To the Editor:
Training exercises are now frequently used in health disaster and emergency medicine to train first responders,1 including the use of tabletop exercises.2–4 Nevertheless, these kinds of drills are not well described in occupational and industrial safety and health literature. They represent an interesting alternative to simulated disaster plans, which require considerable human and technical resources disrupt a company's daily business. Our purpose was to develop a special tabletop exercise training program for health and safety professionals such as occupational physicians and hygienists.
We organized a 1 day-session about disaster fundamentals for 28 occupational physicians who were training for a master's degree in emergency medicine training. A tabletop exercise was made based on a scenario of a fire in a plant at risk for chemical explosion. There were 22 victims in the scenario, one of them deceased. Three groups of nine or 10 participants had 1 hour and 15 minutes to discuss and simulate rescue operations from the initial accident to the discharge of the last victims from the triage center. They were supervised by a physician and a nurse who are specialized in disaster training. A model of an industrial plant was displayed on a large tabletop, with figurines and vehicles representing patients, industrial and emergency responders, firemen and police officers, and journalists. Satisfaction and cost were evaluated.
The participants were largely satisfied by the training and believe, as did the teachers, that the exercise illustrated the roles of occupational physicians, the triage center, and intricate logistics during a health disaster. The direct cost of the simulation was $1285 (975 euros), namely $646 for the figurines and $639 for the supervisors for the first year ($46 per participant). Unlike a full simulation, the exercise did not impact daily activities of the company/plant. One year later, the tabletop exercise was performed again with 28 new participants with similar results and reduced costs ($639 for the supervisors, $23 per participants).
Tabletop exercises simulating industrial disasters appear to be a cost-effective way to train health and safety professionals. Similar experiences are reported in other contexts: airport disasters,2 biological threats in a public health preparedness,5,6 and training of medical technicians for emergency.3 Tabletop exercises could also be used to train different categories of participants in similar drills. Considering the purpose of training participants to organize the prevention and the management of industrial disasters in their own company, it was seen as to be effective and more cost-effective than real life disaster simulations.
To conclude, although real life exercises remain essential (especially to challenge emergency responders), tabletop exercises should be studied in more depth for further utilization in industrial settings.
The authors would like to thank the participants of our Master and Olivia Laborde, an English Supervisor in our University, who helps us to improve our English.
Alexis Descatha, MD, PhD
AP-HP, Prehospital Emergency Medical System of Paris' West Suburban (“SAMU 92”)
UVSQ, Occupational Health Unit/INSERM U687
Thomas Loeb, MD
François Dolveck, MD
Nathalie-Sybille Goddet, MD
Valerie Poirier, RN
Michel Baer, MD
AP-HP, Prehospital Emergency Medical System of Paris' West suburban (“SAMU 92”)
Raymond Poincare University Hospital
1. Rutherford WH. The place of exercises in disaster management. Injury
2. Idrose AM, Adnan WA, Villa GF, Abdullah AH. The use of classroom training and simulation in the training of medical responders for airport disaster. Emerg Med J
3. Chi CH, Chao WH, Chuang CC, Tsai MC, Tsai LM. Emergency medical technicians' disaster training by tabletop exercise. Am J Emerg Med
4. Silenas R, Akins R, Parrish AR, Edwards JC. Developing disaster preparedness competence: an experiential learning exercise for multiprofessional education. Teach Learn Med
5. Dausey DJ, Buehler JW, Lurie N. Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats. BMC Public Health
6. Steward D, Wan TT. The role of simulation and modeling in disaster management. J Med Syst
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