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 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.

Utilization of computer simulation to enhance mass casualty incident response skills

1985 ◽  
Vol 14 (5) ◽  
pp. 517 ◽  
Author(s):  
RD Kelley ◽  
KC Harrison ◽  
SM Lyon ◽  
LC Baldwin ◽  
CR Hansen
Keyword(s):  
Computer Simulation ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Incident Response ◽  
Enhance Mass

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

2013 ◽  
Vol 5 (2) ◽  
pp. 32-44
Author(s):  
Duncan T. Wilson ◽  
Glenn I. Hawe ◽  
Graham Coates ◽  
Roger S. Crouch
Keyword(s):  
Decision Support ◽  
Health Assessment ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Support Program ◽  
Incident Response ◽  
Dynamic Nature ◽  
Significant Challenge ◽  
Optimisation Model ◽  
Health Model

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.

Evolution of a mass casualty drill design team: A program evaluation

2021 ◽  
Vol 19 (4) ◽  
pp. 367-377
Author(s):  
Mary E. Moran, PhD ◽  
Derek Ballas, DO ◽  
Nathan Blecker, MD ◽  
Ashley Sedorovich, MS ◽  
Shelly Barker, MD ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Qualitative Evaluation ◽  
Mass Casualty ◽  
Resource Scarcity ◽  
Design Team ◽  
In Situ Simulation ◽  
Weekly Meeting ◽  
Response Plan ◽  
Drill Design

Introduction: The number of mass casualty incidents (MCIs) is increasing. While many healthcare systems have not experienced an MCI, the need for preparedness is ever present. The unique challenges of MCI preparedness require the use of simulation, which has been found to be an effective model for training in medical environments.Objective: To determine common discussion points when a multidisciplinary team designed and implemented in situ MCI simulation drills to enhance our emergency preparedness plan.Design: This was a retrospective qualitative evaluation of the multidisciplinary mass casualty drill design team’s weekly meeting minutes documents. These documents provided insight into the evolution of a mass casualty drill design team and the advancement of our emergency response plan. Results: Continuous discussions surrounding resource restraints helped to inform the emergenceof the three themes, which were “Staff,” “Space,” and “Stuff.” These three themes were further broken down into different subthemes, but there was a continued focus on resource scarcity.Conclusions: Our results indicate the use of an MCI drill design team and in situ simulations assisted in better understanding of how hospital departments struggled with resource scarcity and provided opportunities to strengthen the emergency preparedness response plan. Incorporating a multidisciplinary mass casualty drill design team helped to ensure different perspectives and department needs were acknowledged and addressed through the in situ simulation trainings. 

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.

Use of Alternate Healthcare Facilities as Alternate Transport Destinations during a Mass-Casualty Incident

2010 ◽  
Vol 25 (2) ◽  
pp. 178-182 ◽  
Author(s):  
Erik S. Glassman ◽  
Steven J. Parrillo
Keyword(s):  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Urgent Care ◽  
Definitive Treatment ◽  
Severely Injured ◽  
Severe Injuries ◽  
Healthcare Facilities ◽  
Ambulatory Surgery Centers ◽  
Injured Patients

AbstractThe purpose of this discussion is to review the use of destinations other than the hospital emergency department, to transport patients injured as a result of a mass-casualty incident (MCI). A MCI has the ability to overwhelm traditional hospital resources normally thought of as appropriate destinations for the transport of injured patients. As a result, those with less severe injuries often are required to wait before they can receive definitive treatment. This waiting period, either at the scene of the incident or in the emergency department, can increase morbidity and drain resources that can be better directed toward the transport and care of those more severely injured. Potential alternate transport destinations include physician office buildings, ambulatory care centers, ambulatory surgery centers, and urgent care centers. By allowing for transport to alternate locations, these less severely injured patients can be removed rapidly from the scene, treated, and potentially released. This effort can decrease the strain on traditional resources within the system, better allowing these resources to treat more seriously injured patients.

Infectious Disease Hospital Preparedness: Lessons Learned From the 2019 Measles Outbreak

2021 ◽  
pp. 1-5
Author(s):  
Matthew Fifolt ◽  
Rachael A Lee ◽  
Sarah Nafziger ◽  
Lisa C McCormick
Keyword(s):  
Infectious Disease ◽  
Homeland Security ◽  
Emergency Preparedness ◽  
Disease Transmission ◽  
Early Recognition ◽  
Crisis Response ◽  
Lessons Learned ◽  
Potential Threat ◽  
Hospital Preparedness

Abstract Objective: This paper: (1) explores the real and perceived threats to Emergency Departments (EDs) in addressing infectious disease cases in the US, like measles, and (2) identifies priorities for protecting employees, patients, and others stakeholders through hospital preparedness while streamlining processes and managing costs. Methods: A case study approach was used to describe the events that triggered an infectious disease emergency response in 1 ED in the southeast. Development of the case study was informed by emergency preparedness literature on Homeland Security Exercise and Evaluation Program processes. Results: Hospital staff and administrators identified a number of factors that either positively contributed to disease containment or exacerbated conditions for disease transmission. Successes included early recognition of the potential threat, development of a multidisciplinary taskforce, and implementation of a pre-incident response plan. Challenges comprised of patient flow in crisis response, lab turnaround time, and employee records. Conclusions: The threat of exposure challenged daily operations and raised situational awareness among administrators and providers to issues that might arise during an infectious disease exposure. Recording emergency preparedness successes, remediating challenges, and sharing information with others may help minimize the threat of communicable diseases within hospital settings in the future.

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.

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