Massive Road Traffic Accident Simulated with ‘Patients’ Made Up to Look Injured, Dead
Today at Komfo Anokye Teaching Hospital, a Mass Casualty Incident (MCI) Moulage Simulation was held to train KNUST ER (4th year) nurses how to triage patients and allocate limited healthcare resources during a large manmade or natural disaster. Approximately 45 KNUST 4th year nurses, 12 emergency physicians, 3 emergency medical technicians/paramedics, and 42 KNUST 3rd year nurses participated in the simulation where 50 people played the role of ‘patients’ who were made up to look like they were injured, crying, upset, or dead.
“Disasters overwhelm healthcare resources. Mass Casualty Incidents strain resources,” said U.S. Fulbright-Fogarty Postdoctoral Global Health Fellow and KNUST Visiting Professor Roxane Richter, Ph.D., E.M.T., “These simulations test healthcare systems on their preparedness and response and are ideal teaching interventions that can be used to prepare nurses and other inter-professional personnel to effectively triage – which is a method of prioritizing patients' treatments based on the severity of their condition – and allocating limited resources like human and capital resources.” As a Fogarty researcher, Richter is in Ghana for 9 months, funded through the U.S. National Institutes of Health in Washington D.C., and is currently researching road traffic injuries in mass casualty events at KATH.
Prepare, Respond & Mitigate Casualties
Dr. Richter and Dr. Flowers are the co-teachers of KNUST’s 4th year Emergency Nursing class “Care in Mass Casualties” (SEN #466) this semester. The simulation was part of the nurse’s training in handling disasters when a hospital exceeds their ‘surge capacity’ which is when there is not enough space, supplies, or staffing to handle the number (or type) of patients that come in due to a large accident or disaster. Both Richter and Flowers served in 2005’s Hurricane Katrina in Houston, Texas, when the large city was overwhelmed by some 250,000 – 300,000 injured and ill evacuees from New Orleans in neighboring state of Louisiana.
The goal of an MCI management is to save the largest number of survivors from a Mass Casualty Incident (MCI). These simulations test the healthcare systems’ coordination with other agencies, medical management and treatment, and to balance supply and demand under limitedresource settings. Today’s event used ‘moulage’ – which is the art of applying mock injuries for the purpose of training Emergency Response Teams and other medical and military personnel. The simulation was to introduce healthcare providers to new Mass Casualty triage systems called “START” and “JUMP START” that allow very rapid patient sorting under “START -Simple Triage And Rapid Treatment” systems for adults and children. The nurse-led simulation also introduced providers to using SMART triage tags that show the level of a patient’s injury.
The cooperative KATH/KNUST Mass Casualty Incident Moulage Simulation was financially sponsored by Drs. Richter and Flowers - and supported by Dr. George Oduro, Head of KATH’s Emergency Dept., Dr. Victoria Bam, KNUST Head of Nursing, KATH’s Director of Nursing Services (who donated some of the nurses’ disposable supplies), Nurse Geoffrey Asante, the simulation’s Incident Commander in Charge, and many other officials from KNUST, KATH, and KNUST Hospital.