Emergency Response Training: Part 2

April 16, 2013

A Student-Based Team Approach to Prepare for Emergencies

Ryan Rudesill, Interim Coordinator of Intramurals and Sport Clubs
Mo McAlpine, Associate Director
University of Wisconsin-La Crosse

Editor’s Note: This article is Part 2 of the series, focusing on ‘Red Shirt Reviews’. Part one discussed ‘Developing an Emergency Response Team’.

In Part 1 of this series we looked at how to form an effective Emergency Response Team (ERT). The current article will describe the role of the ERT in performing ‘Red Shirt Reviews’ – hands-on, mock situations that simulate emergencies. The purpose at the University of Wisconsin-La Crosse (UW-L) is to create a non-intimidating environment with real life situations for staff members to practice and become comfortable implementing EAP’s.

Steps to implement Red Shirt Reviews
1. Develop scenarios: scenarios may be based on previous injuries and emergencies experienced in your organization and/or those you have learned about from similar settings. Writing the scenario in the format of a checklist is beneficial to the facilitators as it walks them through the review process. At UW-L, common cases such as rolled ankles, injured fingers, and minor lacerations were the initial reviews created. A checklist of proper procedures for each incident was developed with collaboration between Certified Athletic Trainers (ATC) on campus, the Student Health Center (MD), University Police, and the ERT members. Through time, additional reviews were developed, including cardiac emergencies and head trauma.

A color code is indicated on the checklist for ERT members to know the level of emergency, what to check for, what questions to ask, and how to role-play during the review:

• Red — more serious, life-threatening review; typically involves factors beyond the certification level of staff members; includes shock, CPR, AED, a call to 911 or campus police, and/or major first aid treatment.

Example: http://www.uwlax.edu/recsports/PDF%20Files/ERT/RSR/CPR_RED_CardiacArrest.pdf

• Green — less serious, non-life-threatening review that falls within the scope of certification level of staff members; includes minor first aid treatment that does not progress to shock or require a call to 911 or campus police.

Example: http://www.uwlax.edu/recsports/PDF%20Files/ERT/RSR/FA_GREEN_DislocatedFinger.pdf

Hint: it is easier to create a red shirt review after an incident occurs. Use feedback from your staff, ATC’s, the Student Health Center, and/or campus police.
2. Schedule reviews: scheduling red shirt reviews can be done in a variety of ways to accommodate ERT members. At UW-L, a student coordinator develops a schedule in a Google Doc with five to seven review times per week. This schedule is shared with all members of the ERT so they can sign up for one or more reviews based on their availability.

Typically, a review requires three ERT members: a victim, a primary facilitator to conduct the review, and a secondary facilitator to cover for reviewee (staff member being reviewed).

3. Gather equipment: equipment used for red shirt reviews can vary based on your organization. At UW-L, the following items are used and stored in the same office where the ERT members prepare for a review, ensuring each item is readily available:

• red shirts (“DRILL IN PROGRESS” printed on the front and back to eliminate panic of patrons)
• clipboard with red or green checklist
• training first aid kit
• AED trainer
• manikin
• CPR mask
• two-way radios (different than those used in work environment to avoid causing panic)
• moulage (mixture of Vaseline and corn syrup to create fake skin)

4. Prepare for review: when the time comes for a review, ERT facilitators should meet in a pre-determined, designated space, such as a back room or office. Arriving early allows time to for members to determine roles for the review. Below are other factors to consider or items to have ready prior to starting a review:
Victim

• red shirt
• moulage (if needed)
• understanding of scenario (ability to imply shock, excessive pain, etc.)

Primary Facilitator

• red shirt
• clipboard with red or green checklist
•  mock first aid kit
• AED trainer (if needed)
• manikin (if needed)
• CPR mask (if needed)
• one two-way radio
• understanding of scenario and ability to coach staff member through review as needed

Secondary Facilitator

• red shirt
•  clipboard with front desk checklist
• second two-way radio
• ability to cover for reviewee to ensure continued customer service
• understanding of emergency procedures at front desk to coach staff members not at scene through review

5. Perform review: during a red shirt review, reviewees are expected to follow procedures as if a real emergency were taking place. In a RED level medical emergency, staff radio for assistance, instruct someone to call 911 and campus police, begin CPR, apply and use an AED trainer on a manikin, and complete an injury report. Supplies are available in the training first aid kit to apply gauze, band aids, etc. if necessary.

While review is taking place, the secondary facilitator at the front desk reviews any additional staff members not at the scene to ensure they know what is expected of them. Topics covered include how you would help if you leave the information counter, how you would help if you remain at the information counter, and what additional steps need to be taken after EMS arrives. The secondary facilitator also assists patrons to ensure customer service is not impacted during the review.

ERT members conducting the review must act professionally and perform as the victim to the best of their abilities. It is imperative that all ERT members and reviewees take the situation seriously and act as if the scenario is real. This video http://www.youtube.com/watch?feature=player_embedded&v=_0oB82WJtK4 shows an example of a common red shirt review at UW-L.

6. Debrief reviewees: after a review has finished, all staff members involved sit down with the ERT facilitators for a debriefing. Facilitators discuss positive aspects of the review as well as address any issues. The debriefing can also be used to help answer questions staff members may have to ensure their comfort level if an actual emergency were to occur.

The success of ERT and red shirt reviews is heavily dependent upon the leadership and professionalism of the ERT members. They must be confident and proficient with all emergency action plans and procedures while keeping the scenarios as realistic as possible. Their assistance with red shirt reviews as well as their commitment to evaluating procedures is critical to the ongoing training of student staff members. For further information regarding the UW-L Rec Sports ERT, consult our website (http://www.uwlax.edu/recsports/ert.htm)

The UW-L Recreational Sports Department is indebted to many students who have assisted with the development and presentations of ERT over the past three years. Thank you for your commitment!