[MOBILE TRAUMA SIMULATION IN AN EMERGENCY DEPARTMENT OF A RURAL HOSPITAL IN A CONFLICT AREA IN ISRAEL].

BACKGROUND: In recent years the city of Eilat has come under threat of rocket attacks. This emphasized the need for an upgrade of the city's medical center capabilities in trauma care. Medical simulation has been used for many years in training and for the improvement of trauma care both at the field Level and in hospitals. Although there was significant improvement in the technological aspects of simulations, the use of simulators was restricted mainly to simulation centers and its effectiveness in training and assessment of trauma teams in situ in emergency departments was still not examined.

OBJECTIVES: To train the personnel engaged in trauma care in a small rural medical center in the fastest and most comprehensive manner, using a mobile and highly sophisticated medical simulator.

METHODS: A team of simulation specialists from MSR, Israel Center for Medical Simulation, held a one week long course including all the staff members involved in trauma care, 38 doctors and nurses in total. All drills were recorded and then reviewed in the debriefing. Four staff members were trained in video debriefing at MSR. The participants were requested to complete questionnaires before and after training.

RESULTS: Subjective feelings of competence in the team's ability to treat trauma patients were found to improve after training. Airway management rating of very good improved from 21.05% prior to training to 50% after the course. Chest trauma management and hemorrhage control scores of very good rose from 10.53% and 26.32% before to 42.11% and 55.26% respectively after the course. The highest improvement was measured in teamwork performance, which was ranked as very good: 10.53% before training and elevated to 47.37% after training. A total of 74% of the responders stated that this training program contributed very significantly to their trauma care capabilities.

CONCLUSIONS: The use of mobile medical simulations combined with instructors from within the hospital enabled the training and assessment of the trauma care in situ and in a short time.