ECU Health emergency medicine residents took time away from their regular Wednesday morning classroom sessions and dove into an Emergency Medicine Wilderness Day exercise at Wildwood Park in Greenville.
On May 29, about 20 emergency medicine residents spent their morning in small groups, walking around the park and encountering “patients” with different ailments. From poisoning to animal attacks and drowning scenarios to firework accidents, the experience helped residents prepare for real-world scenarios and eventual board exams. Residents received real-time instruction and feedback from the Brody School of Medicine at East Carolina University faculty as they worked through their training.
The patients for this exercise were standardized patients from Brody’s Office of Clinical Skills Assessment and Education. Standardized patients are trained to mimic real patients so that students can learn. Their role is to help prepare future health care professionals for a variety of patient interfaces.
Dr. Sarah Thead is a second-year emergency medicine resident at ECU Health and said she’s attended the training the last two years and has benefited from the experience.
“It’s a great educational experience every time we do this,” Dr. Thead said. “It’s scenario-based and our faculty try to set up the scenarios similar to how they’ll be set up on our oral board exams, so it’s a fun experience but also really important from an educational perspective as well.”
She said the scenarios change from year to year which helps her and her co-residents as they try to work together and think quickly to help patients experiencing a medical emergency.
Dr. Jennifer M. Bennett, an emergency medicine physician at ECU Health, clinical assistant professor of emergency medicine and medical director of the Simulation Center at Brody, said this kind of exercise is important for a number of reasons.
“It’s a great opportunity to demonstrate how we can all work together, even outside of the emergency department. It’s important to work on these skills in a different environment,” Dr. Bennett said. “It’s also a good opportunity to have some team bonding for the residents. Just getting them out for a day and letting them do something a little bit different, getting them out in the sun, that’s a positive as well.”
Dr. Bennett said having Wildwood Park available to run this exercise has helped this program thrive over the last three years.
Along with Dr. Bennett, Dr. Jennifer Parker-Cote, assistant professor of emergency medicine at Brody, helped to create the simulation and organize the event.
In Dr. Parker-Cote’s simulation, residents had to assess a camper who had ingested a toxic mushroom in the woods. Residents assessed the standardized patient, asked about the patient’s medical history and made recommendations on next steps for care.
“These scenarios allow residents to apply the knowledge they’ve gained through their residency and apply it to real world situations and permits them to improvise in wilderness medicine, which you have to do a lot of times,” Dr. Parker-Cote said. “It’s important to put them through these simulations and have them think critically while working together and trying to move quickly to help our standardized patients.”
The training is another example of the valued partnership between ECU Health and Brody. Residents at an academic health system like ECU Health have support and resources for continued education from faculty and the Interprofessional Clinical Simulation Program at Brody, enriching their clinical training experience. Residents participate in trainings like this to prepare for real situations with real patients both behind the walls of the hospital and out in the community.
Resources
When Dr. Shannon Longshore, the medical director of the pediatric trauma program at ECU Health Medical Center, first joined the hospital, the James and Connie Maynard Children’s Hospital at ECU Health Medical Center wasn’t a verified pediatric trauma center. Now, Maynard Children’s Hospital is one of only four Level I Pediatric Trauma Centers in North Carolina and the only one serving the East.
“It is incredibly fulfilling to reflect on the growth we have experienced over the years, to now achieving verification as Level I Pediatric Trauma Center,” Dr. Longshore said. “Our teams across ECU Health have dedicated their work to constantly improving our care over the course of many years. From prevention, to treatment, and being entrusted to provide critical care at the highest level, this verification is a testament to the mission-driven work that defines our hospital and health system.”
The American College of Surgeons’ (ACS) Verification, Review and Consultation (VRC) Program is designed to assist hospitals in the evaluation and improvement of trauma care and provide objective, external review of institutional capability and performance, accomplished by an on-site review of the hospital by a peer review team experienced in the field of trauma care. There are three levels of ACS trauma center verification, with Level I being the highest verification a trauma center can achieve.
Level I Trauma Centers must be capable of providing system leadership and comprehensive trauma care for all injuries and have adequate depth of resources and personnel. These centers play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research.
Recognizing excellence in pediatric trauma care and community outreach
Dr. Longshore herself has been instrumental in Maynard Children’s Hospital’s continued growth as a trauma center through her research and presentations at national conferences and her work with the Eastern Carolina Injury Prevention Program (ECIPP).
The ACS surveyors noted the value of ECIPP, which aims to create a safer environment, change behavior and change policy to improve the quality of life in eastern North Carolina. Sue Anne Pilgreen currently serves as the executive director of the Safe Communities Coalition and the manager of ECIPP, which has been around since 1995. Between 2020 and 2023, ECIPP was awarded more than $1 million in grant funding, which has supported work in areas such as teen driver safety, suicide prevention, firearm safety, and child passenger and bike safety.
“The surveyors were especially impressed with our work around firearm safety and suicide prevention,” said Pilgreen. “We utilize the pediatric trauma registry data, and that is what drives our work.”
Pilgreen was quick to commend ECIPP team’s work in all areas to prevent injuries, and she highlighted that while most trauma programs have one injury prevention person, ECU Health has an entire team. That enables the program to reach out to rural communities and establish new injury prevention processes.
“Even with our incredible injury prevention team, we recognize that injuries will happen,” said Pilgreen. “To have this Level I Trauma Center with the best of the best gives the opportunities for the best outcomes.”
Other specific strengths noted during the pediatric program’s survey included the addition of two pediatric orthopedic surgeons and a pediatric neurosurgeon; outreach clinical simulations in the region; the collaboration among the pediatric orthopedic surgeon, the neurosurgeon and the Pediatric ICU (PICU); and the recent renovation of the PICU to establish a family-friendly place to care for patients. Of note, a large strength also lauded was the academic research and a collaboration with the Brody School of Medicine at East Carolina University’s Department of Pediatrics.
This expansion of the pediatric trauma research footprint was accomplished through more than 10 publications in nationally recognized journals. Both Erika Greene, manager of the pediatric trauma program, and Elizabeth Seawell, manager of the adult trauma program, credited the collaboration with Brody to produce research and get articles accepted to journals.
“That was a big win for us,” Greene said. “We have an academic medical center with the resources and processes in place to care for injured patients, and we’ve done an amazing job to achieve Level I for pediatrics. We have the capabilities to take the best care of those patients to the highest level of the accrediting body.”
Sustained excellence in adult trauma care
The pediatric trauma center’s new Level I verification accompanies the ECU Health Medical Center’s adult trauma center re-verification of Level I, a title they have proudly held for 40 years.
“We were one of the first Level I Trauma Centers in North Carolina, and we were verified by the American College of Surgeons in 2005,” said Seawell. “We are recognized nationally for how we care for patients in a rural area.”
This recent re-verification was made possible in part due to the resources available to the program including neurosurgical, interventional radiology, orthopedic trauma neurology, and vascular resources, operating room capabilities and blood access, as well as a trauma team of 11 surgeons.
“We are the only Level I Trauma Center for 29 counties, and to reach that far and care for that many patients – we served more than 4,000 patients last year – we have to rely on local community hospitals and emergency response teams to ensure timely transfers and communication,” said Seawell.
Seawell noted that ECU Health Medical Center and Maynard Children’s Hospital have a 60 percent transfer in rate, when the national average is 30 percent, which means they work closely with local EMS agencies, regional transfer facilities, other ECU Health organizations and non-affiliated organizations to serve patients from all over the region.
“The role of our trauma program is to not transfer patients but to have all the resources we need. It provides excellence in patient care and helps keep our patients local,” said Seawell.
Dr. Eric Toschlog, medical director of the adult trauma program, emphasized the tremendous preparation required to achieve Level I. He noted that there are more than 100 standards to prepare for, including paperwork, infrastructure, teamwork and more.
“The visit from ACS is a two-day adventure in stress and anxiety,” Dr. Toschlog said. But at the conclusion, he felt immense pride. “This visit was my seventh in 24 years at ECU Health, and it was clearly our best; we were found to have no deficiencies, and the reviewers used words such as ‘exemplary’ and ‘blown away’ regarding multiple aspects of the trauma center.”
Having two Level I Trauma Centers at ECU Health is no small thing, and both centers achieving the highest level of care is due to the dedication of the trauma center teams.
“I am surrounded by brilliant, compassionate, hardworking, mission-driven individuals who share a singular vision of saving the lives of the patients we have the honor to care for each year. Our success is owed to those truly extraordinary people,” Dr. Toschlog said.
Greenville, N.C. – James and Connie Maynard Children’s Hospital at ECU Health Medical Center received verification from the American College of Surgeons (ACS) Committee on Trauma as a Level I Pediatric Trauma Center, becoming one of only four in the state. Maynard Children’s Hospital now joins ECU Health Medical Center as the only Level I Trauma Centers in eastern North Carolina.
“We are proud of the dedication that all of our team members at Maynard Children’s Hospital have made to prioritizing the delivery of high-quality care close to home, and achieving Level I Trauma Center verification is a demonstration of that commitment,” said Tara Stroud, vice president, Women’s and Children’s Services, Maynard Children’s Hospital. “This verification aligns with our mission to improve the health and well-being of eastern North Carolina by ensuring patients receive prompt and specialized critical care, right here in our region.”
According to the ACS, Level I Trauma Centers must be capable of providing system leadership and comprehensive trauma care for all injuries. In its central role, a Level I Trauma Center must have adequate depth of resources and personnel. Most Level I Trauma Centers are university-based teaching hospitals due to the resources required for patient care, education and research. In addition to providing acute trauma care, these centers have an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research.
“Being a Level I Pediatric Trauma Center reaffirms our ability to provide timely, life-saving care for pediatric trauma patients,” said Dr. Shannon Longshore, pediatric trauma surgeon and medical director of the pediatric trauma unit, ECU Health Medical Center. “We see pediatric patients with injuries as the result of falls, motor vehicle collisions, ATV and dirt bike accidents and firearm injuries. The change from Level II to Level I demonstrates Maynard Children’s Hospital’s ability to maintain the highest level of care for patients and advance research publications, national presence as a trauma center and community outreach.”
In Fiscal Year 2023, ECU Health Medical Center cared for a total of 4,057 patients – 3,721 adult and 336 pediatric cases. Nearly 60 percent of patients at ECU Health Medical Center and Maynard Children’s Hospital are transferred in from other hospitals for a higher level of care; the national average is 30 percent.
ACS listed the following as major strengths of the Pediatric Trauma Program: The Eastern Carolina Injury Prevention Program, the outstanding commitment and quality of care provided by the adult trauma/acute care surgeons, availability of whole blood for pediatric trauma patients, three trauma bays, having at least two radiologist in-house 24/7 performing reads and available for consultation, neurosurgical and orthopedic support, disaster management planning and pediatric rehabilitation center.
Maynard Children’s Hospital was previously verified as a Level II Pediatric Trauma Center first in 2017. The verification lasts for three years, until February 2027. ECU Health Medical Center has been a Level I Trauma Center since 2005 and recently received re-verification in 2024.
“Maynard Children’s Hospital and ECU Health Medical Center serving as the sole Level I Trauma Centers in eastern North Carolina underscores the value of having a robust system of care with different levels of specialization, ensuring patients receive timely and appropriate treatment for all injuries, from pediatric to adult cases,” said Brian Floyd, chief operating officer, ECU Health. “Maynard Children’s Hospital’s recent verification as a Level I Pediatric Trauma Center reflects ECU Health’s commitment to clinical excellence and academic research, leading to tangible, life-saving benefits for the communities and patients we serve.”
ECU Health EastCare participated in the impactful Prom Promise initiative, engaging students at both Perquimans County High School and Richlands High School on April 23 and 24, respectively. The objective was clear: to dissuade teens from driving under the influence during prom season through vivid reenactments of motor vehicle accidents.
Before the re-enactment, students were presented with facts about the dangers of drinking and driving. According to Prom Promise’s founding organization The Prevention Network, one-third of all teen deaths occur in alcohol-related collisions between April and June, and nearly 41% of teens ages 16-19 are likely to drink or use drugs during or after prom.
Chuck Strickland, EastCare’s outreach coordinator at ECU Health, expressed the initiative’s goal of leaving a lasting impression on students, steering them away from driving under any form of impairment.
The events featured realistic depictions of crashed vehicles, complete with students portraying injuries resulting from the collisions. The students witnessed the arrival of first responders who initiated care and extricated individuals with the Jaws of Life, a tool used by emergency rescue personnel to assist in the extrication of victims involved in vehicle accidents. An EastCare helicopter landed on the scene as part of the demonstration, underscoring the importance of quick response required in such emergencies.
“I want to extend my heartfelt appreciation to our local first responders for their invaluable partnership and unwavering dedication in making our DWI reenactment crash demonstration a success,” said Steve Clarke, principal, Richlands High School. “Their professionalism, expertise and commitment to ensuring the safety and well-being of our students and community are truly commendable. We are grateful for their continued support and collaboration in our efforts to educate and empower our students to make responsible choices and prioritize safety at all times.”
Through collaborative efforts and a commitment to education, ECU Health and its partners aspire to instill responsible decision-making and prioritize safety among students – not only during prom season but throughout their lives.
The Eastern Healthcare Preparedness Coalition (EHPC) recently hosted a regional chemical and radiological tabletop exercise at the ECU Health Monroe Center with local and state partners, including those from hospitals, EMS, EastCare, public health, emergency management, hazmat teams from the Williamston Regional Response Team, and specialists from the 42nd Weapons of Mass Destruction Civil Support Team.
The tabletop exercise – intended to help ensure joint response coordination in response to a large-scale chemical or radiological event – included a brief training session followed by a plausible scenario that led to discussion of possible outcomes and discovery of gaps in preparedness planning.
Following the exercise, an after-action plan will be developed, followed by measures to ensure areas of opportunity are addressed.
The goal, according to event organizers, is to ensure all agencies are best prepared to serve the community.
“The tabletop was a fantastic opportunity to collaborate with partners and learn more about regional capabilities available to respond to a radiological incident,” said Christa Radford, Industrial Hygiene Consultant – Eastern Region at the North Carolina Department of Health and Human Services Public Health Preparedness and Response. “EHPC did a great job planning this exercise and bringing the correct response partners together for an extremely successful event.”
EHPC is a multidisciplinary team of medical and nonmedical professionals, established to provide mobile medical support for short and long term disasters or catastrophic events in eastern North Carolina. Roles in which the EHPC can provide support include set up and provision of a mobile field treatment facility, regional and state logistics support, and community alternate care site support.
As the leading health care provider in eastern North Carolina, ECU Health supports EHPC’s mission, in close partnership with other regional and statewide emergency response partners. These partnerships are essential to helping ensure communities across the East have access to high-quality resources and health care, particularly in the event of a disaster situation.
“I feel this exercise was crucial for our disaster preparedness and response,” said Nat Gladding, manager of Hospital Operations at ECU Health Beaufort Hospital. “It helped us assess our readiness, opportunities, and improve coordination between emergency response agencies. The exercise simulated a real-life scenario, allowing agencies the opportunity to practice their regional response to a disaster of this nature. Participation in disaster drills and exercises promote enhancement of our response for the communities of eastern North Carolina.”
In the years following the onset of the COVID-19 pandemic, health care as a whole has fundamentally changed — as have the lives, habits and health care needs of communities across the country.
Today, emergency departments (EDs) everywhere are seeing high volumes while staffing shortages persist. In rural areas with communities that are sicker than many others, these challenges are even more magnified.
“I’ve got patients who can’t see a doctor in the community mixed in with patients who have a pulmonary embolism,” said Dr. Leigh Patterson, chief of services for Emergency Medicine at ECU Health Medical Center and chair of Emergency Medicine at Brody School of Medicine at East Carolina University. “My team and I are trying to see the forest through the trees. Who’s the patient that needs the services? Everyone needs the services, but who’s the patient that medically needs the services next? And that’s hard.”
Meeting the challenge
At ECU Health Medical Center and throughout ECU Health system hospitals, leadership teams have needed to adapt quickly to meet the needs of the many patients seen through EDs.
Alex Baylis, ED nurse manager at ECU Health Medical Center, said she has been proud to see the department’s flexibility and persistence while helping patients through their time in the ED.
“We have flexed and bended, added and changed our spaces, we’ve changed our beds, we’ve changed our staffing patterns, we’ve changed our hours of when team members come in, when team members go home. We’re doing all that we know to do, and have the power to do, to get care to our patients faster and better,” Baylis said. “Right now, we’re facing really difficult barriers and obstacles within our space that are challenging, but we’re doing everything that we can and know to do to help our patients.”
Dr. Patterson echoed Baylis’ sentiment.
“We’ve tried, we are going to continue to try and it isn’t going to look the way it used to look,” Dr. Patterson said. “I think patients have been very understanding when we’ve had to do things in a different way. It is a really ugly reality right now, but we’re going to flex a lot. What I really want people to understand is what you see in the ED is actually all of the hospitals and all of health care right now.”
Matter of perspective
Dr. Patterson said she has seen a great deal of change in eastern North Carolina since she first came to the Brody School of Medicine and ECU Health Medical Center 17 years ago.
When she arrived at what is now ECU Health Medical Center, she became just the fifth female emergency medicine clinician. Today, she said, there are more females than that in the intern class alone.
“I am not the generation that was the first and only,” Dr. Patterson said. “I had other female residents who were with me. We were definitely the minority, but we’re not such a minority today.”
Dr. Patterson estimated there to be about a 50/50 male to female split among emergency medicine training program graduates across the country today and more women are holding education leadership positions.
However, that same shift has been slower to develop on the administrative leadership side.
“It takes some time to get all the way up the ranks so there are probably a dozen women chairs in academic medicine and emergency medicine and other positions like mine,” Dr. Patterson said. “But really, not a large number of us when you consider there are a couple hundred of our programs.”
From an outsider’s perspective, the number of female leaders in the ED may seem unique, but to those on the floor, it’s nothing to bat an eye at.
“We’re kind of past that – ‘Look, that’s so cool.’ Some days we’re still there,” Dr. Patterson said. “A lot of days it’s like, ‘Oh, yeah.’ I mean, I don’t think our nurses notice. We could go 24 hours in one area and it’s all women physicians and it’s just like that’s Tuesday. We don’t stop and notice that.”
Baylis noted that from the nursing perspective, more males in nursing tend to gravitate toward EDs and Intensive Care Units, but on the leadership side it is predominantly females.
Dr. Patterson reflected on the early part of her career and how conversations have shifted and become more normalized. Whether it’s the way patients address female providers or the interactions teams have with each other, she has seen positive change.
“I have men, physicians now who can have open discussions about, ‘Hey, how are you taking your FMLA leave when you have a baby? Are you splitting it, are you taking it at the end?’ The normalization of those conversations, that’s what comes from it,” Dr. Patterson said. “We’re not there all the way, we still have a long way to go. But it was not this normal in my first job.”
Providing compassionate care in trying times
As the care needs in EDs have changed, Baylis and Dr. Patterson noted how crucial it is to connect with patients on a human level and provide high-quality, compassionate care in stressful situations.
Baylis said the mindset of nurses in the ED has changed drastically in the past few years.
“In emergency nursing, you had to have tough skin and be almost hard,” Baylis said. “I think it’s changed with the population that we’re seeing in our patients, but also the care that we’re giving. We’ve learned to be more soft and more caring and taking that time to make a connection. We can be nice while still setting boundaries with our patients.”
Dr. Patterson said providing care in eastern North Carolina is a very unique situation. She shared that she trained at a county hospital in New Orleans and that in large, urban environments, it’s less common that she or her family members would be patients at the same hospital at which she practices.
Here, there is no line.
“So much of what I saw when I was in my own training, in my mind, I could pretend it wasn’t going to happen to me and you get this lovely distance that you don’t have here. And that’s good for you but, wow, some days it’s really hard,” Dr. Patterson said. “This is the same hospital you go to, right? I had my baby here. My husband has been a patient in our ED. My dad has been admitted here. I think this place is really challenging for that because it’s your community, you know, there’s no separation here.”
Baylis and Dr. Patterson said while that challenge exists, they are proud to serve in the same community they call home. What’s not lost on either of them: that solutions they are working to find in support of the communities they serve also directly impact their own family and friends — and light the path for ED teams to follow.
Resources
Frostbite isn’t the only concern with the frigid temperatures expected in eastern North Carolina this weekend.
“You can’t smell it. You can’t see it. You can’t taste it,” said ECU Health Chief for the Division of Medical Toxicology Dr. Jason Hack
Dr. Hack said carbon monoxide poisoning can sicken people when their furnaces malfunction or they use other means to heat their homes.
He said that includes, “HVAC, our heaters in our home. Portable heaters, propane portable heaters that some people might bring in, or if they lose their electricity because of an ice storm or something along those lines, they might want to bring in a generator out of the storm or close to the home.”
Dr. Hack also said people should never sit in a running car to escape the cold if the heat is out at their home.
“Some people would tend to sit in their car and turn on turn on their vehicle while it’s still in their attached garage,” he said, “Even with the door open, these can be sources of enough carbon monoxide to injure or even, unfortunately, kill people within the home itself.”
It’s not a good idea, but a dangerous one, to use the gas stove in your kitchen to warm up the house. Dr. Hack said, “It could be producing low levels of carbon monoxide that might accumulate.”
And the symptoms of carbon monoxide poisoning can be non-specific.
“It can look like a lot of other things,” he said, “Such as weakness or dizziness. Some people complain of some shortness of breath. Headache is one of the most common presenting symptoms of carbon monoxide. Confusion. Some people actually complain of chest pain or palpitations and fainting.”
Dr. Hack said the best defense is a working carbon monoxide detector in every bedroom and living space in the house; he recommends that people to make sure the batteries are fresh and they’re working properly before the cold air arrives this weekend.
According to the National Institutes of Health, about 1,200 people die in the U.S. from accidental CO poisoning annually and more than 100,000 people visit the emergency department each year.
Students from the Brody School of Medicine, ECU College of Nursing, and Department of Physician Assistant Studies participated in the Interprofessional Triage and Emergency Assessment and Management (ITEAM) Day mass casualty training event hosted by the Brody School of Medicine’s Emergency Medicine Interest Group Saturday, Oct. 14. The training provides a unique opportunity for students from different health care disciplines to collaborate and gain hands-on experience in managing emergency events.
Experts from the ECU College of Nursing, Brody School of Medicine, Department of Physician Assistant Studies and ECU Health EastCare gave students interactive instruction in procedural skills, such as basic airway management, hemorrhage control and triage techniques. Students then applied these skills during a mass casualty simulation at the Interprofessional Clinical Simulation Center at the Brody School of Medicine.
“ITEAM Day was beneficial to promote collaboration and interprofessionalism among different health care providers,” said Stephiya Sabu, first year Brody School of Medicine student. “Doing this in the setting of a mass casualty event was important as they can be very stressful, and having this experience beforehand will help in the future if we are ever in that situation.”
This year’s simulation was a mass shooting incident. The Office of Clinical Skills Assessment and Education provided simulated patients, portraying symptoms and behaviors consistent with injuries sustained in a mass shooting, including confusion and panic.
Adding an extra layer of realism to the exercise, the ECU School of Theatre and Dance lent its expertise in moulage and makeup to create lifelike wounds on the simulated patients. The ECU Student Government Association provided funding for food and materials.
Students participating in the simulation were coached by a multi-disciplinary team of experts who provided feedback throughout the training. Chuck Strickland, outreach coordinator with EastCare, served as an instructor and provided invaluable insights into the role Emergency Medical Services (EMS) plays in a mass casualty incident. Students were educated on EMS’s initial response, patient management and treatment strategies.
“It is important for students to know the role EMS plays in initial patient triage and how we would request resources and determine patient destinations,” said Strickland. “EMS identifies the volume of patients and their acuity levels, then gets nurses, physicians and physician assistants to do on-scene care for high acuity patients. Students also learned the role of critical care transport and how those professionals would be engaged.”
Nursing students, medical students and physician assistant students shared their respective expertise while working together to promptly triage and treat patients. Both students and instructors underscored the significance of applying classroom learning to simulated real-life scenarios, highlighting the practical value of such experiences.
“Recent events in our community emphasize the unpredictability of mass casualties and just how terrifying they are,” said Lachlan Younce, first year Brody School of Medicine student. “As a medical student, I seek to understand my role as a medical professional in those situations. Participating in this mass casualty exercise exposed me to vital skills like patient triage, resource-efficient care and the importance of teamwork when working alongside my health care colleagues, including PAs and nurses. I am thankful for how this ITEAM training experience helped me develop my readiness as a medical professional.”
Doctors, nurses and support teams in the ECU Health Medical Center emergency department understand the importance of being prepared for any scenario. That is why the Medical Center ED and Trauma Department teams took part in a mass casualty disaster drill Sept. 7 in an effort to test and improve knowledge of triaging, EPIC documentation, response roles and more as part of the American College of Surgeons accreditation process.
“The more prepared we are now, the more lives we can save,” said exercise director Dr. David Trisler, critical care surgeon at ECU Health Medical Center and clinical assistant professor of trauma and surgical critical care at the Brody School of Medicine at East Carolina University. “Our community depends on us to be there for them during the most difficult circumstances. These types of exercises ensure we will be able to meet that need.”
Mass casualty situations can be difficult to imagine, especially ones that happen here in our local community.
With the use of inflatable mannequins representing the both children and adult patients, the disaster drill consisted of 30-40 casualties brought to the ED following a simulated mass shooting at a local event. Drill participants worked through triaging the patients based on their medical status and moving them through the emergency care and surgical process, using real-time information like numbers of ORs and beds in use during the time of the drill.
For Dr. Eric Toschlog, chief of trauma and acute care surgery for ECU Health Medical Center and Brody and the rest of the emergency department team, preparing for those situations comes with the territory of working at the only Level I Trauma Center in eastern North Carolina.
“The ECU Health Medical Center emergency department serves as a hub for 1.4 million people who live across the region, which highlights the importance of being prepared for any circumstance imaginable,” said Dr. Toschlog. “The more we work to improve our process and understanding, the better prepared we will be to save lives.”
Those involved met immediately following the drill to debrief on the exercise, closely examining strengths and weakness, as well as plans for improvements, all in an effort to ensure the Medical Center emergency department team is well-positioned to provide high-quality care to the community during a time of dire need. The common thread throughout the event and debrief was the direct correlation between preparation and lives that could be saved.
“This was a great opportunity for us to test our knowledge and we certainly learned a lot of valuable lessons that will serve us well,” said Dr. Trisler. “I could not be more proud of the entire ED team for taking the time to participate in this disaster drill.”
Wildwood Park in Greenville served as the perfect setting for “Emergency Medicine Wilderness Day” as ECU Health emergency medicine residents practiced assessing and treating a variety of common outdoor ailments including altitude sickness, lightning strikes, falls from trees and more.
On March 29, approximately 20 emergency medicine residents attended training and worked in small groups to run through simulated injury scenarios with real people. From knowing how to stabilize an injured person, to assessing injuries and helping get them to safety, emergency residents worked together to treat the injuries under the watchful eye of experienced faculty members from the Brody School of Medicine at East Carolina University. Residents received real-time instruction and feedback from faculty as they worked through their training.
Standardized patients from Brody’s Office of Clinical Skills Assessment and Education acted as the patients in each scenario. Standardized patients are trained to mimic real patients so that students can learn. Their role is to help prepare future health care professionals for a variety of patient interfaces.
“There are a number of practical applications for this type of training, especially for our medical residents who get to test their knowledge in the field,” said Dr. Jennifer Bennett, an emergency medicine physician at ECU Health and clinical assistant professor of emergency medicine at Brody. “These scenarios are the types of things that we, as emergency medicine physicians, address somewhat commonly. We can apply the knowledge and skills learned out here to patient care.”
The day was a success, according to Dr. Bennett, who helped create the simulation Emergency Medicine Wilderness Day training event last year alongside Dr. Jennifer Parker-Cote, assistant professor of emergency medicine at Brody. Both doctors helped organize the Wilderness Day, coming up with unique patient scenarios, including the altitude sickness training station which featured a standardized patient acting as a distressed hiker. The residents removed a fake snake from the area, asked the patient questions about their medications and medical history, moved the patient to a lower area and helped get them to further medical care.
“It’s always nice to get outdoors instead of sitting in a lecture hall,” said emergency medicine resident Tyler Ruchti, DO. “When you’re in the hospital, you have all of your tools and all of your equipment and know where it is, and when we come out here and do things like this it’s a change of scenery. You have to think outside the box.”
The training is another example of the valued partnership between ECU Health and Brody. Residents at an academic health system like ECU Health have support and resources for continued education from faculty and the Interprofessional Clinical Simulation Program at Brody, enriching their clinical training experience. Residents are able to participate in trainings like this to prepare for real situations with real patients both behind the walls of the hospital and out in the community.
“This training was partially about simulating complex medical issues that you may encounter in the wilderness as well as providing a little wellness for our residents,” said Dr. Parker-Cote. “This is a fun way to test knowledge and work together as a team. When it comes to education, there are different modalities for teaching. Learning in this type of environment provides us another way of reinforcing the knowledge they have learned throughout their residency, and it prepares them to help their fellow community members no matter the situation.”
Resources
