2002 refresher - National Ski Patrol

Patient Assessment—Responsive Medical Patient (continued)Objective: To demonstrate the ability to determine the baseline condition and specific complaint of a responsive patient with a medical problem.SKILL YES NO NOTATIONSFOCUSED HISTORY AND PHYSICAL EXAM—MEDICAL PATIENT❚ Obtains the SAMPLE history using OPQRST. (CPI)❚❚❚Conducts a medical-focused physical exam of the area of chiefcomplaint; confirms chief complaint.Stabilizes and maintains the patient’s body temperature.Determines the appropriate baseline vital signs.(CPI)❚ Provides care for the chief complaint: interventions = as needed. (CPI)❚❚❚❚Transports the patient off the hill.Performs a detailed physical exam as necessary.Performs ongoing assessment.Did the trainee or OEC technician adequately demonstrate theperformance criteria of these skills?Conducts medical-focused physical examProvides care for chief complaint2002 Refresher Study Guide ❚ 8 ❚ Ski Patrol Magazine

Use of Oxygen and Airway Adjuncts—Administration of OxygenObjective: To demonstrate the correct use of oxygen equipment.SKILL YES NO NOTATIONS❚ Initiates BSI precautions. (CPI)❚ Assembles oxygen cylinder and regulator, and checks for leaks. (CPI)❚ Chooses a delivery device by patient need. (CPI)❚ Selects non-rebreather oxygen mask, connects to regulator, pre-fillsthe regulator, and initially adjusts oxygen flow to 12–15 lpm.❚ Selects nasal cannula, connects to regulator, and adjusts oxygento 6 lpm maximum.❚❚Applies the appropriate oxygen delivery device to the patient andverifies that the patient receives oxygen. If using a non-rebreathermask, readjusts the flow rate to keep the bag half-full on inhalation.Closes the oxygen tank when finished providing oxygen.❚ Bleeds regulator device to “0.”❚Did the trainee or OEC technician adequately demonstrate theperformance criteria of this skill?(CPI)ASSEMBLES OXYGEN CYLINDER AND REGULATORPHOTOS COURTESY OF AMERICAN ACADEMYOF ORTHOPEDIC SURGEONSCracks valve, brieflyAssures the use of gasket Aligns regulator on valve stem Attaches oxygen supply tubingNon-rebreather oxygen maskNasal cannula2002 Refresher Study Guide ❚ 10 ❚ Ski Patrol Magazine

Management of a Fracture At or Near a JointObjective: To demonstrate the immobilization of a fracture site, the adjacent joints, and the extremity for a fracture or dislocation at ornear a joint.SKILL YES NO NOTATIONS❚ Initiates BSI precautions. (CPI)❚❚❚❚Assesses the limb, joint, and mechanism of injury (MOI) to determinethe presence and location of a fracture and/or dislocation.Assesses circulation, motion, and sensation (CMS) of the limb.Prepares the immobilization device for use, taking into account anyabnormal anatomical positioning of the limb.Manually stabilizes the fracture site and the limb.(Note: Continuous manual stabilization must be maintained untila mechanical device is applied and completely secured.)❚ If there is no distal circulation, realigns the limb until unusual (CPI)resistance is met or circulation returns.❚❚Aligns the limb to near-anatomically correct position.Positions, applies, and secures the device without excessive movementof the limb, ensuring that all voids are filled.❚ Makes sure that the fracture site, the joints above and below the injury, (CPI)and the limb are immobilized.❚❚Reassesses the CMS of the limb.Did the trainee or OEC technician adequately demonstrate theperformance criteria of this skill?Prepares the immobilization devicePositions, applies, and secures the deviceImmobilizes the joints above and below the fracture siteReassesses the CMS of the limbSki Patrol Magazine ❚ 11 ❚ 2002 Refresher Study Guide

Management of An Open FractureObjective: To demonstrate the control of bleeding associated with an open fracture and immobilization of the limb.SKILL YES NO NOTATIONS❚ Initiates BSI precautions. (CPI)❚❚Assesses the limb, joint, and mechanism of injury (MOI) to determinethe presence and location of a fracture and/or dislocation.Assesses the circulation, motion, and sensation (CMS) of the limb.❚ Controls any bleeding that is present. (CPI)❚ Exposes the fracture site.❚ Uses direct and indirect pressure, as appropriate.❚ Uses the pressure point, if necessary.❚ Dresses and bandages the wound. (CPI)❚❚Prepares the immobilization device for use, taking into account anyabnormal anatomical positioning of the limb.Manually stabilizes the fracture site and the limb.(Note: Continuous manual stabilization must be maintained untila mechanical device is applied and completely secured.)❚ If there is no distal circulation, realigns the limb until unusual (CPI)resistance is met or circulation returns.❚Aligns the limb to near-anatomically correct position.❚ Positions, applies, and secures the device without excessive movement (CPI)of the limb, ensuring that all voids are filled.❚❚❚Makes sure that the fracture site, the joints above and below the injury,and the limb are immobilized.Reassesses the CMS of the limb.Did the trainee or OEC technician adequately demonstrate theperformance criteria of this skill?Assesses the limbControls bleedingPositions, applies, and secures the deviceReassesses the CMS2002 Refresher Study Guide ❚ 12 ❚ Ski Patrol Magazine

Extrication From Difficult Positions (Jams and Pretzels)Objective: To safely move an injured patient, especially one with a suspected neck or back injury, into a supine, anatomically neutralposition on the ground or onto a long spineboard.SKILL YES NO NOTATIONS❚ Initiates BSI precautions. (CPI)❚❚❚Performs scene size-up and initial patient assessment.Calls for help (additional equipment, personnel, and EMS transport).Provides necessary interventions (maintains airway, performs CPR,and controls bleeding, etc.).(CPI)❚ Stabilizes the cervical spine. (CPI)❚❚❚When additional personnel arrive, manually stabilizes the threereference points (head, shoulders, and hips).Assesses the circulation, motion, and sensation (CMS) of all limbs.Uses axial, smooth motions in small increments, and aligns oneextremity at a time.❚ Aligns all body parts into position 1 (progressing from higher (CPI)to lower numbered position) as early as possible unless painor resistance occurs.❚Positions the patient on a long spineboard, maintaining spinalintegrity at all times.❚ Stabilizes the patient on the long spineboard and reassesses CMS. (CPI)❚❚Reassesses patient status and interventions, and continues with care,evacuation, and transport.Did the trainee or OEC technician adequately demonstrate theperformance criteria of this skill?▼Position 1a▼Position 2a▼Position 3a▼▼Position 1Position 2Position 3Ski Patrol Magazine ❚ 13 ❚ 2002 Refresher Study Guide

YOUR NAME:c.2. a. What are the protocols at your resort for providing emergencycare for a minor in the absence of a parent or guardian?d.e.f.b. What is the protocol for obtaining and documenting permissionfrom a parent or guardian who is not present?g.h.i.3. List, in order of priority, the emergency care you wouldprovide for these patients and justify your transportationdecisions.a.OEC, 3rd ed., chapter 13; OEC, 4th ed., chapter 13Action Questions1. List the injuries and medical conditions described in thisscenario.b.c.d.Ski Patrol Magazine ❚ 17 ❚ 2002 Refresher Study Guide

YOUR NAME:e.n.f.o.g.p.h.q.i.r.j.s.k.t.l.u.m.v.2002 Refresher Study Guide ❚ 18 ❚ Ski Patrol Magazine

YOUR NAME:SCENARIO 3On a very cold night near the end of the tubing session, a 9-yearoldgirl is riding on the outside lane of a large tubing park. Hertube ricochets repeatedly off the dividing lane berms at anincreasing speed and then catapults over the outer berm, downan adjacent embankment, and into a stand of trees. When youarrive, the young girl is lying on her left side, supporting her partiallyflexed right arm across her chest and abdomen. She is sobbingand shivering violently, and you note that she’s wearingjeans and a light windbreaker and has no hat. Your assessmentreveals slow speech with slurred responses; palpable tenderness,swelling, and deformity of the right elbow; a right radial pulsethat is diminished when compared to that on the left; and aweakened hand grasp on the right side. Her initial vital signs are:pulse, 108 and strong; respirations, 20 and shallow.Action Questions1. List the injuries described in this scenario.2. What area management concerns do you see arising from thisscenario?Text Questions1. The initial emergency care for a fracture near a joint withdiminished distal neurovascular function, where the hospitaltransport time is less than one hour, isand .OEC, 3rd ed., chapter 11; OEC, 4th ed., chapter 252. List six signs and symptoms of mild hypothermia.a.3. If you were to provide an EMS interface/communicationsreport before transferring this young girl to the hospital, whatwould you include in the report?b.c.d.e.f.OEC, 3rd ed., chapter 19; OEC, 4th ed., chapter 153. List seven snowsports activities other than alpine skiing andtubing.a.b.c.d.e.f.g.OEC, 3rd ed., chapter 23; OEC, 4th ed., chapter 14Ski Patrol Magazine ❚ 19 ❚ 2002 Refresher Study Guide

notes2002 Refresher Study Guide ❚ 20 ❚ Ski Patrol Magazine

2002 CYCLE A OEC REFRESHERCompletion AcknowledgementHave this signed by the instructor of record at the refresher, and return it to your NSP patrol representative or patrol director to verifythat you have attended and successfully completed all requirements for the 2002 refresher. Please print.Patroller:NSP Member I.D. #:Ski Patrol Registered With:Refresher Location and Date:OEC Instructor of Record Name:OEC Instructor of Record Signature:2002 CYCLE A OEC REFRESHERSupplemental Roster InformationAfter completing the refresher, fill out this form and submit it to the instructor of record. This will help the instructor document yourcompletion of this year’s OEC refresher requirements to the national office. Please print.✁CUT HEREPatroller:NSP Member I.D. #:Address:City: State: Zip:E-mail Address:Ski Patrol Registered With:Region:Refresher Location and Date:OEC Instructor of Record Name:Ski Patrol Magazine ❚ 21 ❚ 2002 Refresher Study Guide

input appreciatedThe National Ski Patrol is committed to offering top-notch training resources that helppatrollers provide the best patient care possible. With the inclusion of content from the new,fourth edition of Outdoor Emergency Care, the 2002 Cycle A refresher presents the perfectopportunity to review updated educational material and incorporate it into your personalskill set.As the refresher process continues to grow and evolve in support of an ever-improvingOEC Program, patroller input is crucial. The OEC Refresher Committee fully recognizesthat the quality of this educational opportunity is dependent on constructive and creativefeedback. When you take the time to contact a committee member or your division OECsupervisor, you invest interest and a desire for continued quality in the OEC Program. Onthe back cover of this study guide you will find the names of the committee members andOEC supervisors, their patrol or division affiliations, and their contact information. Theseindividuals bring together a wealth of patrol experiences and a wide range of backgrounds,and they take pride in presenting materials that are topical and contemporary. They alsofeel passionate about gathering your views. Drop them a note, add your comments to anevaluation form, or send them your ideas. You also may forward comments to the educationdepartment at the national office through its e-mail address, education@nsp.org.The refresher committee is particularly interested in your training needs, ideas for activities,and suggestions for alternative ways to communicate OEC content. Committee membersare also good resources to consult with regard to refresher-related problems that cannotbe dealt with locally. Remember, the quality of your refresher hinges on your input!2002 Refresher Study Guide ❚ 22 ❚ Ski Patrol Magazine

2002 CYCLE A OEC REFRESHERPatroller EvaluationThis evaluation is designed to help local instructors, patrol officers, and the OEC Refresher Committee review and improve theannual OEC refresher. Last year’s responses were greatly appreciated, and we look forward to receiving your feedback again this year.What did you like best?What needs improvement?1. Refresher overall2. Refresher Study Guide3. Scenario Discussion ForumHow helpful to you were the following elements in refreshing this year’s OEC topics?On each continuum below, please circle the ONE number that best represents your impression.Hands-on StationsNot at all helpful Helpful Very helpful1 . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . .3 . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . .5 . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . . . . .7 . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . . . .9Additional Comments:PresentationsNot at all helpful Helpful Very helpful1 . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . .3 . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . .5 . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . . . . .7 . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . . . .9Additional Comments:ScenariosNot at all helpful Helpful Very helpful1 . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . .3 . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . .5 . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . . . . .7 . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . . . .9Additional Comments:Please return this evaluation to the refresher instructor of record before you leave the refresher.DIVISION:PATROL:NAME (OPTIONAL):Ski Patrol Magazine ❚ 23 ❚ 2002 Refresher Study Guide

2002 refresher❂NATIONAL SKI PATROL ❚ OUTDOOR EMERGENCY CAREstudy guideNATIONAL OEC REFRESHER COMMITTEEJohn DobsonWintergreenRoute 1, Box 525Roseland, VA 22967(434) 325-1024jdobson4@aol.comLarry BostHawksnest2517 Saddlehorse LaneGastonia, NC 28506(704) 865-7484nspnc@aol.comCathy SetzerBoyce Park36 Northgait DriveSlippery Rock, PA 16057(724) 458-5451cvsetzer@zoominternet.netStephen FranciscoJune Mountain4738 Tobias AvenueSherman Oaks, CA 91403(818) 389-1661stazski@aol.comLeif BorgesonAssistant Education DirectorNational Ski Patrol133 S. Van Gordon Street,Suite 100Lakewood, CO 80228303.988.1111, ext 174lborgeson@nsp.orgNancy PitstickBrighton1579 E. Parkridge DriveSalt Lake City, UT 84121(801) 943-7609npit@sisna.comBrigitte SchranSummit at Snoqualmie21704 141st Ave. S.W.Vashon Island, WA 98070(206) 463-3447rowyn@blarg.netDIVISION OEC SUPERVISORSAlaska DivisionPaul BrooksP.O. Box 111252Anchorage, AK 99511-1252(907) 346-2938pdbrooks@gci.netCentral DivisionDeb Endly2300 Overlook DriveBloomington, MN 55431(952) 884-8126ezcompany2@msn.comJanet T. Glaeser5445 Peachtree Lane SouthParma, OH 44134-6973(440) 884-9637janet7409@msn.comMary Griffin2739 Bowers Harbor RoadTraverse City, MI 49686(231) 223-4428skigolfemt@aol.comEastern DivisionWilliam F. Halsey3586 Whistlestop LaneElbridge, NY 13060(315) 689-7335ezsailin@twcny.rr.comEdward C. McNamara103 Flanagan Hill RoadSterling, MA 01564(978) 422-8016emcnamara@cmemsc.orgPaul Tracy148 Allwood Rd Unit 4AClifton, NJ 07014-1616(973) 472-0327Dennis A. Zercher4035 West MarketYork, PA 17404(717) 792-2121zerden@juno.comEuropean DivisionLynore WardCMR 480 Box 1111APO, AE 09128-11110049-711-680-4372lward@t-online.deFar West DivisionSandra Jo Bradley1798 Fairhaven CourtOakley, CA 94561(925) 625-8646nspsam@aol.comDouglas Hill9072 Biola LaneGarden Grove, CA 92844-2204(714) 638-2103dch@cadwest.comIntermountain DivisionGreg Bala2857 W Meadowlark LaneIdaho Falls, ID 83402(208) 522-2710Bala@srv.netNorthern DivisionLisa Ellis1010 Bonnie BraeCasper, WY 82601(307) 472-7017lisaellisoec@aol.comPacific NorthwestDivisionKathy Alexander19409 Cherokee RoadBend, OR 97702(541) 382-0044kalexander@mtbachelor.comElizabeth Dodge18808 Wallingford N.Seattle, WA 98133(206) 525-8946dodger@ix.netcom.comProfessional DivisionLeif BorgesonNational Ski Patrol133 S. Van Gordon Street,Suite 100Lakewood, CO 80228(303) 988-1111, ext 174lborgeson@nsp.orgRocky Mountain DivisionAnn GassmanP.O. Box 4449Dillon, CO 80435(970) 667-8814ann.gassman@uswestmail.netSouthern DivisionJudith Kay-Monaghan5966 Norham DriveAlexandria, VA 22315(703) 971-7841j.kay@ltwell.comCanadaSuzanne H. Kenney#207-1460 Pemberton Ave.Squamish BCBC VON 3G0, Canada(604) 892-1029