Volume 3 Issue 2

A model to embed clinical simulation training during ambulance shift work

Paramedic education is now commonly delivered by educational institutions, but there is still a continuous need to ensure the competency of experienced staff and to help with orientation to newly adopted pieces of equipment, brief staff concerning new protocols or guidelines, and to allow them to practise in a safe and controlled environment. A complementary solution to traditional training rooms proposed in this article is to use a mobile simulation unit to take the training where ambulance staff are located, to fulfil their duty of care. The possibility of offering simulation training using a specially designed vehicle while a crew is waiting would improve the efficiency of the use of their time and enhance their training opportunities. There are several options regarding the training vehicle that could be used to fulfil this role depending on the budget and facilities that are to be offered during the training, but only two will be explored in this article. An additional key resource that will be discussed is the team of educators that are required to facilitate such training sessions to ensure they are effective and valuable learning experiences that will enhance pre-hospital care service delivery and benefit patient care. Over time, the training vehicle and its team, supported by an additional ambulance to cover for the team undertaking the training, would conduct their focused simulation training sessions with all the clinical staff of an ambulance service without affecting the rota of the crews or putting temporarily geographical areas at risk. The seeming strengthening link between enhanced levels of patient safety and the use of clinical simulation, while still not fully evidenced, is becoming more established, especially as ways of integrating such activities with day-to-day operations can be developed and adopted.

Providing medical aid to Brazzaville, the Republic of Congo

Following five explosions in Brazzaville, the Republic of Congo on 4 March 2012, a field hospital was flown in from South Africa to help deal with the aftermath. Donated by the Ichikowitz Family Foundation, it aimed to treat the injured patients who were in excess of 2 300.On arrival, a singular old-style army tent, sponsored by the French petroleum company Total, was the only medical service on the site. The tent was manned by staff from the French charity Médecins d'Afrique.Building the hospital from the ground up took eight days and several late nights, during which time the population of the neighbouring refugee camp was growing. A four metre high wooden fence was built around the camp and hospital to keep some sort of control. The Red Cross and several other non-governmental organisations (NGOs) became actively involved, supplying clean water and food aid to the people.Since the events of 4 March 2012, the field hospital has gone on to provide medical aid to the communities of Brazzaville, dealing predominantly with human immunodeficiency virus (HIV), tuberculosis (TB), cholera, hepatitis A, typhoid and malaria.This article is a personal perspective that explains the origins of the field hospital and the work that it has done since 2012.

Effect of low dose high frequency training on paramedic cognitive skills

<strong>Background:</strong> Paramedics in many parts of the US are required to obtain advanced cardiac life support (ACLS) recertification every two years. However, like other healthcare providers, they may experience problems with retention of this knowledge.<strong>Study objectives:</strong> This year-long study examined the difference in ACLS cognitive performance, measured by a modified Megacode, between two groups of paramedics: those who practiced for 10 minutes monthly over 10 months using brief computer-based ACLS scenarios, and those who did not refresh.<strong>Methods:</strong> Participants were randomised into the experimental group using computer gaming for a minimum of 10 minutes a month, and a control group that did not. In month 12, all participants took a post-test Megacode.<strong>Results:</strong> 27 (79%) of the experimental and 18 (95%) of the control group successfully completed the pre-test Megacode. 38 (72%) of all participants passed both the pre- and post-test Megacodes; three (6%) failed both Megacodes, five (9%) of the experimental group who failed the pretest passed the post-test at month 12. Four participants in the experimental group and three in the control group failed the post-test at month 12.<strong>Conclusions:</strong> paramedics recalled ACLS algorithms with or without practice.