Disaster and mass casualty events in the pediatric population

The COVID-19 pandemic is the most serious health crisis of our time. Global public measures have been enacted to try to prevent healthcare systems from being overwhelmed. The trauma and orthopaedic (T&O) community has overcome challenges in order to continue to deliver acute trauma care to patients and plan for challenges ahead. This review explores the lessons learnt, the priorities and the controversies that the T&O community has faced during the crisis. Historically, the experience of major incidents in T&O has focused on mass casualty events. The current pandemic requires a different approach to resource management in order to create a long-term, system-sustaining model of care alongside a move towards resource balancing and facilitation. Significant limitations in theatre access, anaesthetists and bed capacity have necessitated adaptation. Strategic changes to trauma networks and risk mitigation allowed for ongoing surgical treatment of trauma. Outpatient care was reformed with the uptake of technology. The return to elective surgery requires careful planning, restructuring of elective pathways and risk management. Despite the hope that mass vaccination will lift the pressure on bed capacity and on bleak economic forecasts, the orthopaedic community must readjust its focus to meet the challenge of huge backlogs in elective caseloads before looking to the future with a robust strategy of integrated resilient pathways. The pandemic will provide the impetus for research that defines essential interventions and facilitates the implementation of strategies to overcome current barriers and to prepare for future crises.

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Preventing Pediatric Mass Casualty Events

Disaster Management & Response ◽

10.1016/j.dmr.2007.04.002 ◽

2007 ◽

Vol 5 (2) ◽

pp. 25-26 ◽

Cited By ~ 1

Author(s):

Margaret M. McMahon

Keyword(s):

Mass Casualty ◽

Mass Casualty Events

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Altered Standards of Care During an Influenza Pandemic: Identifying Ethical, Legal, and Practical Principles to Guide Decision Making

Disaster Medicine and Public Health Preparedness ◽

10.1097/dmp.0b013e3181ac3dd2 ◽

2009 ◽

Vol 3 (S2) ◽

pp. S132-S140 ◽

Cited By ~ 23

Author(s):

Donna Levin ◽

Rebecca Orfaly Cadigan ◽

Paul D. Biddinger ◽

Suzanne Condon ◽

Howard K. Koh ◽

...

Keyword(s):

Public Health ◽

Planning Process ◽

Influenza Pandemic ◽

State Level ◽

Mass Casualty ◽

Standards Of Care ◽

Public Health Preparedness ◽

Community Stakeholders ◽

Mass Casualty Events ◽

Public Health Officials

ABSTRACTAlthough widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. We describe the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S132–S140)

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When Direct Pressure Is Not Enough: An Educational Technique for Teaching Wound Packing in Athletic Training Education

Athletic Training Education Journal ◽

10.4085/1947-380x-20-085 ◽

2021 ◽

Vol 16 (4) ◽

pp. 278-286

Author(s):

Ashley B. Thrasher ◽

Edward J. Strapp

Keyword(s):

Athletic Training ◽

Clinical Education ◽

Wound Care ◽

Athletic Trainers ◽

Mass Casualty ◽

Laboratory Activity ◽

Civilian Casualty ◽

Mass Casualty Events ◽

Direct Pressure ◽

Educational Technique

Context Uncontrolled hemorrhage is a major cause of preventable death. Wound care and managing external hemorrhage are important skills for athletic trainers. Objective Describe a laboratory activity used to allow students to practice managing uncontrolled external hemorrhage and wound packing. Background The prevalence of active shooter and other mass casualty events has grown, and a trend to move military-based emergency skills into civilian casualty care has emerged. Athletic trainers are uniquely positioned to respond to catastrophic events at the time of injury. Controlling hemorrhage and rapidly applying a tourniquet or administering wound packing have a great effect in preventing death due to severe hemorrhage. Description An educational technique using a pork shoulder was implemented to provide students with experience in wound packing. Clinical Advantage(s) Students describe this activity as a beneficial way to gain experience on an important skill not often seen in the clinical education setting. Conclusion(s) Faculty may consider implementing wound packing using a pork shoulder as a laboratory activity when teaching wound care and external hemorrhage management.

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First Responder Psychological Recovery Following a Mass Casualty Event

Police Psychology and Its Growing Impact on Modern Law Enforcement - Advances in Psychology, Mental Health, and Behavioral Studies ◽

10.4018/978-1-5225-0813-7.ch007 ◽

2017 ◽

pp. 143-157

Author(s):

Sara Garrido ◽

John Nicoletti

Keyword(s):

Psychological Impact ◽

Crisis Response ◽

Mass Casualty ◽

Lessons Learned ◽

Trauma Recovery ◽

Community Members ◽

Mass Casualty Events ◽

Columbine High School ◽

Crime Scene Investigators ◽

The Impact

Mass Casualty Events (MCE) have an extraordinary impact on an entire community. The impact on victims' families, survivors, and community members is often the subject of significant attention; however, rarely does the impact on first responders (law enforcement officers, firefighters, dispatchers, crime scene investigators/photographers, etc.) garner the same coverage. Additionally, agencies can quickly become overwhelmed by the magnitude of the response causing them to overlook the psychological impact of these incidents on their personnel. Serving as specialists in police and public safety psychology, crisis intervention, and trauma recovery, the authors reflect on lessons learned from their response to multiple MCEs, including the 1999 Columbine High School shooting and the 2012 Aurora Century 16 Theater shooting, and offer recommendations to agencies regarding crisis response and trauma recovery.

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