Mass casualty triage

2019 ◽  
pp. 275-288
Author(s):  
Christos Giannou ◽  
Jennifer Turnbull
Keyword(s):  
Clinical Care ◽  
Mass Casualty ◽  
Humanitarian Settings ◽  
Large Numbers ◽  
Key Aspects

This chapter on mass casualty triage outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, including the rationing of care based on priority for treatment, and approaches for paediatrics. It clarifies the differences between medical triage and mass casualty triage, describes the process of balancing needs with the resources available, recognizing situations where large numbers of patients overwhelm resources, and discusses triage models and organization, triage teams, and triage algorithms.

Approach to clinical care in humanitarian contexts

2019 ◽  
pp. 267-274
Author(s):  
Raghu Venugopal
Keyword(s):  
Clinical Care ◽  
Humanitarian Settings ◽  
Key Aspects

This chapter on the approach to clinical care in humanitarian contexts outlines the fundamentals of providing care in humanitarian settings, including overall guidance on clinical care, key aspects of patient triage, and approaches for paediatrics. It providers important overarching considerations for readers, recognizing the realities and challenges in providing care in the field.

Approach to paediatric care

2019 ◽  
pp. 297-306
Author(s):  
Daniel Martinez Garcia ◽  
Harriet Roggeveen ◽  
Jaap Karsten
Keyword(s):  
Decision Making ◽  
Clinical Care ◽  
Clinical Judgement ◽  
Humanitarian Settings ◽  
Paediatric Care ◽  
Paediatric Patients ◽  
Key Aspects

This chapter outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, and approaches for paediatrics. This chapter on the approach to paediatric care in humanitarian, conflict, or disaster setting, aims to assist the non-paediatrician presented with paediatric patients, by highlighting approaches, key insights, and guidance to help with clinical judgement and decision-making.

Medical triage

2019 ◽  
pp. 289-296
Author(s):  
Peter Moons
Keyword(s):  
Clinical Care ◽  
Humanitarian Settings ◽  
Key Aspects

This chapter on medical triage outlines the fundamentals of providing care in humanitarian settings, including overall guidance to clinical care, key aspects of patient triage, and approaches for paediatrics, and emergency triage. It outlines the process of rapidly sorting patients into groups based on the urgency of their condition, ensuring that the most appropriate patients get treatment first hand.

KEY ASPECTS OF TRANSFORMATION OF THE STATE AUTHORITIES IN THE WORLD AND TO THE MODERN SOVERUM UKRAINE: A JOINT AND PERSONALITY

2018 ◽  
Vol 1 (11) ◽  
pp. 164-174
Author(s):  
Оlena Fedorіvna Caracasidi
Keyword(s):  
Separation Of Powers ◽  
Human Life ◽  
State Power ◽  
The State ◽  
Public Power ◽  
The People ◽  
Large Numbers ◽  
The World ◽  
Distribution Of Power ◽  
Key Aspects

The article deals with the fundamental, inherent in most of the countries of the world transformation of state power, its formation, functioning and division between the main branches as a result of the decentralization of such power, its subsidiarity. Attention is drawn to the specifics of state power, its func- tional features in the conditions of sovereignty of the states, their interconnec- tion. It is emphasized that the nature of the state power is connected with the nature of the political system of the state, with the form of government and many other aspects of a fundamental nature.It is analyzed that in the middle of national states the questions of legitima- cy, sovereignty of transparency of state power, its formation are acutely raised. Concerning the practical functioning of state power, a deeper study now needs a problem of separation of powers and the distribution of power. The use of this principle, which ensures the real subsidiarity of the authorities, the formation of more effective, responsible democratic relations between state power and civil society, is the first priority of the transformation of state power in the conditions of modern transformations of countries and societies. It is substantiated that the research of these problems will open up much wider opportunities for the provi- sion of state power not as a center authority, but also as a leading political structure but as a power of the people and the community. In the context of global democratization processes, such processes are crucial for a more humanistic and civilized arrangement of human life. It is noted that local self-government, as a specific form of public power, is also characterized by an expressive feature of a special subject of power (territorial community) as a set of large numbers of people; joint communal property; tax system, etc.

A Mass Youth Organization

2017 ◽  
Author(s):  
Seth Bernstein
Keyword(s):  
World War Ii ◽  
Social Promotion ◽  
Political Society ◽  
World War ◽  
Youth Organization ◽  
Large Numbers ◽  
Material Benefits ◽  
Key Aspects

In the late 1930s, the Komsomol nearly tripled in size. Its emergence as a mass youth organization demanded that the requirements for members become more lax. The expansion of the league was tied to the start of World War II in Europe, which contributed to the stratification of the league between professional organizers and younger members. A consensus emerged among Komsomol leaders and members that material benefits and social promotion were key aspects of membership in political society and in the construction of socialism. By involving large numbers of youth in official culture, youth organizers hoped to cultivate them as defenders of socialism and to prevent them from becoming irredeemable enemies.

scholarly journals Prolonging the Lifetime of Two-Tiered Wireless Sensor Networks with Mobile Relays

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Theodore C. Kotsilieris ◽  
George T. Karetsos
Keyword(s):  
Energy Savings ◽  
Relay Node ◽  
Sensor Nodes ◽  
Wireless Sensor ◽  
Relay Nodes ◽  
Large Numbers ◽  
Sensor Networking ◽  
Key Aspects ◽  
Networking Architectures ◽  
Mobile Relay

We propose a clustering scheme for wireless sensor nodes in hierarchical wireless sensor networking architectures that employs mobile relay nodes in order to achieve energy conservation and network lifetime prolongation. The key aspects of our scheme are relay node relocation and reclustering when failures are detected. The performance of the proposed approach is evaluated via simulations for various topology layouts based on the sensor node population and number of mobile relay nodes employed. The results show significant energy savings in particular for topologies with large numbers of sensors.

Triage in Complex, Coordinated Terrorist Attacks

2019 ◽  
Vol 34 (04) ◽  
pp. 442-448 ◽  
Author(s):  
Matt Pepper ◽  
Frank Archer ◽  
John Moloney
Keyword(s):  
Physiological Stress ◽  
Mass Casualty ◽  
Terrorist Attacks ◽  
Mass Violence ◽  
Patient Movement ◽  
Terror Attacks ◽  
Physiological Variables ◽  
Large Numbers ◽  
Life Saving ◽  
San Bernardino

AbstractIntroduction:Terror attacks have increased in frequency, and tactics utilized have evolved. This creates significant challenges for first responders providing life-saving medical care in their immediate aftermath. The use of coordinated and multi-site attack modalities exacerbates these challenges. The use of triage is not well-validated in mass-casualty settings, and in the setting of intentional mass violence, new and innovative approaches are needed.Methods:Literature sourced from gray and peer-reviewed sources was used to perform a comparative analysis on the application of triage during the 2011 Oslo/Utoya Island (Norway), 2015 Paris (France), and 2015 San Bernardino (California USA) terrorist attacks. A thematic narrative identifies strengths and weaknesses of current triage systems in the setting of complex, coordinated terrorist attacks (CCTAs).Discussion:Triage systems were either not utilized, not available, or adapted and improvised to the tactical setting. The complexity of working with large numbers of patients, sensory deprived environments, high physiological stress, and dynamic threat profiles created significant barriers to the implementation of triage systems designed around flow charts, physiological variables, and the use of tags. Issues were identified around patient movement and “tactical triage.”Conclusion:Current triage tools are inadequate for use in insecure environments, such as the response to CCTAs. Further research and validation are required for novel approaches that simplify tactical triage and support its effective application. Simple solutions exist in tactical triage, patient movement, and tag use, and should be considered as part of an overall triage system.

Comparison of Outcome Tools Used to Test Mass-Casualty Algorithms in the Pediatric Population

2021 ◽  
pp. 1-5
Author(s):  
J. Joelle Donofrio ◽  
Alaa Shaban ◽  
Amy H. Kaji ◽  
Genevieve Santillanes ◽  
Mark X. Cicero ◽  
...  
Keyword(s):  
Injury Severity ◽  
Pediatric Population ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Study Objective ◽  
Large Numbers ◽  
Triage Category ◽  
Level I ◽  
Outcome Tool ◽  
Trauma Activation

Abstract Introduction: Mass-casualty incident (MCI) algorithms are used to sort large numbers of patients rapidly into four basic categories based on severity. To date, there is no consensus on the best method to test the accuracy of an MCI algorithm in the pediatric population, nor on the agreement between different tools designed for this purpose. Study Objective: This study is to compare agreement between the Criteria Outcomes Tool (COT) to previously published outcomes tools in assessing the triage category applied to a simulated set of pediatric MCI patients. Methods: An MCI triage category (black, red, yellow, and green) was applied to patients from a pre-collected retrospective cohort of pediatric patients under 14 years of age brought in as a trauma activation to a Level I trauma center from July 2010 through November 2013 using each of the following outcome measures: COT, modified Baxt score, modified Baxt combined with mortality and/or length-of-stay (LOS), ambulatory status, mortality alone, and Injury Severity Score (ISS). Descriptive statistics were applied to determine agreement between tools. Results: A total of 247 patients were included, ranging from 25 days to 13 years of age. The outcome of mortality had 100% agreement with the COT black. The “modified Baxt positive and alive” outcome had the highest agreement with COT red (65%). All yellow outcomes had 47%-53% agreement with COT yellow. “Modified Baxt negative and <24 hours LOS” had the highest agreement with the COT green at 89%. Conclusions: Assessment of algorithms for triaging pediatric MCI patients is complicated by the lack of a gold standard outcome tool and variability between existing measures.

Terrorism in France

2003 ◽  
Vol 18 (2) ◽  
pp. 92-99 ◽  
Author(s):  
Pierre Carli ◽  
Caroline Telion ◽  
David Baker
Keyword(s):  
Emergency Response ◽  
Life Support ◽  
Mass Casualty ◽  
Lessons Learned ◽  
National Plan ◽  
Medical Response ◽  
Emergency Medical ◽  
Mass Casualty Events ◽  
Psychological Assistance ◽  
Key Aspects

AbstractFrance has experienced two waves of major terrorist bombings since 1980. In the first wave (1985–1986), eight bombings occurred in Paris, killing 13 and injuring 281. In the second wave (1995–1996), six bombings occurred in Paris and Lyon, killing 10 and injuring 262. Based on lessons learned during these events, France has developed and improved a sophisticated national system for prehospital emergency response to conventional terrorist attacks based on its national emergency medical services (EMS) system, Service d' Aide Medicale Urgente (SAMU). According to the national plan for the emergency medical response to mass-casualty events (White Plan), the major phases of EMS response are: (1) alert; (2) search and rescue; (3) triage of victims and provision of critical care to first priority victims; (4) regulated dispatch of victims to hospitals; and (5) psychological assistance.Following the 1995 Tokyo subway sarin attack, a national plan for the emergency response to chemical and biological events (PIRATOX) was implemented. In 2002, the Ministries of Health and the Interior collaborated to produce a comprehensive national plan (BIOTOX) for the emergency response to chemical, biological, radiological, and nuclear events. Key aspects of BIOTOX are the prehospital provision of specialized advance life support for toxic injuries and the protection of responders in contaminated environments. BIOTOX was successfully used during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak in France.

scholarly journals Burn Survival in Mass-Casualty Situation Planning, Preparation, Response: What is the Key?

2008 ◽  
Vol 23 (4) ◽  
pp. 295-296 ◽  
Author(s):  
Fiona Wood
Keyword(s):  
Clinical Care ◽  
Clinical Problem ◽  
Mass Casualty ◽  
Relationship Building ◽  
Mass Casualties ◽  
Mutual Understanding ◽  
Clinical Problem Solving ◽  
Optimal Outcomes ◽  
The Right ◽  
Collaborative Knowledge

When facing a situation involving mass casualties, we must consider the choices we have as individuals and as communities. The range of opportunity and privilege across the world is vast. Set against the background of natural and manmade disasters, how do we provide the right care at the right time for those in need? How can we share our collaborative knowledge?.The recognition of the dignity of those in need is the first step.Relationship building in the time of non-disaster leads to mutual understanding, facilitating care. Medicine brings science and experience into the art of clinical problem-solving. Disaster situations require rapid solutions based on prior planning, communicated with the understanding that optimal outcomes depend upon relationships based on respect, sharing knowledge of the local environmental resources, coupled with clinical care.

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