Disaster simulation tests trauma training of emergency medicine residents
Emergency medicine is all about response. When it comes to disasters like bombings and shootings, time and resources are limited, but medical personnel need to work with what they have to control the situation and ensure everyone’s safety.
Resident physicians from the Department of Emergency Medicine at Penn State Hershey Medical Center recently participated in a drill that simulated one such disaster. The scenario involved a bombing at a marathon where several victims, who were played by actors, required immediate medical attention. The scene was tense as the residents hurried to the victims and began prioritizing them based on the severity of their injuries. Radios blared and lights flared to add to the commotion.
“Does anyone need help?” shouted one resident. “Call the hospitals to give them a heads up!” yelled another. It was just a drill, but it felt quite real as residents treated “bleeding” and “unconscious” victims. Residents worked quickly to clear the scene due to threats of another attack, and they pulled victims into a safe area where they could be treated.
Residents began identifying victims and checking their vital signs. They separated the victims into those who were seriously injured or unconscious and those who were still conscious with minor injuries. Residents applied tourniquets and provided wound care, working cooperatively to care for every victim. They also had to control the crowd and handle the nosy efforts of reporters.
“It’s a balance of caring for the victims and respecting the people around you,” said Dr. Jeffrey Lubin, division chief of transport medicine, in a post-exercise debriefing session with the residents. He also noted that communication is essential.
The residents underwent a similar drill prior to the bombing scenario, and the second time around was undoubtedly more productive, Lubin said.
“It went quickly because everyone had different roles,” one resident remarked. Another resident commented on the limited resources at their disposal during the drill, but Lubin stressed that there will almost always be such problems in a real disaster.
The actors were asked to portray victims as accurately as possible. Some were frantic and uncooperative while others lay limp and lifeless.
“It’s important to have the residents see that it won’t go smoothly,” said Amanda Keiff, one of the actors. “It was fun, but it was an educational opportunity.”
While many residents will never experience this type of crisis situation, these training scenarios give them a sense of what it’s like at the scene. The skills of thinking fast and working as a team are crucial to any crisis situation.
“Most residents don’t have experience with this sort of thing, so it’s about learning the challenges,” said Ilana Erlich, a resident. “You have to step out of your roles and rely on teamwork.”
“This type of training is of critical importance to these future emergency medicine physicians. The hands-on training that immersed them in the action really left an impression on them,” Lubin said. “We know that disasters and mass casualty incidents happen. The concepts learned during the drill will hopefully serve these physicians-in-training and their future patients when the need arises.”