Photo Credit: Peter Hvizdak – New Haven Register
Paramedic students at the University of New Haven’s Fire Science and Professional Studies program are using healthcare simulation to help them improve their skills when treating a pregnant patient. The training aims to help these prospective paramedics develop and master the specialized skills needed to provide care for pregnant women and to prepare these students for the rigors of treating obstetric emergencies.
Only about 1.5% of births in the United States happen outside of a hospital. About 90% of these births were planned home births. While still small, the percentage of American women who choose to give birth outside of a hospital is increasing.
Moreover, about 700 American women die from pregnancy-related complications each year. Time is key for the wellbeing of the woman and the fetus during obstetric emergencies. The earlier a clinician diagnoses and treats the problem, the greater the chance is for a healthy and successful birth.
Although rare, EMS providers will encounter pregnancy-related emergencies during their careers. Since these emergencies can arise at any time during pregnancy, labor, and birth and require immediate intervention, the EMS provider may not have time to take the woman to a hospital. As such, they should be ready to provide her with the care she needs in the field.
During the training, members of the West Shore Fire District in West Haven, CT used Gaumard’s high-fidelity birthing simulator, Victoria. All of the faculty in the program are active paramedics at American Medical Response (AMR) so they designed the training to cover as many obstetrical events as possible.
Victoria’s advanced features made it possible for the students to practice in a realistic environment and experience several obstetric events. Apart from practicing how to deliver a baby during normal labor, the students were also able to practice managing rare events like shoulder dystocia.
Since Victoria’s vitals change as labor progresses, students can develop their assessment skills and learn to identify telltale signs of a life-threating condition like pre-eclampsia. The students can also practice direct interventions like halting hemorrhage and even administer epidural pain relief when needed.
“Oftentimes it’s a test for them to see how they do on their own without any instructor involvement,” said Paul Clini, a faculty member and paramedic with the West Shore Fire District, about training students with Victoria. “We can critique [their performance] with them.”
Although the mother and fetus are two different patients, care for the mother provides care for the fetus; therefore, EMS providers have the responsibility of keeping the mother stable in order to give the fetus the best chance of survival.
However, the skills needed to provide care for pregnant women in the field are difficult to teach because of how infrequently these emergencies occur. As a result, gaps in the EMS student’s knowledge and experience level can occur.
Likewise, obstetric emergencies require immediate and accurate intervention to avoid harm to the mother and child. It would not be practical or ethical to have an inexperienced EMS provider attempt to provide care to a patient.
Additionally, simulation-based training creates a safe environment wherein students can make mistakes, receive feedback, and work to improve their performance. Educators can run specific scenarios multiple times until the students master the skills needed to provide accurate care.
Ultimately, UNH is creating EMS providers who are equipped with the knowledge and skills to ensure better patient outcomes. Simulation-based training helps bridge the experience gap and allows EMS students to gain valuable hands-on practice. As Clini points out: “[UNH] preaches experiential education, learning by doing.”
UNH paramedic students will spend half of their non-classroom time working with Victoria and other patient simulators, totaling 90 hours for an EMT certificate and 300 hours for a paramedic’s bachelor’s degree.