Amy-Leigh Shepherd, ParaSoc Chair, shares her insights into a HEMS Simulation Day
Student Paramedic Societies, or ‘ParaSocs’, have a vitally important role in helping to build the confidence and competence of future paramedics. On the 2nd of October 2021, our Paramedic Society (ParaSoc) at Plymouth University co-hosted a simulation training day with Devon Air Ambulance Trust (DAAT). This event had 29 student members attend, working alongside five Critical Care Paramedics, six live actors and a makeup artist to help make the event as realistic as possible.
Before the event, a pre-reading list was available to members, allowing them to familiarise themselves with current guidelines to help maximise learning on the day. The ParaSoc team worked heavily with Joshua Barker from DAAT to create the following scenarios:
- Post-ROSC following ALS
- Crush Injury Trauma
- Major Trauma
- Paediatric Life-threatening Asthma
- Traumatic Brain Injury with a Pre-Hospital Emergency Anaesthesia Demonstration
Creating realism within the five scenarios allowed us to challenge our student members, encourage shared decision-making, and highlight the importance of good communication and teamwork within a high-pressured environment. Bringing the simulation to life involved a special effects makeup artist creating realistic injuries such as an open femur fracture and packable wounds using silicone prosthetics.
Additionally, makeup created an impression of diaphoresis, cyanosis, and bruising.
The actors were volunteer first year paramedic students who were briefed on how to act surrounding their presenting complaint and when to deteriorate or improve based on clinical interventions. It provided beneficial insight into the profession for the first years and enhanced the authenticity of the simulation for our ParaSoc members.
Clothes were donated for each scenario to encourage students to remove patients’ clothing as they would during traumatic incidents in front-line placements. ParaSoc supplied the volunteers with red clothing to wear underneath their outfits to simulate “skin level”. All participants were instructed to stop cutting clothes when they saw the red undergarments. By physically performing the task, our members felt more comfortable removing clothing in practice and searching for injuries that may be hidden by clothing. Feedback after the event highlighted that this was a beneficial aspect of the day because students felt removing clothing is often overlooked during simulation with a mannequin but is a necessity when conducting a thorough head to toe assessment in the pre-hospital environment.
The five groups rotated through the stations throughout the day, spending 40 minutes in simulation followed by a 20 minute debrief session. Spending an hour on each station allowed our members to embrace the simulation and practice interventions in real-time. An example of this is when administering medication; students used the plastic catheter of the cannula (with the needle disposed of) and attached it to the patient’s skin with a Tegaderm. They would then break open and draw up a placebo medication, often a glass ampoule containing water, or sweetener in a bottle for hydrocortisone. Administering the medication correctly instead of mimicking the procedure added to the realism as we all know how time-consuming and fiddly that can be in a crowded and loud environment!
Each scenario had a different approach to creating a challenging environment to emphasise the importance of good communication in a time-critical situation. The crush injury trauma was based in a dark man-made cave, where the patient had been trapped by a boulder made of cardboard and expanding foam. Each group had split themselves up to form two crews, and each responding group had one torch. Furthermore, a speaker played loud white noise to mimic the sound of the fire service stabilising the rock face, highlighting the importance of good communication and teamwork within a difficult working location. Establishing good holistic care became important in the paediatric life-threatening asthma scenario where students had to manage a frightful mother and a deteriorating patient. All these scenarios were gratefully received by all who attended, who stated it was a challenging but fantastic learning day.
Upon reflection, while the many benefits of this event outweigh the challenges we faced on the day, it is worthy to note that we would reduce the number of scenarios to help prevent fatigue for future events. Nevertheless, the length of each simulation felt realistic to front line placement and the 20 minute debrief afterwards was essential to solidifying learning and clarifying any questions. Our HEMS collaboration day has highlighted how we can get innovative with our ParaSoc CPD events to create a fun learning environment for our fellow students, to help increase their confidence through simulation. We hope that by sharing our experiences of running this event, we can inspire other ParaSocs to create and share their own!
This event would not have been possible without the help of the following people, so a massive thank you again:
- DAAT Critical Care Paramedics (Joshua Barker, Lee Hilton, Glenn Birtwistle, Neil Spencer and Mark Hawley)
- ParaSoc Committee (Nathan Evans; Paul Cook and Cara Clemow)
- Special Effects Makeup Artist (Poppy Shepheard)
- Live Actors + NQP (Shannon Murphy; Sophie Wills; Steve Griffiths; Katy Hope; Emily Carey; Adele Hontoir and Ashley Bowers)
Read the article in the context of the College of paramedics publication
