EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.
Issue link: https://emsworld.epubxp.com/i/131347
IMMEDIATE ACTION DRILLS Low-frequency/high-risk skills, such as needle thoracotomy and cricothyrotomy, are ideal for the development of IADs. emotional response to having successfully navigated the challenge or receiving praise from an instructor. The downside of habit loops is that cues can be very delicate. If the context in which a cue is presented changes, the habit loop is susceptible to failure.10 We might perform poorly when suddenly exposed to stressful and dynamic situations because the context has changed and therefore the cues with it. This is why training to develop habit loops must take place in the context in which they are likely to occur. Application The concept of IADs can be applied to essentially any situation, skill or task that requires dynamic unconscious competence. Examples include troubleshooting a deteriorating airway, application of a tourniquet, responding to sudden changes in a patient's condition or recognition of life-threatening dysrhythmias. Low-frequency/high-risk skills, such as needle thoracotomy and cricothyrotomy, are also ideal for the development of IADs. When developing an IAD for use in EMS education, it is important to first focus on a specific situation, skill or task (e.g., needle thoracotomy). Next, you should identify the desired trigger (e.g., recognition of a tension pneumothorax). You should then develop a short sequence of actions that excludes all ancillary actions. The sequence must be limited to only those essential actions for mitigating the problem. Focus on simplifying the sequence and consider the use of a mnemonic or ditty to make the sequence memorable. Suppose you determine that the essential components in the sequence of needle thoracotomy include palpating the appropriate landmark, inserting the needle over the top of the rib and entering the pleural space with the needle perpendicular to the chest wall. In a simplified version, your students are then taught to P.O.P. (palpate, over, perpendicular) the chest of a patient in whom they recognize signs of a tension pneumothorax. Finally, you must implement the training of your newly developed IAD by drilling students in a context that does not allow them to anticipate performance of the skill. Consider developing numerous IADs that can be drilled with minimal preparation. This will allow you to spontaneously switch gears and capture your students' attention as you see ft. However, this is not a means of initially teaching a given skill. This technique is intended to simplify the sequence so when a challenge is encountered, the students won't choke because they're overthinking the process. Conclusion The individuals responsible for educating future EMS professionals are not only faced with the challenge of teaching knowl- For More Information Circle 27 on Reader Service Card EMSWORLD.com | JUNE 2013 53