For almost 50 years emergency medicine residents at UCSF Fresno have been training EMS providers by organizing and leading a Mass Casualty Incident (MCI) drill in an austere environment, like the Sequoia & Kings Canyon National Parks.
In mass casualty incidents, events that overwhelm or exceed emergency medical resources, particularly in harsh or remote wilderness environments such as national parks, park rangers, law enforcement and firefighters are the first to respond. These emergency medical service providers must be prepared to provide expert emergency lifesaving care.
The Mass Casualty Incident drill teaches how to respond in case of a large MCI with multiple patients and a wide range of injuries including fatalities.
“The goal is to have them practice this because the process of triaging and treating multiple patients and then extricating and transporting those patients needs to be practiced,” said Geoff Stroh, MD, Emergency Medicine faculty at UCSF Fresno, and Parkmedic Program Co-Faculty. “It happens rarely but it's the disaster response that they need to learn.”
This year, Joe Mueller, MD and Rory Brown, MD, second-year emergency medicine residents, organized the MCI drill with the help of Parkmedic faculty Dr. Stroh, Nicholas Black, MD, James McCue, MD; and Amelia Gurley, MD.
“I think this is honestly one of the best parts of our program and one of the main things that brought me here is being able to come out here and work with the rangers in the national parks specifically for patient care and helping them to improve their patient care,” said Dr. Mueller. “Unfortunately, these are things that can happen in our national parks and having a role in training the rangers to better respond to these incidents is just a really, really cool experience.”
In May, the UCSF Fresno drill instructors headed to the Sequoia & Kings Canyon National Parks to execute the MCI drill. Training day began with a lecture and hands-on skills practice. Volunteers were prepared with fake wounds and were taught the patient role they would play in each incident.
Once ready and in place, first responders and park rangers worked to rescue injured campers after a simulated treefall in a campground, caused by extreme weather conditions. The second simulated scenario was a vehicle crash with 16 victims, including fatalities. The rigorous training is meant to challenge first responders with their triage and treatment processes and to prepare them for a real incident.
“They are the ones providing the first medical response in the most austere conditions in our country and we have the incredible privilege in this residency program to teach each and every one of them,” said UCSF Fresno emergency medicine third- year resident Chelsea Meier Lima Nobre de Queiroz, MD.
Dr. Meier Lima Nobre de Queiroz and Dr. Mueller are both from Iowa and chose to do their residency at UCSF Fresno because of the opportunities they saw in the training program. They were excited about the exposure to wilderness medicine and the emergency medicine residency’s strong emphasis on clinical teaching and hands-on training at the only Level 1 trauma center and burn center for Central California.
Previously, Dr. Mueller rotated at UCSF Fresno as a medical student and said he really liked the resident camaraderie while working in the emergency department.
“There's a great community in our program and a lot of support among my co-residents that I find it's an awesome learning environment and an awesome place to provide patient care,” said Dr. Mueller. “The kind of caliber of training we get. It's a very busy ER down in Fresno, and we get great training through that.”
The Mass Casuality Incident Drill works hand-in-hand with the National Park Service where residents and park rangers alike benefit from the program.
By organizing the training, emergency medicine residents not only learn to teach EMS providers how to provide care after a disaster but also learn to coordinate a drill to prepare future emergency room doctors with EMS systems.
