Prehospital Medical Research Articles

Assessing the Effectiveness of Automatic Speech Recognition Technology in Emergency Medicine Settings: A Comparative Study of Four AI-powered Engines.

Cutting-edge automatic speech recognition (ASR) technology holds significant promise in transcribing and recognizing medical information during patient encounters, thereby enabling automatic and real-time clinical documentation, which could significantly alleviate care clinicians' burdens. Nevertheless, the performance of current-generation ASR technology in analyzing conversations in noisy and dynamic medical settings, such as prehospital or Emergency Medical Services (EMS), lacks sufficient validation. This study explores the current technological limitations and future potential of deploying ASR technology for clinical documentation in fastpaced and noisy medical settings such as EMS. In this study, we evaluated four ASR engines, including Google Speech-to-Text Clinical Conversation, OpenAI Speech-to-Text, Amazon Transcribe Medical, and Azure Speech-to-Text engine. The empirical data used for evaluation were 40 EMS simulation recordings. The transcribed texts were analyzed for accuracy against 23 Electronic Health Records (EHR) categories of EMS. The common types of errors in transcription were also analyzed. Among all four ASR engines, Google Speech-to-Text Clinical Conversation performed the best. Among all EHR categories, better performance was observed in categories "mental state" (F1 = 1.0), "allergies" (F1 = 0.917), "past medical history" (F1 = 0.804), "electrolytes" (F1 = 1.0), and "blood glucose level" (F1 = 0.813). However, all four ASR engines demonstrated low performance in transcribing certain critical categories, such as "treatment" (F1 = 0.650) and "medication" (F1 = 0.577). Current ASR solutions fall short in fully automating the clinical documentation in EMS setting. Our findings highlight the need for further improvement and development of automated clinical documentation technology to improve recognition accuracy in time-critical and dynamic medical settings.

Who Says You can't go FAST at Night? Use of a Novel Ultrasound-Capable Night Vision Device for Prehospital Medical Personnel to Identify Noncompressible Truncal Hemorrhage.

Early detection of abdominal hemorrhage via ultrasound has life-saving implications for military and civilian trauma. However, strict adherence to light discipline may prohibit the use of ultrasound devices in the deployed setting. Additionally, current night vision devices remain noncompatible with ultrasound technology. This study sought to assess an innovative night vision device with ultrasound capable picture-in-picture display via a intraabdominal hemorrhage model to identify noncompressible truncal hemorrhage in blackout conditions. 8 post mortem fetal porcine specimens were used and divided into 2 groups: intrabdominal hemorrhage (n = 4) vs no hemorrhage (n = 4). Intrabdominal hemorrhage was modeled via direct injection of 200mL of normal saline into the peritoneal cavity. Under blackout conditions, 5 participants performed a focused assessment with sonography for trauma (FAST) exam on each model using the prototype ultrasound-capable night vision device. Of the 40 FAST exams performed, 95% (N = 38) resulted in the correct identification of intraabdominal hemorrhage. Of the incorrectly identified exams, both were false positives resulting in a 100% sensitivity, 90% specificity, 91% positive predictive value, and a 100% negative predictive value. All participants noted the novel device was easy to use and provided superior visualization for performing FAST exams under blackout conditions. The ultrasound-enabled night vision prototype demonstrated promising results in identifying noncompressible truncal hemorrhage while maintaining strict light discipline in blackout conditions. Further research efforts should be directed at assessing the ability of providers to perform procedures in blackout conditions using the ultrasound-enabled prototype night vision device.

Triage Prehospital EMS and Medical Care

Triage Prehospital EMS and Medical Care

Secondary Ambulance Transfers During the Mass-Casualty Terrorist Attack in Israel on October 7, 2023.

On October 7, 2023, Israel experienced the worst terror attack in its history - 1,200 people were killed, 239 people were taken hostage, and 1,455 people were wounded. This mass-casualty event (MCE) was more specifically a mega terrorist attack. Due to the overwhelming number of victims who arrived at the two closest hospitals, it became necessary to implement secondary transfers to centers in other areas of the country. Historically, secondary transfer has been implemented in MCEs but usually for the transfer of critical patients from a Level 2 or Level 3 Trauma Center to a Level 1 Center. Magen David Adom (MDA), Israel's National Emergency Pre-Hospital Medical Organization, is designated by the Health Ministry as the incident command at any MCE. On October 7, in addition to the primary transport of victims by ambulance to hospitals throughout Israel, they secondarily transported patients from the two closest hospitals - the Soroka Medical Center (SMC; Level 1 Trauma Center) in Beersheba and the Barzilai Medical Center (BMC; Level 2 Trauma Center) in Ashkelon. Secondary transport began five hours after the event started and continued for approximately 12 hours. During this time, the terrorist infiltration was still on-going. Soroka received 650 victims and secondarily transferred 26, including five in Advanced Life Support (ALS) ambulances. Barzilai received 372 and secondarily transferred 38. These coordinated secondary transfers helped relieve the overwhelmed primary hospitals and are an essential component of any MCE strategy.

Validation of Air Medical Prehospital Triage Score in Determining Resource Utilization at Level 1 Trauma Centers

ObjectiveOvertriage (ie, delivering less severely injured patients via helicopter) is costly, raises safety concerns, and reduces efficiency of the trauma system. The Air Medical Prehospital Triage (AMPT) scoring system was developed to determine which trauma patients would gain a survival benefit by air transport. The objective of this study was to evaluate the AMPT scoring system as a method of reducing trauma overtriage when helicopter emergency medical services were used. MethodsA retrospective study of all scene trauma transports delivered by helicopter to 1 of 2 level 1 trauma centers was evaluated for 1) hospital stay less than 1 day and 2) failure to meet 1 of the following criteria for resource utilization: intensive care unit admission, an operative procedure within the first 24 hours, the need for blood products, Injury Severity Score ≥ 16, or death during hospitalization. Helicopter emergency medical services personnel recorded specific criteria from the Centers for Disease Control and Prevention (CDC) field trauma triage guidelines and AMPT that were met by transported trauma patients. ResultsThere were 244 patients in the study population. Eighty-one (33.2%) patients were discharged within 24 hours; 11 (13.5%) of these patients were positive using AMPT scoring, whereas 44 (54.3%) patients met 1 of the CDC criteria. Similarly, 141 (57.8%) patients failed to meet 1 of the level 1 resource criteria; 19 (13.5%) met the AMPT criteria for air medical transport, whereas 84 (59.6%) met 1 of the CDC criteria. Undertriage was 63.5% for AMPT and 20.2% for CDC based on resource utilization criteria. ConclusionThe AMPT score reduced the number of patients who were inappropriately transported to a trauma center. However, this appeared to be at the expense of undertriage. Future studies should focus on developing a refined air medical–specific triage tool that has both low overtriage rates as well as lower undertriage rates.

Dangerous Deception: Hoax Improvised Explosive Devices and their Impact on Prehospital Medical Care During Terrorist Attacks.

Dangerous Deception: Hoax Improvised Explosive Devices and their Impact on Prehospital Medical Care During Terrorist Attacks.

A qualitative assessment of stakeholder perspectives on barriers and facilitators to emergency care delays in Northern Tanzania through the Three Delays.

Emergency conditions cause a significant burden of death and disability, particularly in developing countries. Prehospital and Emergency Medical Services (EMS) are largely nonexistent throughout Tanzania and little is known about the community's barriers to accessing emergency care. The objective of this study was to better understand local community stakeholder perspectives on barriers, facilitators, and potential solutions surrounding emergency care in the Kilimanjaro region through the Three Delays Model framework. A qualitative assessment of local stakeholders was conducted through semi-structured focus group discussions (FGDs) from February to June 2021 with five separate groups: hospital administrators, emergency hospital workers, police personnel, fire brigade personnel, and community health workers. FGDs were conducted in Kiswahili, audio recorded, and translated to English verbatim. Two research analysts separately coded the first two FGDs using both inductive and deductive thematic analysis. A final codebook was then created to analyze the remaining FGDs. A total of 24 participants were interviewed. Thematic analysis revealed that participants identified significant barriers within the Three Delays Model as well as identified an additional delay centered on community members and first aid provision. Perceived delays in the decision to seek care, the first delay, were financial constraints and the lack of community education on emergency conditions. Limited infrastructure and reduced transportation access were thought to contribute to the second delay. Potential barriers to receiving timely appropriate care, the third delay, included upfront payments required by hospitals and emergency department intake delays. Suggested solutions focused on increasing education and improving communication and infrastructure. The findings outline barriers to accessing emergency care from a stakeholder perspective. These themes can support recommendations for further strengthening of the prehospital and emergency care system. Due to logistical constraints, emergency care workers interviewed were all from one hospital and patients were not included.

A nomogram-based clinical tool for acute ischemic stroke screening in prehospital setting.

Background: We believe that designing a new tool which is comparable in terms of both sensitivity and specificity may play an important role in rapid and more accurate diagnosis of acute ischemic stroke (AIS) in prehospital stage. Therefore, we intended to develop a new clinical tool for the diagnosis of AIS in the prehospital stage. Methods: This was a cross-sectional diagnostic accuracy study. All patients transferred to the emergency department (ED) who underwent brain magnetic resonance imaging (MRI) with impression of AIS were evaluated by 9 clinical tools for stroke diagnosis in the pre-hospital phase including Rapid Arterial Occlusion Evaluation (RACE), Cincinnati Prehospital Stroke Scale (CPSS), Los Angeles Prehospital Stroke Screen (LAPSS), Melbourne Ambulance Stroke Screen (MASS), Medic Prehospital Assessment for Code Stroke (Med PACS), Ontario Prehospital Stroke Screening Tool (OPSS), PreHospital Ambulance Stroke Test (PreHAST), Recognition of Stroke in the Emergency Room (ROSIER), and Face Arm Speech Test (FAST), and totally 19 items were reviewed and recorded. The new clinical tool was developed based on backward method of multivariable logistic regression analysis. The discrimination power of the new clinical tool for diagnosis of AIS was assessed with the area under the receiver operating characteristic curve (AUC-ROC). Results: Data from 806 patients were analyzed; of them, 57.4% were men. The mean age of the study patients was 66.9 years [standard deviation (SD) = 13.9]. In the multivariable model, 8 items remained. The AUC-ROC of the new clinical tool was 0.893 [95% confidence interval (CI): 0.869-0.917], and its best cut-off point was score ≥ 3 for positive AIS. At this cut-off point, sensitivity and specificity were 84.42% and 79.72%, respectively. Conclusion: We introduced a new nomogram-based clinical tool for the diagnosis of AIS in the prehospital stage, which has acceptable specificity and sensitivity; moreover, it is comparable with previous tools.

Can Pre-Hospital Medical Management Predict In-Hospital Mortality in Trauma?

The current literature demonstrates an association between both size and presence of TBI and its effects on mortality; however, it does not readily address the morbidity and associated functional outcomes of those who survive. We hypothesize that the likelihood of discharge to home decreases with advancement of age in the presence of TBI. This is a single-center study of trauma registry data, inclusive years July 1, 2016, to October 31, 2021. The inclusion criteria was based upon age (≥40 years), and ICD10 diagnosis of a TBI. Disposition to home without services was the dependent variable. 2031 patients were included in the analysis. We hypothesized correctly that the likelihood of discharge to home decreases (by 6%) with advancement of age (per year) in the presence of intracranial hemorrhage.

Evaluation of critical care burden following traumatic injury from two randomized controlled trials

Trauma resuscitation practices have continued to improve with new advances targeting prehospital interventions. The critical care burden associated with severely injured patients at risk of hemorrhage has been poorly characterized. We aim to describe the individual and additive effects of multiorgan failure (MOF) and nosocomial infection (NI) on delayed mortality and resource utilization. A secondary analysis of harmonized data from two large prehospital randomized controlled trials (Prehospital Air Medical Plasma (PAMPer) Trial and Study of Tranexamic Acid during Air and Ground Medical Prehospital Transport (STAAMP) Trial) was conducted. Only those patients who survived beyond the first 24 hours post-injury and spent at least one day in the ICU were included. Patients were stratified by development of MOF only, NI only, both, or neither and diagnosis of early (≤ 3 days) versus late MOF (> 3 days). Risk factors of NI and MOF, time course of these ICU complications, associated mortality, and hospital resource utilization were evaluated. Of the 869 patients who were enrolled in PAMPer and STAAMP and who met study criteria, 27.4% developed MOF only (n = 238), 10.9% developed NI only (n = 95), and 15.3% were diagnosed with both MOF and NI (n = 133). Patients developing NI and/or MOF compared to those who had an uncomplicated ICU course had greater injury severity, lower GCS, and greater shock indexes. Early MOF occurred in isolation, while late MOF more often followed NI. MOF was associated with 65% higher independent risk of 30-day mortality when adjusting for cofounders (OR 1.65; 95% CI 1.04–2.6; p = 0.03), however NI did not significantly affect odds of mortality. NI was individually associated with longer mechanical ventilation, ICU stay, hospital stay, and rehabilitation requirements, and the addition of MOF further increased the burden of inpatient and post-discharge care. MOF and NI remain common complications for those who survive traumatic injury. MOF is a robust independent predictor of mortality following injury in this cohort, and NI is associated with higher resource utilization. Timing of these ICU complications may reveal differences in pathophysiology and offer targets for continued advancements in treatment.

Translation and cross-cultural adaptation of the Air Medical Prehospital Triage (AMPT) Score for Helicopter Transport of Trauma Patients to Brazilian Portuguese

Introduction: The transport of patients by airplanes or helicopters reduces treatment time, while improving the chances of survival and the quality of life. Due to its costly maintenance and operation service, the air transport of victims depends on appropriate triage criteria for patients eligible for this type of transport. The Air Medical Prehospital Triage (AMPT) Score for Helicopter Transport of Trauma Patients quickly classifies the likelihood of trauma victims benefiting or not from helicopter transport. Objectives: The aim of this study was to translate the AMPT Score and cross-culturally adapt it to Brazilian Portuguese. Methods: This study followed international guidelines for standardized translation processes and was developed from: translation, synthesis, back translation, assessment of equivalences by the expert committee, proposal of the previous version of AMPT Score, application of pre-test/post-test and proposition of the final version of the translated scale. Results: The Wilcoxon Test comparing the experts’ assessment with the positive expected resulted in a p-value = 0.0625 (General) CI 95%. The Content Validity Index (CVI) of the experts committee was calculated as 0.9479. The pre-test data resulted in a Cronbach’s Alpha of 0.920 ± 7.26. The free-marginal Kappa coefficient of pre-test data was 0.89 (95% CI for 0.86, 0.93).The post-test data resulted in a Cronbach’s Alpha of 0.925 ± 5.36. The Wilcoxon Test comparing pre-test with post-test resulted in a p-value of 0.0942. Conclusions: The process resulted in a translation of the AMPT Score with the appropriate equivalences proposed by the literature that is statistically reliable and will be of great value to professionals who work with transporting trauma victims in helicopters. Keywords: Prehospital care; Air ambulances; Helicopter; Triage; Translation.

Meta-Analysis Predictors of Sufficient Pain Management among Children at Pre-hospital Medical Service

Background: Safely treating pain in children is a critical but challenging task for emergency medical teams. Few studies have focused on pain management guidelines at the hospital or department level. This study aimed to examine predictors of good pain management in children in prehospital health services. Subject and Method: This research is a systematic review and meta-analysis study using PRISMA diagrams. The article search was conducted based on the PICO Model eligibility criteria. P: children with pre-hospital acute Pain. I: analgesic administration and male. C: no analgesic administration, and female. O: pain reduction. The articles used were from 5 databases: EBSCO, Pubmed, ProQuest, Scopus, and Science Direct. The search keywords for articles were as follows “pain management” OR “pain reduction” AND “predictors” AND “pre-hospital care” AND “children”. The inclusion criteria in this study include full-text articles with observational study designs, full-text available articles, the relationship size used is the adjusted Odds Ratio, articles published in the 2010-2022 range, and the research outcome is sufficient pain management or efficient pain reduction. Articles were analyzed using the Review Manager 5.3 application. Results: There are 8 articles in this study, 2 from Australia, 1 from the United States, 1 from Switzerland, and 4 articles from the United Kingdom. The article was analyzed using the PRISMA flow diagram. The study results show that analgesic administration has increased the odds of 3.36 times greater for pain reduction than without analgesic administration. This result was statistically significant (aOR= 3.36; 95% CI = 1.94 to 5.82; p<0.001). However, no significant results from the gender that showed there is no different between male and female patients for pain reduction (aOR= 1.12; 95% CI= 0.98 to 1.27; p= 0.100). Conclusion: Analgesic administration is sufficient pain management for children with acute Pain in pre-hospital medical care. Keywords: children, pre-hospital care, pain management, predictors Correspondence: Arief Wahyudi Jadmiko. Nursing Department, Faculty of Health, Universitas Pembangunan Nasional Veteran Jakarta. Jl. Raya Limo Depok 16515 West Java, Indonesia. Email: ariefwjadmiko@gmail.com. Mobile: 085647213628. Indonesian Journal of Medicine (2022), 07(04): 360-370 https://doi.org/10.26911/theijmed.2022.07.04.01

Endeavors and prospects of the on-line Pediatric Prehospital Medical Evaluation and Care

Endeavors and prospects of the on-line Pediatric Prehospital Medical Evaluation and Care

A Multicenter Diagnostic Accuracy Study on Prehospital Stroke Screening Scales.

Stroke is one of the most common debilitating diseases. Although effective treatment is available, a golden time has been defined in this regard. Therefore, prompt action is needed to identify patients with stroke as soon as possible, even in the pre-hospital stage. In recent years, several clinical scales have been introduced for this purpose. We performed the present study to examine the accuracy of eight clinical scales in terms of stroke diagnosis. This multicenter diagnostic accuracy study was conducted in 2019. All patients older than 18 years who were admitted to the emergency department (ED) and underwent brain magnetic resonance imaging (MRI) for a suspected stroke were eligible. All data were gathered through a pre-prepared checklist consisting of three sections, using the clinical records of the patients. The first section of the checklist included basic characteristics and demographic data. The second part included physical examination findings of 19 items related to the 8 scales. The third part was dedicated to the final diagnosis based on the interpretation of brain MRI, which was considered the gold standard for the diagnosis of acute ischemic stroke (AIS) in the current study. The data from 805 patients suspected of stroke were analyzed. In all, 463 patients (57.5%) were male. The participants' age was 6-95 years with a mean age of 66.9 years (SD = 13.9). Of all the registered patients, 562 (69.8%) had an AIS. The accuracy of screening tests was 63.0% to 84.4%. The sensitivity and specificity were 71.9% to 95.7% and 46.5% to 82.8%, respectively. Among all the screening tests, Los Angeles Pre-Hospital Stroke Screening (LAPSS) had the lowest sensitivity, and Medic Prehospital Assessment for Code Stroke (Med PACS) had the highest sensitivity. In addition, Pre-Hospital Ambulance Stroke Test (PreHAST) had the lowest specificity and LAPSS had the highest specificity. Based on the findings of the present study, highly sensitive tests that can be used in this regard are Cincinnati Prehospital Stroke Scale (CPSS), Face-Arm-Speech-Time (FAST), and Med PACS, all of which have about 95% sensitivity. On the other hand, none of the studied tools were desirable (specificity above 95%) in any of the examined cut-offs.

Understanding the Effect of Electronic Prehospital Medical Records in Ambulances: A Qualitative Observational Study in a Prehospital Setting.

Little is known of ambulance professionals’ work practices regarding the use of medical records, their communication with patients, before and during hand over to Emergency Departments (ED). An electronic Prehospital Medical Record (ePMR) has been implemented in all Danish ambulances since 2015. Our aim was to investigate the use of ePMR and whether it affected the ambulance professionals’ clinical practice. We performed a qualitative study with observations of ePMR use in ambulance runs in the North Denmark Region. Furthermore, informal interviews with ambulance professionals was performed. Analysis was accomplished with inspiration from grounded theory. Our main findings were: (1) the ePMR is an essential work tool which aided ambulance professionals with overview of data collection and facilitated a checklist for ED hand overs, (2) mobility and flexibility of the ePMR facilitated conversations and relations with the patients, and (3) in acute severe situations, the ePMR could not stand alone in hand over or communication with the ED. The ePMR affected the ambulance professionals’ work practice in various ways and utilization of ePMR while simultaneously treating patients in ambulances does not obstruct the relation with the patient. To this end, the ePMR appears feasible in collaboration across the prehospital setting.

The Impact of Full-Scale Simulation Training Based on Kolb's Learning Cycle on Medical Prehospital Emergency Teams: A Multilevel Assessment Study.

Using simulation to train teams in out-of-hospital cardiac arrest management is recommended to improve team effectiveness. The aim of this study was to assess the impact of a specific cardiac arrest management simulation training program inspired by the principles of Kolb's learning cycle. All the staff in a medical prehospital emergency unit participated in this program. Both individual and team levels were evaluated: on an individual level, we assessed attitudes toward training and medical knowledge of cardiac arrest management; on a team level, we assessed team behavior during simulated cardiac arrest and learning transfer in clinical practice. In addition to the satisfaction of the participants, the results showed a positive effect on medical knowledge and team behavior and an improvement in the management of patients suffering cardiac arrest. These findings confirm the usefulness of a simulation training program containing the 4 steps of Kolb's cycle for emergency teams.

Prehospital Medical Response to Active Shooter Incidents—The Rescue Task Force Concept

Prehospital Medical Response to Active Shooter Incidents—The Rescue Task Force Concept

STRESS E TRAUMA NA EMERGÊNCIA MÉDICA PRÉ-HOSPITALAR: COPING DISFUNCIONAL COMO MEDIADOR

STRESS E TRAUMA NA EMERGÊNCIA MÉDICA PRÉ-HOSPITALAR: COPING DISFUNCIONAL COMO MEDIADOR

The Triage of Older Adults with Physiologic Markers of Serious Injury Using a State-Wide Prehospital Plan.

In January of 2010, North Carolina (NC) USA implemented state-wide Trauma Triage Destination Plans (TTDPs) to provide standardized guidelines for Emergency Medical Services (EMS) decision making. No study exists to evaluate whether triage behavior has changed for geriatric trauma patients. The impact of the NC TTDPs was investigated on EMS triage of geriatric trauma patients meeting physiologic criteria of serious injury, primarily based on whether these patients were transported to a trauma center. This is a retrospective cohort study of geriatric trauma patients transported by EMS from March 1, 2009 through September 30, 2009 (pre-TTDP) and March 1, 2010 through September 30, 2010 (post-TTDP) meeting the following inclusion criteria: (1) age 50 years or older; (2) transported to a hospital by NC EMS; (3) experienced an injury; and (4) meeting one or more of the NC TTDP's physiologic criteria for trauma (n = 5,345). Data were obtained from the Prehospital Medical Information System (PreMIS). Data collected included proportions of patients transported to a trauma center categorized by specific physiologic criteria, age category, and distance from a trauma center. The proportion of patients transported to a trauma center pre-TTDP (24.4% [95% CI 22.7%-26.1%]; n = 604) was similar to the proportion post-TTDP (24.4% [95% CI 22.9%-26.0%]; n = 700). For patients meeting specific physiologic triage criteria, the proportions of patients transported to a trauma center were also similar pre- and post-TTDP: systolic blood pressure <90 mmHg (22.5% versus 23.5%); respiratory rate <10 or >29 (23.2% versus 22.6%); and Glascow Coma Scale (GCS) score <13 (26.0% versus 26.4%). Patients aged 80 years or older were less likely to be transported to a trauma center than younger patients in both the pre- and post-TTDP periods. State-wide implementation of a TTDP had no discernible effect on the proportion of patients 50 years and older transported to a trauma center. Under-triage remained common and became increasingly prevalent among the oldest adults. Research to understand the uptake of guidelines and protocols into EMS practice is critical to improving care for older adults in the prehospital environment.

Assessing the Efficacy of a One-day Structured Induction Program in Orienting Clinical Staff to a Novel Prehospital Medical Deployment Model

Introduction:St. John Ambulance Victoria provides first aid and medical services at a variety of mass gathering events (MGEs) throughout Victoria. Volunteer healthcare professionals and students (termed “volunteers”) form Medical Assistance Teams (MAT) at these MGEs. MAT deployments manage a variety of patient presentations which include critically ill patients. This reduces high acuity patient transfers to the hospital and, where possible, avoid ambulance and hospital utilization.Aim:To determine the effectiveness of interdisciplinary prehospital simulation workshops in preparing volunteers for MAT deployment at MGEs.Methods:A one-day, simulation-based training session within the MAT environment was implemented to introduce volunteers to the management of various scenarios faced at MGEs. All volunteers were provided an orientation to the equipment and setting up MAT deployments at MGEs. Volunteers then participated in interdisciplinary group-based scenarios such as cardiac arrest management, drug intoxication, spinal injuries, agitated patients, and airway management. To determine the effectiveness of this training session, volunteers were invited to participate in a post-training survey, comprising of Likert scores and open-ended responses.Results:Seventeen volunteers attended the training session with 10 (58.8%) completing the post-training survey. Volunteers were satisfied with environment familiarization in the MAT (Average 4.47/5.00) and found the simulation-based training helpful (Average 3.67/4.00). The induction overall was well-received (4.60/5.00) with volunteers feeling more confident in being deployed at MGEs (4.20/5.00).Discussion:The results of the simulation-based training session were positive with volunteers receptive to the need for a training day prior to MAT deployment at MGEs. The simulation session enables volunteers to be comfortable with working in MAT and managing a diverse range of patients at MGEs. This session is likely to improve interdisciplinary communication and teamwork in the MAT. Future research is aimed at following these volunteers after several MAT deployments to improve the training session for future participants.