# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 5 Virtual Scenario \"Car Accident\"
The layout of the accident and the injured people is such that a maximum space of \(3\times 3\) m is needed. The evening hours were chosen to simulate degraded visibility conditions and thus create a more challenging decision-making situation. The module is designed for a two-car accident at a given time (see Figure 6). The scene itself is supplemented with sounds such as streams and cries of the injured, as well as ambulance  
Figure 4: Avatar. Figure 5: START button to start the module. and engine sounds. The aim is to create as synergistic an experience as possible, so that users can experience complex situations and practise their knowledge of how to handle them using this technology. In this method, training is carried out in two basic methods: the METHANE and the START triage. In terms of METHANE, it is about reporting an accident to the dispatcher by radio, for these training applications the radio has been replaced by a tablet where the user selects the correct answers according to each letter. METHANE is a mnemonic tool whose individual letters represent the following: M--major incident declaration, E--exact location, i.e., the exact location of the incident, T--type of incident, i.e., the nature of the incident, including the number of vehicles, buildings, etc., H--hazards, both present and potential, A--access, i.e., the best route for the emergency services to access the site, or obstacles and bottlenecks to avoid, N--numbers, i.e., the number of casualties, deaths and injuries at the scene, E--emergency services, i.e., an indication of the emergency services already on site and still required [33]. For the training part, the letters are separated by name and the user can only select the correct option. For the test version, a generator is designed that randomly scatters the letters, and in addition to the correct answer selected, it also checks in which order the user started reporting the accident. The already selected buttons are underlined for the user to have a better overview. This helping function can be switched off. In addition, the tablet serves as a confirmation signal, as the crew must announce that they have arrived at the scene. When triaging according to the START method, the user controls the basic functions by which the patient is sorted into one of four basic colours. These functions include heart rate, respiration, and capillary test. In terms of real testing, haptics and touch with the patient are important for these measurements, so smartwatches were used for virtual training to represent the measurement of these functions and give the values. The display of this value has a lifetime (it is displayed for a given amount of time) because of the more realistic simulation of the real process where rescuers must calculate and remember it. This watch indicates by familiar pictures what type of measurement it is. The capillary measurement is simulated using an image that shows a detail of the nail (this principle was used because it is a very detailed measurement that would be simulated on the injured person poorly in terms of virtual reality capabilities). Measurements are taken by holding the hand at selected points for the time shown on the watch (see Figure 7). The JUMP-START method is used to treat children and teenagers to ensure that the paramedic attends to them among the first injured. To perform the application, this means that it is monitored whether children have been treated urgently. Figure 6: Vehicle deployment in a car accident. Visual management was used to ensure correct placement of objects, with locations highlighted in pink (see Figure 8). The objects that the user uses to provide first aid can be found in the rescue bag. Places where to place objects or tape are highlighted in pink. The pink colour was chosen so as not to be confused with the colours that are used and to be very distinctive. Areas where basic functions can be measured have been highlighted with green dots. For the training version these points were not shown.