By Rachel Cooper, Brooke Army Medical Center Public Affairs InternMay 3, 2018
JOINT BASE SAN ANTONIO, Texas -- The San Antonio Uniformed Services Health Education Consortium (Emergency Medical Services) and Disaster Medicine Fellowship hosted the first EMS Residents Day March 29 at the Bulverde Centre for Emergency Health Sciences.
Emergency medicine residents from Brooke Army Medical Center spent the day learning about prehospital medicine and mastering critical care medical procedures while gaining an understanding of the value of civilian partnerships and education.
EMS Residents Day is, "a day where hospital-based doctors gain a perspective on everything that happens before the patient arrives at Brooke Army Medical Center, teaching them critical care skills and showing them that as clean and organized as a hospital trauma bay might be, the outside world is the exact opposite," Air Force Col. Chet Kharod, program director of Military EMS and Disaster Medicine Fellowship said.
During the day, residents spent time in a critical skills lab where they performed medical procedures on cadavers and also practiced prehospital care using an ambulance.
"It's an incredible resource to have actual human bodies, to be able to feel tissue and have muscle memory before it truly matters when we're out there with fewer resources and support," Air Force Maj. (Dr.) Kristen Kann, associate program director of BAMC's Emergency Medicine Residency said.
Air Force Capt. (Dr.) Rachel Ely, emergency medicine resident, said there's only so much training you can do on a mannequin and the residents take any opportunity to get more exposure to practice skills.
Army Capt. (Dr.) Derek Brown, emergency medicine fellow, said they practiced basic airway management, how to ventilate with a mask, intubation, central line placement, chest tube and extremity amputation.
There was a scenario for the residents in which a person is stuck under a large object such as a car, their extremity is trapped and the situation is life threatening, Brown explained.
"In those very rare and dramatic cases you'd opt to amputate an extremity and save the person," he said. "It's a procedure most people only read about."
In the cadaver lab they positioned the cadaver sitting up, lying back, flat on the table, or the ground to get the participants out of their comfort zone.
"We take what we learn from the civilian side [of EMS] and what we know from a deployed [battlefield] setting and try to integrate those two components together," Brown said.
The training event was beneficial to both military and local emergency personnel.
"These EMS physician fellows sharpen their skill set by not only teaching but also sharing their combat experience with civilian counterparts in the prehospital arena," Scotty Bolleter, emergency medical technician, chair of Centre for Emergency Health Sciences, said.
After the residents worked in the critical skills lab they took turns doing en route care on the cadaver as the ambulance drove around.
Kharod said by participating in events like this, the residents are able to understand the challenges a classroom might not be able to teach them.
The residents are able to learn procedures they don't normally do, learn better ways to do procedures and can conduct research on the procedure itself, Brown said.
"Our EM residency is to train the best EM residents in the world and part of that is battlefield readiness," Kann said, adding the practice ensures that when they do a procedure it's their 20th or 30th time doing it.
Kharod said the residents also work with San Antonio EMS and do mass casualty drills and joint training exercises because if a disaster happened, those are the people they'd be side-by-side with.
It's important to increase human contact and foster partnerships before something happens so they already know how to work together, he said.
The residents not only work with military medics but train with San Antonio Fire Department and do a one month prehospital/EMS rotation and interact with civilian EMT medics.
"Otherwise, the only time we see them is when they deliver a patient to us," Ely said.
"We want to create experts in prehospital care who can not only do the procedures to save lives but also teach people and set up systems that will save lives," Kharod said.
"The participants are procedurally doing what they do in an emergency room, but are learning how to work in a prehospital arena and blend those experiences together," Bolleter said.