# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 4 Tactical Exercise Rozvadov 2018--Limits and Restrictions  
The Rozvadov 2018 tactical exercise is considered one of the largest and most logically demanding exercises of the Czech Republic's integrated rescue system in cooperation with a cross-border partner. The scenario of the training was a large traffic accident of a truck, three cars in a place of gathering of people with a larger number of people, when the total number of participants in the gathering was 250. Of these, 170 people were injured and the remaining 80 suffered psychological trauma. Specifically, 15 persons died, 30 persons were affected by failure of basic life functions (priority 1), 35 persons were severely affected (priority 2a), 25 persons were moderately affected (priority 2b) and 65 persons were slightly affected (priority 3). The exercise took place on the area behind the rest area in the cadastral area of the border crossing Rozvadov-Waidhaus, cadastral area Streble, where an unspecified gathering of 250 people took place. Figure 1 shows the location of the event. A lorry drove at high speed into the people gathered at the scene, veering off its route and colliding with three cars travelling along the area of the waiting area in front of the gathering. The vehicles were fully occupied by passengers. The cause of the accident was the medical indisposition of the truck driver, who suffered a myocardial infarction and ran the truck off its route. Monitoring of the reported event took place at the scene as part of the security measures of the reported event, patrols from the District Police Department and the anti-conflict team were present. Medical assistance was provided by the Medical Rescue Service of the Pilsen Region. The description of the event itself shows how demanding the exercise was, especially on human resources. A total of 250 participants were deployed at the scene in the role of mannequins, i.e., including mannequins simulating truck drivers, crews of three cars (four persons/car), three mannequins were placed in the nearest forest stand for tracking practice. The total number of mannequinswas supplemented by 10 film mannequins simulating devastating mechanical injuries incompatible with life. The mannequins were students of the Faculty of Health Care Studies of the University of West Bohemia in Pilsen, who were professionally masked and instructed about their disability, including symptoms and  
Figure 1: Location of the emergency within the framework of the implemented exercise Rozvadov 2018.  
their manifestations, they were marked with orientation cards with fictitious identification data, description of injuries, values of basic life functions in Czech and German. A total of 170 mannequins, who simulated injuries, were realistically moved to predetermined facilities. A total of 80 participants simulating psychological trauma were provided with psychological intervention services at the exercise site by the psychological intervention teams of the individual components of the integrated rescue system. The aim of the exercise specifically for the Medical Rescue Service of the Pilsen Region was to test the activation and functionality of the Traumatology Plan of the Medical Rescue Service of the Pilsen Region. In connection with the verification of the procedure according to the plan, it was specifically about the division into individual teams, the development of individual stations, primary re-sorting, secondary medical sorting, the organization of routing and removal of the injured and registration of the injured-deceased. In this context, the submission of the first information from the accident scene to the health operations centre and the triage of casualties were identified as key activities to the virtual reality training. A detailed description of the activities and activities within the training is described, including a timeline, in Table 1.  
To assess the readiness of the components of the integrated rescue system, a conference was held as well as semi-structured interviews with training participants.