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Mass casualty event

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
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
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
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.
September 3, 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
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
Hideaki Anan, Yasuhiro Otomo, Hisayoshi Kondo, Masato Homma, Yuichi Koido, Kazuma Morino, Kenichi Oshiro, Kiyokazu Harikae, Osamu Akasaka
This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course...
October 2016: Prehospital and Disaster Medicine
Yasuhiko Ajimi, Masaru Sasaki, Yasuyuki Uchida, Ichiro Kaneko, Shinya Nakahara, Tetsuya Sakamoto
UNLABELLED: Introduction Primary triage in a mass-casualty event setting using low-visibility tags may lead to informational confusion and difficulty in judging triage attribution of patients. In this simulation study, informational confusion during primary triage was investigated using a method described in a prior study that applied Shannon's Information Theory to triage. Hypothesis Primary triage using a low-visibility tag leads to a risk of informational confusion in prioritizing care, owing to the intermingling of pre- and post-triage patients...
October 2016: Prehospital and Disaster Medicine
Carolina Figueiredo Freitas, Claudia Garcia Serpa Osorio-de-Castro, Kimberley Irene Shoaf, Raulino Sabino da Silva, Elaine Silva Miranda
Recently, Brazil has hosted mass events with recognized international relevance. The 2014 FIFA World Cup was held in 12 Brazilian state capitals and health sector preparedness drew on the history of other World Cups and Brazil's own experience with the 2013 FIFA Confederations Cup. The current article aims to analyze the treatment capacity of hospital facilities in georeferenced areas for sports events in the 2016 Olympic Games in the city of Rio de Janeiro, based on a model built drawing on references from the literature...
August 1, 2016: Cadernos de Saúde Pública
Dana R Martin, Susan B Furr, Susan Hayes Lane, Martha Bramlett
AIM: The purpose of this article is to address ways in which a nursing faculty can build nursing leadership competencies into a nursing programme. This article describes the use of simulation as a compelling learning strategy. BACKGROUND: Nurses need to be prepared to meet the demands of mass casualty events. With the growing need for major incident training, leadership competency development is a critical gap in the literature. EVALUATION: A collaborative simulation was used to help students apply classroom knowledge...
July 28, 2016: British Journal of Nursing: BJN
Lindsay A Beaton-Green, Ruth C Wilkins
Biodosimetry is a method for measuring the dose of radiation to individuals using biological markers such as chromosome damage. Following mass casualty events, it is important to provide this information rapidly in order to assist with the medical management of potentially exposed casualties. Currently, the gold standard for biodosimetry is the dicentric chromosome assay, which accurately estimates the dose from the number of dicentric chromosomes in lymphocytes. To increase throughput of analysis following a large-scale mass casualty event, this assay has been adapted for use on the imaging flow cytometer...
2016: Methods in Molecular Biology
A P Padley
The Great War began just over a century ago and this monumental event changed the world forever. 1915 saw the emergence of gas warfare-the first weapon of mass terror. It is relevant to anaesthetists to reflect on these gases for a number of reasons. Firstly and most importantly we should acknowledge and be aware of the suffering and sacrifice of those soldiers who were injured or killed so that we could enjoy the freedoms we have today. Secondly, it is interesting to consider the overlap between poison gases and anaesthetic gases and vapors, for example that phosgene can be formed by the interaction of chloroform and sunlight...
July 2016: Anaesthesia and Intensive Care
Aura Ganz, James M Schafer, Zhuorui Yang, Jun Yi, Graydon Lord, Gregory Ciottone
We investigate the utility of DIORAMA-II system which provides enhanced situational awareness within a disaster scene by using real-time visual analytics tools and a collaboration platform between the incident commander and the emergency responders. Our trials were conducted in different geographical areas (feature-rich and featureless regions) and in different lighting conditions (daytime and nighttime). DIORAMA-II obtained considerable time gain in efficiency compared to conventional paper based systems. DIORAMA-II time gain was reflected in reduction of both average triage time per patient (up to 34...
2016: International Journal of Telemedicine and Applications
R C Wilkins, Z Carr, D C Lloyd
In 2007 the World Health Organization established an international network of biodosimetry laboratories, the BioDoseNet. The goal of this network was to support international cooperation and capacity building in the area of biodosimetry around the world, including harmonisation of protocols and techniques to enable them to provide mutual assistance during a mass casualty event. In order to assess the progress and success of this network, the results of the second survey conducted in 2015 that assessed the capabilities and capacities of the members of the network, were compared to the similar first survey conducted in 2009...
July 15, 2016: Radiation Protection Dosimetry
Peter K Rogan, Yanxin Li, Ruth Wilkins, Farrah N Flegal, Joan H M Knoll
The dose from ionizing radiation exposure can be interpolated from a calibration curve fit to the frequency of dicentric chromosomes (DCs) at multiple doses. As DC counts are manually determined, there is an acute need for accurate, fully automated biodosimetry calibration curve generation and analysis of exposed samples. Software, the Automated Dicentric Chromosome Identifier (ADCI), is presented which detects and discriminates DCs from monocentric chromosomes, computes biodosimetry calibration curves and estimates radiation dose...
July 13, 2016: Radiation Protection Dosimetry
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