BLS for Prehospital Providers Course

Welcome, Introductions, and Housekeeping

BLS PHP Agenda Why the BLS for Prehospital Providers Course (BLS PHP)? Differences between BLS for Healthcare Providers (BLS HCP) and BLS PHP, and how to position these with the Training Network Defining and setting expectations of new concepts within BLS training —Debriefing —Chest compression fraction (CCF) —Team performance Takeaways —How are the BLS PHP course keys accessible? —BLS PHP Product Orientation and other resources on the Instructor Network (IN) 3

Training Objectives for BLS PHP Discuss how historical feedback from the EMS community shaped the development of the course Describe course flexibility to customize local protocols Explain the format (“flipping the classroom”) Review the BLS PHP Course content Demonstrate the high-performance team concept (“pit crew”) Review key components of the BLS PHP online portion Review key components of the BLS PHP classroom portion Identify procedure for how Training Centers and instructors administer course keys to student Review purpose and value for additional supporting materials for the BLS PHP Course, such as the Instructor Supplement, instructor packaging, Lesson Plans, and other resources. 4

History and Purpose of New BLS Course Specific EMS Scenarios EMS Field Application Local Protocols High- Quality CPR Overview

In 2012, the AHA assembled an EMS Advisory Panel consisting of field providers from around the country. That group made the following recommendations: Design a specific BLS curriculum for prehospital providers that includes EMS-specific scenarios and skills practice Make the scenarios entirely EMS oriented and realistic for the prehospital environment Include the high-performance team concept to increase the level of competence Curriculum that teaches how to set up the scene for high-quality CPR Historical Feedback and the Evolution of PHP

BLS PHP is a new customizable learning experience, combining online and classroom-based training into one high-performance program created specifically for prehospital professionals. The total experience is what is learned and verified in the online portion, mixed with the implementation strategies experienced in the classroom. Course Flexibility ― Local Protocols

Course Design ― aka “Flipping the Classroom” Flip the classroom Online component Classroom component 8

BLS PHP Course―An Inside Look

Initiate the Chain of Survival Perform prompt, high-quality CPR with C-A-B sequence (adult/child/infant) Initiate early use of AED (adult/child/infant) Provide appropriate breaths Practice the minor BLS differences for children and infants Practice team CPR (adult/infant) BLS PHP Course Content

Focus on pit crew approach to teach how to conduct a code with teams varying from 2 to 6 people Introduce the concept of debriefing to BLS Instructors Scenario-based training that may represent a student’s next call in the field Develop core course segments that provide the opportunity for medical directors to tailor the course to local response protocols High-Performance Teams

BLS PHP Course Components: Online Portion

Scenario- Based Training Specific situations that EMS encounters Tiered responses Interactive Content Same objectives and exit criteria as BLS HCP “See the Science” Course Flexibility Centrally (computer lab) Distributed (stations or home) No student manual Interactive Web Components

EMS-oriented scenarios and realistic settings for the prehospital environment Termination of resuscitation Drowning Pit crew approach Scenario-Based Training

Same objectives as BLS HCP Same exit criteria See the Science buttons allow students to drill deeper into the “Why?” Interactive Content

Online exam BLS HCP with EMS focus Certificate of completion Written Exam

BLS PHP Course Components: Classroom Portion

Classroom Components Uses same standards and science as BLS HCP Uses same card as BLS HCP Same evaluation criteria Requires motor skills demonstration for all skills Practice of and emphasis on high-quality CPR

Customization Components Local Protocols Role of Ventilation Medical vs Trauma Use of AED Pit Crew Compression Protocols Termination Criteria Interagency Roles

Pit Crew Approach―Instructor Capturing and optimizing the percentage of arrest time that high-quality chest compressions are performed has a predictable improvement in survival. Improving CCF to achieve the 80% threshold increases survival by 200% to 300%. Instructors in this course can calculate CCF by any of the following 3 methods: ―2-stopwatch technique ―Using the Full Code Pro application ―Using instrumented manikins that capture performance data 20

BLS Debriefing From the 2010 AHA Guidelines for CPR and ECC: “Debriefing as a technique to facilitate learning should be included in all ALS courses (Class I, LOE B)” “Debriefing of actual resuscitation events can be a useful strategy to improve future performance (Class IIa, LOE C)” ―Peer to peer ―Nonthreatening ―Assists individuals and teams to reflect on and improve performance 21

Local Protocols AHA guidelines: Resource Provide guidance Lend supportive information Substantiate― they are based upon available science Many use AHA guidelines to devise local treatment protocols Protocols and guidelines aren’t always parallel 22

Demo of a High-Performance Team in Action

Team Dynamics Suggested roles for a 6-member team: 1. Compressor: Does 5 cycles of chest compressions 2. Airway: Opens the airway; provides bag-mask ventilation (and uses airway adjuncts as appropriate) 3. Monitor/Defibrillator: Brings and operates an AED (ACLS and PALS providers bring a manual monitor/defibrillator); may alternate with Compressor every 5 cycles. If a monitor is present, it should be placed in a position where it can be seen by everyone 4. Team Leader: Assigns roles and makes treatment decisions; provides feedback (when needed) to the rest of the team 5. Observer/Recorder: Records the time of interventions (and frequency and duration of interruptions in compressions); communicates these to the Team Leader 6. IV/IO/Medications (ACLS provider role): Initiates IV/IO access; administers medications 24

How could you improve the actions of the teams you observed (for the cardiac arrest in vehicle, child drowning, and cardiac arrest in bathroom scenarios)? Do your teams do anything different from what you observed in the scenarios that you think improves patient outcomes? Are there observational or clinical data you could share to help improve team performance? Would you like clarification on any actions or components of the video? Questions for Discussion: Team Performance

High-Performance Team Activity

How could you improve the actions of the teams you observed (for the cardiac arrest in vehicle, child drowning, and cardiac arrest in bathroom scenarios)? Do your teams do anything different from what you observed in the scenarios that you think improves patient outcomes? Are there observational or clinical data you could share to help improve team performance? Would you like clarification on any actions or components of the video? Questions for Discussion: Team Performance

BLS PHP: How to Review Materials and Distribute Course Keys

Availability and Distribution of Course Keys

Instructor Supplement Contains the tools needed to teach the classroom portion Includes agenda, outlines, and Lesson Plans Use with the BLS for Healthcare Provider Instructor Manual 30

Instructor Supplement and CD Classroom DVD 31 Instructor Package

Lesson Plans New concept Response to Training Network feedback 32

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Other BLS PHP Resources on the Instructor Network Equipment List Team Diagram Questions for Discussion FAQs Course Requirements Training Memo 34

Post Workshop Evaluation Please use this link to complete a short survey on the workshop you have attended: 35