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Fass,Bryan.(nd).How to train like an EMT.Retrieved from https://www.jems.com/operations/tips-and-exercises-to-improve-your-fitness-for-ems-challenges/

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JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

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EMS providers drive around in the perfect stretching and exercise device. Your rig has steps, handles and pull bars galore-essentially everything you and your partner need to get and stay fit. With resolution season upon us again, it's time to turn over a new leaf and set some goals.

Every aspect of your job is 100% physical, so it only makes sense that being fit for duty won't only reduce your chances of getting hurt, but will also lower the rate and severity of injury if you do. The weight of your gear, step height on the truck, and weight of the cot and the patient-everything requires a balance of strength, flexibility and muscular endurance.

The challenge lies in getting fit, and ultimately getting "EMS fit." The job will beat you down if you let it, so getting motivated, staying motivated and determining your resistance points are paramount.
THE CHANGE EQUATION
With more than 25 years' experience of training others to get fit, I've come to realize that it's almost impossible to predict the factors that will cause people not to make fitness and wellness a lifestyle, a mindset and, eventually, a habit. Some common ones are lack of time, financial stressors, or even pressure from a spouse or family member.

Since goals are rarely met or maintained, ¹ you need to get all the skeletons out of the closet before you set one. Take out a piece of paper and run through this drill. It only takes a few minutes, and it will open your eyes to how to truly succeed and create a lasting behavior change. At the top of the page, write down the change equation:
D x V x F > R.

D - Dissatisfaction with your current situation. Write down your dissatisfaction(s) with your health and wellness.

V - Vision of your future state; these are positive possibilities. Write down what you want the future to be.

F - First steps in the direction of positive change. Write down the first steps you're willing to take.

All of these variables must be greater than:

R - Resistance to change. Predict where these resistance points might occur, from where and whom.
MYTHS DISPELLED
An important first step to establishing a healthy lifestyle is to dispel some of the common myths surrounding exercise. This will ultimately help you to succeed where you may have failed in the past.

1. No pain no gain. This is perhaps one of the biggest myths in fitness: that to succeed, you have to be covered in sweat and be exhausted and sore for five days afterward. Yes, you do have to work out hard and for at least 30-45 minutes 3-4 days per week, but there's a point of diminishing return.² If you work out too hard, too often and combine that with shift work, your body will actually go the opposite direction. You need time to heal, rest and fuel your body after the workout.

2. I have to be perfect. To get good at something you have to do a lot of that something, and fitness is no different. Expect to fail and embrace failure when it happens because that's how you learn and grow. Remember, as long as you're moving forward, you're still moving.

BRING IN YOUR PARTNER
Now that we know the hows and whys, you can start to determine your goals and map out a fitness plan. But let's take it one step further: motivate your partner, too.

You probably already work well with your partner. When you respond to calls, your combined efforts deliver the best patient care possible, and you always have each other's back. They're the best "accountability partner" you can have, so why not hold each other accountable for fitness and nutrition goals as well? The only stipulation is that as accountability partners, you must be strict with one another.

Having a partner in fitness will help keep you motivated. People who train in a group or with a partner do much better and build better long-term habits than people who try to grit it out themselves. You have someone to monitor rest periods between sets-45-60 seconds is ideal-and encourage you to push out an extra rep or two. You also have someone to watch your form to make sure you're not cheating. Plus, a friend to share your fitness victories with is always a great bonus.
BEGINNING YOUR FITNESS REGIMEN
Getting started is easier than you think, and you and your partner can start on the road to physical fitness right now.

a. Pre-shift stretching: You can integrate some quick movement-based, active stretches into your pre-shift routine by following a "check off the truck, check off your body" routine. In other words, use your daily pre-shift truck check as your golden time to move better, feel better, wake up, reduce pain and lower your chance of injury by adding a few minutes of stretching exercises. (See Figure 1, below.)
Figure 1: Active stretching exercises (Figures courtesy Bryan Fass)
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b. Foam rolling: Wouldn't it be awesome to give yourself a massage before every shift or every workout? It's possible with foam rollers, which have been around for years and are used throughout professional sports, in physical therapy and by weekend warriors. Spending 60-90 seconds on each calf, glute, inner thigh/hip-flexor and upper back will both increase range of motion and tissue temperature. Foam rolling is essentially your warm up and your massage in one tool; it's arguably the best $40 you'll ever spend.

c. Mobility matters: The next step is to work on some mobility drills. The beauty of mobility training is that when done properly, they can build both mobility-the ability for your joints and soft tissue to move well-and stability.

Stability is the key to almost everything in fitness because without the ability to stabilize the body and control movement, you'll only cause pain and injury. You have to have the mobility and stability to stop whatever movement you started and control the load.

The Turkish get up exercise is a perfect movement that will build mobility, flexibility and stability. (See Figure 2, below.) Do three repetitions on each side with a light weight or kettle bell.
Figure 2: Turkish get up Steps:

1. Lie on the floor with your arm straight up over your chest and one leg bent at the hip and knee.

2. Thrust the bent leg forward raising your upper body off the floor and coming up into a seated position.

3. Come up onto one knee with your arm straight.

4. Stand upright with your arm fully extended overhead.

5. Reverse the steps to lower back down to the start position.

Complete all reps on one side before switching to the other side.

d. Activate: Now that you move well, can move objects well and can control the movements you started, it's time to finally start training. If you're tempted to skip directly to training, don't. The above steps are critical first steps in a scientifically designed fitness program and you and your partner should include them in all your training.

To get you started, Figures 3 and 4 provide you with a two-week protocol that will make you stronger, move better and feel better. You can only move patients well if you move well, so learning to have good postural control is paramount. All you'll need for these workouts is resistance tubing bands. Week 1 should be three sets of 15 reps with 45-60 seconds rest between sets. Do this routine two times per week with 20 minutes of cardio right after. Week 2 is similar, but we're adding more resistance and building on the muscular stability and endurance you built in week 1. You can alternate these workouts for a month before moving on to more advanced exercises.
Figure 3: Week 1 exercise routine
For each exercise, do three sets of 15 reps with 45-60 seconds rest between sets. Do this routine two times per week with 20 minutes of cardio right after.
Exercise 1: Glute bridge Steps: Exercise 2: Quad hip abduction Steps: Exercise 3: Step down Steps: Exercise 4: Foot up split squat Steps: Figure 4: Week 2 exercise routine
For each exercise, do three sets of 15 reps with 45-60 seconds rest between sets. Do this routine two times per week with 20 minutes of cardio right after.
Exercise 1: Turkish get up
See Figure 2, above, for this exercise.
Exercise 2: Close pulldown Steps: Exercise 3: Extension Steps:

1. Start in a squat position holding the handles between your feet with your arms straight.

2. Stand upright, raising the handles overhead with your arms straight.

Exercise 4: Lunge Steps: Exercise 5: Pallof press Steps: STAY THE COURSE
To succeed in any fitness program, the final step is to rewire your brain to think of fitness and wellness not as "working out" but as critical training to help you do your job well. Working out is a common day-to-day thing, and thinking of your fitness regimen as such will lead to failed resolutions. Just like your on-the-job training, your fitness regimen should run in preplanned phases.

When I was a paramedic, I worked a long week of 12-hour shifts followed by a short week of 12-hour shifts. On the long weeks, I programmed in more cardio and a lot of mobility work to stay loose and feel good without creating any soreness or excessive muscle fatigue. This allowed me plenty of time to heal and recover from a busy week. On the short weeks, I programmed in more intensity and heavier weights because I had the extra days off to recover and heal. You can follow the same approach for 24-hour shifts-it's the work to rest ratio that really matters (plus some good nutrition, of course).

Structuring planned phases of training will keep your regimen fresh, fun, new and challenging. This way, you never get bored; you avoid over-training and can even program your training around your shift schedule. An intensity month followed by a heavy lifting month broken up by cardio weeks is a great way to constantly meet and exceed your goals.
REFERENCES
1. Shilts MK, Horowitz M, Townsend MS. Goal setting as a strategy for dietary and physical activity behavior change: A review of the literature. Am J Health Promot. 2004;19(2):81-93.

2. Gambetta V: Athletic development: The art and science of functional sports conditioning. Human Kinetics: Champaign, Ill., 69-71, 2007.
More Provider Wellness from JEMS.com

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Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.)

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Tips and Exercises to Improve your Fitness for EMS Challenges - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

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EMS providers drive around in the perfect stretching and exercise device. Your rig has steps, handles and pull bars galore-essentially everything you and your partner need to get and stay fit. With resolution season upon us again, it's time to turn over a new leaf and set some goals.

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Coach,Paramedic.(2020,December 2).How to get fit like an EMT.Retreved form https://www.youtube.com/watch?v=oEJRGCTCHQ8&t=500s

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How To Get Fit for EMS (How To Get Fit To Be An EMT/Paramedic)

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Baily,Lance.(2020,April.7)EMT tranining Virtual Reality.Retrieved from-https://www.healthysimulation.com/23800/vrpatients/

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VRpatients Unveils New Virtual Reality Training Platform for EMS First Responders | HealthySimulation.com

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Unveiled today, VRpatients is an immersive virtual patient platform perfect for educating and training EMS first responders, either online or through Virtual Reality (VR). EMS Programs looking to immediately provide distance education and training opportunities should absolutely learn more about the…

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Looker, Rachel.( 2019,Jun. 24)EMT training Augmented Reality.Retrieved from https://www.naco.org/articles/virtual-reality-enhances-training-county-emts

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Travis County, Texas is using virtual reality to improve training for emergency medical technicians

Virtual reality can be more than just playing a 3D video game.

"I think it's more than an entertainment technology," said Scott Smith, a professor at Texas State University in San Marcos, Texas and president of Augmented Training Systems, a company that is focusing on developing training for first responders.

Austin-Travis County is using virtual reality to improve training for emergency medical technicians (EMTs) when it comes to their AMBUS, an ambulance bus that is used for mass casualty disasters.

The AMBUS is capable of transporting up to 24 seated patients at a time, according to Keith Noble, who is the commander over the homeland security and emergency management divisions with Austin-Travis County Emergency Medical Services (EMS). The vehicle can go 700 miles before needing to refuel and can remain stationary for up to three days.

There are currently 14 AMBUS units in the state of Texas that are used as part of a statewide response to large disasters, according to Noble. The AMBUS in Austin-Travis County is often used locally and serves as a first aid station at big events, he said. The most action it has seen so far was in 2017, during Hurricane Harvey.

The idea for the virtual reality training came when Noble was approached by the city's Computer and Technology Management department which was looking for an idea to use virtual reality to submit for a grant. Noble said he had always been looking for ways to do different trainings with the AMBUS because it's significantly different than a regular ambulance.

Austin-Travis County received the grant money for the idea and created basic, 3D mapping of the AMBUS similar to a Google map where a user can click around and see the inside of the bus.

After completing the 3D mapping, Austin-Travis County EMS collaborated with Smith and Augmented Training Systems to develop virtual and augmented reality "atmospheres" to help train EMTs.

The county entered another contest for a smart cities initiative and received a $35,000 grant to create a prototype using this new technology.

"It allows people to be immersed in situations they could not normally train in and be under stress and different circumstances that are hard to replicate and are real-life situations," Smith said.

Smith spent time with Austin-Travis County EMS and Noble, who is a consultant for Augmented Training Systems, to better understand their training needs and find gaps in the process so they could focus on building an appropriate training modality.

"We wanted to make something that was more effective and allow them to have a system to move forward that we could adapt and evolve as their training needs evolved," he said.

The company first designed a 360-degree interactive map that allows users to walk through the AMBUS. The map can be accessed at any time and from any location.

After designing the interactive map, they created a fully 3D-rendered AMBUS environment that can be used for different scenarios and allows the user to track their data for improvement. A user can put on a headset, move around the AMBUS, open drawers, find supplies and immerse themselves within the virtual environment as if the AMBUS was physically in front of them.

The company also created an augmented reality environment which allows EMTs to use any space to project a holographic AMBUS that's to the scale of the real AMBUS. Users can use an empty hallway or large room as their training space.

These methods provide EMTs with more ways to familiarize themselves with the vehicle and feel more confident in their emergency response skills when serving as AMBUS crew.

Before the virtual rendering, crew members only received one initial AMBUS training, Noble said.

"They don't really get training after that on the AMBUS until they're thrown into the middle of chaos in the middle of a disaster like Hurricane Harvey," Noble said.

What makes working on the AMBUS even more challenging is a different setup and layout compared to a regular ambulance, making it hard to find certain supplies and know where items are located.

The virtual reality prototype was tested during a cadet class.

"We tested how well things worked between VR [virtual reality] and AR [augmented reality] and just the regular training they get," Noble said. "They greatly improved their knowledge of the bus and error rates and finding stuff."

The virtual reality and augmented reality trainings improved cadets' memory recall for locating objects by 45 percent and improved their speed by nearly 30 percent.

"Significant when you're talking about trying to save lives," Smith said.

During the training, cadets located certain items in the AMBUS while they were being timed. The VR system tracked their number of errors so they could review their progress.

"If they're not learning where they need to perform, then they're not going to perform well when they get there," Smith said.

The virtual reality training is more cost effective compared to in-person training, which can get expensive bringing in employees on overtime, Noble said.

He explained that EMS medics will now have annual, virtual training on the AMBUS to become more familiar with its inner workings. EMTs can access the program whenever they want a refresher or for "just-in-time training" to review material if they know a certain disaster may impact the area.

"For burning a building, you can only burn a building once," Smith said. "With virtual reality, I can burn 27 different buildings with 27 different chemicals. I can create stress that normally can't be created in a normal space."

Noble said he believes virtual reality training is specifically beneficial for low-frequency events that require unique training such as disasters, active shooter training or hazardous materials.

"Those situations are really difficult to train for in real life," Noble said. "First of all, it's very expensive and it's also hard to replicate."

He said the county wants to work on creating virtual reality training for infectious diseases in the future.

"For those types of events that happen very infrequently, once or twice a year, but it's high risk, it's life or death type situations, the virtual and augmented reality training has just become very useful," Noble said.

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Virtual reality enhances training for county EMTs

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Travis County, Texas is using virtual reality to improve training for emergency medical technicians Virtual reality can be more than just playing a 3D video game. "I think it's more than an entertainment technology," said Scott Smith, a professor at Texas State University in San Marcos, Texas and president of Augmented Training Systems, a company that is focusing on developing training for first responders.

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Lexpol. (nd). EMT Training Mixed Reality .Retrieved form https://www.ems1.com/ems-products/education/videos/real-life-training-without-real-life-consequences-virtual-reality-ems-training-E1YpgF2Mt7BpRxnd/

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What would you do if you could train for a real life medical emergency while avoiding any real life consequences? VRpatients can help you do just that. VRpatients offers practitioners and trainers real life training by immersing them into realistic scenes where they interact with a patient inside a scenario in real-time. The system grades every aspect of the user's response based on the trainer's preferred protocols. Every aspect of the case scene is fully customizable - from the patient's presenting symptoms, to the environment. The practitioner interviews, assesses, treats and transports the patient in a timed window, and can repeat the scenario as many times as needed until skill mastery. Trainers can also objectively assess a student/practitioners critical thinking skills and field readiness. Available online or in fully immersive VR using a VR headset, it's the closest you can come to real life training without real life consequences. Watch this video to see how it works.

More about VRpatients:

VRpatients is a physiologically-based healthcare training application that immerses users into virtual clinical case scenarios where they can interview, assess, diagnose and treat patients in real-time.

In less than 30 minutes, educators and trainers can build the clinical cases based on their own protocols using the application's intuitive case authoring tool that comes equipped with lifelike patient modeling, realistic moulage and animations presented in over 25 living environments.

The cases are brought to life for students, who are assigned a case before "going inside" the application to interact directly with the patient avatar and treat in real-time.

Following case completion, students' critical thinking skills and competency are objectively assessed using VRpatients' enhanced grading rubric. Students can learn from their mistakes and repeat a case as many times as needed for skill mastery.

Available through a remote, online platform or in full immersion using a VR headset, VRpatients gives educators and trainers indisputable insight into a student or practitioner's knowledge and readiness for patient care in the field. It's real life training without real life consequences.

Check out VRPatients: https://vrpatients.com

Like, Share, Follow, & Subscribe VRpatients:

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Video: Real Life Training Without Real Life Consequences [Virtual Reality EMS Training]

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What would you do if you could train for a real life medical emergency while avoiding any real life consequences? VRpatients can help you do just that. VRpatients offers practitioners and trainers real life training by immersing them into realistic scenes where they interact with a patient inside a scenario in real-time.