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In this episode, our first scenario is designed to show poorly implemented BLS care. Without a proper organized history, using “tunnel vision” for a patient complaint, and not using proper immobilization techniques downstream consequences are sure to follow. Use this first scenario to critique what you might do better during this case. Practicing and using frameworks such as “XABCDE” or “MARCH” can help keep our assessments organized and able to efficiently and fully evaluate our patients. The second scenario is our take on a way to handle this scenario using optimal BLS assessment and care. Notice the introduction, consideration of injuries, exposing and exam of the injury, splint placement, and proper immobilization techniques that lead to a much better experience for the patient and the providers.
0:23 Introduction to the importance of BLS assessment
0:38 Scenario 1: Poorly implemented BLS care: no introduction, patient complaint “tunnel vision”, improper immobilization of injury
2:53 Implications of poor BLS care
4:11 The importance of primary and secondary survey, recognizing injuries, a standardized approach to a trauma patient using the acronyms “XABCDE” or “MARCH”
5:04 Scenario 2: Optimal BLS assessment and care: introducing yourself, considering other injuries, exposing the injury, assessing CSM, padding splints, reassessing CSM after splint placment.
6:45 Discussion of proper field assessment, immobilizing fractures, basic interventions to control pain, limb ischemia managment
7:52 Discussion/use of this video
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As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission - Helping Save Lives - could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
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