Rural Emergency Medicine Simulation Training and Resource - British Columbia

Why do Emergency Simulation Rounds'? Or a larger question than why ER simulation is why RURAL physician ER training and simulation?

Most current Health Authorities have credentialing standards for rural family doctors working in emergency departments. This usually involves being current in ACLS and often ATLS. Although both these courses have merit, the reality is that for every patient seen in a rural hospital requiring a chest tube, cric, or even cardiac arrest, you will usually see 5 - 10 patients or more with acute pulmonary edema, anaphylaxis, sepsis and other immediate life threatening critical illnesses for which no ongoing credentialing standards are required.

I talk to residents about my "95, 4, 1" rule. 95% of patients in a rural ER will be what you would see in your regular office - the colds, rashes and prescription refills. 4% of patients in a rural ER will have a severe illness that needs immediate attention, admission or referral. The final 1% will be the 'critical' life threatening patient that needs immediate resuscitation. The field of emergency medicine is changing rapidly and the treatment of critical illnesses in the ER is part of this change. Rural physicians need to be aware of the 'critical care' side of medicine. Family doctors need to be knowledgeable, comfortable and willing to use IV drugs, ventilators, emergency procedures and all the other aspects that are entailed in treating immediate life threatening illnesses. In other words, family doctors have to be able to be 'resuscitationists'.

In summary, I believe patients being treated in a rural emergency should receive the same level of care they would receive in an urban emergency.