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Pa. college students gain valuable experience in mass casualty simulation

Pennsylvania College of Health Sciences students faced a truck crashing into the chemistry lab and exploding

By Lucy Albright

LANCASTER, Pa. — In the simulated hospital at Pennsylvania College of Health Sciences, a team of medical students hover over their patient, a lifelike plastic manikin.

Nursing student Stephanie Zdrojewski is operating a bag valve mask, pumping air into the manikin’s lungs, while other nursing students grab medication from a cart at the request of faculty member Alex Borzok. As nurse practitioner in the scenario, Borzok intubates the patient, then two sonography students wheel in an ultrasound machine.

In the simulated mass casualty incident held Thursday on the college’s East Lampeter Township campus, a truck has just crashed into a chemistry lab, causing an explosion that injures 13 and leaves one person dead.

Going into the scenario, the students — who are from the college and Lancaster EMS’s training academy — didn’t know those details. Only that they’d have to work together to help their patients.

Paramedic and EMT students flocked to the scene, checking vitals and putting patients in neck braces. Four patients in gurneys were taken upstairs to the college’s simulated hospital. The others were bussed over to Lancaster General Hospital in downtown Lancaster, for a simulation exercise happening there.

Though no one was actually dying in the college’s simulated emergency room, 44-year-old Zdrojewski was feeling the magnitude of the situation. As she operated the bag valve mask, she tried to focus on keeping the patient’s breaths at the correct rate.

“And then when people would ask other things, I’m like, ‘OK, I need to walk and chew gum at the same time,’” the Little Britain Township resident said.

According to Kristen Zulkosky, director of the Center for Excellence at the college, Thursday was the college’s first time doing a disaster simulation of this size. The project is a collaboration among the college, Penn Medicine Lancaster General Health and the Lancaster County Coroner’s Office.

The simulation provides a chance for students of different disciplines to work together and learn about each other, something Zulkosky said isn’t always available in a classroom setting. Simulations also let medical students think on their toes and make decisions, Zulkosky said.

In an interview a couple days before the simulation, Zulkosky stressed the importance of realism — achieved through scripts, bruise makeup and the college’s mock emergency room. The simulation also featured a team from the county coroner’s office, which identified and removed the dead victim.

“We need to make sure that our participants — who are our students — suspend their disbelief,” Zulkosky said.

Though the pressure was on, no one actually died. And no one got a bad grade.

“One thing that we want students to understand is that it’s a safe learning environment, so they can make mistakes and it won’t harm a patient,” Zulkosky said.

Instead of being graded on their performance, students are encouraged to learn from their errors — and to do better next time. One common takeaway, Zulkosky said, is the importance of communication.

The exercise had some bumps along the way.

Richard Pearson, director of education for Lancaster EMS, said that they had to slow down the simulation to decrease the flow of patients to the college’s mock ER. Pearson and another instructor joined the exercise as EMT assistants, he said, something they hadn’t originally planned to do.

“They’re students, they’re not going to know what to do,” Pearson said. “So you kind of have to be prepared to stop and say, ‘OK, let’s learn.’”

Zdrojewski, who wants to work in an emergency department after graduation, said this experience gave her a taste of what that would be like.

“It was very chaotic but I think it was a great learning experience,” she said.

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