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Mass casualty incident

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
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
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
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
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
Ilana Bank, Elene Khalil
OBJECTIVES: Pediatric hospital disaster responders must be well-trained and prepared to manage children in a mass-casualty incident. Simulations of various types have been the traditional way of testing hospital disaster plans and training hospital staff in skills that are used in rare circumstances. The objective of this longitudinal, survey-based, observational study was to assess the effect of disaster response and management-based experiential learning on the knowledge and confidence of advanced learners...
October 2016: Prehospital and Disaster Medicine
Renee Y Hsia, Mengtao Dai, Ran Wei, Sarah Sabbagh, N Clay Mann
STUDY OBJECTIVE: The location of a patient's residence is often used for emergency medical services (EMS) system planning. Our objective is to evaluate the association between patient residence and emergency incident zip codes for 911 calls. METHODS: We used data from the 2013 National Emergency Medical Services Information System (NEMSIS) Public-Release Research Dataset. We studied all 911 calls with a valid complaint by dispatch, identifying zip codes for both the residence and incident locations (n=12,376,784)...
July 25, 2016: Annals of Emergency Medicine
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
Andre Pennardt, Rich Kamin, Craig Llewellyn, Geoff Shapiro, Philip A Carmona, Richard B Schwartz
Tactical emergency medical support (TEMS) is a critical component of the out-of-hospital response to domestic high-threat incidents such as hostage scenarios, warrant service, active shooter or violent incidents, terrorist attacks, and other intentional mass casualty-producing acts. From its grass-roots inception in the form of medical support of select law enforcement special weapons and tactics (SWAT) units in the 1980s, the TEMS subspecialty of prehospital care has rapidly grown and evolved over the past 40 years...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Sarah Power, Charles Symons, Holly Carter, Emma Jones, Richard Amlôt, Joanne Larner, Hazem Matar, Robert P Chilcott
Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination...
July 2016: Health Security
Paula M Morgan
First responders are exposed to various types of disasters throughout their career. Because of their roles, they are often regarded as stronger people than individuals from other occupations. A systematic review of literature was conducted to determine if distinct characteristics exist that make first responders more susceptible to psychological trauma. Five categories of traits were found to put first responders at risk for psychological problems: personal, predisposing, peridisposing, postdisposing, and protective...
May 2016: Journal of Emergency Management: JEM
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
Adriano Valerio, Matteo Verzè, Francesco Marchiori, Igor Rucci, Lucia De Santis, Irene Aprili, Lucia Antolini, Anna Sannino, Alessia Canello, Enrico Checchin, Francesca Mazzola, Sara Ferrari, Marta Garon, Alberto Schonsberg, Stefano Tardivo
Carbon monoxide acute intoxication is a common cause of accidental poisoning in industrialized countries and sometimes it produces a real mass casualty incident. The incident described here occurred in a church in the province of Verona, when a group of people was exposed to carbon monoxide due to a heating system malfunction. Fifty-seven people went to the Emergency Department. The mean carboxyhemoglobin (COHb) level was 10.1±5.7% (range: 3-25%). The clinicians, after medical examination, decided to move 37 patients to hyperbaric chambers for hyperbaric oxygen (HBO) therapy...
July 4, 2016: Disaster Medicine and Public Health Preparedness
Cullen Case
This article provides an overview of Radiation Injury Treatment Network® (RITN), its preparedness activities and capabilities, including training and educating over 11,500 hospital staff, coordinating over 500 exercises, developing treatment guidelines, developing standard operating procedures, and being recognized by the U.S. federal government as a national response asset. The RITN provides comprehensive evaluation and treatment for victims with marrow toxic injuries. Many of the casualties from the detonation of an improvised nuclear device (IND) (a...
August 2016: Health Physics
Natalia I Ossetrova, Patrick H Ney, Donald P Condliffe, Katya Krasnopolsky, Kevin P Hieber
Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues...
August 2016: Health Physics
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