Emergency crews make sure a theoretical patient is secure, warm and ready for transport by BC Ambulance to Dr. Helmcken Hospital. Local highway rescue, fire and medical crews collaborated in a health care simulation training exercise that saw a theoretical patient be extracted from a car wreck, transported to hospital and attended to by emergency medical staff. (Screenshot / Ken Matheson documentary video)

Simulation training helps medical team keep sharp

The Dr. Helmcken Hospital nurses and physicians use simulation training to continue learning.

Early this year, the team at Dr. Helmcken Hospital took part in a simulation exercise focusing on hypothermia. Wells Gray Park has a lot of backcountry access for skiing and snowmobiling and hypothermia is a real concern, especially with newcomers to the area, said Jordan Scott, registered nurse at the hospital.

In the simulation, the nurses and physicians of Dr. Helmcken worked with BC Ambulance, local Search and Rescue and the RCMP to put together a picture of what might happen in an emergency such as backcountry trekkers becoming lost or injured, and requiring treatment for hypothermia.

The situation was acted out by a few locals and filmed by local videographer Ken Matheson, and it’s all part of a bigger program undertaken at Dr. Helmcken Hospital.

“Bad things happen in rural (emergency rooms) same as they happen everywhere else, but they happen very rarely,” said Dr. John Soles, who assisted with simulation training while working at Dr. Helmcken Hospital. “The only real way of getting good at managing things that happen rarely…you basically have to practice.”

The team at Dr. Helmcken Hospital has been running monthly simulations for the last couple of years. While they’re not all as elaborate as the hypothermia simulation, they do help the medical team refresh their knowledge.

Unlike an emergency room in larger municipalities such as Kamloops, Kelowna or Vancouver, rural and remote centres, like Clearwater, can experience days or a week of a low intensity environment before having a critical emergency come through the hospital doors.

This lull can affect the skill set of the hospital staff and how they react to certain situations. The simulation training exercises aim to be not just a refresher for the medical team, but also as a way to test the room, the inventory and their communication with each other. The exercises also are performed in the same area where they work, meaning the monthly simulations take place at the hospital.

“If you go to the hospital, you expect if you’re really sick that you’re going to be managed appropriately and get to the right area and the right place to get treated,” said Scott, who also is the training coordinator for the hospital.

Every time a simulation is done, the team is able to note where they do well, what might need improvement and if the layout of the emergency room is accessible. It also helps the team to feel more comfortable when an emergency inevitably shows up in the emergency room to work as a team and stay up to date with their skills.

The Dr. Helmcken Hospital medical team has been performing simulated training exercises for quite some time, a passion of now-retired Dr. John Soles, but new funding has allowed for a designated coordinator.

The exercises are funded in part by the Facility Engagement Initiative, an on-going province-wide initiative focused on strengthening communication, relationships and collaboration between physicians and other medical professionals that work in hospitals and health authorities, Amy Thain, Clearwater chapter coordinator for the Rural and Remote Division of Family Practice told The Times.

Funding also comes from the Rural Coordination Centre of B.C. which focuses to improve health education and advocates for rural health.

Simulation training hasn’t always been a norm in the medical field, but they are becoming more popular, said Scott. And while the simulations help the team out a lot, there’s things that just can’t be planned.

“You don’t want to rise to the occasion, you want to fall to your training,” he said. “It’s so true. I’ll have people in training exercises and they’ll do great but then if you add in five people, you add in an unknown factor, you add in all these things and then the stress and the adrenaline — it’s really hard to mimic that training.”

Nevertheless, the team has seen huge improvements when doing the simulations, said Dr. Soles, and it’s why they continue to do them. The medical team at Dr. Helmcken works very closely with BC Ambulance paramedics, something not often seen in other areas, and the paramedics will usually join them in their training sessions.

They’ve also brought in outside resources into their training to see what happens before a patient comes to them at the hospital. These larger projects have brought in highway rescue, the RCMP and local fire departments.

A notable exercise saw a collaboration between highway rescue, the Clearwater and Vavenby fire departments and BC Ambulance.

Nelson Hindle from Clearwater Towing donated a vehicle so the emergency crews could simulate rescuing a driver from a vehicle. Matheson again joined in the efforts, filming the rescue as highway and fire crews performed an extraction. This footage was then played for the team at the hospital before the “patient” was brought in.

This allowed the team to see what the patient had gone through before being delivered to the ER. Cold temperatures, a tight space, large equipment and dangerous materials all stood between emergency crews and the patient.

Then, it was the hospital team’s turn to look after the patient the way they would in an emergency situation. This was also recorded and played for the pre-hospital crew.

The collaboration doesn’t end with crews in Clearwater. Dr. Helmcken Hospital staff often need to arrange transport to Kamloops, Kelowna or Vancouver, and knowing how those situations operate is also important. In a “code orange” or mass casualty simulation done recently, the medical team in Kelowna was contacted in a mock consultation in the intensive care unit.

“It’s a lot of moving parts,” said Scott. “It was a pretty cool exercise and we learned a ton and it just fosters a community environment of training and working together, which is great.”