# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 6 Discussion
To master the METHANE method, the student must mention his/her call sign (M--major incident), the exact location of the accident site (E--exact location), the type (T--type of incident), the possible hazards at the scene (H--hazards), the access routes (A--access to scene), the number and type of post-incident casualties (N--number of casualties) and the medical resources present and needed (E--emergency services). In the case of the START and JumpSTART methods, the student must be familiar with the triage procedure. Basic procedures for securing persons with various injuries include stopping massive external bleeding, clearing the airway, and placing the casualty in a stable position. In the case of stopping massive external bleeding, the individual entering the virtual environmenthas several options--finger pressure in the wound, pressure dressing, pressure points, and tourniquet. In each scenario, the use of a tourniquet is necessary if a particular case generates a casualty with amputation or crushing of a limb. In doing so, the tourniquet must be at least 5 centimetres wide, always placed over the casualty's clothing, inserted between the wound and the heart, as close to the wound as possible, always placed at the site of the bone--on the arm, on the thigh. The tourniquet is never loosened, and it is always necessary to write the time of strangulation on the affected part of the body. The strangulated part of the body is always raised higher. The airway is cleared by head position or, in case of suspected spinal/spinal cord injury, initially only by advancing the jaw. Placement in a stable position is performed in unconscious persons with normal respiratory activity without suspicion of possible spinal/spinal cord injury, i.e., without an injury mechanism, which is not an appropriate procedure in the event of a road traffic accident. For acquisition, verification, consolidation and revision of knowledge and skills, a basic training for paramedics was prepared in the context of the car accident module. This is training that does not fall under emergency situations but is very important from the point of view of the functioning of integrated rescue services. The developed training set is designed specifically for the medical components of the rescue system. These are the basic types that they will encounter even in a normal call-out (which does not fall under an emergency). The module is divided into 3 parts. The first part contains two basic modules that train new candidates on the equipment of the rescue vehicle (ambulance) and the use of the portable defibrillator (AED). The second part focuses on the use of the pulmonary ventilator, which has become widely used in recent years due to the COVID-19 pandemic. This application should make the job easier for new paramedics who meet a pulmonary ventilator and are unsure how to proceed. The last part is a supporting database for previous models to arrange their diversity. It is a database of 3D models of people and children, which are categorized into four basic groups according to the START (Jump-Start) method. The development of this database involved working with regional emergency services to define the most common injuries and symptoms patients would have for a given diagnosis. As a result, of this input, a database of 80 models was created, containing 20 children and 60 adults evenly distributed in groups according to the colours of the START method. Each model has a pre-defined pulse, respiratory rate and force, capillary colouration and a critical time that determines how long it takes for its condition to deteriorate. Critical time is crucial for patients who must be among the first to be treated by emergency services. It simulates real-life situations where rescuers must decide within moments who to save as a priority. The database was created to allow for rotation of casualties in each module and to mandate wide scalability of testing for new and current members of the emergency services.