Through SafetyCampus.org, we offer the most complete and thorough safety training available. Interactive courses and community resources will teach you what to do in an emergency. ECSI has recently released its online programs in Adult CPR, AED, First Aid, and Professional Rescuer CPR, and more may be released by the time you read this newsletter.

Educational Centers and Instructors can purchase access codes for these courses and provide these codes to anyone who wants to complete the knowledge components of a course online. A nice feature is that the student can complete the online course in the convenience of his or her home or business. Once the knowledge portion is complete, the user will contact the Educational Center or Instructor to complete the "skills only" portion of the training and earn an official course completion card. Educational Centers and Instructors can schedule these skills examinations around the skills portion of traditional courses or schedule separate skills-only testing days.

Using the online access code is simple. After purchasing a passcode, the student logs on, enters the passcode, and chooses a personalized username and password. This makes returning back to the course quick and easy. If you have any questions about offering these programs, please contact us.

A unique opportunity afforded to the ECSI Educational Centers is a listing as a skill testing location. When people in the community complete a course through our website, they can then find your Educational Center while searching for places to complete skill testing. This is another way ECSI helps drive business to you. If you failed to take advantage of this opportunity when you signed up with us, please update your profile by sending an email to rnixon@jbpub.com.

Look for our Course Catalog to preview the available courses and purchase your access codes. Returning users can click on My SafetyCampus on our website to login to the course.

What's New With the Website?
Here are other programs being released in the next few weeks. Click on any of the links to learn more about the program.

Professional Rescuer CPR
Bloodborne Pathogens
Wilderness First Aid
Good Samaritan
Primeros auxilios y RCP Basicos (Spanish edition of First Aid, CPR, and AED)

Have you toured the website yet? This newsletter is but one of the featured sections on the website at www.safetycampus.org. Others sections include:
About ECSI
Bookstore
FAQs (Frequently Asked Questions) 
ECSI Administration
eLearning (skills video clips, flashcards, etc...)
Anatomy review
Interactive Glossary

National Rollouts
We have been traveling across the United States conducting program orientations, establishing new Educational Centers, and answering questions. Recently we conducted rollouts at:

• Clincon - Orlando, FL
• PA EMS Conference - Lancaster, PA

Others places you will see us at this fall include:

• National Recreation and Parks Association Congress - Reno, NV
• EMS Expo - Atlanta, GA
• Vital Signs - Buffalo, NY

Look for email announcements soon.

The AAOS Emergency Care and Safety Institute is off to a great start.  Since announcing the creation of the training network, we have received a steady flow of calls asking about the organization, as well as a steady flow of online registrations for Educational Centers and Instructors.  We have also received several queries about online training, asking if such courses are beneficial and if a person can obtain a course completion card.

Online or e-learning has seen tremendous growth over the past several years.  There are advantages to e-learning such as cost savings and convenience.  The cost savings can be seen in reduced fees for online training, since the learner does not have to pay for an instructor to deliver the content.  Reduction in overtime costs can also be seen when comparing online costs to the fees that could be incurred when sending on-duty personnel to sit in a classroom for several hours.  Convenience is also key.  People who want to complete the training can do so at their own pace, when they have time to devote to the program.  Online or e-learning can be completed while on duty over an expanded time.  There are no set class schedules to follow.

The online portion of any program only addresses the didactic or content portion of the course.  It does not provide skills practice or skills testing.  To fully complete a course of instruction leading to a course completion card, the learner must contact an Instructor or Educational Center to make arrangements for a skills assessment.  If the employer is also an Instructor and/or Educational Center, then the learner simply contacts the trainer and sets a date and time for the skills test.

Is online or e-learning a panacea - no.  But it is a tool that can be used effectively when coordinating or developing training programs to be delivered in-house to on-duty personnel.

ECSI has many online programs for CPR, First Aid, AED and is developing others.  Watch for our announcements coming out soon!

Robert Nixon
Program Director

Cape May Court House, NJ - A man was charged with child abuse for not applying enough sunblock to his mentally disabled 12-year-old for a day at the beach, leaving the boy with severe burns.  The boy suffered large, bleeding blisters on his back and face.
Source:  Associated Press, May 27, 2004

Kremmling, CO - Four men remained hospitalized after they were struck by lightning while playing golf.  The bolt also injured 15 others; they were treated for minor injuries.  One victim said, "All of a sudden, it felt like someone hit me over the head with a baseball bat."  In May a 47-year-old man was killed when lightning struck a driving range at a golf course in Littleton, CO.
Source:  Associated Press, June 21, 2004

Baring, WA - A 33-year-old man fell 1,000 feet to his death after his parachute failed to open during a recreational jump.  The man jumped from the north face of Baring Mountain.
Source:  Associated Press, July 7, 2004

Millinocket, ME - A rockslide on a popular trail near Mount Katahdin seriously injured one hiker and killed another who became trapped under a boulder. The injured hiker and two other people caught in the rockslide were rescued after about 60 searchers worked through the night to find them.
Source:  Associated Press, June 28, 2004

The Centers for Disease Control and Prevention (CDC) recently released Deaths:Injuries, 2001.  This is the most recent compilation.

Injury deaths are those caused by acute exposure to physical agents (e.g. mechanical force, heat, electricity, chemicals, and ionizing radiation) in amounts that exceed the threshold of human tolerance.  An injury death may also be the result of a sudden lack of an essential substance (e.g. oxygen in the case of drowning).

Causes of death involving injuries are more prominent among the leading causes of death in the United States.  These are the highlights regarding injury mortality.

• 157,078 resident deaths occurred in the United States as the result of injuries.
• Unintentional injuries were the fifth leading cause of death overall and the leading cause for those under 35 years of age.  Suicide and homicide were the 11th and 13th leading causes, respectively.
• 65% of injury deaths were classed as unintentional, 20% were suicides, 13% were homicides.
• An estimated total of 2,988 deaths resulted from the September 11, 2001 terrorist attacks in New York City, Pennsylvania, and Virginia.
• Persons aged 75 years old and over have the highest injury death rates.
• The 5 leading mechanisms of injury death accounted for 78% of all injury deaths and were (in rank order):
  - Motor-vehicle traffic (27%)
  - Firearm (19%)
  - Poisoning (14%)
  - Fall (10%)
  - Suffocation (8%)
• Firearm suicide accounted for 57% of all firearm-related deaths.
• Age-adjusted death rates due to injury were highest in New Mexico, Alaska, and Mississippi and were lowest in California and Massachusetts.
• A head injury was mentioned in 32% of injury deaths.  Poisoning and toxic effects were the second most common injury condition (16%).
• 63% of poisoning deaths were classified as unintentional, 23% as suicides, 13% as undetermined intent, and the remainder as homicides.
• 93% of unintentional poisonings were drug related.  Of suicides involving poisoning, 69% were drug related and 28% were due to exposure to gases and vapors.
• Narcotics were involved in about half of all unintentional poisonings.  Cocaine was more commonly mentioned than other narcotic drugs.

Source:  National Vital Statistics Reports, June 2, 2004

When students are reading to prepare for a class or exam, you need questions that get students thinking about the material. Study questions intended to guide the students' reading are often helpful, however, these questions do not automatically guarantee better learning.  Students sometimes tend to look only for answers to the questions, while disregarding the other content of the chapter.  Instead, use questions designed to produce more thoughtful study.  High-level questions, rather than low-level factual questions, increase the effectiveness of a student processing the reading. 

Communicating with a senior who is hearing impaired.

With the population getting older and with the older person having more medical complaints, EMTs and paramedics are often called to assist a geriatric patient.  A dilemma can arise when the older adult is hearing impaired.  Below are some tips for communicating with a hearing impaired older adult. These are abstracted from Geriatric Education for Emergency Medical Services, authored by the American Geriatrics Society, and published by Jones and Bartlett Publishers.

• Ask the patient if he or she has a hearing aid and if he or she would like to use it.  Allow a few moments for the patient to apply the hearing aid. 
• Get close to the patient, approximately 18 inches away, so that he or she can see you and, if necessary, read your lips.
• Position yourself at the patient's eye level.
• Eliminate background noise if possible.  Turn off radios, televisions, beeping cardiac monitors, etc.  Only one EMT or paramedic should be questioning the patient.  Multiple sources of questions can be confusing.
• Make sure that room light or sunlight is on your face, and not shining into the patient's eyes.
• Do not shout or yell, as it will only distort your mouth and make lip-reading difficult, if not impossible.
• If necessary, allow the patient to use your stethoscope.  Place the ear tips gently into the patient's ears while you speak normally toward the diaphragm of the stethoscope.
• Use short sentences and rephrase questions or comments that are not understood.
• Wait for the patient to answer.  Hearing and processing your questions may take a little longer in the older adult.

Heat Stress
Alton Thygerson, Ed. D.

When the temperature rises, the heat can--and often does--create a multitude of problems.  Anyone can get heat illness, and, in fact, a lot of people do. Some suffer only from heat cramps, while those who are less fortunate may be laid low by heat exhaustion or devastated by heat stroke.  It is helpful to review the effects of warm weather on the human body, the illnesses that may result, and what you can do.
    Several disorders exist along a spectrum of heat illnesses. Some common heat illnesses include heat cramps, heat exhaustion, and heat stroke. Only heat stroke is life threatening, while the others are more common.  Untreated heat stroke victims always die.

Heat cramps. Heat cramps are painful muscular spasms that happen suddenly. They usually involve the back of the leg muscles (calf and hamstring muscles) or the abdominal muscles.  They tend to happen immediately after exertion and are caused by salt (sodium chloride) depletion.  Victims may be drinking water without adequate salt content.  However, some experts disagree because the typical American diet is heavy with salt.

Heat exhaustion. Heat exhaustion is characterized by heavy perspiration with normal or slightly above normal body temperatures.  It is caused by water or salt depletion, or both.  Some experts believe that a better term would be severe dehydration.  It happens in workers or athletes who do not drink enough fluids while working or exercising in hot environments.  Symptoms include severe thirst, fatigue, headache, nausea, vomiting, and sometimes diarrhea. The affected person often mistakenly believes he or she has the flu. Uncontrolled heat exhaustion can evolve into heat stroke.

Heat stroke.  Two types of heat stroke exist:  classic and exertional. 
    Classic heat stroke, also known as the "slow cooker," may take days to develop.  This type is often seen during summer heat waves and typically affects poor, elderly, chronically ill, alcoholic, or obese persons.  Because the elderly, often with additional medical problems, are usually involved, this type of heat stroke has a 50 percent death rate even with medical care.  It results from a combination of a hot environment and dehydration. 
    Exertional heat stroke is also more common in the summer.  It is frequently seen in athletes, laborers, and military personnel who often sweat profusely. This type is known as the "fast cooker."  In other words, this type affects healthy, active individuals when strenuously working or playing in a warm environment.  Exertional heat stroke victims will usually be sweating (about 50%), while the classic victims are not sweating.  Its rapid onset does not allow enough time for severe dehydration to occur.
    There are several ways to distinguish heat stroke from heat exhaustion.  For example, if the victim feels extremely hot when touched, suspect heat stroke.
    Another major mark of heat stroke is that mental status (behavior) changes drastically--ranging from slight confusion and disorientation to coma.   In between these extreme conditions, victims usually become irrational, agitated, or even aggressive and may have seizures.  In severe cases, the victim can go into a coma in less than one hour, so rescuers must be quick.  The longer a coma lasts, the less the chance for survival.
    A third way of distinguishing heat stroke from heat exhaustion is by rectal temperature.  However, this is not very practical because conscious heat stroke victims may not cooperate, and taking a rectal temperature can be embarrassing to both victim and rescuer.  Moreover, rectal thermometers are seldom available and the whole procedure of finding the right thermometer and then using it wastes time and distracts from important emergency care.

    Less serious heat illnesses include heat syncope, heat edema, and prickly heat.

• Heat syncope, in which a person becomes dizzy or faints after exposure to high temperatures, is a self-limiting condition.  Victims should lie down in a cool place when it occurs.  Victims who are not nauseated can drink water.
• Heat edema, which is also a self-limiting condition, causes ankles and feet to swell from heat exposure.  It is more common in women unacclimatized to a hot climate.  It is related to salt and water retention and tends to disappear after acclimatization.  Wearing support stockings and elevating the legs may help reduce the swelling.
• Prickly heat, also known as a heat rash, is an itchy rash that develops on the unevaporated moisture left on skin wet from sweating.  Treat by drying and cooling the skin.

    Because most heat illness occurs during the first days of heat exposure, the main preventive measure is acclimation.  To better handle the heat, the body adjusts by decreasing the salt content in sweat and increases the sweating rate.
    Year-round exercise and physical activity can help you prepare for hot weather.  Such activity raises the body's core temperature so it becomes accustomed to heat.  Full acclimation, however, requires exercise or physical activity in hot weather.  This can be done with a minimum of 60 to 90 minutes of exercise in the heat each day for one to two weeks.
    Workers who live in a continuously hot climate have an advantage over those living in cooler temperatures.  When new workers are exposed to hot weather, they should be teamed with veterans of the heat who know how much water they need to drink.
    Here are some preventive measures you should take to avoid heat illness.

• Avoid dehydration.  A good rule of thumb for fluid replacement is to drink one cup every 20 minutes while working or exercising in the heat.
• Dress in light-colors, which reflect the heat rather than absorbing sunlight.  Also, porous clothing allows evaporative heat loss, and loose-fitting clothing allows air to circulate to your body.
• Rest frequently, preferably in the shade.  This applies especially if you are not fully acclimated, are older, are markedly overweight, or have heart disease.
• Wipe cool water on exposed areas of the skin.

    Heat illnesses are avoidable. With knowledge, preparation, fluid replacement, and prompt emergency care, there is no need for heat casualties to be a factor for those working or exercising in warm weather.

Attention Continuing Education Providers!

The American Geriatrics Society and the National Council of State EMS Training Coordinators are pleased to bring you Geriatric Education for Emergency Medical Services (GEMS), a new national continuing education curriculum.  This exciting new program is the first of its kind--designed specifically for First Responders, EMTs, Paramedics, and any other emergency care provider.

The GEMS course is designed to address all of the special needs of the older population, including the geriatric objectives as identified in the EMT-Basic, EMT-Intermediate, and EMT-Paramedic National Highway Traffic Safety Administration (NHTSA) National Standard Curricula.  Learn more about the course, the resources, and becoming a GEMS Course Coordinator online at www.GEMSsite.com.

Now you can complete the GEMS Course Coordinator Orientation online! It's simple. 

Just visit http://www.GEMSsite.com, select the Online Course Coordinator Orientation from the Course Coordinator page, complete the application, the orientation, and the online quiz, and email your results to the American Geriatrics Society.  Upon successful completion of the orientation and the quiz, you will become a GEMS Course Coordinator.

Read about the qualifications to become a GEMS Course Coordinator at http://www.GEMSsite.com/course_starting.cfm
 
The proportion of the aged in society today is greater than ever before, and growing faster than any other segment of our population. Current indications are that approximately 34% of calls for emergency medical services, or 3.4 million emergency responses involve patients over the age of 60. GEMS represents the most credible and complete source of prehospital medical information for older adults.

The GEMS course is innovative, comprehensive, and highly visual with:

• Case-Based Lectures 
• Live Action Video 
• Hands-on Skill Stations  
• Small Group Scenarios

Take an interactive tour of the GEMS course! To learn more about the GEMS Course, the Online Course Coordinator Orientation, or to enroll today, visit www.GEMSsite.com or contact your Public Safety Specialist at 1-800-832-0034.
 
Look for Doorway Thoughts: Cross-Cultural Health Care for Older Adults, a new handbook from the American Geriatrics Society that addresses the role of ethnicity in health decision-making in America, recently published by Jones and Bartlett.   Learn more at http://www.jbpub.com/catalog/0763733385/

Conference Schedule:

Jones and Bartlett Publishers will be attending the following conferences in September and October:

9/7-9/12/2004   NAEMSE, Los Angeles, CA

9/12-9/17/2004 NCSEMSTC, Kansas City, MO     

9/12-9/17/2004 National Safety Council Congress,  New Orleans, LA

9/13-9/19/2004  2004 KY EMS Conference and Trade Show, Owensboro, KY  

9/17-9/19/2004 Indiana 2004 Emergency Response Conference, Indianapolis EMS 

9/19-9/21/2004 Georgia EMS Educators Conference,  Macon, GA

9/30-10/3/2004 2004 Emergency Cardiovascular Care Update, EMS, New Orleans, LA

10/12-10/16/2004  National Recreation and Parks Association Congress, Reno, NV

10/20-10/23/2004  EMS Expo.  Atlanta, GA

10/28-10/30/2004  New York State Vital Signs.  Buffalo, NY
 

To view our complete conference calendar, please visit http://www.emszone.com/company/conferences.htm