Friday, February 9, 2018

Be that someone. #BeThe1To.

This tweet by Dr. Sue King, our Director of Elementary and Secondary Education, about a young boy named Patrick Turner really got to me:


I looked-up to Catherine. She was the oldest of my cousins, the wise one. The voice of reason that kept us in check when our plots and plans the rest of us were making were about to take a not-so-good turn. The smart yin for our reckless yang.

About 15 years ago, Catherine took her life. Several years later her husband Thierry did the same, orphaning their grade school aged son Hamelin. Both (unbeknownst to me) had battled anxiety and depression for years. She is buried in a plot next to my grandmother in the tiny village of Chalou-Moulineux, about two hours south of Paris, in the heart of the grain-belt of France.




The cemetery is right up the road from my grandparent's house, a place filled with countless childhood memories, my Happy Place. Here's their house, with the deep red shutters and entry gate:




Hypertension is often referred to as the "Silent Killer". The same can be said of suicide.

I'm no therapist. I'm not a counselor. I'm not a social worker. I'm a Dad, husband, teacher and paramedic. I see the effects of stress, anxiety and depression at school, at home and in the back of the ambulance. At times they seem almost inescapable. What strikes me most is their manifestation at school.

At school. The place where elementary school kids ran off the bus to enter. The place where young hands jumped up in the air excitedly, wanting to get picked to clap erasers or empty the pencil sharpener at the end of the day. The place where the overall vibe was joy.

Something happens between elementary and middle and high school to many (if not most) students. No longer do they race into the building. No longer is it a competition to earn the right to do classroom "chores". No longer are the halls filled with joys and excitement.

Don't get me wrong; high school halls are not macabre passageways connecting classroom crypts. But there is a much different vibe with the older kids. Sure they have mellowed-out. Some have found their "It" or their "Why". Others are still finding their way. And some are drowning.

Drowning in personal anguish. Personal demons. Hell at home. Hell in the cafeteria. Hell in school in general. Or all the aforementioned. These are the kids that need an ear. These are the kids that need a homeroom teacher with a keen eye for something askew. These are the kids that need someone to reach out and ask about their day. These are the kids that we may not teach but see in the hallway every day. And one day something is off, amiss.

Kids can be under so much pressure from parents, themselves, teachers, coaches, recruiters, colleges, and employers. This stress can be so overwhelming that it becomes difficult for them to function or to even enjoy life. They need someone to turn to. Someone to talk to. Someone to talk it out with. Someone to confide in. Someone to listen. Someone to care.

I wish Catherine, Thierry and Patrick Turner had had someone in their corner that could have stopped them.

Be that someone. #BeThe1To

Tuesday, January 30, 2018

Case Study: Days 1 through Day 5

I greeted students at the door and invited them to grab a seat wherever they felt comfortable in the classroom (#flexible seating, arranged in a circle around the room).


#flexibleseating - why not be comfortable when learning?


While they were filling out #IWishMyTeacherKnew slips, I took attendance and asked students their preferred name/nickname/pronunciation. I then pointed up to this banner and read it out loud to set the tone for the semester:

Student-made banner (from @medicalaxioms on Twitter)


I requested a volunteer and walked them out into the hallway. I asked the student to "play unconscious" and lay on a blanket I set out in the middle of the classroom (see classroom picture above). When we returned to the classroom, I gave the class this task:


Brainstorm, to the best of your abilities, causes for concern and/or questions surrounding this scenario. Here is what they came-up with in their stated order, in their exact words:





Next, I asked them as a group to determine 1) what they thought their highest priority concerns were and/or 2) which of these concerns could be accomplished or determined without delay. The seven circled concerns reflect that (above).

Next, I asked them to prioritize these seven concerns in a logical order.

Once this was done (with some guidance and input from me) we started diving into each of the seven concerns, in order. Each of these is accompanied by hands-on demonstrations by students:
Scene safety: awareness of dangers in the form of weapons, assailants, traffic (if on the highway), used hypodermic needles, etc. We all need to go home in one piece at the end of our shift.

Scene survey: looking for clues such as flipped-over rug (suggesting a trip & fall), a ladder (suggesting a fall), overturned or smashed furniture (suggesting an assault), pills or bottles on the floor (suggesting overdose or intoxication).

Skin color:
  • Pale —> shunting blood from the skin to the core
  • Flushed —> distributing blood to the skin
  • Cyanotic —> profoundly hypoxic, only have minutes to act
  • Jaundiced (yellow) —> dysfunction
  • "Normal"

Level of Consciousness (AVPU):
  • Alert: eyes open & tracking
  • Verbal: eyes open & patient responds to verbal stimulus
  • Pain: only responds to verbal stimulus
  • U: unresponsive/unconscious

Circulation:
  • pulse (carotid):
    • yes —> fine
    • no —> initiate AED and immediate chest compressions
  • control massive external bleeding:
    • direct pressure
    • elevation
    • pressure points (brainstorm common pulse locations prior)
    • tourniquet

Airway: patient MUST have a patent airway

Breathing:
  • yes & adequate —> fine
  • no and/or inadequate --> airway adjunct:
    • oropharyngeal airway (OPA) for no gag reflex
    • nasopharyngeal airway (NPA) for gag reflex

The end result of this portion of the case study is that students are able to assess life-threatening conditions within 30 seconds of patient contact.

Next up: History & Physicals (H&Ps)!