The scenario was all too real: an active shooter is rampaging through a building when he decides to set it on fire. Soon, victims are flooding into the local hospital. Many have gunshot wounds, others bear lacerations, and some are choking from smoke inhalation. All are panicked.
That was the mock disaster drill emergency medicine residents were surprised with this past month. Their task was to save as many lives as possible.
“We do this at least every two years, mainly because we want to be ready when disaster strikes,” said Professor of Emergency Medicine Stephen Borron, M.D., who coordinated the disaster drill. “We try to simulate disasters in an environment where everyone can make mistakes, but it doesn’t hurt anyone — that helps us learn from our mistakes and increases our preparedness.”
Dr. Borron is known for creating realistic disaster scenarios to prepare residents for what they may face in the real world. In the past, victim injuries have mimicked those in the news — like the shrapnel injuries that were seen at the Boston Marathon bombing. The scenarios are always large-scale, with mass casualties that usually overwhelm emergency responders.
Mock, also known as moulage, injuries are taken just as seriously as if they were real. Two hours before this year’s surprise drill, students from the Gayle Greve Hunt School of Nursing (GGHSON) — who were charged with playing the victims — were applying makeup, fake wounds, and charcoal to imitate burns. They also memorized their symptoms and rehearsed their characters. One student played a worried pregnant woman, terrified that her unborn baby had been injured. Another played an injured patient who was also drunk, causing a scene in the emergency room.
“This was absolutely helpful; simulation is one of the key parts of residency,” said Adam Villalba, a third-year resident in emergency medicine who ran through the drill. “It’s something that you will always remember as a physician and can refer back to in the future. The mistakes that you make here in simulation are the most valuable lessons because you’re less likely to make them when you’re out actually performing them in real life.”
Villalba was tasked with treating incoming patients at TTUHSC El Paso’s Regional Simulation and Training Center, which was set up as a hospital. Other residents were dropped off at the scene of the crime to triage victims — the process of ordering patients who need treatment based on the severity of their injuries.
Nurses in the GGHSON also had the opportunity to test their skills. Those who were not playing victims and evaluating the medical care they received were paired with emergency responders to treat incoming patients at the hospital or directly at the crime scene.
“What was unique about the experience is that I was not expecting to work one-on-one with another doctor,” said James Parker, a GGHSON student. “It was interesting to see how we could interact with each other to benefit the patient.”
During the two-hour drill, residents and nurses encountered a plethora of hiccups that they are also likely to face in the real world, including a shortage of blood and operating rooms.
“That’s when our health care providers are really tested,” Dr. Borron explained. “Their decisions at that point in time will affect whether patients live or die; it’s up to them to apply what they’ve learned to achieve the best possible outcome.”
Dr. Borron added, “In a disaster like this, you won’t be able to save everyone. Our health care providers need to realize that early on and apply their resources toward those who have a fighting chance.”
The Department of Emergency Medicine would like to thank the Texas Tech Police Department and the ProAction Emergency Services Institute for participating in the drill. During the scenario, campus police officers practiced how to protect health care providers who are treating patients at an active crime scene. Students who are training to be paramedics at the ProAction Emergency Services Institute participated by transporting patients in gurneys and stretchers from the disaster scene to the hospital. Staff in the Regional Simulation and Training Center also played a key role in organizing the drill.
Photos by Tommie Morelos, Office of Institutional Advancement.