Our recent High Acuity Low Occurrence (HALO) Sim Day was developed to provide cross-specialty, interdisciplinary training, equipping staff from multiple departments with the skills needed to manage critically unwell patients in the Emergency Department. The training emphasized human factors and non-technical skills, ensuring effective teamwork, leadership, and decision-making under pressure across the multidisciplinary team (MDT) while maintaining high-level clinical management.

We were pleased to collaborate with colleagues from Anaesthetics and Intensive Care, with invaluable facilitation from experts across departments. A special thanks to Dr. Scott Castell from The Air Ambulance Service for sharing his expertise and insights. The day was well received by both doctors and nurses, and we look forward to providing this essential training to more staff throughout the summer.

Here is our HALO Sim Day Guide, featuring a structured Lesson Plan and Revision Guide designed for curriculum-based learning with scenario-based training. All scenarios are linked to the RCEM and FICM curriculums, making it a valuable resource for trainees and educators nationwide.

Scenarios covered were:

• Traumatic head injury with time critical transfer.

• Obstetric emergency.

• Acute Behavioural Disturbance with complex procedural sedation.

• Inhalation injury, cyanide poisoning.

• Paediatric trauma.

• Penetrating chest trauma.

We are aiming to run this consistently every 6 months. Overall, we want to improve inter-specialty management, training experience and be in a better state of readiness for things that rarely occur whilst using the human factor and non-technical skills we learn as a transferrable experience in everything we do.

Positive feedback received after first session

“Excellent faculty. Very well organised.”

“Great to work with other specialties.”

“Interprofessional working with Nurses and ACPs across a variety of sims was great”

Example bar charts showing staff confidence Levels before and after teaching intervention on Obstetric Emergencies

Feedback on what to improve