Teaching the subject of emergency medicine at faculty of medicine, University of Ostrava

Summary

Aim:
The aim of the presented article is to summarize our experience with teaching the subject of Emergency Medicine at the Institute of Emergency Medicine of the Faculty of Medicine, University of Ostrava (ÚMK LFOU).

Material and methods:
Teaching of students: The subject of Emergency Medicine is a compulsory part of the curriculum for students of the 5^th year of the Faculty of Medicine, University of Ostrava. It consists of theoretical and practical parts. Students of the medical faculty thus have the possibility to verify in practice what they have learned in the theoretical part. The study subject includes simulation of terrain conditions but also conditions in healthcare establishments. Postgraduate education of physicians: Due to the incidents which occurred in the world within the last ten years, but also in our region (three large-scale incidents), we attempt to broaden and improve the quality of education of physicians but also non-medical healthcare professionals with organizing postgraduate courses on models in the Educational Centre of the Institute of Emergency Medicine at University Hospital Ostrava, or with organized trainings, which attempt to simulate the conditions of large-scale incidents and emergency situations. International cooperation: We managed to establish a close cooperation with colleagues from Poland, in the course of an Interreg V-A project. We organize courses together, both in the Czech Republic and Poland. The aim of these courses in not only to broaden our experience but also the experience of our Polish colleagues.

Conclusion:
Taking into consideration the terrorist attacks and military conflicts of the late years, it is important for us to educate our students and physicians, and to prepare them for situations with multiple injured casualties. The aim of the research activities performed at ÚMK LF OU is to develop new nursing and surgical procedures for the management of consequences of incidents, and decreasing the morbidity and lethality of the injured during large-scale incidents.

Keywords:
Emergency medicine, large-scale incident, terrorism.

INTRODUCTION

Institute of Emergency Medicine (ÚMK) was founded at the Faculty of Medicine, University of Ostrava (LF OU) on 1^st January 2014, and it is a teaching and research workplace dealing with the area of emergency medicine, the problems of which have been rapidly developing all around the world in the recent years, due to the increasing threat of terrorism and military conflicts. ÚMK provides theoretical and practical education of physicians and students of the Faculty of Medicine in diagnostics, nursing and treatment of patients injured during large-scale incidents and emergency situations. The aim of research activities performed at ÚMK is to develop new nursing and surgical procedures for managing consequences of incidents, and decreasing morbidity and lethality of the injured during large-scale incidents. Large-scale incidents related to coal mining and steelworks predominated in our region in the past. In the course of the last ten years, the Traumatology Plan of the hospital has been activated three times, due to large scale incidents related to accidents of trams and trains (twice in 2008, once in 2015).

MATERIAL AND METHODS

Teaching of students

The subject of Emergency Medicine is a compulsory part of the curriculum for students of the 5^th year of the Faculty of Medicine, University of Ostrava. It consists of a theoretical part, where specialists in various fields (traumatology surgeons, members of the Integrated Rescue System, explosive system specialists, lecturers from the Technical University Ostrava and war surgeons) transfer their experience and knowledge from their practice to students, regarding elimination of consequences of various disasters and emergency situations, anthropogenic as well as natural. The second part of the course consists of practical training, when the students have the possibility to see, and also try in practice, providing treatment for injured in various terrain conditions, but also in a healthcare establishment.

Postgraduate education of physicians

Due to various incidents which occurred in the world in the last ten years, but also considering the incidents in our region (three large-scale incidents), we feel it is necessary that the physicians of our hospital, but also physicians and non-medical healthcare professionals from the Czech Republic, were prepared for situations when it is necessary to provide immediate treatment to a large number of casualties. That is why we are attempting to broaden and improve the quality of education of physicians but also non-medical healthcare professionals by organizing courses in the Educational Centre of the Institute of Emergency Medicine at University Hospital Ostrava, or by organizing exercises, the aim of which is to simulate large-scale incidents and emergency situations.

ATLS Course

ATLS (Advanced Trauma Life Support) course for physicians and healthcare professionals from the whole Czech Republic was held in June 2016, within the project of “Emergency Medicine”, in cooperation between the University of Ostrava and the University Hospital in Hradec Králové.

International cooperation

Thanks to an Interreg V-A project, we also managed to establish a close cooperation with our colleagues from Poland. We organize common courses together, both in the Czech Republic and Poland. The aim of these courses is not only to broaden our knowledge and experience but also the knowledge and experience of our Polish colleagues.

Exercise “Explosion at Emergency Room of UH Ostrava”

Our activities within the “Emergency Medicine” project include education of physicians in everyday working environment and processes. That is why we attempt to simulate situations which we believe may pose a problem during care organization in our hospital. On 12^th April 2017, we simulated an explosion of amateur-made explosive system at the Emergency Room of UH Ostrava, with a simulation of 11 injured healthcare professionals, 3 of whom died during the incident, 5 were seriously wounded (2 of them with burn injuries), and 3 patients with minor injuries. In this way, we wanted to manage a simulated situation, when the triage and treatment of patients must be realized outside of the excellently equipped premises of Emergency Admission. We also wanted to find out, how the employees of the hospital will react to injury or death of their colleague. That is why we also engaged specialists in psychological intervention in the simulation.

CONCLUSION

Students of medical, as well as non-medical study programmes of Faculty of Medicine, University of Ostrava have positively welcomed the subject of Emergency Medicine, which is being taught at the faculty. Due to the increasing number of terrorist attacks and military conflicts, it is important for us to educate and prepare our students and physicians for management of situations with a large number of casualties. We believe it is important to educate not only students and healthcare professionals, but also the general public. Members of the general public are among the first witnesses of the incident, and the first-aid provided by the general public before the arrival of rescue services is more than necessary, and may save lives. It is our aim for the future to ensure that the subject of Emergency Medicine is taught at all universities, not only on medical faculties but also on faculties of humanity studies and technical specializations. Because: He who is well prepared has half won the battle.

Martin Novák, MD

martin.novak@fno.cz