1. Virtual First Responder
Clinical Foundations of Medicine Elective Series
Second Life Safari
Marc R. Stephens
University of Phoenix
CMP521
Cynthia Mefford
18 October, 2008

2. Lesson Objectives
Working in collaborative groups, Medical students will explore the use of Second Life as a training system to simulate disaster triage.
Students will investigate a simulated mass casualty incident scenario, gather and analyze available data, and differentiate between the levels of the START system in triaging the disaster victims.

3. START Simple Triage And Rapid Transportation
Method used to effectively and efficiently evaluate all of the victims during a mass casualty incident (MCI).
The first-arriving medical personnel will use a triage tool called a triage tag to categorize the victims by the severity of their injury.
Once they have a better handle of the MCI, the on-scene personnel will call in to request for the additional appropriate resources and assign the incoming emergency service personnel their tasks.
The victims will be easily identifiable in terms of what the appropriate care is needed by the triage tags they were administered.
This method was developed in 1983 by the staff members of Hoag Hospital and Newport Beach Fire Department located in California.
(Wikipedia, 2008, Triage)

4. START spectrum
(Momeni, 2007, slide 10)

5. Triage Systems & Tags
The most common classification uses the internationally accepted four color code system.
Red indicates high priority treatment or transfer, e.g. Massive Hemorrhage, Tension Pneumothorax.
Yellow signals medium priority, e.g. Isolated Simple Femur fracture.
Green is used for ambulatory patients, e.g. Isolated Abrasions, contusions, sprains.
Black for dead or those with minimal chance of survival, e.g. Massive Head Injuries, 95% coverage with third degree burns.
(Momeni, 2007, slide 14)

6. Blue Category
Blue category includes patients who will probably not survive but who should transported and treated after priority one (red) but before priority two (yellow) patients.
This would relieve prehospital personnel from making some of the decisions regarding expectant cases.
This category however, is not generally accepted.
(Momeni, 2007, slide 15)

7. Pre-hospital triage: START
(Momeni, 2007, slide 16)

8. Play2Train is a virtual training space in Second Life designed to support Strategic National Stockpile (SNS), Simple Triage and Rapid Transportation (START), Risk Communication and Incident Command System (ICS) Training.
Play2Train Facility
(IBAPP, 2008, screenshots)

9. Triage Simulation Activity
Your team arrives on the scene of a mass casualty incident…

10. Triage Simulation Activity
Locate the victims
Assess condition
Assign START level

11. Virtual First Responder Activity
Break into groups of 3-4 students.
Each group will work together to identify the 8 victims at the scene and assign each victim a color-coded triage level.
Students will click on the victim mannequin to simulate the initial assessment.
This will deliver a text notecard to the student which will identify the victim number for tracking, and describes the status of the victim.
Based on this data the team should make its assessment and assign a color to the victim. Each team should make note of their assessment for each victim privately (do not put colored objects on the mannequins in SL).
All of the groups come together for a whole-class discussion and analysis of each victim.
Color-coded cards are placed on victims as each case is discussed.
Examine the scene as a whole. Where should the emergency response vehicles rally to receive the victims?
Close with discuss of the activity itself.

12. References
Idaho Bioterrorism Awareness and Preparedness Program. (2008). Training in virtual environments. IBAPP Website. Retrieved October 18, 2008, from
Momeni, A. (2007). Disaster Triage. Emergency Health Manager Training Program. Retrieved October 10, 2008, from
Wikipedia. (2008). Triage. Wikipedia, the free encyclopedia. Retrieved October 18, 2008, from