How to play the EMS Simulator

Therapies

We tried out best to be as universal as possible with treatment protocols in the simulator.  This is easier at the BLS level than at the ALS level since the bigger drug box means more differences in how each region, service, and medical director treats patients.  In general you should perform interventions that are medically indicated and in the arena of widely accepted medicine, but try not to be too cutting edge or experimental since we can’t really accommodate the preferences of every physician who writes protocols.

For example, shock ventricular fibrillation, but don’t be too disappointed when you don’t see an option for double sequence defibrillation with two monitors since that is not widespread standard of care.  

EMS Mana

You get EMS mana for doing things that are case-specific and considered to be medically indicated.  This includes assessments, interview questions, vital signs, and treatments.  You lose EMS mana for doing things that are clearly not indicated (putting your AED on a conscious talking patient) or dangerous (giving a paralytic to a patient with an isolated ankle injury).  

You can rack up some easy EMS mana by doing all the textbook items from the NREMT skills sheet such as performing a full primary assessment (such as assessing airway, breathing, and circulation on talking conscious patients), a complete interview (SAMPLE), and a physical exam that appropriate to the complaint (breath sounds in dyspneic patients),  Basic vitals signs and diagnostics will also get you EMS Mana, but unnecessary procedures will not (glucometry on fully lucid patients with no history of diabetes).  

Download the NREMT skills sheet here.

On Scene Time

Everything you do eats up time, so if you pat down every asthmatic from head to toe you will end up bloating your On Scene Time score, and Walter Reeves wants you taking the next job ASAP.   Stay away from actions that don’t make sense  like asking trauma patients OPQRST questions (“Does this stab wound radiate anywhere?”). Clicking every menu button you see is definitely not the best way to play this game.

Evidence-Based Practice (EVP)

We tried to weigh interventions fairly without being the EVP police.  Many people don’t believe the data supports giving epinephrine in cardiac arrest, but it’s still the standard of care and taught in most resuscitation programs such as ACLS.  We wanted to make an entertaining internet game, not  pass judgement on how you practice.  If you do something that is historically accepted you’ll likely get a +1 EMS Mana out of the game.  If you miss something that most texts would consider standard of care  the summary will tell you you missed something in the treatment.  If you do something silly or dangerous to the patient you’ll rack up a Mortimer Moment.

Try to have fun with it - that’s what we made it for.