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FAQ 4: How can one best insure that local emergency medical personnel are knowledgeable about the special needs of Laryngectomees?

Answer provided by Paul Galioni, Susanville, CA
(A laryngectomee and ex-paramedic)

As a former paramedic I can tell you that the best training is to offer yourself and urge others to offer themselves as a 'victim' at trainings.

This does two things: (1) It gets the point across and (2) they will remember you personally - a great benefit.

Most people learn by 'hands-on' because the experience is tactile and visual more than auditory. Most people are not good auditory learners - which is why many do not and cannot complete courses where the material is presented in purely verbal form.

The classic film/video is one produced by the ACS titled 'Check the Neck' which was used in conjunction with CPR training.

The problem with just showing a film is that behavior doesn't change much from just watching a movie - one reason why when we present in ER even the most seasoned ER nurse will shove an oxygen canula under our nose. It isn't that they haven't seen the movies or heard the lecture or even seen a larrie - they have. But people forget.

You see, emergency medicine is a very finely choreographed dance, and it works so well because much happens from habit. It works because 99 percent of the time the dance works perfectly. It may look like chaos from the roadside or from the waiting room - but
you are witnessing one of the most amazing dances in the world - the "Dance of Life".

Movies will stick for just a little bit - maybe. If you see one larrie every five years you are going to forget - and many ER's never see a larrie. The fact that the first thing they do is shove a canula under your nose may seem like the height of incompetence - it isn't. You are taking it way too personally. If you were unconscious they would very rapidly find your stoma - and if your were REALLY out of it as soon as they went to put in an airway they would find out.

My experience is that you should offer yourself and get your friends to offer themselves as 'victims' at trainings. Or ask whoever is in charge of trainings at your local hospital to cover airway use in stomatized patients. You see, if you are conscious you can move the canula or mask to your neck. If you can't then you have some pretty major hurt going on and the film will not tell ER staff or field personnel what they need to know. The film was made for relatively amateurish adventures in first aid in the field, and is not meant for professionals - professionals use very different equipment than Basic Life Support trained people use.

So - to really change the behavior of people they need hands on experience. Your experience with emergency medicine while conscious is not the same experience you would have were you unconscious. They are two completely different dances. They only look the same to the general public.

Just as I cannot tell the difference between an opera sung with stunning grace and an opera sung with professional competence - people not trained don't see the subtle differences.

And, above all, just remember that your medical providers are people and are allowed to make mistakes. Even if they make a mistake with you. The problem is when a pattern of mistakes occur and no corrective action is taken. That is what BUMQA - Board of Medical Quality Assurance - is all about.

If you want the freedom to make mistakes, you must give that right to others. Just because you go to medical school doesn't exempt you from the frailties of human life. Medical School makes you a Doctor, not perfect. Give your medical care providers a
break. It is a drag when you are the one the mistake is made upon - but that is the nature of mistakes when people provide services for others - it is simply Human Nature.

Training can never be simply "show a movie talk a little bit and go home". If it were, we would all be doctors and lawyers and accountants or CEO's for Trans-National conglomerates pulling in millions of dollars a year.

So - if people are truly concerned let them get involved with their community. Don't show a movie - show yourself.


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