Enhancing Hospital Surge Capacity for Mass Casualty Events

JAMA ◽  
2009 ◽  
Vol 302 (5) ◽  
pp. 565 ◽  
Author(s):  
Kobi Peleg
Keyword(s):  
Mass Casualty ◽  
Surge Capacity ◽  
Mass Casualty Events

Hospital Surge Capacity: A Web-Based Simulation Tool for Emergency Planners

2017 ◽  
Vol 12 (4) ◽  
pp. 513-522 ◽  
Author(s):  
Matthew F. Toerper ◽  
Gabor D. Kelen ◽  
Lauren M. Sauer ◽  
Jamil D. Bayram ◽  
Christina Catlett ◽  
...  
Keyword(s):  
Disaster Response ◽  
Mass Casualty ◽  
Simulation Tool ◽  
Urban Hospital ◽  
Surge Capacity ◽  
User Input ◽  
Response Strategies ◽  
Mass Casualty Events ◽  
Bed Capacity ◽  
Nationally Representative

AbstractThe National Center for the Study of Preparedness and Catastrophic Event Response (PACER) has created a publicly available simulation tool called Surge (accessible at http://www.pacerapps.org) to estimate surge capacity for user-defined hospitals. Based on user input, a Monte Carlo simulation algorithm forecasts available hospital bed capacity over a 7-day period and iteratively assesses the ability to accommodate disaster patients. Currently, the tool can simulate bed capacity for acute mass casualty events (such as explosions) only and does not specifically simulate staff and supply inventory. Strategies to expand hospital capacity, such as (1) opening unlicensed beds, (2) canceling elective admissions, and (3) implementing reverse triage, can be interactively evaluated. In the present application of the tool, various response strategies were systematically investigated for 3 nationally representative hospital settings (large urban, midsize community, small rural). The simulation experiments estimated baseline surge capacity between 7% (large hospitals) and 22% (small hospitals) of staffed beds. Combining all response strategies simulated surge capacity between 30% and 40% of staffed beds. Response strategies were more impactful in the large urban hospital simulation owing to higher baseline occupancy and greater proportion of elective admissions. The publicly available Surge tool enables proactive assessment of hospital surge capacity to support improved decision-making for disaster response. (Disaster Med Public Health Preparedness. 2018;12:513–522)

Early Diagnosis and Intervention in Mass Casualty Events

2008 ◽  
Author(s):  
Ilan Kutz ◽  
Rachel Dekel ◽  
Shaul Schreiber ◽  
Victor Resnick ◽  
Ornah T. Dolberg ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Mass Casualty ◽  
Mass Casualty Events

Non-Pediatric Nurses’ Willingness to Provide Care to Pediatric Patients during a Disaster: An Assessment of Pediatric Surge Capacity in Four Midwestern Hospitals

2021 ◽  
pp. 1-6
Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick
Keyword(s):  
Pediatric Patients ◽  
Response Rate ◽  
Mass Casualty ◽  
Pediatric Care ◽  
Pediatric Nurses ◽  
Surge Capacity ◽  
Factors Associated ◽  
Pediatric Hospitals ◽  
Survey Response Rate ◽  
Mass Casualty Event

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.

COVID-19: lessons learnt and priorities in trauma and orthopaedic surgery

2021 ◽  
Author(s):  
S Madanipour ◽  
F Iranpour ◽  
T Goetz ◽  
S Khan
Keyword(s):  
Elective Surgery ◽  
Risk Mitigation ◽  
Mass Casualty ◽  
Health Crisis ◽  
Lessons Learnt ◽  
Mass Casualty Events ◽  
Trauma Networks ◽  
Major Incidents ◽  
Bed Capacity ◽  
Orthopaedic Community

The COVID-19 pandemic is the most serious health crisis of our time. Global public measures have been enacted to try to prevent healthcare systems from being overwhelmed. The trauma and orthopaedic (T&O) community has overcome challenges in order to continue to deliver acute trauma care to patients and plan for challenges ahead. This review explores the lessons learnt, the priorities and the controversies that the T&O community has faced during the crisis. Historically, the experience of major incidents in T&O has focused on mass casualty events. The current pandemic requires a different approach to resource management in order to create a long-term, system-sustaining model of care alongside a move towards resource balancing and facilitation. Significant limitations in theatre access, anaesthetists and bed capacity have necessitated adaptation. Strategic changes to trauma networks and risk mitigation allowed for ongoing surgical treatment of trauma. Outpatient care was reformed with the uptake of technology. The return to elective surgery requires careful planning, restructuring of elective pathways and risk management. Despite the hope that mass vaccination will lift the pressure on bed capacity and on bleak economic forecasts, the orthopaedic community must readjust its focus to meet the challenge of huge backlogs in elective caseloads before looking to the future with a robust strategy of integrated resilient pathways. The pandemic will provide the impetus for research that defines essential interventions and facilitates the implementation of strategies to overcome current barriers and to prepare for future crises.

Preventing Pediatric Mass Casualty Events

2007 ◽  
Vol 5 (2) ◽  
pp. 25-26 ◽  
Author(s):  
Margaret M. McMahon
Keyword(s):  
Mass Casualty ◽  
Mass Casualty Events

Altered Standards of Care During an Influenza Pandemic: Identifying Ethical, Legal, and Practical Principles to Guide Decision Making

2009 ◽  
Vol 3 (S2) ◽  
pp. S132-S140 ◽  
Author(s):  
Donna Levin ◽  
Rebecca Orfaly Cadigan ◽  
Paul D. Biddinger ◽  
Suzanne Condon ◽  
Howard K. Koh ◽  
...  
Keyword(s):  
Public Health ◽  
Planning Process ◽  
Influenza Pandemic ◽  
State Level ◽  
Mass Casualty ◽  
Standards Of Care ◽  
Public Health Preparedness ◽  
Community Stakeholders ◽  
Mass Casualty Events ◽  
Public Health Officials

ABSTRACTAlthough widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. We describe the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S132–S140)

scholarly journals When Direct Pressure Is Not Enough: An Educational Technique for Teaching Wound Packing in Athletic Training Education

2021 ◽  
Vol 16 (4) ◽  
pp. 278-286
Author(s):  
Ashley B. Thrasher ◽  
Edward J. Strapp
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
Wound Care ◽  
Athletic Trainers ◽  
Mass Casualty ◽  
Laboratory Activity ◽  
Civilian Casualty ◽  
Mass Casualty Events ◽  
Direct Pressure ◽  
Educational Technique

Context Uncontrolled hemorrhage is a major cause of preventable death. Wound care and managing external hemorrhage are important skills for athletic trainers. Objective Describe a laboratory activity used to allow students to practice managing uncontrolled external hemorrhage and wound packing. Background The prevalence of active shooter and other mass casualty events has grown, and a trend to move military-based emergency skills into civilian casualty care has emerged. Athletic trainers are uniquely positioned to respond to catastrophic events at the time of injury. Controlling hemorrhage and rapidly applying a tourniquet or administering wound packing have a great effect in preventing death due to severe hemorrhage. Description An educational technique using a pork shoulder was implemented to provide students with experience in wound packing. Clinical Advantage(s) Students describe this activity as a beneficial way to gain experience on an important skill not often seen in the clinical education setting. Conclusion(s) Faculty may consider implementing wound packing using a pork shoulder as a laboratory activity when teaching wound care and external hemorrhage management.

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