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mass casualty

Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
Myeong-Il Cha, Gi Woon Kim, Chu Hyun Kim, Minhong Choa, Dai Hai Choi, Inbyung Kim, Soon Joo Wang, In Sool Yoo, Han Deok Yoon, Kang Hyun Lee, Suck Ju Cho, Tag Heo, Eun Seog Hong
OBJECTIVE: To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. METHODS: Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent...
September 2016: Clin Exp Emerg Med
Paul M Arnaboldi, Mariya Sambir, Christina D'Arco, Lauren A Peters, Jos F M L Seegers, Lloyd Mayer, Alison A McCormick, Raymond J Dattwyler
Yersinia pestis, one of history's deadliest pathogens, has killed millions over the course of human history. It has attributes that make it an ideal choice to produce mass casualties and is a prime candidate for use as a biological weapon. When aerosolized, Y. pestis causes pneumonic plague, a pneumonia that is 100% lethal if not promptly treated with effective antibiotics. Currently, there is no FDA approved plague vaccine. The current lead vaccine candidate, a parenterally administered protein subunit vaccine comprised of the Y...
October 13, 2016: Vaccine
Jason P Stopyra, William P Bozeman, David W Callaway, James Winslow, Henderson D McGinnis, Justin Sempsrott, Lisa Evans-Taylor, Roy L Alson
There is some controversy about whether ballistic protective equipment (body armor) is required for medical responders who may be called to respond to active shooter mass casualty incidents. In this article, we describe the ongoing evolution of recommendations to optimize medical care to injured victims at such an incident. We propose that body armor is not mandatory for medical responders participating in a rapid-response capacity, in keeping with the Hartford Consensus and Arlington Rescue Task Force models...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
Mary Sproull, Kevin Camphausen
With the possibility of large-scale terrorist attacks around the world, the need for modeling and development of new medical countermeasures for potential future chemical, biological, radiological and nuclear (CBRN) has been well established. Project Bioshield, initiated in 2004, provided a framework to develop and expedite research in the field of CBRN exposures. To respond to large-scale population exposures from a nuclear event or radiation dispersal device (RDD), new methods for determining received dose using biological modeling became necessary...
October 6, 2016: Radiation Research
Eric Gregoire, Liz Ainsbury, Leonardo Barrios, Céline Bassinet, Paola Fattibene, Ulrike Kulka, Ursula Oestreicher, Gabriel Pantelias, Georgia Terzoudi, Francois Trompier, Philippe Voisin, Anne Vral, Andrzej Wojcik, Laurence Roy
PURPOSE: The European Network of Biological and Physical Retrospective Dosimetry 'RENEB' has contributed to European radiation emergency preparedness. To give homogeneous dose estimation results, RENEB partners must harmonize their processes. MATERIALS AND METHODS: A first inter-comparison focused on biological and physical dosimetry was used to detect the outliers in terms of dose estimation. Subsequently, trainings were organized to improve both tools dose estimation...
August 11, 2016: International Journal of Radiation Biology
Kelly R Klein, Frederick M Burkle, Raymond Swienton, Richard V King, Thomas Lehman, Carol S North
INTRODUCTION: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. METHODS: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage...
2016: PLoS Currents
Laura G Ebbeling, Eric Goralnick, Matthew J Bivens, Meg Femino, Claire G Berube, Bryan Sears, Leon D Sanchez
OBJECTIVE: Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation...
2016: American Journal of Disaster Medicine
Ferdia Bolster, Ken Linnau, Steve Mitchell, Eric Roberge, Quynh Nguyen, Jeffrey Robinson, Bruce Lehnert, Joel Gross
The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage...
September 13, 2016: Emergency Radiology
Susan P Smith, Joseph F Cosgrove, Peter J Driscoll, Andrew Smith, John Butler, Peter Goode, Carl Waldmann, Christopher J Vallis, Fiona Topham, Michael Monty Mythen
In the past three decades, mass casualty incidents have occurred worldwide at multiple sporting events and other mass gatherings. Organisational safety and healthcare provision can consequently be scrutinised post-event. Within the UK, such incidents in the 1980s provided incentives to improve medical services and subsequent high profile UK-based international sporting events (London Olympics and Paralympics 2012, Glasgow Commonwealth Games 2014, Rugby World Cup 2015) added a further catalyst for developing services...
September 9, 2016: Emergency Medicine Journal: EMJ
Luca Carenzo, Francesco Ragozzino, Davide Colombo, Federico Lorenzo Barra, Francesco Della Corte, Pier Luigi Ingrassia
OBJECTIVE: Hospitals play a pivotal role as basic healthcare providers during mass casualty incidents (MCIs). Radiological studies and emergency laboratory test are of high importance for the management of hospital patients. However, it is known that during these events, they can generate significant bottlenecks. Appropriate request of such tests is of utmost importance to not generate delays in the patient flow. The aim of this paper is to describe a software designed to increase the realism of hospital-based MCI training through a realistic reproduction of radiology and laboratory departments...
September 3, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Alexander L Eastman, William Fabbri, Kathryn Brinsfield, Lenworth Jacobs
No abstract text is available yet for this article.
November 2016: Journal of Trauma and Acute Care Surgery
Kieran C O'Doherty, Emily Christofides, Jeffery Yen, Heidi Beate Bentzen, Wylie Burke, Nina Hallowell, Barbara A Koenig, Donald J Willison
BACKGROUND: Health research increasingly relies on organized collections of health data and biological samples. There are many types of sample and data collections that are used for health research, though these are collected for many purposes, not all of which are health-related. These collections exist under different jurisdictional and regulatory arrangements and include: 1) Population biobanks, cohort studies, and genome databases 2) Clinical and public health data 3) Direct-to-consumer genetic testing 4) Social media 5) Fitness trackers, health apps, and biometric data sensors Ethical, legal, and social challenges of such collections are well recognized, but there has been limited attention to the broader societal implications of the existence of these collections...
2016: BMC Medical Ethics
D Lorenz, W Armbruster, Ch Vogelgesang, H Hoffmann, A Pattar, D Schmidt, T Volk, D Kubulus
No abstract text is available yet for this article.
September 2016: Der Anaesthesist
Albert L Wiley
This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents...
September 2016: Radiation Protection Dosimetry
Ivonne Romero, Ana Ilsa Lamadrid, Jorge Ernesto González, Tania Mandina, Omar García
The possibility to reduce the culture time and volume of blood and reagents required for the chemical Premature Chromosome Condensation (PCC) assay is demonstrated in this work. Peripheral whole blood was exposed to gamma radiation (1-20 Gy). Lymphocytes were cultured for 40 h, using 50 μl of blood and 450 μl of culture medium. The dose-response curves were adjusted, using length ratio (LR) of the longest to the shortest chromosome piece, and the frequency of rings per cell. No statistical differences were found between the results obtained with this method and those reported with the classical PCC assay culture...
October 2016: International Journal of Radiation Biology
Octávia Monteiro Gil, Pedro Vaz, Horst Romm, Cinzia De Angelis, Ana Catarina Antunes, Joan-Francesc Barquinero, Christina Beinke, Emanuela Bortolin, Christopher Ian Burbidge, Alexandra Cucu, Sara Della Monaca, Mercedes Moreno Domene, Paola Fattibene, Eric Gregoire, Valeria Hadjidekova, Ulrike Kulka, Carita Lindholm, Roberta Meschini, Radhia M'Kacher, Jayne Moquet, Ursula Oestreicher, Fabrizio Palitti, Gabriel Pantelias, Alegria Montoro Pastor, Irina-Anca Popescu, Maria Cristina Quattrini, Michelle Ricoul, Kai Rothkamm, Laure Sabatier, Natividad Sebastià, Sylwester Sommer, Georgia Terzoudi, Antonella Testa, François Trompier, Anne Vral
PURPOSE: To identify and assess, among the participants in the RENEB (Realizing the European Network of Biodosimetry) project, the emergency preparedness, response capabilities and resources that can be deployed in the event of a radiological or nuclear accident/incident affecting a large number of individuals. These capabilities include available biodosimetry techniques, infrastructure, human resources (existing trained staff), financial and organizational resources (including the role of national contact points and their articulation with other stakeholders in emergency response) as well as robust quality control/assurance systems...
October 4, 2016: International Journal of Radiation Biology
Alexandra L Mathews, Ming-Huei Cheng, John-Michael Muller, Miffy Chia-Yu Lin, Kate W C Chang, Kevin C Chung
INTRODUCTION: Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster. METHODS: A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed...
August 16, 2016: Injury
Christopher J Gordon, Christine Jorm, Boaz Shulruf, Jennifer Weller, Jane Currie, Renee Lim, Adam Osomanski
BACKGROUND: Teamwork training is an essential component of health professional student education. A valid and reliable teamwork self-assessment tool could assist students to identify desirable teamwork behaviours with the potential to promote learning about effective teamwork. The aim of this study was to develop and evaluate a self-assessment teamwork tool for health professional students for use in the context of emergency response to a mass casualty. METHODS: The authors modified a previously published teamwork instrument designed for experienced critical care teams for use with medical and nursing students involved in mass casualty simulations...
2016: BMC Medical Education
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