457 The Tabletop Exercise: A Useful Strategy for Practicing Your Institution’s Burn Mass Casualty Response Plan
Bibliographic record
Abstract
Burn centers must prepare for mass casualty events. The purpose of this investigation is to report a table-top mock mass casualty exercise (TTE) in our regional adult ABA-verified burn center conducted in conjunction with our entire hospital institution. The exercise involved 175 participants from 25 hospital departments and personnel from our regional critical care referral, air MedEvac, and paramedic services. A pre-exercise drill on April 7th at 2100h collected data that mimicked occupancy and resources from a typical weekend night, to be used in the actual TTE on May 3, 2018. The TTE took place in a large auditorium where each service had its own table and personnel. All communication and actions were represented using the resources available from the preliminary exercise, (e.g. available staff, open and occupied beds, ventilators, available operating rooms), on “game boards” and using “game pieces” at each table, to simulate what would occur in a real event. Every 3 minutes we paused to evaluate the current situation and priorities. The TTE lasted 105 minutes. The scenario was an explosion at a theatre 3 miles from the hospital. Initially 200-300 potential casualties were reported. The first casualties arrived within 25 minutes and a total of 60 casualties (40 ambulatory, 20 by ambulance) arrived over the ensuing 30 minutes, of which 25 were Canadian Triage Acuity Scale level 1 & 2. Five patients, all intubated, had burns: 2 with burns > 30% TBSA, 2 with burns < 30% TBSA but with associated penetrating and orthopedic trauma, and one with trivial burns and smoke inhalation. All could be placed in the burn center after clearing beds by discharging or transferring to the ward or hallway five existing burn in-patients. Two patients intubated for smoke inhalation but without burns went to the ICU. Coordination between the burn centre, ICU, OR, and blood bank was good. Ventilators were available for all patients. The blood bank had sufficient 5% albumin in stock. Important deficiencies were: 1) Fan out lists were insufficient to contact all burn team staff 2) Absence of a stock of burn supplies solely reserved for the arrival of approximately 5 intubated burn patients (e.g. fluids, dressing, vascular access kits) 3) Inefficient coordination with infection control/prevention/housekeeping for rapid cleaning of freshly cleared burn rooms for incoming wounded, and 4) Insufficient evening/weekend social services coverage to support the influx of family members and friends of the injured. A tabletop exercise provided a comprehensive analysis of our burn center’s preparedness AND unpreparedness for a mass casualty incident. The TTE is a useful approach to help an institution improve readiness for mass casualty incidents.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".