Tabletop exercise
Operational
The purpose of this exercise is to expose participants to ethical and conflicting decisions frequently encountered during EMT deployments. Emergency operations are marked by an imbalance between the huge needs and the scarcity of resources available. This lack of resources can sometimes have fatal consequences for patients that in normal conditions will survive. This imbalance means a high burden for EMT staff who has to take decisions in this difficult circumstances and face its consequences. While caring for their patients, EMT members also have to inform and support patients’ family and relatives, who are also going through a stressful situation.
During this exercise the EMT members will be confronted with patients in very critical conditions and a set of resources to treat these patients. The team will have to decide how to allocate the available resources in order to save the highest number of patients. A role player will also intervene during the exercise, taking the role of a father whose child is admitted within the EMT facility in a critical state. The team members will have to deal with the father while rapidly decide on the treatment to the critical patients, whose state will change and worsen as the exercise advances.
See the complete table with learning objectives in the annex « Exercise 3 - Learning Objectives ».
| Approximate time required | Task | Instructions for delivery |
|---|---|---|
| 5 min | Exercise briefing |
Delivered out of role. The trainers will explain the scenario in which the exercise is set, to allow participants to get immersed in the role and follow instructions.
Simulated setting: 10 am, 2 days after deployment. The team is working at the EMT facility in Montyland |
| 5 min | Split in groups | The training manager will ask the team to divide in groups of 5-7 people (each group should include different EMT profiles). It must be clarified that each group will perform the same exercise, so the groups are not supposed to interact with each other. |
| 10 min | Resource familiarization |
Once every group is located in a different space, the trainers will hand over the cards with the available resources.
Add inject 1: Each group will receive the set of cards with resources and start to familiarise with the resources they have in their EMT before patients arrive. |
| 10 min | First 3 patients arrive |
Add inject 2: Each group will receive the cards of the first 3 patients, who arrive at the same time in the facility, and start working together to decide how to treat them.
Trainers will leave each group to discuss about what to do with the patients. |
| 10 min | Father arrives |
Add inject 3: The father of the child being treated by the team arrives at the EMT facility, showing a very anxious and threatening behaviour and asking to see his son immediately. He claims his son is being treated without his consent.
Each group will have to deal with this situation while treating the patients |
| 15 min | Next 2 patients arrive |
Add inject 4: Each group will receive the cards of the next 2 patients, who arrive at the same time in the facility. The team will need to manage the situation with the father and the new patients.
Trainers will leave each group to discuss about what to do with the patients. |
| 15 min | Worsening conditions |
Add inject 5: Each group will receive information about the changes in one of the patients conditions, which are worsening and will lead to a cardiac arrest.
The team will have 15 more minutes for discussion. |
| 30 min | Exercise debriefing | Delivered out of role. Refer to the annex « Exercise Debriefing » |
| Total time (approx.): 2h | ||
| Inject number | When? | To whom? | Inject summary |
|---|---|---|---|
| 1 | Once the team has splitted in groups | To each group | Resources available |
| 2 | 10 min after inject 1 | To each group | First 3 patients arrive |
| 3 | 10 min after inject 2 | To each group | Father arrive |
| 4 | 10 min after inject 3 | To each group | Next 2 patients arrive |
| 5 | 15 min after inject 4 | To each group | Worsening of patient conditions |
See the detailed description of the injects in the annex « Exercise 3 - Injects ».
Before starting the exercise make sure:
Trainers and facilitators have carefully read the exercise objectives and description
There is a medical doctor within the trainers/facilitator team who can follow the exercise and adapt patient conditions according to the decisions made by the team
There is an appropriate space for the groups to separate and work independently
All the needed materials (see Resources section) are available