Riding With Haiti Air Ambulance Part 7: Dedication to Improvement

EMS World contributor and advisory board member Kevin Collopy is volunteering this month with the first air ambulance service in Haiti. He’s chronicling the experience with a series of blog posts. Earlier posts:

Part 1: https://www.emsworld.com/article/12075142;
Part 2: https://www.emsworld.com/article/12075601;
Part 3: https://www.emsworld.com/article/12076210;
Part 4: https://www.emsworld.com/article/12076579;
Part 5: https://www.emsworld.com/article/12077006;
Part 6: https://www.emsworld.com/article/12077179.

If you ask most people if they want to spend a Saturday at work taking a class in a second language, nearly all (me included) would say you’re crazy. Ask of a group of Haitian EMTs, and they say “When can we start?” Today we spent nine hours teaching the basics of prehospital trauma care and a systematic approach to a patient assessment, then had the opportunity to celebrate EMS Week 2015 with a little Haiti Air Ambulance flair.

Three EMTs and three communication specialists complete HAA’s daytime helicopter operations, and all of them have other jobs. However, when given the opportunity to spend an entire day in class, every team member was excited. Thanks to the generosity of New Hanover Regional EMS, all team members received their own donated PHTLS textbook. We distributed the books at the beginning of the week and by Saturday had already spent hours reviewing the enclosed DVDs and clarifying the book’s contents as the EMTs highlighted everything they wanted to remember. I think they highlighted 95% of the books! Before “class” even began at 9 a.m., every one of them was in their seat, in uniform, and had paper for taking notes.

Delivering presentations to learners for whom English is a second language takes patience and a willingness to repeat things—frequently. After beginning with an overview of trauma care and why it’s important, we spent three hours discussing a primary ABCDE assessment. It required a careful balance to teach to both EMTs and non-medically trained communication specialists, but their willingness to learn and desire to be included during the group’s learning opportunities were more than enough motivation for this instructor to take all the time needed to ensure they understood the material.

Lunch took a little longer than normal as Dawn, the HAA chief flight nurse, and Stacy HAA chief flight paramedic, had prepared lunch for their team and bought each of them some celebratory gifts. Each crew member was provided with a survival rescue knife. You’d have thought there was no meal as everyone was so excited about their gifts that several ran outside to try both knives and flints (no fires were lit). To celebrate the international cohesiveness of EMS Week 2015, we were fortunate to have gifts from EMS1, which provided each team member a t-shirt and a challenge coin.

After lunch we were back to learning and spent several hours discussing critical systems and management of primary assessment problems. Most of the Haitians had only ever discussed tourniquet application, so it was incredible to watch their eyes when one of them applied an actual tourniquet to my arm and got to leave it there for five minutes. By leaving it on we had the opportunity to see cyanosis, feel a cold extremity and observe how the arm flushed during reperfusion.

We all know nobody can sit in lecture all day, so after wrapping those up we spent three hours outside going through and debriefing several simulations. Since none of them had ever been an actual patient, we took extra time to leave students on backboards for an extended time (only 40 minutes total) so they could experience the discomfort of immobilization. The lesson hit home, and the dangers of extended immobilization were well understood!

When the simulations were complete, we offered open time to practice any skills anyone desired. Typically when such opportunities are offered to classes, everyone looks at their watch and thinks about being done. This group did the exact opposite and took over an hour to practice traction splinting, arm splinting, and BVM masking and ventilation.

By the end of the day we had to tell the team they looked mentally exhausted and, while they wanted to keep listening, it was time to stop. It was refreshing as an instructor to have an audience so engaged, with such a passion for learning. While we were fortunate to make it through the day without a flight request, the time couldn’t have been better spent than by sharing information with an enthusiastic group of learners that tomorrow can apply their knowledge at both Haiti Air Ambulance and the hospital where they work side-by-side with physicians and nurses to care for the critically ill and injured.

Kevin T. Collopy, BA, FP-C, CCEMT-P, NREMT-P, WEMT, is an educator, e-learning content developer and author of numerous articles and textbook chapters. He is also the clinical education coordinator for AirLink/VitaLink in Wilmington, NC, and a lead instructor for Wilderness Medical Associates. Contact him at ktcollopy@gmail.com.