Simulation Ambulances of The EMS Vienna
The EMS Vienna (=Emergency Medical Services)
More than 230,000 rescue runs in 2021. Around 1,200 emergency calls in 24 hours, more than 120 emergency vehicles, a network of rescue stations covering the entire city of Vienna. Around 930 full-time paramedics, technical and administrative staff, and a pool of 140 emergency doctors from the hospitals of the Vienna Hospital Association and the Vienna Trauma Center of AUVA. All these impressive figures illustrate the immense commitment that the EMS Vienna performs around the clock, 365 days a year, for all Viennese. As the largest rescue organization in Vienna, the EMS Vienna is responsible for most emergency medical interventions in Vienna. Since its foundation in 1881, it has made a significant contribution to Vienna being one of the safest cities in the world.
Constant readiness, absolute mobility and standardized procedures are indispensable basic requirements for the EMS Vienna to arrive at the scene of an emergency as quickly as possible and to ensure the best possible patient care and health. Every emergency call demands full effort from the rescue forces: From emergency medical knowledge, communication and action guidelines to calmness in critical stress situations, many specific skills are demanded of rescue personnel. To meet all these diverse requirements, the rescue forces of the EMS Vienna must regularly undergo training, education and performance checks that go far beyond the legal minimum.
Training and Education at The EMS Vienna
The training and education of the emergency forces is provided by the Department of Education and Training of EMS Vienna. This institution, which is part of the EMS Vienna, is responsible for the emergency medical training of the staff of the EMS Vienna, but also of employees of other rescue organizations as well as other blue-light organizations such as the Federal Police or the Vienna Fire Department. In addition to theoretical content, the teaching program of the Department of Education and Training of EMS Vienna also includes many practice-oriented units such as realistic simulation training.
Following the example of aviation, where this method has long been established, these hands-on training sessions are used not only for training, but also for certification and regular performance checks. For this purpose, a training room with simulation technology was built at the rescue station of the EMS Vienna in Simmering (=11th district of Vienna) in 2018. With the previous training offer in the teaching rooms of the Department of Education and Training of EMS Vienna as well as the training station in Simmering, emergency forces could be well prepared for patient care on site. The new project of simulation ambulances now represents an important expansion of this training offer and the available simulation scenarios.
“With the school station in Simmering, we embarked on the path of simulation technology; with the simulation ambulances, we perfected it and made it independent of time and place.”
Dr. Rainer Gottwald
Head of the EMS Vienna
Simulation Training in the Ambulance
The Ambulance Scenario
In addition to on-site care, patient transport in ambulances is also one of the key tasks of the EMS Vienna. Numerous simulation centers therefore have decommissioned ambulances for training purposes, which are equipped with various AV components (cameras, microphones, etc.) and are available as a permanently installed setting for simulation training. The EMS Vienna is taking this a significant step further. Instead of simply integrating an old ambulance statically in a simulation center, the EMS Vienna's new project puts the simulation where the mission takes place: in the active emergency vehicle. And that is not all. The project of the EMS Vienna, which is unique in Europe, not only plans to modify one or two ambulances for such an application, but to currently be able to use 18 (!) active ambulances of the EMS Vienna as mobile training rooms for video-based simulations. In other words, part of the vehicle fleet of the EMS Vienna will become a fleet of mobile simulation rooms on four wheels. But how can such an ambitious project idea be implemented technically?
The Project Idea
The extremely complex implementation of this project idea was realized in close cooperation between the EMS Vienna, the vehicle manufacturer Dlouhy and SIMStation. The basic idea was to equip all new vehicles with a functional SIMStation network structure already during manufacture. This basic simulation structure, consisting of network switches, high-duty cables, and magnetic brackets, provides the technical basis for the video-based simulation training. In contrast to conventional approaches, which involve retrofitting finished emergency vehicles for simulation purposes (which quickly reaches its limits), here the simulation capability was already considered during the planning of the emergency vehicles. This anticipatory approach reveals an immense advantage: The entire SIMStation network structure can be completely installed behind the interior paneling by the vehicle manufacturer. The simulation ambulances are therefore indistinguishable from conventional rescue vehicles – neither in terms of their appearance nor their functionality. The fully installed network equipment and the cabling running behind the interior paneling do not interfere in any way with the normal operation of a rescue vehicle. And they accordingly do not interfere with the course of a simulation training.
The Process of an Ambulance Simulation
The SIMStation network structure forms the functional basis of video-based simulation training in the modified ambulances. But how does such training take place in reality? To carry out training, the SIMStation network structure of an ambulance only needs to be linked with a SIMStation Essential and a practice patient monitor/defibrillator. The ultra-mobile SIMStation product line, of which two are currently in use at the EMS Vienna, includes three IP cameras, a room microphone, and a control PC. The entire system can be stored in an easily transportable aluminum case. The trainers can therefore take the entire equipment to the respective location of the desired ambulance in a convenient and highly flexible manner. Directly on site, before the training begins, the SIMStation Essential cameras and microphone as well as the training monitor are attached in just a few simple steps to strategically important positions in the ambulance (using magnetic holders positioned behind the paneling) and connected to the SIMStation network structure via slots that are already integrated. In the driver's cab, in turn, there is a network connection for the SIMStation control laptop, which, with the help of the SIMStation software, enables the control of all AV components as well as the configuration and recording of the simulation scenario. All the requirements for a training – simulation, control, and debriefing units – are thus met. The simulation training can begin.
“The ambulances equipped with the mobile SIMStation system provide us with completely new perspectives in the training and education of our staff as well as in quality assurance and performance checks.”
Michael Girsa, MBA
Head of the Department of Education and Training of EMS Vienna
The Advantages of the Project
So far, 18 new ambulances of the EMS Vienna are already in use, enabling mobile, video-based simulation training based on the modifications described above. The advantages that result from this project are numerous:
- The existing simulation structure
Thanks to the innovative design, the basic AV structure for video-based simulation training is already integrated in the ambulances. The remaining, easily transportable equipment (cameras, microphone, laptop, training monitor) only needs to be plugged in and is perfectly positioned and fully operational from the beginning. System assembly and disassembly each take only 5 minutes and – like the handling of the entire SIMStation Essential system – are easy and completely intuitive.
- The authentic training environment
The simulation trainings take place directly in the actual rescue vehicles. These are so-called in-situ trainings, i.e., trainings that take place in the real working environment of the emergency forces. In terms of the setting – from the spatial conditions to the used equipment – the greatest possible authenticity is therefore guaranteed. Since the cabling, all connections and brackets are located behind the vehicle paneling, the authenticity of the environment is not affected in any way by the AV equipment.
- Immediacy of the training
Thanks to the mobile SIMStation Essential, the trainers come to the employees and not vice versa. The rescue forces therefore do not have to be informed in advance about the training or its content. The advantage: The simulation participants are confronted with a scenario of an emergency completely unprepared – a premise that also applies to real rescue operations. Mobile simulation training thus reproduces the character of the unpredictable in rescue operations in an extremely authentic way.
- Absolute mobility
As the simulation trainings take place in the real emergency vehicles, the trainings can in principle be carried out anywhere (with the obvious condition that no active operation is taking place at the time). Thus, in addition to the timing, the location of the ambulance training is fully flexible. The trainers can take the simulation directly to rescue teams all over Vienna.
- Perfect test conditions
Regarding the environment and conditions, the above-mentioned points provide perfect requirements for regular performance checks of the rescue forces (i.e., their knowledge and skills). These activities are indispensable for maintaining the level of training and knowledge of the rescue forces at a consistently high level.
- Optimal use of resources
Since every ambulance is potentially also a simulation room, the use of personnel resources can be made much more efficient. This is important because the fundamental unpredictability of operational intervals (i.e., when and where an operation must take place) results in frequent idle times for the rescue forces. This idle time can now be filled productively through targeted training activities.
- An entire simulation fleet
Thanks to the project, the EMS Vienna has a permanently available training infrastructure. If an ambulance is not suitable for simulation training due to an operation or possible technical defects, other ambulances in the fleet that are not in use are freely available for video-based simulation training.
Video-supported simulation training is not only used by the EMS Vienna as a means of training, education, and employee checks, but is also seen as a great opportunity to strengthen the skills of the rescue forces and to provide them with valuable experience and security for practical emergencies. In this sense, this is a great project from which both the EMS Vienna as an institution and the individual employees benefit. But not only that: as a qualitative method, video-based simulation training ensures a significant increase in training and care standards. And that is something we all benefit from – especially the patients.