The Rulebook

Welcome to the Rulebook section. Here you will find all of the relevant information required when participating in the games. We advise all competitors and judges read over the rules prior to taking part in the competition in order to have the best experience when taking part.

This can be a very dry read, we should know, we had to write it. Here you will find all of the infomation you will require when taking part, from where you need to be during the day to what tasks will be simulated and what you will be doing for real. A good grasp of the rules will be imperitive tor any competitor who wishes to get the most of of the 2 day experience.

In addition to these rules, competitors and judges will recive an infomation pack on the day. this will include the event timetable (which may be subject to change hence why we cant publish it here), a site map, and a comprehensive scope of practice.

1. The Competition and game objectives

The competition

The Paramedic Games is a team-based simulation competition in which teams will compete in a number of challenging scenarios designed to test all aspects of paramedic practice. The competition will take place on Liverpool John Moores University (LJMU) Mount pleasant campus, running over 2 days. It will consist of 8 scenarios up to 40 minutes in length in which teams will be awarded points based on their knowledge, skills, and teamwork, plus the completion of additional bonus tasks. Competitors will consist of 10 teams and must complete every scenario. The winner will be the team with the most points at the end of the competition (potential 1000 points maximum) and will be announced at the awards ceremony.

Judging and scoring

Each scenario will be presided over by an individual judge who will be a currently registered paramedic and/or a member of the LJMU faculty. Judges will be briefed on their scenario prior to the competition to ensure they are following up-to-date best practice guidelines. Judges will score each scenario out of 100 points based on a scoring sheet specific to each scenario. Scoring criteria include but are not limited to: clinical skills, patient interactions, history taking, teamwork, diagnosis and treatment, professional values, correct diagnosis, and implementing the correct treatment pathway. Teams will be scored as a whole and not on an individual basis so teamwork is essential.

1. Awarding points is at the judge's discretion.
2. Judges may deduct points accrued during their scenario for unsafe practice, at their discretion. (Section 3b).
3. Judges may deduct points for safety infractions on a minor (-5), moderate (-10), and major (-20) scale. A minor infraction will consist of a deviation from best practice that is not in the best interest of the patient (failing to gain consent or not protecting a patient's dignity in good time, etc). A moderate infraction is something that has the potential to cause harm (not carrying out drug checks, leaving the front door wide open when attending a birth and letting the cold in, etc). A major infraction has the potential to cause serious harm or death (administering the wrong drugs that would result in serious patient harm or death, serious deviation from guidelines without good cause, operating outside of your scope of practice)
4. Judges may make multiple deductions for multiple infractions during one scenario, however, should an infraction occur that meets several of the above criteria, only the higher infraction penalty will be deducted (eg. Failing to carry out drug checks resulting in the incorrect medication being administered. While this may fall foul of a moderate and major infraction, only the major penalty -20 will be applied)
5. The level of infraction is at the discretion of the judge and will take into account the context of the scenario. However, judges must ensure consistency throughout all of their scenarios to ensure fairness.
6. Judges may stop a scenario IAW section 4a.i.
7. Judges will not reveal scores to teams, individual team score sheets and some feedback may be made available at the end of the competition.
8. Judges will not provide feedback, assistance or advice throughout a scenario or at any stage while the competition is underway, but they are encouraged to make feedback notes available for students to review upon completion of the competition.
9. The judge's decision is final.

There will also be an additional 200 points on offer for the successful completion of several tasks outlined in section 6.

100 points potential per scenario (8 scenarios total).

200 points potential for additional tasks.

Total potential score 1000 points.

Awards

Paramedic Games Award:

This will be awarded to the team who scores the most points throughout the competition. 2nd and 3rd place awards will be assigned to the 2nd and 3rd highest scoring teams respectively.

Service User Award:

This will be awarded to a team chosen by service users based on whom they believe provided the most holistic care, made them feel the most comfortable, and included them in their decision-making. Essentially, the team that provided the most patient-centred care throughout the competition.

This is a great place to tell users a story about your website and let them know more about what you offer. You may want to share information about your company's background, your team, or the services you provide. Be sure to keep the tone and voice consistent throughout the site so users become familiar with your brand.

gain confidence

"I feel as though I have learnt so many skills throughout the past two days and I will now transfer what I have learnt whilst out on placement as well as daily life. I feel confident and feel as though I've pushed through my stage fright."

2. Venue
infomation

The competition will take place wholly on the LJMU campus. Competitors are free to enter and leave the campus at their will, but are reminded they will require their student ID for access.

Introduction brief/ debrief

An introductory brief for competitors and spectators will be held in lecture theatre TB122. This is compulsory for all competitors in order to compete. Once all scenarios are complete, teams are required to attend a debrief at the end of Day 2 in lecture theatre Stanton Fuller in which scenario feedback will be given, this may or may not be individualised to specific team performance. Any team member not attending either brief may result in disqualification of the whole team unless arranged prior with the Game Organisers/staff. Competitors are encouraged, but not required, to attend the award ceremony held on completion of the debrief.

Venue access for competitors

Competitor access to areas of the campus where scenarios are taking place will be limited to teams competing in that scenario at that specific time, in accordance with the timetable.

1. While every effort will be made to notify teams of areas they should/should not be, we advise all competitors to avoid areas where scenarios are taking place unless their timesheet specifies them to be competing there.
2. Any competitor attempting to gain an unfair advantage for their or any other teams by observing/attempting to observe scenarios other than those in which their team is currently competing, or distracting other teams during a scenario will have points deducted from their team score. Serious infringements will result in the disqualification of the whole team.
3. The amount of points deducted and what constitutes a serious infringement is at the discretion of the Game Organisers.

Professionalism

Competitors are required to display appropriate professional behaviour at all times while on the LJMU campus or in uniform. Points may be deducted from teams whose members display inappropriate behaviour. Serious infringements will result in the disqualification of the whole team.

1. What constitutes inappropriate behaviour will align with LJMU policy and the discretion of the event staff and LJMU faculty.
2. The amount of points deducted and what constitutes a serious infringement is at the discretion of the Game Organisers.

Paramedic Games

13/14 June

Teams

Teams are required to compete in uniform and boots. Hard hats and high visibility clothing are not required but may be worn at the discretion of individual team members.

Team numbers

Each team will consist of 6 team members made up from all 3 cohorts and universities. At least one member of every team must be trained to use a full paramedic skill set (students from years 2 and 3, see section 3b. for full paramedic skill set) and at least one member must be a year 1 student (technician skill set, see section 3b.). The remaining members can be of either skill set.

1. Teams will be allocated in advance of the competition by the Paramedic Games Organisers.
2. Each team should consist of 2 1st-year students, 2 2nd-year students, and 2 3rd-year students where possible, However, this may be subject to change depending on the number of participants on the day.
3. Every effort will be made to ensure you are teamed with at least one person of your choice, however, this is not guaranteed.*
4. Once the competition has begun (start of introductory brief section 2a.) teams cannot be changed except where one team may be disadvantaged due to team members being unable to continue in the competition*.
5. In the event a team member from a team of fewer than 5 members is unable to complete the competition, a team with additional members may be asked to, and must, contribute a member with the required skill set so long as it leaves their team with the required personnel**

*This will only be required in extreme circumstances and we ask that you continue in the spirit of good sportsmanship.

** every effort will be made to ensure this is done as fairly as possible, conditions for moving teams can be discussed with the Paramedic Games Organisers at the time. Considerations and conditions of the day will be taken into account where scoring may be affected.

Scope of practice

The scope of practice students are scored by will reflect their relevant training and experience in university. This includes drug administration and interventions.

1. Students in Year 1 will be scored within the scope of practice of an Emergency Medical Technician 2 (EMT 2). Interventions include airway management (up to and including I-Gel insertion); Basic Life Support; and administration of PO, Buccal, Sublingual, PR, nebulised and IM medication. A full list of medications can be found in appendix 1 under Emergency Medical Technician 2.* EMT2s will be considered competent in drawing up and preparing all medications, preparing a giving set, and assisting the paramedic with cannulation and intubation.
2. Students in Years 2 and 3 will be operating under the scope of practice of a paramedic (see appendix 1, paramedic for drug administration*). Interventions include all those covered by EMT2 with the addition of airway management up to and including intubation, cannulation, IO access and ALS.
3. Operating outside of your scope of practice constitutes unsafe practice and points may be deducted at the discretion of the judging staff.

* This information is intended as a guide for types of medication under a specific scope of practice. For drugs, dosages, and routes, JRCALC guidelines should be followed. The scope of practice for paramedics will follow that laid out by the HCPC and not an individual trust.

Allocating team members

Teams will be informed of their members on the day of the event. Each scenario may require a different number of team members of various skill sets. Not every team member has to complete all scenarios but every team member must take clinical lead in at least one scenario. (See section 4b.). If for any reason you are not happy with your team, we will do our best to rearrange, however, this is by no means guaranteed.

Expand your
comfort zone

The Paramedic Games is all about allowing students to push themselves, leaving their comfort zone behind. It gives students the chance to take the lead, test their skills, and build their team working skills. They are safe to make mistakes. Although, with our level of high fidelity simulation, it may not always feel that way.

Mitch Clark, Paramedic / Game organiser

Competition rules

This section is arguably the most important to read and understand. It lays out how you will approach each scenario and the specifics of what you can and cannot do.

Simulation safety

The competition will involve the use of actors and service users, so safety must be always adhered to. The following physical parameters can be gained with the patient's consent and viewed on a simulated monitor:

ECG*
Heart Rate
Pulse (Patient pulse may differ from that of the actor in which case the scenario judge will notify the team)
Pulse oximetry
Capnography
Temperature
Non-invasive blood pressure monitoring
Respiratory rate
Auscultation
Percussion
Simulated blood glucose

*live Patients in scenarios that require procedures requiring the removal of clothing will utilise a base layer system. This will consist of a (RED) clothing base layer which will be used to simulate a patient's skin. When removing clothing, you may do so until the base layer in which case any observations will be carried out at this level.

In addition, the following procedures can be performed on the simulation equipment provided:

CPR
Airway management
Surgical airway procedures
Needle decompression
IV/IO access
Cutting of clothing
Defibrillation – manual or AED

Deviating from the safety protocols will be deemed unsafe practice, judges or service users may stop the scenario if they feel unsafe. The scenario may be forfeited and teams will only be allocated points accrued so far.

Judges may decide to deduct points accrued from that scenario due to unsafe practice at their discretion.

Scenarios

There will be 8 scenarios in total spread out over 2 days. Each scenario will be up to 40 minutes long (section 4c.), although the scenario may end early if a team believes they have achieved all they can on scene and are ready to transport their patient. Teams will be provided with some information about each scenario, similar in content to that provided by a mobile data terminal, or by ambulance control. Teams should not always expect this information to be 100% accurate to what they will actually encounter. This information will also state the number of team members required for the scenario, the skill level of the clinical lead, and any special instructions (such as 2 team members attending, while the 3rd and 4th wait to be called in as backup) any team member not competing in that scenario may observe but are to in no way interfere or confer.

1. At the start of each scenario, the judge may provide additional instructions/introduction.
2. Teams should decide in advance who will be participating in the scenario and amend this information on their MDT printout.
3. Teams must make the clinical lead known by filling out the table of assigned roles on the MDT printout and presenting this to the judge at the start of a scenario.
4. Teams should approach the environment as seen (I.e. checking for danger or catastrophic haemorrhage, if you can’t see it, it's not there).
5. Teams should be dressed in PPE appropriate for that scenario (gloves minimum when contacting a patient)
6. Conferring between team members taking part in the scenario is allowed and encouraged (you will be scored on teamwork).
7. Teams should clearly state any drugs they are administering and their dosage for the benefit of the judge (if the judge didn’t hear it, it didn’t happen).
8. When administration of a drug utilising simulation equipment if required (such as using a cannulation arm) this should be done with the simulation equipment as close to the actual administration site as possible. The maximum distance of the simulation equipment will be at the judges/actors discretion however every effort must be made to simulate administration as close to real life as possible. I.e. the cannulation arm must be within the immediate area of the actors arm and not simply placed on a table in the same room that is convenient for the team.
9. If any backup is requested at any point, this should be clearly stated. You should state the type of backup you would like to request and why you would like to request it for the benefit of the judge.
10. Any information that cannot be simulated or provided by the patient will be provided by the judge in real-time, or when the appropriate examination takes place.
11. Participants are required to shower before entering the pool area and are reminded there is strictly no diving, no heavy petting, and no bombing. (-10 points for each infringement)
12. Scenario time is strictly limited, the scenario will start/end at the allocated time. e.g. if the scenario is due to start at 10:00, the timer and scenario will begin irrespective of whether the team is present or not. This means if a patient is deteriorating, they will continue to do so from the start time until the team shows up and administers the appropriate intervention. Likewise, a scenario will end at the time specified by the timetable, irrespective of how far the team has progressed.
13. If a team deems they have completed the scenario and implemented their chosen clinical pathway, they should state this to the judge, provide a pre-alert when required and the scenario will end.
14. While teams will be scored appropriately for timely interventions, the competition is not a race and teams are encouraged to utilise the required allocated time within the context of the scenario (e.g. trauma patients may require rapid intervention and transport, for which teams will be scored, but teams will not be penalised for taking their time when scenarios are not time critical)
15. Points may be deducted if non-competing team members attempt to intervene or offer advice.
16. Teams are not allowed to share information about the scenarios, observe other teams during scenarios, or try and obtain information about scenarios and/or competition tasks from any source before participating in each scenario. Violation of this rule by any team member will result in the disqualification of the whole team.

Scenario timing

Time constraints for the day are very strict and rigorous. A timetable will be provided to teams informing them of the location and start time of the scenarios they are to attend and their duration (section 6). To ensure every team has a chance to complete all scenarios, every scenario will terminate at its allotted time. The minimum amount of time between any 2 scenarios is 20 minutes, however, most scenarios will have 40 minutes or more between them. Teams are free to utilise this time as they wish, although they should restock any disposable equipment they require, plan their team for the next scenario, and travel to the location in good time. A period for lunch has been factored into the day.

1. Each team is responsible for knowing where they need to be and at what time organisers will be available for guidance.
2. Teams arriving late to a scenario will be deducted 10 points from their overall score, in addition to restricting the time they have left to complete it.

Equipment

All equipment and equipment bags will be provided by Liverpool John Moores University and only the equipment provided should be utilised (excluding stethoscopes, tough cuts, pens, and touches). Each team will be allocated a response bag, airway bag, intubation bag, and cannulation bag, with associated equipment. Competitors may wish to utilise their own stethoscope, pen torch, and tough-cut scissors (although these can also be provided). They may also utilise their JRCALC pocketbook or JRCALC app. Each team will have a period of 20 minutes to check their kit and proceed to their first scenario after the introduction. Each scenario will have an iSimulate and drugs bag already in place, ready for use.

1. Each team is responsible for checking their own kit at the start of each day and throughout the competition.
2. Kit replenishment will be available throughout the day outside of G.01 (communal area) however, it is the responsibility of the team to ensure they have all the kit they need.
3. Teams are responsible for moving any kit they believe they will require to each scenario.
4. Teams should ensure all sharps are disposed of correctly and in a timely manner. Points may be deducted by judges for unsafe practice.
5. Any damaged equipment should be reported and replaced as soon as possible. Please inform a member of the faculty or paramedic games staff.

Drugs

All liquid presentation drugs will be simulated utilising water for injection. Likewise, any drug that would normally require reconstitution may be simulated using water for injection. This should be drawn up in the correct dose as you would for the real drug that it simulates. Administration of the drug will be in accordance with section 4.a.simulation safety.

What you had to say

" ...it was one of the best things I have even done in university!! It allowed me to meet new people and get my confidence back"

2023 competitor

Additional information

Student applicants

The university has invited several applicants to the university to witness the competition. Each applicant will be assigned a team that they will follow through the event. We encourage you to involve the applicants as much as you can and make them feel welcome. While they cannot participate in scenarios, please make them feel included by taking the time to explain what you can once the scenario has concluded.

Photography/Videography

It is highly likely there will be a lot of picture-taking and videos of the day. Therefore we assume by taking part, you are providing permission to have your picture taken and participate in any videos. If for any reason you do not wish to be in any event media, please make this known to us at the earliest opportunity.