Imagining something you’ve never seen isn’t easy. In real life, if you are told to save someone’s life by stopping an arterial bleed that you can’t see, it could be a catastrophe. Being familiar with various injuries and knowing what to do is a necessary preparation for first responders. When EMTs train on realistic looking victims, it helps when and if they encounter the real deal in the field.
“Moulage (French: casting/moulding) is the art of applying mock injuries for the purpose of training Emergency Response Teams and other medical and military personnel.” [Wikipedia]
Making a healthy individual into a (sometimes gross) battered and bleeding trauma victim look-alike calls for moulage, a morbid art using makeup to create realistic and challenging injuries. When an EMT trains during a disaster preparation drill, they are learning and reinforcing skills that can help minimize further injury and hopefully save lives. Seeing a gross, distracting injury can affect the responder’s ability to act effectively, so the more he/she knows what to expect, the easier it should be to treat a patient.
One EMT said that no matter how many times she used a traction splint in practice, the first time she actually saw a broken femur in the field was a shock.
Mock disaster drills are used to assess which skills are needed, which are in need of improvement and what works. Victims are best when they remain “in character” guarding, screaming, being confused and more. First responders often find themselves getting emotionally involved when the scenario is convincingly real, and that is good preparation for them should they ever find themselves dealing with the real-life equivalent.
Depending who is in charge of the moulage mock, injuries can be simple bloody spots or they can be more authentic looking and interactive, such as blisters that seep or “bones” that protrude. The use of interactive wounds and actors who remain in character playing out the symptoms with the appropriate groans, tears and screams, will give the training first responder an opportunity to make his own assessment and decisions regarding treatment, unlike being fed verbal cues from a proctor. When the EMT is allowed to use his own senses, it leads to better skill in the field.
Whether practice drills are all out simulations with moulage and actors, or simple classroom role playing, repeated practice will refine skills and make reaction time quicker. Hands on repetition helps to enforce textbook lessons. Even frequent assessments practiced on fellow students will force each EMT candidate to learn. Lectures have their benefits, but it is the active manual training that brings mere words to learned skills.
Instructors should involve students in active scenarios as well. One new EMT called his instructor after an EDP session to thank him for teaching him to remain aware of surroundings and potential threats; he said that the training saved him and fellow crew members on a recent call.
Each agency should plan disaster drills and other exercises based on local threats and hazards — if the area is rural, then drills might take into account the need for operational challenges like hiking trails and distances to hospitals; if the town borders a deep river, the agency members should be adept with water emergencies; and if a major heavily trafficked highway runs through the response area, responders should be aware of roadway hazards and trauma caused by MVAs.
Continued training is important in order to keep responders able to meet the area’s needs.