scholarly journals Design Strategies to Improve Emergency Departments’ Performance During Mass Casualty Incidents: A Survey of Caregivers

2019 ◽  
Vol 13 (1) ◽  
pp. 206-220
Author(s):  
Shabboo Valipoor ◽  
Hesamedin Hakimjavadi ◽  
Giuliano De Portu
Keyword(s):  
Emergency Departments ◽  
Patient Flow ◽  
Care Facility ◽  
Emergency Operation ◽  
Mass Casualty ◽  
Physical Design ◽  
Mass Casualty Incidents ◽  
Design Strategies ◽  
Online Questionnaire ◽  
Critical Patients

Objectives: To identify effective facility design strategies to improve the performance of healthcare providers and patient flow during mass casualty incidents (MCIs) in emergency departments. Background: Emergency departments (EDs) are the first line of medical care in MCIs. While operational surge management plans are well described in literature, physical design strategies to improve performance and patient flow during disasters are discussed scarcely. Method: An online questionnaire was sent to EDs’ caregivers nationwide asking them to rate the effectiveness of nine physical design strategies, discussed in the literature, to improve caregivers’ performance and patient flow during MCIs. Assessed strategies were about providing expandable departments and care areas, alternate care facilities for the least sick to maximize care areas for critical patients, care areas from nonemergency units, increased number of decontamination units, dedicated isolation units, within-hospital and close emergency operation centers, and within-hospital media areas. Results: All suggested strategies were rated as effective. The most effective and agreed-upon solution was identified as maximizing the care area for critical patients by establishing an alternate care facility with separate entrance and exit doors from the emergency department for the least critical patients. The least effective and agreed-upon strategy was identified as locating a media unit within the hospital outside of the ED. Conclusions: Caregivers who work in EDs consider design strategies to be effective in surge management during disasters. Designers can consider implementing identified strategies in designing new emergency departments or expansion and renovation projects.

Injury patterns of mass casualty incidents involving high-speed passenger ferries presenting to accident and emergency departments in Hong Kong: a retrospective review

Injury ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 252-259 ◽  
Author(s):  
Rex Pui Kin Lam ◽  
Ronald Tat Ming Wong ◽  
Eric Ho Yin Lau ◽  
Kin Wa Wong ◽  
Arthur Chi Kin Cheung ◽  
...  
Keyword(s):  
Hong Kong ◽  
Retrospective Review ◽  
Emergency Departments ◽  
High Speed ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Injury Patterns ◽  
Accident And Emergency

scholarly journals Mass Casualty Incidents and Disaster Participation in Real versus Simulated Events in Romania

2016 ◽  
Vol 62 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Adrian Stănescu ◽  
Cristian Boeriu ◽  
Sanda-Maria Copotoiu
Keyword(s):  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Online Questionnaire ◽  
Non Profit ◽  
Proper Method ◽  
Study Results ◽  
The Common ◽  
Communication Evaluation ◽  
Year 2013

Abstract Background: The current study outlines some of the main particularities of both real and simulated mass casualty incidents (MCI) and disasters in Romania as reported by medical and paramedical participating personnel. Methods: A non-profit organization in Romania trained 1250 doctors, nurses and paramedics for proper MCI interventions through a dedicated programme for the last part of the year 2013. Half a year later, an email with a unique link to an online questionnaire was sent to each participant to assess their opinion over the participation in real or already simulated MCI or disasters. The questionnaire consisted of 25 specific topics, out of which only a fraction were considered for the current study. Results: Out of all participants, 145 doctors, 184 nurses and 115 paramedics provided valid answers, totaling 444 responders. Most participants were satisfied with the information about the location and type of the incident they would respond to. The amplitude of a given event is generally well anticipated under simulation conditions as compared to real events, where the amplitude tends to be higher rather than lower than expected (p=0.0082). About three quarters of participants under real or simulated events repeated or demanded repeating the information trafficked through mobile radios, almost a quarter misinterpreted the information, and almost a half reported delayed operations due to miscommunication. Conclusions: Simulations are a proper method of communication evaluation for mass casualty incidents and disasters, which can also stress the common communication issues encountered during a real MCI unfolding.

scholarly journals Mass Casualty Management in the Emergency Department – Lessons Learned in Beirut, Lebanon - Part II

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
The Past ◽  
To Receive

The first article in this series (Part I) discussed the abundant exposure of our emergency department (ED) to mass casualty incidents (MCIs), particularly over the past 14 years. This experience led us to define practical strategies that emergency departments can use to develop their own MCI response plans. In the first part, our main focus was to highlight the abrupt nature of MCIs and the subsequent need to use disaster drills. Additionally, we discussed the importance of having a tiered response and activation as well as other lessons learned from our experience to maximize the preparedness of the emergency department to receive mass casualty.In this article, we discuss the optimal way to triage patients. In addition, we will tackle the best methods for documentation and communication, which are vital yet overlooked during mass casualty incidents. We will also elaborate on what we learned from dealing with outbursts of anger and violence in the ED during MCIs and how to ensure the safety of the ED staff.

scholarly journals Mass Casualty Management in the Emergency Department - Lessons Learned in Beirut, Lebanon - Part I

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Pivotal Role ◽  
Front Door ◽  
Short Period ◽  
Effective Planning

Over the last century, mass casualty incidents (MCIs) affected many nations and their emergency departments. The unscheduled arrival of large number of injured victims over a short period of time often causes major chaos and crowding. When a rapid surge in operational needs overwhelms available Emergency Department (ED) resources and personnel, the chaos and overwhelming mismatch between needs and resources can quickly spread to the rest of the hospital.1, 2 Nonetheless, as the front door of the hospital, the ED plays a pivotal role in determining the quality and effectiveness of an institution’s MCI response. This requires effective planning, which translates into preparedness. Unfortunately, many EDs are overburdened even on regular days. Damaged infrastructure further compounds the challenge.

scholarly journals Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

2021 ◽  
pp. 1-11
Author(s):  
Wesley D Jetten ◽  
Jeroen Seesink ◽  
Markus Klimek
Keyword(s):  
Scoping Review ◽  
Life Support ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Lay People ◽  
Online Databases ◽  
Healthcare Experience ◽  
Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

scholarly journals Efficiency and Teamwork in Emergency Departments: Perception of Staff on Design Interventions

2021 ◽  
pp. 193758672110231
Author(s):  
Sahar Ahmadpour ◽  
Sara Bayramzadeh ◽  
Parsa Aghaei
Keyword(s):  
Work Environment ◽  
Emergency Departments ◽  
Online Survey ◽  
The Body ◽  
Healthcare Outcomes ◽  
Design Strategies ◽  
Design Features ◽  
Staff Members ◽  
Enhance Efficiency ◽  
Efficient Work

Objectives: The goal of this study is twofold: (1) identifying design strategies that enhance efficiency and support teamwork in emergency departments (EDs) and (2) identifying design features that contribute to the spread of COVID-19, based on staff perception. Background: Due to increasing ED visits annually, an efficient work environment has become one of the main concerns in designing EDs. According to the literature, an efficient work environment and teamwork improve healthcare outcomes and positively impact staff satisfaction. During the COVID-19 pandemic, EDs faced various changes such as workflow and space usage. Few studies explored staff perceptions about the influence of design features on efficiency, teamwork, and the COVID-19 spread. Method: An online survey with 14 open- and closed-ended questions was distributed among ED staff members to collect data about unit design features that impact efficiency, teamwork, and the COVID-19 spread. Results: The central nursing station was one of the preferred configurations that increased efficiency and teamwork in EDs. Decentralizing disposal rooms in small-size EDs and decentralizing the medication room in large-size EDs with more than 65 exam rooms can decrease staff walking steps. Flexibility to expand treatment spaces on demand, one-way track circulation path, and changing the air pressure in COVID-19 treatment areas were some of the staff suggestions for future EDs. Conclusion: The findings of this study contribute to the body of knowledge that EDs’ physical environments can impact efficiency and teamwork among staff and, consequently, healthcare outcomes. Compartmentalization of the ED layout can reduce the spread of COVID-19.

A call for collective learning from mass casualty incidents

Injury ◽  
2021 ◽  
Author(s):  
Amila Ratnayake ◽  
Sanjeewa Garusinghe ◽  
Miklosh Bala ◽  
Tamara J. Worlton
Keyword(s):  
Mass Casualty ◽  
Collective Learning ◽  
Mass Casualty Incidents

Does Self-reporting Facilitate History Taking in Food Poisoning Mass-casualty Incidents?

2014 ◽  
Vol 29 (4) ◽  
pp. 417-420 ◽  
Author(s):  
Ya-I Hsu ◽  
Ying C. Huang
Keyword(s):  
Health Care ◽  
Medical History ◽  
Food Poisoning ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Control Group ◽  
History Taking ◽  
Care Providers ◽  
Time Required ◽  
Experimental Group

AbstractIntroductionMedical history is an important contributor to diagnosis and patient management. In mass-casualty incidents (MCIs), health care providers are often overwhelmed by large numbers of casualties. An efficient, reliable, and affordable method of information collection is essential for effective health care response.Hypothesis/ProblemIn some MCIs, self-reporting of symptoms can decrease the time required for history taking, without sacrificing the completeness of triage information.MethodsTwo resident doctors and a number of seventh graders who had previous experience of abdominal discomfort were invited to join this study. A questionnaire was developed to collect information on common symptoms in food poisoning. Each question was scored, and enrolled students were randomly divided into two groups. The experimental group students answered the questionnaire first and then were interviewed to complete the medical history. The control group students were interviewed in the traditional way to collect medical history. Time of all interviews was measured and recorded. The time needed to complete the history taking and completeness of obtained information were compared with students’ t tests, or Mann-Whitney U tests, based on the normality of data. Comprehensibility of each question, scored by enrolled students, was reported by descriptive statistics.ResultsThere were 41 students enrolled: 22 in the experimental group and 19 in the control group. Time to complete history taking in the experimental group (163.0 seconds, SD=52.3) was shorter than that in the control group (198.7 seconds, SD=40.9) (P=.010). There was no difference in the completeness of history obtained between the experimental group and the control group (94.8%, SD=5.0 vs 94.2%, SD=6.1; P=.747). Between the two doctors, no significant difference was found in the time required for history taking (185.2 seconds, SD=42.2 vs 173.1 seconds, SD=58.6; P=.449), or the completeness of information (94.1%, SD=5.9 vs 95.0%, SD=5.0; P=.601). Most of the questions were scored “good” in comprehensibility.ConclusionSelf-reporting of symptoms can shorten the time of history taking during a food poisoning mass-casualty event without sacrificing the completeness of information.HsuY, HuangYC. Does self-reporting facilitate history taking in food poisoning mass-casualty incidents?Prehosp Disaster Med. 2014;29(4):1-4.

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