Simulation for Pediatric Disaster and Multiple Casualty Incident Training

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.