I once did 10 cardiac arrests in one day. They were all v-fib arrests. I managed each code from the moment I arrived to find CPR in progress to the moment the patients were whisked off to the cardiac cath lab. I got 10 successful ET tubes, and despite the studies that show ET intubation may be harmful in cardiac arrest, all my patients survived. I also got tons of great compliments from the young health care workers who called me in to save the day.
A lifetime worth of cardiac arrest saves all in an afternoon.
Letâ€™s hear it for sim labs!
The hospital dental school was running scenarios for their students where their patients would experience sudden chest pain, then arrest requiring the students to start CPR and call 911. That was my cue to enter the room. Normally, the role of paramedic would have been played by a paramedic from the hospital fire department, but the fire department medics had multiple disasters that day so their humble EMS Coordinator was left to play the hero role.
The best part of my sim lab experience was the next six real cardiac arrests I did â€“ including a walk out of the hospital save â€“ went flawlessly (as far as execution anyway). I was on top of my game. (Unfortunately I got less praise from the onlookers than I did in the sim lab. The save patient, an elderly man, arrested on top of a prostitute, who was quite shaken up, while the rest of the people milling about in the house couldnâ€™t have been less interested.)
Practice does make perfect. And many of us (myself included) practice far too little than we should. I did a cardiac arrest a month ago after not doing one for some time, and while I managed, I was much more plodding than when I was fresh off my sim lab role.
Recently, I conducted a number of skill sessions scenarios that involved asking regional paramedics to follow some algorithms, and some of the medics did not do as well as I would have expected. While every month we practice STEMI care and it has paid off with our hospital winning Mission:Lifeline Gold for STEMI care, and some of our local services also winning Mission:Lifeline awards, these unpracticed scenarios did not go nearly as smoothly as the STEMI ones. You can lecture all you want about different topics, but few things beat hands on simulation. Show me your stuff. Do you have the muscle memory and the quickness under pressure when immediate action is needed. What do you do for a bad asthmatic who is dying in front of you? How about a patient in full blown anaphylaxis? How quick can you respond? How about an obstructed airway (Canâ€™t intubate, canâ€™t ventilate)? How quickly can you cut the throat and hit the right spot?
Does your service run practice scenarios? They should. Even commercial high-volume services should find a way to make this happen. Maybe Iâ€™m dreaming.
Some people take it on themselves to practice, and they deserve mega praise.
I write all this as a prelude to talking about the JEMS games. For those of you who are unfamiliar with them, EMS teams from across the country come together to run scenarios in front of a large audience of their peers to win pride and cash. The scenarios I understand are pretty crazy, lots of surprises in the midst of chaos. Bus crashes with babies being born, etc. I know a guy who twice participated in the JEMS Games and had a great time. I give him a ton of credit for the hard work and practice that went into his preparation for the Games and for having the guts to put his skills on the line for all to judge.
The JEMS Games are a part of EMS Today in Baltimore this coming February 25-27.
Here is some more info:
Highlights: The objective of the JEMS Games is to create a fun, challenging and educational experience for emergency medical personnel that results in them being better prepared for challenges that they may encounter in the field. More importantly, itâ€™s a goal of the JEMS Games to enlighten and invigorate EMS personnel from all over the world to deliver the same quality and compassionate care to all patients they encounter after participating in the JEMS Games competition.
The JEMS Games introduces competitors and audiences to new techniques and technology that can be used to manage patients of all levels of criticality. The competition also enables participants to share their expertise, experience, techniques and technology with EMS colleagues from throughout the world
Winning Teams will be awarded: 1st Place: $1,000; 2nd Place: $750; 3rd Place: $500
To participate: Contact Ryan Kelly at firstname.lastname@example.org
Video Link: http://www.emstoday.com/jems-games.html
If you havenâ€™t been, try the JEMS Conference next February 25-27, 2016 in Baltimore.
Use this link to register:
Save $100 off registration if you use the code SCRIBE.
Note: As part of the JEMS Blogger network, I am going to be doing some posts trying to get people to go to EMS Today. They are giving me a free pass, which I wonâ€™t be able to use, and it is non-transferable. I am writing the posts because I believe it is a great experience, and wish I could go, but canâ€™t.
Order Mortal Men Today.