Its been a tough lesson to learn in the last few months that it is easier to maintain skill and knowledge than it is to try and replace it once time and disuse have taken their toll. The theory is that the subjects and skills least used should be the most often refreshed, but the tendency is to focus on the things that you use the most.
I don't think that cpr should require refreshment quite as often as we do it. I've used the heck out of my cpr cert and I try and being an instructor, I've never met a medic that really needed more information than an update on the latest numbers; we're now @ 30-2 for 2 rescuer adult cpr. Most people who have a card will look at that last sentence, nod their heads and do good cpr. For those who don't do good cpr, we should be less shy about reccomending re mediation.
When I study I like to take a lot of quizzes. Quiz banks are helpful because they give you bench marks. You figure out very quickly what you know and what you don't know. Focus on what you don't know. I do very well with high yield studying. It is the basis of many of these professional test prep program.
Focus on your most weakly reinforced areas.
The other day I was given an opportunity to put my hands on every piece of equipment on my truck. The question that the training director asked first was which equipment was new to me. I've never had any contact with a king airway until now. When I first stared out in EMS in 2002the king was largely unknown if it existed at all. I was trained on comb i-tubes and ET tubes as primary airway devices (though I now question the wisdom of the "8 intubate" crowd) so I focused on building familiarity with this new adjunct. I'll hit the lab again every few weeks to focus on proficiency, for this and other skills.
The second question that was asked of me was which items have I not used recently. I needed to brush up on a lot of my secondary splinting devices. Localized trauma requiring more splinting than a frac pack is less frequent than the more generalized multi-system trauma. For a shotgun blast of splinting, a frac pack and long back board can take you a long way. More involved secondary devices, the traction splints especially as well as the KED, tend to gather dust being brought out only slight more often the. MAST trousers and the ever present sandbag. I was able to retrain on these devices without having to sacrifice my pride.
My goal for the next year is to begin going through each device and skill that I could possibly employ and brush up. Its been far too long for some of these, and I'd hate to be ill equipped to handle a situation, but honestly I've let too much knowledge and skill atrophy to approach this with the type of confidence that I would like to. While I'm still competent, I'm taking aim at greater proficiency.
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