Published 12:00 am Sunday, September 29, 2013

GREENSBORO — A call goes out over the radio for emergency medical services to respond to the scene of a fire.
First responders have doused the flames, but paramedics arrive to find one man badly burnt and a boy with a compound fracture of his arm — broken, they’re told, as he tried to run for help.
They go to work at once, talking to their patients, calling out for a helicopter to bring the burned man to a hospital, asking about vital signs.
A few minutes later, a man walks from the bushes, asking for help. He’s complaining of chest pains, and shortly afterward is unconscious.
One medic cuts off the man’s shirt and gets ready to apply a heart monitor.
Minutes later, he’s diagnosed an abnormal heart rhythm and prepares to shock the man’s heart back into rhythm. He succeeds, and starts treating for symptoms of a possible heart attack.
Then, a judge steps from the side of the scene and calls out, “Time!”
The audience of about 200 people, on bleachers set up around the scene, breaks into loud applause.
And Rowan County EMS paramedics Aaron Thurston and Dan Medina stand up from their simulated patients, smiling.
This was the scenario at Sunday’s 23rd annual N.C. Paramedic Competition, held at the Koury Convention Center in Greensboro.
Rowan County EMS beat eight other teams in the region, and 40 statewide, to become one of five agencies in the state selected as a finalist.
The winner will be announced Tuesday night at a banquet held as part of the annual Emergency Medicine Today Conference.
“Medicine is as much an art as it is a science,” said Medina, who at 21 is in his second year with Rowan County EMS.
He became a paramedic last year, and finished his nursing degree at Cabarrus College of Health Sciences in May.
Medina said the reason for these competitions is that the science of medicine is not always everything.
“It’s in the way you were trained,” Medina said. “The art is in the way the paramedic approaches the actual patient.”
Reviewing their performance in Thurston’s hotel room after the competition, they went over the details of how they responded — little things that might be taken into account in the judging.
From the moment they entered the ballroom, their focus was on clear communication, Thurston and Medina said.
The first simulated patient “had suffered facial and upper body burns,” Thurston said. “Our big concern is airway burns.”
In a flash fire of the type being simulated, Thurston said, many people’s instinct is to gasp. That brings superheated gasses into the throat and lungs.
From the moment he knew the scenario, “I was watching for it, early on. I had everything in place ready to go, expecting his airway to fail.”
Those scenarios are role-playing taken to the extreme.
This year’s competition presented a simulated incident that N.C. Office of Emergency Medical Services Chief Regina Godette-Crawford said could actually happen: a propane fire at an illicit moonshine still.
The secondary incident — the suspected heart attack victim — was a “curveball,” Thurston said, but nonetheless an example of how an accident scene can become more complicated.
From the moment the simulated emergency dispatch goes out, a judge accompanies the team at all times.
And although the actors portraying patients give responses, whenever a medic says he’s checking for vital signs, the judge responds with facts that represent symptoms.
Example: when Medina said he would check the suspected heart patient’s blood pressure and heart rate, he was told that there was a blood pressure reading, but no discernible pulse — a sign the patient’s heart was beating abnormally.
When the time came to simulate opening an airway for the burn patient, and to simulate shocking the other patient’s heart into rhythm, mannequins were brought in.
Thurston said the point of the competitions is to demonstrate skill, not so much “winning.”
“I’ve competed for years at the regionals, and placed second several times,” Thurston said.
He said this was the first statewide competition Rowan EMS has reached since the 1990s.
They practiced and ran through various scenarios numerous times after winning the regional competition in July, Medina said.
One of their competitors, Mecklenburg County’s EMS, reached out to offer advice, Thurston said. “That’s true brotherhood,” he said.
Godette-Crawford told the Post that Rowan County residents “should feel very impressed that their team made it here.”
James “Tripp” Winslow, medical director for the N.C. EMS Office, said the purpose of the events is “to showcase paramedics in action and the high-level skills that are necessary to take care of people in a pre-hospital setting.”
The competition presents “true to life issues” — plausible, if unlikely, accident scenes and injuries, meant to test paramedics’ responses and have them think on their feet.
Past scenarios have included a plane crash, an accident at a stock car race and a construction scaffolding collapse.
The competition is open to any agency in the state that provides paramedic services, Godette-Crawford said.
In addition to Rowan’s two-person team, competitors included paramedics from Davidson County EMS and two teams each from Pender, Curry and Cumberland counties’ emergency medical services.
Each two-person team had 13 minutes to respond to the same simulation and were judged on their choices, their communication and their individual handling of events.
“Our communication with each other, our initial scene size up,” Thurston said.
Thurston became a volunteer firefighter in 1994, working with various departments before going on to become an emergency medical technician in 1997, then earning paramedic certification in 2000 from Western Carolina University.
For him, taking part in competitions is not about winning.
“I do it to push myself to be better at my job,” Thurston said.

Contact Hugh Fisher via the editor’s desk at 704-797-4244.