2018 TEAM PLAYBOOK 20-21 SEPTEMBER | GOLD COAST, AUSTRALIA FERNO - - PDF document

20-21 SEPTEMBER | GOLD COAST, AUSTRALIA

2018 TEAM PLAYBOOK

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FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

2 CONTENTS

Important Dates / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 3 Useful Contacts / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 3 Social Media / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 3 Introduction / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 4 Team Composition / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 5 Registration and Entry Fee / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 5 Registration Process / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 5 Mandatory Forms / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 5 Uniforms / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 6 Team Check-In / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 6 Team Lock Down / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 7 Permissible Equipment / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 7 Equipment Supplied by FernoSim / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 8 Medications Supplied / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 9 Body Substance Isolation (BSI) and Personal Protective Equipment (PPE) / / / / / / / / / / / / / / / / / 10 The FernoSim Competition Process / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 10 Scoring of the Final Competition / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 11 Awards Ceremony / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 11 Procedural Guidelines / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 12 Key Skills / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 12 Reference Material / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / 17

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3 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

Important Dates

DATE TIME DESCRIPTION Friday 20 JULY 2018 17:00 AEDT REGISTRATION DEADLINE Thursday 20 September 09:30 - 11:30 Team check-in, Briefjng and FernoSim gear inspection 12:00* Group 1 transfer to FernoSim Preliminary Challenge 12:30 - 16:00* FernoSim Preliminary Challenge Evening PAIC 2018 Welcome Reception Friday 21 September All Day Conference & Exhibition 16:30 Team Lock Down / Communications Black Out 17:30 - 21:00 FernoSim Finals Saturday 25 November All Day Conference & Exhibition Evening PAIC2018 Dinner and FernoSim Presentation Fees section. * A Preliminary Challenge will be held should FernoSim registrations exceed a threshold ** The PAIC 2018 Welcome Reception is included in the Conference Fee and only open to registered delegates. Participating FernoSim teams are eligible for a deeply discounted conference fee. Refer

Useful Contacts

FernoSim Registration Ceserina Thomson fernosim@ferno.com.au +61 (0)411 601202 FernoSim Challenge Rules Colin Allen fernosim@ferno.com.au +61 (0)417 745576

Social Media

Join us on social media! Follow us on Facebook, Instagram, Twitter or YouTube for news, tips and behind-the-scenes fun and share your own stories in the lead up to the competition. The official hashtags are #FernoSim and #PAIC2018 Ferno Australia Paramedic Sim Challenge FernoSim @FernoSim Ferno Australia (FernoSim Playlist)

Fees

FernoSim Challenge AU $200 per team (maximum of four per team) PAIC 2018 (Optional) AU $350 per person - special discounted registration fee for team members only and covers PAIC2018 sessions and Welcome Reception Gala Dinner TBA - still in negotiation BACK TO CONTENTS PAGE

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FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

4 INTRODUCTION

Objectives The objective of the Ferno Australia Paramedic Simulation Challenge (FernoSim) is to create a fun, challenging and educational experience for emergency medical personnel. Our aim is to promote paramedic excellence and provide an opportunity that results in team individuals being better prepared for the many challenges they may encounter in the fjeld. FernoSim provides a platform for paramedics to hone their collective professional skills. It’s also an opportunity for participants expand their professional network and to share their expertise, experience, techniques and technology with colleagues from around the world. About the FernoSim Challenge FernoSim Preliminary Challenge Should the number of registrations exceed a set threshold, a Preliminary Challenge will be held on 20 September. The Preliminary Challenge will consist of a number of 10-minute scenarios conducted at work skill stations to challenge your clinical skills and knowledge, team communications and effjciency. The six highest scoring teams will go through to the FernoSim Finals. FernoSim Finals Challenge The FernoSim Final will be held on Friday 21st September. The Challenge is a 20-minute, scenario-based incident that tests each team’s ability to manage multiple patients with varying illnesses or injuries in front of a large AUience of their peers. The Competition focuses directly on each team’s ability to:

• Effjciently work as a team;
• Gain control of a scene including conducting a thorough scene and hazard assessment;
• Patient and crowd control;
• Zero in on each patient’s illness or injury and manage each condition in a complete, compassionate and

effjcient manner. The competition also serves as an exceptional learning opportunity for the AUience and participating teams. These rules and regulations are designed to ensure standardisation in team preparation and on-site operation and administration of the FernoSim, operated by the FernoSim organising committee. To ensure consistency with the rules and regulations, only the designated FernoSim Coordinator is permitted to render an interpretation of the rules and regulation, offjcially address team concerns or make on-site operational/ administrative decisions.

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5 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

Team Composition

• An eligible team comprises three individuals capable of functioning together or individually in prehospital
• situations. Examples of eligible roles include paramedics, EMTs and military paramedics.
• One team member must be an Intensive Care Paramedic or equivalent.
• A fourth (alternate) team member may be registered with a team (and so designated) and substituted in the

event of illness or injury of one of the three primary team members or other reason acceptable to FernoSim

• ffjcials. The alternate must be so identifjed at the time of registration and may only be substituted with the

advance notifjcation and approval of the FernoSim Coordinator.

• Physicians and physician assistants are not eligible for this competition, even if they also hold EMT or EMT-

paramedic certifjcation. Registration and Entry Fee Registration for the FernoSim is strictly limited and accepted on a fjrst-come-fjrst-served basis. A team is not considered to be registered without submitting a complete application and entry fee. Registration fees for the Paramedic component of FernoSim is AU $200 per team of up to 4 members and includes participation in Ferno Australia Paramedic Simulation Challenge 2018. The FernoSim schedule has been devised to avoid timetable clashes with the PAIC program. Apart from Team Lock Down, teams are free to attend all conference sessions. The special discount rate for FernoSim team members is AU $350 per person. Tickets to the PAIC2018 Conference Awards Dinner are not included in the conference fee. Tickets can be purchased

• nline during the conference registration process. It is mandatory for at least two team members to be present at the

Dinner to receive Awards. Registration Process

• Complete and submit the forms included in the FernoSim Team Application Kit.
• Return the forms by email to Ceserina Thomson - fernosim@ferno.com.au

Mandatory Forms An interactive FernoSim Entry Forms Pack is available for download which can be completed on your computer or tablet, stored to your device and returned to us by email. The Forms can also be printed and hand completed if you

• prefer. The Entry Forms Pack includes suffjcient forms for all team members as follows:
• Team Application Form (1)
• Participation Agreement & Liability Release Form (4)
• Code of Conduct Form (1)
• Permission & Photo Release Form (4)

NOTE: Failure to complete the waiver, or failure to abide by the principles and practices outlined in the waiver, will result in a team or team member’s disqualifjcation without any refund. Submit all your registration materials to:

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Uniforms We can guarantee there’s going to be alot of photos and video taken throughout FernoSim for broadcast far and

• wide. So please can each team member wear their department or FernoSim competition uniforms during the

FernoSim challenge and at the awards presentation. Team Check-in and Briefing

• Please be prompt and present at the designated start time as there’s alot to get through.
• All team members will be required to present offjcial, current EMS certifjcation cards at check-in.
• Team Check-in venue and time will be confjrmed closer to the date.
• The Briefjng will cover aspects of FernoSim, procedures and what to expect during the challenge. The Briefjng will

not include details of the scenario. #YouWish!

• FernoSim will provide all response and trauma kits, consumables, simulated drugs and equipment as deemed

necessary for the scenario. After the Briefjng is your opportunity to inspect all the equipment. Team Lock Down During the FernoSim challenge, all competing teams will be sequestered in a secured holding area while not competing to ensure the secrecy of the scenario details. A communications black out will come into play once Lock Down begins. After competing in the Competition, teams will not return to the holding area. Designated FernoSim Crew or Security will be responsible for gathering and returning all of the teams’ gear and equipment which is returned to you after completion of their scenario. Teams are welcome to attend the remainder of the FernoSim Challenge as a spectator - most do. During Lock Down:

• No mobile phones, smart watches, Get Smart shoe phones, tablets or communications/messaging/email/

web access devices are allowed in the Team Holding Area nor are they to be carried by team members during competition phases. Your electronic goodies will be collected and returned to you after completion of your scenario.

• Rest room breaks will be supervised by a FernoSim Crew member to prohibit competitors from conversing with

individuals who have seen or competed in the event.

• Team members waiting to compete who are found using a cell phone, communicating or engaging in

conversation relative to the competition while outside the Lock Down Room will be disqualifjed from the competition and may cause their team to be disqualifjed.

• Light snacks and beverages will be available to sequestered competitors.

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7 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

Provision of Restricted Information to Other Teams or Team Members

• A lead judge will coordinate the movement of teams throughout the competition to maintain security of the

event and a recommended timeline.

• The team order for competing in scenarios will be determined randomly by the FernoSim Coordinator.
• Team members who have completed a FernoSim scenario must not discuss or divulge details of the scenario to

teams who have not yet completed the scenario(s). Permissible Equipment No portable equipment may be carried on the competitor’s body or in/on the competitor’s uniform during the competition, with the exception of:

• A stethoscope
• Patient contact gloves
• Eye protection
• Pen
• Blank or ruled notepad and/or clipboard
• Trauma scissors
• Penlight and/or fmashlight.

This includes, but is not limited to scene ID vests, IV/IO catheters, rescue airways laryngoscopes or laryngoscope blades. Review/reference “cheat sheets” will not be allowed in the competition. Examples include printed or electronic fjeld drug guides, quick reference drug calculations or formulas, radio report summary cards, and any other material that would provide an advantage to the competing team. The only exception is a paediatric, length-based resuscitation tape which a team may carry in their kits/bags.

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Equipment Supplied by FernoSim The following equipment will be provided on site and therefore FernoSim teams are not required to bring these items. EQUIPMENT QUANTITY NOTES Monitor / Defjbrillator / Pacer / SpO2/Capnography capable 1 To Be Advised Oxygen Unit 1 CPAP Unit with O2 adaptors 1 complete unit Long spine board, straps head device 1 Cervical collars - adult & child sizes (adjustable col- lars acceptable) 1 full set Bag-valve mask with connective tubing 1 Thermometer (oral, digital or rectal) 1 Glucometer 1 Pulse oximeter (may be integral to cardiac monitor) 1 Suction device with suction tubing and catheters/ handles capable of oropharyngeal and endotra- cheal 1 Safety goggles or face shield 1 per team member Sharps container 1 Kits/Bags of equipment to include drugs, IV sup- plies, airway devices, ET tube holders, trauma dressings etc. 1 One full kit per team will be given prior to commencing the scenario Gloves and other body substance isolation per- sonal protective equipment Suffjcient for each team member Masks not necessary because of interference they may cause with communication between a competitor and FernoSim judges ETCO2 device 1 Laryngoscope handle and blades 1 adult and 1 paediatric handle Video laryngoscopes not permitted Triage tags 20 triage tags

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9 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

Medications The following medications will be provided in the supplied Drug Kit. Teams should be prepared in the use

• f all these medications.

A Adrenaline Amiodarone Aspirin Atropine B Benztropine C Calcium gluconate 10% Ceftriaxone Clopidogrel D Droperidol E Enoxaparin F Fentanyl Furosemide G Glucagon Glucose 10% Glucose 5% Glucose gel Glyceryl trinitrate H Heparin Hydrocortisone Hydroxocobalamin Hypertonic saline 7 /5% I Ibuprofen Insulin Isoprenaline K Ketamine L Lidocaine 1% Loratadine M Magnesium sulphate Metraminol Methoxyfmurane Metoprolo Midazolam N Naloxone Noradrenaline O Ondansetron Oxygen Oxytocin P Packed red blood cells Paracetamol Phenytoin R Rocuronium S Sabutamol Sodium bicarbonate Sodium chloride T Tececplase Ticagrelor Triofjban Tranexamic acid W Water for injection

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If your country/region/EMS system uses a drug considered to be equivalent/comparable to any of these medications, and you have concerns that no drug(s) on this list are equal in action to your specifjc medication(s) in question, you must notify the competition organiser as soon as possible or by 30 August 2018 at the latest of:

• 1. The drug(s) in question
• 2. The drug(s) on the above list that it will be used in place of
• 3. The indications for its use
• 4. The contraindications of its use
• 5. How the drug is carried (precharged syringe, vial or ampule).

Body Substance Isolation (BSI) and Personal Protective Equipment (PPE)

• Competitors must don all necessary BSI/PPE equipment just prior to the start of the scenario.
• Mask protection is not necessary due to interference with communication between competitors and judging

stafg.

• All sharps used during the scenario must be disposed of in a puncture-resistant container comparable to those

available in the health-care setting.

• Failure to safely discard a needle or catheter will result in team disqualifjcation.

The FernoSim Competition Process The competition will be conducted in a special FERNOSIM arena located within Sea World Resort Conference Centre. Video cameras will project the action on a screen to allow spectators to have a close-up view of patient parameters and team performance. A microphone attached to each team’s leader will allow the AUience to hear orders given, assessments and care being completed and overall professional approach of the competing team. Finalists must be present at the Team Holding Area for Lock Down at the designated time. Team competition

• rder will be determined by a random drawing. Each team will be given a time slot and sequestered during the
• competition. Non-alcoholic beverages and a light meal will be provided. We suggest bringing your own printed

reading material, playing cards etc. for entertainment. The competition will involve all teams performing in front of an AUience and multiple judges in a 20-minute scenario. One team member must be identifjed as the team leader. Competitors will be briefed on the fjnal event when they are brought into the arena area to compete. Each team will be judged on their overall ability to assess and treat all patients involved in the scenario, request appropriate agencies or resources (if applicable) and successfully complete the maximum amount of skill and treatment objectives for the incident in the available time. Each team will be presented with multiple patients with varying levels of acuity. Competitors will be expected to efgectively assess each patient, properly intervene and competently overcome scenario-based challenges. Competitors competing in the scenario should practice performing assessments and treatment options as outlined in the assigned reference materials. We also recommend team preparation to include practicing all skills. Since clinical

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11 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

profjciency and timely intervention are key components of the scoring process, every competitor should be prepared well in advance. Scoring of the Final Competition Scoring for the Competition will place an emphasis on each team’s ability to assess and treat multiple patients effjciently and efgectively in the 20 minutes maximum timeframe. As with any Competition, the decision of the judges in assessing penalties, and the overall ranking will be fjnal and not subject to debate or challenge. Awards Ceremony - Saturday, 22 September All teams accepted to participate in the Competition will assemble in uniform at the pre-dinner drinks venue at a time to be confjrmed, to be properly recognised for their training and participation in the competition. The Bronze (3rd place), Silver (2nd place) and Gold (1st place) teams (and team Alternates) will then be announced and awarded their medals. Procedural Guidelines To ensure continuity of judging, guidelines for performing BLS and ALS skills will be presented to each competing

• team. All team members will be expected to be familiar with proper performance of each skill.

For the competition, you should make decisions based on the knowledge that:

• 4 ambulances and an ALS helicopter are available to assist you on

scene /

• Two hospitals are available within 20 minutes transportation time

from the arena - one of which is a Level 1 (highest level) Trauma Centre /

• The closest hospital to your location is less than 10 minutes away /

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Simulation It is diffjcult to accurately portray diseases in a manikin or actor despite advances in moulage techniques. As such, each competitor will need to verbalize assessment, procedure or treatment information to gain the appropriate

• points. For example, simply inserting an IV into a manikin arm will not show the judge that the competitor entered

at the proper angle, looked for a fmash of blood, lowered the needle angle and advanced the catheter without the needle. The collective goal of the organizers is to create as close to reality simulations as possible. Despite the best intentions, some diseases and/or injuries will not appear exactly as they would in a true scenario. Competitors cannot assume that what they see is precisely what is intended. With that in mind, a feedback judge will provide any information that the team requests but will not voluntarily ofger information without solicitation. Direct questions must be asked for specifjc information. For instance, asking questions such as, “How does the patient look?” will not allow the judge to divulge details. In this case, the competitor should ask such questions as, “I am inspecting the chest. What do I see?” When performing skills, competitors must actually do the procedure from start to fjnish on the manikin provided. If the skill cannot feasibly be performed, the competitor will need to state each step of the skill. Example: Pleural decompression

• I am locating the site in the second intercostal space midclavicular.
• I am cleansing the site with iodine.
• I am inserting a two-inch 14-gauge angiocatheter along the 3rd rib.
• Is there a release of air?
• I am connecting a 3-way stopcock to prevent air from entering the pleural space while allowing a means for air

escape.

• I am immobilizing the catheter as I would an impaled object.

Key skills To assist teams in practicing for the competition, key skills are outlined below to provide a basis for standardization. Each is outlined in general terms and not meant to be a defjnitive reference point. Consult the referenced textbooks for a step-by-step guide to performing interventions. Basic Airway Management (This skill will be performed on a manikin):

• Verbalize to the judge what equipment is selected to obtain full credit for the intervention.
• Ventilate the patient as deemed necessary by conditions present. Size and insert an airway adjunct (NPA, OPA,

etc.) as indicated by the scenario.

• Verify proper placement and airway patency.
• Continue to provide ventilations at appropriate rate and depth.
• For nebulizer use, properly assemble the device, connect it to oxygen and insert the proper dose of medication

into the unit.

• For non-rebreather mask use, infmate the bag prior to placing it onto the patient.

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13 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

Advanced Airway Management (Perform the intervention as outlined in the textbook references): Properly secure the airway using current acceptable fjeld practices as outlined by the referenced textbooks. Intubation or cricothyroidotomy will be performed on a manikin. Selection of the proper equipment must be verbalized to the judges to receive full credit.

• Correctly achieve airway patency in accordance with accepted fjeld standards (e.g., maintaining C-spine

immobilization while performing a trauma intubation.) The team will be disqualifjed if airway patency is not achieved when necessary.

• Assess for airway patency after each intervention is performed. At least three methods of confjrmation must be

assessed to ensure patency. Examples include: equal rise and fall of chest, end-tidal CO2 detection, increased pulse oximetry values, visualization of tube passing through the vocal cords, and auscultation of lung fjelds plus epigastric region.

• If indicated and chosen for use by a team, successfully assemble, set and deliver treatment via a CPAP device.

Intravenous/Intraosseous Access (Perform the intervention as outlined in the textbook references):

• Determine the need for the intervention and select the proper supplies.
• Correctly attach the solution set to the IV bag of choice using aseptic technique.
• Determine insertion site and relay that information to judges. Cannulate the vein or bone using proper technique.
• Dispose of sharps into proper containers. Failure to properly dispose of a catheter (e.g., exposed needle lying on

the ground) will result in team disqualifjcation.

• Assess for IV/IO patency using accepted techniques. The feedback judge will state, “IV/IO is patent” when the skill

has been correctly done.

• Employ a pressure infuser and set the fmow control wheel to the proper measurement to administer the desired

amount of fmuid. Administering Medications (Perform the intervention as outlined in the textbook references):

• Select the proper drug to be administered. You cannot administer the wrong medication. For example, if you pick

up epinephrine, you cannot say that it is diphenhydramine and/or administer it as diphenhydramine. If a team member does so, intentionally or accidentally, the team will be disqualifjed.

• Select the appropriate injection site and cleanse/prep it accordingly, using actual aseptic technique.
• Administer the correct dose (to be verifjed by judge).
• Assess for patient changes.
• Dispose of sharps into appropriate container. Failure to properly dispose of a catheter (e.g., exposed needle lying
• n the ground) will result in team disqualifjcation.

Electrical Interventions (Perform the intervention as outlined in the textbook references):

• Determine the need for electrical intervention—pacing, cardioversion or defjbrillation.
• Prepare all equipment necessary for intervention.
• Properly place the paddles/patches.
• Verbally and physically clear all people from the patient prior to discharging paddles/patches.
• Reassess for changes in patient status and need for additional therapy. Pleural Decompression (Perform the

intervention as outlined in the textbook references):

• Determine the need for the intervention.
• Verbalize the proper insertion site.
• Prepare all necessary equipment.
• Secure the catheter to the patient in a safe and secure manner. Reassess for changes in patient status.

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Immobilizing the Spine (Perform the intervention as outlined in the textbook references):

• Determine the need for the intervention.
• Hold manual C-spine stabilization and apply a cervical collar.
• Properly secure cervical collar in place.
• Properly lift or logroll the patient as indicated by patient condition.
• Completely secure the patient to the backboard via at least three straps.

Fracture Immobilization (Perform the intervention as outlined in the textbook references):

• Determine the need for the intervention.
• Assess distal pulse, motor, sensation and capillary refjll before and after splinting.
• Apply traction (if indicated for a femur fracture) unless a life threat is present that does not justify extra time

necessary for the application of a traction splint.

• Realign injured extremity as deemed necessary, particularly if no pulse is detected or is reported absent by a

judge.

• Secure the extremity to the splinting device.

Wound Care (Perform the intervention as outlined in the textbook references):

• Determine the need for the intervention. Information will need to be obtained from the feedback judge to

determine the severity of the injury.

• Control external bleeding using direct pressure, elevation, pressure points and/or tourniquet(s) as deemed

appropriate.

• Apply dressings and bandaging as needed.
• Secure the dressing in place.
• Assess distal pulse, motor, sensation and capillary refjll once bandage and dressing are in place.

Newborn Delivery (Perform the intervention as outlined in the textbook references):

• Prepare the patient and area for delivery.
• Assemble equipment as deemed necessary.
• Deliver the baby using the manikin as a simulated mother and child.
• Cut the umbilical cord in two places no closer than 4 to 6 cm from the infant.
• Perform any necessary interventions to resuscitate the baby.
• Perform post-delivery care on both mother and baby.

Cardiopulmonary Resuscitation (Perform the intervention as outlined in the current American Heart Association [AHA] Guidelines):

• Determine the need for the intervention. A manikin will be used that will allow for proper rate and depth of

compressions.

• Perform CPR as indicated in the 2013 AHA Guidelines.
• Reassess as indicated.

Initial Assessment:

• Determine if the airway is open by questioning the feedback judge.
• Assess for breathing.
• Assess for circulation.

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15 FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

• Determine the initial level of consciousness using the AVPU scale.
• Expose and examine for life threats and/or bleeding.

Detailed Examination:

• Inspect, auscultate, and palpate as needed for all aspects of the examination.
• Verbalize what you are assessing throughout the entire examination. Use of mnemonics, such as DCAP BTLS is

acceptable; however, you must tell the judge what each letter stands for the fjrst time you use this abbreviated version.

• You must actually examine the body parts as you go. In other words, telling the feedback judge that you

are listening for breath sounds while the stethoscope dangles around your neck will not result in points or information. Patient Triage:

• Determine the need for the triage of more than one patient.
• Place a color-coded triage tag on each patient with the proper priority selected for each patient based on the

resources available to you. Triage scoring will be based on the following injuries/conditions presented on clearly notated cards attached to patients/manikins: RED (First priority patients you feel could survive for at least 30 minutes if removed, treated and sent to a defjnitive care facility)

• Unconscious
• Burns with airway/respiratory involvement
• Open chest or abdominal wounds (regardless of size or depth) = potential for internal bleeding
• Uncorrectable airway or respiratory problem
• Uncontrollable external hemorrhage
• Pneumothorax, tension pneumothorax, hemothorax or hemopneumothorax
• Shock (Signs of signifjcant depletion of blood volume)
• Emotionally uncontrollable patients (that you need to have removed from the scene to maintain the safety and

control of the scene)

• Complex medical problems (impending cardiac arrest, chest pain, pregnant patient who is traumatized to any

extent)

• Fracture of both femurs (potential to lose 1500 cc of blood internally)
• Fractured extremity with pulse absent (even when manipulated)

YELLOW (Second priority patients you feel could survive for at least 60 minutes if removed treated and sent to a defjnitive care facility)

• Burns not afgecting the airway
• Conscious head injuries
• Spinal injuries (No dyspnea present)
• Moderate blood loss (signs of shock not present)

GREEN (Third priority patients you feel could survive for at least 90 minutes if removed treated and sent to a hospital

• r other treatment facility.)
• Minor injuries
• Minor fractures
• Walking wounded (with minor injuries and no RED or Yellow indications/conditions)

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FERNO AUSTRALIA PARAMEDIC SIMULATION CHALLENGE

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BLACK (Individuals that are deceased on scene, or those you do not feel could survive for more than 10 minutes after you triage them even if sent to a hospital immediately.)

• Mortally wounded multi-systems trauma patients
• Agonal respirations
• Pulses and respirations absent during your fjrst contact with them
• Decapitated

Re-triage any inappropriately tagged (prioritized) patients you fjnd on arrival of your crew. This may consist of a triage tag/color-coded triage indicator in place or a patient located on an inappropriately colored triage tarp. Criteria for Induced Hypothermia

• ROSC not related to blunt/penetrating trauma or hemorrhage
• Temperature after ROSC greater than (>) 34 C degrees
• Blind Insertion Airway Device (BIAD) or ETT in place and patient not able to follow simple commands

Procedure guidelines

• Perform neurological exam
• Assess temperature
• Apply ice packs to groin and axilla (Minimum of 4 ice packs to be applied: at least one in each area)
• Administer cold saline bolus (30 mL/kg) to maximum of 2 liters
• Reassess temperature:
• If temperature is < 33 C, discontinue cooling measures
• If temperature is > 33 C and the patient is shivering, administer a paralytic (Etomidate, ketamine or

benzodiazepine are acceptable). Reference material The following textbooks will be used in the selection and scoring of the scenarios:

• Brady’s Paramedic Care Principles & Practice, Second Edition, Brady Publishing;
• Advanced Cardiac Life Support, American Heart Association;
• Basic & Advanced Prehospital Trauma Life Support (PHTLS), 5th Edition, NAEMT, published by Mosby/JEMS

Publishing;

• American Heart Association (AHA) 2014 Guidelines for Cardiopulmonary Resuscitation and Emergency

Cardiovascular Care.