Carenzo Luca, Bazurro Simone, Colombo Davide, Petrini Flavia, Ingrassia Pier Luigi
Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.
Research Center in Emergency and Disaster Medicine (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy.
Disaster Med Public Health Prep. 2021 Apr;15(2):151-154. doi: 10.1017/dmp.2019.163. Epub 2020 Mar 2.
Anesthesiologists play a pivotal role in mass-casualty incidents management. Disaster medicine is part of the anesthesiologist's core skills; however, dedicated training is still scarce and, often, it does not follow a standardized program.
We designed and delivered a crash course in disaster medicine for Italian anesthesiology residents participating in the nationwide program, Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) Academy Critical Emergency Medicine 2019. Residents totaling 145, from 39 programs, participated in a 75-minute workstation on the principles of disaster management. Following this, each participant was involved in a full-scale mass-casualty drill. A plenary debriefing followed to present simulation data, maximize feedback, and highlight all situations needing improvement.
Overall, participant performance was good: Triage accuracy was 85% prehospital and 84% in-hospital. Evacuation flow respected triage priority. During the debriefing, residents were very open to share and reflect on their experiences. A narrative qualitative analysis of the debriefing highlights that many participants felt overwhelmed by events during the exercise. Participants in coordination positions shared how they appreciated the need to switch from a clinical mindset to a managerial role.
This was an invaluable experience for anesthesiology trainees, providing them with the skill set to understand the fundamental principles of a mass-casualty response.
麻醉医生在大规模伤亡事件管理中发挥着关键作用。灾难医学是麻醉医生核心技能的一部分；然而，专门的培训仍然稀缺，而且往往没有遵循标准化的课程。
我们为参加全国性项目“意大利麻醉、镇痛、复苏与重症监护学会（SIAARTI）学院2019年危急重症医学”的意大利麻醉住院医师设计并提供了一门灾难医学速成课程。来自39个项目的145名住院医师参加了一个关于灾难管理原则的75分钟工作站培训。在此之后，每位参与者都参与了一次全面的大规模伤亡演练。随后进行了全体汇报，展示模拟数据，最大化反馈，并突出所有需要改进的情况。
总体而言，参与者表现良好：院前分诊准确率为85%，院内为84%。疏散流程遵循分诊优先级。在汇报过程中，住院医师们非常愿意分享和反思他们的经历。对汇报的叙述性定性分析表明，许多参与者在演练过程中对事件感到不知所措。担任协调职位的参与者分享了他们如何认识到从临床思维模式转变为管理角色的必要性。
这对麻醉学实习生来说是一次宝贵的经历，为他们提供了理解大规模伤亡应对基本原则的技能。
