scholarly journals Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

2020 ◽  
Vol 17 (7) ◽  
pp. 2385
Author(s):  
Maya Siman-Tov ◽  
Benny Davidson ◽  
Bruria Adini
Keyword(s):  
Emergency Preparedness ◽  
Geographical Location ◽  
Evaluation Process ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Medical Facilities ◽  
Potential Risks ◽  
The Impact ◽  
And Training ◽  
Secondary Contamination

Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

scholarly journals Manchester Arena bombing: lessons learnt from a mass casualty incident

2018 ◽  
Vol 166 (2) ◽  
pp. 72-75 ◽  
Author(s):  
Ross J Craigie ◽  
P J Farrelly ◽  
R Santos ◽  
S R Smith ◽  
J S Pollard ◽  
...  
Keyword(s):  
Terrorist Attack ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Improvised Explosive Device ◽  
Lessons Learnt ◽  
Simulation And Training ◽  
The Uk ◽  
Improvised Explosive ◽  
London Bombings ◽  
And Training

On 22 May 2017 Salman Abedi detonated an improvised explosive device in the Manchester Arena resulting in 23 deaths (including the attacker). This was the deadliest terrorist attack on UK soil since the 2005 London bombings, but was only one of five mass casualty terrorist attacks in the UK in 2017. Preparation for mass casualty incidents (MCI) is obligatory, involving such methods as multiagency tabletop exercises, mock hospital exercises, as well as simulation and training for clinicians in managing the injuries that would be anticipated in such an event. Even in the best prepared units, such an incident will pose significant challenges due to the unpredictable nature of these events with respect to timing and number of casualties. Following an MCI, local and national reviews are undertaken to assess the effectiveness of the response, but also to identify areas where lessons can be learnt and to disseminate these to allow inclusion in future planning. We present the experience following a mass casualty terrorist incident along with a number of lessons learnt from this event.

scholarly journals Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident

2014 ◽  
Vol 29 (5) ◽  
pp. 538-541 ◽  
Author(s):  
Benjamin W. Wachira ◽  
Ramadhani O. Abdalla ◽  
Lee A. Wallis
Keyword(s):  
Emergency Department ◽  
Emergency Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Shopping Mall ◽  
Major Incident ◽  
Local Health ◽  
Publication Type ◽  
Communication Assessment

AbstractAt approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital.This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.WachiraBW, AbdallaRO, WallisLA. Westgate shootings: an emergency department approach to a mass-casualty incident. Prehosp Disaster Med. 2014;29(5):1-4.

scholarly journals An armed assailant in our hospital: Are we prepared?

2021 ◽  
Vol 50 (9) ◽  
pp. 712-716
Author(s):  
Sohil Pothiawala ◽  
Rabind Charles ◽  
Wai Kein Chow ◽  
Kheng Wee Ang ◽  
Karen Hsien Ling Tan ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Hospital Setting ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Incident Response ◽  
Potential Threat ◽  
Healthcare Facilities ◽  
Response Strategies ◽  
Hospital Preparedness ◽  
Response Plan

ABSTRACT While armed assailant attacks are rare in the hospital setting, they pose a potential risk to healthcare staff, patients, visitors and the infrastructure. Singapore hospitals have well-developed disaster plans to respond to a mass casualty incident occurring outside the hospital. However, lack of an armed assailant incident response plan can significantly reduce the hospital’s ability to appropriately respond to such an incident. The authors describe various strategies that can be adopted in the development of an armed assailant incident response plan. Regular staff training will increase staff resilience and capability to respond to a potential threat in the future. The aim of this article is to highlight the need for the emergency preparedness units of all hospitals to work together with various stakeholders to develop an armed assailant incident response plan. This will be of great benefit for keeping healthcare facilities safe, both for staff as well as for the community. Keywords: Armed assailant, hospital, preparedness, response, strategies

scholarly journals (A213) Review of the Mass Casualty Incident after a Bomb Explosion in a Crowded Restaurant

2011 ◽  
Vol 26 (S1) ◽  
pp. s59-s59
Author(s):  
S.S. Shettar ◽  
K.V. Kelkar ◽  
A.V. Jamkar ◽  
Y.V. Gawali ◽  
V. Kapil ◽  
...  
Keyword(s):  
Fatal Outcome ◽  
Blast Injury ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Blast Injuries ◽  
Injury Patterns ◽  
Medical Facilities ◽  
Life Threatening ◽  
Enclosed Space ◽  
Type Of Injury

Terror struck Pune on 13 Feb. 2010 as a powerful bomb ripped apart a popular restaurant, killing nine people and injuring more than 45. A retrospective analysis of the injury patterns was done.Materials and MethodsThe CDC template, viz. “Bomb Surveillance Form” was used for the data collection, that was analyzed by SPSS version 15 software.ResultsOf the 50 survivors transferred to the four nearby hospitals, 11 (22%) of them had severe life threatening injuries, with 19 patients (38%) having primary blast injuries, Secondary type of injury was seen in, and 22% had tertiary injuries. Orthopedic (24%) and burn injuries (36%) were prominent. The mortality rate was 16%.DiscussionThe occurrence of MCI in an unexpected scenario overwhelms the medical resources and challenges the emergency medical facilities. Analysis of the injuries revealed that fatal outcome was related to presence of shock, severe lung, bowel injury, presence of more than four types of injury and greater than 50% burns.StrengthsHighlights the importance of being able to recognize the blast injury patterns and their management.LimitationsInability to compare with other blast injuries due to several missing data.ConclusionBlast injury sustained in a small, enclosed space is one of the most serious and complicated forms of multiple trauma. Hospitals and civic authorities must be prepared to counter this menace of modem times. Not everything that is faced can be changed, but nothing can be changed until it is faced.

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.

Die a Hero or Live Long Enough to Become the Villain: Mass Casualty Preparedness in Hospitals and Protecting Doctors from Liability during Mass Casualty Events

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Ashley Tseung
Keyword(s):  
Public Health ◽  
United States ◽  
Emergency Preparedness ◽  
Preventive Measures ◽  
The United States ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Public Health Emergency ◽  
Terrorist Attacks ◽  
Mass Casualty Events

AbstractSince 9/11, the United States and the international community have emphasized the need to protect people from terrorist attacks. The Boston Bombing that took place on April 15, 2013, showed that even with all of the preventive measures in place, the United States is not immune from terrorist attacks. If there had been a bioterrorist attack in Boston instead of a homemade bomb, the amount of casualties would likely have been a lot higher. Many hospitals lack effective emergency preparedness plans that address bioterrorist attacks. One area that will help prepare nations during a mass casualty incident or public health emergency involves implementing effective mass casualty preparedness plans for hospitals. This paper analyzes mass casualty preparedness in hospitals and demonstrates the need to have legislation in place to protect doctors who treat patients during mass casualty events.

Reading, Writing, Responding: Educators’ Perceptions of Safety, Preparedness, and Lockdown Drills

2021 ◽  
pp. 089590482110156
Author(s):  
Jaclyn Schildkraut ◽  
Amanda B. Nickerson ◽  
Kirsten R. Klingaman
Keyword(s):  
Emergency Preparedness ◽  
School Safety ◽  
Urban School District ◽  
Perceived Safety ◽  
Staff Members ◽  
School Based ◽  
Student Safety ◽  
The Impact ◽  
And Training ◽  
Made In

Lockdown drills are routinely conducted in schools across the U.S., yet little is known about the impact of such practices on participants—particularly for the faculty, staff, and administrators charged with student safety. The present study considers the effects of lockdown drills and associated emergency response training on perceived safety and preparedness at school for a sample of 3,000 school-based personnel in a large urban school district. After participating in drills and training, significant gains were made in perceived emergency preparedness, particularly among faculty and staff members, while perceived school safety—which already was particularly high—remained unaffected compared to ratings at baseline. Additionally, significant differences were found based upon respondent demographics, highlighting the importance in assessing subgroups’ needs during planning and implementation. Implications for school administration and relevant policymakers related to lockdown drills and training are considered within the context of creating a culture of preparedness.

scholarly journals Tragedy Meets GME: The Impact of the October 1st Mass Casualty Incident on Academic Attending and Resident Physicians

2019 ◽  
Vol 34 (s1) ◽  
pp. s72-s72
Author(s):  
Suzanne Roozendaal ◽  
Gregory Guldner ◽  
Hoda Abou-Zaid ◽  
Jason Siegal ◽  
Ross Berkeley ◽  
...  
Keyword(s):  
Social Support ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Perceived Social Support ◽  
Medical Center ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Graduate Medical ◽  
Post Traumatic Growth ◽  
The Impact

Introduction:On October 1, 2017, a gunman fired on a festival in Las Vegas, Nevada, killing 58 people and wounding over 500. Multiple casualties were received at two nearby hospitals that sponsor residency programs: Sunrise Hospital and Medical Center and University Medical Center.Aim:To evaluate the impact of the most lethal mass-shooting event in US history on graduate medical education (GME) at the involved hospitals.Methods:Anonymized surveys were sent to 210 physicians at SMC and 110 physicians at UMC. Surveys incorporated 4 validated instruments: The Post Traumatic Growth Inventory (PTGI), The Impact of Events Scale-Revised (IES-R), The Multidimensional Scale of Perceived Social Support (MSPSS), and The Team Cohesion Factor (TCF).Results:Sixty-six physicians completed the surveys (38 attendings; 17 residents). 10% of physicians scored in the likely posttraumatic stress disorder (PTSD) range and 15% found themselves avoiding or struggling with managing similar patients, though overall survey response rate was low. The majority of physicians did not believe the event impacted their specific GME activities. No attending physician rated the event as negative in terms of global impact on GME, and 34% rated it as positive. However, 12 of 17 residents rated the event as a hurdle in its GME impact. A regression model predicting the IES-R score demonstrated a trend that those with higher pre-event stress and lower social support reported more adverse impact (p<0.06).Discussion:We believe our study is the first to examine the impact of mass casualty traumatic events on graduate medical education. Attendings and residents differ in their global perception of the impact, with attendings viewing it as a positive event and residents as a challenge. Pre-event level of stress and perceived social support predicted the impact of the event and may partially explain these results if residents and attendings vary on these parameters.

scholarly journals Ensuring Emergency Preparedness through Systematic Evaluations

2019 ◽  
Vol 34 (s1) ◽  
pp. s76-s76
Author(s):  
Gila Margalit ◽  
Orna Rachaminov ◽  
Yuval Levy ◽  
Bruria Adini ◽  
Amir Grinberg
Keyword(s):  
Emergency Preparedness ◽  
Trauma Center ◽  
Mass Casualty ◽  
Home Front ◽  
Administrative Professionals ◽  
Emergency Scenarios ◽  
High Level ◽  
Relative Change ◽  
Chemical Incidents ◽  
The Impact

Introduction:Hospitals are required to maintain emergency preparedness 24/7. In order to maintain readiness, Israeli hospitals operate Emergency Committees comprised of medical, nursing, and administrative professionals who are responsible for capacity building including the development of plans, infrastructure, equipment, training, crisis management, and learning lessons. The Ministry of Health (MOH) and Home Front Command (HFC) conduct a comprehensive, structured evaluation of emergency preparedness in every hospital every two to three years.Aim:To assess the impact of a periodical evaluation on levels of emergency preparedness over time in a level one trauma center.Methods:Evaluation of emergency preparedness is conducted by approximately 12 evaluators from the MOH and HFC, encompassing mass casualty incidents (MCIs), mass toxicological/chemical incidents (MTEs), radiological and biological events, earthquakes and conflicts. Evaluations are based on objective parameters, relayed to hospitals prior to the evaluation. The hospital’s level of emergency preparedness is graded and improvements that must be implemented are delineated. The grades of four evaluations conducted from 2011 to 2018 were compared to identify trends in preparedness.Results:Mean levels of emergency preparedness in the 2018 versus 2011 evaluations presented an increase concerning all threats, including MCIs (92 vs. 90), MTEs (99 vs. 77, respectively), biological events (96 vs. 73, respectively), radiological events (91 vs. 79), earthquakes (87 vs. 60, respectively), and conflicts (95 vs. 74). The relative change in levels of preparedness was more noted concerning biological events and earthquakes.Discussion:A periodical evaluation by governing authorities seems to motivate the hospital’s administrations to invest efforts in building and maintain a high level of emergency preparedness. Systematic evaluations conducted bi-annually contributed to improved readiness for diverse emergency scenarios, including for threats that less frequently materialize.

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