A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts

Abstract Background The project “ARMIHN” (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, previous MCI-ID were especially caused by pathogens such as Influenza virus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the associated interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes. Methods A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed. Results The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 min. Based on their specialist expertise, 14 of the 31 listed clinics were selected. Conclusion The purpose of the study was to provide an analysis of the current situation and show how involved parties would cope an MCI. A description of processes and resources at the Port of Hamburg will be used when designing a management plan for responding to an MCI-ID.

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A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts

10.21203/rs.3.rs-307791/v1 ◽

2021 ◽

Author(s):

Angelina Klein ◽

Julian Heuser ◽

Esther Henning ◽

Nadine Spössel ◽

Ann-Christin Kordsmeyer ◽

...

Keyword(s):

Infectious Diseases ◽

Organizational Development ◽

Organizational Structures ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Work Processes ◽

Existing Structures ◽

Cruise Ships ◽

Operational Concept

Abstract BACKGROUND The project “ARMIHN” (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, an MCI-ID can also be caused by pathogens such as Influenzavirus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the relating interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes. METHODS A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed. RESULTS The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 minutes. Based on their specialist expertise, 14 of the 31 listed clinics were selected. CONCLUSION Based on identified existing structures and the determination of medical resources, an operational concept for an MCI-ID in the port can be adapted and can contribute to enhanced coping with this situation. Subsequently, the derived operational concept will be tested for practical suitability in several exercises within the present project.

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Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

British Journal of Radiology ◽

10.1259/bjr.20150984 ◽

2016 ◽

Vol 89 (1061) ◽

pp. 20150984 ◽

Cited By ~ 22

Author(s):

Ferco H Berger ◽

Markus Körner ◽

Mark P Bernstein ◽

Aaron D Sodickson ◽

Ludo F Beenen ◽

...

Keyword(s):

Disaster Management ◽

Mass Casualty Incident ◽

Management Plan ◽

Mass Casualty ◽

Radiology Department ◽

Emergency Imaging

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(P1-38) Emergency Department Preparedness for Training Management Plan towards Mass Casualty Incidents

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11003700 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s110-s111

Author(s):

W.L. Chan

Keyword(s):

Emergency Department ◽

Food Poisoning ◽

Management Plan ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Working Relationships ◽

Work Processes ◽

Hospital Emergency ◽

New Information ◽

Planning Department

It is important to equip emergency department (ED) staff with skills to manage mass casualty incidents (MCI) as disasters strike without warning. Our hospital, Tan Tock Seng Hospital, has been the national screening centre for severe acute respiratory distress syndrome (SARS) and H1N1 outbreaks in 2003 and 2009. Furthermore, our ED has managed casualties from mass food poisoning in the community. We would like to share our experiences in training our staff for MCI. For the ED to operate smoothly in a MCI, comprehensive training of staff during “peace” time is essential. We have a selected team of doctors and nurses as the department disaster workgroup. This team, together with the hospital emergency planning department, prepare the disaster protocols using an “all hazard approach concept” and aim to minimise variations between different protocols (Conventional, Infectious disease, Hazmat, Radioactive MCI). These protocols are updated regularly, with new information disseminated to all staff. Next, all staff must be well-versed in the protocols. New staffs undergo orientation programmes to familiarize them with the work processes. Regular audits are conducted to ensure that the quality is well-maintained. Additionally, training also occurs at the inter-departmental and national levels. There are regular activation exercises to test inter-departmental response to MCI and collaborations with Ministry of Health to conduct disaster exercises e.g. the biennial Kingfisher Exercise in preparation for radiation-related MCI. Such exercises improve communication and working relationships within the ED and with other departments. The camaraderie developed can act as a pillar of support during stressful times of MCI. Lastly, the ED staffs attend local and international courses and conferences to update ourselves on the latest training and knowledge in the handling of MCI. This allows us to share our ideas and to learn from our local and international counterparts, and helps better prepare ourselves.

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Emergency Medical Consequence Planning and Management for National Special Security Events After September 11: Boston 2004

Disaster Medicine and Public Health Preparedness ◽

10.1097/dmp.0b013e318184556e ◽

2008 ◽

Vol 2 (3) ◽

pp. 166-173 ◽

Cited By ~ 8

Author(s):

Kristy A. Kade ◽

Kathryn H. Brinsfield ◽

Richard A. Serino ◽

Elena Savoia ◽

Howard K. Koh

Keyword(s):

Public Health ◽

September 11 ◽

Mass Casualty Incident ◽

Management Plan ◽

Mass Casualty ◽

Lessons Learned ◽

Federal State ◽

Medical Consequence ◽

Emergency Medical ◽

State And Local

ABSTRACTThe post-September 11 era has prompted unprecedented attention to medical preparations for national special security events (NSSE), requiring extraordinary planning and coordination among federal, state, and local agencies. For an NSSE, the US Secret Service (USSS) serves as the lead agency for all security operations and coordinates with relevant partners to provide for the safety and welfare of participants. For the 2004 Democratic National Convention (DNC), designated an NSSE, the USSS tasked the Boston Emergency Medical Services (BEMS) of the Boston Public Health Commission with the design and implementation of health services related to the Convention. In this article, we describe the planning and development of BEMS’ robust 2004 DNC Medical Consequence Management Plan, addressing the following activities: public health surveillance, on-site medical care, surge capacity in the event of a mass casualty incident, and management of federal response assets. Lessons learned from enhanced medical planning for the 2004 DNC may serve as an effective model for future mass gathering events. (Disaster Med Public Health Preparedness. 2008;2:166–173)

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Effect the Education of Mass Casualty Incident (MCI) on Knowledge, Attitude, Practice and Satisfaction in Red Crescent Rescuers of Hamadan

Scientific Journal of Hamedan Nursing and Midwifery Faculty ◽

10.21859/nmj-25016 ◽

2017 ◽

Vol 25 (1) ◽

pp. 44-51

Author(s):

Arezo Karampourian ◽

Zohreh Ghomian ◽

Katayoun Jahangiri ◽

Behroz Karkhanei

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty

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

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.19 ◽

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.

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A call for a global terrorism-related mass casualty incident response research consortium

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01572-1 ◽

2021 ◽

Author(s):

Amila Ratnayake ◽

◽

Kirthi Abayajeewa ◽

Samiddhi Samarakoon ◽

Tamara Worlton

Keyword(s):

Mass Casualty Incident ◽

Mass Casualty ◽

Incident Response ◽

Global Terrorism ◽

Research Consortium

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The potential benefits of enzymatic debridement in multi-casualty burns incidents

Trauma ◽

10.1177/14604086211002583 ◽

2021 ◽

pp. 146040862110025

Author(s):

John Kiely ◽

Ibrahim Natalwala ◽

Joseph Stallard ◽

Orla Austin ◽

Umair Anwar ◽

...

Keyword(s):

Intensive Care ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Burn Wound ◽

Post Injury ◽

Wound Debridement ◽

Potential Benefits ◽

Goal Directed Fluid Therapy ◽

Male Patients ◽

Enzymatic Debridement

Bromelain-based enzymatic debridement (ED) is a topical treatment that is growing in popularity for the non-surgical management of burn wounds. Although initially used for small injuries, experience has grown in using it for burns >15% Total Burns Surface Area (TBSA). A household explosion resulted in burns to multiple patients, with four requiring burn wound debridement. This case report demonstrates their management using ED. Four adult male patients were treated with ED, mean age 38.4 years. Their injuries ranged from 5–24% TBSA (mean 14.9%), with a high proportion of intermediate-deep dermal injury to their faces and limbs. Our centre has performed enzymatic debridement since 2016 and all senior burns surgeons and burns intensive care specialists in the team are experienced in its use. We perform enzymatic debridement using Nexobrid™ (Mediwound Ltd., Israel). Three patients were managed on a single theatre list, using ED for their burns at 19, 16 and 23 hours post-injury. One patient had ED of his injuries on intensive care at 18 hours. Patients with >15% TBSA were treated in a critical care setting with goal directed fluid therapy. Through the use of enzymatic debridement we were able to achieve burn debridement for four patients in under 24 hours. While not a true mass casualty incident, our experience suggests that for an appropriately resourced service it is likely to have advantages in this scenario. We suggest that burns services regularly using this technique consider inclusion into mass casualty protocols, with training to staff to enable provision in such an incident.

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