In order to do a proper role-play of a medical scenario, you need a patient. Since this is a training exercise, it's not done with real trauma victims. It's done with dummies. Who are the dummies who volunteer to get slathered in fake blood and lie on a gurney for imitation chest compressions? You guessed it: the kids of the instructors.
C'mon. You'd do it, wouldn't you? It's the next best thing to being an extra in a Freddy Kruger flick.
I remember one year when I was nine or ten years old. I played the part of a nine-year-old boy who had been hit by a car and thrown sixty feet across the pavement. My only job was to lay semi-conscious (and unresponsive) on the gurney, head locked in a neck brace, and breathe shallow breaths. Meanwhile, a parade of students would come through and ply their trade on my fake-blood-smeared body. Yeah. When I told the kids at school, they were all jealous.
Now be reminded that many of the students need to pass the ATLS in order to get a post in a trauma hospital. And for many of these students, such a post is the holy grail of jobs. They want it badly. Therefore they must pass this course. Remember taking the SAT in high school? Yeah, imagine that, but with one thousand times the pressure. Many students at ATLS are nervous. Really nervous.
Anxiety is natural in these situations, of course. It can have unexpected side effects, however, for the dummy on the stretcher, especially since one of the first moves a physician has to make is to take the pulse of the patient. And unlike the nurse at your bedside, a trauma physician examining a young lad is going to take the pulse at a very vulnerable place: your neck.
One student entered the room, received his brief on the patient's (my) situation, and approached my fake-bloody body on the gurney. He put his fingers on my neck to take my pulse, and looked up at the instructor. The instructor gave him a number. I have no idea the significance of that number. What I do know is that the student didn't know what to do next. So he froze. Like a deer in the headlights. With his fingers pressing on my carotid artery.
They had told me that my job was to lie there, be unresponsive, and breathe shallowly. Well, the last one clearly wasn't going to be a problem. However, to a ten-year-old, the weight of a zombified med student cutting off one's blood supply to the brain is pretty scary. I remember feeling that pressure on my neck, wondering if this role-play was going to turn into the real thing. I felt my eyes get larger with alarm. I don't know how long this student fumbled for the right next step, but to the kid on the gurney it seemed like an eternity. So much so that I think I gasped when he finally took his hand away and moved on to blood pressure.
As long as he didn't have to get out those shock paddles, I would be all right. Don't lock up with those on, man.
Praise the Lord, he didn't need the shock paddles; and I have no idea whether he passed the exam or not. I was just the dummy. From the experience, however, I did learn that you should never let a panicked med student take your pulse. He may not give it back.
The next year I got to play a motorcycle rider who had rolled over the hood of a Buick and got the hood ornament stuck under his helmet behind the ear. As a result I learned valuable lesson number two: how to take the helmet off an unconscious rider without doing further damage to the neck.
I've not had to use either piece of knowledge yet, thank God. But you never know.
~emrys
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