Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing

2017 ◽  
Vol 12 (3) ◽  
pp. 379-385 ◽  
Author(s):  
Mazen El Sayed ◽  
Ali F. Chami ◽  
Eveline Hitti
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Staff ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Preparedness Plan ◽  
Security Issues ◽  
Response System ◽  
General Response

AbstractMass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital’s existing disaster preparedness plan. Casualties’ arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital’s resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2018; 12: 379–385)

scholarly journals (A108) Hospital Disaster Planning: The Structured Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s30-s30
Author(s):  
G.E.A. Khalifa
Keyword(s):  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Emergency Services ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Preparedness Plan ◽  
Hospital Disaster Preparedness

BackgroundDisasters and incidents with hundreds, thousands, or tens of thousands of casualties are not generally addressed in hospital disaster plans. Nevertheless, they may occur, and recent disasters around the globe suggest that it would be prudent for hospitals to improve their preparedness for a mass casualty incident. Disaster, large or small, natural or man-made can strike in many ways and can put the hospital services in danger. Hospitals, because of their emergency services and 24 hour a day operation, will be seen by the public as a vital resource for diagnosis, treatment, and follow up for both physical and psychological care.ObjectivesDevelop a hospital-based disaster and emergency preparedness plan. Consider how a disaster may pose various challenges to hospital disaster response. Formulate a disaster plan for different medical facility response. Assess the need for further changes in existing plans.MethodsThe author uses literature review and his own experience to develop step-by-step logistic approach to hospital disaster planning. The author presents a model for hospital disaster preparedness that produces a living document that contains guidelines for review, testing, education, training and update. The model provides the method to develop the base plan, functional annexes and hazard specific annexes.

scholarly journals Planning for the Use of Imaging in Mass Casualty Incidents

2019 ◽  
Vol 34 (s1) ◽  
pp. s159-s159
Author(s):  
Deborah Starkey ◽  
Denise Elliott
Keyword(s):  
Disaster Preparedness ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Challenging Situation ◽  
Mass Fatality Incidents ◽  
Forensic Radiography ◽  
Mass Fatality

Introduction:A mass casualty incident presents a challenging situation in any health care setting. The value of preparation and planning for mass casualty incidents has been widely reported in the literature. The benefit of imaging, in particular, forensic radiography, in these situations is also reported. Despite this, the inclusion of detailed planning on the use of forensic radiography is an observed gap in disaster preparedness documentation.Aim:To identify the role of forensic radiography in mass casualty incidents and to explore the degree of inclusion of forensic radiography in publicly available disaster planning documents.Methods:An extended literature review was undertaken to identify examples of forensic radiography in mass casualty incidents, and to determine the degree of inclusion of forensic radiography in publicly available disaster planning documents. Where included, the activity undertaken by forensic radiography was reviewed in relation to the detail of the planning information.Results:Limited results were identified of disaster planning documents containing detail of the role or planned activity for forensic radiography.Discussion:While published accounts of situation debriefing and lessons learned from past mass casualty incidents provide evidence for integration into future planning activities, limited reports were identified with the inclusion of forensic radiography. This presentation provides an overview of the roles of forensic radiography in mass casualty incidents. The specific inclusion of planning for the use of imaging in mass fatality incidents is recommended.

scholarly journals Code Orange: A Systematic Review of Psychosocial Disaster Response

2019 ◽  
Vol 34 (s1) ◽  
pp. s69-s70 ◽  
Author(s):  
Melissa B. Korman ◽  
Lauren Goldberg ◽  
Cailtin Klein ◽  
Marjan Khanjani ◽  
Gemma Cox ◽  
...  
Keyword(s):  
Disaster Response ◽  
Psychological Treatment ◽  
Data Extraction ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Free Text ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Mass Trauma ◽  
Disaster Situation

Introduction:Survivors of mass casualty incidents are vulnerable to both physical and psychological injuries. Hospitals need to triage the walking wounded victims, their loved ones, and witnesses for symptoms of emotional distress to ensure that those who are traumatized benefit from proactive psychological treatment. Hospitals must also manage the influx of searching family and friends, and be able to reunite them with their loved ones, to reduce chaos and prevent hospital skipping.Aim:To analyze previous research on institutional psychosocial disaster response, what has or has not worked, and lessons learned in order to develop evidence-based future planning suggestions.Methods:A literature search was conducted on the following electronic databases: (Medline 2007 to July 2018), (Embase 2007 to July 2018), (PsycInfo 2007 to July 2018). A combination of subject headings and free text keywords were used to perform the searches. After removing duplicates, abstracts were screened independently by two reviewers for the following inclusion criteria: 1) crisis intervention (in a disaster situation), 2) mention of psychosocial response or lack thereof and lessons learned, 3)relevant outcomes, 4) OECD countries, and 5) journal articles published 2007–Present. Review articles were excluded. Primary and secondary reviewers are in the process of discussing discrepancies. Data extraction will be conducted from all articles that meet the inclusion criteria. Key themes to be analyzed include psychological casualties, searching family and friends, and family reunification plans.Results:The initial search yielded 6,267 results. 5,294 articles remained after duplicates were removed. Of the 4,890 reviewed thus far, 269 articles met inclusion criteria.Discussion:Although a wealth of existing literature notes the need for an effective psychosocial response in mass trauma and disaster situations, no prior study has analyzed the efficacy of such interventions or laid out an evidence-based plan. This study will fill this much-needed gap in the literature.

The Evacuation of Thai Citizens During Japan’s 2016 Kumamoto Earthquakes: An ICT Perspective

2017 ◽  
Vol 12 (sp) ◽  
pp. 669-677 ◽  
Author(s):  
Natt Leelawat ◽  
Anawat Suppasri ◽  
Panon Latcharote ◽  
Fumihiko Imamura ◽  
◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Critical Role ◽  
Public Information ◽  
Lessons Learned ◽  
The 2016 Kumamoto Earthquakes ◽  
Information And Communication ◽  
Disaster Preparedness And Response ◽  
2016 Kumamoto Earthquakes

In April 2016, the Kumamoto earthquakes in Japan killed 50 people and injured more than 3,000. Because Japan is a primary tourist destination for Thai citizens, due in part to the current visa relaxation policy, many Thai people were visiting Japan when these earthquakes occurred. However, while a variety of public information related to the imminent danger and disaster response was broadcast and published, foreigners sometimes had little access to or understanding of local notices or instructions because of language barriers.This study researches the evacuation process for Thai citizens – including tourists, students, and residents from Thailand – in the disaster-affected areas during the 2016 Kumamoto earthquakes. Through prompt collaboration among the relevant organizations, particularly the Royal Thai Embassy in Tokyo, the evacuation of Thai citizens was successfully completed within a few days. Moreover, some other foreigners were also assisted by the Thai embassy. This paper presents an overview of the evacuation process, including the critical role of information and communication technology (ICT) in disseminating information, transmitting rescue requests, and providing emergency communications. The lessons learned from these efforts can be applied in future natural disasters, especially for foreign organizations working in similar capacities overseas. In addition, this study suggests disaster preparedness and response guidelines for tourists when traveling overseas.

Leadership as a Component of Crowd Control in a Hospital Dealing with a Mass-Casualty Incident: Lessons Learned from the October 2000 Riots in Nazareth

2007 ◽  
Vol 22 (6) ◽  
pp. 522-526 ◽  
Author(s):  
Moshe Pinkert ◽  
Yuval Bloch ◽  
Dagan Schwartz ◽  
Isaac Ashkenazi ◽  
Bishara Nakhleh ◽  
...  
Keyword(s):  
Emergency Services ◽  
Hospital Management ◽  
Hospital Staff ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Management Control ◽  
Lessons Learned ◽  
Great Effort ◽  
Public Health Agencies ◽  
Crowd Control

AbstractIntroduction:Crowd control is essential to the handling of mass-casualty incidents (MCIs).This is the task of the police at the site of the incident. For a hospital, responsibility falls on its security forces, with the police assuming an auxiliary role. Crowd control is difficult, especially when the casualties are due to riots involving clashes between rioters and police. This study uses data regarding the October 2000 riots in Nazareth to draw lessons about the determinants of crowd control on the scene and in hospitals.Methods:Data collected from formal debriefings were processed to identify the specifics of a MCI due to massive riots. The transport of patients to the hospital and the behavior of their families were considered.The actions taken by the Hospital Manager to control crowds on the hospital premises also were analyzed.Results:During 10 days of riots (01–10 October 2000), 160 casualties, including 10 severely wounded, were evacuated to the Nazareth Italian Hospital. The Nazareth English Hospital received 132 injured patients, including one critically wounded, nine severely wounded, 26 moderately injured, and 96 mildly injured. All victims were evacuated from the scene by private vehicles and were accompanied by numerous family members. This obstructed access to hospitals and hampered the care of the casualties in the emergency department. The hospital staff was unable to perform triage at the emergency department's entrance and to assign the wounded to immediate treatment areas or waiting areas. All of the wounded were taken by their families directly into the “immediate care” location where a great effort was made to prioritize the severely injured. In order to control the events, the hospital's managers enlisted prominent individuals within the crowds to aid with control. At one point, the mayor was enlisted to successfully achieve crowd control.Conclusions:During riots, city, community, and even makeshift leaders within a crowd can play a pivotal role in helping hospital management control crowds. It may be advisable to train medical teams and hospital management to recognize potential leaders, and gain their cooperation in such an event. To optimize such cooperation, community leaders also should be acquainted with the roles of public health agencies and emergency services systems.

A tabletop school bus rollover: Connecticut-wide drills to build pediatric disaster preparedness and promote a novel hospital disaster readiness checklist

2019 ◽  
Vol 14 (2) ◽  
pp. 75-87
Author(s):  
Mark X. Cicero, MD ◽  
Klevi Golloshi, BS ◽  
Marcie Gawel, MSN ◽  
James Parker, MD ◽  
Marc Auerbach, MD, MSci ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Coalition Building ◽  
National Guidelines ◽  
School Bus ◽  
Surge Capacity ◽  
Preparedness Plan ◽  
Public Health Officials ◽  
Complete Survey ◽  
Survey Responses

Objective: To assess emergency medical services (EMS) and hospital disaster plans and communication and promote an integrated pediatric disaster response in the state of Connecticut, using tabletop exercises to promote education, collaboration, and planning among healthcare entities.Design: Using hospital-specific and national guidelines, a disaster preparedness plan consisting of pediatric guidelines and a hospital checklist was created by The Connecticut Coalition for Pediatric Disaster Preparedness.Setting: Five school bus rollover tabletop exercises were conducted, one in each of Connecticut’s five EMS regions. Action figures and playsets were used to depict patients, healthcare workers, vehicles, the school, and the hospital.Participants: EMS personnel, nurses, physicians and hospital administrators.Intervention: Participants had a facilitated debriefing of the EMS and prehospital response to disasters, communication among prehospital organizations, public health officials, hospitals, and schools, and surge capacity, capability, and alternate care sites. A checklist was completed for each exercise and was used with the facilitated debriefing to generate an after-action report. Additionally, each participant completed a postexercise survey.Main Outcome Measures: Each after-action report and postexercise survey was compared to established guidelines to address gaps in hospital specific pediatric readiness.Results: Exercises occurred at five hospitals, with inpatient capacity ranging 77-1,592 beds, and between 0 and 221 pediatric beds. There were 27 participants in the tabletop exercises, and 20 complete survey responses for analysis (74 percent). After the exercises, pediatric disaster preparedness aligned with coalition guidelines. However, methods of expanding surge capacity and methods of generating surge capacity and capability varied (p 0.031).Conclusion: Statewide tabletop exercises promoted coalition building and revealed gaps between actual and ideal practice. Generation of surge capacity and capability should be addressed in future disaster education.

Using Mixed Methods to Assess Pediatric Disaster Preparedness in the Hospital Setting

2014 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Rita V. Burke ◽  
Tae Y. Kim ◽  
Shelby L. Bachman ◽  
Ellen I. Iverson ◽  
Bridget M. Berg
Keyword(s):  
Mixed Methods ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Setting ◽  
Mass Casualty ◽  
Disaster Victims ◽  
Qualitative Feedback ◽  
Disaster Exercise ◽  
Communication Equipment

AbstractIntroductionChildren are particularly vulnerable during disasters and mass-casualty incidents. Coordinated multi-hospital training exercises may help health care facilities prepare for pediatric disaster victims.ProblemThe purpose of this study was to use mixed methods to assess the disaster response of three hospitals, focusing on pediatric disaster victims.MethodsA full-functional disaster exercise involving a simulated 7.8-magnitude earthquake was conducted at three Los Angeles (California USA) hospitals, one of which is a freestanding designated Level I Pediatric Trauma Center. Exercise participants provided quantitative and qualitative feedback regarding their perceptions of pediatric disaster response during the exercise in the form of surveys and interviews. Additionally, trained observers provided qualitative feedback and recommendations regarding aspects of emergency response during the exercise, including communication, equipment and supplies, pediatric safety, security, and training.ResultsAccording to quantitative participant feedback, the disaster exercise enhanced respondents’ perceived preparedness to care for the pediatric population during a mass-casualty event. Further, qualitative feedback from exercise participants and observers revealed opportunities to improve multiple aspects of emergency response, such as communication, equipment availability, and physician participation. Additionally, participants and observers reported opportunities to improve safety and security of children, understanding of staff roles and responsibilities, and implementation of disaster triage exercises.ConclusionConsistent with previous investigations of pediatric disaster preparedness, evaluation of the exercise revealed several opportunities for all hospitals to improve their ability to respond to the needs of pediatric victims. Quantitative and qualitative feedback from both participants and observers was useful for comprehensively assessing the exercise's successes and obstacles. The present study has identified several opportunities to improve the current state of all hospitals’ pediatric disaster preparedness, through increased training on pediatric disaster triage methods and additional training on the safety and security of children. Regular assessment and evaluation of supplies, equipment, leadership assignments, and inter-hospital communication is also suggested to optimize the effectiveness and efficiency of response to pediatric victims in a disaster.BurkeRV, KimTY, BachmanSL, IversonEI, BergBM. Using mixed methods to assess pediatric disaster preparedness in the hospital setting. Prehosp Disaster Med. 2014;29(6): 1-7.

scholarly journals Real-Time Monitoring Electronic Triage Tag System for Improving Survival Rate in Disaster-Induced Mass Casualty Incidents

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 877
Author(s):  
Ju Young Park
Keyword(s):  
Survival Rate ◽  
Vital Sign ◽  
Disaster Response ◽  
Electricity Consumption ◽  
Mass Casualty ◽  
Ease Of Use ◽  
Mass Casualty Incidents ◽  
Design Development ◽  
Prehospital Triage ◽  
Rapid Prototyping Model

This study was conducted to contribute to active disaster response by developing internet of things (IoT)-based vital sign monitoring e-triage tag system to improve the survival rate at disaster mass casualty incidents fields. The model used in this study for developing the e-triage tag system is the rapid prototyping model (RAD). The process comprised six steps: analysis, design, development, evaluation, implementation, and simulation. As a result of detailed assessment of the system design and development by an expert group, areas with the highest score in the triage sensor evaluation were rated “very good”, with 5 points for continuous vital sign data delivery, portability, and robustness. In addition, ease of use, wearability, and electricity consumption were rated 4.8, 4.7, and 4.6 points, respectively. In the triage application evaluation, the speed and utility scored a perfect 5 points, and the reliability and expressiveness were rated 4.9 points and 4.8 points, respectively. This study will contribute significantly to increasing the survival rate via the development of a conceptual prehospital triage for field applications and e-triage tag system implementation.

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