Three people who have dedicated their lives to emergency care are bringing to Bulgaria the gold standard training in trauma life support that emergency services around the world work to. PHTLS (prehospital trauma life support) is a system for assessing and providing first aid to casualties before they arrive at hospital that is used by paramedics, medics, military, firefighters and other trained rescuers. It is enshrined in the emergency medicine standard and in most countries is mandatory for all those working in emergency and rescue services. It is a uniform protocol that standardizes the actions of rescuers and reduces the fatality rate at incidents.
“It took us nearly a year, but we were able to get licensed and accredited by the Emergency Medical Technicians Association in the United States. This is the only worldwide organization that licenses trainers according to globally recognized quality standards”, say Veselina, Rumen and Georgi. They start together with Dr. Teodor Tsankov, Dr. Ilian Avramov, Ioanna Georgieva and Lyubomir Petrov. They became the first PHTLS instructors and continue to work together as a team.
For many years Veselina Kehayova was the only female emergency medic in the fire department. She boarded the ambulance 36 years ago. The first ten years were spent at the Central Medical Center – Sofia.
“I joined the fire department in 1999. Back then, it didn’t have the training we now provide to our trainees. I had to improve on the fly. I didn’t have a case of death in the ambulance, I don’t know luck or a job well done, but I had a few casualties that I roared like a child after”, she says.
In addition to preparing for fire response and getting patients down fire ladders, she has a specialty in diving medicine and helps divers search for drowning victims.
She met her fate with Rumen Bozhilov, a colleague from the Emergency Service. Besides colleagues, the two became life companions. They decided to create the country’s first centre for the professional training of paramedics and to pass on their experience to young people for whom rescue would also become a passion and a destiny. He has experience in medical support for naval and combat military units, specialization in diving medicine and in an instructor training center in Amsterdam.
Their son George gets “both feet in the ER” after a casual evening conversation.
“I wanted to become a firefighter, but they wouldn’t accept me. I was disappointed, but I didn’t give up. Both my mother and father constantly shared stories from their jobs, but I hadn’t thought of emergency medicine as my profession. One evening, after another conversation between us, I had this idea and became a trainee at their professional centre. I read everything I could find at home, graduated and was accepted to work at the CSMP Sofia”, says Georgi.
After the first few addresses he realised that this was his place.
“I walked in, as the doctor I worked with on my first duty said, “with both feet in the ER”, as from the very first address I had to conduct life-saving techniques and keep my composure, after all it was my first encounter with a patient. I did not hesitate to act as I was taught”, he adds.
Eight years of addresses followed, working in a ward… But like his mother, George realised that the surgery and the hospital were not for him. Both are dynamic natures and feel best in the ambulance. Georgi becomes an instructor and national coordinator of the PHTLS course.
“I didn’t think he would go the route of the emergency medic. Usually parents make their kids follow them, but it’s a tough and specific job. For an emergency medic, paramedic and anyone who wants to work emergency medicine the most important thing is to be willing to help people and have a big heart. We have trainees who go to practice in the ER throw the team and say – “this is not for me!”, says Veselina.
They have already trained over 500 paramedics and many people who just want to know how to give first aid.
“Anyone who wants to work in emergency care should want to help people in distress. They need to read constantly, keep up with what’s new, know why they’re there and that it’s not for everyone. Not everyone can swallow what they have seen and experienced. Some situations last a lifetime, others are easier to get through, but the satisfaction after a patient saved, a life saved, a family saved is indescribable,” says George.
Most traumatic for him is the memory of a car accident in which a friend died in his arms.
“There are challenges on every duty. You don’t know where you’re going, you don’t know what’s going to happen, are you going to make it, the adrenaline rises, the senses sharpen, you get down and act! And there’s a lot of charm in that”, he is convinced. The paramedic profession definitely has a future, because the shortage in the emergency and rescue services is being felt more and more seriously, and in a number of European countries paramedics are the backbone of the Emergency Services. This is also the aim of the Union of Paramedics – to elevate the profession to its rightful place.
Georgi Borisov will be part of the team that will represent Bulgaria in the EURO SimCup competitions – one of the most exciting events during the Congress of the European Society of Emergency Medicine (EUSEM), which will be held this autumn in Vienna. This is a simulation competition in which teams from all over the world compete in intense and realistic emergency care scenarios.
Bulgaria has been approved to take part in the competition for the first time, and the application has been submitted by the Union of Paramedics under the auspices of the Association of Emergency Care Workers, who are Bulgaria’s official representative in the European Society of Emergency Medicine. This will be another step towards establishing Bulgarian doctors and paramedics on the international stage and demonstrating their high skills in simulated emergency situations, including mass casualty incidents and disasters. Their participation is essential for sharing Bulgarian experience and learning global best practices.
