Objectives: A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event.Methods: Utilizing a virtual reality cave automatic virtual environment (CAVE) and high-fidelity human patient simulator (HPS), a group of experts modeled a football stadium that experienced a terrorist explosion during a football game. Avatars (virtual patients) were developed by expert consensus that demonstrated a spectrum of injuries ranging from death to minor lacerations. A group of paramedics was assessed by observation for decisions made and action taken. A critical action checklist was created and used for direct observation and viewing videotaped recordings.Results: Of the 12 participants, only 35.7% identified the type of incident they encountered. None identified a secondary device that was easily visible. All participants were enthusiastic about the simulation and provided valuable comments and insights.Conclusions: Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack. ACADEMIC EMERGENCY MEDICINE 2008; 15:1152-1159 ª 2008 by the Society for Academic Emergency MedicineKeywords: first responders, mass casualty, disaster, virtual reality, human patient simulator T raining is essential for effective disaster response.1 However, training for high-acuity, low-frequency events provides great challenges for first responders.2 The infrequent nature of such events leads to less collective experience and little empirical research. 3 The rehearsal necessary for knowledge retention is impeded by few practice opportunities. The high acuity makes realistic simulation extremely difficult, yet also mandates the very performance familiarity that the low frequency inhibits. Increasing the likelihood that appropriate decisions are made in the stress and chaos of the moment requires sophisticated training that goes beyond that of most first responders. 4,5The specific roles of first responders vary by department and professional training. Ideally, all first responders should have a basic knowledge of communication needs, triage techniques, and hazard identification. However, advanced medical training allows for better utilization of the high-fidelity mannequins and the acquisition of more complex data.Postevent analyses suggest recurring failures that even very senior emergency responders commit despite years of experience and high levels of traditional training.6-13 Some of these errors have potentially significant medical implications. These include, but are not limited to:1. Failures in adhering to triage protocols, including avoiding overtreatment ⁄ secondary management and appropriate resource requests and allocation. [13][14][15][16] 2. Poor intraagency, interagency, and scene-to-hospital communications, including failures in information manageme...
Three hundred paramedics were given the survey, and 95 (32%) responded. More than 80% of paramedics polled would not remain on duty if there were no vaccine and no protective gear. Even if protective gear was available but the vaccine was unavailable, only 39% of respondents would remain on duty. Finally, although 91% of paramedics would remain on duty if they were fully protected, this number falls to 38% if the respondent believed that his or her immediate family was not protected. The results of this survey are relevant to current concerns about an influenza pandemic. Every effort must be made to protect first-responders from pandemic influenza and educate them about it.
Students' and educators' responses to high-fidelity patient simulation were very positive. The ability to practice without risk must be weighed against the cost of this new technology.
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