scholarly journals LO094: Mass casualty incident training for rural Canadian municipalities: a mobile education unit initiative

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S62-S63
Author(s):  
F. Besserer ◽  
M. Hogan ◽  
T. Oliver ◽  
J. Froh
Keyword(s):  
Disaster Preparedness ◽  
Flipped Classroom ◽  
National Level ◽  
Pilot Project ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Disaster Plan ◽  
Mobile Education

Introduction / Innovation Concept: The Shock Trauma Air Rescue Society (STARS®) is a charitable, non-profit organization that is dedicated to providing a safe, rapid, highly specialized emergency medical transport system for the critically ill and injured. The STARS® Mobile Education Unit (MEU) is comprised of a high fidelity simulation suite that mimics a hospital emergency room, installed in a specially equipped motorhome (SEM) that can wirelessly operate a high fidelity human mannequin. The MEU provides an excellent opportunity to combine continuing medical education for resuscitation and MCI management. At present, no formal MCI education process exists in Saskatchewan. Curriculum, Tool, or Material: The Saskatchewan STARS® MEU delivers a phased MCI education initiative to rural and regional centers within the province. The educational initiative is sub-divided into three stages: 1. pre-exercise knowledge translation using a flipped classroom approach, 2. on-site tabletop exercise (TTX) and, 3. high-fidelity simulation session with a review of MCI management principles . Sites perform a Hazard Vulnerability Analysis (HVA) following stage 2 and the highest identified site-specific risks are utilized during the development of the simulated scenarios for stage 3. During stage 2, participants also complete a pre and post-exercise survey. The survey evaluates the educational component, the tabletop exercise component and the perceived pre and post tabletop exercise competencies for the management of MCI. In the pilot project, two regional sites completed the tabletop exercise. The pre-exercise survey evaluated perceived MCI and disaster preparedness for the region. Only 8% and 25% of participants at each site respectively, reported that their disaster plan had been trialed in tabletop, full exercise or real activation within the past three years. Participants strongly agreed that the tabletop exercise was a valuable experience (86% and 88% respectively). More robust data will become available as the initiative transitions out of the pilot stage to formal operations. Conclusion: A formal MCI training program implemented through the STARS® MEU for rural Saskatchewan municipalities enables participants and their organizations to both review and enhance their current emergency management plans. This initiative will aim to establish a foundation for future collaboration at the provincial and national level for rural MCI training and preparedness.

scholarly journals (A108) Hospital Disaster Planning: The Structured Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s30-s30
Author(s):  
G.E.A. Khalifa
Keyword(s):  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Emergency Services ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Preparedness Plan ◽  
Hospital Disaster Preparedness

BackgroundDisasters and incidents with hundreds, thousands, or tens of thousands of casualties are not generally addressed in hospital disaster plans. Nevertheless, they may occur, and recent disasters around the globe suggest that it would be prudent for hospitals to improve their preparedness for a mass casualty incident. Disaster, large or small, natural or man-made can strike in many ways and can put the hospital services in danger. Hospitals, because of their emergency services and 24 hour a day operation, will be seen by the public as a vital resource for diagnosis, treatment, and follow up for both physical and psychological care.ObjectivesDevelop a hospital-based disaster and emergency preparedness plan. Consider how a disaster may pose various challenges to hospital disaster response. Formulate a disaster plan for different medical facility response. Assess the need for further changes in existing plans.MethodsThe author uses literature review and his own experience to develop step-by-step logistic approach to hospital disaster planning. The author presents a model for hospital disaster preparedness that produces a living document that contains guidelines for review, testing, education, training and update. The model provides the method to develop the base plan, functional annexes and hazard specific annexes.

scholarly journals Small-Scale High-Fidelity Simulation for Mass Casualty Incident Readiness

2021 ◽  
Vol 6 (4) ◽  
Author(s):  
Seanne Facho ◽  
Andrea Weiers ◽  
Amber Jones ◽  
Sage Wexner ◽  
Jessie Nelson
Keyword(s):  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Small Scale ◽  
High Fidelity ◽  
High Fidelity Simulation

scholarly journals Hospital Disaster Preparedness in Switzerland Over a Decade: A National Survey

2018 ◽  
Vol 13 (03) ◽  
pp. 433-439
Author(s):  
Simone Dell’Era ◽  
Olivier Hugli ◽  
Fabrice Dami
Keyword(s):  
Public Health ◽  
Health Care ◽  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Disaster Plan ◽  
Root Cause ◽  
Swiss Health ◽  
Hospital Disaster Preparedness

ABSTRACTObjectiveThe present study aimed to provide a comprehensive assessment of Swiss hospital disaster preparedness in 2016 compared with the 2006 data.MethodsA questionnaire was addressed in 2016 to all heads responsible for Swiss emergency departments (EDs).ResultsOf the 107 hospitals included, 83 (78%) returned the survey. Overall, 76 (92%) hospitals had a plan in case of a mass casualty incident, and 76 (93%) in case of an accident within the hospital itself. There was a lack in preparedness for specific situations: less than a third of hospitals had a specific plan for nuclear/radiological, biological, chemical, and burns (NRBC+B) patients: nuclear/radiological (14; 18%), biological (25; 31%), chemical (27; 34%), and burns (15; 49%), and 48 (61%) of EDs had a decontamination area. Less than a quarter of hospitals had specific plans for the most vulnerable populations during disasters, such as seniors (12; 15%) and children (19; 24%).ConclusionsThe rate of hospitals with a disaster plan has increased since 2006, reaching a level of 92%. The Swiss health care system remains vulnerable to specific threats like NRBC. The lack of national legislation and funds aimed at fostering hospitals’ preparedness to disasters may be the root cause to explain the vulnerability of Swiss hospitals regarding disaster medicine. (Disaster Med Public Health Preparedness. 2019;13:433-439)

scholarly journals Development and Implementation of First Hospital-Based Epidemic Outbreak Management Plan: Lessons Learned from Nepal

2019 ◽  
Vol 34 (s1) ◽  
pp. s56-s56
Author(s):  
Ashis Shrestha ◽  
Michael Khouli ◽  
Sumana Bajracharya ◽  
Rose House ◽  
Joshua Mugele
Keyword(s):  
National Level ◽  
Disaster Medicine ◽  
Lessons Learned ◽  
World Health ◽  
High Fidelity ◽  
Disaster Plan ◽  
Outbreak Management ◽  
Incident Command ◽  
Hospital Systems ◽  
Response Plan

Introduction:Patan Hospital, located in Kathmandu Valley, Nepal is a 400-bed hospital that has a long history of responding to natural disasters. Hospital personnel have worked with the Ministry of Health (MOH) and the World Health Organization (WHO) to develop standardized disaster response plans that were implemented in multiple hospital systems after the earthquake of 2015. These plans focused primarily on traumatic events but did not account for epidemics despite the prevalence of infectious diseases in Nepal.Aim:To develop and test a robust epidemic/pandemic response plan at Patan Hospital in Kathmandu that would be generalizable to other hospitals nationwide.Methods:Using the existing disaster plan in conjunction with public health and disaster medicine experts,we developed an epidemic response plan focusing on communication and coordination (between the hospital and MOH, among hospital administration and staff), logistics and supplies including personal protective equipment (PPE), and personnel and hospital incident command (IC) training. After development, we tested the plan using a high-fidelity, real-time simulation across the entire hospital and the hospital IC using actors and in conjunction with the MOH and WHO. We adjusted the plan based on lessons learned from this exercise.Results:Lessons learned from the high-fidelity simulation included the following: uncovering patient flow issues to avoid contamination/infection; layout issues with the isolation area, specifically accounting for donning/doffing of PPE; more sustained duration of response compared to a natural disaster with implications for staffing and supplies; communication difficulties unique to epidemics; need for national and regional surveillance and inter-facility planning and communication. We adjusted our plan accordingly and created a generalizable plan that can be deployed at an inter-facility and national level.Discussion:We learned that this process is feasible in resource-poor hospital systems. Challenges discovered in this process can lead to better national and system-wide preparedness.

scholarly journals Kuala Lumpur train collision during the COVID-19 pandemic

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Alzamani M. Idrose ◽  
Fikri M. Abu-Zidan ◽  
Nurul Liana Roslan ◽  
Khairul Izwan M. Hashim ◽  
Saiyidi Mohd Azizi Mohd Adibi ◽  
...  
Keyword(s):  
Hospital Management ◽  
Standard Operating Procedure ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Base Station ◽  
Lessons Learned ◽  
Kuala Lumpur ◽  
Disaster Plan ◽  
Incident Command ◽  
Green Zone

Abstract Background Two city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1–43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths. Conclusions The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

scholarly journals P057: Evidence-based medicine (EBM) simulation: teaching real-time literature searching to emergency medicine residents using a flipped classroom and high-fidelity simulation

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S83-S84
Author(s):  
I. Gray ◽  
S. Dong ◽  
D. Ha
Keyword(s):  
Emergency Medicine ◽  
Evidence Based Medicine ◽  
Flipped Classroom ◽  
Literature Search ◽  
Evidence Based ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Stable Patient ◽  
Literature Searching ◽  
Based Medicine

Innovation Conept: Evidence-based medicine (EBM), including literature search skills, is an objective of the Emergency Medicine (EM) residency curriculum. Traditional teaching of this topic utilized a classroom-based, librarian-lead session that presented an overview of many search engines. Feedback from past sessions indicated that learners retained little after the session. To be effective, EBM needs to be brought to the bedside. We created a session to engage EM residents and improve their efficiency in literature searching during an EM shift. Methods: We conducted a needs assessment among EM residents in our program. In response to this and to maximize impact of teaching, we created an EBM workshop on literature searching that used a flipped classroom approach and high-fidelity simulation. The session was designed for a small group (12 junior residents), with the goals of being interactive, engaging and practice-relevant. Feedback was collected on the simulation experience. Curriculum, Tool or Material: With a librarian, we created a brief list of EM-relevant databases. It included tips for searching and links to the corresponding sites / apps. Students received the list 7 days prior and were instructed to set up the resources on their smartphones. Pre-readings also covered the hierarchy of evidence and formulating a good clinical (PICO) question. All students participated in the high-fidelity simulation, with one volunteer leader. The case involved a stable patient. Residents proceeded with initial case assessment until they faced a management decision that required a literature search. All residents participated on their smart phones. Collectively, it took 5 minutes to find a study that adequately addressed the clinical question. The patient was managed accordingly and symptoms resolved. Feedback on the simulation was abundantly positive. Students found it engaging, practical and realistic. It helped them learn to efficiently search the literature while managing a stable patient. Conclusion: Using a multi-modal teaching strategy that includes simulation makes teaching EBM literature searching more interesting, engaging and applicable to EM practice. Future work will look at creating further sessions to reinforce and promote retention of key concepts and integrate them into EM practice.

Disaster preparedness: experience from a smoke inhalation mass casualty incident

2006 ◽  
Vol 13 (6) ◽  
pp. 330-334 ◽  
Author(s):  
Siang-Hiong Goh ◽  
Ling Tiah ◽  
Hoon-Chin Lim ◽  
Elaine Kim-Choon Ng
Keyword(s):  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Smoke Inhalation

scholarly journals Use of Moulage in Multi-Disciplinary Mass Casualty Incident (MCI) Training: Cost-Effective Tool or an Expectation?

2019 ◽  
Vol 34 (s1) ◽  
pp. s19-s19
Author(s):  
Sasha Rihter ◽  
Veronica Coppersmith
Keyword(s):  
Emergency Medicine ◽  
Training Session ◽  
Cost Effective ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Emergency Physicians ◽  
Disaster Plan ◽  
Before And After ◽  
Training Cost

Introduction:A 2018 poll by the American College of Emergency Physicians shows 93% of surveyed doctors believe their emergency department is not fully prepared for patient surge capacity in the event of a natural or man-made disaster. While an emergency disaster plan is activated during any incident where resources are overwhelmed, many US emergency physicians today think of a mass casualty incident (MCI) as the inciting event. To better prepare our communities, an MCI simulation took place in Chicago 2018 with participation from local and federal representatives. Included were Chicago fire, police, and emergency medical services agencies, emergency medicine physicians, resident participants, and medical student volunteer victims.Aim:The study’s aim was to determine whether resource intensive moulage was an expected component or a beneficial adjunct, if moulage-based training would improve physician preparedness, and if such a training would increase the likelihood of future involvement in local disaster preparations. Analysis was performed on pre- and post-training surveys completed by participants. By reviewing the benefits versus cost, future MCI simulation planners can efficiently use their funds to achieve training goals.Methods:Thirty-two emergency medicine physicians were surveyed before and after a five-hour training session on October 20, 2018, which included 89 moulage victims. Twenty-four after-event surveys were completed. All completed surveys were utilized in data analysis.Results:Of polled participants, a 68% improvement in general preparedness was achieved. While only 19% of participants cited current involvement in their facility’s disaster planning in pre-event survey, the likelihood of involvement after training was 8.2/10. Overall, the importance of moulage an essential component to such trainings remained constant.Discussion:Moulage is an expected and crucial element to MCI training and should be incorporated as extensively as resources allow. MCI trainings improve physician preparedness and potentially increase physician involvement in disaster planning at home institutions.

scholarly journals Disaster Preparedness and Response for the Burn Mass Casualty Incident in the Twenty-first Century

2017 ◽  
Vol 44 (3) ◽  
pp. 441-449 ◽  
Author(s):  
Randy D. Kearns ◽  
David E. Marcozzi ◽  
Noran Barry ◽  
Lewis Rubinson ◽  
Charles Scott Hultman ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
First Century ◽  
Twenty First Century ◽  
Disaster Preparedness And Response
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