The Power of Realism and Expertise in Trauma Care Education

Description:

Welcome to another exciting episode of The LIFESAVING CHRONICLES, brought to you by the National Safety Training Center! In this episode, host Dave Kotz enters the fascinating world of trauma education with special guests David Parry from Techline Technologies Incorporated and Steve Wisner, an experienced instructor at the National Safety Training Center.

In This Episode:

• Introduction to Techline Technologies: David Parry shares insights about his company, which specializes in manufacturing realistic trauma simulations, including task trainers, wearable wounds, and the Tom Mannequin.
• Importance of Realistic Training: Discover why hands-on, realistic training is crucial for building muscle memory and effective trauma response.
• Advanced Training Tools: Learn about the B80 Task Trainer, Tom Mannequin, and wearable wounds, and how these tools enhance the training experience.
• Instructor Expertise: Steve Wisner discusses the value of having instructors with real-world experience and how it impacts the quality of training.
• Creating Realistic Scenarios: Explore how to set up realistic training scenarios using advanced tools and the importance of thinking outside the box.
• Collaborative Training: The benefits of integrating resources and working with local organizations to create comprehensive training experiences.

Key Takeaways:

• The significance of using advanced, realistic training tools in trauma education.
• The impact of experienced instructors on the effectiveness of training.
• Practical tips for setting up realistic training scenarios and utilizing local resources.

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Transcript

0:00

Mhm. Mhm. Hey everyone. It's Dave Kotz from the National Safety Training Center and the LIFESAVING CHRONICLES, here with another exciting episode. This time we're delving into the interesting aspects of trauma education. So i've got some special guests with us today. Number one is David Parry. David, tell us a little bit about yourself and your amazing business. My company is Techline Technologies Incorporated. We're based out of Willow Grove, Pennsylvania, and we manufacture trauma simulations. We make everything from Task trainers to wearable wounds to the TOMMANIKIN®that's sold by North American Rescue. We've been in business since 2001. We've been making trauma sims since 2007, and we've been doing training since 2015. Dave and I met many years ago when we did some joint training and we were testing some of his very advanced supplies. And I think he's- I think he's selling himself short. Those products are nothing short of amazing. We have some video we'll include here of them actually be in use, so you'll see exactly what they are. Okay. And that's one of the things we'll talk about that differentiates trauma education is this realistic type of training. Alright, so before we get into more detail, I want to introduce the other guest, Steve Wisner, who's an instructor that works with us here at National Safety Training Center. Steve, tell us a little bit about your background. How are you doing, Dave? Nice to see you. Like Dave said, I've been working for him for quite a few years. My background is I retired out of the United States military. I've worked every from conventional to special operations units. I also have experience on the civilian side as an EMT and a fireman and I also work out for part on private security. So it's one of those things I have a different mix up of things that come into play; especially my background. Some of the stuff I've actually done for real. Not just, hey, tabletop, here we go. It's stuff that I've actually had the experience in. So I think you have the perfect level of experience both as a combat soldier who seen fire and done care under fire, as well, as the experience as a civilian firefighter, EMT in private security, all that intersection, the X as it were, see how I got that in makes you a wonderful addition to our instructor cadre. So now that we've got introductions out of the way, I basically want to explore two topics with both of you folks. One is having the right equipment to provide excellent training. And the second is going to be having the right staff, subject matter experts, instructors, et cetera and why having those people on there for giving the training makes an enormous difference. We've seen classes that get taught with CPR mannequins. Halloween costumes. Some of the stuff shocks me. Dave, tell us specifically about your Task trainer and the wearable wounds and how you set up these trauma simulations for the classes, whether it's TECC, stop the bleed, or tactical combat casualty care. How do you set that up with your products? Dave, it's really important that people are doing hands on skills and they need to have actual feedback from the devices. You mentioned some of the things that you've heard of. I've heard of blow up dolls and store mannequins being used in TCCC classes. Everyone's heard, Oh, use a yoga block for your wound packing trainers. There's a whole lot of do it yourself going on- finding ways to make training tools. Because everybody who's really into this, knows that you need to have hands on because chalk and talk or click and learn is not the best. You really need to be able to build that muscle memory and do it, hopefully in a realistic way that you're getting good feedback. So when we build things like our B80 Task trainer, that thing is a 37 pound lower torso with an amputated leg and a gunshot wound to the pelvis. And you have to put your tourniquet on properly. You need to put it on tight. You need to put it on high enough that it's up on the leg, not right on the edge of the wound. You need to tighten it all the way and properly to get the bleeding to stop. You're using fake blood so that you're not having a red light green light tell you whether or not it's bleeding. It's absolutely visual. The wound packing, you need to be able to secure that artery and pack to the artery to get it to stop bleeding. And you need to be able to you can actually use the the junctional tourniquets and the abdominal aortic tourniquets to get it to stop. So there's not a whole lot of ways that you can realistically do that outside of B80 Task trainer. It's a phenomenal tool. It's a great technique. And there's no substitute for actually doing that. Other than finding some person who wants to volunteer to have that done to them. We prefer not to get shot. It's an absolutely wonderful product. You're going to see blood flowing out of this leg until you take the appropriate actions to stop that bleeding. If you don't take appropriate actions, the bleeding will continue. And at some point, when we run out of blood, that's the sign that you have not been successful. So that's one great product. And I think that's probably the product that we use the most or is the most iconic for tactical emergency casualty care. But there are others that are available, too. What else do you got David? I'll tell you what, we make the TOMMANIKIN® and the TOMMANIKIN®, that one's really the the flagship product. That is a breathing, bleeding, talking mannequin that is incredibly rugged. It is very intuitive for the instructor to run and it allows you to do nasal airways, oral airways, crikes, needle decompressions, IVs, IOs, IOs in three different locations. Lets you do chest seals, chest tubes, lets you do splinting, tourniquets, junctional tourniquets. It has pulses. You can change out the eyes so that you have uneven pupils. You can change the breathing, not just the rate, but whether or not both lungs are inflating. It's really a great training prop. And most importantly, it is incredibly rugged. We've run it over with vehicles. We've dropped it out of airplanes. We've done full decon with it. It's really a great device and it weighs 187 pounds. So it's a realistic weight. It's flexible like a person and you absolutely have to overcome the challenges of moving a deadweight person through whatever train you're on. So if you need to get that mannequin behind cover and you're up against the wall, you got to be able to get that mannequin up and over the wall and not worry about breaking your mannequin. That incredible durability is is the name of the game and the steel frame survives awful awful things happening to it. So I, I remember when we were first demoing Tom, one of the things that we needed to find out is would Tom survive submersion. And we submerged Tom in a little stream or a brook, and Tom did great. I remember it going more along the lines of Hey, where's that one mannequin? Oh, it's down in the creek. So we we went ahead and sure enough, they did an extraction. They took it all the way down using the terrain to stay low and got that mannequin all the way down to the end of the into the creek and up, and then over to the casualty collection point. That was, one of the early gen mannequins. And now we have one that's designed specifically for submerge, that you can actually submerge to nine meters. Wow. Yeah it's pretty resilient. So before we get into the tactical experience of the instructors and the cadre, there's one other product that I just want to highlight that I know I use when I teach these classes that you guys make, which is these wounds in a box, or the wearable wounds. So the wearable wounds are very funky, and I will never forget the first class that I took using your products. The operator of the wearable wound ended up with a remote control in their hand so they could activate the bleeding whenever they wanted to. And I swear this person waited to my face was directly over the mannequin to hit the button. I just took a blast right to the face. I swear they were doing that on purpose. So tell us a little bit about the wearable wounds and how that fits into the training scenarios. And then maybe we'll talk briefly about the wound in a box, then it's Steve's turn. Our original design was based on an army requirement where we needed to build trauma sims that were wearable, that could be put on soldiers that they could run hip pocket training and we had the concept of it was, Doc, there's 2 hours until the armory opens up, train my soldiers. And you need to be able to bust out this box of wounds, grab a couple of volunteers, pull them around the corner, put wounds on them, and then call the first couple of soldiers around to treat their squadmate. So it was had to be fast donning, fast doffing, had to be extremely realistic. It had to be functional. It needed to do something besides look scary. We have wounds that are packable. We have wounds that are uh, pretty involved, that you need to actually put on tourniquets, put on dressings to stop the bleeding. So that was the wearable wounds. But what's really nice is if you have the wearable wounds, you can put them on people, you can put them on mannequins and you can expand your scenarios tremendously. We've got about a hundred different styles of wearable wounds. And then we also have a self adhesive wounds, which are not not as complicated as the wearables, but they, all our wounds that can be used to create burns, to create lacerations in a really fast and fluid manner. So you could be running your tactical scenario and let's say somebody is stepping into the fatal funnel of the doorway. You can walk up to them and you're dead. You've got a gunshot wound now or put the wound on their arm, their leg. And now you've created a medical piece to your tactical scenario. And it really changes the course of your your training, So Dave, I think you transitioned it perfectly there from having the technology and the equipment to create the scenarios, to having the instructor cadre that has the experience, both teaching and the experience under fire to know what to do to make this training, more valuable. That gets me into Steve's expertise. Steve, why don't you tell us a little bit about why having the instructor cadre have had down range experience, why is that so critical and important? It's definitely important because you think about it. We've all taken classes, where you have the person and they can show you all these certifications they've been through and then you go ahead and you talk to them and you know about real world and it's a they don't know how to react. So when you have the instructors actually have that real world experience like myself and some of the other instructors I teach with, we we know what's going to happen. We know what to expect. It's like one of those things when you look at, for instance, with our CPR videos, remember do CPR, you look at the video for the Red Cross and they tell you all this, and it's that great acting they have and everything that, but it doesn't go ahead and tell you what's literally going to happen, somebody is going to go ahead and vomit or, you're going to go ahead and crack the cartilage, things like that. That real world experience doesn't come in for the people who don't have it. And I've seen that a lot. I've gotten into a lot of that debate with people. Since I've gotten out of the military about how things are really going to work in that type of scenario. And, looking at them and talking to them, all of a sudden I find out how many times have you been involved in this? They're like not once, I read a book and I saw them like, that's great, I've lived this. I've actually, one, I know I went ahead and had a debate with somebody one day about something, and I say, it's a lot different when you actually have rounds that are flying past your head. Opposed to, hey, this is what we're going to go ahead and do- or, in the background, we're going to play the simulation. Same thing with, a lot of these wounds that Techline makes, it, they're great because it's actually a real world. Instead, you go ahead, you have that training scenario where they put an X on your arm, they're like, this is your wound. Read this card. At the end of the day, it's great, but you really can't go ahead and, it's, very different when, you have an X on your arm or you're reading this card, how you're going to treat than if you actually have something that's actually, bleeding at the time, and you have to go ahead and stop it. It does give you a different feel and it makes you react differently. It sometimes, shows you, hey, maybe, you're solid in your skills and or sometimes you need work. And it's nothing to go ahead, put you on a pedestal or think that, hey, you're down there, at the bottom of the ground, it's just to go ahead and show you where you're at. And maybe you need that work. It puts you on. It gives you a little more pressure then just not having it at all and being a nice calm scenario; know nothing's going to happen. Steve, I will never forget one of the first scenarios that we did with David's crew in Bernardsville, New Jersey. We talked about why military folks and, tactical operators have that vest, what's up with that vest. We had the EMTs, we didn't give them a whole lot of coaching. He said, just do what you'd normally do. And they brought in their jump bag and they had a bag in their hands on one of those little band aid boxes and they were going into the scene. And then when we made the noises, the gunshot noises, because we make these things realistic when the gunshots happened, they dropped their gear and you can literally watch these people run in a circle, not knowing where to go. That is why tactical operators wear the vest with all the stuff on it, because you can't drop it, it's attached to you. Another thing too is a lot of people I've realized on the civilian side of things, they don't think outside the box. They don't want to think outside the box because they're afraid to get in trouble. My biggest thing I always say, it's easier to ask for forgiveness than permission. If I'm going to go ahead and have to do something to either make somebody feel better to save somebody's life. I'm going to go ahead and do it. I'll deal with the consequences of what is later. And that's one thing these guys, they don't, Oh this protocol this state that says this, that, and I understand we had the protocols in place, but sometimes in a perfect world, you can't go by them. You have to go ahead and Hey, I need to go ahead and fix B, what am I going to use from A to go ahead and do that? And I don't have it in my box or it's not going to work. And I think that's the problem. The other ones are so just, this has how it has to go and we all know real life is not like that. It's not going to go ahead and be, by the book. A lot of times that book goes out the window and I think that's one thing I've noticed on the military side of things with us and a lot of people, I've served with and things like that is that we're so quick to think outside that box and they get away from that book training. We should all have a plan every time we're going to a scenario, whether it's a heart attack, a drowning whatever the scenario you're responding to an emergency, we should all have a plan. But that plan goes out the window once the first shots are fired. You need to come up with a different plan. I see a lot in the security world. When I say private security, I deal with a lot of music venues, festivals, things like that. And some of the teams I have, and even some of these GMs or, bands, they have, like I said, they have a plan. And I'm always like, okay, that plan in a perfect world, you want everything to go, but it's not going to be a perfect world. Sometimes you got to think on the fly. A lot of times we do, they go ahead and adjust that plan. I think that's another problem. Some people can't think on the fly. There's some people that are good at being able to make a plan and others that are good at following that plan. So it's just, you guys see where everybody is. That gets down to leadership, training people to be leaders. So we can have the best technology, we can have the best equipment, we can even have instructors that have amazing experience. But training people to use this as their primary tool to be able to adapt, improvise, overcome. That is a amazing tool that not everyone possesses, and when it happens, it's a wonderful thing. We see it, we know when it happens, you watch people come in with their plan, and then they have to start thinking where they wanted to have a casualty collection point on the grassy knoll, and all of a sudden that's not an available resource, they have to come up with something else, and you watch them think through it, and either it's successful or it's unsuccessful, and they learn either way. And Dave, I know here's one thing we've seen, we've been teaching together for, years. Sometimes I go, we'll say a little eccentric with some of my scenarios and I just come up with them too, but I'll change stuff up on people all the time. When, you can tell, and it's the group that I think is a little bit tougher, that's going to go ahead and think that they're playing together. I'm going to go ahead and throw them for a loop every single time- which you have to, and then that's the biggest thing too, for me and because they don't really get it and it's, what we do, the products we use from Techline, that's everything is literally, it's to throw those people for a loop because we can actually make the things bleed. When we go ahead, they get to see the stuff real life when we're using stuff from animals to go ahead and show, a lot of different organs like that stuff they can actually hands on and actually see and it makes you realize a little bit more of that. Yeah. You know what, this is great training. And it's, you're something, you're getting something out of it and a great experience out of it. And you actually get to see it, not just Oh yeah. They put some red on that. So that's what it was, with the red magic marker and a red Sharpie. No that's not how it should be. Yeah. Steve, I'm recalling one of the scenarios that we did and we used the wounds, the wearable wounds from Techline, but we also used a chainsaw. Remember the chainsaw? Oh, I do remember the chainsaw yes. I believe we took the chain off the saw because we didn't need to have any unintended injuries. But we had a chainsaw in our PHTLS class. We try and make the scenarios as realistic as possible. I know one of the questions people seem to have is, okay, where do I get this equipment and where do I find people who are willing to wear these wounds? And we'll link in the description box below the links to Techline Technologies. So you can find out where to contact David Parry and his team, and they can help you get those resources. How to find people to put them on is the next challenge. Sometimes we use our children. Steve has used his, I have used mine. I think Dave Parry has had his one or two of his kids involved in the scenario. That's great. You can use scouting organizations. You can use people, students from a school. You can use other people from a local fire department or ambulance that aren't taking the training. They may be on the waiting list or are going to take it next year. They can participate as victims. There's a wide variety, but those are the most common ones that I've seen and I love using my children in the scenarios, although now they've become more medically sophisticated than I am. So we're recruiting. If you want to be a victim, you can contact us. We'll get y'all set up. You think about a great thing coming up, the last place to like to do is drama clubs. You go ahead and put in there too. They will act and I I've definitely gone ahead and got my share of kids from that, besides, my daughter's very much involved in drama. So that is a great thing too. They will act. They do what we'll do when they need. And they get that what's going to happen. They're not going to go in Oh my God, they're throwing this fake blood. They're like, yeah, let's do they're all about it. And they'll play the parts up, which is a good thing. So the drama club is important for two aspects. One, you can get some actors and actresses from the drama club, but second, the people who do makeup, theatrical makeup are wonderful. The products from Techline work hand in hand with moulage. The moulage is a technical term. It basically means theatrical level makeup. And think of the, like your friend that makes the scariest Halloween costumes. That's what we're talking about. If it is totally scary and looks like they're missing fingers or things are poking out of places they shouldn't be poking out of, that's what we want. We want to create those scenarios. Steve mentioned it before, particularly as you get a certain level of sophistication to your students, throw them the monkey wrench. Throw them a bone that's sticking out of a wound that does not belong to that patient. It's an extra bone from another victim and see how they react. It's very interesting. And Steve, you can affirm that's a realistic scenario that happens in combat situations. Yep. Yes, it does. Pretty cool stuff. All right, so we've talked about the importance of the right equipment and the cool stuff that Techline provides. We talked about a couple of the other things that we've used in the past, be it chainsaws. And I know we tend to use pig trachea when we do our surgical airways. There are simulations that Techline and others provide that are simulating cutting into someone's trachea. Cutting into live tissue, that pig trachea that we actually have to pay for. I figured we could get it from the butcher for free. Now they make us pay. Someone apparently likes to eat this stuff. I don't know who. They'll yell at me in the comments, I'm sure. Yeah. You tend to have to order them for biological supplies. If you want one that's going to last a couple of days unrefrigerated. So it gets, costly. It is costly and it's cool. it is a cool factor when you're cutting into live tissue and you can see how it works. So, again, whether it's chainsaws, live tissue, advanced simulation products, those are all great things to have. Then having the right instructor cadre that has that experience, You combine those two things, that provides course experience that is really a theatrical production. I think, and I think my colleagues here would agree, that when you take a TCCC, or Tactical Combat Casualty Care class, it should look and feel like a theatrical production with a final scene that everyone gets to play a role in. That's where people get the most experience out of it. If you're taking a class or you took a tactical emergency casualty care class and your final scenario involved a tabletop discussion, you probably did not get as much out of that class as you would out of one of ours. David, any other conclusions you want to talk about? No, I find that, really there's no substitute for hands on. You need to break up your classroom day with with doing some skills training and then you need to if you can work in as many scenarios as possible. Our motto is train more, bleed less. We want to run more of the scenarios whenever possible. Run as many as you can. It's hands on experiential training. That's what sets us apart from the less expensive, less theatrical, tabletop exercises. Steve, what other conclusions do you have? Just two other things I would go ahead and say also, look around if anybody's, when they go to do training that, look and see what you have in your area. I know the area I'm at Jersey Shore, like I said, I deal a lot with music venues that's one of the biggest things I look at. What type of scenario we could possibly do if we're doing something around here? What's something that's realistic that could literally happen? I look at the area because every area is something unique. Where your hospitals are? What resources you have for that can come to you and help out? How well trained are they? These are things that maybe people have to do joint training, get together and, just know how each other works. And the other thing I would go ahead and just kind of caveat what we were saying before is that it's all about the experience. Instructors that come in that are very well experienced and you're in that class, maybe you need to go ahead and swallow your pride a little bit and listen to what they're saying because they're trying to do stuff to make you safe. And I think that's the end of the day, that's one of the things that everybody thinks. Especially when they get up to certain- the EMS service, fire service, even law enforcement, it's always one of those things. I'm here for this reason. It's that's great. But how much have you experienced? So somebody is coming in to go ahead and help you, you got to use what your assets are. And if you have so many people coming into the world to help you teach, like we all do, we truly love what we do. I think it's one of those things, maybe you guys swallow your pride and listen to us for a while. That's one thing I've just noticed. We get it on both ends. Some people that really want to learn and other ones that are just there because they have to take a class, but they end up learning something at the end. And they're like, wow, I didn't even think about this. I thought I knew everything. It's no you don't because it's what we do. So you know, that's a big thing that's definitely has to come around and people have to think about. It's another thing that we as instructor cadre take a look at the people in your class, knowing your audience. Not only knowing the audience, but knowing the resources around. We created a scenario with New Jersey transit, where we did a hostage situation on a transit bus and we had the TOMMANIKIN® on the bus that we had to extricate. We had the shooters we had to subdue, and so your integrated rescue task force, the law enforcement aspect had to subdue threats, the medical aspect had to evaluate patients, and collectively they had to move people together. Definitely, Steve you're right. Using the resources around you as instructors is a wonderful set of experiences. Hey, listen, it's been fantastic talking to you both. I think hopefully we've imparted some of our knowledge to who's ever listening out there. I hope you will use this to elevate your teaching ability, both in the resources that you use, the teaching tools you have and as well as finding instructors and staff and subject matter experts that have had this unfortunate experience so they can impart that to your student. Thank you again for listening. Thank you for standing by here at the LIFESAVING CHRONICLES. We hope to see you in our classroom soon and have an awesome day.