BLOG ENTRY 4
Observe the world around you and reflect on … Habits, ‘truth’ or other phenomenon that have grown from tradition or other source (e.g. family, disciplinary or cultural) and become part of our ‘practice’ that may or not have any evidence base for the practice. 

I have been a mother for 15 years and a Registered Nurse for over 20 years. During this time I have been told by family, friends and colleagues that the use of steam is beneficial in the management of croup. I have implemented this method myself both as a mother
(using a home humidifier and the steam from a shower) and a nurse (using a mist tent). I have also encouraged others to apply this method.

The use of steam to manage croup began in the 19th century and has been a mainstay treatment in hospitals and homes throughout the 20th century and into the 21st century (Defendi, 2011). Despite its widespread use, this method has not been scientifically validated, and therefore has no place in evidence based practice (Johnson, 2009).

It was believed that steam moistened airway secretions, decreased viscosity and soothed inflamed mucosa, thereby relieving the hoarse like cough associated with croup.

Studies including the randomised control trial conducted by Scolnick et al. in 2006, and systematic reviews of the literature such as Moore and Little in 2007, have concluded that there is no difference in the outcome between children who were exposed to steam treatment and and those who were not.

In fact, the use of steam in the management of croup is currently regarded as dangerous due to the potential for scalds and burns in young children in the home environment. In the hospital environment concerns have been raised regarding the risk of fungus and molds being present in the "mist tents", as well as the anxiety and agitation which the child may experience while being separated from parents during treatment (Defendi, 2011).

However, when I have used the steam method myself, I believed it was easing the symptoms associated with croup. Was I imagining this, was it coincidence or something else. Maybe further research needs to be undertaken to prove or disprove this theory.

I welcome your comments on the experiences you may have had with the management of croup with steam.



References

Defendi, G. (2011). Croup treatment and management. Retrieved from
http://emedicine.medscape.com/article/962972-treatment

Johnson, D. (2009). Croup. Retrieved from Online version of  BMJ Clinical Evidence
 http://www.clinicalevidence.com

Moore, M. & Little, P. (2007). Humidified air inhalation for treating croup: a systematic review and meta-analysis. Family Practitioner, 24(4), 295-301.

Scolnik, D., Coates, A., Stephens, D., DaSilva, Z., Lavine, E. & Schuh, S. (2006). Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: a randomized controlled trial. JAMA, 295(11), 1274-80.

 BLOG ENTRY 3
 OBSERVE THE WORLD AROUND YOU AND CONSIDER A PROBLEM TO BE SOLVED.....REFLECT ON THE

PROBLEM: What needs to be solved?

The reluctance of bystanders/community members in providing prompt and appropriate delivery of first aid treatment at the scene of a road traffic crash.

CONTEXT: Describe the problem space.

This problem occurs on all roads in Australia.

All vehicles and individuals (including drivers, passengers and pedestrians) travelling on the roads are affected.

REALITIES: Who are the key actors?

Road users - drivers, passengers and pedestrians

Government departments and policy makers

Bystanders/community members

Researchers

TENSIONS: What are the tensions from the problem/practice space?

It is widely accepted that many deaths and disabilities resulting from road crashes can be prevented, with immediate treatment by a person with first aid training (Galwey, 2007). The two factors which are most likely to kill following a road crash are airway obstruction and uncontrolled bleeding (Arbon and Hayes, 2007). Research has identified that simple first aid measures, such as maintaining an airway and managing bleeding have the capacity to maintain life until emergency services arrive (Arbon and Hayes, 2007).

Studies suggest that many lay persons do not stop at the scene of an accident, or if they do stop they are reluctant to render assistance (Mabbott, 2001, p.2). Much of this behaviour has been attributed to a low level of knowledge and skills, which leads to a lack of confidence in an individual’s ability to offer effective assistance. Current research provides evidence that first aid training leads to an increase in confidence and consequently intervention rates among the community (Arbon and Hayes, 2007, p. 8).

The Australian Bureau of Statistics (2008), estimates that less than one-third of Australian households have a member with a current first aid qualification. Therefore, it is safe to assume that the majority of Australians are unable to provide appropriate and timely first aid to casualties of a road traffic crash.

PROBLEM DEFINITION: What would the problem look like if it were solved?

Death rates and severe injury rates will be reduced due to prompt and appropriate delivery of first aid treatment by trained community members at the scene of road traffic crashes.

CONCEPTS: What possible concepts might provide a solution?

Mandatory, regular first aid training for holders of a drivers licence.

Introduction of compulsory first aid training prior to obtaining a drivers licence .

First aid courses provided at no expense.

New methods of first aid training delivery. e.g. accessible via internet.

First aid training provided as part of the school curriculum.

First aid training provided during ante natal classes.

First aid training compulsory at all workplaces.

Compulsory first aid kits in vehicles.

References

Australian Bureau of Statistics (2008). Household Preparedness for Emergencies: NSW, Vic., Qld and ACT, Oct 2007. Retrieved from:

http://www.abs.gov.au/ausstats/abs@.nsf/PrimaryMainFeatures/4818.0.55.001

Galwey, R 2007. ‘Inquiry into young driver safety and education programs’ St John Ambulance Australia. Submission No. 49.

Mabbott, N 2001, ‘Harm minimisation for victims of road trauma’, Australian Road

Research Board, no. 339.  Retrieved from:

http://www.arrb.com.au/admin/file/content13/c6/ARR339%20Harm%20minimisation.pdf

Adam Hills Advance Australia Fair

Contextual lens
I wonder what sort of contextual lens these firies were wearing, and I am sure these lenses would have been well and truly adjusted when they got back to the station.
(However, at the risk of totally shattering my professional contextual lens, I do think this video is hilarious!!!)

Fire truck drives through Eltham flood in Melbourne, Australia.

BLOG ENTRY 2 (Continued)
Access three other student blogs – explain how this informed any new perspectives
After reading Larrys blog I was compelled to discuss the ongoing problem of people entering and driving through floodwaters.
 As a member of the QFRS, recent training has a strong focus on swiftwater rescue. The government in conjunction with QFRS have also launched a media campaign surrounding the dangers of entering floodwaters.You may have seen the ads "If it's flooded, forget it" However, this remains a huge issue and many people are still ignoring the dangers. My question is WHY?
Is this issue about an individuals contextual lens. Like Larry said, do people see themselves as immortal, or do they have the mentality that "it wont happen to me"?
Like the photo below do some people believe that because they have a 4WD that the current will not be strong enough to carry them away?

Don’t think that being in a 4WD makes you invincible. Water deeper than the bottom of your door is enough to float your vehicle away or douse the engine, causing it to stall. Even slow-moving floodwater can wash away the road surface underneath.

Do people not realise the damage water can do to road surfaces, that are hidden when the road is flooded, as evidenced by the next photo?

Flooding can cause extensive damage to roads, just like the one in this picture. When the road is flooded, you won’t be able to see what’s lurking below. If travelling, be sure to look out for changed road conditions and never ignore ‘Road Closure’ signs. They have been placed there for your safety.

If it’s flooded, forget it.

 AND, I think most importantly, how can we use the different contextual realities of individuals to develop programs and campaigns that improve awareness and stop people from entering floodwater.

What would stop YOU from driving through floodwaters??????

Photos shared from the QFRS facebook page

BLOG ENTRY 2
 Access three other student blogs – explain how this informed any new perspectives

I read with interest Robertos blog regarding the dilemma he faced when he was confronted with the death of a friends son, in his role as police officer in a small country town. I was also interested in Angelas response.
As a nurse and an active member of QLD fire and rescue who works and has worked in a small country town for many years, I have been faced with similar circumstances, especially working in A and E and attending road crashes with the firies.
In a small community it follows that the services provided are small and have minimal staff. You generally know most people in the town, or you know their family.
I believe that when confronted with tragedy such as the death of a community member in such a close environment you must continue to act in a professional manner as much as you possibly can. This is an extremely difficult thing to do. However, if you dont try to hold on to some part of your professionalism (as Roberto was endeavouring to do) the outcome can be even worse.
For example, as a nurse who may be confronted with a potentially fatal accident ( and in small country towns often one of 2 or 3 staff members) to lose your professionalism may mean the difference between making life and death decisions.
For Roberto, I am guessing that he needed to remain professional as the only police officer and investigator in town who may be required to give unbiased evidence in the future.
Professionalism allows us to do our jobs as well as we can, and unfortunately this may make us look cold, but that is the price you may need to pay in order to ensure the best possible outcome.
Another important point I would like to make is that as a professional who attends distressing incidents  I believe that it is often necessary to take a step back and "put on your professional face" to protect yourself. It is not that you dont care anymore, it is more the need to create a barrier against these horrible events or else they will overwhelm you and you wont be much help to anyone.
I hope what I have said makes some sense and allows others to see things from a different perspective (contextual lens).
Yours Sincerely, Stacey

BLOG ENTRY 1
Observe the world around you … in particular a personal or news event unfolding … reflect on

• • the contextual lens yourself and others wear;
  • the influence this may have on how the situation is perceived by various parties; and
  • how these factors might ultimately influence the outcomes from the event.

Hi guys,
           I have never attempted a blog before, but from what I gather it is just a rambling flow of your personal thoughts??????? Anyway here goes.............
I have been following the tragic story of 4 year old Jesse Wickman who died during the floods near Ipswich on the 11th of January last year.
Media reports claim that Jesse, his mother, father and his 9 year old brother were stranded on the roof of their car in raging floodwaters at Minden, QLD.
While two swift water rescue firefighters managed to save the rest of trapped family, 4 yr old Jesse died after a tether connecting his life jacket to one of the rescuers failed.
An inquest is currently being held in Brisbane.
The following issues have been raised concerning the tragic death of Jesse Wickman;
-The life jacket which tethered Jesse to the rescuer was adult size and much too big for him
-There are no procedures which state or sanction the use of a tethering device
-A communication breakdown led to a 5 hour delay before a search was begun for the missing boy


As I have been following the media coverage of this story, I have been torn between (what I consider to be) 2 different contextual realities. What the mother experienced that day (as I am a mother) and what the rescuers experienced that day (as I am a member of the QLD Fire and Rescue Service).
As a mother who believed her child to be safe in the expert hands of the rescuer only to see him swept away in the floodwaters would be heartbreaking and life-shattering to say the least.
As a rescuer who was doing their job to the very best of their ability to have a child ripped from their arms to such a devastating end would be distressing and harrowing to say the least.
These 2 different contextual realities may have a major influence on how the events in this situation are perceived. As an investigator, it is vitally important to base conclusions on facts which are not clouded by pre-existing emotions and beliefs.
Would the mother need to place blame for the death of her son? Would this cloud her judgement of the facts of this event?
Did faulty equipment or poor decision making contribute to the death of this child? Was training adequate for the type of rescue being performed?
AND would the outcome have been better or worse if no rescue was attempted at all???????
Thoughts anyone??????????