(P1-19) Disaster Medical System in APEC Japan 2010

Background and MethodThe preparedness for mass casualty is needed in political event. We have the experience to build up the disaster medical system in G8 summit in Okinawa and Hokkaido. But these two areas were resort area which had little population. This time Japan hosted APEC JAPAN 2010 which held in Yokohama City. We reported disaster medical system for this event in big city.ResultWe mobilized DMAT from 21 hospitals whole Japan. We set 11 teams in Yokohama city, 10 teams in 2 Airports. DMAT inspected rerated disaster base hospitals. These hospitals made the plan for receive mass casualty included the victims by CBRNE event and had the exercise. They set up the decontamination system during APEC leader's week. We also have the contingency plan to coordinate with fire department. This contingency plan included transportation plan for hospitals and coordination plan in site. In transportation plan, sever casualty transported dispersal for hospital in Yokohama within 25. For over 25, sever casualty transported intensive for 4 hospitals in Yokohama. After stabilization treatment in these hospitals, the casualty transported dispersal from these hospitals to outside of Yokohama. In coordinate plan in site included job description in command and control, decontamination and medical relief post.DiscussionWe established disaster medical system for APEC JAPAN 2010. This event hold in Yokohama City had the big population. Compare with former G8 summit, medical system put importance in mass casualty event. As a result, non mass casualty event happened. But this preparedness will contribute not only future same kind events but also accidental mass casualty event such as train accident.

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Lessons learned from a landslide catastrophe in Rio de Janeiro, Brazil

American Journal of Disaster Medicine ◽

10.5055/ajdm.2013.0131 ◽

2013 ◽

Vol 8 (4) ◽

pp. 253-258 ◽

Cited By ~ 10

Author(s):

Bruno Monteiro Tavares Pereira, MD, MSc ◽

Wellington Morales, MD ◽

Ricardo Galesso Cardoso, MD ◽

Rossano Fiorelli, MD, PhD ◽

Gustavo Pereira Fraga, MD, PhD ◽

...

Keyword(s):

Rio De Janeiro ◽

Fire Department ◽

Mass Casualty ◽

Lessons Learned ◽

Medical Examiner ◽

Hospital Organization ◽

Mountain Area ◽

Mass Casualty Event ◽

Short Period ◽

Future Events

Introduction: On January, 2011, a devastating tropical storm hit the mountain area of Rio de Janeiro State in Brazil, resulting in flooding and mudslides and leaving 30,000 individuals displaced.Objective: This article explores key lessons learned from this major mass casualty event, highlighting prehospital and hospital organization for receiving multiple victims in a short period of time, which may be applicable in similar future events worldwide.Methods: A retrospective review of local hospital medical/fire department records and data from the Health and Security Department of the State were analyzed. Medical examiner archives were analyzed to determine the causes of death.Results: The most common injuries were to the extremities, the majority requiring only wound cleaning, debridement, and suture. Orthopedic surgeries were the most common operative procedures. In the first 3 days, 191 victims underwent triage at the hospital with 50 requiring admission to the hospital. Two hundred fifty patients were triaged at the hospital by the end of the fifth day.The mortis cause for the majority of deaths was asphyxia, either by drowning or mud burial.Conclusion: Natural disasters are able to generate a large number of victims and overwhelm the main channels of relief available. Main lessons learned are as follows: 1) prevention and training are key points, 2) key measures by the authorities should be taken as early as possible, and 3) the centralization of the deceased in one location demonstrated greater effectiveness identifying victims and releasing the bodies back to families.

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How Will Military/Civilian Coordination Work for Reception of Mass Casualties from Overseas?

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00007184 ◽

2009 ◽

Vol 24 (5) ◽

pp. 380-388 ◽

Cited By ~ 3

Author(s):

Colin Mackenzie ◽

John Donohue ◽

Philip Wasylina ◽

Woodrow Cullum ◽

Peter Hu ◽

...

Keyword(s):

Homeland Security ◽

Medical Center ◽

Mass Casualty ◽

Medical System ◽

Mass Casualties ◽

Walter Reed Army Medical ◽

Mutual Aid ◽

Incident Command ◽

Mass Casualty Event ◽

Functional Exercise

AbstractIntroduction:In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed “urge” capacity of Maryland NDMS Hospitals.Methods:Three tabletop exercises and a functional exercise were performed using a simulated, overseas, military mass-casualty event. The first tabletop exercise was with military and civilian NMDS partners.The second tested the revised NDMS activation plan. The third exercised the Authorities of State Emergency Medical System and Walter Reed Army Medical Center Directors of Emergency Medicine over Maryland NDMS hospitals, and their Medical Mutual Aid Agreement.The functional exercise used Homeland Security Exercise Evaluation Program tools to evaluate reception, triage, staging, and transportation of 160 notional patients (including 20 live, moulaged “patients”) and one canine.Results:The first tabletop exercise identified deficiencies in operational protocols for military/civilian mass-casualty reception, triage, treatment, and problems with sharing a Unified Command. The second found improvements in the revised NDMS activation plan.The third informed expectations for NDMS hospitals. In the functional exercise, all notional patients were received, triaged, dispatched, and accounted in military and five civilian hospitals within two hours. The canine revealed deficiencies in companion/military animal reception, holding, treatment, and evacuation. Three working groups were suggested: (1) to ensure 100% compliance with triage tags, patient accountability, and return of equipment used in mass casualty events and exercises; (2) to investigate making information tech-nology and imaging networks available for Emergency Operation Centers and Incident Command; and (3) to establish NDMS training, education, and evaluation to further integrate and support civil-military operations.Conclusions:The exercises facilitated military/state inter-agency coopera-tion, resulting in revisions to the Maryland Emergency Operations Plan across all key state emergency response agencies. The recommendations from these exercises likely apply to the vast majority of NDMS activities in the US.

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A Burn Mass Casualty Event Due to Boiler Room Explosion on a Cruise Ship: Preparedness and Outcomes

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70095-x ◽

2007 ◽

Vol 2007 ◽

pp. 104-105

Author(s):

R.E. Salisbury

Keyword(s):

Mass Casualty ◽

Cruise Ship ◽

Mass Casualty Event ◽

Boiler Room

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Non-Pediatric Nurses’ Willingness to Provide Care to Pediatric Patients during a Disaster: An Assessment of Pediatric Surge Capacity in Four Midwestern Hospitals

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.3 ◽

2021 ◽

pp. 1-6

Author(s):

Terri Rebmann ◽

Rachel L. Charney ◽

Rebecca L. Eschmann ◽

M. Colleen Fitzpatrick

Keyword(s):

Pediatric Patients ◽

Response Rate ◽

Mass Casualty ◽

Pediatric Care ◽

Pediatric Nurses ◽

Surge Capacity ◽

Factors Associated ◽

Pediatric Hospitals ◽

Survey Response Rate ◽

Mass Casualty Event

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.

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Postexposure Interventions to Prevent Infection With HBV, HCV, or HIV, and Tetanus in People Wounded During Bombings and Other Mass Casualty Events—United States, 2008: Recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness

Disaster Medicine and Public Health Preparedness ◽

10.1097/dmp.0b013e318187ac66 ◽

2008 ◽

Vol 2 (3) ◽

pp. 150-165 ◽

Cited By ~ 10

Author(s):

Louisa E. Chapman ◽

Ernest E. Sullivent ◽

Lisa A. Grohskopf ◽

Elise M. Beltrami ◽

Joseph F. Perz ◽

...

Keyword(s):

Public Health ◽

Disease Control ◽

Emergency Response ◽

Mass Casualty ◽

Acute Injury ◽

Mass Casualties ◽

Public Health Preparedness ◽

Mass Casualty Event ◽

Public Health Officials ◽

Centers For Disease Control

ABSTRACTPeople wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

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Challenges of Major Incident Management When Excess Resources are Allocated: Experiences from a Mass Casualty Incident after Roof Collapse of a Military Command Center

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00001710 ◽

2004 ◽

Vol 19 (2) ◽

pp. 179-184 ◽

Cited By ~ 21

Author(s):

Luis Romundstad ◽

Knut Ole Sundnes ◽

Johan Pillgram-Larsen ◽

Geir K. Røste ◽

Mads Gilbert

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty ◽

Major Incident ◽

Incident Management ◽

Field Hospital ◽

Rescue Work ◽

Incident Command ◽

Set Up ◽

Minor Injuries ◽

Command Center

AbstractDuring a military exercise in northern Norway in March 2000, the snowladen roof of a command center collapsed with 76 persons inside. Twentyfive persons were entrapped and/or buried under snow masses. There were three deaths. Seven patients had serious injuries, three had moderate injuries, and 16 had minor injuries.A military Convalescence Camp that had been set up in a Sports Hall 125 meters from the scene was reorganized as a causality clearing station. Officers from the Convalescence Camp initially organized search and rescue. In all, 417 persons took part in the rescue work with 36 ambulances, 17 helicopters, three ambulance airplanes and one transport plane available. Two ambulances, five helicopters and one transport aircraft were used. Four patients were evacuated to a civilian hospital and six to a field hospital.The stretcher and treatment teams initially could have been more effectively organized. As resources were ample, this was a mass casualty, not a disaster. Firm incident command prevented the influx of excess resources.

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Disaster Response to a Mass Casualty Incident in a Hospital Fire by Regional Disaster Medical Assistance Team: Characteristics of Hospital Fire

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.164 ◽

2020 ◽

pp. 1-4

Author(s):

Jae Ho Jang ◽

Jin-Seong Cho ◽

Youg Su Lim ◽

Sung Youl Hyun ◽

Jae-Hyug Woo ◽

...

Keyword(s):

Medical Records ◽

Medical Staff ◽

Disaster Response ◽

Fire Department ◽

Treatment Method ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Medical Assistance ◽

Fire Disaster ◽

Field Triage

ABSTRACT Objective: A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital. Methods: The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient’s characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method. Results: DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector. Conclusions: For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients’ medical records, and to reorganize the DMAT dispatch system.

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Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.45 ◽

2018 ◽

Vol 13 (02) ◽

pp. 243-255 ◽

Cited By ~ 3

Author(s):

Tener Goodwin Veenema ◽

Fiona Boland ◽

Declan Patton ◽

Tom O’Connor ◽

Zena Moore ◽

...

Keyword(s):

Health Care ◽

Emergency Response ◽

Large Scale ◽

Mass Casualty ◽

Republic Of Ireland ◽

Emergency Responders ◽

Mass Casualty Event ◽

Service Readiness ◽

The Republic ◽

Professional Disciplines

ABSTRACTObjectiveUltimately, a country’s capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland.MethodsA cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland. Data collection was achieved using the Qualtrics® Research Suite. Descriptive statistics and appropriate tests of comparison between professional disciplines were conducted using Stata 13.ResultsA total of 385 respondents, registered nurses (43.4%), paramedics (37.9%), medical doctors (10.1%), and administrators/managers (8.6%), participated in the study. In general, a level of knowledge of MCEs and knowledge of clinical response activities and self-assessed clinical competence varied drastically across many aspects of the survey. Knowledge and confidence also varied across professional disciplines (P<0.05) with nurses, in general, reporting the least knowledge and/or confidence.ConclusionsThe results demonstrate that serious deficits exist in HCP knowledge, skills, and self-perceived abilities to participate in a large-scale MCE. Results also suggest a poor knowledge base of existing major emergency response plans. (Disaster Med Public Health Preparedness. 2019;13:243–255)

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(A284) Improving Hospital Mass Casualty Preparedness through Ongoing Readiness Evaluation

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11002688 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s79-s79

Author(s):

B. Adini ◽

D. Laor ◽

T. Hornik-Luria ◽

A. Goldberg ◽

D. Schwartz ◽

...

Keyword(s):

Acute Care ◽

Emergency Preparedness ◽

Life Experience ◽

Real Life ◽

High Standard ◽

Acute Care Hospitals ◽

Mass Casualty ◽

Evaluation Tool ◽

Effective Response ◽

Mass Casualty Event

BackgroundIsraeli Hospitals are required to maintain a high level of emergency preparedness.ObjectivesTo investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).MethodsEvaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.ResultsA significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.DiscussionThis study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.ConclusionsUtilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.

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