EMS Equipment
By Will Chapleau

Thoughts On EMS Equipment Training
Many of you are getting ready to head to the Fire Department Instructors Conference (FDIC) in Indianapolis as you read this.

In honor of the word’s largest fire department training conference, I thought it appropriate to focus on training relative to emergency medical service (EMS) equipment.

To begin with, in order to plan for EMS equipment training, we need to think about the audience or whom will we be training. The obvious answer is EMS personnel, but it’s not that simple.

The Entire Department
While many of us have managed with two-person response teams, we have also taken advantage of other fire department personnel that may be at the scene to help us. Optimal fire department EMS response takes full advantage of all available personnel and for them to be most useful to us, we need to include the entire department in EMS equipment training.

There are three training events relative to equipment. The first is new people or new equipment. The second is continuing training or review of equipment and procedures. The third is incident related.

Certainly, all people new to your department need to be trained on all the equipment. The department should have a policy and procedure that ensures new personnel are oriented to all of the EMS equipment and how it operates.

Any new equipment brought into service should be trained on as well. The importance of training with new people or new equipment is to ensure EMS equipment is used in the manner it was designed to operate. When people learn bad operating habits, it’s difficult to unlearn them. So getting it right at the start is important.

One of the continuing problems in our business is that some of our gear and operations are seldom used. In order to ensure good outcomes, it becomes important to include a review of equipment and operations as part of regular planned continuing education. A regular schedule of review and practice should be scheduled to rotate through all of the equipment on your rigs.

Incident-Related Training
The third training event is incident-related training. This comes out of your quality assurance program or incident review. This type of training follows an incident in which it was determined that performance could be enhanced by subsequent training. This form of training can take advantage of the event and use it to underscore the importance of using the equipment properly.

While no one wants less than optimal performance on any run, it’s important to recognize that training specific to an event can be the most powerful. It becomes clearly relevant to the students when they can see the effect on outcomes.

At the beginning of this piece, I mentioned the value of EMS equipment training for the entire department rather than just the personnel assigned to the ambulance. The idea is that when called to assist, our fire personnel can be of better use if they understand how our equipment works and in what situations it is to be used.

Let’s look at some examples.
Patient handling equipment is the most obvious benefit to department-wide EMS equipment training. We often call upon non-EMS fire department personnel to assist us with moving our patients around.

Particularly with our aging populations and the frequency of large and obese patients needing assistance, we need all the help we can get. I am sure many of you have been involved with patient-handling situations in which personnel unfamiliar with how our gear works, or even what it’s for, cause a near disaster by using the gear incorrectly.

Using the right gear in the right situation and using it correctly will prevent injury to our patients and to us.

An extension of patient handling is spinal immobilization. Long spine boards, short board, Kendrick Extrication Device (KED) or Oregon splints, or in some areas vacuum mattresses. All of these devices have a specific operation and purpose and require more than the two ambulance personnel to do effectively.

All department personnel should be trained on spinal immobilization skills using the gear you have. Assistance in logrolling or extricating patients will be much smoother if it is practiced on a regular basis with all personnel.

Basic splinting skills can easily be taught. This is of even greater importance with the wide variety of splints available now. We should still teach all personnel how to make a splint using pillows, towels and boards or cardboard but it’s even more important to teach the proper use of the commercial splints you may have.

Electronic Monitors
You may have some of the air or vacuum splints that are widely available. These splints are for use in very specific situations, and there is a method to applying them. So training is important to ensure their optimal use.

Traction and whole body fracture management systems are also available, and again there are specific situations for which they are appropriate, and their application must follow proper technique.

You might not think there is much utility in training non-medical people on your electronic monitors, but it’s important to include them in department-wide training. The simplest answer to the question of why is so that everyone knows what the gear does and what it would be used for.

I’ve found myself many times – and I’m sure many of you have also – in situations where I had to begin working on a patient and relied on non-medical personnel to bring me the things I needed.
The importance of being able to identify the things we need and where to find them cannot be underestimated. Don’t be shy either about explaining how it works and what the monitor shows. I remember several calls over my time in the field in which non-medical personnel were looking at a monitor and at one point someone would say to me, “Is it supposed to look like that?” In doing so, they called to my attention something I needed to know.

The Back Of The Box
Another place where a little help from our friends is nice is in the back of the box. Make sure to provide a little training in the arrangements and contents of all the compartments.

Department-wide training should include reviewing the back of the box so everyone knows where your things are so that when you send someone to the rig to get something there is a high expectation of success.

Let me close with a word about vehicles. I don’t know how your department governs driving vehicles, but in many places people are assigned to a certain vehicle and they may not be trained to drive that vehicle, let alone any of the others.

This is where cross training shows its importance. How many times have you been at a scene where the driver assigned to a vehicle is involved in an operation away from the vehicle and we need the vehicle moved?

We all need to know enough about all of our vehicles to be able to move them in an emergency. All of us find ourselves in EMS operations in which all medical personnel have to be in the back with the patient. So someone else is called upon to drive the ambulance.

Your ambulance most likely has nuances that an unfamiliar driver may not find intuitive which could result in problems. High-idle switches, battery switches and even practices like whether or not the emergency brake is engaged can present challenges to unfamiliar drivers. Not knowing these things results in battery drawdown or more serious damage to the vehicle.

So, if you don’t have one, make a plan today. Work all of your EMS equipment into a regular training program for all your personnel to review. Put together a thorough orientation and training package for new personnel and a process for working new equipment into the department with everyone training on it.

Finally, if you’re not doing it already, set up a process of incident review that includes developing training in response to the event.

Editor’s Note: Will Chapleau, who has 30 years of EMS experience, is the Advanced Trauma Life Support (ATLS) program manager for the American College of Surgeons. He is the former chief of the Chicago Heights (Ill.) Fire Department, has served since 1996 as the chairperson for the Prehospital Trauma Life Support (PHTLS) program of the National Association of Emergency Medical Technicians and has been a member of its international faculty since 1984. He is a board member of the National Association of EMS Educators.