Major Incident Preparation for Acute Hospitals: Current State-of-the-Art, Training Needs Analysis, and the Role of Novel Virtual Worlds Simulation Technologies

Cohen, Daniel C.; Sevdalis, Nick; Patel, Vishal; Taylor, David G.; Batrick, Nicola; Darzi, Ara

doi:10.1016/j.jemermed.2012.03.023

Cited by 17 publications

(18 citation statements)

References 37 publications

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“…Response 11,21,30,34,35,26,36,37,38,39,40 Response is determined by first receivers willingness to respond to unknown CBRNe exposure and the organisational management of surge capacity 3. Decontamination 5,13,16,23,41,42,43,44,45,46 Decontamination remains an area of ambiguity, amplified by first receivers lack of knowledge on decontamination procedures 4. PPE problems 13,30,41,45,47,48 Inadequate PPE provision, dexterity issues, and cumbersome fit results in PPE problems…”

Section: Resultsmentioning

confidence: 99%

“…The importance of effective decontamination within the ED was emphasised by a number of studies 13,41,42 . They suggested it was imperative for EDs to have the appropriate facilities, equipment, and capability to respond to CBRNe exposure.…”

Section: Decontaminationmentioning

confidence: 99%

“…1.Organisational 5 -Policies and procedures 2. Technological 12,22,26,31,32 -Decontamination 13,41,42 -Communication 27,28 -Security 12,22,31 -Clinical care 39,56,57 -Treatment 22,31,32 3. Individual 29,30 -Willingness to respond 34,35 -PPE 13,41,47,48,49…”

Section: Secondary Findingsmentioning

confidence: 99%

See 2 more Smart Citations

Emergency Department Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events: A Systematic Review

Razak

Hignett

Barnes

2018

Prehosp. Disaster med.

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IntroductionA Chemical, Biological, Radiological, Nuclear, and explosive (CBRNe) event is an emergency which can result in injury, illness, or loss of life. The emergency department (ED) as a health system is at the forefront of the CBRNe response with staff acting as first receivers. Emergency departments are under-prepared to respond to CBRNe events - recognizing key factors which underlie the ED CBRNe response is crucial to provide evidence-based knowledge to inform policies and, most importantly, clinical practice.ProblemChallenges in detection, decontamination, and diagnosis are associated with the ED CBRNe response when faced with self-presenting patients.MethodsA systematic review was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An in-depth search strategy was devised to identify studies which focused on the ED and CBRNe events. The inclusion criteria were stringent in terms of the environment (ED), participants (first receivers), situation (CBRNe response), and actions (detection, decontamination, and diagnosis). Fifteen databases and topic-specific journals were searched. Studies were critically appraised using the Mixed Methods Appraisal Tool (MMAT). Papers were thematically coded and synthesized using NVivo 10 (QSR International Ltd, Melbourne, Australia).ResultsSixty-seven full-text papers were critically appraised using the MMAT; 70% were included (n = 60) as medium- or high-quality studies. Data were grouped into four themes: preparedness, response, decontamination, and personal protective equipment (PPE) problems.DiscussionThis study has recognized the ED as a system which depends on four key factors - preparedness, response, decontamination, and PPE problems - which highlight challenges, uncertainties, inconsistencies, and obstacles associated with the ED CBRNe response. This review suggests that response planning and preparation should be considered at three levels: organizational (policies and procedures); technological (decontamination, communication, security, clinical care, and treatment); and individual (willingness to respond, PPE, knowledge, and competence). Finally, this study highlighted that there was a void specific to detection and diagnosis of CBRNe exposure on self-presenting patients in the ED.Conclusion:The review identified concerns for both knowledge and behaviors which suggests that a systems approach would help understand the ED response to CBRNe events more effectively. The four themes provide an evidence-based summary for the state of science in ED CBRNe response, which can be used to inform future policies and clinical procedures.RazakS, HignettS, BarnesJ. Emergency department response to chemical, biological, radiological, nuclear, and explosive events: a systematic review. Prehosp Disaster Med. 2018;33(5):543–549.

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Section: Resultsmentioning

confidence: 99%

Section: Decontaminationmentioning

confidence: 99%

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Emergency Department Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events: A Systematic Review

Razak

Hignett

Barnes

2018

Prehosp. Disaster med.

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“…Although there has been prior virtual reality work for disaster readiness training and education using virtual environments, and computergenerated imagery, our search of the literature did not reveal studies using 360 VR for pediatric disasters or MCIs. 13,17,[27][28][29][30][31][32] This novel approach may prove to be a valuable training and education tool for disaster preparedness.…”

Section: Importancementioning

confidence: 99%

360 virtual reality pediatric mass casualty incident: A cross sectional observational study of triage and out‐of‐hospital intervention accuracy at a national conference

et al. 2020

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Objective With adolescent mass casualty incidents (MCI) on the rise, out‐of‐hospital readiness is critical to optimize disaster response. We sought to test the feasibility and acceptability of a 360 Virtual Reality (360 VR) platform for disaster event decisionmaking. Methods This was a cross‐sectional observational assessment of a subject's ability to triage and perform out‐of‐hospital interventions using a 360 VR MCI module. A convenience sample of attendees was recruited over 1.5 days from the American College of Emergency Physicians (ACEP) national conference in San Diego, CA. Results Two hundred and seven (207) subjects were enrolled. Ninety‐six (46%) subjects identified as attendings, 66 (32%) as residents, 13 (6%) as medical students, 4 (2%) as emergency medical technicians and 28 (14%) as other. When comparing mean scores between groups, physicians who were <40 years old had mean scores higher than physicians who were >40 years old (8.7 vs 6.5, P < 0.001). Residents achieved higher scores than attendings (8.6 vs 7.5, P = 0.005). Based on a 5‐point Likert scale, participants felt the 360 VR experience was engaging (median = 5) and enjoyable (median = 5). Most felt that 360 VR was more immersive than mannequin‐based simulation training (median = 5). Conclusion We conclude that 360 VR is a feasible platform for assessing triage and intervention decisionmaking for adolescent MCIs. It is well received by subjects and may have a role as a training and education tool for disaster readiness. In this era of distanced learning, 360 VR is an attractive option for future immersive educational experiences.

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“…22 -24 Cost savings associated with reductions in CVC-related bloodstream infections are estimated to be substantial. 25 However, the evaluation of most simulation-based procedural skills training is not rigorous. Trainee satisfaction or self-reported improvement in knowledge and confidence are often used as surrogate markers for efficacy.…”

Section: Procedural Skills Trainingmentioning

confidence: 99%

Simulation in emergency care

Ranniger

Littlewood

2014

Emergency Care and the Public's Health

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Major Incident Preparation for Acute Hospitals: Current State-of-the-Art, Training Needs Analysis, and the Role of Novel Virtual Worlds Simulation Technologies

Cited by 17 publications

References 37 publications

Emergency Department Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events: A Systematic Review

Emergency Department Response to Chemical, Biological, Radiological, Nuclear, and Explosive Events: A Systematic Review

360 virtual reality pediatric mass casualty incident: A cross sectional observational study of triage and out‐of‐hospital intervention accuracy at a national conference

Simulation in emergency care

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