As we go into Winter here in Sydney we are gearing up for the August HEMS Team Induction Training. The following piece provides an overview of the philosophy and content of the training, which was originally written for a NSW Ambulance publication:
The Greater Sydney Area Helicopter Emergency Medical Service has helicopter bases at Sydney, Wollongong and Orange and provides a paramedic-doctor team to accident scenes, remote area rescue, and for the interhospital transport of critically ill and injured patients. Our doctors also work closely with NSW Ambulance flight nurses during long range fixed wing retrieval missions.
Every six months, new doctors are trained alongside new and existing critical care paramedics in a course that has become a world leader in its class, attracting participants from all over the planet.
The purpose of the first week of training, called the HEMS Team Induction Course, is to get critical care doctors and intensive care paramedics ready for the prehospital & retrieval medicine environment. This week consists of 60 hours of workshops, simulations, skill stations, and assessments, culminating in a 90 minute multi-station exam. 12 hour days are punctuated by additional practice, study, exercise (running around the airport), and unhealthy quantities of coffee.
In February there were 37 participants on the course, consisting of not just our own NSW Ambulance doctors and paramedics, but also doctors sent from Lismore, Canberra, the Royal Flying Doctors at Dubbo, CareFlight NSW Ltd, the Australian Defence Force, and overseas prehospital specialists. We trained individuals from Australia, Britain, Ireland, the USA, Norway, Poland, and Hungary.
The course is unique in several aspects. Firstly, the focus is on team performance, not individual success. Physican-paramedic teams are trained together and tested together, strengthening the teamwork and cooperation within the team and keeping the focus always on the patient. This generates a healthy competitiveness between teams, all striving for the best exam score!
Another key component is cross training. Physicians are taught logistic and scene management skills which traditionally are the responsibility of the paramedic. Paramedics are taught all the life, limb, and sight-saving surgical techniques in an animal lab that are the doctors’ responsibility to perform. Although paramedics do not directly perform these procedures on patients, this greater understanding of each others’ roles results in more effective team coordination and mutual support, with the aim of smoother, faster missions.
Simulation is the key to performance improvement. We strive to put clinicians ‘in the zone’ so that it feels as real as possible. One way to do this is to use human actors rather than the unrealistic manikins that can’t scream or become agitated and combative.
Everyone reading this knows that prehospital care can be really tough for a number of reasons. To prepare our teams for the more acute pressures of the job, we include stress exposure training as an increasing component of the simulations throughout the week, culminating in a fairly extreme ‘stress inoculation’ station as part of the end of week exam. A strong element throughout the course is human factors training, which includes imparting the tools required to minimise the effects of stress on performance. Many of these lessons have been learned in sporting and military domains, and translate well into prehospital practice.
The opportunity to run this training every six months provides us with a ‘training laboratory’, in which we continue to improve the quality and effectiveness of the training based on participant feedback and team performance. A massive and complex logistic exercise, we welcome qualified NSW Ambulance staff to act as helpers to act in simulations and to provide other hands-on support. Anyone interested in helping with the HEMS Team Induction Course in August 2016 or February 2017 should contact Paul Kernick via the NSW Ambulance intranet.