Power ECEPower ECE
Exercise Creator and Evaluator
Torino,12 Novembre 2008
Davide Colombo, MDDavide Colombo, MDS.C.D.U. Anestesia, Terapia Intensiva e Rianimazione GeneraleA.O.U. Maggiore della Carità - NovaraUniversità “A. Avogadro”del Piemonte Orientale
Real size simulation in disaster medicine
Real size simulation in disaster medicine
� Poor number of paper
� Best system to test plan
� Great stress for partecipants
But…But…
� Cost/efficacy
� Expensive organization
� Difficult to evalue
Tasks for a Successful ExerciseTasks for a Successful Exercise
ReviewPlan
ReviewPlan
DevelopScheduleDevelop
Schedule
DetermineExercise
Scope
DetermineExercise
Scope
AssessCapability
AssessCapability
ConductNeeds
Assessment
ConductNeeds
Assessment
WritePurpose
Statement
WritePurpose
Statement
SendExerciseDirective
SendExerciseDirective
OrganizeEvaluation
Team
OrganizeEvaluation
Team
OrganizeDesignTeam
OrganizeDesignTeam
PrepareObjectivesPrepare
ObjectivesBef
ore
ReviewPlan
ReviewPlan
DevelopScheduleDevelop
Schedule
DetermineExercise
Scope
DetermineExercise
Scope
AssessCapability
AssessCapability
ConductNeeds
Assessment
ConductNeeds
Assessment
WritePurpose
Statement
WritePurpose
Statement
SendExerciseDirective
SendExerciseDirective
OrganizeEvaluation
Team
OrganizeEvaluation
Team
OrganizeDesignTeam
OrganizeDesignTeam
PrepareObjectivesPrepare
ObjectivesBef
ore
ReviewPlan
ReviewPlan
DevelopScheduleDevelop
Schedule
DetermineExercise
Scope
DetermineExercise
Scope
AssessCapability
AssessCapability
ConductNeeds
Assessment
ConductNeeds
Assessment
WritePurpose
Statement
WritePurpose
Statement
SendExerciseDirective
SendExerciseDirective
OrganizeEvaluation
Team
OrganizeEvaluation
Team
OrganizeDesignTeam
OrganizeDesignTeam
PrepareObjectivesPrepare
ObjectivesBef
ore
WriteNarrative
WriteNarrative
WriteMessages
WriteMessages
DevelopEvaluation
Format
DevelopEvaluation
Format
List Major &DetailedEvents
List Major &DetailedEvents
FinalizeExercise
Enhancements
FinalizeExercise
Enhancements
DetermineExpectedActions
DetermineExpectedActions
ConductExerciseConductExercise
ConductPost -Exercise
Meeting
ConductPostexercise
Meeting
ConductFollow -UpActivities
ConductFollowupActivities
WriteAfter -Action
Report
WriteAfter -Action
Report
Dur
ing
Aft
er
WriteNarrative
WriteNarrative
WriteMessages
WriteMessages
DevelopEvaluation
Format
DevelopEvaluation
Format
List Major &DetailedEvents
List Major &DetailedEvents
FinalizeExercise
Enhancements
FinalizeExercise
Enhancements
DetermineExpectedActions
DetermineExpectedActions
ConductExerciseConductExercise
ConductPost -Exercise
Meeting
ConductPostexercise
Meeting
ConductFollow -UpActivities
ConductFollowupActivities
WriteAfter -Action
Report
WriteAfter -Action
Report
Dur
ing
Aft
er
WriteNarrative
WriteNarrative
WriteMessages
WriteMessages
DevelopEvaluation
Format
DevelopEvaluation
Format
List Major &DetailedEvents
List Major &DetailedEvents
FinalizeExercise
Enhancements
FinalizeExercise
Enhancements
DetermineExpectedActions
DetermineExpectedActions
ConductExerciseConductExercise
ConductPost -Exercise
Meeting
ConductPostexercise
Meeting
ConductFollow -UpActivities
ConductFollowupActivities
WriteAfter -Action
Report
WriteAfter -Action
Report
Dur
ing
Aft
er
Key PointsKey Points
�Scenario
�Set up�Set up
�Victims
�Realism
To Evaluate an exerciseTo Evaluate an exerciseIt allow to identify:
� If you reach the goal
� How improving C&C chain
� How improving system and protocol� How improving system and protocol
� Weakness in skill
� Equipment
ObjectiveObjective
To build a software able to:
�Victim database�To help in setting up the simulation�To collect and analyze data
Victims’ databaseVictims’ database
STORYBOARDSTORYBOARDSTORYBOARDSTORYBOARDSTORYBOARDSTORYBOARDSTORYBOARDSTORYBOARD
Running the drillRunning the drill
Vital signVital signVital signVital signVital signVital signVital signVital sign
Running the Drill…Running the Drill…
After Action ReviewAfter Action Review
Maps and
movements
Communication
Digital
photographsReplay controls
Component
tree
Statistics
Replay time
Communication
analysis
Time line
CITE® Explorer System for integration and visualization of information from complex processes using multimedia
STATSSTATS
ResultsResults
EMDM 2006: Gallery car crash, Simulated Hospital in an airport Hangar
� To modify disaster � To modify disaster activation procedure
� To improve communication system
� To modify personnel on call list
ResultsResults
EMDM 2007: Air collision, Ospedale Regionale della Valle d’Aosta involved DEA, ICU and Radiology
� To modify procedure to manage in airport disaster
� To modify access road to � To modify access road to Hospital
� To modify in Hospital victim’s route
� To modify radiology and Laboratory use
� To test computerized triage system
RisultatiRisultatiRed Cross Civil Protection simulation 2007:
Burn in Elderly residence, Pre-Hospital
� To test technical
� Ambulance and truck � Ambulance and truck mobilization
� Difficult to evacuate patients
� Not Clear definition in C&C Chain
RisultatiRisultatiEMDM 2008: Bomb during Rock Concert,
Ospedale Borgomanero involved DEA, ICU and RAdiology
� Real patient manage in the same space of simulatedspace of simulated
� Real test of Hospital plan
� High realism level
� Still analyzing
Further developmentsFurther developments
�Connection with real system to manage mass casualty events
�Interconnection between real size and �Interconnection between real size and computerized simulation
Power ECEPower ECE
Exercise Creator and Evaluator
Torino,12 Novembre 2008
Davide Colombo, MDDavide Colombo, MDS.C.D.U. Anestesia, Terapia Intensiva e Rianimazione GeneraleA.O.U. Maggiore della Carità - NovaraUniversità “A. Avogadro”del Piemonte Orientale