"That Guy" in EFR class

[ToddG]

I'm about 2/3 of the way through the American Red Cross Emergency First Responder program. This past Saturday, we had an incident in class. Hopefully, some of the experienced folks here can offer insight and advice.

History: "That Guy" is Indiana Jones, so nicknamed because he's clearly desperate to get out into the world and have some hairy adventures. He's already been through First Aid, CPR, and perhaps some other ARC programs. This is a guy who now has three bags full of medical gear in his trunk and has admitted that he's been "patrolling" some of the major highways in the Baltimore area. He claims he's stopped to help 200-300 people so far. This is the guy who is constantly shouting out answers to every question the teacher asks so we all know he's the smartest. This is the guy who interrupts the teacher to give other students direction during practicals. This is the guy whose neck I'm going to snap before the class is over.

Incident:

In the morning, we are taught how to backboard a potential spinal injury. During the exercises, Indiana scrapes his knuckles and begins to bleed rather profusely. Luckily, one of the students (a full time nurse) sees it immediately and tells him to back away. Indiana patches himself up, puts on a pair of rubber gloves, and continues with the class. We all felt ok with that.

In the afternoon, we do our first blind practical: team walks into the room, instructor is on the ground simulating multiple simultaneous injuries.

Instructor/victim/patient is also chewing gum. So during the "secondary survey" -- which Indiana Jones is doing -- he asks her to open her mouth, at which point he goes to remove the gum. She clearly tells him, gloves or no gloves, he's not sticking his bleeding hand into her mouth. While all this is going on, we've put her on the backboard, I've splinted her lower left leg, another student has splinted her right arm, etc.

So the teacher is basically immobilized and trying to watch what we're doing.

Indiana Jones, out of nowhere, stands up and while hovering over all of us, he takes off his gloves, removes the bandages from his hand, and "looks to see if he's still bleeding." Apparently, when the instructor said he couldn't put his hand in her mouth, he decided he should check to see if he was really still bleeding. Seriously.

So I happen to look up as he's doing this and yell "STOP" ... but he keeps on doing what he's doing. He manages to get some blood on the pants leg of the student holding stabilization at the head (we hadn't done the pads or head straps yet) before everyone else catches up to what's happening and he's made to go away.

We immediately get the instructor released from the straps and everyone takes a break to wash up and check themselves. When we come back, the instructor says we'll do another scenario and this time I'm to be the team leader. I flat out refuse to have Indiana Jones on my team. I then walk over to the backboard with the instructor and we check it for blood. Sure enough, there are a few small drops of blood on it. She puts on some gloves to clean it off but I suggest we skip the backboard for the scenario until someone can really disinfect it.

It was right about then that we realized Indiana Jones was re-bandaging himself back at the table he was sharing with another student, potentially contaminating not only the table but this other students' personal effects.

The instructor, realizing the entire situation was out of control, sent everyone home.

I spoke with her after class and she is trying to juggle the fact that Indiana is now all butt hurt (my words, not hers) with the fact that most of the rest of the class doesn't want to get within 10 feet of him. My advice -- and perhaps this was off base since this is way out of my lane -- was to treat Indiana like any other professional rescuer she would have dealt with while she was at Johns Hopkins or down post-Katrina or whatever. Would she have taken that guy aside and read him the riot act? I assume so.

So my real question is this, assembled medical experts: how much lime do I need to decompose a 300# body?

[Jay Cunningham]

Yikes.

Blood borne pathogens are nothing to trifle with. We had a guy disassembling a wooden pallet a few years back and a board with a long staple popped out and right into a big vein on his arm. Of course when he pulled it out we had a geyser. We tracked his blood trail across the operating deck into a small office where bystanders were standing around *eating pizza*. I got those morons out of there pretty quickly... "yes, I'd like pepperoni, mushrooms and hepatitis please"...

[Derek_Connor]

300lb Body needs 43.234lbs of Lime.

In all seriousness though, this guy does sound like darwin needs to pay him a visit.

On the flip side, and do not take this the wrong way, I am surprised the instructor cancelled the class for that day. While I would never sign up for someone bleeding on me, my clothes, any of my personal property, I'd assume there were 10+ people there for this class? All paying (or employer paid)? Thats alot of time off/scheduled out of office training etc that is now put off to another day.

Its a shame he couldn't have been dismissed for the asshat he was, and you guys could of used the proper universal precautions and continued on with the training.

[Alex F]

He weighs 300 pounds?!

[OPPFOR]

I crossed paths with a guy like this about a year ago. He was a large man, very book smart, very annoying, and could not stop talking about his CPR certification. He was trying to get over to Iraq as a contractor/operator with CPR certification.

Is his first name Pat/Patrick by any chance????

[ToddG]

Derek -- There are only six people in the class due to attrition, etc. I don't blame the instructor for cutting class short. Many of the other students were clearly agitated and she had her own issues to deal with ... she was, after all, the person who was strapped down to the board Indiana was bleeding on.

We have four more days of class and I'm confident we'll cover everything we need to.

Glock-Fu -- Names are withheld to protect the innocent and/or stupid.

[buzz_knox]

So my real question is this, assembled medical experts: how much lime do I need to decompose a 300# body?

This isn't the right question for someone with a JD to ask. The proper question is how do you make it justifiable so you don't need the lime?

[ST911]

So my real question is this, assembled medical experts: how much lime do I need to decompose a 300# body?

I teach in the fire/EMS service, met "that guy" (if I had a nickel...), and sympathize.

We have three locals that show up to every training event. All three answer every question, know everything, have done everything, ask everything in spite of it, and have war stories aplenty from their years of service, despite having low individual call volume.

They're plentiful.

No offense to the fine folks at ARC, but they seem to congregate there. ARC classes are open enrollment, widely available, low cost, and cognitively accessible to the lowest common denominator. As it should be, but they get more riff-raff as a result.

Unfortunately, higher HQ allows...actually requires...more tolerance of these types because they add reportable stats, pay on time, and show up in the field. Single voices complaining to HHQ are louder than they would be in other venues or pursuits.

There are ways to give them tasks or divert them so that they have less opportunity for input. I like to make them my training mannequins. They get the attention they crave, but I can more easily focus it where I need it to go. Having them wear an O2 mask helps keep them quiet, but you obviously can't do it all week.

Good news on your BBP contamination: Transmission rates for exposures that are "not significant exposures" (as defined) are virtually nonexistent. Little comfort, but it might help. Get your shots, some 1:100 bleach dilution or some quat, and you'll be fine.

[exkc135driver]

I know little-to-nothing about first aid (and in fact did not know that blood was so dangerous, so clearly I need to start taking courses), but as an instructor in a few things and student in many things, I do know a little about Indy and his many cousins.

There isn’t a lot you can do about the guy whose opinion of his skills/knowledge vastly exceeds his actual abilities. What this guy is actually trying to do is teach the class. He knows he can’t do that, so he makes sure that he is the first to answer every question, volunteer for every assignment, and generally attempt to make himself the center of attention. As an instructor, I have been known to politely ask him, with a smile on my face, to give the others an opportunity to participate. As a student I have on rare occasion in class looked him directly in the eye and said in a loud voice, “Indy, we all know you know it all, but the rest of us are here to learn, so how about shutting up and letting the rest of us get in a word edgewise?” That tactic has never made me popular with the Indies of this world, and generally results in me being rebuked by the instructor (who suddenly realizes that he should have said/done something several classes ago), but it achieves the desired result. For a while, anyway.

If this bozo is “patrolling” your local roads, I hope that Maryland hasn’t enacted a Good Samaritan law.

[Barbara]

I had his sister in my class. 100 lbs. overweight, slightly older than me even, and a complete pain in the butt. When the younger folks, especially women, were doing scenarios, she'd roll her eyes at the slightest misstep, talk to them like they were idiots, and then when we were doing exercises in class (ie: recognizing things like shock in a patient) she'd come up with disease diagnoses that would make Dr. House proud (cause they expect basic students to not only diagnose, but probably treat rare genetic illnesses, right?) We constantly got to hear her tales of brilliance and valor in her daytime medical assistant job.

Funny thing is, she failed part of her final..because she doesn't "do well under pressure."