Gofrit O N, Leibovici D, Shemer J, Henig A, Shapira S C
Israel Defense Forces, Medical Corps, Tel Aviv Israel University, Israel.
Prehosp Disaster Med. 1997 Apr-Jun;12(2):97-101.
Full-scale disaster drills are complex, expensive, and may involve hundreds or thousands of people. However, even when carefully planned, they often fail to manifest the details of medical care given to the casualties during the drill.
To assess the feasibility of integrating physicians among the simulated casualties of a hospital disaster drill.
A total of 178 physicians graduating an Advanced Trauma Life Support (ATLS) course participated in eight hospital disaster drills during 1994 as "Smart Victims." The participants were given cards with descriptions of their injury and detailed instructions on how to manipulate their medical condition according to the medical care provided in the hospital. They also were given coded questionnaires to fill out during the process of the drill. Conclusions were drawn from analysis of the questionnaires and from a roundtable discussion following each drill.
The "smart casualties" made comments on the following topics: 1) triage (over-triage in 9%, and under-triage in 4%); 2) treatment sites; 3) medical equipment usage (i.e., shortage of ventilators and splinting devices); 4) medical knowledge and care rendered by the hospital staff; 5) evacuation and escorting of the wounded; 6) management of patients with post-traumatic stress disorder; and 7) medical documentation. Their comments contributed valuable information on the quality of medical care and organization, and identified obstacles that otherwise would have been overlooked. The "smart casualties" were very cooperative and indicated that their participation in the drill contributed to their understanding of disaster situations in hospitals.
Integrating physicians among the simulated casualties in a hospital disaster drill may contribute to achieving the objectives of hospital disaster drills and add to disaster management education of the simulated casualty physicians.
全面灾难演习复杂、昂贵，可能涉及数百或数千人。然而，即便精心策划，演习中往往仍无法呈现对伤亡人员的医疗救治细节。
评估在医院灾难演习的模拟伤亡人员中安排医生的可行性。
1994年，共有178名完成高级创伤生命支持（ATLS）课程的医生作为“智能伤员”参与了八次医院灾难演习。给参与者发放卡片，上面描述了他们的伤情以及根据医院提供的医疗救治如何控制自身病情的详细说明。还发给他们编码问卷，以便在演习过程中填写。通过对问卷的分析以及每次演习后的圆桌讨论得出结论。
“智能伤员”就以下主题发表了意见：1）分诊（9%分诊过度，4%分诊不足）；2）治疗地点；3）医疗设备使用情况（即呼吸机和夹板装置短缺）；4）医院工作人员的医学知识和提供的护理；5）伤员的疏散和护送；6）创伤后应激障碍患者的管理；7）医疗记录。他们的意见为医疗护理质量和组织提供了有价值的信息，并发现了一些原本会被忽视的障碍。“智能伤员”非常配合，并表示他们参与演习有助于他们了解医院的灾难情况。
在医院灾难演习的模拟伤亡人员中安排医生，可能有助于实现医院灾难演习的目标，并增强对模拟伤亡医生的灾难管理教育。
