State successes: Prehospital simulation project highlights power of state-level collaboration

The Massachusetts EMSC State Partnership Program, in collaboration with five hospitals, recently published the results of a state-wide education program–including high-fidelity simulation–for 187 prehospital practitioners. In a manuscript published in Frontiers in Pediatrics, project leads wrote that participants, who were both emergency medical technicians and paramedics, demonstrated increased knowledge in pediatric emergency care management and increased confidence in handling pediatric cases.

Most importantly, participants reported change in practice.

“Prehospital encounters with critically ill children represent low-frequency, high-stakes events,” wrote the co-authors, many of whom are part of the MA EMSC State Partnership Program Advisory Council. “In national estimates, <1% of pediatric transports involve interventions such as advanced airway management or cardiopulmonary resuscitation (CPR). Yet EMS providers are an essential link in the chain of survival, and when needed, these pediatric skills must be executed effectively.”

The simulation curriculum developed by the team comprised three scenarios and was implemented through five sessions, led by a faculty lead at each site, over a six-month period. 

“The shared effort allowed us to reach a wide range of EMS providers across the state and over several months without undue burden on one hospital or simulation center,” says Caitlin Farrell, MD, the study’s lead author, a pediatric emergency medicine physician at Boston Children's Hospital, and an EMSC Fellow. 

Farrell encourages other states to leverage the resources developed through the Massachusetts project. “The simulation cases and debriefing guides are included in the published manuscript. I am also happy to talk with anyone interested in a similar project.”

“Executing such a large-scale training is a monumental task,” notes Kathleen Adelgais, MD,  MPH/MSPH, Prehospital Domain Co-Lead at the EMSC Innovation & Improvement Center (EIIC). “This work demonstrates the importance of collaboration between EMSC programs and front-line clinicians and educators to improve care for children.”

As for what the collaboration might lead to next? 

“We are looking forward to a return to in-person training and simulation as the COVID world evolves,” says Farrell. “The MA EMSC Program is currently working on bringing pediatric education and resources to our EMS community through increased PALS [pediatric advanced life support] participation, piloting a virtual reality pediatric program, and developing our EMS PECC [pediatric emergency care coordinator] workforce.”

This work was also shared during an American Academy of Pediatrics webinar on prehospital pediatric preparedness in 2021 and as a poster and presentation at the EMSC 2021 All-Grantee Meeting. 

For tips on launching a similar project in your state, contact caitlin.farrell@childrens.harvard.edu.

Photo credit: Sarita Chung, MD