We’ve all been there, sitting in a small room watching a presentation on a subject, where the presenting style doesn’t encourage you to learn. After a day or two, you begin to question how much of the training you’re able to remember.  For first aid, remembering key procedures, questions and mnemonics is vital to help save someone’s life; yet if you’re just being read what’s on the screen in front of you, are you really taking it all in? 

The majority of first aid training providers use manikins for CPR training and trainees on the course to practise general first aid skills, such as bandaging a wound or dealing with an unconscious casualty. But how well does this really set trainees up for the real live world? How much do the delegates on the first aid course remember? Is there any way that the training can be improved to ensure the trainees are set and ready in the best way possible? The answer to the last question, in short, is yes.

What is casualty simulation?

Casualty simulation, by definition, is the skill of accurately portraying injury or illness in as realistic a way as possible. To the trainer, it’s an interesting, yet novel addition to first aid training; providing realistic and interactive sessions that allow participants to feel empowered and want to return. To the trainee, however, it is something more. It is an opportunity to get hands-on with simulated casualties, test what it is like to work under pressure with the apprehension and uncertainty of how an individual will react to their first aid treatment and skills.

A woman portraying an individual having a heart attack using casualty simulation skills.

How casualty simulation makes a difference in first aid training

Casualty simulation benefits everyone in a multitude of ways, however, it is sometimes easier to visualise these by comparing a number of standard first aid training scenarios. 

Scenario 1 – An unconscious casualty

Without casualty simulation With casualty simulation
The casualty is portrayed by a member of staff or first aid trainee. The casualty is quietly lying in the middle of the floor space and, when moved into the recovery position, their hand remains by the face and the casualty rolls with ease into the correct position. The casualty is portrayed by a person unknown to the training group. They are found lying next to chairs, or other objects, making ‘snoring’ breathing sounds. They do not maintain any position and their head may flop to one side if moved. They become a dead-weight when rolled into the recovery position; hands, arms and legs do not stay put.

Scenario 2 – Laceration to an arm

Without casualty simulation With casualty simulation
A trainee or colleague portrays the casualty and walks into the room with fake blood representing a 3 cm long laceration. They are screaming hysterically, reluctant to be treated by a first aider. When a bandage is applied there is little to no change in their reaction or acting. A volunteer or an individual that is not known to the group walks into the room. They use their hand and body posture to protect the simulated laceration. They portray someone in pain, frustrated and upset at how the injury was caused. There may be evidence of a broken cup, sharp object or other item nearby to help illustrate the scenario. When being treated their face winces and they will sound out their pain.

Scenario 3 – Burns to Arms

Without casualty simulation With casualty simulation
The first aid trainee is seated in the room with reddening to simulate burns on their arms, mainly of superficial kind. They act in mild pain. First Aiders pour water over the burns and apply film to provide initial help, there is no change to the casualty’s acting when there is an increase in pain from treatment. The casualty, played by an unknown individual, rushes into the room in a panic. They indicate how and where the accident occurred by use of a backstory or props. They act in considerable pain at the location of the burn(s) and the burns are simulated in the specific / realistic location where they are likely to have happened (e.g. inner arms if the arms were defensively raised from an explosion). When water is poured on to it, or the burn is handled by the first aider, the casualty simulator acts out more pain. Depending on the cause of the burn there may be clothing or other objects ‘melted’ into the skin.

Benefits for first aid learners and trainees

  • Improved communication skills between injured parties and themselves
  • Improved communication and handover skills between other first responders and themselves
  • Increased confidence in the use of first aid kits
  • Exposure to simulated injuries or illnesses and what they may look like / how they will manifest in real life
  • Better casualty handling and given care
  • Confidence in the use of own first aid skills when dealing with an unknown person

Benefits for the first aid trainers and training organisations

  • More interactive training sessions for the learners
  • A better learning experience
  • Better training course reviews
  • More unique courses

Why investing in special effects make-up alone may not be enough

You’ll be surprised at how much of a difference casualty simulation, when used correctly, makes. In our previous articles, we discussed how make-up is only one of three key elements of casualty simulation. An unequal balance of these causes scenarios to become unrealistic and the training to be less beneficial. Investing in special effects make-up kits can provide a useful initial step forward; introducing trainees or learners to what real wounds look like. But a further emphasis needs to go on the correct portrayal of injuries, illnesses and reactions through acting. Without this secondary part it is possible to have a ‘casualty’ with a broken leg who doesn’t react or respond correctly should it be inadvertently knocked or moved without prior communication. The trainee therefore cannot improve their situational awareness or communication skills as they would not know anything different.

Aside from make-up, other injury simulation aids can be easily applied and removed but their nature does not allow it to be blended into the casualty’s skin nor can it be adjusted to match a specific scenario or staged scene.

Focussing on casualty simulation as a whole concept is key. Invest time in researching realistic and up-to-date scenarios that are relevant to the delegates attending your first aid training. Use the first aid training course to bring them out of their comfort zone and allow them to practise and better prepare themselves for the real world.

Find out more

The charity Casualties Union has been helping training providers make their first aid simulations more realistic for the past eighty years! You can learn about what Casualties Union do, request their assistance for your first aid training or make an enquiry about volunteering by visiting this page or calling 08700 780 590. You can also watch an example of realistic training involving emergency services here. Don’t forget to also explore our social media accounts for all the latest news about our volunteering.