EMS Training That Builds Competence & Saves Lives

It is common that healthcare professionals encounter bleeding in patients they are caring for, creating the need for quick decision-making. A recent article states, “among patients who arrive at the emergency department for trauma, hemorrhage is the leading cause of death within the first hour”, and that “nearly 50% of deaths are a result of hemorrhage” within the first 24 hours.¹

But quick decision-making does not begin in the Emergency Department. Emergency Medical Services (EMS) professionals, as first responders, piece together the puzzle of where and how the patient is injured. Once they have determined the source of the trauma, they act quickly to provide life-saving care, which may include intubation to assist with breathing, wound care, assessment and control of bleeding, and preparation for safe transport to the hospital. Once at the hospital, EMS provides essential communication to the receiving emergency team, including the current patient status, as well as their estimate of blood loss and other information needed to provide seamless care to the patient.  

Most people cannot imagine the breadth of knowledge that EMS professionals must maintain to care for trauma patients in the prehospital environment. This need for expansive knowledge requires ongoing training to build not only competence, but also confidence to perform the needed skills for the job. It is easy to understand that safety errors can be made in high-stakes situations, especially for providers who are not prepared.

A recently published Delphi study found considerable “knowledge gaps related to the association between EMS educational program curricula, education methods, and real-world practice.”² The top priority for further research includes the “characteristics defining entry-level competency of the EMS professional.” The identified gaps around the education of EMS professionals include a need for improving not only student education, but also faculty’s ability to deliver curriculum that will meet the needs of patients in any prehospital environment. This education includes the following simulation components:  

• Characteristics of high-quality effective simulations in EMS education
• Effects of classroom simulations on EMS student performance in the field
• Presence and effects of diversity and cultural humility in EMS classroom materials and lab environment (e.g., textbooks, presentations, patient simulations)

When asking the EMS providers about the reason for safety errors in EMS care, a qualitative survey of 2,000 EMS professionals found five dominant themes:   

• Poor Judgement errors, such as missed or incorrect interpretation of diagnosis
• Poor skill / knowledge-based errors causing incorrect management of a patient.
• Fatigue-related errors, work overload, stress, burnout, causing lapses in concentration.
• Bad attitude, lack of confidence, and fear, leading to human error.
• Communication errors caused by language barriers or failure to communicate with medical services or the patient.³

It is logical that correctly assessing the amount of blood loss is essential in providing safe and effective life-saving treatments. However, visually estimating blood loss has proven to be much more difficult than it sounds. One study that focused on visually approximating blood loss showed “no association between specialty, years of experience, or confidence in ability with consistency or accuracy of estimating blood loss”.⁴

Another study found that “only 8% of estimates were within 20% of the true value” of blood loss. ⁵ In a study related to hemorrhage of postpartum patients, results show that “two-thirds of cases of immediate PPH (65.4%) were misdiagnosed using visual estimation”.³ Interestingly, blood loss can be either under or overestimated. One study concluded that “underestimation of the correct amount of blood tends to increase with large blood volumes, whereas small blood volumes often are overestimated”.⁶

During the EMS expo, “thousands of EMS professionals from hundreds of agencies across the globe will unite to engage in real-world training, participate in ground-breaking education, and connect with fellow attendees” at the EMS World Expo in New Orleans. Limbs & Things is proud to exhibit in support of improving EMS education using our high-quality, affordable training products focused on safe trauma care. 

Important products in our EMS range include:

• AirSim Difficult Airway Training Manikin
• TruMan Trauma X
• TruCric
• Chest Drain & Needle Decompression Trainer
• TruWound
• Advanced Venipuncture Arm
• Clean Bleed® Mat – Blood and Fluid Loss Simulator

Be sure to stop by and see us at the EMS World Expo 2023 on Booth #657.

We are so grateful for the many dedicated EMS professionals who help to make our world safer every day.

¹ Autotransfusion: Stat Pearls

² Defining priorities for emergency medical services education research: a modified Delphi study

³ Factors that influence human error and patient safety in the pre-hospital emergency care setting

⁴ Estimation of blood loss is inaccurate and unreliable.

⁵ Emergency Physician Estimation of Blood Loss

⁶ Accuracy of Visually Estimated Blood Loss in Surgical Sponges by Members of the Surgical Team