Emergo Train System – a tool for scientific studies

Models and simulations can support experimental research on disaster medical respons management, human factors and decision making. Structured data collection from simulation exercises can provide quantative and qualitative results that allows comparison. The publications below relate to use of Emergo Train System.


ETS includes process indicators and outcome indicators. After an exercise the results of process indicators for management can be related to the end result of patient outcome.

Flauto A., Marcis L, Pallavicini P., Calzolari F., Nanetti T., Scopelliti A., Fabbri M., Cremonini S., Imbriaco G. (2024). Mass Casualty Incident Preparedness for Airport Emergencies: Report from an Aeroplane crash simulation at Guglielmo Marconi Airport, Bologna (Italy)
https://www.cambridge.org/core/journals/disaster-medicine-and-public-health-preparedness/article/mass-casualty-incident-preparedness-for-airport-emergencies-report-from-an-aeroplane-crash-simulation-at-guglielmo-marconi-airport-bologna-italy/C7BB7572564750754898D8E51ED7AFC9/share/221b2996722d3dce21b0bb7c3edb82bcb397bf1869c5067064a0b4cbe470fa28

Waring, S., Skryabina E., Goodwin D., Lino D., Amlôt R. (2021).What components of emergency preparedness exercises improve healthcare practitioners’ emergency response learning? International Journal of Disaster Risk Reduction.
https://doi.org/10.1016/j.ijdrr.2021.102357

Middlemiss, V. (2020).An evaluation of non-technical skills development through Emergency Preparedness , Resilience and Response exercises for health sector personnel. University of Bath.
https://researchportal.bath.ac.uk/en/studentTheses/an-evaluation-of-non-technical-skills-development-through-emergen

Kim, J., & Lee, O. (2020). Effects of a simulation-based education program for nursing students responding to mass casualty incidents: A pre-post intervention study. Nurse Education Today, 85, 104297. https://doi.org/10.1016/j.nedt.2019.104297

Crombie, A., Faulkner, P., Watson, I., & Savy, B. (2020). Smooth move: The use of the Emergo Train® system in transitioning to a new hospital. International Journal of Healthcare Management, 13(3), 186–188.
https://doi.org/10.1080/20479700.2017.1389480

Berggren, P., & Hernandez, E. B. (2020). Validation of new ETS material. Patient bank for Bomb blast victims (ETS-2020-02). Region Östergötland.

Joensuu, R., & Poikolainen, M. (2019). Mass casualty incident preparedness with Emergo Train System tabletop exercise in New Children’s Hospital Emergency Department [HUS]
https://www.theseus.fi/bitstream/handle/10024/262943/Joensuu_Raisa%20Poikolainen_Mia.pdf?sequence=2&isAllowed=y

Berggren, L. (2019). Emergo Train System ® En modul anpassad för Räddningstjänsten (LIU-IDA/KOGVET-A–19/017–SE). Linköpings universitet.

Berggren, P., Hornwall, J., Kristedal, E., & Pettersson, J. (2019). ETS kongress 2018 (KMC/ETS-2019-002). Region Östergötland.

Cronan, K., & Winn, L. (2019). Development of an Evacuation Exercise for Residential Aged Care Facilities Using the Emergo Train System (ETS). WADEM Congress on Disaster and Emergency Medicine 2019, 34(s1), s1–s1.
https://doi.org/10.1017/s1049023x19000220

Berggren, P., Lidberg, H., Ranåker, L., & Hornwall, J. (2019). Utvärdering av modul räddningstjänst för Emergo Train System (KMC/ETS-2019-001). Region Östergötland.

Rybing, J. (2018). Studying Simulations with Distributed Cognition [Linköping University Electronic Press]. https://doi.org/10.3384/diss.diva-145307

Berggren, P., Herrera Velasquez, M., Pettersson, J., Henning, O., Lidberg, H., & Johansson, B. J. E. (2018). Reflection in Teams for Training of Prehospital Command and Control Teams. In K. Boersma & B. Tomaszewski (Eds.), ISCRAM 2018.

NSW Health Emergency Management Unit Office of the State HSFAC. (2018). Exercise Alecto 4. Evaluation report (Issue March).

Crombie, A., Faulkner, P., Watson, I., Savy, B. (2017). Smooth move: The use of the Emergo Train System in transitioning to a new hospital. [International Journal of Healthcare Management]. https://doi.org/10.1080/20479700.2017.1389480

Berggren, P., Pettersson, J., Jonson, C.-O., Prytz, E. G., Carlsson, H., & Nilsson, H. (2017). The importance of using the designated duty officers when assessing a medical response organization. European Journal of Public Health, 27(Supplement 3), 435.

Herrera Velasquez, M. (2017). The Use of Shared Priorities in Prehospital Medical Management (No. LIU-IDA/KOGVET-G–17/011–SE). Linköping: Linköping University.

Jonson, C.-O., Pettersson, J., Rybing, J., Nilsson, H., & Prytz, E. G. (2017). Short simulation exercises to improve emergency department nurses’ self-efficacy for initial disaster management: Controlled before and after study. Nurse Education Today, 55, 20–25. http://doi.org/10.1016/j.nedt.2017.04.020

Lampi, M. (2017). Triage. Management of the Trauma Patient. Linköping University Medical Faculty, Dissertation No. 1563. Linköping, Sweden: Linköping University Electronic Press.

Rybing, J., Larsson, J., Jonson, C.-O., & Prytz, E. (2016). Preliminary Validation Results of DigEmergo for Surge Capacity Management. Proceedings of the International ISCRAM Conference 2016, (May).

Rybing, J., Nilsson, H., Jonson, C.-O., & Bång, M. (2016). Studying distributed cognition of simulation-based team training with DiCoT. Ergonomics, 59(3), 423–434. http://doi.org/10.1080/00140139.2015.1074290

Rybing, J., Prytz, E., Hornwall, J., Nilsson, H., Jonson, C.-O., & Bång, M. (2016). Designing a Digital Medical Management Training Simulator Using Distributed Cognition Theory. Simulation & Gaming, 48(1), 131–152. http://doi.org/10.1177/1046878116676511

Socialstyrelsen. (2016). Hälso- och sjukvårdens förmåga att hantera en allvarlig händelse med många skadade. Erfarenheter och lärdomar av Övning TYKO (No. S2016/01460/FS). Stockholm.

Nilsson, A., Åslund, K., Lampi, M., Nilsson, H., & Jonson, C.-O. (2015). Improved and sustained triage skills in firemen after a short training intervention. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 23(81), 1–6. http://doi.org/10.1186/s13049-015-0162-7

Nilsson, H., Lidberg H., Jonson C-O. (2014). PS- Prehospital Sjukvårdsledning Ett nationellt koncept

Lampi, M., Vikström, T., & Jonson, C.-O. (2013). Triage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident: a prospective cross-sectional survey. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 21(90), 1–6. http://doi.org/10.1186/1757-7241-21-90

Nilsson, H., Jonson, C.-O., Vikström, T., Bengtsson, E., Thorfinn, J., Huss, F., … Sjöberg, F. (2013). Simulation-assisted burn disaster planning. Burns, 39(6), 1122–1130. http://doi.org/10.1016/j.burns.2013.01.018

Nilsson, H. (2012). Demand for Rapid and Accurate Regional Medical Response at Major Incidents (No. Linköping University Medical Dissertations No. 1350). Linköping: Linköping Univeristy. Download here >>>

Rådestad, M., Nilsson, H., Castrén, M., Svensson, L., Rüter, A., & Gryth, D. (2012). Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 20(1), 1–8. http://doi.org/10.1186/1757-7241-20-58

Gryth, D., Rådestad, M., Nilsson, H., Nerf, O., Svensson, L., Castrén, M., & Rüter, A. (2010). Evaluation of Medical Command and Control Using Performance Indicators in a Full-Scale, Major Aircraft Accident Exercise. Prehospital and Disaster Medicine, 25(2), 118–123. http://doi.org/10.1017/S1049023X00007834

Nilsson, H., Vikström, T., & Rüter, A. (2010). Quality control in disaster medicine training – Initial regional medical command and control as an example. American Journal of Disaster Medicine, Vol. 5, No. 1, January/February 2010

Rüter, A., & Vikström, T. (2009). Improved Staff Procedure Skills Lead to Improved Management Skills: An Observational Study in an Educational Setting. Prehospital and Disaster Medicine, 24(5), 376–379. http://doi.org/10.1017/S1049023X00007172

Wakasugi, M., Nilsson, H., Hornwall, J., Vikström, T., & Rüter, A. (2009). Can performance indicators be used for pedagogic purposes in disaster medicine training? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 17(15), 1–5. http://doi.org/10.1186/1757-7241-Received

Nilsson, H. & Rüter, A. (2008). Management of resources at major incidents and disasters in relation to patient outcome: a pilot study of an educational model. European Journal of Emergency Medicine 2008;15:162-165

Rüter, A., Örtenwall, P., & Vikström, T. (2007). Staff procedure skills in management groups during exercises in disaster medicine. Prehospital and Disaster Medicine, 22(4), 318–21. http://doi.org/10.1017/S1049023X00004933

Rüter, A. (2006). Disaster medicine- performance indicators, information support and documentation. A study of an evaluation tool (No. Linköping University Medical Dissertations No. 972). Linköping University. Retrieved from papers3://publication/uuid/D974C29A-4464-40B5-9A69-27D11999AD8F

Carbonell, D., & Mark, P. R. (2006). The Emergo Train System—will it work in Australia? The Australian Journal of Emergency Management, 21(1), 60–61.

Rüter, A., Nilsson, H., & Vilkström, T. (2006). Performance indicators as quality control for testing and evaluating hospital management groups: A pilot study. Prehospital Disaster Medicine, 21(6), 423–426. http://doi.org/10.1017/S1049023X00004131