02 December 2019, 4:06 AM
In the simulation room, there’s an emergency. A 60 year old man has been brought in suspected of drowning in the river at Ballina - and the doctors in the room are trying to save him.The man is actually Sim Man - a high fidelity manikin who talks, breathes, has a pulse and costs $80K.He is a part of the training equipment for the Emergency Medicine Education and Training (EMET) program, which gives rural doctors a chance to keep up to date with training while still living in a regional area.Last week, a summer emergency situation training event at the Lismore-based University Centre for Rural Health involved 30 medical professionals from the local taking part in a series of simulations dealing with airway management, snake bite and near-drowning.EMET trainer Helen Briggs monitors the simulation.Overseeing the Sim Man in this room were two career medical officers and a clinical nurse specialist from Byron Bay.They discussed their roles - who will be the team leader, who will monitor pulse, breathing and circulation.“It’s something that all teams need to do first in an emergency”, explained Helen Briggs, the EMET program manager.Helen stands at a computer, monitoring the doctors, their trainer and Sim Man from behind a glass window.Sim Man’s vital signs are controlled by Helen’s computer – his heart and breathing rate, his voice and reactions to whatever the doctors are doing to resuscitate him.“Looks like he could be homeless,” one of the doctors said.The medical professionals work with Sim Man during the simulation. The doctors are looking at the monitors Sim Man is connected to and as his heart stops, they restart his heart and give Cardiopulmonary Resuscitation (CPR). “I can see how effective their compressions are on the computer,” Helen said.“They have given adrenaline and are checking his response again.”One of the doctors speaks to Sim Man and the dummy responds groaning, saying “my chest hurts”.The doctors confer and say to the trainer that they think his lungs might be wet.The trainer replies “yes they are wet”.With the patient revived and sitting up, the doctors put in an emergency retrieval call to the Westpac rescue helicopter.The doctors have saved their patient within the 15 minutes given to them for the simulation, and they now debrief with each other how the situation went.Helen Briggs and Northern NSW Regional Training Hub Medical Education Support Officer Nikki Murphy, who will be soon be taking over Helen's EMET training support role.“We also provide training and supervision at remote sites and emergency departments in the Northern Rivers area and visit doctors who wouldn’t normally get access to ongoing training,” Helen said.“We work with them in their own rooms, with their own equipment so they can deal with problems in a real environment.“We help doctors identify issues and provide advice about improvising and improving systems.“Then they can feel more confident in dealing with critically ill or complex patients.“There’s a higher attrition rate for doctors in regional areas and this training helps them stay here – and it also better supports our communities.“There is only one doctor at Urbenvillw now, and one at Bonalbo – and he’s not there full time anymore.”Pictured: Emergency Medicine Education and Training (EMET) program faculty staff Helen Briggs - Program Support Office, Dr Martin Chase – EMET Lead & Emergency Medicine Physician (FACEM) and Dr Andre Danforth - Emergency Medicine Physician (FACEM).Helen said the EMET program is funded by the Commonwealth Department of Health’s Specialist Training Program, with support from the Australasian College for Emergency Medicine. “It’s not a program that gets automatically re-funded every year,” she said.“It’s an important service for clinicians in regional and remote areas and we’re always trying to get more funding from the department of health.Helen said dealing with emergency situations could be stressful for doctors and having the opportunity to practice on Sim Man in a controlled situation gives the doctors more confidence.EMET lead trainer and Lismore Base Hospital Emergency specialist, Dr Martin Chase, said the hands on, practical training also used equipment from the hospital’s Emergency Department “Medical staff are involved in designing the training course and identifying the areas of focus,” he said. “We run the simulation training in multi-disciplinary teams and practise lifesaving and time critical emergency procedures with participants from Emergency Departments and other places such as rural health facilities in the Northern Rivers region.This workshop is held bi-annually in the Northern NSW Local Health District and supports medical teams in the smaller, peripheral sites with Emergency Medicine training to provide better outcomes for patients.