Disaster Simulation

Summary of Narrative Script of 8-minute Video Presentation

Disaster preparedness plans currently in effect in the new independent states, as reported by emergency professionals working there, are neither regionally-based nor coordinated. Nations are facing resource shortages in the post-Soviet era and have not organized along this principle. Disaster preparedness in the Republic of Armenia has not been considered a priority of the medical community there. The country’s lack of civilian preparedness came to light especially during the earthquake of 1988 as a coordinated rescue and medical effort was not put into place until volunteers from the United States and other countries arrived on-scene.

Faculty of Boston University Medical Center and University of Massachusetts Medical Center have worked with the Emergency Ambulance Service of Yerevan, Armenia to improve disaster planning for the city of Yerevan and for other areas throughout the Republic. The program was partially funded by the American International Health Alliance under cooperative agreement with the United States Agency for International Development during the initial period, and since has relied upon private donations.

A 100-hour basic and intermediate emergency medicine course for prehospital providers was created and taught to Armenian emergency professionals. The course stressed the fundamentals of splinting, packaging patients for transport, triage, and other elements of a rapid response that are normally practiced in the United States. One component of the program was a disaster management module that included a simulation of a mass casualty incident. Brief incident command training was provided to the participants of the training program. The drill consisted of a simulated explosion at a military school outside the city.

An objective of the drill was to see if the physicians, nurses, and drivers who staff the ambulances in Yerevan could work together as a cohesive patient care unit. The concept of patient care unit represents a change in the paradigm for delivery of prehospital care in Armenia. Until now, ambulance drivers have had no involvement in patient care responsibilities and nurses have had little. The training program stressed the fact that teamwork would provide better patient care and free physicians to provide leadership in patient care activities. Footage of the disaster drill, shot by a local TV station and broadcast during the evening news, is available on videocassette.