When disaster strikes

On June 12, 2016, the worst mass shooting in U.S. history claimed the lives of 49 people and left 53 wounded.

Victims were transported to Orlando Regional Medical Center (ORMC), the only Level I trauma center in Central Florida, located just three blocks away. In the first hour following the shooting, 38 victims were taken to the hospital, with ORMC receiving a total of 50 emergency patients, including one SWAT team member.

“I was not there when they rolled in,” said Phil Nagsuk, MD, a general surgical resident at ORMC and a 2015 graduate of Texas A&M College of Medicine. “I was part of the relief team, and I took several of these patients into the operating room over the following days and weeks.”

During his third year in medical school, Nagsuk participated in Texas A&M College of Nursing’s Disaster Day, a one-day, nursing student-led interprofessional simulation activity that helps prepare future health care professionals for when disaster strikes.

Preparation is Key

Created by Texas A&M College of Nursing, Disaster Day brings together students from Texas A&M College of Nursing, College of Medicine, School of Public Health, Irma Lerma Rangel College of Pharmacy, Veterinary Medicine & Biomedical Sciences and hundreds of community volunteers to simulate a catastrophic event resulting in multiple injuries of varying severity. It is up to student nurses, doctors and pharmacists to assess, prioritize and treat human patients in the midst of chaos, with minimal access to medicine and equipment.

For the first time since the event was established, veterinary students also participated in Disaster Day in 2017, because the health and safety of pets and animals are often integrally linked together with their owners. A 2008 survey conducted study by the American Humane Association reported that 47 percent of respondents would decline rescue assistance if they had to leave their pets behind. For that reason, many local, state and federal agencies are adding animal evacuation planning to their emergency management plans.

The Texas A&M Veterinary Emergency Team, the only state-level veterinary medical care provider in the State of Texas Emergency Response Plan was onsite, participating in the simulation. The team’s mission is, in part, to provide veterinary medical care of animals that are injured or that become ill as a result of a disaster.

Practice Makes Perfect

In its ninth year, 2017, Disaster Day was held on March 30 and involved a hurricane scenario. In the past, volunteers have also staged chemical fire, train derailment, explosion and wildfire scenarios with mass casualty simulations that bring interdisciplinary student teams together with community organizations to diagnose, treat and care for standardized patients (SPs).

All SPs receive training on how to convey information about the specific injuries and illnesses that they have been assigned, and make up is applied to create mock injuries so the cases seem more realistic. Students learn about working together on an interdisciplinary team, how to prioritize cases and how to treat patients under less than ideal conditions.

“The challenge of having so many moving pieces requires the entire health care team to communicate and work together,” said Erica Cashion, 2017 Disaster Day Incident Commander and senior nursing student. “The value of the experience comes with the interprofessional collaborations and having students think and work outside of their typical practice environments, and under extreme pressure.”

Scope of Practice

Coordinating Disaster Day is a huge undertaking, with almost 400 community volunteers working to ensure that 325 future Texas health care providers have an engaging learning experience throughout the simulation. Five student committees lay most of the groundwork for the annual event, coordinating fundraising, supplies, case studies, volunteers, public relations and moulage (the art of applying mock injuries for the purposes of teaching healthcare workers how to treat specific wounds). With almost 800 student and community participants, the College of Nursing’s Disaster Day is arguably the largest student-led disaster event in the nation.

While improving patient outcomes is a primary focus of the Disaster Day simulation, it may also help broaden the participants’ perspectives and lay a foundation for a faster and healthier community recovery.

“If it were possible for all health care students to participate in a large-scale disaster simulation, it would be wonderful,” said Nagsuk. “If not for the mass casualty response aspect, then at least for the experience of having many different disciplines coming together to accomplish a monumental task, and learning how each piece of the health care puzzle fits together to make the whole.”