CAMP RILEA, Ore. –
When an Army National Guard medic needs to practice skills on a patient, the resources are fairly limited. Splinting a classmate or briefly placing a tourniquet on a squad-member is about the extent of the hands-on simulations.
Placing a chest tube or shocking a patient with an Automated External Defibrillator is something most Army medics hope to never use, but recently medics assigned to the Kentucky CBRNE Enhanced Response Force Package (CERFP), got to do exactly that in a real-life emergency trauma simulation.
“I’ve only read about this, I’ve never done it before,” said Army National Guard Sgt.
Ryan Stull, Headquarters and Headquarters Company, 103rd Chemical Battalion medic.
“This is as real as we can get without having a real-world trauma patient,” he said.
The HAL Mobile Team Trainer is a $38,000 piece of equipment that includes a wireless mannequin that can run a wide-range of medical scenarios. HAL is controlled with a computer tablet at distances up to 300 meters and can respond to questions posed by medical staff. It sweats, can bleed, breathes and has a pulse.
It was used to enhance the training of Mobile Medical Response Teams (MMRT) comprised of Guardsmen from Oregon, Idaho, Kentucky and Utah; healthcare providers associated with the State Emergency Registry of Volunteers- Oregon and FEMA representatives during Operation Cascadia Rising June 7-9, at Camp Rilea, Oregon. The exercise simulated a 9.0 earthquake along the Cascadia Subduction Zone and tsunami that could follow in the event of a real earthquake.
“I’ve never got to use anything like that before outside of the school house,” said Army Guard Sgt. Caitlyn Hernandez.
“There were a lot of states involved with this and civilians which brought more knowledge and experience put into play with these scenarios,” she said.
Hernandez was teamed with a civilian volunteer Emergency Department doctor during one iteration of training with HAL. After an assessment, the medical team determined a chest tube was required, something that would usually be halted and “simulated,” by talking the observer through the procedure.
“He walked us through the chest tube insertion and it was interesting to feel inside the mannequin’s chest for exactly what we are clinically taught,” she said. “I wouldn’t have received that feeling or experience anywhere else.”
According to Paul W. Burley of Kaiser Permanente, the company that provided the simulators for Cascadia Rising, the mannequins were developed for anesthesiologists to practice airway management for surgical patients.
“Studies show that repetitiveness and hands on simulation leads to that muscle memory in a trauma situation,” Burley said.
“If you’re not doing the correct intervention, the mannequin won’t get better, so this demands teams to communicate and work together on a responsive patient rather than talking through table-top drills, which is how we get that muscle memory,” he said.
While National Guard medics are familiar with combat medicine, the HAL provided much-needed training for dealing with assisting civilians in accidents or trauma caused by aftermath.
Army Guard Sgt. Ryan Hunter, a medic assigned to the 206th Engineer Battalion, but attached to KY-CERFP, said the training mirrored what he has received as a civilian paramedic for Madison County Emergency Medical Service.
“I’ve been exposed to it pretty frequently with my civilian work, and the benefit of high-fidelity simulation with expert instruction cannot be understated,” he said.
“In the Guard medical side of things, it’s somewhat of a rarity and I am incredibly happy that the junior medics were exposed to it.
“It provides us with a great opportunity to employ perishable skills, train in clinical decision making, act under stress as a cohesive team in a safe environment,” he said.
The team worked a simulated code – where a patient’s heart stops beating – and had to quickly and concisely communicate effectively to save the patient’s life.
“This training encourages them to take the lead in the skills of their ability,” said Dr. Erin Schneider of Kaiser Permanente.
“The single most important thing in a trauma situation is establishing team roles and communication, then your clinical kicks in,” she said. “This team was by the book and communicated very well.
“I think the people of Kentucky should know that if the real thing happens,” Schneider said, “[these medics] know immediately what to do because they’re practiced on definitive care and they are extremely knowledgeable on their job.”