Do ski instructors have to have basic first aid and/or CPR certification?

[Tricia]

@Jasmine is a Ski Patroller at Northstar. She performed CPR on a skier who collapsed near her station last winter. He's alive to ski again.
I know a few instructors who happen to have CPR certs but that's of their own accord and has nothing to do with their job(s) as an instructor.

Do you think it should be a requirement for instructors?
I'm inclined to think that its better to leave it to the Patrol, if for no other reason than the protocol that's in place.

 

[Jilly]

FYI, @Monique first aid is primarily associated with the ABCs (sometimes D)--Airway, Breathing, and Circulation (and deadly bleeding or defibrillation.) It does not involve diagnosis and treatment of an injury.

This is what I found out when I went for a course after 20 years. I took basic first aid in high school, then again during a shut down at work. We were doing splints, pressure doughnuts etc. Fast forward and it's ABC, check and turn them over to the recovery position....I thought it was useless really after knowing the other stuff. But there are AED's now everywhere and it's not hard to figure out.

I'm sure the CSIA position is that injured people are left to the patroller unless it's one of your students. Then a whole different protocol comes into effect.

 

[Long Hair Hippy]

I’ve always thought it was odd that my daughters softball coaches are required to have concussion training but not CPR or first aid.

It would be nice if everyone in our society had at least a basic understanding of CPR and basic first aid skills, especially those who are working in environments with lots of people of varying ages. Early intervention is crucial for someone who is in cardiac arrest. If a ski instructor is able to identify the situation, correctly call for help and do basic CPR until patrol arrives with additional resources... that could very well be the difference of saving a life vs not.

If one were to paint a picture of a ski school patron suddenly collapsing, instructor calling patrol, patrol responding to assess, patrol then calling in for resources such as an AED /advanced airway equipment, beginning CPR and finally advanced resources arriving. A lot of crucial time could potentially lapse. It might take 3 to 5 minutes before patrol is initially on scene and another 3-5 minutes before the additional resources are there.

If that instructor were trained in the basics and could intervene immediately, that patron is going to have a much better chance for survival and hopefully the instructor will have a long term repeat customer who leaves nice tips!

While making CPR/First Aid training mandatory for instructors might be a bit tough, making training available and encouraging instructors to take advantage of it would be beneficial to everyone out on the hill.

Heck…you never know when your number is going to be up!

 

[ScotsSkier]

Race coaches teach/train folks to ski closer and closer to the edge of danger. Instructors teach folks to ski more and more difficult terrain safer and safer

Yes, but it is more because when an athlete goes down hard there are normally coaches in close attendance so can often be there in 15-30 seconds rather than the 3-5 minutes for patrol. That is both CPR and First Aid are mandatory components (and the first aid wasn't some 1 hour class, for me it was like a 20 hour course and testing with biannual refreshers). The purpose is NOT to supplant Patrol (dont worry Pais Alto!) or give treatment but to be able to take any emergency action necessary to stabilize/manage the situation till Patrol/Specialist medical gets there. Pretty much along the lines of the ABC mentioned earlier.

 

[hbear]

Would be nice, CPR and basic first aid skills should be taught in schools from my perspective.

Costs shouldn't be prohibitive in the big picture as one only needs to certify CPR and first aid instructors who then can cascade the training to the rest of the team/school/etc. Cost per participant would be negligible.

And with the change in recommendations (a big part to increase the willingness of people to assist so they don't have to perform mouth to mouth on a stranger with no barrier precautions in place) there should be little excuse for a trained bystander not to assist. From a liability perspective (unless you have additional advanced training) the liability to the bystander viewed through a "good Samaritan" or "reasonable assistance" lens so one doesn't need to worry about "messing up" provided one does what they are trained to do and not grossly negligent for performing things they are not.

 

[pais alto]

If one were to paint a picture of a ski school patron suddenly collapsing, instructor calling patrol, patrol responding to assess, patrol then calling in for resources such as an AED /advanced airway equipment, beginning CPR and finally advanced resources arriving. A lot of crucial time could potentially lapse. It might take 3 to 5 minutes before patrol is initially on scene and another 3-5 minutes before the additional resources are there.!

Where I work, patrol would respond immediately with an AED and advanced airway equipment to any report of a collapse or loss of consciousness (or a tree strike for that matter). We all carry CPR masks and basic airways and aspirin in our vests. We always have ILS and/or ALS patrollers on duty for advanced medications and interventions. I can't speak for other patrols but I expect most would respond with their full capability rather than send someone to assess and then call for resources. Just sayin'.

 

[Karen_skier2.0]

Heck…you never know when your number is going to be up!

At our ski club (houses 72 people), the average age is 55. For that reason, we are getting an AED for the house--hope we will never need to use it. However, we figure ~$1500 is a good investment.

 

[Karen_skier2.0]

Would be nice, CPR and basic first aid skills should be taught in schools from my perspective.

Costs shouldn't be prohibitive in the big picture as one only needs to certify CPR and first aid instructors who then can cascade the training to the rest of the team/school/etc. Cost per participant would be negligible.

And with the change in recommendations (a big part to increase the willingness of people to assist so they don't have to perform mouth to mouth on a stranger with no barrier precautions in place) there should be little excuse for a trained bystander not to assist. From a liability perspective (unless you have additional advanced training) the liability to the bystander viewed through a "good Samaritan" or "reasonable assistance" lens so one doesn't need to worry about "messing up" provided one does what they are trained to do and not grossly negligent for performing things they are not.

I'm pleased to say that some of the high schools around here do train in CPR, AED, and basic first aid. However, I am not sure if they actually go through the certification. It's either in health or PE. Plus, in anatomy, teachers can reinforce with students where to apply pressure if someone is bleeding.

First hand experience--my dad called me a bit panicked since my mom cut her finger. Even though he was a patroller 30 years ago, I could hear in the background that she was freaking out. I had to remind my dad where to apply pressure in her axilla (armpit) to control the bleeding, elevate the arm, put the tip on ice, and the basic steps before he took her to the hospital. I had not had an emergency situation like that in awhile (since athletic training in college), but even with my dad's experience, sometimes it can throw you.

 

[Karen_skier2.0]

@Jasmine is a Ski Patroller at Northstar. She performed CPR on a skier who collapsed near her station last winter. He's alive to ski again.
I know a few instructors who happen to have CPR certs but that's of their own accord and has nothing to do with their job(s) as an instructor.

Do you think it should be a requirement for instructors?
I'm inclined to think that its better to leave it to the Patrol, if for no other reason than the protocol that's in place.

Personally, I think it should be taught in high schools and/or college. I believe it is something everyone should know.

After reading that article on the incidence of heart attacks on the slope and how time sensitive these issues can be, maybe it should be strongly encouraged, and perhaps phased in over a period of years. The ski area could bring in a certified CPR/AED instructor to minimize costs. I believe it's a 3 hour course. Just my 2 cents.

 

[Tricia]

Karen, I get it, really I do. I am ashamed with myself that I haven't renewed my CPR cred.
If you come into the ski shop where I work and ask for a band-aid, I am supposed to direct you to the clinic or ski patrol, even if its for something as simple as a blister from boots or ice skates. If I give you a band-aid, I'm technically administering first aid and I am not directed to do that.

If this organization is not allowing me to give a customer a band-aid, and they have stopped having "fit to ride" for their instructors because its costly, they are not likely to train for CPR/AED.


This may be a liability thing, or it may be a employee performance thing, or......???

 

[pais alto]

The purpose is NOT to supplant Patrol (dont worry Pais Alto!)

Ha! Not worried at all. "You got this? Great! Here, I'll hold your jacket."

 

[Karen_skier2.0]

Karen, I get it, really I do. I am ashamed with myself that I haven't renewed my CPR cred.
If you come into the ski shop where I work and ask for a band-aid, I am supposed to direct you to the clinic or ski patrol, even if its for something as simple as a blister from boots or ice skates. If I give you a band-aid, I'm technically administering first aid and I am not directed to do that.

If this organization is not allowing me to give a customer a band-aid, and they have stopped having "fit to ride" for their instructors because its costly, they are not likely to train for CPR/AED.


This may be a liability thing, or it may be a employee performance thing, or......???

The whole liability thing is a pain. So much for having good customer service or being a good samaritan. At least I've seen a lot of ski areas that have small doseage of OTC medication available on the hill at the cafeteria. I guess if the shop sold band-aids, it would be alright.

Hey, my renewal is out-of-date also. After doing it every few years since my teens, I know it's still between the ears. I was just looking into getting recertified and then getting my instructor certification.

My first time I got certified I was about 13 or 14--when I was doing junior ski patrol stuff. I was never a patroller, but since my dad was taking the classes to become volunteer patroller, and I had to be there anyway, I just did the training and helped them study for the tests.

@Tricia , I'm just stating my opinion, not trying to shame anyone. When I worked at IBM, they actually paid for a few people (including me) per building to obtain CPR & First Aid certification. The site was huge (up to 7,000 employees at the time), and every week there was what we called "the Monday morning heart attack". The manager of our contractors had a heart attack driving away from the building, struck a row of cars, and didn't survive.

For the low percentage of successful CPR attempts, there have been four family and or very local incidents happen in the last month. Three of the four lived. I guess that's what prompted the post in the first place.

 

[DoryBreaux]

When the ski school hires (beginner) instructors, they make sure the person can breathe and that he/she can learn to demonstrate beginning ski teaching movement.

Ay! I resemble that remark!

 

[dean_spirito]

But can patrollers make it there in 4 minutes for CPR? (I know this would be a rare occurrence, but a few things have happened to people I know in the last few weeks where immediate CPR made a difference.)

I don't know any ski areas that require their instructors to be CPR/first aid certified. Heck, I don't know of many that even require that their instructors be certified to teach skiing! USASA and USSA coaches, however, are required to maintain current CPR/first aid certifications and concussion training.

I did perform CPR once while on the clock at Copper Mountain. I was teaching a private lesson with a young female student of mine. She needed to use the restroom, so I brought her to a base area and waited outside. While I was waiting, an older gentleman collapsed in front of me. I really didn't know what the resort's policy or preference was regarding this type of situation, but it didn't matter. I was going to help however I possibly could. I instructed a few onlookers to assist in the effort; I asked one to call patrol, I asked another to call 911, and I asked a third to run into a building in the base area and find an AED. I was doing compressions within 20 seconds of the individual collapsing. I had the AED hooked up within 2 minutes of the individual collapsing and was being advised to shock. Patrol and EMS showed up at almost the same time, approximately 6-7 minutes after the individual had collapsed. When more qualified people showed up on scene, I stepped back, exchanged information with a patroller who was starting an incident report, and then continued on with my lesson.

When I finished my lesson, I went back to the building where we do our checkout with a supervisor. At that point, I was informed that the patient didn't make it and that I would have to meet with some people to talk about what happened. I met with the heads of patrol and a coroner. Everyone thanked me for doing what I could. They also said that the man was 80, had just arrived in town from Texas, and had a history of heart disease. In an attempt to make me feel better, the coroner said that even a cardiologist with all of the drugs in the world wouldn't have been able to save him. I took comfort in knowing that he died in his ski boots, enjoying a sport that we all love so much.

On a more positive note, one year later a few members on this site and I did CPR on a snowboarder that took a truly horrible fall. I can't speak for others, but at the time I did not think this individual was going to make it (probably because I watched the fall from start to finish and didn't think it was physically possible for the human body to survive that type of trauma). To my surprise, one month later we were informed that the individual had been released from the hospital.

Do I think ski instructors should be CPR certified? Yes. Do I think everyone should be CPR certified? Absolutely! Why not? You may just end up saving someone's life.

 

[SkiNurse]

@Karen_skier2.0 , I was once in a lesson at Breck at the end of the season. We were on Vertigo when a student fell and dislocated her shoulder. She was in terrible pain. Ski patrol arrived just a few minutes later.

Later, the instructor told me that he had dislocated his own shoulder many times and could have easily popped the student's back in - but for liability reasons, he wasn't allowed to do so.

Now, who knows about the facts and whether it would be a good idea, but it suggests that at Breck, instructors are discouraged from providing medical assistance.

I'd hope CPR would be a different matter ... although in the last CPR course I took, we were told that if you're doing CPR on a person, there is only a tiny chance that they're going to come out of it alive ... In fact, wikipedia has an interesting chart. I'm not sure what all the distinctions are, but it says "Bystander Compression-only Resuscitation" survival rate is only 13%. https://en.wikipedia.org/wiki/Cardiopulmonary_resuscitation .. I guess what I'm saying is, if you go into cardiac arrest on the mountain - even if your instructor does know CPR, odds are it's over.

Survival is doubled with bystander CPR than without.
New England Journal of Medicine
http://www.nejm.org/doi/full/10.1056/NEJMoa1405796

 

[Bill Talbot]

Do I think ski instructors should be CPR certified? Yes. Do I think everyone should be CPR certified? Absolutely! Why not? You may just end up saving someone's life.

You overestimate many peoples ability to deal with things even more difficult that what to watch on their TV. Many folks don't cope well in emergencies, much less have the composure to give first aid, especially CPR.

Sad but true.

 

[dean_spirito]

You overestimate many peoples ability to deal with things even more difficult that what to watch on their TV. Many folks don't cope well in emergencies, much less have the composure to give first aid, especially CPR.

Sad but true.

I think you underestimate what people are capable of when actually faced with a life or death situation. I little bit of training can go a long way when people's lives are on the line.

 

[SkiNurse]

I think you underestimate what people are capable of when actually faced with a life or death situation. I little bit of training can go a long way when people's live are on the line.

I get to see this every day in my job.

 

[Karen_skier2.0]

You overestimate many peoples ability to deal with things even more difficult that what to watch on their TV. Many folks don't cope well in emergencies, much less have the composure to give first aid, especially CPR.

Sad but true.

Since the courses give people steps to do in an emergency, this does decrease the panic level. I think people will surprise you.

 

[MikeS]

Would be nice, CPR and basic first aid skills should be taught in schools from my perspective.

Costs shouldn't be prohibitive in the big picture as one only needs to certify CPR and first aid instructors who then can cascade the training to the rest of the team/school/etc. Cost per participant would be negligible.

And with the change in recommendations (a big part to increase the willingness of people to assist so they don't have to perform mouth to mouth on a stranger with no barrier precautions in place) there should be little excuse for a trained bystander not to assist. From a liability perspective (unless you have additional advanced training) the liability to the bystander viewed through a "good Samaritan" or "reasonable assistance" lens so one doesn't need to worry about "messing up" provided one does what they are trained to do and not grossly negligent for performing things they are not.

Unfortunately, the cost is more than just paying to have one person trained as an CPR/FA instructor. I spent a number of years as a Red Cross Lifeguard Instructor, which meant I was also a CPR/ First Aid instructor as well. You have to pay the ARC for every certification card you issue. It's a nominal cost, something like $5 per card if I remember correctly. Still in the minimal cost range.

The big cost comes when you actually have to conduct the training. You're looking at paying all of your instructors an extra day or two of training, because that's how long the CPR and First Aid inital classes take. Then those certifications expire. CPR used to be annual, but I think now it is 2 years. First aid used to be 3 years, but I think that may now be 2 as well. So every year, you're going to have to recertify half of your veteran staff, as well as do an initial training for all your new hires. Depending on the size of the instructor corps, you're talking about hundreds to thousands of extra hours of training pay that the mountain has to lay out.

Doing back of napkin math based on my home mountain, we have 350 instructors. We usually have about 70-80 new instructors a year. So the initial cost to get everyone certified would be somewhere in the ballpark of $30-40K, depending on what each instructors' training base rate is. The annual ongoing cost would be somewhere between $12-$20K. That's a lot of capital outlay to do training, when you are in a location that has an entire other department dedicated to providing the service that training is for.

If you want to sink that kind of money, I'm of the opinion that it should be put into background checks for instructors. I've worked in child and social services for years, and I've been background checked up the wazoo. But for instructing, where I could have an all day private with a young child, where we're off by ourselves and nobody really knows where we are... not even a thought of background checks.