scholarly journals Seven First Minutes - Community Emergency Response Training

2019 ◽  
Vol 34 (s1) ◽  
pp. s18-s18
Author(s):  
Raphael Herbst ◽  
Eli Jaffe
Keyword(s):  
General Public ◽  
Emergency Services ◽  
Medical Training ◽  
Study Groups ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Emergency Responders ◽  
Accurate Picture ◽  
Unique Experience ◽  
Improve Patient

Introduction:Following a mass casualty incident (MCI), it can take several minutes for emergency medical services (EMS) to arrive. The course was developed by Magen David Adom (MDA) based on unique experience in dealing with MCIs, and the time between alerting emergency services to such an incident until they arrive. The course is focused on teaching the general public to channel their desire to help in such a situation into useful skills which can potentially improve patient outcomes. The seminar focuses on key principles such as safety, calling for help, providing an accurate picture of the scene, and initiating basic treatment with an emphasis on hemorrhage control.Aim:MDA examined the ability of the general public with no previous medical training to perform a basic triage and treatment in an MCI situation. Additionally, the study examined the abilities of the study groups to manage a scene until the arrival of EMS based on the principles taught in the course.Methods:MDA has sent teams of instructors around the world to teach over 1,000 participants. Upon completing the course, the participants partake in a drill that assesses their ability to manage a scene of 20 patients. Their ability to initiate the call for help, provide an accurate picture, initiate treatment, and give an accurate report to arriving emergency responders are examined.Results:The average times were recorded. Within 38 seconds, dispatch was alerted to the situation. Within 2:30 minutes, treatment was initiated for all patients. Within 4:37 minutes, the scene was fully under control, and within 6:37 minutes, an accurate report was transferred to EMS on the scene.Discussion:The participants demonstrated an unexpected willingness to learn, practice, and partake in the drills, and the results were unexpected.

scholarly journals Simple Emergency Triage (SET) – the new perspective on mass casualty incident triage

2020 ◽  
Vol 7 (2) ◽  
pp. 120-123
Author(s):  
Jerzy Jaskuła ◽  
Marek Siuta
Keyword(s):  
Personal Experience ◽  
Emergency Services ◽  
Statistical Data ◽  
First Aid ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Starting Point ◽  
Analysis And Synthesis ◽  
The Subject ◽  
New Perspective

The aim: Incidents with large number of casualties present a major challenge for the emergency services. Incident witnesses are always the first on scene. Authors aim at giving them an algorithm arranging the widely known first aid rules in such way, that the number of potential fatalities before the services’ arrival may be decreased. Material and methods: The authors’ main aim was creating an algorithm for mass casualty incident action, comprising elements not exceeding first aid skill level. Proceedings have been systematized, which led to creation of mass casualty incident algorithm. The analysis was based on the subject matter literature, legal acts and regulations, statistical data and author’s personal experience. Results: The analysis and synthesis of data from various sources allowed for the creation of Simple Emergency Triage (SET) algorithm. It has been proven – on theoretical level – that introducing an organized way of proceeding in mass casualty incident on the first aid level is justified. Conclusions: The SET algorithm presented in the article is of an implemental character. It may be a supplement to basic first aid skills. Algorithm may also be the starting point for further empirical research aimed at verifying its effectiveness.

scholarly journals Putting the Theoretical to Practical Use

2019 ◽  
Vol 34 (s1) ◽  
pp. s161-s161
Author(s):  
Eli Jaffe
Keyword(s):  
Medical Students ◽  
Self Efficacy ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Life And Death ◽  
Emergency Responders ◽  
Mature Students ◽  
Daunting Task ◽  
The Mean ◽  
First Time

Introduction:Managing an MCI (Mass Casualty Incident) can be a daunting task for emergency responders. Effective management can be a matter of life and death but can be directly impacted by the feelings of the incident commander.Aim:Students were trained to be incident commanders, then following the course were given a survey. In the days following the training, an MCI occurred involving a train full of passengers. The students were then given another survey to assess their readiness following the practical use of their studies.Methods:Students were given a survey to determine their mean level of confidence in managing MCIs prior to training, and following the training. Following the training, there was an increase in confidence. After the training, there was an MCI in which their theoretical knowledge was put to the test.Results:The pre-training self-efficacy mean scores of younger students (M=3.5, SD+0.23) increased after the training (M=3.8, SD+0.28) and rose even more following the presentation of the Turin train accident (M=4, SD+0.26). While a similar increase in self-efficacy was found among the more mature students post-training compared to the level prior to the training (M=3.7, SD+0.44 versus M=3.4, SD+0.56), the mean self-efficacy score of the mature students decreased following the presentation of the Turin train accident to the pre-training level (M=3.4, SD+0.51).Discussion:Mean scores of self-efficacy and confidence in managing MCIs were found to be higher among medical students that were previously trained in coping with MCIs compared to medical students who participated in such a training program for the first time.

scholarly journals MP01: Use of an unmanned aerial vehicle to provide situational awareness in a simulated mass casualty incident

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S40-S40
Author(s):  
A. K. Sibley ◽  
T. Jain ◽  
B. Nicholson ◽  
M. Butler ◽  
S. David ◽  
...  
Keyword(s):  
Situational Awareness ◽  
Optimal Strategies ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Treatment Area ◽  
Incident Command ◽  
Emergency Responders ◽  
Video Footage ◽  
Scene Management ◽  
Patient Localization

Introduction: Situational awareness (SA) is essential for maintenance of scene safety and effective resource allocation in mass casualty incidents (MCI). Unmanned aerial vehicles (UAV) can potentially enhance SA with real-time visual feedback during chaotic and evolving or inaccessible events. The purpose of this study was to test the ability of paramedics to use UAV video from a simulated MCI to identify scene hazards, initiate patient triage, and designate key operational locations. Methods: A simulated MCI, including fifteen patients of varying acuity (blast type injuries), plus four hazards, was created on a college campus. The scene was surveyed by UAV capturing video of all patients, hazards, surrounding buildings and streets. Attendees of a provincial paramedic meeting were invited to participate. Participants received a lecture on SALT Triage and the principles of MCI scene management. Next, they watched the UAV video footage. Participants were directed to sort patients according to SALT Triage step one, identify injuries, and localize the patients within the campus. Additionally, they were asked to select a start point for SALT Triage step two, identify and locate hazards, and designate locations for an Incident Command Post, Treatment Area, Transport Area and Access/Egress routes. Summary statistics were performed and a linear regression model was used to assess relationships between demographic variables and both patient triage and localization. Results: Ninety-six individuals participated. Mean age was 35 years (SD 11), 46% (44) were female, and 49% (47) were Primary Care Paramedics. Most participants (80 (84%)) correctly sorted at least 12 of 15 patients. Increased age was associated with decreased triage accuracy [-0.04(-0.07,-0.01);p=0.031]. Fifty-two (54%) were able to localize 12 or more of the 15 patients to a 27x 20m grid area. Advanced paramedic certification, and local residency were associated with improved patient localization [2.47(0.23,4.72);p=0.031], [-3.36(-5.61,-1.1);p=0.004]. The majority of participants (78 (81%)) chose an acceptable location to start SALT triage step two and 84% (80) identified at least three of four hazards. Approximately half (53 (55%)) of participants designated four or more of five key operational areas in appropriate locations. Conclusion: This study demonstrates the potential of UAV technology to remotely provide emergency responders with SA in a MCI. Additional research is required to further investigate optimal strategies to deploy UAVs in this context.

Managing a Mass CO Poisoning: Critical Issues and Solutions From the Field to the Hyperbaric Chamber

2016 ◽  
Vol 11 (2) ◽  
pp. 251-255 ◽  
Author(s):  
Adriano Valerio ◽  
Matteo Verzè ◽  
Francesco Marchiori ◽  
Igor Rucci ◽  
Lucia De Santis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Carbon Monoxide ◽  
Emergency Services ◽  
Carbon Monoxide Poisoning ◽  
Heating System ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Accidental Poisoning ◽  
Complex Situation ◽  
First Case

AbstractCarbon monoxide acute intoxication is a common cause of accidental poisoning in industrialized countries and sometimes it produces a real mass casualty incident. The incident described here occurred in a church in the province of Verona, when a group of people was exposed to carbon monoxide due to a heating system malfunction. Fifty-seven people went to the Emergency Department. The mean carboxyhemoglobin (COHb) level was 10.1±5.7% (range: 3-25%). The clinicians, after medical examination, decided to move 37 patients to hyperbaric chambers for hyperbaric oxygen (HBO) therapy. This is the first case report that highlights and analyses the logistic difficulties of managing a mass carbon monoxide poisoning in different health care settings, with a high influx of patients in an Emergency Department and a complex liaison between emergency services. This article shows how it is possible to manage a complex situation with good outcome. (Disaster Med Public Health Preparedness. 2017;11:251–255)

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.

Factors influencing responders’ perceptions of preparedness for terrorism

2016 ◽  
Vol 25 (4) ◽  
pp. 520-533 ◽  
Author(s):  
Annelie Holgersson ◽  
Dzenan Sahovic ◽  
Britt-Inger Saveman ◽  
Ulf Björnstig
Keyword(s):  
Work Experience ◽  
Emergency Services ◽  
Management Training ◽  
Mass Casualty ◽  
Terrorist Attacks ◽  
Content Type ◽  
Emergency Responders ◽  
Factors Influencing ◽  
Management Capability ◽  
Related Occupation

Purpose – The purpose of this paper is to analyse factors influencing perceptions of preparedness in the response to terrorist attacks of operational personnel in Swedish emergency organizations. Design/methodology/approach – Data were collected using a questionnaire distributed to operational personnel from the police, rescue and ambulance services in eight Swedish counties; 864 responses were received and analysed. Findings – Three aspects of the perception of preparedness for terrorist attacks among Swedish emergency responders were studied: willingness to respond; level of confidence with tasks; and estimated management capability. Factors which positively influenced these perceptions were male sex, training in first aid and dealing with mass casualty incidents, terrorism-related management training (MT), table-top simulations, participation in functional exercises, and access to personal protective equipment (PPE); work experience was inversely related. Occupation in police or rescue services was positively associated with willingness to respond whereas occupation within the emergency medical services was positively associated with estimated management capability. Practical implications – These findings show that terrorism-related MT and access to PPE increase the perceptions of preparedness for terrorism among the emergency services, aiding judgements about investments in preparedness by crisis management planners. Originality/value – Limited research in disaster management and hazard preparedness has been conducted in a European context, especially regarding terrorism. Little is known about aspects of preparedness for terrorism in Sweden, particularly from the perspective of the emergency responders.

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.

Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?

2017 ◽  
Vol 11 (3) ◽  
pp. 305-309 ◽  
Author(s):  
Stefano Badiali ◽  
Aimone Giugni ◽  
Lucia Marcis
Keyword(s):  
Group Versus ◽  
Time Frame ◽  
Mass Casualty Incident ◽  
Medical Intervention ◽  
Mass Casualty ◽  
Mass Casualties ◽  
Exact Test ◽  
Triage Protocol ◽  
Train System ◽  
Improve Patient

AbstractObjectiveSTART (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether “last-minute” START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients.MethodsIn this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher’s exact test for a P value<0.01. Under- and over-triage ratios were analyzed as well.ResultsThe START group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (P<0.01). Under- and over-triage were, respectively, 2.73% and 3.08% for the START group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 “preventable deaths” on 6000 cases because of incorrect triage, whereas the START group had 91.ConclusionsEven a “last-minute” training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305–309)

scholarly journals (P2-7) Patient Distribution during a Mass-Casualty Incident: The 25 February 2009 Turkish Airlines Crash in Amsterdam

2011 ◽  
Vol 26 (S1) ◽  
pp. s137-s137 ◽  
Author(s):  
I.L.E. Postma ◽  
H. Weel ◽  
M. Heetveld ◽  
F. Bloemers ◽  
T. Bijlsma ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Major Trauma ◽  
Injury Severity ◽  
Emergency Services ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Trauma Centers ◽  
Risk Area ◽  
High Risk Area ◽  
Number Of Patients

BackgroundDifficulties have been reported in patient distribution during mass-casualty incidents (MCIs). In this retrospective, descriptive study, the regional Patient Distribution Protocol (PDP) and the management of the patient distribution after the Turkish Airlines airplane crash on 25 February 2009 near Schiphol Airport in Amsterdam were analyzed.MethodsAnalysis of the of PDP involving the 126 surviving victims of the crash, by collecting data on Medical Treatment Capacity (MTC), number of patients received per hospital, triage classification, Injury Severity Scale (ISS) score, secondary transfers, distance from the crash site, and critical mortality rate.ResultsThe PDP holds two inconsistent definitions of MTC. The PDP was not followed. Four hospitals received 133–213% of their MTC, and five hospitals received one patient. There were 14 receiving hospitals (distance from crash: 5.8–53.5 km); thre hospitals within 20 km of the crash did not receive any patients. Major trauma centers received 89% of the “critical” casualties and 92% of the casualties with ISS score ≥ 16. They also received 10% of “minor” casualties and 29% of casualties with ISS score < 8. Only three patients were secondarily transferred, and no casualties died in, or on the way to, the hospital (critical mortality rate = 0%).ConclusionsPatient distribution was effective, as secondary transfers were low, and the critical mortality rate was zero. The regional PDP could not be followed during this MCI. Uneven casualty distribution was seen in the hospitals. The regional PDP is inconsistent, and should be updated in a new cooperation between Emergency Services, surrounding hospitals and vSchiphol Airport, a high risk area, for which area-specific PDPs must be designed.

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