High-Tech Training Preps Agency

High-Tech Training Preps Agency

By James Careless Jan 09, 2012

It was the type of incident a fire/EMS unit dreads. On January 8, 2011, 19 people were shot in a Tuscon, AZ, supermarket parking lot including Congresswoman Gabrielle Giffords. Six people died as a result. The rest were saved due to speedy, knowledgeable assistance from the Northwest Fire/Rescue District (NWFD) response unit. (Giffords herself survived, despite being shot in the head at point-blank range.)

Coincidentally, NWFD’s people were prepared to deal with a mass casualty event. One month before, they had joined with the Arizona Simulation Technology and Education Center (ASTEC) in conducting a mass casualty field exercise. The exercise, which was staged at NWFD Station 31, simulated a two car collision with seven victims. 

All of the victims were realistically portrayed by a range of iStan patient simulators. Made by Medical Educational Technologies, iStan manikins look and react like real patients, with reactive eyes, varied breathing and authentic sounds. The iStans are able to deliver pre-recorded human speech reactions, or relay live audio from a human actor nearby. At the same time, the manikins output diagnostic data in real-time to either wired or wireless monitors. During exercises, this data can be used by EMS to monitor the manikins’ reaction to treatments in real-time. After the fact, the iStan data can be reviewed by educators to see how EMS staff performed under pressure, and aid them in making improvements for next time.

During the December 2010 mass casualty exercise, the iStan manikins simulated a 6-year-old boy with an epidural hematoma, a 72-year-old man having a STEMI cardiac event and a 36-year-old female in active labor with a partial abruption.

“The female iStan was so realistic, that it even gave birth,” says Sean Culliney, NWFD’s EMS training coordinator. “The unit has a little pump built in that pushes the fetus out. You can even specify a normal, breech, or prolapsed cord birth.”

The NWFD’s investment in iStan training manikins made the difference in lives saved on January 8, 2011. So did the department’s commitment to other forms of IT-based education, including distance education courses conducted with  ASTEC and Web-based training for the department’s 10 stations/30 shifts.

The department’s move to IT-based training didn’t occur overnight. Instead, it took seven years for the NWFD’s institutional culture to change from resistance to acceptance. So what changed people’s minds?

“We realized that we needed to be able to see what we were doing and how we doing,” Culliney says. “Take paper-based EMS medical records: You cannot perform real-time queries on such records to see how many IV setups happen on a daily basis, and what other choices EMS personnel are making on the job. In contrast, electronic records can be queried quickly, and responses/outcomes assessed.”

Electronic data also makes a difference during training. Take the iStan manikin: Using its real-time diagnostics outputs—and patient-like responses—EMS staff can see what’s happening and react as they would during actual incidents.

“Using passive training dummies, the staff would typically ask the trainer, ‘What am I seeing,’ and then respond,” says Culliney. “This is not what happens in the real world: You see the patient and make decisions without the benefit of a trainer standing over your shoulder. The iStans bring this reality to a mass casualty exercise. The person being trained is confronted by the kinds of data they would see in an actual incident, and works with this data without resorting to the trainer.”

Continue Reading

From an EMS staffer’s point of view, the iStan’s realism could pose a danger to their career. This is because any mistakes they make during training are on the record for all to see.

“This is why it is so important not to use IT-based training in a disciplinary manner,” Culliney says. “We use the training data to help our staff improve their decisions after the fact, but never to penalize them.”

On a larger scale, using IT-based training helps the NWFD make meaningful performance improvements. “Historically, people have looked at improving response times as the way to enhance EMS performance,” Culliney says. “But getting to the scene quicker means nothing if the treatment you provide isn’t effective and life-saving. This is why the iStan and other forms of IT-based training are so important. Properly analysed, their data can help our people make better decisions during actual events—and provide better care in the field.”

The lives saved during the Tucson shootings speaks to the effectiveness of the NWFD’s IT-based training program. This excellence was recently recognized by the Congressional Fire Services Institute and the MedicAlert Foundation, when they presented the NWFD with a Excellence in Fire Service-Based EMS Award for Best Practices by a Career Fire Department.

“IT-based training helps our people do their jobs better,” Sean Culliney concludes. “It helps us save lives, which is the whole point of what we do.”

James Careless is a freelance writer with extensive experience covering computer technologies.

Residents who register with the program provide important details about health conditions and even bedroom locations so rescue workers spend less time searching for victims.
Inc. magazine ranked GD 2503 on its 36th annual Inc. 5000, the most prestigious ranking of the nation's fastest-growing private companies.
Developed with the help of paramedics, bystanders who witness a heart attack or cardiac arrest can use the app to send an SOS to nearby CPR-trained people, check if someone has called the emergency number 119, and alerts them of nearby AEDs.
Verizon brought responders together to see the benefit of new technologies.
Previously used between first responders to share urgent information during disasters, BerksAlert can now alert residents of local emergencies.
Vitals is an app that provides first responders with an individual's diagnosis, medications and caregiver contact info so they know how to respond appropriately to people with mental or physical disabilities.
Healthcare leaders select Redivus Health clinical decision support platform as Best in Show and winner of Clinical Information Management category.
The Pulsepoint app sends alerts from dispatch calls to citizens who know CPR if a nearby person needs aid before EMS can arrive.
Emergency Reporting’s integration with StreetWise links the data used or produced in the apparatus during a response with data stored in a department’s records, significantly improving accuracy, situational awareness, safety and efficiency during emergency response.
Pulsara knows that time is brain and radios can be unreliable, which is why their communications app for EMS to relay clear, accurate patient information to the ED has been improving patient care.

More than 300 state and local agencies have added drones to their arsenals, including a Texas police department that used a drone to spot an escaped convict. The drones can be used to locate active shooters inside buildings, people trapped in burning buildings, and lost hikers.

Redivus Health was selected as a finalist for its innovative, industry leading product, which improves patient care by providing physicians, nurses and paramedics with actionable, clinical guidance during a critical care event.
Frank Gresh, MS, discussed the risks that agencies face in cybersecurity breaches and how they can protect themselves from these threats.
Canada’s premier event for paramedic personnel draws attendees from coast to coast.
Thousands of public safety communications officials will attend this international event next week in Denver, Colorado.