Mock mass casualty event gives students ‘real-life’ experience

Brandon Casanova stood under a tent, set up in a large grass field behind Campbell University’s Smith Hall. He peered over that morning’s organized chaos, an unrelenting summer heat wave already in full swing. 

Things wouldn’t get any cooler. A train crashed and many were hurt, some severely. 

Screams in the sticky heat. Crash victims, some missing limbs, or bleeding profusely. Others unconscious. 

One woman, her face black with soot, struggled to breathe. 

Casanova was unfazed, seemingly oblivious to distraction. He stood still, calm. He quietly, yet clearly, talked with patients. At the same time he talked to students, relaying instructions — concisely, succinctly. 

Casanova, a retired sergeant first class in the Army’s elite Special Forces, took part in a mock mass casualty incident at Campbell on June 22. Casanova had just quit his job. This coming semester, he’ll begin the PA program at Campbell. 

“I like it so much, it’s what made me apply here,” Casanova said of the mass casualty incident. 

The train wreck wasn’t real — subterfuge and makeup — but organizers, participants and instructors acted as though it was.  

The annual event is held by the College of Pharmacy & Health Sciences and features first-year students in the Physician Assistant (PA) program. Some 120 people from the PA program and other university health sciences programs, including children and alums, played a role — whether patient, instructor, doctor or emergency worker. 

Special moulage pieces and trauma equipment were brought to campus, enhancing realism and teaching students to manage multiple patients while also allowing them to reiterate triage protocol and emergency treatment techniques. After field triage, patients were taken to a simulated medical facility, on the second floor of Smith Hall, to receive additional care.  

Casanova was one of several Instructors from the Joint Special Operations Medical Training Center who took part to share expertise. Other groups included the Buies Creek Fire Department and Harnett County Emergency Services.  

Kenneth Lorkiewicz is a training captain for Harnett County EMS. He became a paramedic in 1985 and has worked in the field since, including 15 years in Harnett County.  

Lorkiewicz, much like Casanova, stood with the students. 

Pointing toward patients — one after another — asking and listening. 

An unstable pelvic fracture. What do we do? Determine a patient’s needs and start treatment, he told them. IVs, fluids? 

He knows what real disasters, historic catastrophes, look like.  

Lorkiewicz was with an elite search-rescue team in the Danbury, Connecticut area. The team was activated into service after the second tower of the World Trade Center fell on Sept. 11, 2001. His team was in New York for about two weeks after the attack, he says. 

“I’ve seen everything,” he said. “I couldn’t tell you have the (stuff) I’ve done.”

Benjamin Britt, a first-year PA student this year, served as incident planner and commander. Britt met with students in Smith Hall just before the event. Dividing them into groups and delegating duties. 

“These patients are going to have complex problems,” he told them.  

The mass casualty incident, he said, gives students a chance to apply and practice medical decision-making in a high-stress environment, albeit a simulated one. 

Britt also took part in the event as a paramedic in Harnett County before entering the PA program at Campbell.  

“Our program is focused on community health, community involvement,” Britt said. “So, it would not be out of this ordinary … if a mass casualty event were to happen here in Harnett County, for providers from the hospital to be brought to something like this.” 

A primary mission of Campbell’s schools of health sciences and medicine includes serving the underserved, as well as bringing those services to people in rural communities who don’t have quick or easy access to a hospital or other health or medical services. 

It’s about exposing students to those aspects of medicine, said Britt, who is originally from Pinehurst and a Campbell undergrad. 

“The goal of this event,” he said, “is to create a realistic scenario that will challenge the knowledge and skills of the students in prioritizing and managing a variety of injuries and medical complaints.

“A lot of them, throughout this entire year, have learned bits and pieces of these skills, and now, today, is a chance for them to put it all together and figure out how it works with a real person,” Britt said. 

In Smith Hall, students worked with instructors. In one room, a student, using a dummy, worked furiously to restart a simulated heart. Across the hall, students worked with another simulation, using for the first time during the mock mass casualty incident a Glidescope — a instrument that’s connected to a video monitor — to intubate another figurative patient. 

Cumulatively, said Kathleen Jones, the event was an excellent learning experience. 

“I think the students have gotten a lot out of it,” said Jones, a nursing course director, instructor in the College of Pharmacy & Health Sciences. 

“I’ve chatted with them, and they said they were intimidated by this at first, but they appreciated the experience. This was their first time … walking in, so they don’t know what they don’t know yet. And now, this at least gives them a chance to kind of see, ‘This is what we do, this is how things work. …’” 

Said Ashley Nordan, assistant professor of Physician Assistant Practice and MCI faculty adviser, “Though only a portion of our students will likely go on to work in emergency medicine or similar fields, the principles learned, especially as it relates to interprofessional collaboration, can be applied in all areas of medicine.”