From Theory to Practice: The Impact of In-Situ Full Scale Drills on Mass Casualty Incidence Preparedness among Emergency Medical Technicians and Emergency Department Staff in a Peripheral Hospital in Lebanon.

Introduction: The effective management of mass casualty incidents (MCIs) is essential for all emergency medical services (EMS) and emergency department staff, though training at peripheral or satellite hospitals is often insufficient. Globally, these hospitals often receive an influx of patients from MCIs, but do not have the resources available in the larger hospitals. This study used an in-situ drill and retrospective pre-post drill surveys to assess the impact of this type of drill on improving preparedness to handle MCIs in a peripheral Emergency Department in Lebanon. Methods: An in-situ full-scale drill was conducted in which EMS personnel triaged patients on-site and made transport decisions to a participating peripheral hospital. Hospital staff received the patients, triaged, and initiated proposed management. Retrospective pre-post surveys were distributed to 55 participants for self-assessment of knowledge and comfort with multiple competencies related to preparedness. Results: 34 surveys were filled out. Preliminary results indicate the drill significantly enhanced participants’ preparedness, with notable improvements in all areas. Statistical analysis of the data using a combination of statistical techniques is currently underway to confirm these findings. This will provide a comprehensive understanding of how effective the disaster drill was in improving preparedness and whether certain factors influence the outcomes. Conclusion: The findings underscore the critical role of in-situ full-scale drills in enhancing the preparedness of EMS and hospital staff for mass casualty scenarios, specifically in peripheral hospitals. Continuous training and the implementation of realistic simulations are recommended to address remaining gaps and ensure comprehensive readiness for future MCIs as these hospitals are likely to receive patients from an MCI. This study highlights the importance of including both EMS and peripheral hospitals in MCI preparedness and further development of MCI training programs focused in these settings.