Repeat Training Needed for Epi Autoinjectors and Asthma Inhalers

AutoinjectorA recent study from the University of Texas shows that patients frequently do not understand how to self-administer medications with epinephrine autoinjectors and asthma inhalers – considered by most to be easy-to-use medical devices.

Contrary to opinion, this study showed only 7 percent of asthma inhaler users were able to demonstrate correct use of their device. Common errors were not realizing that a horn-type sound from the spacer indicated the inhalation was performed imperfectly and not shaking the inhaler before administering the second medication puff.

In the case of epinephrine autoinjectors only 16 percent of patients with were able to demonstrate correct use. The most common error was not holding the unit in place for at least 10 seconds after triggering. Other errors included the failure to place the needle end of the device on the thigh and failure to depress the device forcefully enough to activate the injection.

Mistakes such as these is one of the reasons Iridia provides support for first responders transitioning from an EMA-FR to an Emergency Medical Responder (EMR) license level – Learn more about the EMR Program.

EMR license protocols outline the roles and responsibilities of firefighters and paramedics who respond to a medical emergency on-scene. The goal of the protocols is to quickly identify and respond to any life threatening medical emergency. Within these protocols, first responders are trained on how to use these devices correctly to support patients should they need to use an inhaler or autoinjector. 

Additionally, Iridia demonstrates proper use of these devices in our Critical Intervention Workshops, designed to review and test emergency response procedures in Non-Hospital settings such as private surgery centers, outpatient and diagnostic facilities.

It is an overlooked fact that many healthcare providers assume patients know how to use these devices. Instead, healthcare providers should take the time to understand the difficulty patients are having with these devices. Most mistakes made by users in the study would have resulted in diminished doses – impacting potentially life-saving treatment if the need arose.

“Repeated verbal instruction and, perhaps even more effective, repeated visual education, including demonstration using trainer devices, are highly recommended. Novel methods of providing this repetitive training for patients are needed,” says Dr. Bonds, author of the study.

 

A Look at the Sun Peaks EMR Pilot

Sun Peak Fire Rescue

Sun Peaks

Sun Peaks Fire Rescue is a rare department. Staffed by 3 full-time fire officers and 20 volunteer firefighters, they have made significant improvements in meeting the emergency response needs of Sun Peaks Mountain Resort Municipality.

These improvements were driven by the need for trained emergency response personnel to attend at the scene of an incident promptly where BC Ambulance paramedics were unable to do so.  To meet this need, Fire Chief Bill Stoner lobbied for his firefighters to improve their pre-hospital emergency skills and training.  As a result of his efforts, Sun Peaks was one of two B.C. fire departments chosen for a pilot project allowing firefighters to use the Emergency Medical Response (EMR) protocols.  SPFR then embarked on the process of upgrading their training of their firefighters to the EMR level. 

Having completed the EMR upgrade and with the assistance of Iridia, Sun Peaks Fire Rescue entered into a pre-hospital care consultation process. Included in this consultation process were the Emergency Health Services Commission, the BC Ambulance Service, BC Ambulance paramedics and emergency room physicians. Through this collaboration, a defined framework was established within which EMR skills could be utilized by the Sun Peaks firefighters. 

Emergency Medical Responder protocols outline the roles and responsibilities of firefighters and paramedics who respond to a medical emergency on-scene. The goal of the protocols is to quickly identify and respond to any potential life threatening medical emergency.

Using the EMR protocols provides firefighters with better tools to attend to a patient’s needs. It allows firefighters to use additional pain relief as well as immobilization tools when responding to emergency situations.

The EMR pilot is an ongoing effort. At this point, the pilot has improved documentation on patient care and interaction between Sun Peaks firefighters, paramedics and physicians. Further improvements in this pre-hospital care will be made throughout the duration of the project and the citizens of Sun Peaks will enjoy the benefits of collaboration and innovation that this pilot project brings.

Comments from Sun Peaks Fire Chief Bill Stoner:

“Sun Peaks Mountain Resort Municipality is a world class resort town which enjoys a number of outstanding facilities.  One facility that the town is lacking however is a British Colombia Ambulance Station.  As such, Sun Peaks depends on ambulance service from the neighbouring community of Kamloops.  Because of this lengthy wait for emergency transport, Sun Peaks Fire undertook a pilot project in 2011 which allows firefighters to operate at the level of Emergency Medical Responder (EMR).  It is believed that using EMR protocol will improve the level of pre-ambulance care that Sun Peaks Fire can offer its patients.
When Sun Peaks began utilizing EMR protocols its members recognized a number of significant benefits; firefighter’s patient assessment skills improved, so they were able to deliver better information to ambulance personnel; the ability to provide Nitro and ASA to patients showing the signs and symptoms of a heart attack was also unquestionably beneficial.   The benefit that provided the most profound impact however, was the ability to provide pain relief with Entonox.
 Although most patients who complain of severe pain are not suffering life threatening conditions, they are experiencing a situation that is distressing, not only to themselves but also to their families and friends, as well as to the first responders who attend the scene; it’s tough to watch someone suffer without being able to help.  Due to the 45 minute wait for an ambulance, Sun Peaks Fire’s patients have had to endure this pain.  With EMR protocol however, fire department members can use Entonox to assist with pain relief.  This relief makes the patient more comfortable and alleviates the stress suffered by friends, family and first responders. 
As Sun Peaks gathers its ongoing statistical data on the EMR Pilot and the potential effects and benefits in saving lives; one thing is for sure, delivering enhanced pre hospital care has allowed its members to provide much better service to the people in the community and great customer service is what Sun Peaks Fire strives to deliver.”

For more information on our service offerings for At Iridia we are thrilled to have the opportunity to have worked with Fire Chief Bill Stoner and Sun Peaks Fire Rescue in the development of the EMR program. We believe the EMR pilot is just the beginning. There is a bright future for BC fire departments and the delivery of pre-hospital care.

 

Sun Peaks – Emergency Medical Responder Protocol

Gallery

Currently, Iridia is working with Sun Peaks Fire Rescue in the development of an Emergency Medical Responder (EMR) protocol.   Emergency Medical Responder Protocol Sun Peaks was one of two B.C. fire departments chosen for a pilot project allowing firefighters to … Continue reading