Full Circle of Simulation

This fall two things happened that ended up being related, though I didn’t know it at the time. One happened in September when I took over as lab coordinator for my school’s paramedic program. Now I am having lots of fun coordinating our students’ skill practice and running simulation scenarios. The other was that my parents cleaned out their attic and gave us my Lego sets from when I was a child. Since then I’ve spent hours with my four-year-old putting them together. This brought back a lot of memories, I realized that in many ways my job now is similar to how I used to play as a child.

I suppose I wanted to be a paramedic since watching Emergency reruns and playing with a doctor kit as a toddler. In the early 90’s I never missed an episode of Rescue 911, and read Pat Ive’y EMT: Beyond the Lights and Sirens and Paul Shapiro’s Paramedic memoirs. When I was 9 my grandfather gave me a police scanner, and when a call was nearby a friend and I would sometimes ride our bikes to scenes. Sometimes we arrived first and would wait outside the house, and fortunately there were no safety threats on scenes were that happened.

In my Lego town there was a fire station, police station, and hospital, and there were a lot of accidents at the gas station, airport, and houses.  The responses mirrored how the area services responded to calls, down to the tones that alerted them. For EMS calls there was a rescue truck from the Kenmore Fire Department, a paramedic chase truck from the Town of Tonawanda Police, and an ambulance labeled as one of five area private companies in business at the time, one of which I would later work for. I also had  the Buffalo Fire stations mapped out and had mutual aid plans.

When my father brought a rolling sled to work under our car, my friend and I also took it over and used it as a stretcher and used my sister’s stuffed animals as patients. We also made a backboard out of scrap plywood, defibrillator paddles out of Constructs and used the case as ECG monitor (later I would be disappointed that I never got to use the paddles – all of the real defibrillators I would later use had patches). We had some real ECG strips that paramedics had given us when we went to visit, and made some of our own based on what we saw on television. We used an empty shampoo bottle as a BVM, IV bags with sandwich bags, strings, and sewing needles, and were dispatched on Fisher Price walkie-talkies.

At my job now we have an ambulance built into our lab, and use real stretchers and real gear bags. We have a life size mannequin that breathes, talks, and occasionally dies. We have monitor/defibrillators and an iPad-based simulator that students safely use with each other. We use YouTube and ReelDx videos for scenes, and have makeup to moulage injuries. We play local EMS scanner feeds over speakers in the lab, and students get alerted and dispatched to calls on Motorola radios. Now I’m working on sending students emails to an iPad with call information so they can practice using a CAD and mapping programs. We have some fun, but it is also serious. Students have to pass these scenarios in order to go on to their internship.

My parents wished I had the same attention to detail playing paramedic as I had for my school work. Although I knew about Cheyne-Stokes Respirations, intubating and starting IV’s, that defibrillation is for V-fib, not asystole, and that a lot of people who call an ambulance don’t really need one, I was a weak math and science student. For a while I even took a bus to another school for remedial math classes. I remained a B and C student through high school and did not think I was smart enough to be an EMT, let alone a paramedic.

Looking back I can’t believe how lucky I’ve been in my career. Responding to calls around Buffalo and my parents’ neighborhood as an EMT along with the people I idolized growing up was a truly a dream come true. Then I spent 10 years working as a paramedic with a clinically advanced service where I was able to start teaching and writing. Along the way I met an incredibly loving and supportive wife, and I have made enough money to support our family without having to work overtime.

Now I teach at a school that encourages creativity and risk taking, and do a lot of the same things I played as a child. I have it pretty good, and I don’t take any of it for granted.

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