Skip to main content

Simulation for Pediatric Disaster and Multiple Casualty Incident Training

  • Chapter
  • First Online:
Comprehensive Healthcare Simulation: Pediatrics

Part of the book series: Comprehensive Healthcare Simulation ((CHS))

Abstract

Multiple casualty incidents (MCIs) are infrequent events that strain available healthcare resources, while disasters completely overwhelm them. These events vary in etiology, number of victims, duration, and the available healthcare resources of the impacted communities. In a pediatric environment, simulation offers a means of learning to specifically care for children in disasters and MCIs, explore the interface between emergency medical services and hospital care, and evaluate and practice disaster/MCI-specific skills, such as mass triage and family reunification. Another role of simulation in disaster and MCI planning is testing response strategies, such as the efficacy of multiple triage methods and revealing limitations of decontamination strategies, among others. Following a disaster or MCI simulation, debriefing learners and participants about perceived self-efficacy and team communication is crucial. A cyclical model, ranging from gap assessment to tabletop exercises, followed by live simulations and scripted debriefing, then a follow-up plan to make specific changes to disaster/MCI response and ongoing reevaluation, increases the likelihood that simulation will improve and sustain the response to actual disasters and MCIs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American Academy of Pediatrics Committee on Medical Liability, Task Force on Terrorism. The pediatrician and disaster preparedness. Pediatrics. 2006;117:560–5.

    Article  Google Scholar 

  2. Kim SJ, Kim CH, Shin SD, Lee SC, Park JO, Sung J. Incidence and mortality rates of disasters and mass casualty incidents in Korea: a population-based cross-sectional study, 2000–2009. J Korean Med Sci. 2013;28:658–66.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cicero MX, Brown L, Overly F, et al. Creation and Delphi-method refinement of pediatric disaster triage simulations. Prehosp Emerg Care. 2014;18(2):282–9.

    Article  PubMed  Google Scholar 

  4. Connor SB. When and why health care personnel respond to a disaster: the state of the science. Prehosp Disaster Med. 2014;29:270–4.

    Article  PubMed  Google Scholar 

  5. Cone DC, Cummings BA. Hospital disaster staffing: if you call, will they come? Am J Disaster Med. 2006;1:28–36.

    PubMed  Google Scholar 

  6. Thomalla F, Downing T, Spanger-Siegfried E, Han G, Rockström J. Reducing hazard vulnerability: towards a common approach between disaster risk reduction and climate adaptation. Disasters. 2006;30:39–48.

    Article  PubMed  Google Scholar 

  7. Arnold JL. Disaster medicine in the 21st century: future hazards, vulnerabilities, and risk. Prehosp Disaster Med. 2002;17:3–11.

    PubMed  Google Scholar 

  8. Lerner E, Schwartz R, Coule P, Pirrallo R. Use of SALT triage in a simulated mass-casualty incident. Prehosp Emerg Care. 2010;14:21–5.

    Article  PubMed  Google Scholar 

  9. D’Andrea SM, Goralnick E, Kayden SR. Boston Marathon bombings: overview of an emergency department response to a mass casualty incident. Disaster Med Public Health Prep. 2013;7:118–21.

    Article  PubMed  Google Scholar 

  10. Bulut Y, Güven M, Otlu B, et al. Acute otitis media and respiratory viruses. Eur J Pediatr. 2007;166:223–8.

    Article  PubMed  Google Scholar 

  11. Guha-Sapir D, van Panhuis WG, Lagoutte J. Short communication: patterns of chronic and acute diseases after natural disasters—a study from the International Committee of the Red Cross field hospital in Banda Aceh after the 2004 Indian Ocean tsunami. Trop Med Int Health. 2007;12:1338–41.

    Article  PubMed  Google Scholar 

  12. Brantley MD, Lu H, Barfield WD, Holt JB, Williams A. Mapping US pediatric hospitals and subspecialty critical care for public health preparedness and disaster response, 2008. Disaster Med Public Health Prep. 2012;6:117–25.

    Article  PubMed  Google Scholar 

  13. Rubinson L, Hick JL, Hanfling DG, et al. Definitive care for the critically ill during a disaster: a framework for optimizing critical care surge capacity: from a Task Force for Mass Critical Care summit meeting, January 26–27, 2007, Chicago, IL. Chest. 2008;133:18S–31S.

    Article  PubMed  Google Scholar 

  14. Kollek D, Karwowska A, Neto G, Sandvik H, Lyons S, Spivey J, et al. Pediatrics in disasters. In: Kollek D, editor. Disaster preparedness for healthcare facilities. Shelton: People’s Medical Publishing House-USA; 2013.

    Google Scholar 

  15. Brandenburg MA, Arneson WL. Pediatric disaster response in developed countries: ten guiding principles. Am J Disaster Med. 2007;2:151–62.

    PubMed  Google Scholar 

  16. Kerns CE, Elkins RM, Carpenter AL, Chou T, Green JG, Comer JS. Caregiver distress, shared traumatic exposure, and child adjustment among area youth following the 2013 Boston Marathon bombing. J Affect Disord. 2014;167:50–5.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kollek D, Karwowska A. Populations at risk-paediatrics. Radiat Prot Dosimetry. 2009;134:191–2.

    Article  PubMed  Google Scholar 

  18. Langhan M, Keshavarz R, Richardson LD. How comfortable are emergency physicians with pediatric patients? J Emerg Med. 2004;26:465–9.

    Article  PubMed  Google Scholar 

  19. Berger JT. Resource stewardship in disasters: alone at the bedside. J Clin Ethics. 2012;23:336–7.

    PubMed  Google Scholar 

  20. Hick JL, Hanfling D, Cantrill SV. Allocating scarce resources in disasters: emergency department principles. Ann Emerg Med. 2012;59:177–87.

    Article  PubMed  Google Scholar 

  21. Timm N, Reeves S. A mass casualty incident involving children and chemical decontamination. Disaster Manag Response. 2007;5:49–55.

    Article  PubMed  Google Scholar 

  22. Chung S, Shannon M. Reuniting children with their families during disasters: a proposed plan for greater success. Am J Disaster Med. 2007;2:113–7.

    PubMed  Google Scholar 

  23. McCormick LC, Hites L, Wakelee JF, Rucks AC, Ginter PM. Planning and executing complex large-scale exercises. J Public Health Manag Pract. 2014;20(Suppl 5):S37–43.

    Article  PubMed  Google Scholar 

  24. Cicero MX, Auerbach MA, Zigmont J, Riera A, Ching K, Baum CR. Simulation training with structured debriefing improves residents’ pediatric disaster triage performance. Prehosp Disaster Med. 2012;27:239–44.

    Article  PubMed  Google Scholar 

  25. Franc-Law J, Ingrassia P, Ragazzoni L, Corte F. The effectiveness of training with an emergency department simulator on medical student performance in a simulated disaster. CJEM. 2010;12:27–32.

    PubMed  Google Scholar 

  26. Silenas R, Akins R, Parrish A, Edwards J. Developing disaster preparedness competence: an experiential learning exercise for multiprofessional education. Teach Learn Med. 2008;20:62–8.

    Article  PubMed  Google Scholar 

  27. Scott JA, Miller GT, Issenberg SB, et al. Skill improvement during emergency response to terrorism training. Prehosp Emerg Care. 2006;10:507–14.

    Article  PubMed  Google Scholar 

  28. Kotora JG, Clancy T, Manzon L, Malik V, Louden RJ, Merlin MA. Active shooter in the emergency department: a scenario-based training approach for healthcare workers. Am J Disaster Med. 2014;9:39–51.

    Article  PubMed  Google Scholar 

  29. Dausey DJ, Buehler JW, Lurie N. Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats. BMC Public Health. 2007;7:92.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Leow JJ, Brundage SI, Kushner AL, et al. Mass casualty incident training in a resource-limited environment. Br J Surg. 2012;99:356–61.

    Article  CAS  PubMed  Google Scholar 

  31. Hsu EB, Li Y, Bayram JD, Levinson D, Yang S, Monahan C. State of virtual reality based disaster preparedness and response training. PLoS Curr. 2013;5:p ii.

    Google Scholar 

  32. Lowe C. Pediatric prehospital medicine in mass casualty incidents. J Trauma. 2009;67:S161–7.

    Article  PubMed  Google Scholar 

  33. Foltin G, Tunik M, Curran J, et al. Pediatric nerve agent poisoning: medical and operational considerations for emergency medical services in a large American city. Pediatr Emerg Care. 2006;22:239–44.

    Article  PubMed  Google Scholar 

  34. Gold J, Montano Z, Shields S, et al. Pediatric disaster preparedness in the medical setting: integrating mental health. Am J Disaster Med. 2009;4:137–46.

    PubMed  Google Scholar 

  35. Pfefferbaum B, Newman E, Nelson SD. Mental health interventions for children exposed to disasters and terrorism. J Child Adolesc Psychopharmacol. 2014;24:24–31.

    Article  PubMed  Google Scholar 

  36. Vincent DS, Berg BW, Ikegami K. Mass-casualty triage training for international healthcare workers in the Asia-Pacific region using manikin-based simulations. Prehosp Disaster Med. 2009;24:206–13.

    PubMed  Google Scholar 

  37. Ramirez M, Kubicek K, Peek-Asa C, Wong M. Accountability and assessment of emergency drill performance at schools. Fam Community Health. 2009;32:105–14.

    Article  PubMed  Google Scholar 

  38. Nathawad R, Roblin PM, Pruitt D, Arquilla B. Addressing the gaps in preparation for quarantine. Prehosp Disaster Med. 2013;28:132–8.

    Article  PubMed  Google Scholar 

  39. Savoia E, Preston J, Biddinger PD. A consensus process on the use of exercises and after action reports to assess and improve public health emergency preparedness and response. Prehosp Disaster Med. 2013;28:305–8.

    Article  PubMed  Google Scholar 

  40. Wallis LA, Carley S. Comparison of paediatric major incident primary triage tools. Emerg Med J. 2006;23:475–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Cross KP, Cicero MX. Head-to-Head comparison of disaster triage methods in pediatric, adult, and geriatric patients. Ann Emerg Med. 2013;61:668–76.e667.

    Article  PubMed  Google Scholar 

  42. Cone DC, Serra J, Kurland L. Comparison of the SALT and Smart triage systems using a virtual reality simulator with paramedic students. Eur J Emerg Med. 2011;18(6):314–21.

    Article  PubMed  Google Scholar 

  43. Vincent D, Sherstyuk A, Burgess L, Connolly K. Teaching mass casualty triage skills using immersive three-dimensional virtual reality. Acad Emerg Med. 2008;15:1160–5.

    Article  PubMed  Google Scholar 

  44. Ballow S, Behar S, Claudius I, Stevenson K, Neches R, Upperman J. Hospital-based disaster preparedness for pediatric patients: how to design a realistic set of drill victims. Am J Disaster Med. 2008;3:171–80.

    PubMed  Google Scholar 

  45. Nager A, Khanna K. Emergency department surge: models and practical implications. J Trauma. 2009;67:S96–9.

    Article  PubMed  Google Scholar 

  46. Fertel B, Kohlhoff S, Roblin P, Arquilla B. Lessons from the “Clean Baby 2007” pediatric decontamination drill. Am J Disaster Med. 2009;4:77–85.

    PubMed  Google Scholar 

  47. Freyberg C, Arquilla B, Fertel B, et al. Disaster preparedness: hospital decontamination and the pediatric patient–guidelines for hospitals and emergency planners. Prehosp Disaster Med. 2008;23:166–73.

    PubMed  Google Scholar 

  48. Cole SL, Siddiqui J, Harry DJ, Sandrock CE. WiFi RFID demonstration for resource tracking in a statewide disaster drill. Am J Disaster Med. 2011;6:155–62.

    PubMed  Google Scholar 

  49. Chung S, Shannon M. Reuniting children with their families during disasters: a proposed plan for greater success. Am J Disaster Med. 2007;2:113–7.

    PubMed  Google Scholar 

  50. Brandenburg MA, Watkins SM, Brandenburg KL, Schieche C. Operation Child-ID: reunifying children with their legal guardians after Hurricane Katrina. Disasters. 2007;31:277–87.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark X. Cicero MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Cicero, M., Weiner, D. (2016). Simulation for Pediatric Disaster and Multiple Casualty Incident Training. In: Grant, V., Cheng, A. (eds) Comprehensive Healthcare Simulation: Pediatrics. Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-319-24187-6_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24187-6_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24185-2

  • Online ISBN: 978-3-319-24187-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics