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GREENSBORO — Roger Horton and Barry McMillian of Surry County EMS walk quickly onto a NASCAR pit road. They assess the scene and begin a verbal rundown of patient count and injuries.

Two men down. One with a head injury. One with a chest injury. Both hit by a race car.

“He’s speaking. His eyes are open,” Horton says of the patient with a head injury. He talks and touches the patient, asking if he can feel, searching for paralysis.

Horton and McMillian begin to stabilize their patients when another man cries out and collapses nearby. Horton rushes over and begins asking bystanders what happened.

The man has no pulse, isn’t breathing and has no gag reflex. Horton begins CPR.

But soon, the patient with the head injury begins to convulse and McMillian and Horton have their hands full.

After several minutes, the time keeper yells time. Spectators begin cheering and clapping. McMillian and Horton are drenched in sweat.

The team begins to pick up their gear and volunteers begin setting up the scene for the next competitors.

This is the 20th annual North Carolina Paramedic Competition, held this year at the Koury Convention Center.

The competition is based on real-life scenarios filled with stressful situations and few resources. “This could very easily happen,” spectator and EMS member Scott Wheeler of Youngsville said. “You could be on a scene and not have any other responders.”

Dan McGuire of Guilford County EMS participated in the competition regionals in July. He and partner Heather Lowdermilk responded to a community college shooting where there were three victims, including a pregnant woman.

McGuire said he’d like to see the score sheets to see where he could improve.

Regina Crawford, interim director of the state EMS office, said teams are measured on performance and quality. Judges look at how teams assess scene safety, address patient needs and how quickly they respond. Teams are given from 12 to 15 minutes during the competition. They never know what scenario they’re walking into.

The goal is “improved quality of care and skill level” across the state, Crawford said.

Horton and McMillian were the 2009 state champs.

The competitions help EMS teams work on skills they may not use on a day-to-day basis, Horton said.

Sequestered in a room away from the scene were the remaining teams.

Carl McKnight and Ron Patterson of Lincoln County EMS said they talked with veteran competitors about what to expect and practiced scenarios set up by co-workers.

Dale Harold and Kenneth Vaught of Surry County EMS practiced twice a week since May to get ready for regionals and state. This is their first year competing.

Anticipation is the hardest part, Harold said. “The anxiety will go down when we see the scenario,” he said.

Vaught said the practice has helped improve his daily skills.

Drexdal Pratt, former state director of EMS and now director of the state division of health services regulation, thought of and created the competition. He said the event is much more competitive now than it was two decades ago.

Pratt said the competition isn’t dominated by the state’s urban counties. “I think the smaller counties have been aggressive at getting in the competition,” he said.

This year’s competitors were the 2009 champs from Surry EMS, a second Surry team, Lincoln County EMS, Stokes County EMS, Duplin County EMS and Cumberland County EMS.

The 2010 winners will be announced Tuesday.

Contact E.A. Seagraves at 883-4422, Ext. 241, or elizabeth.seagraves@news-record.com