Modeling Uncertain and Dynamic Casualty Health in Optimization-Based Decision Support for Mass Casualty Incident Response

When designing a decision support program for use in coordinating the response to Mass Casualty Incidents, the modelling of the health of casualties presents a significant challenge. In this paper we propose one such health model, capable of acknowledging both the uncertain and dynamic nature of casualty health. Incorporating this into a larger optimisation model capable of use in real-time and in an online manner, computational experiments examining the effect of errors in health assessment, regular updates of health and delays in communication are reported. Results demonstrate the often significant impact of these factors.

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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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Education and Training for Mass-Casualty Incidents: A One-Day Concept Combining Theoretical Background, Interactive Workshops, and Hands-On Training in a Real-Time Simulation

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00013121 ◽

2005 ◽

Vol 20 (S1) ◽

pp. 54-55

Author(s):

K. Wilhelm ◽

F. William ◽

C. Günzel ◽

H. Estner

Keyword(s):

Real Time ◽

Education And Training ◽

Mass Casualty ◽

Theoretical Background ◽

Mass Casualty Incidents ◽

Real Time Simulation ◽

Time Simulation ◽

Hands On ◽

And Training

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Mobile Decision Support Tool for Emergency Departments and Mass Casualty Incidents (EDIT): Initial Study

JMIR mhealth and uhealth ◽

10.2196/10727 ◽

2018 ◽

Vol 6 (6) ◽

pp. e10727 ◽

Cited By ~ 1

Author(s):

Nicholas Boltin ◽

Diego Valdes ◽

Joan M Culley ◽

Homayoun Valafar

Keyword(s):

Decision Support ◽

Emergency Departments ◽

Decision Support Tool ◽

Initial Study ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Support Tool

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An Integrated Information and Decision-Support System for the Management of Mass Casualty Incidents

IFAC-PapersOnLine ◽

10.1016/j.ifacol.2019.12.096 ◽

2019 ◽

Vol 52 (19) ◽

pp. 199-204

Author(s):

Henrik Berndt ◽

Michael Herczeg

Keyword(s):

Decision Support ◽

Decision Support System ◽

Support System ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Integrated Information

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Real-time geotracking and cataloging of mass casualty incident markers in a search and rescue training simulation: Pilot study

American Journal of Disaster Medicine ◽

10.5055/ajdm.2019.0319 ◽

2019 ◽

Vol 14 (2) ◽

pp. 89-95

Author(s):

Kendall Park, BS ◽

Kourtney Meiss ◽

Luke Guerdan ◽

Ev Cheng ◽

Josiah Burchard ◽

...

Keyword(s):

Pilot Study ◽

Real Time ◽

Task Force ◽

Pilot Trial ◽

Field Trials ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Search And Rescue ◽

Data Infrastructure ◽

Training Simulation

Objective: Search and rescue after mass casualty incidents relies on robust data infrastructure. Federal Emergency Management Agency (FEMA’s) Task Force 1 (TF1) trains its volunteers to locate and virtually tag scene incidents using a global positioning satellite (GPS) device programmed with markers for each incident (Iron Sights). The authors performed a pilot study comparing Iron Sights™ to a Wi-Fi-based real-time incident geolocation and virtual tagging dashboard (Panacea™) in creating a dynamic common operating picture.Design: Twenty-nine stations were placed at a predefined scene incident, each featuring a set of varying waypoint markers using standard FEMA/TF1 nomenclature. Two volunteers performed the experiment for both the Iron Sights and Panacea systems, digitally tagging all station waypoints.Setting: TF1 simulation training field. Main outcome measure(s): Metrics compared included GPS location precision, marker accuracy, and delay between scene sweep and common operational picture (COP) generation.Results: Two hundred and sixty-one waypoints were digitally tagged after excluding three stations for missing data. The average GPS location difference for all waypoints between Iron Sights and Panacea was 3.65 m. Marker tagging accuracy between Iron Sights and Panacea was equivalent and not statistically different (78.8 percent vs 66.2 percent, respectively, p = 0.11). Waypoints were tagged in 26.59 minutes and 10.55 minutes on average, respectively. Time from scene sweep to virtual COP generation was 7.97 minutes for Iron Sights after complete scene sweep and 37 seconds for Panacea for each waypoint posting in real-time.Conclusions: Panacea generated the COP in real-time compared to a delay with Iron Sights while maintaining the same location precision and marker accuracy. This pilot trial successfully demonstrated the ability to provide real-time actionable intelligence to incident commanders during mass casualty search and rescue missions. Larger field trials are recommended to refine the system and broaden its capabilities.

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1600: REAL-TIME TRACKING OF MASS CASUALTY INCIDENT MARKERS IN A SEARCH-AND-RESCUE TRAINING SIMULATION

Critical Care Medicine ◽

10.1097/01.ccm.0000510273.32108.0d ◽

2016 ◽

Vol 44 (12) ◽

pp. 475-475

Author(s):

Kendall Park ◽

Salman Ahmad ◽

John Gillis ◽

Prasad Calyam ◽

Amy Cheng ◽

...

Keyword(s):

Real Time ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Search And Rescue ◽

Real Time Tracking ◽

Training Simulation

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Defining the Problem, Main Objective, and Strategies of Medical Management in Mass-Casualty Incidents Caused by Terrorist Events

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0000563x ◽

2008 ◽

Vol 23 (1) ◽

pp. 82-89 ◽

Cited By ~ 10

Author(s):

Itamar Ashkenazi ◽

Boris Kessel ◽

Oded Olsha ◽

Tawfik Khashan ◽

Meir Oren ◽

...

Keyword(s):

Medical Management ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Traditional Management ◽

Treat Ment ◽

Impact On Survival ◽

Life Threatening ◽

Management Roles ◽

Terrorist Events

AbstractBased on the experience of managing >20 such events during the last decade, the authors' understanding of a mass-casualty incident is that it is an event in which there may be many victims, but only a few that actually suffer from life-threatening injuries. To make an impact on survival, one must identify those who are severely wounded as quickly as possible and offer those patients opti-mal care. Experienced trauma physicians are the most important resource available to achieve this objective, and they should be allocated to the treat-ment of seriously injured victims instead of more traditional management roles such as triage and incident manager.

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Triage During Mass Gatherings

Prehospital and Disaster Medicine ◽

10.1017/s1049023x12001446 ◽

2012 ◽

Vol 27 (6) ◽

pp. 531-535 ◽

Cited By ~ 13

Author(s):

Sheila A. Turris ◽

Adam Lund

Keyword(s):

Large Scale ◽

Scoring Systems ◽

Mass Casualty Incident ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Limited Resources ◽

Mass Gathering ◽

Publication Type ◽

Mass Gatherings ◽

Field Triage

AbstractTriage is a complex process and is one means for determining which patients most need access to limited resources. Triage has been studied extensively, particularly in relation to triage in overcrowded emergency departments, where individuals presenting for treatment often are competing for the available stretchers. Research also has been done in relation to the use of prehospital and field triage during mass-casualty incidents and disasters.In contrast, scant research has been done to develop and test an effective triage approach for use in mass-gathering and mass-participation events, although there is a growing body of knowledge regarding the health needs of persons attending large events. Existing triage and acuity scoring systems are suboptimal for this unique population, as these events can involve high patient presentation rates (PPR) and, occasionally, critically ill patients. Mass-gathering events are dangerous; a higher incidence of injury occurs than would be expected from general population statistics.The need for an effective triage and acuity scoring system for use during mass gatherings is clear, as these events not only create multiple patient encounters, but also have the potential to become mass-casualty incidents. Furthermore, triage during a large-scale disaster or mass-casualty incident requires that multiple, local agencies work together, necessitating a common language for triage and acuity scoring.In reviewing existing literature with regard to triage systems that might be employed for this population, it is noted that existing systems are biased toward traumatic injuries, usually ignoring mitigating factors such as alcohol and drug use and environmental exposures. Moreover, there is a substantial amount of over-triage that occurs with existing prehospital triage systems, which may lead to misallocation of limited resources. This manuscript presents a review of the available literature and proposes a triage system for use during mass gatherings that also may be used in the setting of mass-casualty incidents or disaster responses.TurrisSA, LundA. Triage during mass gatherings. Prehosp Disaster Med. 2012;27(6):1-5.

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