Full-scale simulation exercise-A preparedness for trauma mass casualty incident: Nepal

Area of Science:

• Emergency Medicine
• Healthcare Management
• Disaster Preparedness

Background:

• Effective hospital incident command systems (HICS) are vital for managing mass casualty incidents.
• Triage and patient transfer protocols are critical components of emergency medical services.
• Coordination between hospitals and external agencies is essential during large-scale emergencies.

Purpose of the Study:

• To evaluate the functionality of the hospital incident command system, triage, treatment areas, and external communication during a simulation exercise.
• To identify specific gaps in knowledge and skills related to emergency response procedures within a hospital setting.

Main Methods:

• An observational, full-scale simulation exercise was conducted across six hospitals.
• A semisurprise drill utilized simulated patients and moulage for realism.
• Observations were systematically recorded using a validated checklist for scoring.

Main Results:

• The exercise identified significant gaps in running the incident command center and patient transfer from ambulance to triage.
• External coordination and communication also presented challenges during the simulation.
• The overall mean score achieved was 73.2%, indicating room for improvement.

Conclusions:

• The hospital incident command system requires enhancement to improve operational efficiency.
• Triage and patient transfer skills need further development and training.
• Strengthening external coordination is necessary for seamless emergency response.