scholarly journals The pan-London intensive care burden of a mass casualty incident (7 July 2005)

Injury Extra ◽  
2007 ◽  
Vol 38 (4) ◽  
pp. 117-118
Author(s):  
K. Fong ◽  
J. Lohn ◽  
P. Ward ◽  
P. Shirley ◽  
M. Healey ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Care Burden

The potential benefits of enzymatic debridement in multi-casualty burns incidents

Trauma ◽  
2021 ◽  
pp. 146040862110025
Author(s):  
John Kiely ◽  
Ibrahim Natalwala ◽  
Joseph Stallard ◽  
Orla Austin ◽  
Umair Anwar ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Burn Wound ◽  
Post Injury ◽  
Wound Debridement ◽  
Potential Benefits ◽  
Goal Directed Fluid Therapy ◽  
Male Patients ◽  
Enzymatic Debridement

Bromelain-based enzymatic debridement (ED) is a topical treatment that is growing in popularity for the non-surgical management of burn wounds. Although initially used for small injuries, experience has grown in using it for burns >15% Total Burns Surface Area (TBSA). A household explosion resulted in burns to multiple patients, with four requiring burn wound debridement. This case report demonstrates their management using ED. Four adult male patients were treated with ED, mean age 38.4 years. Their injuries ranged from 5–24% TBSA (mean 14.9%), with a high proportion of intermediate-deep dermal injury to their faces and limbs. Our centre has performed enzymatic debridement since 2016 and all senior burns surgeons and burns intensive care specialists in the team are experienced in its use. We perform enzymatic debridement using Nexobrid™ (Mediwound Ltd., Israel). Three patients were managed on a single theatre list, using ED for their burns at 19, 16 and 23 hours post-injury. One patient had ED of his injuries on intensive care at 18 hours. Patients with >15% TBSA were treated in a critical care setting with goal directed fluid therapy. Through the use of enzymatic debridement we were able to achieve burn debridement for four patients in under 24 hours. While not a true mass casualty incident, our experience suggests that for an appropriately resourced service it is likely to have advantages in this scenario. We suggest that burns services regularly using this technique consider inclusion into mass casualty protocols, with training to staff to enable provision in such an incident.

scholarly journals From intensive care to step-down units: Managing patients throughput in response to COVID-19

2020 ◽  
Author(s):  
Vanni AGNOLETTI ◽  
Emanuele RUSSO ◽  
Alessandro CIRCELLI ◽  
Marco BENNI ◽  
Giuliano BOLONDI ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Initial Assessment ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
System Collapse ◽  
Step Down ◽  
Critical Patients

Abstract Quality problem or issue The on-going COVID-19 pandemic may cause the collapse of healthcare systems because of unprecedented hospitalization rates. Initial assessment A total of 8.2 individuals per 1000 inhabitants have been diagnosed with COVID-19 in our province. The hospital predisposed 110 beds for COVID-19 patients: on the day of the local peak, 90% of them were occupied and intensive care unit (ICU) faced unprecedented admission rates, fearing system collapse. Choice of solution Instead of increasing the number of ICU beds, the creation of a step-down unit (SDU) close to the ICU was preferred: the aim was to safely improve the transfer of patients and to relieve ICU from the risk of overload. Implementation A nine-bed SDU was created next to the ICU, led by intensivists and ICU nurses, with adequate personal protective equipment, monitoring systems and ventilators for respiratory support when needed. A second six-bed SDU was also created. Evaluation Patients were clinically comparable to those of most reports from Western Countries now available in the literature. ICU never needed supernumerary beds, no patient died in the SDU, and there was no waiting time for ICU admission of critical patients. SDU has been affordable from human resources, safety and economic points of view. Lessons learned COVID-19 is like an enduring mass casualty incident. Solutions tailored on local epidemiology and available resources should be implemented to preserve the efficiency and adaptability of our institutions and provide the adequate sanitary response.

scholarly journals Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

2021 ◽  
pp. 1-11
Author(s):  
Wesley D Jetten ◽  
Jeroen Seesink ◽  
Markus Klimek
Keyword(s):  
Scoping Review ◽  
Life Support ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Lay People ◽  
Online Databases ◽  
Healthcare Experience ◽  
Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

Intentional mass-casualty incident simulation-based training: a qualitative study into nursing students’ perceptions and experiences

2021 ◽  
pp. 105051
Author(s):  
Luis Martin-Ibañez ◽  
Pablo Roman ◽  
María del Mar Diaz-Córtes ◽  
Cayetano Fernández-Sola ◽  
José Granero-Molina ◽  
...  
Keyword(s):  
Nursing Students ◽  
Qualitative Study ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Simulation Based

MASS CASUALTY INCIDENT (MCI) TRAINING: SCHOOLS, COMMUNITY AND UNIVERSITY COLLABORATION

2021 ◽  
Author(s):  
Kimberly Budisalich ◽  
Lori Lioce ◽  
Gary Maddux ◽  
Norven Goddard ◽  
Ishella Fogle ◽  
...  
Keyword(s):  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Training Schools

Inadequate Mass-Casualty Knowledge Base Adversely Affects Treatment Decisions by Trauma Care Providers: Survey on Hospital Response following a Terrorist Bombing

2009 ◽  
Vol 24 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Itamar Ashkenazi ◽  
Oded Olsha ◽  
William P. Schecter ◽  
Boris Kessel ◽  
Tawfik Khashan ◽  
...  
Keyword(s):  
Knowledge Base ◽  
Trauma Care ◽  
Critical Evaluation ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Further Education ◽  
Emergency Medical Technicians ◽  
Care Providers ◽  
Hospital Response ◽  
Terrorist Bombing

AbstractHealthcare professionals require a unique knowledge base to function effectively during a hospital's response to a mass-casualty incident (MCI). A survey of 128 physicians, nurses, and emergency medical technicians involved in trauma care was conducted to assess their knowledge base and how it affected their decision-making in response to a MCI following a terrorist bombing. Three-quarters of the study group responded that ≥20% of the surviving victims were critically injured. Only half of the responders indicated that the main objective of medical management is identifying and treating patients with critical injuries. Forty percent of responders indicated that they would not triage a critically injured victim to immediate care. This survey indicates that further education in the principles of MCI management should be based on critical evaluation of the literature.

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