The screams of injured patients and gunshots rang out across Ballarat's ACU campus as fourth year paramedicine and nursing graduates took part in a mass casualty disaster exercise along with army medics and the city's emergency services.
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More than 300 people from ACU, Victoria Police, the Country Fire Authority, State Emergency Service, St John Ambulance, Ballarat Health Services, two Victorian Medical Assistance Teams and 3 Health Battalion from Adelaide took part in the exercise - the first held since 2019.
The scenario began with a vehicle-borne attack, running victims down, from a gunman with two hostages. The gunman then entered a building, shooting victims, before letting off an improvised explosive device in the university's quadrangle and continuing his shooting rampage in another building.
To make the emergency as realistic as possible volunteers, most from other years of the paramedicine and nursing course and university staff, were made up with fake wounds and injuries to be triaged.
Event coordinator Associate Professor Helen Webb said the disaster response, back after a two-year COVID break, was vital to understanding the workings of a mass casualty scene, chains of command, control and rapidly-changing situations.
"These large scale exercises are scarce and the more opportunity to work with other agencies the better the response will be in a real situation," she said.
"What we focus on is command, control and inter-operability so it's a win-win situation and everyone gets something out of it," she said.
About 60 graduating paramedicine and nursing dual degree students formed the health response, taking on the roles of health commander, communication, casualty clearing officer and triage officers with the remainder of students on the triage team treating the casualties.
"This is a phenomenal experience which gives our students the opportunity to work alongside emergency services for real and experience emergency services interoperability," Associate Professor Webb said.
"We know with previous incidents in the world, the best outcomes in emergencies are when service personnel know each other."
After police dealt with the gunman, the other emergency services moved in to complete their roles.
Associate Professor Webb said the exercise would challenge the paramedicine and nursing graduates with tough decisions needing to be made about injuries patients and who they can and cannot save.
Australian Army medicos also took part in the exercise for the first time, with one of the lieutenants also a former graduate of ACU and Associate Professor Webb also an army reserve officer.
Ballarat police Senior Sergeant Anthony Traynor said almost 20 police from Ballarat and Buninyong, and the operational safety tactics team, took part in the exercise.
"It is essential for health students and paramedics to have realism to their training and to be able to exercise how our plans all link in with each other," he said.
ACU nursing and paramedicine student Eideann Sly, acting as emergency communications officer, said the in-depth realism of the exercise was invaluable for the students.
"It's pretty much the only opportunity we get to practice mass casualty. We've got the ADF here from Adelaide and working with police, CFA and SES so the focus of the day is on command, control and inter-operability.
"We can practice with mannequins ... but they don't provide the screaming, the running around, the real sounds of a mass casualty event so this gives us a complete immersion and opportunity to work with all the services," they said.
Fellow student Thomas Marcus said as a new graduate, going in to the real world, this would prepare them for something they all hope will not occur.
"This prepares us to be in the position where we might actually be the initial crew at a mass casualty accident ... and it's about as realistic as it can get with actual human patients acting, mannequins and a wide-spread centre," he said
"We get to learn from this and hopefully we are prepared better for future scenarios ... and it's a great way for us to finish out four years of learning."
He said a previous graduate had been one of the first on site at a mass casualty event and was the most experienced person there because of his involvement in a previous ACU training exercise.
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ACU Ballarat Campus Dean, Professor Bridget Aitchison, said the annual exercise provided crucial insight into real-world mass-casualty events, allowing students to finetune their training, learn and make mistakes without putting lives at risk.
"Our students are in their fourth year of study, so they have done their practical experience on placement, but nothing really prepares them for a mass casualty or disaster of this scale," she said.
"They don't know how they will respond until they are in it, and by doing a simulation that's as close as possible to the real thing they get firsthand experience of what it's like to be in that pressure cooker."
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