Abstract
Mass Casualty Incidents (MCI) occur when the number of patients in an incident exceed the number of available resources, require a multi-disciplinary approach and are protracted; fortunately, they are rare. When they do occur, first responders –including paramedics, police and fire fighters - must respond instantly and effectively. This article introduces research on use of an MCI simulation as the capstone subject for a degree program preparing student paramedics for the disorder and chaos of their first MCI. The University of Tasmania’s (UTAS) Sydney campus ran three iterations of an MCI simulation for students in the Bachelor of Paramedic Practice degree. The MCI required paramedics to respond to a gas explosion involving mass casualties in a public setting - using 30 moulage enhanced (makeup-based mock injuries) simulated patients in varying degrees of distress. The MCI scenario was specifically designed as an immersive experience within which participants could review their current capabilities. This article reflects on the impact of the third iteration, drawing on post event interviews to review experiences occurring during/after such large scale, complex, stress-inducing simulations. Fidelity to conditions in real MCIs was elevated through use of intrusive noise, simulated patients and live radio communications. The impact on participants – both facilitators and students as patients or paramedics – has been long lasting. Future research will consider the extent to which the effect of emotional engagement and skills acquisition persist and re-surface long after the event is over.
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References
Garling, P.: Special Commission of Inquiry Acute Care Services in NSW Public Hospitals. Final Report of the Special Commission of Inquiry Acute Care Services in NSW Public Hospitals (2008) (2014). ISBN 978-1-921301-83-4. http://www.lawlink.nsw.gov.au/acsinquiry. Accessed 22 Apr 2014
Kobayashi, L., Shapiro, M., Suner, S., Williams, K.: Disaster medicine: the potential role of high fidelity medical simulation for mass casualty incident training. R I Med. J. 86(7), 196–200 (2003)
Admi, H., Eilon, Y., Hyams, G., Utitz, L.: Management of mass casualty events: the Israeli experience. J. Nurs. Scholarsh. 43(2), 211–219 (2011)
Vincent, D.S., Burgess, L., Berg, B., Connolly, K.: Teaching mass casualty triage skills using iterative multi-manikin simulations. Prehosp. Emerg. Care 13(2), 241–246 (2003)
Shover, H.: Understanding the chain of communication during a disaster. Perspect. Psychiatr. Care 43(1), 4–14 (2007)
Fernandez, A.R., Studnek, J.R., Margolis, G.S., Crawford, J.M., Bentley, M.A., Marcozzi, D.: Disaster preparedness of national certified emergency medical services professionals. Acad. Emerg. Med. 18(4), 403–412 (2011)
Wilkinson, W., Avstreih, D., Gruppen, L., Beier, K.P., Woolliscroft, J.: Using immersive simulation for training first responders for mass casualty incidents. Acad. Emerg. Med. 15(11), 1152–1159 (2008)
Chaput, C.J., Deluhery, M.R., Stake, C.E., Martens, K.A., Cichon, M.E.: Disaster training for prehospital providers. Prehosp. Emerg. Care 11(4), 458–465 (2007)
Wetta-Hall, R., Fredrickson, D., Ablah, E., Cook, D., Molgaard, C.: Knowing who your partners are: terrorism preparedness training for nurses. J. Contin. Educ. Nurs. 37(3), 106–112 (2006)
Gillett, B., et al.: Simulation in a disaster drill: comparison of high fidelity simulators verse trained actors. Acad. Emerg. Med. 15(11), 1144–1151 (2008)
Jones, C., Jones, P., Waller, C.: Simulation in prehospital care: teaching, testing and fidelity. J. Paramed. Pract. 3(8), 430–434 (2011)
Spencer, C.: Managing mass casualty events is just the application of normal activity on a grander scale for the emergency health services, or is it? J. Emerg. Prim. Heal. Care 9(1) (2011)
Kaplan, B., Connor, A., Ferranti, E., Holmes, L., Spencer, L.: Use of emergency preparedness disaster simulation with undergraduate nursing students. Public Health Nurs. 29(1), 44–51 (2011)
Power, D., et al.: An evaluation of high fidelity simulation training for paramedics in Ireland. Int. Paramed. Pract. 2(1), 11–18 (2013)
Collins, J.P., Harden, R.M.: The use of real patients, standardised patients and simulators in clinical examinations. AMEE Medical Education Guide No. 13, Association for Medical Education in Europe, UK, pp. 1–6 (2004)
Segers, M., Van der Haar, S.: The experiential learning theory. In: Kolb, D., Boud, D., Dochy, F., Gijbels, D., Segers, M., Van den Bossche, P. (eds.) Theories of Learning in the Workplace, pp. 52–65. Routledge, London & New York (2011)
Gaba, D.: The future vision of simulation in healthcare. Simul. Healthc. 2(2), 126–135 (2007)
Peabody, F.W.: The care of the patient. JAMA 88, 877–882 (1927)
Braun, V., Clarke, V.: Using thematic analysis in psychology. Qual. Res. Psychol. 3(2), 77–101 (2006)
Kolb, D.: Experiential Learning: Experience as the Source of Learning and Development, pp. 34–36. Prentice-Hall, Englewood Cliffs (1984)
Bridgstock, R.: The graduate attributes we’ve overlooked: enhancing graduate employability through career management skills. High. Educ. Res. Dev. 28(1), 31–44 (2009)
Seropian, M., Brown, K., Gavilanes, J., Driggers, B.: Simulation: not just a manikin. J. Nurs. Educ. 43(4), 164–169 (2004)
Lasater, K.: High-Fidelity simulation and the development of clinical judgement: student experiences. J. Nurs. Educ. 46(6), 269–276 (2007)
Regehr, C., Goldberg, G., Hughes, J.: Exposure to human tragedy, empathy and trauma in ambulance paramedics. Am. J. Orthopsychiatry 72(4), 505–513 (2002)
Hung, K., Chan, E., Graham, C.: Disaster training: lessons learnt from the 2008 Sichuan China earthquake. Int. Paramed. Pract. 1(4), 133–140 (2012)
McLeod, A.: Caring, competence and professional identities in medical education. Adv. Heal. Sci. Educ. 16, 375–394 (2011)
Australian Emergency Management Institute: Australian Emergency Management Handbook 3, 2nd edn. ISBN 978-1-921152-29-0. Commonwealth Government, Commonwealth Attorney-General’s Department, 1-100, Australia, Grey Publishing (2012)
Ziv, A., Wolpe, P.R., Small, S.D., Glick, S.: Simulation-based medical education: an ethical imperative. Acad. Med. 78(8), 783–788 (2003)
O’Brien, K., Hartley, P., Dawson, D., Quick, J., Moore, A.: Work readiness in paramedic graduates: what are employers looking for? Int. Paramed. Pract. 3(4), 98–104 (2013)
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Lyndon-James, P., Leigh, E. (2022). Ordering the Disorder: Preparing Paramedics for Unexpected and Unsafe Mass Casualty Incidents. In: Dhar, U., Dubey, J., Dumblekar, V., Meijer, S., Lukosch, H. (eds) Gaming, Simulation and Innovations: Challenges and Opportunities. ISAGA 2021. Lecture Notes in Computer Science, vol 13219. Springer, Cham. https://doi.org/10.1007/978-3-031-09959-5_16
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