EMS Should Train like Navy SEALs

 

 
 
 

William K. Atkinson, PhD, MPH, MPA, EMT-P | | Friday, June 24, 2011


When a major news story breaks, such as the recent demise of Osama Bin Ladin, the story is heard almost instantly around the world. First it’s tweets, then website posts, then TV and radio news stories. We hear audio clips, see maps and watch video shot from helmet-mounted cameras.

We’re also subjected to official and unofficial clarification of the details that modify “the real story”—almost by the minute—with the truth lying somewhere in the mix of information. And if the events themselves weren’t significant enough to be uniquely intriguing on their own, thousands of different sub-stories almost immediately take on a life of their own. This is a good example of what we now know as the routine and expected nature of instant communication.

This changing and ever-evolving instant print, broadcast and social media is also a good analogy for what field care providers experience when engaged in an emergency situation. Not everything is always as it first appears, and the need to clarify your understanding and make modifications is required for an appropriate and effective response. For those in emergency services with “boots on the ground,” what you know—and from an outcome standpoint, what you don’t know—can, and often does, change the course of the events, and on some occasions, history.

It’s worth noting that a major difference exists between being a recipient of the news vs. a participant in the news. If you were a member of the Navy SEAL team engaged in the now infamous raid in Pakistan on Osama Bin Ladin’s hide-in-plain-sight compound, you know that it took years of preparation, specialized training and intense simulation that culminated in the successful 40-minute, on-site operation.

Without simulation training, these elite Navy SEALs wouldn’t have been able to complete their mission. Success was all in the training. You may ask where simulation fits for you and me in our less-front-page daily activities. Professionals in any field can spend a lifetime preparing for missions that are relatively short in actual contact time. This is true for soldiers, astronauts, physicians, nurses and paramedics—all of whom spend significant time preparing academically, technically, scientifically and physically for procedures and missions that involve a limited number of critical minutes, hours, days or weeks.

Considered alone, many of the individual things soldiers and care providers study in school or practice may not appear specifically linked to the mission or betterment of the individual, but I believe that every single element of training can and does make a difference in mission outcomes. In the case of emergency services and medicine, training can mean the difference between life and death.

In the past, emergency services preparation and education was limited to classroom-based presentations and discussions. EMS providers would walk and talk through the process, often using themselves as mock patients. Teachers would ask questions and students respond with the textbook answer. But what if things on-scene don’t go according to plan? The response cannot be taught by a textbook, and in the moment, during a scene response, providers may not be mentally or physically prepared for what can and often does happen.

Education, practice and re-education are critical for emergency responders to become comfortable and more adept at caring for the sick and critically ill. Technology is changing the way prehospital care is delivered and how emergency response is taught.

Today, scenario-based programs more frequently involve computer games and human patient simulators, enabling EMS providers to have the opportunity to practice a response or a skill repeatedly in a safe, realistic environment. This repetitive, realistic practice helps engrain second-nature responses to that early morning car crash, baby delivery in a rural community or cardiac arrest. Simulation training offers the opportunity to practice skills complete with snafus and what ifs, and simulation training helps instill competence and confidence, improve and enhance communication, impart experience with uncommon situations and procedures and identify areas of opportunity.

So whether you’re a soldier participating in the early morning raid on Bin Ladin’s compound, an astronaut on a mission to the space station or a care provider responding to a mass casualty event, practice and training makes all the difference. It isn’t magic that enables a skilled response—it’s education and practice using all the tools in our educational arsenal from textbooks to simulation. It’s this education and practice that elevates the professionals among us.

 




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Related Topics: Training

 
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William K. Atkinson, PhD, MPH, MPA, EMT-Pis the president and CEO of WakeMed Health & Hospitals and a JEMS editorial board member. He has devoted more than 30 years of his career to improving our nation’s emergency medical and prehospital care system.

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