Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. -MH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 , I'm sorry I can't provide any help, since you are already going through the legal issues you're already going to anywhere I would advise. That said, when you get through all the hurdles, would you consider posting a short summary of what you have learned so that the rest of us can learn from your experience? My limited experience with using translators for the deaf is that you need a couple of them because they do trade out on a frequent basis but they have never had me alter a conversation in order for them to keep up. The ones who do this professionally are very skilled. (I even saw one who did a back-translation of sign to verbal for a deaf presenter at a conference one time.) Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Hudson Sent: Monday, August 04, 2008 3:50 PM To: texasems-l Subject: Deaf Student I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. -MH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 Mike, I had a young girl in my EMT class at Tyler Junior College. She did great. The next semester she enrolled in the paramedic curriculum. During the course of the first semester, I grew a beard. One night following class she came to me and said, " Mr. , I can't read your lips with that beard. " I had no idea she was deaf. I had taught her one semester in the EMT course and did not know she was deaf. Anyway, I went home that night and shaved off my beard. Just thought this might be interesting to you. > > I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. > > > >-MH > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 I remember that same student. She wasn't entirely deaf - she had a hearing aid and supplemented it with reading lips, which was why she couldn't " hear " when grew a beard. The issue she had with me that changed the way I do things was that I was bad about talking to the markerboard/blackboard - talking while writing. I learned to write and then face the group before I would speak about what I had written. It helped tremendously. Sometimes we don't realize what bad habits we have as instructors or how things we do (like grow a beard or not enunciate clearly with our lips) can affect our students. Some hearing impaired students are reluctant to let the instructors know because they fear being treated differently. Jane Dinsmore To: texasems-l@...: raaems605@...: Mon, 4 Aug 2008 20:37:37 -0400Subject: Re: Deaf Student Mike, I had a young girl in my EMT class at Tyler Junior College. She did great. The next semester she enrolled in the paramedic curriculum. During the course of the first semester, I grew a beard. One night following class she came to me and said, " Mr. , I can't read your lips with that beard. " I had no idea she was deaf. I had taught her one semester in the EMT course and did not know she was deaf. Anyway, I went home that night and shaved off my beard. Just thought this might be interesting to you. > > I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. > > > >-MH > > > > > > > > > > > > > > > > > > > > > _________________________________________________________________ Got Game? Win Prizes in the Windows Live Hotmail Mobile Summer Games Trivia Contest http://www.gowindowslive.com/summergames?ocid=TXT_TAGHM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 Excellent point Jane. When I took my first instructor class in the days of horse and buggy the lead instructor hand a habit of opening and closing a Rodgers Pointer (trip to LaDonna for anyone under 30 that knows what that is) drove most of us mad, in his demo for the taping of your 5 minute teach back he says " do I do that all the time? " The class in near unison said YES he stopped. Taping ones self can be an eye opener. LNM from Baku, Azerbaijan Sent via BlackBerry by AT & T Re: Deaf Student Mike, I had a young girl in my EMT class at Tyler Junior College. She did great. The next semester she enrolled in the paramedic curriculum. During the course of the first semester, I grew a beard. One night following class she came to me and said, " Mr. , I can't read your lips with that beard. " I had no idea she was deaf. I had taught her one semester in the EMT course and did not know she was deaf. Anyway, I went home that night and shaved off my beard. Just thought this might be interesting to you. > > I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. > > > >-MH > > > > > > > > > > > > > > > > > > > > > _________________________________________________________________ Got Game? Win Prizes in the Windows Live Hotmail Mobile Summer Games Trivia Contest http://www.gowindowslive.com/summergames?ocid=TXT_TAGHM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 As a lifelong learner with a life long hearing impairment I think I can add something here. I would encourage instructors to watch where students are sitting (is it always on the same side of the room), body language (do they turn their head so that their face is pointed toward you shoulder even if they are making eye contact...this points the ear to the mouth) or do they seem to look frustrated when there is a lot of background noise interfering with the sound of your voice. Jane is right; a lot of people don't want to draw attention and over the years have learned to compensate for their disabilities. (Particularly if it's a partial loss that's not bad enough for hearing aids like mine is.) One time when I was teaching a class and we were discussing disabilities I mentioned that I had one. Of a class that was half disability examiners and half support staff, it was the support staff that identified my hearing disability first. They noticed the body language. Watch your students for clues and if you feel comfortable ask them in private if they have any issues and what you can do as an instructor to help them be successful. It's usually a little thing like Jane and mentioned that can make a world of difference to the student. It can also help build the trust/respect between student-teacher so that the student isn't afraid of asking for help if they need it. Barry Barry Sharp, MSHP, CHES Program Coordinator Tobacco Prevention & Control Texas Dept. of State Health Services Barry.Sharp@... PLEASE NOTE NEW MAILING ADDRESS: P.O. Box 149347 Mail Code 2018 Austin, Texas 78714-9347 ________________________________ From: texasems-l [mailto:texasems-l ] On Behalf Of Jane Dinsmore Sent: Tuesday, August 05, 2008 9:35 AM To: texasems-l Subject: RE: Deaf Student I remember that same student. She wasn't entirely deaf - she had a hearing aid and supplemented it with reading lips, which was why she couldn't " hear " when grew a beard. The issue she had with me that changed the way I do things was that I was bad about talking to the markerboard/blackboard - talking while writing. I learned to write and then face the group before I would speak about what I had written. It helped tremendously. Sometimes we don't realize what bad habits we have as instructors or how things we do (like grow a beard or not enunciate clearly with our lips) can affect our students. Some hearing impaired students are reluctant to let the instructors know because they fear being treated differently. Jane Dinsmore To: texasems-l@... <mailto:texasems-l%40yahoogroups.comFrom> : raaems605@... <mailto:raaems605%40nctv.comDate> : Mon, 4 Aug 2008 20:37:37 -0400Subject: Re: Deaf Student Mike, I had a young girl in my EMT class at Tyler Junior College. She did great. The next semester she enrolled in the paramedic curriculum. During the course of the first semester, I grew a beard. One night following class she came to me and said, " Mr. , I can't read your lips with that beard. " I had no idea she was deaf. I had taught her one semester in the EMT course and did not know she was deaf. Anyway, I went home that night and shaved off my beard. Just thought this might be interesting to you. > > I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. > > > >-MH > > > > > > > > > > > > > > > > > > > & ! gt; > __________________________________________________________ Got Game? Win Prizes in the Windows Live Hotmail Mobile Summer Games Trivia Contest http://www.gowindowslive.com/summergames?ocid=TXT_TAGHM <http://www.gowindowslive.com/summergames?ocid=TXT_TAGHM> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 That is wonderful advice, Barry. Even seasoned instructors don't always have the experience to pick this kind of stuff up, and your advice is beneficial to us all. Jane Dinsmore To: texasems-l@...: barry.sharp@...: Tue, 5 Aug 2008 10:16:45 -0500Subject: RE: Deaf Student As a lifelong learner with a life long hearing impairment I think I canadd something here. I would encourage instructors to watch wherestudents are sitting (is it always on the same side of the room), bodylanguage (do they turn their head so that their face is pointed towardyou shoulder even if they are making eye contact...this points the earto the mouth) or do they seem to look frustrated when there is a lot ofbackground noise interfering with the sound of your voice. Jane is right; a lot of people don't want to draw attention and over theyears have learned to compensate for their disabilities. (Particularlyif it's a partial loss that's not bad enough for hearing aids like mineis.) One time when I was teaching a class and we were discussingdisabilities I mentioned that I had one. Of a class that was halfdisability examiners and half support staff, it was the support staffthat identified my hearing disability first. They noticed the bodylanguage.Watch your students for clues and if you feel comfortable ask them inprivate if they have any issues and what you can do as an instructor tohelp them be successful. It's usually a little thing like Jane and mentioned that can make a world of difference to the student. Itcan also help build the trust/respect between student-teacher so thatthe student isn't afraid of asking for help if they need it.BarryBarry Sharp, MSHP, CHESProgram CoordinatorTobacco Prevention & ControlTexas Dept. of State Health ServicesBarry.Sharp@... NOTE NEW MAILING ADDRESS:P.O. Box 149347Mail Code 2018Austin, Texas 78714-9347________________________________From: texasems-l [mailto:texasems-l ] OnBehalf Of Jane DinsmoreSent: Tuesday, August 05, 2008 9:35 AMTo: texasems-l@...: RE: Deaf StudentI remember that same student. She wasn't entirely deaf - she had ahearing aid and supplemented it with reading lips, which was why shecouldn't " hear " when grew a beard. The issue she had with methat changed the way I do things was that I was bad about talking to themarkerboard/blackboard - talking while writing. I learned to write andthen face the group before I would speak about what I had written. Ithelped tremendously.Sometimes we don't realize what bad habits we have as instructors or howthings we do (like grow a beard or not enunciate clearly with our lips)can affect our students. Some hearing impaired students are reluctant tolet the instructors know because they fear being treated differently.Jane DinsmoreTo: texasems-l@...<mailto:texasems-l%40yahoogroups.comFrom> : raaems605@...<mailto:raaems605%40nctv.comDate> : Mon, 4 Aug 2008 20:37:37-0400Subject: Re: Deaf StudentMike, I had a young girl in my EMT class at Tyler Junior College. Shedid great. The next semester she enrolled in the paramedic curriculum.During the course of the first semester, I grew a beard. One nightfollowing class she came to me and said, " Mr. , I can't read yourlips with that beard. " I had no idea she was deaf. I had taught her onesemester in the EMT course and did not know she was deaf. Anyway, I wenthome that night and shaved off my beard. Just thought this might beinteresting to you. > > I will have a deaf student in anEMT program starting next month. Looking for insight and experience anyinstructor of coordinator has had with classroom management,translators, skills sessions, ect. We're already going through all ofthe legal disabilities processes. BTW, the NR is no help(duh). Pleasee-mail privately. > > > >-MH > > > > > > > > > > > > > > > > > > > & !gt; > __________________________________________________________Got Game? Win Prizes in the Windows Live Hotmail Mobile Summer GamesTrivia Contesthttp://www.gowindowslive.com/summergames?ocid=TXT_TAGHM<http://www.gowind\ owslive.com/summergames?ocid=TXT_TAGHM> [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 First I wear a hearing aid so I know you can do EMS with a hearing deficit. But if student is completely deaf would they ever be able to actually do EMS work? I ask because so much of out treatment is based on what our senses including hearing tell us. A monitor can tell you a persons heart has electrical activity, our fingers can tell us they have mechanical activity, but our hearing detects whether the heart is lub dub or is got extra sounds that could indicate a problem, just as one example. Also hearing is required to get an accurate picture of lung function. Again we have capnography, we also see chest rise and fall, we can feel their breath, and we can smell it(wish we didn't sometimes). But we would miss again many problems by not getting the lung sounds. I'm not saying the education would not be benificial but just wonder if you could really do EMS if completely deaf? Now another thought though. In the past I lived near a College for the Deaf and made many friends which was hard to do. Why? Because the deaf community is tight knit and like anyone else, are more comfortable with others with similiar life situations. Also some have been ridiculed or had problems with hearing people so choose to isolate themselves. So perhaps this deaf EMS student could help bridge a gap between the hearing and deaf communitys in your area. Perhaps this student would be able to help the deaf community learn how to properly utilize the 911 system and at the same time help hearing providers to better know how to treat those with hearing impairments. Look at the paramedic and other EMS texts and there is a paragraph or two about how to treat a deaf patient. We all could benefit from a greater understanding of the deaf community. Sorry for my rambling thoughts and questions. Renny Spencer EMT-I Paramedic Student (will I ever finish? ;/ ) > > I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately. > > -MH > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 I think those are terrific thoughts, Renny. I do think it would be very difficult if the student is entirely deaf to fully function in the 911 environment due to the need to be able to hear so many things. However, that doesn't mean there is no PLACE in the EMS environment for people who are hearing impaired or even totally deaf. I think it is definitely an underserved population in our patient groups, and the best person to assist the EMS community in those issues is someone who suffers those issues. In fact, that goes for most of our special needs populations. Just because someone may have difficulty hearing the patient's breath sounds, heart sounds, or even their verbalized patient history doesn't mean that there is no role for them, any more than it means my friend at LCRA who is in a wheelchair shouldn't function as a First Responder. I hear tell that he has been known to thrown himself on the floor out of the wheelchair to do ventilations or even compressions (he has massive upper body strength). He may not can lift a patient or carry a stretcher, but he has a role and is heavily involved in education. Jane Dinsmore To: texasems-l@...: spenair@...: Tue, 5 Aug 2008 18:05:18 +0000Subject: Re: Deaf Student First I wear a hearing aid so I know you can do EMS with a hearing deficit. But if student is completely deaf would they ever be able to actually do EMS work? I ask because so much of out treatment is based on what our senses including hearing tell us. A monitor can tell you a persons heart has electrical activity, our fingers can tell us they have mechanical activity, but our hearing detects whether the heart is lub dub or is got extra sounds that could indicate a problem, just as one example. Also hearing is required to get an accurate picture of lung function. Again we have capnography, we also see chest rise and fall, we can feel their breath, and we can smell it(wish we didn't sometimes). But we would miss again many problems by not getting the lung sounds.I'm not saying the education would not be benificial but just wonder if you could really do EMS if completely deaf?Now another thought though. In the past I lived near a College for the Deaf and made many friends which was hard to do. Why? Because the deaf community is tight knit and like anyone else, are more comfortable with others with similiar life situations. Also some have been ridiculed or had problems with hearing people so choose to isolate themselves. So perhaps this deaf EMS student could help bridge a gap between the hearing and deaf communitys in your area. Perhaps this student would be able to help the deaf community learn how to properly utilize the 911 system and at the same time help hearing providers to better know how to treat those with hearing impairments. Look at the paramedic and other EMS texts and there is a paragraph or two about how to treat a deaf patient. We all could benefit from a greater understanding of the deaf community. Sorry for my rambling thoughts and questions.Renny SpencerEMT-IParamedic Student (will I ever finish? ;/ )>> I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately.> > -MH> _________________________________________________________________ Get Windows Live and get whatever you need, wherever you are. Start here. http://www.windowslive.com/default.html?ocid=TXT_TAGLM_WL_Home_082008 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 My points exactly. Why can't there be a certified deaf EMT taking care of deaf patients???? Everybody always says think out of the box. Let's actually do something outside of the box. Many thanks to those who I have communicated with on this list, very inspiring and uplifting. We handicap people by our designs. I have found our regulators and certification agencies really don't have a plan for people with disabilities. It's thrown out to the coordinator/program to take the hit. Teaching since 1985 and coordinating since 1990, I've found this about every time I've had a student with a disability. Through a response I found an organization for hearing impaired healthcare providers. They are a wealth of information. Go to www.amphl.org<http://www.amphl.org/> This is a good thread of discussion. -MH ________________________________ From: texasems-l [texasems-l ] On Behalf Of Jane Dinsmore [texas.paramedic@...] Sent: Tuesday, August 05, 2008 2:42 PM To: texasems-l Subject: RE: Re: Deaf Student I think those are terrific thoughts, Renny. I do think it would be very difficult if the student is entirely deaf to fully function in the 911 environment due to the need to be able to hear so many things. However, that doesn't mean there is no PLACE in the EMS environment for people who are hearing impaired or even totally deaf. I think it is definitely an underserved population in our patient groups, and the best person to assist the EMS community in those issues is someone who suffers those issues. In fact, that goes for most of our special needs populations. Just because someone may have difficulty hearing the patient's breath sounds, heart sounds, or even their verbalized patient history doesn't mean that there is no role for them, any more than it means my friend at LCRA who is in a wheelchair shouldn't function as a First Responder. I hear tell that he has been known to thrown himself on the floor out of the wheelchair to do ventilations or even compressions (he has massive upper body strength). He may not can lift a patient or carry a stretcher, but he has a role and is heavily involved in education. Jane Dinsmore To: texasems-l@...<mailto:texasems-l%40yahoogroups.comFrom>: spenair@...<mailto:spenair%40yahoo.comDate>: Tue, 5 Aug 2008 18:05:18 +0000Subject: Re: Deaf Student First I wear a hearing aid so I know you can do EMS with a hearing deficit. But if student is completely deaf would they ever be able to actually do EMS work? I ask because so much of out treatment is based on what our senses including hearing tell us. A monitor can tell you a persons heart has electrical activity, our fingers can tell us they have mechanical activity, but our hearing detects whether the heart is lub dub or is got extra sounds that could indicate a problem, just as one example. Also hearing is required to get an accurate picture of lung function. Again we have capnography, we also see chest rise and fall, we can feel their breath, and we can smell it(wish we didn't sometimes). But we would miss again many problems by not getting the lung sounds.I'm not saying the education would not be benificial but just wonder if you could really do EMS if completely deaf?Now another thought though. In the past I lived near a College for the Deaf and made many friends which was hard to do. Why? Because the deaf community is tight knit and like anyone else, are more comfortable with others with similiar life situations. Also some have been ridiculed or had problems with hearing people so choose to isolate themselves. So perhaps this deaf EMS student could help bridge a gap between the hearing and deaf communitys in your area. Perhaps this student would be able to help the deaf community learn how to properly utilize the 911 system and at the same time help hearing providers to better know how to treat those with hearing impairments. Look at the paramedic and other EMS texts and there is a paragraph or two about how to treat a deaf patient. We all could benefit from a greater understanding of the deaf community. Sorry for my rambling thoughts and questions.Renny SpencerEMT-IParamedic Student (will I ever finish? ;/ )>> I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately.> > -MH> __________________________________________________________ Get Windows Live and get whatever you need, wherever you are. Start here. http://www.windowslive.com/default.html?ocid=TXT_TAGLM_WL_Home_082008 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 And don't forget inspection of the anterior chest wall for barrel chest, palpating for symmetric chest expansion and lumps, masses, and crepitus, diaphoresis, temperature, color, intercostal retractions or bulging, jugular vein flatness or distention, looking for kyphosis, pectus excavatum, pectus carinatum, scoliosis, respiratory patterns, and, as you noted, checking for increased or decreased tactile fremitus, rhonchal fremitus, and pleural frection fremitus, tracheal shift, finding the point of maximum impulse of the heart (PMI), looking at the neck for retractions, muscular hypertrophy, the face for general facial expression, pursed lips, dilated nares, and so forth. I mention these things not to be a smartass, but to point out how much there is to know about physical examination that doesn't involve hearing, that can be done through palpation and inspection. GG > > " I also question how we can certify a person who can not auscultate > heart sounds, or blood pressures or collect a history from the majority > of the patients they would come into contact with. " > > You mean, as opposed to the thousands of already-practicing EMTs who use > the NIBP machine to get a pressure, the pulse oximeter to get a heart > rate, and who classify lung sounds as " junky, " on the odd occasion where > they actually *do* listen to a chest, and who do more talking during a > patient interview than listening? > > That kind of certified EMT? > > Well, let's see...how about palpating blood pressures , backed up by > automatic NIBP, checking for respiratory effectiveness by palpating, > inspecting, feeling for tactile fremitus, etc, using waveform > capnography to detect bronchospasm, and when interviewing patients, > making *eye contact* with them and encouraging them to talk - which, by > the way, the hearing EMT should be doing anyway? > > And if you're auscultating heart sounds in the back of the rig, the vast > majority of the time, you can classify those sounds as " lub-dub " or > " Powerstroke diesel engine. " > > I will grant you, however, that auscultating on the scene does allow us > to hear an occasional S3 or S4 sound through the far more frequently > heard " Hurst tool, " " hysterical bystander " or " radio traffic. " > > -- > Grayson, CCEMT-P > www.kellygrayson. ww > > > ************** Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos. (http://autos.aol.com/cars-BMW-128-2008/expert-review?ncid=aolaut00050000000017 ) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 Jane, You may remember we had this situation here at TJC and it was a serious learning experience for all of us. It took two folks per class to sign for the student and the clinical aspect was hospital only. I think a partial hearing loss is a situation that many of us myself included deal with on a daily basis. For the totally deaf student it is going to be very difficult to put them in an uncontrolled environment. My particular student was not able to read lips or hear anything at all. It did have an effect on his course work since he was not able to hear first hand what was being said even though his signers were very diligent and actually read the chapters ahead of the class. I also question how we can certify a person who can not auscultate heart sounds, or blood pressures or collect a history from the majority of the patients they would come into contact with. It was my understanding our student had job waiting on him with the school for the deaf in Austin and he indicated that DSHS was going to grant him an exemption. I have not seen where any of that came to pass. Dave T. Subject: RE: Re: Deaf Student To: texasems-l Date: Tuesday, August 5, 2008, 2:42 PM I think those are terrific thoughts, Renny. I do think it would be very difficult if the student is entirely deaf to fully function in the 911 environment due to the need to be able to hear so many things. However, that doesn't mean there is no PLACE in the EMS environment for people who are hearing impaired or even totally deaf. I think it is definitely an underserved population in our patient groups, and the best person to assist the EMS community in those issues is someone who suffers those issues. In fact, that goes for most of our special needs populations. Just because someone may have difficulty hearing the patient's breath sounds, heart sounds, or even their verbalized patient history doesn't mean that there is no role for them, any more than it means my friend at LCRA who is in a wheelchair shouldn't function as a First Responder. I hear tell that he has been known to thrown himself on the floor out of the wheelchair to do ventilations or even compressions (he has massive upper body strength). He may not can lift a patient or carry a stretcher, but he has a role and is heavily involved in education. Jane Dinsmore To: texasems-l@yahoogro ups.comFrom: spenair (AT) yahoo (DOT) comDate: Tue, 5 Aug 2008 18:05:18 +0000Subject: Re: Deaf Student First I wear a hearing aid so I know you can do EMS with a hearing deficit. But if student is completely deaf would they ever be able to actually do EMS work? I ask because so much of out treatment is based on what our senses including hearing tell us. A monitor can tell you a persons heart has electrical activity, our fingers can tell us they have mechanical activity, but our hearing detects whether the heart is lub dub or is got extra sounds that could indicate a problem, just as one example. Also hearing is required to get an accurate picture of lung function. Again we have capnography, we also see chest rise and fall, we can feel their breath, and we can smell it(wish we didn't sometimes). But we would miss again many problems by not getting the lung sounds.I'm not saying the education would not be benificial but just wonder if you could really do EMS if completely deaf?Now another thought though. In the past I lived near a College for the Deaf and made many friends which was hard to do. Why? Because the deaf community is tight knit and like anyone else, are more comfortable with others with similiar life situations. Also some have been ridiculed or had problems with hearing people so choose to isolate themselves. So perhaps this deaf EMS student could help bridge a gap between the hearing and deaf communitys in your area. Perhaps this student would be able to help the deaf community learn how to properly utilize the 911 system and at the same time help hearing providers to better know how to treat those with hearing impairments. Look at the paramedic and other EMS texts and there is a paragraph or two about how to treat a deaf patient. We all could benefit from a greater understanding of the deaf community. Sorry for my rambling thoughts and questions.Renny SpencerEMT-IParamed ic Student (will I ever finish? ;/ )>> I will have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately.> > -MH> ____________ _________ _________ _________ _________ _________ _ Get Windows Live and get whatever you need, wherever you are. Start here. http://www.windowsl ive.com/default. html?ocid= TXT_TAGLM_ WL_Home_082008 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 Dave, I had a student in a class that I coordinated in Waskom, Texas. Although he was legally deaf, he wanted to take the EMT-Basic course. I contacted TDSHS regarding the auscultation of B/P and was told that he would have to pass the skills station, just like any other student. The student found a stethoscope for hearing impaired which cost between $300 and $400. He was able to pass the auscultaion of B/P. I was really impressed with his desire to become certified and to spend that much money on the equipment necessary. Champion EMS > Jane, > >You may remember we had this situation here at TJC and it was a serious learning experience for all of us. It took two folks per class to sign for the student and the clinical aspect was hospital only. I think a partial hearing loss is a situation that many of us myself included deal with on a daily basis. For the totally deaf student it is going to be very difficult to put them in an uncontrolled environment. My particular student was not able to read lips or hear anything at all. It did have an effect on his course work since he was not able to hear first hand what was being said even though his signers were very diligent and actually read the chapters ahead of the class. I also question how we can certify a person who can not auscultate heart sounds, or blood pressures or collect a history from the majority of the patients they would come into contact with. It was my understanding our student had job waiting on him with the school for the deaf in > > Austin and he indicated that DSHS was going to grant him an exemption. I have not seen where any of that came to pass. > > > >Dave T. > > > > > > > > > >Subject: RE: Re: Deaf Student > >To: texasems-l > >Date: Tuesday, August 5, 2008, 2:42 PM > > > >I think those are terrific thoughts, Renny. I do think it would be very difficult if the student is entirely deaf to fully function in the 911 environment due to the need to be able to hear so many things. However, that doesn't mean there is no PLACE in the EMS environment for people who are hearing impaired or even totally deaf. I think it is definitely an underserved population in our patient groups, and the best person to assist the EMS community in those issues is someone who suffers those issues. > > > >In fact, that goes for most of our special needs populations. Just because someone may have difficulty hearing the patient's breath sounds, heart sounds, or even their verbalized patient history doesn't mean that there is no role for them, any more than it means my friend at LCRA who is in a wheelchair shouldn't function as a First Responder. I hear tell that he has been known to thrown himself on the floor out of the wheelchair to do ventilations or even compressions (he has massive upper body strength). He may not can lift a patient or carry a stretcher, but he has a role and is heavily involved in education. > > > >Jane Dinsmore > > > >To: texasems-l@yahoogro ups.comFrom: spenair (AT) yahoo (DOT) comDate: Tue, 5 Aug 2008 18:05:18 +0000Subject: Re: Deaf Student > > > >First I wear a hearing aid so I know you can do EMS with a hearing deficit. But if student is completely deaf would they ever be able to actually do EMS work? I ask because so much of out treatment is based on what our senses including hearing tell us. A monitor can tell you a persons heart has electrical activity, our fingers can tell us they have mechanical activity, but our hearing detects whether the heart is lub dub or is got extra sounds that could indicate a problem, just as one example. Also hearing is required to get an accurate picture of lung function. Again we have capnography, we also see chest rise and fall, we can feel their breath, and we can smell it(wish we didn't sometimes). But we would miss again many problems by not getting the lung sounds.I'm not saying the education would not be benificial but just wonder if you could really do EMS if completely deaf?Now another thought though. In the past I lived near a College for the Deaf and > > made many friends which was hard to do. Why? Because the deaf community is tight knit and like anyone else, are more comfortable with others with similiar life situations. Also some have been ridiculed or had problems with hearing people so choose to isolate themselves. So perhaps this deaf EMS student could help bridge a gap between the hearing and deaf communitys in your area. Perhaps this student would be able to help the deaf community learn how to properly utilize the 911 system and at the same time help hearing providers to better know how to treat those with hearing impairments. Look at the paramedic and other EMS texts and there is a paragraph or two about how to treat a deaf patient. We all could benefit from a greater understanding of the deaf community. Sorry for my rambling thoughts and questions.Renny SpencerEMT-IParamed ic Student (will I ever finish? ;/ )>> I will > > have a deaf student in an EMT program starting next month. Looking for insight and experience any instructor of coordinator has had with classroom management, translators, skills sessions, ect. We're already going through all of the legal disabilities processes. BTW, the NR is no help(duh). Please e-mail privately.> > - MH> > > > >____________ _________ _________ _________ _________ _________ _ > >Get Windows Live and get whatever you need, wherever you are. Start here. > >http://www.windowsl ive.com/default. html?ocid= TXT_TAGLM_ WL_Home_082008 > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2008 Report Share Posted August 6, 2008 " I also question how we can certify a person who can not auscultate heart sounds, or blood pressures or collect a history from the majority of the patients they would come into contact with. " You mean, as opposed to the thousands of already-practicing EMTs who use the NIBP machine to get a pressure, the pulse oximeter to get a heart rate, and who classify lung sounds as " junky, " on the odd occasion where they actually *do* listen to a chest, and who do more talking during a patient interview than listening? That kind of certified EMT? Well, let's see...how about palpating blood pressures , backed up by automatic NIBP, checking for respiratory effectiveness by palpating, inspecting, feeling for tactile fremitus, etc, using waveform capnography to detect bronchospasm, and when interviewing patients, making *eye contact* with them and encouraging them to talk - which, by the way, the hearing EMT should be doing anyway? And if you're auscultating heart sounds in the back of the rig, the vast majority of the time, you can classify those sounds as " lub-dub " or " Powerstroke diesel engine. " I will grant you, however, that auscultating on the scene does allow us to hear an occasional S3 or S4 sound through the far more frequently heard " Hurst tool, " " hysterical bystander " or " radio traffic. " -- Grayson, CCEMT-P www.kellygrayson.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2008 Report Share Posted August 7, 2008 After pointing out most of these assessment techniques, the NR told me deaf people are not suited for EMS and need to look for another profession.... -MH ________________________________ From: texasems-l [texasems-l ] On Behalf Of wegandy1938@... [wegandy1938@...] Sent: Wednesday, August 06, 2008 9:22 PM To: texasems-l Subject: Re: Re: Deaf Student And don't forget inspection of the anterior chest wall for barrel chest, palpating for symmetric chest expansion and lumps, masses, and crepitus, diaphoresis, temperature, color, intercostal retractions or bulging, jugular vein flatness or distention, looking for kyphosis, pectus excavatum, pectus carinatum, scoliosis, respiratory patterns, and, as you noted, checking for increased or decreased tactile fremitus, rhonchal fremitus, and pleural frection fremitus, tracheal shift, finding the point of maximum impulse of the heart (PMI), looking at the neck for retractions, muscular hypertrophy, the face for general facial expression, pursed lips, dilated nares, and so forth. I mention these things not to be a smartass, but to point out how much there is to know about physical examination that doesn't involve hearing, that can be done through palpation and inspection. GG In a message dated 8/6/08 6:52:43 PM, Grayson902@...<mailto:Grayson902%40aol.com> writes: > > " I also question how we can certify a person who can not auscultate > heart sounds, or blood pressures or collect a history from the majority > of the patients they would come into contact with. " > > You mean, as opposed to the thousands of already-practicing EMTs who use > the NIBP machine to get a pressure, the pulse oximeter to get a heart > rate, and who classify lung sounds as " junky, " on the odd occasion where > they actually *do* listen to a chest, and who do more talking during a > patient interview than listening? > > That kind of certified EMT? > > Well, let's see...how about palpating blood pressures , backed up by > automatic NIBP, checking for respiratory effectiveness by palpating, > inspecting, feeling for tactile fremitus, etc, using waveform > capnography to detect bronchospasm, and when interviewing patients, > making *eye contact* with them and encouraging them to talk - which, by > the way, the hearing EMT should be doing anyway? > > And if you're auscultating heart sounds in the back of the rig, the vast > majority of the time, you can classify those sounds as " lub-dub " or > " Powerstroke diesel engine. " > > I will grant you, however, that auscultating on the scene does allow us > to hear an occasional S3 or S4 sound through the far more frequently > heard " Hurst tool, " " hysterical bystander " or " radio traffic. " > > -- > Grayson, CCEMT-P > www.kellygrayson. ww > > > ************** Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos. (http://autos.aol.com/cars-BMW-128-2008/expert-review?ncid=aolaut00050000000017 ) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2008 Report Share Posted August 7, 2008 Did you get that in writing by chance? If so I'd love to hear the JD's take on the ADA aspects of any such denials of certification? LNM from Baku, Azerbaijan Sent via BlackBerry by AT & T Re: Re: Deaf Student And don't forget inspection of the anterior chest wall for barrel chest, palpating for symmetric chest expansion and lumps, masses, and crepitus, diaphoresis, temperature, color, intercostal retractions or bulging, jugular vein flatness or distention, looking for kyphosis, pectus excavatum, pectus carinatum, scoliosis, respiratory patterns, and, as you noted, checking for increased or decreased tactile fremitus, rhonchal fremitus, and pleural frection fremitus, tracheal shift, finding the point of maximum impulse of the heart (PMI), looking at the neck for retractions, muscular hypertrophy, the face for general facial expression, pursed lips, dilated nares, and so forth. I mention these things not to be a smartass, but to point out how much there is to know about physical examination that doesn't involve hearing, that can be done through palpation and inspection. GG In a message dated 8/6/08 6:52:43 PM, Grayson902@...<mailto:Grayson902%40aol.com> writes: > > " I also question how we can certify a person who can not auscultate > heart sounds, or blood pressures or collect a history from the majority > of the patients they would come into contact with. " > > You mean, as opposed to the thousands of already-practicing EMTs who use > the NIBP machine to get a pressure, the pulse oximeter to get a heart > rate, and who classify lung sounds as " junky, " on the odd occasion where > they actually *do* listen to a chest, and who do more talking during a > patient interview than listening? > > That kind of certified EMT? > > Well, let's see...how about palpating blood pressures , backed up by > automatic NIBP, checking for respiratory effectiveness by palpating, > inspecting, feeling for tactile fremitus, etc, using waveform > capnography to detect bronchospasm, and when interviewing patients, > making *eye contact* with them and encouraging them to talk - which, by > the way, the hearing EMT should be doing anyway? > > And if you're auscultating heart sounds in the back of the rig, the vast > majority of the time, you can classify those sounds as " lub-dub " or > " Powerstroke diesel engine. " > > I will grant you, however, that auscultating on the scene does allow us > to hear an occasional S3 or S4 sound through the far more frequently > heard " Hurst tool, " " hysterical bystander " or " radio traffic. " > > -- > Grayson, CCEMT-P > www.kellygrayson. ww > > > ************** Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos. (http://autos.aol.com/cars-BMW-128-2008/expert-review?ncid=aolaut00050000000017 ) Quote Link to comment Share on other sites More sharing options...
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