Cardiac & Resuscitation, JEMS Games, Training

Simulation Plays Key Role in 2012 JEMS Games

Issue 4 and Volume 37.

There was tremendous enthusiasm, new products and technology at this year’s EMS Today Conference & Exposition in Baltimore. But nowhere was the buzz more apparent than at the JEMS Games Clinical Skills Competition.

This year, 14 teams competed for more than $30,000 in prizes, including a $10,000
Verathon Glidescope Ranger video laryngoscope and a Masimo RAD-57 CO-oximeter. But the real star of the show was the latest simulation technology from Laerdal.

Their wireless, Bluetooth-controlled Sim-Man Essential simulator allowed us to take clinical care and competition to unprecedented levels.

The Laerdal/JEMS simulation and competition planning committee decided to use a comprehensive, integrated educational approach. This year, we selected asthma as the theme. In December, we published a comprehensive clinical education article on the management of an acute asthma patient.

In that article, we announced that an asthma patient would appear somewhere in the JEMS Games competition. Teams managed an acute asthma patient in the preliminary and final competition scenarios.

We had announced the asthma patient in advance for several reasons. The main reason was because asthma can hit all age groups and rapidly progress to cardiac arrest if not assessed and treated quickly. Another addition this year was Laerdal’s comprehensive Discover Simulation Toolkit, which was provided to each JEMS Games attendee. It included free access to the asthma simulation used during the Games.

It was an unprecedented, turn-key approach to EMS education that incorporated pre-test and post-test opportunities, on-site clinical education and two webcasts presented by Laerdal after the Games to help services implement the simulation. It was our hope that the teams registered to compete in the competition would prepare for this patient challenge and that attendees at the final competition would also have read the asthma article to add to their educational experience. We were anxious to see how the teams would perform.

Did they practice their asthma protocols? Would they “arrest” the symptoms before the patient progressed into cardiac arrest? And would they be able to perform and maintain consistent CPR for eight to 10 minutes during the grueling competition?

We revamped the preliminary competition course, incorporating the latest Laerdal wireless simulation technology in a way that would allow us to present each competing team with a “patient” that they would manage throughout the eight stations of the course. This allowed for us to set our patient “free” and for the teams to manage the same patient though the entire course. They rescued the patient from a hazardous environment, assessed his condition, including his deteriorating respiratory drive and abnormal capnography reading. As they cared for the patient, he lapsed into cardiac
arrest, forcing the crews to perform compressions-only CPR before and after they moved him through a tunnel and across an elevated platform to get him to a safe area for proper resuscitation.

This was all performed under the watchful eye of Laerdal’s simulation experts, who followed each team’s progress and changed patient vital signs and responses all along the rescue and resuscitation route.

Our efforts paid off, and we witnessed some of the best, coordinated care we had ever seen in the competition. It was apparent that the teams had studied up on asthma care. We also witnessed some amazing performances and use of technology and innovations.

A young team from the Virginia Tech Rescue Squad, which placed first in their local Advanced Life Support Skills competition at the National Collegiate EMS Foundation a week before the JEMS Games, inspired us by energetically and professionally performing to the best of their ability with just one ALS provider and two EMTs. They didn’t finish first in the scoring, but won the hearts of the judges and staff with their high energy, enthusiasm and near-perfect CPR.

Sussex County (Del.) EMS used a small, multi-function metronome attached to one team member’s uniform epaulet to not only help the team perform CPR at the proper AHA CPR rate, but also to allow a team member to adjust an important IV drip rate perfectly with the push of a button.

Cumberland County EMS took the gold in the finals with a near perfect score on the asthma patient, but we felt all of the teams were winners this year because they all managed the final scenario with skill, composure and professionalism. Most importantly, they took our lead and were prepared for the care of the acute asthma patient, helping us meet our educational objective for the event. JEMS