Role of Air-Medical Evacuation in Mass-Casualty Incidents—A Train Collision Experience

2009 ◽  
Vol 24 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Amit Assa ◽  
Dan-Avi Landau ◽  
Erez Barenboim ◽  
Liav Goldstein
Keyword(s):  
Mass Casualty ◽  
Search And Rescue ◽  
Mass Casualty Incidents ◽  
Medical Decision ◽  
Trauma Centers ◽  
Medical Evacuation ◽  
Major Disaster ◽  
Trauma Victims ◽  
Medical Teams ◽  
Accident Site

AbstractBackground:On 21 June 2005, a passenger train collided with a truck near Revadim, Israel.The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report.Methods:A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted.Results:The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision.Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The airmedical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time.Conclusions:Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region.This operation highlighted the necessity for flexibility in medical decision-making and the need for non-conventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.

Large-Scale Airmedical Transport from a Peripheral Hospital to Level-1 Trauma Centers after Remote Mass-Casualty Incidents in Israel

2009 ◽  
Vol 24 (6) ◽  
pp. 549-555 ◽  
Author(s):  
Ophir Lavon ◽  
Dan Hershko ◽  
Erez Barenboim
Keyword(s):  
Large Scale ◽  
Medical Personnel ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Preparedness Plan ◽  
Peripheral Hospital ◽  
Number Of Patients ◽  
Level 1

AbstractIntroduction:Mass-casualty incidents (MCIs) result in the evacuation of many patients to the nearest medical facility. However, an overwhelming number of patients and the type and severity of injuries may demand rapid, mass airmedical transport to more advanced medical centers. This task may be challenging, particularly after a MCI in a neighboring country. The Israeli Air Force Rescue and Airmedical Evacuation Unit (RAEU) is the main executor of airmedical transport in Israel, including MCIs.Problem:The available data on airmedical transport from remote MCIs are limited. The objective of this study was to evaluate the airmedical transport from a rural hospital after two remote MCIs.Methods:The study was retrospective and reviewed descriptive records of airmedical transports.Results:The RAEU was involved in airmedical transports from a peripheral hospital shortly after two remote MCIs that occurred in the Sinai desert near the Egyptian-Israeli border. Nineteen (22.4%) and 25 (100%) of the treated trauma patients from each event were airmedically transported to Level-1 Trauma Centers in Israel within hours of the dispatch. The rapid dispatch and accumulation of medical personnel and equipment was remarkable. The airmedical surge capacity was broad and sufficient. Cooperation with local authorities and a tailored boarding procedure facilitated a quality outcome.Conclusions:The incorporation of a large-scale airmedical transport program with designated multidisciplinary protocols is an essential component to a remote disaster preparedness plan.

An Analysis of Mass Casualty Incidents in the Setting of Mass Gatherings and Special Events

2014 ◽  
Vol 8 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Sheila A. Turris ◽  
Adam Lund ◽  
Ronald R. Bowles
Keyword(s):  
Emergency Services ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Mass Gatherings ◽  
The Past ◽  
Special Events ◽  
Large Numbers ◽  
Structural Failures ◽  
Code Violations ◽  
Medical Teams

AbstractObjectivesMass gatherings (MGs) and special events typically involve large numbers of people in unfamiliar settings, potentially creating unpredictable situations. To assess the information available to guide emergency services and onsite medical teams in planning and preparing for potential mass casualty incidents (MCIs), we analyzed the literature for the past 30 years.MethodsA search of the literature for MCIs at MGs from 1982 to 2012 was conducted and analyzed.ResultsOf the 290 MCIs included in this study, the most frequently reported mechanism of injury involved the movement of people under crowded conditions (162; 55.9%), followed by special hazards (eg, airplane crashes, pyrotechnic displays, car crashes, boat collisions: 57; 19.6%), structural failures (eg, building code violations, balcony collapses: 38; 13.1%), deliberate events (26; 9%), and toxic exposures (7; 2.4%). Incidents occurred in Asia (71; 24%), Europe (69; 24%), Africa (48; 17%), North America (48; 27%), South America (27; 9%), the Middle East (25; 9%), and Australasia (2; 1%). A minimum of 12 877 deaths and 27 184 injuries resulted.ConclusionsBased on our findings, we recommend that a centralized database be created. With this database, researchers can further develop evidence to guide prevention efforts and mitigate the effects of MCIs during MGs. (Disaster Med Public Health Preparedness. 2014;0:1-7)

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.

Mass-Casualty Training Exercise Using High-Fidelity Computerized Simulators and Involving Time and Resource Limitation

2021 ◽  
Vol 36 (3) ◽  
pp. 313-320
Author(s):  
Phillip A. Jacobson ◽  
Paul N. Severin ◽  
Dino P. Rumoro ◽  
Shital Shah
Keyword(s):  
Health Care ◽  
Resource Limitation ◽  
Mass Casualty ◽  
Health Care Personnel ◽  
High Fidelity ◽  
Medical Team ◽  
Training Exercise ◽  
The Mean ◽  
Medical Teams

AbstractPurpose:Training emergency department (ED) personnel in the care of victims of mass-casualty incidents (MCIs) is a highly challenging task requiring unique and innovative approaches. The purpose of this study was to retrospectively explore the value of high-fidelity simulators in an exercise that incorporates time and resource limitation as an optimal method of training health care personnel in mass-casualty care.Methods:Mass-casualty injury patterns from an explosive blast event were simulated for 12 victims using high-fidelity computerized simulators (HFCS). Programmed outcomes, based on the nature of injuries and conduct of participants, ranged from successful resuscitation and survival to death. The training exercise was conducted five times with different teams of health care personnel (n = 42). The exercise involved limited time and resources such as blood, ventilators, and imaging capability. Medical team performance was observed and recorded. Following the exercise, participants completed a survey regarding their training satisfaction, quality of the exercise, and their prior experiences with MCI simulations. The Likert scale responses from the survey were evaluated using mean with 95% confidence interval, as well as median and inter-quartile range. For the categorical responses, the frequency, proportions, and associated 95% confidence interval were calculated.Results:The mean rating on the quality of experiences related trainee survey questions (n = 42) was between 4.1 and 4.6 on a scale of 5.0. The mean ratings on a scale of 10.0 for quality, usefulness, and pertinence of the program were 9.2, 9.5, and 9.5, respectfully. One hundred percent of respondents believed that this type of exercise should be required for MCI training and would recommend this exercise to colleagues. The five medical team (n = 5) performances resulted in the number of deaths ranging from two (including the expectant victims) to six. Eighty percent of medical teams attempted to resuscitate the “expectant” infant and exhausted the O- blood supply. Sixty percent of medical teams depleted the supply of ventilators. Forty percent of medical teams treated “delayed” victims too early.Conclusion:A training exercise using HFCS for mass casualties and employing limited time and resources is described. This exercise is a preferred method of training among participating health care personnel.

A call for collective learning from mass casualty incidents

Injury ◽  
2021 ◽  
Author(s):  
Amila Ratnayake ◽  
Sanjeewa Garusinghe ◽  
Miklosh Bala ◽  
Tamara J. Worlton
Keyword(s):  
Mass Casualty ◽  
Collective Learning ◽  
Mass Casualty Incidents

Does Self-reporting Facilitate History Taking in Food Poisoning Mass-casualty Incidents?

2014 ◽  
Vol 29 (4) ◽  
pp. 417-420 ◽  
Author(s):  
Ya-I Hsu ◽  
Ying C. Huang
Keyword(s):  
Health Care ◽  
Medical History ◽  
Food Poisoning ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Control Group ◽  
History Taking ◽  
Care Providers ◽  
Time Required ◽  
Experimental Group

AbstractIntroductionMedical history is an important contributor to diagnosis and patient management. In mass-casualty incidents (MCIs), health care providers are often overwhelmed by large numbers of casualties. An efficient, reliable, and affordable method of information collection is essential for effective health care response.Hypothesis/ProblemIn some MCIs, self-reporting of symptoms can decrease the time required for history taking, without sacrificing the completeness of triage information.MethodsTwo resident doctors and a number of seventh graders who had previous experience of abdominal discomfort were invited to join this study. A questionnaire was developed to collect information on common symptoms in food poisoning. Each question was scored, and enrolled students were randomly divided into two groups. The experimental group students answered the questionnaire first and then were interviewed to complete the medical history. The control group students were interviewed in the traditional way to collect medical history. Time of all interviews was measured and recorded. The time needed to complete the history taking and completeness of obtained information were compared with students’ t tests, or Mann-Whitney U tests, based on the normality of data. Comprehensibility of each question, scored by enrolled students, was reported by descriptive statistics.ResultsThere were 41 students enrolled: 22 in the experimental group and 19 in the control group. Time to complete history taking in the experimental group (163.0 seconds, SD=52.3) was shorter than that in the control group (198.7 seconds, SD=40.9) (P=.010). There was no difference in the completeness of history obtained between the experimental group and the control group (94.8%, SD=5.0 vs 94.2%, SD=6.1; P=.747). Between the two doctors, no significant difference was found in the time required for history taking (185.2 seconds, SD=42.2 vs 173.1 seconds, SD=58.6; P=.449), or the completeness of information (94.1%, SD=5.9 vs 95.0%, SD=5.0; P=.601). Most of the questions were scored “good” in comprehensibility.ConclusionSelf-reporting of symptoms can shorten the time of history taking during a food poisoning mass-casualty event without sacrificing the completeness of information.HsuY, HuangYC. Does self-reporting facilitate history taking in food poisoning mass-casualty incidents?Prehosp Disaster Med. 2014;29(4):1-4.

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