Reauthorization Reminder

Nancy Liebig, VP of Client Services, Technical Support

Back in May, HSI announced the updates to the reauthorization pages in the Otis Training Center Manager portal, including the release of a new requalification option. Many of you have called in for assistance with these options, which prompted us to release a reminder in this month’s newsletter.

Any instructor who has taught their minimum of 2 classes in the last 2 years has options to reauthorize in the Otis portal. However, the option utilized is contingent on how long they’ve been expired (or past their stated instructor-authorization date). We wanted to reiterate those options based on how far the instructor is past the date of expiration of authorization:

1) Reauthorization Within 90 Days of Expiration

Instructors who are within 90 days prior to, or 90 days past, their 2-year authorization date and who have taught their required minimum 2 classes per authorization period (for Instructor Trainers, their required minimum 2 IDC classes).

2) Reauthorization 90 Days After Expiration

Instructors whose authorizations have been expired more than 90 days, but less than 365 days, must requalify prior to reauthorizing. There are two methods for requalification:

1. The instructor can requalify by presenting other current and acceptable teaching and provider credentials (reciprocity)  - or-
2. Successful completion of the online HSI Emergency Care Instructor Requalification Course. This course is $75.00, which includes the online reauthorization fee. Instructors who reauthorize by requalification must complete the assigned HSI Emergency Care Instructor Requalification Course online within 60 days of it being assigned. Once completed, the instructor’s authorization period will be extended to 2 years from the course completion date.

3) Reauthorization One Year After Expiration

Instructors whose authorization is expired one year or longer must meet the Terms and Conditions for New Instructor or Instructor Trainer Authorization, found in the TCAM. This can be accomplished by the successful completion of the blended (online & face-to-face) HSI Emergency Care Instructor Development Course or by presenting other current and acceptable teaching and provider credentials (i.e., via reciprocity).

Often, an instructor has reciprocal instructor credentials (i.e., holds a current instructor authorization or combination of credentials with another nationally recognized organization). That candidate is able to reauthorize using those reciprocal credentials at any time regardless of how long past expiration they are with ASHI or MEDIC First Aid.

As always, we understand new options can cause some confusion, and our team is here to help. If you still have questions, please do not hesitate to call the Client Services team at any time during our regular business hours from 8 a.m. – 8 p.m. Eastern Time, Monday through Friday.

Awarding Continuing Education Hours for EMS Providers

Ralph Shenefelt, Senior Vice President, Regulatory & Quality Assurance

As an accredited organization of CAPCE, HSI is committed to providing high quality EMS Continuing Education. Our CAPCE Organizational Accreditation demonstrates that HSI has voluntarily submitted to an objective assessment of its ability to meet established standards for educational planning, implementation, and evaluation, and that it has met or exceeded those criteria.* CAPCE accreditation exists so that EMS providers have access to standard-driven continuing education activities and are awarded credit for participating in those activities. HSI courses offering CAPCE-approved EMS continuing education hours (CEH) provide a CEH certificate for students who wish to claim CEH credit.

The following HSI courses are CAPCE Accredited:

American Safety & Health Institute

• Basic Life Support
• Advanced Cardiac Life Support
• Pediatric Advanced Life Support

As an accredited organization of CAPCE, HSI and its Training Centers and instructors are required to collect and submit information from each EMS provider who completes a CAPCE-accredited course. While this information must be collected and submitted to HSI, students who are EMS providers are not obligated to accept the CEH or to claim the CEH certificate.

To Offer CEH for ASHI Courses:

1. Before, during, or within 30 days of the blended or classroom course, use the CAPCE Data Collection Form to collect the required information from each EMS professional.
   - The form can be found in Otis>Documents> Curriculum/Program Tool> CAPCE CEH for EMS Professionals
2. Purchase CAPCE CEH credits for EMS professionals
   - Otis>Store>Store Search>“CAPCE”
3. Enter the required information from each EMS professional into the CAPCE roster.
   - HSI will report the CEH directly to CAPCE.
4. Print or email the CAPCE CEH certificate to the student(s).

If you have questions about purchasing CEH for EMS professionals who complete a CAPCE-approved ASHI course, log in to the Otis-supported Training Center Manager, send an email to customerservice@hsi.com, or give us a call at 800-447-3177.

*CAPCE represents only that its accredited programs have met CAPCE standards for accreditation. CAPCE accreditation does not represent that the content conforms to any national, state, or local standard or best practice of any nature.  

AED Trainers – How Do I Choose?

Corey Abraham, Director, Instructor Development

It’s a dilemma I’m sure every instructor has gone through. You’re going to teach a class for a new customer that has AEDs, or maybe a long-time customer has recently purchased an AED, and now it’s time to train their team on how to use their device. Maybe they will ask for device-specific training (ouch…you’ve invested in trainers and they’ve purchased a competitor’s device). Or perhaps they don’t ask for device-specific trainers. Either way, you want to give them the best training experience possible because that is what good emergency care instructors like you do.

Purchasing training equipment is most likely the most important, and expensive, investment instructors and Training Centers make. Whether it’s manikins or AED trainers, you want to get the most bang for your buck as you anticipate the training needs of your current and future customers.

Here are a few things to consider as you research purchasing (or re-purchasing) AED trainers:

Functionality – How does the AED trainer operate? Does it require additional equipment or material as it cycles through its prompts (i.e. manikin strips or remote control)? Does it have different scenarios to choose from (low battery, pads not sticking, etc.)? Is it difficult to get the device ready for the next student as your practice groups work through their training?

Expense – Because you will most likely be buying multiple devices for use in class (remember: MEDIC First Aid and ASHI training requires one for each manikin, so you may be purchasing 2-5 AED trainers, for example), cost is definitely a major consideration. Yet there’s more to this than the simple question of price. As mentioned above, is there additional equipment or materials you will need to purchase for the operation of the device? How many uses can you get out of a set of pads? What type and how many batteries does it take for each device? If there is ever a change to the guidelines that affects AEDs or the CPR algorithm, can the device be updated or will you have to purchase all new trainers?

Customer Expectation – This is really a question of whether you decide to go device-specific, that is to say purchasing an AED trainer model that matches a manufacturer’s device, or go the non-specific route and purchase a trainer that’s not developed by an AED manufacturer. All the AED manufacturers have their own trainer(s) and they have a wide range in price and functionality. This could be a good option for those Training Centers that are also selling AEDs to their customers and steering them toward a specific device. For those TCs, you have the benefit of knowing in advance what type of device your customer has, and you will have invested in your equipment accordingly.

If you choose to go a non-specific route, the functionality and expense of your generic AED trainers come into play as discussed above.

Ultimately, choosing an AED trainer should fit into the business strategy of your Training Center with regard to budget and customer service, always with the goal of continuing to provide the best training experience you can!

Questions about the AED trainers available from HSI? Give your representative a call at 800-447-3177. 

How Do We Improve Layperson Willingness to Use AEDs?

Bill Rowe, Director, Content Development

Years ago, I was amazed by a study on AED implementation at the Chicago area airports. It was one of the first studies to identify the potential impact AEDs could have on survival rates from sudden cardiac arrest. Over a two-year period, 11 out of 21 non-traumatic cardiac arrest patients survived (52%).

As surprising as the survival rate percentage was, the number that actually struck me the most was the fact that 6 of the rescuers in the 11 successful resuscitations had no prior training or experience in using an AED. Literally, they just decided to pick one off the wall and give it a go.

Usability is the term used by AED manufacturers to describe the foolproof nature of operating one successfully. It is a key principle in AED research and development. Even though training increases the likelihood of successful AED use, it is highly likely that an untrained person can effectively use one as well.

A good friend of mine who had a significant historical influence on AED development and training often mused, “If we can just get someone to pull an AED off the wall, we’ve probably done our job.” 

Nice concept, but how are we doing in the real world? Well, here’s the deal: The research is in and the majority of laypeople are still not willing to use an AED. The reasons why may surprise you (or may not). It seems to have a whole lot more to do with user confidence than with AED operation:

• People are afraid they will use an AED incorrectly
• They are afraid of hurting the person the AED is used on
• They are afraid of getting hurt by the AED

Maybe, as emergency care instructors, we are not addressing these concerns as well as we thought. Maybe we need to start focusing a bit more on things that help build user confidence.

Incorrect Use

It’s one thing to learn how to operate an AED in a classroom, but it is a wildly different thing to actually use one in a real-life emergency. One of the highlights of usability is that AEDs are pretty much designed for an untrained user. Without user involvement, they complete an analysis of a heart’s electrical status and, importantly, make the actual decision that a shock should be delivered.

Audio voice instructions tell users what to do and simple graphic images on the pads show exactly where to place them. Impressing upon students the foolproof nature of using an AED can be a big part of building confidence in their ability to use one correctly.

Hurting a Person in Sudden Cardiac Arrest  

Not limited to AED use, the classic classroom statement has been that “You can’t make cardiac arrest any worse.” Embrace that concept when building student confidence in making a decision to get involved in performing CPR and using an AED.

Specifically in regard to an AED, a 40-year history has shown them to be extremely reliable in determining when a shock is needed. Essentially, they only shock when a shock is necessary. They don’t shock when one is not required. A user can’t accidentally or intentionally deliver a shock.

Getting Hurt by an AED

The first commercially available AED, the “Heart-Aid” from the Cardiac Resuscitator Corporation, weighed in at a whopping 19 pounds. To emphasize the inherent safe use of the device way back then, the running joke was to “not drop it on your foot” while using it.

The biggest concern of an AED user is accidentally getting shocked by that big jolt of electricity when defibrillation occurs.

Defibrillator pads replaced the need to use hand-held paddles while defibrillating. Adhesive on the pads secure them firmly to the chest wall and eliminate the need for a rescuer to hold them in place. Basically, AED defibrillation is hands-free.

Pads are also very efficient in making sure a large portion of the electrical current goes through the body from pad to pad, and that very little current escapes onto the skin surface around the pads. While a user could experience a sensation of the current by accident, if in contact with the skin surface during defibrillation (especially around the pads), the amount of energy delivered is generally accepted to be too low to be dangerous (but probably annoying). Some more recent “high-performance CPR” protocols even involve keeping the CPR compressor’s gloved hands near, or even on, the chest wall during defibrillation.     

Final Thought

As an emergency care instructor, take a moment to reflect on how you build user confidence in regard to what the study has showed us. Remember that the majority of people we train and send out into the world are not willing to use an AED in an emergency. Be creative and see what you can do to help improve user confidence and future AED use. Let’s see what we can do to help turn this tide back.

If you enjoyed this article, we've got more on the ASHI and MEDIC First Aid blog! For Sudden Cardiac Arrest Awareness Month, we’re focusing on AEDs, so be sure to subscribe today. You can sign up here: https://emergencycare.hsi.com/blog

Training Center Profiles

Meet Your Peers

Running your own Training Center is both rewarding and challenging. Read on to learn how your peers get it all done and the lessons they’ve learned along the way.

TC Name: United Airlines San Francisco Tech Ops Center

Director of Training: Rick Brown

Instructor and Survey Responder: Leonard Slape

How long have you been an ASHI or MEDIC First Aid TC?

31 years as an emergency care instructor, with 3-5 years as an internal, MEDIC First Aid TC

Based on what you know now, what advice would you have given yourself when you were starting out.

Practice doing a presentation IN FRONT OF A MIRROR, just like an actor practicing his lines. It builds your confidence level, and it also lets you have an opportunity to evaluate your facial expressions and physical reactions to the dialogue. Having that control and confidence in front of a classroom ADDS to your credibility!

Of your business or training investments that cost less than $500, what has given you the best return?

AED simulator

Does your organization offer refresher training?

In our organization, it is required to maintain certification for those who have it.

Where do you go to stay current with the latest industry information and knowledge?

JAMA, American Cardiology Institute, ASHI communications, CEUs that I take periodically to maintain my CMA-AAMA certification.

What is the biggest training challenge at your company?

Getting ALL employees engaged in this training and making them aware of the value of having this knowledge

What is the most difficult part of managing an internal Training Center?

We have to pull the employees out of service for a full shift to accommodate the class, but … getting the employees to actually participate willingly is the most significant challenge, from my perspective.

Can you share a favorite Good Samaritan story about your students?

I had one person tell how he came upon a woman who collapsed on the street right in front of him... a total stranger, but fully unresponsive. [My student went into] "fight or flight" mode, and jumped in to help immediately. [He began] CPR and continued for approximately 6 minutes until medics arrived at the scene and took over the patient's care. He was commended for saving this woman's life by the Paramedic unit, and even had the opportunity to meet the victim (at her request) while she recovered. She suffered from Cardiomegaly, and would never have survived without this man intervening swiftly.

Do you have any specific training tips, such as props, scenarios, or exercises, that you would like to share?

I share my past personal experiences as an EMT, and also my knowledge of cardiology (I have a pacemaker and have had open-heart surgery). One "misnomer" that I love to cover is that, "You cannot 'jump start' a heart with an AED.” A key prop that I use in every class … is to print and hand out copies of rhythm strips for Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT). I explain that there are only two shockable rhythms, as described in our curriculum. I then tell the participants that this is [additional information to help them see how] they are not "jump starting the heart,” but "repolarizing the heart from an arrhythmia.” When they see the squiggly line of Ventricular Fibrillation or the "tombstone waves" of Pulseless Ventricular Tachycardia, it makes [what the AED does] REAL in their eyes, and not just a “machine that shocks the heart.”

Taking that extra two minutes of explanation with visual aids, available on Google, really makes an impact and also tells them how important it is to follow the prompts from the AED in a timely manner.

I also suggest getting "hands on" with performance exercises, and not just telling the class to do what they have seen on the video. Get down on the floor with the mannequin, show the proper way to perform compressions and rescue breaths, then show a bad example of the same exercise. This is not just about instructor credibility, but gives the attendee a real live demonstration that helps their overall performance.  I also feel that it will give them the confidence and courage to engage should the "real deal" ever come before them.

TC Name: Aksa Health Skills, Bangalore, India. https://aksahealthskills.in/

Director: Akhosh Somarajan

How long have you been in business?

3 years, with 8-9 months as an ASHI external TC

What is the biggest challenge for your business?

Educating students about the benefits of ASHI. They know other competitive brands, but we are glad that ASHI is [becoming more well-known] in India.

What do you do to market your training business?

We created awareness [events] at various cities. We visited colleges and hospitals to tell them about [the quality of the ASHI programs.]

Based on what you know now, what advice would you have given yourself when you were starting out?

I would recommend that every health care provider [train with] ASHI.

What are your plans for your Training Center for the next 5-10 years?

[Train more students while keeping costs down]

Of your business or training investments that cost less than $500, what has given you the best return?

ASHI programs

Where do you go to stay current with the latest industry information and knowledge?

Online

Can you share a favorite Good Samaritan story about your students?

Recently, after the training [at a hospital], the staff was able to resuscitate a patient who experienced cardiac arrest during an MRI. They followed the steps for CPR in the proper sequence and resuscitated the patient. [From prior training, they previously performed CPR incorrectly.] The best part was [that the] teamwork during resuscitation was great after [our] classes. The hospital staff [was very appreciative] for the training we gave.

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