Comparison of two disaster drills' management performed by trained and not-trained students: key times evaluation

Introduction

The aim of this report is to compare two disaster exercises' management of students with different backgrounds. To our knowledge nobody has ever compared two exercises, probably because of the difficulty in their evaluation. We implemented a tool for an objective evaluation [1] and we used it for this purpose.

Methods

Both drills represented a ceiling collapse over a crowded room with a similar amount of casualties and similar severity index. The START triage system was used.

The trained students (T) were attending the European Master in Disaster Medicine (EMDM), while the not-trained students (NT) were at the beginning of an introductory course in disaster medicine. During the exercises we recorded key victim-provider interaction times [2] using victim-based data collection. Each victim had their own data card to record triage and time information.

Results

In this preliminary report we present data regarding the scene length of stay (LOS) and triage to collecting area/advanced medical post time (T-AMP). The LOS was 67.5 (50.0 to 111.0) minutes (25 to 75 IQR) for T as compared with 145.0 (110.0 to 150.0) minutes (25 to 75 IQR) for NT (P < 0.001). Stratification according to assigned triage code showed no difference for high-priority codes (reds and yellows) as opposed to the green code (55.0 (47.0 to 75.0) minutes for T vs 145.0 (141.0 to 155.0) minutes for NT with P < 0.01). T-AMP was 10.0 (3.0 to 34.5) minutes for T as compared with 63.5 (19.5 to 104.3) minutes for NT (P < 0.001). Stratification according to triage code showed no difference for red codes between T and NT but showed a difference for yellow codes (36.5 (15.0 to 82.0) vs 71.0 (30.0 to 99.0) minutes) and green codes (7.0 (3.0 to 12.0) vs 85.0 (17.3 to 115.0) minutes) with P < 0.01.

Conclusions

Both teams evacuated red codes before the yellow ones in similar time. T-AMP was shorter considering global, yellow and green codes for T as opposed to NT. Global and green LOS was also shorter in the T group as opposed to NT. Training seems to influence global exercise management, less affecting red codes but with an impact on yellow and green evacuation strategies.