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Mass-Casualty Training Exercise Using High-Fidelity Computerized Simulators and Involving Time and Resource Limitation

Published online by Cambridge University Press:  13 April 2021

Phillip A. Jacobson Open the ORCID record for Phillip A. Jacobson [Opens in a new window] ,
Paul N. Severin ,
Dino P. Rumoro  and
Shital Shah
Phillip A. Jacobson*
Affiliation:
Department of Pediatrics, Section of Critical Care, Rush University Medical Center and John H. Stroger Jr Hospital of Cook County, Chicago, IllinoisUSA
Paul N. Severin
Affiliation:
Department of Pediatrics, Section of Critical Care, Rush University Medical Center and John H. Stroger Jr Hospital of Cook County, Chicago, IllinoisUSA
Dino P. Rumoro
Affiliation:
Department of Emergency Medicine, Rush University Medical Center, Chicago, IllinoisUSA
Shital Shah
Affiliation:
Department of Health Systems Management, Rush University and Department of Emergency Medicine, Rush University Medical Center, Chicago, IllinoisUSA
*
Correspondence: Phillip Jacobson, MD, 9419 Hamlin Ave, Evanston, Illinois60203USA, E-mail: [email protected]
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Abstract

Purpose:

Training emergency department (ED) personnel in the care of victims of mass-casualty incidents (MCIs) is a highly challenging task requiring unique and innovative approaches. The purpose of this study was to retrospectively explore the value of high-fidelity simulators in an exercise that incorporates time and resource limitation as an optimal method of training health care personnel in mass-casualty care.

Methods:

Mass-casualty injury patterns from an explosive blast event were simulated for 12 victims using high-fidelity computerized simulators (HFCS). Programmed outcomes, based on the nature of injuries and conduct of participants, ranged from successful resuscitation and survival to death. The training exercise was conducted five times with different teams of health care personnel (n = 42). The exercise involved limited time and resources such as blood, ventilators, and imaging capability. Medical team performance was observed and recorded. Following the exercise, participants completed a survey regarding their training satisfaction, quality of the exercise, and their prior experiences with MCI simulations. The Likert scale responses from the survey were evaluated using mean with 95% confidence interval, as well as median and inter-quartile range. For the categorical responses, the frequency, proportions, and associated 95% confidence interval were calculated.

Results:

The mean rating on the quality of experiences related trainee survey questions (n = 42) was between 4.1 and 4.6 on a scale of 5.0. The mean ratings on a scale of 10.0 for quality, usefulness, and pertinence of the program were 9.2, 9.5, and 9.5, respectfully. One hundred percent of respondents believed that this type of exercise should be required for MCI training and would recommend this exercise to colleagues. The five medical team (n = 5) performances resulted in the number of deaths ranging from two (including the expectant victims) to six. Eighty percent of medical teams attempted to resuscitate the “expectant” infant and exhausted the O- blood supply. Sixty percent of medical teams depleted the supply of ventilators. Forty percent of medical teams treated “delayed” victims too early.

Conclusion:

A training exercise using HFCS for mass casualties and employing limited time and resources is described. This exercise is a preferred method of training among participating health care personnel.

Keywords

high fidelitymass casualtysimulation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 3 , June 2021 , pp. 313 - 320
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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