Presentation
Making Mass Casualty Incident Training Simulations Accessible to All
DescriptionA Mass Casualty Incident (MCI) is an emergency in which the number of casualties exceeds the available resources for the immediate medical treatment and evacuation required. Emergency medical services must perform pre-hospital triage, and strategically choose the order in which to treat and evacuate casualties. MCI management is a skill that takes experience and practice. Preparing for this role is therefore a crucial part of emergency medical personnel training, as they may be called upon to act as incident commander. Traditionally, training simulations are large scale Field Drills. These include real ambulances, stretchers, radios, and a large area. Sometimes there are paid actors to play patients. The drill is generally scheduled weeks in advance, as it usually requires logistical pre-planning, such as coordination with the local community and designation of radio frequencies to be used during the drill. Since the planning and expense of the drill is significant, there are often only a few opportunities for the trainees to practice; just enough for them to experience the chaos of an MCI a few times, or maybe even only once. Many trainees never get to practice the role of incident commander at all, since there is not enough time to give all participants that opportunity. And smaller agencies are often unable to run these types of drills at all due to budget or other constraints; classroom style courses or tabletop exercises are the main educational tools, which while helpful, do not simulate the pandemonium or quick decision-making that an incident commander must learn to deal with in a real MCI.
Magen David Adom, Israel’s National EMS service, has developed a simple way to simulate an MCI, in which trainees can practice many of the same skills that they would in a Field Drill. Called the “Sukkah Drill” (because of its similarity to the temporary hut structure used to celebrate the holiday of Sukkot), the setup requires a classroom and three canvas “walls” arranged in a C shape (right, left, and back) as three sections of an MCI. Each section includes multiple casualties that are represented by “casualty cards.” Written on every card is a description of one casualty’s injuries and general appearance. These are pinned to the outside surfaces of the canvas walls. Some cards specify an urgent casualty that will be deceased within a specific period if not promptly “treated” or “evacuated.” One drill instructor simulates the dispatch center via short-range walkie-talkie. To mimic loud sounds and confusion like in a real MCI, strobe lights and sirens are added into the background.
Using video and audio recordings of six Field Drills and seven Sukkah Drills, we conducted a comparative study between the Field Drill and the Sukkah Drill of the main tasks that an incident commander performs during the major stages of an MCI. Our list included 14 tasks that any Incident Commander should perform, such as designating a safe-zone for triage, communicating with team-members, and prioritizing evacuation of more severe casualties. We found that most tasks (13/14) were (or were not) performed at similar rates in both the Field and Sukkah Drills. Therefore, although the Sukkah Drill is not as realistic as a Field Drill, it can be used to practice many of the same skills that are practiced during a Field Drill. The chaotic atmosphere and requirements for the Incident Commander to communicate with others create a level of psychological realism as well.
The main advantages of the Sukkah Drill are that it is low cost, easily constructed, and reproducible. It can be used by any EMS agency, even those with limited resources or low budgets. It is run indoors, so weather conditions will not affect training schedules, and it can be re-set multiple times, so that trainees can practice skills repeatedly. The Sukkah Drill makes simulation-based MCI training and education available to all.
Magen David Adom, Israel’s National EMS service, has developed a simple way to simulate an MCI, in which trainees can practice many of the same skills that they would in a Field Drill. Called the “Sukkah Drill” (because of its similarity to the temporary hut structure used to celebrate the holiday of Sukkot), the setup requires a classroom and three canvas “walls” arranged in a C shape (right, left, and back) as three sections of an MCI. Each section includes multiple casualties that are represented by “casualty cards.” Written on every card is a description of one casualty’s injuries and general appearance. These are pinned to the outside surfaces of the canvas walls. Some cards specify an urgent casualty that will be deceased within a specific period if not promptly “treated” or “evacuated.” One drill instructor simulates the dispatch center via short-range walkie-talkie. To mimic loud sounds and confusion like in a real MCI, strobe lights and sirens are added into the background.
Using video and audio recordings of six Field Drills and seven Sukkah Drills, we conducted a comparative study between the Field Drill and the Sukkah Drill of the main tasks that an incident commander performs during the major stages of an MCI. Our list included 14 tasks that any Incident Commander should perform, such as designating a safe-zone for triage, communicating with team-members, and prioritizing evacuation of more severe casualties. We found that most tasks (13/14) were (or were not) performed at similar rates in both the Field and Sukkah Drills. Therefore, although the Sukkah Drill is not as realistic as a Field Drill, it can be used to practice many of the same skills that are practiced during a Field Drill. The chaotic atmosphere and requirements for the Incident Commander to communicate with others create a level of psychological realism as well.
The main advantages of the Sukkah Drill are that it is low cost, easily constructed, and reproducible. It can be used by any EMS agency, even those with limited resources or low budgets. It is run indoors, so weather conditions will not affect training schedules, and it can be re-set multiple times, so that trainees can practice skills repeatedly. The Sukkah Drill makes simulation-based MCI training and education available to all.
Event Type
Oral Presentations
TimeTuesday, March 269:15am - 9:37am CDT
LocationSalon A-4
Simulation and Education