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https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#1
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28065200/testing-the-start-triage-protocol-can-it-improve-the-ability-of-nonmedical-personnel-to-better-triage-patients-during-disasters-and-mass-casualties-incidents
#2
Stefano Badiali, Aimone Giugni, Lucia Marcis
OBJECTIVE: START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. METHODS: In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group)...
January 9, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28024651/dedicated-mass-casualty-incident-hospitals-an-overview
#3
J J Mark Haverkort, Mirjam B de Jong, Maurizio Foco, Daniele Gui, Masad Barhoum, Gila Hyams, Hany Bahouth, Michael Halberthal, Luke P H Leenen
INTRODUCTION: Hospitals worldwide are preparing for mass casualty incidents (MCIs). The Major Incident Hospital in the Netherlands was constructed 25 years ago as a dedicated hospital for situations wherein a sudden increase in medical surge capacity is mandated to handle an MCI. Over the years, more initiatives of dedicated MCIs have arisen. Herein, we compared the MCI facilities from three countries considering the reasons for construction and the functionality. METHODS: Three dedicated mass casualty hospitals and one hospital with a largely fortified structure were compared...
November 23, 2016: Injury
https://www.readbyqxmd.com/read/27964769/paramedic-application-of-a-triage-sieve-a-paper-based-exercise
#4
Glen Cuttance, Kathryn Dansie, Tim Rayner
: Introduction Triage is the systematic prioritization of casualties when there is an imbalance between the needs of these casualties and resource availability. The triage sieve is a recognized process for prioritizing casualties for treatment during mass-casualty incidents (MCIs). While the application of a triage sieve generally is well-accepted, the measurement of its accuracy has been somewhat limited. Obtaining reliable measures for triage sieve accuracy rates is viewed as a necessity for future development in this area...
December 14, 2016: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/27957642/radiology-response-in-the-emergency-department-during-a-mass-casualty-incident-a-retrospective-study-of-the-two-terrorist-attacks-on-22-july-2011-in-norway
#5
Victoria Solveig Young, Heidi B Eggesbø, Christine Gaarder, Pål Aksel Næss, Tone Enden
OBJECTIVES: To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. METHODS: We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. RESULTS: Nine patients from the explosion and 15 from the shooting were included...
December 12, 2016: European Radiology
https://www.readbyqxmd.com/read/27851235/1600-real-time-tracking-of-mass-casualty-incident-markers-in-a-search-and-rescue-training-simulation
#6
Kendall Park, Salman Ahmad, John Gillis, Prasad Calyam, Amy Cheng, Josiah Burchard, Kourtney Meiss, Luke Guerdan
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27825363/pre-hospital-management-of-mass-casualty-civilian-shootings-a-systematic-literature-review
#7
Conor D A Turner, David J Lockey, Marius Rehn
BACKGROUND: Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice...
November 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27790383/mass-casualty-decontamination-guidance-and-psychosocial-aspects-of-cbrn-incident-management-a-review-and-synthesis
#8
Holly Carter, Richard Amlôt
INTRODUCTION: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents...
September 27, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27790381/mass-casualty-decontamination-in-a-chemical-or-radiological-nuclear-incident-further-guiding-principles
#9
Holly Carter, Richard Amlôt, Richard Williams, G James Rubin, John Drury
This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties' needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al...
September 15, 2016: PLoS Currents
https://www.readbyqxmd.com/read/27788698/a-pilot-study-examining-the-speed-and-accuracy-of-triage-for-simulated-disaster-patients-in-an-emergency-department-setting-comparison-of-a-computerized-version-of-canadian-triage-acuity-scale-ctas-and-simple-triage-and-rapid-treatment-start-methods
#10
Gwynn Curran-Sills, Jeffrey M Franc
OBJECTIVE: To compare emergency department triage nurses' time to triage and accuracy of a simulated mass casualty incident (MCI) population using a computerized version of CTAS or START systems. METHODS: This pilot study was a prospective trial using a convenience sample. A total of 20 ED triage nurses, 10 in each arm of the study, were recruited. The paper-based questionnaire contained nine simulated MCI vignettes. An expert panel arrived at consensuses on the wording of the vignettes and created a standard triage score from which to compare the study participants...
October 28, 2016: CJEM
https://www.readbyqxmd.com/read/27757716/simedis-a-discrete-event-simulation-model-for-testing-responses-to-mass-casualty-incidents
#11
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
https://www.readbyqxmd.com/read/27752635/a-study-on-the-disaster-medical-response-during-the-mauna-ocean-resort-gymnasium-collapse
#12
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
https://www.readbyqxmd.com/read/27734440/medical-provider-ballistic-protection-at-active-shooter-events
#13
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...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27651979/qualitative-analysis-of-surveyed-emergency-responders-and-the-identified-factors-that-affect-first-stage-of-primary-triage-decision-making-of-mass-casualty-incidents
#14
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
https://www.readbyqxmd.com/read/27649749/a-comparison-of-command-center-activations-versus-disaster-drills-at-three-institutions-from-2013-to-2015
#15
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
https://www.readbyqxmd.com/read/27623691/emergency-radiology-and-mass-casualty-incidents-report-of-a-mass-casualty-incident-at-a-level-1-trauma-center
#16
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
https://www.readbyqxmd.com/read/27613753/a-practical-approach-to-events-medicine-provision
#17
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
https://www.readbyqxmd.com/read/27603200/virtual-laboratory-and-imaging-an-online-simulation-tool-to-enhance-hospital-disaster-preparedness-training-experience
#18
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
https://www.readbyqxmd.com/read/27574325/use-of-clinical-decision-guidance-as-a-new-public-health-tool-for-the-medical-management-of-internal-contamination-in-radiological-mass-casualty-scenarios
#19
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
https://www.readbyqxmd.com/read/27557790/capabilities-of-the-reneb-network-for-research-and-large-scale-radiological-and-nuclear-emergency-situations
#20
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
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