Sunday, May 7, 2006

Emergency Response Workbook, American Red Cross

Title: Emergency Response Workbook
Author: American Red Cross
Rating: Neutral

This is the companion workbook to the first aid textbook I have been reading for my first aid class. Alas it is just as full of errors and goofs as the textbook is.

In addition, however, here you are exposed to the astoundingly stupid kinds of test questions that the Red Cross expects you to answer about first aid. The questions break down into three categories as I see things:
  • Stupid questions. As a first responder, do I need to know what the most common cause of injuries to people in some age range is? No, I don't. I need to know how to help keep them alive if they are injured. I hate to say it, but I'd guess that a third or so of the questions in this book (and on the tests that I have and will be taking) are of this nature. It's fine as background material, and it might aid in comprehension and retention, but when the rubber meets the road and I hop off the fire engine on Highway 17 to pull someone out of a burning car, it is pointless. In my mind, testing me on it is pointless too.
  • Questions with no good answer. There are various reasons this happens. Sometimes the question doesn't give you enough information, and all the answers make assumptions. Sometimes they are assuming a particular kind of first responder, and various answers might be right depending on the point of view you're taking as the responder. Sometimes they just make no sense at all. This is perhaps 5% of the questions here.
  • Reasonable questions. These are actually relevant questions that test your retention of specific facts you need to know to perform first aid at the minimum level to get the certificate. They make up the rest of the content.
If it seems like I might be clutching at straws here, let me demonstrate with an example. To do so, you need to know that the first and foremost thing stressed with first responders is not to become another victim. If you have any doubt about what is going on, your job is to keep back, keep others away, and call for more advanced help. Simple, eh? And it makes a LOT of sense in cases like (say) hazardous materials spills, fires, etc. If you lack the training and the gear, staying safe and keeping others safe is a great thing to do.

OK, with that in mind, there was a question on my midterm that said something like: you've come upon an accident at a busy intersection just below a hill. There are 4 victims. 3 of them are in X, Y, and Z condition. The 4th victim was thrown from the car and is lying in the middle of a lane of oncoming traffic. What do you do about that 4th victim? Your answer choices are things like "ignore him and care for others", "move him", "park a vehicle to block traffic so he won't get hit", and so on.

Note the total lack of detail. What sort of first responder am I? A fire fighter with a truck full of equipment and help, or am I entirely on my own? How busy is it? Is the victim lying in the road visible to oncoming traffic, or is he below the rise so he's going to get hit any second now? What risk would I be in if I went into that lane of traffic to look him over? Also note that having been thrown from a car means a high likelihood of neck or back injuries, among other things, and you don't move those folks without cervical collars, head restraints, and backboards unless you absolutely have to.

Well, after you digest all of that and guess at an answer (since none of the answers are really right) you find out they think the answer is to move the victim out of traffic. Now as a fire fighter in training I know that is the right answer, but as a fire fighter I am expected to take certain risks to help others. Without more detail, I have no idea if a citizen first responder should do that or not. And it certainly seems like it might violate the "don't become another victim" teaching. But fine. Whatever.

Later in the same exam, though, I hit a different question that says something like: a car accident has occurred. A car has left the road and hit a building. The victim is inside the vehicle and appears unconscious. You can see blood. Blah blah. The building is damaged but seems stable. (My emphasis.) What do you do about this victim? And the choices - among other things - are "wait for advanced help to stabilize the building" and "treat the victim now".

Here again, I have all kinds of problems. If it seems stable, as a fire fighter, I have news for you: I am going to go treat the victim. By the time an engineer shows up and says things really are safe the victim could have died of shock or any number of other things. But the answer they wanted was wait for advanced help. Now we're back to not becoming another victim. And while I respect that point of view, I hope it is obvious that the answer for the first question and the answer for the second question are in conflict in terms of what the first responder is expected to actually do.

That's the kind of thing a good editor would have found and avoided. If it was only one or two questions like this, I'd probably just ignore it, but it is endemic to the entire book, as well as the tests that I have to take. The Red Cross really needs to get some professional educators involved in their test material creation, along with that previously mentioned editor. This stuff could all be so much better than it is.