The Challenge of Mass Casualty Incident Response Simulation Exercise Design and Creation: A Modified Delphi Study

Weinstein, Eric S.; Bortolin, Michelangelo; Lamine, Hamdi; Herbert, Teri Lynn; Hubloue, Ives; Pauwels, Sofie; Burke, Rita V.; Cicero, Mark X.; Dugas, Phoebe O. Toups; Oduwole, Elizabeth O.; Ragazzoni, Luca; Corte, Francesco Della

doi:10.1017/dmp.2023.71

Cited by 3 publications

(2 citation statements)

References 103 publications

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Section: Introductionmentioning

confidence: 99%

“…MCI preparedness requires that simulation exercises are used to identify and eliminate issues before an actual emergency occurs. Exercise recommendations and corrective actions are essential to improving response systems and mechanisms to manage emergencies effectively (1,2). Swedish surgical surge capacity was studied through a survey distributed to key surgical and anaesthesia/ICU staff in all Swedish emergency hospitals in 2015 (3).…”

Section: Introductionmentioning

confidence: 99%

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Determining surgical surge capacity with a hybrid simulation exercise

Blimark,

Robinson,

Jacobson

et al. 2023

Front. Public Health

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BackgroundTo help test and improve surgical surge capacity, mass casualty incident (MCI) exercises generate valuable information. Both large scale table-top exercises (TTX) and full-scale exercises (FSX) have limitations if you want to test an organisation’s capability and structure. A hybrid exercise incorporating the advantages of TTX and FSX is a possible way forward, but is no standardised exercise method, yet. This study aims at evaluating the exercise results to determine the feasibility of a hybrid TTX/FSX exercise for an organization’s capability and structure.MethodsA hybrid MCI simulation using moulaged figurants and simulation cards was designed, where the emergency department of a level 1 trauma centre receives 103 casualties over 4 h. After registration and triage, all casualties are expected to be resuscitated in real time and are transferred for further treatment inside the hospital (radiology, operating theatres, intensive care unit (ICU)/postop and wards). When reaching operation theatre, ICU or ward, figurants are replaced by simulation cards. Observers ensured that those procedures performed were adequate and adhered to realistic times. Use of resources (materials, drugs etc.) were registered. Primary endpoint was average time spent in the emergency department, from time of arrival, to transfer out. Secondary endpoints were related to patient flow and avoidable fatalities.ResultsThe hospital managed to deal with the flow of patients without collapse of existing systems. Operating theatres as well as ICU and ward beds were available at the end of the exercise. Several details in the hospital response were observed that had not been noticed during previous TTX.ConclusionFSX have a valuable role in training, equipping, exercising, and evaluating MCI management. Hybrid simulations combining both FSX and TTX may optimise resource utilisation and allow more frequent exercises with similar organisational benefit.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determining surgical surge capacity with a hybrid simulation exercise

Blimark,

Robinson,

Jacobson

et al. 2023

Front. Public Health

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A Brief Report of Response Team Members’ Perspectives on an Interteam Full-Scale Mass Casualty Incident Exercise in Norway

Leonardsen,

Westmark,

Syversen

et al. 2024

Disaster med. public health prep.

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Introduction A mass casualty incident (MCI) is unpredictable and involves many casualties at the same time and place. This brief report will present the results from an evaluation a full-scale MCI exercise, aiming to increase preparedness for such events, from the perspectives of future health-care professionals, as well as personnel in various emergency teams taking part in MCI response. Methods All participants in a 2-day, full-scale MCI exercise (N = 206) were invited to participate in an investigator-developed survey. Results In total, 124 participants (60.2%) responded to the questionnaire. Most of the respondents were satisfied with the information and frames of the full-scale MCI exercise. Based on their experiences, over half of the respondents perceived that the county ambulance, police, and fire departments were well prepared in case of an MCI in the future. Reported areas of improvement were specifically related to communication lines and triage. Conclusion Weakness in communication lines and triage were assumed a threat to effective handling of MCIs. However, further studies are needed to decide the content needed in MCI exercises to effectively increase regional preparedness for such events.

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Evaluation of rescue management in incidents with a high casualty rate – results of own research

Witkowski,

Perończyk,

Siedlis

et al. 2024

Emerg Med Serv

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Aim: Analysis of emergency management during a medical triage involving a large number of patients. Material and methods: The triage of thirty injured patients carried out by paramedics and advanced first aid rescuers was subject to evaluation. The actors posing as patients were instructed regarding their role and their symptoms, with each of them additionally given makeup and styled. Results: In the primary triage, 17 victims were assessed by members of the National Fire Services, 2 of whom were given the wrong priority rating. The re¬maining 13 patients were triaged by paramedics, with 2 mistakes in priority assessment — 5 patients were marked as black. In the second stage, triage was administered to 25 patients, in majority by paramedics (17 patients), who gave an incorrect priority rating to 2 of them. The retriage was conducted only by paramedics (25 patients) – in case of a single patient, the triage rating was incorrect, and in two cases, the color rating was not given whatsoever. No statisti¬cally significant differences were found between paramedics and Advanced First Aid-graduate rescuers representing National Fire Services Conclusions: The conclusions of the study point towards a good level of knowledge and skills exhibited by paramedics and Advanced First Aid graduates representing the National Fire Services. However, the analysis of the course of the training exercise has also revealed the necessity of continuously polishing your skills through training and incident simulations as far as proceeding during mass casualty incidents is concerned.

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The Challenge of Mass Casualty Incident Response Simulation Exercise Design and Creation: A Modified Delphi Study

Cited by 3 publications

References 103 publications

Determining surgical surge capacity with a hybrid simulation exercise

Determining surgical surge capacity with a hybrid simulation exercise

A Brief Report of Response Team Members’ Perspectives on an Interteam Full-Scale Mass Casualty Incident Exercise in Norway

Evaluation of rescue management in incidents with a high casualty rate – results of own research

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