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Case Trains Flight Nurses for Disasters, Captures International Attention

Actors playing the part of victims exposed to phosgene gas
Actors playing the part of victims exposed to phosgene gas

Plumes of white smoke and toxic gas billow out the windows and doors of the freestanding building. People inside begin to pour out onto the lawn. Some can walk, others are crawling on all fours. They are coughing and having trouble breathing and complaining of burning in their eyes and skin.

The fire department is here, and a team of emergency workers is assembled on the lawn to asses the situation. They seem a little confused at first -there is some giggling at the antics of the victims. Which isn't all that shocking once you know they are all actors who have agreed to participate in what is actually a MOCK disaster scenario. It's all part of the National Flight Nursing Academy run by Case Western Reserve's Bolton School of Nursing. Christopher Manacci founded the program 5 years ago because he believes it's important for flight nurses to have hands-on training on how to handle real-life disaster scenarios.

MANACCI: It's one thing to train somebody how to manage an airway or put in a central line when you in a nice sterile environment in an intensive care unit, which is what these people do every day, but to ask them to do the same things with the restrictions of an unstructured environment makes it a whole different ball game.

Manacci says the flight Nurse training program is the first and only such program in the world - though that is beginning to change. This year participants have come from around the US, Canada, Australia and even Japan - where they plan to create there own flight nurse training program using Case Western Reserve as a model. Despite the fact that flight nurses routinely care for some of the most seriously ill patients, there is still no consensus on the minimum training required for the job. Christopher Manacci hopes that academic programs like this one will challenge the status quo and help raise the bar of patient care.

MANACCI: When you have people who are armed with the ability to provide high levels of intervention, you have a different product and your product now is not one that simply transports the patient, but one that actually evaluates and treats the patient, based on real need, based on real time scenarios

NURSE: A hospital in the air.

MANACCI: Absolutely.

Of course, everyone here knows that - today at least - nobody's life is truly on the line. But this disaster is about as authentic an experience as these students are bound to get outside of the real thing.

As the day wears on, would-be victims follow cues given by the director and act out a proscribed set of symptoms until they received the appropriate treatment. They are triaged, cared for, and prepared for transport by ground or air, just as in a real disaster.

TORER: I basically stopped breathing, my lung sounds diminished, my blood pressure went really low and I had pinkish sputum that I coughed up and they had to intubate me and give me steroids an vasopressors and fluids. And I got better.

CUDA: You got better? Did you have to go to the hospital?

TORER: I'm already there. (laughs)

The week-long training camp provides students with nursing training that is tailored to the specific demands of flying - things like the effects of altitude, air safety, and specialized traumas. Flight nurse and student Stephanie Steiner says for her the mock disaster is very life-like.

STEINER: It kind of puts everything together for you and it really gives you a good foundation of what things could really be like out there especially if you haven't done flight nursing before.

Gretchen Cuda, 90.3.