Mass Casualty Response to San Antonio Sniper Incident

1985 ◽  
Vol 1 (S1) ◽  
pp. 355-356
Author(s):  
Prentis B. Vaughn
Keyword(s):  
San Antonio ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Disaster Situation ◽  
The Many

A widely attended, well-publicized annual event in San Antonio, Texas each spring is Fiesta Week. Fiesta Week begins with the Battle of Flowers parade. In April 1979, a deranged gunman began to fire upon parade participants and bystanders. The area-wide disaster plan was activated in order to deal with the many casualties resulting from his actions. This paper provides a description of the disaster situation and describes the implementation of the mass casualty plan.Over 300,000 people lined the parade route as the parade began. Gunfire erupted shortly after the start of the parade in an area where approximately 4,000 people had moved to observe the festivities. The first casualties included police and several parade spectators. Instinctively, onlookers sought cover behind cars, barrels and other parade barricades. Authorities estimated that about 500 people were pinned down by the gunfire.

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.

scholarly journals Implementation of Periop Disaster Response Exercise Program at Gold Coast Health

2019 ◽  
Vol 34 (s1) ◽  
pp. s81-s81
Author(s):  
Andrew Donohue ◽  
Tenzin Lamdark ◽  
Jo Lavin ◽  
Natalia Hupalo ◽  
Martin Wullschleger
Keyword(s):  
Disaster Response ◽  
Exercise Program ◽  
Mass Casualty ◽  
Gold Coast ◽  
University Hospital ◽  
Response Model ◽  
Clinical Environment ◽  
Disaster Plan ◽  
Preparation Phase ◽  
Response Exercise

Introduction:With the move into Gold Coast University Hospital, a new disaster plan was developed in 2017. To assess preparedness for the Commonwealth Games (April 2018), a number of mass casualty exercises were conducted, including a large multi-agency exercise with Queensland Police and Ambulance Services. During this preparation phase, senior clinicians from the perioperative area clarified their sub-plans and developed a novel model of periop response.Aim:This study assesses this model of response and evaluates it within the context of periop disaster exercises.Methods:The periop response model evolved through multi-disciplinary key stakeholder engagement into a defined model of surgical, anesthetic, and periop nursing responses with dedicated roles and parallel communication streams from ED to OR by the respective specialties. Throughout different disaster exercises, this model of response was tested, refined, and evaluated by formal post-exercise debriefs and group meetings.Results:Since May 2017, seven different mass casualty exercises with periop response were performed; firstly, a table-top (EmergoTrainSystem) format was used, which revealed communication and logistical deficiencies. After model refinement, further exercises were accomplished, all within the clinical environment, including movements of mock patients from ED to OR. These exercises generated improvements in communication, coordination, and logistics. Every exercise was also used to test more detailed information, communication, and organizational tasks of the various involved craft groups, such as notification, call-in lists, whiteboard structure, transport facilitation, and many more. Overall, our newly developed periop response model proved to be robust and successful, even with rotating personnel through different roles.Discussion:Apart from the success of the periop response model, other hospital areas (ICU, bed and ward management) became involved. With growing interest and staff turn-over a regular periop disaster response exercise program has now been established. This model of periop response has potential for use in other health systems.

scholarly journals (P1-40) Development of Hospital Triage Training at the Chris Hani Baragwanath Hospital

2011 ◽  
Vol 26 (S1) ◽  
pp. s111-s111
Author(s):  
F. Plani
Keyword(s):  
Standard Of Care ◽  
Secondary Level ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Resuscitation Room ◽  
Staff Members ◽  
Interprofessional Training ◽  
Tertiary Survey ◽  
Suitable Treatment ◽  
Disaster Training

Development of Hospital Triage Training at the Chris Hani Baragwanath Hospital F. Plani1, E Degiannis, P Lingham No disaster training had ever been carried out at the CHBH, the biggest hospital in the world with over 2900 beds and over 5000 staff members. The 2010 Disaster Plan required that all clinical staff undergo the appropriate training. Basic Interprofessional Training for Trauma Disasters 411 staff members attended a half day course during May/June 2010, presented and sponsored by CHBH Trauma Directorate consultants. The aims of the course were to disseminate the trauma disaster plan in interdisciplinary and interprofessional fashion, clarify hospital triage, familiarize staff with Trauma Unit equipment, and practice resuscitations in mass casualty incidents. The course started with presentations on CHBH Disaster Plans and Protocols and Principles of Triage and Standard of Care in Disasters. This was followed by 3 multiple patient scenarios with rotating groups, over a whole hospital floor with: 1) 50 mixed patients outside the hospital; 2) 10 serious patients in the ER; 3) 10 patients deteriorating later in a ward or ICU. Next were individual patient resuscitations, Primary, Secondary, Tertiary Survey and “hand-over”, patient resuscitations in a disaster, using the contents from “Disaster Bags” and questionnaires to assess confidence and suitable treatment areas (Red, Yellow, Green, OT) for allocation in a disaster. The course was wrapped up by a familiarization visit to ED and the colour coded areas.ResultsFinal questionnaires demonstrated that all participants were a lot more confident in the triage of patients and the initial resuscitation using the implements found in the resuscitation room and the “Disaster Bags”. The course has been adopted as part of staff orientation at all professional levels from 2011 onwards, and is in the process to be extended to secondary level hospitals in Gauteng, RSA.

scholarly journals (A219) Development of a Hospital Disaster Plan for Countries with Limited Resources

2011 ◽  
Vol 26 (S1) ◽  
pp. s60-s60 ◽  
Author(s):  
F. Plani
Keyword(s):  
Hospital Staff ◽  
Mass Casualty ◽  
World Cup ◽  
Private Funding ◽  
Disaster Plan ◽  
Staff Members ◽  
Resource Limited ◽  
The World ◽  
Critical Issues ◽  
Disaster Training

The Chris Hani Baragwanath Hospital (CHBH) in South Africa is the largest in the world, with 2,900 beds. Its trauma unit boasts 15 resuscitation bays, while the triage area has space for 40 stretchers. There are 5,000 trauma resuscitations performed yearly, out of 50,000 patients seen in the Trauma Emergency Department. There is an eight-bed Trauma Intensive Care Unit (ICU) and a 56-bed Trauma Ward. There also are 25 stepdown beds, 70 outlying beds, a six-bed Burn ICU, 20-bed ward, and a 24-bed shortstay ward. There are about 80 resuscitations and 70 trauma emergency operations weekly. However, the hospital is severely limited in financial and human resources, with only 2–3 interns, two registrars, and one trauma consultant on-call. The hospital is at > 130% bed occupancy. The CHBH was designated as the main disaster hospital for the 2010 FIFA World Cup, due to its proximity to the 96,000-seat Soccer City. Nominal disaster plans existed, but there were no resources, preparations, or knowledge, as was the case with most other government hospitals. The Trauma Directorate developed a new plan for the World Cup, future mass-casualty incidents at CHBH, and for other resource limited hospitals. The plans are centered on four critical issues: (1) preparedness of hospital structure and staff; (2) dissemination of the plan; (3) disaster training; and (4) the development of “Disaster Bags” for 350 casualties A free disaster course trained > 400 staff members on in-hospital triage and trauma management. All hospital staff were allocated specific functions in case of disasters. This is the first time the CHBH has had an integrated disaster plan, with separate equipment allocation, through private funding, and involving all disciplines.

A New Method for Simulated Mass Casualty Evaluation: The Beilinson Hospital Exercise

1989 ◽  
Vol 4 (2) ◽  
pp. 122-126
Author(s):  
D. Simon ◽  
Y.L. Danon ◽  
C. Chaimoff ◽  
A. Shachar
Keyword(s):  
Functional Performance ◽  
Mass Casualty ◽  
New Method ◽  
Mass Casualties ◽  
Disaster Victims ◽  
Administrative Procedure ◽  
Simulation Techniques ◽  
Disaster Situation ◽  
And Performance ◽  
Definition Of

AbstractA new method for evaluating the capabilities and performance of a general hospital in masscasualty exercises is described. This method is based on the use of simulation techniques which are realistic relative to the types and availability of the manpower required and to the time consumed by the assessments, interventions, and administrative duties and demands for each casualty encountered and the total workload thrust on the hospital by the cumulative requirements of all of the casualties. The simulation can be accomplished only after the time and equipment required for every possible diagnostic, therapeutic, and administrative procedure has been assessed for the specific hospital. Thereafter, it is possible to define the exact type and quantity of resources, in terms of time and manpower, consumed cumulatively by every simulated casualty assessed and treated during the exercise. The simulated victims are selected from a pool of young physicians who are briefed thoroughly by senior staff physicians prior to the exercise. Thus, the simulated subjects are provided lists of problems and the appropriate options for treatment. They also serve as controllers in the definition of time and manpower consumed for their specific injury set. Given this setting, it is possible to assess the functional performance of a hospital as a unit and for each of its components and also realistically estimate its capacity to manage disaster victims using a simulation of a disaster situation with mass casualties.

scholarly journals Kuala Lumpur train collision during the COVID-19 pandemic

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Alzamani M. Idrose ◽  
Fikri M. Abu-Zidan ◽  
Nurul Liana Roslan ◽  
Khairul Izwan M. Hashim ◽  
Saiyidi Mohd Azizi Mohd Adibi ◽  
...  
Keyword(s):  
Hospital Management ◽  
Standard Operating Procedure ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Base Station ◽  
Lessons Learned ◽  
Kuala Lumpur ◽  
Disaster Plan ◽  
Incident Command ◽  
Green Zone

Abstract Background Two city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1–43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths. Conclusions The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

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 Hospital Disaster Preparedness in Switzerland Over a Decade: A National Survey

2018 ◽  
Vol 13 (03) ◽  
pp. 433-439
Author(s):  
Simone Dell’Era ◽  
Olivier Hugli ◽  
Fabrice Dami
Keyword(s):  
Public Health ◽  
Health Care ◽  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Disaster Plan ◽  
Root Cause ◽  
Swiss Health ◽  
Hospital Disaster Preparedness

ABSTRACTObjectiveThe present study aimed to provide a comprehensive assessment of Swiss hospital disaster preparedness in 2016 compared with the 2006 data.MethodsA questionnaire was addressed in 2016 to all heads responsible for Swiss emergency departments (EDs).ResultsOf the 107 hospitals included, 83 (78%) returned the survey. Overall, 76 (92%) hospitals had a plan in case of a mass casualty incident, and 76 (93%) in case of an accident within the hospital itself. There was a lack in preparedness for specific situations: less than a third of hospitals had a specific plan for nuclear/radiological, biological, chemical, and burns (NRBC+B) patients: nuclear/radiological (14; 18%), biological (25; 31%), chemical (27; 34%), and burns (15; 49%), and 48 (61%) of EDs had a decontamination area. Less than a quarter of hospitals had specific plans for the most vulnerable populations during disasters, such as seniors (12; 15%) and children (19; 24%).ConclusionsThe rate of hospitals with a disaster plan has increased since 2006, reaching a level of 92%. The Swiss health care system remains vulnerable to specific threats like NRBC. The lack of national legislation and funds aimed at fostering hospitals’ preparedness to disasters may be the root cause to explain the vulnerability of Swiss hospitals regarding disaster medicine. (Disaster Med Public Health Preparedness. 2019;13:433-439)

Beirut Explosion: The Largest Non-Nuclear Blast in History

2021 ◽  
pp. 1-2
Author(s):  
Mariana Helou ◽  
Mahmoud El-Hussein ◽  
Kurtulus Aciksari ◽  
Flavio Salio ◽  
Francesco Della Corte ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Rapid Response ◽  
Red Cross ◽  
Disaster Plan ◽  
Maximum Capacity ◽  
The Many ◽  
Health Care Centers

Abstract A massive explosion have ripped Beirut on August 4, 2020, leaving behind more than 6000 casualties, 800 regular floor admissions, 130 intensive care unit admissions, and over 200 deaths. Buildings were destroyed, hospitals in Beirut were also destroyed, others became nonfunctional. A disaster code was initiated in all the hospitals. Victims were transported by the Lebanese Red Cross or by volunteers to the nearest hospital that was still functional. Hospitals were flooded in patients, the coordination between health care centers was missing. Each hospital was functioning to its maximum capacity. With the many challenges we had, a rapid response was initiated. An effective triage done outside the Emergency had the major role in saving lives. After the Beirut Explosion, an assessment of the disaster plan and a major evaluation of the hospitals’ coordination is needed.

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