Charlton exercise keeps crews on their toes

As a crew steps around the dismantled wreckage of a vehicle, they are called to their next patient, a child who has drowned in a backyard pool nearby. Hours earlier the LifeFlight rescue helicopter roared overhead as they watched the Queensland Fire Emergency Service (QFES) pull a patient attempting to end their life from a gas-filled van, Matt Stirling writes.

Thankfully this isn’t the ultimate day from hell for the crew; it’s a massive training exercise the QAS Darling Downs Clinical Education Unit has organised to test teamwork and communication against a background of screeching metal, helicopter blades, and cries for help from bloodied actors.

In fact, it’s because these extreme cases occur so infrequently that the realistic scenarios were designed to practice procedures and inter-agency cooperation in a lower-pressure environment.

More than three months of planning culminated in early February when 150-plus personnel from QAS, QFES, Queensland Police Service, Lifeflight, State Emergency Service and Darling Downs Health descended upon the Charlton QFES facility, and the little township on Toowoomba’s outskirts suddenly became a hive of activity.

The various agencies were separated into smaller teams to rotate through four mock incidents harnessing the strengths of each emergency agency to achieve a successful outcome for the patients, whether they be a manikin or a moulaged volunteer. The scenarios they faced were:

1. Active armed offender experiencing an acute behavioural disturbance, including two patients with stab wounds, on the top floor of a complex.

2. Paediatric drowning in a backyard pool.

3. Two-vehicle high mechanism road traffic crash with three patients requiring extrication.

4. A patient in a vehicle with has poisoning.

QAS organiser Jess Megaw said the simulations were important to build relationships within the different clinical roles in the QAS teams as well as with other agencies.

“These are not the type of jobs we go to everyday; they are high acuity and low frequency incidents,” Jess said.

“When we hold trainings like this, it mitigates the chance of things going wrong in a real-life scenario and ensures we're working towards the best outcomes for patients.”

As a self-confessed ‘hands-on learner’, Jess said the hyper-realistic scenarios were the best way to prepare learners like herself.

“Once I’ve done it in a scenario setting, I’ll feel much calmer and better prepared when I do it in real life,” she said.

“This then makes the job run more smoothly and creates a better outcome for those patients.”

Jess said the lengthy planning for such a logistical exercise was vindicated by a large presence of paramedics who clearly focused on improving their clinical and professional skills.

This was exemplified by the learnings of three new Critical Care Program interns who took on a leadership role in each of scenarios.

As if to lash some further adversity upon the already unpredictable scenarios, a heavy downpour interrupted the final rotation of the day.

The storm may have contributed to a legitimate traffic crash on the highway next to the training ground.

As the exercise ran well into the evening, the participants were rewarded for conquering the scenarios by coming together to face the final challenge, a mass-casualty incident (MCI) that required an extensive effort to triage a bus full of patients, who were pretending to be either injured, deceased, and everything in between.

Overall, the organisers evaluated a number of key performance indicators to improve knowledge and skills for any MCI incident that may occur, including the organisation of defined roles within an MCI, the understanding of the initial information flow and the role of forward command, and the evaluation of triage and clinical management of patients.

Despite the logistics involved in running multiple scenarios with a large number of participants, the event ran smoothly, and Jess said she was impressed with the enthusiasm and professionalism on display.