Reading & Understanding a Textbook

Reading and writing, are usually the first two things we learn when we start school. Hand in hand with these two are their brothers and sister; spelling and grammar. If they are the first and foremost things we learn every year in approximately 12 years of school, then why are so many people so bad at it. I am no expert; in fact you probably will find some grammar and punctuation mistakes in this blog. But, no matter, I will attempt to offer some helpful hints on how to read EMT technical material for all you students out there.
First know that reading a textbook is very different than reading a novel or story.

Starting a chapter

1. Read the preview or objectives first. They will point you in the direction your attention should take and set the stage for serious learning later.

2. Read the summary next. It will tell you what is most important.

3. Skim the text. This step will help you develop a big picture by looking for headings, bold print and main ideas.

4. Pay attention to the vocabulary. Find definitions of new or difficult words now. Is there a glossary? (A glossary is an alphabetized list of words and their meanings) Write them down so you do not forget.

5. Examine charts, pictures and diagrams. Ask yourself why is this important.

6. If you have done all of the above, you are now ready for in-depth reading. This is reading more slowly and following the reasoning of the text, since now you have a pretty good idea of what is important.

7. Take notes while you read. It keeps your brain from getting tired.

8. After you have read a few paragraphs, stop & think about what you have read. If you do not understand, then go back and reread. If it is still confusing, try to google the concept. Sometimes the internet has an easier or different way of explaining things.

9. To be a successful reader and understand what you are reading you need to be awake & alert. Don't try this when you are sleepy, you will drool on the book.

10. Even the best readers must reread and take notes to remember what they read.

11. It is quite acceptable to write or make notes in the margins of your textbook or use bright colors of sticky notes.

12. Instead of just taking regular notes, also make some Mind Maps (grouping related information in a highly visual manner) as popularized by Tony Buzan (Use Both Sides of Your Brain). Two examples are Arrow Graphics and showing Contrasts and Similarities, shown below.

Mind maps DO make a measurable difference in the scientific studies of learning. Some EMT Instructors will try and simplify things and make them for you, others will give you handouts that seem to be more complicated than the textbook. In either case, you should start making your own. It will help you to study and really learn the information.

Well, I hope there were some or all parts of this article that you found helpful. Like all things, reading takes practice. Keep practicing!

Medical Terminology for the EMT Student

Meet...Yosef Travis

Yosef has been an instructor at Emergency Care Programs for some time and is happy to share his EMT history with our students. Let us know if you have any questions for Yosef.

When did you decide you want to become an EMT?
On my second day of college, I walked into the student run EMS squad and signed up. My brother and his wife had both volunteered there, so it was the first thing on my mind. I ended up spending all my time there between classes and held a variety of officer positions.

What 1 event (good/bad/ugly) in life factored into your decision to save lives and become an EMT?
Nothing earth shattering led to my decision to become an EMT. My first job was in human services, so I guess it just made sense for me. I was already volunteering at an EMS squad when I took the EMT course, so I'm sure the peer influence helped too!

Tell me the best way to find an EMT job?
It really depends on what you want to do with your EMT certification. However, many EMTs start in private transport companies and either work their way up or move along to hospital/municipal positions once they have some experience.

What is your Level of Certification? EMT/Paramedic/Lab Instructor/Lead Instructor
I'm an Emergency Medical Technician – Basic (EMT-B) and a Certified Instructor Coordinator (CIC).

How challenging is it being an EMT?
It's challenging because there is a high level of stress that comes with being involved in EMS. It's also physically challenging, so staying fit is an absolute necessity. I encourage my students to think about why they want to be an EMT. I hope that they can focus on those reasons when the work gets tough.

How do you keep sharp in your own skills?
It's actually easier for me as an instructor to keep sharp, because I interact with a whole range of EMTs and I use my conversations with them to constantly improve my own practice. I recommend to all EMTs that they find opportunities to review and improve their skills by reading journals, participating in skill drills, and talking to experienced EMTs who strive to stay on top of their game.

How's the comradery on the job with your fellow EMTs?
There are a lot of truly dedicated EMTs and paramedics who I have met who have helped me and influenced me as an EMT. With these colleagues, there's always the awareness that we are all there for each other and for the same end goal. Sure, there are some who are just "punching the timecard", but much of the EMS community in NYS is comprised of people who really care, about their patients, about their partners, and about the community.

What advice can you give others who want to become an EMT?
Clarify to yourself what your motivation is for becoming an EMT. Seek out mentors who will guide you and offer a listening ear when the going gets tough. And above all, never mock any patient (even among your colleagues), because it's a slippery slope once you stop respecting the people for whom you are supposed to care.

Why do you enjoy teaching your students?
For me, it is truly satisfying to take a new class on a journey through the ins and outs of prehospital care and see them go on to become dedicated EMTs (and perhaps EMS educators)!

How do you encourage others to follow this career path?
Everyone who takes a class with me has already made a decision to become an EMT. It is my responsibility to help them nurture that original idea and develop a strong knowledge and skill base, so they can reach their true potential in EMS.

Being an EMT Student

The first time I walked into the classroom, I was nervous.

Why had I come - was I making the right decision? I wanted to help people, some of my family members had become ill from stroke, heart disease and diabetes and I wanted to help them. They were getting older. I wanted to know what to do in emergencies, like those people I saw on TV or in the movies. They seemed to always know.

Once I got into CPR and bleeding & bandaging, I was hooked. I found a friend who wanted to pass as much as I did. We studied together before and after class.

We made index cards with important facts and flashed them to each other like in Jeopardy. It was hard, but we kept studying and practicing and having a good time. We would compete to see who could get the higher grades and before we knew it the course was over and we had passed our state exams.

I couldn't help it - I loved the flashing lights, the uniforms and working with the medical equipment.

I felt good because I was now part of something much bigger than myself. I knew the city in a way other people did not. I had my fingers on its pulse and knew when it was hurt and scared or celebrating and 'under the influence.' I watched more experienced EMT's and hospital personnel and yes, I continued to study. Emergency care is an ever-changing and evolving field, and I wanted to learn all I could. Then, with my EMT certification and my driver's license I got a job!

Helpful Hints on How to Pass your First EMT Class

1. Find a private & quiet space or corner in your home where you can set up a table, chair and lamp and where you can leave your study materials out without anyone disturbing them.

2. Purchase the book at or before the first day of class. Purchase a highlighter.

3. Post a wall calendar at your study space and mark the dates assignments are due. Look at you class schedule daily. Stay ahead of the reading.

4. Buy a pack of index cards so you can write down vocabulary words or names of medical conditions with the meanings + signs and symptoms written on the back. Carry them around and test yourself whenever you have some spare time during the day.

5. Always complete the assigned reading one or two days before the class.

6. List questions about the assigned reading the day before the class.

7. Listen carefully to the lecture & take notes. If the instructor has not answered your questions in the lecture, then ask.

8. Listen carefully when they review quizzes/exams. Many questions are repeated over and over again.

9. Find a friend in the class that lives near you. Plan to meet before or after class to review notes and test each other on your stack of index cards.

10. During skill sessions, make sure you take your turn at doing the skill. Don't be afraid of making mistakes, practice makes perfect. Sitting there watching others does not develop muscle memory.

11. Attend as many free tutoring sessions as you can. Bring questions, take notes.

12. The book is not a novel (story) and cannot be read that way. Some pages need to be read over and over. Go to your study area every day when you are fully awake and study one topic at a time. Small bites are easier to digest.

13. Be your own coach. Someone needs to make you sit down & study and if mom and dad aren't available any more, then that person is you....READ/STUDY/READ!


CPR & First Aid in your Workplace

If you have spent just one time not knowing what to do in an emergency, then it is time to learn.

We previously spoke about spending a few hours at your workplace learning CPR, so now I must reiterate the benefits of also learning basic first aid skills. There can be hours at the office that turn out to be unproductive time, so why not schedule a CPR and Basic First Aid class for just a few hours before, after or during the work day.

It is knowledge that everyone needs to know so why not do it where you spend the majority of your time. It will not take long and, chances are, it will help you, your loved ones and people around you.

Scheduling a CPR and Basic First Aid Class for your workplace is easy. Depending on how many people you have in your group, the instructor(s) will come to you, bringing along manikins, AED trainers and First Aid supplies so you can practice the skills being taught. All they need is some space. I can remember training groups of people in the hallways, lobbies, libraries or conference rooms of schools, court buildings and even museums. There was never a time when we didn't have fun doing it either. Heart Attacks, Stroke, Allergic Reactions, Diabetes, Choking, Bleeding, Burns, Bites are some of the topics that can be covered. You can also ask that specific subjects be covered if your workplace has a need or an interest. In workplaces dealing with machinery, traumatic injuries can be covered whereas in court buildings with a gym, then medical issues such as heart attacks, stroke and diabetic emergencies would be discussed. We can easily taylor your 'need to know' into a CPR and Basic First Aid Class for your organization, teaching it all in the same day or breaking it up into parts.

Treat your employees to something more important than monthly birthday parties. Allow us to teach them skills that could save a life.

Meet...Todd Rosenhaus

Todd has been an instructor with Emergency Care Programs for many years and is happy to share his EMT history with our students. Let us know if you have any questions for Todd ?

When did you decide you want to become an EMT?
It all started because of the TV show "EMERGENCY" that I watched (and still watch) when I was growing up.

What 1 event (good/bad/ugly) in life factored into your decision to save lives and become an EMT?
Knowing First aid has always been in my family, so I was taught early before becoming an EMT. It was always important to know I had the potential to save a life. Becoming an EMT has just given me more tools to work with.

Did you volunteer / intern as an EMT before you made it your career?
I have been a volunteer for over 30 years. EMS is an unpaid career for me. I do it to give back to the community.

Tell me the best way to find an EMT job?
You need to work hard and do your leg-work, every ambulance company is different. You need to be confident.

What is your Level of Certification? EMT/Paramedic/Lab Instructor/Lead Instructor
I am an EMT and a Senior Instructor (CIC). I also hold a National Registry EMT certificate.

How challenging is it being an EMT?
It's only challenging if you do not put time into your class. Everything is not going to be handed to you on a "Silver Platter". You need to study, practice, and not be afraid to ask questions.

How do you keep sharp in your own skills?
Besides performing my skills on the ambulance, every time I talk to students about a skill, or demonstrate hands on about a skill, I keep sharp.

How is your family life affected – are they supportive of your job?
They always support me; they understand why I do it so maybe they will follow.

What is your most inspirational "save"?
Any save that a person is able to survive is inspirational.

What was your greatest "loss" on the job and how did it affect you?
The greatest loss is that my best friend cannot work with me anymore. He was hurt while working on 9/11 and because of his injuries, and he cannot work. So for a while it was hard to talk to him about EMS but it has been getting better.

How's the comradery on the job with your fellow EMTs?
It's a second family.

What advice can you give others who want to become an EMT?
You need to want it not just for a job but to care that you will make a difference.

Why do you enjoy teaching your students?
I love knowing that I am teaching people who want to make a difference.

How do you encourage others to follow this career path?
I tell them the truth: you are going to have good, bad and ugly days and you need to take it one day at a time. But just think! You will be making a difference to someone.

Words of wisdom for our students / future-EMT's?
Practice, Practice, Practice

CPR in the workplace. Why you want to train your employees.

According to the American Time Use Survey, put out by the Bureau of Labor Statistics, Americans spend approximately 8 hours a day working at their jobs. The next largest chunk of time is spent sleeping at approximately 7.8 hours. Most jobs are conducted in an environment with other players, whether they are your office mates, partners, team or group.

A good way to break out of the mold of everyday work activities is to conduct a CPR Training Class at your work environment. Besides being a welcome change of pace, it stimulates thoughts on healthy living and saving lives. Is there a better way to spend a few hours?

Most CPR classes include a discussion on heart healthy living habits vs. unhealthy ones. This is included to emphasize the fact that individual's who have more than one unhealthy habit, have a much higher risk of developing cardiac and vascular damage than people who follow prudent heart living. This information on unhealthy habits has been slow to reach the public because of many years of advertising lies. They claim tobacco, soft drinks, fast food and breakfast cereals (cigarettes, sugar, salt) are part of the American lifestyle and you MUST have it in your homes and consume large quantities of it. They not only convince you to buy it, but your children as well. It has taken years for the government to put restrictions on the advertising and sale of tobacco products. Unfortunately, much too late for my parents, aunts and uncles who were persuaded that smoking was the thing to do in the roaring 20's. (1920's that is) They died long painful deaths from every kind of cancer. We need to, absolutely, learn what can hurt us, how to prevent it, and what to do if it does. All office or corporate workers can easily learn 'hand's only CPR'. Add in choking (the Heimlich Maneuver) and the use of a public access AED and you have a complete CPR Class.

To be able to recognize the warning signs of heart attacks is knowledge worth having for everyone:

1. Uncomfortable pressure, tightness or squeezing in the chest area.
2. Sweating, nausea or shortness of breath.
3. Back pain or pain moving down the arm or up to the jaw.
4. Skin might be pale, cool and wet.

Encourage your manager or boss to arrange a CPR class for your organization. And when the CPR Instructor arrives at your place of work with the manikins, pay attention and ask questions. Don't worry; they will make it interesting and fun. Just wear clothing that will be comfortable when kneeling over a manikin.

After cardiac problems, the second leading cause of death in Americans is stroke. (A clot or bleed in the brain instead of the heart)

We need to know those warning signs also because FAST transport to a stroke center is the only thing that can reverse permanent disability and death. Here are the Stroke (brain attack) warning signs:

1. F =Facial drooping
2. A =Arm weakness
3. S =Speech difficulties
4. T =Time to call 911

The more people that know CPR, AED and the Heimlich maneuver, then the more people we can keep alive until the ambulance arrives. Knowing CPR is knowledge and knowledge is definitely power.

Meet....Karen Fiorello

Karen has been an instructor with Emergency Care Programs for over a decade and is happy to share her EMT history with our students. Let us know if you have any questions for Karen :)

When did you decide you want to become an EMT?
I actually took the class in high school but was unable to take the state exam due to some personal issues but I loved it. Since then, I became a police officer and then was able to find the time later on to go back and take another original class. I passed with flying colors and I decided that I also wanted to teach people how to save a life.

What 1 event (good/bad/ugly) in life factored into your decision to save lives and become an EMT?
I delivered a baby as a police officer and I knew then I needed to get my EMT Certification. The baby was fine.

Did you volunteer / intern as an EMT before you made it your career?
I volunteered and I still volunteer. I give back to my community in Long Island by volunteering for my local fire house.

Tell me the best way to find an EMT job?
Perseverance and coming to the realization that all jobs are important whether you are doing transport or 911. So apply to many places and understand that no matter who you work for , your job is to save lives.

What is your Level of Certification? EMT/Paramedic/Lab Instructor/Lead Instructor
EMT/CLI/ CIC Lead Instructor

How challenging is it being an EMT?
It's very challenging. You never know what your next call is going to be and no two calls are ever the same. They might be similar but each person is an individual - treat them as such and with respect.

How do you keep sharp in your own skills?
I keep sharp by volunteering and keeping myself out there. Also when I teach I practice my skills as well as teach them.

How is your family life affected – are they supportive of your job?
Sometimes it's hard when you get calls in the middle of the night or stuck on snow standbys but the family supports my decision and is very proud if me

What is your most inspirational "save"?
I have had many but I guess saving my great aunt when she went into respiratory arrest she was 85. She is now 88 and is wonderful- she teaches tap dancing to 3 classes and takes the train from Brooklyn to the city for ballroom dancing .

What was your greatest "loss" on the job and how did it affect you?
9/11 as an EMT and a police officer I will never be the same there are no words to describe how I feel and how badly it has affected me.

How's the comradery on the job with your fellow EMTs?
Working with other EMT's and paramedics is interesting to say the least. Most have a good sense of humor and joke around when the time is right. I think this is kind of a coping mechanism to help deal with the sadder aspects of the job. Most everyone knows when it's time to be serious though.

What advice can you give others who want to become an EMT?
We are a family with both ups and downs but we always have each other's back and will be there when anyone of them needs help. They are your family.

Why do you enjoy teaching your students?
I love being able to give information that may one day save a person's life , I love when they are enthusiastic ... the joy of seeing students so excited when they pass and knowing that I had a hand in it and maybe one day seeing them out in the field.

How do you encourage others to follow this career path?
I encourage them by letting them know they need a passion for this job and that the rewards when you save someone will be so worth it.

Words of wisdom for our students / future-EMT's?
Treat everyone like they are your family members. Practice like the EMT'S you want to come to your house to take care of your family members. Have a sense of humor; if nothing affects you any longer and you have empathy or compassion talk to someone... but never let it get that far.

Stop the Bleed

The world has changed drastically in the last 30 some years. Even our language has evolved. No longer do we use terms like; pay phones, rotary dials, transistor radios, beepers, cassette recorders. We also, no longer use that technology. We are now somewhere between self-driving cars and booking tickets to Mars.
Healthcare has also changed with the times, and some diseases once in circulation have been eradicated. Unfortunately though, new strains of 'not so good stuff' have come into the present.

EMS is trying its best to keep up. One of the things we have to look forward to is a discussion on whether or not to train EMT's in scenes of ASHE (active shooter/hostile event). If you are interested in this topic, EMSWORLD magazine (March 2017 / Vol. 46, NO. 3) has excellent articles on the subject. One is a roundtable discussion with 4 top experts and I strongly encourage you to find the publication and read the article.

One of the first questions they ask of these experts is whether or not EMS should be more proactive in assisting casualties in mass shootings? Some of the experts in this article say scene safety might be an illusion. The questions they bring up must cause us to think. No one can truly say that a scene is absolutely safe until you are far from it, in the safety of your ambulance, driving away. They will not be asking EMT's to go into the line of fire but all of them agree that the emergency system needs a solution.

Another question brought up in this article is weather it is feasible to expect the police to help with the medical stabilization of patients. E. Reed Smith, MD states, " the law enforcement officer who is no longer stopping the killing can very quickly switch over to stopping the dying." He goes on to say that the scope of practice for the police would be very much the same as a current lay-person's knowledge: bleeding control, tourniquet use, compression only CPR, public-access defibrillation, and maintaining body temperature.

What I found enlightening is that some of these experts are advocating for hemorrhage control kits to be displayed right beside AED's in public places. In fact there is a program out there called Stop the Bleed. The goal of the Stop the Bleed program is to make training in bleeding control as common as CPR training and Combat Application Tourniquets (C-A-T's) publicly available, with enough pressure bandages to treat 8 patients, mounted alongside your public-access AED. The article states, "The recommendation to train citizens and all first responders to stop bleeding came out of the Hartford Consensus." "This committee was formed in direct response to the 2012 mass shooting at Sandy Hook Elementary School in Newtown, CT, which left 20 children and 6 staff members dead."

Ed Racht, MD, sums it up and says that an important part of the strategy of responding to ASHE's is preparing law enforcement and other responders for aggressive hemorrhage control. "If law enforcement-which has the training and expertise to go deeper into the uncontrolled hot zone –can rapidly identify and control significant bleeding and bring patients to safety, they can have a significant impact on patient outcome and loss of life." The question is, will they want to?

A similar thing took place when many fire departments strongly encouraged the fire fighters to become CFR's (Certified First Responders), which is the level below EMT. A very large amount of fire fighters I have come across clearly stated to me that all they wanted to do was fight fires. Maybe this narrow tunnel thinking needs to change to a much broader vison and training in the present world of violence and terrorism.

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