tissue, increasing the wound's size and the amount of damage.

Cavitation describes the formation of cavities in tissue caused by a passing bullet. Much like a boat moving through water; the bullet disrupts not only the tissues that are directly in its path but also those in its wake. Therefore, the area that is damaged by medium- and high-velocity bullets can be many times larger than the diameter of the bullet itself. This is one reason that exit wounds are often many times larger than entrance wounds.

Bullets differ in composition and shape. As a result, their behavior also differs. Many have a metal jacket over a soft core that may or may not be exposed at the tip of the bullet. This soft core, especially if it has a hollow point, allows the bullet to expand on impact, thus increasing its diameter up to two-and-one-half times.

Emergency Care

Every victim must be checked to locate the entrance wound and a possible exit wound. Gunshot victims must be treated for shock. To treat for shock, lay the victim down and elevate the legs eight to 12 inches. When you locate the wound, control bleeding by applying a dry, sterile dressing over the wound and maintaining pressure (be sure to protect yourself against contact with the blood by wearing medical exam gloves, using extra gauze pads, cloths, or towels).

If a sucking sound is heard through a chest wound, apply an occlusive dressing and seal the dressing by taping down three of the four sides. Obtain more advanced medical care as quickly as possible.

In most states, the law requires all gunshot wounds to be reported to the local law enforcement agency. This applies to unintentional incidents as well as homicides and suicides.

Just Published!
Pediatric Airway Management for the Prehospital Professional
Marianne Gausche-Hill, MD
ISBN: 0-7637-2066-6

30 million children a year seek emergency care in U.S. emergency departments.

What impact do these statistics have on your practice as an EMS provider? One of the first decisions EMS providers make is whether to manage the pediatric patient's needs in the field or initiate rapid transport. The question of which procedure to use is a complex one and requires knowledge of what intervention is most effective, has the least complications, and promises a better outcome.

Prepare yourself with Pediatric Airway Management for the Prehospital Professional by Marianne Gausche-Hill, MD.

Emergency management of the pediatric airway requires an understanding of the anatomic, physiologic, and behavioral differences in infants and children. It also requires specific skills that EMS providers do not have many opportunities to practice. A comprehensive, easily understandable text, Pediatric Airway Management for the Prehospital Professional teaches EMS providers how the pediatric airway is different from the adult airway, and it thoroughly covers the assessment and management of pediatric airway emergencies. Superb four color, real-life photographs and illustrations appear throughout.

Instructors are invited to contact your Public Safety Specialist at 1-800-832-0034 to request your complimentary review copy.

To purchase a copy of this essential new text without risk today, contact your Public Safety Specialist at 1-800-832-0034. Don't wait to place your order!

To view our complete list of Public Safety programs, visit http://www.EMSZone.com

Conference Schedule:

For a list of upcoming conferences Jones and Bartlett will be attending, please visit: http://www.EMSZone.com/company/conferences.htm