Edited Version November 15, 2000 Transcript
EIIP Tech Arena Online Presentation

MUSTER: Multi-User System for Training Emergency Response

Soren Beck
Regional Sales Manager

Amy Sebring, Moderator
EIIP Technical Projects Coordinator

The original unedited transcript of the November 15, 2000 online Virtual Tech Arena presentation is available in the EIIP Virtual Library Archives (http://www.emforum.org/vlibrary/livechat.htm). The following version of the transcript has been edited for easier reading and comprehension. Typos were corrected, date/time/names attributed by the software to each input were deleted but the content of questions and responses are as stated by each participant. Answers to participants’ questions are grouped beneath the appropriate question to facilitate meaning.


Amy Sebring: Welcome to the EIIP Tech Arena! Today we are featuring MUSTER: Multi-User System for Training Emergency Response. Background information for today's session may be found at <http://www.emforum.org/varena/001115.htm>.

Now it is our pleasure to introduce the Regional Sales Manager for MUSTER-USA, Soren Beck. Soren Beck is an experienced teaching staff member working many years for educational institutions and with a background as Commander in the Royal Danish Navy.

He has significant educational experience from the Danish Naval Academy where he introduced interactive education tools and use of the Internet. Welcome Soren, and thank you for taking the time to be with us today.


Soren Beck: Thanks, MUSTER - Multi User System for Training Emergency Response - is a new simulation tool for training paramedics, doctors, nurses, EMTs, fire fighters, EMS personnel, decision-makers, etc. in disaster medicine.

In a disaster situation the decision-makers' abilities to cooperate are crucial to the success of the whole operation. MUSTER is a multi-user system that allows trainees to interact with one another and thereby learn individual skills as well as coordinated performance as a part of a larger rescue team. "Experience is the best teacher" but as the number of disasters is low, it is important to use other means within emergency management to prepare rescue teams for coping with emergency situations.

Field exercises are very important but have limitations. They are expensive, difficult to organize and therefore too infrequent to satisfy the total need for training. The need for a dynamic interactive training tool as a supplement to the field exercises is therefore evident. MUSTER satisfies this need.

With MUSTER you can:

* design scenarios to your specific requirements and medical tools and standards

* make simultaneous training of up to twenty persons

* perform dynamic patient simulation

* give extensive feed-back based on the build-in evaluation functions.

In some cases, drills may be completely replaced by MUSTER. In other cases, MUSTER can be used for preparation or evaluation of live/actual operations/exercises. Simulated training sessions in MUSTER are realistic, inexpensive and easy to arrange.

The core of the training simulation is the IVD (Intra Vascular Deficit) model. The IVD model is developed by doctors and simulates a patient's condition based on the injuries and treatment he or she receives. The patients in a scenario can be defined individually. Each patient can suffer a combination of 100 different injuries on the body in three levels. Each injury can be a wound, fracture or a burn. Each patient is also described by age, sex, weight, height, etc. This makes it possible to take into account the desired injury pattern for various accidents/disaster decisions.


The display is divided into four main areas: location, agents, resources and communication:

1) The location indicates the position of the trainee. This can be the accident location, triage, treatment area, hospital, inside an ambulance, etc. You can move patients between different locations, either walk, use stretchers, cars, ambulances, medevac helicopters, etc.

2) Agents are members of the of the rescue team, doctors, paramedics, nurses, EMTs, rescuers, police officers, firechiefs, firefighters, civilians, etc. Each trainee takes the role of an agent.

3) Resources are a list of medical tools, first-aid material, medicine, apparatus and other equipment.

4) Communication will take place by using the radio-button, and messages can be written to individuals or everybody.


At the beginning of the training session each trainee is assigned a role, e.g. the coordinator/On-Scene-Commander", paramedic, EMT, helper, etc. A typical session starts off with you being called to an accident. At the scene you are confronted with a number of injured people. Depending on your role, you diagnose, prioritize, dress/undress, treat, move, etc. the injured. The ability to cooperate, prioritize, make the right diagnostic, and use the available resources is a very important factor.

The features to evaluate a patient are complete: palpate, dialogue with the patient, measurements, medical observations, classification, handling (move, raise, lay down), medical records, dress/undress, etc.

Measurements and observations include: blood pressure, respiratory quality/frequency, pulse, pupil response, skin, jugular veins, central venous pressure, urine production, and capillary response.

The list of medical tools available is complete and is only limited by your individual medical protocols. A list of actors, medical tools and transports are listed here.


The Supervisor: The instructor or teacher is controlling the session by the MUSTER Supervisor screen. The scenario database contains a selection of sessions depending on your training requirement and the trainees' education level. The simulator can manage up to twenty trainees simultaneously. The Supervisor can closely follow the session, patient status, all actions made by the trainees and can also pause the session, communicate to individuals or all via the communication panel.


Evaluation: One of the central elements in the MUSTER training software is the evaluation and debriefing features. MUSTER has a log (with a time record) that records the agent's actions during the session, messages sent, etc. When debriefing the trainees, the supervisor can easily reconstruct all actions and view and present them in an easy and clear way.

The IVD-curves describes what is happening to the injured, expected life time with and without treatment, any improvement of IVD status made by the students/trainees, etc.

Injuries and Patient image: this is a complete picture of the patients with all the injuries, description of injuries etc.


This was a short presentation of what you can do with modern simulation software to enhance your EMS training. MUSTER version 1 has been on the market for a year and an improved version (version 2) will be released January 2001. Mid-2001 we expect an Internet-based version (MUSTER 2.5) to be released.

As an appreciation of your interest for MUSTER we can offer a five-user version of MUSTER for a very attractive price. A five-user version of MUSTER version 1.2 for only $450, but without scenario support - or MUSTER version 2 (5-user) for $985, inclusive one-year support. The support includes 20 hours operational and technical support, modification of scenarios to yours medical protocols, etc. However, these prices are far under retail prices and will only be valid until end of next week, and only for people or organizations participating in this online EMS forum.Please e-mail me at <[email protected]> or go to our Website: <http://muster.hypermart.net>and email me from here. I am now ready for questions!

[Audience Questions & Answers]

Amy Sebring: Thank you, Soren. Audience, please enter a question mark (?) to indicate you wish to be recognized, go ahead and compose your comment or question, but wait for recognition before hitting the enter key or clicking on Send. We now invite your questions/comments.


Kevin Farrell: It appears that the product is used to train using medical treatment protocols. Does the product scale to train in other areas, such as command and control?

Soren Beck: MUSTER was made for training coordination. The patient mode is only a part of the software. This is why it is a MULTI-USER software. You really need to have 5-20 users training together to get the benefit of this software.


Avagene Moore: In my former life as the local EM director and working closely with hospitals and EMS, I can see the value of this training tool. What kind of learning curve is involved in getting all players up to speed? Is there a tutorial with the product?

Soren Beck: It takes one session and 15-30 minutes to get used to the graphical user interface. It was our users (hospitals, paramedics, etc.) who designed the user interface.

We have an extensive manual, we prefer also to provide support and help for the first on-line session.


David Crews: Has there been any thought of making this an operational management tool in the field under actual conditions? A palm top computer with wireless technology could make it a reality by relaying the info to hospitals, EOC, ICS etc.

Soren Beck: We have so far been reluctant to use it for operational management. It will take extensive testing to do this. So far we have concentrated on the learning features, and will most likely stick to that.


Isabel McCurdy: Soren Re: transport. Do they include passenger cars, police vehicles, etc? So often during a crisis people are transported by alternate means and this has implications for the emergency response community.

Soren Beck: Yes, this is why you also can play police officer, journalist and civilians because they are a part of real life actions you have to take into account in any situation.


Amy Sebring: Soren, what improvements will be included in version 2.0?

Soren Beck: Graphical user interface, we now support burn wounds in addition to fracture and wounds palpate, medical treatment and airways is also improvements.


Kevin Farrell: Very well, we have seen the medical protocol segment, but what about hazmat or NBC events. Anything there for decon, control and containment, firefighting, rescue, command and control, resource management, public information, evacuation, and so forth?

Soren Beck: Yes, the first version of MUSTER was for paramedics, now also hospitals. Now we have an order to deliver MUSTER for general emergency management; including police, civil defense, military, government, EMS, etc. Everything will build up in modules, and be on the market in 2 years.


Roger Fritzel: My question is similar to Kevin's. Specifically, can individuals be trained to handle the kind of injuries arising from chemical warfare agents? And be trained to avoid contamination that might be present on the victims?

Soren Beck: Yes, there has been significant interest for these areas and because you can make your own scenarios, MUSTER can do this also.


Gil Gibbs: Does your set of equipment include the use of latex gloves? I didn't see them in the list.

Soren Beck: No, but they can be added like any other medical tools!


Derri Hanson: What about a version for NGO's involved in Emergency Management?

Soren Beck: We have delivered MUSTER to WHO in Nepal. We can discuss arrangements with NGO's.


Amy Sebring: Soren, in your normal package, are future upgrades included, or is there a separate maintenance plan available?

Soren Beck: Version 1.2 included free upgrades to MUSTER 2. In addition, we have a small annual support fee to make sure that our customers get the help needed.


David Crews: This looks like a great training tool. I was also taught "train the same as you are going to respond" That's why my comment on this as an operational tool. With continuing technological advances this looks like it has a lot of potential.

Soren Beck: We hope for an Internet version this summer! This will eliminate the need for transport, time, cost etc. but there are some operational hurdles we need to overcome.


Isabel McCurdy: Is MUSTER being used in any Canadian settings?

Soren Beck: Not yet, we are in negotiations with a few!


Kevin Farrell: Is the product Windows specific, or is it available to non-windows platforms? Will the Internet version be platform independent running through a web browser?

Soren Beck: Windows 98, 2000, NT, Mac, Linux! The software is written in JAVA and therefore Internet ready (technical).

Kevin Farrell: WooHoo!!


Amy Sebring: Soren, I realize you would lose the coordination features, but can this be run as a single user training without a Supervisor?

Soren Beck: The single user version also has the supervisor function. So you have in reality two functions in this version also, the actor (trainee) and the supervisor.

Amy Sebring: Ok, so does that mean there must be a Supervisor participating to run it?

Soren Beck: Yes, but that will be you too in the single user version. This version is mostly for practicing the patient model.

Final Question:

Avagene Moore: Has your product been on the market long enough to get feedback from users? If so, can you share any overall evaluations or reactions to the training received?

Soren Beck: Yes, and we are in constant dialogue with the users and improving the software based on these inputs. But most improvements are handled by modifying the scenarios. Please call me if you have any other questions <[email protected]>, 703-765-8357.


Amy Sebring: Thank you very much, Soren for being with us today. We very much appreciate your time and effort. Please stand by a moment while we take care of some business. We will have a text transcript posted later today, and reformatted versions with links to the slides at the end of the week. Avagene, can you tell us what is on for next week please?

Avagene Moore: Thank you, Amy. Soren, on behalf of the EIIP, we appreciate your time and effort in this fine presentation. We wish you the best with your product.

Next week, Wednesday November 22, 12:00 Noon EST, our featured speaker is Dr. Joanne McGlown who is online with us today. Joanne is an Asst. Professor at Jacksonville State University in Alabama and also does hospital / emergency medical consulting work. (I am sure she is interested in MUSTER, Soren). Joanne will share information about the "New JCAHO Emergency Management Standards for Health Care Facilities." Make your plans to join us next week. That all for now, Amy.

Amy Sebring: Thanks, Ava. If you are not on our mailing list and would like to receive weekly notices and our newsletter, please see <http://mail.wces.net:81/guest/RemoteListSummary/EIIP> to subscribe.

Thanks to all our participants today. We will adjourn the session for now, but you are welcome to remain for open discussion. You no longer need to use question marks. Please help us express our appreciation to Soren for today's presentation.