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haztacmedic
10-10-2006, 09:56
Ive been instructing the new CLS curriculum for nearly a year now and I agree with the new skills and the deletion of a lot of the old buddy aid stuff. I try to add real life experiences to the class where they apply. What Im asking from any QP but in particular 18-D and SOCM and 91W members is this: Is there anything else that you would include in the class that adds to the class in a way the printed materials and PP presentations lack. (the neat to know type stuff) What type of common sense stuff would you add based on experience.

Another important question to me is: What would you include in the course if you were revising the CLS course?

I am not asking for any opsec violations. I will use the information you provide to assist me in my final year for teaching this course.

My primary motivation for teaching this course is to help soldiers save lives.

Thank you for any input
HTM

highspeedmdd
10-22-2006, 15:55
Well, here are my 2 pennies.

A lot of guys who are CLS qualified seem to think they know all about cric'ing someone.

They all seem to want to cut horizontally across the membrane in one fell swoop/ Good idea to cut vertical along the midline, seek out the membrane and blunt disect or cut once it is found. This helps prevent trauma to lots of vital organs and tissues.

Also, everyone seems to think you can breath through a strw or even a Skillcraft pen. Try it sometime. Doesnt work on a healthy uncompromised adult. It wont work on a patient. I told my soldiers to keep tubing in their pockets for special occassions.

ender18d
10-22-2006, 18:19
Well, here are my 2 pennies.

A lot of guys who are CLS qualified seem to think they know all about cric'ing someone.

They all seem to want to cut horizontally across the membrane in one fell swoop/ Good idea to cut vertical along the midline, seek out the membrane and blunt disect or cut once it is found. This helps prevent trauma to lots of vital organs and tissues.

Also, everyone seems to think you can breath through a strw or even a Skillcraft pen. Try it sometime. Doesnt work on a healthy uncompromised adult. It wont work on a patient. I told my soldiers to keep tubing in their pockets for special occassions.

FWIW: When I wenth through, the 18d course was teaching the horizontal incision method. I believe it still is. (Correct me if I'm wrong). My understanding is that the advantage of this method is that its easier to keep track of the anatomical landmarks with this approach, as opposed to straying high or low after the initial incision. The vertical approach to cric also offers the danger of an unskilled operator damaging the thyroid. The horizontal approach also mirrors the lines of tension, although of course scarring is the last concern when a cric is being considered. The dangers of going too deep and lateral with a horizontal approach are mitigated by tenting the skin, rolling it between the fingers to ensure that no vital structures are trapped, and then making the superficial incision.

I have seen a resident physician get off course and nick an IJ on a vertical approach for a trach...

As far as I'm concerned either approach entails pitfalls if one uses poor technique and is not aware of the relevant anatomy.

BTW.... I'll add those "cric keyrings" we got issued a while back to the list of things that won't poke through a neck.

Agree 100% on breathing through a pen.

soldierdoc_2005
10-23-2006, 12:20
Our Unit just finished CLS for our infantry troops.

Something we try to always do is PRAC APP them right after the didactic presentation. Seems to ease the pains of the Army standard "death by power point".

On the last day, we run a full speed scenario to show them how to put it all together.

Then, we culminate with an STX out doors where we have them work a casualty under TC3. We have them approach, evaluate, evacuate to a "safe" area, treat, then litter carry to a CCP and call in a 9 Line.

They all seem to love that part when we do the AAR because it gives them a chance to see that "in the field" dressings slip, tape doesn't stick to wet skin real well, and reinforces the "continuously reevaluate your casualty" mind-set.

haztacmedic
10-23-2006, 12:52
Highspeedmdd: Performing a Cricothyrotomy (needle or sugical) is not a CLS skill that is taught in the CLS curriculum. Interesing information to share though. Thanks

Rumblyguts
10-23-2006, 13:06
Hello

Wow, just read the above post and it looks like CLS has come a long ways since '94. Good to see!

I'm no expert and am probably stepping out of my lane here, but looking at the above "scenarios" aspect reminded me of a couple Wilderness First Responder courses that I've taken.

The courses run a good combination of classroom and scenarios (like the above post). Each student is evaluated as a scene leader, and as a primary and secondary caregiver to the patients. The major scenarios are videotaped for feedback. I'm not sure if CLS is like this now, but it sure helped me learn the big vs. small picture.

One teaching technique really stands out in my mind:
You are the rescuer and the patient his partner are on the other side of river/impediment of some sort. As the rescuer, you have to talk the patient's friend through your treatments. This little technique worked great for developing clear communication, highlighting lingo/slang/proper nomenclature, and emphasized using your brain more than a "drilled" body (describe a blood sweep as opposed to doing it). It was a refreshing twist to the hands-on elements and used a different part of the brain for all of that educational psychology stuff.

Well, that's my .002 worth.

Cheers,
Bill

Jgood
10-23-2006, 18:58
Am not in the medical feild in any way, but have taken CLS course a couple of diff times(each time there has been a MOI update). I would like to see added to the program more time spent on lowlight treatment and like soldierdoc_2005
did with their class a start to finish approached(from approach to 9 line) added to all MOI for the course.

1/221 Cav medics put on a great course they used movie props,strobe lights, blanks etc during the hands on praticals. we stressful and very productive. first time i had given a IV with a red lens light with all kinds of distractions.