December 5, 2012
Human volunteers have long served as "victims" for disaster drills, but there are limits to the life-saving procedures participants can practice when working on living, breathing people who are very much alive and well.
That's why the Rural Health Innovation Collaborative has begun offering its high-tech human patient simulators for such drills so students from member colleges and universities can get hands-on experience amid the backdrop of a real-world emergency.
The simulators enable students to perform such procedures as inserting chest tubes to prevent collapsed lungs or perform CPR or defibrillation to restart a heart beating, said Jack Jaeger, director of the RHIC Simulation Center at Terre Haute's Union Hospital.
"It's a whole different ballgame when you take the simulators out into the field," Jaeger said. "Without all of the support equipment that we have at the center, the students have to work on the fly a little more. It's just like it's real life. When you have a mass casualty incident, you're not going to have everything all prim and proper. You need to do with what you have. That adaptability is what makes mass casualty practice so important. Unless you have been in the situation, you can't get used to doing it."
Jaeger recently loaded several patient simulators into a trailer and transported them the short distance to Indiana State University's Statesman Towers for an "active shooter" drill that marked the first time students had trained in conjunction with university police.
The event, staged inside the vacant 15-story building that formerly housed the Scott College of Business, had adrenaline flowing for both students and veteran law enforcement officers.
First reports were unclear on just where the incident was taking place, either the second floor or the third floor. University police immediately assembled two teams of four officers each. They raced up the stairs to search both floors and quickly found they were dealing with more than a shooting.
"Smoke everywhere, lights were off, stuff was thrown everywhere. It was a mess," said Cpl. Daniel Parmer, whose team entered the third floor to discover the shooter or shooters had also tossed a hand grenade.
Injured students lay throughout the floor. Some had gunshot wounds while others had been hit by shrapnel and suffered burns as a result of the grenade. But the officers had to find the person or persons responsible before they - or anyone - could tend to the victims.
"You had to use your flashlights. You've got people yellin' and screamin'," Parmer said. "Unfortunately for us, we've got to realize if they're a threat, and if they're not a threat we have to move on. We can't tend to them when we're looking for a shooter."
Within minutes another team of officers found the suspect on the second floor, arrested him and determined he was acting alone, paving the way for emergency medical responders to move in for the second phase of a drill involving police and students from Indiana State and Ivy Tech Community College.
"After the police went up and took care of the shooter, secured the area, we were first to go up," said Jeffery McMillan of Cloverdale, a paramedic student at Ivy Tech. "We went to all of the rooms tagging patients. We had tags that marked them from critical to not critical, as in ‘walking wounded'."
McMillan and other Ivy Tech paramedic students then brought the more seriously injured patients to a triage center Indiana State nursing and physician assistant studies students had set up on the ground floor of the building, where nursing student Jill Slaven of Rockville took over.
"My role was to be the one directing people where to go," she said, explaining that she and her fellow students, under the guidance of faculty members who were also on hand, had set aside three color-coded areas of treatment - red, green or yellow depending on the severity of injuries.
"If they transferred to a different area, we had to keep track of those patients and if they transferred out of the hospital we had to keep track of those patients so we knew where they were and they could be accounted for," she said.
"When real life situations happen, if you don't get trained, you get so caught up in the emotion and all of the excitement going on that you almost get lost and don't do anything, which is even worse," said Krista Irwin of Greencastle, a physician assistant student at Indiana State. "If we practice then we know what to expect and it brings it to real life."
In previous drills, Lindsey Graft of Terre Haute, also a physician assistant student, played the role of the health care provider she is studying to become. This time, she gained a different perspective as a victim, sporting grotesque make-up on her face to simulate the effects of a third-degree burn from a grenade explosion.
"It was just different ... to see the different degrees of injuries as a as a patient and to see the collaboration between the nurses, the PAs (physician assistants) and the paramedics and how they worked together to treat all of the different injuries," Graft said.
Jaeger rated the drill as "fantastic," especially when it came to communications between the students from Indiana State and Ivy Tech and university police, which is a major goal of the RHIC's commitment to inter-professional education, he said.
McMillan, who is already an emergency medical technician, was also impressed by how smooth the drill went.
"I work for an ambulance service. I go to the hospital, see (hospital staff) for 10 minutes and leave," he said. "In this situation we get to see what everybody does right here and in the chaos of everything it's amazing how well everybody works together."
Photo: http://isuphoto.smugmug.com/photos/i-6jkHff7/0/L/i-6jkHff7-L.jpg - Deidra Johnson of Indianapolis, a senior nursing major at Indiana State University, uses a bag valve mask to help restore a "victim's" breathing during an active shooter drill Nov. 30, 2012. Other nursing and physician assistant studies students also tend to the patient, actually a human patient simulator from the Rural Health Innovation Collaborative Simulation Center. (ISU/Rachel Keyes)
Photo: http://isuphoto.smugmug.com/photos/i-XqgzR37/0/L/i-XqgzR37-L.jpg - Indiana State University Police Officer Jordan Gentry wields a simulated handgun as he and fellow officers search for a suspect during an active shooter drill inside a vacant classroom building on Nov. 30, 2012. (ISU/Rachel Keyes)
Photo: http://isuphoto.smugmug.com/photos/i-F8DHRFj/0/L/i-F8DHRFj-L.jpg - Nursing and physician assistant studies students from Indiana State University and paramedic students from Ivy Tech Community College tend to victims during an active shooter drill Nov. 30, 2012 inside a vacant classroom building at Indiana State. (ISU/Rachel Keyes)
Contact: Jack Jaeger, director, Simulation Center, Rural Health Innovation Collaborative, 812-238-4625 or email@example.com
Writer: Dave Taylor, media relations director, Office of Communications and Marketing, Indiana State University and communications committee chair, Rural Health Innovation Collaborative, 812-237-3743 or firstname.lastname@example.org
Disaster drills at Indiana State University have recently taken on a new element - human patient simulators, which enable students to practice real-world medical procedures under the stress of an emergency situation.