At the end of August a team from the Academy went out to Jaffna, in the Northern Province of Sri Lanka to deliver the first ambulance instructor and ambulance crew training courses. A site visit took place earlier in the year which included a needs assessment for training their ambulance staff. The ambulance service has an NHS system in mind and is free to all within the Northern Province. The service started in January 2016 following a donation of 100 ambulances from Japan, however the ambulance staff were yet to be trained.
Week 1 saw us take 12 medical officers (Doctors) from across the province through an ambulance instructor course. We spent three days translating the emergency medicine they already know into ambulance practice, which included a lot of scenario and simulation work. The centre we had for training was excellent, lots of interesting places and spaces to run simulations and make the training as realistic as we could.
The doctors were incredibly receptive to the training and saw it as a great refresher for their own emergency care skills. They got stuck into every simulation and worked well as team to learn quite a lot of new skills in a short space of time. The final two days were spent covering teaching and learning strategies and discussing how they were going to deliver the Basic Ambulance Crew Course (BACC) to 24 ambulance staff in week 2. The second week also promised to be a challenge for the academy team as it would be delivered wholly in Tamil.
The instructor course was a long intensive week, but we had great fun delivering it and saw 12 doctors go from no prehospital experience to a group that could happily operate on ambulances and care for patients outside of their normal hospital setting.
Week 2 saw 24 ambulance staff, both drivers and attendants come from across the region to take part in the first Basic Ambulance Crew Course (BACC). They were a mixed group, some with many years’ experience including a lot of trauma experience during the civil war. Others were less experienced which meant we had a really good balance when running the simulations. That said, those with lots of experience had not really had any formal training and so all took great pride in learning new skills and were absolutely committed to getting it right. It was refreshing to have a group of students and instructors so invested in their education and it ensured an excellent two weeks on this project.
We took a lot of pictures (c5000!), and a selection of the best will be uploaded to Flickr very soon. Our next steps are to return to Jaffna in the next 6 months to quality assure a course delivered by their new ambulance instructors and continue discussions on how best to develop their service to best meet the needs of the population.
A fantastic project, and I look forward to working with colleagues in Sri Lanka for many years to come.
We had the pleasure of hosting 10 delegates for a College of Paramedics CPD event this week - the topic was Paediatric Resuscitation. The morning started with some resuscitation reminders and a short discussion on clinical human factors.
Of the 10, there was a good mix of students and registrants from a variety of different NHS Trusts. All worked on frontline for the ambulance service.
A couple of interesting findings from the mornings discussion:
Our intention for the day was for delegates to leave with increased confidence in managing paediatric emergencies, this would be achieved using our immersive interactive classrooms.
From a human factors point of view, it was beneficial to understand from the beginning that none of the group have done any paediatric assessment or post-registration courses. It meant that there were no assumptions made about abilities within the group, so that they could enter each scenario knowing that there skill levels were fairly similar.
This left us somewhat confused...
With lots of emphasis on ALS assessments to gain employment (usually, if not always on adults) we should, and so, expect Paramedics to be very good at it. For the most part, we are (for adults) but two reports (Jewkes, 2001 and Houston & Pearson, 2010) highlighted some years ago that paediatric education was lacking and that it was highly likely an ambulance person with no specific paediatric training could attend a child.
And so in 2016, it seems that those findings may still be the case. Now we just had a snapshot of 10 people, so I would be interested to understand what happens where you work. Please comment on the blog posts, but I'd like to survey the College membership later this year to get a more significant picture from across the country.
Academy Director and Paramedic
Jewkes F. Current topic: Prehospital emergency care for children. Arch Dis Child [Internet]. 2001 Feb 1 [cited 2015 Jul 13];84(2):103–5. Available from: http://adc.bmj.com/content/84/2/103.full
Houston R, Pearson GA. Ambulance provision for children: a UK national survey. Emerg Med J [Internet]. 2010 Aug 1 [cited 2015 May 2];27(8):631–6. Available from: http://emj.bmj.com/content/early/2010/05/31/emj.2009.088880
The Academy team have returned from a fantastic weekend in Oxford at the inaugural Student Paramedic International Rally of Emergency Simulations (SPIRES) event, organised by Oxford Brookes University in association with the College of Paramedics.
12 teams took part and were made up of student paramedics from Turkey, Australia and the UK, who competed against each other in 8 challenging simulations over an intensive day.
I delivered the paediatric scenario, which was great fun (I had fun anyway!!) The setting was Nottinghill Carnival in London, a 6 year old child in status epilepticus. The team were working on foot with limited equipment available. It was as much a human factors sim as it was about clinical interventions - the environment was dark, loud music played throughout and confined spaces were created to fully immerse the teams into the situation.
All teams did very well under challenging circumstances, with variations in clinical practice seen from the international teams. Also, some teams realised why your kit should always be kept nearby - some naughty bystanders 'removed' it from the scene!!!
Other scenarios included a confused older adult, major trauma, mass casualty, obstetric emergency all designed and supported by conference sponsors and the team at Oxford Brookes. All were challenging and required a team approach to manage each situation - I was hugely impressed with the standard of care on display from all the teams that took part.
At the end of the evening, I had the pleasure of presenting the final award, on behalf of the College of Paramedics, to the Plymouth A team (below)! Over the course of the day this team showed true teamwork, dedication and clinical excellence to score the highest mark overall. Very well done team!
An exciting conference programme followed on day 2, with local and international speakers giving their perspective on the profession and clinical practice. Some truly inspiring talks were given over the course of the day, which I have no doubt will have broadened the horizons of those students in attendance.
Finally, I want to give a huge thank you to Georgette, Antonia and the team of staff and student volunteers that created this event and made it such a huge success. And thanks also to the College of Paramedics and event sponsors for their support, without which the weekend would not have been possible.
Students were engaged, enthusiastic and focussed - and most of all they enjoyed it and have key learning points to take back to their own practice. Meducation at its finest!
Oh, and no pressure team, but I can't wait for SPIRES 2017, I've already started thinking of a new paediatric simulation......!!!
By Will Broughton, Academy Director and Paramedic Educator
(@WilBroughton / @AcademyProDev)
A short piece on what I have taken away from day 1 at #smaccDUB.
What a day! First visit to SMACC and I was not disappointed!
The conference opened with a laser / smoke / visual effects display leading straight into session 1 - the John Hinds plenary.
The morning session provided a very fitting tribute to Dr John Hinds (aka Delta 7). Dr Victoria Brazil opened with a session dedicated to feedback methods, her take-home messages:
From the memory of Dr John Hinds came the following the quote:
'Make your intentions honourable, the patient is at the centre of everything'
This was met with #WhatWouldJohnDo, food for thought next time you encounter a challenging situation.
Tribute was given from Dr Hinds partner and mentor and a video showcasing his life was concluded with a standing ovation - demonstrating the impact this amazing doc has had on the medical community.
Next up for me:
My final thought for the day came from an Australian Army video in the last session - it was quite simple:
'The standard YOU walk past is the standard YOU are willing to accept.'
'If you're not willing to uphold those basic standards, then get out!'
By Will Broughton, Academy Director and Paramedic (@WilBroughton)