Incorporating the Pediatric Trauma Module Into Singapore’s Disaster Medical Responders’ Course

Introduction: In a mass casualty incident, adult medicine-trained emergency physicians and nurses may need to treat pediatric casualties, as part of Field Medical Teams (FMTs) deployed to pre-hospital First Aid Posts. These healthcare professionals are often unaccustomed to managing pediatric patients, who present relatively infrequently to adult general hospital emergency departments in Singapore. A pediatric pre-hospital trauma module was developed to address this gap in knowledge and skills, potentially improving the survival of pediatric casualties in a disaster scenario. Methods: The pediatric module was embedded in the National Disaster Medical Responders’ Course (DMRC) to ensure all emergency medicine medical and nursing staff would progressively benefit from this training. The learning objectives included: 1) effective clinical management of pediatric trauma in a pre-hospital environment with limited medical resources; 2) efficient management of team dynamics in organizing the FMT’s response to pediatric trauma management in a pre-hospital environment; and 3) accurate prioritization during pediatric trauma triaging and evacuation to hospital in a pediatric-predominant mass casualty incident. The curriculum included the following aspects: triage; initial assessment and primary survey; airway, breathing, circulation, and disability considerations focusing on differences between adult and pediatric patients; and team dynamics. Course content was delivered via pre-recorded lectures (given the ongoing COVID-19 pandemic) and hands-on skill stations in small groups. Results: From April 2022-August 2024, 50 courses with 1144 participants from public healthcare institutions were conducted. Of the participants, 246/1144 (21.5%) were doctors, 787/1144 (68.8%) were nurses, 65/1144 (5.7%) were allied health, and 46/1144 (4.0%) were administrative staff. Conclusion: Medical responders in a mass casualty incident need to be prepared for managing pediatric casualties, which are infrequently encountered in daily clinical practice. This module is an important component of Singapore’s disaster medical curriculum and will contribute to disaster preparedness for the vulnerable pediatric population.