Incorporating mass casualty incidents training in surgical education program

Joshi, Arbin; Abdelsattar, Jad M.; Castro-Varela, Alejandra; Wehrle, Chase J.; Cullen, Christian; Pei, Kevin Y.; Arora, Tania K.; Dechert, Tracey; Kauffmann, Rondi M.

doi:10.1007/s44186-022-00018-z

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Prior studies have shown a relationship between the risk of PTSD and both a sense of helplessness and the degree of prior training in MCIs. 5,27,28 Consistent with this finding we found an inverse relationship between prior training in MCIs, including training on their psychological impact, and the impact of a traumatic exposure on GME physicians. Institutions should prioritize training in MCIs and the psychological impact of these events as a strategy for mitigating clinician distress.…”

Section: Discussionsupporting

confidence: 85%

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

Guldner

Roozendaal²,

Berkeley

et al. 2022

WestJEM

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Introduction: Our aim was to determine the psychological and educational impact of the 2017 Las Vegas mass shooting on the graduate medical education (GME) mission within two cohorts of resident physicians and attending faculty at two nearby academic trauma centers. Methods: A cross-sectional survey assessed 55 resident physicians and attending faculty involved in the acute care of the patients from the mass shooting. We measured the psychological impact of the event, post-traumatic growth, team cohesion, social support, and known risk factors for post-traumatic stress disorder (PTSD). Additionally, we assessed the impact of the event on GME-specific tasks. Results: Attending faculty and physicians in training in GME residencies evaluated over 300 penetrating trauma patients in less than 24 hours, and approximately 1 in 3 physicians had a patient die under their care. Despite this potential for psychological trauma, the majority of clinicians reported minimal distress and minimal impact on GME activities. However, 1 in 10 physicians screened positive for possible PTSD. Paradoxically, the minority of physicians who sought psychological counseling after the event (20%) were not those who reported the highest levels of distress. Residents generally assessed the event as having an overall negative impact on their educational goals, while attendings reported a positive impact. Psychological impact correlated inversely with social support and the amount of prior education relating to mass casualty incidents (MCI) but correlated directly with the degree of stress prior to the event. Conclusion: Despite the substantial level of exposure, most resident physicians did not report significant psychological trauma or an impact on their GME mission. Some reported post-traumatic growth. However, a minority reported a significant negative impact; institutions should consider broad screening efforts to detect and assist these individuals after a MCI. Social support, stress reduction, and education on MCIs may buffer the effects of future psychologically traumatic events on physicians in training.

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Section: Discussionsupporting

confidence: 85%

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

Guldner

Roozendaal²,

Berkeley

et al. 2022

WestJEM

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“…Surgical residents have been evaluated for readiness as well as preparedness, both indicating that continued education on the topic to be benfeficial. [11][12][13] While preparedness and readiness for MCE's in the form of general surgery education is important, it does not change the readiness or preparedness of a health care system for an MCE. This continues to be a protocol level problem, despite how important the surgical residents or Graduate Medical Education offices deem the topic.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have evaluated the importance of educating residents on MCEs, but not their utilization in-hospital protocols. [11][12][13] This study reviews and evaluates the use of mass casualty protocol, patient outcomes, and more importantly the role of residents in the management of MCE victims at a Level I trauma center.…”

Section: Introductionmentioning

confidence: 99%

The Oregon District Shooting: Reviewing the Pre-Hospital Protocols and the Role of the Resident During a Multiple Casualty Event

Walk

Ross

Kranker

et al. 2022

The American Surgeon™

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Background: Review of multiple casualty events (MCEs) protocols in an academic trauma center and more importantly role of residents in management of MCEs has not been discussed. Also, no real-world examples have been described. This study reviews utilization of multiple casualty protocols by the area hospitals and EMS along with role of residents in one such real-world MCE Methods: A mass shooting event in the Oregon District in Dayton, Ohio from 2019 was reviewed. MCE protocols from a Level I trauma center were reviewed as well as patient outcomes and role of residents. Results: A total of 10 casualties were observed and 38 patients presented to hospitals throughout the city. There were 25 patients presented to the Level I trauma center, 1 to the Level II trauma center, and 12 to the Level III trauma centers in the community. Surgical and Emergency residents performed initial triage upon arrival to the ED, managed resuscitation, and performed various procedures under supervision of attending staff. A total of 5 patients required emergent surgery and 4 patients required tourniquets. All patients that were presented to the hospitals survived. Conclusion: MCEs are going to continue, and healthcare systems should have protocols in place. Residents are a valuable resource to hospital systems that provide trauma services. Creation of a protocol with the assistance of EMS will allow first responders to utilize resources available. We recommend testing of this protocol, as an MCE in your area may not be a matter of if, but when.

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Mass Casualty Events: Preparedness and Response for Trauma Centers and Institutions

Loera,

Prakash

2024

Creating a Modern Trauma Center

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Incorporating mass casualty incidents training in surgical education program

Cited by 5 publications

References 28 publications

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

The Oregon District Shooting: Reviewing the Pre-Hospital Protocols and the Role of the Resident During a Multiple Casualty Event

Mass Casualty Events: Preparedness and Response for Trauma Centers and Institutions

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