The EMS Syllabus

Here's a general outline of the process:

• Pre-briefing; 5 minutes (Explain the goals, expectations and logistics)

• Scenario; 20 minutes A realistic case scenario that aligns with the learning objectives.

• Debriefing and feedback; 10 minutes (review the learning objective and constructive   feedback)

• Repeat and reinforce; Additional simulation to address specific aspects that require improvements.

• Evaluation and continuous improvement;  Assess performance, and use feedback data for future scenarios.

1. Trauma Resuscitation

2. Respiratory distress

3. Sepsis Management

4. Stroke Management

5. Pediatric respiratotry failure

6. Team communication and Crisis resource management

7. Obstetric emergency

8. Code green

9. Neonatal resuscitation

10. Cardiac arrest

 A 35-year-old male is brought to the ED after a motor vehicle accident. The patient is unconscious with a Glasgow Coma Scale (GCS) score of 10. His vital signs include a blood pressure of 90/60 mmHg, heart rate of 120 bpm, respiratory rate of 28 breaths per minute, and oxygen saturation of 88% on room air. Physical examination reveals multiple injuries, including a femur fracture, a tension pneumothorax on the right side, and abdominal tenderness.

Learning objectives;

• Primary assessment (ABCD, Vitals and Critical actions)

  • • • 1. Airway checking, C-collar application, spine board application, 

        2. Oxygen with FM 

        3. Tension pneumothorax release followed by ICD

        4. IV fluid resuscitation

        5. Identification of Class 4 hemorrhagic shock (due to right femur shaft fracture and scalp laceration) and initiate massive blood transfusion (1:1:1) O negative 

        6. Call for help for eFAST (positive), and start Tranexamic acid 1 gm. 

        7. ECG and ABG (airway adjuncts)

        8. Pelvis X-ray and Chest X-ray

        9. Pain medication (look for allergies)

A 55-year-old male presents with sudden onset dyspnea, tachypnea, and accessory muscle use. Auscultation reveals decreased breath sounds on the right side and wheezing in all lung fields.

AA 70-year-old female with a urinary tract infection develops a fever, hypotension, tachycardia, and altered mental status.

AA 65-year-old male presents with sudden-onset right-sided weakness, facial droop, and slurred speech.

A 3-year-old child presents with severe respiratory distress, nasal flaring, and increased work of breathing.

 During a busy night shift in the emergency department, a conflict arises between two nurses, Amy and John. Both nurses are experienced professionals but have different communication styles and approaches to patient care. They are assigned to work together on a critical case, and tensions escalate due to their conflicting opinions on the patient's treatment plan.

A pregnant patient presents with sudden-onset vaginal bleeding, abdominal pain, and signs of hypovolemic shock

 The TL received a call at 8.30 pm that a boat capsized at Tanur around one hour back, expecting ~40 victims. 

Learning points

1. The preparation you do as a TL (Logistics and internal manpower)

2. Inform EP and HOD (Facilitate Crisis committee (HOD, CMS, and Administrator) meeting)

3. Facilitate ICS

4. Activate Code green

5. Surge capacity (capability)

6. Reverse triaging

7. Ask about the triage principle difference - Entry point triage Vs SALT (deploy EMS in coordination with the incident commander of the district, collector office).

8. Pre-briefing; 

9. Address unexpected challenges (hazardous material exposure & Just-in-time training)

10. Cardiac arrest case in between - do nothing (resource management).

11.  Debriefing.

12. Address specifically the communication issues (over-crowding).

AA full-term newborn is born with poor muscle tone, apnea, and inadequate respiratory effort.

APresentation: A 60-year-old patient collapses suddenly, becomes unresponsive, and has no palpable pulse.