There was an opportunity for a great job opening.

All I had to do was get my Occupational First Aid Level 3 (OFA 3) certification. It was  daunting because I’d have to use two weeks holidays from work to take the course and I had no idea what I was getting into but I wanted that job.

Didn’t matter, I was in.

I registered for the course with a local community college and was scared to death the first day as I had no idea what I’d be learning. There were all these new terms, mnemonics, and stress that I wasn’t expecting.

A full two weeks of practicing emergency scenario after emergency scenario and then came the practical exam. It was intense.

I watched a couple of students around me fail because they didn’t follow certain protocols. That only made me more nervous.

But I passed it and got the job I was hoping for.

It can get pretty confusing which First Aid course is the best one for Massage Therapists to take.

There are a variety of different levels, descriptions and requirements for each one.

In some places where it’s mandated to have your certificate, the companies to use may be specified by your College.

However courses can be offered by independent companies working under bigger national organizations, community colleges, private education institute’s, the national companies themselves and also by individual trainers.

So which one is the right course and who’s the best provider?

Here are the top four courses for a Massage Therapist to take and some ways to find the best providers to use.

How to Determine Which First Aid Course To Take

Standard First Aid CPR-C     

This course is a great starting point for Massage Therapists.

There are different levels of CPR instruction ranging as CPR-A, B, C and HCP (healthcare provider).

With each level of CPR you are introduced to a greater range of the population and given more responsibility. A CPR-A certification allows you to perform Cardiopulmonary Resuscitation on adults as well as learning how to use an AED (Automated External Defibrillator).

As you move up to a CPR-C it gets you into doing CPR on children and infants as well as learning how to use an AED.

With greater range in population and responsibility in CPR also comes more range and responsibility in delivering first aid. An Emergency First Aid Course (where typically CPR-A & B would be taught) only covers minor emergencies and wounds in addition to the CPR component.

With a Standard First Aid CPR-C you learn to deal with life threatening emergencies as well as how to deal with different injuries to prevent them from becoming a life threatening emergency. Various topics covered would include:

• Airway, Breathing and Circulation Emergencies
• Wounds
• Head and Spine Injuries
• Injuries involving Bones, Muscles, Joints
• Sudden medical emergencies
• Heat and Cold related Emergencies
• Poisonings

All of the above are things that we as Massage Therapists could deal with in practice, at outreaches, on-site massage or even in day-to-day life with our families.

If you want to get just a little more advanced than a Standard First Aid, then the HCP (Health Care Professional) course would be a good starting point. It teaches you how to use devices other than your body to help people breathe as well as how to do Rescue Breathing, 2 person CPR and pulse checks (which you already know).

Workplace Emergency First Aid (W.E.F.A)

This course used to be called OFA 1 and was meant for use in various workplaces.

Much of the First Aid component to the course is very similar to Standard First Aid CPR-C. However since its intent is for employees in a workplace there is a far more legal aspect to it. There are entire components in the course regarding documentation of injuries and the First Aid that was performed on a worker. It also covers topics relating to:

• Occupational Health and Safety
• Workplace Written Procedures.
• First Aid Records
• Emergency Procedures.

While this course isn’t a typical First Aid course for most Massage Therapy clinics, I could see it being used in cases where a spa or larger clinic has employees instead of contractors.

Usually with this course one employee is designated as the First Aid person and any First Aid treatment, record keeping and First Aid room protocols are that employees responsibility.

First Responder

This is the course that Massage Therapists who want to be involved with sports teams should look into. More often it is becoming the standard course required by Sport Massage organizations and Sport Professional Practice Groups.

In some sport leagues and organizations it is a requirement for team therapists to have this certification. For instance within the BCHL the league has requirements that each team must live up to for game day operations. Their regulations stipulate that there must be:

• A team trainer that is: A doctor or no less than; a licensed Ambulance Paramedic; Occupational First Aid level 2 or 3; a Registered Nurse; Certified Athletic Therapist (they graduate their program with a First Responder license) or a Licensed First Responder Level 3 with AED, Spinal Management and basic airway management endorsements.
• An alternate medical person that must be at each home game to look after the treatment of players with all the same qualifications as listed for the team trainer.

At a minimum each team is required to have two First Responder Level 3’s at each game. So having this certification is not only a requirement to get involved, but may be a good stepping stone for those Massage Therapists who want to go this route with their career.

This course teaches you some more advanced care for medical emergencies and injuries in preparation to transfer the patient to Paramedics when they arrive on scene.

In the course you will learn:

• More advanced CPR
• Treating acute Soft Tissue, Musculoskeletal, Head, Spine, Chest, Abdominal and Pelvic injuries
• Sudden Illness
• Dealing with special populations, Childbirth (hope I never have to), Reaching and Moving People, Transport and Multiple Casualty Incidents

The closest equivalent course I could find for the U.S. is the Red Cross’ program “Basic Life Support For Healthcare Providers” (at least what I could find). Having this type of certification is important for working in these types of environments because the risk for injury is so much greater than a typical clinical setting. You are there to provide support to your athlete until ambulance arrives and the work you have done provides a base for the paramedics to work off of.

First Responder certifications also have limitations, they are meant to be used within certain distances from a hospital (typically under 20min travel time). This is the same certification most fire department personnel are trained to, as they are usually on scene to assist ambulance paramedics with medical calls.

With that in mind, the course is taught with the idea and assumption that you will be working with other trained responders and you would work together as a team providing care.

OFA 3 (Occupational First Aid)

This certification is the next step up from the First Responder program.

Although you learn many of the same techniques and protocols as the First Responder, you learn more about educating untrained people how to help. The course was intended for helping injured workers in industrial settings (logging, sawmills, heavy industry) with the assumption that you are the designated first aid person with untrained workers around you to help.

Where the First Responder program is designed to be within 20 minutes of a hospital, the OFA 3 is focused on providing advanced first aid for those more than 20 minutes from hospital, so you are also trained in transport. Learning how to position patients for loading on an emergency helicopter and how to provide care while transporting someone to either a hospital or an ambulance meeting you at a designated place.

For Massage Therapists this course would be good one for those who want to work in fishing lodges, heli-ski resorts, some tourism lodges and back country resorts. While it is probably not a requirement to get a job in these places it definitely wouldn’t hurt to have on your resume.

One of my friends who worked at a fishing resort said there were no other healthcare professionals on-site, so one of the guides was trained in first aid. We as healthcare professionals have a duty to help should something happen and our patients should have the confidence that we can help them in an emergency.

Photo by: Lyndsay Esson

How To Determine Which Provider To Use 

The first time I did my OFA 3, I was registered with a local company and excited to start the course.

I talked to one of the First Aid attendants at work and told him I was proudly registered and ready to go. When I told him who I was taking the course with he instantly looked at me and said “cancel it, DO NOT take it with them”. Then he told me the best place and instructor to use.

This is a valuable lesson.

If you’re taking any level of First Aid training, talk to some of the local people in your community that are in the industry. Get advice on who the best teachers and providers are. When teaching courses I’m shocked when people tell me that they didn’t learn some of the basics the last time they took First Aid.

In the US the Occupational Safety and Health Administration (OSHA) identifies American Heart Association, American Red Cross, National Safety Council (NSC), and private institutions as the main providers for training.

In Canada some of the bigger providers are the Heart and Stroke Foundation, Canadian Red Cross, St. John Ambulance and Canadian Ski Patrol.

Many of the independent instructors work under a license to teach first aid from one of the above companies. Look for a provider offering courses that are nationally recognized. Each Province or State may have their own standard that you must meet, try to find the courses that are nationally recognized or easily transferable in case you decide to move, it will save you having to re-certify before your license expires.

With so many courses out there take your time to decide which one is right for you and your practice. Whether you’re in a clinic, a sports team or working in an outback resort having the right certification will be a benefit to you, your career and your patients.

Hopefully after you’ll do a better job than these guys.

It was around 1am Monday morning, when I realized there was an issue.

He was one of the guys that mentored me when I started working at the mill.

We were all standing around at work telling stories and joking around. (Yes I know 1am is an ungodly time to be working).

Tonight, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.

I invited him to come and sit down for a coffee.

Walking him into First Aid shack, I sat him down and asked how he was feeling:

“not good”

How did your weekend go?

“I don’t remember, apparently I didn’t show up to work on Friday”

Did you leave the house to go to work that day?

“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”

As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.

Can you lift your arms above your head for me?

The right arm went up, left one didn’t move.

Can you kick your legs out for me?

The right one kicked out, left one stayed put.

We need to get you to the hospital.

“Just let me drive home and I’ll get the wife to take me in”

No, I’m calling an ambulance.

Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:

    “Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)

    “You should thank that little jerk, he saved your life”

The FAST Way To Stroke Recognition

Recognizing that someone suffered a stroke can be difficult depending on its severity.

Recognition is also one of the most important things in treating a stroke, since getting the person to advanced medical care increases the chance of limiting a strokes damage.

My friend in the story had gone three days without his family or friends noticing there was something wrong. He had no memory of the weekend and drove 45 minutes to work that night, with only the right side of his body working properly.

The Canadian Red Cross Emergency Care Manual gives the easiest way to recognize a stroke by using the mnemonic, F.A.S.T.

Here’s how you can use it to help figure out if the person has suffered a stroke:

Face

• have a look at the persons face and check to see if there is weakness on one side
• look and see if there is a noticeable droop around the eyes and mouth
• have them smile and check if both sides are moving equal

Arm

• check to see if there is any loss of sensation or weakness on one side
• assess how one side moves compared to the other side (remember in the story how he could only lift one arm above his head)
• this weakness can be present in the legs as well

Speech

• difficulty speaking
• slurred speech
• remember that one side of the body is typically affected, so even motor control of the mouth and tongue will be difficult

Time

• It is important to get them help ASAP to prevent things getting worse
• even the person’s concept of time and memory can be affected

The patient could also have sudden headaches, dizziness, confusion and a temporary loss of consciousness.

There are three main causes to a stroke.

• Tumors.
• A clot in the brain that either develops within an artery, or a mass makes its way to the brain from somewhere else in the body.
• An artery rupturing.

Although there is nothing we can do to help as far as the cause of the stroke, our ability to recognize the issue is key. If one of your patients is ever complaining of headaches, dizziness, confusion and in any way resembles the issues associated with F.A.S.T we need to get them to a hospital.

Stroke Survivors Conference, Department of Health Ireland. Photo: Mark Stedman/Photocall Ireland

9-1-1 And What You Can Do

Your safety is always the top priority.

In this case we can assume it is a safe environment since we are talking about your clinic and also safe to assume there is no spinal injury associated with the patient.

If you remember your last first aid course we always do a Primary and then a Secondary Survey (if everything in the Primary is okay and we aren’t doing any kind of life safety interventions).  In the Primary Survey we are checking for ABCs (Airway, Breathing, Circulation).

Since the person is talking to us we already know that they have an airway, they’re breathing and of course have circulation, Primary done.

In the Secondary survey we want to do a head to toe check. This is where the F.A.S.T mnemonic will become more evident.

Having the patient move limbs and using facial expressions will show you what part of the body, and to what extent the patient is having problems.

Now that we know what the problem is we want to get the patient into their most comfortable position (which will vary, but typically will be laying down) and if we haven’t done so already call 9-1-1

After calling 9-1-1 stay with the person and try to keep them as alert as possible. Our biggest responsibility is to stay with them in case they lose consciousness or require CPR intervention.

If a person loses consciousness (or prefers to lay down for comfort) but is still breathing, we need to get them laid down with their affected side up. The side that still has motor control and sensation must be on the ground. In case they begin to vomit, having gravity and motor control working together will help to keep their airway clear.

Since they still have sensation on that side, they will be able to know if anything is underneath them causing discomfort. This helps to prevent getting pressure sores as they could be in this position for a long time during transport to hospital.

I bumped into that friend about five years after his stroke. He wasn’t the man he used to be as the stroke had taken a toll on him. But he was still upright, walking and had his same old sense of humour.

I was sure glad to see him and even happier I was able to help him years before.

He didn’t call me a little jerk that day and even though he’s bigger than me, he could have at least called me a big jerk, I’m at least 5’10”!