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Tabletop Simulation Exercise of Critically Ill Patient Evacuation from a Hospital Fire

Published online by Cambridge University Press:  06 May 2019

Jiyoung Noh
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
Hyun Soo Chung
Affiliation:
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, South Korea
Hye Mi Jin
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
Jayoung Hur
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
Min Ji Kim
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
Chan Mi Kang
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
Ga Hyun Lee
Affiliation:
Center for Disaster Relief, Training, and Research, Yonsei University Severance Hospital, Seoul, South Korea
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Abstract

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Introduction:

Recent hospital fire incidents in South Korea have heightened the importance of patient evacuation. Moving patients from an intensive care unit (ICU) or emergency department (ED) setting is a challenge due to the complexity of moving acutely unwell patients who are reliant on invasive monitoring and organ support. Despite the importance of patient evacuation, the readiness of ICU and ED for urgent evacuation has not been assessed.

Aim:

To enhance the readiness and competencies of workers from ICU and ED in the evacuation of patients during a simulated tabletop fire exercise.

Methods:

A tabletop simulation exercise was developed by the Center for Disaster Relief, Training, and Research referencing the fire evacuation manual developed by the hospital’s ICU and ED. The scenario consisted of evacuating patients horizontally and vertically from each department. The participants’ actions were assessed using a checklist. A debriefing was completed after the exercise to discuss the gaps observed. A post-survey questionnaire was used to evaluate the exercise and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.

Results:

A total of 22 and 29 people participated in the exercise from ICU and ED, respectively. Knowledge and confidence improved post-exercise for both ICU and ED scenarios (p<0.05). Course satisfaction was 7.9 and 8.7, respectively for ICU and ED exercise. Correct performance rates for ICU and ED were 59% and 58%, respectively. Common gaps noted for both ICU and ED were wearing protective masks, patient hand-over communication, and preparation for resources.

Discussion:

There need to be exercises to recognize system gaps in place for hospital fire evacuation preparedness. Tabletop simulation exercises are ideal tools for this purpose. Although this was a short 90-minute exercise, this increased familiarity with the evacuation plan, tested the plan, and allowed for identification of gaps.

Type
Poster Presentations
Copyright
© World Association for Disaster and Emergency Medicine 2019