Injury patterns of mass casualty incidents involving high-speed passenger ferries presenting to accident and emergency departments in Hong Kong: a retrospective review

Injury ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 252-259 ◽  
Author(s):  
Rex Pui Kin Lam ◽  
Ronald Tat Ming Wong ◽  
Eric Ho Yin Lau ◽  
Kin Wa Wong ◽  
Arthur Chi Kin Cheung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Retrospective Review ◽  
Emergency Departments ◽  
High Speed ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Injury Patterns ◽  
Accident And Emergency

The Epidemiology of Household Rodenticides Poisoning in Hong Kong and its Risk Factors for Developing Coagulopathy

2014 ◽  
Vol 21 (6) ◽  
pp. 339-345 ◽  
Author(s):  
N Othman ◽  
Ck Chan ◽  
Fl Lau
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Emergency Departments ◽  
Multiple Logistic Regression Analysis ◽  
Case Series ◽  
Female Ratio ◽  
Intentional Ingestion ◽  
Accident And Emergency ◽  
Case Series Study ◽  
Clinically Significant

Objective To (1) describe the epidemiology of household rodenticides poisoning in Hong Kong, (2) evaluate the proportion of patients who have develop coagulopathy after rodenticide poisoning, (3) identify the risk factors for developing coagulopathy in rodenticide poisoning. Design Case series study. Setting Sixteen accident and emergency departments in Hong Kong. Patients Patients with household rodenticide ingestion who presented to accident and emergency departments during the period from July 2008 to February 2012. Results 110 patients were reported to have rodenticide exposure during the study period. Eighty-seven patients were included in the final analysis. The mean age was 40.1 and the male-to-female ratio was 1.29:1 (49:38). Most patients (91%) took the rodenticide intentionally. Sixty-nine patients (79%) exposed to anticoagulants type of rodenticide based on history or laboratory findings. The ingredient of the rodenticide ingested in 18 patients (21%) was untraceable. The only clinically significant presentation reported after rodenticide exposure was coagulopathy. Thirty-one patients (36%) developed coagulopathy with an international normalised ratio greater or equal to 1.3. Clinical significant bleeding was only observed in one patient. Presence of coagulopathy in rodenticide poisoning was significantly associated with older patient, intentional ingestion, ingestion of warfarin, ingestion of more than one pack and presence of co-ingestion. Multiple logistic regression analysis showed that only two factors were independent predictor of coagulopathy: Ingestion of warfarin rodenticide (p=0.001, odds ratio [OR] = 18.20, 95% confidence interval [CI]=3.44-96.42), and ingestion of more than one pack of rodenticide (p=0.02, OR=10.01, 95% CI=1.43-69.87). Conclusions Clinically significant household rodenticide poisoning in Hong Kong is solely related to ingestion of anticoagulant type of rodenticide. Patients who have ingested warfarin rodenticide and higher ingestion dose are more likely in developing coagulopathy. (Hong Kong j.emerg.med. 2014;21:339-345)

scholarly journals Effective Healthcare Worker-Patient Communication in Hong Kong Accident and Emergency Departments

2015 ◽  
Vol 22 (2) ◽  
pp. 69-83 ◽  
Author(s):  
D Slade ◽  
E Chandler ◽  
J Pun ◽  
M Lam ◽  
Cmim Matthiessen ◽  
...  
Keyword(s):  
Hong Kong ◽  
Healthcare Worker ◽  
Emergency Departments ◽  
Patient Communication ◽  
Accident And Emergency

scholarly journals Design Strategies to Improve Emergency Departments’ Performance During Mass Casualty Incidents: A Survey of Caregivers

2019 ◽  
Vol 13 (1) ◽  
pp. 206-220
Author(s):  
Shabboo Valipoor ◽  
Hesamedin Hakimjavadi ◽  
Giuliano De Portu
Keyword(s):  
Emergency Departments ◽  
Patient Flow ◽  
Care Facility ◽  
Emergency Operation ◽  
Mass Casualty ◽  
Physical Design ◽  
Mass Casualty Incidents ◽  
Design Strategies ◽  
Online Questionnaire ◽  
Critical Patients

Objectives: To identify effective facility design strategies to improve the performance of healthcare providers and patient flow during mass casualty incidents (MCIs) in emergency departments. Background: Emergency departments (EDs) are the first line of medical care in MCIs. While operational surge management plans are well described in literature, physical design strategies to improve performance and patient flow during disasters are discussed scarcely. Method: An online questionnaire was sent to EDs’ caregivers nationwide asking them to rate the effectiveness of nine physical design strategies, discussed in the literature, to improve caregivers’ performance and patient flow during MCIs. Assessed strategies were about providing expandable departments and care areas, alternate care facilities for the least sick to maximize care areas for critical patients, care areas from nonemergency units, increased number of decontamination units, dedicated isolation units, within-hospital and close emergency operation centers, and within-hospital media areas. Results: All suggested strategies were rated as effective. The most effective and agreed-upon solution was identified as maximizing the care area for critical patients by establishing an alternate care facility with separate entrance and exit doors from the emergency department for the least critical patients. The least effective and agreed-upon strategy was identified as locating a media unit within the hospital outside of the ED. Conclusions: Caregivers who work in EDs consider design strategies to be effective in surge management during disasters. Designers can consider implementing identified strategies in designing new emergency departments or expansion and renovation projects.

Medical consequences of suicide bombing mass casualty incidents: The impact of explosion setting on injury patterns

Injury ◽  
2009 ◽  
Vol 40 (7) ◽  
pp. 698-702 ◽  
Author(s):  
Yona Kosashvili ◽  
Mark I. Loebenberg ◽  
Guy Lin ◽  
Kobi Peleg ◽  
Feigenberg Zvi ◽  
...  
Keyword(s):  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Suicide Bombing ◽  
Injury Patterns ◽  
The Impact

scholarly journals Communication in Hong Kong Accident and Emergency Departments

2015 ◽  
Vol 2 ◽  
pp. 233339361557671 ◽  
Author(s):  
Eloise Chandler ◽  
Diana Slade ◽  
Jack Pun ◽  
Graham Lock ◽  
Christian M. I. M. Matthiessen ◽  
...  
Keyword(s):  
Hong Kong ◽  
Emergency Departments ◽  
Accident And Emergency

scholarly journals Mass Casualty Management in the Emergency Department – Lessons Learned in Beirut, Lebanon - Part II

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
The Past ◽  
To Receive

The first article in this series (Part I) discussed the abundant exposure of our emergency department (ED) to mass casualty incidents (MCIs), particularly over the past 14 years. This experience led us to define practical strategies that emergency departments can use to develop their own MCI response plans. In the first part, our main focus was to highlight the abrupt nature of MCIs and the subsequent need to use disaster drills. Additionally, we discussed the importance of having a tiered response and activation as well as other lessons learned from our experience to maximize the preparedness of the emergency department to receive mass casualty.In this article, we discuss the optimal way to triage patients. In addition, we will tackle the best methods for documentation and communication, which are vital yet overlooked during mass casualty incidents. We will also elaborate on what we learned from dealing with outbursts of anger and violence in the ED during MCIs and how to ensure the safety of the ED staff.

scholarly journals Mass Casualty Management in the Emergency Department - Lessons Learned in Beirut, Lebanon - Part I

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Pivotal Role ◽  
Front Door ◽  
Short Period ◽  
Effective Planning

Over the last century, mass casualty incidents (MCIs) affected many nations and their emergency departments. The unscheduled arrival of large number of injured victims over a short period of time often causes major chaos and crowding. When a rapid surge in operational needs overwhelms available Emergency Department (ED) resources and personnel, the chaos and overwhelming mismatch between needs and resources can quickly spread to the rest of the hospital.1, 2 Nonetheless, as the front door of the hospital, the ED plays a pivotal role in determining the quality and effectiveness of an institution’s MCI response. This requires effective planning, which translates into preparedness. Unfortunately, many EDs are overburdened even on regular days. Damaged infrastructure further compounds the challenge.

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