Emergency Training Research Articles

The Impact of the Advances in Labour and Risk Management (ALARM) Course on Learners’ Perceptions of their Own and Others’ Professions

Background: Simulation-based training in emergencies is beneficial for all professionals who work in obstetrics. However, managing obstetric emergencies requires both technical and non-technical skills such as teamwork. Interprofessional education (IPE) offers an effective strategy for learning competencies in collaboration and teamwork. The Advances in Labour and Risk Management (ALARM) course offers a platform for simulated training in obstetric emergencies and has been offered for learners in maternity care at our university for the past five years. Objective: The aim of the project was to explore the impact of interprofessional learning during the ALARM course on the attitudes and perceptions of learners in maternity care. Methods: A two-part questionnaire was administered to midwifery students and to family medicine and obstetric residents before and after the ALARM course. The questionnaire incorporated the Interdisciplinary Educational Perception Scale (IEPS) and open-ended qualitative responses. Results: Despite openness to and awareness of the importance of collaboration for patient care demonstrated in the qualitative analysis, there was a statistically significant difference between learners’ pre- and post-ALARM IEPS scores, indicating more negative perceptions of IPE following the intervention. Conclusion: Learners in maternity care are aware of the need for collaboration in practice. More explicit attention to teamwork and collaboration as a component of the ALARM course would promote development of both technical skills and nontechnical collaborative competencies. This article has been peer reviewed.

Precision medicine within health professions education: Defining a research agenda for emergency medicine using a foresight and strategy technique (FaST) review

AbstractBackgroundPrecision medicine, sometimes referred to as personalized medicine, is rapidly changing the possibilities for how people will engage health care in the near future. As technology to support precision medicine exponentially develops, there is an urgent need to proactively improve our understanding of precision medicine and pose important research questions (RQs) related to its inclusion in the education and training of future emergency physicians.MethodsA seven‐step process was employed to develop a research agenda exploring the intersection of precision and emergency medicine education/training. A literature search of articles about precision medicine was conducted first, which informed the creation of future four scenarios in which trainees and practicing physicians regularly discuss and incorporate precision medicine tools into their discussions and work. Based on these futurist narratives, potential education RQs were generated by an expert panel. A total of 59 initial questions were subsequently categorized and refined to a priority list through a nominal group voting method. The top/priority questions were presented at the 2023 SAEM Consensus Conference on Precision Medicine, Austin, Texas, for further input.ResultsEight high‐value education RQs were developed, reflecting a holistic view of the challenges and opportunities for precision medicine education in the knowledge, skills, and attitudes relevant to emergency medicine. These questions contend with topics such as most effective pedagogical methods; intended resulting outcomes and behaviors; the generational differences between practicing emergency physicians, educators, and future trainees; and the desires and expectations of patients.ConclusionsEmergency medicine and emergency physicians must be prepared to understand precision medicine and incorporate this information into their “toolbox” of thinking, problem solving, and communication with patients and colleagues. This research agenda on how best to educate future emergency physicians in the use of personalized data to provide optimal health care is the focus of this article.

Research on emotion modeling of intelligent agents in earthquake evacuation simulation

In recent years, virtual reality (VR) has been widely used in emergency drills, skills training and other fields of science education. However, existing VR emergency training platforms lack intelligent agents endowed with emotional and cognitive abilities, making them challenging to evoke user emotions and achieve immersion. Moreover, existing emotion contagion methods of virtual agents lack analysis on whether the emotions of virtual agents can infect users in the real world. Therefore, we proposed an emotional cognitive model (ECM) that simulates the emotional contagion of intelligent agents in a VR earthquake emergency training platform. To evaluate the proposed model, we conducted a user study requiring the user to control an avatar for evacuation training during a simulated earthquake. The user’s brain signals are measured using EEG, fNIRS, and eye-tracking devices to analyze whether the user was affected by the emotions of other intelligent agents. The results show that intelligent agents with emotional cognition can evoke user’s emotions in earthquake emergency training.

Clinical acute and emergency medicine curriculum-focus on internal medicine : Recommendations for advanced training in internal medicine in the emergency department

In Germany, physicians qualify for emergency medicine by combining aspecialty medical training-e.g. internal medicine-with advanced training in emergency medicine according to the statutes of the State Chambers of Physicians largely based upon the Guideline Regulations on Specialty Training of the German Medical Association. Internal medicine and their associated subspecialities represent an important column of emergency medicine. For the internal medicine aspects of emergency medicine, this curriculum presents an overview of knowledge, skills (competence levels I-III) as well as behaviours and attitudes allowing for the best treatment of patients. These include general aspects (structure and process quality, primary diagnostics and therapy as well as indication for subsequent treatment; resuscitation room management; diagnostics and monitoring; general therapeutic measures; hygiene measures; and pharmacotherapy) and also specific aspects concerning angiology, endocrinology, diabetology and metabolism, gastroenterology, geriatric medicine, hematology and oncology, infectiology, cardiology, nephrology, palliative care, pneumology, rheumatology and toxicology. Publications focussing on contents of advanced training are quoted in order to support this concept. The curriculum has primarily been written for internists for their advanced emergency training, but it may generally show practising emergency physicians the broad spectrum of internal medicine diseases or comorbidities presented by patients attending the emergency department.

Multicenter evaluation to determine the deficiencies of emergency nurses in forensic case management

IntroductionEmergency services are the first places where victims and/or perpetrators of different types of violence are brought for medical treatment. Emergency service nurses are the first health workers who first encounter with the forensic case, first communicate and are in an important position in the rapid and accurate continuation of the forensic process. In this study, it was aimed to determine the level of knowledge of emergency department nurses regarding the management of forensic cases. MethodsThe study was a cross-sectional, descriptive. Ninety-eight emergency nurses working in the emergency departments of three different public hospitals in the same province participated in the study. Study data were collected with the “Nurse Personal Information Form” and the “Knowledge Levels of Nurses related to the Approaches to Forensic Cases Questionnaire”. Results70.4 % of the nurses participating in the study were women, their mean age was (X ± SD = 27.36 ± 5.21). It is seen that 87.8 % of the nurses have a total working time in the emergency unit between 1 and 5 years and 11.2 % have received training on forensic nursing. “Total Knowledge Score” of undergraduate graduate nurses The mean score was higher and there was a significant difference between the groups (p > 0.05). The nurses who received in-service training and forensically evaluated all cases admitted to the emergency department had a higher mean score in the “Knowledge Score Regarding the Duties of Nurses Regarding Forensic Cases” mean was higher and there was a significant difference between the groups (p > 0.05). ConclusionWe recommend the use of institutional guides/protocols together with in-service training for emergency nurses to provide medically and legally correct forensic care and to have sufficient knowledge.

Current progress in international pediatric emergency medicine.

Over the past four decades, pediatric emergency Medicine (PEM) has witnessed significant global development, with a notable increase in training programs and official recognition by regulatory bodies. However, disparities persist in the recognition of PEM as an independent subspecialty, availability of training programs on a global scale, academic recognition, and the ability to provide high-quality care to children worldwide. There is paucity of published literature regarding development of PEM globally. This review explores the current trends and challenges in international pediatric emergency medicine. Current trends in international pediatric emergency medicine encompass the provision of training in pediatric-focused emergency and acute care, increased propagation of evidence-based guidelines specific to the care of children, the growth of collaborative research networks and interest groups within national and international societies. Simultaneously, the field continues to face challenges such as the lack of recognition, inequities in access, and a lack of dissemination of global PEM initiatives. While recent advancements have significantly enhanced the state of international pediatric emergency medicine, including pediatric specific research networks and training programs, barriers still hinder its overall quality. Many of these obstacles are not unique to pediatric emergency medicine but are directly affected by financial disparities and lack of governmental and public recognition of the essential role of pediatric emergency care.

A feasibility study of a handmade ultrasound-guided phantom for paracentesis

BackgroundSimulation-based training is effective for ultrasound (US)-guided procedures. However, commercially developed simulators are costly. This study aims to evaluate the feasibility of a hand-made phantom for US-guided paracentesis.MethodsWe described the recipe to prepare an agar phantom. We collected the US performance data of 50 novices, including 22 postgraduate-year (PGY) residents and 28 undergraduate-year (UGY) students, who used the phantom for training, as well as 12 emergency residents with prior US-guided experience. We obtained the feedback after using the phantom with the Likert 5-point scale. The data were presented with medians and interquartile ranges (IQRs) and analyzed by the Wilcoxon rank sum test.ResultsWhile emergency residents demonstrated superior performance compared to trainees, all trainees exhibited acceptable proficiency (global rating of ≥ 3, 50/50 vs. 12/12, p = 1.000) and comparable needle steadiness [5 (5) vs. 5 (5), p = 0.223]. No significant difference in performance was observed between PGYs [5 (4–5)] and UGYs [5 (4–5), p = 0.825]. No significant differences were observed in terms of image stimulation, puncture texture, needle visualization, drainage simulation, and endurance of the phantom between emergency residents and trainees. However, experienced residents rated puncture texture and draining fluid as “neutral” (3/5 on the Likert scale). The cost of the paracentesis phantom is US$16.00 for at least 30 simulations, reducing it to US$6.00 without a container.ConclusionsThe paracentesis phantom proves to be a practical and cost-effective training tool. It enables novices to acquire paracentesis skills, enhances their US proficiency, and boosts their confidence. Nevertheless, further investigation is needed to assess its long-term impact on clinical performance in real patients.Trial registrationNCT04792203 at the ClinicalTrials.gov.

Edukasi Tanggap Bencana: Pelatihan Kesiapsiagaan Pramuka Tingkat Penegak dan Pandega

Simple Emergency Management (SEM) is a straightforward approach to managing emergencies. Non-professionals need to understand the fundamental theories and practices of emergency response. This community service program aimed to offer education and training to scout members of the Penegak and Pandega groups in the Kwartir regions of Gunungkidul, Bantul, Sleman, Kulonprogo, and DIY City. The training program's methodology incorporated a blend of mini-lectures, small group discussions, and hands-on practice. A pre-test was administered before the training, followed by a post-test afterward to evaluate its effectiveness. Statistical analysis of the pre-test and post-test scores of the respondents (n = 25) revealed a notable improvement, with average scores increasing from 57.20 to 85.00. This increase was statistically significant, as evidenced by a p-value of 0.000, according to the Wilcoxon test. These results indicate a significant enhancement in the participants' knowledge following the SEM emergency training.

Enhancing interprofessional collaboration in paediatric training: Insights from profession-specific experiences and implications for future education.

There is limited evidence on trainees' and instructors' needs and perspectives concerning interprofessional simulation-based trainings. We aimed to study task distribution among team members, profession-specific learning effects and enhancing collaboration and competencies within medical teams. This prospective study examined expectations and experiences of medical and nursing students during paediatric emergency training in a tertiary care centre with questionnaires before and after a training. Further, expert interviews were conducted to identify the needs for interprofessional training. Results were used to design a standardised checklist for structured preparation of interprofessional paediatric emergency management training. Of the nursing students, 82% initially intended to assume the role of the team leader, but only 5.8% did so during training. Both professions emphasised the significance of effective communication and transparent task distribution for successful collaboration. Experts highlighted the importance of proficiency in basic technical skills and identified non-technical skills such as closed-loop communication and the 10-4-10 principle as crucial for both professions. The study revealed profession-specific variations in the intention of acquiring the team leader or member role. Interprofessional training emerges as a potential strategy to dismantle these structures and promote shared responsibilities. The checklist aims to facilitate structured preparation of a training.

Forensic Hypoglycaemia & Neuroglycopenia — A Clinical Legal Social Endocrinology Challenge for 2024, Forensic Law in Hypoglycaemia 4

Forensic Hypoglycaemia & Neuroglycopenia — A Clinical Legal Social Endocrinology Challenge for 2024, Forensic Law in Hypoglycaemia 4

EFEKTIVITAS PELATIHAN GAWAT DARURAT DENGAN METODE CHAIR SIDE TALK TERHADAP KEMAMPUAN IBU DALAM PENANGANAN KEJANG DEMAM ANAK

Ability is a skill of an individual in mastering a skill and being used to do various tasks in a job. Mothers are the most important role in the family when children are sick and mothers tend to be unprepared to deal with children with febrile seizures. However, based on the experience of mothers in Mander Village, Tambakboyo District, shows that there has been no socialization of emergency training using the chair side talk method on the mother's ability to handle febrile seizures in children. The purpose of this study was to determine the effectiveness of emergency training with the chair side talk method on the mother's ability to treat children's febrile seizures (RT 18 RW 09 Mander Village, Tambakbooyo District). The research method used is pre-experimental, with a one-group pre-post test design. The research sample was 28 women from Mander Village, Tambakboyo District who were selected by simple random sampling. SOP research instruments and questionnaire sheets. The analysis of this study used the Wilcoxon test. The results showed that most of the mothers' abilities in dealing with children with febrile seizures before being given training were categorized as incapable, and after being given emergency training using the chair side talk method, most of them were categorized as capable. The results of statistical tests showed that there was a difference in the ability of mothers to handle febrile seizures after being given training with the chair side talk method with p-value = 0.000 at a = 0.05 (p <0.05). It is hoped that after having the child's ability to have seizures, the mother can take care of the child during a seizure

Simulation training for medical emergencies: Evaluation of dentists' long-term learning skills and confidence.

As the population ages and more patients experience medical emergencies during dental treatments, dentists must competently and confidently manage these situations. We developed a simulation training course for medical emergencies in the dental setting using an inexpensive vital sign simulation app for smartphones/tablets without the need for an expensive simulator. However, the duration for which this effect is maintained is unclear. This study was performed to evaluate the long-term educational effect at 3, 6, and 12 months after taking the course. Thirty-nine dental residents participated in this course. Scenarios included vasovagal syncope, anaphylaxis, hyperventilation syndrome, and acute coronary syndrome, each of which the participants had to diagnose and treat. The participants were evaluated using a checklist for anaphylaxis diagnosis and treatment skills immediately after and 3, 6, and 12 months after the course. The participants were also surveyed about their confidence in diagnosing and treating these conditions by questionnaire before, immediately after, and 3, 6, and 12 months after the course. The checklist scores for anaphylaxis were significantly lower at 3, 6, and 12 months after the course than immediately after the course. The percentage of participants who provided a correct diagnosis and appropriate treatment for vasovagal syncope, hyperventilation syndrome, and acute coronary syndrome was lower at all reassessments than immediately after the course. Because medical emergency management skills and confidence declined within 3 months, it would be useful to introduce a refresher course approximately 3 months after the initial course to maintain skills and confidence.

Pharmacy residency training program increases residents' confidence in inpatient medical emergency response.

The benefits of pharmacists' involvement in medical emergencies are well established, but optimal methods of training pharmacists for emergency response are unknown. The primary objective of this report is to describe the design and evaluation of a pharmacy resident medical emergency response training (PR-MERT) program for preparing trainees to respond to hospital medical emergencies, including cardiac arrest and rapid sequence intubation (RSI). The PR-MERT program was a year-long longitudinal experience designed to prepare postgraduate year 1 pharmacy residents for medical emergency response. During the first month, the residents completed an orientation session that encompassed several lectures, certification by the American Heart Association in basic life support and advanced cardiovascular life support, standardized simulation scenarios, and mock medical emergencies. The trainees continued to utilize these skills and clinical knowledge through a longitudinal didactic lecture series, resident case conferences, and practice-based application by responding to real-life medical emergencies. Residents were assessed and coached throughout the program by clinical pharmacy preceptors and a "code coach" with extensive medical emergency response experience. After the year-long training, residents completed an anonymous survey assessing self-confidence and the structure of the program. The results showed improved confidence in medication selection and dosing, as well as anticipating the needs of the team and speaking up in cardiac arrest and RSI situations. Residents were satisfied with the training offered and structure of the program. The development of a PR-MERT program at an academic medical center was successful in achieving longitudinal learning objectives and improving residents' confidence in responding to medical emergencies. The implementation of a similar medical emergency training curriculum in inpatient pharmacy residency programs may be beneficial.

Abstract WMP46: Rurality Affects Access to Mechanical Thrombectomy for Large Vessel Occlusion Stroke on a Global Scale

Introduction: Global mechanical thrombectomy access (MTA) for large vessel occlusion (LVO) stroke is extremely low. Rural patients are less likely to receive initial care at a thrombectomy-capable hospital. While regional studies have suggested rurality as a barrier to MTA, the magnitude and variability of this effect across countries is unknown. The aim of this study is to evaluate the association of country-level % of the rural population with access to mechanical thrombectomy. Methods: We conducted an online survey of 75 countries through the Mission Thrombectomy 2020+ (MT2020+) global professional peer network between November 22, 2020, and February 28, 2021. Questions included country-level availability of MT centers, operators, procedures, reimbursement, emergency medical services, cultural barriers, and other factors affecting systems of stroke care. MTA was defined as the estimated proportion of patients with thrombectomy-eligible LVOs receiving MT in each region annually. We used the World Bank data to obtain the income class based on per capita GNI of a country and the proportion of rural population expressed as % of total population of each country. In the final analysis, 60 countries were included. We used multivariable-adjusted generalized linear models with logit link to evaluate the association of rural population % with MT access. Results: The median country-level % of rural population among 60 countries was 30.5% (IQR 16.1-45.7%). In univariable generalized linear models, each 5% increase in country-level % of rural population was associated with 22% lower odds of MT access (OR 0.78, 95%CI 0.70-0.86, p<0.001). After adjustment for differences in country-level % of GDP spent on healthcare, reimbursement for MT, country’s income class, prehospital emergency services (EMS) system availability, training, and triage systems, each 5% increase in % of rural population was associated with 6% lower odds of MT access (OR 0.94, 95%CI 0.90-0.99, p=0.013). Conclusion: The % of rural population of countries is a significant independent negative predictor of access to mechanical thrombectomy. The % of rural populations and its distribution within countries needs to be carefully studied, as policies to improve access are created and implemented.

Tertiary Trauma Survey on Emergency Department Observational Units: A Systematic Literature Review.

In today's competitive world with a fast-paced lifestyle, trauma is on the rise and is globally recognized as the leading cause of mortality, morbidity, and disability.Despite the development of major trauma centers and the introduction of advanced trauma training courses and management guidelines, there remains a substantial risk of missed or delayed diagnosis of injuries with potentially life-changing physical, emotional, and financial implications. The proportion of such incidents is potentially higher in busy emergency departments and developing countries with fewer dedicated major trauma centers or where focused emergency and trauma training and skills development is still in its infancy. In the last decade, tertiary trauma surveys have been recognized as an important re-assessment protocol in reducing such missed injuries or delayed diagnoses in patients involved in major trauma. This naturally leads to the presumption that tertiary trauma surveys could also play an important role in observational medicine. This also brings into question whether a standardized tertiary trauma survey of major trauma patients on emergency observation units could reduce missed injuries, especially in low-income countries with fewer resources and trauma expertise. Thus, the purpose of this systematic literature review is to explore the potential role of tertiary trauma survey as a tool to reducing missed or delayed diagnosis in the emergency observation units and its applicability and feasibility in less-developed healthcare systems and in low- and middle-income countries. A broad-based systematic literature review was conducted to include electronic databases, grey literature, reference lists, and bibliographies using the keywords: tertiary trauma survey, major trauma, observational medicine, emergency observation units, clinical decision unit, adult, missed injuries, and delayed diagnosis. Over 19,000 citations were identified on initial search. Following a review of abstracts, application of inclusion and exclusion criteria, and review of the full article, 19 publications were finally selected for the purpose of this systematic literature review. Current evidence shows a general trend that tertiary trauma surveys performed 24 hours after admission playan important role in identifying injuries missed at the time of initial primary and secondary survey, and its implementation in observational medicine could prove beneficial, especially in resource-depleted healthcare systems.

Developing an Effective Team-Based Emergency Training Program for Medical Students

Developing an Effective Team-Based Emergency Training Program for Medical Students

Evaluating emergency service response to COVID-19: A scoping review.

The issue of how emergency services (police, fire, ambulance, local authorities) respond to pandemics has received greater research focus recently in relation to the COVID-19 outbreak, which saw agencies going beyond usual roles to support communities for prolonged periods. A critical appraisal is needed of this published evidence to take stock of what is known about the effectiveness of emergency service response to Covid-19. A scoping review of scientific and grey literature identified 17 qualitative (N=9), quantitative (N=6), or mixed methods (N=2) studies from across the UK and internationally that focus on the effectiveness of emergency service response to the Covid-19 outbreak. A narrative review was conducted using an interpretive approach. Papers were read, summarised, and then sorted into inductive themes that addressed some aspect of the review question. Eight critical themes emerged from the narrative review. Across countries, emergency services were required to quickly adapt working practices to reduce spread of infection, support partner agencies facing unprecedented demands, and make effective use of limited resources. Use of technology, access to timely, accurate and relevant information, strong leadership, prior experience, and emergency training were critical to this. However, most research is descriptive rather than evaluative. Overall, findings highlight the need for further research that examines what mechanisms facilitate and hinder emergency response to pandemics. This scoping review provides a knowledge framework for informing future research that can support emergency services in preparing for events of national and international significance.

Outline and validation of a new dispatcher-assisted cardiopulmonary resuscitation educational bundle using the Delphi method

AimDispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is time-dependent. To date, evidence-based training programmes for dispatchers are lacking. This study aimed to reach expert consensus on an educational bundle content for dispatchers to provide DA-CPR using the Delphi method. MethodAn educational bundle was created by the Swedish Resuscitation Council consisting of three parts: e-learning on DA-CPR, basic life support training and audit of emergency out-of-hospital cardiac arrest calls. Thereafter, a two-round modified Delphi study was conducted between November 2022 and March 2023; 37 experts with broad clinical and/or scientific knowledge of DA-CPR were invited. In the first round, the experts participated in the e-learning module and answered a questionnaire with 13 closed and open questions, whereafter the e-learning part of the bundle was revised. In the second round, the revised e-learning part was evaluated using Likert scores (20 items). The predefined consensus level was set at 80%. ResultsDelphi rounds one and two were assessed by 20 and 18 of the invited experts, respectively. In round one, 18 experts (18 of 20, 90%) stated that they did not miss any content in the programme. In round two, the scale-level content validity index based on the average method (S-CVI/AVE, 0.99) and scale-level content validity index based on universal agreement (S-CVI/UA, 0.85) exceeded the threshold level of 80%. ConclusionExpert consensus on the educational bundle content was reached using the Delphi method. Further work is required to evaluate its effect in real-world out-of-hospital cardiac arrest calls.

Rural and regional maternity managers’ and educators’ views of the Maternity and Newborn Emergencies (MANE) education program in Victoria, Australia: a qualitative descriptive study

BackgroundAustralia has one of the lowest perinatal morbidity and mortality rates in the world, however a cluster of perinatal deaths at a regional health service in the state of Victoria in 2015 led to state-wide reforms, including the introduction of the Maternity and Newborn Emergencies (MANE) program. MANE was a 2-day interprofessional maternity education program delivered by external expert facilitators to rural and regional Victorian maternity service providers. An independent evaluation found that the MANE program improved the confidence and knowledge of clinicians in managing obstetric emergencies and resulted in changes to clinical practice. While there is a large volume of evidence that supports the use of interprofessional education in improving clinicians’ clinical practice, the impact of these programs on the overall safety culture of a health service has been less studied. Managers and educators have an important role in promoting the safety culture and clinical governance of the heath service. The aim of this study, therefore, was to explore Victorian rural and regional maternity managers’ and educators’ views and experiences of the MANE program.MethodsMaternity managers and educators from the 17 regional and rural health services across Victoria that received the MANE program during 2018 and 2019 were invited to participate. Semi-structured interviews using mostly open-ended questions (and with a small number of fixed response questions) were undertaken. Qualitative data were transcribed verbatim and analysed thematically. Descriptive statistics were used for quantitative data.ResultsTwenty-one maternity managers and educators from the 17 health services participated in the interviews. Overall, participants viewed the MANE program positively. Four themes were identified: the value of external facilitation in providing obstetric emergency training; improved awareness and understanding of clinical governance; improved clinical practice; and the importance of maintaining the program. Participants agreed that MANE had improved the confidence (94%) and skills (94%) of clinicians in managing obstetric emergencies, as well as confidence to escalate concerns (94%), and most agreed that it had improved clinical practice (70%) and teamwork among attendees (82%).ConclusionMaternity managers and educators were positive about MANE; they considered that it contributed to improving factors that impact the safety culture of health services, with delivery by external experts considered to be particularly important. Given the crucial role of maternity managers and educators on safety culture in health services, as well in program facilitation, these findings are important for future planning of maternity education programs across the state.Trial registrationTrial registration was not required for this study.

Initial emergency training of traffic police officers of the Ministry of Internal Affairs of Russia.

The subject of the study is the peculiarities of learning to drive a car. The object of the study is to train the initial actions of traffic police officers of the Ministry of Internal Affairs of Russia in the management of operational vehicles in extreme situations. Formation of practical skills in emergency training in the event of extreme situations. The authors consider in detail the location of the driver in the car, substantiate recommendations for the correct landing of the driver, which ensures his readiness for emergency actions. The authors give practical recommendations on the location of the hands on the steering wheel, so that, without losing control of the steering wheel, the driver can interact with the controls of the car. The authors pay special attention to the formation of the so-called "stability triangle" in the student of emergency driving, which includes (shoulders pressed against the back of the seat; the left foot in a resting place; the heel of the right foot, resting on the floor). Research methods: the dialectical method of scientific cognition, a systematic approach and analysis were used in the research process. Taking into account the complexity of the problem under consideration, general scientific and private scientific methods are used in the study: logical method, synthesis, structural and functional analysis and modeling methods. Implementation of the proposed recommendations in the practice of emergency training. The main conclusions of the study are the methodological recommendations proposed by the authors on training at the primary stage of emergency training for traffic police officers of the Ministry of Internal Affairs of Russia. The initial actions for the correct position of the body behind the driver's seat, methods of rotating the steering wheel with both two hands and one, as well as the development of practical skills in emergency training in the event of extreme situations are considered. A special contribution of the authors to the study of the topic is their proposed methodology for teaching emergency training to traffic police officers of the Ministry of Internal Affairs of Russia. The authors consider the technique of driving a car with one hand to ensure full control of the steering wheel. The novelty of the study lies in the disclosure of the basic methodological techniques of initial training in emergency driving, which allows drivers to predict and prevent possible traffic accidents.