The contest

How teams are graded.

A team is two people from the same North Carolina or South Carolina EMS agency, in the same uniform. At least one is a paramedic, or in paramedic school. For years as many as twelve teams could enter, one from a service, and the two scenario scores were averaged. Later the field was the first ten teams, and the two scores were combined.

1 Who can enter

  • Open to any rescue or EMS agency in North Carolina or South Carolina providing paramedic-level care: paid or volunteer, air or ground, state, local, or federal.
  • Both members come from the same agency and wear the same uniform. One is named captain. At least one is a paramedic or in paramedic school.
  • Physicians and physician assistants are not eligible, even if they also hold an EMT certification.
  • The same two people compete both days. Members of the hosting service, part-time or full-time, may not compete.
  • The field is a set number of teams, one from a service, first completed entry and fee. It has been twelve teams, and in recent years the first ten.
  • Both members must be checked in before the published team-and-judges meeting.

2 The scenarios

  • Every team receives the same two problems. There may be more than one patient, and more than one location.
  • One team competes at a time. The committee sets the time limit.
  • Care follows what every service in the team’s state may use under NCOEMS or South Carolina DHEC. Pilot drugs and experimental procedures are not allowed. Drugs need not be in date, but they must be labeled.
  • Scenarios run in bad weather unless the chairman judges the hazard worse than ordinary duty: close lightning or extreme wind. They may be outdoors, indoors, or both.
  • No improvising except where the chairman or a judge instructs it.

3 Scoring

  • Judges score only what they are assigned and only what they see. Decisions are final. They are not reopened by video.
  • Score sheets stay with the committee. Teams do not receive them, during or after.
  • Points are given only for the parts of the problem a team actually completes.
  • The two scenario scores make the team score. For years they were averaged. Later they were combined. A tie is broken by the chairman on professionalism, communication, treatment, organization, and scene safety.
  • Awards go to first through fourth. Fifth place and below are not announced.

4 Patients, secrecy, and phones

  • Patients are briefed the day of the event. They do not volunteer information. Unconscious patients, including manikins, give nothing: what you see is what you have, unless a team asks a judge.
  • Phones, radios, and pagers come off the teams before Friday’s meeting and before Saturday’s sequester. Staff do not hold them.
  • Talking about the scenario with someone who has already competed is grounds for disqualification. So is posting about it, in any form, before the banquet is over.
  • One photographer per team may photograph that team, after identifying themselves to the chairman. Spectators shoot only from the viewing area, for personal use.

5 Equipment

  • The team’s own fully stocked ambulance is the equipment cache. The committee may limit what can be carried into a scenario, and will say so beforehand.
  • No mechanical CPR devices, no pre-connected IV sets, no IV poles, no drug cards or reference books. One Broselow tape is allowed. One cardiac monitor per team.
  • On the body: stethoscope, gloves, eye protection, a pen, blank paper, trauma shears, and a penlight or flashlight. No scene vest full of pockets.
  • Broken or lost gear is the team’s responsibility.

6 Judges and the written exam

  • Judging follows National Registry practical standards, current paramedic textbooks, AHA guidelines for BLS, ACLS, and PALS, U.S. DOT curricula, and the guidelines of NCOEMS and South Carolina DHEC.
  • Judges do not comment on a performance during the event, and they do not leave the competition area except on a break the chairman knows about.
  • They may stop a scenario for delay, unsafe action, or misconduct.
  • The written exam is optional: 75 multiple-choice questions, 45 minutes, written by the event chairman and not shown beforehand. It is an individual contest. The top three receive plaques. It does not change the scenario ranking.